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Ethical concerns about randomly assigning patients to suboptimal or placebo arms and the paucity of willing participants for randomization into control and experimental groups have renewed focus on the use of historical controls in clinical trials. Although databases of historical controls have been advocated, no published reports have described the technical and informatics issues involved in their creation.

Early diagnosis of pneumonia and discrimination between this disease and chronic obstructive pulmonary disease (COPD) exacerbations in patients with COPD are crucial for optimal clinical management and treatment.

In 2005, the authors published a paper, 'Will the wave finally break? A brief view of the adoption of electronic medical records in the United States', which predicted that rapid adoption of electronic health records (EHR) would occur in the next 5 years given appropriate incentives. The wave has finally broken with the stimulus of the health information technology for economic and clinical health legislation in 2009, and there have [...]

To present a system that uses knowledge stored in a medical ontology to automate the development of diagnostic decision support systems. To illustrate its function through an example focused on the development of a tool for diagnosing pneumonia.

We sought to determine the extent to which adoption of health information technology (HIT) by physician practices may differ from the extent of use by individual physicians, and to examine factors associated with adoption and use.

The rapid change in healthcare has focused attention on the necessary development of a next-generation electronic health record (EHR) to support system transformation and more effective patient-centered care. The Department of Veterans Affairs (VA) is developing plans for the next-generation EHR to support improved care delivery for veterans. To understand the needs for a next-generation EHR, we interviewed 14 VA operational, clinical and informatics leaders for their vision about system [...]

The Leapfrog CPOE evaluation tool has been promoted as a means of monitoring computerized physician order entry (CPOE). We sought to determine the relationship between Leapfrog scores and the rates of preventable adverse drug events (ADE) and potential ADE.

As healthcare systems continue to expand and interconnect with each other through patient sharing, administrators, policy makers, infection control specialists, and other decision makers may have to take account of the entire healthcare 'ecosystem' in infection control.

Incorporating accurate life expectancy predictions into clinical decision making could improve quality and decrease costs, but few providers do this. We sought to use predictive data mining and high dimensional analytics of electronic health record (EHR) data to develop a highly accurate and clinically actionable 5 year life expectancy index.