Predicting Patient No-Shows: Situated Machine Learning with Imperfect Data.

Patients who do not show up for scheduled appointments are a considerable cost and concern in healthcare. In this study, we predict patient no-shows for outpatient surgery at the endoscopy ward of a hospital in Denmark. The predictions are made by training machine leaning (ML) models on available data, which have been recorded for purposes other than ML, and by doing situated work in the hospital setting to understand local data practices and fine-tune the models.

[Not Available].

Extrapulmonary tuberculosis (TB) in the gastrointestinal tract is a rare, but yet an essential differential diagnosis to patients with complex fistula disease, since the initiation of immunosuppressive therapy for presumed Crohn's disease can lead to a fulminant course of TB. This case report presents a young Danish woman with a progressive complex fistula disease, where cause and treatment were uncovered by interprofessional collaboration between pulmonologists, gastroenterologists and surgeons including a screening test for TB as well as multiple biopsies from the anal fistula tissue.

Health Professionals' eHealth Literacy and System Experience Before and 3 Months After the Implementation of an Electronic Health Record System: Longitudinal Study.

Background: The implementation of an integrated electronic health record (EHR) system can potentially provide health care providers with support standardization of patient care, pathways, and workflows, as well as provide medical staff with decision support, easier access, and the same interface across features and subsystems. These potentials require an implementation process in which the expectations of the medical staff and the provider of the new system are aligned with respect to the medical staff's knowledge and skills, as well as the interface and performance of the system. Awareness of the medical staff's level of eHealth literacy may be a way of understanding and aligning these expectations and following the progression of the implementation process.

[International experiences with electronic health records in the hospital sector].

Vast amounts of resources have been invested in electronic health records (EHRs) to improve productivity, quality and patient safety. Systematic reviews of the current empirical research into the effects of EHR systems show that the hopes and promises of digitisation are largely unrealised. As pointed out in this review, there are several possible reasons for these disappointing results, including bad systems design, inappropriate configuration, poor organisational implementation and too little focus on complementary innovations.

[Copy and paste in electronic health records].

In this review, the use of copy-paste (CP) in electronic health records is discussed. CP was introduced in the health sector of USA as a means to reduce the time spent on writing clinical notes. However, CP poses risks to patient safety and the quality of documentation.

Differences in the Level of Electronic Health Literacy Between Users and Nonusers of Digital Health Services: An Exploratory Survey of a Group of Medical Outpatients.

Background: Digitalization of health services ensures greater availability of services and improved contact to health professionals. To ensure high user adoption rates, we need to understand the indicators of use and nonuse. Traditionally, these have included classic sociodemographic variables such as age, sex, and educational level.

Whiteboard icons to support the blood-test process in an emergency department: an observational study of temporal patterns.

The competent treatment of emergency department (ED) patients requires an effective and efficient process for handling laboratory tests such as blood tests. This study investigates how ED clinicians go about the process, from ordering blood tests to acknowledging their results and, specifically, assesses the use of whiteboard icons to support this process. On the basis of observation and interviews we find that the blood-test process is intertwined with multiple other temporal patterns in ED work.

[Cholecystic fistula with atypical symptoms].

We report a patient with spontaneous cholecystocolonis fistula secondary to cholelithiasis. A 93 year-old woman was admitted because of weight loss, diarrhoea and upper abdominal pain. Ultrasound examination revealed air in the biliary tract and cholescientigraphy revealed a fistula between the gallbladder and right colon.

Long-term pathologic changes of alpha1-acid glycoprotein (orosomucoid) glycoforms in autoimmune thyroid disease.

Objective: We measured alpha1-acid-glycoprotein (AGP) in patients with autoimmune thyroid disease to study a possible relationship between microheterogeneity of the naturally occurring glycoforms of AGP and autoimmune thyroid disease.

