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Accuracy in the recording of pressure ulcers and prevention after implementing an electronic health record in hospital care.

https://arctichealth.org/en/permalink/ahliterature155835
Source
Qual Saf Health Care. 2008 Aug;17(4):281-5
Publication Type
Article
Date
Aug-2008
Author
L. Gunningberg
M Fogelberg Dahm
A. Ehrenberg
Author Affiliation
Surgery Division, Uppsala University Hospital, Uppsala, Sweden. lena.gunningberg@akademiska.se
Source
Qual Saf Health Care. 2008 Aug;17(4):281-5
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Data Collection - methods - standards
Hospitals, University
Humans
Medical Records Systems, Computerized
Pressure Ulcer - epidemiology - prevention & control
Prevalence
Retrospective Studies
Sweden
Abstract
To compare the accuracy in recording of pressure-ulcer prevalence and prevention before and after implementing an electronic health record (EHR) with templates for pressure-ulcer assessment.
All inpatients at the departments of surgery, medicine and geriatrics were inspected for the presence of pressure ulcers, according to the European Pressure Ulcer Advisory Panel-methodology, during 1 day in 2002 (n = 357) and repeated in 2006 (n = 343). The corresponding patient records were audited retrospectively for the presence of documentation on pressure ulcers.
In 2002, the prevalence of pressure ulcers obtained by auditing paper-based patient records (n = 413) was 14.3%, compared with 33.3% in physical inspection (n = 357). The largest difference was seen in the geriatric department, where records revealed 22.9% pressure ulcers and skin inspection 59.3%. Four years later, after the implementation of the EHR, there were 20.7% recorded pressure ulcers and 30.0% found by physical examination of patients. The accuracy of the prevalence data had improved most in the geriatric department, where the EHR showed 48.1% and physical examination 43.2% pressure ulcers. Corresponding figures in the surgical department were 22.2% and 14.1%, and in the medical department 29.9% and 10.2%, respectively. The patients received pressure-reducing equipment to a higher degree (51.6%) than documented in the patient record (7.9%) in 2006.
The accuracy in pressure-ulcer recording improved in the EHR compared with the paper-based health record. However, there were still deficiencies, which mean that patient records did not serve as a valid source of information on pressure-ulcer prevalence and prevention.
PubMed ID
18678726 View in PubMed
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Acute myocardial infarction (AMI) in Finland--baseline data from the FINMONICA AMI register in 1983-1985.

https://arctichealth.org/en/permalink/ahliterature223821
Source
Eur Heart J. 1992 May;13(5):577-87
Publication Type
Article
Date
May-1992
Author
J. Tuomilehto
M. Arstila
E. Kaarsalo
J. Kankaanpää
M. Ketonen
K. Kuulasmaa
S. Lehto
H. Miettinen
H. Mustaniemi
P. Palomäki
Author Affiliation
National Public Health Institute, Department of Epidemiology, Helsinki, Finland.
Source
Eur Heart J. 1992 May;13(5):577-87
Date
May-1992
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Data Collection - methods - standards
Female
Finland - epidemiology
Humans
Incidence
International Cooperation
Male
Middle Aged
Myocardial Infarction - diagnosis - epidemiology - mortality
Registries - standards - statistics & numerical data
Sex Factors
Space-Time Clustering
Time Factors
World Health Organization
Abstract
The acute myocardial infarction (AMI) register of the FINMONICA study, the Finnish part of the WHO-coordinated multinational MONICA project, operates in the provinces of North Karelia and Kuopio in eastern Finland and in Turku, Loimaa and in communities around Loimaa in southwestern Finland. The AMI register serves as an instrument for the assessment of trends in mortality from coronary heart disease (CHD) and of the incidence and attack rates of AMI among 25-64-year-old residents of the study areas. This report describes the methods used in the FINMONICA AMI register and the findings during the first 3 years of the study, in 1983-1985. The criteria of the multinational WHO MONICA project were used in the classification of fatal events and in the diagnosis of non-fatal definite AMI, but based on the experience within the FINMONICA study, stricter diagnostic criteria than those originally described in the WHO MONICA protocol were used for non-fatal possible AMI. This led to a marked improvement in the comparability of the data from the three study areas with regard to the incidence and attack rates of non-fatal AMI. During the 3-year period the total number of registered events was 6266 among men and 2092 among women. Among men the incidence and attack rates of AMI and mortality from CHD were higher in eastern than in southwestern Finland. Also among women the incidence and attack rates of AMI were higher in eastern than in southwestern Finland, whereas there was no regional difference in mortality from CHD among women. The mortality findings of the FINMONICA AMI Register were in good agreement with the official CHD mortality statistics of Finland.
Notes
Erratum In: Eur Heart J 1992 Aug;13(8):1153
PubMed ID
1618197 View in PubMed
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An assessment of the usefulness of demographic data provided by surrogate respondents in a case-control study of Parkinson's disease.

