scholarly journals The intelligent use and clinical benefits of electronic medical records in multiple sclerosis

2014 ◽  
Vol 11 (2) ◽  
pp. 205-211 ◽  
Author(s):  
Mary F Davis ◽  
Jonathan L Haines
2020 ◽  
Author(s):  
Eileen Yu ◽  
Alexis Adams-Clark ◽  
Alison Riehm ◽  
Caroline Franke ◽  
Ryoko Susukida ◽  
...  

Abstract Background: Electronic medical records (EMRs) have transformed the way healthcare professionals manage and share patient data while providing integrated and comprehensive care. However, the rate of EMR use among psychiatrists is generally lower compared to physicians in other medical disciplines, in part due to concerns over patients’ experience of stigma surrounding mental health. This paper explores the willingness to share medical records among people with multiple sclerosis (MS), who experience higher rates of psychiatric comorbidities compared to the general population. It also examines the role that stigma plays in patients’ preferences regarding the sharing of their electronic medical records. Methods: MS patients were surveyed regarding their co-occurring psychiatric and non-psychiatric diagnoses, willingness to share their health information electronically among their treating doctors, and levels of self and societal stigma associated with their various co-occurring diagnoses. Results: 96.44% and 87.14% of participants were willing to share their non-psychiatric and psychiatric diagnoses, respectively; 97.70% and 92.78% were willing to share non-psychiatric and psychiatric medications, respectively. MS patients with a psychiatric co-occurring diagnosis, compared to those without, were significantly more likely to share their psychiatric diagnosis (AOR = 2.59) and psychiatric medications (AOR = 3.19). Those with both non-psychiatric and psychiatric co-occurring diagnoses were significantly more likely to share their psychiatric diagnosis (AOR = 3.84) and psychiatric medications (AOR = 7.02) than patients with no co-occurring diagnosis other than MS. Five (substance use, personality, eating, psychotic, and neurodevelopmental disorders) of the top six diagnoses for which societal stigma was greater than self stigma, and three (sexual, anxiety, and mood disorders) of the top five diagnoses for which self stigma was greater than societal stigma were psychiatric diagnoses. High levels of societal stigma correlated with decreased likelihood in sharing non-psychiatric medications, while high levels of self stigma were associated with a greater decrease in patient willingness to share psychiatric medications. Conclusions: Despite the presence of stigma decreasing patient willingness to share medical records, people with MS who had psychiatric disorders, compared to those without, endorsed greater willingness to share their health records electronically.


2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Sohyun Park ◽  
Hui Jai Lee ◽  
Jonghwan Shin ◽  
Kyoung Min You ◽  
Se Jong Lee ◽  
...  

Background. Activated charcoal is the most frequently and widely used oral decontaminating agent in emergency departments (EDs). However, there is some debate about its clinical benefits and risks. In Korea, activated charcoal with sorbitol was unavailable as of the mid-2015, and our hospital had been unable to use it from September 2015. This study examined the differences of clinical features and outcomes of patients during the periods charcoal was and was not available. Methods. We retrospectively reviewed the electronic medical records of patients who had visited an urban tertiary academic ED for oral drug poisoning between January 2013 and January 2017. Results. For the charcoal-available period, 413 patients were identified and for the charcoal-unavailable period, 221. Activated charcoal was used in the treatment of 141 patients (34%) during the available period. The mortality rates during the available and unavailable periods were 1.9 and 0.9%, respectively (p = 0.507). There was also no interperiod difference in the development of aspiration pneumonia (9.9 versus 9.5%, p = 0.864), the endotracheal intubation rate (8.4 versus 7.2%, p = 0.586), and vasopressor use (5.3 versus 5.0%, p = 0.85). Intensive care unit (ICU) admission was higher in the unavailable period (5.8 versus 13.6%, p = 0.001). ICU days were lower in the unavailable period (10 [4.5-19] versus 4 [3-9], p = 0.01). Hospital admission (43.3 versus 29.9%, p = 0.001) was lower in the unavailable period. Conclusions. In this single center study, there appeared to be no difference in mortality, intubation rates, or vasopressor use between the charcoal-available and charcoal-unavailable periods.


