Decision Support Techniques: Mathematical or statistical procedures used as aids in making a decision. They are frequently used in medical decision-making.Decision Support Systems, Clinical: Computer-based information systems used to integrate clinical and patient information and provide support for decision-making in patient care.Decision Making, Computer-Assisted: Use of an interactive computer system designed to assist the physician or other health professional in choosing between certain relationships or variables for the purpose of making a diagnostic or therapeutic decision.Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.Drug Therapy, Computer-Assisted: Adjunctive computer programs in providing drug treatment to patients.Decision Support Systems, Management: Computer-based systems that enable management to interrogate the computer on an ad hoc basis for various kinds of information in the organization, which predict the effect of potential decisions.Expert Systems: Computer programs based on knowledge developed from consultation with experts on a problem, and the processing and/or formalizing of this knowledge using these programs in such a manner that the problems may be solved.Medical Order Entry Systems: Information systems, usually computer-assisted, that enable providers to initiate medical procedures, prescribe medications, etc. These systems support medical decision-making and error-reduction during patient care.Medical Records Systems, Computerized: Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.Electronic Health Records: Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.Diagnosis, Computer-Assisted: Application of computer programs designed to assist the physician in solving a diagnostic problem.Electronic Prescribing: The use of COMPUTER COMMUNICATION NETWORKS to store and transmit medical PRESCRIPTIONS.Decision Trees: A graphic device used in decision analysis, series of decision options are represented as branches (hierarchical).Reminder Systems: Systems used to prompt or aid the memory. The systems can be computerized reminders, color coding, telephone calls, or devices such as letters and postcards.Medication Systems, Hospital: Overall systems, traditional or automated, to provide medication to patients in hospitals. Elements of the system are: handling the physician's order, transcription of the order by nurse and/or pharmacist, filling the medication order, transfer to the nursing unit, and administration to the patient.Ambulatory Care Information Systems: Information systems, usually computer-assisted, designed to store, manipulate, and retrieve information for planning, organizing, directing, and controlling administrative activities associated with the provision and utilization of ambulatory care services and facilities.User-Computer Interface: The portion of an interactive computer program that issues messages to and receives commands from a user.Knowledge Management: The leveraging of collective wisdom within an organization as a catalyst to increase responsiveness and innovation.Systems Integration: The procedures involved in combining separately developed modules, components, or subsystems so that they work together as a complete system. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed)Therapy, Computer-Assisted: Computer systems utilized as adjuncts in the treatment of disease.Attitude to Computers: The attitude and behavior associated with an individual using the computer.Hospital Information Systems: Integrated, computer-assisted systems designed to store, manipulate, and retrieve information concerned with the administrative and clinical aspects of providing medical services within the hospital.Software Design: Specifications and instructions applied to the software.Computer Systems: Systems composed of a computer or computers, peripheral equipment, such as disks, printers, and terminals, and telecommunications capabilities.Medication Errors: Errors in prescribing, dispensing, or administering medication with the result that the patient fails to receive the correct drug or the indicated proper drug dosage.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Point-of-Care Systems: Laboratory and other services provided to patients at the bedside. These include diagnostic and laboratory testing using automated information entry.Workflow: Description of pattern of recurrent functions or procedures frequently found in organizational processes, such as notification, decision, and action.Knowledge Bases: Collections of facts, assumptions, beliefs, and heuristics that are used in combination with databases to achieve desired results, such as a diagnosis, an interpretation, or a solution to a problem (From McGraw Hill Dictionary of Scientific and Technical Terms, 6th ed).Artificial Intelligence: Theory and development of COMPUTER SYSTEMS which perform tasks that normally require human intelligence. Such tasks may include speech recognition, LEARNING; VISUAL PERCEPTION; MATHEMATICAL COMPUTING; reasoning, PROBLEM SOLVING, DECISION-MAKING, and translation of language.Decision Making, Organizational: The process by which decisions are made in an institution or other organization.Programming Languages: Specific languages used to prepare computer programs.Medical Informatics: The field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Clinical Pharmacy Information Systems: Information systems, usually computer-assisted, designed to store, manipulate, and retrieve information for planning, organizing, directing, and controlling administrative activities associated with the provision and utilization of clinical pharmacy services.Decision Theory: A theoretical technique utilizing a group of related constructs to describe or prescribe how individuals or groups of people choose a course of action when faced with several alternatives and a variable amount of knowledge about the determinants of the outcomes of those alternatives.Software: Sequential operating programs and data which instruct the functioning of a digital computer.Computers, Handheld: A type of MICROCOMPUTER, sometimes called a personal digital assistant, that is very small and portable and fitting in a hand. They are convenient to use in clinical and other field situations for quick data management. They usually require docking with MICROCOMPUTERS for updates.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Internet: A loose confederation of computer communication networks around the world. The networks that make up the Internet are connected through several backbone networks. The Internet grew out of the US Government ARPAnet project and was designed to facilitate information exchange.Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task.Information Systems: Integrated set of files, procedures, and equipment for the storage, manipulation, and retrieval of information.Medication Systems: Overall systems, traditional or automated, to provide medication to patients.Information Storage and Retrieval: Organized activities related to the storage, location, search, and retrieval of information.Diffusion of Innovation: The broad dissemination of new ideas, procedures, techniques, materials, and devices and the degree to which these are accepted and used.Hypermedia: Computerized compilations of information units (text, sound, graphics, and/or video) interconnected by logical nonlinear linkages that enable users to follow optimal paths through the material and also the systems used to create and display this information. (From Thesaurus of ERIC Descriptors, 1994)Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)VermontDrug Information Services: Services providing pharmaceutic and therapeutic drug information and consultation.Admitting Department, Hospital: Hospital department responsible for the flow of patients and the processing of admissions, discharges, transfers, and also most procedures to be carried out in the event of a patient's death.Health Level Seven: An American National Standards Institute-accredited organization working on specifications to support development and advancement of clinical and administrative standards for healthcare.Natural Language Processing: Computer processing of a language with rules that reflect and describe current usage rather than prescribed usage.Physicians: Individuals licensed to practice medicine.United StatesDatabases as Topic: Organized collections of computer records, standardized in format and content, that are stored in any of a variety of computer-readable modes. They are the basic sets of data from which computer-readable files are created. (from ALA Glossary of Library and Information Science, 1983)Vocabulary, Controlled: A specified list of terms with a fixed and unalterable meaning, and from which a selection is made when CATALOGING; ABSTRACTING AND INDEXING; or searching BOOKS; JOURNALS AS TOPIC; and other documents. The control is intended to avoid the scattering of related subjects under different headings (SUBJECT HEADINGS). The list may be altered or extended only by the publisher or issuing agency. (From Harrod's Librarians' Glossary, 7th ed, p163)Logic: The science that investigates the principles governing correct or reliable inference and deals with the canons and criteria of validity in thought and demonstration. This system of reasoning is applicable to any branch of knowledge or study. (Random House Unabridged Dictionary, 2d ed & Sippl, Computer Dictionary, 4th ed)Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Medical Records, Problem-Oriented: A system of record keeping in which a list of the patient's problems is made and all history, physical findings, laboratory data, etc. pertinent to each problem are placed under that heading.Health Information Management: Management of the acquisition, organization, retrieval, and dissemination of health information.Evidence-Based Medicine: An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)Information Management: Management of the acquisition, organization, storage, retrieval, and dissemination of information. (From Thesaurus of ERIC Descriptors, 1994)Inappropriate Prescribing: The practice of administering medications in a manner that poses more risk than benefit, particularly where safer alternatives exist.Formularies, Hospital: Formularies concerned with pharmaceuticals prescribed in hospitals.Drug Prescriptions: Directions written for the obtaining and use of DRUGS.Computer Communication Networks: A system containing any combination of computers, computer terminals, printers, audio or visual display devices, or telephones interconnected by telecommunications equipment or cables: used to transmit or receive information. (Random House Unabridged Dictionary, 2d ed)Clinical Laboratory Information Systems: Information systems, usually computer-assisted, designed to store, manipulate, and retrieve information for planning, organizing, directing, and controlling administrative and clinical activities associated with the provision and utilization of clinical laboratory services.TennesseeData Display: The visual display of data in a man-machine system. An example is when data is called from the computer and transmitted to a CATHODE RAY TUBE DISPLAY or LIQUID CRYSTAL display.Patient Participation: Patient involvement in the decision-making process in matters pertaining to health.Patient Education as Topic: The teaching or training of patients concerning their own health needs.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Disease Management: A broad approach to appropriate coordination of the entire disease treatment process that often involves shifting away from more expensive inpatient and acute care to areas such as preventive medicine, patient counseling and education, and outpatient care. This concept includes implications of appropriate versus inappropriate therapy on the overall cost and clinical outcome of a particular disease. (From Hosp Pharm 1995 Jul;30(7):596)Meaningful Use: Using certified ELECTRONIC HEALTH RECORDS technology to improve quality, safety, efficiency, and reduce HEALTHCARE DISPARITIES; engage patients and families in their health care; improve care coordination; improve population and public health; while maintaining privacy and security.Neural Networks (Computer): A computer architecture, implementable in either hardware or software, modeled after biological neural networks. Like the biological system in which the processing capability is a result of the interconnection strengths between arrays of nonlinear processing nodes, computerized neural networks, often called perceptrons or multilayer connectionist models, consist of neuron-like units. A homogeneous group of units makes up a layer. These networks are good at pattern recognition. They are adaptive, performing tasks by example, and thus are better for decision-making than are linear learning machines or cluster analysis. They do not require explicit programming.CD-ROM: An optical disk storage system for computers on which data can be read or from which data can be retrieved but not entered or modified. A CD-ROM unit is almost identical to the compact disk playback device for home use.Technetium Tc 99m Mertiatide: A technetium diagnostic aid used in renal function determination.Models, Theoretical: Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment.Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.Bayes Theorem: A theorem in probability theory named for Thomas Bayes (1702-1761). In epidemiology, it is used to obtain the probability of disease in a group of people with some characteristic on the basis of the overall rate of that disease and of the likelihood of that characteristic in healthy and diseased individuals. The most familiar application is in clinical decision analysis where it is used for estimating the probability of a particular diagnosis given the appearance of some symptoms or test result.Nursing Care: Care given to patients by nursing service personnel.Terminology as Topic: The terms, expressions, designations, or symbols used in a particular science, discipline, or specialized subject area.Online Systems: Systems where the input data enter the computer directly from the point of origin (usually a terminal or workstation) and/or in which output data are transmitted directly to that terminal point of origin. (Sippl, Computer Dictionary, 4th ed)Organizational Innovation: Introduction of changes which are new to the organization and are created by management.IndianaUnified Medical Language System: A research and development program initiated by the NATIONAL LIBRARY OF MEDICINE to build knowledge sources for the purpose of aiding the development of systems that help health professionals retrieve and integrate biomedical information. The knowledge sources can be used to link disparate information systems to overcome retrieval problems caused by differences in terminology and the scattering of relevant information across many databases. The three knowledge sources are the Metathesaurus, the Semantic Network, and the Specialist Lexicon.Cooperative Behavior: The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)Medical Staff, Hospital: Professional medical personnel approved to provide care to patients in a hospital.Technology Assessment, Biomedical: Evaluation of biomedical technology in relation to cost, efficacy, utilization, etc., and its future impact on social, ethical, and legal systems.Health Plan Implementation: Those actions designed to carry out recommendations pertaining to health plans or programs.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Patient Care Planning: Usually a written medical and nursing care program designed for a particular patient.Evaluation Studies as Topic: Studies determining the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. For drugs and devices, CLINICAL TRIALS AS TOPIC; DRUG EVALUATION; and DRUG EVALUATION, PRECLINICAL are available.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)Data Mining: Use of sophisticated analysis tools to sort through, organize, examine, and combine large sets of information.Telemedicine: Delivery of health services via remote telecommunications. This includes interactive consultative and diagnostic services.Fuzzy Logic: Approximate, quantitative reasoning that is concerned with the linguistic ambiguity which exists in natural or synthetic language. At its core are variables such as good, bad, and young as well as modifiers such as more, less, and very. These ordinary terms represent fuzzy sets in a particular problem. Fuzzy logic plays a key role in many medical expert systems.Vanuatu: A republic consisting of an island group in Melanesia, in the southwest Pacific Ocean. Its capital is Port-Vila. It was called New Hebrides until 1980. It was discovered in 1606 by the Portuguese, forgotten for 160 years, then visited by Bougainville in 1768 and Captain Cook in 1774. It was under joint British and French administration from 1906 until it became independent in 1980 under the name of Vanuatu. The name is native, meaning our land. (From Webster's New Geographical Dictionary, 1988, p833 & Room, Brewer's Dictionary of Names, 1992, p570)Quality Assurance, Health Care: Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.Infant, Postmature: An infant born at or after 42 weeks of gestation.MEDLINE: The premier bibliographic database of the NATIONAL LIBRARY OF MEDICINE. MEDLINE® (MEDLARS Online) is the primary subset of PUBMED and can be searched on NLM's Web site in PubMed or the NLM Gateway. MEDLINE references are indexed with MEDICAL SUBJECT HEADINGS (MeSH).Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Pest Control: The reduction or regulation of the population of noxious, destructive, or dangerous plants, insects, or other animals. This includes control of plants that serve as habitats or food sources for animal pests.Organizational Case Studies: Descriptions and evaluations of specific health care organizations.Formularies as Topic: Works about lists of drugs or collections of recipes, formulas, and prescriptions for the compounding of medicinal preparations. Formularies differ from PHARMACOPOEIAS in that they are less complete, lacking full descriptions of the drugs, their formulations, analytic composition, chemical properties, etc. In hospitals, formularies list all drugs commonly stocked in the hospital pharmacy.Database Management Systems: Software designed to store, manipulate, manage, and control data for specific uses.Automatic Data Processing: Data processing largely performed by automatic means.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Drug Agonism: Phenomena and pharmaceutics of compounds that selectively bind to a specific receptor and trigger a response. They mimic the action of endogenous biochemical molecules. Their effect can be countered by antagonists (DRUG ANTAGONISM).Integrated Advanced Information Management Systems: A concept, developed in 1983 under the aegis of and supported by the National Library of Medicine under the name of Integrated Academic Information Management Systems, to provide professionals in academic health sciences centers and health sciences institutions with convenient access to an integrated and comprehensive network of knowledge. It addresses a wide cross-section of users from administrators and faculty to students and clinicians and has applications to planning, clinical and managerial decision-making, teaching, and research. It provides access to various types of clinical, management, educational, etc., databases, as well as to research and bibliographic databases. In August 1992 the name was changed from Integrated Academic Information Management Systems to Integrated Advanced Information Management Systems to reflect use beyond the academic milieu.Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence.Physicians, Primary Care: Providers of initial care for patients. These PHYSICIANS refer patients when appropriate for secondary or specialist care.PennsylvaniaCommunication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Personal Health Services: Health care provided to individuals.Systematized Nomenclature of Medicine: Controlled vocabulary of clinical terms produced by the International Health Terminology Standards Development Organisation (IHTSDO).Databases, Factual: Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Patient Care: The services rendered by members of the health profession and non-professionals under their supervision.Quality Improvement: The attainment or process of attaining a new level of performance or quality.Information Dissemination: The circulation or wide dispersal of information.Risk Management: The process of minimizing risk to an organization by developing systems to identify and analyze potential hazards to prevent accidents, injuries, and other adverse occurrences, and by attempting to handle events and incidents which do occur in such a manner that their effect and cost are minimized. Effective risk management has its greatest benefits in application to insurance in order to avert or minimize financial liability. (From Slee & Slee: Health care terms, 2d ed)Hospital Communication Systems: The transmission of messages to staff and patients within a hospital.Drug-Related Side Effects and Adverse Reactions: Disorders that result from the intended use of PHARMACEUTICAL PREPARATIONS. Included in this heading are a broad variety of chemically-induced adverse conditions due to toxicity, DRUG INTERACTIONS, and metabolic effects of pharmaceuticals.Practice Management, Medical: The organization and operation of the business aspects of a physician's practice.