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Clinical decision support systems

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https://www.readbyqxmd.com/read/29148566/factors-that-influence-the-provision-of-intrapartum-and-postnatal-care-by-skilled-birth-attendants-in-low-and-middle-income-countries-a-qualitative-evidence-synthesis
#1
REVIEW
Susan Munabi-Babigumira, Claire Glenton, Simon Lewin, Atle Fretheim, Harriet Nabudere
BACKGROUND: In many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29148314/clinical-decision-support-systems-in-hospital-care-using-ubiquitous-devices-current-issues-and-challenges
#2
Mirza Mansoor Baig, Hamid GholamHosseini, Aasia A Moqeem, Farhaan Mirza, Maria Lindén
Supporting clinicians in decision making using advanced technologies has been an active research area in biomedical engineering during the past years. Among a wide range of ubiquitous systems, smartphone applications have been increasingly developed in healthcare settings to help clinicians as well as patients. Today, many smartphone applications, from basic data analysis to advanced patient monitoring, are available to clinicians and patients. Such applications are now increasingly integrating into healthcare for clinical decision support, and therefore, concerns around accuracy, stability, and dependency of these applications are rising...
November 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29144250/case-not-closed-prescription-errors-12-years-after-computerized-physician-order-entry-implementation
#3
Gili Kadmon, Michal Pinchover, Avichai Weissbach, Shirley Kogan Hazan, Elhanan Nahum
OBJECTIVE: To assess the prolonged impact of computerized physician order entry (CPOE) on medication prescription errors in pediatric intensive care patients. STUDY DESIGN: This observational study was conducted at a pediatric intensive care unit in which a CPOE (Metavision, iMDsoft, Israel) with a limited clinical decision support system was implemented between 2004 and 2007. Since then, no changes were made to the systems. We analyzed 2500 electronic prescriptions (1250 prescriptions from 2015 and 1250 prescriptions from 2016)...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29141738/dynamic-clinical-algorithms-digital-technology-can-transform-health-care-decision-making
#4
David Bell, Noni Gachuhi, Nassim Assefi
Most health care in low-income countries is delivered at a primary care level by health workers who lack quality training and supervision, often distant from more experienced support. Lack of knowledge and poor communication result in a poor quality of care and inefficient delivery of health services. Although bringing great benefits in sectors such as finance and telecommunication in recent years, the Digital Revolution has lightly and inconsistently affected the health sector. These advances offer an opportunity to dramatically transform health care by increasing the availability and timeliness of information to augment clinical decision-making, based on improved access to patient histories, current information on disease epidemiology, and improved incorporation of data from point-of-care and centralized diagnostic testing...
November 6, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29137965/a-novel-bagging-c4-5-algorithm-based-on-wrapper-feature-selection-for-supporting-wise-clinical-decision-making
#5
Shin-Jye Lee, Zhaozhao Xu, Tong Li, Yun Yang
From the perspective of clinical decision-making in a Medical IoT-based healthcare system, achieving effective and efficient analysis of long-term health data for supporting wise clinical decision-making is an extremely important objective, but determining how to effectively deal with the multi-dimensionality and high volume of generated data obtained from Medical IoT-based healthcare systems is an issue of increasing importance in IoT healthcare data exploration and management. A novel classifier or predicator equipped with a good feature selection function contributes effectively to classification and prediction performance...
November 11, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29137666/utilization-of-the-behavior-change-wheel-framework-to-develop-a-model-to-improve-cardiometabolic-screening-for-people-with-severe-mental-illness
#6
Christina Mangurian, Grace C Niu, Dean Schillinger, John W Newcomer, James Dilley, Margaret A Handley
BACKGROUND: Individuals with severe mental illness (e.g., schizophrenia, bipolar disorder) die 10-25 years earlier than the general population, primarily from premature cardiovascular disease (CVD). Contributing factors are complex, but include systemic-related factors of poorly integrated primary care and mental health services. Although evidence-based models exist for integrating mental health care into primary care settings, the evidence base for integrating medical care into specialty mental health settings is limited...
November 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29136338/the-perspectives-of-medical-specialists-from-different-disciplines-on-the-management-of-systemic-lupus-erythematosus-an-interview-study
#7
David J Tunnicliffe, Davinder Singh-Grewal, Jonathan C Craig, Shilpanjali Jesudason, Peter Tugwell, Ming-Wei Lin, Sean G O'Neill, Daniel Sumpton, Allison Tong
OBJECTIVES: Systemic lupus erythematosus (SLE) is a complex autoimmune disease that can affect multiple organ systems, with specialists from many disciplines often involved, which may lead to inconsistent care. We aimed to describe the attitudes and perspectives of specialists from different medical disciplines on the management of people with SLE. METHODS: Face-to-face, semi-structured interviews were conducted with rheumatologists (n=16), nephrologists (n=16), and immunologists (n=11) providing care to adults with SLE from 19 centers across Australia in 2015...
