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https://www.readbyqxmd.com/read/27933555/pharmacist-s-comprehensive-geriatric-assessment-introduction-and-evaluation-at-elderly-patient-admission
#1
Faiza Rhalimi, Mounir Rhalimi, Alain Rauss
BACKGROUND: The role of the clinical pharmacist within the healthcare system remains unclear. OBJECTIVE: Our objective was to describe a pharmacist's comprehensive geriatric assessment (pCGA) at admission of elderly patients and to assess its relevance in terms of medication compliance and pharmacist interventions (PIs). METHODS: We conducted a prospective interventional study over 29 months in a 34-bed medical/rehabilitation geriatric ward in a French geriatric hospital...
December 8, 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27933156/improving-the-accuracy-of-electronic-prescribing-in-west-bay-health-center-in-qatar
#2
Wafaa Yousuf, Sheren Elkomy, Mona Soliman, Noof Al-Mansouri, Mohamed Salem, Amal Al-Ali, Mohamed H Mahmoud, Hisham Elmahdi
Primary healthcare in Qatar uses electronic prescribing to reduce the risk of medication errors. Electronic prescribing is supported by computerized Physician Order Entry systems through Cerner (electronic medical record system). There are still prescription errors, despite electronic prescribing being in place for one year at West Bay Health Center. West Bay Health Center is a famous primary healthcare center in Qatar. It is a training center for the family medicine residency program, which is accredited by the accreditation council of general medical education international (ACGME-I)...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#3
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27932665/statistical-analysis-of-a-low-cost-method-for-multiple-disease-prediction
#4
Mohsen Bayati, Sonia Bhaskar, Andrea Montanari
Early identification of individuals at risk for chronic diseases is of significant clinical value. Early detection provides the opportunity to slow the pace of a condition, and thus help individuals to improve or maintain their quality of life. Additionally, it can lessen the financial burden on health insurers and self-insured employers. As a solution to mitigate the rise in chronic conditions and related costs, an increasing number of employers have recently begun using wellness programs, which typically involve an annual health risk assessment...
December 8, 2016: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/27932531/development-of-type-2-diabetes-mellitus-phenotyping-framework-using-expert-knowledge-and-machine-learning-approach
#5
Rina Kagawa, Yoshimasa Kawazoe, Yusuke Ida, Emiko Shinohara, Katsuya Tanaka, Takeshi Imai, Kazuhiko Ohe
BACKGROUND: Phenotyping is an automated technique that can be used to distinguish patients based on electronic health records. To improve the quality of medical care and advance type 2 diabetes mellitus (T2DM) research, the demand for T2DM phenotyping has been increasing. Some existing phenotyping algorithms are not sufficiently accurate for screening or identifying clinical research subjects. OBJECTIVE: We propose a practical phenotyping framework using both expert knowledge and a machine learning approach to develop 2 phenotyping algorithms: one is for screening; the other is for identifying research subjects...
December 7, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27932381/improving-the-efficiency-of-care-for-pediatric-patients-hospitalized-with-asthma
#6
Kathleen W Bartlett, Victoria M Parente, Vanessa Morales, Jillian Hauser, Heather S McLean
BACKGROUND: Asthma exacerbations are a leading cause of hospitalization among children. Despite the existence of national pediatric asthma guidelines, significant variation in care persists. At Duke Children's Hospital, we determined that our average length of stay (ALOS) and cost for pediatric asthma admissions exceeded that of our peers. Our aim was to reduce the ALOS of pediatric patients hospitalized with asthma from 2.9 days to 2.6 days within 12 months by implementing an asthma pathway within our new electronic health record...
December 8, 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27931207/a-comparative-study-classification-vs-user-based-collaborative-filtering-for-clinical-prediction
#7
Fang Hao, Rachael Hageman Blair
BACKGROUND: Recommender systems have shown tremendous value for the prediction of personalized item recommendations for individuals in a variety of settings (e.g., marketing, e-commerce, etc.). User-based collaborative filtering is a popular recommender system, which leverages an individuals' prior satisfaction with items, as well as the satisfaction of individuals that are "similar". Recently, there have been applications of collaborative filtering based recommender systems for clinical risk prediction...
December 8, 2016: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/27930734/pathogenic-mutations-in-cancer-predisposing-genes-a-survey-of-300-patients-with-whole-genome-sequencing-and-lifetime-electronic-health-records
#8
Karen Y He, Yiqing Zhao, Elizabeth W McPherson, Quan Li, Fan Xia, Chunhua Weng, Kai Wang, Max M He
BACKGROUND: It is unclear whether and how whole-genome sequencing (WGS) data can be used to implement genomic medicine. Our objective is to retrospectively evaluate whether WGS can facilitate improving prevention and care for patients with susceptibility to cancer syndromes. METHODS AND FINDINGS: We analyzed genetic mutations in 60 autosomal dominant cancer-predisposition genes in 300 deceased patients with WGS data and nearly complete long-term (over 30 years) medical records...
