Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Records”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources
PubMed2002

EEG and evoked potential recording from the subthalamic nucleus for deep brain stimulation of intractable epilepsy.

OBJECTIVES: The substantia nigra in the animal model has been implicated in the control of epilepsy. The substantia nigra pars reticulata (SNpr) receives afferents from the subthalamic nucleus (STN), which thus may have an effect on the control of epilepsy. There is evidence in the animal model of a direct connection from the cortex to the STN. High-frequency STN stimulation is being used in experimental trial for the management of intractable epilepsy. Our primary objective in this study was to determine if there was epileptiform activity recorded from the STN in association with scalp recorded epileptiform activity to support the presence of a pathway from the cortex to the STN in humans as described in animals that may be important for the management of epilepsy. This article describes the interictal and ictal electroencephalographic (EEG) findings as well as evoked potential recordings from the STN in these patients with intractable epilepsy. METHODS: Four patients (3 males) ranging from 19 to 45 years with intractable focal epilepsy refractory to anti-epileptic drugs were studied. Two patients failed vagal nerve stimulation and one patient had previous epilepsy surgery. Depth electrodes were implanted stereotactically in the STN bilaterally. A comparative analysis of the interictal and ictal activities recorded from the scalp and STN electrodes was performed. Median nerve somatosensory evoked potentials (SEPs) and auditory evoked potentials (AEPs) were also recorded. RESULTS: Interictal sharp waves recorded in the scalp EEG were always negative in polarity. These sharp waves were always associated with sharp waves recorded at the ipsilateral STN electrode contacts that were always positive in polarity. In addition repetitive spikes were recorded independently at the left or right STN electrode contacts, with no reflection at the scalp. These spikes were extremely stereotyped, of high amplitude and short duration, and were positive or negative in polarity. Focal scalp EEG seizures were also recorded at the ipsilateral STN electrodes. In 3 patients SEPs were recorded from the contralateral STN electrodes corresponding to the P14/N18 far-field complex. In two patients AEPs were recorded, and wave V (near-field) and wave VII (far-field) from the contralateral STN electrodes. CONCLUSIONS: This study demonstrates that scalp recorded epileptiform activity is reflected at the ipsilateral STN either following or preceding the scalp sharp waves. The STN sharp waves are most probably an expression of the direct cortico-STN glutamatergic pathways that have been demonstrated previously in animals. This pathway in man may be important with regard to a possible mechanism for the treatment of epilepsy with STN stimulation.

Action Potentials↗
PubMed2001

Axillary and tympanic membrane temperature recording in the preterm neonate: a comparative study.

STUDY AIMS: The aim of this study is to compare axillary temperature recordings with those of the tympanic membrane, in healthy preterm neonates, to ascertain whether there is any significant difference between the two recordings, in particular in relation to postnatal age, and if so to evaluate the clinical implications. RATIONALE: Immature thermoregulatory mechanisms, and small body size, mean preterm neonates are prone to temperature maintenance problems, and thermal stress is associated with increased morbidity and mortality. In order to ensure minimal handling, the ideal method of temperature recording would be rapid, painless and reproducible, and accurately reflect core temperature, whilst considering safety, comfort, ease of procedure and cost effectiveness. Recording of the tympanic membrane temperature is rapid and noninvasive, however, the accuracy of this method in preterm neonates has not been established. STUDY DESIGN: A comparative descriptive design was used, to describe differences in the recorded temperature in healthy preterm neonates, of gestational age of 27-37 weeks, related to temperature recording. METHOD: A second comparison was undertaken to establish difference in mean temperature recordings dependant on postnatal age of the baby in days. The sample included all babies fitting the selection criteria, admitted to the Neonatal Unit during the study period. Following approval by the local research ethics committee tympanic membrane and axillary temperatures were recorded consecutively for 7 days (n=154), using the Genius Model 3000A tympanic thermometer and a glass and mercury thermometer. RESULTS: A t-test demonstrated a statistically significant difference between the recordings (P < 0.05), tympanic membrane recordings being higher. However, analysis of variance indicated that this difference was not associated with postnatal age, and thus the presence of vernix in the auditory canal (P > 0.05). The findings were not, however, deemed clinically significant in that no change in care or treatment resulted from differences in temperature recordings. CONCLUSIONS: Whilst the findings cannot be applied to sick preterm neonate, it was concluded that tympanic membrane temperature recordings in healthy preterm neonates are safe, accurate, easy, and comfortable for the baby, and appropriate with this client group provided staff are trained in the technique.

