Journal of the American Medical Informatics Association : JAMIA
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J Am Med Inform Assoc · Mar 2013
Multicenter Study Controlled Clinical TrialImpact of a clinical decision support system on antibiotic prescribing for acute respiratory infections in primary care: quasi-experimental trial.
To assess the effect of a clinical decision support system (CDSS) integrated into an electronic health record (EHR) on antibiotic prescribing for acute respiratory infections (ARIs) in primary care. ⋯ A CDSS embedded in an EHR had a modest effect in changing prescribing for adults where antibiotics were inappropriate but had a substantial impact on changing the overall prescribing of broad-spectrum antibiotics among pediatric and adult patients.
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J Am Med Inform Assoc · Mar 2013
Identifying primary and recurrent cancers using a SAS-based natural language processing algorithm.
Significant limitations exist in the timely and complete identification of primary and recurrent cancers for clinical and epidemiologic research. A SAS-based coding, extraction, and nomenclature tool (SCENT) was developed to address this problem. ⋯ SCENT is proof of concept for SAS-based natural language processing applications that can be easily shared between institutions and used to support clinical and epidemiologic research.
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J Am Med Inform Assoc · Mar 2013
A practical approach to achieve private medical record linkage in light of public resources.
Integration of patients' records across resources enhances analytics. To address privacy concerns, emerging strategies such as Bloom filter encodings (BFEs), enable integration while obscuring identifiers. However, recent investigations demonstrate BFEs are, in theory, vulnerable to cryptanalysis when encoded identifiers are randomly selected from a public resource. This study investigates the extent to which cryptanalysis conditions hold for (1) real patient records and (2) a countermeasure that obscures the frequencies of the identifying values in encoded datasets. ⋯ Performance of cryptanalysis against BFEs based on patient data is significantly lower than theoretical estimates. The proposed countermeasure makes BFEs resistant to known practical attacks.