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At least 163 records · Page 9Linked to original sources
PubMed1992

Holter monitor recording for the detection of myocardial ischemia: validation of a new recorder and chest lead positions.

OBJECTIVE: To validate the Reynolds Tracker II Holter system using newly described lead positions during both upright treadmill exercise and in the recumbent position following exercise. The specific lead positions HL1 and HL2 were chosen to detect anterior and postero-inferior myocardial ischemia, respectively, without interfering with the surgical field in the hypothetical situation of open-heart surgery. Similar lead positions have previously been used to monitor myocardial ischemia during induction of anesthesia, but have never been validated by comparison with 12-lead modified electrocardiogram (ECG) recording. METHODS: To validate the authors' 'chosen' Holter lead positions (HL1 and HL2), both at the fifth intercostal space just lateral to the midclavicular line and on the back, 1.5 cm to the left of the vertebral column, respectively) 49 candidates for routine treadmill exercise testing underwent a simultaneous Holter monitor recording using the described lead positions. DATA ANALYSIS: The Holter ECG recordings were separately analyzed by two physicians unaware of patients' identity. RESULTS: Using the modified 12-lead ECG as the 'gold standard', the sensitivity of Holter for detecting ischemia (defined as 0.1 mV or ST depression lasting at least 60 s) was 77 and 83%, and its specificity was 100 and 92%, respectively, for observers 1 and 2. Most episodes of myocardial ischemia were detected by the modified lead V5 for the 12-lead ECG and by HL1 for the Holter recording. Using the Holter Tracker II system and the chosen lead positions, it was possible to detect successfully most episodes of exercise-induced myocardial ischemia. CONCLUSION: Holter monitoring might be useful in detecting perioperative myocardial ischemia.

Coronary Disease↗
PubMed2002

Estimation of energy intake in clinical practice: a comparison between a food record protocol and a precoded food record book.

The aim of this study was to compare energy intake estimated from a clinical food record protocol (CFRP) with that from a precoded food record book (PFRB) as reference method. Food and fluid consumption were recorded in 10 older patients using a CFRP in parallel with a PFRB during a 6-day period. The results showed that there were no significant differences in mean energy intake estimated from the CFRP as compared with that estimated from the PFRB. The correlation coefficient between the calculated daily energy intake from the CFRP and PFRB was 0.96. The differences in energy intake (kcal/day) between the CFRP and PFRB, plotted against their mean value for 10 patients, showed that results were within the limits of agreement (mean +/- 2SD) for nine patients. The differences in each day's energy intake between the two methods plotted against their mean value showed that 97% of the estimated daily energy intake was within the limits of agreement. The weighted kappa between the two methods was 0.76. The CFRP would seem to be acceptable for the estimation of mean energy intake in the hospital setting.

Aged↗
PubMedDate not supplied

Establishing electronic patient record standards using paper-based record functions and standards.

The South Australian Health Commission has embarked on a long term project to establish an Electronic Patient Record (EPR) for South Australia. The process requires extensive evaluation at the conclusion of each phase of development using a range of existing and purpose-developed evaluation tools. This paper describes a purpose-developed evaluation tool that uses the functional aspects of, and existing standards for, paper-based medical records in hospitals as its basis. The resulting EPR Standards are a tool which can be used to establish a benchmark against which to evaluate the efficiency and effectiveness of an electronic patient record.

Benchmarking↗
PubMed1981

Privacy Act of 1974; new system of records--Department of Health and Human Services; Public Health Service. Notification of a new system of records: 09-25-0143.

