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Critical care information systems

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https://www.readbyqxmd.com/read/28227033/advanced-analytics-for-outcome-prediction-in-intensive-care-units
#1
Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Ali Jalali, Dieter Bender, Mohamed Rehman, Vinay Nadkanri, C Nataraj, Mohamed Rehman, Ali Jalali, Vinay Nadkanri, Dieter Bender, C Nataraj
In this paper we present a new expert knowledge based clinical decision support system for prediction of intensive care units outcome based on the physiological measurements collected during the first 48 hours of the patient's admission to the ICU. The developed CDSS algorithm is composed of several stages. First, we categorize the collected data based on the physiological organ that they represent. We then extract clinically relevant features from each data category and then rank these features based on their mutual information with the outcome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227001/mechanism-for-safe-remote-activation-of-networked-surgical-and-poc-devices-using-dynamic-assignable-controls
#2
Martin Kasparick, Max Rockstroh, Stefan Schlichting, Frank Golatowski, Dirk Timmermann, Martin Kasparick, Max Rockstroh, Stefan Schlichting, Frank Golatowski, Dirk Timmermann, Stefan Schlichting, Martin Kasparick, Max Rockstroh, Frank Golatowski, Dirk Timmermann
The number of devices within an operating room (OR) increases continuously as well as the complexity of the complete system. One key enabler to handle the complexity is an interoperable and vendor independent system of networked medical devices. To build up such an interoperable system we use the proposed IEEE 11073 SDC standards (IEEE P11073-10207, -20701, -20702) for networked point-of-care (PoC) and surgical devices. One of the major problems within the OR is that typically every device has its own control unit...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28219965/a-public-health-response-to-opioid-use-in-pregnancy
#3
Stephen W Patrick, Davida M Schiff
The use of opioids during pregnancy has grown rapidly in the past decade. As opioid use during pregnancy increased, so did complications from their use, including neonatal abstinence syndrome. Several state governments responded to this increase by prosecuting and incarcerating pregnant women with substance use disorders; however, this approach has no proven benefits for maternal or infant health and may lead to avoidance of prenatal care and a decreased willingness to engage in substance use disorder treatment programs...
February 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28218158/influence-of-integrated-community-and-facility-based-interventions-on-select-maternal-and-neonatal-outcomes-in-northern-karnataka-india-lessons-for-implementation-and-measurement
#4
Rajaram Subramanian Potty, Mohan Harnahalli Lakkappa, Arin Kar, Mallika Bidappa, Ramesh Banadakoppa Manjappa, Krishnamurthy Jayanna
BACKGROUND: Sukshema project provided technical assistance to National Health Mission of government of Karnataka to improve maternal, newborn and child health (MNCH) outcomes in eight districts of Karnataka between 2009 and 2015. The project designed tools, processes and provided mentoring to frontline workers, community structures, and facilities to improve demand generation and quality of MNCH services. OBJECTIVES: To assess over time changes in selected MNCH care indicators among women who had delivered in the past 2 months in Bagalkot and Koppal districts...
January 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28214475/hunter-and-new-england-healthpathways-a-4-year-journey-of-integrated-care
#5
Jane S Gray, Judith R Swan, Margaret A Lynch, Tracey M Tay, Marika-Jane Mackenzie, John H Wiggers, Karen A Harrison, Robert C McDonald, Ian P O'Dea, Louise M Harrigan, Sandra M Fitzgerald
Objective This paper describes the 4-year journey of Hunter and New England HealthPathways - a password-protected web-based portal designed to provide localised evidence-informed clinical and referral information to support general practice at the point of care.Methods A process evaluation was conducted in 2013, with a case study comparison performed in 2014 to assess impact of HealthPathways on patient referral and access to specialist care, followed by a review in 2016 of utilisation of the online portal to assess whether healthcare providers continued to access HealthPathways...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28212677/fit-for-purpose-perspectives-on-rapid-reviews-from-end-user-interviews
#6
Lisa Hartling, Jeanne-Marie Guise, Susanne Hempel, Robin Featherstone, Matthew D Mitchell, Makalapua L Motu'apuaka, Karen A Robinson, Karen Schoelles, Annette Totten, Evelyn Whitlock, Timothy J Wilt, Johanna Anderson, Elise Berliner, Aysegul Gozu, Elisabeth Kato, Robin Paynter, Craig A Umscheid
BACKGROUND: There is increasing demand for rapid reviews and timely evidence synthesis. The goal of this project was to understand end-user perspectives on the utility and limitations of rapid products including evidence inventories, rapid responses, and rapid reviews. METHODS: Interviews were conducted with key informants representing: guideline developers (n = 3), health care providers/health system organizations (n = 3), research funders (n = 1), and payers/health insurers (n = 1)...
