Browsing by Subject "decision support systems"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    A randomized study on the usefulness of an electronic outpatient hypoglycemia risk calculator for clinicians of patients with diabetes in a safety-net institution
    (Taylor & Francis, 2020) Weiner, Michael; Cummins, Jonathan; Raji, Annaswamy; Ofner, Susan; Iglay, Kristy; Teal, Evgenia; Li, Xiaochun; Engel, Samuel S.; Knapp, Kristina; Rajpathak, Swapnil; Baker, Jarod; Chatterjee, Arnaub K.; Radican, Larry; Medicine, School of Medicine
    Objective: Hypoglycemia (HG) occurs in up to 60% of patients with diabetes mellitus (DM) each year. We assessed a HG alert tool in an electronic health record system, and determined its effect on clinical practice and outcomes. Methods: The tool applied a statistical model, yielding patient-specific information about HG risk. We randomized outpatient primary-care providers (PCPs) to see or not see the alerts. Patients were assigned to study group according to the first PCP seen during four months. We assessed prescriptions, testing, and HG. Variables were compared by multinomial, logistic, or linear model. ClinicalTrials.gov ID: NCT04177147 (registered on 22 November 2019). Results: Patients (N = 3350) visited 123 intervention PCPs; 3395 patients visited 220 control PCPs. Intervention PCPs were shown 18,645 alerts (mean of 152 per PCP). Patients’ mean age was 55 years, with 61% female, 49% black, and 49% Medicaid recipients. Mean baseline A1c and body mass index were similar between groups. During follow-up, the number of A1c and glucose tests, and number of new, refilled, changed, or discontinued insulin prescriptions, were highest for patients with highest risk. Per 100 patients on average, the intervention group had fewer sulfonylurea refills (6 vs. 8; p < .05) and outpatient encounters (470 vs. 502; p < .05), though the change in encounters was not significant. Frequency of HG events was unchanged. Conclusions: Informing PCPs about risk of HG led to fewer sulfonylurea refills and visits. Longer-term studies are needed to assess potential for long-term benefits.
  • Thumbnail Image
    Item
    The state of the art in clinical knowledge management: An inventory of tools and techniques
    (2010-01) Sittig, Dean F.; Wright, Adam; Simonaitis, Linas; Carpenter, James D.; Allen, George O.; Doebbeling, Bradley N.; Sirajuddin, Anwar Mohammad; Ash, Joan S.; Middleton, Blackford
    Purpose To explore the need for, and use of, high-quality, collaborative, clinical knowledge management (CKM) tools and techniques to manage clinical decision support (CDS) content. Methods In order to better understand the current state of the art in CKM, we developed a survey of potential CKM tools and techniques. We conducted an exploratory study by querying a convenience sample of respondents about their use of specific practices in CKM. Results The following tools and techniques should be priorities in organizations interested in developing successful computer-based provider order entry (CPOE) and CDS implementations: (1) a multidisciplinary team responsible for creating and maintaining the clinical content; (2) an external organizational repository of clinical content with web-based viewer that allows anyone in the organization to review it; (3) an online, collaborative, interactive, Internet-based tool to facilitate content development; (4) an enterprise-wide tool to maintain the controlled clinical terminology concepts. Even organizations that have been successfully using computer-based provider order entry with advanced clinical decision support features for well over 15 years are not using all of the CKM tools or practices that we identified. Conclusions If we are to further stimulate progress in the area of clinical decision support, we must continue to develop and refine our understanding and use of advanced CKM capabilities.
  • Thumbnail Image
    Item
    Torque-assisting Compressed Air Energy Storage Hydraulic Wind Drivetrains
    (IEEE, 2016-02) Chen, Moyuan; Santos, Sofia M.; Izadian, Afshin; Department of Engineering Technology, School of Engineering and Technology
    In this paper, Compressed Air Energy Storage (CAES) as a popular technology for wind energy storage, is mathematically integrated with a hydraulic wind power system. Hydraulic machinery as prime-movers is utilized to gain the benefit of eliminating costly and heavy gearboxes. The goal of this work is to improve the power delivery performance while maintaining a stable frequency generation in a 600kW hydraulic wind power system. Simulation results demonstrate that the integration of compressed air energy storage has improved the quality of power delivery such that the maximum power demand can be delivered while maintaining the frequency under variable wind speeds.
  • Thumbnail Image
    Item
    A wireless strain sensor for wound monitoring with direct laser-defined patterning on a commercial dressing
    (IEEE, 2016-01) Rahimi, Rahim; Ochoa, Manuel; Zieger, Michael; Sood, Rajiv; Ziaie, Babak; Department of Surgery, IU School of Medicine
    Controlled mechanical strain or stress on a wound site can promote accelerated neovascularization and cellular proliferation for improved wound healing; however, these mechanical forces have not been properly quantified due to a lack of standardized technique. As a solution, we developed a wireless strain sensor on a commercial wound dressing. The sensor consists of a flexible antenna coil whose resonant frequency changes in response to applied strain. The frequency change of the sensor is observed to be a linear function of applied strain in the range of 0-35%, with an average sensitivity of 150 kHz/%strain and negligible hysteresis. The sensor is fabricated through a simple process that consist of defining a screen-printing mask directly over the wound dressing using laser machining. The fabrication technique can be scaled up for mass production using roll-to-roll methods.