scholarly journals OP8 Are clinically obese children at increased risk of hospital admission? a longitudinal analysis using linked electronic health records in wales and scotland

2018 ◽  
Author(s):  
LJ Griffiths ◽  
M Cortina-Borja ◽  
A Bandyopadhyay ◽  
K Tingay ◽  
BL De Stavola ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Hospital Admission ◽  
Longitudinal Analysis ◽  
Obese Children ◽  
Health Records ◽  
Increased Risk ◽  
Electronic Health

Pediatric hypertension: diagnostic patterns derived from electronic health records

Diagnosis ◽  
2018 ◽  
Vol 5 (3) ◽  
pp. 157-160 ◽  
Author(s):  
Goutham Rao ◽  
Sara Naureckas ◽  
Avisek Datta ◽  
Nivedita Mohanty ◽  
Victoria Bauer ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Target Organ Damage ◽  
Correct Diagnosis ◽  
Primary Care Providers ◽  
Care Providers ◽  
Pediatric Hypertension ◽  
Health Records ◽  
Factors Associated ◽  
Increased Risk ◽  
Electronic Health

Abstract Background Pediatric hypertension is a serious problem associated with target organ damage in children and an increased risk for adult hypertension. African-American and Latino children are disproportionately affected. Unfortunately, due to a variety of factors, including the complexity of blood pressure (BP) standards, pediatric hypertension is undiagnosed in the majority of cases. We sought to identify factors associated with correct diagnosis and to better understand diagnosis of hypertension by studying the diagnostic paths of a small number of children. Methods Data were extracted from electronic health records (EHRs) of children who met criteria for hypertension. Logistic regression was used to identify factors associated with correct diagnosis. Diagnostic paths for 20 diagnosed children were extracted through chart review and analyzed. Results Among 1478 hypertensive children, only 85 were diagnosed (6.1%). Age ≥12 compared to age ≤6 was associated with correct diagnosis [odds ratio (OR) of 1.96, 95% confidence interval (CI) (1.16, 3.32)]. Diagnostic paths revealed that primary care providers (PCPs) make the diagnosis based on multiple readings over time and order laboratory tests appropriately. Conclusions Hypertension is missed in a large proportion of all children. Effective, systematic approaches to diagnosis are necessary.

scholarly journals ‘Real time’ monitoring of antipsychotic prescribing in patients with dementia: a study using the Clinical Record Interactive Search (CRIS) platform to enhance safer prescribing

2020 ◽  
Vol 9 (1) ◽  
pp. e000778
Author(s):  
Craig Colling ◽  
Christoph Mueller ◽  
Gayan Perera ◽  
Nicola Funnell ◽  
Justin Sauer ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Real Time ◽  
Clinical Record ◽  
Free Text ◽  
Real Time Monitoring ◽  
Health Records ◽  
Interactive Search ◽  
Increased Risk ◽  
Antipsychotic Prescribing ◽  
Electronic Health

BackgroundThe use of antipsychotic drugs in dementia has been reported to be associated with increased risk of cerebrovascular events and mortality. There is an international drive to reduce the use of these agents in patients with dementia and to improve the safety of prescribing and monitoring in this area.ObjectivesThe aim of this project was to use enhanced automated regular feedback of information from electronic health records to improve the quality of antipsychotic prescribing and monitoring in people with dementia.MethodsThe South London and Maudsley NHS Foundation Trust (SLaM) incorporated antipsychotic monitoring forms into its electronic health records. The SLaM Clinical Record Interactive Search (CRIS) platform provides researcher access to de-identified health records, and natural language processing is used in CRIS to derive structured data from unstructured free text, including recorded diagnoses and medication. Algorithms were thus developed to ascertain patients with dementia receiving antipsychotic treatment and to determine whether monitoring forms had been completed. We used two improvement plan-do-study-act cycles to improve the accuracy of the algorithm for automated evaluation and provided monthly feedback on team performance.ResultsA steady increase in antipsychotic monitoring form completion was observed across the study period. The percentage of our sample with a completed antipsychotic monitoring form more than doubled from October 2017 (22%) to January 2019 (58%).Conclusion‘Real time’ monitoring and regular feedback to teams offer a time-effective approach, complementary to standard audit methods, to enhance the safer prescribing of high risk drugs.

scholarly journals Preeclampsia and Cardiovascular Disease in a Large UK Pregnancy Cohort of Linked Electronic Health Records

