AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
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Clinical study has found early detection and intervention to be essential for preventing clinical deterioration in patients at general hospital units. In this paper, we envision a two-tiered early warning system designed to identify the signs of clinical deterioration and provide early warning of serious clinical events. The first tier of the system automatically identifies patients at risk of clinical deterioration from existing electronic medical record databases. ⋯ We employ machine-learning techniques to analyze data from both tiers, assigning scores to patients in real time. The assigned scores can then be used to trigger early-intervention alerts. Preliminary study of an early warning system component and a wireless clinical monitoring system component demonstrate the feasibility of this two-tiered approach.
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AMIA Annu Symp Proc · Jan 2011
Medical record and imaging evaluation to identify arterial tortuosity phenotype in populations at risk for intracranial aneurysms.
High arterial tortuosity may signify early arterial pathology which may precede development of intracranial aneurysms. We measured arterial tortuosity of intracranial vessels and reviewed the medical records of three groups of patients: with intracranial aneurysms, without aneurysms but at increased clinical risk, and controls without aneurysms or associated risk factors. ⋯ We found increased arterial tortuosity in the Loeys-Dietz syndrome cases. A combination of medical record screening for Marfan syndrome or Loeys-Dietz symptoms such as aneurysms and evaluation of arterial tortuosity by a curve of scores from medical images may identify previously undiagnosed cases of Loeys-Dietz syndrome.
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AMIA Annu Symp Proc · Jan 2011
Falling through the cracks: information breakdowns in critical care handoff communication.
Handoffs have been recognized as a major healthcare challenge primarily due to the breakdowns in communication that occur during transitions in care. Consequently, they are characterized as being "remarkably haphazard". ⋯ Using a mixed inductive-deductive analysis approach, we identified two critical sources for information breakdowns - lack of standardization in handoff communication events and unsuccessful completion of pre-turnover coordination activities. We propose strategic solutions that can effectively help mitigate the handoff communication breakdowns.
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AMIA Annu Symp Proc · Jan 2011
Comparative StudyVoice-dictated versus typed-in clinician notes: linguistic properties and the potential implications on natural language processing.
In this study, we comparatively examined the linguistic properties of narrative clinician notes created through voice dictation versus those directly entered by clinicians via a computer keyboard. Intuitively, the nature of voice-dictated notes would resemble that of natural language, while typed-in notes may demonstrate distinctive language features for reasons such as intensive usage of acronyms. ⋯ The results suggest that between the narrative clinician notes created via these two different methods, there exists a considerable amount of lexical and distributional differences. Such differences could have a significant impact on the performance of natural language processing tools, necessitating these two different types of documents being differentially treated.
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AMIA Annu Symp Proc · Jan 2011
Development and evaluation of a prototype search engine to meet public health information needs.
Grey literature is information not available through commercial publishers. It is a sizable and valuable information source for public health (PH) practice but because documents are not formally indexed the information is difficult to locate. Public Health Information Search (PHIS) was developed to address this problem. ⋯ Increased document collection size and enhanced result rankings improved search effectiveness from 28% to 55%. PHIS would work best in conjunction with Google or another broad coverage Web search engine when searching for documents and reports as opposed to local health data and primary disease information. PHIS could enhance both the quality and quantity of PH search results.