Ontology based EMR for decision making in health care using SNOMED CT

BACKGROUND : Currently, hypertension is one of the diseases with greater risk of mortality in the world. Particularly in Chile, 90% of the population with this disease has idiopathic or essential hypertension. Essential hypertension is characterized by high blood pressure rates and it´s cause is unknown, which means that every patient might requires a different treatment, depending on their history and symptoms. Different data, such as history, symptoms, exams, etc., are generated for each patient suffering from the disease. This data is presented in the patient’s medical record, in no order, making it difficult to search for relevant information. Therefore, there is a need for a common, unified vocabulary of the terms that adequately represent the diseased, making searching within the domain more effective. OBJECTIVE The objective of this study is to develop a domain ontology for essential hypertension , therefore arranging the more significant data within the domain as tool for medical training or to support physicians’ decision making will be provided. METHODS The terms used for the ontology were extracted from the medical history of de-identified medical records, of patients with essential hypertension. The Snomed-CT’ collection of medical terms, and clinical guidelines to control the disease were also used. Methontology was used for the design, classes definition and their hierarchy, as well as relationships between concepts and instances. Three criteria were used to validate the ontology, which also helped to measure its quality. Tests were run with a dataset to verify that the tool was created according to the requirements. RESULTS An ontology of 310 instances classified into 37 classes was developed. From these, 4 super classes and 30 relationships were obtained. In the dataset tests, 100% correct and coherent answers were obtained for quality tests (3). CONCLUSIONS The development of this ontology provides a tool for physicians, specialists, and students, among others, that can be incorporated into clinical systems to support decision making regarding essential hypertension. Nevertheless, more instances should be incorporated into the ontology by carrying out further searched in the medical history or free text sections of the medical records of patients with this disease.

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Evidence use as sociomaterial practice? A qualitative study of decision-making on introducing service innovations in health care

Public Management Review ◽

10.1080/14719037.2021.1883098 ◽

2021 ◽

pp. 1-25

Author(s):

Simon Turner ◽

Danielle D´Lima ◽

Jessica Sheringham ◽

Nick Swart ◽

Emma Hudson ◽

...

Keyword(s):

Health Care ◽

Decision Making ◽

Qualitative Study ◽

Evidence Use

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Health Care Analysis on Myocardial Revascularization in Patients with Chronic Coronary Artery Disease: The Multicenter REVASK Study: Design and Protocol

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0040-1721391 ◽

2020 ◽

Author(s):

Andreas Beckmann ◽

Eva-Maria Bitzer ◽

Mareike Lederle ◽

Peter Ihle ◽

Jochen Walker ◽

...

Keyword(s):

Coronary Artery Disease ◽

Health Care ◽

Decision Making ◽

Coronary Artery ◽

Myocardial Revascularization ◽

Care Providers ◽

Chronic Coronary Artery Disease ◽

Care Guideline ◽

Artery Disease

AbstractCoronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are available for revascularization of coronary artery disease (CAD) with the aims to reduce cardiovascular morbidity and mortality and to improve disease-related quality of life in particular. The German National Care Guideline (NVL-cKHK) on chronic CAD recommends the establishment of so-called heart teams for decision making in myocardial revascularization to improve the quality of care. Preferred recommendations for PCI or CABG are given for different patient subgroups depending on patient characteristics, concomitant diseases, and coronary morphology. The myocardial revascularization study (REVASK) is a noninterventional cohort study on care of patients undergoing PCI or CABG based on retrospective statutory health insurance (SHI) routine data, registry data from the German Cardiac Society (DGK) resp., the German Society for Thoracic and Cardiovascular Surgery (DGTHG), combined with prospective primary data collection from health care providers and patients. The primary goal is to investigate whether and to which extent heart teams, consisting of cardiologists and cardiac surgeons, increase guideline adherence in decision making for myocardial revascularization. Ultimately the study project aims to improve patient care in terms of decision making for appropriate myocardial revascularization. Through the consistent implementation of the German National Care Guideline on chronic Coronary Artery Disease (NVL-cKHK) and the European Guidelines on myocardial revascularization, the reduction of morbidity, mortality and the reduced need for subsequent revascularization procedures are also desirable from a health economics perspective.

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Covid-19 FAQ’s in Paediatric and Congenital Cardiology – AEPC position paper.

Cardiology in the Young ◽

10.1017/s1047951120005028 ◽

2021 ◽

pp. 1-21

Author(s):

Skaiste Sendzikaite ◽

Ruth Heying ◽

Ornella Milanesi ◽

Katarina Hanseus ◽

Ina Michel-Behnke

Keyword(s):

Health Care ◽

Decision Making ◽

Health Care Systems ◽

Scientific Data ◽

Position Paper ◽

Paediatric Cardiology ◽

European Paediatric ◽

Care Systems ◽

The Times ◽

Almost All

Abstract The Covid-19 pandemic has had a huge influence in almost all areas of life, affecting societies, economics and health care systems worldwide. The paediatric cardiology community is no exception. As the challenging battle with Covid-19 continues, professionals from the Association for the European Paediatric and Congenital Cardiology (AEPC) receive many questions regarding Covid-19 in a Paediatric and Congenital Cardiology setting. The aim of this paper is to present the AEPC position on frequently asked questions based on the most recent scientific data, as well as to frame a discussion on how to take care of our patients during this unprecedented crisis. As the times are changing quickly and information regarding Covid-19 is very dynamic, continuous collection of evidence will help guide constructive decision-making.