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Documentation: Systematic organization, storage, retrieval, and dissemination of specialized information, especially of a scientific or technical nature (From ALA Glossary of Library and Information Science, 1983). It often involves authenticating or validating information.Clinical Medicine: The study and practice of medicine by direct examination of the patient.Academic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.Individualized Medicine: Therapeutic approach tailoring therapy for genetically defined subgroups of patients.Nurse's Practice Patterns: Patterns of practice in nursing related to provision of services including diagnosis and treatment.Hospitals, University: Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.Drug Monitoring: The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Computer Security: Protective measures against unauthorized access to or interference with computer operating systems, telecommunications, or data structures, especially the modification, deletion, destruction, or release of data in computers. It includes methods of forestalling interference by computer viruses or so-called computer hackers aiming to compromise stored data.Diagnostic Errors: Incorrect diagnoses after clinical examination or technical diagnostic procedures.Unnecessary Procedures: Diagnostic, therapeutic, and investigative procedures prescribed and performed by health professionals, the results of which do not justify the benefits or hazards and costs to the patient.Medical Errors: Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (DIAGNOSTIC ERRORS), errors in the administration of drugs and other medications (MEDICATION ERRORS), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from MALPRACTICE in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent.Clinical Protocols: Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.PubMed: A bibliographic database that includes MEDLINE as its primary subset. It is produced by the National Center for Biotechnology Information (NCBI), part of the NATIONAL LIBRARY OF MEDICINE. PubMed, which is searchable through NLM's Web site, also includes access to additional citations to selected life sciences journals not in MEDLINE, and links to other resources such as the full-text of articles at participating publishers' Web sites, NCBI's molecular biology databases, and PubMed Central.Fees, Pharmaceutical: Amounts charged to the patient or third-party payer for medication. It includes the pharmacist's professional fee and cost of ingredients, containers, etc.Hospitals, Group Practice: Hospitals organized and controlled by a group of physicians who practice together and provide each other with mutual support.Semantics: The relationships between symbols and their meanings.Radioisotope Renography: Graphic tracing over a time period of radioactivity measured externally over the kidneys following intravenous injection of a radionuclide which is taken up and excreted by the kidneys.Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease.Diagnostic Techniques and Procedures: Methods, procedures, and tests performed to diagnose disease, disordered function, or disability.Nursing Staff, Hospital: Personnel who provide nursing service to patients in a hospital.Telenursing: Delivery of nursing services via remote telecommunications.Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Radiology Information Systems: Information systems, usually computer-assisted, designed to store, manipulate, and retrieve information for planning, organizing, directing, and controlling administrative activities associated with the provision and utilization of radiology services and facilities.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.Drug Dosage Calculations: Math calculations done for preparing appropriate doses of medicines, taking into account conversions of WEIGHTS AND MEASURES. Mistakes are one of the sources of MEDICATION ERRORS.Betahistine: A histamine analog and H1 receptor agonist that serves as a vasodilator. It is used in MENIERE DISEASE and in vascular headaches but may exacerbate bronchial asthma and peptic ulcers.Cluster Analysis: A set of statistical methods used to group variables or observations into strongly inter-related subgroups. In epidemiology, it may be used to analyze a closely grouped series of events or cases of disease or other health-related phenomenon with well-defined distribution patterns in relation to time or place or both.Utah
Value of control: The value of control is a quantitative measure of the value of controlling the outcome of an uncertainty variable. Decision analysis provides a means for calculating the value of both perfect and imperfect control.Clinical decision support system: A clinical decision support system (CDSS) is a health information technology system that is designed to provide physicians and other health professionals with clinical decision support (CDS), that is, assistance with clinical decision-making tasks. A working definition has been proposed by Robert Hayward of the Centre for Health Evidence: "Clinical Decision Support systems link health observations with health knowledge to influence health choices by clinicians for improved health care".Computer Support Services: Computer Support Services, Inc., or CSSI, is an multi-national company providing technology solutions and professional services.The Final Decision: The Final Decision is an episode from season 1 of the animated TV series X-Men Animated Series.Knowledge acquisition: Knowledge acquisition is the process used to define the rules and ontologies required for a knowledge-based system. The phrase was first used in conjunction with expert systems to describe the initial tasks associated with developing an expert system, namely finding and interviewing domain experts and capturing their knowledge via rules, objects, and frame-based ontologies.Computer-aided diagnosis: In radiology, computer-aided detection (CADe), also called computer-aided diagnosis (CADx), are procedures in medicine that assist doctors in the interpretation of medical images. Imaging techniques in X-ray, MRI, and Ultrasound diagnostics yield a great deal of information, which the radiologist has to analyze and evaluate comprehensively in a short time.Recursive partitioning: Recursive partitioning is a statistical method for multivariable analysis. Recursive partitioning creates a decision tree that strives to correctly classify members of the population by splitting it into sub-populations based on several dichotomous independent variables. The process is termed recursive because each sub-population may in turn be split an indefinite number of times until the splitting process terminates after a particular stopping criterion is reached.Immersive technologySustainable gardening: Sustainable gardening includes the more specific sustainable landscapes, sustainable landscape design, sustainable landscaping, sustainable landscape architecture, resulting in