Abstract:
OBJECTIVES:Data collected within the German nosocomial infection surveillance system KISS are recommended as reference data for judging nosocomial infection rates in German intensive care units (ICUs). It is unknown whether the KISS data tend to under- or overestimate the true infection incidence rates. In this article, methodological aspects of the SIR1 study on the incidence of nosocomial infections are discussed, with the aim of estimating unbiased incidence rates of nosocomial infections in interdisciplinary German ICUs and examining whether the KISS data are representative. METHODS:We discuss the following methodological issues: 1) Sample size estimation. 2) Stratified random sampling of German ICUs. 3) Investigation of seasonal effects. 4) Statistical modeling of incidence rates using a negative binomial regression model. 5) Comparison of weighted incidence rates with the standardized rate ratio (SRR). RESULTS:Random sampling proved difficult to realize in practice since many ICUs refused to participate, particularly those in small hospitals. Analysis was adjusted for hospital size. No seasonal trends were found in the KISS data. Due to marked differences between ICUs, the number of infections is over-dispersed compared to a Poisson model, so negative binomial regression was used. Fifty ICUs were observed for two consecutive months each, corresponding to 21,832 patient days, during which 262 infections occurred. Infections were more frequent in large hospitals. The incidence rates provided by the SIR study are on average (SRR) 1.89 (1.63-2.20) times as large as those estimated by the KISS system. CONCLUSION:For estimating nosocomial infection incidence rates, random sampling and statistical modeling of over-dispersion were successfully performed. The study provides evidence that the KISS surveillance system tends to underestimate the true incidence rates of nosocomial infections in German ICUs.
journal_name
Methods Inf Medjournal_title
Methods of information in medicineauthors
Rücker G,Schoop R,Beyersmann J,Schumacher M,Zuschneid Isubject
Has Abstractpub_date
2006-01-01 00:00:00pages
424-9issue
4eissn
0026-1270issn
2511-705Xpii
06040424journal_volume
45pub_type
杂志文章,多中心研究abstract:OBJECTIVES:This paper addresses the design of a platform for the management of medical decision data in the ICU. Whenever new medical data from laboratories or monitors is available or at fixed times, the appropriate medical support services are activated and generate a medical alert or suggestion to the bedside termin...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/me0480
更新日期:2008-01-01 00:00:00
abstract::This paper presents a tutorial introduction to the handling of uncertainty and decision-making in medical reasoning systems. It focuses on the central role of uncertainty in all of medicine and identifies the major themes that arise in research papers. It then reviews simple Bayesian formulations of the problem and pu...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:INTRODUCTION:This article is part of the Focus Theme of Methods of Information in Medicine on "Biosignal Interpretation: Advanced Methods for Studying Cardiovascular and Respiratory Systems". OBJECTIVES:The aim of this study is to assess the reliability of the estimated Nocturnal Heart Rate (HR), recorded through a be...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/ME13-02-0053
更新日期:2014-01-01 00:00:00
abstract::Acute appendicitis is the most common cause of acute abdomen requiring surgical intervention. The clinical diagnosis of acute appendicitis is not always easy due to variable symptomatology, particularly at the onset. The contributions of history-taking and physical examination in the diagnosis of acute appendicitis wa...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::Requirements and approaches of Software Engineering education in the field of Medical Informatics are described with respect to the impact of (1) experiences characterizing the "software misery", (2) status and tendencies in software methodology, and (3) educational status and needs in computer science education influ...
journal_title:Methods of information in medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-11-01 00:00:00
abstract::We conducted a pilot randomised trial of computerised templates for the management of asthma and diabetes in general practice in six general practices in North London. Uptake of the guidelines by general practitioners and practice nurses was assessed using qualitative (semi-structured interviews designed to assess the...
