Derivation and validation of a search algorithm to retrospectively identify CRRT initiation in the ECMO patients

SummaryThe role of extracorporeal membrane oxygenation (ECMO) in refractory cardiorespiratory failure is gaining momentum with recent advancements in technology. However, the need for dialysis modes such as continuous renal replacement therapy (CRRT) has also increased in the management for acute kidney injury. Establishing the exact timing of CRRT initiation in these patients from the electronic medical record is vital for automated data extraction for research and quality improvement efforts.We aimed to derive and validate an automated Electronic Health Records (EHR) search strategy for CRRT initiation in patients receiving ECMO.We screened 488 patients who received ECMO and a total of 213 patients underwent CRRT. We evaluated random 120 patients, 60 for derivation and 60 for validation cohorts. Following implementation of eligibility criteria, the algorithm was derived in 55 out of 120 ECMO/CRRT patients. The search algorithm was developed using first-time chart entry of ‘access pressure drop’ at CRRT initiation. The algorithm was then validated in an independent subset of 52 patients from the same time period. The overall agreement between electronic search algorithm and a comprehensive manual medical record review in the derivation and validation subsets, using ‘access pressure drop’ as the reference standard, was compared to assess CRRT initiation time.In the derivation subset (N=55), the automated electronic search strategy achieved an excellent agreement with manual search (D =0.99, 54 were identified electronically, and 55 upon manual review). There was no time difference observed in 49/54(89%) patients, while in the remaining 5 (9%) patients time difference was within 15 minutes. In the validation cohort (N=52), agreement was 100 % (D = 1.0, both methods identified 52 patients). Out of 52 patients, 47 (90%) had no time difference between the methods, for the remaining 5 (10%) patients, differences were within 15 minutes.The use of an electronic search strategy resulted in determining an accurate CRRT initiation time among ECMO patients.

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Retrospective Derivation and Validation of a Search Algorithm to Identify Emergent Endotracheal Intubations in the Intensive Care Unit

Applied Clinical Informatics ◽

10.4338/aci-2013-05-ra-0033 ◽

2013 ◽

Vol 04 (03) ◽

pp. 419-427 ◽

Cited By ~ 9

Author(s):

V.M. Velagapudi ◽

J.A. Onigkeit ◽

B.W. Pickering ◽

V. Herasevich ◽

R. Kashyap ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Medical Record ◽

Sensitivity And Specificity ◽

Search Strategy ◽

Search Algorithm ◽

Search Algorithms ◽

Critically Ill Patient ◽

Predictive Values ◽

Automated Search

Summary Background: The development and validation of automated electronic medical record (EMR) search strategies are important in identifying emergent endotracheal intubations in the intensive care unit (ICU). Objective: To develop and validate an automated search algorithm (strategy) for emergent endotracheal intubation in the critically ill patient. Methods: The EMR search algorithm was created through sequential steps with keywords applied to an institutional EMR database. The search strategy was derived retrospectively through a secondary analysis of a 450-patient subset from the 2,684 patients admitted to either a medical or surgical ICU from January 1, 2010, through December 31, 2011. This search algorithm was validated against an additional 450 randomly selected patients. Sensitivity, specificity, and negative and positive predictive values of the automated search algorithm were compared with a manual medical record review (the reference standard) for data extraction of emergent endotracheal intubations. Results: In the derivation subset, the automated electronic note search strategy achieved a sensitivity of 74% (95% CI, 69%-79%) and a specificity of 98% (95% CI, 92%-100%). With refinements in the search algorithm, sensitivity increased to 95% (95% CI, 91%-97%) and specificity decreased to 96% (95% CI, 92%-98%) in this subset. After validation of the algorithm through a separate patient subset, the final reported sensitivity and specificity were 95% (95% CI, 86%-99%) and 100% (95% CI, 98%-100%). Conclusions: Use of electronic search algorithms allows for correct extraction of emergent endotracheal intubations in the ICU, with high degrees of sensitivity and specificity. Such search algorithms are a reliable alternative to manual chart review for identification of emergent endotracheal intubations.

