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https://www.readbyqxmd.com/read/29744666/development-of-an-alert-framework-based-on-the-practices-in-the-medical-front
#1
Takuya Sakata, Kenji Araki, Tomoyoshi Yamazaki, Koichi Kawano, Minoru Maeda, Muneo Kushima, Sanae Araki
At the University of Miyazaki Hospital (UMH), we have accumulated and semantically structured a vast amount of medical information since the activation of the electronic health record system approximately 10 years ago. With this medical information, we have decided to develop an alert system for aiding in medical treatment. The purpose of this investigation is to not only to integrate an alert framework into the electronic heath record system, but also to formulate a modeling method of this knowledge. A trial alert framework was developed for the staff in various occupational categories at the UMH...
May 9, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/29677965/medical-records-online-for-patients-and-effects-on-the-work-environment-of-nurses
#2
Åsa Cajander, Jonas Moll, Sara Englund, Anastasia Hansman
In 2012 Patients Accessible Electronic Health Records (PAEHR) was introduced in Region Uppsala, Sweden. When PAEHR was introduced heath care professionals were very concerned especially in relation to potential negative effects on their work environment. However, few studies exist that investigate in what way work environments have been affected, and no studies have focused on the nurses' working in primary care. Hence, the purpose of this study was to fill this gap through seven interviews with primary care nurses that were transcribed and thematically analysed...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29627106/clinical-features-associated-with-nascent-left-ventricular-diastolic-dysfunction-in-a-population-aged-40-to-55-years
#3
Jonathan D Mosley, Rebecca T Levinson, Evan L Brittain, Deepak K Gupta, Eric Farber-Eger, Christian M Shaffer, Josh C Denny, Dan M Roden, Quinn S Wells
Diastolic dysfunction (DD), an abnormality in cardiac left ventricular (LV) chamber compliance, is associated with increased morbidity and mortality. Although DD has been extensively studied in older populations, co-morbidity patterns are less well characterized in middle-aged subjects. We screened 156,434 subjects with transthoracic echocardiogram reports available through Vanderbilt's electronic heath record and identified 6,612 subjects 40 to 55 years old with an LV ejection fraction ≥50% and diastolic function staging...
March 13, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29423624/treatment-initiation-for-new-episodes-of-depression-in-primary-care-settings
#4
Beth Waitzfelder, Christine Stewart, Karen J Coleman, Rebecca Rossom, Brian K Ahmedani, Arne Beck, John E Zeber, Yihe G Daida, Connie Trinacty, Samuel Hubley, Gregory E Simon
BACKGROUND: Depression is prevalent and costly, but despite effective treatments, is often untreated. Recent efforts to improve depression care have focused on primary care settings. Disparities in treatment initiation for depression have been reported, with fewer minority and older individuals starting treatment. OBJECTIVE: To describe patient characteristics associated with depression treatment initiation and treatment choice (antidepressant medications or psychotherapy) among patients newly diagnosed with depression in primary care settings...
February 8, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29396593/impact-of-opioid-use-on-health-care-utilization-and-survival-in-patients-with-newly-diagnosed-stage-iv-malignancies
#5
Dylan Zylla, Grant Steele, Alice Shapiro, Sara Richter, Pankaj Gupta
PURPOSE: Patients with advanced cancers frequently experience pain. Opioids are commonly prescribed to treat cancer-related pain, but their use might be associated with undesirable consequences including adverse effects and tumor progression, resulting in increased heath care utilization and shorter survival. We examined these possibilities in a large cohort of patients diagnosed with ten common advanced malignancies. METHODS: We identified 1386 newly diagnosed patients with stage IV non-hematologic malignancies from 2005 to 2013 and ascertained opioid utilization within 90 days of starting anti-cancer treatment using electronic medical record and tumor registry data...
