Modelling in Clinical Practice with Web Services and BPEL

2011 ◽  
pp. 208-220
Author(s):  
Iain Morrison ◽  
Bryn Lewis ◽  
Sony Nugrahanto
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Information System ◽  
Clinical Information ◽  
Clinical Decision ◽  
Quality Of Healthcare ◽  
Critical Areas ◽  
Service Modelling ◽  
Tools And Techniques ◽  
Traditional Approaches

The aim of increasing the quality of healthcare has led to the development of a number of ‘guideline’ systems whereby clinicians receive assistance in decision making in a given care context – for example in areas such as prescribing or therapeutics. These guidelines range in complexity and functionality from simple textual references through to executable modules which can subsume some of the clinical decision making process. In the latter case, ensuring consistent and interoperable engagement between the guideline engine, clinical information system and patient record can become problematic. Critical areas include vocabulary and terminology (in differing use contexts) and the interfaces and interaction between different sub-systems where traditional approaches have been focussed on tightly coupling of sub-systems and in the generation of special purpose ‘glue’ languages and logic. In this paper, we briefly describe an approach to clinical, information and service modelling. This approach uses tools and techniques gaining increasing acceptance in the e-Commerce domain, which shares many of the technical and interoperability problems present in e-Health.

scholarly journals Health record systems that meet clinical needs

2012 ◽  
Author(s):  
Gabriella Negrini
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Patient Safety ◽  
Health Care Professionals ◽  
Clinical Decision Making ◽  
Clinical Information ◽  
Clinical Decision ◽  
Health Record ◽  
Record System ◽  
Health Records

Introduction Increased attention has recently been focused on health record systems as a result of accreditation programs, a growing emphasis on patient safety, and the increase in lawsuits involving allegations of malpractice. Health-care professionals frequently express dissatisfaction with the health record systems and complain that the data included are neither informative nor useful for clinical decision making. This article reviews the main objectives of a hospital health record system, with emphasis on its roles in communication and exchange among clinicians, patient safety, and continuity of care, and asks whether current systems have responded to the recent changes in the Italian health-care system.Discussion If health records are to meet the expectations of all health professionals, the overall information need must be carefully analyzed, a common data set must be created, and essential specialist contributions must be defined. Working with health-care professionals, the hospital management should define how clinical information is to be displayed and organized, identify a functionally optimal layout, define the characteristics of ongoing patient assessment in terms of who will be responsible for these activities and how often they will be performed. Internet technology can facilitate data retrieval and meet the general requirements of a paper-based health record system, but it must also ensure focus on clinical information, business continuity, integrity, security, and privacy.Conclusions The current health records system needs to be thoroughly revised to increase its accessibility, streamline the work of health-care professionals who consult it, and render it more useful for clinical decision making—a challenging task that will require the active involvement of the many professional classes involved.

scholarly journals Use of EHR-based simulation to diagnose aetiology of information gathering issues in struggling learners: a proof of concept study

2017 ◽  
Vol 4 (2) ◽  
pp. 92-94 ◽  
Author(s):  
Vishnu Mohan ◽  
Gretchen Scholl ◽  
Jeffrey A Gold
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Large Fraction ◽  
Clinical Information ◽  
Clinical Decision ◽  
Information Gathering ◽  
High Fidelity ◽  
Struggling Learners ◽  
Effective Decision Making ◽  
Main Component

Learners who struggle with clinical decision making are often the most challenging to identify and remediate. While for some learners, struggles can be directly traced to a poor knowledge base, for many others, it is more difficult to understand the reason for their struggles. One of the main component of effective decision making is access to accurate and complete clinical information. The electronic health record (EHR) is the main source of clinical information and, with its widespread adoption, has come increased realisation that a large fraction of users have difficulty in effectively gathering and subsequently processing information out of the EHR. We previously documented that high-fidelity EHR-based simulation improves EHR usability and, when combined with eye and screen tracking, generates important measures of usability. We hypothesised that the same simulation exercise could help distinguish whether learners had difficulty in knowledge, information gathering or information processing. We report the results of the first three struggling learners who participated in this exercise. In each case, the simulation was able to ‘diagnose’ the aetiology for the learners’ struggle and assist in formulating an appropriate solution. We suggest that high-fidelity EHR-based simulation can be a powerful tool in the standard approach to understanding struggling learners.

