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https://www.readbyqxmd.com/read/28431419/creation-and-validation-of-an-automated-algorithm-to-determine-postoperative-ventilator-requirements-after-cardiac-surgery
#1
Eilon Gabel, Ira S Hofer, Nancy Satou, Tristan Grogan, Richard Shemin, Aman Mahajan, Maxime Cannesson
BACKGROUND: In medical practice today, clinical data registries have become a powerful tool for measuring and driving quality improvement, especially among multicenter projects. Registries face the known problem of trying to create dependable and clear metrics from electronic medical records data, which are typically scattered and often based on unreliable data sources. The Society for Thoracic Surgery (STS) is one such example, and it supports manually collected data by trained clinical staff in an effort to obtain the highest-fidelity data possible...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430829/effect-of-a-price-transparency-intervention-in-the-electronic-health-record-on-clinician-ordering-of-inpatient-laboratory-tests-the-price-randomized-clinical-trial
#2
Mina S Sedrak, Jennifer S Myers, Dylan S Small, Irving Nachamkin, Justin B Ziemba, Dana Murray, Gregory W Kurtzman, Jingsan Zhu, Wenli Wang, Deborah Mincarelli, Daniel Danoski, Brian P Wells, Jeffrey S Berns, Patrick J Brennan, C William Hanson, C Jessica Dine, Mitesh S Patel
Importance: Many health systems are considering increasing price transparency at the time of order entry. However, evidence of its impact on clinician ordering behavior is inconsistent and limited to single-site evaluations of shorter duration. Objective: To test the effect of displaying Medicare allowable fees for inpatient laboratory tests on clinician ordering behavior over 1 year. Design, Setting, and Participants: The Pragmatic Randomized Introduction of Cost data through the electronic health record (PRICE) trial was a randomized clinical trial comparing a 1-year intervention to a 1-year preintervention period, and adjusting for time trends and patient characteristics...
April 21, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28430682/attempted-development-of-a-tool-to-predict-anesthesia-preparation-time-from-patient-related-and-procedure-related-characteristics
#3
Kamal Maheshwari, Jing You, Kenneth C Cummings, Maged Argalious, Daniel I Sessler, Andrea Kurz, Jacek Cywinski
BACKGROUND: Operating room (OR) utilization generally ranges from 50% to 75%. Inefficiencies can arise from various factors, including prolonged anesthesia preparation time, defined as the period from induction of anesthesia until patients are considered ready for surgery. Our goal was to use patient-related and procedure-related factors to develop a model predicting anesthesia preparation time. METHODS: From the electronic medical records of adults who had noncardiac surgery at the Cleveland Clinic Main Campus, we developed a model that used a dozen preoperative factors to predict anesthesia preparation time...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430572/lessons-about-so-called-difficult-patients-from-the-uk-controversy-over-patient-access-to-electronic-health-records
#4
Federica Lucivero
Increasing numbers of patients have direct access to their electronic health records (EHRs). Proponents of direct access argue that it empowers patients by making them more informed and offering them more control over their health and care. According to some proponents of patients' access to EHRs, clinicians' concerns about potential negative implications are grounded in a form of paternalism that protects clinicians' authority. This paper draws upon narratives from patients in the United Kingdom (UK) who have access to their EHRs and suggests strategies for moving beyond these controversies between proponents and critics of the system...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28429973/the-role-of-paediatric-nurses-in-medication-safety-prior-to-the-implementation-of-electronic-prescribing-a-qualitative-case-study
#5
Albert Farre, Gemma Heath, Karen Shaw, Teresa Jordan, Carole Cummins
Objectives To explore paediatric nurses' experiences and perspectives of their role in the medication process and how this role is enacted in everyday practice. Methods A qualitative case study on a general surgical ward of a paediatric hospital in England, one year prior to the planned implementation of ePrescribing. Three focus groups and six individual semi-structured interviews were conducted, involving 24 nurses. Focus groups and interviews were audio-recorded, transcribed, anonymized and subjected to thematic analysis...