February 2, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29389426/registry-assessment-of-peripheral-interventional-devices-rapid-registry-assessment-of-peripheral-interventional-devices-core-data-elements
#6
W Schuyler Jones, Mitchell W Krucoff, Pablo Morales, Rebecca W Wilgus, Anne H Heath, Mary F Williams, James E Tcheng, J Danica Marinac-Dabic, Misti L Malone, Terrie L Reed, Rie Fukaya, Robert A Lookstein, Nobuhiro Handa, Herbert D Aronow, Daniel J Bertges, Michael R Jaff, Thomas T Tsai, Joshua A Smale, Margo J Zaugg, Robert J Thatcher, Jack L Cronenwett
OBJECTIVE: The current state of evaluating patients with peripheral artery disease and more specifically of evaluating medical devices used for peripheral vascular intervention (PVI) remains challenging because of the heterogeneity of the disease process, the multiple physician specialties that perform PVI, the multitude of devices available to treat peripheral artery disease, and the lack of consensus about the best treatment approaches. Because PVI core data elements are not standardized across clinical care, clinical trials, and registries, aggregation of data across different data sources and physician specialties is currently not feasible...
February 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29367497/registry-assessment-of-peripheral-interventional-devices-rapid-%C3%A3-registry-assessment-of-peripheral-interventional-devices-core-data-elements
#7
W Schuyler Jones, Mitchell W Krucoff, Pablo Morales, Rebecca W Wilgus, Anne H Heath, Mary F Williams, James E Tcheng, J Danica Marinac-Dabic, Misti L Malone, Terrie L Reed, Rie Fukaya, Robert Lookstein, Nobuhiro Handa, Herbert D Aronow, Daniel J Bertges, Michael R Jaff, Thomas T Tsai, Joshua A Smale, Margo J Zaugg, Robert J Thatcher, Jack L Cronenwett, Durham Nc, Silver Spring Md, Tokyo Japan, New York Ny, Providence Ri, Burlington Vt, Newton Mass, Denver Colo, Tempe Ariz, Santa Clara Calif, Minneapolis Minn, Lebanon Nh
BACKGROUND: The current state of evaluating patients with peripheral artery disease and more specifically of evaluating medical devices used for peripheral vascular intervention (PVI) remains challenging because of the heterogeneity of the disease process, the multiple physician specialties that perform PVI, the multitude of devices available to treat peripheral artery disease, and the lack of consensus about the best treatment approaches. Because PVI core data elements are not standardized across clinical care, clinical trials, and registries, aggregation of data across different data sources and physician specialties is currently not feasible...
January 25, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29201868/the-scope-of-big-data-in-one-medicine-unprecedented-opportunities-and-challenges
#8
REVIEW
Molly E McCue, Annette M McCoy
Advances in high-throughput molecular biology and electronic health records (EHR), coupled with increasing computer capabilities have resulted in an increased interest in the use of big data in health care. Big data require collection and analysis of data at an unprecedented scale and represents a paradigm shift in health care, offering (1) the capacity to generate new knowledge more quickly than traditional scientific approaches; (2) unbiased collection and analysis of data; and (3) a holistic understanding of biology and pathophysiology...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28743191/successful-utilization-of-an-electronic-pain-diary-in-a-multinational-phase-3-interventional-study-of-pediatric-sickle-cell-anemia
#9
Lori E Heath, Matthew M Heeney, Carolyn C Hoppe, Samuel Adjei, Tsiri Agbenyega, Mohamed Badr, Nicoletta Masera, Chunmei Zhou, Patricia B Brown, Joseph A Jakubowski, Carlton Dampier
BACKGROUND/AIMS: Patients with sickle cell anemia can experience recurrent pain episodes, which affect quality of life. The reported prevalence of pain is higher in studies using patient diaries than in healthcare facility utilization data. Determining Effects of Platelet Inhibition on Vaso-Occlusive Events was a multinational study that assessed the efficacy and safety of prasugrel in reducing the rate of vaso-occlusive events in children with sickle cell anemia (NCT01794000) and included an electronic patient-reported outcome diary to record pain occurrence...
