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Clinical informatics

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https://www.readbyqxmd.com/read/28415593/cysteine-and-glycine-rich-protein-2-csrp2-transcript-levels-correlate-with-leukemia-relapse-and-leukemia-free-survival-in-adults-with-b-cell-acute-lymphoblastic-leukemia-and-normal-cytogenetics
#1
Shu-Juan Wang, Ping-Zhang Wang, Robert Peter Gale, Ya-Zhen Qin, Yan-Rong Liu, Yue-Yun Lai, Hao Jiang, Qian Jiang, Xiao-Hui Zhang, Bin Jiang, Lan-Ping Xu, Xiao-Jun Huang, Kai-Yan Liu, Guo-Rui Ruan
Relapse is the major cause of treatment-failure in adults with B-cell acute lymphoblastic leukemia (ALL) achieving complete remission after induction chemotherapy. Greater precision identifying persons likely to relapse is important. We did bio-informatics analyses of transcriptomic data to identify mRNA transcripts aberrantly-expressed in B-cell ALL. We selected 9 candidate genes for validation 7 of which proved significantly-associated with B-cell ALL. We next focused on function and clinical correlations of the cysteine and glycine-rich protein 2 (CSRP2)...
March 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28410247/ce-original-research-creating-an-evidence-based-progression-for-clinical-advancement-programs
#2
Kathleen G Burke, Tonya Johnson, Christine Sites, Jane Barnsteiner
Findings on the developmental progression of eight nursing competencies and related knowledge, skill, and attitudes. ABSTRACT: Background: The Institute of Medicine (IOM) and the Quality and Safety Education for Nurses (QSEN) project have identified six nursing competencies and supported their integration into undergraduate and graduate nursing curricula nationwide. But integration of those competencies into clinical practice has been limited, and evidence for the progression of competency proficiency within clinical advancement programs is scant...
April 13, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28396108/augmented-nurse-care-management-in-ckd-stages-4-to-5-a%C3%A2-randomized-trial
#3
Steven Fishbane, Sofia Agoritsas, Alessandro Bellucci, Candice Halinski, Hitesh H Shah, Vipul Sakhiya, Leah Balsam
BACKGROUND: Outcomes for patients with late-stage chronic kidney disease (CKD) in the United States are suboptimal. There is poor education and preparation for end-stage kidney disease, as well as a high rate of hospitalization in this group of patients. STUDY DESIGN: A randomized, parallel-group, 2-arm, controlled trial. SETTING & PARTICIPANTS: The study was conducted at 3 sites: a clinic of an academic medical center, a public hospital academic clinic, and a community-based private practice...
April 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28392728/external-quality-assessment-beyond-the-analytical-phase-an-australian-perspective
#4
REVIEW
Tony Badrick, Stephanie Gay, Euan J McCaughey, Andrew Georgiou
External Quality Assessment (EQA) is the verification, on a recurring basis, that laboratory results conform to expectations for the quality required for patient care. It is now widely recognised that both the pre- and post-laboratory phase of testing, termed the diagnostic phases, are a significant source of laboratory errors. These errors have a direct impact on both the effectiveness of the laboratory and patient safety. Despite this, Australian laboratories tend to be focussed on very narrow concepts of EQA, primarily surrounding test accuracy, with little in the way of EQA programs for the diagnostic phases...
February 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/28388645/combining-clinical-and-genomics-queries-using-i2b2-three-methods
#5
Shawn N Murphy, Paul Avillach, Riccardo Bellazzi, Lori Phillips, Matteo Gabetta, Alal Eran, Michael T McDuffie, Isaac S Kohane
We are fortunate to be living in an era of twin biomedical data surges: a burgeoning representation of human phenotypes in the medical records of our healthcare systems, and high-throughput sequencing making rapid technological advances. The difficulty representing genomic data and its annotations has almost by itself led to the recognition of a biomedical "Big Data" challenge, and the complexity of healthcare data only compounds the problem to the point that coherent representation of both systems on the same platform seems insuperably difficult...
