scholarly journals Standard work tools for dynamic stereoelectroencephalography using ROSA: naming convention and perioperative planning

2021 ◽  
pp. 1-9
Author(s):  
Salma M. Bakr ◽  
Ajay Patel ◽  
Mohamed A. Zaazoue ◽  
Kathryn Wagner ◽  
Sandi K. Lam ◽  
...  
Keyword(s):  
Phase I ◽  
The United States ◽  
Multicenter Studies ◽  
Common Data Elements ◽  
Standard Work ◽  
Naming Convention ◽  
Depth Electrodes ◽  
Nursing Guidelines ◽  
Data Elements ◽  
Perioperative Planning

OBJECTIVEThe grid-based orthogonal placement of depth electrodes (DEs), initially defined by Jean Talairach and Jean Bancaud, is known as stereo-electroencephalography (sEEG). Although acceptance in the United States was initially slow, advances in imaging and technology have spawned a proliferation of North American epilepsy centers offering sEEG. Despite publications highlighting minimal access techniques and varied indications, standard work for phase I targeted DE has not been defined. In this article, the authors propose the term “dynamic sEEG” and define standard work tools and related common data elements to promote uniformity in the field.METHODSA multidisciplinary approach from July to August 2016 resulted in the production of 4 standard work tools for dynamic sEEG using ROSA: 1) a 34-page illustrated manual depicting a detailed workflow; 2) a planning form to collocate all the phase I data; 3) a naming convention for DEs that encodes the data defining it; and 4) a reusable portable perioperative planning and documentation board. A retrospective review of sEEG case efficiency was performed comparing those using standard work tools (between July 2016 and April 2017) with historical controls (between March 2015 and June 2016). The standard work tools were then instituted at another epilepsy surgery center, and the results were recorded.RESULTSThe process for dynamic sEEG was formally reviewed, including anesthesia, positioning, perioperative nursing guidelines, surgical steps, and postoperative care for the workflow using cranial fixation and ROSA-guided placement. There was a 40% improvement in time per electrode, from 44.7 ± 9.0 minutes to 26.9 ± 6.5 minutes (p = 0.0007) following the development and use of the manual, the naming convention, and the reusable portable perioperative planning and documentation board. This standardized protocol was implemented at another institution and yielded a time per electrode of 22.3 ± 4.4 minutes.CONCLUSIONSThe authors propose the term dynamic sEEG for stereotactic depth electrodes placed according to phase I workup data with the intention of converting to ablation. This workflow efficiency can be optimized using the standard work tools presented. The authors also propose a novel naming convention that encodes critical data and allows portability among providers. Use of a planning form for common data elements optimizes research, and global adoption could facilitate multicenter studies correlating phase I modality and seizure onset zone identification.

Reexamining COVID-19 Self-Reported Symptom Tracking Programs in the United States: An Updated Framework Synthesis (Preprint)

2021 ◽  
Author(s):  
Miranda Lynn Janvrin ◽  
Jessica Korona-Bailey ◽  
Tracey Pérez Koehlmoos
Keyword(s):  
The United States ◽  
Time Frame ◽  
Vaccine Hesitancy ◽  
Demographic Information ◽  
Common Data Elements ◽  
Intended Audience ◽  
The Public ◽  
Pandemic Response ◽  
Data Elements ◽  
Google Search

