scholarly journals Improving the Efficacy of the Data Entry Process for Clinical Research With a Natural Language Processing–Driven Medical Information Extraction System: Quantitative Field Research (Preprint)

2019 ◽  
Author(s):  
Jiang Han ◽  
Ken Chen ◽  
Lei Fang ◽  
Shaodian Zhang ◽  
Fei Wang ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Natural Language Processing ◽  
Language Processing ◽  
Congenital Heart ◽  
Medical Information ◽  
Data Entry ◽  
Elapsed Time ◽  
Manual Group ◽  
Information Extraction System

BACKGROUND The growing interest in observational trials using patient data from electronic medical records poses challenges to both efficiency and quality of clinical data collection and management. Even with the help of electronic data capture systems and electronic case report forms (eCRFs), the manual data entry process followed by chart review is still time consuming. OBJECTIVE To facilitate the data entry process, we developed a natural language processing–driven medical information extraction system (NLP-MIES) based on the i2b2 reference standard. We aimed to evaluate whether the NLP-MIES–based eCRF application could improve the accuracy and efficiency of the data entry process. METHODS We conducted a randomized and controlled field experiment, and 24 eligible participants were recruited (12 for the manual group and 12 for NLP-MIES–supported group). We simulated the real-world eCRF completion process using our system and compared the performance of data entry on two research topics, pediatric congenital heart disease and pneumonia. RESULTS For the congenital heart disease condition, the NLP-MIES–supported group increased accuracy by 15% (95% CI 4%-120%, P=.03) and reduced elapsed time by 33% (95% CI 22%-42%, P<.001) compared with the manual group. For the pneumonia condition, the NLP-MIES–supported group increased accuracy by 18% (95% CI 6%-32%, P=.008) and reduced elapsed time by 31% (95% CI 19%-41%, P<.001). CONCLUSIONS Our system could improve both the accuracy and efficiency of the data entry process.

Assessment of Needs for Counseling After Prenatal Diagnosis of Congenital Heart Disease – A Multidisciplinary Approach

2018 ◽  
Vol 230 (05) ◽  
pp. 251-256 ◽  
Author(s):  
Alexander Kovacevic ◽  
Andreas Simmelbauer ◽  
Sebastian Starystach ◽  
Michael Elsässer ◽  
Christof Sohn ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Prenatal Diagnosis ◽  
Medical Staff ◽  
Congenital Heart ◽  
Multidisciplinary Approach ◽  
Medical Information ◽  
Coping Resources ◽  
Effective Counseling ◽  
Demographical Data

Abstract Background Congenital heart disease is the most common cause of major congenital anomalies. After prenatal diagnosis effective counseling is crucial. However, little research has been undertaken in determining the most effective techniques. Objectives To develop a questionnaire suitable to assess parental needs for counseling. Material and Methods A questionnaire was developed by pediatric cardiologists, maternal-fetal-medicine specialists and sociologists. Likert scaled and open-ended questions are combined with socio-demographical data. The questionnaire was prospectively pilot-tested on 17 parents. We present first analyses of n=41 parents. Results Response rate was 89.5%. The dependent variable “effective counseling” was measured in 5 dimensions (transfer of medical information, trust in medical staff, transparency of treatment process, coping resources and perceived situational control). The questionnaire’s internal consistency is high (Cronbach’s alpha>0.7). First analyses show that 44.7% perceived counseling as successful. Transfer of medical information seems difficult (36.6% success rate). Trust in medical staff was high with 75%. Conclusions This newly developed tool measures counseling success in five dimensions. A multidisciplinary approach is recommended as methodological expertise is essential for constructing adequate tests. Preliminary data indicate that transfer of medical information is not easily achieved. Further analyses are needed to identify factors that determine counseling success.

An Active Surveillance and Referral Program to Ensure Respiratory Syncytial Virus Prophylaxis for the Pediatric Congenital Heart Disease Population: A Quality Improvement Project

2014 ◽  
Vol 7 (2) ◽  
pp. 154-159
Author(s):  
Carman R. DeMare ◽  
Catherine O’Keefe
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Respiratory Syncytial Virus ◽  
Congenital Heart ◽  
Data Entry ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Improvement Project ◽  
Number Of Patients ◽  
Syncytial Virus

Background: Congenital heart disease (CHD) is the leading cause of death within the first year of life because of birth defects. Complications related to respiratory infection caused by respiratory syncytial virus (RSV) increase risks in the CHD population. Prevention is key to minimizing risk, and administration of RSV prophylaxis, palivizumab, is recommended for infants with hemodynamically significant heart disease. Objective: Use the electronic medical record (EMR) to identify and ensure appropriate referral of CHD patients eligible for RSV prophylaxis. Design: Comparative, cross-sectional study design. Setting: Cardiac specialty clinic of a regional children’s hospital. Population: CHD patients younger than 24 months of age eligible for RSV prophylaxis. Intervention: Use the EMR to develop a method for identifying CHD patients eligible for RSV prophylaxis and implement a referral process. Results: Similar number of patients in the 2 RSV seasons studied. Rates of eligibility for RSV prophylaxis over the 2 seasons were the same. Improvements in documentation of eligibility by the provider from the first season to the second. Limitations: Inability to determine referral rates. Initial EMR search did not identify patients eligible for RSV prophylaxis. Inconsistent EMR data entry. Conclusions: Ongoing education on eligibility for RSV prophylaxis. Need for automated EMR referral. Ongoing evaluation of EMR systems identifying patients eligible for RSV prophylaxis.