February 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28211981/first-report-of-factors-associated-with-satisfaction-in-patients-with-neurofibromatosis
#7
Eric Riklin, Mojtaba Talaei-Kheoi, Vanessa L Merker, Monica R Sheridan, Justin T Jordan, Scott R Plotkin, Ana-Maria Vranceanu
Patient satisfaction is an integral part of quality health care. We assessed whether health literacy and psychosocial factors are associated with patient satisfaction among adults with neurofibromatosis. Eighty adults (mean age = 44 years; 55% female, 87% white) with NF (50% NF1, 41% NF2, and 9% schwannomatosis) completed an adapted Functional, Communicative, and Critical Health Literacy Questionnaire (FCCHL), the Health Literacy Assessment, a series of Patient Reported Outcome Measures Information System (PROMIS) psychosocial tests, and demographics before the medical visit...
March 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28211064/selecting-postoperative-adjuvant-systemic-therapy-for-early-stage-breast-cancer-a-critical-assessment-of-commercially-available-gene-expression-assays
#8
REVIEW
David M Hyams, Eric Schuur, Javier Angel Aristizabal, Juan Enrique Bargallo Rocha, Cesar Cabello, Roberto Elizalde, Laura García-Estévez, Henry L Gomez, Artur Katz, Aníbal Nuñez De Pierro
Risk stratification of patients with early stage breast cancer may support adjuvant chemotherapy decision-making. This review details the development and validation of six multi-gene classifiers, each of which claims to provide useful prognostic and possibly predictive information for early stage breast cancer patients. A careful assessment is presented of each test's analytical validity, clinical validity, and clinical utility, as well as the quality of evidence supporting its use.
February 17, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28210563/neoadjuvant-therapy-for-treatment-of-breast-cancer-the-way-forward-or-simply-a-convenient-option-for-patients
#9
COMMENT
Abhishek Chatterjee, John K Erban
The complexity of managing early stage breast cancer is well known. Optimal treatment is increasingly multidisciplinary and in the modern era informed by sophisticated molecular tools to help select and guide therapy. Major phase III trials have determined that the order of systemic therapy relative to surgery does not influence important endpoints such as event free survival and overall survival (OS), but questions remain as to how best to utilize these most essential services. For example, there is still uncertainty regarding the ideal timing, intensity, and duration of proposed therapy...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28196693/public-perceptions-of-overlapping-surgery
#10
Michael Kent, Richard Whyte, Aaron Fleishman, David Tomich, Lachlan Forrow, James Rodrigue
BACKGROUND: Overlapping surgery is highly contentious, both in regards to the safety of the practice and the degree to which patients should be informed. However, no study has surveyed attitudes of the general public in regards to overlapping surgery, and willingness to consent to such a procedure. STUDY DESIGN: A survey regarding overlapping surgery was completed by participants using Amazon Mechanical Turk (mTurk), an online crowd-sourcing worksite. Responders completed a 51-question survey regarding their knowledge of overlapping surgery, expectations regarding disclosure during the informed consent process, and their willingness to participate in such a procedure...
February 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28185977/the-central-role-of-relationships-to-trauma-informed-integrated-care-for-children-and-youth
#11
Jonathan D Brown, Melissa A King, Lawrence S Wissow
OBJECTIVE: Primary care plays an essential role in the primary and secondary prevention of children's mental health problems. A growing series of trials have demonstrated the capacity of primary care providers to deliver care that specifically addresses risks to healthy social and emotional development by incorporating mental health services into their routines and integrating their work with the mental health care system. This paper describes elements common to various integration schemes that seem essential to their success...
February 6, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28185593/decentralization-and-health-system-performance-a-focused-review-of-dimensions-difficulties-and-derivatives-in-india
#12
REVIEW
Bhuputra Panda, Harshad P Thakur
INTRODUCTION: One of the principal goals of any health care system is to improve health through the provision of clinical and public health services. Decentralization as a reform measure aims to improve inputs, management processes and health outcomes, and has political, administrative and financial connotations. It is argued that the robustness of a health system in achieving desirable outcomes is contingent upon the width and depth of 'decision space' at the local level. Studies have used different approaches to examine one or more facets of decentralization and its effect on health system functioning; however, lack of consensus on an acceptable framework is a critical gap in determining its quantum and quality...
