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https://www.readbyqxmd.com/read/28926294/predictors-of-death-in-the-hospital-for-patients-with-chronic-serious-illness
#1
Katy Hicks, Lois Downey, Ruth A Engelberg, James A Fausto, Helene Starks, Ben Dunlap, James Sibley, William Lober, Nita Khandelwal, Elizabeth T Loggers, J Randall Curtis
BACKGROUND: Most people prefer to die at home, yet most do not. Understanding factors associated with terminal hospitalization may inform interventions to improve care. OBJECTIVE: Among patients with chronic illness receiving care in a multihospital healthcare system, we identified the following: (1) predictors of death in any hospital; (2) predictors of death in a hospital outside the system; and (3) trends from 2010 to 2015. DESIGN: Retrospective cohort using death certificates and electronic health records...
September 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28926204/acceptability-of-clinical-decision-support-interface-prototypes-for-a-nursing-electronic-health-record-to-facilitate-supportive-care-outcomes
#2
Janet Stifter, Vanessa E C Sousa, Alessandro Febretti, Karen Dunn Lopez, Andrew Johnson, Yingwei Yao, Gail M Keenan, Diana J Wilkie
PURPOSE: To determine the acceptability, usefulness, and ease of use for four nursing clinical decision support interface prototypes. METHODS: In a simulated hospital environment, 60 registered nurses (48 female; mean age = 33.7 ± 10.8; mean years of experience = 8.1 ± 9.7) participated in a randomized study with four study groups. Measures included acceptability, usefulness, and ease of use scales. FINDINGS: Mean scores were high for acceptability, usefulness, and the ease of use for all four groups...
September 19, 2017: International Journal of Nursing Knowledge
https://www.readbyqxmd.com/read/28926002/polygenic-loading-for-major-depression-is-associated-with-specific-medical-comorbidity
#3
T H McCoy, V M Castro, L Snapper, K Hart, J L Januzzi, J C Huffman, R H Perlis
Major depressive disorder frequently co-occurs with medical disorders, raising the possibility of shared genetic liability. Recent identification of 15 novel genetic loci associated with depression allows direct investigation of this question. In cohorts of individuals participating in biobanks at two academic medical centers, we calculated polygenic loading for risk loci reported to be associated with depression. We then examined the association between such loading and 50 groups of clinical diagnoses, or topics, drawn from these patients' electronic health records, determined using a novel application of latent Dirichilet allocation...
September 19, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28925416/extracting-autism-spectrum-disorder-data-from-the-electronic-health-record
#4
Ruth A Bush, Cynthia D Connelly, Alexa Pérez, Halsey Barlow, George J Chiang
BACKGROUND: Little is known about the health care utilization patterns of individuals with pediatric autism spectrum disorder (ASD). OBJECTIVES: Electronic health record (EHR) data provide an opportunity to study medical utilization and track outcomes among children with ASD.  Methods: Using a pediatric, tertiary, academic hospital's Epic EHR, search queries were built to identify individuals aged 2-18 with International Classification of Diseases, Ninth Revision (ICD-9) codes, 299...
July 19, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28925415/quality-requirements-for-electronic-health-record-systems-a-japanese-german-information-management-perspective
#5
Alfred Winter, Katsuhiko Takabayashi, Franziska Jahn, Eizen Kimura, Rolf Engelbrecht, Reinhold Haux, Masayuki Honda, Ursula H Hübner, Sozo Inoue, Christian D Kohl, Takehiro Matsumoto, Yasushi Matsumura, Kengo Miyo, Naoki Nakashima, Hans-Ulrich Prokosch, Martin Staemmler
BACKGROUND: For more than 30 years, there has been close cooperation between Japanese and German scientists with regard to information systems in health care. Collaboration has been formalized by an agreement between the respective scientific associations. Following this agreement, two joint workshops took place to explore the similarities and differences of electronic health record systems (EHRS) against the background of the two national healthcare systems that share many commonalities...
August 7, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28924986/supplementing-electronic-health-records-through-sample-collection-and-patient-diaries-a-study-set-within-a-primary-care-research-database
#6
Rebecca M Joseph, Jamie Soames, Mark Wright, Kirin Sultana, Tjeerd P van Staa, William G Dixon
PURPOSE: To describe a novel observational study that supplemented primary care electronic health record (EHR) data with sample collection and patient diaries. METHODS: The study was set in primary care in England. A list of 3974 potentially eligible patients was compiled using data from the Clinical Practice Research Datalink. Interested general practices opted into the study then confirmed patient suitability and sent out postal invitations. Participants completed a drug-use diary and provided saliva samples to the research team to combine with EHR data...
