AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
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AMIA Annu Symp Proc · Oct 2007
Supporting multidisciplinary staff meetings for guideline-based breast cancer management: a study with OncoDoc2.
In order to reduce practice variations and offer cancer patients the best treatments according to reference guidelines, therapeutic decisions have to be taken, in France, by "multidisciplinary staff meetings'' (MSMs) as patient-specific care plans which are then implemented by cancer specialists. OncoDoc2 is a CDSS implementing CancerEst guidelines, a "local reference guideline'', on breast cancer management. The system has been assessed in a pragmatic before/after study. ⋯ The MSM decision compliance rate with the reference guideline was significantly higher in the after period, increasing from 79% to 93%. MSM decision analysis showed that missing steps in treatment plans were the main cause of noncompliance during the before period. This cause was drastically reduced in the after period.
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Sparklines, embedded contextual information graphics, can help reduce diagnostic errors by highlighting trends in data, simplifying cognitive tasks and providing context for decision making. Examples applied to heparin induced thrombocytopenia, cardiac catheterization and pediatric viral illness illustrate the concept. Sparklines are ideal in situations where the limited textual data representations obfuscate interpretation, the graphic aids interpretation of the data, or the graphic guides decision making.
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AMIA Annu Symp Proc · Oct 2007
Use of RxNorm to exchange codified drug allergy information between Department of Veterans Affairs (VA) and Department of Defense (DoD).
Under a congressional mandate, VA and DoD have built a framework to exchange standardized, codified patient drug allergy information through a mediation terminology. Initially, the Unified Medical Language System (UMLS) was deemed to be the most appropriate translator. After both agency files were mapped to UMLS, DoD could understand 45 percent of VA's mapped terms and VA could understand 26 percent of DoD's mapped terms. ⋯ An analysis was conducted to estimate mediation improvement using RxNorm. Both agency files were re-mapped to RxNorm. By utilizing the RxNorm defined relationships between brand names and generics and between variants of therapeutic moieties , DoD will understand 74 percent of VA terms and VA will understand 58 percent of DoD terms.
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AMIA Annu Symp Proc · Oct 2007
Leveraging electronic medical record (EMR) systems along with other health information systems (HIS) to improve data capture and reporting for a surgical quality improvement program at a tertiary care institution and integrated health system.
Many EMR systems are focused on documentation but are not designed for discrete clinical data capture for outcomes and quality measurement. This requires new clinical workflow and methods to capture patient specific data as part of usual care, without negative impact on productivity. We describe a process to harness tools within a commercially available EMR, together with other electronic data sources to improve the accuracy and efficiency and scalability of a surgical quality reporting program.
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AMIA Annu Symp Proc · Jan 2007
Semantic query generation from eligibility criteria in clinical trials.
Towards the goal of automated eligibility determination for clinical trials from electronic health records, we propose a method to formulate Semantic Web based queries using the free-text eligibility criteria on clinicaltrials.gov.