A historical narrative review through the field of tocolysis in threatened preterm birth.

Preterm birth presents a significant challenge in clinical obstetrics, requiring effective strategies to reduce associated mortality and morbidity risks. Tocolytic drugs, aimed at inhibiting uterine contractions, are a key aspect of addressing this challenge. Despite extensive research over many years, determining the most effective tocolytic agents remains a complex task, prompting better understanding of the underlying mechanisms of spontaneous preterm birth and recording meaningful outcome measures.

Virtual reality hypnosis for needle-related procedural pain and fear management in children: a non-inferiority randomized trial.

Unlabelled: Needle-related procedures can cause pain and fear in children and may lead to avoidance of future medical care. The aim of this study is to investigate whether virtual reality hypnosis (VRH) is non-inferior to medical hypnosis (MH) by a trained healthcare provider in reducing pain in children. This non-inferiority randomized trial was conducted at a teaching hospital in the Netherlands.

Impact of ethnicity and neighborhood deprivation on preterm birth: How does urban living play a role?

Objective: Women of Black and other non-Western ethnicity and women who live in deprived neighborhoods are at increased risk for preterm birth (PTB). These women may live clustered in certain urban areas. If ethnicity reflects a biological rather than a socioeconomic risk factor, women should have a PTB risk independent of the urban area where they live.

Tocolysis with nifedipine versus atosiban and perinatal outcome: an individual participant data meta-analysis.

Background: Worldwide, nifedipine and atosiban are the two most commonly used tocolytic agents for the treatment of threatened preterm birth. The aim of this study was to evaluate the effectiveness of nifedipine and atosiban in an individual participant data meta-analysis (IPDMA).

Methods: We investigated the occurrence of adverse neonatal outcomes in women with threatened preterm birth by performing an IPDMA, and sought to identify possible subgroups in which one treatment may be preferred.

Tocolysis compared with no tocolysis in women with threatened preterm birth and ruptured membranes: A propensity score analysis.

Introduction: In women with preterm ruptured membranes and contractions, the administration of tocolysis is controversial. This study compares tocolysis with no tocolysis in women with threatened preterm birth and ruptured membranes.

Objective: To compare tocolysis with no tocolysis in women with threatened preterm birth and ruptured membranes.

An Applied Healthcare Data Science Roadmap for Nursing Leaders: A Workshop Development, Conceptualization, and Application.

Nurse leaders working with large volumes of interdisciplinary healthcare data are in need of advanced guidance for conducting analytics to improve population outcomes. This article reports the development of a roadmap to help nursing leaders use data science principles and tools to inform decision-making, thus supporting research and approaches in clinical practice that improve healthcare for all. A consensus-building and iterative process was utilized based on the Cross-Industry Standard Process for Data Mining approach to big data science.

Effects of tocolysis with nifedipine or atosiban on child outcome: follow-up of the APOSTEL III trial.

Objective: To compare the long-term effects of tocolysis with nifedipine or atosiban on child outcome at age 2.5-5.5 years.

Evaluation of Flowsheet Documentation in the Electronic Health Record for Residence, Living Situation, and Living Conditions.

Social determinants of health (SDOH) are important considerations in diagnosis, prevention, and health outcomes. However, they are often not well documented in the EHR and found primarily in unstructured or semi-structured text. Building upon previous work, we analyzed all flowsheet data in 2013 for information related to the SDOH topic areas of Residence, Living Situation, and Living Conditions.

Residence, Living Situation, and Living Conditions Information Documentation in Clinical Practice.

Social determinants of health (SDOH) have an important role in diagnosis, prevention, health outcomes, and quality of life. Currently, SDOH information in electronic health record (EHR) systems is often contained in unstructured text. The objective of this study is to examine an important subset of SDOH documentation for Residence, Living Situation and Living Conditions in an enterprise EHR informed by previous model representations.

[Fibronectin test in threatened preterm labour: cost-saving but not yet widely implemented in the Netherlands].

Objective: Analysis of national implementation of the foetal fibronectin test in the diagnostics of threatened preterm labour in the Netherlands, and indication of the possible obstacles and consequences of implementation or no implementation.

Design: National questionnaire, retrospective cohort study and cost-effectiveness calculation.

Methods: We approached all hospitals in the Netherlands (n = 86) with a questionnaire on use of the fibronectin test.

Patient-Centered Network of Learning Health Systems: Developing a resource for clinical translational research.

Introduction: The Learning Health System Network clinical data research network includes academic medical centers, health-care systems, public health departments, and health plans, and is designed to facilitate outcomes research, pragmatic trials, comparative effectiveness research, and evaluation of population health interventions.

Methods: The Learning Health System Network is 1 of 13 clinical data research networks assembled to create, in partnership with 20 patient-powered research networks, a National Patient-Centered Clinical Research Network.

Results And Conclusions: Herein, we describe the Learning Health System Network as an emerging resource for translational research, providing details on the governance and organizational structure of the network, the key milestones of the current funding period, and challenges and opportunities for collaborative science leveraging the network.

