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https://www.readbyqxmd.com/read/28449053/fresh-fruit-consumption-and-all-cause-and-cause-specific-mortality-findings-from-the-china-kadoorie-biobank
#1
Huaidong Du, Liming Li, Derrick Bennett, Ling Yang, Yu Guo, Timothy J Key, Zheng Bian, Yiping Chen, Robin G Walters, Iona Y Millwood, Junshi Chen, Junzheng Wang, Xue Zhou, Le Fang, Yijun Li, Xianzhi Li, Rory Collins, Richard Peto, Zhengming Chen
Background: Higher fruit consumption is associated with lower risk of cardiovascular disease (CVD). Substantial uncertainties remain, however, about the associations of fruit consumption with all-cause mortality and mortality from subtypes of CVD and major non-vascular diseases, especially in China. Methods: In 2004-08, the nationwide China Kadoorie Biobank Study recruited > 0.5 million adults aged 30-79 years from 10 diverse localities in China. Fresh fruit consumption was estimated using an interviewer-administered electronic questionnaire, and mortality data were collected from death registries...
April 24, 2017: International Journal of Epidemiology
https://www.readbyqxmd.com/read/28448781/assessment-of-clinical-pharmacy-interventions-to-reduce-outpatient-use-of-high-risk-medications-in-the-elderly
#2
Sarah C Weddle, A Shaun Rowe, Julie W Jeter, Rachel C Renwick, Shaunta' M Chamberlin, Andrea S Franks
BACKGROUND: Use of high-risk medications in the elderly (HRME) and drug-disease (Rx-DIS) interactions in the elderly, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) Measures, are significantly associated with mortality, hospital admission, and need for emergency care. No published studies to date evaluate interventions to reduce the use of HEDIS-defined HRME, although many studies have postulated a beneficial effect of such interventions. OBJECTIVE: To evaluate the effect of pharmacist interventions on use of HRME and Rx-DIS interactions in the outpatient elderly population...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448775/exploring-electronic-medical-record-and-self-administered-medication-risk-screening-tools-in-a-primary-care-clinic
#3
Mark J Makowsky, Ken Cor, Tat Wong
BACKGROUND: Electronic medical record (EMR) screening for indicators of medication risk could improve efficiency in identifying primary care clinic patients in need of clinical pharmacist care compared with patient self-reporting. OBJECTIVES: To (a) compare the performance of an EMR medication risk assessment questionnaire (MRAQ) with a self-administered (SA) MRAQ and (b) explore each tool's ability to predict indicators of health behavior, health status, and health care utilization...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28447144/-standardized-collection-of-presenting-complaints-in-the-emergency-room-integration-of-coded-presenting-complaints-into-the-electronic-medical-record-system-of-an-emergency-department-and-their-value-for-health-care-research
#4
F Greiner, D Brammen, M Kulla, F Walcher, B Erdmann
BACKGROUND: The point of entry of a patient in emergency care is a symptom or a complaint. To evaluate subsequent processes in an emergency department until a diagnosis is made, this information has to be taken into account. OBJECTIVES: We report the introduction of coded presenting complaints into the electronic medical record system of an emergency department and describe the patients based on these data. METHODS: The CEDIS presenting complaint list was integrated into the emergency department information system of an emergency department (38,000 patients/year)...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28447101/development-and-use-of-a-clinical-decision-support-tool-for-behavioral-health-screening-in-primary-care-clinics
#5
Timothy E Burdick, Rodger S Kessler
OBJECTIVE: Screening, brief intervention, and referral for treatment (SBIRT) for behavioral health (BH) is a key clinical process. SBIRT tools in electronic health records (EHR) are infrequent and rarely studied. Our goals were 1) to design and implement SBIRT using clinical decision support (CDS) in a commercial EHR; and 2) to conduct a pragmatic evaluation of the impact of the tools on clinical outcomes. METHODS: A multidisciplinary team designed SBIRT workflows and CDS tools...
April 26, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28447098/application-of-natural-language-processing-and-network-analysis-techniques-to-post-market-reports-for-the-evaluation-of-dose-related-anti-thymocyte-globulin-safety-patterns
#6
Taxiarchis Botsis, Matthew Foster, Nina Arya, Kory Kreimeyer, Abhishek Pandey, Deepa Arya
OBJECTIVE: To evaluate the feasibility of automated dose and adverse event information retrieval in supporting the identification of safety patterns. METHODS: We extracted all rabbit Anti-Thymocyte Globulin (rATG) reports submitted to the United States Food and Drug Administration Adverse Event Reporting System (FAERS) from the product's initial licensure in April 16, 1984 through February 8, 2016. We processed the narratives using the Medication Extraction (MedEx) and the Event-based Text-mining of Health Electronic Records (ETHER) systems and retrieved the appropriate medication, clinical, and temporal information...
