An r2rml-based Approach to Map Dengue Patient Database to Ontology

Abstract:Many clinics are interested to use software packages in daily practice, but lack of integration of such packages seriously limits their scope. In practice this often entails switching between programs and interrupting the run of an individual program. A multi-task approach would not solve this problem as it would not eliminate the need to input the same data many times, as often occurs when using separate packages. The construction of a Multi-Service Medical Software package (MSx2) is described, which was also developed as an example of practical integration of some clinically relevant functions. The package runs on a personal computer in an MS-DOS environment and integrates a time-oriented medical record management unit (TOMRU) for data of ambulatory patients, and a drug information management unit (DIMU) concerning posology, content, effects, and possible interactions. Of the possible database configurations allowed by MSx2, the cardiology patient database (MSx2/C) and hypertensive patient database (MSx2/H) were developed and described here. Clinical information to be included in the configurations was obtained after discussion and consensus of clinical practitioners. MSx2/C was distributed to several hundred clinical centers during computerized courses to train future users. MSx2 can easily transfer patient data to statistical processing packages.

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Does the shoe-lace technique aid direct closure of fasciotomy wounds after acute compartment syndrome of the lower leg? a retrospective case-control study

Scandinavian Journal of Surgery ◽

10.1177/14574969211019639 ◽

2021 ◽

pp. 145749692110196

Author(s):

P. Suomalainen ◽

T.-K. Pakarinen ◽

I. Pajamäki ◽

M. K. Laitinen ◽

H.-J. Laine ◽

...

Keyword(s):

Compartment Syndrome ◽

Outcome Measurement ◽

Controlled Trial ◽

Lower Leg ◽

Conventional Technique ◽

Tibia Fracture ◽

Acute Compartment Syndrome ◽

Retrospective Case ◽

Direct Closure ◽

Patient Database

Background & aim: Tibia fractures are relatively common injuries that are accompanied with acute compartment syndrome in approximately 2% to 20% of cases. Although the shoe-lace technique, where vessel loops are threaded in a crisscross fashion and tightened daily, has been widely used, no studies have compared the shoe-lace technique with the conventional one. The aim of this study was to compare the shoe-lace technique with the conventional technique. Materials and Methods: We identified 359 consecutive patients with intramedullary nailed tibia fracture and complete medical records including outpatient data between April 2007 and April 2015 from electronic patient database of our institute. The use of the shoe-lace technique was compared to conventional one (in which wounds were first left open with moist dressings). Main outcome measurement is direct closure of fasciotomy wounds. Results: From 359 consecutive patients with intramedullary nailed tibia fracture, fasciotomy was performed on 68 (19%) patients. Of these, the shoe-lace technique was used in 47 (69%) patients while in 21 (31%) patients, the shoe-lace technique was not applied. Side-to-side approximation was successful in 36 patients (77%) in the shoe-lace+ group and 7 patients (33%) in the shoe-lace– group (p = 0.002). Conclusion: The main finding of our comparative study was that the shoe-lace technique seems to ease direct closure of lower leg fasciotomy wounds, and thus reduces the frequency of free skin grafts. Our finding needs to be confirmed in a high-quality randomized controlled trial.

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Relationship of hospital volume on outcomes in patients with acute pulmonary embolism: Analysis of a 70,000 patient database

Vascular Medicine ◽

10.1177/1358863x20970263 ◽

2020 ◽

pp. 1358863X2097026

Author(s):

Mark Finkelstein ◽

Mario A Cedillo ◽

David C Kestenbaum ◽

Obaib S Shoaib ◽

Aaron M Fischman ◽

...

Keyword(s):