2017: PloS One
https://www.readbyqxmd.com/read/28379326/an-automated-pharmacist-driven-initiative-improves-quality-of-care-for-staphylococcus-aureus-bacteremia
#6
Eric Wenzler, Fei Wang, Debra A Goff, Beth Prier, John Mellett, Julie E Mangino, Karri A Bauer
Background: Infectious diseases (ID) consultation and antimicrobial stewardship intervention have been shown to improve the management of Staphylococcus aureus bacteremia (SAB). As the workload of antimicrobial stewardship programs (ASPs) continues to increase, ASPs must find a way to maximize the efficiency of the program while optimizing patient outcomes. The objective of this study was to evaluate the impact of incorporating health informatics into the management of SAB via a pharmacist-driven initiative...
April 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28366166/a-path-to-precision-in-the-icu
#7
REVIEW
David M Maslove, Francois Lamontagne, John C Marshall, Daren K Heyland
Precision medicine is increasingly touted as a groundbreaking new paradigm in biomedicine. In the ICU, the complexity and ambiguity of critical illness syndromes have been identified as fundamental justifications for the adoption of a precision approach to research and practice. Inherently protean diseases states such as sepsis and acute respiratory distress syndrome have manifestations that are physiologically and anatomically diffuse, and that fluctuate over short periods of time. This leads to considerable heterogeneity among patients, and conditions in which a "one size fits all" approach to therapy can lead to widely divergent results...
April 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28358291/feasibility-and-utility-of-an-integrated-medical-imaging-and-informatics-smartphone-system-for-management-of-acute-stroke
#8
Kristina Shkirkova, Eftitan Y Akam, Josephine Huang, Sunil A Sheth, May Nour, Conrad W Liang, Michael McManus, Van Trinh, Gary Duckwiler, Jason Tarpley, Fernando Vinuela, Jeffrey L Saver
Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28352925/implementation-of-a-single-sign-on-system-between-practice-research-and-learning-systems
#9
Saptarshi Purkayastha, Judy W Gichoya, Siva Abhishek Addepally
BACKGROUND: Multiple specialized electronic medical systems are utilized in the health enterprise. Each of these systems has their own user management, authentication and authorization process, which makes it a complex web for navigation and use without a coherent process workflow. Users often have to remember multiple passwords, login/logout between systems that disrupt their clinical workflow. Challenges exist in managing permissions for various cadres of health care providers. OBJECTIVES: This case report describes our experience of implementing a single sign-on system, used between an electronic medical records system and a learning management system at a large academic institution with an informatics department responsible for student education and a medical school affiliated with a hospital system caring for patients and conducting research...
March 29, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28350627/data-staff-and-money-leadership-reflections-on-the-future-of-public-health-informatics
#10
Jonathon P Leider, Gulzar H Shah, Karmen S Williams, Akrati Gupta, Brian C Castrucci
CONTEXT: Health informatics can play a critical role in supporting local health departments' (LHDs') delivery of certain essential public health services and improving evidence base for decision support. However, LHDs' informatics capacities are below an optimum level. Efforts to build such capacities face ongoing challenges. Moreover, little is known about LHD leaders' desires for the future of public health informatics. OBJECTIVES: Conduct a qualitative analysis of LHDs' future informatics plans, perceived barriers to accomplishing those plans, and potential impact of future advances in public health informatics on the work of the public health enterprise...
May 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28346130/defining-health-information-exchange-scoping-review-of-published-definitions
#11
Ather Akhlaq, Aziz Sheikh, Claudia Pagliari
OBJECTIVE: The term Health Information Exchange (HIE) is often used in health informatics, yet uncertainties remain about its precise meaning. This study aimed to capture and analyse existing definitions in order to map variations in its use and the concepts associated with it. METHODS: Systematic literature search to identify published definitions of HIE and equivalent terms such as Clinical Information Exchange. Medline, Web of Science, Library Information Science and Technology Abstracts, EMBASE and CINAHL Plus were searched to identify relevant research, and Google to identify grey literature...
