A cross-sectional study examining convergent validity of a frailty index based on electronic medical records in a Canadian primary care program

Abstract Background: The Netherlands Triage Standard (NTS) is a widely used decision support tool for telephone triage at Dutch out-of-hours primary care services (OHS-PC), which, however, has never been validated against clinical outcomes. We aimed to determine the accuracy of the NTS urgency allocation for patients with neurological symptoms suggestive of a transient ischaemic attack (TIA) or stroke, with the clinical outcomes TIA, stroke, and other (neurologic) life-threatening events (LTEs) as the reference.Method: A cross-sectional study of telephone triage recordings of patients with neurological symptoms calling the OHS-PC between 2014 and 2016.The allocated NTS urgencies were derived from the electronic medical records of the OHS-PC. The clinical outcomes were retrieved from the electronic medical records of the patients’ own general practitioners. The accuracy of a high NTS urgency allocation (medical help within three hours) was calculated in terms of sensitivity, specificity, positive and negative predictive values (PPV and NPV) with the clinical outcomes TIA/stroke/other LTEs as the reference.Results: Of 1,269 patients, 635 (50.0%) received the diagnosis TIA/stroke (34.2% TIA/minor stroke, 15.8% major ischaemic or haemorrhagic stroke), and 4.8% other LTEs. For TIA/stroke/other LTEs, the sensitivity and specificity of the NTS urgency allocation were 0.72 (95%CI 0.68-0.75) and 0.48 (95%CI 0.43-0.52), and the PPV and NPV were 0.62 (95%CI 0.60-0.64) and 0.58 (95%CI 0.54-0.62).Conclusions: The NTS decision support tool used in Dutch OHS-PC performed poor to moderately regarding safety (sensitivity) and efficiency (specificity) in allocating adequate urgencies to patients with and without TIA/stroke/other LTEs.

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Accuracy of telephone triage in suspected transient ischaemic attack or stroke: A cross-sectional study

10.21203/rs.3.rs-27478/v1 ◽

2020 ◽

Author(s):

Daphne Carmen Erkelens ◽

Frans H. Rutten ◽

Loes T. Wouters ◽

L. Servaas Dolmans ◽

Esther de Groot ◽

...

Keyword(s):

Clinical Outcomes ◽

Electronic Medical Records ◽

Medical Records ◽

Decision Support Tool ◽

Cross Sectional Study ◽

Sectional Study ◽

Telephone Triage ◽

Cross Sectional ◽

Support Tool ◽

Ischaemic Attack

Abstract BackgroundThe Netherlands Triage Standard (NTS) is a widely used decision support tool for telephone triage at Dutch out-of-hours primary care services (OHS-PC), which, however, has never been validated against clinical outcomes. We aimed to determine the accuracy of the NTS urgency allocation for patients with neurological symptoms suggestive of a transient ischaemic attack (TIA) or stroke, with the clinical outcomes TIA, stroke, and other (neurologic) life-threatening events (LTEs) as the reference.MethodA cross-sectional study of telephone triage recordings of patients with neurological symptoms calling the OHS-PC between 2014 and 2016.The allocated NTS urgencies were derived from the electronic medical records of the OHS-PC. The clinical outcomes were retrieved from the electronic medical records of the patients’ own general practitioners. The accuracy of a high NTS urgency allocation (medical help within three hours) was calculated in terms of sensitivity, specificity, positive and negative predictive values (PPV and NPV) with the clinical outcomes TIA/stroke/other LTEs as the reference.ResultsOf 1,269 patients, 635 (50.0%) received the diagnosis TIA/stroke (34.2% TIA/minor stroke, 15.8% major ischaemic or haemorrhagic stroke), and 4.8% other LTEs. For TIA/stroke/other LTEs, the sensitivity and specificity of the NTS urgency allocation were 0.72 (95%CI 0.68–0.75) and 0.48 (95%CI 0.43–0.52), and the PPV and NPV were 0.62 (95%CI 0.60–0.64) and 0.58 (95%CI 0.54–0.62).ConclusionsThe NTS decision support tool used in Dutch OHS-PC performed poor to moderately regarding safety (sensitivity) and efficiency (specificity) in allocating adequate urgencies to patients with and without TIA/stroke/other LTEs.Trial registration: the Netherlands National Trial Register, identification number NTR7331.

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Utilization of Electronic Medical Records Data for Medical Research in a Hospital in China: A Cross-Sectional Study (Preprint)

10.2196/preprints.24405 ◽

2020 ◽

Author(s):

Rui Li ◽

Yue Niu ◽

Sarah Robbins Scott ◽

Chu Zhou ◽

Lan Lan ◽

...