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Associação entre Eventos Endodônticos e Casos de Osteonecrose dos Maxilares por Exposição a Bisfosfonato

REVISTA FIMCA ◽

10.37157/fimca.v4i1.10 ◽

2017 ◽

Vol 4 (1) ◽

pp. 59-71

Author(s):

Maiara Vieira Abreu ◽

Mariana Fampa Fogacci ◽

Davi Da Silva Barbirato

Keyword(s):

Search Strategy ◽

Scientific Evidence ◽

Daily Routine ◽

Eligibility Criteria ◽

Osteonecrosis Of The Jaws ◽

Manual Search ◽

Dental Procedures ◽

Exposure Factor ◽

The Relationship ◽

Probable Diagnosis

Introdução: Pacientes em tratamento com bisfosfonatos ou mesmo com queixa principal de uma lessão bucal com diagnóstico provável de osteonecrose dos ossos maxilares por uso de bisfosfonatos podem ser frequentes na rotina diária de atendimento odontológico. Objetivos: A presente pesquisa objetiva revisar de forma sistematizada os estudos existentes sobre a relação entre procedimentos endodônticos e eventos de osteonecrose em ossos maxilares expostos a Bisfosfonatos. Materiais e Métodos: A estratégia de busca sistemática de artigos contemplou as principais fontes de evidência científica, bases de dados convencionais e também fontes de dados não publicados, além de busca manual das referências bibliográficas dos artigos pré-selecionados. A busca foi feita utilizando-se as palavras-chave obtidas por descritores relacionados com a pergunta a ser respondida. Resultados: A busca inicial resultou em 683 artigos. Apés a aplicação dos critetérios de eligibilidade, oito artigos foram selecionados para a tabulação e coleta de dados. Apenas dois estudos avaliaram causalidade entre procedimentos endodônticos e eventos de osteonecrose nos ossos maxilares, em pacientes usuários de bisfosfonatos. Dos procedimentos odontolôgicos avaliados, os menos frequentemente relacionados com os casos dessa patologia foram as terapias endodônticas (0,8% dos casos). Conclusão: A realização de procedimentos endodônticos em pacientes que fazem uso de bisfosfonatos pode resultar em casos de osteonecrose dos ossos maxilares. Entretanto, mais estudos são necessários para investigar a possiíel relação de causalidade entre o fator de exposição (procedimentos endodônticos) e o desfecho (osteonecrose dos maxilares, em pacientes usuários de bisfosfonatos) estudados. Introduction: Patients treated with bisphosphonates or even with a major complaint of a buccal lesion with probable diagnosis of osteonecrosis of the maxillary bones due to the use of bisphosphonates may be frequent in the daily routine of dental care. Objectives: The present study aims to systematically review existing studies on the relationship between endodontic procedures and events of osteonecrosis in maxillary bones exposed to bisphosphonates. Materials and Methods: The systematic search strategy of articles included the main sources of scientific evidence, conventional databases as well as unpublished data sources, and manual search of the bibliographic references of the pre- selected articles. The search was done using the keywords obtained by descriptors related to the question to be answered. Results: The initial search resulted in 683 articles. After applying the eligibility criteria, eight articles were selected for tabulation and data collection. Only two studies evaluated causality between endodontic procedures and events of osteonecrosis in maxillary bones in patients using bisphosphonates. Of the dental procedures evaluated, the least frequently related cases of this pathology were endodontic therapies (0.8% of cases). Conclusion: Performing endodontic procedures in patients who use bisphosphonates may result in cases of osteonecrosis of the maxillary bones. However, further studies are needed to investigate the possible causal relationship between the exposure factor (endodontic procedures) and the outcome (osteonecrosis of the jaws in patients using bisphosphonates).

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An Integrative Review Considering the Impact of Storytelling and Sharing Interventions in Stroke

Behavioral Sciences ◽

10.3390/bs11060088 ◽

2021 ◽

Vol 11 (6) ◽

pp. 88

Author(s):

Rana Alawafi ◽

Sheeba Rosewilliam ◽

Andrew Soundy

Keyword(s):