April 26, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28447016/deriving-meaningful-insights-from-clinical-trial-and-postmarketing-safety-data-perspectives-from-india
#7
REVIEW
Anand Harugeri, Vineet Shastri, Chanakya Patel
Today, drug safety data collection in India is both manual and electronic with reporting of potential overlapping and duplicate data, which is likely incomplete for further review and analysis. Furthermore, standardized data collection and timelines are not aligned with international standards. Complete coverage of safety data from all sources throughout the life of the drug cannot be ensured. There is no requirement to submit periodic safety data in clinical trials to regulatory authority. There is clearly a lack of emphasis on deriving meaningful safety data insights for ensuring patient safety...
April 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/28446446/the-cardiovascular-health-in-ambulatory-care-research-team-performance-indicators-for-the-primary-prevention-of-cardiovascular-disease-a-modified-delphi-panel-study
#8
Jack V Tu, Laura C Maclagan, Dennis T Ko, Clare L Atzema, Gillian L Booth, Sharon Johnston, Karen Tu, Douglas S Lee, Arlene Bierman, Ruth Hall, R Sacha Bhatia, Andrea S Gershon, Sheldon W Tobe, Claudia Sanmartin, Peter Liu, Anna Chu
BACKGROUND: High-quality ambulatory care can reduce cardiovascular disease risk, but important gaps exist in the provision of cardiovascular preventive care. We sought to develop a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. METHODS: As part of the Cardiovascular Health in Ambulatory Care Research Team initiative, we established a 14-member multidisciplinary expert panel to develop a set of indicators for measuring primary prevention performance in ambulatory cardiovascular care...
April 25, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28445684/patient-staffing-and-health-centre-factors-associated-with-annual-testing-for-sexually-transmissible-infections-in-remote-primary-health-centres
#9
Belinda Hengel, Handan Wand, James Ward, Alice Rumbold, Linda Garton, Debbie Taylor-Thomson, Bronwyn Silver, Skye McGregor, Amalie Dyda, Jacqueline Mein, Janet Knox, Lisa Maher, John Kaldor, Rebecca Guy
Background: In high-incidence Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) settings, annual re-testing is an important public health strategy. Using baseline laboratory data (2009-10) from a cluster randomised trial in 67 remote Aboriginal communities, the extent of re-testing was determined, along with the associated patient, staffing and health centre factors. Methods: Annual testing was defined as re-testing in 9-15 months (guideline recommendation) and a broader time period of 5-15 months following an initial negative CT/NG test...
April 27, 2017: Sexual Health
https://www.readbyqxmd.com/read/28445624/the-role-of-publicly-funded-family-planning-sites-in-health-insurance-enrollment
#10
Jennifer Yarger, Sara Daniel, M Antonia Biggs, Jan Malvin, Claire D Brindis
CONTEXT: Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment. METHODS: In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance...
April 26, 2017: Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/28445530/computation-of-adherence-to-medication-and-visualization-of-medication-histories-in-r-with-adherer-towards-transparent-and-reproducible-use-of-electronic-healthcare-data
#11
Alexandra Lelia Dima, Dan Dediu
Adherence to medications is an important indicator of the quality of medication management and impacts on health outcomes and cost-effectiveness of healthcare delivery. Electronic healthcare data (EHD) are increasingly used to estimate adherence in research and clinical practice, yet standardization and transparency of data processing are still a concern. Comprehensive and flexible open-source algorithms can facilitate the development of high-quality, consistent, and reproducible evidence in this field. Some EHD-based clinical decision support systems (CDSS) include visualization of medication histories, but this is rarely integrated in adherence analyses and not easily accessible for data exploration or implementation in new clinical settings...
2017: PloS One
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#12
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
April 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28444652/-establishment-of-specialized-pediatric-palliative-home-care-in-the-medical-valley-of-the-european-metropolitan-area-nuremberg
#13
Steven Hébert, Chara Gravou-Apostolatou, Wolfgang Rascher
Background As part of the 2007 health reform in Germany the structure of outpatient palliative care for children and adolescents was adopted for the first time and then implemented in Erlangen-Nuremberg in 2009. Methods The introduction of Pediatric Palliative Home Care (PPHC) at the Hospital for Children and Adolescents at the University of Erlangen-Nuremberg was retrospectively analyzed between the years 2009 to 2014. Referring medical records (paper-based and electronic) were evaluated systematically. Results Considering 69 patients within this study, 44 (63...
March 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28444383/optimizing-drug-dose-alerts-using-commercial-software-throughout-an-integrated-health-care-system
#14
Salim M Saiyed, Peter J Greco, Glenn Fernandes, David C Kaelber
All default electronic health record and drug reference database vendor drug-dose alerting recommendations (single dose, daily dose, dose frequency, and dose duration) were silently turned on in inpatient, outpatient, and emergency department areas for pediatric-only and nonpediatric-only populations. Drug-dose alerts were evaluated during a 3-month period. Drug-dose alerts fired on 12% of orders (104 098/834 911). System-level and drug-specific strategies to decrease drug-dose alerts were analyzed. System-level strategies included: (1) turning off all minimum drug-dosing alerts, (2) turning off all incomplete information drug-dosing alerts, (3) increasing the maximum single-dose drug-dose alert threshold to 125%, (4) increasing the daily dose maximum drug-dose alert threshold to 125%, and (5) increasing the dose frequency drug-dose alert threshold to more than 2 doses per day above initial threshold...
