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Information retrieval performance of probabilistically generated, problem-specific computerized provider order entry pick-lists: a pilot study.

OBJECTIVE: The aim of this study was to preliminarily determine the feasibility of probabilistically generating problem-specific computerized provider order entry (CPOE) pick-lists from a database of explicitly linked orders and problems from actual clinical cases. DESIGN: In a pilot retrospective validation, physicians reviewed internal medicine cases consisting of the admission history and physical examination and orders placed using CPOE during the first 24 hours after admission. They created coded problem lists and linked orders from individual cases to the problem for which they were mos

Handheld computer-based decision support reduces patient length of stay and antibiotic prescribing in critical care.

OBJECTIVE: This study assessed the effect of a handheld computer-based decision support system (DSS) on antibiotic use and patient outcomes in a critical care unit. DESIGN: A DSS containing four types of evidence (patient microbiology reports, local antibiotic guidelines, unit-specific antibiotic susceptibility data for common bacterial pathogens, and a clinical pulmonary infection score calculator) was developed and implemented on a handheld computer for use in the intensive care unit at a tertiary referral hospital. System impact was assessed in a prospective "before/after" cohort trial las

Generating hypotheses by discovering implicit associations in the literature: a case report of a search for new potential therapeutic uses for thalidomide.

The availability of scientific bibliographies through online databases provides a rich source of information for scientists to support their research. However, the risk of this pervasive availability is that an individual researcher may fail to find relevant information that is outside the direct scope of interest. Following Swanson's ABC model of disjoint but complementary structures in the biomedical literature, we have developed a discovery support tool to systematically analyze the scientific literature in order to generate novel and plausible hypotheses. In this case report, we employ the

Domain-constrained generation of clinical condition sets to help test computer-based clinical guidelines.

The paper describes T/Gen, a prototype computer-based tool designed to help maintain the knowledge in a computer-based clinical practice guideline that provides patient-specific recommendations. T/Gen takes as input a set of clinical conditions to which a guideline must react, and allows the user to specify domain-specific constraints as to which combinations of conditions do not make sense or do not need to be exhaustively tested against one another. T/Gen automatically generates constrained sets of combinations of clinical conditions, each corresponding to a clinical case (or to several clos

Machine learning for an expert system to predict preterm birth risk.

OBJECTIVE: Develop a prototype expert system for preterm birth risk assessment of pregnant women. Normal gestation involves a term of 40 weeks, but because 8-12% of the newborns in the United States are delivered prior to 37 weeks' gestation, problems associated with prematurity continue to plague individuals, families, and the health care system. DESIGN: A knowledge-base development methodology used machine learning, statistical analysis, and validation techniques to analyze three large datasets (18,890 subjects and 214 variables). The dependent (i.e., decision) variable studied was weeks of

The ASH Research Collaborative Sickle Cell Disease Research Network: past, present, and future.

AbstractHistorically, sickle cell disease (SCD) has been overshadowed by progress in other hematologic disorders, but recent advances are reshaping its clinical and research landscape. Despite SCD reducing life expectancy by >20 years even with optimal care, transformative initiatives are fostering hope for improved outcomes. The American Society of Hematology (ASH) established the ASH Research Collaborative Sickle Cell Disease Research Network as a comprehensive program to revolutionize SCD research in the United States. This Network comprises a collection of innovative, research-focused coop

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… The group advises on alignment with national data and medical informatics standards, obtains input and feedback on data quality needs and priorities from the Research Network, and consults for the Scientific Research Project Team regarding feasibility of Data Hub research proposals. … To support scalability in both size and scope, the program leverages modern informatics approaches to create analytic data sets using EHR-standardized coding systems, such as International Classification of Diseases, Ninth Revision (ICD-9), International Classification of Diseases, Tenth Revision (ICD …

Multimorbidity among elderly in Bangladesh.