November 14, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29135746/computerized-clinical-decision-support-system-utilization-in-nursing-a-scoping-review-protocol
#8
Dóris Ribeiro Ortiz, Flávia de Oliveira Motta Maia, Diley Cardoso Franco Ortiz, Heloísa Helena Ciqueto Peres, Paulino Artur Ferreira de Sousa
The objective of this scoping review is to comprehensively identify and examine the available literature on computerized clinical decision support systems utilized in nursing. The following focus questions will be used as an initial starting point in order to map and discuss important characteristics of the work done in this field.
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29133283/open-source-electronic-health-record-systems-for-low-resource-settings-systematic-review
#9
REVIEW
Assel Syzdykova, André Malta, Maria Zolfo, Ermias Diro, José Luis Oliveira
BACKGROUND: Despite the great impact of information and communication technologies on clinical practice and on the quality of health services, this trend has been almost exclusive to developed countries, whereas countries with poor resources suffer from many economic and social issues that have hindered the real benefits of electronic health (eHealth) tools. As a component of eHealth systems, electronic health records (EHRs) play a fundamental role in patient management and effective medical care services...
November 13, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29132628/the-use-of-computerized-physician-order-entry-with-clinical-decision-support-reduces-practice-variance-in-ordering-preoperative-investigations-a-retrospective-cohort-study
#10
Eileen Yilin Sim, Daryl Jian An Tan, Hairil Rizal Abdullah
BACKGROUND AND GOAL OF STUDY: Over-ordering of routine preoperative investigations is prevalent. Adherence to institutional guidelines differs among physicians. Our institution integrated a Clinical Decision Support (CDS) model into our hospital's Computerized Physician Ordering Entry (CPOE) system to guide physician orders. We investigate if the implementation of CDS into CPOE increases physician adherence to our institutional guidelines. METHODS: A retrospective cohort study in a tertiary academic hospital over 18 months...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29127480/quality-assessment-of-atopic-dermatitis-clinical-practice-guidelines-in-%C3%A2-%C3%A2-18-years
#11
Luz de María Díaz Granados, María Adelaida Quijano, Paola Andrea Ramírez, Natalia Aguirre, Gloria Sanclemente
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects the patients' quality of life greatly often from a very young age. Its worldwide incidence in children and adults varies, but it is usually among the first ten causes of dermatological consultation worldwide. There is a wide variety of treatment options for this condition including topical and systemic regimes. The decision to choose a treatment option in dermatological diseases is greatly influenced by the personal experience of each specialist, which increases variability in the selection of available therapies...
November 10, 2017: Archives of Dermatological Research
https://www.readbyqxmd.com/read/29126196/interface-information-interaction-a-narrative-review-of-design-and-functional-requirements-for-clinical-decision-support
#12
Kristen Miller, Danielle Mosby, Muge Capan, Rebecca Kowalski, Raj Ratwani, Yaman Noaiseh, Rachel Kraft, Sanford Schwartz, William S Weintraub, Ryan Arnold
Objective: Provider acceptance and associated patient outcomes are widely discussed in the evaluation of clinical decision support systems (CDSSs), but critical design criteria for tools have generally been overlooked. The objective of this work is to inform electronic health record alert optimization and clinical practice workflow by identifying, compiling, and reporting design recommendations for CDSS to support the efficient, effective, and timely delivery of high-quality care. Material and Methods: A narrative review was conducted from 2000 to 2016 in PubMed and The Journal of Human Factors and Ergonomics Society to identify papers that discussed/recommended design features of CDSSs that are associated with the success of these systems...
November 6, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29124460/medical-egg-freezing-the-importance-of-a-patient-centered-approach-to-fertility-preservation
#13
Marcia C Inhorn, Daphna Birenbaum-Carmeli, Lynn M Westphal, Joseph Doyle, Norbert Gleicher, Dror Meirow, Hila Raanani, Martha Dirnfeld, Pasquale Patrizio
PURPOSE: This binational qualitative study of medical egg freezing (MEF) examined women's motivations and experiences, including their perceived needs for patient-centered care in the midst of fertility- and life-threatening diagnoses. METHODS: Forty-five women who had undertaken MEF were interviewed in the USA (33 women) and in Israel (12 women) between June 2014 and August 2016. Interviews lasted approximately 1 h and were conducted by two senior medical anthropologists, one in each country...
November 9, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/29122544/population-health-management-for-inflammatory-bowel-disease
#14
REVIEW
Parambir S Dulai, Siddharth Singh, Lucilla Ohno-Machado, William J Sandborn
Inflammatory bowel diseases (IBD) are chronic and impose significant, multi-dimensional burdens on patients and healthcare systems. The increasing prevalence of IBD will only worsen this problem globally-population health management (PHM) strategies are needed to increase quality of care and population health outcomes while reducing healthcare costs. We discuss the key components of PHM in IBD. Effective implementation of PHM strategies requires accurate identification of at-risk patients and of key areas of variability in care...
