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https://www.readbyqxmd.com/read/28636072/using-chief-complaint-in-addition-to-diagnosis-codes-to-identify-falls-in-the-emergency-department
#1
Brian W Patterson, Maureen A Smith, Michael D Repplinger, Michael S Pulia, James E Svenson, Michael K Kim, Manish N Shah
OBJECTIVES: To compare incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information and to examine the clinical characteristics of visits "missed" in the ICD-9-based scheme. DESIGN: Retrospective electronic record review. SETTING: Academic medical center ED. PARTICIPANTS: Individuals aged 65 and older seen in the ED between January 1, 2013, and September 30, 2015...
June 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28634539/using-mhealth-technologies-to-improve-the-identification-of-behavioral-health-problems-in-urban-primary-care-settings
#2
Martha Staeheli, Robert H Aseltine, Elizabeth Schilling, Daren Anderson, Bruce Gould
INTRODUCTION: Behavioral health disorders remain under recognized and under diagnosed among urban primary care patients. Screening patients for such problems is widely recommended, yet is challenging to do in a brief primary care encounter, particularly for this socially and medically complex patient population. METHODS: In 2013, intervention patients at an urban Connecticut primary clinic were screened for post-traumatic stress disorder, depression, and risky drinking (n = 146) using an electronic tablet-based screening tool...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28634427/leveraging-food-and-drug-administration-adverse-event-reports-for-the-automated-monitoring-of-electronic-health-records-in-a-pediatric-hospital
#3
Huaxiu Tang, Imre Solti, Eric Kirkendall, Haijun Zhai, Todd Lingren, Jaroslaw Meller, Yizhao Ni
The objective of this study was to determine whether the Food and Drug Administration's Adverse Event Reporting System (FAERS) data set could serve as the basis of automated electronic health record (EHR) monitoring for the adverse drug reaction (ADR) subset of adverse drug events. We retrospectively collected EHR entries for 71 909 pediatric inpatient visits at Cincinnati Children's Hospital Medical Center. Natural language processing (NLP) techniques were used to identify positive diseases/disorders and signs/symptoms (DDSSs) from the patients' clinical narratives...
2017: Biomedical Informatics Insights
https://www.readbyqxmd.com/read/28634172/identifying-an-oxygenation-index-threshold-for-increased-mortality-in-acute-respiratory-failure
#4
Brandon G Hammond, Pamela Garcia-Filion, Paul Kang, Mounica Y Rao, Brigham C Willis, Heidi J Dalton
BACKGROUND: The objective of this work was to examine current oxygenation index (OI) data and outcomes using electronic medical record data to identify a specific OI value associated with mortality. METHODS: This study was a retrospective electronic medical record data review from the pediatric ICU of Phoenix Children's Hospital, with data mining for variables to calculate OIs on subjects age 1 month to 20 y mechanically ventilated >24 h, excluding those with known intracardiac shunts or cyanotic heart disease...