BACKGROUND Early in the pandemic Koehlmoos et al (2020) completed a framework synthesis of currently available self-reported symptom tracking programs for COVID19. This framework described the programs, partners/affiliates, funding, responses, platform, and intended audience, among other considerations. OBJECTIVE This current study seeks to update the existing framework with the aim of identifying developments in the landscape and highlighting how programs have adapted to changes in pandemic response. METHODS Our team developed a framework to collate information on current COVD19 self-reported symptom tracking programs using the best-framework method. All programs from the previous article were included to document changes. New programs were discovered using a Google search for keywords. The time frame for the search for programs ranges from March 1, 2021, to May 6, 2021. RESULTS We screened 33 programs; 8 were included in our final framework synthesis. We identified multiple common data elements, including demographic information like race, age, gender, and affiliation (all were associated with universities, medical schools, or schools of public health). Dissimilarities included questions regarding vaccination status, vaccine hesitancy, social distancing adherence, testing, and mental health. CONCLUSIONS At this time, the future of self-reported symptom tracking for COVID-19 is unclear. Some sources have speculated that COVID-19 may become a yearly occurrence much like the flu, and if so, the data that these programs generate is still valuable. However, it is unclear if the public will maintain the same level of interest in reporting their symptoms on a regular basis if the COVID19 becomes more routine.

scholarly journals Understanding Contextual Differences in Residential LTC Provision for Cross-National Research: Identifying Internationally Relevant CDEs

2019 ◽  
Vol 5 ◽  
pp. 233372141984059 ◽  
Author(s):  
Elena O. Siegel ◽  
Annica Backman ◽  
Yi Cai ◽  
Claire Goodman ◽  
Oscar Noel Ocho ◽  
...  
Keyword(s):  
The United States ◽  
Term Care ◽  
Common Data Elements ◽  
Working Definition ◽  
Centered Care ◽  
Definition Of ◽  
Data Elements ◽  
Measurement Infrastructure ◽  
Contextual Differences

Long-term care (LTC) reflects a growing emphasis on person-centered care (PCC), with services oriented around individuals’ needs and preferences. Addressing contextual and cultural differences across countries offers important insight into factors that facilitate or hinder application of PCC practices within and across countries. This article takes an international lens to consider country-specific contexts of LTC, describing preliminary steps to develop common data elements that capture contextual differences across LTC settings globally. Through an iterative series of online, telephone, and in-person sessions, we engaged in in-depth discussions with 11 colleague experts in residential LTC and coauthors from six countries (China and Hong Kong, England, Sweden, Thailand, Trinidad and Tobago, and the United States). Our discussions yielded rich narrative describing a vast range in types of LTC settings, leading to our development of a working definition of residential LTC. Scope of services, funding, ownership, and regulations varied greatly across countries and across different residential LTC settings within countries. Moving forward, we recommend expanding our activities to countries that reflect different stages of residential LTC development. Our goal is to contribute to a larger initiative underway by the WE-THRIVE consortium to establish a global research measurement infrastructure that advances PCC internationally.

scholarly journals Measuring What Matters in Long-Term Care: Common Data Elements in Brazil, China, and the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 160-160
Author(s):  
Michael Lepore ◽  
Kirsten Corazzini ◽  
Sheryl Zimmerman
Keyword(s):  
Healthy Aging ◽  
Long Term Care ◽  
The United States ◽  
Term Care ◽  
Common Data Elements ◽  
Low Resource ◽  
Person Centered Care ◽  
Centered Care ◽  
Data Elements

Abstract Internationally sharable common data elements on residential long-term care (LTC) settings, such as nursing homes and assisted living facilities, can facilitate comparisons across diverse LTC settings for valuable insights on LTC regulation and oversight, practice and operations, infrastructure development, human resources issues, and quality and safety. However, such insights are predicated on the premise that data elements capture information that matters to the full LTC community, including residents, relatives and staff, and are able to be collected across diverse care settings, including low-resource contexts. A critique of much current LTC measurement is its focus on deficits and loss, rather than thriving, person-centered care, and healthy aging, which have been established as important to LTC communities internationally. Further, measurement burden, cultural differences in perceptions of data sharing, and data infrastructure differences are key issues for international data. An international collaborative of LTC researchers—Worldwide Elements to Harmonize Research in Long-Term Care Living Environments (WE-THRIVE)—has developed a set of common data elements that are recommended for parsimoniously assessing key outcomes, workforce and staffing, person-centered care, and the contexts within which LTC settings operate. The studies in this symposium provide insights into the validation and implementation of WE-THRIVE recommended measures in diverse, low-resource LTC contexts, including LTC settings in Brazil, China, and rural Midwest US. Study findings validate WE-THRIVE measures, and provide new knowledge to inform capacity-building for the measurement of person-centered care and healthy aging outcomes in diverse, low-resource, LTC settings.

