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The authors developed a prototype Shared Health Research Information Network (SHRINE) to identify the technical, regulatory, and political challenges of creating a federated query tool for clinical data repositories. Separate Institutional Review Boards (IRBs) at Harvard's three largest affiliated health centers approved use of their data, and the Harvard Medical School IRB approved building a Query Aggregator Interface that can simultaneously send queries to each hospital and display aggregate counts [...]

Alerts and prompts represent promising types of decision support in electronic prescribing to tackle inadequacies in prescribing. A systematic review was conducted to evaluate the efficacy of computerized drug alerts and prompts searching EMBASE, CINHAL, MEDLINE, and PsychINFO up to May 2007. Studies assessing the impact of electronic alerts and prompts on clinicians' prescribing behavior were selected and categorized by decision support type. Most alerts and prompts (23 out of [...]

OBJECTIVE To determine the significance of the English Wikipedia as a source of online health information. DESIGN The authors measured Wikipedia's ranking on general Internet search engines by entering keywords from MedlinePlus, NHS Direct Online, and the National Organization of Rare Diseases as queries into search engine optimization software. We assessed whether article quality influenced this ranking. The authors tested whether traffic to Wikipedia coincided with epidemiological trends and news [...]

The Obesity Challenge, sponsored by Informatics for Integrating Biology and the Bedside (i2b2), a National Center for Biomedical Computing, asked participants to build software systems that could "read" a patient's clinical discharge summary and replicate the judgments of physicians in evaluating presence or absence of obesity and 15 comorbidities. The authors describe their methodology and discuss the results of applying Lockheed Martin's rule-based natural language processing (NLP) capability, ClinREAD. We [...]

OBJECTIVE The authors present a system developed for the Challenge in Natural Language Processing for Clinical Data-the i2b2 obesity challenge, whose aim was to automatically identify the status of obesity and 15 related co-morbidities in patients using their clinical discharge summaries. The challenge consisted of two tasks, textual and intuitive. The textual task was to identify explicit references to the diseases, whereas the intuitive task focused on the prediction of [...]

OBJECTIVE Electronic health records (EHRs) have the potential to advance the quality of care, but studies have shown mixed results. The authors sought to examine the extent of EHR usage and how the quality of care delivered in ambulatory care practices varied according to duration of EHR availability. METHODS The study linked two data sources: a statewide survey of physicians' adoption and use of EHR and claims data reflecting quality [...]

OBJECTIVE To compare information obtained from narrative and structured electronic sources using anti-hypertensive medication intensification as an example clinical issue of interest. DESIGN A retrospective cohort study of 5,634 hypertensive patients with diabetes from 2000 to 2005. MEASUREMENTS The authors determined the fraction of medication intensification events documented in both narrative and structured data in the electronic medical record. The authors analyzed the relationship between provider characteristics and concordance between [...]

The authors studied current levels of computerization in dental clinics and the attitudes of dentists towards dental computerization in metropolises in China. A survey consisting of 22 questions was e-mailed or mailed to a random sample of 354 dentists. Of all respondents, 80.5% reported using a computer in their practice. The authors found that administrative tasks were the first to be computerized. A majority of respondents supported the statement that [...]

To identify some of the challenges that medical residents face in addressing their information needs in an inpatient setting, by examining how voice capture in natural language of clinical questions fits into workflow, and by characterizing the focus, format, and semantic content and complexity of their questions.