Clinical Research Informatics

This seminar describes programs and resources available through the Biomedical Informatics component of the UMCCTS

Supraclavicularis proprius muscle associated with supraclavicular nerve entrapment

Entrapment neuropathy of the supraclavicular nerve is rare and, when it occurs, is usually attributable to branching of the nerve into narrow bony clavicular canals. We describe another mechanism for entrapment of this nerve with the aberrant muscle; supraclavicularis being found during the routine dissection of an embalmed 82-year-old cadaver. Our report details a unique location for this rare muscular variation whereby the muscle fibres originated posteriorly on the medial aspect of the clavicle before forming a muscular arch over the supraclavicular nerve and passing laterally towards the trapezius and acromion. We recommend that in clinical instances of otherwise unexplained unilateral clavicular pain or tenderness, nerve compression from the supraclavicularis muscle must be borne in mind.

A Systematic Review of Electronic Portal Usage Among Patients with Diabetes

The objectives of this review were (1) to examine characteristics associated with enrollment and utilization of portals among patients with diabetes and (2) to identify barriers and facilitators of electronic patient portal enrollment and utilization. PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were systematically searched for papers reporting original research using quantitative or qualitative methods on characteristics, barriers, and facilitators associated with portal enrollment and utilization among patients with diabetes in the United States. The search was limited to articles published between February 1, 2005 (the date of the national symposium on personal health records) and January 1, 2014. Sixteen articles were identified. Of these, nine were quantitative, three were qualitative, and four used mixed-methods. Several demographic characteristics, having better-controlled diabetes, and providers who engaged in and encouraged portal use were associated with increased portal enrollment and utilization. Barriers to portal enrollment included a lack of patient (1) capacity, (2) desire, and (3) awareness of portal/portal functions. Barriers to portal utilization included (1) patient capacity, (2) lack of provider and patient buy-in to portal benefits, and (3) negative patient experiences using portals. Facilitators of portal enrollment and utilization were providers and family members recommending and engaging in portal use. Improved usability, increased access, educating patients how to use and benefit from portals, and greater endorsement by providers and family members might increase portal enrollment and utilization. As more providers and hospitals offer portals, addressing barriers and leveraging facilitators may help patients with diabetes achieve potential benefits

Identification of Relationships Between Patients Through Elements in a Data Warehouse Using the Familial, Associational, and Incidental Relationship (FAIR) Initiative: A Pilot Study

BACKGROUND: Over the last several years there has been widespread development of medical data warehouses. Current data warehouses focus on individual cases, but lack the ability to identify family members that could be used for dyadic or familial research. Currently, the patient\u27s family history in the medical record is the only documentation we have to understand the health status and social habits of their family members. Identifying familial linkages in a phenotypic data warehouse can be valuable in cohort identification and in beginning to understand the interactions of diseases among families. OBJECTIVE: The goal of the Familial, Associational, and Incidental Relationships (FAIR) initiative is to identify an index set of patients\u27 relationships through elements in a data warehouse. METHODS: Using a test set of 500 children, we measured the sensitivity and specificity of available linkage algorithm identifiers (eg, insurance identification numbers and phone numbers) and validated this tool/algorithm through a manual chart audit. RESULTS: Of all the children, 52.4% (262/500) were male, and the mean age of the cohort was 8 years old (SD 5). Of the children, 51.6% (258/500) were identified as white in race. The identifiers used for FAIR were available for the majority of patients: insurance number (483/500, 96.6%), phone number (500/500, 100%), and address (497/500, 99.4%). When utilizing the FAIR tool and various combinations of identifiers, sensitivity ranged from 15.5% (62/401) to 83.8% (336/401), and specificity from 72% (71/99) to 100% (99/99). The preferred method was matching patients using insurance or phone number, which had a sensitivity of 72.1% (289/401) and a specificity of 94% (93/99). Using the Informatics for Integrating Biology and the Bedside (i2b2) warehouse infrastructure, we have now developed a Web app that facilitates FAIR for any index population. CONCLUSIONS: FAIR is a valuable research and clinical resource that extends the capabilities of existing data warehouses and lays the groundwork for family-based research. FAIR will expedite studies that would otherwise require registry or manual chart abstraction data sources

Familial, Associational, & Incidental Relationships (FAIR)

Identifying familial linkages in a phenotypic data warehouse can be valuable in cohort identification, and beginning to understand interactions of diseases among families. The goal of the Familial, Associational, & Incidental Relationships (FAIR) system is to identify an index set patients’ relationships through elements in a data warehouse. Using a test set of 500 children, we measured the sensitivity and specificity of available linkage algorithm (e.g.: insurance id and phone numbers) and validated this tool/algorithm through a manual chart audit. Sensitivity varied from 16% to 87%, and specificity from 70% to 100% using various combinations of identifiers. Using the “i2b2” warehouse infrastructure, we have now developed a web app that facilitates FAIR for any index population

Effect of immune system stimulation and divergent selection for residual feed intake on digestive capacity of the small intestine in growing pigs

Residual feed intake (RFI) is a measure of feed efficiency that reflects differences in the efficiency of the use of feed for maintenance and growth. The consequences of genetic selection for RFI on intestinal nutrient digestion capacity, particularly during immune system stimulation (ISS), are poorly documented. Our objective was to evaluate the impact of ISS and genetic selection for RFI on apparent ileal digestibility (AID) of nutrients, and intestinal nutrient transport and barrier function

What makes for prize-winning television?

We investigate the determinants of success in four international television awards festivals between 1994 and 2012. We find that countries with larger markets and greater expenditure on public broadcasting tend to win more awards, but that the degree of concentration in the market for television and rates of penetration of pay-per-view television are unrelated to success. These findings are consistent with general industrial organisation literature on quality and market size, and with media policy literature on public service broadcasting acting as a force for quality. However, we also find that ‘home countries’ enjoy a strong advantage in these festivals, which is not consistent with festival success acting as a pure proxy for television quality