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Clinical informatics

Luis I Rodriquez, Todd J Smaka, Michael Mahla, Richard H Epstein
BACKGROUND: In the United States, anesthesia information management systems (AIMS) are well established, especially within academic practices. Many hospitals are replacing their stand-alone AIMS during migration to an enterprise-wide electronic health record. This presents an opportunity to review choices made during the original implementation, based on actual usage. One area amenable to this informatics approach is the configuration in the AIMS of quick buttons for typical drug doses...
October 11, 2016: Anesthesia and Analgesia
Peter Rijnbeek
Massive numbers of electronic health records are currently being collected globally, including structured data in the form of diagnoses, medications, laboratory test results, and unstructured data contained in clinical narratives. This opens unprecedented possibilities for research and ultimately patient care. However, actual use of these databases in a multi-center study is severely hampered by a variety of challenges, e.g., each database has a different database structure and uses different terminology systems...
September 2016: Journal of Hypertension
Rae Woong Park
Big data indicates the large and ever-increasing volumes of data adhere to the following 4Vs: volume (ever-increasing amount), velocity (quickly generated), variety (many different types), veracity (from trustable sources). The last decade has seen huge advances in the amount of data we routinely generate and collect in pretty much everything we do, as well as our ability to use technology to analyze and understand it. The routine operation of modern health care systems also produces an abundance of electronically stored data on an ongoing basis as a byproduct of clinical practice...
September 2016: Journal of Hypertension
Daniel Ngui, Michael J H Qiu, Michael Mann
OBJECTIVE: In order to address the systematic and practice management issues associated with managing hypertension, we undertook a quality improvement project at a multi-physician clinic in Vancouver, British Columbia, Canada. We piloted an evidence-based electronic medical record (EMR) hypertension management dashboard based on the 2014 Canadian Hypertension Education Program (CHEP) guideline recommendations. Since June 1, 2015, our chronic disease coordinator utilized our EMR HTN Dashboard to generate patient recalls, create physician reminders and to enhance internal clinic referrals to provide 1:1 patient hypertension self-management education by physicians and our clinical pharmacist team...
September 2016: Journal of Hypertension
Michael Popovich, Brandy Altstadter, Lara Hargraves Popovich, B S Biology
The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages health information exchange between clinical care and public health through Meaningful Use measures. Meaningful Use specifically identifies objectives to support a number of public health programs including immunizations, cancer registries, syndromic surveillance, and disease case reports. The objective is to improve public and population health. Stage 2 of Meaningful Use focused on compliance to sending of information to public health...
2016: Online Journal of Public Health Informatics
Kevin T Nead, Greg Gaskin, Cariad Chester, Samuel Swisher-McClure, Joel T Dudley, Nicholas J Leeper, Nigam H Shah
We recently found an association between androgen deprivation therapy (ADT) and Alzheimer's disease. As Alzheimer's disease is a disease of advanced age, we hypothesize that older individuals on ADT may be at greatest risk. We conducted a retrospective multi-institutional analysis among 16,888 individuals with prostate cancer using an informatics approach. We tested the effect of ADT on Alzheimer's disease using Kaplan-Meier age stratified analyses in a propensity score matched cohort. We found a lower cumulative probability of remaining Alzheimer's disease-free between non-ADT users age ā‰„70 versus those age <70 years (pā€‰<ā€‰0...
October 18, 2016: Scientific Reports
Mark Doyle, Gerald M Pohost, C Noel Bairey Merz, Leslee J Shaw, George Sopko, William J Rogers, Barry L Sharaf, Carl J Pepine, Diane V Thompson, Geetha Rayarao, Lindsey Tauxe, Sheryl F Kelsey, Robert W W Biederman
BACKGROUND: We introduce an algorithmic approach to optimize diagnostic and prognostic value of gated cardiac single photon emission computed tomography (SPECT) and magnetic resonance (MR) myocardial perfusion imaging (MPI) modalities in women with suspected myocardial ischemia. The novel approach: bio-informatics assessment schema (BIAS) forms a mathematical model utilizing MPI data and cardiac metrics generated by one modality to predict the MPI status of another modality. The model identifies cardiac features that either enhance or mask the image-based evidence of ischemia...
