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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 1467 Research Studies DisplayedFrehn JL, Starn BE, Rodriguez HP
Care redesign to support telemedicine implementation during the COVID-19 pandemic: federally qualified health center personnel experiences.
During the COVID-19 pandemic, federally qualified health centers (FQHCs) swiftly adopted telemedicine. In-depth interviews with FQHC staff revealed that while telemedicine improved access and reduced no-shows, it also hindered the development of strong clinician-patient relationships due to limitations in building interpersonal connections. To overcome this, FQHCs employed various strategies, such as triaging appointment types, addressing social needs remotely, and establishing new protocols for ensuring patient privacy during virtual visits. Additionally, they emphasized the need to improve remote monitoring capabilities for marginalized populations. This study highlights the need for guidelines and evidence-based practices to enhance telemedicine use in FQHCs, focusing on strengthening interpersonal connections, addressing social needs, and protecting patient privacy. Future research should investigate how telemedicine can best complement in-person care to optimize patient outcomes and clinic efficiency in safety net settings.
AHRQ-funded; HS000046.
Citation: Frehn JL, Starn BE, Rodriguez HP .
Care redesign to support telemedicine implementation during the COVID-19 pandemic: federally qualified health center personnel experiences.
J Am Board Fam Med 2023 Oct 11; 36(5):712-22. doi: 10.3122/jabfm.2022.220370R2..
Keywords: Telehealth, Health Information Technology (HIT), COVID-19, Community-Based Practice, Clinician-Patient Communication, Patient and Family Engagement
Parikh NR, Francisco LS, Balikai SC
Development and evaluation of I-PASS-to-PICU: a standard electronic template to improve referral communication for interfacility transfers to the pediatric ICU.
The objective of this study was to develop and evaluate a standard electronic referral template (I-PASS-to-PICU) to improve communication for interfacility pediatric ICU (PICU) transfers. I-PASS-to-PICU was developed in a single PICU, designed with an electronic health record-supported clinical note template by adapting elements from an evidence-based handoff program, to support information exchange between referring clinicians and receiving PICU physicians. Usability testing with receiving PICU physicians using simulated and actual calls revealed good usability on the System Usability Scale. The authors planned further evaluation of the template’s effectiveness in improving information exchange during real-time PICU practice.
AHRQ-funded; HS026965.
Citation: Parikh NR, Francisco LS, Balikai SC .
Development and evaluation of I-PASS-to-PICU: a standard electronic template to improve referral communication for interfacility transfers to the pediatric ICU.
Jt Comm J Qual Patient Saf 2024 May; 50(5):338-47. doi: 10.1016/j.jcjq.2024.01.010..
Keywords: Children/Adolescents, Transitions of Care, Intensive Care Unit (ICU), Electronic Health Records (EHRs), Health Information Technology (HIT), Communication, Critical Care
Tokede B, Brandon R, Lee CT
Development and validation of a rule-based algorithm to identify periodontal diagnosis using structured electronic health record data.
This article describes the development and validation of an automated electronic health record (EHR) based algorithm to suggest a periodontal diagnosis. It was based on materials from the 2017 World Workshop on the Classification of Periodontal Diseases and Conditions. Findings suggested that a rule-based algorithm using EHR data can be implemented with moderate accuracy in support of chairside clinical diagnostic decision making, and may be particularly useful for inexperienced clinicians. The authors noted that grey-zone cases where clinical judgement will be required still exist and that future applications of similar algorithms will depend upon the quality of EHR data.
AHRQ-funded; HS027938.
Citation: Tokede B, Brandon R, Lee CT .
Development and validation of a rule-based algorithm to identify periodontal diagnosis using structured electronic health record data.
J Clin Periodontol 2024 May; 51(5):547-57. doi: 10.1111/jcpe.13938..
Keywords: Dental and Oral Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality
Kelly MM, Kieren MQ, Coller RJ
Pediatric open notes: caregiver experiences since the 21st Century Cures Act.
This progress report discusses the impact of the 2020 21st Century Cures Act Final Rule, which mandates that patients and their caregivers have free, secure, and immediate access to their electronic health information, including clinical notes. The authors discuss the results of a study where they surveyed parents who were offered access to clinical notes during their child’s hospital stay. The benefit most frequently cited by parents was the ability to recapitulate their child’s care plan, while the most mentioned challenge was confusion caused by misunderstanding note content. Policy implications are discussed that might mitigate challenges including sociodemographic disparities as well as language barriers and limited health literacy. They present technological solutions such as use of AI algorithms to identify and filter confidential, potentially sensitive, information to different tiers of access that would allow adolescents a greater degree of control over their personal information. The use of natural language processing also has the potential to automatically translate medical language into more patient and family-friendly terms.
