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https://www.readbyqxmd.com/read/28423780/development-and-evaluation-of-a-case-based-retrieval-service
#1
Emilie Pasche, Marcello Chinali, Julien Gobeill, Patrick Ruch
Identifying similar patients might greatly facilitate the treatment of a given patient, enabling to observe the response and outcome to a particular treatment. Case-based retrieval services dealing with natural language processing are of major importance to deal with the significant amount of unstructured clinical data. In this paper, we present the development and evaluation of a case-based retrieval (CBR) service tested on a collection of Italian pediatric cardiology cases. Cases are indexed and a search engine is proposed...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28410277/use-of-population-pharmacokinetics-and-electronic-health-records-to-assess-piperacillin-tazobactam-safety-in-infants
#2
Sara Salerno, Christoph P Hornik, Michael Cohen-Wolkowiez, P Brian Smith, Lawrence C Ku, Matthew S Kelly, Reese Clark, Daniel Gonzalez
BACKGROUND: Piperacillin, in combination with tazobactam, is frequently used in infants for treating nosocomial infections, although safety data in this population are limited. Electronic health record (EHR) data can be used to evaluate drug safety in infants, but measures of drug exposure are lacking. METHODS: To relate simulated piperacillin exposure with adverse events (AEs) in infants using EHR data, we identified infants discharged from 333 neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2012...
April 13, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28339689/genomic-decision-support-needs-in-pediatric-primary-care
#3
Jeffrey W Pennington, Dean J Karavite, Edward M Krause, Jeffrey Miller, Barbara A Bernhardt, Robert W Grundmeier
Clinical genome and exome sequencing can diagnose pediatric patients with complex conditions that often require follow-up care with multiple specialties. The American Academy of Pediatrics emphasizes the role of the medical home and the primary care pediatrician in coordinating care for patients who need multidisciplinary support. In addition, the electronic health record (EHR) with embedded clinical decision support is recognized as an important component in providing care in this setting. We interviewed 6 clinicians to assess their experience caring for patients with complex and rare genetic findings and hear their opinions about how the EHR currently supports this role...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28324321/structured-data-entry-in-the-electronic-medical-record-perspectives-of-pediatric-specialty-physicians-and-surgeons
#4
Ruth A Bush, Cynthia Kuelbs, Julie Ryu, Wen Jiang, George Chiang
The Epic electronic health record (EHR) platform supports structured data entry systems (SDES), which allow developers, with input from users, to create highly customized patient-record templates in order to maximize data completeness and to standardize structure. There are many potential advantages of using discrete data fields in the EHR to capture data for secondary analysis and epidemiological research, but direct data acquisition from clinicians remains one of the largest obstacles to leveraging the EHR for secondary use...
May 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28291152/medical-student-documentation-in-the-emergency-department-in-the-electronic-health-record-era-a-national-survey
#5
Ryan A Virden, F Meridith Sonnett, Abu N G A Khan
OBJECTIVES: Implementation of electronic health record (EHR) has generated a new challenge in the practice of medical student documentation in the emergency department (ED). This study discerns both the current practices and consensus opinions of pediatric ED directors and Association of American Medical Colleges (AAMC) student representatives regarding best practices for documentation by medical students in the ED EHR nationwide. METHODS: The authors conducted a cross-sectional Web-based survey of the directors of academic pediatric EDs and AAMC student representatives using Qualtric survey engine...
March 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28135880/electronic-heath-record-prompts-may-increase-screening-for-secondhand-smoke-exposure
#6
Katharine E H Thomas, Steve Kisely, Fernando Urrego
INTRODUCTION: The American Academy of Pediatrics recommends that pediatricians promote smoking cessation among caregivers at every visit. Currently, there are inconsistencies between recommendations and clinical practice. This study aims to compare results generated from 3 intervention methods on the rate at which pediatricians screen for secondhand smoke exposure (SHSe). METHODS: Pediatricians were randomly assigned to 1 of 3 intervention groups: no lecture, changes in electronic health record (EHR) (G1); lecture, no changes in the EHR (G2); or a lecture and EHR changes (G3)...
January 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28112025/validation-of-the-use-of-electronic-health-records-for-classification-of-adhd-status
#7
Siobhan M Gruschow, Benjamin E Yerys, Thomas J Power, Dennis R Durbin, Allison E Curry
OBJECTIVE: To validate an electronic health record (EHR)-based algorithm to classify ADHD status of pediatric patients. METHOD: As part of an applied study, we identified all primary care patients of The Children's Hospital of Philadelphia [CHOP] health care network who were born 1987-1995 and residents of New Jersey. Patients were classified with ADHD if their EHR indicated an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of "314...