BackgroundMultimorbidity among the elderly is a major public health problem in most of the developing countries, including Bangladesh, where the population is moving towards aging. Multimorbidity was defined as the co-occurrence of at least two chronic diseases in a person whether as a coincidence or not. Little attention has been paid to the study of the prevalence of multimorbidity among the elderly in Bangladesh.ObjectiveThe objectives of this study were to estimate the prevalence of multimorbidity among hospitalized elderly.MethodsA cross-sectional study was conducted in two tertiary level

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… Dhaka, Bangladesh : Bangladesh Bureau of Statistics, Statistics and Informatics Division ; 2013 . 27 Khanam MA , Streatfield PK , Kabir ZN , et al. Prevalence and patterns of multimorbidity among elderly people in rural Bangladesh: a cross‐sectional study . … Dhaka, Bangladesh : Bangladesh Bureau of Statistics, Statistics and Informatics Division ; 2015 . 34 van Oostrom SH , Picavet HS , van Gelder BM , et al. Multimorbidity and comorbidity in the Dutch population ‐ Data from general practices . …

Adaptation of digital integration of PROMs and PREMs in oncology during implementation: a scoping review.

PurposeDigital tools facilitate the timely collection of patient-reported outcome and experience measures (ePROMs/PREMs), but there is no consistent reporting on the technical and content adaptations made essential to implementing these digital tools in a specific context. Adaptations made to ePROMs/ePREMs can improve data quality, clinical management, and patient outcomes. We explored how studies report on adaptations and the reasons and types of these during an implementation process of ePROMs/ePREMs systems in routine cancer care.MethodsWe conducted a systematic scoping review. We searched

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… phases with continuous on-site monitoring and team meetings for emerging issues Study staff Quantitative: outcomes; qualitative: notes, observation Usability and Agile Principles Warrington, 2019 [ 36 ] Iterative testing, feedback collection and integration through regular review Oncologists, nurses, informatics … The studies included a large variety of stakeholders in the adaptation process, ranging from oncologists, nursing and allied staff, clinical and administrative teams, technology partners, study staff, study authors, health informatics experts, researchers, advisory workgroups, etc. …

Exploring the role of health-related quality of life measures in predictive modelling for oncology: a systematic review.

Health related quality of life (HRQoL) is increasingly assessed in oncology research and routine care, which has led to the inclusion of HRQoL in prediction models. This review aims to describe the current state of oncological prediction models incorporating HRQoL. A systematic literature search for the inclusion of HRQoL in prediction models in oncology was conducted. Selection criteria were a longitudinal study design and inclusion of HRQoL data in prediction models as predictor, outcome, or both. Risk of bias was assessed using the PROBAST tool and quality of reporting was scored with an ad

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… Journal of Radiation Oncology Informatics, 11 (2), 4. 10.5166/jroi.11.2.1 12. Wang, X., Oldani, M. J., Zhao, X., Huang, X., & Qian, D. (2014). A review of cancer risk prediction models with genetic variants. Cancer Informatics . 10.4137/cin.s13788 13. … BMC Medical Informatics & Decision Making, 21 (1), 1–8. 10.1186/s12911-021-01564-0 61. Versteegh, M., van der Helm, I., Mokri, H., Oerlemans, S., Blommestein, H., & van Baal, P. (2022). Estimating quality of life decrements in oncology using time to death. …

Оценка и анализ < < Биаса > > крупных языковых моделей для подготовки синтетических электронных медицинских записей: сравнительное исследование.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Синтетические электронные медицинские записи (ЭПЧ), генерируемые крупными языковыми моделями (ЛММ), открывают возможности для клинического обучения и типовой подготовки при одновременном решении проблем, связанных с неприкосновенностью частной жизни. Однако различия в показателях деятельности и демографические отклонения в этих моделях по-прежнему недостаточно изучены, что создает угрозу для справедливого медицинского обслуживания. ЦЕЛЬ: Данное исследование было направлено на систематическую оценку эффективности различных МУП в создании синтетических ЭПЧ и критическую оц

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… Beyond large-scale generative models, conventional EHR performance metrics have been explored in medical informatics. … Given that health informatics fundamentally relies on reliable, equitable data for clinical decision-making, Llama2’s success in predictive accuracy and data extraction underscores its value. …

Can electronic assessment tools improve the process of shared decision-making? A systematic review.