sustainable sites. It comprises a disparate group of horticultural interests that can share the aims and objectives associated with the international post-1980s sustainable development and sustainability programs developed to address the fact that humans are now using natural biophysical resources faster than they can be replenished by nature.Roger Gould: Roger Gould, M.D.List of software development philosophies: This is a list of approaches, styles, and philosophies in software development not included in the category tree of software development philosophies. It contains also software development processes, software development methodologies and single practices, principles and laws.National Clinical Guideline CentreWi, Inc.: Wi, Inc. (pronounced as an initialism, "double-u i.Log management knowledge base: The Log Management Knowledge Base is a free database of detailed descriptions on over 20,000 event logs generated by Windows systems, syslog devices and applications.http://www.Mexican International Conference on Artificial Intelligence: MICAI (short for Mexican International Conference on Artificial Intelligence) is the name of an annual conference covering all areas of Artificial Intelligence (AI), held in Mexico. The first MICAI conference was held in 2000.RDF query language: An RDF query language is a computer language, specifically a query language for databases, able to retrieve and manipulate data stored in Resource Description Framework format.Translational bioinformatics: Translational Bioinformatics (TBI) is an emerging field in the study of health informatics, focused on the convergence of molecular bioinformatics, biostatistics, statistical genetics, and clinical informatics. Its focus is on applying informatics methodology to the increasing amount of biomedical and genomic data to formulate knowledge and medical tools, which can be utilized by scientists, clinicians, and patients.Medication Administration Record: A Medication Administration Record or MAR (eMAR for electronic versions) is the report that serves as a legal record of the drugs administered to a patient at a facility by a health care professional. The MAR is a part of a patient's permanent record on their medical chart.Loss function: In mathematical optimization, statistics, decision theory and machine learning, a loss function or cost function is a function that maps an event or values of one or more variables onto a real number intuitively representing some "cost" associated with the event. An optimization problem seeks to minimize a loss function.Mac OS X Server 1.0Palm (PDA): Palm handhelds were Personal Digital Assistants (PDAs) that ran the Palm OS.Internet organizations: This is a list of Internet organizations, or organizations that play or played a key role in the evolution of the Internet by developing recommendations, standards, and technology; deploying infrastructure and services; and addressing other major issues.Clonal Selection Algorithm: In artificial immune systems, Clonal selection algorithms are a class of algorithms inspired by the clonal selection theory of acquired immunity that explains how B and T lymphocytes improve their response to antigens over time called affinity maturation. These algorithms focus on the Darwinian attributes of the theory where selection is inspired by the affinity of antigen-antibody interactions, reproduction is inspired by cell division, and variation is inspired by somatic hypermutation.Patient-Reported Outcomes Measurement Information System: The Patient Reported Outcomes Measurement Information System (PROMIS®) provides clinicians and researchers access to reliable, valid, and flexible measures of health status that assess physical, mental, and social well–being from the patient perspective. PROMIS measures are standardized, allowing for assessment of many patient-reported outcome domains—including pain, fatigue, emotional distress, physical functioning and social role participation—based on common metrics that allow for comparisons across domains, across chronic diseases, and with the general population.Conference and Labs of the Evaluation Forum: The Conference and Labs of the Evaluation Forum (formerly Cross-Language Evaluation Forum), or CLEF, is an organization promoting research in multilingual information access (currently focusing on European languages). Its specific functions are to maintain an underlying framework for testing information retrieval systems and to create repositories of data for researchers to use in developing comparable standards.Hyperlinks in virtual worlds: Hyperlinks are, at present, a novel feature in virtual world platforms, aside from hyperlinks in the in-built chat clients between users' avatars. In the latter 2000s, however, a number of architectures were created for various decentralized virtual world platforms in order to facilitate easier travel of avatars between two or more separately-hosted grids or servers.Halfdan T. MahlerVermont Seal of Quality: The Seal program has been discontinued. The seal was being abused by being used by companies that were sourcing their products from out of state while Vermont farmers who produced products entirely in state were being denied the right to use the seal.METeOR: METeOR (Metadata Online Registry), Australia’s repository for national metadata standards for health, housing and community services statistics and information. METeOR is a Metadata registry based on the 2003 version of the ISO/IEC 11179 Information technology - Metadata registries standard.Dragomir R. Radev: Dragomir R. Radev is a University of Michigan computer science professor and Columbia University computer science adjunct professor working on natural language processing and information retrieval.Samuel Bard (physician): Samuel Bard (April 1, 1742 – May 24, 1821) was an American physician. He founded the first medical school in New York.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,Semantic translation: Semantic translation is the process of using semantic information to aid in the translation of data in one representation or data model to another representation or data model. Semantic translation takes advantage of semantics that associate meaning with individual data elements in one dictionary to create an equivalent meaning in a second system.Logic gate: In electronics, a logic gate is an idealized or physical device implementing a Boolean function; that is, it performs a logical operation on one or more logical inputs, and produces a single logical output. Depending on the context, the term may refer to an ideal logic gate, one that has for instance zero rise time and unlimited fan-out, or it may refer to a non-ideal physical deviceJaeger, Microelectronic Circuit Design, McGraw-Hill 1997, ISBN 0-07-032482-4, pp.Domain name drop list: A domain name drop list is a list containing the expired domain names that will be deleted from the domain name registry in the near future. These lists are typically used by domainers to locate expiring domain names with value.Dr. Ezekiel R. Dumke College of Health Professions: The Dr. Ezekiel R.Bestbets: BestBETS (Best Evidence Topic Reports) is a system