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28429757/soft-electronics-enabled-ergonomic-human-computer-interaction-for-swallowing-training
#6
Yongkuk Lee, Benjamin Nicholls, Dong Sup Lee, Yanfei Chen, Youngjae Chun, Chee Siang Ang, Woon-Hong Yeo
We introduce a skin-friendly electronic system that enables human-computer interaction (HCI) for swallowing training in dysphagia rehabilitation. For an ergonomic HCI, we utilize a soft, highly compliant ("skin-like") electrode, which addresses critical issues of an existing rigid and planar electrode combined with a problematic conductive electrolyte and adhesive pad. The skin-like electrode offers a highly conformal, user-comfortable interaction with the skin for long-term wearable, high-fidelity recording of swallowing electromyograms on the chin...
April 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28428130/development-and-validation-of-an-algorithm-to-accurately-identify-atopic-eczema-patients-in-primary-care-electronic-health-records-from-the-uk
#7
K Abuabara, A M Magyari, O Hoffstad, Z K Jabbar-Lopez, L Smeeth, H C Williams, J M Gelfand, D J Margolis, S M Langan
Electronic health records hold great promise for clinical and epidemiologic research. Undertaking atopic eczema (AE) research using such data is challenging due to its episodic and heterogeneous nature. We sought to develop and validate a diagnostic algorithm that identifies AE cases based on codes used for electronic records used in the UK Health Improvement Network (THIN). We found that at least one of 5 diagnosis codes plus two treatment codes for any skin-directed therapy were likely to accurately identify patients with AE...
April 18, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28427898/pharmacist-impact-on-pediatric-vaccination-errors-and-missed-opportunities-in-the-setting-of-clinical-decision-support
#8
Kelly A Wise, Sonya J Sebastian, Anna C Haas-Gehres, Melissa D Moore-Clingenpeel, Kristen E Lamberjack
OBJECTIVE: To determine pharmacist impact on vaccination errors and missed opportunities in the pediatric primary care setting with the presence of clinical decision support (CDS) by comparing a clinic with a pharmacist and CDS to a clinic with CDS alone. DESIGN: A retrospective chart review of patients' electronic medical records compared vaccination errors and missed opportunities between 2 pediatric primary care clinics. SETTING: Two urban, pediatric primary care clinics were selected for the study...
April 17, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28427727/implementation-of-human-trafficking-education-and-treatment-algorithm-in-the-emergency-department
#9
Amber Egyud, Kimberly Stephens, Brenda Swanson-Bierman, Marge DiCuccio, Kimberly Whiteman
PROBLEM: Health care professionals have not been successful in recognizing or rescuing victims of human trafficking. The purpose of this project was to implement a screening system and treatment algorithm in the emergency department to improve the identification and rescue of victims of human trafficking. The lack of recognition by health care professionals is related to inadequate education and training tools and confusion with other forms of violence such as trauma and sexual assault...
April 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28427477/plasma-chitotriosidase-activity-versus-ccl18-level-for-assessing-type-i-gaucher-disease-severity-protocol-for-a-systematic-review-with-meta-analysis-of-individual-participant-data
#10
Tatiana Raskovalova, Patrick B Deegan, Ruby Yang, Elena Pavlova, Jérome Stirnemann, José Labarère, Ari Zimran, Pramod K Mistry, Marc Berger
BACKGROUND: Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder caused by deficiency in acid beta-glucosidase. GD exhibits a wide clinical spectrum of disease severity with an unpredictable natural course. Plasma chitotriosidase activity and CC chemokine ligand 18 (CCL18) have been exchangeably used for monitoring GD activity and response to enzyme replacement therapy in conjunction with clinical assessment. Yet, a large-scale head-to-head comparison of these two biomarkers is currently lacking...