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new system of records, 09-25-0143, Biomedical Research: Records of Subjects in Clinical, Epidemiologic and Biometric Studies of the National Institute of Allergy and Infectious Diseases, HHS/NIH/NIAID. We are also proposing routine uses for this system. This system will be used to support (1) epidemiologic, clinical and biometric investigations into the causes, nature (morbidity and mortality), outcome, therapy and cost of infectious, immunologic and related diseases; (2) review and evaluation of the progress of these research projects, and identification and planning for improvements or for additional research. The population and statistical studies supported by this system may be conducted or managed by Institute staff as well as others outside the Institute. This system comprises records maintained in a number of distinct research projects. The number and specific nature of projects will change over time as new ones are started and as work on existing projects is completed.

Communicable Disease Control↗
PubMed1992

Recording centric and eccentric occlusal disturbances with a new recording device.

A recording device termed a "Kleinrok Functiograph" was introduced to simultaneously document condylar- and tooth-guided mandibular movements on the same plate. The Functiograph instrument permitted objective monitoring of mandibular movement without tooth contact, with all tooth contacts, and allowed analysis of the correlation of these two recordings. After 10 years of conducting investigations on centric occlusion using the Functiograph instrument combined with clinical, radiographic, and electromyographic studies, it was possible to differentiate the horizontal Functiograph recordings of normal and disturbed centric occlusion at a clinically acceptable vertical dimension. Two types of centric occlusal disturbances were classified to accelerate diagnosis and standardize communication.

Centric Relation↗
PubMed2001

Does the medical record cover the symptoms experienced by cancer patients receiving palliative care? A comparison of the record and patient self-rating.

The aim of this study was to investigate the extent to which the symptoms experienced by advanced cancer patients were covered by the medical records. Fifty-eight patients participated in the study. On the day of first encounter with our palliative care department, a medical history was taken, and on this or the following day, the patients completed the EORTC Quality of Life Questionnaire (EORTC QLQ-C30), Edmonton Symptom Assessment System (ESAS), and Hospital Anxiety and Depression Scale (HADS). The symptomatology reported in the patient-completed questionnaires was compared with the symptomatology mentioned by the physician in the medical record. The analysis revealed good concordance concerning pain, but most other symptoms or problems were reported much more often by patients than by their doctors. Reasons for these discrepancies are discussed. It is suggested that the doctor's knowledge of the patient's symptomatology might gain from more systematic screening and transfer of information from patient self-assessment questionnaires to the medical records.

Adult↗
PubMed2000

The Mosoriot medical record system: design and initial implementation of an outpatient electronic record system in rural Kenya.

Mosoriot Health Center is a rural primary care facility situated on the outskirts of Eldoret, Kenya in sub-Saharan Africa. The region is characterised by widespread poverty and a very poor technology infrastructure. Many houses do not have electricity, telephones or tap water. The health center does have electricity and tap water. In a collaborative project between Indiana University and the Moi University Faculty of Health Sciences (MUFHS), we designed a core electronic medical record system within the Mosoriot Health Center, with the intention of improving the quality of health data collection and, subsequently, patient care. The electronic medical record system will also be used to link clinical data from the health center to information collected from the public health surveys performed by medical students participating in the public health research programs of Moi University. This paper describes the processes involved in the development of the computer-based Mosoriot medical record system (MMRS) up to the point of implementation. It particularly focuses on the decisions and trade-offs that must be made when introducing this technology into an established health care system in a developing country.

Humans↗
PubMedDate not supplied

Towards personal health record: current situation, obstacles and trends in implementation of electronic healthcare record in Europe.

In this article, we define the electronic healthcare record and present its purpose as a tool for continuity of care. We briefly describe the current situation of usage and focus on the major challenges to wide implementation in Europe and beyond. Finally, we point out trends that show stronger involvement of the patients-citizens in the health care prevention and promotion processes, and discuss the impact on the future development of the electronic healthcare record into personal health records.

Computer Systems↗
PubMed1997

Comparison of dietary assessment methods in a southern French population: use of weighed records, estimated-diet records and a food-frequency questionnaire.

