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epic guidelines

Wesley Winn, Irshad A Shakir, Heidi Israel, Lisa K Cannada
INTRODUCTION: The electronic medical record (EMR) is standard in institutions. While there is not concern for legibility of notes and access to charts, there is an ease of copy and paste for daily notes. This may not lead to accurate portrayal of patient's status. Our purpose was to evaluate the use of copy and paste functions in daily notes of patients with injuries at high risk for complications. METHODS: IRB approval was obtained for a retrospective review. Inclusion criteria included patients aged 18 and older treated at our Level 1 Trauma Center after implementation of Epic Systems Corporation, Verona, WI, USA...
January 2017: Journal of Clinical Orthopaedics and Trauma
Samip R Master, Glenn Morris Mills, Richard P Mansour
169 Background: In this era of electronic health records (EHR), quality monitoring can be a fast repetitive process. Having access to the relational database of the EHR permits rapid case identification and quality indicator determination. We hereby describe evaluation of hepatitis B testing prior to rituximab administration, a quality measure as per ASCO guidelines. METHODS: We connected SQL Query Manager with EPIC Clarity database. Using the object model for medication orders, location and department, we used SQL language to build a temporary dataset of all patients who have a completed order for a Rituximab infusion at a specific department location within the past 6 months...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
H T Jørstad, S M Boekholdt, N J Wareham, K T Khaw, R J G Peters
INTRODUCTION: Dutch cardiovascular disease (CVD) prevention guidelines recommend the use of modified SCORE risk charts to estimate 10-year risk of fatal and nonfatal CVD (myocardial infarction, cerebrovascular disease and congestive heart failure). This combined risk is derived from the SCORE mortality risk using multipliers. These multipliers have been shown to underestimate overall CVD risk. We aimed to compare the current Dutch risk charts with charts that estimate a broader range of clinically relevant CVD using updated multipliers...
March 2017: Netherlands Heart Journal
Soufiane Lilih, Marieke Pereboom, Ruud T M van der Hoeven, Aukje K Mantel-Teeuwisse, Matthijs L Becker
OBJECTIVE: Gastrointestinal bleedings are the most frequently occurring reason for medication-related hospital admissions, which are potentially preventable. We implemented a clinical decision support system that recommends to prescribe gastrointestinal prophylaxis in patients with an increased risk according to the Dutch guideline. Our primary objective was to determine whether the implementation resulted in improved compliance with this guideline for gastrointestinal prophylaxis. A secondary objective was to determine whether implementation resulted in a reduction of the number of drug safety alerts...
January 2017: International Journal of Medical Informatics
Joanne Wong, Adam Sutherland
AIM: Ketamine is used for post-operative analgesia. There has been recent disruption in it's supply. It is usually prescribed by patient's weight (3 mg/kg in 50 ml 0.9% saline) at a rate of 1-5 ml/hr (1-5 microgram/kg/minute). To conserve ketamine supplies our policy was changed to a concentrated "standardised" concentration of ketamine (250 mg in 50 ml 0.9% sodium chloride) that could be run for a maximum of 72 hrs. There is evidence demonstrating no relationship between duration of infusion and microbiological contamination for 72 hrs...
September 2016: Archives of Disease in Childhood
Heather A Ward, Teresa Norat, Kim Overvad, Christina C Dahm, H Bas Bueno-de-Mesquita, Mazda Jenab, Veronika Fedirko, Fränzel J B van Duijnhoven, Guri Skeie, Dora Romaguera-Bosch, Anne Tjønneland, Anja Olsen, Franck Carbonnel, Aurélie Affret, Marie-Christine Boutron-Ruault, Verena Katzke, Tilman Kühn, Krassimira Aleksandrova, Heiner Boeing, Antonia Trichopoulou, Pagona Lagiou, Christina Bamia, Domenico Palli, Sabina Sieri, Rosario Tumino, Alessio Naccarati, Amalia Mattiello, Petra H Peeters, Elisabete Weiderpass, Lene Angell Åsli, Paula Jakszyn, J Ramón Quirós, María-José Sánchez, Miren Dorronsoro, José-María Huerta, Aurelio Barricarte, Karin Jirström, Ulrika Ericson, Ingegerd Johansson, Björn Gylling, Kathryn E Bradbury, Kay-Tee Khaw, Nicholas J Wareham, Magdalena Stepien, Heinz Freisling, Neil Murphy, Amanda J Cross, Elio Riboli
Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors...