Age Factors↗
PubMed2001

Reproducibility of antroduodenal motility during prolonged ambulatory recording.

Ambulatory recording of antroduodenal manometry is a novel technique with several advantages over standard stationary manometry recording. Although the feasibility of this technique in clinical practice has been demonstrated, reproducibility of antroduodenal motility recorded by means of ambulatory manometry has not been investigated. To test whether antroduodenal motility recorded by ambulatory manometry is reproducible, we performed two 24-h ambulatory antroduodenal manometry recordings in 18 healthy subjects according to an identical protocol with a 1-week interval. Motility was recorded with a five-channel solid-state catheter. Postprandial motility was recorded after consumption of two test meals and interdigestive motility was recorded nocturnally. Postprandial antroduodenal motor characteristics were identical between the separate recordings. The number and duration of nocturnal cycles of the interdigestive migrating motor complex were also in the same range. Phase III characteristics in general were not different between the two recordings. Only minor alterations were observed in the duration of phase III motor fronts with duodenal onset and in the number of interdigestive cycles concluded by duodenal onset phase III. Parameters obtained by qualitative analysis were comparable between the two recordings. The antroduodenal motility pattern, when measured by ambulatory recording with solid state catheters under standardized conditions, is very reproducible.

Adult↗
PubMed1991

In vivo magnetic and electric recordings from nerve bundles and single motor units in mammalian skeletal muscle. Correlations with muscle force.

Recent advances in the technology of recording magnetic fields associated with electric current flow in biological tissues have provided a means of examining action currents that is more direct and possibly more accurate than conventional electrical recording. Magnetic recordings are relatively insensitive to muscle movement, and, because the recording probes are not directly connected to the tissue, distortions of the data due to changes in the electrochemical interface between the probes and the tissue are eliminated. In vivo magnetic recordings of action currents of rat common peroneal nerve and extensor digitorum longus (EDL) muscle were obtained by a new magnetic probe and amplifier system that operates within the physiological temperature range. The magnetically recorded waveforms were compared with those obtained simultaneously by conventional, extracellular recording techniques. We used the amplitude of EDL twitch force (an index of stimulus strength) generated in response to graded stimulation of the common peroneal nerve to enable us to compare the amplitudes of magnetically recorded nerve and muscle compound action currents (NCACs and MCACs, respectively) with the amplitudes of electrically recorded nerve compound action potentials (NCAPs). High, positive correlations to stimulus strength were found for NCACs (r = 0.998), MCACs (r = 0.974), and NCAPs (r = 0.998). We also computed the correlations of EDL single motor unit twitch force with magnetically recorded single motor unit compound action currents (SMUCACs) and electrically recorded single motor unit compound action potentials (SMUCAPs) obtained with both a ring electrode and a straight wire serving as a point electrode. Only the SMUCACs had a relatively strong positive correlation (r = 0.768) with EDL twitch force. Correlations for ring and wire electrode-recorded SMUCAPs were 0.565 and -0.366, respectively. This study adds a relatively direct examination of action currents to the characterization of the normal biophysical properties of peripheral nerve, muscle, and muscle single motor units.

Action Potentials↗
PubMed2006

Accuracy of healthcare worker recall and medical record review for identifying infectious exposures to hospitalized patients.