Barriers to care in urban and rural dwelling adults with congenital heart disease

2021 ◽  
pp. 1-6
Author(s):  
Lidija McGrath ◽  
Marshall Taunton ◽  
Sheldon Levy ◽  
Adrienne H. Kovacs ◽  
Craig Broberg ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Medical Information ◽  
Medical Center ◽  
Adult Congenital Heart Disease ◽  
Academic Medical Center ◽  
Cardiac Care ◽  
Insurance Premiums ◽  
Adult Congenital

Abstract Introduction: Adults with congenital heart disease (CHD) face a unique set of medical, psychological, and social challenges, and access to specialised adult congenital heart disease care has been associated with improved outcomes. Rural adults with CHD may represent a uniquely disadvantaged group given additional challenges when accessing specialised care. The aim of this study was to investigate the challenges faced by adults with CHD in accessing outpatient cardiac care, with a specific focus on understanding differences between urban- and rural-dwelling patients. Methods: This cross-sectional, survey-based study took place in the adult congenital heart disease clinic at an urban academic medical center. Additional medical information was abstracted in a retrospective manner from the electronic health record. In addition to descriptive statistics, t-tests and Chi-square tests were performed to investigate differences between urban and rural dwelling patients. Results: A total of 100 patients participated in the study (mean age 40 ± 13 years, 60% female, 18% rural dwelling). Across the total sample, the median driving distance to clinic was 20 miles (interquartile range 12–77); it was 15 miles for urban dwellers and 77 miles for rural dwelling patients (p < 0.001). The most commonly identified barriers to cardiac clinic visits were financial losses related to taking time off from work (39%), distance of clinic from home (33%), and weather (33%). Compared to urban dwelling patients, on average those who were rural dwelling had a lower level of education (p = 0.04), more difficulty paying insurance premiums (p < 0.001) and copays (p = 0.005), and were more likely to identify the distance from clinic (p = 0.05) and having to go into the city (p = 0.02) as barriers to clinic appointments. Conclusions: The financial impact and distance to clinic were the most commonly identified barriers to outpatient cardiac care in this cohort of adults with CHD. These barriers, along with difficulty paying insurance premiums, are more common in rural dwelling patients. Initiatives such as telemedicine visits or providing financial subsidies for travel and treatment could help to expand specialty adult congenital heart disease care and better serve this growing patient population.

Helping Parents Cope With the Diagnosis of Congenital Heart Defect: An Experimental Study

PEDIATRICS ◽  
1977 ◽  
Vol 59 (2) ◽  
pp. 266-272
Author(s):  
Mary Jo Kupst ◽  
Sandra Blatterbauer ◽  
James Westman ◽  
Jerome L. Schulman ◽  
Milton H. Paul
Keyword(s):  
Experimental Study ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Medical Information ◽  
Intervention Strategy ◽  
Intervention Strategies ◽  
Team Approach ◽  
Psychological Issues ◽  
Personal Interaction

An experimental study was designed to help parents cope with the implications of the diagnosis of congenital heart disease. Intervention strategies involving clarification of medical information, discussion of psychological issues, and a combination of the two, were more effective than no intervention in helping parents to gain an accurate understanding of the diagnosis and other medical information. Regardless of the intervention strategy used, satisfaction was generally high, and parent anxiety did not appear to fluctuate during the course of the visit. The team approach was recommended for use in pediatric specialty clinics where time is often short, and a more personal interaction may he needed.

Abstract 16947: Barriers to Care in Urban and Rural Dwelling Patients With Adult Congenital Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Lidija B McGrath ◽  
Marshall Taunton ◽  
Sheldon Levy ◽  
Adrienne Kovacs ◽  
Craig S Broberg ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Medical Information ◽  
Medical Center ◽  
Adult Congenital Heart Disease ◽  
Academic Medical Center ◽  
Cardiac Care ◽  
Insurance Premiums ◽  
Adult Congenital

Introduction: Adult congenital heart disease (ACHD) patients face a unique set of medical, psychological, and social challenges, and access to specialized ACHD care has been shown to improve their outcomes. Rural ACHD patients may represent a uniquely disadvantaged group given their complex health care needs and the distance they must travel to access care. The aim of this study was to investigate the challenges faced by ACHD patients in accessing outpatient cardiac care, with a specific focus on understanding barriers related to distance from care. Methods: This cross-sectional, survey-based study took place in the ACHD clinic at an academic medical center in a metropolitan area. Additional medical information was abstracted in a retrospective manner from the electronic health record. T-tests and Chi-square tests were used to investigate the relationship between variables. Results: A total of 100 patients participated in the study (mean age 40 ± 13 years, 60% female, 18% rural dwelling). The median driving distance to clinic was 20 miles (interquartile range 12 to 77 miles). The most commonly identified barriers to cardiac clinic visits were the financial losses related to taking time off from work (39%), distance of clinic from home (33%), and the weather (33%), whereas finding a ride to clinic, finding childcare, or the time of available clinic appointments were not perceived as significant barriers. As compared to urban dwelling patients, those who were rural dwelling had a lower level of education (p=0.04), more difficulty paying insurance premiums (p<0.001) and copays (p=0.005), and were more likely to identify the distance from clinic (p=0.05) and having to go into the city (p=0.02) as barriers to clinic appointments. Conclusions: Loss of compensation from taking time off work to attend a visit and distance to clinic were the most commonly identified barriers to outpatient cardiac care in this cohort of ACHD patients. These barriers, along with difficulty paying insurance premiums, are more common in rural dwelling patients. Initiatives such as telemedicine visits or providing financial subsidies for travel and treatment could help to expand specialty ACHD care and better serve this growing patient population.

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