BackgroundPatient involvement in decision-making plays a prominent role in improving the quality of healthcare. Despite this, shared decision-making is not routinely implemented. However, electronic assessment tools that capture patients' history, symptoms, opinions and values prior to their medical appointment are used by healthcare professionals during patient consultations to facilitate shared decision-making.ObjectiveTo assess the effectiveness of electronic assessment tools to improve the shared decision-making process.MethodA systematic review was conducted following PRISMA guidelines. P

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… Journal of the American Medical Informatics Association 17(4): 403–410. Ruland CM, White T, Stevens M, et al. (2003) Effects of a computerized system to support shared decision making in symptom management of cancer patients: preliminary results. … Journal of the American Medical Informatics Association 10(6): 573–579. Ryan JM, Corry JR, Attewell R, et al. (2002) A comparison of an electronic version of the SF-36 general health questionnaire to the standard paper version. Quality of Life Research 11(1): 19–26. …

Доверие, информационная оценка и общение между людьми, живущими с множественным склерозом.

Справочная информация: Люди, страдающие множественным склерозом (МС), все чаще обращаются в Интернет за информацией о своем состоянии и лечении. Вместе с тем информация о состоянии здоровья в онлайновом режиме существенно варьируется по качеству, и пациенты часто не имеют грамотности в области электронного здравоохранения, необходимой для проведения различия между надежными и ненадежными источниками. Цель: В этом исследовании рассматривается вопрос о том, каким образом лица, имеющие НР в Соединенном Королевстве, стремятся получить, оценить и оценить качество онлайновой информации по вопросам з

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… The adapted instrument was reviewed for content and face validity by the research team, which included health informatics and pharmacy expertise, and by a small number of people with lived experience of MS. … Infodemiology and infoveillance: Framework for an emerging set of public health informatics methods to analyze search, communication and publication behavior on the Internet J. Med. Internet Res. 2009 11 e11 10.2196/jmir.1157 PMC2762766 19329408 11. Berhanu D. Leal Rato M. Canhoto A.I. …

Курс химиотерапии, вызванной периферической нейропатией (CIPN) у гематологических пациентов, проходящих лечение винкристином, бортезомидомидом или линалидомидом: исследование НОВИТ.

Для оценки и описания периферической нейропатии, вызванной химиотерапией (CIPN), широко известное осложнение лечения рака с использованием различных методологий у гематологов. В это исследование были включены методы лечения с помощью винкристина, бортезомида или линалидомида. Пациенты осматривались до начала лечения (базового) перед каждым циклом химиотерапии, one через месяц после окончания лечения и one Год после исходного показателя с использованием результатов, сообщенных пациентами (Функциональная оценка раковых заболеваний/гинекологическая онкология) Group-Ntx-13 (ФАКТ/GOG-Ntx-13) и резу

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… Harris PA Taylor R Thielke R Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support J Biomed Inform 2009 42 377 381 10.1016/J.JBI.2008.08.010 18929686 PMC2700030 Harris PA, Taylor R, Thielke R et al (2009) … Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. …

Цифровая двойная модель для подкрепления клинического решения на основе фактических данных при многократном лечении миэломы.

За последнее десятилетие в области лечения миеломы (ММ) был достигнут значительный прогресс. Несмотря на эффективность новых веществ, реакция пациентов, как правило, остается весьма непредсказуемой. С ростом когнитивной нагрузки, создаваемой за счет сложного и меняющегося ландшафта лечения, инструменты оказания помощи, основанные на данных, становятся все более популярными. Подходы, основанные на модели, такие как цифровые близнецы (ДТ), позволяют имитировать возможные ответы на набор входных параметров, основанных на ретроспективных наблюдениях. В контексте поддержки принятия решений о лечени

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… Drug knowledge bases and their applications in biomedical informatics research . Brief Bioinform . ( 2019 ) 20 ( 4 ): 1308 – 21 . 10.1093/bib/bbx169 29304188 27. … The role of explanations on trust and reliance in clinical decision support systems . 2015 International conference on healthcare Informatics ( 2015 ). p. 160 – 9 . 49. Gaebel J Keller J Schneider D Lindenmeyer A Neumuth T Franke S . …

Нацеливание ионных каналов в неврологии и психиатрии: является ли фармакологическая беспорядочность препятствием или возможностью?