journal_title:Methods of information in medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVES:To assess the impact of a CPOE system on medication-related communication of nurses and physicians. METHODS:In six internal medicine wards of an academic medical center, two questionnaires were used to evaluate nurses' attitudes toward the impact of a paper-based medication system and then a CPOE system on ...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/ME0572
更新日期:2009-01-01 00:00:00
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journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/ME0582
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:The healthcare sector is facing an enormous acceleration due to the emergence of new knowledge, drugs, devices and diseases. Professional competence, continuing education, service excellence and patient benefits can be facilitated by the developments in information and computer technology--computer literacy ...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
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journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.1055/s-0040-1715127
更新日期:2020-05-01 00:00:00
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journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:2001-05-01 00:00:00
abstract::Many clinics are interested to use software packages in daily practice, but lack of integration of such packages seriously limits their scope. In practice this often entails switching between programs and interrupting the run of an individual program. A multi-task approach would not solve this problem as it would not ...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVES:To discuss the advantages and disadvantages of an interfaced approach to clinical information systems architecture. METHODS:After many years of internally building almost all components of a hospital clinical information system (HELP) at Intermountain Health Care, we changed our architectural approach as we...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To explain the common conformance and interoperability testing requirements of eHealth applications through two case studies; one using a prominent eHealth messaging standard, namely HL7 v3 [1], and the other using Integrating the Healthcare Enterprise (IHE) [2] Profiles and to describe how these testing requ...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/ME09-02-0022
更新日期:2010-01-01 00:00:00
abstract::The medical information systems of the future will probably include the entire medical record as well as a knowledge base, providing decision support for the physician during patient care. Data dictionaries will play an important role in integrating the medical knowledge bases with the clinical databases. This article...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract::This paper tries to compare six Health Informatics/Medical Informatics (HI/MI) programs by a number of attributes in standardized form. The different programs and their curricula were summarized at the 5th IMIA Working Conference on HI/MI Education at Heidelberg/Heilbronn. The presentation is condensed to a synoptical...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVES:To provide a comprehensive bottom-up categorization of model-based segmentation techniques that allows to select, implement, and apply well-suited active contour models for segmentation of medical images, where major challenges are the high variability in shape and appearance of objects, noise, artifacts, pa...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::A Bonhoeffer-van der Pol equation with a stable limit cycle is proposed as a model of the pacemaker in the sino-atrial node to explain heart rate regulation. Standard tools, such as the phase transition curve in nonlinear dynamic system theory, are used to analyze the model and results are compared with other studies ...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to develop a solution to preserve security and privacy in a healthcare environment where health-sensitive information will be accessed by many parties and stored in various distributed databases. The solution should maintain anonymous medical records and it should be able to lin...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/me9116
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:Compiling individual records coming from different sources is necessary for multi-center studies. Legal aspects can be satisfied by implementing anonymization procedures. When using these procedures with a different key for each study it becomes almost impossible to link records from separate data collection...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/me0546
更新日期:2008-01-01 00:00:00
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journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/ME9222
更新日期:2009-01-01 00:00:00
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journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:2000-12-01 00:00:00
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journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/ME10-01-0069
更新日期:2012-01-01 00:00:00
abstract::Four tabular and two graphical techniques for the presentation of laboratory test results were evaluated in a reaction time experiment with 25 volunteers. Artificial variables and values were used to represent sets of 12 laboratory tests to eliminate the possible effects of clinical experience. Analyses focused on fou...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
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journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/ME14-01-0007
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:IMIA, the International Medical Informatics Association, has adopted the IMIA Strategic Plan, "Towards IMIA 2015". In order to turn the vision into reality, we invite all members of IMIA, and others with an interest in our work, to engage in activities designed to achieve the key strategic goals of the plan. ...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:To contribute a new perspective on recent investigations into the scientific foundations of medical informatics (MI) and bioinformatics (BI). To support efforts that could generate synergies and new research directions. METHODS:MI and BI are compared and contrasted from a philosophy of science perspective. ...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract::Pathfinder is an expert system that assists surgical pathologists with the diagnosis of lymph-node diseases. The program is one of a growing number of normative expert systems that use probability and decision theory to acquire, represent, manipulate, and explain uncertain medical knowledge. In this article, we descri...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVES:The log-binomial model is recommended for calculating the prevalence ratio in cross-sectional studies with binary outcomes. However, convergence problems may occur as this model is numerically unstable. If this happens, the Poisson model should be used, but the Poisson model variance needs to be adjusted. He...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.1160/me0416
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Information systems integration is hard, especially when semantic and business process interoperability requirements need to be met. To succeed, a unified methodology, approaching different aspects of systems architecture such as business, information, computational, engineering and technology viewpoints, has...
journal_title:Methods of information in medicine
pub_type: 杂志文章
doi:10.3414/ME09-02-0012
更新日期:2010-01-01 00:00:00