2018 ◽  
Vol 9 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Vincent Damotte ◽  
Pierre-Antoine Gourraud

2013 ◽  
Vol 20 (e2) ◽  
pp. e334-e340 ◽  
Author(s):  
Mary F Davis ◽  
Subramaniam Sriram ◽  
William S Bush ◽  
Joshua C Denny ◽  
Jonathan L Haines

2018 ◽  
Vol 25 (3) ◽  
pp. 408-418 ◽  
Author(s):  
Vincent Damotte ◽  
Antoine Lizée ◽  
Matthew Tremblay ◽  
Alisha Agrawal ◽  
Pouya Khankhanian ◽  
...  

Background: Electronic medical records (EMR) data are increasingly used in research, but no studies have yet evaluated similarity between EMR and research-quality data and between characteristics of an EMR multiple sclerosis (MS) population and known natural MS history. Objectives: To (1) identify MS patients in an EMR system and extract clinical data, (2) compare EMR-extracted data with gold-standard research data, and (3) compare EMR MS population characteristics to expected MS natural history. Methods: Algorithms were implemented to identify MS patients from the University of California San Francisco EMR, de-identify the data and extract clinical variables. EMR-extracted data were compared to research cohort data in a subset of patients. Results: We identified 4142 MS patients via search of the EMR and extracted their clinical data with good accuracy. EMR and research values showed good concordance for Expanded Disability Status Scale (EDSS), timed-25-foot walk, and subtype. We replicated several expected MS epidemiological features from MS natural history including higher EDSS for progressive versus relapsing–remitting patients and for male versus female patients and increased EDSS with age at examination and disease duration. Conclusion: Large real-world cohorts algorithmically extracted from the EMR can expand opportunities for MS clinical research.


2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 31-31
Author(s):  
Przemyslaw Twardowski ◽  
Stuart Atkinson ◽  
Deborah Boldt-Houle ◽  
A. Oliver Sartor

31 Background: LHRH agonists are the most frequently used drugs for the delivery of androgen deprivation therapy (ADT) for PCa. Evidence suggests achieving and sustaining T levels ≤20 ng/dL with ADT is desirable and correlates with improved disease-specific survival in advanced PCa patients. However, T levels may rise above castration level (50 ng/dL) between injections, especially if a subsequent dose is delayed. Increase in prostate-specific antigen (PSA) level on ADT may represent true disease progression to castration resistant PCa, or may be a result of late ADT dosing and inadequate T suppression. Current study evaluated timeliness of LHRH agonist dosing, subsequent rate of T breakthroughs and frequency of T/PSA testing prior to dosing in PCa patients. Methods: A retrospective review of electronic medical records and associated claims data (1/1/07-6/30/16) of LHRH agonist injections (n=85,030) evaluated the frequency of late dosing (defined as occurring after day 32, 97, 128, 194 for 1-, 3-, 4-, 6-month formulations, respectively), T tests >20 ng/dL and frequency of T/PSA tests prior to dosing. Results: 26.9% of injections were late: 14.4% were ≤1 week late, 3.1% were between 1-2 weeks late and 9.4% were >2 weeks late. 43% of T values exceeded 20 ng/dL for late injections; while only 21% exceeded this level for early/on-time injections. 83% of LHRH injections had a PSA value drawn prior to dosing; however, only 13% had a similarly timed T assessment. Conclusions: Overall, >25% of injections were late. For late injections, the proportion of T tests with T >20 ng/dL was higher compared to when the dosing was early/on-time. Late injections correlated with ineffective T suppression (>20 ng/dL) over 40% of the time. For all injections, T levels were not monitored as frequently as PSA levels. Considering the potential clinical benefits of maintaining effective T suppression throughout the course of ADT, clinicians should ensure treatments are delivered within approved dosing instructions, routinely monitor T levels and consider prescribing treatments with proven efficacy through the dosing interval to maintain T ≤20 ng/dL.


PLoS ONE ◽  
2015 ◽  
Vol 10 (2) ◽  
pp. e0116718 ◽  
Author(s):  
Ashutosh Malhotra ◽  
Michaela Gündel ◽  
Abdul Mateen Rajput ◽  
Heinz-Theodor Mevissen ◽  
Albert Saiz ◽  
...  

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