Can long-term historical data from electronic medical records improve surveillance for epidemics of acute respiratory infections? A systematic evaluation

Abstract OBJECTIVE To describe signalment, clinical signs, serologic test results, treatment, and outcome of dogs with Coccidioides osteomyelitis (COM) and to compare those findings with findings for dogs with osteosarcoma (OSA). ANIMALS 14 dogs with COM and 16 dogs with OSA. PROCEDURES Data were retrospectively gathered from electronic medical records. RESULTS Dogs with COM were younger and weighed less than dogs with OSA. Six dogs with COM had appendicular lesions, 5 had axial lesions, and 3 had both appendicular and axial lesions; 9 had monostotic disease, and 5 had polyostotic disease. Axial lesions and nonadjacent polyostotic disease were more common in dogs with COM than in dogs with OSA, but radiographic appearance was not different between the 2 groups. Median IgG titer at diagnosis of COM was 1:48 and was significantly decreased after 6 and 12 months of treatment. Percentage of dogs with COM that had clinical signs was significantly decreased after 1, 3, 6, and 12 months of treatment. One year after initiation of treatment, 9 of 9 dogs were still receiving fluconazole and 8 of 9 dogs had positive results for serum IgG titer testing. CLINICAL RELEVANCE Dogs with COM typically had a rapid improvement in clinical signs after initiating treatment with fluconazole but required long-term antifungal treatment. Dogs with COM differed from dogs with OSA, but radiographic features had a great degree of overlap between groups, confounding the ability to make a diagnosis on the basis of diagnostic imaging alone.

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Abstract DP-004: DESCRIBING THE ODDS OF LONG-TERM SURVIVAL AMONG WOMEN DIAGNOSED WITH HIGH-GRADE SEROUS OVARIAN CANCER USING ELECTRONIC MEDICAL RECORDS

10.1158/1557-3265.ovcasymp18-dp-004 ◽

2019 ◽

Author(s):

Christina L. Clarke ◽

Lawrence H. Kushi ◽

Jessica Chubak ◽

Pamala A. Pawloski ◽

Joanna E. Bulkley ◽

...

Keyword(s):

Ovarian Cancer ◽

Electronic Medical Records ◽

Medical Records ◽

High Grade ◽

Serous Ovarian Cancer ◽

Term Survival ◽

Long Term Survival

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The effectiveness of varenicline versus nicotine replacement therapy on long-term smoking cessation in primary care: a prospective cohort study of electronic medical records

International Journal of Epidemiology ◽

10.1093/ije/dyx109 ◽

2017 ◽

Vol 46 (6) ◽

pp. 1948-1957 ◽

Cited By ~ 27

Author(s):

Gemma MJ Taylor ◽

Amy E Taylor ◽

Kyla H Thomas ◽

Timothy Jones ◽

Richard M Martin ◽

...

Keyword(s):

Primary Care ◽

Smoking Cessation ◽

Cohort Study ◽

Replacement Therapy ◽

Nicotine Replacement Therapy ◽

Electronic Medical Records ◽

Prospective Cohort Study ◽

Medical Records ◽

Prospective Cohort

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An antibiotic stewardship programme to reduce inappropriate antibiotic prescribing for acute respiratory infections in rural Chinese primary care facilities: study protocol for a clustered randomised controlled trial

10.21203/rs.3.rs-18556/v1 ◽

2020 ◽

Author(s):

Chao Zhuo ◽

Xiaolin Wei ◽

Zhitong Zhang ◽

Joseph Paul Hicks ◽

Jinkun Zheng ◽

...

Keyword(s):

