Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve monitoring.With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the created an automatic system identify diabetic patients, detect administration, check for recent measurement, and remind clinicians glucose. Interrupted time series propensity score matching were used quantify pre- postintervention...

When the phase I postanesthesia care unit (PACU) is at capacity, completed cases need to be held in operating room (OR), causing a "PACU delay." Statistical methods based on historical data can optimize PACU staffing achieve least possible labor cost given service level. A decision support process alert charge nurses that or near maximum census might effective lessening incidence of delays and reducing over-utilized OR time, but only if alerts are timely (i.e., neither too late nor early act...

The role of informatics in public health has increased over the past few decades, and coronavirus disease 2019 (COVID-19) pandemic underscored critical importance aggregated, multicenter, high-quality, near-real-time data to inform decision-making by physicians, hospital systems, governments. Given impact on perioperative care services (eg, elective procedure delays; information sharing related interventions critically ill patients; regional bed-management under crisis conditions),...

An accurate computable representation of food and drug allergy is essential for safe healthcare. Our goal was to develop a high-performance, easily maintained algorithm identify medication allergies sensitivities from unstructured entries in electronic health record (EHR) systems.

Consider a case that has been ongoing for longer than the scheduled duration. The anesthesiologist estimates there is 1 hour remaining. Forty-five minutes later not yet finished, and closure started. We showed previously mean (expected) time remaining approximately hour, 15 minutes. relationship direct mathematical consequence of log-normal probability distributions operating room (OR) durations. test hypothesis that, with an accurate probabilistic model, until begins estimated would be from...

The objective of this study was to examine the cross-cultural differences PANSS across six geo-cultural regions. specific aims are (1) measurement properties PANSS; and (2) how each 30 items function regions.Data obtained for 1,169 raters from 6 different regions: Eastern Asia (n = 202), India 185), Northern Europe 126), Russia & Ukraine 197), Southern 162), United States 297). A principle components analysis assessed unidimensionality subscales. Rasch rating scale examined among item...

Rapid and reliable methods of text communication to mobile anesthesia care providers are important patient efficient operating room management. Anesthesia departments implementing automated send messages devices for abnormal vital signs, clinical recommendations, quality care, compliance or billing issues. The most time-critical communications determine maximum acceptable latencies. We studied the reliability several alphanumeric messaging systems identify an appropriate technology such...

Background Considering the increasing attention to study of failed clinical trials, goal this was identify sources unreliability in a trial by assessing scores on Positive and Negative Syndrome Scale (PANSS). Methods This is substudy from phase 2 double-blind, placebo-controlled schizophrenia. Using generalizability theory, assesses reliability 3 conditions: raters, time points (PANSS evaluations, 1 week apart), subjects for groups (placebo responders, placebo nonresponders, treatment...

In Brief BACKGROUND: Surgical cancellation rates typically are reported as the number of cancelled cases divided by scheduled cases. However, total minutes also has financial impact on surgeons' productivity. Cancellation can instead be calculated based Hospitals benchmark rates, since not all cancellations preventable (e.g., those due to new onset patient symptoms requiring further workup and treatment before surgery safely proceed). If mean estimated duration were same that cases, would...

Tablet computers and smart phones have gained popularity in anesthesia departments for educational patient care purposes. VigiVU(™) is an iOS application developed at Vanderbilt University remote viewing of perioperative information, including text message notifications delivered via the Apple Push Notification (APN) service. In this study, we assessed reliability APN service.Custom software was written to send a every minute devices (iPad(®), iPod Touch(®), iPhone(®)) wireless local area...

BACKGROUND: Although the surgical pause or time-out is a required part of most hospitals’ standard operating procedures, little known about quality execution in routine clinical practice. An interactive electronic was implemented to increase team compliance with procedure and improve communication among members room. We sought identify nonroutine events that occur during room, including distractions interruptions, deviations from protocol, problem-solving strategies used by room mitigate...

With the increasing use of new regulatory tools, like Food and Drug Administration's breakthrough designation, there are challenges for European health technology assessors (HTAs) to make an accurate assessment long-term value performance chimeric antigen receptor T-cell (CAR-T) therapies, particularly orphan conditions, such as acute lymphoblastic leukaemia. The aim this study was demonstrate a novel methodology harnessing longitudinal real-world data, extracted from electronic records...

Background Major depressive disorder (MDD) is common worldwide and can be highly disabling. People with MDD face many barriers to treatment may not experience full symptom relief even when treated. Therefore, new modalities are needed for MDD. Digital therapeutics (DTx) provide people an additional option. Objective This study aimed describe a phase 3 remote, multicenter, randomized, masked, sham-controlled trial evaluating the efficacy of smartphone app–based DTx (CT-152) in adult...

Abstract Background “Wrong surgery” is defined as wrong site, operation, or patient, with estimated incidence up to 1 per 5,000 cases. Responding national attention on surgery, our objective was create a care redesign intervention minimize the rate of surgery. Methods The authors created an electronic system using existing intraoperative documentation present time-out checklist large in-room displays. Time-out dynamically interposed forced-function step between “patient-in-operating room”...

To estimate the impact COVID-19 pandemic on healthcare resource utilization (HCRU) among individuals with major depressive disorder (MDD).

Assessment of clinical competence is essential for residency programs and should be guided by valid, reliable measurements. We implemented Baker's Z-score system, which produces measures traditional core competency assessments performance summative scores. Our goal was to validate use scores estimate the number evaluations needed measures.We performed generalizability studies variance components raw Z-transformed absolute peer-relative decision produce at least 90% classification high-stakes...

Background: Considering the scarcity of longitudinal assessments reliability, there is need for a more precise understanding cognitive decline in Alzheimer’s Disease (AD). The primary goal was to assess changes inter-rater test retest reliability and internal consistency scores ADAS-Cog. Methods: 2,618 AD subjects were enrolled seven randomized, double-blind, placebo-controlled, multicenter-trials from 1986 2009. Reliability, internal-consistency cross-sectional analysis ADAS-Cog MMSE across...