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https://www.readbyqxmd.com/read/28230455/outcomes-of-pharmacy-led-hepatitis-c-direct-acting-antiviral-utilization-management-at-a-veterans-affairs-medical-center
#1
Sendra Yang, Rachel B Britt, Mohamed G Hashem, Jamie N Brown
BACKGROUND: The Veterans Affairs Health (VA) Administration has reported hepatitis C virus (HCV) infection rates among veterans to be twice that of the general U.S population. New HCV direct-acting antiviral (DAA) treatment options offer superior sustained virologic response (SVR) rates, improved side-effect profiles, and shortened treatment courses; yet, these new HCV DAAs are expensive, and utilization management strategies are needed to optimize use and improve clinical outcomes. A VA medical center uses pharmacist-led HCV DAA utilization management strategies that includes clinical guidance, optimizing operational flow, budget tracking and forecasting, and patient outcomes tracking...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230449/real-world-glycemic-control-from-glp-1ra-therapy-with-and-without-concurrent-insulin-in-patients-with-type-2-diabetes
#2
Mukul Singhal, Sudhir Unni, Marisa Schauerhamer, Hiep Nguyen, Jeff Hurd, Carrie McAdam-Marx
BACKGROUND: Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are recommended as add-on therapy in patients with uncontrolled type 2 diabetes (T2D), with no specific guidance as to timing versus insulin. Furthermore, real-world data assessing GLP-1RA outcomes with or without concurrent insulin therapy are lacking. OBJECTIVE: To identify glycemic response with GLP-1RAs by insulin use in patients with T2D at 1-year follow-up to inform decisions regarding GLP-1RA use with or without insulin...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230448/opioid-use-for-pain-management-after-implementation-of-a-medicaid-short-acting-opioid-quantity-limit
#3
Catherine S Riggs, Sarah J Billups, Samantha Flores, Rachana J Patel, Rachel M F Heilmann, Jessica L Milchak
BACKGROUND: The United States is currently experiencing an opioid abuse epidemic. Many policies and programs have been implemented at local, state, and national levels in an attempt to decrease prescription opioid addiction and overdose. On August 1, 2014, Colorado Medicaid implemented a policy change that limited the quantity of short-acting opioids (SAOs) that could be filled through the Medicaid benefit to no more than 4 tablets per day, or 120 tablets in 30 days. OBJECTIVE: To compare mean total daily dose (TDD) of opioids purchased by Kaiser Permanente Colorado (KPCO) Medicaid patients before and after implementation of the Medicaid SAO quantity limit...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28229916/ongoing-nursing-training-influence-on-the-completion-of-electronic-pressure-ulcer-records
#4
María López, José María Jiménez, Isabel Peña, María José Cao, María Simarro, María José Castro
INTRODUCTION: Pressure ulcer (PU) care in nursing at the Hospital Clínico Universitario de Valladolid (HCUV) in Spain includes basic care and its registration through the electronic GACELA Care tool. To assess and evaluate the nursing intervention in PU evolution, a training programme was carried out to unify criteria on PU assessment, treatment, evaluation and monitoring. OBJECTIVE: To assess the influence of training on the completion of PU records in the GACELA Care application, and identify the level of satisfaction of the nurses after its use...
February 14, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28229839/-the-impact-of-electronic-monitoring-on-healthcare-associated-infections-the-role-of-the-hvital-platform
#5
Rita Fontes Oliveira, Lídia Castro, José Pedro Almeida, Carlos Alves, António Ferreira
INTRODUCTION: In Portugal, 9.8% of patients admitted were inflicted with healthcare associated infections, corresponding to a prevalence of 11.7%. The Hospital de São João has developed a business intelligence platform able to supervise (the patients), monitor (the clinical condition) and notify (the healthcare personnel): HViTAL. This study aims to assess the impact of electronic monitoring on healthcare associated infections since the year of HViTAL implementation. MATERIAL AND METHODS: We evaluated data since January 2008 (moment from which computerized records exist) until December 2011, comparing them with subsequent data, those corresponding to January 2012 (implementation date of HViTAL) until 19 October 2015...