April 20, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28427463/combination-of-sofosbuvir-pegylated-interferon-and-ribavirin-for-treatment-of-hepatitis-c-virus-genotype-1-infection-a-systematic-review-and-meta-analysis
#11
Fardin Dolatimehr, Hamidreza Karimi-Sari, Mohammad Saeid Rezaee-Zavareh, Seyed Moayed Alavian, Bita Behnava, Mohammad Gholami-Fesharaki, Heidar Sharafi
BACKGROUND: Hepatitis C virus (HCV) infection is an important cause of chronic liver disease which has been affected 3% of world's population. Some studies have shown that adding Sofosbuvir (SOF), an HCV polymerase inhibitor to the conventional therapy of Pegylated-interferon (PegIFN) plus Ribavirin (RBV) can increase the rate of sustained virologic response (SVR) among HCV-infected patients. This study was conducted to determine the effect of combination therapy with PegIFN and RBV plus SOF for chronic hepatitis C genotype 1 infection using systematic review with meta-analysis...
April 20, 2017: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
https://www.readbyqxmd.com/read/28427124/-contemporary-use-of-ticagrelor-in-patients-with-acute-coronary-syndrome-after-discharge
#12
J Liu, H B Yan, L Song, Y H Hua, H J Zhao, C Liu, P Zhou, J N Li, Y Tan, Y M Yang, Y Wu
Objective: To investigate the degree and determinants of using ticagrelor among discharged patients with acute coronary syndrome (ACS). Methods: Patients with ACS in Fuwai hospital who were given ticagrelor after discharge between Jan. 2015 to Jun. 2015 were analyzed.The clinical characteristics and adherence to ticagrelor of these patients were collected by reviewing the electronic medical records and telephone interview.Date were statistically-analyzed. Results: Among all screened 404 patients, 158 (39.1%) patients prematurely stopped ticagrelor within 12 months, while 119(29...
April 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28426535/frailty-in-hiv-infected-people-a-new-risk-factor-for-bone-mineral-density-loss
#13
Sylvie Bregigeon, Anne Galinier, Olivia Zaegel-Faucher, Carla E Cano, Véronique Obry, Hélène Laroche, Sophie Trijau, Armelle Saout, Isabelle Poizot-Martin
OBJECTIVE: This study aims to assess the association between bone mineral density (BMD) and frailty in a cohort of HIV-infected patients. DESIGN: A cross-sectional study in an HIV outpatient unit where nearly 1,000 patients are monitored. METHODS: Subjects undergoing bone densitometry were proposed an evaluation of frailty using criteria of the Cardiovascular Health Study (CHS) and the Study of Osteoporotic Fractures (SOF). Frailty markers (FM) were weight-loss, self-reported exhaustion, physical activity, grip strength, chair stands, and slow gait...
April 19, 2017: AIDS
https://www.readbyqxmd.com/read/28426439/high-mortality-among-patients-with-opioid-use-disorder-in-a-large-healthcare-system
#14
Yih-Ing Hser, Larissa J Mooney, Andrew J Saxon, Karen Miotto, Douglas S Bell, Yuhui Zhu, Di Liang, David Huang
OBJECTIVES: Elevated mortality has been observed among individuals with opioid use disorder (OUD) treated in addiction specialty clinics or programs. Information about OUD patients in general healthcare settings is needed in light of the current effort to integrate addiction services into primary healthcare systems. This study examined mortality rates, causes of death, and associated risk factors among patients with OUD in a large general healthcare system. METHODS: Mortality data were linked with electronic health records of 2576 OUD patients cared for in a large university health system from 2006 to 2014...
April 20, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28426345/economic-evaluation-of-ezetimibe-treatment-in-combination-with-statin-therapy-in-the-united-states
#15
Glenn M Davies, Ami Vyas, Carl A Baxter
AIMS: This study assessed the cost-effectiveness of ezetimibe with statin therapy versus statin monotherapy from a United States (US) payer perspective, assuming the impending patent expiration of ezetimibe. METHODS: A Markov-like economic model consisting of 28 distinct health states was used. Model population data were obtained from US linked claims and electronic medical records, with inclusion criteria based on diagnostic guidelines. Inputs came from recent clinical trials, meta-analyses, and cost-effectiveness analyses...
