AMIA Annu Symp Proc - Making audit actionable: an example algorithm for blood pressure management in chronic kidney disease.

Tópicos

{ clinic(1479) use(1117) guidelin(835) }
{ decis(3086) make(1611) patient(1517) }
{ ehr(2073) health(1662) electron(1139) }
{ patient(2315) diseas(1263) diabet(1191) }
{ perform(1367) use(1326) method(1137) }
{ record(1888) medic(1808) patient(1693) }
{ patient(1821) servic(1111) care(1106) }
{ algorithm(1844) comput(1787) effici(935) }
{ model(2341) predict(2261) use(1141) }
{ blood(1257) pressur(1144) flow(957) }
{ activ(1138) subject(705) human(624) }
{ treatment(1704) effect(941) patient(846) }
{ data(3008) multipl(1320) sourc(1022) }
{ can(774) often(719) complex(702) }
{ inform(2794) health(2639) internet(1427) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ assess(1506) score(1403) qualiti(1306) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ extract(1171) text(1153) clinic(932) }
{ design(1359) user(1324) use(1319) }
{ general(901) number(790) one(736) }
{ howev(809) still(633) remain(590) }
{ visual(1396) interact(850) tool(830) }
{ health(3367) inform(1360) care(1135) }
{ monitor(1329) mobil(1314) devic(1160) }
{ model(2656) set(1616) predict(1553) }
{ cost(1906) reduc(1198) effect(832) }
{ sampl(1606) size(1419) use(1276) }
{ can(981) present(881) function(850) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ detect(2391) sensit(1101) algorithm(908) }
{ model(3404) distribut(989) bayesian(671) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ system(1976) rule(880) can(841) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ concept(1167) ontolog(924) domain(897) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ care(1570) inform(1187) nurs(1089) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ compound(1573) activ(1297) structur(1058) }
{ studi(1119) effect(1106) posit(819) }
{ spatial(1525) area(1432) region(1030) }
{ model(3480) simul(1196) paramet(876) }
{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ gene(2352) biolog(1181) express(1162) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ time(1939) patient(1703) rate(768) }
{ use(2086) technolog(871) perceiv(783) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }

Resumo

Despite widespread use of clinical guidelines, actual care often falls short of ideal standards. Electronic health records (EHR) can be analyzed to provide information on how to improve care, but this is seldom done in sufficient detail to guide specific action. We developed an algorithm to provide practical, actionable information for care quality improvement using blood pressure (BP) management in chronic kidney disease (CKD) as an exemplar. We used UK clinical guidelines and EHR data from 440 patients in Salford (UK) to develop the algorithm. We then applied it to 532,409 individual patient records, identifying 11,097 CKD patients, 3,766 (34%) of which showed room for improvement in their care: either through medication optimization or better BP monitoring. Manual record reviews to evaluate accuracy indicated a positive-predictive value of 90%. Such algorithms could help improve the management of chronic conditions by providing the missing link between clinical audit and decision support.

Resumo Limpo

despit widespread use clinic guidelin actual care often fall short ideal standard electron health record ehr can analyz provid inform improv care seldom done suffici detail guid specif action develop algorithm provid practic action inform care qualiti improv use blood pressur bp manag chronic kidney diseas ckd exemplar use uk clinic guidelin ehr data patient salford uk develop algorithm appli individu patient record identifi ckd patient show room improv care either medic optim better bp monitor manual record review evalu accuraci indic positivepredict valu algorithm help improv manag chronic condit provid miss link clinic audit decis support