Keyword(s):

Medical Research ◽

Electronic Medical Records ◽

Medical Records ◽

Cross Sectional Study ◽

Data Availability ◽

Sectional Study ◽

Data Utilization ◽

Cross Sectional ◽

Research Activities ◽

Per Capita

BACKGROUND With the proliferation of electronic medical records systems (EMRs), there is an increasing interest in utilizing EMRs data for medical research, yet there is no quantitative research on EMRs data utilization for medical research purposes. OBJECTIVE Understand the current status of clinical data utilization in clinical research activities, including trends in recent years and differences between different populations, to find out the present problems in the use of EMR data for research, and provide a reference for promoting the utilization of EMR data in scientific research. METHODS For this descriptive, cross-sectional study, the utilization of EMRs data by staff at Xuanwu Hospital in Beijing, China between 2016 and 2019 was analyzed. The utilization of EMRs data was described as the number of requests, the proportion of requesters, and the frequency of requests per capita. The comparison by year, professional title, and age was conducted by double-sided chi square test. RESULTS From 2016 to 2019, EMRs data utilization was poor, as the proportion of requesters was 5.8% and the frequency was 0.1 times / person / year. The frequency per capita gradually slowed and more older, senior level staff used EMRs data compared to younger staff. CONCLUSIONS The value of using EMRs data for research purposes does not get enough attention among researchers in Chinese hospitals. Ensuring equal availability of EMRs data and highlighting the benefits of such systems can help promote its use in research settings. Future research should focus on mechanisms that encourage data utilization, ensure fair data availability, and promote data sharing.

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Speech therapy aspects in patients’ palliative care

Revista CEFAC ◽

10.1590/1982-0216/202123610421 ◽

2021 ◽

Vol 23 (6) ◽

Author(s):

Luísa Bello Gabriel ◽

Elana de Menezes Rossetto ◽

Vera Beatris Martins ◽

Monalise Costa Batista Berbert

Keyword(s):

Palliative Care ◽

Medical Records ◽

Speech Therapy ◽

Care Program ◽

Cross Sectional Study ◽

Oral Feeding ◽

Sectional Study ◽

Cross Sectional ◽

Language Assessments

ABSTRACT Purpose: to describe the speech therapy aspects of patients treated by the palliative care team in a hospital. Methods: an observational and cross-sectional study, performed from medical records of patients treated under Palliative Care Program, in a hospital, from July to September 2018. Information from the anamnesis and speech-language assessments, which were analyzed by frequency measures, were collected. Results: the sample was composed by 41 medical records, including 25 males and 16 females, with an average age of 61.2 years and hospitalization average time of 20.7 days. Oral feeding was present in 73% of the sample. It was observed that 24% of the patients had impaired expressive language, 56% had reduced maximum phonation times and 34% showed altered mobility phonoarticulatory organs. For swallowing, 22% showed difficulty in some consistency. A nutritional feeding was verified in 74% of the sample and the remaining was making use of comfort feeding. In relation to assistance, 46% of the sample was under management, 7% in therapy, and the remaining did not have follow-up indication. Conclusion: relevant alterations to orofacial motricity, voice, language and swallowing were found in patients under palliative care.

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Prescribing of Xylometazoline in the Outpatient Department of a Public Hospital

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i3931018 ◽

2021 ◽

pp. 1-4

Author(s):

Nehad J. Ahmed ◽

Menshawy A. Menshawy

Keyword(s):

Emergency Department ◽

Electronic Medical Records ◽

Medical Records ◽

Public Hospital ◽

Cross Sectional Study ◽

Outpatient Department ◽

Prescription Data ◽

Sectional Study ◽

Prescribing Pattern ◽

Cross Sectional

Objective: The aim of this study is to analyze the prescribing pattern of Xylometazoline in the outpatient department in a public hospital. Methods: This is a retrospective cross-sectional study that was conducted in a public hospital in alkharj. Prescription data was collected from electronic medical records in the outpatient department. Results: A total of 600 patients received xylometazoline during the study time. 55% of them were males and more than 57% of them aged less than 10 years. More than 86% of the prescriptions were prescribe by the emergency department followed by E.N.T department (13%). Most of the patients received xylometazoline for 3 days and 15.17% of them received it for 5 days. Conclusion: Xylometazoline was prescribed commonly in the outpatients department and could cause several adverse events so its prescribing should be assessed continuously to prevent its adverse effects and to decrease its interactions with drugs.

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