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JMIR Medical Informatics

Liyan Pan, Guangjian Liu, Xiaojian Mao, Huixian Li, Jiexin Zhang, Huiying Liang, Xiuzhen Li
BACKGROUND: Central precocious puberty (CPP) in girls seriously affects their physical and mental development in childhood. The method of diagnosis-gonadotropin-releasing hormone (GnRH)-stimulation test or GnRH analogue (GnRHa)-stimulation test-is expensive and makes patients uncomfortable due to the need for repeated blood sampling. OBJECTIVE: We aimed to combine multiple CPP-related features and construct machine learning models to predict response to the GnRHa-stimulation test...
February 12, 2019: JMIR Medical Informatics
Rumeng Li, Baotian Hu, Feifan Liu, Weisong Liu, Francesca Cunningham, David D McManus, Hong Yu
BACKGROUND: Bleeding events are common and critical and may cause significant morbidity and mortality. High incidences of bleeding events are associated with cardiovascular disease in patients on anticoagulant therapy. Prompt and accurate detection of bleeding events is essential to prevent serious consequences. As bleeding events are often described in clinical notes, automatic detection of bleeding events from electronic health record (EHR) notes may improve drug-safety surveillance and pharmacovigilance...
February 8, 2019: JMIR Medical Informatics
Azraa Amroze, Terry S Field, Hassan Fouayzi, Devi Sundaresan, Laura Burns, Lawrence Garber, Rajani S Sadasivam, Kathleen M Mazor, Jerry H Gurwitz, Sarah L Cutrona
BACKGROUND: Electronic health record (EHR) access and audit logs record behaviors of providers as they navigate the EHR. These data can be used to better understand provider responses to EHR-based clinical decision support (CDS), shedding light on whether and why CDS is effective. OBJECTIVE: This study aimed to determine the feasibility of using EHR access and audit logs to track primary care physicians' (PCPs') opening of and response to noninterruptive alerts delivered to EHR InBaskets...
February 7, 2019: JMIR Medical Informatics
Qian Liu, Qiuyi Chen, Jiayi Shen, Huailiang Wu, Yimeng Sun, Wai-Kit Ming
BACKGROUND: Thirdhand smoke has been a growing topic for years in China. Thirdhand smoke (THS) consists of residual tobacco smoke pollutants that remain on surfaces and in dust. These pollutants are re-emitted as a gas or react with oxidants and other compounds in the environment to yield secondary pollutants. OBJECTIVE: Collecting media reports on THS from major media outlets and analyzing this subject using topic modeling can facilitate a better understanding of the role that the media plays in communicating this health issue to the public...
January 29, 2019: JMIR Medical Informatics
Patrick Essay, Tala B Shahin, Baran Balkan, Jarrod Mosier, Vignesh Subbian
BACKGROUND: Many intensive care units (ICUs) utilize telemedicine in response to an expanding critical care patient population, off-hours coverage, and intensivist shortages, particularly in rural facilities. Advances in digital health technologies, among other reasons, have led to the integration of active, well-networked critical care telemedicine (tele-ICU) systems across the United States, which in turn, provide the ability to generate large-scale remote monitoring data from critically ill patients...
January 24, 2019: JMIR Medical Informatics
Rajat Kumar Agarwal, Amit Sedai, Kumari Ankita, Lalith Parmar, Rakesh Dhanya, Sunil Dhimal, Reshma Sriniwas, Ashwini Gowda, Pooja Gujjal, Pushpa H, Suman Jain, J Dasaratha Ramaiah, Sujata Jali, Neelavva Rayappa Tallur, Stalin Ramprakash, Lawrence Faulkner
BACKGROUND: Successful models of information and communication technology (ICT) applied to cost-effective delivery of quality care in low- and middle-income countries (LMIC) are an increasing necessity. Severe thalassemia is one of the most common life-threatening noncommunicable diseases of children globally. OBJECTIVE: The aim was to study the impact of ICT on quality of care for severe thalassemia patients in LMIC. METHODS: A total of 1110 patients with severe thalassemia from five centers in India were followed over a 1-year period...