December 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28720625/developing-electronic-health-record-ehr-strategies-related-to-health-center-patients-social-determinants-of-health
#10
Rachel Gold, Erika Cottrell, Arwen Bunce, Mary Middendorf, Celine Hollombe, Stuart Cowburn, Peter Mahr, Gerardo Melgar
BACKGROUND: "Social determinants of heath" (SDHs) are nonclinical factors that profoundly affect health. Helping community health centers (CHCs) document patients' SDH data in electronic health records (EHRs) could yield substantial health benefits, but little has been reported about CHCs' development of EHR-based tools for SDH data collection and presentation. METHODS: We worked with 27 diverse CHC stakeholders to develop strategies for optimizing SDH data collection and presentation in their EHR, and approaches for integrating SDH data collection and the use of those data (eg, through referrals to community resources) into CHC workflows...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28607680/increasing-the-uptake-of-electronic-prescribing-in-primary-care
#11
Nazia Imambaccus, Samuel Glace, Rory Heath
Electronic prescribing is a form of paperless prescribing that is reported to reduce prescription mistakes and increases the cost effectiveness of the process. In England, around 1.5 million prescriptions are generated in general practice daily. Thus by reducing costs and increasing efficiency of this system through electronic prescribing, costs can be driven down. In this Quality Improvement project, a GP practice in London with approximately 3000 patients on record was assessed for its electronic prescribing rates throughout 3 intervention cycles over a period of 2 months...
2017: BMJ Quality Improvement Reports
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
#12
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/28174820/effect-of-a-novel-clinical-decision-support-tool-on-the-efficiency-and-accuracy-of-treatment-recommendations-for-cholesterol-management
#13
Marianne R Scheitel, Maya E Kessler, Jane L Shellum, Steve G Peters, Dawn S Milliner, Hongfang Liu, Ravikumar Komandur Elayavilli, Karl A Poterack, Timothy A Miksch, Jennifer Boysen, Ron A Hankey, Rajeev Chaudhry
BACKGROUND: The 2013 American College of Cardiology / American Heart Association Guidelines for the Treatment of Blood Cholesterol emphasize treatment based on cardiovascular risk. But finding time in a primary care visit to manually calculate cardiovascular risk and prescribe treatment based on risk is challenging. We developed an informatics-based clinical decision support tool, MayoExpertAdvisor, to deliver automated cardiovascular risk scores and guideline-based treatment recommendations based on patient-specific data in the electronic heath record...
February 8, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28135880/electronic-heath-record-prompts-may-increase-screening-for-secondhand-smoke-exposure
#14
RANDOMIZED CONTROLLED TRIAL
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 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/28024199/physical-and-mental-health-comorbidities-of-epilepsy-population-based-cross-sectional-analysis-of-1-5-million-people-in-scotland
#15
Christopher J Weatherburn, Craig A Heath, Stewart W Mercer, Bruce Guthrie
PURPOSE: To measure the prevalence of physical and mental health comorbidities in people with epilepsy in a large population cohort, and to examine the prevalence of depression accounting for other physical comorbidity. METHODS: Population-based, cross-sectional descriptive epidemiology analysis of primary care electronic records for 1,510,742 people aged 14+ years, examining the prevalence of 39 comorbidities. RESULTS: 12,720 people with epilepsy were identified (prevalence 8...
