keyword
MENU ▼
Read by QxMD icon Read
search

Clinical decision support systems

keyword
https://www.readbyqxmd.com/read/29776002/the-chaos-of-hospitalisation-for-patients-with-critical-limb-ischaemia-approaching-major-amputation
#1
Susan Monaro, Sandra West, Jana Pinkova, Janice Gullick
AIMS AND OBJECTIVES: To illuminate the hospital experience for patients and families when major amputation has been advised for critical limb ischaemia (CLI). BACKGROUND: CLI creates significant burden to the health system and the family, particularly as the person with CLI approaches amputation. Major amputation is often offered as a late intervention for CLI in response to the marked deterioration of an ischaemic limb, and functional decline from reduced mobility, intractable pain, infection and/or toxaemia...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29775092/a-prospective-multi-centre-us-clinical-trial-to-determine-accuracy-of-febridx-point-of-care-testing-for-acute-upper-respiratory-infections-with-and-without-a-confirmed-fever
#2
Nathan I Shapiro, Wesley H Self, Jeffrey Rosen, Stephan C Sharp, Michael R Filbin, Peter C Hou, Amisha D Parekh, Michael C Kurz, Robert Sambursky
BACKGROUND: FebriDx is a 10-minute disposable point-of-care test designed to identify clinically significant systemic host immune responses and aid in the differentiation of bacterial and viral respiratory infection by simultaneously detecting C-reactive protein (CRP) and myxovirus resistance protein A (MxA) from a fingerstick blood sample. FebriDx diagnostic accuracy was evaluated in the emergency room and urgent care setting. METHODS: A prospective, multicentre, observational cohort study of acute upper respiratory tract infections (URIs), with and without a confirmed fever at the time of enrolment, was performed to evaluate the diagnostic accuracy of FebriDx to identify clinically significant bacterial infection with host response and acute pathogenic viral infection...
May 18, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29774168/evaluating-the-potential-for-maximized-t-cell-redistribution-entropy-to-improve-abscopal-responses-to-radiotherapy
#3
Rachel Walker, Jonathan D Schoenfeld, Shari Pilon-Thomas, Jan Poleszczuk, Heiko Enderling
The potential for local radiation therapy to elicit systemic (abscopal) anti-tumor immune responses has been receiving a significant amount of attention over the last decade. We recently developed a mathematical framework designed to simulate the systemic dissemination of activated T cells among multiple metastatic sites. This framework allowed the identification of non-intuitive patterns of T cell redistribution after localized therapy, and offered suggestions as to the optimal site to irradiate in order to increase the magnitude of an immune-mediated abscopal response...
September 2017: Convergent Science Physical Oncology
https://www.readbyqxmd.com/read/29768579/-cost-effectiveness-analysis-of-spontaneous-vaginal-delivery-and-elective-cesarean-for-normal-risk-pregnant-women-in-the-brazilian-unified-national-health-system
#4
Aline Piovezan Entringer, Márcia Pinto, Marcos Augusto Bastos Dias, Maria Auxiliadora de Souza Mendes Gomes
The purpose of this study was to conduct a cost-effectiveness analysis of spontaneous vaginal delivery and elective cesarean (with no clinical indication) for normal risk pregnant women, from the perspective of the Brazilian Unified National Health System. An analytical decision model was developed and included the choice of delivery mode and clinical consequences for mothers and newborns, from admission for delivery to hospital discharge. The reference population consisted of normal risk pregnant women with singleton, at-term gestations in cephalic position, subdivided into primiparas and multiparas with prior uterine scar...
May 10, 2018: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/29768417/what-are-the-implications-for-practice-that-arise-from-studies-of-medication-taking-a-systematic-review-of-qualitative-research
#5
Mohammed Ahmed Rashid, Nadia Llanwarne, Natalie Heyns, Fiona Walter, Jonathan Mant
BACKGROUND: Despite several decades of evidence supporting the benefits of taking medications in various diseases and healthcare settings, a significant proportion of prescribed treatments are not taken. This review sought to synthesise qualitative research exploring experiences of medication taking around the world, and to determine whether there were consistent messages arising from these studies. METHODS AND FINDINGS: 5 databases (MEDLINE, PsycINFO, EMBASE, SCOPUS, CINAHL) were systematically searched to identify published research papers using qualitative methodologies, which explored medication-taking experiences in patients, citizens, carers, relatives and clinicians...