November 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28229371/overall-survival-and-metastasis-resections-in-patients-with-metastatic-colorectal-cancer-using-electronic-medical-records
#6
Eetu Heervä, Maija Lavonius, Panu Jaakkola, Heikki Minn, Raija Ristamäki
PURPOSE: Treatment for patients with metastatic colorectal cancer is chemotherapy commonly combined with monoclonal antibodies against vascular endothelial growth factor (bevacizumab) or epidermal growth factor receptor (cetuximab or panitumumab), the efficacy of which has been proven in randomized controlled trials. The objective of the current retrospective study was to analyze the impact of targeted therapy, adverse events, and dose reduction on overall survival (OS) and metastasis resection rates...
February 23, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28229341/assessment-of-cetuximab-induced-infusion-reactions-and-administration-rechallenge-at-an-academic-medical-center
#7
Ellen Burke, Michelle Rockey, Dennis Grauer, Dave Henry, Prakash Neupane
Cetuximab is approved for treatment of squamous cell carcinoma of the head and neck (SCCHN). Cetuximab is generally well tolerated, but does carry a black box warning for infusion reactions (IRs). Incidence of IR in clinical trials was 15-20% for all grades and 3-5% for grades III-IV. Retrospective studies reported a higher incidence of all grade IRs and grades III-IV IR in areas of the Southeastern United States. Information regarding rechallenge doses after an IR has not been well described. At our institution, we frequently rechallenge on the same day after an initial IR...
April 2017: Medical Oncology
https://www.readbyqxmd.com/read/28228662/risk-of-gynecomastia-and-breast-cancer-associated-with-the-use-of-5-alpha-reductase-inhibitors-for-benign-prostatic-hyperplasia
#8
Katrina Wilcox Hagberg, Hozefa A Divan, Shona C Fang, J Curtis Nickel, Susan S Jick
BACKGROUND: Clinical trial results suggest that 5-alpha reductase inhibitors (5ARIs) for the treatment of benign prostatic hyperplasia (BPH) may increase the risk of gynecomastia and male breast cancer, but epidemiological studies have been limited. PATIENTS AND METHODS: We conducted a cohort study with nested case-control analyses using the UK Clinical Practice Research Datalink. We identified men diagnosed with BPH who were free from Klinefelter syndrome, prostate, genital or urinary cancer, prostatectomy or orchiectomy, or evidence of gynecomastia or breast cancer...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28228372/progress-in-the-enhanced-use-of-electronic-medical-records-data-from-the-ontario-experience
#9
Mavis Jones, Chad Koziel, Darren Larsen, Plumaletta Berry, Elena Kubatka-Willms
BACKGROUND: This paper describes a change management strategy, including a self-assessment survey tool and electronic medical record (EMR) maturity model (EMM), developed to support the adoption and implementation of EMRs among community-based physicians in the province of Ontario, Canada. OBJECTIVE: The aim of our study was to present an analysis of progress in EMR use in the province of Ontario based on data from surveys completed by over 4000 EMR users. METHODS: The EMM and the EMR progress report (EPR) survey tool clarify levels of capability and expected benefits of improved use...
February 22, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28228138/current-management-practices-for-patients-presenting-with-low-back-pain-to-a-large-emergency-department-in-canada
#10
Matthew L Nunn, Jill A Hayden, Kirk Magee
BACKGROUND: Low back pain (LBP) is one of the leading causes of disability. Presentations to the emergency department (ED) are common and consume significant healthcare resources. However, treatment of patients with LBP is variable and highly physician dependent. Our study objective was to describe the demographic and clinical characteristics of patients presenting to the ED with LBP, the diagnostic strategies employed by ED physicians, and the subsequent management. METHODS: We conducted a retrospective study using clinical and electronic health data at the Queen Elizabeth II Health Science Center's Charles V...