January 25, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/28340241/pragmatic-trial-informatics-a-perspective-from-the-nih-health-care-systems-research-collaboratory
#12
Rachel L Richesson, Beverly B Green, Reesa Laws, Jon Puro, Michael G Kahn, Alan Bauck, Michelle Smerek, Erik G Van Eaton, Meredith Zozus, W Ed Hammond, Kari A Stephens, Greg E Simon
Pragmatic clinical trials (PCTs) are research investigations embedded in health care settings designed to increase the efficiency of research and its relevance to clinical practice. The Health Care Systems Research Collaboratory, initiated by the National Institutes of Health Common Fund in 2010, is a pioneering cooperative aimed at identifying and overcoming operational challenges to pragmatic research. Drawing from our experience, we present 4 broad categories of informatics-related challenges: (1) using clinical data for research, (2) integrating data from heterogeneous systems, (3) using electronic health records to support intervention delivery or health system change, and (4) assessing and improving data capture to define study populations and outcomes...
March 14, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339721/analysis-of-professional-competencies-for-the-clinical-research-data-management-profession-implications-for-training-and-professional-certification
#13
Meredith N Zozus, Angel Lazarov, Leigh R Smith, Tim E Breen, Susan L Krikorian, Patrick S Zbyszewski, Shelly K Knoll, Debra A Jendrasek, Derek C Perrin, Demetris N Zambas, Tremaine B Williams, Carl F Pieper
Objective: : To assess and refine competencies for the clinical research data management profession. Materials and Methods: : Based on prior work developing and maintaining a practice standard and professional certification exam, a survey was administered to a captive group of clinical research data managers to assess professional competencies, types of data managed, types of studies supported, and necessary foundational knowledge. Results: : Respondents confirmed a set of 91 professional competencies...
February 16, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28333789/nursing-informatics-competency-assessment-for-the-nurse-leader-the-delphi-study
#14
Sarah Collins, Po-Yin Yen, Andrew Phillips, Mary K Kennedy
OBJECTIVE: The aim of this study was to identify nursing informatics competencies perceived as relevant and required by nurse leaders. BACKGROUND: To participate as a full partner in healthcare leadership among rapidly advancing health information technologies (HITs), nurse leaders must attain knowledge of informatics competencies related to their clinical leadership roles and responsibilities. Despite this increased need to engage in HIT-related decision making, a gap remains in validated informatics competencies specific to the needs of nurse leaders...
April 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28328253/a-comprehensive-index-for-predicting-risk-of-anemia-from-patients-diagnoses
#15
Matthew G Tuck, Farrokh Alemi, John F Shortle, Sanj Avramovic, Charles Hesdorffer
This article demonstrates how time-dependent, interacting, and repeating risk factors can be used to create more accurate predictive medicine. In particular, we show how emergence of anemia can be predicted from medical history within electronic health records. We used the Veterans Affairs Informatics and Computing Infrastructure database to examine a retrospective cohort of 9,738,838 veterans over an 11-year period. Using International Clinical Diagnoses Version 9 codes organized into 25 major diagnostic categories, we measured progression of disease by examining changes in risk over time, interactions in risk of combination of diseases, and elevated risk associated with repeated hospitalization for the same diagnostic category...
