OntoPharma: ontology based clinical decision support system to reduce medication prescribing errors

Background: Clinical decision support systems (CDSS) have been shown to reduce medication errors. However, they are underused because of different challenges. One approach to improve CDSS is to use ontologies instead of relational databases. The primary aim was to design and develop OntoPharma, an ontology based CDSS to reduce medication prescribing errors. Secondary aim was to implement OntoPharma in a hospital setting. Methods: A four-step process was proposed. (1) Defining the ontology domain. The ontology scope was the medication domain. An advisory board selected four use cases: maximum dosage alert, drug-drug interaction checker, renal failure adjustment, and drug allergy checker. (2) Implementing the ontology in a formal representation. The implementation was conducted by Medical Informatics specialists and Clinical Pharmacists using Protégé-OWL. (3) Developing an ontology-driven alert module. Computerised Physician Order Entry (CPOE) integration was performed through a REST API. SPARQL was used to query ontologies. (4) Implementing OntoPharma in a hospital setting. Alerts generated between July 2020/ November 2021 were analysed. Results: The three ontologies developed included 34,938 classes, 16,672 individuals and 82 properties. The domains addressed by ontologies were identification data of medicinal products, appropriateness drug data, and local concepts from CPOE. When a medication prescribing error is identified an alert is shown. OntoPharma generated 823 alerts in 1046 patients. 401 (48.7%) of them were accepted. Conclusions: OntoPharma is an ontology based CDSS implemented in clinical practice which generates alerts when a prescribing medication error is identified. To gain user acceptance OntoPharma has been designed and developed by a multidisciplinary team. Compared to CDSS based on relational databases, OntoPharma represents medication knowledge in a more intuitive, extensible and maintainable manner

Can the vicious cycle of obscure or intractable gastrointestinal bleeding be broken in patients with atrial fibrillation subject to anticoagulant therapy? The role of percutaneous left atrial appendage closure

Gastrointestinal bleeding of obscure origin or with an intractable cause is particularly common in patients with atrial fibrillation subject to oral anticoagulant therapy. This condition is highly recurrent and therefore gives rise to high morbidity and mortality rates, thus entailing a vicious cycle that is difficult to solve.Percutaneous left atrial appendage closure has become a therapeutic alternative for patients with atrial fibrillation and a contraindication for oral anticoagulation. This technique would allow the discontinuation of oral anticoagulants, thus helping to reduce the risk for gastrointestinal bleeding, and would also be protective against embolic events in this group of patients, thereby eventually breaking this vicious cycle.We report our experience with percutaneous left atrial appendage closure in the management of patients with atrial fibrillation who are subject to oral anticoagulation therapy and suffer from obscure or intractable gastrointestinal bleeding

Medicalized Hotel as an Alternative to Hospital Care for Management of Noncritical COVID-19

Background: Since the first wave of COVID-19, alternatives to conventional hospitalization have been proposed for the provision of different levels of care, ranging from shelter during quarantine to hospital-level medical care. Objective: To describe the adaptation of a hotel by a hospital-at-home team to provide hospital-level care to patients with COVID-19 during the first wave of the pandemic in Barcelona, Spain. Methods: Hospital Clínic de Barcelona (HCB) is a 750-bed, public, tertiary teaching hospital serving 560 000 persons in the metropolitan area of Barcelona, Spain. In March 2020, the hospital-at-home unit was instructed to medicalize a hotel ('health hotel' [HH]) in downtown Barcelona. The aim of this initiative was to help decongest hospitals in the area by admitting patients with low dependency (Barthel Index score >60) and mild to severe COVID-19 from emergency departments or COVID-19 hospital wards, according to Centers for Disease Control and Prevention clinical guideline

Estudio del identificador de celda (Cell ID) en un sistema LTE y análisis de su uso mediante simulaciones

Analitzar mitjançant l'ús de l'eina de software "Atoll" l'ús de Cell-Id.[ANGLÈS] Project that studies the Cell ID, fundamental parameter in the LTE system planning. The study has a theorical base and a practical one that tests the Cell ID effect through 3 scenarios of a LTE network located in Barcelona.[CASTELLÀ] Proyecto que estudia el Cell ID, parámetro fundamental en la planificación del sistema LTE. El estudio se compone de una base teorica i de una practica, en la cual, a traves de 3 escenarios se prueba el efecto que tiene el Cell ID en una red LTE situada en Barcelona.[CATALÀ] Projecte que estudia el Cell ID, paràmetre funamental en la planificació del sistema LTE. L'estudi es compon d'una base teòrica i pràctica en la qual, a través de 3 escenaris, es prova l'efecte que té el Cell ID en una xarxa LTE situada a Barcelona

Estudio del identificador de celda (Cell ID) en un sistema LTE y análisis de su uso mediante simulaciones

Analitzar mitjançant l'ús de l'eina de software "Atoll" l'ús de Cell-Id.[ANGLÈS] Project that studies the Cell ID, fundamental parameter in the LTE system planning. The study has a theorical base and a practical one that tests the Cell ID effect through 3 scenarios of a LTE network located in Barcelona.[CASTELLÀ] Proyecto que estudia el Cell ID, parámetro fundamental en la planificación del sistema LTE. El estudio se compone de una base teorica i de una practica, en la cual, a traves de 3 escenarios se prueba el efecto que tiene el Cell ID en una red LTE situada en Barcelona.[CATALÀ] Projecte que estudia el Cell ID, paràmetre funamental en la planificació del sistema LTE. L'estudi es compon d'una base teòrica i pràctica en la qual, a través de 3 escenaris, es prova l'efecte que té el Cell ID en una xarxa LTE situada a Barcelona

Estudio del identificador de celda (Cell ID) en un sistema LTE y análisis de su uso mediante simulaciones

Analitzar mitjançant l'ús de l'eina de software "Atoll" l'ús de Cell-Id.[ANGLÈS] Project that studies the Cell ID, fundamental parameter in the LTE system planning. The study has a theorical base and a practical one that tests the Cell ID effect through 3 scenarios of a LTE network located in Barcelona.[CASTELLÀ] Proyecto que estudia el Cell ID, parámetro fundamental en la planificación del sistema LTE. El estudio se compone de una base teorica i de una practica, en la cual, a traves de 3 escenarios se prueba el efecto que tiene el Cell ID en una red LTE situada en Barcelona.[CATALÀ] Projecte que estudia el Cell ID, paràmetre funamental en la planificació del sistema LTE. L'estudi es compon d'una base teòrica i pràctica en la qual, a través de 3 escenaris, es prova l'efecte que té el Cell ID en una xarxa LTE situada a Barcelona

Can the vicious cycle of obscure or intractable gastrointestinal bleeding be broken in patients with atrial fibrillation subject to anticoagulant therapy? The role of percutaneous left atrial appendage closure

Gastrointestinal bleeding of obscure origin or with an intractable cause is particularly common in patients with atrial fibrillation subject to oral anticoagulant therapy. This condition is highly recurrent and therefore gives rise to high morbidity and mortality rates, thus entailing a vicious cycle that is difficult to solve.Percutaneous left atrial appendage closure has become a therapeutic alternative for patients with atrial fibrillation and a contraindication for oral anticoagulation. This technique would allow the discontinuation of oral anticoagulants, thus helping to reduce the risk for gastrointestinal bleeding, and would also be protective against embolic events in this group of patients, thereby eventually breaking this vicious cycle.We report our experience with percutaneous left atrial appendage closure in the management of patients with atrial fibrillation who are subject to oral anticoagulation therapy and suffer from obscure or intractable gastrointestinal bleeding