Resumos Similares

J Am Med Inform Assoc - Effect of clinical decision support on documented guideline adherence for head CT in emergency department patients with mild traumatic brain injury. ( 0,758740511131077 )
BMC Med Inform Decis Mak - Practice guidelines and clinical risk assessment models: is it time to reform? ( 0,708063495800641 )
BMC Med Inform Decis Mak - Beyond the threshold: real-time use of evidence in practice. ( 0,694388054669487 )
BMC Med Inform Decis Mak - A conceptual framework and protocol for defining clinical decision support objectives applicable to medical specialties. ( 0,685678424163035 )
J Am Med Inform Assoc - Building better guidelines with BRIDGE-Wiz: development and evaluation of a software assistant to promote clarity, transparency, and implementability. ( 0,678990702911688 )
J Telemed Telecare - A pilot study of a novel home telemonitoring system for oncology patients receiving chemotherapy. ( 0,672035491348263 )
Appl Clin Inform - Monitoring adherence to evidence-based practices: a method to utilize HL7 messages from hospital information systems. ( 0,671955955814362 )
Methods Inf Med - From clinical practice guidelines to computer-interpretable guidelines. A literature overview. ( 0,670926449586497 )
BMC Med Inform Decis Mak - Development of a prototype clinical decision support tool for osteoporosis disease management: a qualitative study of focus groups. ( 0,662031281747273 )
AMIA Annu Symp Proc - Exceptions handling within GLARE clinical guideline framework. ( 0,658552774098175 )
J Biomed Inform - The impact of emerging standards adoption on automated quality reporting. ( 0,653940987349801 )
Telemed J E Health - Utilization of the American Telemedicine Association's clinical practice guidelines. ( 0,651306592184401 )
Int J Med Inform - Complexity and the science of implementation in health IT--knowledge gaps and future visions. ( 0,644902226330926 )
J Am Med Inform Assoc - The feasibility of automating audit and feedback for ART guideline adherence in Malawi. ( 0,641261583426301 )
Int J Med Inform - From clinical practice guidelines, to clinical guidance in practice - impacts for computerization. ( 0,640614521671795 )
J Am Med Inform Assoc - Evaluation of computer-generated reminders to improve CD4 laboratory monitoring in sub-Saharan Africa: a prospective comparative study. ( 0,639869026087321 )
Appl Clin Inform - An internet portal for the development of clinical practice guidelines. ( 0,637899020383415 )
J. Med. Internet Res. - Feasibility of a wiki as a participatory tool for patients in clinical guideline development. ( 0,635808926948274 )
J Am Med Inform Assoc - How is the electronic health record being used? Use of EHR data to assess physician-level variability in technology use. ( 0,634767601986116 )
J Am Med Inform Assoc - High-priority drug-drug interactions for use in electronic health records. ( 0,632709826850811 )
AMIA Annu Symp Proc - An Algorithm Using Twelve Properties of Antibiotics to Find the Recommended Antibiotics, as in CPGs. ( 0,621309198453291 )
Int J Med Inform - The effect of computerized decision support on barriers to guideline implementation: a qualitative study in outpatient cardiac rehabilitation. ( 0,61985785973396 )
Res Synth Methods - A tool to assess the quality of a meta-analysis. ( 0,614744272475365 )
J Biomed Inform - Feasibility of encoding the Institute for Clinical Systems Improvement Depression Guideline using the Omaha System. ( 0,613478284812088 )
AMIA Annu Symp Proc - Extending the GuideLine Implementability Appraisal (GLIA) instrument to identify problems in control flow. ( 0,61025175490546 )
Healthc (Amst) - Meaningful use: Floor or ceiling? ( 0,607056315119979 )
Comput Methods Programs Biomed - A real time online assessment system with modelized architecture on clinical infometrics for patient reported outcomes of prostate cancer. ( 0,605808299995808 )
Comput Methods Programs Biomed - Supporting adaptive clinical treatment processes through recommendations. ( 0,603249269819569 )
BMC Med Inform Decis Mak - Use of handheld computers in clinical practice: a systematic review. ( 0,602907817195517 )
J. Med. Internet Res. - An evaluation of web-based clinical practice guidelines for managing problems associated with cannabis use. ( 0,601872194517793 )
AMIA Annu Symp Proc - Representation of Clinical Nursing Protocols Using GEM II & GEM Cutter. ( 0,600627843106775 )
Appl Clin Inform - The association between use of a clinical decision support tool and adherence to monitoring for medication-laboratory guidelines in the ambulatory setting. ( 0,600380031470011 )
J Am Med Inform Assoc - A multi-layered framework for disseminating knowledge for computer-based decision support. ( 0,59659628395727 )
Appl Clin Inform - Actionable recommendations in the Bright Futures child health supervision guidelines. ( 0,595428259427824 )
