Understanding the evolution of NSAID: a knowledge domain visualization approach to evidence-based medicine

The 9th International Conference on Information Visualization (IV 2005), (London, England, July 6-8, 2005), pp. 945-952. Retrieved 6/21/2006 from http://www.pages.drexel.edu/~cc345/papers/iv2005.pdf.Finding the most rigorous, updated, and well received clinical evidence is a crucial and challenging task in the practice of Evidence-Based Medicine (EBM). In this article, we describe a knowledge domain visualization-based quantitative approach that is designed to support the task of searching for highquality clinical evidence in the medical literature. We illustrate the use of this new approach with the knowledge domain of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). A sample of the literature is visualized in a base map depicting structural and temporal properties of emerging themes and references made by such themes over time. In addition, the visualization highlights the rigorousness of a published clinical trial in terms of the type of study design retrieved dynamically from PubMed. The contribution of this approach is that it offers users an integrated search environment so that the rigorousness, recentness, and consensus of clinical evidence can be assessed with the support of visual exploration facilities

TEACH (Train to Enable/Achieve Culturally Sensitive Healthcare)

Personnel from diverse ethnic and demographic backgrounds come together in both civilian and military healthcare systems, facing diagnoses that at one level are equalizers: coronary disease is coronary disease, breast cancer is breast cancer. Yet the expression of disease in individuals from different backgrounds, individual patient experience of disease as a particular illness, and interactions between patients and providers occurring in any given disease scenario, all vary enormously depending on the fortuity of the equation of "which patient happens to arrive in whose exam room." Previously, providers' absorption of lessons-learned depended on learning as an apprentice would when exposed over time to multiple populations. As a result, and because providers are often thrown into situations where communications falter through inadequate direct patient experience, diversity in medicine remains a training challenge. The questions then become: Can simulation and virtual training environments (VTEs) be deployed to short-track and standardize this sort of random-walk problem? Can we overcome the unevenness of training caused by some providers obtaining the valuable exposure to diverse populations, whereas others are left to "sink or swim"? This paper summarizes developing a computer-based VTE called TEACH (Training to Enable/Achieve Culturally Sensitive Healthcare). TEACH was developed to enhance healthcare providers' skills in delivering culturally sensitive care to African-American women with breast cancer. With an authoring system under development to ensure extensibility, TEACH allows users to role-play in clinical oncology settings with virtual characters who interact on the basis of different combinations of African American sub-cultural beliefs regarding breast cancer. The paper reports on the roll-out and evaluation of the degree to which these interactions allow providers to acquire, practice, and refine culturally appropriate communication skills and to achieve cultural and individual personalization of healthcare in their clinical practices

Clinical Communications - Human Factors For The Hidden Network In Medicine

Medicine is practiced not only through encounters and other interactions between patients and providers, but also through documentation of event-centered information via the patient record, and through patient-centered communications between clinicians and between clinicians and patients (and their families). Human factors has been heavily involved in the first two, contributing to design and evaluation of medical devices, identification and remediation of safety issues, and analysis and modifications to electronic health records and their interface. These same two areas have also received widespread research support and capital investment, while the third - clinical communications - has remained in the background for research, investment and human factors involvement. Yet clinical communication is vitally important. Health care providers communicate with patients directly in encounters, and when the communications fail, patients know it, are unhappy, and disparities in treatment, some systematic, arise (Brach & Fraserirector, 2004). In all but the simplest cases, providers also communicate with each other about the care of patients. These patient-centered communications (PCCs) occur through the hidden network of relationships linking providers with each other and with patients. These PCCs are largely ephemeral, occurring in encounter rooms and via phone calls, pagers, hallway chat, and increasingly, tasking within EHRs. Research has begun to indicate that this mesh of PCCs can have substantial effects on outcomes (Kahn and Angus, 2011). When these PCCs fail, negative outcomes occur, but we know little of what good PCCs look like, or how to encourage or train them. Virtually no PCC data is captured in EHRs or elsewhere. All this points to a fertile but undiscovered country for human factors. This panel brings together four leading researchers with different perspectives on this domain: how clinical communication has evolved with the practice of medicine and communication technology; what we know about and can learn from failures of clinical communications; how leading edge training technology can help clinicians acquire adaptive communication expertise; and how broader issues of teamwork and organization affect and are affected by communication needs. Copyright 2012 by Human Factors and Ergonomics Society, Inc. All rights reserved

Clinical Communications – Human Factors for the Hidden Network In Medicine

Medicine is practiced not only through encounters and other interactions between patients and providers, but also through documentation of event-centered information via the patient record, and through patient-centered communications between clinicians and between clinicians and patients (and their families). Human factors has been heavily involved in the first two, contributing to design and evaluation of medical devices, identification and remediation of safety issues, and analysis and modifications to electronic health records and their interface. These same two areas have also received widespread research support and capital investment, while the third - clinical communications - has remained in the background for research, investment and human factors involvement. Yet clinical communication is vitally important. Health care providers communicate with patients directly in encounters, and when the communications fail, patients know it, are unhappy, and disparities in treatment, some systematic, arise (Brach & Fraserirector, 2004). In all but the simplest cases, providers also communicate with each other about the care of patients. These patient-centered communications (PCCs) occur through the hidden network of relationships linking providers with each other and with patients. These PCCs are largely ephemeral, occurring in encounter rooms and via phone calls, pagers, hallway chat, and increasingly, tasking within EHRs. Research has begun to indicate that this mesh of PCCs can have substantial effects on outcomes (Kahn and Angus, 2011). When these PCCs fail, negative outcomes occur, but we know little of what good PCCs look like, or how to encourage or train them. Virtually no PCC data is captured in EHRs or elsewhere. All this points to a fertile but undiscovered country for human factors. This panel brings together four leading researchers with different perspectives on this domain: how clinical communication has evolved with the practice of medicine and communication technology; what we know about and can learn from failures of clinical communications; how leading edge training technology can help clinicians acquire adaptive communication expertise; and how broader issues of teamwork and organization affect and are affected by communication needs. Copyright 2012 by Human Factors and Ergonomics Society, Inc. All rights reserved