Search Strategy ◽

Critical Appraisal ◽

Knowledge Exchange ◽

Social Comparisons ◽

Integrative Review ◽

Study Quality ◽

Data Display ◽

Eligibility Criteria ◽

Three Stages ◽

The Impact

Background: Review-based research is needed which can establish the psychosocial outcomes and mechanisms of “storytelling and sharing” interventions for people with stroke. This information will act to inform the value and development of such interventions. Methods: An integrative review was conducted in three stages: (a) a systematic search strategy was undertaken to focus on articles between 2009 until January 2020 to locate articles the considered storytelling and sharing interventions for people diagnosed with stroke; (b) critical appraisal was undertaken to assess study quality; and (c) synthesis within three stages including data reduction, data display and conclusion. Results: Fourteen articles (including 727 participants) were identified that met the eligibility criteria. Five themes were identified that represented the outcome and mechanisms that appeared to be associated with a stroke intervention. These included introducing the concept of hope and learning to be positive, the enhanced ability to cope, the impact of loneliness and social interaction, impact on emotions, depression and related emotions such as fear. Conclusions: Storytelling interventions appear to impact loneliness, introduce positivity and hope and enable coping through knowledge exchange. The main mechanisms which appeared to influence these outcomes were social comparisons and social control.

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Safety assessment of essential medicines for elderly people: a bibliographic survey

Brazilian Journal of Pharmaceutical Sciences ◽

10.1590/s1984-82502014000200006 ◽

2014 ◽

Vol 50 (2) ◽

pp. 269-284 ◽

Cited By ~ 4

Author(s):

Fabiana Rossi Varallo ◽

Fernanda Mariana de Oliveira ◽

Patrícia de Carvalho Mastroianni

Keyword(s):

Elderly People ◽

Safety Assessment ◽

Search Strategy ◽

Adverse Drug Events ◽

The Elderly ◽

Essential Medicines ◽

Age Group ◽

Over The Counter ◽

Manual Search

Certain medicines are considered potentially inappropriate (PIM) for elderly people as they increase the risk of adverse drug events (ADE) and because safer alternative therapies are available on the market. In this context, in order to identify the instruments that assess the quality of medical prescriptions for elderly and to determine which drugs are considered PIM, a bibliographic survey was conducted in PUBMED, LILACS and PAHO databases, in February and March/2010. The search strategy included the use of health descriptors and a manual search in the references cited by selected papers. During the period of data collection, 15 instruments were identified. In 2012, with the publication of the update of Beers criteria, this instrument was included in the study. We identified 163 PIM of 25 therapeutic classes, of which 125 (76.7%) are marketed in Brazil. Of these, 31 (24.8%) are essential medicines (RENAME 2012), of which 13 have safer therapeutic equivalents and 19 (15.2%) are over-the-counter drugs. Data suggest the need for inclusion of safer alternatives for the elderly in the national list of essential medicines and the pharmaceutical care for early detection of ADE in this age group, in order to contribute to the safe use of medicines.

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Reporting of the Role of the Expert Searcher in Cochrane Reviews

Evidence Based Library and Information Practice ◽

10.18438/b85k52 ◽

2006 ◽

Vol 1 (4) ◽

pp. 3 ◽

Cited By ~ 9

Author(s):

Li Zhang ◽

Margaret Sampson ◽

Jessie McGowan

Keyword(s):

Systematic Reviews ◽

Search Strategy ◽

Data Extraction ◽

Cochrane Library ◽

Eligibility Criteria ◽

Statistical Decision ◽

Cochrane Reviews ◽

Statistical Decisions ◽

Search Quality

Introduction - This study applied the principles of evidence based information practice to clarify the role of information specialists and librarians in the preparation of Cochrane systematic reviews and to determine whether information specialists impact the quality of searching in Cochrane systematic reviews. Objectives - This research project sought to determine how the contribution of the person responsible for searching in the preparation of Cochrane systematic reviews was reported; whether the contribution was recognized through authorship or acknowledgement; the qualifications of the searcher; and the association between the type of contributorship and characteristics of the search strategy, assessability, and the presence of certain types of errors. Methods - Data sources: The Cochrane Database of Systematic Reviews, The Cochrane Library 3 (2002). Inclusion criteria: The study included systematic reviews that met the following criteria: one or more sections of the Cochrane Highly Sensitive Search Strategy were utilised, primary studies were either randomised controlled trials (RCTs) or quasi-RCTs, and included and excluded studies were clearly identified. Data extraction: Two librarians assessed the searches for errors, establishing consensus on discordant ratings. Results - Of the 169 reviews screened for this project, 105 met all eligibility criteria. Authors fulfilled the searching role in 41.9% of reviews studied, acknowledged persons or groups in 13.3%, a combination in 9.5%, and the role was not reported in 35.2% of reviews. For the 78 reviews in which meta-analyses were performed, the positions of those responsible for statistical decisions were examined for comparative purposes. The statistical role was performed by an author in 47.4% of cases and unreported in the same number of cases. Insufficient analyzable data was obtained regarding professional qualifications (3/105 for searching, 2/78 for statistical decisions). Search quality was assessed for 66 searches across 74 reviews. In general, it was more possible to assess the search quality when the searcher role was reported. An association was found between the reporting of searcher role and the presence of a consequential error. There was no association between the number of consequential errors and how the contribution of the searcher was reported. Conclusions - Qualifications of the persons responsible for searching and statistical decision-making were poorly reported in Cochrane reviews, but more complete role reporting is associated with greater assessability of searches and fewer substantive errors in search strategies.