https://arctichealth.org/en/permalink/ahliterature222820
Source
J Clin Epidemiol. 1992 Nov;45(11):1219-27
Publication Type
Article
Date
Nov-1992
Author
F. Wang
K M Semchuk
E J Love
Author Affiliation
Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Alberta, Canada.
Source
J Clin Epidemiol. 1992 Nov;45(11):1219-27
Date
Nov-1992
Language
English
Publication Type
Article
Keywords
Age Factors
Alberta - epidemiology
Bias (epidemiology)
Case-Control Studies
Data Collection - methods - standards
Educational Status
Epidemiologic Methods
Ethnic Groups
Evaluation Studies as Topic
Family
Female
Humans
Income
Male
Marital status
Parkinson disease - epidemiology
Reproducibility of Results
Abstract
This study, based upon data from 40 non-demented Parkinson's disease cases and 101 community controls, and similar data provided by either the spouse (n = 110) or an adult child (n = 31) of each index subject, attempted to assess the usefulness of various demographic data provided by the surrogate respondents for the index subjects. The data were collected by personal interview using a structured questionnaire specifically developed for this study. Ninety-one percent of the index subjects and their surrogates provided information on the annual family income and 98% provided other demographic information. The analysis was done by three groups: the case-surrogates, the control-surrogates and the combined index subject-surrogates, and within each group by the two types of surrogates for the index subjects: the spouse vs adult child. The overall percent agreement between the index subjects and their surrogates varied from moderate for annual family income (54.1%), to good for educational level (61.6%) and to excellent for ethnic origin (82.6%), for age +/- 1 year (97.9%) and for marital status (100.0%). No significant differences in agreement were found for any of these demographic variables either between the case-surrogate group and the control-surrogate group, or between the spouse surrogates and the child surrogates. These findings suggest that spouses and adult children can provide valid information and are equally reliable informants concerning the demographic characteristics of index subjects in a case-control study of Parkinson's disease and, possibly, of other diseases.
PubMed ID
1432002 View in PubMed
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An evaluation of hospital discharge records as a tool for serious work related injury surveillance.

https://arctichealth.org/en/permalink/ahliterature170085
Source
Occup Environ Med. 2006 Apr;63(4):290-6
Publication Type
Article
Date
Apr-2006
Author
H. Alamgir
M. Koehoorn
A. Ostry
E. Tompa
P. Demers
Author Affiliation
Department of Health Care & Epidemiology, University of British Columbia, Vancouver, BC, Canada. hasanat@interchange.ubc.ca
Source
Occup Environ Med. 2006 Apr;63(4):290-6
Date
Apr-2006
Language
English
Publication Type
Article
Keywords
Accidents, Occupational - statistics & numerical data
Adult
British Columbia - epidemiology
Cohort Studies
Data Collection - methods - standards
Female
Hospital Records - standards
Humans
Industry
Male
Medical Records - standards
Middle Aged
Patient Discharge - statistics & numerical data
Reproducibility of Results
Sensitivity and specificity
Wood
Wounds and Injuries - epidemiology
Abstract
To identify and describe work related serious injuries among sawmill workers in British Columbia, Canada using hospital discharge records, and compare the agreement and capturing patterns of the work related indicators available in the hospital discharge records.
Hospital discharge records were extracted from 1989 to 1998 for a cohort of sawmill workers. Work related injuries were identified from these records using International Classification of Disease (ICD-9) external cause of injury codes, which have a fifth digit, and sometimes a fourth digit, indicating place of occurrence, and the responsibility of payment schedule, which identifies workers' compensation as being responsible for payment.
The most frequent causes of work related hospitalisations were falls, machinery related, overexertion, struck against, cutting or piercing, and struck by falling objects. Almost all cases of machinery related, struck by falling object, and caught in or between injuries were found to be work related. Overall, there was good agreement between the two indicators (ICD-9 code and payment schedule) for identifying work relatedness of injury hospitalisations (kappa = 0.75, p
Notes
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PubMed ID
16556751 View in PubMed
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Comparison of user groups' perspectives of barriers and facilitators to implementing electronic health records: a systematic review.

