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Medial double arthrodesis with lateral column sparing and arthrodiastasis: a radiographic and medical record review.

Correction of valgus hindfoot deformity can be successfully achieved with arthrodesis of the subtalar and talonavicular joints through a single medial based incision. The advantages of medial double arthrodesis compared with the standard triple arthrodesis 2-incision approach include the absence of a lateral incision and a few degrees of residual mobility through the unfused calcaneocuboid joint (CCJ). The CCJ has often been noted to distract and decompress with the abduction correction achieved through medial double fusion. The primary goal of the present retrospective study was to identify t

The Schedule for Evaluating Persistent Symptoms (SEPS): a new method of recording medically unexplained symptoms.

BACKGROUND: Medically unexplained symptoms are difficult to measure and in most cases the diagnosis is made either from independent data such as consultants' opinions or medical outcomes, or by proxy measures such as numbers of symptoms or consultations. A valid self-rated measure would be of value in assessing this highly prevalent condition. AIMS: To describe a new scale of nine items, the Schedule for Evaluation of Persistent Symptoms (SEPS), its properties, its internal consistency, its distribution in a sample of 470 medical patients, its relationship to social functioning and health anx

The natural language of the surgeon's clinical note in outcomes assessment: a qualitative analysis of the medical record.

BACKGROUND: Physician-generated clinical notes are the central document in recording the clinical decision-making and outcome of care. This is particularly true in an environment where outcomes assessment is becoming increasingly important. The hypothesis of this study is that these notes are inadequate to assess patient-centered outcomes and determine surgeons' core competencies. METHODS: We preformed a retrospective review of postoperative clinical notes of general surgery patients for a 1-month period. Information from these notes underwent qualitative analysis using the reductionist thema

Тщательное воспроизведение ассоциаций генотипа-фенотипа с множественными заболеваниями в электронной медицинской записи.

В качестве одного из подходов к быстрому формированию крупных, разнообразных групп для обнаружения и воспроизведения ассоциаций генотипа-фенотипа были предложены крупномасштабные базы данных ДНК, связанные с электронными системами медицинской записи (ЭМР). Однако неизвестно, в какой степени такие ресурсы способны реализовать это обещание. Мы изучили вопрос о том, можно ли использовать биохранитель ДНК, связанный с ЭМR, для обнаружения известных генотипно-фенотипных ассоциаций для five Болезни. Twenty-one СНП, которые ранее были замешаны в качестве обычных вариантов, предрасположенных к экспери

Poor validation of medical record ICD-9 diagnoses of gout in a veterans affairs database.

OBJECTIVE: Diagnostic codes based on medical records or claims data have been used to identify patient populations with gout for important epidemiologic and clinical studies. We evaluated whether we can document the accuracy of such diagnoses by review of medical records and then on direct interviews with a subset of patients. METHODS: Electronic medical records of 289 patients with 2 visits with ICD-9 codes for gout were extensively reviewed to search for documentation of features that would classify patients as having gout by 3 sets of proposed criteria, the American College of Rheumatology…

An electronic medical record intervention increased nursing home advance directive orders and documentation.

OBJECTIVES: To develop an electronic medical record intervention to improve documentation of patient preferences about life-sustaining care, detail of resuscitation and treatment-limiting orders, and concordance between these orders and patient preferences. DESIGN: Prospective before-after intervention trial. SETTING: Veterans Affairs nursing home with an electronic medical record for all clinical information, including clinician orders. PARTICIPANTS: All 224 nursing home admissions from May 1 to October 31, 2004. MEASUREMENTS: Completion of an advance directive discussion note by the prim

[Comparison of generative artificial intelligence and physicians in differential diagnosis and treatment planning based on initial hospital medical records].