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Temporomandibular disorder and serum levels of progesterone and estrogen: Systematic review

Research Society and Development ◽

10.33448/rsd-v10i6.15654 ◽

2021 ◽

Vol 10 (6) ◽

pp. e21310615654

Author(s):

Ricado Felipe Ferreira da Silva ◽

Irami Araújo-Filho ◽

Amália Cinthia Meneses do Rego ◽

Bruna Dantas da Silva ◽

José Renato Cavalcanti Queiroz ◽

...

Keyword(s):

Temporomandibular Disorder ◽

Clinical Manifestations ◽

Serum Levels ◽

Reproductive Age ◽

Eligibility Criteria ◽

Manual Search ◽

Stomatognathic System ◽

Hormonal Fluctuations ◽

Post Menopause ◽

Time Restriction

Temporomandibular Disorder (TMD) is a pathology of the stomatognathic system characterized by a set of clinical disorders that includes a temporomandibular joint, a masticatory musculature and associated structures. It is the most common orofacial pain condition of non-dental origin and which is increasing among adults in the age group between 18 and 45 years with a not well defined etiology, mainly not with regard to its higher prevalence in women than men. The present study aimed to evaluate the literature if there is a relationship between the levels of progesterone and estrogen with the clinical manifestations of TMD. The systematic search was carried out in the following electronic databases: PubMed, Web of Science, SciELO, and LILACS, Scopus, Embase and Google Scholar in addition to a complementary manual search of cross-references of original articles. There was no time restriction. The descriptors used were "TMD" or "TMJ" and "progesterone" and "estrogen". Initially, 132 articles were found, were 15 presented the eligibility criteria to be read in full. In the end, 4 studies were included in the review. The conclusion was that most studies relate the variations of progesterone and estrogen to the symptoms of the disease; however, there are differences between them. Thus, it is recommended to carry out studies that analyze this relationship, leading to hormonal fluctuations ranging from reproductive age to post-menopause.

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Odontogenic Keratocyst

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v17i2.266 ◽

2021 ◽

Vol 17 (2) ◽

pp. 52-61

Author(s):

Marwa A. Hamied ◽

Salwa M. Al-Shaikhani ◽

Zana D. Ali

Keyword(s):

English Language ◽

Odontogenic Keratocyst ◽

Hard Copy ◽

English Studies ◽

Eligibility Criteria ◽

Virtual Database ◽

Manual Search ◽

Language Studies ◽

Wait And See ◽

Early Diagnose

Purpose: to review in detail various aspects of odontogenic keratocyst, emphasizing recent nomenclature, clinical, histopathological, recurrence, and management of odontogenic keratocyst. Methods: To achieve the objective of this review, a manual search was done in hard copy books of oral and maxillofacial pathology, and an electronic search was done in the google website, oral and maxillofacial pathology E-books, virtual database sites, such as PubMed, Research Gate, Academia, and Google scholar using the descriptors: odontogenic cyst, kerato odontogenic tumor, odontogenic keratocyst, and jaws cystic lesion. The eligibility criteria for selecting articles were: to be in the English language, studies published in journals, or indexed in these databases until 2021. Exclusion criteria were: articles in any languages other than English, studies presented in duplicate between the bases, whose theme did not contemplate the objective proposed in this review, or those not available in the digital environment. Data collection occurred from October to December 2020, followed by a thorough evaluation of the studies found, including an exploratory, selective, analytical, and interpretative reading. Summary and conclusions: the odontogenic keratocyst is noteworthy because of its unusual growth pattern, the tendency to recur, and association with an inherited syndrome. The renaming of odontogenic keratocysts as keratocystic odontogenic tumors has been one of the most debatable changes in the terminology of odontogenic lesions in recent years. Early diagnose of this lesion is important to perform the more conservative treatment. A wait-and-see policy, with yearly follow-up for the first five years and every two years after that, is strongly advocated.

