John Pestian, Malik Spencer, Pawel Matykiewicz, Kejian Zhang, Alexander A Vinks, Tracy Glauser
{"title":"Personalizing Drug Selection Using Advanced Clinical Decision Support.","authors":"John Pestian, Malik Spencer, Pawel Matykiewicz, Kejian Zhang, Alexander A Vinks, Tracy Glauser","doi":"10.4137/bii.s2506","DOIUrl":"https://doi.org/10.4137/bii.s2506","url":null,"abstract":"<p><p>This article describes the process of developing an advanced pharmacogenetics clinical decision support at one of the United States' leading pediatric academic medical centers. This system, called CHRISTINE, combines clinical and genetic data to identify the optimal drug therapy when treating patients with epilepsy or Attention Deficit Hyperactivity Disorder. In the discussion a description of clinical decision support systems is provided, along with an overview of neurocognitive computing and how it is applied in this setting.</p>","PeriodicalId":88397,"journal":{"name":"Biomedical informatics insights","volume":"2 ","pages":"19-29"},"PeriodicalIF":0.0,"publicationDate":"2009-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/bii.s2506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28495829","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}
Laurence Alpay, John Verhoef, Bo Xie, Dov Te'eni, J H M Zwetsloot-Schonk
{"title":"Current Challenge in Consumer Health Informatics: Bridging the Gap between Access to Information and Information Understanding.","authors":"Laurence Alpay, John Verhoef, Bo Xie, Dov Te'eni, J H M Zwetsloot-Schonk","doi":"10.4137/bii.s2223","DOIUrl":"https://doi.org/10.4137/bii.s2223","url":null,"abstract":"<p><p>The number of health-related websites has proliferated over the past few years. Health information consumers confront a myriad of health related resources on the internet that have varying levels of quality and are not always easy to comprehend. There is thus a need to help health information consumers to bridge the gap between access to information and information understanding-i.e. to help consumers understand health related web-based resources so that they can act upon it. At the same time health information consumers are becoming not only more involved in their own health care but also more information technology minded. One way to address this issue is to provide consumers with tailored information that is contextualized and personalized e.g. directly relevant and easily comprehensible to the person's own health situation. This paper presents a current trend in Consumer Health Informatics which focuses on theory-based design and development of contextualized and personalized tools to allow the evolving consumer with varying backgrounds and interests to use online health information efficiently. The proposed approach uses a theoretical framework of communication in order to support the consumer's capacity to understand health-related web-based resources.</p>","PeriodicalId":88397,"journal":{"name":"Biomedical informatics insights","volume":"2 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/bii.s2223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28945408","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}
David E Axelrod, Naomi Miller, Judith-Anne W Chapman
{"title":"Avoiding Pitfalls in the Statistical Analysis of Heterogeneous Tumors.","authors":"David E Axelrod, Naomi Miller, Judith-Anne W Chapman","doi":"10.4137/bii.s2222","DOIUrl":"https://doi.org/10.4137/bii.s2222","url":null,"abstract":"<p><p>Information about tumors is usually obtained from a single assessment of a tumor sample, performed at some point in the course of the development and progression of the tumor, with patient characteristics being surrogates for natural history context. Differences between cells within individual tumors (intratumor heterogeneity) and between tumors of different patients (intertumor heterogeneity) may mean that a small sample is not representative of the tumor as a whole, particularly for solid tumors which are the focus of this paper. This issue is of increasing importance as high-throughput technologies generate large multi-feature data sets in the areas of genomics, proteomics, and image analysis. Three potential pitfalls in statistical analysis are discussed (sampling, cut-points, and validation) and suggestions are made about how to avoid these pitfalls.</p>","PeriodicalId":88397,"journal":{"name":"Biomedical informatics insights","volume":"2 ","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/bii.s2222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28744515","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}
{"title":"HIPAA, HIPAA, Hooray?: Current Challenges and Initiatives in Health Informatics in the United States.","authors":"Sanjaya Joshi","doi":"10.4137/bii.s2007","DOIUrl":"https://doi.org/10.4137/bii.s2007","url":null,"abstract":"<p><p>A review of the current challenges, trends and initiatives around the various regulations as related to Health Informatics in the United States is presented. A summary of the functions in a workflow-based approach organized into the process and compliance for HIPAA, secure email and fax communications interfaces, e-prescriptions and patient safety and the health information technology savings claims versus costs follows: HIPAA compliance is complex; data interoperability and integration remains difficult.Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule.Integration of e-prescribing and NPI data is an area where health informatics can make a real difference.Medical errors remain high.There are no real savings yet from the usage of health information technologies; the costs for implementation remain high, and the business model has not evolved to meet the needs.Health Information Technology (Health IT) projects continue to have a significant failure rate; Open Source technologies are a viable alternative both for cost reduction and scalability. A discussion on the macro view of health informatics is also presented within the context of healthcare models and a comparison of the U.S. system against other countries. </p>","PeriodicalId":88397,"journal":{"name":"Biomedical informatics insights","volume":"1 ","pages":"45-54"},"PeriodicalIF":0.0,"publicationDate":"2008-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/bii.s2007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34680035","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}