https://arctichealth.org/en/permalink/ahliterature134945
Source
BMC Med. 2011;9:46
Publication Type
Article
Date
2011
Author
Carrie Anna McGinn
Sonya Grenier
Julie Duplantie
Nicola Shaw
Claude Sicotte
Luc Mathieu
Yvan Leduc
France Légaré
Marie-Pierre Gagnon
Author Affiliation
Research Centre of the Centre Hospitalier Universitaire du Québec, Québec, QC, Canada.
Source
BMC Med. 2011;9:46
Date
2011
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Attitude to Computers
Canada
Data Collection - methods - standards
Electronic Health Records - organization & administration - utilization
Health Knowledge, Attitudes, Practice
Health Plan Implementation - methods - organization & administration
Humans
Patient Acceptance of Health Care - statistics & numerical data
Abstract
Electronic health record (EHR) implementation is currently underway in Canada, as in many other countries. These ambitious projects involve many stakeholders with unique perceptions of the implementation process. EHR users have an important role to play as they must integrate the EHR system into their work environments and use it in their everyday activities. Users hold valuable, first-hand knowledge of what can limit or contribute to the success of EHR implementation projects. A comprehensive synthesis of EHR users' perceptions is key to successful future implementation. This systematic literature review was aimed to synthesize current knowledge of the barriers and facilitators influencing shared EHR implementation among its various users.
Covering a period from 1999 to 2009, a literature search was conducted on nine electronic databases. Studies were included if they reported on users' perceived barriers and facilitators to shared EHR implementation, in healthcare settings comparable to Canada. Studies in all languages with an empirical study design were included. Quality and relevance of the studies were assessed. Four EHR user groups were targeted: physicians, other health care professionals, managers, and patients/public. Content analysis was performed independently by two authors using a validated extraction grid with pre-established categorization of barriers and facilitators for each group of EHR users.
Of a total of 5,695 potentially relevant publications identified, 117 full text publications were obtained after screening titles and abstracts. After review of the full articles, 60 publications, corresponding to 52 studies, met the inclusion criteria. The most frequent adoption factors common to all user groups were design and technical concerns, ease of use, interoperability, privacy and security, costs, productivity, familiarity and ability with EHR, motivation to use EHR, patient and health professional interaction, and lack of time and workload. Each user group also identified factors specific to their professional and individual priorities.
This systematic review presents innovative research on the barriers and facilitators to EHR implementation. While important similarities between user groups are highlighted, differences between them demonstrate that each user group also has a unique perspective of the implementation process that should be taken into account.
Notes
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PubMed ID
21524315 View in PubMed
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The contents and readability of informed consent forms for oncology clinical trials.

https://arctichealth.org/en/permalink/ahliterature147585
Source
Am J Clin Oncol. 2010 Aug;33(4):387-92
Publication Type
Article
Date
Aug-2010
Author
Winson Y Cheung
Gregory R Pond
Ronald J Heslegrave
Katherine Enright
Larissa Potanina
Lillian L Siu
Author Affiliation
Harvard School of Public Health, Boston, Massachusetts, USA.
Source
Am J Clin Oncol. 2010 Aug;33(4):387-92
Date
Aug-2010
Language
English
Publication Type
Article
Keywords
Clinical Trials as Topic
Comprehension
Consent Forms - classification - standards
Data Collection - methods - standards
Humans
Informed consent
Neoplasms - therapy
Ontario
Patient Selection
Reproducibility of Results
Research - standards
Risk assessment
Risk factors
Truth Disclosure
Abstract
To compare the quality of informed consent forms (ICF) for different trial phases, funding sources, oncology subspecialties, disease settings, and intervention modalities.
ICF for prospectively conducted clinical trials were examined for their descriptions of benefits and risks, study alternatives, voluntary participation, and confidentiality. Readability was assessed with Flesch Reading Ease (FRE) score and Flesch-Kincaid Reading Grade Level.
Among 262 evaluable trials, ICF contained an average of 3982 words, 379 sentences, and 10.5 pages. The mean FRE score and Reading Grade Level were 61.2 and 7.4, respectively. All ICF explicitly stated that the intervention was investigational. Only 2 (1%) promised direct personal benefits, 16 (6%) suggested the chance of cure or prolonged survival, and 89 (34%) indicated a potential for tumor response. Conversely, 239 (91%) mentioned the risk of serious harms, 217 (83%) admitted that some side effects could be unknown or unpredictable, and 126 (48%) reported hospitalization or death as a possibility. Alternatives to participation, right to withdraw from study, and data confidentiality were addressed in 242 (92%), 254 (97%), and 260 (99%) ICF, respectively. Hematology, industry-funded, metastatic, and systemic therapy trials were most likely to highlight major risks (P
PubMed ID
19884804 View in PubMed
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[COPD treatment in general practice in Denmark is into a rapid development].