October 1, 2016: Journal of Attention Disorders
https://www.readbyqxmd.com/read/28094094/sira-p-development-and-testing
#8
Kristina L Foster, Lacey D Bergerhofer, Janis B Smith, Michele M Fix, Adrienne Olney, Ashley Sherman
OBJECTIVES: To describe the development of a new skin risk assessment scale called Skin Injury Risk Assessment and Prevention (SIRA+P) and to establish initial reliability and validity of the scale among patients ranging in age from birth, including pre-term, to adulthood, regardless of age or acuity of illness. STUDY DESIGN: The single-site study was a retrospective chart review to evaluate the measurement properties of SIRA+P. Charts of 385 patients of all ages and in all units (including the neonatal and pediatric intensive care units) of a free-standing children's hospital were included...
January 13, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/27965068/pda-based-self-work-sampling-study-of-pediatric-interns-quantifies-workday-and-educational-value
#9
Joyce K Campbell, Michael V Ortiz, Mary C Ottolini, Sarah Birch, Dewesh Agrawal
OBJECTIVE: Optimizing clinical proficiency and education of residents has become more important with restricted residency duty hours. Our objective was to investigate how interns spend their time on inpatient rotations and the perceived educational value of workday activities. METHODS: A descriptive, self-work sampling study using a personal digital assistant (PDA) to randomly query interns on inpatient rotations in real time as to their activity and the perceived educational value of that activity on a 4-point Likert scale...
December 10, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#10
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27902553/perspectives-and-uses-of-the-electronic-health-record-among-us-pediatricians-a-national-survey
#11
Julie W Doberne, Travis Redd, Daniel Lattin, Thomas R Yackel, Carl O Eriksson, Vishnu Mohan, Jeffrey A Gold, Joan S Ash, Michael F Chiang
Little is known about how existing electronic health records (EHRs) influence the practice of pediatric medicine. A total of 808 pediatricians participated in a survey about workflows using the EHR. The EHR was the most commonly used source of initial patient information. Seventy-two percent reported requiring between 2 and 10 minutes to complete an initial review of the EHR. Several moderately severe information barriers were reported regarding the display of information in the EHR. Pediatricians acquire information about new patients from EHRs more often than any other source...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27875603/emr-based-intervention-improves-lead-screening-at-an-urban-family-medicine-practice
#12
Kathryn McGrath, Krys Foster, Patrick Doggett, Marc Altshuler, Jewel Osborne-Wu, Christine Castellan, Kelly Lopez, Pheobe Askie, Daniel Chung, Laura Parente, Yury Parra
BACKGROUND AND OBJECTIVES: Elevated blood lead levels have well-described detrimental effects to growth and development in children, yet screening rates remain low. We sought to determine if a reminder within the electronic health record (EHR) could change provider behavior and improve blood lead level (BLL) screening test ordering rates in an urban academic family medicine practice. METHODS: Baseline BLL test ordering rates were calculated for children ages 9-72 months...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27851007/1371-using-lactate-and-blood-pressure-to-classify-shock-in-pediatric-sepsis-an-ehr-based-approach
#13
Halden Scott, Lina Brou, Sara Deakyne, Lalit Bajaj
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27688362/predicting-severe-pneumonia-outcomes-in-children
#14
Derek J Williams, Yuwei Zhu, Carlos G Grijalva, Wesley H Self, Frank E Harrell, Carrie Reed, Chris Stockmann, Sandra R Arnold, Krow K Ampofo, Evan J Anderson, Anna M Bramley, Richard G Wunderink, Jonathan A McCullers, Andrew T Pavia, Seema Jain, Kathryn M Edwards
BACKGROUND: Substantial morbidity and excessive care variation are seen with pediatric pneumonia. Accurate risk-stratification tools to guide clinical decision-making are needed. METHODS: We developed risk models to predict severe pneumonia outcomes in children (<18 years) by using data from the Etiology of Pneumonia in the Community Study, a prospective study of community-acquired pneumonia hospitalizations conducted in 3 US cities from January 2010 to June 2012...
October 2016: Pediatrics
https://www.readbyqxmd.com/read/27638908/national-trends-in-safety-performance-of-electronic-health-record-systems-in-children-s-hospitals
#15
Juan D Chaparro, David C Classen, Melissa Danforth, David C Stockwell, Christopher A Longhurst
Objective: To evaluate the safety of computerized physician order entry (CPOE) and associated clinical decision support (CDS) systems in electronic health record (EHR) systems at pediatric inpatient facilities in the US using the Leapfrog Group's pediatric CPOE evaluation tool. Methods: The Leapfrog pediatric CPOE evaluation tool, a previously validated tool to assess the ability of a CPOE system to identify orders that could potentially lead to patient harm, was used to evaluate 41 pediatric hospitals over a 2-year period...
