Studies in health technology and informatics
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Stud Health Technol Inform · Sep 2019
ReviewDevelopment and Usability Analysis of a Multimedia eConsent Solution.
More and more medical data is being stored digitally in routine care. The secondary use of patient data is only possible to a limited extent for data protection reasons. In order to enable a long-term and far-reaching use of secondary data, a possible approach is to obtain "broad consent" from patients, e.g. on research projects whose purpose is still unknown at the time of consent. ⋯ The next steps will include further refinements of the prototype based on the feedback received and a subsequent study with a broader user group aimed at introducing an eConsent tool as part of a patient portal.
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Stud Health Technol Inform · Sep 2019
Dynamic Pocket Card for Implementing ISBAR in Shift Handover Communication.
A risk factor for patient safety are communication failures among health professionals. Communication standards such as SBAR or ISBAR (situation, background, assessment, recommendation) aim at improving the exchange of information between health professionals by specifying a certain structure and content of information. However, those tools are not well established in daily clinical practice and IT support is missing which results in unstructured, inefficient and error prone information exchange. ⋯ We collected requirements in collaboration with a hospital and developed a prototype. Within the application, nurses can take notes on the five information categories of ISBAR, which allows to reproduce the information in reporting situations in a structured manner. In future, it will be assessed in a pilot phase whether the digital pocket card is suitable for everyday clinical use.
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Stud Health Technol Inform · Sep 2019
Alarm Fatigue: Using Alarm Data from a Patient Data Monitoring System on an Intensive Care Unit to Improve the Alarm Management.
Excessive numbers of clinical alarms reduce the awareness of caregivers. Frequent alarms, many of which are non-actionable, can lead to cognitive overload, stress, and desensitization to alarms, called "Alarm Fatigue", which can severely impact patient safety. ⋯ The developed system answers the users' needs in terms of readily providing them information on a daily basis, but also serves as a data source for further research. Further work is needed to include alarm sources from outside the patient monitoring infrastructure.
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Stud Health Technol Inform · Aug 2019
Model Performance Metrics in Assessing the Value of Adding Intraoperative Data for Death Prediction: Applications to Noncardiac Surgery.
We tested the value of adding data from the operating room to models predicting in-hospital death. We assessed model performance using two metrics, the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC), to illustrate the differences in information they convey in the setting of class imbalance. Data was collected on 74,147 patients who underwent major noncardiac surgery and 112 unique features were extracted from electronic health records. ⋯ AUROC increased as more features were added, but changes were small for some modeling approaches. In contrast, AUPRC, which reflects positive predicted value, exhibited improvements across all models. Using AUPRC highlighted the added value of intraoperative data, not seen consistently with AUROC, and that with class imbalance AUPRC may serve as the more clinically relevant criterion.
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Stud Health Technol Inform · Aug 2019
Decentralized Privacy-Preserving Platform for Clinical Data Sharing and Analysis.
Collection and management of clinical data for administration and analysis is a time-consuming and complex task, especially when multiple data providers been involved. Even if people are willing to take on the burden for it, there is still no mature solution to protect data privacy for distributed data providers. Distributed ledger is an emerging technology that supports decentralized data sharing and management. ⋯ Our system, built on Hyperledger Fabric, used smart contract to execute data aggregation and provide basic analysis methods. The system used ledger and world status to record data access history and other metadata. This decentralized platform enables data providers to proactively share and protect their data, Thus can simplify clinical data collection procedure and promote efficient collaboration between providers.