International journal of medical informatics
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Comparative Study
Structured electronic operative reporting: comparison with dictation in kidney cancer surgery.
The purpose of this study was to evaluate the functionality of eKidney as a structured reporting tool in operative note generation. To do this, we compared completeness and timeliness of eKidney template-generated nephrectomy OR notes with standard narrative dictation. ⋯ We have demonstrated that the use of structured reporting improves the completeness and timeliness of documentation in kidney cancer surgery. eKidney is an example of the power of templates in ensuring that important details of a procedure are recorded. Future studies looking at user satisfaction, and research and educational potential of eKidney would be valuable.
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Social media allows for instant access to, and dissemination of, information around the globe. Access to social media in low- and middle-income countries has increased exponentially in recent years due to technological advances. Despite this growth, the use of social media in low- and middle-income countries is less well-researched than in high-income countries. ⋯ Social media has the ability to facilitate disease surveillance, mass communication, health education, knowledge translation, and collaboration amongst health providers in low- and middle-income countries. Misinformation or poorly communicated information can contribute to negative health behaviours and adverse health outcomes amongst consumers, as well as hysteria and chaos. Organizations using social media should provide accurate and readable information. Promotion of credible social media sites by governments, health care professionals and researchers, as well as education on the appropriate use of social media, could help to lessen the effect of misinformation. This is a nascent body of literature and future research should investigate the relative effectiveness of various platforms for different users, other potential uses, and pursue a broader geographical focus.
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Use of an anesthesia information management system (AIMS) does not insure record completeness and data accuracy. Mandatory data-entry fields can be used to assure data completeness. However, they are not suited for data that is mandatory depending on the clinical situation (context sensitive). For example, information on equal breath sounds should be mandatory with tracheal intubation, but not with mask ventilation. It was hypothesized that employing context-sensitive mandatory data-entry fields can insure high data-completeness and accuracy while maintaining usability. ⋯ Using context-sensitive mandatory fields in an anesthesia information management system was associated with high record completeness rate and data concordance. In addition, the system's usability was rated as very good by its users.
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Severity of illness scores used in critical care for benchmarking, quality assurance and risk stratification have been mainly created in high-income countries. In low and middle-income countries (LMICs), they cannot be widely utilized due to the demand for large amounts of data that may not be available (e.g. laboratory results). We attempt to create a new severity prognostication model using fewer variables that are easier to collect in an LMIC. ⋯ Our study proposes a new ICU mortality prediction model using simple logistic regression on a small set of easily collected variables may be better suited than currently available models for use in low and middle-income countries.
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Randomized Controlled Trial
Improving resident's skills in the management of circulatory shock with a knowledge-based e-learning tool.
Correct clinical management of circulatory shock in emergency departments (ER) and intensive care units (ICU) is critical. In this context, the transmission of professional skills by means of the practical supervision of real cases at the point of care entails important issues that can be widely overcome with the use of computer knowledge-based e-learning tools. ⋯ Web-oriented knowledge-based e-learning computer tools such as Shock-Instructor can significantly reduce the learning time of ER and ICU residents, while enhancing their assimilation of evidence-based medicine and both the survival rate and health condition of patients with shock.