November 6, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29119468/clinical-decision-support-and-optional-point-of-care-testing-of-renal-function-for-safe-use-of-antibiotics-in-elderly-patients-a-retrospective-study-in-community-pharmacy-practice
#15
Mette Heringa, Annemieke Floor-Schreudering, Peter A G M De Smet, Marcel L Bouvy
OBJECTIVE: The aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice. METHODS: Community pharmacists used a clinical decision support system (CDSS) for seven antibiotics. Alerts were generated during prescription processing in the case of previously registered renal impairment and when no information on renal function was available for patients aged 70 and over...
November 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29118679/an-electronic-health-record-data-driven-model-for-identifying-older-adults-at-risk-of-unintentional-falls
#16
Adam Baus, Jeffrey Coben, Keith Zullig, Cecil Pollard, Charles Mullett, Henry Taylor, Jill Cochran, Traci Jarrett, Dustin Long
Screening for risk of unintentional falls remains low in the primary care setting because of the time constraints of brief office visits. National studies suggest that physicians caring for older adults provide recommended fall risk screening only 30 to 37 percent of the time. Given prior success in developing methods for repurposing electronic health record data for the identification of fall risk, this study involves building a model in which electronic health record data could be applied for use in clinical decision support to bolster screening by proactively identifying patients for whom screening would be beneficial and targeting efforts specifically to those patients...
2017: Perspectives in Health Information Management
https://www.readbyqxmd.com/read/29116992/enhancing-worker-health-through-clinical-decision-support-cds-an-introduction-to-a-compilation
#17
Margaret S Filios, Eileen Storey, Sherry Baron, Genevieve B Luensman, Richard N Shiffman
OBJECTIVE: This article outlines an approach to developing clinical decision support (CDS) for conditions related to work and health. When incorporated in electronic health records, such CDS will assist primary care providers (PCPs) care for working patients. METHODS: Three groups of Subject Matter Experts (SMEs) identified relevant clinical practice guidelines, best practices, and reviewed published literature concerning work-related asthma, return-to-work, and management of diabetes at work...
November 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29116390/cad-rads-a-new-clinical-decision-support-tool-for-coronary-computed-tomography-angiography
#18
Borek Foldyna, Bálint Szilveszter, Jan-Erik Scholtz, Dahlia Banerji, Pál Maurovich-Horvat, Udo Hoffmann
Coronary computed tomography angiography (CTA) has been established as an accurate method to non-invasively assess coronary artery disease (CAD). The proposed 'Coronary Artery Disease Reporting and Data System' (CAD-RADS) may enable standardised reporting of the broad spectrum of coronary CTA findings related to the presence, extent and composition of coronary atherosclerosis. The CAD-RADS classification is a comprehensive tool for summarising findings on a per-patient-basis dependent on the highest-grade coronary artery lesion, ranging from CAD-RADS 0 (absence of CAD) to CAD-RADS 5 (total occlusion of a coronary artery)...
November 7, 2017: European Radiology
https://www.readbyqxmd.com/read/29111383/disturbed-glutathione-antioxidative-defense-is-associated-with-structural-brain-changes-in-neuroleptic-na%C3%A3-ve-first-episode-psychosis-patients
#19
K Langbein, J Hesse, A Gussew, B Milleit, S Lavoie, G P Amminger, C Gaser, G Wagner, J R Reichenbach, U-C Hipler, D Winter, S Smesny
BACKGROUND: Oxidative stress and impaired antioxidant defense are reported in schizophrenia and are thought to be associated with disturbed neurodevelopment, brain structural alterations, glutamatergic imbalance, negative symptomatology, and cognitive impairment. To test some of these assumptions we investigated the glutathione (GSH) antioxidant defense system (AODS) and brain structural abnormalities in drug-naïve individuals with first acute episode of psychosis (FEP). METHOD: The study involved 27 drug-naïve FEP patients and 31 healthy controls (HC)...
October 18, 2017: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/29105793/what-can-we-learn-in-drug-allergy-management-from-world-health-organization-s-international-classifications
#20
REVIEW
Luciana Kase Tanno, Maria Jose Torres, Mariana Castells, Pascal Demoly
Drug hypersensitivity reactions (DHRs) represent growing health problem worldwide, affecting more than 7% of the general population and represent an important public health problem. However, knowledge in DHRs morbidity and mortality epidemiological data is still not optimal and international comparable standards remain poorly accessed. Institutional databases worldwide increasingly use the WHO International Classification of Diseases (ICD) system to classify diagnoses, health services utilization and death data...
November 6, 2017: Allergy
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