Nir Menachemi, Ebrahim Randeree, Darrell E Burke, Eric W Ford
{"title":"Planning for Hospital IT Implementation: A New Look at the Business Case.","authors":"Nir Menachemi, Ebrahim Randeree, Darrell E Burke, Eric W Ford","doi":"10.4137/bii.s1035","DOIUrl":"10.4137/bii.s1035","url":null,"abstract":"<p><p>Compared to organizations in other industries, hospitals are slow to adopt information technology (IT). Those planning for system implementation must understand the barriers to IT adoption which, in healthcare, include the relatively high acquisition and maintenance costs of sophisticated administrative and clinical information systems. Understanding the overall business case is particularly important for hospital IT planners. This paper describes the literature that examines benefits from using health IT. In addition, we focus on a series of studies conducted in Florida that provide generalizable evidence regarding the overall business case associated with hospital adoption for information systems. These studies focus broadly on the improved financial, operational, and clinical performance associated with IT. </p>","PeriodicalId":88397,"journal":{"name":"Biomedical informatics insights","volume":"1 ","pages":"29-44"},"PeriodicalIF":0.0,"publicationDate":"2008-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34680034","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}
{"title":"Closing the Loop: Facilitating the Use of Autopsy Information in Medical Decision Making and Managed Care.","authors":"Peter N Nemetz","doi":"10.4137/bii.s899","DOIUrl":"10.4137/bii.s899","url":null,"abstract":"<p><p>This paper advances the somewhat paradoxical hypothesis that the emergence of managed care which threatens to accelerate the decline of the autopsy may, in fact, offer an opportunity for its re-emergence as an important tool of quality and cost control. A simplified autopsy-based management information structure is proposed to close the loop where information currently gleaned from the autopsy is frequently unused or underutilized in medical decision making and managed care. </p>","PeriodicalId":88397,"journal":{"name":"Biomedical informatics insights","volume":"1 ","pages":"21-8"},"PeriodicalIF":0.0,"publicationDate":"2008-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34680033","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}
Enzo Grossi, Riccardo Marmo, Marco Intraligi, Massimo Buscema
{"title":"Artificial Neural Networks for Early Prediction of Mortality in Patients with Non Variceal Upper GI Bleeding (UGIB).","authors":"Enzo Grossi, Riccardo Marmo, Marco Intraligi, Massimo Buscema","doi":"10.4137/bii.s814","DOIUrl":"https://doi.org/10.4137/bii.s814","url":null,"abstract":"<p><strong>Background: </strong>Mortality for non variceal upper gastrointestinal bleeding (UGIB) is clinically relevant in the first 12-24 hours of the onset of haemorrhage and therefore identification of clinical factors predictive of the risk of death before endoscopic examination may allow for early corrective therapeutic intervention.</p><p><strong>Aim: </strong>1) Identify simple and early clinical variables predictive of the risk of death in patients with non variceal UGIB; 2) assess previsional gain of a predictive model developed with conventional statistics vs. that developed with artificial neural networks (ANNs).</p><p><strong>Methods and results: </strong>Analysis was performed on 807 patients with nonvariceal UGIB (527 males, 280 females), as a part of a multicentre Italian study. The mortality was considered \"bleeding-related\" if occurred within 30 days from the index bleeding episode. A total of 50 independent variables were analysed, 49 of which clinico-anamnestic, all collected prior to endoscopic examination plus the haemoglobin value measured on admission in the emergency department. Death occurred in 42 (5.2%). Conventional statistical techniques (linear discriminant analysis) were compared with ANNs (Twist® system-Semeion) adopting the same result validation protocol with random allocation of the sample in training and testing subsets and subsequent cross-over. ANNs resulted to be significantly more accurate than LDA with an overall accuracy rate near to 90%.</p><p><strong>Conclusion: </strong>Artificial neural networks technology is highly promising in the development of accurate diagnostic tools designed to recognize patients at high risk of death for UGIB.</p>","PeriodicalId":88397,"journal":{"name":"Biomedical informatics insights","volume":"1 ","pages":"7-19"},"PeriodicalIF":0.0,"publicationDate":"2008-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/bii.s814","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34680032","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}
{"title":"Experiences from the Architectural Migration of a Joint Replacement Surgery Information System.","authors":"Samuli Niiranen, Ari Välimäki, Jari Yli-Hietanen","doi":"10.4137/bii.s800","DOIUrl":"https://doi.org/10.4137/bii.s800","url":null,"abstract":"The goal of this study is to present the experiences gathered from the migration of an existing and deployed joint replacement surgery information system from a classical 2-tier architecture to a 4-tier architecture. These include discussion on the motivation for the migration and on the technical benefits of the chosen technical migration path and an evaluation of user experiences. The results from the analysis of clinical end-user and administrator experiences show an increase in the perceived performance and maintainability of the system and a high level of acceptance for the new system version.","PeriodicalId":88397,"journal":{"name":"Biomedical informatics insights","volume":"1 ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2008-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/bii.s800","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34680031","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}