October 31, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/28152838/a-schematic-case-episode-format-to-aid-in-choosing-wisely
#13
B Brooke Mann, Jad Hayes, Lalan S Wilfong, Marcus A Neubauer
: 181 Background: The recommendations of the Choosing Wisely campaign are evidence -based strategies to reduce cost without sacrificing outcomes. Yet tying the recommendations to indicators of use at the physician and case level has been challenging. As practices become responsible for total cost of care, an easy to use analytic method to determine appropriate use will be critical. We here describe a tool for rapid assessment of individual cases to achieve that objective. METHODS: The population was a payer defined cohort of lung cancer patients treated at Texas Oncology (TxO)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152826/patient-and-clinician-perspectives-on-treatment-decision-making-for-african-american-men-with-prostate-cancer
#14
Sarah Abramson, Daniel Walker, Lindsey Sova, Jenny J Lin, Kezhen Fei, Rebeca Franco, Ann Scheck McAlearney
: 186 Background: Prostate cancer is the most common cancer for men in the US, yet the burden of this disease falls disproportionately on African Americans (AAs). The disparity's etiology is complex. Surgery and radiotherapy offer similar survival but historically have different rates of performance with younger and white men more likely to undergo surgery and AAs more likely to experience underuse. This study aims to examine treatment decision-making (TDM) processes for AA men from patient and physician perspectives...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152700/establishing-a-value-framework-for-cancer-specific-patient-satisfaction-ps-across-a-large-health-system
#15
Frances Cartwright
: 100 Background: The Mount Sinai Health System and the Tisch Cancer Institute (TCI) includes 7 hospitals and 6 ambulatory oncology centers in New York City, with over 9,000 new cancer cases seen annually. In order to address PS across these multiple sites, we established a framework to enhance value encompassing 4 domains: Infrastructure, Responsibility, Outcomes and Monitoring. METHODS: Infrastructure. A quality dashboard was developed and distributed across all system sites...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152684/the-kaiser-permanente-breast-cancer-survivorship-national-clinical-algorithm-regional-variation-in-implementation-processes-strategies-within-an-integrated-health-care-system
#16
Erin Elizabeth Hahn, Joanne E Schottinger, Susan E Kutner, Mark B Littlewood
: 104 Background: Kaiser Permanente (KP) is an integrated healthcare system providing comprehensive services to over 10 million members. The KP Interregional Breast Care Leaders, a multidisciplinary clinician group, developed a comprehensive evidence/consensus-based algorithm for breast cancer survivors, the KP Breast Cancer Survivorship National Clinical Algorithm (BCSNCA). The BCSNCA is intended to reduce variation in medical and psychosocial surveillance and improve outcomes by providing guidance to locally implemented survivorship programs, ie, recommendations for surveillance, late effects management, and risk reduction...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149228/exhaust-system-related-burns-affecting-children-a-uk-perspective-and-literature-review
#17
P V Vermaak, C E Deall, C McArdle, T Burge
Burns caused by exhaust systems in children may be associated with considerable morbidity. Current epidemiological data varies, but no data are available for the UK population. We aim to identify the pattern of exhaust-related burns affecting children who presented to a regional centre for paediatric burn care in the UK. Patients who sustained burns related to exhaust mechanisms between May 2005 and August 2012 were identified via the departmental database. Data collected included patient demographics, burn injury information, management and outcomes...
June 30, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28144914/the-sarcopenia-and-physical-frailty-in-older-people-multi-component-treatment-strategies-sprintt-randomized-controlled-trial-design-and-methods
#18
Francesco Landi, Matteo Cesari, Riccardo Calvani, Antonio Cherubini, Mauro Di Bari, Raphael Bejuit, Jerome Mshid, Sandrine Andrieu, Alan J Sinclair, Cornel C Sieber, Bruno Vellas, Eva Topinkova, Timo Strandberg, Leocadio Rodriguez-Manas, Fabrizia Lattanzio, Marco Pahor, Ronenn Roubenoff, Alfonso J Cruz-Jentoft, Roberto Bernabei, Emanuele Marzetti
The sustainability of health and social care systems is threatened by a growing population of older persons with heterogeneous needs related to multimorbidity, frailty, and increased risk of functional impairment. Since disability is difficult to reverse in old age and is extremely burdensome for individuals and society, novel strategies should be devised to preserve adequate levels of function and independence in late life. The development of mobility disability, an early event in the disablement process, precedes and predicts more severe forms of inability...
January 31, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28144679/leveraging-the-value-of-human-relationships-to-improve-health-outcomes-lessons-learned-from-the-openmrs-electronic-health-record-system
#19
Suranga N Kasthurirathne, Burke W Mamlin, Theresa Cullen
OBJECTIVES: Despite significant awareness on the value of leveraging patient relationships across the healthcare continuum, there is no research on the potential of using Electronic Health Record (EHR) systems to store structured patient relationship data, or its impact on enabling better healthcare. We sought to identify which EHR systems supported effective patient relationship data collection, and for systems that do, what types of relationship data is collected, how this data is used, and the perceived value of doing so...
February 1, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28140617/progressive-consent-and-specimen-accrual-models-to-address-sustainability-a-decade-s-experience-at-an-oregon-biorepository
#20
John A Ost, Paul W Newton, Duncan R Neilson, Joseph A Cioffi, P Ashley Wackym, R Serene Perkins
BACKGROUND: The Legacy Biorepository is a College of American Pathologists-accredited biorepository operating within a seven-hospital healthcare system, with a decade's experience in specimen accrual, storage, and distribution. While standardization of our practices through accreditation remains a priority, we along with others face challenges with regard to sustainability. Purposeful changes in our consent process, which we term "progressive consent," are expected to improve sustainability and operational flexibility while increasing our scientific impact...
February 2017: Biopreservation and Biobanking
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