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Dorsal Preservation Rhinoplasty: A Literature Review

The American Journal of Cosmetic Surgery ◽

10.1177/07488068211065833 ◽

2021 ◽

pp. 074880682110658

Author(s):

Mark R. Stevens ◽

Shohreh Ghasemi ◽

Fargol Mashhadi Akbar Boojar ◽

Mahmood Dashti

Keyword(s):

Search Strategy ◽

Randomized Clinical Trials ◽

Case Reports ◽

Data Extraction ◽

Experimental Studies ◽

Underlying Structure ◽

Medical Databases ◽

Manual Search ◽

Total Preservation

Acceptance of the preservation principle in rhinoplasty surgery has increased dramatically, and surgeons worldwide are now performing preservation rhinoplasty, leading to an expanding list of indications and techniques. Rhinoplasty surgeons are increasingly opting for rhinoplasty preservation because of its conservative approach and more predictable outcome. This review aims to evaluate the efficacy of dorsal preservation rhinoplasty, as well as the techniques, indications, surgical protocols, complications, and any practical challenges associated with this type of rhinoplasty. A number of medical databases, including Medline-PubMed, Embase, and Scopus, were searched. These searches were supplemented with a manual search using the keyword “preservation rhinoplasty” (PR) during the 1970 to May 2020 time span. The search strategy was limited to case reports, randomized clinical trials, and prospective studies of preservation dorsal rhinoplasty in journals published in English. A total of 150 articles that incorporated preservation dorsal rhinoplasty as a newer surgical technique were reviewed: 136 from PubMed, 17 experimental studies from Embase, 17 clinical studies from Scopus, and 8 studies identified by data extraction. Preservation rhinoplasty represents a paradigm shift in rhinoplasty philosophy. While techniques continue to improve, the philosophy remains the same: preserving and reshaping the existing nasal structures. Although not all patients benefit from and are satisfied with PR and some may only benefit from partial PR, preserving the anatomy allows for a more intuitive operation and natural results. For a more exhaustive review, readers are encouraged to turn their attention to dorsal preservation as a versatile and adaptable technique. Dorsal preservation avoids long-term issues with the middle vault and keystone area, and the patient benefits from total preservation, as the underlying structure can be reshaped without disruption.

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B waves: a systematic review of terminology, characteristics, and analysis methods

Fluids and Barriers of the CNS ◽

10.1186/s12987-019-0153-6 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 3

Author(s):

Isabel Martinez-Tejada ◽

Alexander Arum ◽

Jens E. Wilhjelm ◽

Marianne Juhler ◽

Morten Andresen

Keyword(s):

Systematic Review ◽

Intracranial Pressure ◽

Literature Search ◽

Search Strategy ◽

Morphological Characteristics ◽

Systematic Review Protocol ◽

Eligibility Criteria ◽

Wave Characteristics ◽

Search Terms ◽

Review Protocol

Abstract Background Although B waves were introduced as a concept in the analysis of intracranial pressure (ICP) recordings nearly 60 years ago, there is still a lack consensus on precise definitions, terminology, amplitude, frequency or origin. Several competing terms exist, addressing either their probable physiological origin or their physical characteristics. To better understand B wave characteristics and ease their detection, a literature review was carried out. Methods A systematic review protocol including search strategy and eligibility criteria was prepared in advance. A literature search was carried out using PubMed/MEDLINE, with the following search terms: B waves + review filter, slow waves + review filter, ICP B waves, slow ICP waves, slow vasogenic waves, Lundberg B waves, MOCAIP. Results In total, 19 different terms were found, B waves being the most common. These terminologies appear to be interchangeable and seem to be used indiscriminately, with some papers using more than five different terms. Definitions and etiologies are still unclear, which makes systematic and standardized detection difficult. Conclusions Two future lines of action are available for automating macro-pattern identification in ICP signals: achieving strict agreement on morphological characteristics of “traditional” B waveforms, or starting a new with a fresh computerized approach for recognition of new clinically relevant patterns.

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