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Development of an Ontology to Model Medical Errors, Information Needs, and the Clinical Communication Space 建立医疗差错、信息需求和临床沟通空间的本体模型
Proceedings. AMIA Symposium Pub Date : 2002-11-01 DOI: 10.1197/jamia.M1235
P. Stetson, Lawrence K. McKnight, S. Bakken, C. Curran, Tate T. Kubose, J. Cimino
{"title":"Development of an Ontology to Model Medical Errors, Information Needs, and the Clinical Communication Space","authors":"P. Stetson, Lawrence K. McKnight, S. Bakken, C. Curran, Tate T. Kubose, J. Cimino","doi":"10.1197/jamia.M1235","DOIUrl":"https://doi.org/10.1197/jamia.M1235","url":null,"abstract":"Medical errors are common, costly and often preventable. Work in understanding the proximal causes of medical errors demonstrates that systems failures predispose to adverse clinical events. Most of these systems failures are due to lack of appropriate information at the appropriate time during the course of clinical care. Problems with clinical communication are common proximal causes of medical errors. We have begun a project designed to measure the impact of wireless computing on medical errors. We report here on our efforts to develop an ontology representing the intersection of medical errors, information needs and the communication space. We will use this ontology to support the collection, storage and interpretation of project data. The ontology's formal representation of the concepts in this novel domain will help guide the rational deployment of our informatics interventions. A real-life scenario is evaluated using the ontology in order to demonstrate its utility.","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1197/jamia.M1235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66391487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 33
Using a Clinical Data Repository to Estimate the Frequency and Costs of Adverse Drug Events 使用临床数据存储库估计药物不良事件的频率和成本
Proceedings. AMIA Symposium Pub Date : 2002-11-01 DOI: 10.1197/JAMIA.M1222
J. Einbinder, K. Scully
{"title":"Using a Clinical Data Repository to Estimate the Frequency and Costs of Adverse Drug Events","authors":"J. Einbinder, K. Scully","doi":"10.1197/JAMIA.M1222","DOIUrl":"https://doi.org/10.1197/JAMIA.M1222","url":null,"abstract":"As a result of increased attention to medical errors, many institutions are contemplating increased use of information technology and clinical decision support. We conducted a retrospective analysis to estimate the frequency and cost of adverse drug events (ADEs) for inpatients at the University of Virginia. Applying published criteria for the detection of potential adverse events, we used a clinical data warehouse to identify patients and cases with potential ADEs. Again using published criteria, we then estimated the actual number of adverse drug events and preventable adverse drug events, as well as their attributable costs and excess length of stay. Our results showed a higher estimate (10.4-11.5 events per 100 admissions) for ADEs than seen in the ADE Prevention Study, highlighting the importance of considering the generalizability of published ADE studies to other settings. Our analysis demonstrates that retrospective analysis can be an efficient and powerful technique to evaluate rules and criteria used to detect ADEs and to assess their impact.","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1197/JAMIA.M1222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66391656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 30
The Operating Room Charge Nurse: Coordinator and Communicator 手术室主管护士:协调者和沟通者
Proceedings. AMIA Symposium Pub Date : 2002-11-01 DOI: 10.1197/JAMIA.M1231
Jacqueline A. Moss, Yan Xiao, S. Zubaidah
{"title":"The Operating Room Charge Nurse: Coordinator and Communicator","authors":"Jacqueline A. Moss, Yan Xiao, S. Zubaidah","doi":"10.1197/JAMIA.M1231","DOIUrl":"https://doi.org/10.1197/JAMIA.M1231","url":null,"abstract":"To achieve the potential inherent in the use of computer applications in distributed environments, we need to understand the information needs of users. The purpose of this descriptive study was to document the communication of an operating room charge nurse to inform the design of technological communication applications for operating room coordination. A data collection tool was developed to record: 1) the purpose of the communication, 2) mode of communication, 3) the target individual, and 4) the length of time taken for each occurrence. The chosen data collection categories provided a functional structure for data collection and analysis involving communication. Study findings are discussed within the context of application design.","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1197/JAMIA.M1231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66391377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 42
Generation of Dynamically Configured Check Lists for Intra-Operative Problems: Using a Set Covering Algorithm 术中问题动态配置检查表的生成:使用集合覆盖算法
Proceedings. AMIA Symposium Pub Date : 2002-11-01 DOI: 10.1197/JAMIA.M1221
T. Sawa, L. Ohno-Machado