scholarly journals TPGen: Prescription Generation Using Knowledge-guided Translator

2021 ◽  
Author(s):  
Chunyang Ruan ◽  
Hua Luo ◽  
Yingpei Wu ◽  
Yun Yang
Keyword(s):  
Decision Making ◽  
Machine Translation ◽  
Language Processing ◽  
Clinical Decision Making ◽  
Clinical Information ◽  
Clinical Decision ◽  
Proposed Model ◽  
Translation Mechanism ◽  
Mining Complex ◽  
Model Improvement

Abstract Background: Prescriptions contain a lot of clinical information and play a pivotal role in the clinical diagnosis of Traditional Chinese Medicine (TCM), which is a combination of herb to treat the symptoms of a patient from decision-making of doctors. In the process of clinical decision-making, a large number of prescriptions have been invented and accumulated based on TCM theories. Mining complex and the regular relationships between symptoms and herbs in the prescriptions are important for both clinical practice and novel prescription development. Previous work used several machine learning methods to discover regularities and generate prescriptions but rarely used TCM knowledge to guide prescription generation and described why each herb is predicted for treating a symptom. Methods: In this work, we employ a machine translation mechanism and propose a novel sequence-to-sequence (seq2seq) architecture termed TPGen to generate prescriptions. TPGen consisting of an encoder and a decoder is a well-known framework for resolving the machine translation problem in the natural language processing (NLP) domain. We use the lite transformer and Bi-directional Gate Recurrent Units(Bi-GRUS) as a fundamental model in TPGen, and integrate TCM clinical knowledge to guide the model improvement termed TPGen+. Results: We conduct extensive experiments on a public TCM dataset and clinical data. The experimental results demonstrate that our proposed model is effective and outperforms other state-of-the-art methods in TCM expert evaluation. The approach will be beneficial for clinical prescription discovery and diagnosis

Decision-Making in Medical Research and Clinical Practice: Theory and Methodology of Laboratory Data Evaluation by Predictors, Indicators and Indices

1975 ◽  
Vol 14 (03) ◽  
pp. 113-117 ◽  
Author(s):  
J. Sebag ◽  
P. Hall
Keyword(s):  
Decision Making ◽  
Medical Research ◽  
Clinical Decision Making ◽  
Laboratory Data ◽  
Clinical Decision ◽  
Research Education ◽  
Health Indices ◽  
Traditional Approaches ◽  
Near Future ◽  
Over Time

A method designed to aid clinical decision-making is described. Predictors and Indicators are criteria that reflect the likelihood of disease and health, based on a retrospective analysis of the frequencies of diseases or diagnoses associated with symptoms, signs, and tests (SST’s). The approach is primarily based upon the SST’s of an individual and how these vary over time. This differs from traditional approaches which operate primarily from a disease-or diagnostic-oriented perspective. Such approaches are, therefore, useful in areas of medical research, education, and paraclinical service units, but have a limited value for patient-care. Static and dynamic health indices aid clinical decision-making by summarizing the SST-oriented Predictor and Indicator evaluations into individualized indices that can be monitored over time.The methodology of employing this approach for the evaluation of laboratory data is presented. The application of these techniques to a battery of laboratory tests will be presented in the near future.