OBJECTIVE: To determine the validity of using healthcare worker (HCW) recall of patient interactions and medical record review for contact tracing in a critical care setting. DESIGN: Trained observers recorded the interactions of nurses, respiratory therapists, and service assistants with study patients in a medical-surgical intensive care unit. These observers' records were used as the reference standard to test the criterion validity of using HCW recall data or medical record review data to identify exposure characteristics. We assessed the effects of previous quarantine of the HCW (because of possible exposure) and the availability of patients' medical records for use as memory aids on the accuracy of HCW recall. SETTING: A 10-bed medical-surgical intensive care unit at Mount Sinai Hospital in Toronto, Ontario. PATIENTS: Thirty-six HCWs observed caring for 16 patients, for a total of 55 healthcare worker shifts. RESULTS: Recall accuracy was better among HCWs who were provided with patient medical records as memory aids (P<.01). However, HCWs tended to overestimate exposures when they used patient medical records as memory aids. For 6 of 26 procedures or care activities, this tendency to overestimate was statistically significant (P<.05). Most HCWs with true exposures were identified by means of this technique, despite the overestimations. Documentation of the activities of the 4 service assistants could not be found in any of the patients' medical records. Similarly, the interactions between 6 (19%) of 32 other patient-HCW pairs were not recorded in patients' medical records. CONCLUSIONS: Data collected from follow-up interviews with HCWs in which they are provided with patient medical records as memory aids should be adequate for contact tracing and for determining exposure histories. Neither follow-up interviews nor medical record review alone provide sufficient data for these purposes.

Disease Transmission, Infectious↗
PubMed1995

Use of sensory-evoked potentials recorded from the human occiput for intraoperative physiologic monitoring of the spinal cord.

STUDY DESIGN: This is a report of a prospective case series. OBJECTIVE: The purpose of this study was to determine whether evoked potential activity recorded from occipital scalp electrodes in humans is similar to that recorded in animals, and to evaluate the independence of this activity from the classical somatosensory-evoked potential. SUMMARY OF BACKGROUND DATA: Intraoperative somatosensory-evoked potentials can be of limited usefulness in predicting spinal cord injury because they are transmitted primarily through the dorsal columns, and therefore do not reflect integrity of important ventral pathways. It recently has been shown in animal studies that a sensory-evoked potential recorded from the cerebellum is mediated via ventral tracts and is useful as an adjunct to the somatosensory-evoked potential in spinal cord monitoring. METHODS: Twenty-five patients undergoing spinal or posterior fossa surgery were consecutively entered into the study. Evoked responses were recorded transcranially from over the cerebellar hemispheres and from the vertex. Recordings were made directly from the surface of the cerebellar hemispheres in seven of these patients. RESULTS: Waveforms could be recorded and reproduced in all but one of the patients. The overall appearance of the occipital recordings was similar to the appearance of responses obtained in animals. The mean latency of the first negative peak recorded from the ipsilateral occiput was 33.0 msec (standard deviation, 3.7 msec) compared with 52.4 msec (standard deviation, 6.1 msec) for the somatosensory-evoked potential. In addition, the amplitude of this response (0.35 microV; standard deviation, 0.20 microV) was independent of the amplitude of the somatosensory-evoked potential (0.76 microV; standard deviation, 0.69 microV). In five cases, one evoked potential could be recorded in the absence of the other. Recordings from the surface of the cerebellum were of the same morphology, but of greater amplitude than the transcranial recordings. CONCLUSION: Evoked responses can be reliably recorded from over the occiput and show characteristics independent of the classical somatosensory-evoked potential. These responses are very similar to the cerebellar-evoked potential recently characterized in animals and may provide a method for assessing the physiologic integrity of the ventral tracts of the spinal cord in humans.

Animals↗
PubMed1995

Coherent spatiotemporal patterns of ongoing activity revealed by real-time optical imaging coupled with single-unit recording in the cat visual cortex.

1. We examined the spatiotemporal organization of ongoing activity in cat visual areas 17 and 18, in relation to the spontaneous activity of individual neurons. To search for coherent activity, voltage-sensitive dye signals were correlated with the activity of single neurons by the use of spike-triggered averaging. In each recording session an area of at least 2 x 2 mm of cortex was imaged, with 124 diodes. In addition, electrical recordings from two isolated units, the local field potential (LFP) from the same microelectrodes, and the surface electroencephalogram (EEG) were recorded simultaneously. 2. The optical signals recorded from the dye were similar to the LFP recorded from the same site. Optical signals recorded from different cortical sites exhibited a different time course. Therefore real-time optical imaging provides information that is equivalent in many ways to multiple-site LFP recordings. 3. The spontaneous firing of single neurons was highly correlated with the optical signals and with the LFP. In 88% of the neurons recorded during spontaneous activity, a significant correlation was found between the occurrence of a spike and the optical signal recorded in a large cortical region surrounding the recording site. This result indicates that spontaneous activity of single neurons is not an independent process but is time locked to the firing or to the synaptic inputs from numerous neurons, all activated in a coherent fashion even without a sensory input. 4. For the cases showing correlation with the optical signal, 27-36% of the optical signal during spike occurrence was directly related to the occurrence of spontaneous spikes in a single neuron, over an area of 2 x 2 mm. In the same cortical area, 43-55% of the activity was directly related to the visual stimulus. 5. Surprisingly, we found that the amplitude of this coherent ongoing activity, recorded optically, was often almost as large as the activity evoked by optimal visual stimulation. The amplitude of the ongoing activity that was directly and reproducibly related to the spontaneous spikes of a single neuron was, on average, as high as 54% of the amplitude of the visually evoked response that was directly related to optimal sensory stimulation, recorded optically. 6. Coherent activity was detected even at distant cortical sites up to 6 mm apart.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMedDate not supplied