OBJECTIVE: The main objective of the study was to develop appropriate dietary assessment instruments for the French Mediterranean region and to validate the measurements they provide. SUBJECTS AND METHODS: Three different assessment methods were submitted to a sample of 150 male and female volunteers. 98 completed the protocol, which consisted of a 4 d weighed dietary record (PETRA) and a 7 d estimated-diet record (S7) based on a check list and a set of photographs, both these records being completed once in each season of the year, and a semi-quantitative (standard portion) food-frequency questionnaire (FFQ) including questions eliciting socio-demographic and anthropometric data, which was completed once only. The days when PETRA was used to evaluate food consumption coincided with the first 4 d of S7 (S4). RESULTS: Validation was based on nutrients and foods. Energy-adjusted Pearson correlation coefficients between S4 and PETRA ranged from 0.32 for vitamin E to 0.81 for vitamin C (mean: 0.65 for 21 nutrients). There was practically no misclassification in opposite extreme quartiles. Spearman correlation coefficients ranged from 0.63 for fish and sea-food to 0.90 for wine (mean: 0.76 for 16 food groups). There was practically no misclassification in opposite extreme quartiles. De-attenuated energy-adjusted Pearson correlation coefficients between FFQ and S7 ranged from 0.22 for proteins and monounsaturated fatty acids to 0.80 for iron (mean: 0.45). 10% or less of subjects were misclassified in opposite extreme quartiles (except for vitamin C, 12%). Spearman correlation coefficients ranged from 0.25 for green-yellow-red raw vegetables to 0.76 for wine (mean: 0.42). 8% or less of subjects were misclassified in opposite extreme quartiles (except for citrus fruit, 11%). CONCLUSIONS: Portion estimation using the set of photographs was validated by the correlation between S4 and PETRA for both nutrients and foods. The FFQ provides a reasonably reliable measure of macronutrient intake and a good measure of micronutrient intake when compared with the data in the literature. It performs less well for food intake. Better results can be achieved for FFQ: (i) by using the set of photographs instead of standard portions and (ii) by adding further questions on foods which are insufficiently covered.

Adult↗
PubMed1987

Records as a data source: the case for health visitor records.

Health records as a source of research data are examined. A case study approach is adopted to evaluate the reliability of health visitor records as a data source. It is argued that such records may be a rich source of epidemiological data although their deficiencies should be acknowledged.

Child↗
PubMed2000

Computerization of leprosy records: national leprosy recording and reporting system in China.

This paper describes the national system of leprosy recording and reporting in China and the computerization of records. The system was designed for data collection at local level and data entry by optically scanned or manual mode as well as for sophisticated data analysis. The major functions include data entry, data check, sum-up, maintenance, communication, inquiry, statistics, graph and print. A total of 17 options for epidemiological and clinical data analysis are available. Through the implementation for about 10 years, the system has gained widespread acceptance. This acceptance would facilitate introduction of computer analysis to other leprosy projects and other disease control programs in China. Up to 1998, a database of more than 740,000 records covering all the leprosy patients detected since 1949 had been established by this system.

Adolescent↗
PubMed1993

Electronic medical record systems as a basis for computer-based patient records.

In summation, some document imaging systems offer the capability to form what may be called electronic medical record (EMR) systems. These systems are adaptations of current paper-based record management systems into the digital environment, but they offer far more capabilities than strictly archival, historical functions. Some of the capabilities that create EMR systems will also be necessary for development of CPRs, these capabilities are listed as follows: mass storage and image management; direct capture, storage, and retrieval of digital information (native format); large volume, high-speed, client-server networks; multi-media information management; high-power, flexible database tools; workflow process software; flexible, full function security; user customizable features; and alerts and reminders. Selection and implementation of document imaging systems should, at present, be undertaken with great care to insure that the platform may be utilized to form an electronic medical record with a clear migration path to the CPR.

Database Management Systems↗
PubMed1980

Public Health Service--Privacy Act of 1974. Notification of new system of records: "clinical research; records of subjects in intramural research, epidemiology, demography, and biometry studies on aging.".