To report or not to report: a proposal on how to deal with altered test results in hemolytic samples

2017 ◽  
Vol 55 (8) ◽  
pp. 1109-1111 ◽  
Author(s):  
Janne Cadamuro ◽  
Cornelia Mrazek ◽  
Elisabeth Haschke-Becher ◽  
Sverre Sandberg
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Information ◽  
Clinical Decision ◽  
General Information ◽  
The Other ◽  
Test Results ◽  
Scientific Discussion ◽  
Laboratory Values ◽  
Test Result

Abstract Preanalytically altered test results are a challenge every laboratory has to face. The release of such results may be to the harm of the patient by triggering wrong clinical decision making in monitoring or treatment. On the other hand, their deletion also might be to the harm of the patient by delaying the time to decision making as the exact value sometimes is not even necessary but rather an answer to the question “Is it raised or lowered”. Based on this dilemma and forced to produce laboratory values without any clinical information on the respective patient, laboratories have developed their own preferred way on how to deal with preanalytically altered test results. Some release the value with a comment, some reject the value with or without a comment and others again provide only general information about the hemolytic sample. To date there is no guideline or standardization to this postanalytical topic. Therefore, with this opinion paper, we want to start the scientific discussion on this important issue by providing one possible method to overcome the lack of clinical information which the laboratory would need to correctly decide whether or not to release an altered test result. We suggest providing the clinician with all the information on the hemolytic sample and its impact on the respective parameter needed to make his/her own decision on the usage of the respective test result. We believe that reporting a preanalytically altered laboratory value including a respective comment is preferable to not reporting it.

Health Economic Implications of Complications Associated With Pancreaticoduodenectomy

2019 ◽  
pp. 144-167
Author(s):  
Jason Wang ◽  
Laurence Weinberg
Keyword(s):  
Decision Making ◽  
Health Economic ◽  
Clinical Decision Making ◽  
Clinical Information ◽  
Clinical Decision ◽  
Tertiary Hospital ◽  
Hospital Environment ◽  
Activity Based Costing ◽  
Economic Implications ◽  
High Acuity

Clinical costing is a powerful tool to bridge the disconnect between financial and clinical information, and is an ideal platform to conduct research aimed at informing value-based clinical decision making. This chapter will provide an example of the utility of activity-based costing to elucidate the costs of complications following pancreaticoduodenectomy, a high acuity procedure with high costs. It will show the significance of clear clinical costing in targeting cost containment in a tertiary hospital environment.

scholarly journals Shades of grey: how and why we make mistakes

2020 ◽  
Vol 24 (3) ◽  
pp. 123-145
Author(s):  
A. A. Uchevatkin ◽  
A. L. Yudin ◽  
N. I. Afanas'yeva ◽  
E. A. Yumatova
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Cognitive Strategies ◽  
Diagnostic Errors ◽  
Clinical Information ◽  
Clinical Decision ◽  
Final Diagnosis ◽  
Negative Consequences ◽  
Pathological Changes ◽  
The Impact

Purpose: to consider the epidemiology and classification of errors in radiologic diagnostics.Materials and methods. The analysis of articles devoted to elucidating the possible causes of diagnostic errors published before 2019 is carried out. A retrospective analysis of the research results revealed the most frequent cognitive biases affecting clinical decision making. Strategies have been developed to combat these distortions, which minimize the likelihood of errors.Discussion. Image analysis by doctors is a complex work based on a combination of psychophysiological and cognitive processes, which in itself is subject to a wide variety of errors, including perception errors (when pathological changes are simply skipped) and cognitive errors (those cases when pathological changes are detected visually but incorrectly interpreted). Although some of the changes in the radiation images may be skipped due to technical or physical limitations of the modality (resolution, signal-to-noise ratio, artifacts, etc.), most diagnostic discrepancies are associated with an incorrect interpretation of the findings by radiologists.Conclusions. Cognitive distortions can significantly affect the process of making diagnostic decisions, and lead to medical errors and negative consequences for patients. Various cognitive strategies and metacognitive practices can help minimize the impact of bias on decision making and reduce the frequency of diagnostic errors. Knowing one’s limitations and possibilities in interpreting radiation research, as well as understanding the role of the radiologist in the formation of the final diagnosis and, accordingly, in the fate of the patient, can lead to a more thoughtful analysis of images and clinical information and improve the quality of the diagnostic decision-making process.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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