Clinical Data Entry & Protocol Tracking System

CLINICAL DATA ENTRY & PROTOCOL TRACKING SYSTEM (CDEPT) is a software framework designed to provide the tools necessary to rapidly develop web based data entry and data management systems for clinical trails and medical research studies. A software framework defines a model, approach, procedures and tools for creating new protocols for clinical studies. As a framework this software is able to gain efficiency by providing standard approaches and tools for commonly needed capabilities such as construction of data entry routines, validation of data, audit trails and monitoring the completeness and timeliness of data collection. However, as a framework this software provides far greater flexibility, expandability and customization than is typical in a turnkey or off the shelf application. CDEPT is designed around a three-tiered software development model widely used on Internet. This model consists of browsers, web server and database servers. This software is mostly designed to run on two major browsers Internet Explorer and Netscape

Utilizing RxNorm to Support Practical Computing Applications: Capturing Medication History in Live Electronic Health Records

RxNorm was utilized as the basis for direct-capture of medication history data in a live EHR system deployed in a large, multi-state outpatient behavioral healthcare provider in the United States serving over 75,000 distinct patients each year across 130 clinical locations. This tool incorporated auto-complete search functionality for medications and proper dosage identification assistance. The overarching goal was to understand if and how standardized terminologies like RxNorm can be used to support practical computing applications in live EHR systems. We describe the stages of implementation, approaches used to adapt RxNorm's data structure for the intended EHR application, and the challenges faced. We evaluate the implementation using a four-factor framework addressing flexibility, speed, data integrity, and medication coverage. RxNorm proved to be functional for the intended application, given appropriate adaptations to address high-speed input/output (I/O) requirements of a live EHR and the flexibility required for data entry in multiple potential clinical scenarios. Future research around search optimization for medication entry, user profiling, and linking RxNorm to drug classification schemes holds great potential for improving the user experience and utility of medication data in EHRs.Comment: Appendix (including SQL/DDL Code) available by author request. Keywords: RxNorm; Electronic Health Record; Medication History; Interoperability; Unified Medical Language System; Search Optimizatio

Diabetes mellitus and pulmonary tuberculosis, association or co-incidence?

Objectives: To evaluate the effect of Diabetes Mellitus (DM) on clinical and diagnostic methods and radiological features of pulmonary TB, in comparison to non diabetic pulmonary TB patients, in Golestan province, Northeast of Iran. Methodology: In this retrospective cross-sectional study during 2004-2008, medical records of patients with definite diagnosis of pulmonary TB were reviewed. Demographic data, clinical & diagnostic method and radiological findings were studied. Radiological data and lung High Resolution computed tomographic scan (lung HRCT) were done by two different radiologists. After data entry into SPSS-16, Fischer's exact test and chi-square test were used to compare the two groups (TB with DM & without it). P-value 0.05). Multilobar cavities were significantly more reported in diabetics (p-value = 0.014). No statistical differences were seen between two groups radiologically. Conclusion: Tuberculosis could be more invasive in diabetic patients especially females hence they should be given more attention

Long-term outcomes of transobturator tension-free vaginal tapes as secondary continence procedures

Acknowledgements We thank Dr. Karmakar (Research Fellow— University of Aberdeen) for sending out the questionnaires and collating the responses. We thank Lindsey Grant for performing the independent data entry cross-check. A special gratitude goes to all the participants whose excellent cooperation over the years made this study successful. Funding The initial phase of this study (up to 3-year follow-up) was funded by the Henry Smith Charity. Dr. Karmakar was funded by IUGA Clinical Fellowship Grant 2014.Peer reviewedPostprin

Comparing Speed of Provider Data Entry: Electronic Versus Paper Methods

Electronic health record (EHR) systems have significant potential advantages over traditional paper-based systems, but they require that providers assume responsibility for data entry. One significant barrier to adoption of EHRs is the perception of slowed data-entry by providers. This study compares the speed of data-entry using computer-based templates vs. paper for a large eye clinic, using 10 subjects and 10 simulated clinical scenarios. Dataentry into the EHR was significantly slower (p<0.01) than traditional paper forms

Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process

Comparing Speed of Provider Data Entry: Electronic Versus Paper Methods

Electronic health record (EHR) systems have significant potential advantages over traditional paper-based systems, but they require that providers assume responsibility for data entry. One significant barrier to adoption of EHRs is the perception of slowed data-entry by providers. This study compares the speed of data-entry using computer-based templates vs. paper for a large eye clinic, using 10 subjects and 10 simulated clinical scenarios. Dataentry into the EHR was significantly slower (p<0.01) than traditional paper forms

Is OpenSDE an alternative for dedicated medical research databases? An example in coronary surgery

Background. When using a conventional relational database approach to collect and query data in the context of specific clinical studies, a study with a new data set usually requires the design of a new database and entry forms. OpenSDE (SDE = Structured Data Entry) is intended to provide a flexible and intuitive way to create databases and entry forms for the collection of data in a structured format. This study illustrates the use of OpenSDE as a potential alternative to a conventional approach with respect to data modelling, database creation, data entry, and data extraction. Methods. A database and entry forms are created using OpenSDE and MSAccess to support collection of coronary surgery data, based on the Adult Cardiac Surgery Data Set of the Society of Thoracic Surgeons. Data of 52 cases are entered and nine different queries are designed, and executed on

Clinical Fellowships, Faculty Hiring, and Community Values

This Essay explores clinical hiring practices as an expression of community values. In particular, it discusses how lawyers become clinical faculty to reflect on whether and how prior clinical teaching experience should be assessed for entry-level clinical applicants in order to effectuate equity and inclusion within law schools and the clinical community. Publicly available data suggest that a majority of recent entry-level clinical faculty have prior clinical teaching experience as fellows or staff attorneys. What does this apparent hiring preference for prior teaching experience mean for the composition of the clinical community, especially with respect to equity and inclusion? As many fellowship programs include clinical pedagogical training, should clinical faculty be concerned about prioritizing applicants with prior clinical experience-or view such experience as a valuable factor in an applicant\u27s dossier? If clinical fellows are prioritized in hiring, what does that mean for the clinical community and its values? The Essay concludes with suggestions for specific, concrete steps that law schools and the clinical community can take to promote equity and inclusion in fellowship programs and entry-level hiring

International Guillain-Barré Syndrome Outcome Study (IGOS): protocol of a prospective observational cohort study on clinical and biological predictors of disease course and outcome in Guillain-Barré syndrome

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy with a highly variable clinical presentation, course, and outcome. The factors that determine the clinical variation of GBS are poorly understood which complicates the care and treatment of individual patients. The protocol of the ongoing International GBS Outcome Study (IGOS), a prospective, observational, multi-centre cohort study that aims to identify the clinical and biological determinants and predictors of disease onset, subtype, course and outcome of GBS is presented here. Patients fulfilling the diagnostic criteria for GBS, regardless of age, disease severity, variant forms, or treatment, can participate if included within two weeks after onset of weakness. Information about demography, preceding infections, clinical features, diagnostic findings, treatment, course and outcome is collected. In addition, cerebrospinal fluid and serial blood samples for serum and DNA is collected at standard time points. The original aim was to include at least 1000 patients with a follow-up of 1-3 years. Data are collected via a web-based data entry system and stored anonymously. IGOS started in May 2012 and by January 2017 included more than 1400 participants from 143 active centres in 19 countries across 5 continents. The IGOS data/biobank is available for research projects conducted by expertise groups focusing on specific topics including epidemiology, diagnostic criteria, clinimetrics, electrophysiology, antecedent events, antibodies, genetics, prognostic modelling, treatment effects and long-term outcome of GBS. The IGOS will help to standardize the international collection of data and biosamples for future research of GBS. ClinicalTrials.gov Identifier: NCT01582763