designed by emergency physicians at Manchester Royal Infirmary, UK. It was conceived as a way of allowing busy clinicians to solve real clinical problems using published evidence.Theory of Motivated Information Management: Theory of Motivated Information Management or TMIM, is a social-psychological framework that examines the relationship between information management and uncertainty. The theory posits that individuals are “motivated to manage their uncertainty levels when they perceive a discrepancy between the level of uncertainty they have about an important issue and the level of uncertainty they want” (Guerrero et al.Priscus (saint): Priscus is one of several Catholic saints and martyrs. In the 1921 Benedictine Book of Saints there are seven figures named Priscus mentioned.Truven Health Analytics: $96,000 thousands USD (2013)Acknowledgement (data networks): In data networking, an acknowledgement (or acknowledgment) is a signal passed between communicating processes or computers to signify acknowledgement, or receipt of response, as part of a communications protocol. For instance, ACK packets are used in the Transmission Control Protocol (TCP) to acknowledge the receipt of SYN packets when establishing a connection, data packets while a connection is being used, and FIN packets when terminating a connection.Agilent ChemStation: Agilent ChemStation is a software package to control Agilent liquid chromatography and gas chromatography systems such as the 1050, 1100 and 1200 Series HPLC system. It is an evolution of the Hewlett-Packard ChemStation System.Outline of Tennessee: The following outline is provided as an overview of and topical guide to Tennessee:Screen buffer: In computing, a screen buffer is a part of computer memory used by a computer application for the representation of the content to be shown on the computer display.Patient participation: Patient participation, also called shared decision-making, is a process in which both the patient and physician contribute to the medical decision-making process. Under this operating system, health care providers explain treatments and alternatives to patients in order to provide the necessary resources for patients to choose the treatment option that most closely aligns with their unique cultural and personal beliefs.Online patient education: Online Patient Education also known as Online Patient Engagement is a method of providing medical information and education to patients using Learning Management Systems delivered through the Internet.Evaluation of bariatric Centers of Excellence Web sites for functionality and efficacy.Bio Base EuropeDisease management (health): Disease management is defined as "a system of coordinated healthcare interventions and communications for populations with conditions in which patient self-care efforts are significant."Care Continuum Alliance.Physical neural network: A physical neural network is a type of artificial neural network in which an electrically adjustable resistance material is used to emulate the function of a neural synapse. "Physical" neural network is used to emphasize the reliance on physical hardware used to emulate neurons as opposed to software-based approaches which simulate neural networks.Cassidy Live!Von Neumann regular ring: In mathematics, a von Neumann regular ring is a ring R such that for every a in R there exists an x in R such that . To avoid the possible confusion with the regular rings and regular local rings of commutative algebra (which are unrelated notions), von Neumann regular rings are also called absolutely flat rings, because these rings are characterized by the fact that every left module is flat.Incremental cost-effectiveness ratio: The incremental cost-effectiveness ratio (ICER) is a statistic used in cost-effectiveness analysis to summarise the cost-effectiveness of a health care intervention. It is defined by the difference in cost between two possible interventions, divided by the difference in their effect.Hyperparameter: In Bayesian statistics, a hyperparameter is a parameter of a prior distribution; the term is used to distinguish them from parameters of the model for the underlying system under analysis.International Committee on Aeronautical Fatigue and Structural IntegrityBiological pathway: A biological pathway is a series of actions among molecules in a cell that leads to a certain product or a change in a cell. Such a pathway can trigger the assembly of new molecules, such as a fat or protein.Indiana University School of Dentistry: The Indiana University School of Dentistry (IUSD) is the dental school of Indiana University. It is located on the Indiana University – Purdue University Indianapolis campus in downtown Indianapolis.Statutory auditor: Statutory auditor is a title used in various countries to refer to a person or entity with an auditing role, whose appointment is mandated by the terms of a statute.Document-centric collaboration: Document-centric collaboration is a new approach to working together on projects online which puts the document and its contents at the centre of the process.Implementation research: Implementation research is the scientific study of methods to promote the uptake of research findings. Often research projects focus on small scale pilot studies or laboratory based experiments, and assume that findings can be generalised to roll out into a practice based domain with few changes.Global Risks Report: The Global Risks Report is an annual study published by the World Economic Forum ahead of the Forum’s Annual Meeting in Davos, Switzerland. Based on the work of the Global Risk Network, the report describes changes occurring in the global risks landscape from year to year and identifies the global risks that could play a critical role in the upcoming year.Closed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.Essex School of discourse analysis: The Essex School constitutes a variety of discourse analysis, one that combines theoretical sophistication – mainly due to its reliance on the post-structuralist and psychoanalytic traditions and, in particular, on the work of Lacan, Foucault, Barthes, Derrida, etc. – with analytical precision, since it focuses predominantly on an in-depth analysis of political discourses in late modernity.Process mining: Process mining is a process management technique that allows for the analysis of business processes based on event logs. The basic idea is to extract knowledge from event logs recorded by an information system.Telecare: Telecare is the term for offering remote care of elderly and physically less able people, providing the care and reassurance needed to allow them to remain living in their own homes. The use of sensors may be part of a package which can provide support for people with illnesses such as dementia, or people at risk of falling.Vague setTransport in Vanuatu: Vanuatu's undeveloped road system, with fewer than 100 miles of paved roads, consists mostly of dirt tracks suitable only for four-wheel-drive vehicles.The Peace Corps Welcomes You to Vanuatu.
(1/2098) The cost effectiveness of strategies for the treatment of intestinal parasites in immigrants.