New York ◽

Pulmonary Embolism ◽

Length Of Stay ◽

New York State ◽

Multivariable Analysis ◽

High Volume ◽

Categorical Variables ◽

Patient Database ◽

Very High ◽

Total Charges

Positive relationships between volume and outcome have been seen in several surgical and medical conditions, resulting in more centralized and specialized care structures. Currently, there is a scarcity of literature involving the volume–outcome relationship in pulmonary embolism (PE). Using a state-wide dataset that encapsulates all non-federal admissions in New York State, we performed a retrospective cohort study on admitted patients with a diagnosis of PE. A total of 70,443 cases were separated into volume groups stratified by hospital quartile. Continuous and categorical variables were compared between cohorts. Multivariable regression analysis was conducted to assess predictors of 1-year mortality, 30-day all-cause readmission, 30-day PE-related readmission, length of stay, and total charges. Of the 205 facilities that were included, 128 (62%) were labeled low volume, 39 (19%) medium volume, 23 (11%) high volume, and 15 (7%) very high volume. Multivariable analysis showed that very high volume was associated with decreased 30-day PE-related readmission (OR 0.64; 95% CI, 0.55 to 0.73), decreased 30-day all-cause readmission (OR 0.84; 95% CI, 0.79 to 0.89), decreased 1-year mortality (OR 0.85; 95% CI, 0.80 to 0.91), decreased total charges (OR 0.96; 95% CI, 0.94 to 0.98), and decreased length of stay (OR 0.94; 95% CI, 0.92 to 0.96). In summary, facilities with higher volumes of acute PE were found to have less 30-day PE-related readmissions, less all-cause readmissions, shorter length of stay, decreased 1-year mortality, and decreased total charges.

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Infection management processes in intensive care and their association with mortality

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkab103 ◽

2021 ◽

Author(s):

Leigh P. Fitzpatrick ◽

Bianca Levkovich ◽

Steve McGloughlin ◽

Edward Litton ◽

Allen C. Cheng ◽

...

Keyword(s):

Intensive Care ◽

New Zealand ◽

Hospital Mortality ◽

Process Of Care ◽

Infection Management ◽

Hierarchical Logistic Regression ◽

Management Processes ◽

Patient Database ◽

Improving Patient Care ◽

The Relationship

Abstract Background ICU-specific tables of antimicrobial susceptibility for key microbial species (‘antibiograms’), antimicrobial stewardship (AMS) programmes and routine rounds by infectious diseases (ID) physicians are processes aimed at improving patient care. Their impact on patient-centred outcomes in Australian and New Zealand ICUs is uncertain. Objectives To measure the association of these processes in ICU with in-hospital mortality. Methods The Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database and Critical Care Resources registry were used to extract patient-level factors, ICU-level factors and the year in which each process took place. Descriptive statistics and hierarchical logistic regression were used to determine the relationship between each process and in-hospital mortality. Results The study included 799 901 adults admitted to 173 ICUs from July 2009 to June 2016. The proportion of patients exposed to each process of care was 38.7% (antibiograms), 77.5% (AMS programmes) and 74.0% (ID rounds). After adjusting for confounders, patients admitted to ICUs that used ICU-specific antibiograms had a lower risk of in-hospital mortality [OR 0.95 (99% CI 0.92–0.99), P = 0.001]. There was no association between the use of AMS programmes [OR 0.98 (99% CI 0.94–1.02), P = 0.16] or routine rounds with ID physicians [OR 0.96 (99% CI 0.09–1.02), P = 0.09] and in-hospital mortality. Conclusions Use of ICU-specific antibiograms was associated with lower in-hospital mortality for patients admitted to ICU. For hospitals that do not perform ICU-specific antibiograms, their implementation presents a low-risk infection management process that might improve patient outcomes.

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Diagnostic amyloid proteomics: experience of the UK National Amyloidosis Centre

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2019-1007 ◽

2020 ◽

Vol 58 (6) ◽

pp. 948-957 ◽

Cited By ~ 3

Author(s):

Diana Canetti ◽

Nigel B. Rendell ◽

Janet A. Gilbertson ◽

Nicola Botcher ◽

Paola Nocerino ◽

...

Keyword(s):

Simple Algorithm ◽

Enzymatic Digestion ◽

The Body ◽

Clinical Samples ◽

Correct Identification ◽

Pathogenic Variants ◽

Amyloidogenic Protein ◽

Patient Database ◽

Serious Disease ◽

The Uk

AbstractSystemic amyloidosis is a serious disease which is caused when normal circulating proteins misfold and aggregate extracellularly as insoluble fibrillary deposits throughout the body. This commonly results in cardiac, renal and neurological damage. The tissue target, progression and outcome of the disease depends on the type of protein forming the fibril deposit, and its correct identification is central to determining therapy. Proteomics is now used routinely in our centre to type amyloid; over the past 7 years we have examined over 2000 clinical samples. Proteomics results are linked directly to our patient database using a simple algorithm to automatically highlight the most likely amyloidogenic protein. Whilst the approach has proved very successful, we have encountered a number of challenges, including poor sample recovery, limited enzymatic digestion, the presence of multiple amyloidogenic proteins and the identification of pathogenic variants. Our proteomics procedures and approaches to resolving difficult issues are outlined.

