Disentangling the phenotypic patterns of hypertension and chronic hypotension.

Objective: 2017 blood pressure (BP) categories focus on cardiac risk. We hypothesize that studying the balance between mechanisms that increase or decrease BP across the medical phenome will lead to new insights. We devised a classifier that uses BP measures to assign individuals to mutually exclusive categories centered in the upper (Htn), lower (Hotn) and middle (Naf) zones of the BP spectrum; and examined the epidemiologic and phenotypic patterns of these BP-categories.

Evaluating a Large Language Model's Ability to Answer Clinicians' Requests for Evidence Summaries.

Objective: This study investigated the performance of a generative artificial intelligence (AI) tool using GPT-4 in answering clinical questions in comparison with medical librarians' gold-standard evidence syntheses.

Methods: Questions were extracted from an in-house database of clinical evidence requests previously answered by medical librarians. Questions with multiple parts were subdivided into individual topics.

Using a Natural Language Processing Approach to Support Rapid Knowledge Acquisition.

Implementing artificial intelligence to extract insights from large, real-world clinical data sets can supplement and enhance knowledge management efforts for health sciences research and clinical care. At Vanderbilt University Medical Center (VUMC), the in-house developed Word Cloud natural language processing system extracts coded concepts from patient records in VUMC's electronic health record repository using the Unified Medical Language System terminology. Through this process, the Word Cloud extracts the most prominent concepts found in the clinical documentation of a specific patient or population.

Knowledgebase strategies to aid interpretation of clinical correlation research.

Objective: Knowledgebases are needed to clarify correlations observed in real-world electronic health record (EHR) data. We posit design principles, present a unifying framework, and report a test of concept.

Materials And Methods: We structured a knowledge framework along 3 axes: condition of interest, knowledge source, and taxonomy.

Systematic review of international studies evaluating MDRD and CKD-EPI estimated glomerular filtration rate (eGFR) equations in Black adults.

Use of race adjustment in estimating glomerular filtration rate (eGFR) has been challenged given concerns that it may negatively impact the clinical care of Black patients, as it results in Black patients being systematically assigned higher eGFR values than non-Black patients. We conducted a systematic review to assess how well eGFR, with and without race adjustment, estimates measured GFR (mGFR) in Black adults globally. A search across multiple databases for articles published from 1999 to May 2021 that compared eGFR to mGFR and reported outcomes by Black race was performed.

Using SPI-Hub™ to Promote the Key Role of Prepublishing in Healthcare.

With the need to quickly advance knowledge dissemination in rapid-paced fields, and more recently in response to the urgency of the COVID-19 pandemic, prepublishing has been brought to the forefront. SPI-Hub™, a publicly available journal selection decision support tool, is being strategically enhanced to address prospective authors' critical needs in navigating and selecting the most appropriate preprint or traditional publication venue.

Design and implementation of a massive open online course on enhancing the recruitment of minorities in clinical trials - Faster Together.

Background: Racial and ethnic minorities are often underrepresented in clinical trials, threatening the generalizability of trial results. Several factors may contribute to underrepresentation of minorities in clinical trials, including lack of training for researchers and staff on the importance of diversity in clinical trials and effective strategies for recruiting and retaining minority populations.

Methods: Applying community engaged research principles, we developed a massive open online course (MOOC) to help research team members develop knowledge and skills to enhance the recruitment of minorities in clinical trials.

A narrative review of the impact of the transition to ICD-10 and ICD-10-CM/PCS.

Objectives: The United States transitioned to the tenth version of the International Classification of Diseases (ICD) system (ICD-10) for mortality coding in 1999 and to the International Classification of Diseases, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) on October 1, 2015. The purpose of this study was to conduct a narrative literature review to better understand the impact of the implementation of ICD-10/ICD-10-CM/PCS.

Materials And Methods: We searched English-language articles in PubMed, Web of Science, and Business Source Complete and reviewed websites of relevant professional associations, government agencies, research groups, and ICD-10 news aggregators to identify literature on the impact of the ICD-10/ICD-10-CM/PCS transition.

SPI-Hub™: a gateway to scholarly publishing information.

Background: Advances in the health sciences rely on sharing research and data through publication. As information professionals are often asked to contribute their knowledge to assist clinicians and researchers in selecting journals for publication, the authors recognized an opportunity to build a decision support tool, SPI-Hub: Scholarly Publishing Information Hub™, to capture the team's collective publishing industry knowledge, while carefully retaining the quality of service.

Case Presentation: SPI-Hub's decision support functionality relies on a data framework that describes journal publication policies and practices through a newly designed metadata structure, the Knowledge Management Journal Record™.

Why equating all evidence searches to systematic reviews defies their role in information seeking.

All too often the quality and rigor of topic investigations is inaccurately conveyed to information professionals, resulting in a mischaracterization of the research, which, if left unchecked and published, may in turn mislead potential readers. Accurately understanding and categorizing the types of topic investigation searches that are requested of information professionals is critical to both meeting requestors' needs and reflecting their intended methodological approaches. Information professionals' expertise can be an invaluable resource to guide users through the investigative and publication process.

Collection of social determinants of health in the community clinic setting: a cross-sectional study.

Background: Addressing social and behavioral determinants of health (SBDs) may help improve health outcomes of community clinic patients. This cross-sectional study explored how assessing SBDs can be used to complement health data collection strategies and provide clinicians with a more in-depth understanding of their patients.

Methods: Adult patients, ages 18 and older, at an urban community health care clinic in Tennessee, U.

Internet-Based Assessment of Oncology Health Care Professional Learning Style and Optimization of Materials for Web-Based Learning: Controlled Trial With Concealed Allocation.