scholarly journals Common Data Elements for Concussion in Tertiary Care: Phase One in Ontario

2017 ◽  
Vol 44 (6) ◽  
pp. 676-683 ◽  
Author(s):  
Cindy Hunt ◽  
Alicja Michalak ◽  
Donna Ouchterlony ◽  
Shawn Marshall ◽  
Cheryl Masanic ◽  
...  
Keyword(s):  
Brain Injury ◽  
Data Collection ◽  
Clinical Care ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
The United States ◽  
Shared Vision ◽  
Common Data Elements ◽  
Consensus Statements ◽  
Data Elements

AbstractBackground:Standardized data collection for traumatic brain injury (TBI) (including concussion) using common data elements (CDEs) has strengthened clinical care and research capacity in the United States and Europe. Currently, Ontario healthcare providers do not collect uniform data on adult patients diagnosed with concussion.Objective:The Ontario Concussion Care Strategy (OCCS) is a collaborative network of multidisciplinary healthcare providers, brain injury advocacy groups, patient representatives, and researchers with a shared vision to improve concussion care across the province, starting with the collection of standardized data.Methods:The International Framework of Functioning Disability and Health was selected as the conceptual framework to inform the selection of CDEs. The CDEs recommended by the OCCS were identified using key literature, including the National Institute of Neurological Disorders and Stroke–Zurich Consensus Statements for concussion in sport and the Ontario Neurotrauma Foundation Concussion/mTBI clinical guidelines.Results:The OCCS has recommended and piloted CDEs for Ontario that are readily available at no cost, clinically relevant, patient friendly, easy to interpret, and recognized by the international scientific community.Conclusions:The implementation of CDEs can help to shift Ontario toward internationally recognized standard data collection, and in so doing yield a more comprehensive evidence-based approach to care while also supporting rigorous research.

scholarly journals Development, Evaluation, and Implementation of a Pan-African Cancer Research Network: Men of African Descent and Carcinoma of the Prostate

2018 ◽  
pp. 1-14
Author(s):  
Caroline Andrews ◽  
Brian Fortier ◽  
Amy Hayward ◽  
Ruth Lederman ◽  
Lindsay Petersen ◽  
...  
Keyword(s):  
African Descent ◽  
Genomic Data ◽  
Buffy Coat ◽  
Sub Saharan Africa ◽  
Research Network ◽  
Inherited Disease ◽  
Multicenter Studies ◽  
Common Data Elements ◽  
Carcinoma Of The Prostate ◽  
Data Elements

Purpose Cancer of the prostate (CaP) is the leading cancer among men in sub-Saharan Africa (SSA). A substantial proportion of these men with CaP are diagnosed at late (usually incurable) stages, yet little is known about the etiology of CaP in SSA. Methods We established the Men of African Descent and Carcinoma of the Prostate Network, which includes seven SSA centers partnering with five US centers to study the genetics and epidemiology of CaP in SSA. We developed common data elements and instruments, regulatory infrastructure, and biosample collection, processing, and shipping protocols. We tested this infrastructure by collecting epidemiologic, medical record, and genomic data from a total of 311 patients with CaP and 218 matched controls recruited at the seven SSA centers. We extracted genomic DNA from whole blood, buffy coat, or buccal swabs from 265 participants and shipped it to the Center for Inherited Disease Research (Baltimore, MD) and the Centre for Proteomics and Genomics Research (Cape Town, South Africa), where genotypes were generated using the UK Biobank Axiom Array. Results We used common instruments for data collection and entered data into the shared database. Double-entered data from pilot participants showed a 95% to 98% concordance rate, suggesting that data can be collected, entered, and stored with a high degree of accuracy. Genotypes were obtained from 95% of tested DNA samples (100% from blood-derived DNA samples) with high concordance across laboratories. Conclusion We provide approaches that can produce high-quality epidemiologic and genomic data in multicenter studies of cancer in SSA.