{"title":"Generation of Dynamically Configured Check Lists for Intra-Operative Problems: Using a Set Covering Algorithm","authors":"T. Sawa, L. Ohno-Machado","doi":"10.1197/JAMIA.M1221","DOIUrl":"https://doi.org/10.1197/JAMIA.M1221","url":null,"abstract":"We present a prototype of a decision support system for anesthesia that applies set covering theory. The system is designed to generate dynamically configured check-lists for intra-operative problems. These lists have the potential to help anesthesiologists detect and manage problems in a timely manner. The items in the lists consist of major complications that should be considered for a particular case. A set covering algorithm that accommodates multiple problem sets was used to implement the prototype. A simulated case and the system behavior are presented. The ultimate goals of a system such as the one presented are to function as an intelligent alarm module for electronic monitors and to facilitate the task of correcting intra-operative problems.","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1197/JAMIA.M1221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66391632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Perceived Information Needs and Communication Difficulties of Inpatient Physicians and Nurses 住院医师护士感知信息需求与沟通困难
Proceedings. AMIA Symposium Pub Date : 2002-11-01 DOI: 10.1197/JAMIA.M1230
Lawrence K. McKnight, P. Stetson, S. Bakken, C. Curran, J. Cimino
{"title":"Perceived Information Needs and Communication Difficulties of Inpatient Physicians and Nurses","authors":"Lawrence K. McKnight, P. Stetson, S. Bakken, C. Curran, J. Cimino","doi":"10.1197/JAMIA.M1230","DOIUrl":"https://doi.org/10.1197/JAMIA.M1230","url":null,"abstract":"In order to understand the differing perceptions of information needs and communication patterns of healthcare professionals as they relate to medical errors, we conducted a survey and 5 focus group sessions of inpatient physicians and nurses. Although nurses and physicians stated differing information needs, both groups expressed significant problems with obtaining patient, domain and institution-specific information in a timely manner. Identification of appropriate providers and establishing contact with those people was perceived as the most pressing communication need. All focus group participants felt that communication difficulties were common and could give examples in which such difficulties led to adverse events. Our studies suggest that information needs and communication difficulties are common and can lead to medical errors or near misses. Many of these problems may be amenable to information technology solutions.","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1197/JAMIA.M1230","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66391308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 107
Medical Quality Assessment by Scoring Adherence to Guideline Intentions 通过对指南意图的依从性评分来评估医疗质量
Proceedings. AMIA Symposium Pub Date : 2002-11-01 DOI: 10.1197/JAMIA.M1236
Aneel A. Advani, Yuval Shahar, M. Musen
{"title":"Medical Quality Assessment by Scoring Adherence to Guideline Intentions","authors":"Aneel A. Advani, Yuval Shahar, M. Musen","doi":"10.1197/JAMIA.M1236","DOIUrl":"https://doi.org/10.1197/JAMIA.M1236","url":null,"abstract":"Quality assessment of clinician actions and patient outcomes is a central problem in guideline- or standards-based medical care. In this paper we describe an approach for evaluating and consistently scoring clinician adherence to medical guidelines using the intentions of guideline authors. We present the Quality Indicator Language (QUIL) that may be used to formally specify quality constraints on physician behavior and patient outcomes derived from medical guidelines. We present a modeling and scoring methodology for consistently evaluating multi-step and multi-choice guideline plans based on guideline intentions and their revisions.","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1197/JAMIA.M1236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66391585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 45
Patient Safety in Guideline-Based Decision Support for Hypertension Management: ATHENA DSS 基于指南的高血压管理决策支持中的患者安全:ATHENA DSS
Proceedings. AMIA Symposium Pub Date : 2002-11-01 DOI: 10.1197/JAMIA.M1218
M. Goldstein, B. B. Hoffman, R. Coleman, S. Tu, R. Shankar, M. O'Connor, S. Martins, Aneel A. Advani, M. Musen
{"title":"Patient Safety in Guideline-Based Decision Support for Hypertension Management: ATHENA DSS","authors":"M. Goldstein, B. B. Hoffman, R. Coleman, S. Tu, R. Shankar, M. O'Connor, S. Martins, Aneel A. Advani, M. Musen","doi":"10.1197/JAMIA.M1218","DOIUrl":"https://doi.org/10.1197/JAMIA.M1218","url":null,"abstract":"The Institute of Medicine recently issued a landmark report on medical error.1 In the penumbra of this report, every aspect of health care is subject to new scrutiny regarding patient safety. Informatics technology can support patient safety by correcting problems inherent in older technology; however, new information technology can also contribute to new sources of error. We report here a categorization of possible errors that may arise in deploying a system designed to give guideline-based advice on prescribing drugs, an approach to anticipating these errors in an automated guideline system, and design features to minimize errors and thereby maximize patient safety. Our guideline implementation system, based on the EON architecture, provides a framework for a knowledge base that is sufficiently comprehensive to incorporate safety information, and that is easily reviewed and updated by clinician-experts.","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1197/JAMIA.M1218","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66391461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 68
