Search AMIA.org

General practice research databases are increasingly used to study intended and unintended effects of treatments. However, confounding by indication remains a major problem. The randomized database study methodology has been proposed as a method to combine the strengths of observational database (generalizability) and the strength of the randomized clinical trial (RCT) design (randomization). We developed an infrastructure that enables the execution of randomized database studies with treatment randomization facilitated by [...]

To generate and measure the reliability for a reference standard set with representative cases from seven broad syndromic case definitions and several narrower syndromic definitions used for biosurveillance.

Mechanical ventilators are designed to generate alarms when patients become disconnected or experience other critical ventilator events. However, these alarms can blend in with other accustomed sounds of the intensive care unit. Ventilator alarms that go unnoticed for extended periods of time often result in permanent patient harm or death. We developed a system to monitor critical ventilator events through our existing hospital network. Whenever an event is identified, the [...]

The state of Massachusetts has significant early experience in planning for and implementing interoperability networks for exchange of clinical and financial data. Members of our evolving data-sharing organizations gained valuable experience that is of potential benefit to others regarding the governance, policies, and technologies underpinning regional health information organizations. We describe the history, roles, and evolution of organizations and their plans for and success with pilot projects.

As we move toward an era when health information is more readily accessible and transferable, there are several issues that will arise. This article addresses the challenges of information filtering, context-sensitive decision support, legal and ethical guidelines regarding obligations to obtain and use the information, aligning patient and health professionals' expectations in regard to the use and usefulness of the information, and enhancing data reliability. The authors discuss the issues [...]

This paper describes an institutional approach taken to build a primary care reference portal. The objective for the site is to make access to and use of clinical reference faster and easier and to facilitate the use of evidence-based answers in daily practice. Reference objects were selected and metadata applied to a core set of sources. Metadata were used to search, sort, and filter results and to define deep-linked queries [...]

A systematic review of the literature was performed to examine the impact of electronic health records (EHRs) on documentation time of physicians and nurses and to identify factors that may explain efficiency differences across studies. In total, 23 papers met our inclusion criteria; five were randomized controlled trials, six were posttest control studies, and 12 were one-group pretest-posttest designs. Most studies (58%) collected data using a time and motion methodology [...]

To help biomedical researchers recognize dynamically introduced abbreviations in biomedical literature, such as gene and protein names, we have constructed a support system called ALICE (Abbreviation LIfter using Corpus-based Extraction). ALICE aims to extract all types of abbreviations with their expansions from a target paper on the fly.

MediClass is a knowledge-based system that processes both free-text and coded data to automatically detect clinical events in electronic medical records (EMRs). This technology aims to optimize both clinical practice and process control by automatically coding EMR contents regardless of data input method (e.g., dictation, structured templates, typed narrative). We report on the design goals, implemented functionality, generalizability, and current status of the system. MediClass could aid both clinical operations [...]

We studied the effect of a structured electronic communication service on health care spending, comparing doctor office and laboratory spending for a group of patients before and after the service became available to them relative to changes in a control group. In the treatment group, doctor office spending and laboratory spending fell in the period after the service became available, relative to the control group (p 0.05). A rough estimate [...]