scholarly journals Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States

2017 ◽  
Vol 61 (4) ◽  
Author(s):  
Michael J. Satlin ◽  
Liang Chen ◽  
Gopi Patel ◽  
Angela Gomez-Simmonds ◽  
Gregory Weston ◽  
...  
Keyword(s):  
New York ◽  
Empirical Therapy ◽  
Carbapenem Resistance ◽  
The United States ◽  
Resistance Mechanisms ◽  
Rapid Diagnostics ◽  
Multicenter Studies ◽  
Content Type ◽  
Medical Centers ◽  
Carbapenem Resistant

ABSTRACT Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types (cps), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or had undergone transplantation. The prevalences of carbapenem resistance among Klebsiella pneumoniae, Enterobacter spp., and Escherichia coli bacteremias were 9.7%, 2.2%, and 0.1%, respectively. Ninety percent of CRE were K. pneumoniae and 92% produced K. pneumoniae carbapenemase (KPC-3, 48%; KPC-2, 44%). Two CRE produced NDM-1 and OXA-48 carbapenemases. Sequence type 258 (ST258) predominated among KPC-producing K. pneumoniae (KPC-Kp). The wzi154 allele, corresponding to cps-2, was present in 93% of KPC-3-Kp, whereas KPC-2-Kp had greater cps diversity. Ninety-nine percent of CRE were ceftazidime-avibactam (CAZ-AVI)-susceptible, although 42% of KPC-3-Kp had an CAZ-AVI MIC of ≥4/4 μg/ml. There was a median of 47 h from bacteremia onset until active antimicrobial therapy, 38% of patients had septic shock, and 49% died within 30 days. KPC-3-Kp bacteremia (adjusted odds ratio [aOR], 2.58; P = 0.045), cancer (aOR, 3.61, P = 0.01), and bacteremia onset in the intensive care unit (aOR, 3.79; P = 0.03) were independently associated with mortality. Active empirical therapy and combination therapy were not associated with survival. Despite a decade of experience with CRE, patients with CRE bacteremia have protracted delays in appropriate therapies and high mortality rates, highlighting the need for rapid diagnostics and evaluation of new therapeutics.

scholarly journals TBI surveillance using the common data elements for traumatic brain injury: a population study

2013 ◽  
Vol 6 (1) ◽  
Author(s):  
Latha Ganti Stead ◽  
◽  
Aakash N Bodhit ◽  
Pratik Shashikant Patel ◽  
Yasamin Daneshvar ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Population Study ◽  
Common Data Elements ◽  
The Common ◽  
Data Elements

Abstract 11: mActive: A Blinded, Randomized mHealth Trial Supporting Digital Tracking and Smart Texting for Promotion of Physical Activity

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Seth S Martin ◽  
David I Feldman ◽  
Roger S Blumenthal ◽  
Steven R Jones ◽  
Wendy S Post ◽  
...  
Keyword(s):  
Physical Activity ◽  
Phase I ◽  
Real Time ◽  
Phase Ii ◽  
The United States ◽  
Step Count ◽  
Daily Step ◽  
Baseline Activity ◽  
Daily Step Count ◽  
Digital Tracking

