Developing decision support systems in clinical bioinformatics

There is a growing demand for tools to support clinicians utilize genomic results generated by molecular diagnostic and cytogenetic methods in support of their decision-making. This chapter reviews existing experience and methods for the design, implementation and evaluation of clinical bioinformatics electronic decision support systems (EDSS). It provides a roadmap for identifying decision tasks for automation and selecting optimal tools for building task-specific systems. Key success factors for EDSS implementation and evaluation are also outlined.21 page(s

Near-hanging as presenting to hospitals in Queensland: Recommendations for practice

Near-hanging is an increasing presentation to hospitals in Australasia. We reviewed the clinical management and outcome of these patients as they presented to public hospitals in Queensland. A retrospective clinical record audit was made at five public hospitals between 1991 and 2000. Of 161 patients enrolled, 82% were male, 8% were Indigenous and 10% had made a previous hanging attempt. Chronic medical illnesses were documented in 11% and previous psychiatric disorders in 42%. Of the 38 patients with a Glasgow Coma Scale score (GCS) of 3 on arrival at hospital, 32% returned to independent living and 63% died. Fifty two patients received CPR, of whom 46% had an independent functional outcome. Independent predictors of mortality were a GCS on hospital arrival of 3 (AOR 150, CI 95% 12.4-1818,