July 2016: British Journal of Nutrition
Lindsey A Knake, Monika Ahuja, Erin L McDonald, Kelli K Ryckman, Nancy Weathers, Todd Burstain, John M Dagle, Jeffrey C Murray, Prakash Nadkarni
BACKGROUND: The use of Electronic Health Records (EHR) has increased significantly in the past 15 years. This study compares electronic vs. manual data abstractions from an EHR for accuracy. While the dataset is limited to preterm birth data, our work is generally applicable. We enumerate challenges to reliable extraction, and state guidelines to maximize reliability. METHODS: An Epic™ EHR data extraction of structured data values from 1,772 neonatal records born between the years 2001-2011 was performed...
April 29, 2016: BMC Pediatrics
Sophie D Fosså, Anne Holck Storås, Eivind A Steinsvik, Tor Aa Myklebust, Lars M Eri, Jon H Loge, Alv A Dahl
OBJECTIVES: In patients with prostate cancer, evaluation of quality of care requires the inclusion of patient-reported outcomes measures assessed by validated and reliable instruments. Basic psychometric tests of the Norwegian version of the Expanded Prostate Cancer Index Composite with 26 items (EPIC-26) were performed in this study. MATERIAL AND METHODS: Translation of the original questionnaire (University of California, Los Angeles Prostate Cancer Index Composite), field testing and retranslation were done according to published guidelines...
August 2016: Scandinavian Journal of Urology
Esther Roura, Noémie Travier, Tim Waterboer, Silvia de Sanjosé, F Xavier Bosch, Michael Pawlita, Valeria Pala, Elisabete Weiderpass, Núria Margall, Joakim Dillner, Inger T Gram, Anne Tjønneland, Christian Munk, Domenico Palli, Kay-Tee Khaw, Kim Overvad, Françoise Clavel-Chapelon, Sylvie Mesrine, Agnès Fournier, Renée T Fortner, Jennifer Ose, Annika Steffen, Antonia Trichopoulou, Pagona Lagiou, Philippos Orfanos, Giovanna Masala, Rosario Tumino, Carlotta Sacerdote, Silvia Polidoro, Amalia Mattiello, Eiliv Lund, Petra H Peeters, H B as Bueno-de-Mesquita, J Ramón Quirós, María-José Sánchez, Carmen Navarro, Aurelio Barricarte, Nerea Larrañaga, Johanna Ekström, David Lindquist, Annika Idahl, Ruth C Travis, Melissa A Merritt, Marc J Gunter, Sabina Rinaldi, Massimo Tommasino, Silvia Franceschi, Elio Riboli, Xavier Castellsagué
BACKGROUND: In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC). METHODS AND FINDINGS: We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study...
2016: PloS One
Selina A Smith, Joyce Q Sheats, Mary S Whitehead, Ernestine Delmoor, Thomas Britt, Cassandra L Harris, Janette Robinson-Flint, L Monique Porche-Smith, Kayellen Edmonds Umeakunne, Steven S Coughlin
Supplementing nutrition education with skills-building activities may enhance community awareness of diet-related cancer prevention guidelines. To develop a cookbook with lifestyle tips, recipes were solicited from the National Black Leadership Initiative on Cancer (NBLIC) community coalitions and dietary intake advice from participants in the Educational Program to Increase Colorectal Cancer Screening (EPICS). With guidance from a chef and registered dietitian, recipes were tested, assessed, and transformed; lifestyle advice was obtained from focus groups...
