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Category : Rapid Learning Healthcare System

Manuscript: Identifying primary and recurrent cancers using a SAS-based natural language processing algorithm

Abstract Objective Significant limitations exist in the timely and complete identification of primary and recurrent cancers for clinical and epidemiologic research. A SAS-based coding, extraction, and nomenclature tool (SCENT) was developed to address this problem. Materials and methods SCENT employs hierarchical classification rules to identify and extract information from electronic pathology reports. Reports are
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MANUSCRIPT: Ten Commandments for Effective Clinical Decision Support: Making the Practice of Evidence-based Medicine a Reality

A b s t r a c t While evidence-based medicine has increasingly broad-based support in health care, it remains difficult to get physicians to actually practice it. Across most domains in medicine, practice has lagged behind knowledge by at least several years. The authors believe that the key tools for closing
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MANUSCRIPT: The GuideLine Implementability Appraisal (GLIA): development of an instrument to identify obstacles to guideline implementation

Background: Clinical practice guidelines are not uniformly successful in influencing clinicians' behaviour toward best practices. Implementability refers to a set of characteristics that predict ease of (and obstacles to) guideline implementation. Our objective is to develop and validate a tool for appraisal of implementability of clinical guidelines. http://www.biomedcentral.com/content/pdf/1472-6947-5-23.pdf
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MANUSCRIPT: Why Don’t Physicians Follow Clinical Practice Guidelines? A Framework for Improvement

Context Despite wide promulgation, clinical practice guidelines have had limited effect on changing physician behavior. Little is known about the process and factors involved in changing physician practices in response to guidelines. Objective To review barriers to physician adherence to clinical practice guidelines. http://rds.epi-ucsf.org/ticr/syllabus/courses/66/2009/10/22/Lecture/readings/Cabana.JAMA.1999.pdf
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MANUSCRIPT: Enhancing the Use of Clinical Guidelines: A Social Norms Perspective

This article reviews the history of guideline development and use, assesses the current state of implementation, identifies obstacles to adoption, and suggests strategies to overcome these obstacles. The major finding is that the current approach to development, dissemination, and encouraged use of guidelines is inconsistent with knowledge of psychology. The major recommendations are that the approach to translation
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Reflecting on what is missing in medical education – A letter to a mentor.

Below is an excerpt from a letter I recently sent to a friend and mentor. I hope by sharing it it may inspire others to think through these issues, and hopefully to share their ideas with the community.   Dear (Mentor): We began our conversation with the definition of learning: "Learning is the extraction
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ABSTRACT: A study on determining the perception of learning organisation applications by health sector workers.

Abstract It is stated that in this century not only the societies, but also the communities have to confront with a reconstruction process due to the rapid developments and reformations. It is believed that it is only possible for the organisations to achieve their goals as long as they adapt to
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RESOURCE: Informatics Professor: Implementing the Learning Healthcare System Can Be Facilitated Using the Principles of Evidence-Based Medicine

The enthusiasm for big data and for the use of analytics and business intelligence with that data is reaching a fevered pitch. I share that enthusiasm, but also know from both my clinical and my informatics experience that knowledge will not emanate just by turning on the data spigot from
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MANUSCRIPT: Towards comprehensive syntactic and semantic annotations of the clinical narrative — Albright et al. — Journal of the American Medical Informatics Association

Abstract Objective To create annotated clinical narratives with layers of syntactic and semantic labels to facilitate advances in clinical natural language processing (NLP). To develop NLP algorithms and open source components. Methods Manual annotation of a clinical narrative corpus of 127 606 tokens following the Treebank schema for syntactic information, PropBank schema for
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ABSTRACT: The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals — Wu et al. — Journal of the American Medical Informatics Association

Abstract Background Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness.Objectives To describe the effects of different communication interventions and their problems.Design Prospective observational case study using a
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