Retrospective analysis of the clinical utility of ambulatory electrocardiographic (Holter) recordings in syncopal dogs: 44 cases (1991-1995).

The objective of this study was to evaluate retrospectively the clinical utility of ambulatory (Holter) electrocardiographic monitoring in syncopal dogs and to compare the Holter recording with the clinic electrocardiogram (ECG) in these animals. Fifty Holter reports and 44 medical records from 44 dogs were evaluated. A syncopcal episode occurred during monitoring in 24% of the recordings. No obvious relationship was found between the frequency of syncope occurring before Holter recording and the likelihood of a dog having an episode during recording. Holter recordings were helpful in establishing a diagnosis 42% of the time, but no relationship was detected between the frequency of episodes occurring before Holter recording and the likelihood of a diagnostically useful Holter. An arrhythmia was ruled out as the cause of syncope in 12% of the recordings and was implicated as the cause of syncope in 30% of recordings. Of these, 20% were ventricular tachyarrhythmias and 10% were bradyarrhythmias including pacemaker failure. Ambulatory electrocardiographic recordings led to a therapeutic change in 38% of cases. A comparison of the Holter recordings and clinic ECGs documented the expected increased sensitivity for Holter detection of arrhythmias. The average clinic ECG heart rate consistently exceeded the average Holter heart rate with a mean difference between the average heart rates recorded by the two techniques of 31 bpm (range -8-87 bpm).

Animals↗
PubMed1993

Users and uses of patient records. Report of the Council on Scientific Affairs. Council on Scientific Affairs, American Medical Association.

At present, there is significant momentum for developing and implementing computer-based patient records systems. It is essential that their development be guided by the functional requirements of the users and uses of patient records. Users can be grouped into seven categories: providers, patients, educators, researchers, payers, managers and reviewers, and licensing and accrediting agencies and professional associations. Uses of patient records include fostering continuity of care, supporting diagnosis and choice of therapy, assessing and managing health risks, documenting the services provided, maintaining accurate medical histories, billing and verifying payment, documenting professionals' experience, teaching students, preparing conferences and presentations, conducting research, formulating practice guidelines, and providing data to support utilization review, quality assurance, accreditation, and licensure. Patient records can be classified as primary records used by professionals while providing health care services or secondary records derived from primary records to aid nonclinical users. Protecting the confidentiality of patient information will restrict access to primary records for some users and should prevent inclusion of sensitive data in secondary records. The design features to be incorporated into computer-based record systems should expand the record's function from that of a simple device for documenting events into a powerful tool for providing and managing care.

American Medical Association↗
PubMedDate not supplied

Are automated anesthesia records better?