BACKGROUND: Currently, more than 600,000 immigrants enter the United States each year from countries where intestinal parasites are endemic. At entry persons with parasitic infections may be asymptomatic, and stool examinations are not a sensitive method of screening for parasitosis. Albendazole is a new, broad-spectrum antiparasitic drug, which was approved recently by the Food and Drug Administration. International trials have shown albendazole to be safe and effective in eradicating many parasites. In the United States there is now disagreement about whether to screen all immigrants for parasites, treat all immigrants presumptively, or do nothing unless they have symptoms. METHODS: We compared the costs and benefits of no preventive intervention (watchful waiting) with those of universal screening or presumptive treatment with 400 mg of albendazole per day for five days. Those at risk were defined as immigrants to the United States from Asia, the Middle East, sub-Saharan Africa, Eastern Europe, and Latin America and the Caribbean. Cost effectiveness was expressed both in terms of the cost of treatment per disability-adjusted life-year (DALY) averted (one DALY is defined as the loss of one year of healthy life to disease) and in terms of the cost per hospitalization averted. RESULTS: As compared with watchful waiting, presumptive treatment of all immigrants at risk for parasitosis would avert at least 870 DALYs, prevent at least 33 deaths and 374 hospitalizations, and save at least $4.2 million per year. As compared with watchful waiting, screening would cost $159,236 per DALY averted. CONCLUSIONS: Presumptive administration of albendazole to all immigrants at risk for parasitosis would save lives and money. Universal screening, with treatment of persons with positive stool examinations, would save lives but is less cost effective than presumptive treatment. (+info)
(2/2098) An interactive videodisc program for low back pain patients.
Decisions about back pain treatment are often made in the presence of both physician and patient uncertainty. Therefore, we developed a computerized, interactive video program to help patients make informed decisions about undergoing low back surgery. Program development was guided by the shared decision-making model, a comprehensive literature synthesis, information from administrative databases, and focus groups of patients and physicians. Core segments are tailored to each patient's age and diagnosis; and include a narrative, excerpts from patient interviews, animated graphics illustrating spinal anatomy, and tabular summaries of the benefits and risks of both surgical and non-surgical treatment. As part of a multifocal information dissemination effort, interactive videodiscs were placed in five medical facilities in two Washington State counties. Patients (N = 239) who viewed the video program completed short evaluation forms. The majority rated the video's understandability (84%) and interest (64%) as very good or excellent. Most patients felt the amount of information provided was appropriate (75%) and over half (56%) believed the discussion of surgical versus non-surgical treatment was completely balanced. Fewer patients (17%) remained undecided about therapy after watching the program than before (29%). We conclude that interactive videodisc technology offers substantial promise as a means of involving patients in their own medical decision making. (+info)
(3/2098) Strategy and cost in investigating solitary pulmonary nodules.
OBJECTIVE: To compare the probability of cancer in a solitary pulmonary nodule using standard criteria with Bayesian analysis and result of 2-[F-18] fluoro-2-deoxy-D-glucose-positron emission tomographic (FDG-PET) scan. SETTING: A university hospital and a teaching Veteran Affairs Medical Center. METHODS: Retrospective analysis of 52 patients who had undergone both CT scan of the chest and a FDG-PET scan for evaluation of a solitary pulmonary nodule. FDG-PET scan was classified as abnormal or normal. Utilizing Bayesian analysis, the probability of cancer using "standard criteria" available in the literature, based on patient's age, history of previous malignancy, smoking history, size and edge of nodule, and presence or absence of calcification were calculated and compared to the probability of cancer based on an abnormal or normal FDG-PET scan. Histologic study of the nodules was the gold standard. RESULTS: The likelihood ratios for malignancy in a solitary pulmonary nodule with an abnormal FDG-PET scan was 7.11 (95% confidence interval [CI], 6.36 to 7.96), suggesting a high probability for malignancy, and 0.06 (95% CI, 0.05 to 0.07) when the PET scan was normal, suggesting a high probability for benign nodule. FDG-PET scan as a single test alone was more accurate than the standard criteria and standard criteria plus PET scan in correctly classifying nodules as malignant or benign. CONCLUSION: FDG-PET scan as a single test was a better predictor of malignancy in solitary pulmonary nodules than the standard criteria using Bayesian analysis. FDG-PET scan can be a useful adjunct test in the evaluation of solitary pulmonary nodules. (+info)
(4/2098) Financial and organizational determinants of hospital diversification into subacute care.
OBJECTIVE: To examine the financial, market, and organizational determinants of hospital diversification into subacute inpatient care by acute care hospitals in order to guide hospital managers in undertaking such diversification efforts. STUDY SETTING: All nongovernment, general, acute care, community hospitals that were operating during the years 1985 through 1991 (3,986 hospitals in total). DATA SOURCES: Cross-sectional, time-series data were drawn from the American Hospital Association's (AHA) Annual Survey of Hospitals, the Health Care Financing Administration's (HCFA) Medicare Cost Reports, a latitude and longitude listing for all community hospital addresses, and the Area Resource File (ARF) published in 1992, which provides county level environmental variables. STUDY DESIGN: The study is longitudinal, enabling the specification of temporal patterns in conversion, causal inferences, and the treatment of right-censoring problems. The unit of analysis is the individual hospital. KEY FINDINGS: Significant differences were found in the average level of subacute care offered by investor-owned versus tax-exempt hospitals. After controlling for selection bias, financial performance, risk, size, occupancy, and other variables, IO hospitals offered 31.3 percent less subacute care than did NFP hospitals. Financial performance and risk are predictors of IO hospitals' diversification into subacute care, but not of NFP hospitals' activities in this market. Resource availability appears to expedite expansion into subacute care for both types of hospitals. CONCLUSIONS: Investment criteria and strategy differ between investor-owned and tax-exempt hospitals. (+info)
(5/2098) Evaluating the sale of a nonprofit health system to a for-profit hospital management company: the Legacy Experience.
