AMIA Annu Symp Proc - Phenome based analysis as a means for discovering context dependent clinical reference ranges.

Tópicos

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

Resumo

Robust electronic medical records (EMR's) have made large-scale phenome-based analysis feasible. The context-dependent phenome of a large ICU-based EMR database (MIMIC II) was explored, as a function of a clinical feature: white blood cell count (WBC). Phenome visualization led to the discovery that peak WBC in the range 15-45 K/?l was highly associated with the diagnoses of Clostridium difficile and bacterial sepsis; thus, it is conceivable that clinicians might delay ordering targeted antimicrobials towards C. difficile for patients with peak WBC in this range. This hypothesis was confirmed, with significant delays in this group (median 135 vs. 85 hours, p = 0.002). These delays could be associated with adverse effects on patient health and high hospitalization costs (e.g. an additional $3,000,000 for the MIMIC II cohort). In conclusion, context-dependent clinical reference ranges are critical to clinical decision making; furthermore, important findings can be discovered through EMR-driven phenome association studies.

Resumo Limpo

robust electron medic record emr made largescal phenomebas analysi feasibl contextdepend phenom larg icubas emr databas mimic ii explor function clinic featur white blood cell count wbc phenom visual led discoveri peak wbc rang kl high associ diagnos clostridium difficil bacteri sepsi thus conceiv clinician might delay order target antimicrobi toward c difficil patient peak wbc rang hypothesi confirm signific delay group median vs hour p delay associ advers effect patient health high hospit cost eg addit mimic ii cohort conclus contextdepend clinic refer rang critic clinic decis make furthermor import find can discov emrdriven phenom associ studi