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Simulation of a Hospital Disaster Plan: A Virtual, Live Exercise

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00005999 ◽

2008 ◽

Vol 23 (4) ◽

pp. 346-353 ◽

Cited By ~ 16

Author(s):

Jeffrey M. Franc-Law ◽

Michael Bullard ◽

F. Della Corte

Keyword(s):

Emergency Department ◽

Patient Flow ◽

Learning Experience ◽

Significant Degree ◽

Primary Objective ◽

Simulated Patients ◽

Disaster Plan ◽

Actual Patient ◽

Patient Database ◽

Rate Limiting

AbstractIntroduction:Currently, there is no widely available method to evaluate an emergency department disaster plan. Creation of a standardized patient data- base and the use of a virtual, live exercise may lead to a standardized and reproducible method that can be used to evaluate a disaster plan.Purpose:A virtual, live exercise was designed with the primary objective of evaluating a hospital's emergency department disaster plan. Education and training of participants was a secondary goal.Methods:A database (disastermed.ca) of histories, physical examination findings, and laboratory results for 136 simulated patients was created using information derived from actual patient encounters.The patient database was used to perform a virtual, live exercise using a training version of the emergency department's information system software.Results:Several solutions to increase patient flow were demonstrated during the exercise. Conducting the exercise helped identify several faults in the hospital disaster plan, including outlining the important rate-limiting step. In addition, a significant degree of under-triage was demonstrated. Estimates of multiple markers of patient flow were identified and compared to Canadian guidelines. Most participants reported that the exercise was a valuable learning experience.Conclusions:A virtual, live exercise using the disastermed.ca patient database was an inexpensive method to evaluate the emergency department disaster plan. This included discovery of new approaches to managing patients, delineating the rate-limiting steps, and evaluating triage accuracy. Use of the patient timestamps has potential as a standardized international benchmark of hospital disaster plan efficacy. Participant satisfaction was high.

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Validity And Limitations Of The Longitudinal Patient Database France For Use In Pharmacoepidemiological And Pharmacoeconomics Studies

Value in Health ◽

10.1016/j.jval.2015.03.115 ◽

2015 ◽

Vol 18 (3) ◽

pp. A18 ◽

Cited By ~ 5

Author(s):

S.L. Jouaville ◽

H. Miotti ◽

G. Coffin ◽

B. Sarfati ◽

A Meihoc

Keyword(s):

Patient Database

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Role of MRI in diagnosing the primary site of origin in indeterminate cases of uterocervical carcinomas: a systematic review and meta-analysis

British Journal of Radiology ◽

10.1259/bjr.20210428 ◽

2021 ◽

Author(s):

Pooja Jain ◽

Ankita Aggarwal ◽

Rohini Gupta Ghasi ◽

Amita Malik ◽

Ritu Nair Misra ◽

...

Keyword(s):

Confidence Interval ◽

Meta Analysis ◽

Uterine Cancer ◽

Tumor Location ◽

Apparent Diffusion Coefficient Values ◽

Study Selection ◽

Apparent Diffusion ◽

Patient Database ◽

Cancer Intervention

Objective: To perform a literature review assessing role of MRI in predicting origin of indeterminate uterocervical carcinomas with emphasis on sequences and imaging parameters. Methods: Electronic literature search of PubMed was performed from its inception until May 2020 and PICO model used for study selection; population was female patients with known/clinical suspicion of uterocervical cancer, intervention was MRI, comparison was by histopathology and outcome was differentiation between primary endometrial and cervical cancers. Results: Eight out of 9 reviewed articles reinforced role of MRI in uterocervical primary determination. T2 and Dynamic contrast were the most popular sequences determining tumor location, morphology, enhancement, and invasion patterns. Role of DWI and MR spectroscopy has been evaluated by even fewer studies with significant differences found in both apparent diffusion coefficient values and metabolite spectra. The four studies eligible for meta-analysis showed a pooled sensitivity of 88.4% (95% confidence interval 70.6 to 96.1%) and a pooled specificity of 39.5% (95% confidence interval 4.2 to 90.6%). Conclusions: MRI plays a pivotal role in uterocervical primary determination with both conventional and newer sequences assessing important morphometric and functional parameters. Socioeconomic impact of both primaries, different management guidelines and paucity of existing studies warrants further research. Prospective multicenter trials will help bridge this gap. Meanwhile, individual patient database meta-analysis can help corroborate existing data. Advances in knowledge: MRI with its classical and functional sequences helps in differentiation of the uterine ‘cancer gray zone’ which is imperative as both primary endometrial and cervical tumors have different management protocols.

