The development of a data-matching algorithm to define the ‘case patient’

2013 ◽  
Vol 37 (1) ◽  
pp. 54 ◽  
Author(s):  
Shelley Cox ◽  
Rohan Martin ◽  
Piyali Somaia ◽  
Karen Smith

Objectives. To describe a model that matches electronic patient care records within a given case to one or more patients within that case. Method. This retrospective study included data from all metropolitan Ambulance Victoria electronic patient care records (n = 445 576) for the time period 1 January 2009–31 May 2010. Data were captured via VACIS (Ambulance Victoria, Melbourne, Vic., Australia), an in-field electronic data capture system linked to an integrated data warehouse database. The case patient algorithm included ‘Jaro–Winkler’, ‘Soundex’ and ‘weight matching’ conditions. Results. The case patient matching algorithm has a sensitivity of 99.98%, a specificity of 99.91% and an overall accuracy of 99.98%. Conclusions. The case patient algorithm provides Ambulance Victoria with a sophisticated, efficient and highly accurate method of matching patient records within a given case. This method has applicability to other emergency services where unique identifiers are case based rather than patient based. What is known about the topic? Accurate pre-hospital data that can be linked to patient outcomes is widely accepted as critical to support pre-hospital patient care and system performance. What does this paper add? There is a paucity of literature describing electronic matching of patient care records at the patient level rather than the case level. Ambulance Victoria has developed a complex yet efficient and highly accurate method for electronically matching patient records, in the absence of a patient-specific unique identifier. Linkage of patient information from multiple patient care records to determine if the records are for the same individual defines the ‘case patient’. What are the implications for practitioners? This paper describes a model of record linkage where patients are matched within a given case at the patient level as opposed to the case level. This methodology is applicable to other emergency services where unique identifiers are case based.

2021 ◽  
Author(s):  
Nawar Shara ◽  
Kelley M. Anderson ◽  
Noor Falah ◽  
Maryam F. Ahmad ◽  
Darya Tavazoei ◽  
...  

BACKGROUND Healthcare data are fragmenting as patients seek care from diverse sources. Consequently, patient care is negatively impacted by disparate health records. Machine learning (ML) offers a disruptive force in its ability to inform and improve patient care and outcomes [6]. However, the differences that exist in each individual’s health records, combined with the lack of health-data standards, in addition to systemic issues that render the data unreliable and that fail to create a single view of each patient, create challenges for ML. While these problems exist throughout healthcare, they are especially prevalent within maternal health, and exacerbate the maternal morbidity and mortality (MMM) crisis in the United States. OBJECTIVE Maternal patient records were extracted from the electronic health records (EHRs) of a large tertiary healthcare system and made into patient-specific, complete datasets through a systematic method so that a machine-learning-based (ML-based) risk-assessment algorithm could effectively identify maternal cardiovascular risk prior to evidence of diagnosis or intervention within the patient’s record. METHODS We outline the effort that was required to define the specifications of the computational systems, the dataset, and access to relevant systems, while ensuring data security, privacy laws, and policies were met. Data acquisition included the concatenation, anonymization, and normalization of health data across multiple EHRs in preparation for its use by a proprietary risk-stratification algorithm designed to establish patient-specific baselines to identify and establish cardiovascular risk based on deviations from the patient’s baselines to inform early interventions. RESULTS Patient records can be made actionable for the goal of effectively employing machine learning (ML), specifically to identify cardiovascular risk in pregnant patients. CONCLUSIONS Upon acquiring data, including the concatenation, anonymization, and normalization of said data across multiple EHRs, the use of a machine-learning-based (ML-based) tool can provide early identification of cardiovascular risk in pregnant patients. CLINICALTRIAL N/A


2020 ◽  
Vol 20 (S11) ◽  
Author(s):  
Gaurav Rao ◽  
Salimur Choudhury ◽  
Pawan Lingras ◽  
David Savage ◽  
Vijay Mago

Abstract Background When an Out-of-Hospital Cardiac Arrest (OHCA) incident is reported to emergency services, the 911 agent dispatches Emergency Medical Services to the location and activates responder network system (RNS), if the option is available. The RNS notifies all the registered users in the vicinity of the cardiac arrest patient by sending alerts to their mobile devices, which contains the location of the emergency. The main objective of this research is to find the best match between the user who could support the OHCA patient. Methods For performing matching among the user and the AEDs, we used Bipartite Matching and Integer Linear Programming. However, these approaches take a longer processing time; therefore, a new method Preprocessed Integer Linear Programming is proposed that solves the problem faster than the other two techniques. Results The average processing time for the experimentation data was   1850 s using Bipartite matching,   32 s using the Integer Linear Programming and  2 s when using the Preprocessed Integer Linear Programming method. The proposed algorithm performs matching among users and AEDs faster than the existing matching algorithm and thus allowing it to be used in the real world. Conclusion: This research proposes an efficient algorithm that will allow matching of users with AED in real-time during cardiac emergency. Implementation of this system can help in reducing the time to resuscitate the patient.


