Abstract：
OBJECTIVE:Determine how varying longitudinal historical training data can impact prediction of future clinical decisions. Estimate the "decay rate" of clinical data source relevance. MATERIALS AND METHODS:We trained a clinical order recommender system, analogous to Netflix or Amazon's "Customers who bought A also bought B..." product recommenders, based on a tertiary academic hospital's structured electronic health record data. We used this system to predict future (2013) admission orders based on different subsets of historical training data (2009 through 2012), relative to existing human-authored order sets. RESULTS:Predicting future (2013) inpatient orders is more accurate with models trained on just one month of recent (2012) data than with 12 months of older (2009) data (ROC AUC 0.91 vs. 0.88, precision 27% vs. 22%, recall 52% vs. 43%, all P<10-10). Algorithmically learned models from even the older (2009) data was still more effective than existing human-authored order sets (ROC AUC 0.81, precision 16% recall 35%). Training with more longitudinal data (2009-2012) was no better than using only the most recent (2012) data, unless applying a decaying weighting scheme with a "half-life" of data relevance about 4 months. DISCUSSION:Clinical practice patterns (automatically) learned from electronic health record data can vary substantially across years. Gold standards for clinical decision support are elusive moving targets, reinforcing the need for automated methods that can adapt to evolving information. CONCLUSIONS AND RELEVANCM:Prioritizing small amounts of recent data is more effective than using larger amounts of older data towards future clinical predictions.
journal_name
Int J Med Informjournal_title
International journal of medical informaticsauthors
Chen JH,Alagappan M,Goldstein MK,Asch SM,Altman RBdoi
10.1016/j.ijmedinf.2017.03.006subject
Has Abstractpub_date
2017-06-01 00:00:00pages
71-79eissn
1386-5056issn
1872-8243pii
S1386-5056(17)30059-Xjournal_volume
102pub_type
杂志文章abstract：:The introduction of computer-based information systems (ISs) in public health provides enhanced possibilities for service improvements and hence also for improvement of the population's health. Not least, new communication systems can help in the socialization and integration process needed between the different profe...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(02)00074-6
更新日期：2002-12-18 00:00:00
abstract：OBJECTIVE:To determine whether the use of information technology (IT), measured by Meaningful Use capability, is associated with lower rates of inappropriate utilization of imaging services in hospital outpatient settings. RESEARCH DESIGN:A retrospective cross-sectional analysis of 3332 nonfederal U.S. hospitals using...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2017.10.020
更新日期：2018-01-01 00:00:00
abstract：INTRODUCTION:Clinicians commonly use the modified Rankin Scale (mRS) and the Barthel Index (BI) to measure clinical outcome after stroke. These are potential targets in machine learning models for stroke outcome prediction. Therefore, the quality of the measurements is crucial for training and validation of these model...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2019.103988
更新日期：2019-12-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to develop a prototype personal digital assistant-decision support system (PDA-DSS) based on a clinical practice guideline (CPG) for the management of obesity. DESIGN:The study was composed of four phases: (1) analysis of advanced practice nurse (APN) students' documentation rel...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2007.05.009
更新日期：2007-10-01 00:00:00
abstract：BACKGROUND:Cardiovascular disease is the leading killer globally and secondary prevention substantially reduces risk. Uptake of, and adherence to, face-to-face preventive programs is often low. Alternative models of care are exploiting the prominence of technology in daily life to facilitate lifestyle behavior change. ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2016.01.009
更新日期：2016-12-01 00:00:00
abstract：PURPOSE:To develop, implement and test a novel audience response system (ARS) that allows image based interaction for radiology education. METHODS:The ARS developed in this project is based on standard Personal Digital Assistants (PDAs) (HP iPAQ 114 classic handheld) running Microsoft® Windows Mobile® 6 Classic with a...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2011.05.002
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:Electronic Consultation (e-consults) can provide improved access, enhance patient and provider satisfaction, and reduce beneficiary travel expenses. We explored how e-consults were implemented across three specialty areas, diabetes (Diab), gastroenterology (GI), and neurosurgery (Neuro), at two Veterans Affa...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2017.09.005
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Electronic approaches are becoming more widely used to obtain informed consent for research participation. Electronic consent (e-consent) provides an accessible and versatile approach to the consenting process, which can be enhanced with audio-visual and interactive features to improve participant engagement...
journal_title：International journal of medical informatics
pub_type： 杂志文章,评审
doi：10.1016/j.ijmedinf.2020.104271
更新日期：2020-11-01 00:00:00
abstract：:Funding constraints, demands for improved efficiency, low staff to student ratios and improved computer software (D. Wright, The use of multimedia computers and software in nurse education, Health Inf. 1 (3) (1995) 101-107.) all combine to produce a situation where a dramatic increase in the use of CBE for tertiary nu...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(98)00057-4
更新日期：1998-06-01 00:00:00
abstract：OBJECTIVE:To investigate whether context-specific alerts for potassium-increasing drug-drug interactions (DDIs) in a clinical decision support system reduced the alert burden, increased alert acceptance, and had an effect on the occurrence of hyperkalemia. MATERIALS AND METHODS:In the pre-intervention period all alert...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2019.104013
更新日期：2020-01-01 00:00:00
abstract：:This study evaluated the impact of telemedicine technology on the provision of neurosurgical health services. We focused on the differences between the use of real time audio-visual teleconferencing and teleradiology versus conventional telephone consultations in the referral of neurosurgical patients from a large dis...
