Federated electronic health records research technology to support clinical trial protocol optimization: Evidence from EHR4CR and the InSite platform.

Objective: To determine if inclusion/exclusion (I/E) criteria of clinical trial protocols can be represented as structured queries and executed using a secure federated research platform (InSite) on hospital electronic health records (EHR) systems, to estimate the number of potentially eligible patients.

Methods: Twenty-three clinical trial protocols completed during 2011-2017 across diverse disease areas were analyzed to construct queries that were executed with InSite using EHR records from 24 European hospitals containing records of >14 million patients. The number of patients matching I/E criteria of each protocol was estimated.

Audit of acute exacerbations of chronic obstructive pulmonary disease at Waitemata District Health Board, New Zealand.

Aim: To examine management and outcome of patients admitted to Waitemata District Health Board (WDHB) with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and determine performance according to evidence-based guidelines.

Methods: Retrospective chart review of all patients admitted to WDHB hospitals with primary diagnosis of AECOPD during May and October 2010. 195 admissions (156 patients) were audited.

Short-course Combivir after single-dose nevirapine reduces but does not eliminate the emergence of nevirapine resistance in women.

Background: In the Treatment Options Preservation Study (TOPS) trial, 4 or 7 days of Combivir (CBV; zidovudine/lamivudine) with maternal single-dose nevirapine (sdNVP) significantly reduced the emergence of NVP resistance as determined by virus population genotyping. To detect NVP resistance with greater sensitivity, we analysed TOPS samples by allele-specific real-time PCR (ASP).

Methods: In a random subset of women from each arm of the trial, plasma samples from before and 6 weeks after sdNVP were analysed using ASP at codons 103, 181, 184 and 190.

Barriers to accessing specialist care for older people with chronic obstructive pulmonary disease in rural New Zealand.

Introduction: Access to health care for people living in rural areas presents many challenges. For people who live with chronic obstructive pulmonary disease (COPD), the ability to access specialist health services facilitates improved health outcomes, however many barriers to accessing specialist health care have been identified. This paper reports on the challenges people living with COPD in rural New Zealand (NZ) face in accessing specialist health care services.