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Accuracy of Computer Simulation to Predict Patient Flow during Mass-Casualty Incidents

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00006002 ◽

2008 ◽

Vol 23 (4) ◽

pp. 354-360 ◽

Cited By ~ 5

Author(s):

Jeffrey M. Franc-Law ◽

Micheal J. Bullard ◽

F. Della Corte

Keyword(s):

Emergency Department ◽

Computer Simulation ◽

Patient Care ◽

Patient Flow ◽

Emergency Department Patient ◽

Simulation Software ◽

Simulated Patients ◽

Disaster Plan ◽

Data Set ◽

Patient Database

AbstractIntroduction:Although most hospitals have an emergency department disas- ter plan, most never have been implemented in a true disaster or been tested objectively. Computer simulation may be a useful tool to predict emergency department patient flow during a disaster.Purpose:The aim of this study was to compare the accuracy of a computer simulation in predicting emergency department patient flow during a masscasualty incident with that of a real-time, virtual, live exercise.Methods:History, physical examination findings, and laboratory results for 136 simulated patients were extracted from the disastermed.ca patient database as used as input into a computer simulation designed to represent the emergency department at the University of Alberta Hospital.The computer simulation was developed using a commercially available simulation software platform (2005, SimProcess, CACI Products, San Diego CA). Patient flow parameters were compared to a previous virtual, live exercise using the same data set.Results:Although results between the computer simulation and the live exercise appear similar, they differ statistically with respect to many patient benchmarks. There was a marked difference between the triage codes assigned during the live exercise and those from the patient database; however, this alone did not account for the differences between the patient groups. It is likely that novel approaches to patient care developed by the live exercise group, which are difficult to model by computer software, contributed to differences between the groups. Computer simulation was useful, however, in predicting how small changes to emergency department structure, such as adding staff or patient care areas, can influence patient flow.Conclusions:Computer simulation is helpful in defining the effects of changes to a hospital disaster plan. However, it cannot fully replace participant exercises. Rather, computer simulation and live exercises are complementary, and both may be useful for disaster plan evaluation.

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Psychiatric Consultation after Kidney Transplantation: A 10-Year Single-Center Study Including Outpatients in Japan

The International Journal of Psychiatry in Medicine ◽

10.2190/pm.43.3.a ◽

2012 ◽

Vol 43 (3) ◽

pp. 197-209 ◽

Cited By ~ 5

Author(s):

Katsuji Nishimura ◽

Sayaka Kobayashi ◽

Hiroko Sugawara ◽

Ichiro Nakajima ◽

Hideki Ishida ◽

...

Keyword(s):

Kidney Transplantation ◽

Somatoform Disorders ◽

Psychiatric Consultation ◽

Single Center Study ◽

Routine Clinical Setting ◽

Patient Database ◽

Icd 10 ◽

Long Time ◽

Psychiatric Intervention

Background: The aim of this study was to elucidate the clinical characteristics and frequency of psychiatric consultation in a routine clinical setting after kidney transplantation. Methods: Subjects were 1,139 consecutive recipients who received kidney transplantation at our hospital between January 1997 and September 2006. The hospital patient database was searched to determine whether these recipients received psychiatric consultation after their transplantation during this period. Results: Among 1,139 recipients, 118 (10%) received psychiatric consultation after their transplantation. There were significantly more women among these recipients ( p = 0.036). Many of the recipients had received psychiatric consultation before transplantation ( p < 0.0001) and had received dialysis for a long time ( p = 0.018). There were three main psychiatric diagnoses according to ICD-10 diagnostic criteria in these 118 recipients: 42 (36%) had neurotic, stress-related, and somatoform disorders (F4); 35 (30%) had organic, including symptomatic, mental disorders (F0); and 27 (23%) had mood (affective) disorders (F3). The median length of time between kidney transplantation and initial psychiatric consultation was 57 days (interquartile range: 10–650 days). The lengths were 7 days (6–17 days) for F0, 75 days (18–650 days) for F4, 243 days (35–1,004 days) for F3, and 253 days (10–1,393 days) for other diagnostic groups. Significant differences were observed among these four groups (Jonckheere-Terpstra test, p < 0.001). Conclusion: Our results show that appropriate psychiatric intervention is necessary not only in early stages after kidney transplantation but also over the long term.

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