AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
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Shifts in the supply of and demand for emergency department (ED) services have led to ED overcrowding and make the efficient allocation of ED resources increasingly important. Reliable means of modeling and forecasting the demand for resources are critical to any ED resource planning strategy. Vector Autoregression (VAR) is a flexible multivariate time-series forecasting methodology that is well suited to modeling demand for resources in the ED.
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AMIA Annu Symp Proc · Jan 2007
Clinical decision support to improve antibiotic prescribing for acute respiratory infections: results of a pilot study.
Acute Respiratory Infections (ARIs) are the number one reason for antibiotic prescribing in the United States, and much antibiotic prescribing for ARIs is inappropriate. We designed an electronic health record-integrated, documentation-based clinical decision support system for the care of patients with ARIs, the ARI Smart Form. To evaluate the ARI Smart Form and assess the feasibility of performing a larger trial, we conducted a pilot study with 10 clinicians who used the ARI Smart Form with 26 patients. ⋯ The average duration of use of the ARI Smart Form was 7.5 (SD+/-4.5) minutes. Eight of 10 respondents reported that the ARI Smart Form was either time-neutral or timesaving. The ARI Smart Form requires further evaluation but has the potential to improve workflow and reduce inappropriate antibiotic prescribing.
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STAndards for Reporting of Diagnostic Accuracy (STARD) were published in 2003 and endorsed by some journals but not others. ⋯ In MEDLINE, no differences in indexing quality were found for STARD and non-STARD journals before or after the STARD statement was published in 2003. In EMBASE, indexing in STARD journals improved compared with non-STARD journals (p = 0.02). However, articles in STARD journals had half the number of accurate indexing terms as articles in non-STARD journals, both before and after STARD statement publication (p < 0.001).
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Maintaining critically-ill patients' blood glucose levels within the normoglycemic range has been shown to reduce mortality and morbidity, but it has not been achieved consistently using existing insulin infusion protocols. This study examines blood glucose monitoring in an intensive care unit (ICU) and how blood glucose levels change in response to therapy. Our findings confirm the commonly observed poor compliance of blood glucose levels and motivate for more effective glycemic control.
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AMIA Annu Symp Proc · Jan 2007
Encouraging change in anesthesiology practice through electronic feedback to physicians: results from prototype system.
Implementation of best care practices is difficult because the status quo is often perpetuated; many providers treat patients based on anecdotal experience rather than evidence-based medicine. Our goal was to develop and evaluate an electronic feedback system that feeds back practice and outcome data combined with educational material to anesthesiologists. Best care practices for postoperative nausea/vomiting (PONV) control were selected to evaluate this system because PONV is a common outcome and guidelines have been published.