Frequency and Correlates of Pediatric High-Flow Nasal Cannula Use for Bronchiolitis, Asthma, and Pneumonia.

Background: Heated humidified high-flow nasal cannula (HFNC) is a respiratory support device historically used in pediatrics for infants with bronchiolitis. No large-scale analysis has determined the current frequency or demographic distribution of HFNC use in children. The objective of this study was to determine the frequency and correlates of HFNC use in children presenting to the hospital for asthma, bronchiolitis, or pneumonia.

Use, Impact, Weaknesses, and Advanced Features of Search Functions for Clinical Use in Electronic Health Records: A Scoping Review.

Objective: Although vast amounts of patient information are captured in electronic health records (EHRs), effective clinical use of this information is challenging due to inadequate and inefficient access to it at the point of care. The purpose of this study was to conduct a scoping review of the literature on the use of EHR search functions within a single patient's record in clinical settings to characterize the current state of research on the topic and identify areas for future study.

Methods: We conducted a literature search of four databases to identify articles on within-EHR search functions or the use of EHR search function in the context of clinical tasks.

Hybrid collaborative filtering methods for recommending search terms to clinicians.

With increasing and extensive use of electronic health records (EHR), clinicians are often challenged in retrieving relevant patient information efficiently and effectively to arrive at a diagnosis. While using the search function built into an EHR can be more useful than browsing in a voluminous patient record, it is cumbersome and repetitive to search for the same or similar information on similar patients. To address this challenge, there is a critical need to build effective recommender systems that can recommend search terms to clinicians accurately.

Risk Factors for Bleeding and Clinical Ineffectiveness Associated With Clopidogrel Therapy: A Comprehensive Meta-Analysis.

Although clopidogrel is a frequently used antiplatelet medication to treat and prevent atherothrombotic disease, clinicians must balance its clinical effectiveness with the potential side effect of bleeding. However, many previous studies have evaluated beneficial and adverse factors separately. The objective of our study was to perform a comprehensive meta-analysis of studies of clopidogrel's clinical effectiveness and/or risk of bleeding in order to identify and assess all reported risk factors, thus helping clinicians to balance patient safety with drug efficacy.

Three-Component Mixture Model-Based Adverse Drug Event Signal Detection for the Adverse Event Reporting System.

The US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) is an important source for detecting adverse drug event (ADE) signals. In this article, we propose a three-component mixture model (3CMM) for FAERS signal detection. In 3CMM, a drug-ADE pair is assumed to have either a zero relative risk (RR), or a background RR (mean RR = 1), or an increased RR (mean RR >1).

A comprehensive review and meta-analysis of risk factors for statin-induced myopathy.

Purpose: To aid prescribers in assessing a patient's risk for statin-induced myopathy (SIM), we performed a comprehensive review of currently known risk factors and calculated aggregated odds ratios for each risk factor through a meta-analysis.

Methods: This meta-analysis was done through four phases: (1) Identification of the relevant primary literature; (2) abstract screening using inclusion and exclusion criteria; (3) detailed review and data extraction; and (4) synthesis and statistical analysis.

Results: Out of 44 papers analyzed from 836 papers searched from MEDLINE, 18 different potential risk factors were collected, divided into three categories: three demographics (11 papers), ten clinical factors (31 papers), and five pharmacogenetics/biomarkers (12 papers).

Categorizing Health Outcomes and Efficacy of mHealth Apps for Persons With Cognitive Impairment: A Systematic Review.

Background: Use of mobile health (mHealth) apps is growing at an exponential rate in the United States and around the world. Mild cognitive impairment (MCI), Alzheimer disease, and related dementias are a global health problem. Numerous mHealth interventions exist for this population, yet the effect of these interventions on health has not been systematically described.

A prototype mobile application for triaging dental emergencies.

Background: Evidence suggests that dental emergencies are likely to occur when preferred care is less accessible. Communication barriers often exist that cause patients to receive suboptimal treatment or experience discomfort for extended lengths of time. Furthermore, limitations in the conventional approach for managing dental emergencies prevent dentists from receiving critical information before patient visits.

Finding collaborators: toward interactive discovery tools for research network systems.

Background: Research networking systems hold great promise for helping biomedical scientists identify collaborators with the expertise needed to build interdisciplinary teams. Although efforts to date have focused primarily on collecting and aggregating information, less attention has been paid to the design of end-user tools for using these collections to identify collaborators. To be effective, collaborator search tools must provide researchers with easy access to information relevant to their collaboration needs.

Advancing cognitive engineering methods to support user interface design for electronic health records.

Background: Despite many decades of research on the effective development of clinical systems in medicine, the adoption of health information technology to improve patient care continues to be slow, especially in ambulatory settings. This applies to dentistry as well, a primary care discipline with approximately 137,000 practitioners in the United States. A critical reason for slow adoption is the poor usability of clinical systems, which makes it difficult for providers to navigate through the information and obtain an integrated view of patient data.