Comput. Biol. Med. - Towards automated generation and execution of clinical guidelines: engine design and implementation through the ICU Modified Schofield use case. ( 0,589662974795601 )
BMC Med Inform Decis Mak - Deficiencies in the transfer and availability of clinical trials evidence: a review of existing systems and standards. ( 0,588830272557697 )
Methods Inf Med - An electronic specimen collection protocol schema (eSCPS). Document architecture for specimen management and the exchange of specimen collection protocols between biobanking information systems. ( 0,58859279034291 )
Med Decis Making - Toward Minimum Standards for Certifying Patient Decision Aids: A Modified Delphi Consensus Process. ( 0,587493636499224 )
AMIA Annu Symp Proc - GEM at 10: a decade's experience with the Guideline Elements Model. ( 0,583789567983206 )
BMC Med Inform Decis Mak - Development of a real-time clinical decision support system upon the Web MVC-based architecture for prostate cancer treatment. ( 0,58374544316982 )
J Clin Monit Comput - Ventilator-associated pneumonia: current status and future recommendations. ( 0,58228697535392 )
J Am Med Inform Assoc - Validity of electronic health record-derived quality measurement for performance monitoring. ( 0,578682354361661 )
Health Info Libr J - Developing a long-term condition's information service in collaboration with third sector organisations. ( 0,577961817357255 )
Med Decis Making - Appropriate evidence sources for populating decision analytic models within health technology assessment (HTA): a systematic review of HTA manuals and health economic guidelines. ( 0,57565776697329 )
BMC Med Inform Decis Mak - A systematic development process for patient decision aids. ( 0,574576798581429 )
Perspect Health Inf Manag - Distributed guidelines (DiG): a software framework for extending automated health decision support to the general population. ( 0,572138838134847 )
Health Info Libr J - How doctors make use of online, point-of-care clinical decision support systems: a case study of UpToDate?. ( 0,569352065506183 )
Artif Intell Med - Aggregating evidence about the positive and negative effects of treatments. ( 0,569335887098625 )
J Med Syst - A physician order category-based clinical guideline comparison system. ( 0,569283439497689 )
J Am Med Inform Assoc - An informatics approach to medication adherence assessment and improvement using clinical, billing, and patient-entered data. ( 0,567897216028044 )
BMC Med Inform Decis Mak - Validating archetypes for the Multiple Sclerosis Functional Composite. ( 0,56489234179004 )
J. Med. Internet Res. - Pain-QuILT: clinical feasibility of a web-based visual pain assessment tool in adults with chronic pain. ( 0,564806731298843 )
BMC Med Inform Decis Mak - Teleconsultation in children with abdominal pain: a comparison of physician triage recommendations and an established paediatric telephone triage protocol. ( 0,564109399845108 )
Comput. Biol. Med. - Evaluation of personal health record systems through the lenses of EC research projects. ( 0,564109399845108 )
Brief. Bioinformatics - A survey of error-correction methods for next-generation sequencing. ( 0,56277485953265 )
J Biomed Inform - Measuring clinical pathway adherence. ( 0,562253530231749 )
Methods Inf Med - Snomed CT implementation. Mapping guidelines facilitating reuse of data. ( 0,561408461931376 )
Int J Med Inform - Development and evaluation of data entry templates based on the entity-attribute-value model for clinical decision support of pressure ulcer wound management. ( 0,558387091812076 )
AMIA Annu Symp Proc - Developing nursing computer interpretable guidelines: a feasibility study of heart failure guidelines in homecare. ( 0,557905098782817 )
BMC Med Inform Decis Mak - How to translate therapeutic recommendations in clinical practice guidelines into rules for critiquing physician prescriptions? Methods and application to five guidelines. ( 0,5563058246192 )
J Med Syst - Using recommendation to support adaptive clinical pathways. ( 0,554542370184129 )
AMIA Annu Symp Proc - First-order logic theory for manipulating clinical practice guidelines applied to comorbid patients: a case study. ( 0,549084599863502 )
J Telemed Telecare - Costs and benefits of tele-endoscopy clinics in a remote location. ( 0,548945472689495 )
Artif Intell Med - A pilot study of distributed knowledge management and clinical decision support in the cloud. ( 0,548922925515665 )
Int J Med Inform - Towards an understanding of the information dynamics of the handover process in aged care settings--a prerequisite for the safe and effective use of ICT. ( 0,546818315670538 )
J Am Med Inform Assoc - Clinical decision support with automated text processing for cervical cancer screening. ( 0,545703045548443 )