October 2016: Cardiovascular Diagnosis and Therapy
James M Brown, Neil R Horner, Thomas N Lawson, Tanja Fiegel, Simon Greenaway, Hugh Morgan, Natalie Ring, Luis Santos, Duncan Sneddon, Lydia Teboul, Jennifer Vibert, Gagarine Yaikhom, Henrik Westerberg, Ann-Marie Mallon
High-throughput phenotyping is a cornerstone of numerous functional genomics projects. In recent years, imaging screens have become increasingly important in understanding gene-phenotype relationships in studies of cells, tissues and whole organisms. Three-dimensional (3D) imaging has risen to prominence in the field of developmental biology for its ability to capture whole embryo morphology and gene expression, as exemplified by the International Mouse Phenotyping Consortium (IMPC). Large volumes of image data are being acquired by multiple institutions around the world that encompass a range of modalities, proprietary software and metadata...
October 14, 2016: Briefings in Bioinformatics
Faiyaz Notta, Michelle Chan-Seng-Yue, Mathieu Lemire, Yilong Li, Gavin W Wilson, Ashton A Connor, Robert E Denroche, Sheng-Ben Liang, Andrew M K Brown, Jaeseung C Kim, Tao Wang, Jared T Simpson, Timothy Beck, Ayelet Borgida, Nicholas Buchner, Dianne Chadwick, Sara Hafezi-Bakhtiari, John E Dick, Lawrence Heisler, Michael A Hollingsworth, Emin Ibrahimov, Gun Ho Jang, Jeremy Johns, Lars G T Jorgensen, Calvin Law, Olga Ludkovski, Ilinca Lungu, Karen Ng, Danielle Pasternack, Gloria M Petersen, Liran I Shlush, Lee Timms, Ming-Sound Tsao, Julie M Wilson, Christina K Yung, George Zogopoulos, John M S Bartlett, Ludmil B Alexandrov, Francisco X Real, Sean P Cleary, Michael H Roehrl, John D McPherson, Lincoln D Stein, Thomas J Hudson, Peter J Campbell, Steven Gallinger
Pancreatic cancer, a highly aggressive tumour type with uniformly poor prognosis, exemplifies the classically held view of stepwise cancer development. The current model of tumorigenesis, based on analyses of precursor lesions, termed pancreatic intraepithelial neoplasm (PanINs) lesions, makes two predictions: first, that pancreatic cancer develops through a particular sequence of genetic alterations (KRAS, followed by CDKN2A, then TP53 and SMAD4); and second, that the evolutionary trajectory of pancreatic cancer progression is gradual because each alteration is acquired independently...
October 12, 2016: Nature
Xiao-Ying Zhang, Peiying Zhang
The telemedicine department of a hospital is an emerging branch in upcoming hospitals and may become an essential component of every hospital. It basically utilizes the information technologies along with telecommunication systems in order to provide clinical care and assistance. Furthermore, the branch of telemedicine offers significant opportunities for the process of developmental freedom from illness, early death, and preventable diseases. It advances development by providing relevant drugs and the necessary care aimed to alleviate patient suffering...
October 2016: Experimental and Therapeutic Medicine
Marco Scianna, Luca Munaron
BACKGROUND: Cancer is a heterogeneous disease, which is based on an intricate network of processes at different spatiotemporal scales, from the genome to the tissue level. Hence the necessity for the biomedical and pharmaceutical research to work in a multiscale fashion. In this respect, a significant help derives from the collaboration with theoretical sciences. Indeed, mathematical models can provide insights into tumor-related processes and support clinical oncologists in the design of treatment regime, dosage, schedule and toxicity...
October 3, 2016: Recent Patents on Anti-cancer Drug Discovery
Jinoos Yazdany, Nick Bansback, Megan Clowse, Deborah Collier, Karen Law, Katherine P Liao, Kaleb Michaud, Esi M Morgan, James C Oates, Catalina Orozco, Andreas Reimold, Julia F Simard, Rachel Myslinski, Salahuddin Kazi
BACKGROUND: The Rheumatology Informatics System for Effectiveness (RISE) is a national electronic medical record (EMR)-enabled registry. RISE passively collects data from EMRs of participating practices, provides advanced quality measurement and data analytic capacities, and fulfills national quality reporting requirements. Here we report the registry's architecture and initial data, and demonstrate how RISE is being used to improve the quality of care. METHODS: RISE is a certified Centers for Medicare and Medicaid Services Qualified Clinical Data Registry, allowing collection of data without individual patient informed consent...