STUDY OBJECTIVE: To determine whether data recorded by an information management system is significantly different from that recorded manually. DESIGN: A comparison was made between 13 handwritten and 13 computer-generated anesthesia records by calculating the frequency with which recorded variables were outside predetermined acceptable ranges. Five physiologic variables [systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), end-tidal partial pressure of carbon dioxide (PETCO2), and oxygen saturation by pulse oximeter (SpO2)] were compared during the initial 1 1/2 hours of operation. SETTING: Surgical suite at a university-affiliated hospital. PATIENTS: Thirteen adult patients scheduled for operations that required general anesthesia for longer than 1 1/2 hours. INTERVENTION: In addition to the traditional handwritten anesthesia records, an information management system (ARKIVE Patient Management System, DIATEK, San Diego, CA) was used to collect data from each case. MEASUREMENTS AND MAIN RESULTS: No significant differences were found between the methods in the frequency of elevated SBP, elevated DBP, and tachycardia. However, the manual records showed low SBP, DBP, and HR with a significantly lower frequency (2%, 11%, 1%, respectively) than the automated records (6%, 26%, 5%, respectively; p < 0.01). The automated PETCO2 readings were higher than the upper limit (40 mmHg) with a higher frequency (18%) than the manual records (3%; p < 0.01). On the automated records, SpO2 was noted to be 90% or less on two occasions, but significant desaturation was noted only once on the manual charts. CONCLUSIONS: Observer bias, missed readings, and errors of memory, which affect manual anesthetic records, may cause significant inaccuracy and may be avoided by using automated records generated by information management systems.

Anesthesia, General↗
PubMed1998

Quality evaluation of oral health record-keeping for Finnish young adults.

The objective of this study was to assess the quality of oral health record-keeping in public oral health care in relation to dentists' characteristics. A random computerized selection of 239 subjects, born in 1966-71 and clinically examined during 1994 in an administrative unit of the public oral health service in southern Finland, included 4-5 cases per dentist, the number of dentists being 50. Data concerning actual clinical examinations and treatment courses carried out in public dental clinics came from original oral health records. Criteria for assessment of oral health record entries were based on Finnish health legislation and detailed instructions of health authorities. The results showed that each patient's identity was available in 90% of documents. Recordings concerning continuity of comprehensive care were infrequent; a questionnaire concerning each patient's up-to-date health history was in only 26% of the oral health records. Notes concerning each patient's bite and function of the temporomandibular joint were in 37% of the records, notes about oral soft tissues were in 11%, and the check-up interval was recorded in 21%. Recording of indices on periodontal and dental status varied greatly; the community periodontal index of treatment need was found in 93% and the index of incipient lesions in 16% of the records. Female dentists and dentists younger than 37 years tended to record more information. Dentists should be encouraged to better utilize the options offered by oral health records for individual treatment schemes.

Adult↗
PubMed2003

Textual content, health problems and diagnostic codes in electronic patient records in general practice.

OBJECTIVE: To investigate textual content, health problems and diagnostic codes in everyday electronic patient records. DESIGN: Retrospective and observational database study. SETTING: Primary health care in Stockholm. SUBJECTS: Twenty randomly selected general practitioners with 20 records each. MAIN OUTCOME MEASURES: The frequency of use of problem-oriented medical records. The number of words, problems and diagnostic codes. The completeness and correctness of the diagnostic codes. RESULTS: About 14.5% of 400 studied records were problem-oriented. The mean number of words per record was 99.4, and the mean number of problems managed per record was 1.2. On average, there were 1.1 diagnostic codes per record and this differed widely among GPs and also among the electronic patient record systems. The mean number of codes per problem was 0.9, and the proportion of correct codes was 97.4%. CONCLUSIONS: The electronic patient records in general practice in Stockholm have an extensive textual content. A vast majority of the problems are coded and the completeness and correctness of diagnostic codes are high. It seems that problem-oriented electronic patient record systems enforce coding activities. It is feasible to establish a database of diagnostic data for research and health care planning based on electronic patient records.

Disease↗
PubMed2004

Tracking traffic citations through court adjudications to posting to public driver records.

Research has shown that one of the best predictors of a driver's future crash risk is the number of prior moving traffic violations (e.g., speeding). Public driver records are used by government and nongovernment users to assess drivers' future crash risks. However, the adequacy of such records may be compromised by deficient recordkeeping systems and by court-based diversion programs (e.g., probation before judgment, traffic school election) that allow drivers presumed guilty to avoid convictions in court and posting of the violations to their driver records. Using a case study approach in four jurisdictions in three states, citations issued for traffic violations were tracked through court adjudication to placement on driver records. Individual court case records and driver history records were reviewed. The percentages of citations issued that appeared on driver records were 58-87% for moving violations, 30-94% for driving while impaired (DWI), and 67-95% for occupant restraint violations. Diversion programs were a significant factor in two states, where 21% and 35% of moving violation citations resulted in diversions. Almost all court convictions in each jurisdiction were recorded on driver records, but few citations resulting in diversions were recorded. Thus, diversion programs in some jurisdictions substantially reduce the utility of public driver records as reliable indicators of prior traffic violations and future crash risks. Recordkeeping inefficiencies and errors were less important factors in this study.

