scholarly journals Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index

2021 ◽  
Author(s):  
Lucy M Carter ◽  
Caroline Gordon ◽  
Chee Seng Yee ◽  
Ian Bruce ◽  
David Isenberg ◽  
...  
Keyword(s):  
Disease Activity ◽  
Improve Patient Care ◽  
Routine Practice ◽  
Clinical Settings ◽  
Standard Format ◽  
Tertiary Centre ◽  
Case Vignettes ◽  
Scoring Accuracy ◽  
Improve Patient ◽  
Speed And Accuracy

AbstractObjectiveBILAG-2004 index is a comprehensive disease activity instrument for SLE but administrative burden and frequency of errors limits its use in routine practice. We aimed to develop a tool for more accurate, time-efficient scoring of BILAG-2004 index with full fidelity to the existing instrument.MethodsFrequency of BILAG-2004 items was collated from a BILAG-biologics registry (BILAG-BR) dataset. Easy-BILAG prototypes were drafted to address known issues affecting speed and accuracy. After expert-verification, accuracy and usability of the finalised Easy-BILAG was validated against standard format BILAG-2004 index in a workbook exercise of 10 case vignettes. 33 professionals with a range of expertise from 14 UK centres completed the validation exercise.ResultsEasy-BILAG incorporates all items present in ≥5% BILAG-BR records, plus full constitutional and renal domains into a rapid single-page assessment. An embedded glossary and colour-coding assists scoring each domain. A second page captures rarer manifestations when needed. In the validation exercise, Easy-BILAG yielded higher median scoring accuracy (96.7%) than standard BILAG-2004 documentation (87.8%, p=0.001), with better inter-rater agreement. Easy-BILAG was completed faster (59.5min) than the standard format (80.0min, p=0.04) for 10 cases. An advantage in accuracy was observed with Easy-BILAG use among general hospital rheumatologists (91.3 vs 75.0, p=0.02), leading to equivalent accuracy as tertiary centre rheumatologists. Clinicians rated Easy-BILAG as intuitive, convenient, and well adapted for routine practice.ConclusionEasy-BILAG facilitates more rapid and accurate scoring of BILAG-2004 across all clinical settings which could improve patient care and biologics prescribing. Easy-BILAG should be adopted wherever BILAG-2004 assessment is required.

Translation Research in Practice: An Introduction

2018 ◽  
Vol 23 (2) ◽  
Author(s):  
Marita Titler
Keyword(s):  
Health Outcomes ◽  
Population Health ◽  
Care Delivery ◽  
Implementation Strategies ◽  
Improve Patient Care ◽  
Evidence Base ◽  
Routine Practice ◽  
Translation Research ◽  
Introductory Overview ◽  
Improve Patient

Translation science is a relatively young area of investigation that is rapidly growing. Although a number of healthcare practices have an evidence-base to guide care delivery, their use is not a part of routine practice. The gap between the availability of evidence-based practice (EBP) recommendations and application to improve patient care and population health is linked to poor health outcomes. Translation science, also known as implementation science, is testing implementation interventions to improve uptake and use of evidence to improve patient outcomes and population health. It also helps clarify what implementation strategies work for whom, in what settings, and why. This scientific field emerged to investigate which implementation strategies work to promote use of EBPs, and uncover the mechanisms by which they work. Advancements in translation science can expedite and sustain the successful integration of evidence in practice to improve care delivery, population health, and health outcomes. This article offers an introductory overview of translation science and addresses issues in this field of science such as variation in terminology; theories and models; implementation strategies; and context and implementation related to EBPs.

A tactical framework for EMR adoption

2019 ◽  
Vol 32 (3) ◽  
pp. 148-152
Author(s):  
James Lambley ◽  
Craig Kuziemsky
Keyword(s):  
Information Technologies ◽  
Implementation Strategies ◽  
Improve Patient Care ◽  
Theoretical Models ◽  
Clinical Settings ◽  
Human Diversity ◽  
Health Information Technologies ◽  
Emr Adoption ◽  
Legacy Information Systems ◽  
Improve Patient

Hospitals and other health settings across Canada are transitioning from paper or legacy information systems to Electronic Medical Records (EMR) systems to improve patient care and service delivery. The literature speaks to benefits of EMR systems, but also challenges, such as adverse patient events and provider workflow interruptions. Theoretical models have been proposed to help understand the complex interaction between health information technologies and the healthcare environment, but a shortcoming is the transition from conceptual models to actual clinical settings. The health ecosystem is filled with human diversity and organizational culture considerations that cannot be separated from technical implementation strategies. This paper analyzes literature on EMR implementation and adoption to develop a tactical framework for EMR adoption. The framework consists of six categories, each with a set of seed questions to consider when leading technology adoption projects.

scholarly journals Whole-Genome Sequencing in Relation to Resistance of Mycobacterium Tuberculosis

