scholarly journals Validation of a Smartphone Application for Assessment of Risk of Venous Thromboembolism in Obstetrics and Gynecology

2017 ◽  
Vol 24 (2) ◽  
pp. 33-40 ◽  
Author(s):  
Galila F. Zaher ◽  
Soheir S. Adam

Venous thromboembolism is a serious but potentially preventable condition. However, morbidity and mortality occur due to lack of thrombo-prophylaxis. Obstetrics and gynecology patients are at risk for developing venous thromboembolism. To improve adherence to thromboprophylaxis in this patient population, we developed a smart phone clinical decision support system designed to assess risk score and recommend thromboprophylaxis. Clinical data were collected by review of electronic medical charts. The risk score and thromboprophylaxis recommendations were calculated for each patient by clinical decision support system and by an expert hematologist and results were compared for correlation. We hypothesize that the system is a valid tool for risk assessment in obstetrics and gynecology patients. A total of 188 female patients admitted at King Abdulaziz University Hospital between December 2015 and March 2016 were included. One hundred and sixteen were gynecology, and 72 were obstetric patients with a mean age of 40.7 (± 12.8). The risk score obtained by the system showed a strong correlation with that of the expert hematologist’s opinion (r = 83%). The clinical decision support system showed a good correlation for thromboprophylaxis decision as well. Accessibility and ease of use of clinical decision support system can improve the clinical outcome of hospitalized patients.

JAMA ◽  
2000 ◽  
Vol 283 (21) ◽  
pp. 2816 ◽  
Author(s):  
Pierre Durieux ◽  
Rémy Nizard ◽  
Philippe Ravaud ◽  
Nicolas Mounier ◽  
Eric Lepage

2013 ◽  
Vol 39 (2) ◽  
pp. 138-146 ◽  
Author(s):  
Fernanda Fuzinatto ◽  
Fernando Starosta de Waldemar ◽  
André Wajner ◽  
Cesar Al Alam Elias ◽  
Juliana Fernándes Fernandez ◽  
...  

OBJECTIVE: To determine the impact that implementing a combination of a computer-based clinical decision support system and a program of training seminars has on the use of appropriate prophylaxis for venous thromboembolism (VTE). METHODS: We conducted a cross-sectional study in two phases (prior to and after the implementation of the new VTE prophylaxis protocol) in order to evaluate the impact that the combined strategy had on the use of appropriate VTE prophylaxis. The study was conducted at Nossa Senhora da Conceição Hospital, a general hospital in the city of Porto Alegre, Brazil. We included clinical and surgical patients over 18 years of age who were hospitalized for ≥ 48 h. The pre-implementation and post-implementation phase samples comprised 262 and 261 patients, respectively. RESULTS: The baseline characteristics of the two samples were similar, including the distribution of patients by risk level. Comparing the pre-implementation and post-implementation periods, we found that the overall use of appropriate VTE prophylaxis increased from 46.2% to 57.9% (p = 0.01). Looking at specific patient populations, we observed that the use of appropriate VTE prophylaxis increased more dramatically among cancer patients (from 18.1% to 44.1%; p = 0.002) and among patients with three or more risk factors (from 25.0% to 42.9%; p = 0.008), two populations that benefit most from prophylaxis. CONCLUSIONS: It is possible to increase the use of appropriate VTE prophylaxis in economically constrained settings through the use of a computerized protocol adhered to by trained professionals. The underutilization of prophylaxis continues to be a major problem, indicative of the need for ongoing improvement in the quality of inpatient care.


2019 ◽  
Vol 15 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Zelal Qatawneh ◽  
Mohammad Alshraideh ◽  
Nada Almasri ◽  
Luay Tahat ◽  
Abdullah Awidi

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1309-P
Author(s):  
JACQUELYN R. GIBBS ◽  
KIMBERLY BERGER ◽  
MERCEDES FALCIGLIA

2020 ◽  
Vol 16 (3) ◽  
pp. 262-269
Author(s):  
Tahere Talebi Azad Boni ◽  
Haleh Ayatollahi ◽  
Mostafa Langarizadeh

Background: One of the greatest challenges in the field of medicine is the increasing burden of chronic diseases, such as diabetes. Diabetes may cause several complications, such as kidney failure which is followed by hemodialysis and an increasing risk of cardiovascular diseases. Objective: The purpose of this research was to develop a clinical decision support system for assessing the risk of cardiovascular diseases in diabetic patients undergoing hemodialysis by using a fuzzy logic approach. Methods: This study was conducted in 2018. Initially, the views of physicians on the importance of assessment parameters were determined by using a questionnaire. The face and content validity of the questionnaire was approved by the experts in the field of medicine. The reliability of the questionnaire was calculated by using the test-retest method (r = 0.89). This system was designed and implemented by using MATLAB software. Then, it was evaluated by using the medical records of diabetic patients undergoing hemodialysis (n=208). Results: According to the physicians' point of view, the most important parameters for assessing the risk of cardiovascular diseases were glomerular filtration, duration of diabetes, age, blood pressure, type of diabetes, body mass index, smoking, and C reactive protein. The system was designed and the evaluation results showed that the values of sensitivity, accuracy, and validity were 85%, 92% and 90%, respectively. The K-value was 0.62. Conclusion: The results of the system were largely similar to the patients’ records and showed that the designed system can be used to help physicians to assess the risk of cardiovascular diseases and to improve the quality of care services for diabetic patients undergoing hemodialysis. By predicting the risk of the disease and classifying patients in different risk groups, it is possible to provide them with better care plans.


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