The completeness of electronic medical record data for patients with type 2 diabetes in primary care and its implications for computer modelling of predicted clinical outcomes.

Background: Computer models predicting outcomes among patients with Type 2 Diabetes (T2D) can be used as disease management program evaluation tools. The clinical data required as inputs for these models can include annually updated measurements such as blood pressure and glycated haemoglobin (HbA1c). These data can be extracted from primary care physician office systems but there are concerns about their completeness. Objectives/methods: This study addressed the completeness of routinely collected data extracted from 12 primary care practices in Australia. Data on annual availability of blood pressure, weight, total cholesterol, HDL-cholesterol and HbA1c values for regular patients were extracted in 2103 and analysed for temporal trends over the period 2000 to 2012. An ordinal logistic regression model was used to evaluate associations between patient characteristics and completeness of their records. Primary care practitioners were surveyed to identify barriers to recording data and strategies to improve its completeness. Results: Over the study period completeness of data improved substantially from less than 20% for some parameters up to a level of approximately 80% complete, except for the recording of weight. T2D patients with Ischaemic Heart Disease were more likely to have their blood pressure recorded (OR 1.6, p=0.02). Practitioners’ responses suggest they were not experiencing any major barriers to using their electronic medical record system but did agree with some suggested strategies to improve record completeness. Conclusion: The completeness of routinely collected data suitable for input into computerised predictive models is improving although other dimensions of data quality need to be addressed

Who Cares?: The Official Newsletter of the Student Bar Association

https://scholarship.shu.edu/law_newspapers/1017/thumbnail.jp

Can data extraction from general practitioners’ electronic records be used to predict clinical outcomes for patients with type 2 diabetes?

Background The review of clinical data extraction from electronic records is increasingly being used as a tool to assist general practitioners (GPs) manage their patients in Australia. Type 2 diabetes (T2DM) is a chronic condition cared for primarily in the general practice setting that lends itself to the application of tools in this area.Objective To assess the feasibility of extracting data from a general practice medical record software package to predict clinically significant outcomes for patients with T2DM.Methods A pilot study was conducted involving two large practices where routinely collected clinical data were extracted and inputted into the United Kingdom Prospective Diabetes Study Outcomes Model to predict life expectancy. An initial assessment of the completeness of data available was performed and then for those patients aged between 45 and 64 years with adequate data life expectancies estimated.Results A total of 1019 patients were identified as current patients with T2DM. There were sufficient data available on 40% of patients from one practice and 49% from the other to provide inputs into the UKPDS Outcomes Model. Predicted life expectancy was similar across the practices with women having longer life expectancies than men. Improved compliance with current management guidelines for glycaemic, lipid and blood pressure control was demonstrated to increase life expectancy between 1.0 and 2.4 years dependent on gender and age group.Conclusion This pilot demonstrated that clinical data extraction from electronic records is feasible although there are several limitations chiefly caused by the incompleteness of data for patients with T2DM

A new approach to the chronology of caves 268/272/275 in the Dunhuang Mogao Grottoes: combining radiocarbon dates and archaeological information within a Bayesian statistical framework

The construction chronology of three of the earliest Dunhuang Mogao Grottoes (Caves 268, 272, and 275) has been the subject of ongoing debate for over half a century. This chronology is a crucial topic in terms of further understanding of the establishment of the Dunhuang Mogao Grottoes, early Buddhism in the Gansu corridor, and its relationship with Buddhism developed in the Central Plains. Building upon archaeological, art historical and radiocarbon (14C) dating studies, we integrate new 14C data with these previously published findings utilizing Bayesian statistical modeling to improve the chronological resolution of this issue. Thus, we determine that all three of these caves were constructed around AD 410–440, suggesting coeval rather than sequential construction

Utilizing staff training methods for developing a mathetics error correction procedure in a university classroom.