June 20, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28632576/understanding-the-constipation-conundrum-predictors-of-obtaining-an-abdominal-radiograph-during-the-emergency-department-evaluation-of-pediatric-constipation
#5
Claire A MacGeorge, Daniel C Williams, Natalie Vajta, Kristen Morella, Paul G Thacker, Scott Russell, William T Basco, David G Bundy
OBJECTIVES: Many children with constipation who are evaluated in emergency departments (EDs) receive an abdominal radiograph (AR) despite evidence-based guidelines discouraging imaging. The objectives of this study were to identify predictors associated with obtaining an AR and to determine if ARs were associated with a longer length of stay (LOS) among children with constipation evaluated in the ED. METHODS: A review of billing and electronic health records was conducted in an academic pediatric ED for children ages 0 to 17 years who had a primary discharge diagnosis of constipation from July 2013 to June 2014...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28632540/a-shared-opportunity-for-improving-electronic-medical-record-data
#6
Amanda W Baier, Daniel J Snyder, Izabela C Leahy, Lance S Patak, Robert M Brustowicz
With the recent rapid adoption of electronic medical records (EMRs), studies reporting results based on EMR data have become increasingly common. While analyzing data extracted from our EMR for a retrospective study, we identified various types of erroneous data entries. This report investigates the root causes of the incompleteness, inconsistency, and inaccuracy of the medical records analyzed in our study. While experienced health information management professionals are well aware of the many shortcomings with EMR data, the aims of this case study are to highlight the significance of the negative impact of erroneous EMR data, to provide fundamental principles for managing EMRs, and to provide recommendations to help facilitate the successful use of electronic health data, whether to inform clinical decisions or for clinical research...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28632474/evaluation-of-the-concurrent-use-of-dolutegravir-and-metformin-in-human-immunodeficiency-virus-infected-patients
#7
Anne Masich, Melissa E Badowski, Michelle D Liedtke, Patricia P Fulco
An analysis of the interaction between dolutegravir and metformin was conducted in the HIV ambulatory clinic setting. This was a multicenter, retrospective case series evaluating adult, HIV-infected patients concurrently prescribed dolutegravir and metformin. Historical electronic medical records were utilized to collect case-specific data. Laboratory parameters including serum creatinine (SCr), hemoglobin A1c (HgbA1c), plasma HIV RNA, CD4 cell count, and lactate were reviewed. Adverse drug reactions were assessed using patient-reported gastrointestinal intolerance and hypoglycemic symptoms...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28631523/the-association-among-prematurity-cochlear-hyperintensity-and-hearing-loss
#8
Michael A Wien, Matthew T Whitehead
Background Prematurity is a major risk factor for neonatal hearing loss. Recent advancements in magnetic resonance imaging (MRI) have made it possible to evaluate structural details of the membranous labyrinths in premature infants that have heretofore been inaccessible. Objective We compared the prevalence of abnormal cochlear signal intensity in premature and term neonates and evaluated for a potential link with hearing loss. Materials and methods We retrospectively reviewed 148 consecutive MR exams performed in premature (< 37 weeks' gestation) and term neonates performed over a 30-month period...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28630059/the-role-of-contraindications-in-prescribing-anticoagulants-to-patients-with-atrial-fibrillation-a-cross-sectional-analysis-of-primary-care-data-in-the-uk
#9
Nicola Adderley, Ronan Ryan, Tom Marshall
BACKGROUND: Underuse of anticoagulants in atrial fibrillation (AF) is an international problem, which has often been attributed to the presence of contraindications to treatment. No studies have assessed the influence of contraindications on anticoagulant prescribing in the UK. AIM: To determine the influence of contraindications on anticoagulant prescribing in patients with AF in the UK. DESIGN AND SETTING: Cross-sectional analysis of primary care data from 645 general practices contributing to The Health Improvement Network, a large UK database of electronic primary care records...
June 19, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28629348/applying-the-plan-do-study-act-pdsa-approach-to-a-large-pragmatic-study-involving-safety-net-clinics
#10
Jennifer Coury, Jennifer L Schneider, Jennifer S Rivelli, Amanda F Petrik, Evelyn Seibel, Brieshon D'Agostini, Stephen H Taplin, Beverly B Green, Gloria D Coronado
BACKGROUND: The Plan-Do-Study-Act (PDSA) cycle is a commonly used improvement process in health care settings, although its documented use in pragmatic clinical research is rare. A recent pragmatic clinical research study, called the Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), used this process to optimize the research implementation of an automated colon cancer screening outreach program in intervention clinics. We describe the process of using this PDSA approach, the selection of PDSA topics by clinic leaders, and project leaders' reactions to using PDSA in pragmatic research...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28628351/sleep-in-adolescents-and-young-adults-in-the-year-after-cancer-treatment
#11
Lauren C Daniel, Richa Aggarwal, Lisa A Schwartz
PURPOSE: Adolescents and young adults (AYA) with cancer are a vulnerable group facing more intense treatments, higher symptom burden, and poorer treatment outcomes relative to younger children. Sleep disruption is common during cancer treatment and sleep problems persist into adulthood for some survivors of AYA cancer. The developmental period of adolescence/emerging adulthood confers greater biological and behavioral risk for insufficient sleep relative to older or younger ages. Thus, understanding AYA sleep disturbances shortly after completing treatment can inform interventions to manage cancer-related symptoms and improve quality of life...