2016: PloS One
https://www.readbyqxmd.com/read/27930280/development-of-electronic-medical-record-based-rounds-report-results-in-improved-resident-efficiency-more-time-for-direct-patient-care-and-education-and-less-resident-duty-hour-violations
#9
Phillip B Ham, Toby Anderton, Ryan Gallaher, Mike Hyrman, Erika Simmerman, Annamalai Ramanathan, David Fallaw, Steven Holsten, Charles Gordon Howell
Surgeons frequently report frustration and loss of efficiency with electronic medical record (EMR) systems. Together, surgery residents and a programmer at Augusta University created a rounds report (RR) summarizing 24 hours of vitals, intake/output, labs, and other values for each inpatient that were previously transcribed by hand. The objective of this study was to evaluate the RRs effect on surgery residents. Surgery residents were queried to assess the RRs impact. Outcome measures were time spent preparing for rounds, direct patient care time, educational activity time, rates of incorrect/incomplete data on rounds, and rate of duty hour violations...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27928726/evaluating-the-safety-profile-of-non-active-implantable-medical-devices-compared-with-medicines
#10
REVIEW
Josep Pane, Preciosa M Coloma, Katia M C Verhamme, Miriam C J M Sturkenboom, Irene Rebollo
Recent safety issues involving non-active implantable medical devices (NAIMDs) have highlighted the need for better pre-market and post-market evaluation. Some stakeholders have argued that certain features of medicine safety evaluation should also be applied to medical devices. Our objectives were to compare the current processes and methodologies for the assessment of NAIMD safety profiles with those for medicines, identify potential gaps, and make recommendations for the adoption of new methodologies for the ongoing benefit-risk monitoring of these devices throughout their entire life cycle...
December 7, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/27928190/single-center-retrospective-evaluation-of-inhaled-corticosteroid-use-for-chronic-obstructive-pulmonary-disease-exacerbation-patients-receiving-systemic-corticosteroids
#11
Taylor Steuber, Dane Shiltz
Purpose: To determine the frequency of inappropriate inhaled corticosteroid (ICS) therapy when it is prescribed concurrently with systemic corticosteroids; to identify cost-savings potential in the setting of chronic obstructive pulmonary disease (COPD) exacerbations. Methods: Patients admitted to 1 of 8 hospital locations utilizing an integrated electronic health record within the health system for COPD exacerbations treated with systemic corticosteroids (equivalent to at least 30 mg of oral prednisone) between July 1, 2013 and June 30, 2014 were included in a retrospective chart review...
November 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27927892/a-concept-wide-association-study-of-clinical-notes-to-discover-new-predictors-of-kidney-failure
#12
Karandeep Singh, Rebecca A Betensky, Adam Wright, Gary C Curhan, David W Bates, Sushrut S Waikar
BACKGROUND AND OBJECTIVES: Identifying predictors of kidney disease progression is critical toward the development of strategies to prevent kidney failure. Clinical notes provide a unique opportunity for big data approaches to identify novel risk factors for disease. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We used natural language processing tools to extract concepts from the preceding year's clinical notes among patients newly referred to a tertiary care center's outpatient nephrology clinics and retrospectively evaluated these concepts as predictors for the subsequent development of ESRD using proportional subdistribution hazards (competing risk) regression...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27927866/expert-consensus-on-metrics-to-assess-the-impact-of-patient-level-antimicrobial-stewardship-interventions-in-acute-care-settings
#13
Rebekah W Moehring, Deverick J Anderson, Ronda L Cochran, Lauri A Hicks, Arjun Srinivasan, Elizabeth Dodds Ashley
Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute care settings for the purposes of internal program decision-making. An expert panel rated 90 candidate metrics on a 9-point Likert scale for association with four criteria: improved antimicrobial prescribing, improved patient care, utility in targeting stewardship efforts, and feasibility in hospitals with electronic health records...
December 7, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27926887/the-application-of-genomics-in-diabetes-barriers-to-discovery-and-implementation
#14
James S Floyd, Bruce M Psaty
The emerging availability of genomic and electronic health data in large populations is a powerful tool for research that has drawn interest in bringing precision medicine to diabetes. In this article, we discuss the potential application of genomics to the prediction, prevention, and treatment of diabetes, and we use examples from other areas of medicine to illustrate some of the challenges involved in conducting genomics research in human populations and implementing findings in practice. At this time, a major barrier to the application of genomics in diabetes care is the lack of actionable genomic findings...