The education community agrees that correcting student errors is important for learning. They do not agree on the components that define successful error correcting. Some theories suggest that detailed feedback facilitates adult learning and some suggest that less detail is needed for these learners. Gilbert (1962) applied the scientifically derived methods of Behavior Analysis when designing instruction. This study attempted to develop an efficient error correction procedure for university teachers. Throughout the semester, error correction design efforts between the teachers and the experimenter became more collaborative. While error correction procedures never showed systematic effects on student grades, later versions were viewed more favorably by both teachers and students and were more likely to be implemented accurately. Decreased teacher practice opportunities, due to low student participation, may have decreased the procedure's effectiveness

Intellectual engagement and cognitive ability in later life (the "use it or lose it" conjecture) : Longitudinal, prospective study

Data sharing: All data are available by application to the Aberdeen Birth Cohort steering group (https://www.abdn.ac.uk/birth-cohorts/1921/for-researchers/).Peer reviewedPublisher PD

Three thousand years of wild capuchin stone tool use

The human archaeological record changes over time. Finding such change in other animals requires similar evidence, namely, a long-term sequence of material culture. Here, we apply archaeological excavation, dating and analytical techniques to a wild capuchin monkey (Sapajus libidinosus) site in Serra da Capivara National Park, Brazil. We identify monkey stone tools between 2,400 and 3,000 years old and, on the basis of metric and damage patterns, demonstrate that capuchin food processing changed between ~2,400 and 300 years ago, and between ~100 years ago and the present day. We present the first example of long-term tool-use variation outside of the human lineage, and discuss possible mechanisms of extended behavioural change

Testing the effectiveness of protocols for removal of common conservation treatments for radiocarbon dating

To achieve a reliable radiocarbon date for an object, any contamination that may be of a different age must be removed prior to dating. Samples that have been conserved with treatments such as adhesives, varnishes or consolidants can pose a particular challenge to radiocarbon dating. At the Oxford Radiocarbon Accelerator Unit (ORAU), common examples of such substances encountered include shellac, the acrylic polymers Paraloid B-67 and B-72, and vinyl acetate-derived polymers (e.g. ‘PVA’). Here, a non-carbon containing absorbent substrate called Chromosorb® was deliberately contaminated with a range of varieties or brands of these conservation treatments, as well as two cellulose nitrate lacquers. A selection of chemical pretreatments was tested for their efficiency at removing them. While the varieties of shellac and Paraloid tested were completely removed with some treatments (water/methanol and acetone/methanol/chloroform sequential washes, respectively), no method was found that was capable of completely removing any of the vinyl acetate-derived materials or the cellulose nitrate lacquers. While Chromosorb is not an exact analogue of archaeological wood or bone, for example, this study suggests that it may be possible to remove aged shellac and Paraloid from archaeological specimens with standard organic-solvent-acid-base-acid pretreatments, but it may be significantly more difficult to remove vinyl acetate-derived polymers and cellulose nitrate lacquers sufficiently to provide reliable radiocarbon dates. The four categories of conservation treatment studied demonstrate characteristic FTIR spectra, while highlighting subtle chemical and molecular differences between different varieties of shellac, Paraloid and cellulose nitrate lacquers, and significant differences between the vinyl acetate derivatives

The New Zealand Kauri (Agathis Australis) Research Project: A Radiocarbon Dating Intercomparison of Younger Dryas Wood and Implications for IntCal13

We describe here the New Zealand kauri (Agathis australis) Younger Dryas (YD) research project, which aims to undertake Δ14C analysis of ~140 decadal floating wood samples spanning the time interval ~13.1–11.7 kyr cal BP. We report 14C intercomparison measurements being undertaken by the carbon dating laboratories at University of Waikato (Wk), University of California at Irvine (UCI), and University of Oxford (OxA). The Wk, UCI, and OxA laboratories show very good agreement with an interlaboratory comparison of 12 successive decadal kauri samples (average offsets from consensus values of –7 to +4 14C yr). A University of Waikato/University of Heidelberg (HD) intercomparison involving measurement of the YD-age Swiss larch tree Ollon505, shows a HD/Wk offset of ~10–20 14C yr (HD younger), and strong evidence that the positioning of the Ollon505 series is incorrect, with a recommendation that the 14C analyses be removed from the IntCal calibration database