scholarly journals Comprehensive characterization of COVID-19 patients with repeatedly positive SARS-CoV-2 tests using a large US electronic health record database

2021 ◽  
Author(s):  
Xiao Dong ◽  
Yujia Zhou ◽  
Xiao-ou Shu ◽  
Elmer Bernstam ◽  
Rebecca Stern ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Clinical Manifestations ◽  
Positive Test ◽  
Health Record ◽  
Test Results ◽  
High Prevalence ◽  
Testing Data ◽  
Surrogate Measure ◽  
Electronic Health

Background: In the absence of genome sequencing, two positive molecular SARS-CoV-2 tests separated by negative tests, prolonged time, and symptom resolution remain the best surrogate measure of possible re-infection. Methods: Using a large electronic health record database, we characterized clinical and testing data for 23 patients with repeatedly positive SARS-CoV-2 PCR test results >60 days apart, separated by >2 consecutive negative test results. Prevalence of chronic medical conditions, symptoms and severe outcomes related to COVID-19 illness were ascertained. Results: Median age was 64.5 years, 40% were Black, and 39% were female. 83% smoked within the prior year, 61% were overweight/obese, 83% had immune compromising conditions, and 96% had >2 comorbidities. Median interval between the two positive tests was 77 days. Among the 19 patients with 60-89 days between positive tests, 17 (89%) exhibited symptoms or clinical manifestations indicative of COVID-19 at the time of the second positive test and 14 (74%) were hospitalized at the second positive test. Of the four patients with >90 days between two positive tests, two had mild or no symptoms at the second positive test and one, an immune compromised patient, had a brief hospitalization at the first diagnosis, followed by ICU admission at the second diagnosis three months later. Conclusions: Our study demonstrated a high prevalence of immune compromise, comorbidities, obesity and smoking among patients with repeatedly positive SARS-CoV-2 tests. Despite limitations, including lack of semi-quantitative estimates of viral load, these data may help prioritize suspected cases of reinfection for investigation and continued surveillance.

scholarly journals Comprehensive Characterization of COVID-19 Patients with Repeatedly Positive SARS-CoV-2 Tests Using a Large U.S. Electronic Health Record Database

2021 ◽  
Author(s):  
Xiao Dong ◽  
Yujia Zhou ◽  
Xiao-ou Shu ◽  
Elmer V. Bernstam ◽  
Rebecca Stern ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Electronic Health Record ◽  
Health Record ◽  
Health Consequences ◽  
Sequencing Data ◽  
Testing Data ◽  
Electronic Health ◽  
Comprehensive Characterization

The comprehensive characterization of clinical and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing data for patients with repeatedly positive SARS-CoV-2 tests can help prioritize suspected cases of reinfection for investigation in the absence of sequencing data and for continued surveillance of the potential long-term health consequences of SARS-CoV-2 infection.

scholarly journals Prevalence and Characterization of Yoga Mentions in the Electronic Health Record

2019 ◽  
Vol 32 (6) ◽  
pp. 790-800
Author(s):  
Nadia M. Penrod ◽  
Selah Lynch ◽  
Sunil Thomas ◽  
Nithya Seshadri ◽  
Jason H. Moore
Keyword(s):  
Electronic Health Record ◽  
Health Record ◽  
Electronic Health

Characterization of Public Health Alerts and Their Suitability for Alerting in Electronic Health Record Systems

2011 ◽  
Vol 17 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Nedra Y. Garrett ◽  
Ninad Mishra ◽  
Barbara Nichols ◽  
Catherine J. Staes ◽  
Chuck Akin ◽  
...  
Keyword(s):  
Public Health ◽  
Electronic Health Record ◽  
Health Record ◽  
Electronic Health

scholarly journals An ancillary genomics system to support the return of pharmacogenomic results

2019 ◽  
Vol 26 (4) ◽  
pp. 306-310 ◽  
Author(s):  
Luke V Rasmussen ◽  
Maureen E Smith ◽  
Federico Almaraz ◽  
Stephen D Persell ◽  
Laura J Rasmussen-Torvik ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Health Record ◽  
Test Results ◽  
Actionable Knowledge ◽  
Genomic Test ◽  
Electronic Health ◽  
To Receive

AbstractExisting approaches to managing genetic and genomic test results from external laboratories typically include filing of text reports within the electronic health record, making them unavailable in many cases for clinical decision support. Even when structured computable results are available, the lack of adopted standards requires considerations for processing the results into actionable knowledge, in addition to storage and management of the data. Here, we describe the design and implementation of an ancillary genomics system used to receive and process heterogeneous results from external laboratories, which returns a descriptive phenotype to the electronic health record in support of pharmacogenetic clinical decision support.