2018: PloS One
https://www.readbyqxmd.com/read/29766136/can-necrotizing-soft-tissue-infection-be-reliably-diagnosed-in-the-emergency-department
#6
Sharon M Henry, Kimberly A Davis, Jonathan J Morrison, Thomas M Scalea
Necrotizing soft tissue infections (NSTIs) are associated with a high mortality and require prompt recognition and treatment, consisting of aggressive surgical debridement and critical care support. Diagnosis is a key step, which is generally made in the operating room (OR), but the decision to debride requires guidance. This is frequently made on clinical grounds, but NSTI can be occult in presentation and several other infective processes can mimic NSTI. It is unknown whether the various scoring systems described in the literature can enable clinicians to reliably diagnose NSTI in the emergency department, rather than the OR...
2018: Trauma Surg Acute Care Open
https://www.readbyqxmd.com/read/29765586/design-of-a-clinical-decision-support-system-for-fracture-prediction-using-imbalanced-dataset
#7
Yung-Fu Chen, Chih-Sheng Lin, Kuo-An Wang, La Ode Abdul Rahman, Dah-Jye Lee, Wei-Sheng Chung, Hsuan-Hung Lin
More than 1 billion people suffer from chronic respiratory diseases worldwide, accounting for more than 4 million deaths annually. Inhaled corticosteroid is a popular medication for treating chronic respiratory diseases. Its side effects include decreased bone mineral density and osteoporosis. The aims of this study are to investigate the association of inhaled corticosteroids and fracture and to design a clinical support system for fracture prediction. The data of patients aged 20 years and older, who had visited healthcare centers and been prescribed with inhaled corticosteroids within 2002-2010, were retrieved from the National Health Insurance Research Database (NHIRD)...
2018: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29764106/the-challenges-of-a-complex-and-innovative-telehealth-project-a-qualitative-evaluation-of-the-eastern-quebec-telepathology-network
#8
Hassane Alami, Jean-Paul Fortin, Marie-Pierre Gagnon, Hugo Pollender, Bernard Têtu, France Tanguay
BACKGROUND: The Eastern Quebec Telepathology Network (EQTN) has been implemented in the province of Quebec (Canada) to support pathology and surgery practices in hospitals that are lack of pathologists, especially in rural and remote areas. This network includes 22 hospitals and serves a population of 1.7 million inhabitants spread over a vast territory. An evaluation of this network was conducted in order to identify and analyze the factors and issues associated with its implementation and deployment, as well as those related to its sustainability and expansion...
September 13, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29762678/using-statistical-anomaly-detection-models-to-find-clinical-decision-support-malfunctions
#9
Soumi Ray, Dustin S McEvoy, Skye Aaron, Thu-Trang Hickman, Adam Wright
Objective: Malfunctions in Clinical Decision Support (CDS) systems occur due to a multitude of reasons, and often go unnoticed, leading to potentially poor outcomes. Our goal was to identify malfunctions within CDS systems. Methods: We evaluated 6 anomaly detection models: (1) Poisson Changepoint Model, (2) Autoregressive Integrated Moving Average (ARIMA) Model, (3) Hierarchical Divisive Changepoint (HDC) Model, (4) Bayesian Changepoint Model, (5) Seasonal Hybrid Extreme Studentized Deviate (SHESD) Model, and (6) E-Divisive with Median (EDM) Model and characterized their ability to find known anomalies...
May 11, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29761830/itc-commentary-on-metformin-clinical-drug-drug-interaction-study-design-that-enables-an-efficacy-and-safety-based-dose-adjustment-decision
#10
Maciej J Zamek-Gliszczynski, Xiaoyan Chu, Jack A Cook, Joseph M Custodio, Aleksandra Galetin, Kathleen M Giacomini, Caroline A Lee, Mary F Paine, Adrian S Ray, Joseph A Ware, Matthias B Wittwer, Lei Zhang
Metformin drug-drug interaction (DDI) studies are conducted during development of drugs that inhibit organic cation transporters and/or multidrug and toxin extrusion proteins (OCTs/MATEs). Monitoring solely changes in systemic exposure, the typical DDI study endpoint appears inadequate for metformin, which is metabolically stable, has poor passive membrane permeability, and undergoes transporter-mediated tissue distribution and clearance. Evaluation of renal clearance, antihyperglycemic effects, and potentially lactate as an exploratory safety marker, can support rational metformin dose adjustment...
