Journal of the American Medical Informatics Association : JAMIA
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This paper summarizes much of the research that is applicable to the design of auditory alarms in a medical context. It also summarizes research that demonstrates that false alarm rates are unacceptably high, meaning that the proper application of auditory alarm design principles are compromised. ⋯ The emergence of alarms as a 'hot topic'; an outline of the issues and design principles, including IEC 60601-1-8; the high incidence of false alarms and its impact on alarm design and alarm fatigue; approaches to reducing alarm fatigue; alarm philosophy explained; urgency in audible alarms; different classes of sound as alarms; heterogeneity in alarm set design; problems with IEC 60601-1-8 and ways of approaching this design problem.
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J Am Med Inform Assoc · May 2013
Comparative StudyUse of the International Classification of Diseases, 9th revision, coding in identifying chronic hepatitis B virus infection in health system data: implications for national surveillance.
With increasing use electronic health records (EHR) in the USA, we looked at the predictive values of the International Classification of Diseases, 9th revision (ICD-9) coding system for surveillance of chronic hepatitis B virus (HBV) infection. ⋯ As the USA increases the use of EHR, surveillance using ICD-9 codes may be reliable to determine the burden of chronic HBV infection and would be useful to improve reporting by state and local health departments.
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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.