10.2196/13315 ◽  
2019 ◽  
Vol 21 (7) ◽  
pp. e13315 ◽  
Author(s):  
Lauren A Maggio ◽  
Christopher A Aakre ◽  
Guilherme Del Fiol ◽  
Jane Shellum ◽  
David A Cook

Background Clinicians use electronic knowledge resources, such as Micromedex, UpToDate, and Wikipedia, to deliver evidence-based care and engage in point-of-care learning. Despite this use in clinical practice, their impact on patient care and learning outcomes is incompletely understood. A comprehensive synthesis of available evidence regarding the effectiveness of electronic knowledge resources would guide clinicians, health care system administrators, medical educators, and informaticians in making evidence-based decisions about their purchase, implementation, and use. Objective The aim of this review is to quantify the impact of electronic knowledge resources on clinical and learning outcomes. Methods We searched MEDLINE, Embase, PsycINFO, and the Cochrane Library for articles published from 1991 to 2017. Two authors independently screened studies for inclusion and extracted outcomes related to knowledge, skills, attitudes, behaviors, patient effects, and cost. We used random-effects meta-analysis to pool standardized mean differences (SMDs) across studies. Results Of 10,811 studies screened, we identified 25 eligible studies published between 2003 and 2016. A total of 5 studies were randomized trials, 22 involved physicians in practice or training, and 10 reported potential conflicts of interest. A total of 15 studies compared electronic knowledge resources with no intervention. Of these, 7 reported clinician behaviors, with a pooled SMD of 0.47 (95% CI 0.27 to 0.67; P<.001), and 8 reported objective patient effects with a pooled SMD of 0.19 (95% CI 0.07 to 0.32; P=.003). Heterogeneity was large (I2>50%) across studies. When compared with other resources—7 studies, not amenable to meta-analytic pooling—the use of electronic knowledge resources was associated with increased frequency of answering questions and perceived benefits on patient care, with variable impact on time to find an answer. A total of 2 studies compared different implementations of the same electronic knowledge resource. Conclusions Use of electronic knowledge resources is associated with a positive impact on clinician behaviors and patient effects. We found statistically significant associations between the use of electronic knowledge resources and improved clinician behaviors and patient effects. When compared with other resources, the use of electronic knowledge resources was associated with increased success in answering clinical questions, with variable impact on speed. Comparisons of different implementation strategies of the same electronic knowledge resource suggest that there are benefits from allowing clinicians to choose to access the resource, versus automated display of resource information, and from integrating patient-specific information. A total of 4 studies compared different commercial electronic knowledge resources, with variable results. Resource implementation strategies can significantly influence outcomes but few studies have examined such factors.


Author(s):  
Andrea Boyd Tressler ◽  
Robert Naples ◽  
Paola A. Barrios ◽  
Xue Jia ◽  
Judith C. French ◽  
...  
Keyword(s):  

2006 ◽  
Vol 15 (01) ◽  
pp. 40-42
Author(s):  
P. Knaup ◽  

SummaryTo summarize current excellent research in the field of patient records.Synopsis of the articles selected for the IMIA Yearbook 2006.Current research in the field of patient records analyses users’ needs and attitudes as well as the potential and limitations of electronic patient record systems. Particular topics are the questions physicians have when assessing patients during ward rounds, the timeliness of results when ordered electronically, the quality of documenting haemophilia home therapy, attitudes towards patient access to health records and adequate strategies for record linkage in dependence on the intended purpose.The best paper selection of articles on patient records shows examples of excellent research on methods used for the management of patient records and for processing their content as well as assessing the potential, limitations of and user attitudes towards electronic patient record systems. Computerized patient records are mature, so that they can contribute to high quality patient care and efficient patient management.


2019 ◽  
Vol 15 (3) ◽  
pp. 276-285
Author(s):  
Adam P. Schumaier ◽  
Yehia H. Bedeir ◽  
Joshua S. Dines ◽  
Keith Kenter ◽  
Lawrence V. Gulotta ◽  
...  

2017 ◽  
Vol 19 (5) ◽  
pp. 491-498
Author(s):  
Allison R. Jones ◽  
Michelle R. Brown ◽  
David E. Vance

Donated blood can be broken down into blood components for use in patient care. This article focuses primarily on packed red blood cells (PRBCs), as they experience breakdown during storage that may adversely impact patient outcomes. Patients require PRBC transfusions for a number of clinical reasons. Although transfusions of PRBCs provide some clinical benefit, they are also associated with increased morbidity and mortality across multiple patient populations, albeit the mechanisms underlying this relationship remain unclear. With an aging, more acutely ill population requiring aggressive treatment and a lack of transfusion alternatives, research focused on PRBCs has gained momentum. Proper interpretation of research findings on the part of clinicians depends on accurate data collection that includes aspects of both the transfused blood components and the recipients. The purpose of this article is to examine stored PRBC factors, blood-donor characteristics, transfusion-specific factors, and patient-specific characteristics as they relate to patient outcomes research. Challenges associated with performing and interpreting outcomes of transfusion-related research are presented. Implications of current evidence for patient care, such as awareness of benefits as well as risks associated with blood component transfusion, are also provided.


Neurosurgery by Example: Key Cases and Fundamental Principles provides case-based, high yield content for the spine surgeon and neurosurgeons preparing for the American Board of Neurological Surgeons oral examination. It covers a wide array of spinal pathologies with their presentation, diagnosis, and treatment plans. Postoperative and complication management strategies are offered as well in order to prepare surgeons who can then provide comprehensive patient care for complex spine conditions.


1997 ◽  
Vol 23 (12) ◽  
pp. 695-702 ◽  
Author(s):  
David C. Kibbe ◽  
Mark Bard ◽  
Richard S. Dick ◽  
Victor Dorodny ◽  
Ed Hammond ◽  
...  

2013 ◽  
Vol 278-280 ◽  
pp. 2016-2019 ◽  
Author(s):  
Jian Hua Song ◽  
Zheng Wang ◽  
Lei Zhang

This paper put forward a new retrieval strategy which combines character field matching algorithm with the NNH in Case-Based Reasoning. The new retrieval strategy can reduce the times of symptoms match while streamlining retrieved result, and lower the impact of large symptom value difference in the result. The superiority of the strategy is verified by three target cases.


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