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https://www.readbyqxmd.com/read/28103562/a-decision-support-system-for-tele-monitoring-copd-related-worrisome-events
#1
Mario Merone, Claudio Pedone, Giuseppe Capasso, Raffaele Antonelli Incalzi, Paolo Soda
Chronic Obstructive Pulmonary Disease (COPD) is a preventable, treatable and slowly progressive disease, whose course is aggravated by a periodic worsening of symptoms and lung function lasting for several days. The development of home telemonitoring systems has made possible to collect symptoms and physiological data in electronic records, boosting the development of decision support systems (DSSs). Current DSSs work with physiological measurements collected by means of several measuring and communication devices as well as with symptoms gathered by questionnaires submitted to COPD subjects...
January 17, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28102467/mypod-an-emr-based-tool-that-facilitates-quality-improvement-and-maintenance-of-certification
#2
Loren Berman, Brian Duffy, B Randall Brenn, Charles Vinocur
Maintenance of Certification (MOC) was designed to assess physician competencies including operative case volume and outcomes. This information, if collected consistently and systematically, can be used to facilitate quality improvement. Information automatically extracted from the electronic medical record (EMR) can be used as a prompt to compile these data. We developed an EMR-based program called MyPOD (My Personal Outcomes Data) to track surgical outcomes at our institution. We compared occurrences reported in the first 18 months to those captured in the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) over the same time period...
March 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28087953/tenofovir-induced-nephrotoxicity-a-retrospective-cohort-study
#3
H M Koh, K Suresh
BACKGROUND: Tenofovir (TDF) has been associated with renal function deterioration, but local data regarding the incidence and risk factors for this adverse event were lacking. OBJECTIVES: To determine the incidence of nephrotoxicity in HIV-infected patients on tenofovir-based regimens and to evaluate risk factors involved in tenofovir-associated renal function decline. METHODS: This is a single-centre retrospective cohort study of 440 HIV-infected adults who were started on tenofovirbased antiretroviral regimens...
December 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28077414/implementation-of-a-consumer-focused-ehealth-intervention-for-people-with-moderate-to-high-cardiovascular-disease-risk-protocol-for-a-mixed-methods-process-evaluation
#4
Genevieve M Coorey, Lis Neubeck, Timothy Usherwood, David Peiris, Sharon Parker, Annie Y S Lau, Clara Chow, Kathryn Panaretto, Mark Harris, Nicholas Zwar, Julie Redfern
INTRODUCTION: Technology-mediated strategies have potential to engage patients in modifying unhealthy behaviour and improving medication adherence to reduce morbidity and mortality from cardiovascular disease (CVD). Furthermore, electronic tools offer a medium by which consumers can more actively navigate personal healthcare information. Understanding how, why and among whom such strategies have an effect can help determine the requirements for implementing them at a scale. This paper aims to detail a process evaluation that will (1) assess implementation fidelity of a multicomponent eHealth intervention; (2) determine its effective features; (3) explore contextual factors influencing and maintaining user engagement; and (4) describe barriers, facilitators, preferences and acceptability of such interventions...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28077345/tips-and-traps-lessons-from-codesigning-a-clinician-e-monitoring-tool-for-computerized-cognitive-behavioral-therapy
#5
Frederick Sundram, Susan J Hawken, Karolina Stasiak, Mathijs Fg Lucassen, Theresa Fleming, Matthew Shepherd, Andrea Greenwood, Raechel Osborne, Sally N Merry
BACKGROUND: Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts)...
January 11, 2017: JMIR Mental Health
https://www.readbyqxmd.com/read/28068789/pragmatic-trial-of-video-education-in-nursing-homes-the-design-and-rationale-for-a-pragmatic-cluster-randomized-trial-in-the-nursing-home-setting
#6
Vincent Mor, Angelo E Volandes, Roee Gutman, Constantine Gatsonis, Susan L Mitchell
Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28065330/impact-of-personalized-report-cards-on-nurses-managing-central-lines
#7
Theresa Morrison, Jacqueline Raffaele, Laura Brennaman
BACKGROUND: The purpose of this quality improvement project was to determine the effect of providing feedback to managers and bedside nurses on the nurses' central line-associated bloodstream infection (CLABSI) contributing factors, found on visual and documentation audits. METHODS: This nonexperimental, quality improvement project was conducted in a 715-bed, 2-campus acute care community hospital health care system in Southwest Florida. The intervention consisted of providing confidential feedback on central line audits deviations, through the systematic delivery of unit case reports and personalized nurse report cards...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28051327/are-there-potential-safety-issues-concerning-the-safe-usage-of-electronic-personal-tracking-devices-the-experience-of-a-multi-sport-elite-club
#8
Daniel Medina, Eduard Pons, Antonio Gomez, Marc Guitart, Andres Martin, Jairo Vazquez-Guerrero, Ismael Camenforte, Berta Carles, Roger Font
Despite approval of the use of electronic personal tracking devices (EPTD) during competition by the International Football Association Board (IFAB), other team sport organizations and leagues have banned its use due to "safety concerns", with no evidence to support this assertion. The aim of the current brief report is to provide empirical evidence to support the wide-spread usage across all sports by examining safety issues concerning the use of EPTD in a multi-team sports club. A total of 5 outdoor football teams (first team, second team, under 19, under 18 and first team female) and 3 indoor multi-sport (basketball, futsal and handball) teams have been monitored; accounting for a total of 63...