Representing Residence, Living Situation, and Living Conditions: An Evaluation of Terminologies, Standards, Guidelines, and Measures/Surveys.

Social determinants of health play an important role in diagnosis, prevention, health outcomes, and quality of life. The objective of this study was to examine existing standards, vocabularies, and terminologies for items related to Residence, Living Situation, and Living Conditions and to synthesize them into model representations. Sources were identified through literature and keyword searches, and an examination of commonly used resources.

Direct and Electronic Health Record Access to the Clinical Decision Support for Immunizations in the Minnesota Immunization Information System.

Immunization information systems (IIS) are population-based and confidential computerized systems maintained by public health agencies containing individual data on immunizations from participating health care providers. IIS hold comprehensive vaccination histories given across providers and over time. An important aspect to IIS is the clinical decision support for immunizations (CDSi), consisting of vaccine forecasting algorithms to determine needed immunizations.

Towards the Standardized Documentation of E-Cigarette Use in the Electronic Health Record for Population Health Surveillance and Research.

The debate regarding potential negative health effects of electronic nicotine delivery systems (ENDS), which include electronic cigarettes, has received much recent attention. Currently, it is unknown whether ENDS pose a real health risk to users or those passively exposed to their vapor. With the increased use of these devices, the goal of this study was to examine if and how their use is being documented in the electronic health record (EHR) and the associated implications for clinical research.

Multi-source development of an integrated model for family health history.

Objective: To integrate data elements from multiple sources for informing comprehensive and standardized collection of family health history (FHH).

Materials And Methods: Three types of sources were analyzed to identify data elements associated with the collection of FHH. First, clinical notes from multiple resources were annotated for FHH information.

Exploring electronic health records as a population health surveillance tool of cardiovascular disease risk factors.

The objective of this study was to examine the utility of using electronic health record (EHR) data for periodic community health surveillance of cardiovascular disease (CVD) risk factors through 2 research questions. First, how many years of EHR data are needed to produce reliable estimates of key population-level CVD health indicators for a community? Second, how comparable are the EHR estimates relative to those from community screenings? The study takes place in the context of the Heart of New Ulm Project, a 10-year population health initiative designed to reduce myocardial infarctions and CVD risk factor burden in a rural community. The community is served by 1 medical center that includes a clinic and hospital.

Care everywhere, a point-to-point HIE tool: utilization and impact on patient care in the ED.

Background: Emergency departments (EDs) routinely struggle with gaps in information when providing patient care. A point to point health information exchange (HIE) model has the potential to effectively fill those gaps.

Objective: To examine the utility, perceived and actual, of a point-to-point HIE tool called Care Everywhere (CE) and its impact on patient care in the ED.

Automated extraction of family history information from clinical notes.

Despite increased functionality for obtaining family history in a structured format within electronic health record systems, clinical notes often still contain this information. We developed and evaluated an Unstructured Information Management Application (UIMA)-based natural language processing (NLP) module for automated extraction of family history information with functionality for identifying statements, observations (e.g.

Examining the use, contents, and quality of free-text tobacco use documentation in the Electronic Health Record.

Recent initiatives have emphasized the potential role of Electronic Health Record (EHR) systems for improving tobacco use assessment and cessation. In support of these efforts, the goal of the present study was to examine tobacco use documentation in the EHR with an emphasis on free-text. Three coding schemes were developed and applied to analyze 525 tobacco use entries, including structured fields and a free-text comment field, from the social history module of an EHR system to characterize: (1) potential reasons for using free-text, (2) contents within the free-text, and (3) data quality issues.

Reactions of nurses to the use of electronic health record alert features in an inpatient setting.

While studies have been conducted to assess nurse perception of electronic health records, once electronic health record systems are up and running, there is little to guide the use of features within the electronic health record for nursing practice. Alerts are a promising tool for implementing best practice for patient care in inpatient settings. Yet the use of alerts for inpatient nursing is understudied.

Strategies and technical challenges in allele level Class II typing in 2578 bone marrow transplantation donor-recipient pairs.

Human leukocyte antigen typing of 2578 donor-recipient pairs whose transplantation was facilitated by the National Marrow Donor Program allowed for an in-depth analysis of the accuracy of high-volume allele level testing data. The methods employed provided allele level typing at DRB1/3/5, DQA1, DQB1, DPA1, and DPB1 using sequence-specific oligonucleotide probe hybridization (SSOPH), polymerase chain reaction (PCR) restriction fragment length polymorphism analysis, sequence specific PCR, and direct sequence-based typing (SBT). Each typing was independently tested by two laboratories in Phase 1, and in subsequent phases targeted samples were typed in duplicate by SBT to monitor typing quality.

Maintaining updated DNA-based HLA assignments in the National Marrow Donor Program Bone Marrow Registry.

The National Marrow Donor Program (NMDP) has instituted an approach to address the impact of new alleles on the DNA-based HLA assignments obtained during volunteer donor typing. This approach was applied to the DRB typing results from 371,187 donors received from 14 laboratories in 1999. Samples were tested with a standardized set of sequence specific oligonucleotide reagents and the positive and negative hybridization results transmitted electronically to the NMDP.