November 2016: Diabetes Care
https://www.readbyqxmd.com/read/27925849/development-and-prospective-federal-state-wide-evaluation-of-a-device-for-height-based-dose-recommendations-in-prehospital-pediatric-emergencies-a-simple-tool-to-prevent-most-severe-drug-errors
#15
Jost Kaufmann, Bernhard Roth, Thomas Engelhardt, Alex Lechleuthner, Michael Laschat, Christoph Hadamitzky, Frank Wappler, Martin Hellmich
OBJECTIVE: Drug dosing errors pose a particular threat to children in prehospital emergency care. With the Pediatric emergency ruler (PaedER), we developed a simple height-based dose recommendation system and evaluated its effectiveness in a pre-post interventional trial as the Ethics Committee disapproved randomization due to the expected positive effect of the PaedER on outcome. METHODS: Pre-interventional data were retrospectively retrieved from the electronic records and medical protocols of the Cologne Emergency Medical Service over a two-year period prior to the introduction of the PaedER...
December 7, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27925422/preventing-hospital-acquired-venous-thromboembolism-improving-patient-safety-with-interdisciplinary-teamwork-quality-improvement-analytics-and-data-transparency
#16
REVIEW
Anneliese M Schleyer, Ellen Robinson, Roxana Dumitru, Mark Taylor, Kimberly Hayes, Ronald Pergamit, Daphne M Beingessner, Mark C Zaros, Joseph Cuschieri
BACKGROUND: Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. OBJECTIVE: To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27923649/food-allergy-trends-and-epinephrine-autoinjector-presence-in-summer-camps
#17
Natalie R Schellpfeffer, Harvey L Leo, Michael Ambrose, Andrew N Hashikawa
BACKGROUND: Pediatric campers with food allergies are at greater risk for exposure and anaphylaxis. A diagnosis of asthma increases risk for anaphylaxis. Epidemiological investigations of food-allergic children at high risk for allergic reactions requiring intervention in camp settings are lacking. OBJECTIVE: The objectives of this study were to estimate the prevalence of food allergies among otherwise healthy campers in summer camps throughout the United States and Canada, and to assess asthma comorbidity and determine rates of epinephrine autoinjector prescriptions present in this population...
December 3, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27922762/nonchemotherapy-drug-induced-agranulocytosis-in-children-detected-by-a-prospective-pharmacovigilance-program
#18
Nicolás Medrano-Casique, Hoi Y Tong, Alberto M Borobia, Antonio J Carcas, Jesús Frías, Elena Ramírez
OBJECTIVES: A prospective evaluation of nonchemotherapy drug-induced agranulocytosis (DIA) cases, which are infrequent in the pediatric population. We characterize agranulocytosis cases and assess lab test differences between drug- and nondrug-induced agranulocytosis. METHODS: Through our Prospective Pharmacovigilance Program from Laboratory Signals at Hospital we detected pediatric agranulocytosis cases from July 2007 to December 2010. This program estimates the incidence, drug causality, clinical features, outcomes of DIA pediatric cases, and assesses laboratory differences with respect to non-DIA...
December 6, 2016: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/27922661/fin-tiera-a-tool-for-assessing-technology-induced-errors
#19
Sari Palojoki, Tuuli Pajunen, Lasse Lehtonen, Kaija Saranto
BACKGROUND: Due to the complexity of healthcare processes, the potential for Health Information Systems (HIS) to cause technology-induced errors is a growing concern. Health Information Technology (HIT) errors nearly always threaten good patient care and can lead to patient harm. Instruments to allow hospitals to proactively identify areas of Electronic Health Records (EHR) safety, to set priorities and to intervene before incidents occur are currently underdeveloped. OBJECTIVES: The aim was to design a Finnish questionnaire to measure EHR users' perceptions of common EHR-related safety concerns in a specialized hospital district context through the lens of the theory of socio-technical dimensions...
December 6, 2016: Methods of Information in Medicine
https://www.readbyqxmd.com/read/27920578/recording-of-hospitalizations-for-acute-exacerbations-of-copd-in-uk-electronic-health-care-records
#20
Kieran J Rothnie, Hana Müllerová, Sara L Thomas, Joht S Chandan, Liam Smeeth, John R Hurst, Kourtney Davis, Jennifer K Quint
BACKGROUND: Accurate identification of hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) within electronic health care records is important for research, public health, and to inform health care utilization and service provision. We aimed to develop a strategy to identify hospitalizations for AECOPD in secondary care data and to investigate the validity of strategies to identify hospitalizations for AECOPD in primary care data. METHODS: We identified patients with chronic obstructive pulmonary disease (COPD) in the Clinical Practice Research Datalink (CPRD) with linked Hospital Episodes Statistics (HES) data...
2016: Clinical Epidemiology
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