Introduction: The recent advent of smartphone-linked wearable pedometers offers a novel opportunity to promote physical activity using mobile health (mHealth) technology. Hypothesis: We hypothesized that digital activity tracking and smart (automated, real-time, personalized) texting would increase physical activity. Methods: mActive (NCT01917812) was a 5-week, blinded, sequentially-randomized, parallel group trial that enrolled patients at an academic preventive cardiovascular center in Baltimore, MD, USA from January 17 th to May 20 th , 2014. Eligible patients were 18-69 year old smartphone users who reported low leisure-time physical activity by a standardized survey. After establishing baseline activity during a 1-week blinded run-in, we randomized 2:1 to unblinded or blinded tracking in phase I (2 weeks), then randomized unblinded participants 1:1 to receive or not receive smart texts in phase II (2 weeks). Smart texts provided automated, personalized, real-time coaching 3 times/day towards a daily goal of 10,000 steps. The primary outcome was change in daily step count. Results: Forty-eight patients (22 women, 26 men) enrolled with a mean (SD) age of 58 (8) years, body mass index of 31 (6), and baseline daily step count of 9670 (4350). The phase I change in activity was non-significantly higher in unblinded participants versus blinded controls by 1024 steps/day (95% CI -580-2628, p=0.21). In phase II, smart text receiving participants increased their daily steps over those not receiving texts by 2534 (1318-3750, p<0.001) and over blinded controls by 3376 (1951-4801, p<0.001). The unblinded-texts group had the highest proportion attaining the 10,000 steps/day goal (p=0.02) (Figure). Conclusions: In present-day adult smartphone users receiving preventive cardiovascular care in the United States, a technologically-integrated mHealth strategy combining digital tracking with automated, personalized, real-time text message coaching resulted in a large short-term increase in physical activity.

Achieving More Rapid Door-to-Needle Times and Improved Outcomes in Acute Ischemic Stroke in a Nationwide Quality Improvement Intervention

Stroke ◽  
2021 ◽  
Author(s):  
Ying Xian ◽  
Haolin Xu ◽  
Eric E. Smith ◽  
Jeffrey L. Saver ◽  
Mathew J. Reeves ◽  
...  
Keyword(s):  
United States ◽  
Quality Improvement ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Phase I ◽  
Acute Ischemic Stroke ◽  
Symptom Onset ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
The United States

Background and Purpose: The benefits of tPA (tissue-type plasminogen activator) in acute ischemic stroke are time-dependent. However, delivery of thrombolytic therapy rapidly after hospital arrival was initially occurring infrequently in hospitals in the United States, discrepant with national guidelines. Methods: We evaluated door-to-needle (DTN) times and clinical outcomes among patients with acute ischemic stroke receiving tPA before and after initiation of 2 successive nationwide quality improvement initiatives: Target: Stroke Phase I (2010–2013) and Target: Stroke Phase II (2014–2018) from 913 Get With The Guidelines-Stroke hospitals in the United States between April 2003 and September 2018. Results: Among 154 221 patients receiving tPA within 3 hours of stroke symptom onset (median age 72 years, 50.1% female), median DTN times decreased from 78 minutes (interquartile range, 60–98) preintervention, to 66 minutes (51–87) during Phase I, and 50 minutes (37–66) during Phase II ( P <0.001). Proportions of patients with DTN ≤60 minutes increased from 26.4% to 42.7% to 68.6% ( P <0.001). Proportions of patients with DTN ≤45 minutes increased from 10.1% to 17.7% to 41.4% ( P <0.001). By the end of the second intervention, 75.4% and 51.7% patients achieved 60-minute and 45-minute DTN goals. Compared with the preintervention period, hospitals during the second intervention period (2014–2018) achieved higher rates of tPA use (11.7% versus 5.6%; adjusted odds ratio, 2.43 [95% CI, 2.31–2.56]), lower in-hospital mortality (6.0% versus 10.0%; adjusted odds ratio, 0.69 [0.64–0.73]), fewer bleeding complication (3.4% versus 5.5%; adjusted odds ratio, 0.68 [0.62–0.74]), and higher rates of discharge to home (49.6% versus 35.7%; adjusted odds ratio, 1.43 [1.38–1.50]). Similar findings were found in sensitivity analyses of 185 501 patients receiving tPA within 4.5 hours of symptom onset. Conclusions: A nationwide quality improvement program for acute ischemic stroke was associated with substantial improvement in the timeliness of thrombolytic therapy start, increased thrombolytic treatment, and improved clinical outcomes.

Sign in / Sign up

Export Citation Format

Share Document