Resumos Similares

J Am Med Inform Assoc - Use of electronic clinical documentation: time spent and team interactions. ( 0,718390539553704 )
J. Med. Internet Res. - Patients' continuing use of an online health record: a quantitative evaluation of 14,000 patient years of access data. ( 0,679844211783907 )
J Clin Monit Comput - Impact of non invasive and beat-to-beat arterial pressure monitoring on intraoperative hemodynamic management. ( 0,666951837511295 )
Int J Med Inform - Concept and implementation of a computer-based reminder system to increase completeness in clinical documentation. ( 0,645855983447632 )
J Telemed Telecare - Evaluation of a telemedical care programme for patients with Parkinson's disease. ( 0,643876387599232 )
J Am Med Inform Assoc - Presence of key findings in the medical record prior to a documented high-risk diagnosis. ( 0,643372374694128 )
J Am Med Inform Assoc - Automating the medication regimen complexity index. ( 0,633489769876002 )
J. Med. Internet Res. - Online social network use by health care providers in a high traffic patient care environment. ( 0,633163804323157 )
Comput Methods Programs Biomed - Comparison of documentation time between an electronic and a paper-based record system by optometrists at an eye hospital in south India: a time-motion study. ( 0,631183511154392 )
Int J Med Inform - Structured electronic operative reporting: comparison with dictation in kidney cancer surgery. ( 0,627032336854335 )
Int J Med Inform - Effects of electronic medical record in a Chinese hospital: a time series study. ( 0,620162091504615 )
BMC Med Inform Decis Mak - Determinants of frequency and longevity of hospital encounters' data use. ( 0,61808287257589 )
J Med Syst - The effect of electronic medical record application on the length of stay in a Chinese general hospital: a department- and disease-focused interrupted time-series study. ( 0,61196141985266 )
Methods Inf Med - Caregivers' time utilization before and after the introduction of an electronic nursing documentation system in a residential aged care facility. ( 0,609689201874551 )
Telemed J E Health - Improved access and cycle time with an in-house patient-centered teleglaucoma program versus traditional in-person assessment. ( 0,603286420936846 )
Med Decis Making - Information distortion in physicians' diagnostic judgments. ( 0,601942822241619 )
J Clin Monit Comput - Near real-time notification of gaps in cuff blood pressure recordings for improved patient monitoring. ( 0,601693089928815 )
Int J Med Inform - Implementation of an electronic medical record does not change delivery of preventive care for HIV-positive patients. ( 0,601161544029724 )
Telemed J E Health - Robotic telepresence versus standardly supervised stroke alert team assessments. ( 0,597109775827013 )
J Am Med Inform Assoc - Electronic medical records and physician stress in primary care: results from the MEMO Study. ( 0,595539044914915 )
AMIA Annu Symp Proc - Emergency medical services: the frontier in health information exchange. ( 0,593988704139364 )
Telemed J E Health - Telephotography in trauma: a 2-year clinical experience. ( 0,593950989373515 )
J Am Med Inform Assoc - Electronic medical record use in pediatric primary care. ( 0,591300228942178 )
J Clin Monit Comput - Variations of the analgesia nociception index during general anaesthesia for laparoscopic abdominal surgery. ( 0,586140523773687 )
Int J Health Geogr - Identifying risk factors for healthcare-associated infections from electronic medical record home address data. ( 0,585861968437545 )
AMIA Annu Symp Proc - Potential value of health information exchange for people with epilepsy: crossover patterns and missing clinical data. ( 0,584131688806279 )
Comput Methods Programs Biomed - Pharmacokinetics of insulin lispro in type 2 diabetes during closed-loop insulin delivery. ( 0,583952680563956 )
Int J Neural Syst - Cortical excitability and refractory epilepsy: a three-year longitudinal transcranial magnetic stimulation study. ( 0,583333333333333 )
J Am Med Inform Assoc - A framework for assessing patient crossover and health information exchange value. ( 0,582718054663045 )
J Clin Monit Comput - Transcutaneous continuous carbon dioxide tension monitoring reduced incidence, degree and duration of hypercapnia during combined regional anaesthesia and monitored anaesthesia care in shoulder surgery patients. ( 0,58134310803888 )
Telemed J E Health - Emergency department physician telemedical triage. ( 0,580717042999836 )
J Am Med Inform Assoc - Clinical documentation: composition or synthesis? ( 0,580394357286294 )
J Clin Monit Comput - SNAP II versus BIS VISTA monitor comparison during general anesthesia. ( 0,579024376743431 )
Telemed J E Health - Detection of asymptomatic paroxysmal atrial fibrillation with the trans-telephonic electrocardiograph system. ( 0,575520833333333 )
J. Med. Internet Res. - Clinical outcome and cost-effectiveness of a synchronous telehealth service for seniors and nonseniors with cardiovascular diseases: quasi-experimental study. ( 0,574813437604478 )