April 24, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28444213/representation-of-occupational-information-across-resources-and-validation-of-the-occupational-data-for-health-model
#15
Sripriya Rajamani, Elizabeth S Chen, Elizabeth Lindemann, Ranyah Aldekhyyel, Yan Wang, Genevieve B Melton
Reports by the National Academy of Medicine and leading public health organizations advocate including occupational information as part of an individual's social context. Given recent National Academy of Medicine recommendations on occupation-related data in the electronic health record, there is a critical need for improved representation. The National Institute for Occupational Safety and Health has developed an Occupational Data for Health (ODH) model, currently in draft format. This study aimed to validate the ODH model by mapping occupation-related elements from resources representing recommendations, standards, public health reports and surveys, and research measures, along with preliminary evaluation of associated value sets...
April 22, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28442772/discriminative-and-distinct-phenotyping-by-constrained-tensor-factorization
#16
Yejin Kim, Robert El-Kareh, Jimeng Sun, Hwanjo Yu, Xiaoqian Jiang
Adoption of Electronic Health Record (EHR) systems has led to collection of massive healthcare data, which creates oppor- tunities and challenges to study them. Computational phenotyping offers a promising way to convert the sparse and complex data into meaningful concepts that are interpretable to healthcare givers to make use of them. We propose a novel su- pervised nonnegative tensor factorization methodology that derives discriminative and distinct phenotypes. We represented co-occurrence of diagnoses and prescriptions in EHRs as a third-order tensor, and decomposed it using the CP algorithm...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28442434/clinical-code-set-engineering-for-reusing-ehr-data-for-research-a-review
#17
REVIEW
Richard Williams, Evangelos Kontopantelis, Iain Buchan, Niels Peek
INTRODUCTION: The construction of reliable, reusable clinical code sets is essential when re-using Electronic Health Record (EHR) data for research. Yet code set definitions are rarely transparent and their sharing is almost non-existent. There is a lack of methodological standards for the management (construction, sharing, revision and reuse) of clinical code sets which needs to be addressed to ensure the reliability and credibility of studies which use code sets. OBJECTIVE: To review methodological literature on the management of sets of clinical codes used in research on clinical databases and to provide a list of best practice recommendations for future studies and software tools...
April 22, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28442433/electronic-health-record-as-a-research-tool-frequency-of-exposure-to-targeted-clinical-problems-and-health-care-providers-clinical-proficiency
#18
Tim Wysocki, Maria Carmen G Diaz, James H Crutchfield, James P Franciosi, Lloyd N Werk
OBJECTIVES: The Electronic Health Record (EHR) could provide insight into possible decay in health care providers' (HCP) clinical knowledge and cognitive performance. Analyses of the contributions of variables such as frequency of exposure to targeted clinical problems could inform the development and testing of appropriate individualized interventions to mitigate these threats to quality and safety of care. MATERIALS/METHODS: Nine targeted clinical problems (TCP) were selected for further study, and de-identified, aggregated study data were obtained for one calendar year...
April 22, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28441696/declining-blood-pressure-and-intensification-of-blood-pressure-management-among-people-over-80-years-cohort-study-using-electronic-health-records
#19
Rathi Ravindrarajah, Alex Dregan, Nisha C Hazra, Shota Hamada, Stephen H D Jackson, Martin C Gulliford
BACKGROUND: Management of high blood pressure (BP) in people over 80 years is controversial, but there is limited information available concerning the uptake of hypertension treatment at this age. OBJECTIVE: To evaluate use of antihypertensive drugs and changes in SBP and DBP from 2001 to 2014 in men and women aged 80 years and over. METHODS: Cohort study using primary care electronic health records of 265 225 participants from the UK Clinical Practice Research Datalink...
June 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28441388/a-population-based-approach-for-implementing-change-from-opt-out-to-opt-in-research-permissions
#20
Elizabeth A Marshall, Jim C Oates, Azza Shoaibi, Jihad S Obeid, Melissa L Habrat, Robert W Warren, Kathleen T Brady, Leslie A Lenert
Due to recently proposed changes in the Common Rule regarding the collection of research preferences, there is an increased need for efficient methods to document opt-in research preferences at a population level. Previously, our institution developed an opt-out paper-based workflow that could not be utilized for research in a scalable fashion. This project was designed to demonstrate the feasibility of implementing an electronic health record (EHR)-based active opt-in research preferences program. The first phase of implementation required creating and disseminating a patient questionnaire through the EHR portal to populate discreet fields within the EHR indicating patients' preferences for future research study contact (contact) and their willingness to allow anonymised use of excess tissue and fluid specimens (biobank)...
2017: PloS One
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