September 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28923810/an-innovative-community-based-model-for-improving-preventive-care-in-rural-counties
#7
Zsolt J Nagykaldi, Dewey Scheid, Daniel Zhao, Bhawani Mishra, Tracy Greever-Rice
OBJECTIVE: This quasi-experimental pilot study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices (PCPs) located in a rural county in Oklahoma. A Wellness Coordinator (WC) working with PCPs, the county health department, the county hospital, and a health information exchange (HIE) organization helped county residents receive evidence-based preventive services. METHODS: The WC used a community wellness registry connected to electronic medical records via HIE and called patients at the county level based on PCP-prioritized and tailored protocols...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28923013/pragmatic-clinical-trials-embedded-in-healthcare-systems-generalizable-lessons-from-the-nih-collaboratory
#8
Kevin P Weinfurt, Adrian F Hernandez, Gloria D Coronado, Lynn L DeBar, Laura M Dember, Beverly B Green, Patrick J Heagerty, Susan S Huang, Kathryn T James, Jeffrey G Jarvik, Eric B Larson, Vincent Mor, Richard Platt, Gary E Rosenthal, Edward J Septimus, Gregory E Simon, Karen L Staman, Jeremy Sugarman, Miguel Vazquez, Douglas Zatzick, Lesley H Curtis
BACKGROUND: The clinical research enterprise is not producing the evidence decision makers arguably need in a timely and cost effective manner; research currently involves the use of labor-intensive parallel systems that are separate from clinical care. The emergence of pragmatic clinical trials (PCTs) poses a possible solution: these large-scale trials are embedded within routine clinical care and often involve cluster randomization of hospitals, clinics, primary care providers, etc...
September 18, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28923006/repeat-a-framework-to-assess-empirical-reproducibility-in-biomedical-research
#9
Leslie D McIntosh, Anthony Juehne, Cynthia R H Vitale, Xiaoyan Liu, Rosalia Alcoser, J Christian Lukas, Bradley Evanoff
BACKGROUND: The reproducibility of research is essential to rigorous science, yet significant concerns of the reliability and verifiability of biomedical research have been recently highlighted. Ongoing efforts across several domains of science and policy are working to clarify the fundamental characteristics of reproducibility and to enhance the transparency and accessibility of research. METHODS: The aim of the proceeding work is to develop an assessment tool operationalizing key concepts of research transparency in the biomedical domain, specifically for secondary biomedical data research using electronic health record data...
September 18, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28922677/surgery-significantly-improves-neurocognition-sleep-and-blood-pressure-in-primary-hyperparathyroidism-a-3-year-prospective-follow-up-study
#10
Sara Storvall, Eeva M Ryhänen, Ilkka Heiskanen, Harri Sintonen, Risto P Roine, Camilla Schalin-Jäntti
Surgery for primary hyperparathyroidism (PHPT) improves health-related quality of life (HRQoL), but it is unclear whether the effects are sustained after medium-term (>2 years) follow-up, and whether the results on some or all dimensions of HRQoL will reach that of the general population. We performed a follow-up of HRQoL on average 3.3 years after surgery for PHPT using the 15D in our patient cohort (n=124) and compared the results to those of an age- and gender-standardized general population (n=1099)...
September 18, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28922054/economic-burden-of-pneumococcal-infections-in-children-under-5%C3%A2-years-of-age
#11
Mehmet Ceyhan, Yasemin Ozsurekci, Kubra Aykac, Basak Hacibedel, Egemen Ozbilgili
The present study aimed to determine the cost of childhood pneumococcal infections under 5 years of age and to provide further data for future health economy studies. Electronic medical records of children diagnosed with meningitis caused by S. pneumoniae and all-cause pneumonia, and acute otitis media (AOM) between January 2013-April 2014 were retrospectively evaluated. Direct costs for the treatments of hospitalized patients (pneumonia and pneumococcal meningitis) including costs of healthcare services consisted of costs of hospital bed, examination, laboratory analyses, scanning methods, consultation, vascular access procedures, and infusion and intravenous treatments...
September 18, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28921727/hot-off-the-press-embedded-clinical-decision-support-in-electronic-health-record-decreases-use-of-high-cost-imaging-in-the-emergency-department-embed-study
#12
Corey Heitz, Justin Morgenstern, William K Milne
This longitudinal before/after study of embedded CDRs assessed the effects of clinical decision support on use of common imaging studies. Among high users, rates of CT-brain and CT c-spine were reduced after implementation of embedded clinical decision instruments, while in low users, rates increased. This article summarizes the manuscript and the Skeptics Guide to Emergency Medicine podcast, as well as the ensuing social media/online discussion. This article is protected by copyright. All rights reserved.
