AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
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AMIA Annu Symp Proc · Jan 2006
ReviewDeterminants of success for computerized clinical decision support systems integrated in CPOE systems: a systematic review.
We carried out a systematic review of published trials to identify the methodological characteristics of studies and technical characteristics of computerized clinical decision support systems (CCDSSs) associated with efficacy for the main outcome of the study. Four characteristics of the content of decision support and the way in which the user is provided with assistance seem to be associated with the success of CCDSSs: a) System-initiated interventions, b) Assistance without user control over output, c) Systems in which data are automatically retrieved from the electronic medical record and d) Systems providing corollary actions in CPOE. Major differences in outcome reporting between studies could be reduced by the use of dedicated tools to standardize methodological reporting.
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AMIA Annu Symp Proc · Jan 2006
Randomized Controlled Trial Comparative StudyEffect of e-mail versus postal reminders for mammogram screening.
A randomized controlled trial was undertaken to measure the efficacy of a patient reminder system for females age 40 - 75 in a Midwestern primary care practice. A subset of the population whose email addresses were known was further randomized to measure the effect of email versus postal reminders. A statistically significant increase in completion rates was observed in the intervention group while no difference was found between the email and postal mail groups.
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AMIA Annu Symp Proc · Jan 2006
Randomized Controlled TrialA computerized decision support system improves the accuracy of temperature capture from nursing personnel at the bedside.
To assess the effect of a computerized decision support system (CDSS) on the accuracy of patient temperature recording at the bed side. ⋯ CDSS are effective with nursing personnel in improving the accuracy of temperature capture at the bedside.
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AMIA Annu Symp Proc · Jan 2006
Prospective evaluation of a closed-loop, computerized reminder system for pneumococcal vaccination in the emergency department.
The Emergency Department is a suitable but challenging environment to implement a sustainable pneumococcal vaccination program. To increase vaccination rates for patients > or equal to 65 years old, we prospectively evaluated a closed-loop informatics approach over a 6-week study period. Among the 572 candidate patients, 284 were up-to-date with vaccination, 187 patients refused vaccination, 65 physicians declined to order the vaccine, and 28 patients received the vaccine during the ED visit. The informatics approach increased vaccination rate from a baseline of 49.8% to 54.9% (p < 0.01).
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AMIA Annu Symp Proc · Jan 2006
An early warning system for overcrowding in the emergency department.
Overcrowding of emergency departments impedes health care access and quality nationwide. A real-time early warning system for overcrowding may allow administrators to alleviate the problem before reaching a crisis state. Two original probabilistic models - a logistic regression and a recurrent neural network - were created to predict overcrowding crises one hour in the future. ⋯ All models showed high discriminatory ability in terms of area under the receiver operating characteristic curve (logistic regression = .954; recurrent neural network = .957; EDWIN = .879; NEDOCS = .924). At comparable rates of false alarms, the logistic regression gave more advance notice of crises than other models (logistic regression = 62 min; recurrent neural network = 13 min; EDWIN = 0 min; NEDOCS = 0 min). These results demonstrate the feasibility of using models based on key operational variables to anticipate overcrowding crises in real time.