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Full-Text Articles in Medicine and Health Sciences
Use Of Health Information Technology For Higher-Value Critical Care, Lena Chen, Edward Kennedy, Anne Sales, Timothy Hofer
Use Of Health Information Technology For Higher-Value Critical Care, Lena Chen, Edward Kennedy, Anne Sales, Timothy Hofer
Edward H. Kennedy
To illustrate how data from a comprehensive EHR might contribute to better triage decisions, we examined the records of a cohort of 101,912 patients admitted for reasons other than surgery to 121 VA acute care hospitals in fiscal year 2009. Critical care guidelines continue to maintain that the ICU is the place to care for “the most seriously ill patients.” For the most common noncardiac diagnoses, we found that, in keeping with this guideline, patients with a high severity of illness were much more likely to be admitted to the ICU than were patients with a low severity of illness. …
Improved Cardiovascular Risk Prediction Using Nonparametric Regression And Electronic Health Record Data, Edward Kennedy, Wyndy Wiitala, Rodney Hayward, Jeremy Sussman
Improved Cardiovascular Risk Prediction Using Nonparametric Regression And Electronic Health Record Data, Edward Kennedy, Wyndy Wiitala, Rodney Hayward, Jeremy Sussman
Edward H. Kennedy
Use of the electronic health record (EHR) is expected to increase rapidly in the near future, yet little research exists on whether analyzing internal EHR data using flexible, adaptive statistical methods could improve clinical risk prediction. Extensive implementation of EHR in the Veterans Health Administration provides an opportunity for exploration. Our objective was to compare the performance of various approaches for predicting risk of cerebrovascular and cardiovascular (CCV) death, using traditional risk predictors versus more comprehensive EHR data. Regression methods outperformed the Framingham risk score, even with the same predictors (AUC increased from 71% to 73% and calibration also improved). …