scholarly journals Information Overload and Missed Test Results in Electronic Health Record–Based Settings

2013 ◽  
Vol 173 (8) ◽  
pp. 702 ◽  
Author(s):  
Hardeep Singh ◽  
Christiane Spitzmueller ◽  
Nancy J. Petersen ◽  
Mona K. Sawhney ◽  
Dean F. Sittig
Keyword(s):  
Electronic Health Record ◽  
Information Overload ◽  
Health Record ◽  
Test Results ◽  
Electronic Health

Clinician perspectives on preemptive pharmacogenetic testing to guide chemotherapy dosing in patients with gastrointestinal malignancies.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 54-54
Author(s):  
Kelsey S. Lau-Min ◽  
Lisa A. Varughese ◽  
Maria N. Nelson ◽  
Christine Cambareri ◽  
Nandi J. Reddy ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Medical Center ◽  
Academic Medical Center ◽  
Structured Interview ◽  
Routine Practice ◽  
Health Record ◽  
Theory Approach ◽  
Test Results ◽  
Gastrointestinal Malignancies ◽  
Electronic Health

54 Background: Pharmacogenetic (PGx) testing for germline variants in the DPYD and UGT1A1 genes can be used to guide fluoropyrimidine and irinotecan dosing, respectively. Despite the known association between PGx variants and chemotherapy toxicity, preemptive testing prior to chemotherapy initiation is rarely performed in routine practice. Methods: We conducted a multi-site mixed-methods study to understand clinician attitudes toward PGx testing and to identify facilitators and barriers to using preemptive testing to guide chemotherapy dosing in patients with gastrointestinal malignancies. Each participant completed a demographic survey and semi-structured interview informed by the Consolidated Framework for Implementation Research. Interviews were analyzed using a modified grounded theory approach. Results: A total of 16 medical oncologists and 9 oncology pharmacists from one academic medical center and two community hospitals participated. Fifteen (60%) participants reported feeling comfortable or very comfortable with interpreting PGx test results. While clinicians expressed generally favorable attitudes toward PGx testing, many were hesitant to use it to preemptively guide chemotherapy dosing due to a perceived lack of evidence for this practice. They cited a lack of consensus chemotherapy dosing recommendations in response to PGx test results, as well as concerns about decreased drug efficacy, especially in patients treated with curative intent. Additional barriers included 1) a low prevalence of actionable PGx variants; 2) lengthy PGx test turnaround time; 3) concerns about testing costs and lack of insurance coverage; and 4) burdensome integration of PGx testing into clinical workflows. The electronic health record emerged as a potential tool for the unobtrusive integration of PGx testing into clinical practice–suggested applications included default PGx test orders for eligible patients, discrete reporting of PGx variant results, and clinical decision support to guide subsequent chemotherapy dosing. Conclusions: Successful adoption of preemptive PGx-guided chemotherapy dosing in patients with gastrointestinal malignancies will require a multi-level effort to demonstrate clinical effectiveness while addressing the contextual factors identified in this study. The electronic health record should be explored as a tool to integrate PGx testing into routine practice.

scholarly journals Exploring patients’ perceptions of accessing electronic health records: Innovation in healthcare

2017 ◽  
Vol 25 (1) ◽  
pp. 203-215 ◽  
Author(s):  
Sofie Wass ◽  
Vivian Vimarlund ◽  
Axel Ros
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Patient Involvement ◽  
Decision Makers ◽  
Health Record ◽  
Test Results ◽  
Healthcare Information ◽  
Health Records ◽  
Widespread Implementation ◽  
Electronic Health

The more widespread implementation of electronic health records has led to new ways of providing access to healthcare information, allowing patients to view their medical notes, test results, medicines and so on. In this article, we explore how patients perceive the possibility to access their electronic health record online and whether this influences patient involvement. The study includes interviews with nine patients and a survey answered by 56 patients. Our results show that patients perceive healthcare information to be more accessible and that electronic health record accessibility improves recall, understanding and patient involvement. However, to achieve the goal of involving patients as active decision-makers in their own treatment, electronic health records need to be fully available and test results, referrals and information on drug interactions need to be offered. As patient access to electronic health records spreads, it is important to gain a deeper understanding of how documentation practices can be changed to serve healthcare professionals and patients.

Sign in / Sign up

Export Citation Format

Share Document