February 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28227779/revealing-oral-medication-patterns-from-reconstructed-long-term-medication-history-of-type-2-diabetes
#11
Purnomo Husnul Khotimah, Yuichi Sugiyama, Masatoshi Yoshikawa, Akihiro Hamasaki, Kazuya Okamoto, Tomohiro Kuroda, Purnomo Husnul Khotimah, Yuichi Sugiyama, Masatoshi Yoshikawa, Akihiro Hamasaki, Kazuya Okamoto, Tomohiro Kuroda, Kazuya Okamoto, Purnomo Husnul Khotimah, Yuichi Sugiyama, Akihiro Hamasaki, Masatoshi Yoshikawa, Tomohiro Kuroda
With the growing attention to evidence-based medical guideline development, longitudinal analysis of Electronic Medical Records (EMR) has become a good tool for providing insight into and new knowledge on the existing therapy. For chronic diseases, longitudinal analysis of medication history plays a key role in reaching this goal. However, raw medication data in EMR are not suitable for longitudinal analysis for several reasons. First, many prescriptions have a short duration. Second, the prescription duration may have a gap or overlap with other prescription durations...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227144/optimal-medication-dosing-from-suboptimal-clinical-examples-a-deep-reinforcement-learning-approach
#12
Shamim Nemati, Mohammad M Ghassemi, Gari D Clifford, Shamim Nemati, Mohammad M Ghassemi, Gari D Clifford, Gari D Clifford, Mohammad M Ghassemi
Misdosing medications with sensitive therapeutic windows, such as heparin, can place patients at unnecessary risk, increase length of hospital stay, and lead to wasted hospital resources. In this work, we present a clinician-in-the-loop sequential decision making framework, which provides an individualized dosing policy adapted to each patient's evolving clinical phenotype. We employed retrospective data from the publicly available MIMIC II intensive care unit database, and developed a deep reinforcement learning algorithm that learns an optimal heparin dosing policy from sample dosing trails and their associated outcomes in large electronic medical records...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227040/representativeness-comparisons-of-nurse-and-computer-charting-of-heart-rate-across-nursing-intensity-protocols
#13
Jorge M Luna, Natalie Yip, Rimma Pivovarov, David K Vawdrey, Jorge M Luna, Natalie Yip, Rimma Pivovarov, David K Vawdrey, David K Vawdrey, Rimma Pivovarov, Jorge M Luna, Natalie Yip
Clinical teams in acute inpatient settings can greatly benefit from automated charting technologies that continuously monitor patient vital status. NewYork-Presbyterian has designed and developed a real-time patient monitoring system that integrates vital signs sensors, networking, and electronic health records, to allow for automatic charting of patient status. We evaluate the representativeness (a combination of agreement, safety and timing) of a core vital sign across nursing intensity care protocols for preliminary feasibility assessment...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227038/secure-access-to-patient-s-health-records-using-speechxrays-a-mutli-channel-biometrics-platform-for-user-authentication
#14
Emmanouil G Spanakis, Marios Spanakis, Apostolos Karantanas, Kostas Marias, Emmanouil G Spanakis, Marios Spanakis, Apostolos Karantanas, Kostas Marias, Emmanouil G Spanakis, Apostolos Karantanas, Marios Spanakis, Kostas Marias
The most commonly used method for user authentication in ICT services or systems is the application of identification tools such as passwords or personal identification numbers (PINs). The rapid development in ICT technology regarding smart devices (laptops, tablets and smartphones) has allowed also the advance of hardware components that capture several biometric traits such as fingerprints and voice. These components are aiming among others to overcome weaknesses and flaws of password usage under the prism of improved user authentication with higher level of security, privacy and usability...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227019/prediction-using-patient-comparison-vs-modeling-a-case-study-for-mortality-prediction
#15
Mark Hoogendoorn, Ali El Hassouni, Kwongyen Mok, Marzyeh Ghassemi, Peter Szolovits, Mark Hoogendoorn, Ali El Hassouni, Kwongyen Mok, Marzyeh Ghassemi, Peter Szolovits, Kwongyen Mok, Ali El Hassouni, Peter Szolovits, Marzyeh Ghassemi, Mark Hoogendoorn
Information in Electronic Medical Records (EMRs) can be used to generate accurate predictions for the occurrence of a variety of health states, which can contribute to more pro-active interventions. The very nature of EMRs does make the application of off-the-shelf machine learning techniques difficult. In this paper, we study two approaches to making predictions that have hardly been compared in the past: (1) extracting high-level (temporal) features from EMRs and building a predictive model, and (2) defining a patient similarity metric and predicting based on the outcome observed for similar patients...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226619/application-of-semi-supervised-deep-learning-to-lung-sound-analysis