October 1, 2016: Arthritis Care & Research
J Plaksin, R M Cymerman, R Caso Caso, C Galeano, R Ramasamy, G Gold-von Simson
Drug development (DD) is a multidisciplinary process that spans the translational continuum, yet remains an understudied entity in medical schools and biomedical science institutes. In response to a growing interest and unmet need, we implemented a DD course series that details identification of viable molecular targets, clinical trial design, intellectual property, and marketing. Enrollment is open to faculty, postdoctoral trainees, and MD, PhD, and MS students. After 2 years, 37 students and 23 students completed the fall and spring courses, respectively...
October 1, 2016: Clinical and Translational Science
Kuan Wang, Jiebo Luo
Recent years have witnessed an increasing interest in the application of machine learning to clinical informatics and healthcare systems. A significant amount of research has been done on healthcare systems based on supervised learning. In this study, we present a generalized solution to detect visually observable symptoms on faces using semi-supervised anomaly detection combined with machine vision algorithms. We rely on the disease-related statistical facts to detect abnormalities and classify them into multiple categories to narrow down the possible medical reasons of detecting...
December 2016: EURASIP Journal on Bioinformatics & Systems Biology
Arielle M Fisher, Michael Q Ding, Harry Hochheiser, Gerald P Douglas
BACKGROUND: Free and charitable clinics are a critical part of America's healthcare safety net. Although informatics tools have the potential to mitigate many of the organizational and service-related challenges facing these clinics, little research attention has been paid to the workflows and potential impact of electronic systems in these settings. In previous work, we performed a qualitative investigation at a free clinic dispensary to identify workflow challenges that may be alleviated through introduction of informatics interventions...
September 29, 2016: BMC Health Services Research
Kay Lovelace, Gulzar H Shah
BACKGROUND: Informatics capacity building is resource and personnel intensive. Many local health departments (LHDs) face tradeoffs between using their resources to carry out existing mandates and using resources to build their capacity, for example, through informatics, to deliver essential services in a more effective and efficient manner. OBJECTIVE: The purpose of this case study is to describe how a mid-sized LHD built and used information systems to support its strategic objectives, clinical services, and surveillance...
November 2016: Journal of Public Health Management and Practice: JPHMP
Karmen S Williams, Gulzar H Shah
BACKGROUND: Electronic health records (EHRs) are evolving the scope of operations, practices, and outcomes of population health in the United States. Local health departments (LHDs) need adequate health informatics capacities to handle the quantity and quality of population health data. PURPOSE: The purpose of this study was to gain an updated view using the most recent data to identify the primary storage of clinical data, status of data for meaningful use, and characteristics associated with the implementation of EHRs in LHDs...
November 2016: Journal of Public Health Management and Practice: JPHMP
J Mac McCullough, Kate Goodin
CONTEXT: Numerous software and data storage systems are employed by local health departments (LHDs) to manage clinical and nonclinical data needs. Leveraging electronic systems may yield improvements in public health practice. However, information is lacking regarding current usage patterns among LHDs. OBJECTIVE: To analyze clinical and nonclinical data storage and software types by LHDs. DESIGN: Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County and City Health Officials...
November 2016: Journal of Public Health Management and Practice: JPHMP
Yordan P Raykov, Alexis Boukouvalas, Fahd Baig, Max A Little
The K-means algorithm is one of the most popular clustering algorithms in current use as it is relatively fast yet simple to understand and deploy in practice. Nevertheless, its use entails certain restrictive assumptions about the data, the negative consequences of which are not always immediately apparent, as we demonstrate. While more flexible algorithms have been developed, their widespread use has been hindered by their computational and technical complexity. Motivated by these considerations, we present a flexible alternative to K-means that relaxes most of the assumptions, whilst remaining almost as fast and simple...
2016: PloS One
Amber Delmas, Angelos Oikonomopoulos, Precious N Lacey, Mohammad Fallahi, Daniel W Hommes, Mark S Sundrud
Advances in flow and mass cytometry are enabling ultra-high resolution immune profiling in mice and humans on an unprecedented scale. However, the resulting high-content datasets challenge traditional views of cytometry data, which are both limited in scope and biased by pre-existing hypotheses. Computational solutions are now emerging (e.g., Citrus, AutoGate, SPADE) that automate cell gating or enable visualization of relative subset abundance within healthy versus diseased mice or humans. Yet these tools require significant computational fluency and fail to show quantitative relationships between discrete immune phenotypes and continuous disease variables...
2016: PloS One
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