Accidents, Traffic↗
PubMed1993

Computerised linking of medical records: methodological guidelines.

OBJECTIVES: To report on the development of computer assisted methods for linking medical records and record abstracts. DESIGN: The methods include file blocking, to put records in an order which makes searching efficient; matching, which is the process of comparing records to determine whether they do or do not relate to the same person; linkage, which is the process of assembling correctly matched records into a time sequenced composite record for the individual; and validation checks and corrections, in which any inconsistencies between different records for the same person are identified and corrected. SETTING: The dataset comprising the Oxford record linkage study which includes hospital inpatient records and vital records. RESULTS AND CONCLUSIONS: Probability matching, using an array of identifiers, achieves much higher levels of correct matching than is generally achievable by exact character by character comparisons. The increasing use of information technology to store data about health and health care means that there is increasing scope to link records for research and for patient care. Sophisticated methods to achieve this on a large scale are now available.

England↗
PubMed2003

Village health workers' and traditional birth attendants' record keeping practices in two rural LGAs in Oyo State, Nigeria.

Village health workers (VHWs) and Traditional Birth attendants (TBAs) provide health care services to the communities in which they live, improving access to health care as well as serving as an important link between the periphery (the communities) and the health sector. The data this category of workers generates about their communities will strengthen primary health care management information system in Nigeria. The objective of this study was to assess the knowledge, attitude and practices of VHWs and TBAs regarding record keeping in Ibarapa Central and Akinyele local government areas (LGAs) of Oyo State, Nigeria. Using a pre-tested, semi structured questionnaire and an observation checklist, trained research assistants visited and interviewed all the active, registered VHWs and TBAs in the two LGAs. Results showed that there were a total of 62 and 102 active VHWs/TBAs in Ibarapa Central and Akinyele LGAs respectively with most of them being farmers aged between 30-59 years. Over two-thirds in both LGAs knew the uses of record keeping for monitoring and evaluation purposes and most of them felt that keeping records was easy. Sixty-one percent of the respondents in Ibarapa Central and 96% of those in Akinyele LGA reported keeping records of their health activities. Of those who kept records, two thirds in Ibarapa Central and almost all (96%) in Akinyele LGA reported forwarding the records they keep. The type of records they keep was mostly on patients' treatment and (in Akinyele) delivery records using an exercise book. Most did not have the VHW/TBA record of work or the community profiles (wall chats) developed and recommended by the Federal Ministry of Health (FMOH) because they were not supplied. The factors associated with record keeping included duration as a VHW/TBA, previous training on record keeping, receiving feedback. Recommendations made included ensuring availability of materials and periodic training and re-training of the VHWs/TBAs by the LGAs, and regular provision of feedback by the National Primary Health Care Development Agency (NPHCDA).

Adult↗
PubMed1995

ICOHR: intelligent computer based oral health record.