2019 ◽  
Vol 19 (1) ◽  
pp. 12-21
Author(s):  
M Dohal ◽  
I Porvaznik ◽  
P Kusnir ◽  
J. Mokry
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Current Knowledge ◽  
Improve Patient Care ◽  
Routine Practice ◽  
Whole Genome ◽  
Rapid Diagnostics ◽  
Routine Diagnostics ◽  
Improve Patient

Abstract Tuberculosis, a disease caused by Mycobacterium tuberculosis, represents one of the deadliest infections worldwide. The incidence of resistant forms is increasing year by year; therefore, it is necessary to involve new methods for rapid diagnostics and treatment. One of the possible solutions is the use of whole-genome sequencing (WGS). The WGS provides an identification of complete genome of the microorganism, including all genes responsible for resistance, in comparison with other genotypic methods (eg. Xpert MTB / RIF or Hain line-probes) that are capable to detect only basic genes. WGS data are available in 1-9 days and several online software tools (TBProfiler, CASTB, Mykrobe PredictorTB) are used for their interpretation and analysis, compared to 3-8 weeks in the case of classic phenotypic evaluation. Furthermore, WGS predicts resistance to the first-line antituberculotics with a sensitivity of 85-100% and a specificity of 85-100%. This review elucidates the importance and summarizes the current knowledge about the possible use of WGS in diagnosis and treatment of resistant forms of tuberculosis elucidates. WGS of M. tuberculosis brings new possibilities for rapid and accurate diagnostics of resistant forms of tuberculosis. Introducing WGS into routine practice can help to reduce the spread of resistant forms of tuberculosis as well as to increase the success rate of the treatment, especially through an appropriate combination of antituberculotics ATs. Introduction of WGS into routine diagnostics can, in spite of the financial difficulty, significantly improve patient care.

scholarly journals Biomarkers of Acute and Chronic Kidney Disease

2019 ◽  
Vol 81 (1) ◽  
pp. 309-333 ◽  
Author(s):  
William R. Zhang ◽  
Chirag R. Parikh
Keyword(s):  
Kidney Disease ◽  
Kidney Diseases ◽  
Improve Patient Care ◽  
Cellular Responses ◽  
Systemic Circulation ◽  
Low Molecular Weight ◽  
Clinical Settings ◽  
Chronic Kidney Diseases ◽  
Improve Patient ◽  
Low Molecular Weight Proteins

The current unidimensional paradigm of kidney disease detection is incompatible with the complexity and heterogeneity of renal pathology. The diagnosis of kidney disease has largely focused on glomerular filtration, while assessment of kidney tubular health has notably been absent. Following insult, the kidney tubular cells undergo a cascade of cellular responses that result in the production and accumulation of low-molecular-weight proteins in the urine and systemic circulation. Modern advancements in molecular analysis and proteomics have allowed the identification and quantification of these proteins as biomarkers for assessing and characterizing kidney diseases. In this review, we highlight promising biomarkers of kidney tubular health that have strong underpinnings in the pathophysiology of kidney disease. These biomarkers have been applied to various specific clinical settings from the spectrum of acute to chronic kidney diseases, demonstrating the potential to improve patient care.

Analytical Methods for the Determination of Sartans in Pharmaceutical Formulations and Biological Fluids: A Review

2020 ◽  
Vol 16 (3) ◽  
pp. 208-222
Author(s):  
Miglena Smerikarova ◽  
Stanislav Bozhanov ◽  
Vania Maslarska
Keyword(s):  
Biological Fluids ◽  
Pharmaceutical Preparations ◽  
Improve Patient Care ◽  
Pharmaceutical Formulations ◽  
Treatment Of Hypertension ◽  
Therapeutic Doses ◽  
Reliable Methods ◽  
Improve Patient

Background: Sartans are mostly used as a part of combination with additional medicines in the therapy of essencial hypertension. Preferred combinations are ARB and thiazide diuretics (Hydrochlorothiazide (HCT) and Chlorthalidone (CHL)) or ARB and calcium antagonists. The number of sartans mostly prescribed by specialists is only seven - Candesartan (CDS), Eprosartan (EPS), Irbesartan (IBS), Losartan (LOS), Olmesartan (OMS), Telmisartan (TMS) and Valsartan (VLS). Methods: The widespread use of sartans in the treatment of hypertension requires reliable methods of analysis. Bulk drugs and pharmaceutical preparations should be analyzed to ensure the quality of the medicinal products reaching patients. On the other hand, the analysis of drugs in biological fluids aims to trace and improve patient care by adjusting the therapeutic doses of drugs. According to our knowledge, a review devoted to the analysis of sartans was published in 2014. Results: Spectral methods are widely used in the analysis of bulk drugs and pharmaceutical dosage forms due to their relatively simple procedures, low reagent and sample consumption, speed, precision and accuracy combined with accessibility and comparatively low cost of common apparatus. Many papers for determination of sartans in bulk drugs and pharmaceutical preparations based on liquid chromatographic techniques were published in the available literature. Among these methods, HPLC takes the leading place but UPLC and HPTLC are also present. Conclusion: The widespread use of sartans in the treatment of hypertension requires reliable methods of analysis. Bulk drugs and pharmaceutical preparations should be analyzed to ensure the quality of the medicinal products reaching patients. On the other hand, the analysis of drugs in biological fluids aims to trace and improve patient care by adjusting the therapeutic doses of drugs. Since 2014, many articles have been published on the sartans analysis and this provoked our interest to summarize the latest applications in the analysis of sartans in pharmaceutical formulations and biological media. Articles published from 2014 to 2018 are covered.

scholarly journals How will artificial intelligence and bioinformatics change our understanding of IgA in the next decade?