2015: Jacobs Journal of Food and Nutrition
Khadija M'Rabet-Bensalah, Carole E Aubert, Michael Coslovsky, Tinh-Hai Collet, Christine Baumgartner, Wendy P J den Elzen, Robert Luben, Anne Angelillo-Scherrer, Drahomir Aujesky, Kay-Tee Khaw, Nicolas Rodondi
OBJECTIVE AND BACKGROUND: Anaemia and thyroid dysfunction are common and often co-occur. Current guidelines recommend the assessment of thyroid function in the work-up of anaemia, although evidence on this association is scarce. PATIENTS AND METHODS: In the 'European Prospective Investigation of Cancer' (EPIC)-Norfolk population-based cohort, we aimed to examine the prevalence and type of anaemia (defined as haemoglobin <13 g/dl for men and <12 g/dl for women) according to different thyroid function groups...
April 2016: Clinical Endocrinology
Keisuke Kanda, Teruki Kotegawa, Satoshi Kawatsu, Goro Takahashi, Ichiro Yoshioka, Hidenori Fujiwara, Osamu Adachi, Masatoshi Akiyama, Kiichiro Kumagai, Shunsuke Kawamoto, Yoshikatsu Saiki
BACKGROUND: In Guideline for Surgical and Interventional Treatment of Valvular Heart Disease, revised by Japanese Circulation Society in 2012, mitral valve replacement (MVR) with bioprosthesis is class II b recommendation for patients aged 70 years or older who have no risk factors for thromboembolism. The aim of this study was to evaluate the early postoperative surgical outcomes and the hemodynamic performance with the Epic mitral bioprosthesis. METHODS: Twenty-six consecutive patients underwent MVR with Epic mitral bioprostesis at Tohoku University Hospital between April 2011 and July 2014...
November 2015: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Jessica Langsjoen, Cara Goodell, Eduardo Castro, Jen Thomas, Thomas J Kuehl, Hania Wehbe-Janek, Meghan Hinskey
Current cervical cancer screening guidelines for the care of healthy women include HPV cotesting with all Papanicolaou (Pap) smears after the age of 30. To improve compliance with current guidelines, we instituted two processes: first, simplifying the ordering process to a single order for Pap smear plus HPV cotesting using an electronic medical record system (EMR); and second, providing education for clinic staff. Baseline and postintervention data were collected by retrospective chart review. Patients were selected during three intervals: prior to the transition to Epic EMR, after the transition to Epic, and after an educational intervention...
October 2015: Proceedings of the Baylor University Medical Center
Marjo J Campmans-Kuijpers, Ivonne Sluijs, Ute Nöthlings, Heinz Freisling, Kim Overvad, Heiner Boeing, Giovanna Masala, Salvatore Panico, Rosario Tumino, Sabina Sieri, Ingegerd Johansson, Anna Winkvist, Verena A Katzke, Tilman Kuehn, Peter M Nilsson, Jytte Halkjær, Anne Tjønneland, Annemieke M Spijkerman, Larraitz Arriola, Carlotta Sacerdote, Aurelio Barricarte, Anne M May, Joline W Beulens
BACKGROUND: Substitution of carbohydrates with fat in a diet for type 2 diabetes patients is still debated. OBJECTIVE: This study aimed to investigate the association between dietary carbohydrate intake and isocaloric substitution with (i) total fat, (ii) saturated fatty acids (SFA), (iii) mono-unsaturated fatty acids (MUFA) and (iv) poly-unsaturated fatty acids (PUFA) with all-cause and cardiovascular (CVD) mortality risk and 5-year weight change in patients with type 2 diabetes...
October 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Bertrand Desprez, João Barroso, Claudius Griesinger, Helena Kandárová, Nathalie Alépée, Horst W Fuchs
Alternative test methods often use prediction models (PMs) for converting endpoint measurements into predictions. Two PMs are used for the skin corrosion tests (SCTs) of the OECD Test Guideline No. 431 (TG 431). One is specific to EpiSkin™ test method, whereas EpiDerm™, SkinEthic™ RHE and epiCS® share a common PM. These methods are based on reconstructed human epidermis models wherein cell viability values are measured. Their PMs allow translating those values into sub-categories of corrosive chemicals, Category 1A (Cat1A) and a combination of Categories 1B/1C (Cat1BC), and identifying non-corrosive (NC) chemicals...
