Individual Factors That Affect Laypeople's Understanding of Definitions of Medical Jargon.

Objective: Patients have difficulty understanding medical jargon in electronic health record (EHR) notes. Lay definitions can improve patient comprehension, which is the goal of the NoteAid project. We assess whether the NoteAid definitions are understandable to laypeople and whether understandability differs with respect to layperson characteristics.

MedJEx: A Medical Jargon Extraction Model with Wiki's Hyperlink Span and Contextualized Masked Language Model Score.

This paper proposes a new natural language processing (NLP) application for identifying medical jargon terms potentially difficult for patients to comprehend from electronic health record (EHR) notes. We first present a novel and publicly available dataset with expert-annotated medical jargon terms from 18K+ EHR note sentences (). Then, we introduce a novel medical jargon extraction () model which has been shown to outperform existing state-of-the-art NLP models.

Inadequate diversity of information resources searched in US-affiliated systematic reviews and meta-analyses: 2005-2016.

Objective: Systematic reviews and meta-analyses (SRMAs) rely upon comprehensive searches into diverse resources that catalog primary studies. However, since what constitutes a comprehensive search is unclear, we examined trends in databases searched from 2005-2016, surrounding the publication of search guidelines in 2013, and associations between resources searched and evidence of publication bias in SRMAs involving human subjects.

Study Design: To ensure comparability of included SRMAs over the 12 years in the face of a near 100-fold increase of international SRMAs (mainly genetic studies from China) during this period, we focused on USA-affiliated SRMAs, manually reviewing 100 randomly selected SRMAs from those published in each year.

Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE).

The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally.

Clinical and biological moderators of response to naltrexone in alcohol dependence: a systematic review of the evidence.

Aim: The goal of this systematic review was to identify moderators of naltrexone efficacy in the treatment of alcohol dependence.

Methods: We searched Pubmed, CINHAL, Embase, PsycINFO and the Cochrane Library from 1990 to April 2012 and reference lists of pertinent review articles, which yielded 622 trial, pooled analysis and review articles. Using pre-established eligibility criteria, two reviewers independently determined whether abstracts contained evidence of demographic or biological characteristics, i.

User experiences with pharmacy benefit manager data at the point of care.

Objective: MedsInfo-ED is a model health information exchange project for a network of emergency departments (EDs) in the state of Massachusetts. In this initiative, claims data from pharmacy benefit managers (PBMs) were made available at the point of care to clinicians in the EDs. We performed a qualitative assessment of respondents' experiences with MedsInfo-ED.

Modifying ICD-9-CM coding of secondary diagnoses to improve risk-adjustment of inpatient mortality rates.

Objective: To assess the effect on risk-adjustment of inpatient mortality rates of progressively enhancing administrative claims data with clinical data that are increasingly expensive to obtain. Data Sources. Claims and abstracted clinical data on patients hospitalized for 5 medical conditions and 3 surgical procedures at 188 Pennsylvania hospitals from July 2000 through June 2003.

Piloting nursing-sensitive hospital care measures in Massachusetts.

Under the umbrella of the Massachusetts Hospital Association and Massachusetts Organization of Nurse Executives Patients First Initiative, Massachusetts hospitals tested a subset of NQF-endorsed nursing-sensitive care measures in 2006. In this report, we describe the pilot test, report on pilot test measure data, summarize participant feedback on the tested measures, and offer observations on lessons learned from the pilot test.

Combining administrative and clinical data to stratify surgical risk.

Objective: To evaluate whether administrative claims data (ADM) from hospital discharges can be transformed by present-on-admission (POA) codes and readily available clinical data into a refined database that can support valid risk stratification (RS) of surgical outcomes.

Summary Background Data: ADM from hospital discharges have been used for RS of medical and surgical outcomes, but results generally have been viewed with skepticism because of limited clinical information and questionable predictive accuracy.

Methods: We used logistic regression analysis to choose predictor variables for RS of mortality in abdominal aortic aneurysm repair, coronary artery bypass graft surgery, and craniotomy, and for RS of 4 postoperative complications (ie, physiologic/metabolic derangement, respiratory failure, pulmonary embolism/deep vein thrombosis, and sepsis) after selected operations.

Enhancement of claims data to improve risk adjustment of hospital mortality.

Context: Comparisons of risk-adjusted hospital performance often are important components of public reports, pay-for-performance programs, and quality improvement initiatives. Risk-adjustment equations used in these analyses must contain sufficient clinical detail to ensure accurate measurements of hospital quality.

Objective: To assess the effect on risk-adjusted hospital mortality rates of adding present on admission codes and numerical laboratory data to administrative claims data.

The hazards of using administrative data to measure surgical quality.

Administrative claims data have been used to measure risk-adjusted clinical outcomes of hospitalized patients. These data have been criticized because they cannot differentiate risk factors present at the time of admission from complications that occur during hospitalization. This paper illustrates how valid risk-adjustment can be achieved by enhancing administrative data with a present-on-admission code, admission laboratory data, and admission vital signs.

n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review.

Studies on the relation between dietary n-3 fatty acids (FAs) and cardiovascular disease vary in quality, and the results are inconsistent. A systematic review of the literature on the effects of n-3 FAs (consumed as fish or fish oils rich in eicosapentaenoic acid and docosahexaenoic acid or as alpha-linolenic acid) on cardiovascular disease outcomes and adverse events was conducted. Studies from MEDLINE and other sources that were of > or =1 y in duration and that reported estimates of fish or n-3 FA intakes and cardiovascular disease outcomes were included.

A systematic review and meta-analysis of the impact of omega-3 fatty acids on selected arrhythmia outcomes in animal models.

Epidemiological studies and clinical trials report the beneficial effects of fish or fish oil consumption on cardiovascular disease outcomes including sudden death. We performed a systematic review of the literature on controlled animal studies that assessed the effects of omega-3 fatty acids on selected arrhythmia outcomes. On the basis of predetermined criteria, 27 relevant animal studies were identified; 23 of these were feeding studies, and 4 were infusion studies.

Effects of statins on vascular structure and function: a systematic review.

Purpose: Statins reduce cardiovascular events by more than can be explained by their effects on lipids. We conducted a systematic review of how statins affect vascular structure and function, differences among statins, and correlations between the effects of statins on vascular outcomes and either lipid levels or cardiovascular outcomes.

Methods: We primarily searched MEDLINE (1980 to March 2004) to identify all studies with at least 10 subjects that reported the effects of currently available statins on coronary artery stenosis, carotid intima-media thickness, and endothelial function (excluding studies of drug combinations and subjects with organ transplants).

Effects of statins on nonlipid serum markers associated with cardiovascular disease: a systematic review.

Background: Statins reduce cardiovascular events to a greater extent than can be explained by their effect on lipids. Several studies have attempted to elucidate mechanisms by which statins reduce cardiovascular risk.

Purpose: To summarize the effects of statins on nonlipid serum markers and to correlate statins' effect on serum markers with lipid levels and cardiovascular outcomes.

Linking pharmacoeconomic analyses to results of systematic review and meta-analysis.

Pharmacoeconomic analysis applies quantitative modeling to the assessment of the clinical and economic impact of new drugs. Users of pharmacoeconomic analysis include government agencies, government payers and policy makers, private payers (including managed care organizations) and pharmaceutical companies. Pharmacoeconomic analyses can aid policy decisions, provide support for better allocation of scarce resources and assist clinical decisions.