#16
Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher, Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher, Vivek Miglani, Daniel Chamberlain, Richard Ribon Fletcher, Rahul Kodgule, Daniela Ganelin
The analysis of lung sounds, collected through auscultation, is a fundamental component of pulmonary disease diagnostics for primary care and general patient monitoring for telemedicine. Despite advances in computation and algorithms, the goal of automated lung sound identification and classification has remained elusive. Over the past 40 years, published work in this field has demonstrated only limited success in identifying lung sounds, with most published studies using only a small numbers of patients (typically N<;20) and usually limited to a single type of lung sound...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226493/towards-an-unsupervised-device-for-the-diagnosis-of-childhood-pneumonia-in-low-resource-settings-automatic-segmentation-of-respiratory-sounds
#17
J Sola, F Braun, E Muntane, C Verjus, M Bertschi, F Hugon, S Manzano, M Benissa, A Gervaix, J Sola, F Braun, E Muntane, C Verjus, M Bertschi, F Hugon, S Manzano, M Benissa, A Gervaix, F Hugon, C Verjus, A Gervaix, S Manzano, M Bertschi, E Muntane, M Benissa, J Sola, F Braun
Pneumonia remains the worldwide leading cause of children mortality under the age of five, with every year 1.4 million deaths. Unfortunately, in low resource settings, very limited diagnostic support aids are provided to point-of-care practitioners. Current UNICEF/WHO case management algorithm relies on the use of a chronometer to manually count breath rates on pediatric patients: there is thus a major need for more sophisticated tools to diagnose pneumonia that increase sensitivity and specificity of breath-rate-based algorithms...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226199/mortality-risk-factors-among-patients-with-cirrhosis-and-a-low-%C3%A2-15-meld-sodium-score-an-analysis-of-liver-transplant-allocation-policy-using-aggregated-electronic-health-record-data
#18
K Atiemo, A Skaro, H Maddur, L Zhao, S Montag, L VanWagner, S Goel, A Kho, B Ho, R Kang, J L Holl, M M Abecassis, J Levitsy, D P Ladner
Although the MELDNa score is now used for liver transplant allocation in the United States, mortality prediction may be underestimated by the score. Using aggregated electronic health record data from 7,834 adult patients with cirrhosis, we determined whether the cause of cirrhosis/cirrhosis complications is associated with an increased risk of death among patients with a MELDNa ≤15 and whether patients with the greatest risk of death could benefit from liver transplantation (LT). Over a median follow-up of 2...
February 22, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28225707/nonadherence-to-antiretroviral-therapy-among-hiv-infected-patients-in-zambia-is-concentrated-among-a-minority-of-patients-and-is-highly-variable-across-clinics
#19
Nancy L Czaicki, Charles B Holmes, Izukanji Sikazwe, Carolyn Bolton, Theodora Savory, Mwanza Wa Mwanza, Crispin Moyo, Nancy S Padian, Elvin H Geng
OBJECTIVES: The distribution of adherence to antiretroviral therapy (ART) can indicates whether barriers are concentrated or more distributed. We quantified the medication possession ratio (MPR) and characterized the distribution of medication nonpossession in a network of clinics in Zambia to identify 'hotspots' and predictors of poorer adherence. METHODS: We analyzed a population of adults on ART for more than 3 months who made at least one clinic visit between 1 January 2013 and 28 February 2015...
March 13, 2017: AIDS
https://www.readbyqxmd.com/read/28225368/the-fundus-phenotype-associated-with-the-p-ala243val-best1-mutation
#20
Kamron N Khan, Farrah Islam, Anthony T Moore, Michel Michaelides
PURPOSE: To describe a highly recognizable and reproducible retinal phenotype associated with a specific BEST1 mutation-p.Ala243Val. METHODS: Retrospective review of consecutive cases where genetic testing has identified p.Ala243Val BEST1 as the cause of disease. Electronic patient records were used to extract demographic, as well as functional and anatomical data. These data were compared with those observed with the most common BEST1 genotype, p.Arg218Cys. RESULTS: Eight individuals (six families) were identified with the p...
February 20, 2017: Retina
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