Background. Chronic kidney disease (CKD) is an important predictor of end-stage renal disease, as well a marker increased mortality. The New Opportunities for Early Renal Intervention by Computerised Assessment (NEOERICA) project aimed to assess whether people with undiagnosed CKD who might benefit from early intervention could be identified GP computer records.

Strict control of systolic blood pressure is known to slow progression chronic kidney disease (CKD). Here we compared audit-based education (ABE) guidelines and prompts or usual practice in lowering people with CKD. This 2-year cluster randomized trial included 93 volunteer general practices into three arms 30 ABE practices, 32 prompts, 31 practices. An intervention effect on the primary outcome, pressure, was calculated using a multilevel model predict changes after intervention. The...

Flow theory identifies several structural variables that can be manipulated by an instructional designer. Modifying these may cause increase in the likelihood a learner will motivated to continue with lesson. While some researchers suggest activity contents, such as challenge and goal induce flow experience [1], others hypothesize is enhanced vividness interactivity of presentation [2]. This study investigates effect content, its presentation, interactions between two on (intrinsic...

Background UK primary care is highly computerized; initially led by enthusiastic general practitioners who developed their own systems. This preceded the development of a National Health Service information strategy and an ambitious Programme for IT. Model A 4-element model proposed to explain technology: (1) individual clinician choice; (2) integration into clinical task-–usually office visit; (3) technological developments; (4) organizational factors. Conclusion All 4 elements this have...

Chronic kidney disease (CKD) is a relatively newly recognised but common long-term condition affecting 5 to 10% of the population. Effective management CKD, with emphasis on strict blood pressure (BP) control, reduces cardiovascular risk and slows progression CKD. There currently an unprecedented rise in referral specialist renal services, which are often located tertiary centres, inconvenient for patients, wasteful resources. National international CKD guidelines include quality targets...

Addressing sustainability policy challenges requires tools that can navigate complexity for better processes and outcomes. Attention on Artificial Intelligence (AI) expectations their use by governments have dramatically increased over the past decade. We conducted a narrative review of academic grey literature to investigate how AI are being used adapted public sector decision-making. found academics, governments, consultants expressed positive about AI, arguing could or should be address...

<h3>Background</h3> Improving Access to Psychological Therapies (IAPT) is a new programme designed reduce disease burden the individual and economic society of common mental health problems (CMHP). This first study look at impact IAPT on service utilisation sickness absence using routine data. <h3>Method</h3> The authors used pseudonymised secure privately linked (SAPREL) routinely collected primary, secondary care clinic computer data from two pilot localities. explored antidepressant...

The study aims to investigate associations between behavioural and psychological symptoms of dementia (BPSD) abnormal premorbid personality traits.Data were obtained from 217 patients with a diagnosis probable Alzheimer's disease. Behavioural late-onset assessed the Neuropsychiatric Inventory. Premorbid traits using Standardised Assessment Personality. Abnormal categorised Diagnostic Statistical Manual Mental Disorders fourth edition International Classification Diseases Related Health...

Objective To report problems implementing a data quality programme in osteoporosis. Design Analysis of extracted using Morbidity Information Query and Export Syntax (MIQUEST) from participating general practices' systems recommendations practitioners who attended an action research workshop. Setting Computerised practices different Read code versions to record structured data. Participants 78 predominantly London the south east, with representation north west England. Main outcome measures...

Much of chronic disease is managed in primary care and kidney (CKD) a recent addition. We are conducting cluster randomised study quality improvement interventions CKD (QICKD) - Clinical Trials Registration: ISRCTN56023731. registers have lower than expected prevalence an initial focus group suggested variable levels confidence managing CKD. Our objective to compare practitioner achievement indicators for with hypertension diabetes.We validated new questionnaire test confidence. compared...

The use of health data for public health, surveillance, quality improvement and research is crucial to improve systems care. However, bodies responsible privacy ethics often limit access routinely collected data. Ethical approvals, issues around protecting are dealt with by different layers regulations, making approval processes appear disjointed.To create a comprehensive framework defining the ethical status project providing guidance on access.The comprises principles related questions....

Objectives: To report current levels of obesity and associated cardiac risk using routinely collected primary care computer data. Methods: 67 practices took part in an educational intervention to improve data quality cardiovascular disease. Data were extracted from 435 102 general practice records. 64.3% (229 108/362 861) people age 15 y older had a body mass index (BMI) recording or valid height weight record that enabled BMI be derived. about disease factors also extracted. The prevalence...

Background: There is a lack of tools to evaluate and compare Electronic patient record (EPR) systems inform rational choice or development agenda.Objective: To develop tool kit measure the impact different EPR system features on consultation. Methods:We first developed specification overcome limitations existing methods.We divided this into work packages: (1) developing method display multichannel video consultation; (2) code activities, including computer use verbal interactions; (3)...

The aim of this study was to assess the feasibility using three-channel video explore impact computer on general practitioner (GP) consultations. A previous had highlighted limitations single-channel video: firstly, there a lack information about exactly how being used, and secondly difficulty in interpreting body language consulting clinician. More needed understand consultation, pilot used overcome these constraints. Four doctors consulted, with patient's role played by an actor preset...

Prescribing errors are common and costly. Technology should enable safer prescribing. The two main current methods of doing so computer initiated clinical support software (CDSS) the user information retrieval (IR) systems. However, despite near universal availability computerised prescribing in UK, continue.To evaluate experience UK primary health care professionals using CDSS to consolidate technical opinion literature this area with aim creating useful hypotheses for guiding future...

Referral to psychological therapies is recommended for people with common mental health problems (CMHP) however its impact on healthcare utilisation in long term conditions (LTCs) not known.Routinely collected primary care, therapy clinic and hospital data were extracted the registered population of 20 practices (N = 121,199). These linked using SAPREL (Secure Private Record Linkage) method. We 1118 referred 6711 controls, matched age, gender practice. compared resources by LTCs, 6 months...

The evaluation of demonstration sites set up to provide improved access psychological therapies (IAPT) comprised the study all people identified as having common mental health problems (CMHP), those referred IAPT service, and a sample attenders studied in-depth. Information technology makes it feasible link practice, hospital clinic data evaluate representativeness these samples. However, researchers do not have permission browse without patients' consent. To demonstrate use mixed...