ЦЕЛЬ: Традиционный акцент на разработке высокоспециализированных фармацевтических препаратов ("магические пули") для лечения неврологических и психических расстройств ставится под сомнение формирующимися концепциями патофизиологии, в которых болезни рассматриваются как ненормальные взаимодействия в рамках сложных сетей молекулярных и клеточных компонентов. В так называемой сетевой фармакологии основное внимание уделяется изменению поведения целых систем, а не отдельных компонентов, что является терапевтической стратегией, в которой в идеале использовались бы единичные фармакологические агенты,

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… To gain novel insight into normal and pathological physiology as well as potential therapeutic interventions, a multidisciplinary effort is required that combines high throughput techniques and informatics approaches. …

Pyramidal Decision Support Framework Leverages Subspecialty Expertise across Enterprise to Achieve Superior Cancer Outcomes and Personalized, Precision Care Plans.

The complexity of cancer care requires integrated and continuous support to deliver appropriate care. An expert network with complementary expertise and the capability of multidisciplinary care is an integral part of contemporary oncology care. Appropriate infrastructure is necessary to empower this network to deliver personalized precision care to their patients. Providing decision support as cancer care becomes exponentially more complex with new diagnostic and therapeutic choices remains challenging. City of Hope has developed a Pyramidal Decision Support Framework to address these challeng

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… At COH, the clinical informatics team has had a Pathway and Protocol Informatics Pharmacist (DJ) oversee monthly meetings with the academic disease leads and their specialty PharmDs, along with Epic Beacon builders and the value-based care medical director (LB). … We acknowledge the many other informatics, nursing, administration, electronic health records, quality, pathways, supportive care, and genomics colleagues who made this study possible. …

Integrating Neuroimaging and Genetics via Contrastive Learning for Working Memory.

Understanding working memory's genetic and neural bases is crucial for advancing cognitive neuroscience and identifying biomarkers for cognitive impairments, particularly in the older population. This study integrates SNP and neuroimaging data from the UK biobank to improve the classification of high vs. low working memory capacity and reveal genetic factors associated with brain structure. 1060 SNPs belonging to Protein-Protein Interaction networks of amyloid precursor protein and A β of Alzheimer's disease were integrated with latent features of whole brain gray matter density, extracted by

Caudal and Thalamic Segregation in White Matter Brain Network Communities in Alzheimer's Disease Population.

Neuroimaging studies have demonstrated that Alzheimer's disease (AD) is closely related to changes in neuroanatomy in the form of damage to both grey matter and white matter. However, the exact nature of AD's relationship with white matter anatomical deterioration is not fully understood at a systemic level. To investigate this knowledge gap, we constructed structural brain networks from ADNI-GO/2 diffusion tensor imaging (DTI) images with brain regions of interest (ROIs) as nodes and white matter connections as edges weighted by fiber density. The cohort consists of healthy control (HC), mild

Dynamic Delirium Prediction in the Intensive Care Unit using Machine Learning on Electronic Health Records.

Delirium is a syndrome of acute brain failure which is prevalent amongst older adults in the Intensive Care Unit (ICU). Incidence of delirium can significantly worsen prognosis and increase mortality, therefore necessitating its rapid and continual assessment in the ICU. Currently, the common approach for delirium assessment is manual and sporadic. Hence, there exists a critical need for a robust and automated system for predicting delirium in the ICU. In this work, we develop a machine learning (ML) system for real-time prediction of delirium using Electronic Health Record (EHR) data. Unlike

Transcutaneous Cervical Vagus Nerve Stimulation Reduces Respiratory Variability in the Context of Opioid Withdrawal.

Opioid withdrawal's physiological effects are a major impediment to recovery from opioid use disorder (OUD). Prior work has demonstrated that transcutaneous cervical vagus nerve stimulation (tcVNS) can counteract some of opioid withdrawal's physiological effects by reducing heart rate and perceived symptoms. The purpose of this study was to assess the effects of tcVNS on respiratory manifestations of opioid withdrawal - specifically, respiratory timings and their variability. Patients with OUD (N = 21) underwent acute opioid withdrawal over the course of a two-hour protocol. The protocol invol