OBJECTIVE: To compare the quality of differential diagnoses and diagnostic and treatment plans formulated by generative artificial intellige … in western medicine or traditional Chinese medicine using a 5-point scale. RESULTS: A total of 96 medical records were included, including records from 28 patients with pulmonary infections and 9 patients with rare diseases. (1) Quality of differential diagnosis: For diagnostic omission, scores were higher in the western medicine GenAI subgroup than in the west …

Multimodal Fusion of Echocardiogram Images and Electronic Medical Records for Heart Disease Screening: Retrospective Algorithm Development and Validation Study.

BACKGROUND: Echocardiography is a fundamental imaging modality for the diagnosis of heart disease (HD), but its interpretation remains operator-dependent and lacks standardized, data-driven decision support. Although artificial intelligence has improved image-based diagnosis, the added value and interpretability of integrating routinely collected electronic medical records (EMRs) with echocardiogram (ECHO) for large-scale screening remain underexplored. OBJECTIVE: This study aims to develop an explainable artificial intelligence framework that integrates multimodal data, including ECHO images…

Extracting structured clinical data from pediatric emergency records using LLMs: A multimodel retrospective study of children with medical complexity.

IMPORTANCE: Emergency departments (EDs) face significant documentation burdens due to reliance on unstructured clinical narratives, hindering efficiency, particularly in pediatric care. Large language models (LLMs) offer a potential solution by automating data extraction to improve clinical workflows. OBJECTIVE: To determine whether an LLM can accurately and efficiently extract structured clinical data from free-text pediatric ED records in a non-English setting. DESIGN: Diagnostic accuracy study using retrospective data from 2007 to 2023. Manual clinician classification served as the gold s

A distributed analysis approach for pharmacovigilance data from electronic medical records in German university hospitals: the POLAR_MI ETL Pipeline.

BACKGROUND: The cooperative project "POLypharmacy, drug interActions and Risks" (POLAR_MI) of the Medical Informatics Initiative Germany (MII) aimed at detecting medication-related risks attributed to polymedication in adult patients from German university hospitals. Here, we report technological challenges and solutions to undertake this large-scale multicentre project relying on routine healthcare data stored and processed by the data integration centres, which were recently established at the German university hospitals. METHODS: We developed and implemented a two-step, privacy-preserving,

Beyond ICD-10 Codes: A Multi-class Machine-Learning Approach to Identify True IBD Cases in Electronic Medical Records.

PURPOSE: The adoption of electronic medical records (EMRs) has expanded research opportunities. International Classification of Diseases (ICD) codes are used for case identification but lack sensitivity and specificity. Machine learning (ML) offers an alternative by integrating EMR data to identify cases. This study aimed to develop a multi-class ML model to accurately predict inflammatory bowel disease (IBD) among patients with ICD-10 codes for Crohn's disease (CD) or ulcerative colitis (UC). METHODS: Patients with ≥1 ICD-10 code for CD or UC were identified from the EMR; a random cohort und…

Feasibility Assessment of Extracting Social Determinants of Health From Electronic Medical Records: A Multicenter Study Across Chinese Healthcare Institutions.

BACKGROUND: Social determinants of health (SDoH) are pivotal in influencing health outcomes and disparities across various populations. Real-world data rich in SDoH information, such as electronic medical records (EMRs), can considerably enhance public health interventions. However, in Chinese medical practice, these non-clinical factors are often neglected, with many healthcare providers failing to recognize the importance of SDoH information in the improvement of patient care. The objective of this study is to explore the feasibility and effectiveness of extracting SDoH information from Chin…

Reflexive thematic analysis of emergency department medical records of dementia patients regarding the identification of last days of life.

OBJECTIVES: End-of-life care in the Emergency Department (ED) can be a challenge. Defining goals of care in dementia patients may be more complex. The quality of ED medical records is relevant for better care in the last hours or days of life. In this article, we explore the identification of last days of life recognition in ED records of dementia patients. METHODS: Retrospective qualitative review of ED medical records of patients with dementia in the last 7 days of life using reflexive thematic analysis. This study was conducted at a university tertiary hospital, with a 24 h/7 days polyvale…

Prediction of adverse pregnancy outcomes using machine learning techniques: evidence from analysis of electronic medical records data in Rwanda.