Int J Med Inform - Designing for collaborative interpretation in telemonitoring: re-introducing patients as diagnostic agents. ( 0,545485529779674 )
Comput Methods Programs Biomed - Model-based decision support in diabetes care. ( 0,544942942038036 )
J Biomed Inform - A review of causal inference for biomedical informatics. ( 0,543142366217539 )
Int J Med Inform - Electronic decision protocols for ART patient triaging to expand access to HIV treatment in South Africa: a cross sectional study for development and validation. ( 0,542831753792641 )
BMC Med Inform Decis Mak - Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas. ( 0,538604101420025 )
AMIA Annu Symp Proc - Locating relevant patient information in electronic health record data using representations of clinical concepts and database structures. ( 0,53813823519705 )
Health Info Libr J - Evidence-based medicine: is the evidence out there for primary care clinicians? ( 0,537325681330562 )
Int J Comput Assist Radiol Surg - Formal verification of software-based medical devices considering medical guidelines. ( 0,536468824845288 )
Int J Med Inform - Reducing unnecessary lab testing in the ICU with artificial intelligence. ( 0,536389573160877 )
Int J Med Inform - Changing course to make clinical decision support work in an HIV clinic in Kenya. ( 0,535541027781548 )
Med Decis Making - Early benefit assessment of pharmaceuticals in Germany: manufacturers' expectations versus the Federal Joint Committee's decisions. ( 0,533186920650543 )
BMC Med Inform Decis Mak - Arriba-lib: evaluation of an electronic library of decision aids in primary care physicians. ( 0,531947971383449 )
Int J Comput Assist Radiol Surg - AneuSearch: a software prototype for intracranial aneurysm searching and clinical decision support. ( 0,530514287676855 )
AMIA Annu Symp Proc - Clinician perspectives on the quality of patient data used for clinical decision support: a qualitative study. ( 0,530259743015949 )
BMC Med Inform Decis Mak - Evaluating genomic tests from bench to bedside: a practical framework. ( 0,528707551725803 )
Artif Intell Med - Evaluation of a clinical decision support algorithm for patient-specific childhood immunization. ( 0,526031068344374 )
Telemed J E Health - Exploring the relationship among user satisfaction, compliance, and clinical outcomes of telemedicine services for glucose control. ( 0,524212862876883 )
AMIA Annu Symp Proc - Teleretinal screening for diabetic retinopathy in six Los Angeles urban safety-net clinics: initial findings. ( 0,523470611616896 )
J Biomed Inform - Workflow mining and outlier detection from clinical activity logs. ( 0,522711128458927 )
J Am Med Inform Assoc - Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. ( 0,519354458593441 )
Int J Med Inform - Updating clinical knowledge: an evaluation of current information alerting services. ( 0,517985445199074 )
J Biomed Inform - Lexically suggest, logically define: quality assurance of the use of qualifiers and expected results of post-coordination in SNOMED CT. ( 0,517285910546951 )
Int J Med Inform - USB-based Personal Health Records: an analysis of features and functionality. ( 0,51483393435845 )
Methods Inf Med - Appropriateness of ICD-coded diagnostic inpatient hospital discharge data for medical practice assessment. A systematic review. ( 0,514021752733168 )
BMC Med Inform Decis Mak - Designing a patient-centered personal health record to promote preventive care. ( 0,513676589492549 )
Comput Methods Programs Biomed - Implementation and evaluation of an Asbru-based decision support system for adjuvant treatment in breast cancer. ( 0,512808275864094 )
Int J Med Inform - Effects of two different levels of computerized decision support on blood glucose regulation in critically ill patients. ( 0,510918065818875 )
J. Med. Internet Res. - Human computation as a new method for evidence-based knowledge transfer in Web-based guideline development groups: proof of concept randomized controlled trial. ( 0,510185082756132 )
IEEE Trans Image Process - A protocol for evaluating video trackers under real-world conditions. ( 0,509837870617226 )
AMIA Annu Symp Proc - Cohort amplification: an associative classification framework for identification of disease cohorts in the electronic health record. ( 0,509106119580233 )
J Biomed Inform - Transforming semi-structured life science diagrams into meaningful domain ontologies with DiDOn. ( 0,509091947949122 )
Telemed J E Health - The use of collaboration science to define consensus outcome measures: a telemental health case study. ( 0,508041211538987 )
Appl Clin Inform - Interest in health information exchange in ambulatory care: a statewide survey. ( 0,507974594234938 )
BMC Med Inform Decis Mak - Sensors vs. experts - a performance comparison of sensor-based fall risk assessment vs. conventional assessment in a sample of geriatric patients. ( 0,506675472472971 )