June 19, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28627844/patient-care-in-family-medicine-what-s-new-in-the-2016-literature-findings
#12
Christine Cohidon, Nicolas Senn
During the last two decades in Europe, the scope of activities regarding chronic diseases management in family medicine has increased while technical activities and preventative care have decreased. A new literature review and meta-analysis confirms that the use of electronic health records improves the quality of care. In the field of interprofessionnality, the task delegation in chronic care management to nurses or medical assistants is a source of satisfaction for these professionals. At the same time, this could improve patients' quality of life...
May 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28627415/examination-to-assess-the-clinical-exam-and-documentation-of-spine-pathology-among-orthopaedic-residents
#13
Jack M Haglin, John L Zeller, Kenneth A Egol, Donna P Phillips
BACKGROUND: The Accreditation Council of Graduate Medical Education (ACGME) guidelines require residency programs to teach and evaluate residents in six overarching "core competencies" and document progress through educational milestones. In order to assess the progress of orthopaedic interns' skills in performing a history, physical exam, and documentation of the encounter for a standardized patient with spinal stenosis, a Structured Objective Clinical Examination (OSCE) was conducted for 13 orthopaedic intern residents, following a one month boot camp that included communications skills and curriculum in history and physical examination...
June 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28626830/overweight-obesity-and-risk-of-cardiometabolic-multimorbidity-pooled-analysis-of-individual-level-data-for-120%C3%A2-813-adults-from-16-cohort-studies-from-the-usa-and-europe
#14
Mika Kivimäki, Eeva Kuosma, Jane E Ferrie, Ritva Luukkonen, Solja T Nyberg, Lars Alfredsson, G David Batty, Eric J Brunner, Eleonor Fransson, Marcel Goldberg, Anders Knutsson, Markku Koskenvuo, Maria Nordin, Tuula Oksanen, Jaana Pentti, Reiner Rugulies, Martin J Shipley, Archana Singh-Manoux, Andrew Steptoe, Sakari B Suominen, Töres Theorell, Jussi Vahtera, Marianna Virtanen, Peter Westerholm, Hugo Westerlund, Marie Zins, Mark Hamer, Joshua A Bell, Adam G Tabak, Markus Jokela
BACKGROUND: Although overweight and obesity have been studied in relation to individual cardiometabolic diseases, their association with risk of cardiometabolic multimorbidity is poorly understood. Here we aimed to establish the risk of incident cardiometabolic multimorbidity (ie, at least two from: type 2 diabetes, coronary heart disease, and stroke) in adults who are overweight and obese compared with those who are a healthy weight. METHODS: We pooled individual-participant data for BMI and incident cardiometabolic multimorbidity from 16 prospective cohort studies from the USA and Europe...
June 2017: Lancet. Public Health
https://www.readbyqxmd.com/read/28626270/impact-of-a-student-pharmacist-driven-medication-reconciliation-and-antidepressant-treatment-history-project-at-a-depression-clinic-a-pilot-study
#15
Stella S Tang, Leanna Jaward, Kristen Ward, Sagar V Parikh, Jolene R Bostwick
OBJECTIVES: To improve treatment of patients with depression, a new pilot service project involving student pharmacists who would conduct medication reconciliation and review of antidepressant treatment history was created and evaluated. EXPERIMENTAL DESIGN: A prospective study conducted at the University of Michigan Depression Center. PRINCIPAL OBSERVATIONS: From an initial sample of 78 referrals, 41 subjects were reached by phone, with 34 completing medication reconciliation and antidepressant treatment history...
