Health Information Technology Commons^™

Machine Learning Approach To Extract Diagnostic And Prognostic Thresholds: Application In Prognosis Of Cardiovascular Mortality, Luis J. Mena, Eber E. Orozco, Vanessa G. Felix, Rodolfo Ostos, Jesus D. Melgarejo, Gladys E. Maestre

School of Medicine Publications

Machine learning has become a powerful tool for analysing medical domains, assessing the importance of clinical parameters, and extracting medical knowledge for outcomes research. In this paper, we present a machine learning method for extracting diagnostic and prognostic thresholds, based on a symbolic classification algorithm called REMED. We evaluated the performance of our method by determining new prognostic thresholds for well-known and potential cardiovascular risk factors that are used to support medical decisions in the prognosis of fatal cardiovascular diseases. Our approach predicted 36% of cardiovascular deaths with 80% specificity and 75% general accuracy. The new method provides an innovative …

Clustered Subsampling For Clinically Informed Diagnostic Brain Mapping, Malin Björnsdotter, Diego Sona, Sonny Rosenthal, Justin Dauwels

Research Collection College of Integrative Studies

Brain based diagnostic systems have recently received attention as a tool in the characterization and diagnosis of a variety of neurodevelopmental and psychiatric disorders. Nonetheless, a majority of disorders are still diagnosed entirely based on symptom assessments and behavioral correlates. We therefore propose a method for fusing brain responses with clinical measures for improved diagnosis. To this end, we utilized the flexibility of clustered random subspace brain mapping to detect regions where brain responses in conjunction with a clinical measure could reliably differentiate patients from control subjects. We demonstrate the approach on realistically simulated functional magnetic resonance imaging (fMRI) brain …

Technical Desiderata For The Integration Of Genomic Data Into Electronic Health Records., Daniel R Masys, Gail P Jarvik, Neil F Abernethy, Nicholas R Anderson, George J Papanicolaou, Dina N Paltoo, Mark A Hoffman, Isaac S Kohane, Howard P Levy

Manuscripts, Articles, Book Chapters and Other Papers

The era of "Personalized Medicine," guided by individual molecular variation in DNA, RNA, expressed proteins and other forms of high volume molecular data brings new requirements and challenges to the design and implementation of Electronic Health Records (EHRs). In this article we describe the characteristics of biomolecular data that differentiate it from other classes of data commonly found in EHRs, enumerate a set of technical desiderata for its management in healthcare settings, and offer a candidate technical approach to its compact and efficient representation in operational systems.

High Acceptability For Cell Phone Text Messages To Improve Communication Of Laboratory Results With Hiv-Infected Patients In Rural Uganda: A Cross-Sectional Survey Study, Mark J. Siedner, Jessica E. Haberer, Mwebesa B. Bwana, Norma C. Ware, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Patient-provider communication is a major challenge in resource-limited settings with large catchment areas. Though mobile phone usership increased 20-fold in Africa over the past decade, little is known about acceptability of, perceptions about disclosure and confidentiality, and preferences for cell phone communication of health information in the region.

Methods: We performed structured interviews of fifty patients at the Immune Suppression Syndrome clinic in Mbarara, Uganda to assess four domains of health-related communication: a) cell phone use practices and literacy, b) preferences for laboratory results communication, c) privacy and confidentiality, and d) acceptability of and preferences for text messaging to …

Problems And Issues In Implementing Innovative Curriculum In The Developing Countries: The Pakistani Experience, Syeda Kauser Ali, Lubna A. Baig

Department for Educational Development

Background: The Government of Pakistan identified 4 medical Colleges for introduction of COME, one from each province. Curriculum was prepared by the faculty of these colleges and launched in 2001 and despite concerted efforts could not be implemented. The purpose of this research was to identify the reasons for delay in implementation of the COME curriculum and to assess the understanding of the stakeholders about COME.

Methods: Mixed methods study design was used for data collection. In-depth interviews, mail-in survey questionnaire, and focus group discussions were held with the representatives of federal and provincial governments, Principals of medical colleges, faculty …

Ehrs Connect Research And Practice: Where Predictive Modeling, Artificial Intelligence, And Clinical Decision Support Intersect, Casey C. Bennett, Thomas W. Doub, Rebecca Selove

Center for Prevention Research Publications

Objectives

Electronic health records (EHRs) are only a first step in capturing and utilizing health-related data—the challenge is turning that data into useful information. Furthermore, EHRs are increasingly likely to include data relating to patient outcomes, functionality such as clinical decision support, and genetic information as well, and, as such, can be seen as repositories of increasingly valuable information about patients’ health conditions and responses to treatment over time.