2021 ◽  
Author(s):  
Roman David Bülow ◽  
Daniel Dimitrov ◽  
Peter Boor ◽  
Julio Saez-Rodriguez
Keyword(s):  
Artificial Intelligence ◽  
Multidisciplinary Approach ◽  
Immunoglobulin A ◽  
Improve Patient Care ◽  
Integrated Analysis ◽  
Clinical Expertise ◽  
End Stage ◽  
The Complement System ◽  
Improve Patient ◽  
Generation Sequencing

AbstractIgA nephropathy (IgAN) is the most common glomerulonephritis. It is characterized by the deposition of immune complexes containing immunoglobulin A (IgA) in the kidney’s glomeruli, triggering an inflammatory process. In many patients, the disease has a progressive course, eventually leading to end-stage kidney disease. The current understanding of IgAN’s pathophysiology is incomplete, with the involvement of several potential players, including the mucosal immune system, the complement system, and the microbiome. Dissecting this complex pathophysiology requires an integrated analysis across molecular, cellular, and organ scales. Such data can be obtained by employing emerging technologies, including single-cell sequencing, next-generation sequencing, proteomics, and complex imaging approaches. These techniques generate complex “big data,” requiring advanced computational methods for their analyses and interpretation. Here, we introduce such methods, focusing on the broad areas of bioinformatics and artificial intelligence and discuss how they can advance our understanding of IgAN and ultimately improve patient care. The close integration of advanced experimental and computational technologies with medical and clinical expertise is essential to improve our understanding of human diseases. We argue that IgAN is a paradigmatic disease to demonstrate the value of such a multidisciplinary approach.

scholarly journals Bargain Hunting for Buffered Lidocaine: A Collaborative Discovery of Cost-saving Strategies That Can Improve Patient Care

2020 ◽  
Author(s):  
Curtis L Simmons ◽  
Laura K Harper ◽  
Kathryn J Holst ◽  
Nathan J Brinkman ◽  
Christine U Lee
Keyword(s):  
Sodium Bicarbonate ◽  
Hospital Pharmacy ◽  
Cost Savings ◽  
Improve Patient Care ◽  
Medical Waste ◽  
Radiology Department ◽  
Access Pricing ◽  
Bundled Payments ◽  
Improve Patient ◽  
Procedure Room

Abstract Buffered lidocaine is a local anesthetic option during percutaneous needle-directed procedures in the breast. At our institution, sodium bicarbonate (the buffer) is dispensed in volumes that frequently lead to medical waste and shortages. In this study, we describe how moving the buffering of lidocaine from the procedure room to our clinical hospital pharmacy results in a reduction in costs and improves satisfaction across the breast radiology department. While cost savings are difficult to tease out in practices that opt for bundled payments, we were able to access pricing and supply data and coordinate with our pharmacy to change our practice. Making these changes saves our practice $26 000 a year and allows us to continue to offer buffered lidocaine even during sodium bicarbonate shortages. This manuscript describes how these changes came about and their economic impact.

Sports Medicine and Artificial Intelligence: A Primer

2021 ◽  
pp. 036354652110086
Author(s):  
Prem N. Ramkumar ◽  
Bryan C. Luu ◽  
Heather S. Haeberle ◽  
Jaret M. Karnuta ◽  
Benedict U. Nwachukwu ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Sports Medicine ◽  
Injury Risk ◽  
Industrial Revolution ◽  
Improve Patient Care ◽  
Great Promise ◽  
Patient Reported ◽  
Athlete Injury ◽  
Improve Patient ◽  
Applications Of Ai

Artificial intelligence (AI) represents the fourth industrial revolution and the next frontier in medicine poised to transform the field of orthopaedics and sports medicine, though widespread understanding of the fundamental principles and adoption of applications remain nascent. Recent research efforts into implementation of AI in the field of orthopaedic surgery and sports medicine have demonstrated great promise in predicting athlete injury risk, interpreting advanced imaging, evaluating patient-reported outcomes, reporting value-based metrics, and augmenting the patient experience. Not unlike the recent emphasis thrust upon physicians to understand the business of medicine, the future practice of sports medicine specialists will require a fundamental working knowledge of the strengths, limitations, and applications of AI-based tools. With appreciation, caution, and experience applying AI to sports medicine, the potential to automate tasks and improve data-driven insights may be realized to fundamentally improve patient care. In this Current Concepts review, we discuss the definitions, strengths, limitations, and applications of AI from the current literature as it relates to orthopaedic sports medicine.

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