OBJECTIVE: To introduce and develop a decision model that can be used by the leadership of nonprofit healthcare organizations to assist them in evaluating whether selling to a for-profit organization is in their community's best interest. STUDY SETTING/DATA SOURCES: A case study of the planning process and decision model that Legacy Health System used to evaluate whether to sell to a for-profit hospital management company and use the proceeds of the sale to establish a community health foundation. Data sources included financial statements of benchmark organizations, internal company records, and numerous existing studies. STUDY DESIGN: The development of the multivariate model was based on insight gathered through a review of the current literature regarding the conversion of nonprofit healthcare organizations. DATA COLLECTION/EXTRACTION METHODS: The effect that conversion from nonprofit to for-profit status would have on each variable was estimated based on assumptions drawn from the current literature and on an analysis of Legacy and for-profit hospital company data. PRINCIPAL FINDINGS: The results of the decision model calculations indicate that the sale of Legacy to a for-profit firm and the subsequent creation of a community foundation would have a negative effect on the local community. CONCLUSIONS: The use of the decision model enabled senior management and trustees to systematically address the conversion question and to conclude that continuing to operate as a nonprofit organization would provide the most benefit to the local community. The model will prove useful to organizations that decide to sell to a for-profit organization as well as those that choose to continue nonprofit operations. For those that decide to sell, the model will assist in minimizing any potential negative effect that conversion may have on the community. The model will help those who choose not to sell to develop a better understanding of the organization's value to the community. (+info)
(6/2098) Cost comparison of predictive genetic testing versus conventional clinical screening for familial adenomatous polyposis.
BACKGROUND: Mutations of the APC gene cause familial adenomatous polyposis (FAP), a hereditary colorectal cancer predisposition syndrome. AIMS: To conduct a cost comparison analysis of predictive genetic testing versus conventional clinical screening for individuals at risk of inheriting FAP, using the perspective of a third party payer. METHODS: All direct health care costs for both screening strategies were measured according to time and motion, and the expected costs evaluated using a decision analysis model. RESULTS: The baseline analysis predicted that screening a prototype FAP family would cost $4975/ pound3109 by molecular testing and $8031/ pound5019 by clinical screening strategy, when family members were monitored with the same frequency of clinical surveillance (every two to three years). Sensitivity analyses revealed that the genetic testing approach is cost saving for key variables including the kindred size, the age of screening onset, and the cost of mutation identification in a proband. However, if the APC mutation carriers were monitored at an increased (annual) frequency, the cost of the genetic screening strategy increased to $7483/ pound4677 and was especially sensitive to variability in age of onset of screening, family size, and cost of genetic testing of at risk relatives. CONCLUSIONS: In FAP kindreds, a predictive genetic testing strategy costs less than conventional clinical screening, provided that the frequency of surveillance is identical using either strategy. An additional significant benefit is the elimination of unnecessary colonic examinations for those family members found to be non-carriers. (+info)
(7/2098) Is axillary lymph node dissection indicated for early-stage breast cancer? A decision analysis.
PURPOSE: Axillary lymph node dissection (ALND) has been a standard procedure in the management of breast cancer. In a patient with a clinically negative axilla, ALND is performed primarily for staging purposes, to guide adjuvant treatment. Recently, the routine use of ALND has been questioned because the results of the procedure may not change the choice of adjuvant systemic therapy and/or the survival benefit of a change in adjuvant therapy would be small. We constructed a decision model to quantify the benefits of ALND for patients eligible for breast-conserving therapy. METHODS: Patients were grouped by age, tumor size, and estrogen receptor (ER) status. The model uses the Oxford overviews and three combined Cancer and Leukemia Group B studies. We assumed that patients who did not undergo ALND received axillary radiation therapy and that the two procedures are equally effective. All chemotherapy combinations were assumed to be equally efficacious. RESULTS: The largest benefits from ALND are seen in ER-positive women with small primary tumors who might not be candidates for adjuvant chemotherapy if their lymph nodes test negative. Virtually no benefit results in ER-negative women, almost all of whom would receive adjuvant chemotherapy. When adjusted for quality of life (QOL), ALND may have an overall negative impact. In general, the benefits of ALND increase with the expected severity of adjuvant therapy on QOL CONCLUSION: Our model quantifies the benefits of ALND and assists decision making by patients and physicians. The results suggest that the routine use of ALND in breast cancer patients should be reassessed and may not be necessary in many patients. (+info)
(8/2098) Determining the cost of gastroesophageal reflux disease: a decision analytic model.
OBJECTIVE: To design a decision analytic model to help determine the costs associated with various treatment regimens for gastroesophageal reflux disease (GERD). STUDY DESIGN: A decision analytic model incorporating Markov processes was developed to calculate clinical and direct economic outcomes for patients with GERD after 2 years of treatment. PATIENTS AND METHODS: We used retrospective data in the Markov model to generate clinical and economic outcomes. The primary data sources were the 1993 MarketScan claims database, the 1992 National Hospital Discharge Survey, and the clinical literature. RESULTS: Patients with mild GERD (17.6% of patients) contributed 37.8% of costs, while those with moderate to severe disease (14.4% of patients) contributed 49.9% of costs. The remaining 12.3% of costs was spent on the 68% of patients with non-GERD diagnoses. The class of drugs with the highest acquisition cost--proton pump inhibitors--had the lowest total cost per case. The high level of efficacy of these drugs may explain this result. Sensitivity testing showed no evidence that our model's results depended heavily on any one probability or cost factor. CONCLUSIONS: This model showed that patients with moderate to severe GERD were the most expensive cases to treat and that proton pump inhibitors resulted in the lowest total cost per case. Further testing and manipulation of the model are required to gain a better understanding of the trade-offs involved in different options for GERD management. (+info)