(A259) Objective Triage in the Disaster Setting: Will Children and Expecting Mothers be Triaged Like Others?

IntroductionThe study of disaster triage is made difficult by the complex emotional response of potentially lifesaving intervention that a triage officer must make decisions based on a succinct and efficient algorithm.MethodsWe designed a survey of triage professionals in Chicago, Philadelphia, and Beijing to identify sources of emotional bias that lead to failure of the START triage protocol that result in a lack of correlation between triage priority and clinical outcomes.Results and ConclusionsAmong our subjects, we observed that a pediatric victim is uniformly overtriaged when compared to less injured victims. We examine the possible reasons behind the consistency of this selection, explain the means we used to minimise bias, and propose avenues for further research and clinical implementation of better triage systems and guidelines.

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Clinical Implementation of Predictive Models Embedded within Electronic Health Record Systems: A Systematic Review

Informatics ◽

10.3390/informatics7030025 ◽

2020 ◽

Vol 7 (3) ◽

pp. 25

Author(s):

Terrence C. Lee ◽

Neil U. Shah ◽

Alyssa Haack ◽

Sally L. Baxter

Keyword(s):

Systematic Review ◽

Electronic Health Record ◽

Clinical Outcomes ◽

Predictive Models ◽

Performance Metrics ◽

Predictive Analytics ◽

Health Record ◽

Clinical Implementation ◽

Level Of Evidence ◽

Electronic Health

Predictive analytics using electronic health record (EHR) data have rapidly advanced over the last decade. While model performance metrics have improved considerably, best practices for implementing predictive models into clinical settings for point-of-care risk stratification are still evolving. Here, we conducted a systematic review of articles describing predictive models integrated into EHR systems and implemented in clinical practice. We conducted an exhaustive database search and extracted data encompassing multiple facets of implementation. We assessed study quality and level of evidence. We obtained an initial 3393 articles for screening, from which a final set of 44 articles was included for data extraction and analysis. The most common clinical domains of implemented predictive models were related to thrombotic disorders/anticoagulation (25%) and sepsis (16%). The majority of studies were conducted in inpatient academic settings. Implementation challenges included alert fatigue, lack of training, and increased work burden on the care team. Of 32 studies that reported effects on clinical outcomes, 22 (69%) demonstrated improvement after model implementation. Overall, EHR-based predictive models offer promising results for improving clinical outcomes, although several gaps in the literature remain, and most study designs were observational. Future studies using randomized controlled trials may help improve the generalizability of findings.

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Computational Micrograph Registration with Sieve Processes

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100164660 ◽

1996 ◽

Vol 54 ◽

pp. 440-441

Author(s):

P.J. Phillips ◽

J. Huang ◽

S. M. Dunn

Keyword(s):

Planar Graph ◽

Efficient Algorithm ◽

Spatial Organization ◽

Spatial Arrangement ◽

Stereo Image ◽

Image Model ◽

Geometric Invariants ◽

Point Set

In this paper we present an efficient algorithm for automatically finding the correspondence between pairs of stereo micrographs, the key step in forming a stereo image. The computation burden in this problem is solving for the optimal mapping and transformation between the two micrographs. In this paper, we present a sieve algorithm for efficiently estimating the transformation and correspondence.In a sieve algorithm, a sequence of stages gradually reduce the number of transformations and correspondences that need to be examined, i.e., the analogy of sieving through the set of mappings with gradually finer meshes until the answer is found. The set of sieves is derived from an image model, here a planar graph that encodes the spatial organization of the features. In the sieve algorithm, the graph represents the spatial arrangement of objects in the image. The algorithm for finding the correspondence restricts its attention to the graph, with the correspondence being found by a combination of graph matchings, point set matching and geometric invariants.