March 1, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/27530349/implementation-of-an-inpatient-electronic-referral-system-opt-to-quit-from-the-electronic-health-record-to-the-new-york-state-smokers-quitline-first-steps
#16
Rachel Boykan, Carolyn Milana, Grace Propper, Patricia Bax, Paula Celestino
OBJECTIVES: (1) To implement a new policy-driven referral program, Opt-to-Quit, using electronic data transfer from the electronic health record (EHR) to the New York State Smokers' Quitline (NYSSQL) and (2) to improve referrals to the NYSSQL for smoking caregivers of children admitted to a children's hospital. METHODS: Smoking caregivers of pediatric patients were referred to the NYSSQL through a standardized template built into the EHR, during the child's hospitalization or emergency department encounter...
September 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27522443/electronic-health-records-and-pharmacokinetic-modeling-to-assess-the-relationship-between-ampicillin-exposure-and-seizure-risk-in-neonates
#17
Christoph P Hornik, Daniel K Benjamin, P Brian Smith, Michael J Pencina, Adriana H Tremoulet, Edmund V Capparelli, Jessica E Ericson, Reese H Clark, Michael Cohen-Wolkowiez
OBJECTIVE: To evaluate the relationship between ampicillin dosing, exposure, and seizures. STUDY DESIGN: This was a retrospective observational cohort study of electronic health record (EHR) data combined with pharmacokinetic model derived drug exposure predictions. We used the EHR from 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2012. We included all infants 24-41 weeks gestational age, 500-5400 g birth weight, first exposed to ampicillin prior to 25 days postnatal age...
November 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27453191/provider-use-of-a-novel-ehr-display-in-the-pediatric-intensive-care-unit-large-customizable-interactive-monitor-lcim
#18
Onur Asan, Richard J Holden, Kathryn E Flynn, Yushi Yang, Laila Azam, Matthew C Scanlon
OBJECTIVES: The purpose of this study was to explore providers' perspectives on the use of a novel technology, "Large Customizable Interactive Monitor" (LCIM), a novel application of the electronic health record system implemented in a Pediatric Intensive Care Unit. METHODS: We employed a qualitative approach to collect and analyze data from pediatric intensive care physicians, pediatric nurse practitioners, and acute care specialists. Using semi-structured interviews, we collected data from January to April, 2015...
July 20, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27452794/developing-an-algorithm-to-detect-early-childhood-obesity-in-two-tertiary-pediatric-medical-centers
#19
Todd Lingren, Vidhu Thaker, Cassandra Brady, Bahram Namjou, Stephanie Kennebeck, Jonathan Bickel, Nandan Patibandla, Yizhao Ni, Sara L Van Driest, Lixin Chen, Ashton Roach, Beth Cobb, Jacqueline Kirby, Josh Denny, Lisa Bailey-Davis, Marc S Williams, Keith Marsolo, Imre Solti, Ingrid A Holm, John Harley, Isaac S Kohane, Guergana Savova, Nancy Crimmins
OBJECTIVE: The objective of this study is to develop an algorithm to accurately identify children with severe early onset childhood obesity (ages 1-5.99 years) using structured and unstructured data from the electronic health record (EHR). INTRODUCTION: Childhood obesity increases risk factors for cardiovascular morbidity and vascular disease. Accurate definition of a high precision phenotype through a standardize tool is critical to the success of large-scale genomic studies and validating rare monogenic variants causing severe early onset obesity...
July 20, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27452477/patient-generated-digital-images-after-pediatric-ambulatory-surgery
#20
Matthew W Miller, Rachael K Ross, Christina Voight, Heather Brouwer, Dean J Karavite, Jeffrey S Gerber, Robert W Grundmeier, Susan E Coffin
OBJECTIVE: To describe the use of digital images captured by parents or guardians and sent to clinicians for assessment of wounds after pediatric ambulatory surgery. METHODS: Subjects with digital images of post-operative wounds were identified as part of an on-going cohort study of infections after ambulatory surgery within a large pediatric healthcare system. We performed a structured review of the electronic health record (EHR) to determine how digital images were documented in the EHR and used in clinical care...
July 6, 2016: Applied Clinical Informatics
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