Methods

We describe a case study of 423 patients treated by Centerstone within Tennessee and Indiana in which we utilized electronic health record data to generate predictive algorithms of individual patient …

Systems And Devices For Isothermal Biochemical Reactions And / Or Analysis, Robert W. Doebler Ii, Christopher Cooney, Anna Hickerson, James D. Sterling, Ali Nadim

Business and Information Technology Faculty Research & Creative Works

An isothermal reaction and analysis system may include a receiver to receive sample holders, a thermal control sub system to control a temperature of the receiver, an excitation Subsystem, a detection Subsystem and an analysis Subsystem. Excitation Sources and/or detectors are positioned to enhance data collection. Sample holders may include filters, selectively blocking and passing wavelengths or bands of electromagnetic radiation.

Flowcell Systems For Single Molecule Detection, John G. K. Williams, Gregory R. Bashford, Jiyan Chen, Dan Draney, Nara Narayanan, Bambi L. Reynolds, Pamela Sheaff

Biomedical Imaging and Biosignal Analysis Laboratory

The present invention provides compounds, methods and systems for sequencing nucleic acid using single molecule detection. Using labeled NPs that exhibit charge-switching behavior, single-molecule DNA sequencing in a microchannel sorting system is realized. In operation, sequencing products are detected enabling real-time sequencing as successive detectable moieties flow through a detection channel. By electrically sorting charged molecules, the cleaved product molecules are detected in isolation without interference from unincorporated NPs and without illuminating the polymerase-DNA complex.

Health Information Privacy In The Correctional Environment, Melissa M. Goldstein

Health Policy and Management Faculty Publications

Information technology is considered a transformative element in health care because it facilitates the transparency and sharing of health information, which have always been central to the practice of medicine and the delivery of high-quality care. The widespread use of electronic health records (EHRs) and electronic health information exchange, among other technologies, is considered essential to improving the quality of care, reducing medical errors, reducing health disparities, and advancing the delivery of patient-centered medical care.

Computer Physician Order Entry And Clinical Decision Support Systems: Benefits And Concerns, Joseph Shaffer, Alberto Coustasse

Management Faculty Research

Computerized Physician Order Entry has emerged as the greatest potential to decrease medications errors and improve efficiency. A literature review was conducted in systematic stages that included the research data from the last 25 years. Efficiencies were found with a decrease in overall workload of nurses, pharmacists and clerical workers. This led to decreased operating expenses. A secure way of transferring physician orders electronically will help hospitals and physicians practice a more efficient and higher quality of care in the US healthcare system.

Financial Position And Adoption Of Electronic Health Records: A Retrospective Longitudinal Study, Jay J. Shen, Gregory O. Ginn

School of Public Health Faculty Research

AIM: Financial barriers are a major factor of slow electronic health record (EHR) adoption among US hospitals. All existing literature focuses on relationships between current or short-term financial position and EHR adoption. This study examines relationship between financial position in previous years and the current level of EHR adoption.

METHODS: Retrospective longitudinal data were extracted from (1) the 2009 American Hospital Association (AHA) EHR implementation survey; (2) the 2002 and 2006 Centers for Medicare & Medicaid Cost Reports; and (3) the 2002 and 2006 AHA Annual Survey containing organizational and operational data. The final sample was 2,701 acute care hospitals …

Benefits And Constraints Of Telepsychiatry Utilization In The United States, Bruce A. Stec, Alberto Coustasse

Management Faculty Research

This conference presentation describes the benefits and constraints of utilizing telemedicine primarily focusing on the field of psychiatry in the United States with the current system of healthcare. The utilization of telemedicine in the field of psychiatry is believed to provide better access, quality and care to the patients who necessitate psychiatric care in their overall medical care. Telemedicine has been a successfully integrated program into psychiatric facilities reaching rural, prisons or city facilities based on that it has increased the volume of patients in which physicians can reach out to and diagnose, as well as treat patients with limitations …

Integrating An Automated Diabetes Management System Into The Family Management Of Children With Type 1 Diabetes: Results From A 12-Month Randomized Controlled Technology Trial., Tammy Toscos Phd, Stephen W Ponder, Barbara J Anderson, Mayer B Davidson, Martin L Lee, Elaine Montemayor-Gonzalez, Patricia Reyes, Eric Link, Kevin L Mcmahon

Health Services and Informatics Research

OBJECTIVE: The study objective was to evaluate how the use of a pervasive blood glucose monitoring (BGM) technology relates to glycemic control, report of self-care behavior, and emotional response to BGM of children with type 1 diabetes and their parents.

RESEARCH DESIGN AND METHODS: Forty-eight children aged less than 12 years (mean 8.8 years) with type 1 diabetes were randomly assigned to one of two study groups, a control group (conventional care without technology) or an experimental group (conventional care with technology), and followed for 12 months. Families in the experimental group were given the Automated Diabetes Management System (ADMS), …

Finding The Medicine For Healthcare, Singapore Management University

Perspectives@SMU

Singapore’s healthcare system is lauded internationally as a model that has managed to restrain costs while delivering excellent health outcomes. The country spends below four per cent of its GDP on healthcare and was ranked 6th out of 191 countries on overall health system performance by the World Health Organisation in 2000.