January 4, 2017: International Journal of Sports Physiology and Performance
https://www.readbyqxmd.com/read/28047670/su-f-p-20-predicting-waiting-times-in-radiation-oncology-using-machine-learning
#9
A Joseph, D Herrera, T Hijal, L Hendren, A Leung, J Wainberg, M Sawaf, M Gorshkov, R Maglieri, M Keshavarz, J Kildea
PURPOSE: Waiting times remain one of the most vexing patient satisfaction challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick or in pain, to worry about when they will receive the care they need. These waiting periods are often difficult for staff to predict and only rough estimates are typically provided based on personal experience. This level of uncertainty leaves most patients unable to plan their calendar, making the waiting experience uncomfortable, even painful...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045611/establishment-of-personalized-pain-goals-in-oncology-patients-to-improve-care-and-decrease-costs
#10
Dylan Zylla, Amber Larson, Gladys Chuy, Lisa Illig, Adina Peck, Sarah Van Peursem, James W Fulbright, Pamala A Pawloski, Sara Richter, Jeanne Mettner
PURPOSE: Cancer-related pain is common, negatively affects quality of life and survival, and often requires treatment with opioid analgesics. Patient-reported data that describe the incidence and severity of pain, medication use, and patient satisfaction with care are lacking. METHODS: We analyzed 18 months of outpatient oncology clinic encounters from the electronic medical record to obtain data on pain levels and opioid and nonopioid treatments. In June 2014, we instituted a pain intervention by creating a pain management information handout for patients, educating clinicians on opioid cost-effectiveness, and implementing a nursing protocol to document personalized pain goals (PPGs)...
January 3, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28045349/first-presentation-with-psychotic-symptoms-in-a-population-based-sample
#11
Gregory E Simon, Karen J Coleman, Bobbi Jo H Yarborough, Belinda Operskalski, Christine Stewart, Enid M Hunkeler, Frances Lynch, David Carrell, Arne Beck
OBJECTIVE: Increasing evidence supports the effectiveness of comprehensive early intervention at first onset of psychotic symptoms. Implementation of early intervention programs will require population-based data on overall incidence of psychotic symptoms and on care settings of first presentation. METHODS: In five large health care systems, electronic health records data were used to identify all first occurrences of psychosis diagnoses among persons ages 15-59 between January 1, 2007, and December 31, 2013 (N=37,843)...
January 3, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28033519/characteristics-of-new-depression-diagnoses-in-patients-with-and-without-prior-chronic-opioid-use
#12
Jeffrey F Scherrer, Joanne Salas, F David Schneider, Kathleen K Bucholz, Mark D Sullivan, Laurel A Copeland, Brian K Ahmedani, Thomas Burroughs, Patrick J Lustman
: Chronic use (>90 Days) of opioid analgesics significantly increases the risk of development of new depression episodes (NDE). It is unclear whether depression that develops in this manner is similar to or different from NDE in persons not exposed to opioid analgesic use (OAU). METHODS: VA patients were classified into two groups, those who did not receive an opioid and developed depression (non-OAU+NDE, n=4314) and those that had >90 days OAU and developed NDE (OAU+NDE, n=444)...
December 21, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27983691/evaluation-of-google-glass-technical-limitations-on-their-integration-in-medical-systems
#13
Antonio Martinez-Millana, Jose-Luis Bayo-Monton, Aroa Lizondo, Carlos Fernandez-Llatas, Vicente Traver
Google Glass is a wearable sensor presented to facilitate access to information and assist while performing complex tasks. Despite the withdrawal of Google in supporting the product, today there are multiple applications and much research analyzing the potential impact of this technology in different fields of medicine. Google Glass satisfies the need of managing and having rapid access to real-time information in different health care scenarios. Among the most common applications are access to electronic medical records, display monitorizations, decision support and remote consultation in specialties ranging from ophthalmology to surgery and teaching...