May 15, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28625261/-formulation-of-combined-predictive-indicators-using-logistic-regression-model-in-predicting-sepsis-and-prognosis
#16
Liwei Duan, Sheng Zhang, Zhaofen Lin
OBJECTIVE: To explore the method and performance of using multiple indices to diagnose sepsis and to predict the prognosis of severe ill patients. METHODS: Critically ill patients at first admission to intensive care unit (ICU) of Changzheng Hospital, Second Military Medical University, from January 2014 to September 2015 were enrolled if the following conditions were satisfied: (1) patients were 18-75 years old; (2) the length of ICU stay was more than 24 hours; (3) All records of the patients were available...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28623911/moderate-mental-illness-as-a-predictor-of-chronic-disease-prevention-and-screening
#17
Ginetta Salvalaggio, Christopher Meaney, Rahim Moineddin, Eva Grunfeld, Donna Manca
BACKGROUND: Primary care plays a pivotal role in the provision of both mental health care and chronic disease prevention and screening (CDPS). Unfortunately, moderate mental illness (MMI) is associated with poorer general health outcomes. Part of this burden of illness may be due to reduced CDPS uptake. The Building on the Existing Tools to Improve Chronic Disease Prevention in Primary Care (BETTER) trial recruited 777 participants ages 40-65 from 32 family practice panels, of whom 135 (18...
June 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28623857/vincristine-induced-neuropathy-in-pediatric-patients-with-acute-lymphoblastic-leukemia-in-oman-frequent-autonomic-and-more-severe-cranial-nerve-involvement
#18
Hanan F Nazir, Amna AlFutaisi, Mathew Zacharia, Mohamed Elshinawy, Surekha T Mevada, Abdulhakim Alrawas, Doaa Khater, Deepali Jaju, Yasser Wali
BACKGROUND: Vincristine (VCR) induced peripheral neuropathy is a common complication in children with acute lymphoblastic leukemia (ALL). PROCEDURES: A retrospective data analysis over an interval of 10 years (2006-2016) of all children with ALL seen at Sultan Qaboos University Hospital was carried out. Electronic medical records of eligible patients were reviewed. Patients with clinical evidence of neuropathy and abnormal nerve conduction studies (NCSs) were included in the study...
June 17, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28623116/comparison-of-the-prevalence-of-ruptured-and-unruptured-cerebral-aneurysms-in-a-poor-urban-minority-population
#19
Todd S Miller, David Altschul, Nrupen Baxi, Joaquim Farinhas, David Pasquale, Judah Burns, David Gordon, Jacqueline Bello, Allan Brook, Eugene Flamm
BACKGROUND: Most ruptured cerebral aneurysms are small (<7 mm). Evidence suggests low rupture rates for such lesions (<1% per year). Population studies demonstrate a prevalence rate of 3.2%. This study simultaneously estimates the prevalence of aneurysms in a single geographic population while reporting the observed rate of aneurysmal subarachnoid hemorrhage (aSAH) in the same geographic region composed of a poor urban minority demographic. METHODS: This is an institutional review board-approved, Health Insurance Portability and Accountability Act of 1996-compliant retrospective study performed between 2005 and 2011 at a single center...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28622808/characterizing-and-predicting-rates-of-delirium-across-general-hospital-settings
#20
Thomas H McCoy, Kamber L Hart, Roy H Perlis
OBJECTIVE: To better understand variation in reported rates of delirium, this study characterized delirium occurrence rate by department of service and primary admitting diagnosis. METHOD: Nine consecutive years (2005-2013) of general hospital admissions (N=831,348) were identified across two academic medical centers using electronic health records. The primary admitting diagnosis and the treating clinical department were used to calculate occurrence rates of a previously published delirium definition composed of billing codes and natural language processing of discharge summaries...
May 2017: General Hospital Psychiatry
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