Circulation ◽  
2019 ◽  
Vol 140 (13) ◽  
pp. 1050-1060 ◽  
Author(s):  
Lydia J. Leon ◽  
Fergus P. McCarthy ◽  
Kenan Direk ◽  
Arturo Gonzalez-Izquierdo ◽  
David Prieto-Merino ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Cumulative Incidence ◽  
Chronic Hypertension ◽  
Cardiovascular Disorders ◽  
Hypertensive Disorders Of Pregnancy ◽  
Health Records ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Electronic Health ◽  
The Impact

Background: The associations between pregnancy hypertensive disorders and common cardiovascular disorders have not been investigated at scale in a contemporaneous population. We aimed to investigate the association between preeclampsia, hypertensive disorders of pregnancy, and subsequent diagnosis of 12 different cardiovascular disorders. Methods: We used linked electronic health records from 1997 to 2016 to recreate a UK population-based cohort of 1.3 million women, mean age at delivery 28 years, with nearly 1.9 million completed pregnancies. We used multivariable Cox models to determine the associations between hypertensive disorders of pregnancy, and preeclampsia alone (term and preterm), with 12 cardiovascular disorders in addition to chronic hypertension. We estimated the cumulative incidence of a composite end point of any cardiovascular disorder according to preeclampsia exposure. Results: During the 20-year study period, 18 624 incident cardiovascular disorders were observed, 65% of which had occurred in women under 40 years. Compared to women without hypertension in pregnancy, women who had 1 or more pregnancies affected by preeclampsia had a hazard ratio of 1.9 (95% confidence interval 1.53–2.35) for any stroke, 1.67 (1.54–1.81) for cardiac atherosclerotic events, 1.82 (1.34–2.46) for peripheral events, 2.13 (1.64–2.76) for heart failure, 1.73 (1.38–2.16) for atrial fibrillation, 2.12 (1.49–2.99) for cardiovascular deaths, and 4.47 (4.32–4.62) for chronic hypertension. Differences in cumulative incidence curves, according to preeclampsia status, were apparent within 1 year of the first index pregnancy. Similar patterns of association were observed for hypertensive disorders of pregnancy, while preterm preeclampsia conferred slightly further elevated risks. Conclusions: Hypertensive disorders of pregnancy, including preeclampsia, have a similar pattern of increased risk across all 12 cardiovascular disorders and chronic hypertension, and the impact was evident soon after pregnancy. Hypertensive disorders of pregnancy should be considered as a natural screening tool for cardiovascular events, enabling cardiovascular risk prevention through national initiatives.

scholarly journals Bi-directional association between depression and HF: An electronic health records-based cohort study

2020 ◽  
Vol 10 ◽  
pp. 2235042X2098405
Author(s):  
William V Bobo ◽  
Euijung Ryu ◽  
Tanya M Petterson ◽  
Kandace Lackore ◽  
Yijing Cheng ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Electronic Health Records ◽  
Chronic Conditions ◽  
Newly Diagnosed ◽  
Health Records ◽  
Care Services ◽  
Primary Care Services ◽  
Increased Risk ◽  
Electronic Health

Objective: To determine whether a bi-directional relationship exists between depression and HF within a single population of individuals receiving primary care services, using longitudinal electronic health records (EHRs). Methods: This retrospective cohort study utilized EHRs for adults who received primary care services within a large healthcare system in 2006. Validated EHR-based algorithms identified 10,649 people with depression (depression cohort) and 5,911 people with HF (HF cohort) between January 1, 2006 and December 31, 2018. Each person with depression or HF was matched 1:1 with an unaffected referent on age, sex, and outpatient service use. Each cohort (with their matched referents) was followed up electronically to identify newly diagnosed HF (in the depression cohort) and depression (in the HF cohort) that occurred after the index diagnosis of depression or HF, respectively. The risks of these outcomes were compared (vs. referents) using marginal Cox proportional hazard models adjusted for 16 comorbid chronic conditions. Results: 2,024 occurrences of newly diagnosed HF were observed in the depression cohort and 944 occurrences of newly diagnosed depression were observed in the HF cohort over approximately 4–6 years of follow-up. People with depression had significantly increased risk for developing newly diagnosed HF (HR 2.08, 95% CI 1.89–2.28) and people with HF had a significantly increased risk of newly diagnosed depression (HR 1.34, 95% CI 1.17–1.54) after adjusting for all 16 comorbid chronic conditions. Conclusion: These results provide evidence of a bi-directional relationship between depression and HF independently of age, sex, and multimorbidity from chronic illnesses.

Sign in / Sign up

Export Citation Format

Share Document