December 15, 2016: Sensors
https://www.readbyqxmd.com/read/27982201/incidence-and-prevalence-of-clinically-relevant-pituitary-adenomas-retrospective-cohort-study-in-a-health-management-organization-in-buenos-aires-argentina
#14
Patricia Fainstein Day, Monica Graciela Loto, Mariela Glerean, María Fabiana Russo Picasso, Soledad Lovazzano, Diego Hernán Giunta
Objectives: The main purpose of this study was to estimate the incidence rate and prevalence of clinically relevant pituitary adenomas (PAs) within the Hospital Italiano Medical Care Program (HIMCP), a well-defined population of 150,000 members living in the urban and suburban area of the city of Buenos Aires. We defined clinically relevant PAs as those associated with endocrine dysfunction and/or mass effect. Subjects and methods: A retrospective open cohort study was conducted, including all members of the HIMCP over 18 years old, with active memberships during the period of the study, from January 1st 2003, to January 1, 2014...
November 2016: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27955709/the-characteristics-of-patients-with-mycobacterium-tuberculosis-blood-stream-infections-in-beijing-china-a-retrospective-study
#15
Xiaoqing Liu, Sainan Bian, Yueqiu Zhang, Lifan Zhang, Qiwen Yang, Peng Wang, Yingchun Xu, Xiaochun Shi, Yao Zhang, Roy F Chemaly
BACKGROUND: Published information regarding the clinical characteristics, laboratory findings, and outcomes of patients with Mycobacterium tuberculosis (MTB) blood stream infection (BSI) is limited. We aimed in this study to evaluate the clinical characteristics, laboratory evaluation, and outcomes of patients with MTB BSI. METHODS: All patients diagnosed with MTB BSI at Peking Union Medical College Hospital between January 2008 and May 2014 were identified by examining the electronic database listing results of all blood cultures...
December 12, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27931207/a-comparative-study-classification-vs-user-based-collaborative-filtering-for-clinical-prediction
#16
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/27920019/personalized-diabetes-management-using-electronic-medical-records
#17
Dimitris Bertsimas, Nathan Kallus, Alexander M Weinstein, Ying Daisy Zhuo
OBJECTIVE: Current clinical guidelines for managing type 2 diabetes do not differentiate based on patient-specific factors. We present a data-driven algorithm for personalized diabetes management that improves health outcomes relative to the standard of care. RESEARCH DESIGN AND METHODS: We modeled outcomes under 13 pharmacological therapies based on electronic medical records from 1999 to 2014 for 10,806 patients with type 2 diabetes from Boston Medical Center...
December 5, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27919369/informing-the-development-of-an-internet-based-chronic-pain-self-management-program
#18
Amédé Gogovor, Regina Visca, Claudine Auger, Lucie Bouvrette-Leblanc, Iphigenia Symeonidis, Lise Poissant, Mark A Ware, Yoram Shir, Natacha Viens, Sara Ahmed
BACKGROUND: Self-management can optimize health outcomes for individuals with chronic pain (CP), an increasing fiscal and social burden in Canada. However, self-management is rarely integrated into the regular care (team activities and medical treatment) patients receive. Health information technology offers an opportunity to provide regular monitoring and exchange of information between patient and care team. OBJECTIVE: To identify information needs and gaps in chronic pain management as well as technology features to inform the development of an Internet-based self-management program...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27917851/missing-risks-in-opportunistic-screening-for-type-2-diabetes-crodiabgp-study
#19
Marija Vrca Botica, Linda Carcaxhiu, Josipa Kern, Thomas Kuehlein, Iva Botica, Larisa Gavran, Ines Zelić, Darko Iliev, Dijana Haralović, Anđelko Vrca
Aim To examine two methods of extracting risks for undetected type 2 diabetes (T2D): derived from electronic medical record(EMR) and family medicine (FM) assessment during pre-consultation phase. All risks were structured in three lists of patients' data using Wonca International Classification Committee(WICC). Missing data were detected in each list. Methods A prospective study included a group of 1883 patients(aged 45-70) identified with risks. Risks were assessed based on EMR for continuity variables and FM's assessment for episodes of disease and personal related information...
February 1, 2017: Medicinski Glasnik
https://www.readbyqxmd.com/read/27913059/cha2ds2-vasc-scores-and-major-bleeding-in-patients-with-nonvalvular-atrial-fibrillation-who-are-receiving-rivaroxaban
#20
W Frank Peacock, Sally Tamayo, Manesh Patel, Nicholas Sicignano, Kathleen P Hopf, Zhong Yuan
STUDY OBJECTIVE: Assessing stroke risk associated with nonvalvular atrial fibrillation depends on the evaluation of patient characteristics and clinical features. Clinicians must determine that the net clinical benefit from anticoagulation therapy outweighs its risk, namely, bleeding. Risk assessment for stroke is commonly performed by calculating a CHA2DS2-VASc (congestive heart failure/left ventricular dysfunction, hypertension, ≥75 years, diabetes mellitus, previous stroke or transient ischemic attack or thromboembolism, vascular disease, aged 65 to 74 years, sex female) score...
November 29, 2016: Annals of Emergency Medicine
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