Background: Precision medicine has resulted in increasing complexity in the treatment of cancer. Web-based educational materials can help address the needs of oncology health care professionals seeking to understand up-to-date treatment strategies.

Objective: This study aimed to assess learning styles of oncology health care professionals and to determine whether learning style-tailored educational materials lead to enhanced learning.

National Academy of Medicine Social and Behavioral Measures: Associations With Self-Reported Health.

Introduction: Social and behavioral factors play important roles in physical and mental health; however, they are not routinely assessed in the healthcare system. A brief panel of measures of social and behavioral determinants of health (SBDs) were recommended in a National Academy of Medicine report for use in electronic health records. Initial testing of the panel established feasibility of use and robustness of the measures.

Institute of Medicine Measures of Social and Behavioral Determinants of Health: A Feasibility Study.

Introduction: Social and behavioral factors are known to affect health but are not routinely assessed in medical practice. To date, no studies have assessed a parsimonious panel of measures of social and behavioral determinants of health (SBDs). This study evaluated the panel of SBD measures recommended by the Institute of Medicine and examined the effect of question order.

My Cancer Genome: Evaluating an Educational Model to Introduce Patients and Caregivers to Precision Medicine Information.

This study tested an innovative model for creating consumer-level content about precision medicine based on health literacy and learning style principles. "Knowledge pearl" videos, incorporating multiple learning modalities, were created to explain genetic and cancer medicine concepts. Cancer patients and caregivers (n=117) were randomized to view professional-level content directly from the My Cancer Genome (MCG) website (Group A; control), content from MCG with knowledge pearls embedded (Group B), or a consumer translation, targeted at the sixth grade level, with knowledge pearls embedded (Group C).

Guiding Oncology Patients Through the Maze of Precision Medicine.

As the role of genomics in health care grows, patients increasingly require adequate genetic literacy to fully engage in their care. This study investigated a model for delivering consumer-friendly genetic information to improve understanding of precision medicine using health literacy and learning style principles. My Cancer Genome (MCG), a freely available cancer decision support tool, was used as a testbed.

A personalized approach to deliver health care information to diabetic patients in community care clinics.

Objective: The study's purpose was to test the generalizability of an individualized information prescription model, which has been previously validated for educating patients about hypertension in emergency department and community health center settings. Study investigators assessed the effects of educational materials targeted to health literacy levels and learning styles on patients' diabetes knowledge in a community clinic setting.

Methods: From May to August 2012, 160 patients were recruited and randomized into intervention (n = 81) and control (n = 79) groups.

Strategically aligning a mandala of competencies to advance a transformative vision.

Objective: This paper offers insight into the processes that have shaped the Eskind Biomedical Library's (EBL's) strategic direction and its alignment to the institution's transformative vision.

Setting: The academic biomedical library has a notable track record for developing and pioneering roles for information professionals focused on a sophisticated level of information provision that draws from and fuels practice evolutions.

Strategy: The medical center's overall transformative vision informs the creation of a fully aligned library strategic plan designed to effectively contribute to the execution of key organizational goals.

Using health literacy and learning style preferences to optimize the delivery of health information.

Limited patient understanding of hypertension contributes to poor health outcomes. In 2 sequential randomized studies, the authors determined the impact of administering information tailored to health literacy level alone or in combination with preferred learning style on patients' understanding of hypertension. Patients with high blood pressure were recruited in an academic emergency department.

A pilot study to evaluate learning style-tailored information prescriptions for hypertensive emergency department patients.

Objective: This pilot study explored whether learning style-tailored education materials, "information prescriptions," are effective in increasing hypertension knowledge in emergency room patients.

Methods: In a randomized trial, hypertensive emergency medicine patients received either standard care discharge instructions or discharge instructions in combination with an information prescription individualized to each patient's learning-style preference. Two weeks post-visit, the study team assessed changes in hypertension knowledge via a survey.

Integrating best evidence into patient care: a process facilitated by a seamless integration with informatics tools.

The Vanderbilt University paper discusses how the Eskind Biomedical Library at Vanderbilt University Medical Center transitioned from a simplistic approach that linked resources to the institutional electronic medical record system, StarPanel, to a value-added service that is designed to deliver highly relevant information. Clinical teams formulate complex patient-specific questions via an evidence-based medicine literature request basket linked to individual patient records. The paper transitions into discussing how the StarPanel approach acted as a springboard for two additional projects that use highly trained knowledge management librarians with informatics expertise to integrate evidence into both order sets and a patient portal, MyHealth@Vanderbilt.

Exploring clinician adoption of a novel evidence request feature in an electronic medical record system.

Objective: The research evaluated strategies for facilitating physician adoption of an evidence-based medicine literature request feature recently integrated into an existing electronic medical record (EMR) system.

Methods: This prospective study explored use of the service by 137 primary care physicians by using service usage statistics and focus group and survey components. The frequency of physicians' requests for literature via the EMR during a 10-month period was examined to explore the impact of several enhanced communication strategies launched mid-way through the observation period.

A randomized effectiveness trial of a clinical informatics consult service: impact on evidence-based decision-making and knowledge implementation.

Objective: To determine the effectiveness of providing synthesized research evidence to inform patient care practices via an evidence based informatics program, the Clinical Informatics Consult Service (CICS).

Design: Consults were randomly assigned to one of two conditions: CICS Provided, in which clinicians received synthesized information from the biomedical literature addressing the consult question or No CICS Provided, in which no information was provided.

Measurement: Outcomes were measured via online post-consult forms that assessed consult purpose, actual and potential impact, satisfaction, time spent searching, and other variables.