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to adopt a new system of records. "Clinical Research: Records of Subjects in Intramural Research, Epidemiology, Demography, and Biometry Studies on Aging." DHHS/NIH/NIA, 09-25-0142. These records will be used to accomplish scientific research conducted by intramural scientists employed by the National Institute on Aging (NIA), and by hospitals, universities, research centers and research foundation under contract with NIA. These research activities aim at determining the health status of individuals and changes in health status over time, the incidence and prevalence of certain diseases and problems of the aged in certain populations, and changes that take place as the individuals age who are under study.

Aging↗
PubMed1983

Privacy Act of 1974; altered system of records--PHS. Notification of altered Privacy Act system of records 09-25-0074.

In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to alter system of records 09-25-0074, "Clinical Research: Veterans Administration Bladder and Prostate Cancer Clinical Trials, HHS/NIH/NCI." The purpose of the alteration is to modify an existing system of records into an umbrella system by broadening both the categories of individuals under this system and the purposes for which the system is used. The names of the system of records is also being changed to reflect the alteration. The new name is "Clinical Research: Division of Cancer Biology and Diagnosis Patient Trials, HHS/NIH/NCI."

Civil Rights↗
PubMedDate not supplied

Manual record-keeping and statistical records for the operating room.

Surveys have shown that handwritten anesthesia and circulating records kept in hospital operating rooms may be inadequately maintained and analyzed. Online, fully automated data processing techniques have been applied to reduce the anesthesiologist's recordkeeping workload, but with limited receptivity. An off-line data processing system has been developed using handwritten records to provide both anesthesia and operating room utilization statistics. Evaluation of the system indicates that an online, semiautomated approach applied only to charting vital signs and recording utilization statistics is an appropriate one for future development.

Anesthesia↗
PubMed1995

A portable communicative architecture for electronic healthcare records: the Good European Healthcare Record project (Aim project A2014).

The European Union is supporting research into medical informatics via its Advanced Informatics in Medicine (AIM) program. One of the current AIM projects is the Good European Healthcare Record (GEHR) project. Its objective is to devise an architecture for electronic healthcare records that will enable them to be comprehensive, communicative, and portable to different systems. The work was funded from January 1992 to December 1994. The project team consisted of over 50 personnel representing clinicians, computer scientists, and computer programmers in eight European countries. The partner organizations are Health Data Management Partners (Belgium), Croix Rouge Francaise (France), France Telecom, Association des Medecins et Medicins Dentistes (Luxembourg), Instituto Clinica Geral Zona Norte (Portugal), Medical College of St Bartholomew's Hospital (UK), and SmithKline Beecham (UK). The work of the project has been carried out by three subgroups covering clinical, architecture, and systems aspects. One of the strengths of the project has been that most of the work has been done as collaborations between members of different groups. This has meant that there has been very close contact between clinicians and computer experts. The GEHR project is providing important input into the standardization process in Europe via, for example, PT011 of Working Group 1 of CEN TC/251 (the developing standards for the architecture of healthcare records).

Computer Communication Networks↗
PubMed1998

[Discrepancies between medical records and dispensing records in two large hospital departments in Copenhagen].

This study was performed to investigate the possible differences between prescribed medicine, as entered in the hospital record, and the medicine dispensed to the patients according to the nurse's dispensing records (NDR's) in two clinical departments at a Copenhagen University Hospital. Discrepancies were defined as either dosage differences or drugs only present in one file, and were divided into major and minor discrepancies, according to clinical significance. In the first department, discrepancies were found in 61.4% of the records, and major discrepancies were found in 35.1%. In the second department, discrepancies were found in 70.5% of the cases, and major discrepancies in 42.5%. No correlation was found between the number of drugs per patient and the number of discrepancies. A significant difference exists between what is prescribed, and what is dispensed. This can have clinical as well as legal consequences.

Denmark↗