Integrating tobacco dependence counseling into electronic dental records: a multi-method approach.

Dentistry has historically seen tobacco dependence as a medical problem. As a consequence, dentistry has not adopted or developed effective interventions to deal with tobacco dependence. With the expanded use of electronic dental records, the authors identified an opportunity to incorporate standardized expert support for tobacco dependence counseling during the dental visit.

An ontology-based method for secondary use of electronic dental record data.

A key question for healthcare is how to operationalize the vision of the Learning Healthcare System, in which electronic health record data become a continuous information source for quality assurance and research. This project presents an initial, ontology-based, method for secondary use of electronic dental record (EDR) data. We defined a set of dental clinical research questions; constructed the Oral Health and Disease Ontology (OHD); analyzed data from a commercial EDR database; and created a knowledge base, with the OHD used to represent clinical data about 4,500 patients from a single dental practice.

Computer-assisted guidance for dental office tobacco-cessation counseling: a randomized controlled trial.

Background: Decreases in smoking prevalence from recent decades have slowed, and national goals to reduce tobacco use remain unmet. Healthcare providers, including those in physician and dental teams, have access to evidence-based guidelines to help patients quit smoking. Translation of those guidelines into practice, however, remains low.

From information technology to informatics: the information revolution in dental education.

The capabilities of information technology (IT) have advanced precipitously in the last fifty years. Many of these advances have enabled new and beneficial applications of IT in dental education. However, conceptually, IT use in dental schools is only in its infancy.

Supporting emerging disciplines with e-communities: needs and benefits.

Background: Science has developed from a solitary pursuit into a team-based collaborative activity and, more recently, into a multidisciplinary research enterprise. The increasingly collaborative character of science, mandated by complex research questions and problems that require many competencies, requires that researchers lower the barriers to the creation of collaborative networks of experts, such as communities of practice (CoPs).

Objectives: The aim was to assess the information needs of prospective members of a CoP in an emerging field, dental informatics, and to evaluate their expectations of an e-community in order to design a suitable electronic infrastructure.

The feasibility of a three-dimensional charting interface for general dentistry.

Background: Most current paper- and computer-based formats for patient documentation use a two-dimensional dental chart, a design that originated almost 150 years ago in the United States. No studies have investigated the inclusion of a three-dimensional (3-D) charting interface in a general dental record.

Methods: A multidisciplinary research team with expertise in human-computer interaction, dental informatics and computer science conducted a 14-week project to develop and evaluate a proof of concept for a 3-D dental record.

Heuristic evaluation of clinical functions in four practice management systems: a pilot study.

Background: Dentists report that the complexity and poor usability of practice management systems (PMSs) are factors in the slow adoption of computers at chairside.

Methods: Three dental informatics researchers performed heuristic evaluations of four PMSs to identify potential usability problems that may be encountered during the clinical care process. Each researcher performed three common clinical documentation tasks on each PMS and examined the clinical user interface of each system using a published list of 10 software heuristics.

Clinical computing in general dentistry.

Objective: Measure the adoption and utilization of, opinions about, and attitudes toward clinical computing among general dentists in the United States.

Design: Telephone survey of a random sample of 256 general dentists in active practice in the United States.

Measurements: A 39-item telephone interview measuring practice characteristics and information technology infrastructure; clinical information storage; data entry and access; attitudes toward and opinions about clinical computing (features of practice management systems, barriers, advantages, disadvantages, and potential improvements); clinical Internet use; and attitudes toward the National Health Information Infrastructure.

Comparative case study of two biomedical research collaboratories.

Background: Working together efficiently and effectively presents a significant challenge in large-scale, complex, interdisciplinary research projects. Collaboratories are a nascent method to help meet this challenge. However, formal collaboratories in biomedical research centers are the exception rather than the rule.

Continuing dental education requirements for relicensure in the United States.

Background: Mandatory continuing education (CE) is an almost universal requirement for relicensure of dentists in the United States. In recent years, computer-based methods have become more widely adopted as a vehicle for earning CE credits. To obtain a comprehensive overview of CE requirements in the United States, the authors conducted a survey on how computer-based CE methods are regulated.

Should dentistry be part of the National Health Information Infrastructure?

Background: The National Health Information Infrastructure, or NHII, proposes to improve the effectiveness, efficiency and overall quality of health in the United States by establishing a national, electronic information network for health care. To date, dentistry's integration into this network has not been discussed widely.

Methods: The author reviews the NHII and its goals and structure through published reports and background literature.

Why integration is key for dental office technology.

Background: Information technology, or IT, devices and applications for dental practice have multiplied tremendously during the last two decades. While many of these innovations can bring significant benefits to clinical practice, integrating them into a smooth working environment is a significant challenge.

Methods: The author reviewed the level of integration of different IT-related products for dental practice and analyzed the consequences for work flow and ergonomics.