Evaluating the impact of a computerized surveillance algorithm and decision support system on sepsis mortality.

Objective: We created a system using a triad of change management, electronic surveillance, and algorithms to detect sepsis and deliver highly sensitive and specific decision support to the point of care using a mobile application. The investigators hypothesized that this system would result in a reduction in sepsis mortality.

Methods: A before-and-after model was used to study the impact of the interventions on sepsis-related mortality.

Validation of pre-operative patient self-assessment of cardiac risk for non-cardiac surgery: foundations for decision support.

Objectives: To better characterize patient understanding of their risk of cardiac complications from non-cardiac surgery and to develop a patient driven clinical decision support system for preoperative patient risk management.

Methods: A patient-driven preoperative self-assessment decision support tool for perioperative assessment was created. Patient' self-perception of cardiac risk and self-report data for risk factors were compared with gold standard preoperative physician assessment to evaluate agreement.

Social and behavioral history information in public health datasets.

Social and behavioral history is increasingly recognized as integral for understanding important determinants of disease and critical for patient care, research, clinical guidelines, and public health policies. Social and behavioral history information in the public health domain, specifically large public health surveys, has not been well described. In this study, a content analysis was performed and information model constructed and contrasted with clinically-based models for each of three widely used public health surveys: BRFSS (Behavioral Risk Factor Surveillance System), NHANES (National Health and Nutrition Examination Survey), and NHIS (National Health Interview Survey).

A multi-site content analysis of social history information in clinical notes.

Within Electronic Health Records (EHRs), the social history section contains information relevant to social, behavioral, and environmental determinants of health. While social history is playing an increasingly important role in patient care, biomedical research, and public health, little analysis has been done to describe content in the EHR or the adequacy of existing standards for representing this information. In this study, social history sections from 260 clinical notes containing 989 sentences and 1,439 statements were analyzed from three sources.

Is KRAS mutation associated with interval colorectal cancers?

Background: Colorectal cancers diagnosed in the interval after a complete colonoscopy may occur due to rapid tumor growth. Interval colorectal cancers are associated with microsatellite instability (MSI).

Aims: Our aim was to study the association of KRAS mutation with interval colorectal cancers and MSI.