Even the most extensive hospital information system cannot support all the complex and ever-changing demands associated with a clinical database, such as providing department or personal data forms, and rating scales. Well-designed clinical dialogue programs may facilitate direct interaction of patients with their medical records. Incorporation of extensive and loosely structured clinical data into an existing medical record system is an essential step towards a comprehensive clinical information system, and can best be achieved when the practitioner and the patient directly enter the contents. We have developed a rapid prototyping and clinical conversational system that complements the electronic medical record system, with its generic data structure and standard communication interfaces based on Web technology. We believe our approach can enhance collaboration between consumer-oriented and provider-oriented information systems.
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Otolaryngol Head Neck Surg
January 2025
Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
Objective: Hearing loss (HL) is associated with depression, but existing datasets are limited by the type of data available for both hearing and mental health conditions. The purpose of this study is to determine if there is an association between HL and depressive disorders within a large bi-institutional electronic health record (EHR) system containing more granular diagnostic information.
Study Design: Cross-sectional epidemiologic study.
J Med Virol
February 2025
Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
The determinants of varicella-zoster virus (VZV)-associated central nervous system (CNS) infection have not been fully elucidated. This study aimed to investigate the incidence and risk factors, including immunosuppression, for different manifestations of VZV-associated CNS infection. Patient registers were used to include adults diagnosed with VZV-associated CNS infections between 2010 and 2019 in Sweden.
View Article and Find Full Text PDFBMC Public Health
January 2025
Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
Background: Teenage childbirth is an issue of social and public health concern in Ghana, with high prevalence in some regions, including the Central Region. There is a dire need to understand the experiences of teenagers beyond pregnancies to facilitate comprehensive sexual and reproductive health information and service provision. We explored the postnatal experiences of teenage mothers in five communities in the Central Region of Ghana.
View Article and Find Full Text PDFJMIR Med Inform
January 2025
Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States.
Background: Studies suggest that less than 4% of patients with pulmonary embolisms (PEs) are managed in the outpatient setting. Strong evidence and multiple guidelines support the use of the Pulmonary Embolism Severity Index (PESI) for the identification of acute PE patients appropriate for outpatient management. However, calculating the PESI score can be inconvenient in a busy emergency department (ED).
View Article and Find Full Text PDFJMIR Med Inform
January 2025
School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, United States.
Background: Prediction models have demonstrated a range of applications across medicine, including using electronic health record (EHR) data to identify hospital readmission and mortality risk. Large language models (LLMs) can transform unstructured EHR text into structured features, which can then be integrated into statistical prediction models, ensuring that the results are both clinically meaningful and interpretable.
Objective: This study aims to compare the classification decisions made by clinical experts with those generated by a state-of-the-art LLM, using terms extracted from a large EHR data set of individuals with mental health disorders seen in emergency departments (EDs).
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