April 20, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28426335/chaplaincy-encounters-following-a-suicide-attempt
#16
Marek S Kopacz, Cathleen P Kane, Wilfred R Pigeon, Jason A Nieuwsma
This descriptive study examines the provision of chaplaincy services to veterans who sought health care at a Department of Veterans Affairs (VA) Medical Center following a suicide attempt. A system-wide VA database of suicidal behavior was used to identify a cohort of n = 22,701 veterans who survived a suicide attempt. Next, an electronic review of VA clinical records found that n = 7,447 (32.8%) received chaplaincy services in the 30 days following their attempt. Of this group, the overwhelming majority of first chaplaincy encounters took place in in-patient settings: n = 6890 (92...
April 20, 2017: Journal of Health Care Chaplaincy
https://www.readbyqxmd.com/read/28426332/buprenorphine-treatment-and-patient-use-of-health-services-after-the-affordable-care-act-in-an-integrated-health-care-system
#17
Cynthia I Campbell, Sujaya Parthasarathy, Kelly C Young-Wolff, Derek D Satre
The Affordable Care Act (ACA) was expected to benefit patients with substance use disorders, including opioid use disorders (OUDs). This study examined buprenorphine use and health services utilization by patients with OUDs pre- and post-ACA in a large health care system. Using electronic health record data, we examined demographic and clinical characteristics (substance use, psychiatric and medical conditions) of two patient cohorts using buprenorphine: those newly enrolled in 2012 ("pre-ACA," N = 204) and in 2014 ("post-ACA," N = 258)...
April 20, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28426243/analysis-of-2019-patients-undergoing-revision-anterior-cruciate-ligament-reconstruction-from-a-community-based-registry
#18
Afshin Arianjam, Maria C S Inacio, Tadashi T Funahashi, Gregory B Maletis
BACKGROUND: Knowledge of patient characteristics, surgical fixation, graft choice, outcomes, and concurrent injuries of revision anterior cruciate ligament reconstruction (ACLR) is limited. PURPOSE: To describe the current cohort of revision ACLR captured by a community registry and the outcomes observed in the registered patients. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Patients who underwent revision ACLR registered between February 2005 and June 2014, by 200 surgeons in 46 hospitals, were evaluated...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28425616/statin-use-and-risk-of-multiple-myeloma-an-analysis-from-the-cancer-research-network
#19
Mara M Epstein, George Divine, Chun R Chao, Karen E Wells, Heather Spencer Feigelson, Delia Scholes, Douglas Roblin, Marianne Ulcickas Yood, Lawrence S Engel, Andrew Taylor, Joan Fortuny, Laurel A Habel, Christine C Johnson
Animal and human data suggest statins may be protective against developing multiple myeloma; however, findings may be biased by the interrelationship with lipid levels. We investigated the association between statin use and risk of multiple myeloma in a large US population, with an emphasis on accounting for this potential bias. We conducted a case-control study nested within 6 US integrated healthcare systems participating in the National Cancer Institute-funded Cancer Research Network. Adults aged ≥40 years who were diagnosed with multiple myeloma from 1998-2008 were identified through cancer registries (N=2532)...
April 20, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28425295/provider-and-patient-determinants-of-generic-levothyroxine-prescribing-an-electronic-health-records-based-study
#20
Robert J Romanelli, Vani Nimbal, Sarah K Dutcher, Xia Pu, Jodi B Segal
BACKGROUND: Despite the availability of generic levothyroxine products for more than a decade, uptake of these products is poor. OBJECTIVE: We sought to evaluate determinants of generic prescribing of levothyroxine. METHODS: In a cross-sectional analysis of electronic health records data between 2010 and 2013, we identified adult patients with a levothyroxine prescription from a primary-care physician (PCP) or endocrinologist. We used mixed-effect logistic regression models with random intercepts for prescribing provider to examine predictors of generic levothyroxine prescribing...
April 1, 2017: Annals of Pharmacotherapy
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