March 2017: Big Data
https://www.readbyqxmd.com/read/28327206/lessons-learned-from-additional-research-analyses-of-unsolved-clinical-exome-cases
#16
Mohammad K Eldomery, Zeynep Coban-Akdemir, Tamar Harel, Jill A Rosenfeld, Tomasz Gambin, Asbjørg Stray-Pedersen, Sébastien Küry, Sandra Mercier, Davor Lessel, Jonas Denecke, Wojciech Wiszniewski, Samantha Penney, Pengfei Liu, Weimin Bi, Seema R Lalani, Christian P Schaaf, Michael F Wangler, Carlos A Bacino, Richard Alan Lewis, Lorraine Potocki, Brett H Graham, John W Belmont, Fernando Scaglia, Jordan S Orange, Shalini N Jhangiani, Theodore Chiang, Harsha Doddapaneni, Jianhong Hu, Donna M Muzny, Fan Xia, Arthur L Beaudet, Eric Boerwinkle, Christine M Eng, Sharon E Plon, V Reid Sutton, Richard A Gibbs, Jennifer E Posey, Yaping Yang, James R Lupski
BACKGROUND: Given the rarity of most single-gene Mendelian disorders, concerted efforts of data exchange between clinical and scientific communities are critical to optimize molecular diagnosis and novel disease gene discovery. METHODS: We designed and implemented protocols for the study of cases for which a plausible molecular diagnosis was not achieved in a clinical genomics diagnostic laboratory (i.e. unsolved clinical exomes). Such cases were recruited to a research laboratory for further analyses, in order to potentially: (1) accelerate novel disease gene discovery; (2) increase the molecular diagnostic yield of whole exome sequencing (WES); and (3) gain insight into the genetic mechanisms of disease...
March 21, 2017: Genome Medicine
https://www.readbyqxmd.com/read/28314784/integrative-cancer-pharmacogenomics-to-infer-large-scale-drug-taxonomy
#17
Nehme El-Hachem, Deena M A Gendoo, Laleh Soltan Ghoraie, Zhaleh Safikhani, Petr Smirnov, Christina Chung, Kenan Deng, Alisa Fang, Erin Birkwood, Chantal Ho, Ruth Isserlin, Gary Bader, Anna Goldenberg, Benjamin Haibe-Kains
Identification of drug targets and mechanism of action (MoA) for new and uncharacterized anticancer drugs is important for optimization of treatment efficacy. Current MoA prediction largely relies on prior information including side effects, therapeutic indication, and chemo-informatics. Such information is not transferable or applicable for newly identified, previously uncharacterized small molecules. Therefore, a shift in the paradigm of MoA predictions is necessary towards development of unbiased approaches that can elucidate drug relationships and efficiently classify new compounds with basic input data...
March 17, 2017: Cancer Research
https://www.readbyqxmd.com/read/28302329/the-high-performing-radiology-residency-a-case-study
#18
Lu Anne V Dinglasan, Mary H Scanlon
The primary goal of any radiology residency program is to train clinically competent radiologists. However, some radiology programs go above and beyond basic ACGME requirements and produce highly productive radiologists who contribute to the field in research, education and technology. At the core of such residencies are the people who comprise it, including self-motivated, personable residents and faculty who can facilitate excellence from their trainees. Indeed, radiology residencies which create unique programs in response to evolving resident interests can help foster resident-driven research, advocacy, technological innovation and early leadership...
January 14, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28281427/trends-in-admissions-morbidity-and-outcomes-at-red-cross-war-memorial-children-s-hospital-cape-town-2004-2013
#19
Y Isaacs-Long, L Myer, H J Zar
BACKGROUND: Routinely collected patient information has the potential to yield valuable information about health systems and population health, but there have been few comprehensive analyses of paediatric admissions at South African (SA) hospitals. OBJECTIVES: To investigate trends in hospitalisation and outcomes at Red Cross War Memorial Children's Hospital (RCWMCH), a major referral hospital for children in the Western Cape and SA. Methods. Using routinely collected observational health data from the hospital informatics system, we investigated admissions between 2004 and 2013...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28280932/bits-and-bytes-the-future-of-radiology-lies-in-informatics-and-information-technology
#20
James A Brink, Ronald L Arenson, Thomas M Grist, Jonathan S Lewin, Dieter Enzmann
Advances in informatics and information technology are sure to alter the practice of medical imaging and image-guided therapies substantially over the next decade. Each element of the imaging continuum will be affected by substantial increases in computing capacity coincident with the seamless integration of digital technology into our society at large. This article focuses primarily on areas where this IT transformation is likely to have a profound effect on the practice of radiology. KEY POINTS: • Clinical decision support ensures consistent and appropriate resource utilization...
March 9, 2017: European Radiology
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