Studies in health technology and informatics
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Our main objective is to detect adverse drug events (ADEs) in former hospital stays. As ADEs are rare, that supposes to screen thousands of electronic health records (EHRs). For that purpose, we need to define a data model that has two main objectives: (1) being able to describe hospital stays from various hospitals (2) being tuned so as to prepare the data mining process: as ADEs are not flagged in the datasets, the data model must be optimized for ADE detection. ⋯ It is compatible with many hospitals. It deals with diagnoses, drug prescriptions, lab results and administrative information. It allows for data mining and ADE detection in EHRs.
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Integrated care pathways, a fine-grained form of medical guideline including the explicit recording of any deviation, or 'variance', have been perceived by some as overly prescriptive, limiting clinical freedom and promoting 'cookbook medicine'. However, feeding the results of the analysis of variance back into the development of a pathway could be an effective way of capturing evidence from practice. This paper summarizes research into the development and use of ICPs, and includes some initial findings from a qualitative study involving clinicians that have helped develop or have used ICPs professionally.
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Stud Health Technol Inform · Jan 2009
Scientific evidence for the effectiveness of virtual reality for pain reduction in adults with acute or chronic pain.
The objective of this systematic review was to determine the level of scientific evidence for the effectiveness of VR for pain management in adults with pain. A comprehensive systematic search involving major health care databases was undertaken to identify randomized clinical trials (RCTs) and descriptive studies. Twenty-seven studies were identified that fulfilled the inclusion criteria. ⋯ Moreover, there is limited evidence (Level 2a) of effectiveness of immersive VR compared to no VR for reducing chronic pain. There is currently no published study that has explored the effectiveness of non-immersive VR for chronic pain (level 5). It is concluded that VR can be recommended as a standard or adjunct clinical intervention for pain management at least in the management of acute pain.
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Stud Health Technol Inform · Jan 2009
Randomized Controlled TrialVirtual reality on mobile phones to reduce anxiety in outpatient surgery.
When undergo ambulatory surgical operations, the majority of patients experience high level of anxiety. Different experimental studies have shown that distraction techniques are effective in reducing pain and related anxiety. Since Virtual reality (VR) has been demonstrated a good distraction technique, it has been repeatedly used in hospital contexts for reducing pain in burned patients, but it has never been used during surgical operations. ⋯ In particular, we measured the degree to which anxiety associated with surgical intervention was reduced by distracting patients with immersive VR provided through a cell phone connected to an HMD compared to a no-distraction control condition. A significant reduction of anxiety was obtained after 45 minutes of operation in the VR group, but not in the control group and, after 90 minutes, the reduction was larger in the experimental group than in other one. In conclusion, this study presents an innovative promising technique to reduce anxiety during surgical interventions, even if more studies are necessary to investigate its effectiveness in other kinds of operations and in larger numbers of patients.
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Stud Health Technol Inform · Jan 2009
Intensive care admission and discharge - critical decision-making points.
Delivery of intensive care has many critical points impacting the outcomes of critically ill patients. Two important key events in intensive care are patients' admission and discharge procedures. ⋯ To reveal the complex decision-making, we studied the decision-making processes and information needs of intensive care charge nurses during patients' admission and discharge procedures. We identified several interconnected decision-making steps during these procedures.