Usability of expressive description logics--a case study in UMLS. 表达性描述逻辑的可用性——UMLS中的一个案例研究。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
R Cornet, A Abu-Hanna
{"title":"Usability of expressive description logics--a case study in UMLS.","authors":"R Cornet,&nbsp;A Abu-Hanna","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Research in (medical) terminological knowledge representation is showing an increased interest in the family of Description Logics (DLs), as they allow for automatic reasoning. This interest is driven by an increase in demands on the quality of and reasoning ability with medical terminological knowledge. Recent advances in Computer Science have demonstrated the computational decidability and empirical tractability of quite expressive DLs. The question arises whether this expressivity is usable and useful. This paper motivates and describes an exploratory study to address this question by examining the surplus value of individual DL constructors based on an investigation of UMLS terms. Our study indicates that the disjunction and negation operators comprise very valuable extensions to current DLs. The impact of formalization depends on the involved semantic type; \"Injury and Poisoning\" is one of the semantic types in which a large portion of concepts will benefit from the extension.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244165/pdf/procamiasymp00001-0221.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22138390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
NLM tele-educational application for radiologists to interpret mammography. NLM远程教育应用于放射科医生解释乳房x光检查。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Min Wu, Yuanshui Zheng, Michael North, Etta Pisano
{"title":"NLM tele-educational application for radiologists to interpret mammography.","authors":"Min Wu,&nbsp;Yuanshui Zheng,&nbsp;Michael North,&nbsp;Etta Pisano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The goal of this study was to provide unique tools for an educational program to improve the skills, namely consistency and accuracy, of radiology residents who interpret digital mammograms. The tele-educational tools, created at UNC, will be implemented locally and connected to the National Digital Mammography Archive (NDMA) through the Next Generation Internet (NGI). This application includes an annotation tool, as well as a teaching and testing tool. The annotation tool will allow radiologists to label all imaging findings including the specific location information in mammograms, and make lesion diagnosis based on pathology reports. The teaching tool will allow teachers to demonstrate cases of specific types and diagnoses. Trainees themselves will also be able to use the teaching tool for reviewing of cases of types of their choosing. Our testing tool can test radiology residents inverted exclamation mark performance in interpreting digital mammograms, and provides them detailed performance test results, such as, sensitivity, specificity, ROC curves, AUC values, etc. A local Oracle database was designed and implemented at UNC to support those tools. We developed a method to map information of cases from the local database to DICOM Structure Reports by using XML techniques.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244562/pdf/procamiasymp00001-0950.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22138413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Toward a cognitive taxonomy of medical errors. 医疗差错的认知分类。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Jiajie Zhang, Vimla L Patel, Todd R Johnson, Edward H Shortliffe
{"title":"Toward a cognitive taxonomy of medical errors.","authors":"Jiajie Zhang,&nbsp;Vimla L Patel,&nbsp;Todd R Johnson,&nbsp;Edward H Shortliffe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>One critical step in addressing and resolving the problems associated with human errors is the development of a cognitive taxonomy of such errors. In the case of errors, such a taxonomy may be developed (1) to categorize all types of errors along cognitive dimensions, (2) to associate each type of error with a specific underlying cognitive mechanism, (3) to explain why, and even predict when and where, a specific error will occur, and (4) to generate intervention strategies for each type of error. Based on Reason's (1992) definition of human errors and Norman's (1986) cognitive theory of human action, we have developed a preliminary action-based cognitive taxonomy of errors that largely satisfies these four criteria in the domain of medicine. We discuss initial steps for applying this taxonomy to develop an online medical error reporting system that not only categorizes errors but also identifies problems and generates solutions.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244173/pdf/procamiasymp00001-0975.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22138417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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