journal_title：International journal of medical informatics
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s1386-5056(01)00161-7
更新日期：2001-07-01 00:00:00
abstract：PURPOSE:The speed and high potential impact of avian influenza's (AI) on local bird populations, poultry economies and human health make timely and coordinated characterization, assessment and response to possible threats essential. To collaborate effectively, stakeholders (public health, medical, veterinary, and agric...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2008.06.015
更新日期：2009-03-01 00:00:00
abstract：INTRODUCTION:The availability of comprehensive and accurate medication history information in electronic medical records and through electronic prescribing provides the opportunity to create tailored interventions based on individuals' particular medication information needs. To meet the challenges of providing medicat...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2012.09.007
更新日期：2012-12-01 00:00:00
abstract：:Service-oriented architectures (SOAs) and web service technologies have been proposed to respond to some central interoperability challenges of heterogeneous health information systems (HIS). We propose a model which we are using to define services and solutions for healthcare applications from the requirements in the...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2006.10.001
更新日期：2007-02-01 00:00:00
abstract：BACKGROUND:Worldwide, patients have posted millions of online reviews for their doctors. The rich textual information in the online reviews holds the potential to generate insights into how patients' experience with their doctors differ across nations and how should we use them to improve our health service. OBJECTIVE...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2016.12.007
更新日期：2017-03-01 00:00:00
abstract：:After reporting on characteristics, structure and contents of the specialised informatics-based curriculum for medical informatics (MI) at the University of Heidelberg/University of Applied Sciences Heilbronn, the paper describes the development during the last 5 years, and in particular a complementary health care or...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2003.11.011
更新日期：2004-03-18 00:00:00
abstract：BACKGROUND:The provision of relevant clinical information on pathology requests is an important part of facilitating appropriate laboratory utilization and accurate results interpretation and reporting. PURPOSE:(1) To determine the quantity and importance of handwritten clinical information provided by physicians to t...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2011.06.003
更新日期：2011-09-01 00:00:00
abstract：INTRODUCTION:The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing pr...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2015.04.004
更新日期：2015-08-01 00:00:00
abstract：INTRODUCTION:Information extraction (IE) systems have been proposed in recent years to extract genic interactions from bibliographical resources. They are limited to single interaction relations, and have to face a trade-off between recall and precision, by focusing either on specific interactions (for precision), or g...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2009.03.005
更新日期：2009-12-01 00:00:00
abstract：OBJECTIVES:We aimed to provide an up-to-date contemporary bibliometric view of the telemedicine and telehealth literature and a longitudinal analysis of changes in content themes. METHODS:Software tools were used to extract and process MEDLINE entries. Frequencies of papers by year of publication and outlet were calcu...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2014.07.001
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:Patient access to electronic health records (EHRs) is associated with several determinants and outcomes, which are interrelated. However, individual studies and the reviews summarizing them have only addressed particular aspects, such as policy, usability or health outcomes of adoption. Therefore, no compreh...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2019.05.014
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:Despite strong policy interest in eHealth, actual adoption in many European hospitals is low. PURPOSE:This study develops and tests in a preliminary way an organisational eHealth adoption model rooted in several adoption frameworks to improve understanding of this phenomenon. METHODS:The model is explored ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2017.01.009
更新日期：2017-04-01 00:00:00
abstract：INTRODUCTION:Electronic medical records (EMRs) may address the need for decision and language support for Western clinicians on mobile medical service trips (MSTs) in low resource settings abroad, while providing improved access to records and data management. However, there has yet to be a review of this emerging tech...
journal_title：International journal of medical informatics
pub_type： 杂志文章,评审
doi：10.1016/j.ijmedinf.2016.11.008
更新日期：2017-02-01 00:00:00
abstract：:Can higher quality healthcare practices emerge from the development and use of a loosely integrated set of intranets? This paper examines that question through a series of empirical examples that draw on data from one healthcare organization that was part of a multi-year, multi-industry study of intranets. Some of thi...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2006.06.007
更新日期：2007-06-01 00:00:00
abstract：PURPOSE:Despite the proliferation of telemedicine technology, telemedicine service acceptance has been slow in actual healthcare settings. The purpose of this research is to develop a theoretical model for explaining the predictive factors influencing physicians' willingness to use telemedicine technology to provide he...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2014.05.005
更新日期：2014-08-01 00:00:00
abstract：OBJECTIVES:The intent of this paper is in the examination of health IT implementation processes - the barriers to and facilitators of successful implementation, identification of a beginning set of implementation best practices, the identification of gaps in the health IT implementation body of knowledge, and recommend...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2013.10.009
更新日期：2014-07-01 00:00:00
abstract：INTRODUCTION:The PropeR EHR system (PropeRWeb) is a multidisciplinary electronic health record (EHR) system for multidisciplinary use in extramural patient care for stroke patients. DESIGN:The system is built using existing open source components and is based on open standards. It is implemented as a web application u...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2004.07.004
更新日期：2005-03-01 00:00:00
abstract：INTRODUCTION:Physician satisfaction with electronic medical records has often been poor. Usability has frequently been identified as a source for decreased satisfaction. While surveys can identify many issues, and are logistically easier to administer, they may miss issues identified using other methods This study soug...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2018.01.010
更新日期：2018-04-01 00:00:00
abstract：:Traditionally, diagnosis and treatment have been seen as two distinct tasks. Consequently, most approaches to computer supported health care focus on one of the two-mostly on diagnosis or rather on the interpretation of measurements which is much better understood and formalised. However, in practice diagnosis and tre...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(02)00064-3
更新日期：2002-12-18 00:00:00
abstract：BACKGROUND AND PURPOSE:Teamwork has become a modus operandi in healthcare and delivery of patient care by an interdisciplinary healthcare team (IHT) is now a prevailing modality of care. We argue that a formal and automated support framework is needed for an IHT to properly leverage information technology resources. Su...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2020.104075
更新日期：2020-04-01 00:00:00