Appl Clin Inform - Effects of automated immunization registry reporting via an electronic health record deployed in community practice settings. ( 0,571834617095205 )
Telemed J E Health - Hot spot: impact of July 2011 heat wave in southern Italy (Apulia) on cardiovascular disease assessed by emergency medical service and telemedicine support. ( 0,571785900429472 )
Int J Med Inform - Separate may not be equal: a preliminary investigation of clinical correlates of electronic psychiatric record accessibility in academic medical centers. ( 0,570796617770145 )
J Clin Monit Comput - Reliability of a new 4th generation FloTrac algorithm to track cardiac output changes in patients receiving phenylephrine. ( 0,570674341741593 )
J Clin Monit Comput - Respiratory parameters as a surrogate marker for duration of intubation: potential application of automated vital sign collection. ( 0,568598064932571 )
AMIA Annu Symp Proc - You can lead a horse to water: physicians' responses to clinical reminders. ( 0,56820092936807 )
Med Decis Making - Patient time costs associated with sensor-augmented insulin pump therapy for type 1 diabetes: results from the STAR 3 randomized trial. ( 0,566037525771883 )
Int J Med Inform - An investigation of the efficacy of electronic consenting interfaces of research permissions management system in a hospital setting. ( 0,564232183244247 )
J Am Med Inform Assoc - Meaningful measurement: developing a measurement system to improve blood pressure control in patients with chronic kidney disease. ( 0,56412681340321 )
J Telemed Telecare - Utilization of home telemonitoring in patients 75 years of age and over with complex heart failure. ( 0,561826522596836 )
J Am Med Inform Assoc - Is the quality of data in an electronic medical record sufficient for assessing the quality of primary care? ( 0,561123371239342 )
Appl Clin Inform - Healthcare Information Systems to Assess Influenza Outbreaks: An analysis of the 2009 H1N1 Epidemic in Buenos Aires. ( 0,560751500823453 )
J Am Med Inform Assoc - Patient reported barriers to enrolling in a patient portal. ( 0,56016134970642 )
AMIA Annu Symp Proc - Lexical concept distribution reflects clinical practice. ( 0,560116273784362 )
BMC Med Inform Decis Mak - Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support. ( 0,559563207621578 )
J Telemed Telecare - Using telemonitoring to construct knowledge about homebound patient populations: vital-signs alert rates. ( 0,558927549434573 )
Appl Clin Inform - Evaluating the impact of the electronic health record on patient flow in a pediatric emergency department. ( 0,558148266582399 )
AMIA Annu Symp Proc - Capture of osteoporosis and fracture information in an electronic medical record database from primary care. ( 0,556163296782351 )
J Clin Monit Comput - Goal-directed intraoperative fluid therapy guided by stroke volume and its variation in high-risk surgical patients: a prospective randomized multicentre study. ( 0,556049616914344 )
J Am Med Inform Assoc - Data quality assessment in healthcare: a 365-day chart review of inpatients' health records at a Nigerian tertiary hospital. ( 0,555782321252578 )
Healthc (Amst) - Effects of implementing a protocol for arterial blood gas use on ordering practices and diagnostic yield. ( 0,554825793463616 )
J Clin Monit Comput - The impact of induction of general anesthesia and a vascular occlusion test on tissue oxygen saturation derived parameters in high-risk surgical patients. ( 0,554717392765348 )
Comput Math Methods Med - Effects of first-time overnight CPAP therapy for increasing the complexity of the patient's physiological system. ( 0,551245910526377 )
J. Med. Internet Res. - Online doctor reviews: do they track surgeon volume, a proxy for quality of care? ( 0,548158497495637 )
Int J Med Inform - The effects of an electronic medical record on the completeness of documentation in the anesthesia record. ( 0,546867791609385 )
AMIA Annu Symp Proc - The physical attractiveness of electronic physician notes. ( 0,546324761182258 )
Int J Med Inform - Implementation of computerized provider order entry in a neonatal intensive care unit: Impact on admission workflow. ( 0,545468633152817 )
Telemed J E Health - Nonmydriatic retinal image review at time of endocrinology visit results in short-term HbA1c reduction in poorly controlled patients with diabetic retinopathy. ( 0,544948220360661 )
J Telemed Telecare - A pilot test of a new tool for remote blood pressure monitoring. ( 0,544898781921636 )
J Am Med Inform Assoc - Design and evaluation of a wireless electronic health records system for field care in mass casualty settings. ( 0,54412545203553 )
Health Informatics J - Clinical Document Architecture integration system to support patient referral and reply letters. ( 0,541907897882809 )
Int J Med Inform - The positive financial impact of using an Intensive Care Information System in a tertiary Intensive Care Unit. ( 0,541639010449329 )