May 15, 2018: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29757802/assessing-unwanted-variations-in-rheumatology-clinic-previsit-rooming
#11
Edmond Ramly, Brad Stroik, Diane R Lauver, Heather M Johnson, Patrick McBride, Kristin Steffen Lewicki, Jon Arnason, Christie M Bartels
BACKGROUND: Rheumatologists face time pressures similar to primary care but have not generally benefitted from optimized team-based rooming during the time from the waiting room until the rheumatologist enters the room. OBJECTIVE: The aim of this study was to assess current capacity for population management in rheumatology clinics; we aimed to measure the tasks performed by rheumatology clinic staff (medical assistants or nurses) during rooming. METHODS: We performed a cross-sectional time-study and work-system analysis to measure rooming workflows at 3 rheumatology clinics in an academic multispecialty practice during 2014-2015...
May 11, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/29754670/knowledge-to-action-rationale-and-design-of-the-patient-centered-care-transitions-in-heart-failure-pact-hf-stepped-wedge-cluster-randomized-trial
#12
Harriette G C Van Spall, Shun Fu Lee, Feng Xie, Dennis T Ko, Lehana Thabane, Quazi Ibrahim, Peter R Mitoff, Michael Heffernan, Manish Maingi, Michael C Tjandrawidjaja, Mohammad I Zia, Mohamed Panju, Richard Perez, Kim D Simek, Liane Porepa, Ian D Graham, R Brian Haynes, Dilys Haughton, Stuart J Connolly
INTRODUCTION: Heart Failure (HF) is a common cause of hospitalization in older adults. The transition from hospital to home is high-risk, and gaps in transitional care can increase the risk of re-hospitalization and death. Combining health care services supported by meta-analyses, we designed the PACT-HF transitional care model. METHODS: Adopting an integrated Knowledge Translation (iKT) approach in which decision-makers and clinicians are partners in research, we implement and test the effectiveness of PACT-HF among patients hospitalized for HF...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29753616/an-interoperable-clinical-decision-support-system-for-early-detection-of-sirs-in-pediatric-intensive-care-using-openehr
#13
Antje Wulff, Birger Haarbrandt, Erik Tute, Michael Marschollek, Philipp Beerbaum, Thomas Jack
BACKGROUND: Clinical decision-support systems (CDSS) are designed to solve knowledge-intensive tasks for supporting decision-making processes. Although many approaches for designing CDSS have been proposed, due to high implementation costs, as well as the lack of interoperability features, current solutions are not well-established across different institutions. Recently, the use of standardized formalisms for knowledge representation as terminologies as well as the integration of semantically enriched clinical information models, as openEHR Archetypes, and their reuse within CDSS are theoretically considered as key factors for reusable CDSS...
May 9, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29747628/the-availability-and-effectiveness-of-tools-supporting-shared-decision-making-in-metastatic-breast-cancer-care-a-review
#14
Inge Spronk, Jako S Burgers, François G Schellevis, Liesbeth M van Vliet, Joke C Korevaar
BACKGROUND: Shared decision-making (SDM) in the management of metastatic breast cancer care is associated with positive patient outcomes. In daily clinical practice, however, SDM is not fully integrated yet. Initiatives to improve the implementation of SDM would be helpful. The aim of this review was to assess the availability and effectiveness of tools supporting SDM in metastatic breast cancer care. METHODS: Literature databases were systematically searched for articles published since 2006 focusing on the development or evaluation of tools to improve information-provision and to support decision-making in metastatic breast cancer care...
May 11, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29745311/systemic-delays-in-the-initiation-of-antiretroviral-therapy-for-clinically-eligible-hiv-infected-patients-in-houston-texas-the-providers-report-card
#15
Osaro Mgbere, Maria Rodriguez-Barradas, Karen Joan Vigil, Melanie McNeese, Fazal Tabassam, Nadia Barahmani, Jason Wang, Raouf Arafat, Ekere James Essien
BACKGROUND: The current US HIV treatment guidelines support initiation of antiretroviral therapy (ART) for persons with HIV for personal health benefits and prevention of HIV transmission. However, high levels of adherence to ART are critical to maximize individual and public health benefits. We examined the nonclinical barriers to ART initiation for clinically eligible individuals and the provider- and patient-related factors associated with these barriers among HIV-infected patients in Houston/Harris County, Texas...