https://arctichealth.org/en/permalink/ahliterature114088
Source
Ugeskr Laeger. 2013 Apr 29;175(18):1271-6
Publication Type
Article
Date
Apr-29-2013
Author
Lill Moll Nielsen
Jette Elbrønd
Author Affiliation
lillmoll@dadlnet.dk
Source
Ugeskr Laeger. 2013 Apr 29;175(18):1271-6
Date
Apr-29-2013
Language
Danish
Publication Type
Article
Keywords
Data Collection - methods - standards
Databases, Factual - standards
Denmark - epidemiology
General Practice - standards - trends
Humans
Practice Guidelines as Topic
Pulmonary Disease, Chronic Obstructive - epidemiology - therapy
Quality Assurance, Health Care
Registries - standards
Software
Abstract
In this article the change towards pro-activity in the treatment of chronic obstructive pulmonary disease (COPD) is reviewed. Implementing International Classification of Primary Care and COPD indicators registration provide opportunity for quality assurance by quality reports and follow-up. Changing practice organization supports teamwork for the benefit of the patients. Municipal COPD rehabilitation has become available. Cooperation is improved by an overview of municipal services on www.sundhed.dk and by a correspondence module. Tracing COPD and applying data must be enhanced. In the years to come we will benefit from the collected data for research in general practice.
PubMed ID
23651804 View in PubMed
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Core domains for a person-focused outcome measurement system in cancer (PROMS-Cancer Core) for routine care: a scoping review and Canadian Delphi Consensus.

https://arctichealth.org/en/permalink/ahliterature117068
Source
Value Health. 2013 Jan-Feb;16(1):76-87
Publication Type
Article
Author
Doris Howell
Margaret Fitch
Debra Bakker
Esther Green
Jonathan Sussman
Samantha Mayo
Shan Mohammed
Charlotte Lee
Diane Doran
Author Affiliation
University Health Network and Faculty of Nursing, University of Toronto, Toronto, ON, Canada. doris.howell@uhn.on.ca
Source
Value Health. 2013 Jan-Feb;16(1):76-87
Language
English
Publication Type
Article
Keywords
Canada
Consensus
Data Collection - methods - standards
Decision Making
Delivery of Health Care - standards
Delphi Technique
Feasibility Studies
Humans
Interdisciplinary Communication
Neoplasms - pathology - therapy
Outcome Assessment (Health Care) - methods
Quality of Health Care
Survivors
Abstract
The objectives of this scoping review study were 1) to identify core domains and dimensions for inclusion in a person-focused and self-reported outcome measurement system for cancer and 2) to reach consensus among key stakeholders including cancer survivors on the relevance, acceptability, and feasibility of a core outcome set for collection in routine clinical care.
Following a scoping review of the literature, a Rand Delphi consensus method was used to engage key interdisciplinary decision makers, clinicians, and cancer survivors in reaching consensus on a core patient-reported outcome domain taxonomy and outcome measures.
Of the 21,900 citations identified in the scoping review, 1,503 citations were included in the full article review (380 conceptual articles, 461 psychometric evaluation articles, and 662 intervention studies) and subjected to data abstraction and mapping. Final consensus was reached on 20 domains, related subdimensions, and 45 self-report measures considered relevant and feasible for routine collection in cancer by the Delphi panel (PROMS-Cancer Core).
Standardization of patient-reported outcome data collection is key to assessing the impact of cancer and treatment on the person for population comparison and monitoring the quality of clinical care. The PROMS-Cancer Core taxonomy of domains and outcome measures can be used to guide the development of a patient-reported outcome information system for cancer.
PubMed ID
23337218 View in PubMed
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Data collection on multiple births -- establishing twin registers and determining zygosity.

https://arctichealth.org/en/permalink/ahliterature82154
Source
Early Hum Dev. 2006 Jun;82(6):357-63
Publication Type
Article
Date
Jun-2006
Author
Ohm Kyvik Kirsten
Derom Catherine
Author Affiliation
University of Southern Denmark, Institute of Public Health, Epidemiology, The Danish Twin Registry, JB Winsløwsvej 9B, Odense C. kkyvik@health.sdu.dk
Source
Early Hum Dev. 2006 Jun;82(6):357-63
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Data Collection - methods - standards
Denmark - epidemiology
Diseases in Twins - epidemiology - genetics
Genotype
Humans
Registries
Twin Studies - standards - statistics & numerical data
Twins, Dizygotic - genetics
Twins, Monozygotic - genetics
Abstract
Twins are a valuable resource not only for studies on multiple births themselves, but on the etiology of diseases and other phenotypes. The method of ascertainment and selection of twins can be crucial for such studies and population based twin registries are thus of great importance as tools of research. Accurate determination of zygosity and chorionicity is essential in all studies of multiple births and in their professional care. The parents and the multiples ask for it. It is of pre-and postnatal medical importance and now considered as a prerequisite in several domains of twin research. It is also important for educational reasons as it helps the multiples and their parents and teachers to ascertain identity. The methods are briefly described and a plea is made to the obstetricians and pediatricians to use them systematically at birth. The distribution of zygosity and chorionicity types among spontaneous and induced twin births are illustrated.
PubMed ID
16713137 View in PubMed
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49 records – page 1 of 5.