Int J Med Inform - Does the introduction of an electronic nursing documentation system in a nursing home reduce time on documentation for the nursing staff? ( 0,541602560309064 )
Telemed J E Health - Is telemedicine an answer to reducing 30-day readmission rates post-acute myocardial infarction? ( 0,540818787650471 )
J Med Syst - RBAC-Matrix-based EMR right management system to improve HIPAA compliance. ( 0,539864485443048 )
J Am Med Inform Assoc - Self-reported fever and measured temperature in emergency department records used for syndromic surveillance. ( 0,539761206383829 )
J Clin Monit Comput - The effects of DEX premedication on volatile induction of mask anesthesia (VIMA) and sevoflurane requirements. ( 0,538494053273226 )
J Clin Monit Comput - Ultrasound-guided radial arterial cannulation: long axis/in-plane versus short axis/out-of-plane approaches? ( 0,53813790578989 )
J Am Med Inform Assoc - Electronic medical record systems are associated with appropriate placement of HIV patients on antiretroviral therapy in rural health facilities in Kenya: a retrospective pre-post study. ( 0,5378849147354 )
Appl Clin Inform - A Computerized Alert Screening for Severe Sepsis in Emergency Department Patients Increases Lactate Testing but does not Improve Inpatient Mortality. ( 0,537766229073256 )
J Clin Monit Comput - Intraoperative ICG plasma disappearance rate helps to predict absence of early postoperative complications after orthotopic liver transplantation. ( 0,537362233446528 )
J Clin Monit Comput - Comparison of two devices using near-infrared spectroscopy for the measurement of tissue oxygenation during a vascular occlusion test in healthy volunteers (INVOS? vs. InSpectra?). ( 0,537262505313308 )
Appl Clin Inform - A pilot trial of a computerized renal template note to improve resident knowledge and documentation of kidney disease. ( 0,535428158137027 )
J Telemed Telecare - Telemedicine-supported insulin optimisation in primary care. ( 0,534745033890806 )
J Telemed Telecare - Development of a first-responder dispatch system using a smartphone. ( 0,534485794572207 )
J Am Med Inform Assoc - Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial. ( 0,534288058162941 )
J Am Med Inform Assoc - Lessons learned from the introduction of an electronic safety net to enhance test result management in an Australian mothers' hospital. ( 0,534128496534769 )
J Telemed Telecare - Telemonitoring in chronic obstructive airway disease and adult patients with cystic fibrosis. ( 0,533293267725845 )
J Am Med Inform Assoc - Electronic health records improve clinical note quality. ( 0,532907248507802 )
Int J Med Inform - The perception of medical professionals and medical students on the usefulness of an emergency medical card and a continuity of care report in enhancing continuity of care. ( 0,532264870091949 )
J Med Syst - The meaningful use of EMR in Chinese hospitals: a case study on curbing antibiotic abuse. ( 0,531704184462147 )
Appl Clin Inform - What do physicians read (and ignore) in electronic progress notes? ( 0,531242435191843 )
Appl Clin Inform - Information technology improves Emergency Department patient discharge instructions completeness and performance on a national quality measure: a quasi-experimental study. ( 0,530151628717906 )
J Med Syst - Variability of subspecialty-specific anesthesia-controlled times at two academic institutions. ( 0,529981757388692 )
AMIA Annu Symp Proc - An integrated billing application to streamline clinician workflow. ( 0,529102821363481 )
Int J Med Robot - Angiographic evaluation of graft patency in robotic-assisted coronary artery bypass surgery: 8 year follow-up. ( 0,528058854528692 )
J Telemed Telecare - Relation between telecare implementation and number of treatment days in a Japanese town. ( 0,527359901403648 )
J Clin Monit Comput - Partitioning the resistances along the vascular tree: effects of dobutamine and hypovolemia in piglets with an intact circulation. ( 0,526641479187471 )
Appl Clin Inform - Perceived frequency and impact of missing information at pediatric emergency and general ambulatory encounters. ( 0,525345667562621 )
J Clin Monit Comput - A comparison of response time to desaturation between tracheal oximetry and peripheral oximetry. ( 0,524542246497059 )
AMIA Annu Symp Proc - Validation and enhancement of a computable medication indication resource (MEDI) using a large practice-based dataset. ( 0,523550724637681 )
J Am Med Inform Assoc - Improvement in the workflow efficiency of treating non-emergency outpatients by using a WLAN-based real-time location system in a level I trauma center. ( 0,522931294976656 )
AMIA Annu Symp Proc - Role prediction using Electronic Medical Record system audits. ( 0,522330681960542 )
Telemed J E Health - Telemedicine pre-anesthesia evaluation: a randomized pilot trial. ( 0,519838488502288 )
J Med Syst - Study of the cost-benefit analysis of electronic medical record systems in general hospital in China. ( 0,519369749397343 )