BACKGROUND: Despite substantial progress in maternal and neonatal health, Rwanda's mortality rates remain high, necessitating innovative approaches to meet health related Sustainable Development Goals (SDGs). By leveraging data collected from Electronic Medical Records, this study explores the application of machine learning models to predict adverse pregnancy outcomes, thereby improving risk assessment and enhancing care delivery. METHODS: This study utilized retrospective cohort data from the electronic medical record (EMR) system of 25 hospitals in Rwanda from 2020 to 2023. The independent…

Prevalence and clinical profiles of primary sclerosing cholangitis in China: Data from electronic medical records and systematic literature retrieval.

BACKGROUND & AIMS: Epidemiology of primary sclerosing cholangitis (PSC) is lacking in China. We aimed to estimate the period prevalence and depict the clinical features of PSC in China. METHODS: We identified and included PSC cases between 2000 and 2023 from two sources: electronic medical records (EMR) and systematical literature retrieval (SLR). The period prevalence of PSC was estimated by the multiplier method. Rate ratios (RRs) for PSC prevalence in relation to macroeconomic indicators were calculated by the negative binomial regression model. RESULTS: A total of 1358 PSC cases were ret…

A century of medical records reveal earlier onset of the malaria season in Haut-Katanga induced by climate change.

BACKGROUND: Despite worldwide efforts to eradicate malaria over the past century, the disease remains a significant challenge in the Democratic Republic of the Congo (DRC) today. Climate change is even anticipated to worsen the situation in areas with higher altitudes and vulnerable populations. This study in Haut-Katanga, a highland region, aims to evaluate the effectiveness of past control measures and to explore the impact of climate change on the region's distinct seasonal malaria pattern throughout the last century. METHODS: We integrated colonial medical records (1917-1983) from two maj…

Phenotyping people with a history of injecting drug use within electronic medical records using an interactive machine learning approach.

People with a history of injecting drug use are a priority for eliminating blood-borne viruses and sexually transmissible infections. Identifying them for disease surveillance in electronic medical records (EMRs) is challenged by sparsity of predictors. This study introduced a novel approach to phenotype people who have injected drugs using structured EMR data and interactive human-in-the-loop methods. We iteratively trained random forest classifiers removing important features and adding new positive labels each time. The initial model achieved 92.7% precision and 93.5% recall. Models maintai…

Implementation and Evaluation of Automated, Online Study Recruitment from Computerised Medical Records in a Primary Care Sentinel Surveillance Network.

Infectious intestinal disease (IID) is a syndrome consisting of diarrhoea and vomiting symptoms linked to a causative pathogen. The Third Study of IID (IID3) will report its incidence in the community within the UK and assess how it has changed since the second IID study (IID2) in 2012. We implemented an automated, online patient recruitment process within a national sentinel surveillance network and compared its performance versus IID2 in terms of: Patient recruitment rates and demographic characteristics of recruited participants. We utilised a text messaging system (TMS) running off a compu

Analyzing Comorbidity Patterns in Patients With Thyroid Disease Using Large-Scale Electronic Medical Records: Network-Based Retrospective Observational Study.

BackgroundThyroid disease (TD) is a prominent endocrine disorder that raises global health concerns; however, its comorbidity patterns remain unclear.ObjectiveThis study aims to apply a network-based method to comprehensively analyze the comorbidity patterns of TD using large-scale real-world health data.MethodsIn this retrospective observational study, we extracted the comorbidities of adult patients with TD from both private and public data sets. All comorbidities were identified using ICD-10 (International Classification of Diseases, 10th Revision) codes at the 3-digit level, and those with

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… Electronic medical records (EMRs), a typical real-world data set, are increasingly mined for valuable insights enriched with clinical history information to enhance decision-making [ 12 ]. … Abbreviations benign thyroid disease electronic medical record International Classification of Diseases, 10th Revision Medical Information Mart for Intensive Care phenotypic comorbidity network thyroid cancer thyroid disease thyroid nodule Additional data analysis. …