Design, Patients, Measurements: In a group of 12 fasting thyrotoxic patients (11 females, mean age: 43 years) with newly diagnosed Graves' disease (subgroup 1), we measured serum concentrations of total AGP and its 3 glycoforms (micromol/l, crossed affinity immunoelectrophoresis with con A in the first dimension gel) as well as total thyroxine, total triiodothyronine, thyrotropine, thyroid peroxidase antibodies (anti-TPO), antibodies against the TSH receptor (TRAb, TRAK), at baseline and after 12 months of antithyroid drug therapy (ATD). For comparison, 4 subgroups of thyroid patients (patients with Graves' disease and thyroid associated ophthalmopathy (TAO) (subgroup 2, n = 10), radioiodine treated Graves' patients (subgroup 3, n = 7), Graves' patients without TAO (subgroup 4, n = 13), patients with Hashimoto's thyroiditis (subgroup 5, n = 8)) and 25 normal controls (17 females, mean age: 38 years) were studied.

[Exchange of paraclinical information between the primary and secondary health sectors].

Introduction: The purpose of the study was to investigate the extent to which, biochemical test results obtained in the primary health sector could be regarded as valid information in the clinical assessment of patients admitted to hospital.

Methods: The study was based on a questionnaire, which was designed to assess the value of historical biochemical data in the initial diagnostic process. The data was transferred from the laboratory of Copenhagen general practitioners (KPLL) database to a computer terminal in the emergency medical ward at H:S Bispebjerg Hospital.

Review of thyroid cancer cases among patients with previous benign thyroid disorders.

A previous register linkage study showed an increased risk of thyroid cancer among patients previously discharged from a hospital with a diagnosis of a benign thyroid disorder. In this study, we have reviewed all available medical records, first to validate the earlier result and second to describe the symptomatology of patients with a history of benign thyroid disorder prior to the cancer diagnosis. The previous study identified 189 patients with a benign and subsequent malignant thyroid disorder.

Cancer risk in individuals with benign thyroid disorders.

The risk of cancer was examined in a cohort of 57,326 individuals who were discharged from a Danish hospital with a diagnosis of myxedema, thyrotoxicosis, or goiter. Although the general risk of cancer was only slightly increased, the risk of several sites was significantly above expected. The risk of thyroid cancer especially, was increased with standardized incidence ratios among women of 2.

Sarcoidosis with extensive cutaneous ulceration. Unusual clinical presentation.

A 70-year-old white woman with sarcoidosis and insulin-resistant diabetes mellitus presented with extensive cutaneous ulcerations. Both the cutaneous lesions and the systemic features of sarcoidosis showed a dramatic improvement during oral corticosteroid therapy. When extensive cutaneous ulcerations are present, it is important to consider sarcoidosis, as these may be the only presenting sign of the disease.

Nadolol, propranolol, and thyroid hormones: evidence for a membrane-stabilizing action of propranolol.

Ten normal subjects participated in a placebo-controlled, randomized, parallel study to determine the effects on thyroid hormones of chronic (4 wk) propranolol or nadolol, including observation for 2 wk after their discontinuation. Subjects took placebo for 1 wk, then propranolol or nadolol doses increased weekly to 240 mg/day by 3 wk. After 1 wk of placebo, after 2 wk of the highest dose of propranolol or nadolol, and 2, 4, 6, 9, and 13 days after their discontinuation, thyroid hormone levels were measured by radioimmunoassay and heart rate responses to exercise were assessed.

Oncogenic osteomalacia associated with a mesenchymal chondrosarcoma.

A patient with phosphaturic osteomalacia without chemical or pathological evidence of hyperparathyroidism and subnormal urinary cyclic AMP excretion was treated with vitamin D and phosphates for 9 months with partial improvement of osteomalacia, but not phosphaturia. Subsequent removal of a mesenchymal chondrosarcoma of the foot led to prompt resolution of phosphaturia and healing of the osteomalacia. Although 1,25-dihydroxyvitamin D levels were not obtained before vitamin D therapy, the levels noted during continued severe phosphaturia preoperatively were not lower than those obtained several months postoperatively during the healing phase.

Minoxidil in refractory hypertension: benefits, risks.

The blood pressure of 18 patients with refractory hypertension was controlled by treatment with Minoxidil in combination with Propranolol and diuretics. Ten of these patients were studied prospectively and were found not to have deterioration of carbohydrate tolerance while on Minoxidil therapy. Pericardial effusions occurred in 40% of the patients, including 2 with normal renal function.