January 23, 2019: JMIR Medical Informatics
Gang Luo, Bryan L Stone, Flory L Nkoy, Shan He, Michael D Johnson
BACKGROUND: In children below the age of 2 years, bronchiolitis is the most common reason for hospitalization. Each year in the United States, bronchiolitis causes 287,000 emergency department visits, 32%-40% of which result in hospitalization. Due to a lack of evidence and objective criteria for managing bronchiolitis, clinicians often make emergency department disposition decisions on hospitalization or discharge to home subjectively, leading to large practice variation. Our recent study provided the first operational definition of appropriate hospital admission for emergency department patients with bronchiolitis and showed that 6...
January 22, 2019: JMIR Medical Informatics
Ling Chu, Vaishnavi Kannan, Mujeeb A Basit, Diane J Schaeflein, Adolfo R Ortuzar, Jimmie F Glorioso, Joel R Buchanan, Duwayne L Willett
BACKGROUND: Defining clinical phenotypes from electronic health record (EHR)-derived data proves crucial for clinical decision support, population health endeavors, and translational research. EHR diagnoses now commonly draw from a finely grained clinical terminology-either native SNOMED CT or a vendor-supplied terminology mapped to SNOMED CT concepts as the standard for EHR interoperability. Accordingly, electronic clinical quality measures (eCQMs) increasingly define clinical phenotypes with SNOMED CT value sets...
January 16, 2019: JMIR Medical Informatics
Patricia Ah Williams, Brendan Lovelock, Tony Cabarrus, Marlon Harvey
BACKGROUND: Digital transformation in health care is being driven by the need to improve quality, reduce costs, and enhance the patient experience of health care delivery. It does this through both the direct intervention of technology to create new diagnostic and treatment opportunities and also through the improved use of information to create more engaging and efficient care processes. OBJECTIVE: In a modern digital hospital, improved clinical and business processes are often driven through enhancing the information flows that support them...
January 11, 2019: JMIR Medical Informatics
Anis Sharafoddini, Joel A Dubin, David M Maslove, Joon Lee
BACKGROUND: The data missing from patient profiles in intensive care units (ICUs) are substantial and unavoidable. However, this incompleteness is not always random or because of imperfections in the data collection process. OBJECTIVE: This study aimed to investigate the potential hidden information in data missing from electronic health records (EHRs) in an ICU and examine whether the presence or missingness of a variable itself can convey information about the patient health status...
January 8, 2019: JMIR Medical Informatics
Sue S Feldman, Scott Buchalter, Leslie W Hayes
[This corrects the article DOI: 10.2196/10264.].
January 3, 2019: JMIR Medical Informatics
Xia Jing, Nicholas R Hardiker, Stephen Kay, Yongsheng Gao
BACKGROUND: Ontologies are key enabling technologies for the Semantic Web. The Web Ontology Language (OWL) is a semantic markup language for publishing and sharing ontologies. OBJECTIVE: The supply of customizable, computable, and formally represented molecular genetics information and health information, via electronic health record (EHR) interfaces, can play a critical role in achieving precision medicine. In this study, we used cystic fibrosis as an example to build an Ontology-based Knowledge Base prototype on Cystic Fibrobis (OntoKBCF) to supply such information via an EHR prototype...
December 21, 2018: JMIR Medical Informatics
David M Maslove, Jacob Klein, Kathryn Brohman, Patrick Martin
BACKGROUND: Blockchain technology is emerging as an innovative tool in data and software security. OBJECTIVE: This study aims to explore the role of blockchain in supporting clinical trials data management and develop a proof-of-concept implementation of a patient-facing and researcher-facing system. METHODS: Blockchain-based Smart Contracts were built using the Ethereum platform. RESULTS: We described BlockTrial, a system that uses a Web-based interface to allow users to run trials-related Smart Contracts on an Ethereum network...