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Improving Communications With Patients and Families in Geriatric Care. The How, When, and What

Journal of Patient Experience ◽

10.1177/23743735211034047 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110340

Author(s):

Shirley Chien-Chieh Huang ◽

Alden Morgan ◽

Vanessa Peck ◽

Lara Khoury

Keyword(s):

Health Care ◽

Decision Making ◽

Family Caregivers ◽

Health Care Providers ◽

Tertiary Care ◽

Care Providers ◽

Telephone Interviews ◽

Written Information ◽

Geriatric Unit ◽

Patient Health

There has been little published literature examining the unique communication challenges older adults pose for health care providers. Using an explanatory mixed-methods design, this study explored patients’ and their family/caregivers’ experiences communicating with health care providers on a Canadian tertiary care, inpatient Geriatric unit between March and September 2018. In part 1, the modified patient–health care provider communication scale was used and responses scored using a 5-point scale. In part 2, one-on-one telephone interviews were conducted and responses transcribed, coded, and thematically analyzed. Thirteen patients and 7 family/caregivers completed part 1. Both groups scored items pertaining to adequacy of information sharing and involvement in decision-making in the lowest 25th percentile. Two patients and 4 family/caregivers participated in telephone interviews in part 2. Interview transcript analysis resulted in key themes that fit into the “How, When, and What” framework outlining the aspects of communication most important to the participants. Patients and family/caregivers identified strategic use of written information and predischarge family meetings as potentially valuable tools to improve communication and shared decision-making.

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Unmasking a health care system: the Dutch policy response to the Covid-19 crisis

Health Economics Policy and Law ◽

10.1017/s1744133121000128 ◽

2021 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Iris Wallenburg ◽

Jan-Kees Helderman ◽

Patrick Jeurissen ◽

Roland Bal

Keyword(s):

Health Care ◽

Decision Making ◽

Health Care System ◽

Health Care Systems ◽

Economic Policies ◽

Hard Time ◽

Dutch Health ◽

Care Systems ◽

Policy Systems ◽

Care System

Abstract The Covid-19 pandemic has put policy systems to the test. In this paper, we unmask the institutionalized resilience of the Dutch health care system to pandemic crisis. Building on logics of crisis decision-making and on the notion of ‘tact’, we reveal how the Dutch government initially succeeded in orchestrating collective action through aligning public health purposes and installing socio-economic policies to soften societal impact. However, when the crisis evolved into a more enduring one, a more contested policy arena emerged in which decision-makers had a hard time composing and defending a united decision-making strategy. Measures have become increasingly debated on all policy levels as well as among experts, and conflicts are widely covered in the Dutch media. With the 2021 elections ahead, this means an additional test of the resilience of the Dutch socio-political and health care systems.

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The Application of Multicriteria Decision Analysis Methods in Health Care: A Literature Review

Medical Decision Making ◽

10.1177/0272989x211019040 ◽

2021 ◽

pp. 0272989X2110190

Author(s):

Ilyas Khan ◽

Liliane Pintelon ◽

Harry Martin

Keyword(s):

Health Care ◽

Decision Making ◽

Decision Analysis ◽

Medical Devices ◽

Hybrid Methods ◽

Multicriteria Decision Analysis ◽

Multicriteria Decision ◽

Health Care Decision ◽

Wide Range ◽

Care Decision

Objectives The main objectives of this article are 2-fold. First, we explore the application of multicriteria decision analysis (MCDA) methods in different areas of health care, particularly the adoption of various MCDA methods across health care decision making problems. Second, we report on the publication trends on the application of MCDA methods in health care. Method PubMed was searched for literature from 1960 to 2019 in the English language. A wide range of keywords was used to retrieve relevant studies. The literature search was performed in September 2019. Articles were included only if they have reported an MCDA case in health care. Results and Conclusion The search yielded 8,318 abstracts, of which 158 fulfilled the inclusion criteria and were considered for further analysis. Hybrid methods are the most widely used methods in health care decision making problems. When it comes to single methods, analytic hierarchy process (AHP) is the most widely used method followed by TOPSIS (technique for order preference by similarity to ideal solution), multiattribute utility theory, goal programming, EVIDEM (evidence and value: impact on decision making), evidential reasoning, discrete choice experiment, and so on. Interestingly, the usage of hybrid methods has been high in recent years. AHP is most widely applied in screening and diagnosing and followed by treatment, medical devices, resource allocation, and so on. Furthermore, treatment, screening and diagnosing, medical devices, and drug development and assessment got more attention in the MCDA context. It is indicated that the application of MCDA methods to health care decision making problem is determined by the nature and complexity of the health care problem. However, guidelines and tools exist that assist in the selection of an MCDA method.

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