Primary Care ◽

Antibiotic Stewardship ◽

Respiratory Infections ◽

Inappropriate Prescribing ◽

Antibiotic Prescribing ◽

Acute Respiratory Infections ◽

Care Facilities ◽

Randomised Controlled ◽

Antibiotic Stewardship Programme

Abstract Background: Inappropriate prescribing of antibiotics for acute respiratory infections at primary care level represents the major source of antibiotic misuse in healthcare, and is a major driver for antimicrobial resistance worldwide. In this study we will develop, pilot and evaluate the effectiveness of a comprehensive antibiotic stewardship programme in China’s primary care hospitals to reduce inappropriate prescribing of antibiotics for acute respiratory infections among all ages.Methods: We will use a parallel-group, cluster-randomised, controlled, superiority trial with blinded outcome evaluation but unblinded treatment (providers and patients). We will randomise 34 primary care hospitals from two counties within Guangdong province into the intervention and control arm (1:1 overall ratio) stratified by county (8:9 within-county ratio). In the control arm, antibiotic prescribing and management will continue through usual care. In the intervention arm, we will implement an antibiotic stewardship programme targeting family physicians and patients/caregivers. The family physician components include: 1) training using new operational guidelines, 2) improved management and peer-review of antibiotic prescribing, 3) improved electronic medical records and smart phone app facilitation. The patient/caregiver component involves patient education via family physicians, leaflets and videos. The primary outcome is the proportion of prescriptions for acute respiratory infections (excluding pneumonia) that contain any antibiotic(s). Secondary outcomes will address how frequently specific classes of antibiotics are prescribed, how frequently key non-antibiotic alternatives are prescribed and the costs of consultations. We will conduct a qualitative process evaluation to explore operational questions regarding acceptability, cultural appropriateness and burden of technology use, as well as a cost-effectiveness analysis and a long-term benefit evaluation. The duration of the intervention will be 12 months, with another 24 months post-trial long-term follow-up.Discussion: Our study is one of the first trials to evaluate the effect of an antibiotic stewardship programme in primary care settings in a low- or middle-income country (LMIC). All intervention activities will be designed to be embedded into routine primary care with strong local ownership. Through the trial we intend to impact on clinical practice and national policy in antibiotic prescription for primary care facilities in rural China and other LMICs.Trial registration: ISRCTN, ISRCTN96892547. Registered 18 August 2019, http://www.isrctn.com/ISRCTN96892547

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Evaluation of Viruses Associated With Acute Respiratory Infections in Long-Term Care Facilities Using a Novel Method: Wisconsin, 2016‒2019

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2019.09.003 ◽

2020 ◽

Vol 21 (1) ◽

pp. 29-33 ◽

Cited By ~ 3

Author(s):

Mary M. Checovich ◽

Shari Barlow ◽

Peter Shult ◽

Erik Reisdorf ◽

Jonathan L. Temte

Keyword(s):

Long Term Care ◽

Respiratory Infections ◽

Acute Respiratory Infections ◽

Term Care ◽

Care Facilities ◽

Novel Method

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Direct costs of acute respiratory infections in a pediatric long‐term care facility

Influenza and Other Respiratory Viruses ◽

10.1111/irv.12350 ◽

2015 ◽

Vol 10 (1) ◽

pp. 34-36 ◽

Cited By ~ 4

Author(s):

Meghan T. Murray ◽

Elizabeth Heitkemper ◽

Olivia Jackson ◽

Natalie Neu ◽

Patricia Stone ◽

...

Keyword(s):

Long Term Care ◽

Respiratory Infections ◽

Care Facility ◽

Direct Costs ◽

Acute Respiratory Infections ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility

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An Assessment of Globe Position Dynamics following Transcranial Lateral and Superior Orbital Wall Resections without Rigid Reconstruction: A Case Series of 55 Patients

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0039-1688773 ◽

2019 ◽

Vol 81 (03) ◽

pp. 244-250

Author(s):

Randall G. Krug ◽

Elizabeth A. Bradley ◽

Jamie J. Van Gompel

Keyword(s):

Skull Base ◽

Electronic Medical Records ◽

Medical Records ◽

Significant Risk ◽

Case Series ◽

Time Points ◽

Orbital Wall ◽

Skull Base Approach ◽

Over Time

Background There is no consensus exists regarding which reconstructive approach, if any, should be used after performing transcranial lateral orbital wall resections. Rigid reconstruction is often done to prevent enophthalmos; however, it is not clear if this is a risk with extensive orbital wall resections for transcranial surgery. Objective To assess globe position dynamics in patients that underwent transcranial lateral and superior orbital wall resections without rigid reconstruction to determine if enophthalmos is a significant risk. Methods Preoperative (PO) and postoperative data were retrospectively collected from the electronic medical records of 55 adult patients undergoing lateral and superior orbital wall resections as part of a skull base approach. The globe positions were assessed radiologically at all available time points and used to track relative globe displacements over time. Results An evaluation of PO variables identified a relationship between maximum lesion diameters and globe positions dynamics. The composition of globe position presentations in the population remained relatively stable over time, with only 1 out of 55 patients (1.81%) developing postoperative enophthalmos. An assessment of mean globe displacements revealed improvements in the patients presenting with PO exophthalmos, and stability in the patients presenting with normal PO globe positions. Conclusions Excellent results in long-term postoperative globe position dynamics can be achieved without the use of rigid reconstruction after transcranial lateral and superior orbital wall resections, regardless of the PO globe positioning.

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