September 15, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28921446/can-a-novel-icu-data-display-positively-affect-patient-outcomes-and-save-lives
#13
Natalia Olchanski, Mikhail A Dziadzko, Ing C Tiong, Craig E Daniels, Steve G Peters, John C O'Horo, Michelle N Gong
The aim of this study was to quantify the impact of ProCCESs AWARE, Ambient Clinical Analytics, Rochester, MN, a novel acute care electronic medical record interface, on a range of care process and patient health outcome metrics in intensive care units (ICUs). ProCCESs AWARE is a novel acute care EMR interface that contains built-in tools for error prevention, practice surveillance, decision support and reporting. We compared outcomes before and after AWARE implementation using a prospective cohort and a historical control...
September 18, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28920708/perceived-usefulness-and-perceived-ease-of-use-of-electronic-health-records-among-nurses-application-of-technology-acceptance-model
#14
Ahmad Tubaishat
BACKGROUND: Electronic health records (EHRs) are increasingly being implemented in healthcare organizations but little attention has been paid to the degree to which nurses as end-users will accept these systems and subsequently use them. OBJECTIVES: To explore nurses' perceptions of usefulness and ease-of-use of EHRs. The relationship between these constructs was examined, and its predictors were studied. METHOD: A national exploratory study was conducted with 1539 nurses from 15 randomly selected hospitals, representative of different regions and healthcare sectors in Jordan...
September 18, 2017: Informatics for Health & Social Care
https://www.readbyqxmd.com/read/28919830/identification-of-patients-with-congenital-hemophilia-in-a-large-electronic-health-record-database
#15
Michael Wang, Anissa Cyhaniuk, David L Cooper, Neeraj N Iyer
BACKGROUND: Electronic health records (EHRs) are an important source of information with regard to diagnosis and treatment of rare health conditions, such as congenital hemophilia, a bleeding disorder characterized by deficiency of factor VIII (FVIII) or factor IX (FIX). OBJECTIVE: To identify patients with congenital hemophilia using EHRs. DESIGN: An EHR database study. SETTING: EHRs were accessed from Humedica between January 1, 2007, and July 31, 2013...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/28919106/selecting-relevant-features-from-the-electronic-health-record-for-clinical-code-prediction
#16
Elyne Scheurwegs, Boris Cule, Kim Luyckx, Léon Luyten, Walter Daelemans
A multitude of information sources is present in the electronic health record (EHR), each of which can contain clues to automatically assign diagnosis and procedure codes. These sources however show information overlap and quality differences, which complicates the retrieval of these clues. Through feature selection, a denser representation with a consistent quality and less information overlap can be obtained. We introduce and compare coverage-based feature selection methods, based on confidence and information gain...
September 14, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28915223/quality-measures-a-stakeholder-analysis
#17
Marianne Baernholdt, Nancy Dunton, Ronda G Hughes, Patricia W Stone, Kathleen M White
For quality measures, confusion and discontentment have increased, as availability of electronic data and data collection tools has expanded. We examined current issues with quality measures across 4 stakeholder groups: developers, regulators/endorsers, data collectors, and consumer advocates. There are missing quality measures, issues with data quality and purpose, questionable usability of electronic health records, and an increased measurement burden and cost. Policymakers, administrators, health care professionals, and consumers need to collaborate on measure development and selection...
September 14, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28914640/machine-learning-novel-bioinformatics-approaches-for-combating-antimicrobial-resistance
#18
Nenad Macesic, Fernanda Polubriaginof, Nicholas P Tatonetti
PURPOSE OF REVIEW: Antimicrobial resistance (AMR) is a threat to global health and new approaches to combating AMR are needed. Use of machine learning in addressing AMR is in its infancy but has made promising steps. We reviewed the current literature on the use of machine learning for studying bacterial AMR. RECENT FINDINGS: The advent of large-scale data sets provided by next-generation sequencing and electronic health records make applying machine learning to the study and treatment of AMR possible...
September 12, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28913492/incorporating-airway-examination-photography-into-the-electronic-record
#19
Joshua W Sappenfield, Nik Gravenstein, Judith M Wishin, Chukwudi Obiora Chiaghana, David Smyth, Brenda G Fahy, Terrie Vasilopoulos, Laurie Davies, F Kayser Enneking
BACKGROUND: Photography of the airway has been used in research to validate preoperative airway assessment and the likelihood of identifying the difficult-to-mask ventilate and/or intubate patient. Up till now, no study has demonstrated the perceived utility of incorporation of airway photographs into the anesthesia preassessment. METHODS: The University of Florida Health Presurgical Clinic routinely incorporates three photographs of all adult patients during their preanesthesia visit...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28913416/using-focused-laboratory-management-and-quality-improvement-projects-to-enhance-resident-training-and-foster-scholarship
#20
Matthew D Krasowski, Bradley A Ford, J Stacey Klutts, Chris S Jensen, Angela S Briggs, Robert A Robinson, Leslie A Bruch, Nitin J Karandikar
Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement...
January 2017: Acad Pathol
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