The majority of work on computer use in the dental field has focused on non-clinical practice management information needs. Very few computer-based dental information systems provide management support of the clinical care process, particularly with respect to quality management. Traditional quality assurance methods rely on the paper record and provide only retrospective analysis. Today, proactive quality management initiatives are on the rise. Computer-based dental information systems are being integrated into the care environment, actively providing decision support as patient care is being delivered. These new systems emphasize assessment and improvement of patient care at the time of treatment, thus building internal quality management into the caregiving process. The integration of real time quality management and patient care will be expedited by the introduction of an information system architecture that emulates the gathering and storage of clinical care data currently provided by the paper record. As a proposed solution to the problems associated with existing dental record systems, the computer-based patient record has emerged as a possible alternative to the paper dental record. The Institute of Medicine (IOM) recently conducted a study on improving the efficiency and accuracy of patient record keeping. As a result of this study, the IOM advocates the development and implementation of computer-based patient records as the standard for all patient care records. This project represents the ongoing efforts of The University of Iowa College of Dentistry's collaboration with the University of Uppsala Data Center, Uppsala, Sweden, on a computer-based patient dental record model. ICOHR (Intelligent Computer Based Oral Health Record) is an information system which brings together five important parts of the patient's dental record: medical and dental history; oral status; treatment planning; progress notes; and a Patient Care Database, generated from their clinical care information (the database is also stored in the ICOHR). ICOHR is designed to be integrated into a traditional practice management system. The components of the ICOHR system support the use of various types of clinical care quality management tools, including medical alerts, clinical care guidelines, care modifiers, and diagnostic decision support. Data input is multimodal, so the user may use both voice recognition and direct input with a digitizer board to enter information into the database. ICOHR is designed to be integrated into the clinical environment in an ergonomic fashion in order to facilitate the unobtrusive and efficient acquisition of patient information. ICOHR is currently under clinical evaluation in both private practice and institutional environments. The private practice is a large general dentistry practice with over twenty sites scattered throughout a large metropolitan area. The institutional settings are a College of Dentistry and a Hospital Dentistry program. The evaluations have started in two of the sites and the other site will be phased in during the next six months. Our demonstration of the system will include both prepared presentations of the system's various functions and provide an opportunity for hands-on use of the system for interested attendees.

Artificial Intelligence↗
PubMed1997

The reliability of hand-written and computerised records of birth data collected at Baragwanath hospital in Soweto.

This study examined the reliability of hand written and computerised records of birth data collected during the Birth to Ten study at Baragwanath Hospital in Soweto. The reliability of record-keeping in hand-written obstetric and neonatal files was assessed by comparing duplicate records of six different variables abstracted from six different sections in these files. The reliability of computerised record keeping was assessed by comparing the original hand-written record of each variable with records contained in the hospital's computerised database. These data sets displayed similar levels of reliability which suggests that similar errors occurred when data were transcribed from one section of the files to the next, and from these files to the computerised database. In both sets of records reliability was highest for the categorical variable infant sex, and for those continuous variables (such as maternal age and gravidity) recorded with unambiguous units. Reliability was lower for continuous variables that could be recorded with different levels of precision (such as birth weight), those that were occasionally measured more than once, and those that could be measured using more than one measurement technique (such as gestational age). Reducing the number of times records are transcribed, categorising continuous variables, and standardising the techniques used for measuring and recording variables would improve the reliability of both hand-written and computerised data sets.

Data Collection↗
PubMed1996

Immunization status as determined by patients' hand-held cards vs medical records.

OBJECTIVE: To determine whether patients' hand-held immunization cards provide accurate assessments of immunization status when compared with their corresponding medical records. SETTING: Urban hospital emergency department immunization program. DESIGN: Comparison of 2 criterion standards. PATIENTS: Children aged 4 months to 6 years who presented consecutively with their immunization cards and received routine care in the hospital's pediatric clinic. SELECTION: Of 673 eligible patients seen in the immunization program from November 1992 to October 1993, 140 were randomly selected for comparison of immunization card and medical record immunization dates; in addition, all 123 eligible patients seen between August and October 1994 were selected. Of the total of 263 children, medical records for 257 (98%) were available for review. The dates of diphtheria-tetanus-pertussis, polio, measles-mumps-rubella, and Haemophilus influenzae type b immunization from immunization cards and medical records were recorded, as were patient age, sex, and ethnicity. Immunization card-medical record immunization date pairs were compared. Each immunization card and medical record was categorized as up to date, due for immunization, or delayed 2 months or more for any immunization at the time of the visit. RESULTS: In 218 (85%) of 257 cases, the immunization card and medical record immunization dates were identical (McNemar test, P = .63). The immunization card and medical record agreed that patients were due for immunization in 91 cases and agreed that patients were not due for immunization in 138 cases (kappa = 0.77; 95% confidence interval, 0.70-0.85). The immunization card and medical record agreed that patients were delayed for 1 or more immunizations in 51 cases and agreed that patients were not delayed in 187 cases (kappa = 0.79; 95% confidence interval, 0.71-0.88). CONCLUSION: The hand-held immunization card is a suitable alternative to the medical record when the need for immunization is assessed or when rates of immunization delay in populations are determined.

Emergency Service, Hospital↗