December 21, 2018: JMIR Medical Informatics
Cui He, Qiru Zhou, Wei Chen, Junzhang Tian, Lihua Zhou, Hong Peng, Shuo Luan, Shengfei Wang
BACKGROUND: Health care maldistribution is a long-term problem in China. Telemedicine is an efficient way to deliver medical resources to remote areas; however, there are few studies on the effectiveness and challenges in providing health care from rural to urban areas in China. OBJECTIVE: The objective was to describe the effectiveness and challenges of telemedicine for providing health care from Guangzhou to rural areas in Guangdong Province. METHODS: We designed surveys and conducted them immediately after the consultation and 2-4 weeks later...
December 21, 2018: JMIR Medical Informatics
Nabilah Rahman, Debby D Wang, Sheryl Hui-Xian Ng, Sravan Ramachandran, Srinath Sridharan, Astrid Khoo, Chuen Seng Tan, Wei-Ping Goh, Xin Quan Tan
BACKGROUND: Electronic medical records (EMRs) contain a wealth of information that can support data-driven decision making in health care policy design and service planning. Although research using EMRs has become increasingly prevalent, challenges such as coding inconsistency, data validity, and lack of suitable measures in important domains still hinder the progress. OBJECTIVE: The objective of this study was to design a structured way to process records in administrative EMR systems for health services research and assess validity in selected areas...
December 21, 2018: JMIR Medical Informatics
Yu Zhang, Xuwen Wang, Zhen Hou, Jiao Li
BACKGROUND: Electronic health records (EHRs) are important data resources for clinical studies and applications. Physicians or clinicians describe patients' disorders or treatment procedures in EHRs using free text (unstructured) clinical notes. The narrative information plays an important role in patient treatment and clinical research. However, it is challenging to make machines understand the clinical narratives. OBJECTIVE: This study aimed to automatically identify Chinese clinical entities from free text in EHRs and make machines semantically understand diagnoses, tests, body parts, symptoms, treatments, and so on...
December 17, 2018: JMIR Medical Informatics
Shahryar Eivazzadeh, Johan S Berglund, Tobias C Larsson, Markus Fiedler, Peter Anderberg
BACKGROUND: Several models suggest how the qualities of a product or service influence user satisfaction. Models such as the Customer Satisfaction Index (CSI), Technology Acceptance Model (TAM), and Delone and McLean Information Systems Success demonstrate those relations and have been used in the context of health information systems. OBJECTIVE: This study aimed to investigate which qualities foster greater satisfaction among patient and professional users. In addition, we are interested in knowing to what extent improvement in those qualities can explain user satisfaction and whether this makes user satisfaction a proxy indicator of those qualities...
November 30, 2018: JMIR Medical Informatics
Josette Jones, Meeta Pradhan, Masoud Hosseini, Anand Kulanthaivel, Mahmood Hosseini
BACKGROUND: The increasing use of social media and mHealth apps has generated new opportunities for health care consumers to share information about their health and well-being. Information shared through social media contains not only medical information but also valuable information about how the survivors manage disease and recovery in the context of daily life. OBJECTIVE: The objective of this study was to determine the feasibility of acquiring and modeling the topics of a major online breast cancer support forum...
November 29, 2018: JMIR Medical Informatics
Azizeh K Sowan, Arlienita R Beraya, Adrian Carrola, Charles Reed
BACKGROUND: Informed consent is a complex process to help patients engage in care processes and reach the best treatment decisions. There are many limitations to the conventional consent process that is based on oral discussion of information related to treatment procedures by the health care provider. A conclusive body of research supports the effectiveness of multimedia patient decision aids (PtDAs) in the consent process in terms of patient satisfaction, increased knowledge about the procedure, reduced anxiety level, and higher engagement in the decision making...
November 28, 2018: JMIR Medical Informatics
Jorn Op den Buijs, Mariana Simons, Sara Golas, Nils Fischer, Jennifer Felsted, Linda Schertzer, Stephen Agboola, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Telehealth programs have been successful in reducing 30-day readmissions and emergency department visits. However, such programs often focus on the costliest patients with multiple morbidities and last for only 30 to 60 days postdischarge. Inexpensive monitoring of elderly patients via a personal emergency response system (PERS) to identify those at high risk for emergency hospital transport could be used to target interventions and prevent avoidable use of costly readmissions and emergency department visits after 30 to 60 days of telehealth use...
November 27, 2018: JMIR Medical Informatics
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