December 2015: Toxicology in Vitro: An International Journal Published in Association with BIBRA
M Vitale, M Masulli, A A Rivellese, A C Babini, M Boemi, E Bonora, R Buzzetti, O Ciano, M Cignarelli, M Cigolini, G Clemente, G Citro, L Corsi, E Dall'Aglio, S Del Prato, G Di Cianni, M A Dolci, C Giordano, R Iannarelli, C Iovine, A Lapolla, D Lauro, S Leotta, C Mazzucchelli, V Montani, G Perriello, G Romano, F Romeo, L Santarelli, R Schiano di Cola, S Squatrito, L Tonutti, R Trevisan, A A Turco, C Zamboni, G Riccardi, O Vaccaro
PURPOSE: The optimal macronutrient composition of the diet for the management of type 2 diabetes is debated, particularly with regard to the ideal proportion of fat and carbohydrates. The aim of the study was to explore the association of different proportions of fat and carbohydrates of the diet-within the ranges recommended by different guidelines-with metabolic risk factors. METHODS: We studied 1785 people with type 2 diabetes, aged 50-75, enrolled in the TOSCA...
June 2016: European Journal of Nutrition
Dora Romaguera, Heather Ward, Petra A Wark, Anne-Claire Vergnaud, Petra H Peeters, Carla H van Gils, Pietro Ferrari, Veronika Fedirko, Mazda Jenab, Marie-Christine Boutron-Ruault, Laure Dossus, Laureen Dartois, Camilla Plambeck Hansen, Christina Catherine Dahm, Genevieve Buckland, María José Sánchez, Miren Dorronsoro, Carmen Navarro, Aurelio Barricarte, Timothy J Key, Antonia Trichopoulou, Christos Tsironis, Pagona Lagiou, Giovanna Masala, Valeria Pala, Rosario Tumino, Paolo Vineis, Salvatore Panico, H Bas Bueno-de-Mesquita, Peter D Siersema, Bodil Ohlsson, Karin Jirström, Maria Wennberg, Lena M Nilsson, Elisabete Weiderpass, Tilman Kühn, Verena Katzke, Kay-Tee Khaw, Nick J Wareham, Anne Tjønneland, Heiner Boeing, José R Quirós, Marc J Gunter, Elio Riboli, Teresa Norat
BACKGROUND: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients...
May 7, 2015: BMC Medicine
Janice Gabriel
No abstract text is available yet for this article.
April 23, 2015: British Journal of Nursing: BJN
Alejandro Berlin, Elizabeth Cho, Vickie Kong, Krisha J Howell, Bernadeth Lao, Tim Craig, Andrew Bayley, Peter Chung, Mary Gospodarowicz, Padraig Warde, Charles Catton, Robert G Bristow, Cynthia Ménard
PURPOSE: The purpose of this study was to characterize treatment-related toxicities, health-related quality of life (HRQOL), and biochemical outcomes in patients treated with postoperative image guided intensity modulated radiation therapy (IMRT) for prostate cancer using a consensus guideline for defining the clinical target volume. METHODS AND MATERIALS: Between August 2007 and October 2008, patients considered for radiation therapy (RT) after prostatectomy were enrolled...
September 2015: Practical Radiation Oncology
Lydia Pleotis Howell, Scott MacDonald, Jacqueline Jones, Daniel J Tancredi, Joy Melnikow
BACKGROUND: The electronic health record (EHR) provides opportunity to improve health and enhance appropriate test utilization through decision support. Electronic alerts in the order entry system can guide test use. Few published reports have assessed the impact of automated alerts on compliance of Pap ordering with published screening guidelines. METHODS: Programming rules for Pap test ordering were developed within the EHR (Epic, Madison, WI) of the University of California, Davis Health System using American College of Obstetrics and Gynecology's 2009 guidelines and implemented in primary care clinics in 2010...
2014: Journal of Pathology Informatics
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