January 2018: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/29743225/ambulatory-antibiotic-stewardship-through-a-human-factors-engineering-approach-a-systematic-review
#16
Sara C Keller, Pranita D Tamma, Sara E Cosgrove, Melissa A Miller, Heather Sateia, Julie Szymczak, Ayse P Gurses, Jeffrey A Linder
INTRODUCTION: In the United States, most antibiotics are prescribed in ambulatory settings. Human factors engineering, which explores interactions between people and the place where they work, has successfully improved quality of care. However, human factors engineering models have not been explored to frame what is known about ambulatory antibiotic stewardship (AS) interventions and barriers and facilitators to their implementation. METHODS: We conducted a systematic review and searched OVID MEDLINE, Embase, Scopus, Web of Science, and CINAHL to identify controlled interventions and qualitative studies of ambulatory AS and determine whether and how they incorporated principles from a human factors engineering model, the Systems Engineering Initiative for Patient Safety 2...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29741693/genomics-and-electronic-health-record-systems
#17
Lucila Ohno-Machado, Jihoon Kim, Rodney A Gabriel, Grace M Kuo, Michael A Hogarth
Several reviews and case reports have described how information derived from the analysis of genomes are currently included in electronic health records (EHRs) for the purposes of supporting clinical decisions. Since the introduction of this new type of information in EHRs is relatively new (for instance, the widespread adoption of EHRs in the United States is just about a decade old), it is not surprising that a myriad of approaches has been attempted, with various degrees of success. EHR systems undergo much customization to fit the needs of health systems; these approaches have been varied and not always generalizable...
May 1, 2018: Human Molecular Genetics
https://www.readbyqxmd.com/read/29737468/potential-drug-drug-interactions-in-a-cohort-of-elderly-polymedicated-primary-care-patients-on-antithrombotic-treatment
#18
Katharina Luise Schneider, Kathrin Kastenmüller, Klaus Weckbecker, Markus Bleckwenn, Miriam Böhme, Julia Carolin Stingl
INTRODUCTION: Drug-drug interactions (DDIs) are an important risk factor for adverse drug reactions. Older, polymedicated patients are particularly affected. Although antithrombotics have been detected as high-risk drugs for DDIs, data on older patients exposed to them are scarce. METHODS: Baseline data of 365 IDrug study outpatients (≥ 60 years, use of an antithrombotic and one or more additional long-term drug) were analyzed regarding potential drug-drug interactions (pDDIs) with a clinical decision support system...
May 8, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29736890/a-tutorial-on-model-informed-approaches-to-cardiovascular-safety-with-focus-on-cardiac-repolarisation
#19
S Y A Cheung, J Parkinson, U Wählby-Hamrén, C D Dota, Å M Kragh, L Bergenholm, T Vik, T Collins, C Arfvidsson, C E Pollard, H K Tomkinson, B Hamrén
Drugs can affect the cardiovascular (CV) system either as an intended treatment or as an unwanted side effect. In both cases, drug-induced cardiotoxicities such as arrhythmia and unfavourable hemodynamic effects can occur, and be described using mathematical models; such a model informed approach can provide valuable information during drug development and can aid decision-making. However, in order to develop informative models, it is vital to understand CV physiology. The aims of this tutorial are to present (1) key background biological and medical aspects of the CV system, (2) CV electrophysiology, (3) CV safety concepts, (4) practical aspects of development of CV models and (5) regulatory expectations with a focus on using model informed and quantitative approaches to support nonclinical and clinical drug development...
May 7, 2018: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/29735185/do-pediatric-early-warning-systems-for-hospitalized-children-reduce-mortality
#20
Deborah L McBride
Pediatric early warning systems have been implemented in many children's hospitals in the hope that they would aid in the early identification of hospitalized children who are clinically deteriorating. A large, recently completed multicenter study found that the use of the Bedside Pediatric Early Warning System (BedsidePEWS) did not decrease all-cause mortality compared to usual care hospitals and did not support the use of the BedsidePEWS to reduce mortality. Earlier studies had found that the use of pediatric early warning systems removed communication barriers and empowered nurses to make independent clinical decisions based on a predetermined multidisciplinary plan...
May 4, 2018: Journal of Pediatric Nursing
keyword
keyword
74522
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"