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Accreditation of predoctoral dental education: clinical outcomes assessment

Journal of Dental Education ◽

10.1002/j.0022-0337.1991.55.11.tb02592.x ◽

1991 ◽

Vol 55 (11) ◽

pp. 729-734

Author(s):

MA Boyd ◽

IC Bennett ◽

KC Bentley

Keyword(s):

Clinical Outcomes ◽

Dental Education ◽

Outcomes Assessment ◽

Clinical Outcomes Assessment

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Selecting Skills To Teach Communication Partners: Where Do I Start?

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac21.4.127 ◽

2012 ◽

Vol 21 (4) ◽

pp. 127-135 ◽

Cited By ~ 6

Author(s):

Cathy Binger ◽

Jennifer Kent-Walsh

Keyword(s):

Clinical Outcomes ◽

Intervention Program ◽

Communication Partners ◽

Multiple Challenges

Abstract Clinicians and researchers long have recognized that teaching communication partners how to provide AAC supports is essential to AAC success. One way to improve clinical outcomes is to select appropriate skills to teach communication partners. Although this sometimes seems like it should be a straightforward component of any intervention program, deciding which skills to teach partners can present multiple challenges. In this article, we will troubleshoot common issues and discuss how to select skills systematically, resulting in the desired effects for both communication partners and clients.

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Linguistic Interactions: A Therapeutic Consideration for Adults With Aphasia

Perspectives on Augmentative and Alternative Communication ◽

10.1044/aac17.3.93 ◽

2008 ◽

Vol 17 (3) ◽

pp. 93-98

Author(s):

Lynn E. Fox

Keyword(s):

Clinical Outcomes ◽

Social Contexts ◽

Interaction Models ◽

Social Communities ◽

Wernicke's Aphasia ◽

Communication Challenges ◽

Therapeutic Consideration ◽

Patterns Of Interaction ◽

Structural Language

Abstract Linguistic interaction models suggest that interrelationships arise between structural language components and between structural and pragmatic components when language is used in social contexts. The linguist, David Crystal (1986, 1987), has proposed that these relationships are central, not peripheral, to achieving desired clinical outcomes. For individuals with severe communication challenges, erratic or unpredictable relationships between structural and pragmatic components can result in atypical patterns of interaction between them and members of their social communities, which may create a perception of disablement. This paper presents a case study of a woman with fluent, Wernicke's aphasia that illustrates how attention to patterns of linguistic interaction may enhance AAC intervention for adults with aphasia.

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The Complexity of Health Disparities: More Than Just Black–White Differences

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00199 ◽

2021 ◽

pp. 1-10

Author(s):

Charles Ellis ◽

Molly Jacobs

Keyword(s):

Health Disparities ◽

Clinical Outcomes ◽

The United States ◽

Careful Examination ◽

White Americans ◽

Speech Language Pathology ◽

Death Rates ◽

The Social ◽

Health Related ◽

Language Pathology

Health disparities have once again moved to the forefront of America's consciousness with the recent significant observation of dramatically higher death rates among African Americans with COVID-19 when compared to White Americans. Health disparities have a long history in the United States, yet little consideration has been given to their impact on the clinical outcomes in the rehabilitative health professions such as speech-language pathology/audiology (SLP/A). Consequently, it is unclear how the absence of a careful examination of health disparities in fields like SLP/A impacts the clinical outcomes desired or achieved. The purpose of this tutorial is to examine the issue of health disparities in relationship to SLP/A. This tutorial includes operational definitions related to health disparities and a review of the social determinants of health that are the underlying cause of such disparities. The tutorial concludes with a discussion of potential directions for the study of health disparities in SLP/A to identify strategies to close the disparity gap in health-related outcomes that currently exists.

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Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd20.4.121 ◽

2011 ◽

Vol 20 (4) ◽

pp. 121-123

Author(s):

Jeri A. Logemann

Keyword(s):

Decision Making ◽

Patient Care ◽

Clinical Outcomes ◽

Clinical Judgment ◽

Clinical Decision Making ◽

Evidence Based Practice ◽

Clinical Decision ◽

Evidence Based ◽

Clinical Method ◽

Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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