February 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27919397/a-national-standards-based-assessment-on-functionality-of-electronic-medical-records-systems-used-in-kenyan-public-sector-health-facilities
#16
REVIEW
Samuel Kang'a, Nancy Puttkammer, Steven Wanyee, Davies Kimanga, Jason Madrano, Veronica Muthee, Patrick Odawo, Anjali Sharma, Tom Oluoch, Katherine Robinson, James Kwach, William B Lober
BACKGROUND: Variations in the functionality, content and form of electronic medical record systems (EMRs) challenge national roll-out of these systems as part of a national strategy to monitor HIV response. To enforce the EMRs minimum requirements for delivery of quality HIV services, the Kenya Ministry of Health (MoH) developed EMRs standards and guidelines. The standards guided the recommendation of EMRs that met a preset threshold for national roll-out. METHODS: Using a standards-based checklist, six review teams formed by the MoH EMRs Technical Working Group rated a total of 17 unique EMRs in 28 heath facilities selected by individual owners for their optimal EMR implementation...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27872507/calculated-chemistry-parameters-do-they-need-to-be-harmonised
#17
REVIEW
David Hughes, James Cg Doery, Kay Weng Choy, Robert Flatman
In clinical chemistry, harmonisation of the testing process is a global initiative with the purpose of improving patient safety, allowing better integration of research data and enabling the use of national electronic heath records. In Australia, as in other countries, the initial focus has been on the harmonisation of the more commonly measured analytes. There are also a number of calculated parameters, derived from these measured analytes, which could also be considered for harmonisation. Calculated parameters that are reported by laboratories and used for clinical decision-making should undergo the same robust process of harmonisation as is the case for the measured analytes...
August 2016: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/27512876/a-new-automatic-blood-pressure-kit-auscultates-for-accurate-reading-with-a-smartphone-a-diagnostic-accuracy-study
#18
Hongjun Wu, Bingjian Wang, Xinpu Zhu, Guang Chu, Zhi Zhang
The widely used oscillometric automated blood pressure (BP) monitor was continuously questioned on its accuracy. A novel BP kit named Accutension which adopted Korotkoff auscultation method was then devised. Accutension worked with a miniature microphone, a pressure sensor, and a smartphone. The BP values were automatically displayed on the smartphone screen through the installed App. Data recorded in the phone could be played back and reconfirmed after measurement. They could also be uploaded and saved to the iCloud...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27244791/variations-in-mental-health-diagnosis-and-prescribing-across-pediatric-primary-care-practices
#19
Stephanie L Mayne, Michelle E Ross, Lihai Song, Banita McCarn, Jennifer Steffes, Weiwei Liu, Benyamin Margolis, Romuladus Azuine, Edward Gotlieb, Robert W Grundmeier, Laurel K Leslie, Russell Localio, Richard Wasserman, Alexander G Fiks
BACKGROUND: Primary care pediatricians increasingly care for children's mental health problems, but little is known about practice-level variation in diagnosis and psychotropic medication prescribing practices. METHODS: This retrospective review of electronic heath records from 43 US primary care practices included children aged 4 to 18 years with ≥1 office visit from January 1, 2009, to June 30, 2014. We examined variability in diagnosis and psychotropic prescribing across practices using logistic regression with practice fixed effects and evaluated associations of the availability of colocated or community-based mental health providers or the proportion of children in foster care with diagnosis and prescribing using generalized linear mixed models...
May 2016: Pediatrics
https://www.readbyqxmd.com/read/27242127/overweight-adolescents-with-type-2-diabetes-have-significantly-higher-lipoprotein-abnormalities-than-those-with-type-1-diabetes
#20
Lynae J Hanks, James Heath Pelham, Shalini Vaid, Krista Casazza, Ambika P Ashraf
AIM: Diabetes-associated glucoregulatory derangements may precipitate atherogenesis in childhood and CVD risk, particularly with obesity. We aimed to delineate lipoprotein profile differences between children with type 1 and 2 diabetes who are overweight/obese. METHODS: Data were obtained from electronic medical records of patients ≥85th BMI percentile with type 1 (n=159) and type 2 (n=77) diabetes, ages 12-19y. Group differences were evaluated by correlations and general linear modeling analysis, adjusting for BMI, HbA1c, and diabetes duration...
May 2016: Diabetes Research and Clinical Practice
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