Two-Dimensional Blood Flow Velocity Estimation Using Apparent Speckle Pattern Angle Dependence On Scan Velocity, Tiantian Xu, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

An algorithm which measures the lateral component of blood flow velocity was developed in our previous studies based on the increase in speckle size due to relative motion between moving scatterers and spatial rate of scanner A-line acquisition (scan velocity). In this paper, the apparent dominant angle of the speckle pattern in a straight vessel was investigated and a new method of two-dimensional blood flow velocity estimation is introduced. Different scan velocities were used for data acquisition from blood flow traveling at an angle relative to the ultrasound beam. The apparent angle of the speckle pattern changes with different scan …

Monitoring Cerebral Hemodynamics With Transcranial Doppler Ultrasound During Cognitive And Exercise Testing In Adults Following Unilateral Stroke, Brian P. Watt, Judith M. Burnfield, Edward J. Truemper, Thad W. Buster, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

An observational study was performed as a preliminary investigation into the use of transcranial Doppler ultrasound (TCD) for recording cerebral hemodynamic changes during multiple tasks. TCD is a method of measuring cerebral blood flow (CBF) using ultrasound transducers in contact with the surface of the head. Using the maximum flow envelope of the Doppler spectrum returning from the middle cerebral artery (MCA), standard clinical flow indices can be calculated and displayed in real time providing information concerning perturbations in CBF and their potential cause. These indices as well as flow velocity measurements have been recognized as useful in measuring changes …

Trust In Government And Support For Governmental Regulation: The Case Of Electronic Health Records, Mitchel Herian, Nancy C. Shank, Tarik Abdel-Monem

University of Nebraska Public Policy Center: Publications

Background — This paper presents results from a public engagement effort in Nebraska, USA, which measured public opinions about governmental involvement in encouraging the use of electronic health records (EHRs).

Objective — We examine the role of trust in government in contributing to public support for government involvement in the development of EHR technologies. We hypothesize that trust in government will lead to support for federal and state governmental encouragement of the use of EHRs among doctors and insurance companies. Further, because individual experiences with health-care professionals will reduce perceptions of risk, we expect that support for governmental involvement will …

The Emergence And Potential Impact Of Medicine 2.0 In The Healthcare Industry, Terra Stump, Sarah Zilch, Alberto Coustasse

Management Faculty Research

Medicine 2.0 has emerged within healthcare information technology to enable more defined relationships among providers and patients. Physicians, hospitals, and patients are using Medicine 2.0 through social networking to maintain their foothold in the evolution of medical technologies. The authors’ purpose was to determine potential improvements that Medicine 2.0 has on communication and collaboration of healthcare information. Research has shown that Medicine 2.0 has integrated into the healthcare industry and is enabling an increase in communication in healthcare matters. The provider-patient relationship is improving through the use of Medicine 2.0 and has positively impacted society so far.

Feasibility And Compliance With Daily Home Ecg Monitoring Of The Qt Interval In Heart Transplant Recipients, Erik V. Carter, Kathleen T. Hickey, David M. Pickham, Lynn V. Doering, Belinda Chen, Patricia R. E. Harris, Barbara J. Drew

Collected Faculty Scholarship

About 13% of adult heart transplant recipients do not survive to one year and a major cause of death is acute cellular allograft rejection.^1,2 According to the 2009 annual United States data published from the International Society for Heart Lung Transplantation Registry, acute rejection occurs in 25 – 35% of transplant recipients within the first year following transplant surgery.³ In order to detect the early stages of rejection so that more aggressive and early immunosuppressant therapy can be initiated, frequent biopsies of heart tissue are performed (typically, weekly or every other week in the first 3 months and …

New Portable Tool To Screen Vestibular And Visual Function—National Institutes Of Health Toolbox Initiative, Rose Marie Rine, Dale Roberts, Bree A. Corbin, Roberta Mckean-Cowdin, Rohit Varma, Jennifer Beaumont, Jerry Slotkin, Michael C. Schubert

Physical Therapy Faculty Research

As part of the National Institutes of Health Toolbox initiative, we developed a low-cost, easy-to-administer, and time-efficient test of vestibular and visual function. A computerized test of dynamic visual acuity (cDVA) was used to measure the difference in visual acuity between head still and moving in yaw. Participants included 318 individuals, aged 3 to 85 years (301 without and 17 with vestibular pathology). Adults used Early Treatment of Diabetic Retinopathy Study (ETDRS) optotypes; children used ETDRS, Lea, and HOTV optotypes. Bithermal calorics, rotational chair, and light box testing were used to validate the cDVA. Analysis revealed that the cDVA test …