AHRQ-funded; HS027214; HS027894.
Citation: Kelly MM, Kieren MQ, Coller RJ .
Pediatric open notes: caregiver experiences since the 21st Century Cures Act.
Acad Pediatr 2024 May-Jun; 24(4):556-58. doi: 10.1016/j.acap.2023.10.001..
Keywords: Children/Adolescents, Caregiving, Electronic Health Records (EHRs), Health Information Technology (HIT), Policy
Freed K, Taylor MG, Toledo P
Readability, content, and quality of online patient education materials on anesthesia and neurotoxicity in the pediatric population.
This study’s aim was to evaluate readability, content, and quality of Internet-based patient education materials (PEMs) on anesthesia in the pediatric population and neurotoxicity. In 2016 the FDA released a warning statement against use of general anesthetic drugs in children and pregnant women due to concerns about neurotoxicity, and a number of websites of US medical centers with pediatric anesthesia fellowship programs had posted PEMs on the effects of anesthesia in the pediatric population and neurotoxicity. The quality of the PEMs was assessed with the Patient Education Material Assessment Tool for Print. Readability of the PEMs to the recommended sixth-grade reading level was compared using a one-sample t-test. The authors identified 27 PEMs pertaining to pediatric anesthesia and eight to neurotoxicity. Mean readability of all PEMs was greater than a sixth-grade reading level. While only 13% of PEMs on anesthesia for pediatric patients mentioned the FDA warning, all of the neurotoxicity materials did. The materials had good understandability (83%) but poor actionability (60%).
AHRQ-funded; HS025267.
Citation: Freed K, Taylor MG, Toledo P .
Readability, content, and quality of online patient education materials on anesthesia and neurotoxicity in the pediatric population.
Am J Perinatol 2024 May; 41(S 01):e341-e47. doi: 10.1055/s-0042-1754408..
Keywords: Children/Adolescents, Education: Patient and Caregiver, Medication, Medication: Safety, Patient Safety, Health Information Technology (HIT)
Babiarz Babiarz, Ryu H, Williams C
Slicing through silos: development and evaluation of a hospital-based telehealth hepatitis C virus treatment program.
This single site prospective cohort study aimed to measure linkage to care with a hepatitis C virus (HCV) clinician and initiation of HCV treatment in hospitalized patients with substance use disorder (SUD). This hospital-based telehealth program initially assessed patients in-person by a social worker then seen via telehealth by a clinician who prescribed either glecaprevir/pibrentasvir or sofosbuvir/velpatasvir. In/person and/or telephonic outreach was then conducted by the research team during and after hospitalization. If the patient was cured of HCV, it was confirmed by sustained virologic response at 12 weeks (SVR12) post-treatment. All 25 patients enrolled had a history of SUD and 18 were unstably housed. Nineteen patients initiated treatment and 14 successfully completed treatment. Twelve patients completed post-treatment labs, including two who prematurely discontinued treatment. Eleven patients achieved confirmed cure with SVR12.
AHRQ-funded; HS026370.
Citation: Babiarz Babiarz, Ryu H, Williams C .
Slicing through silos: development and evaluation of a hospital-based telehealth hepatitis C virus treatment program.
Int J Drug Policy 2024 May; 127:104396. doi: 10.1016/j.drugpo.2024.104396..
Keywords: Hepatitis, Telehealth, Health Information Technology (HIT)
Idnay B, Liu J, Fang Y
Sociotechnical feasibility of natural language processing-driven tools in clinical trial eligibility prescreening for Alzheimer's disease and related dementias.
This study investigated the sociotechnical feasibility of natural language processing (NLP)-driven tools for Alzheimer’s disease and related dementia research (ADRD) prescreening so that researchers can effectively identify eligible clinical trial participants. The authors conducted a randomized experiment with 60 clinical research staff using three prescreening tools (Criteria2Query, Informatics for Integrating Biology and the Bedside [i2b2], and Leaf). Usability of each tool was analyzed using the Health Information Technology Usability Evaluation Scale. Leaf had the highest score for usability followed by Criteria2Query and i2b2. Cognitive complexity was found to be affected by age, computer literacy, and number of criteria, but wasn’t significantly associated with usability. The authors concluded that adopting NLP for ADRD prescreening demands careful task delegation, comprehensive training, precise translation of eligibility criteria, and increased research accessibility.
AHRQ-funded; HS028752.
Citation: Idnay B, Liu J, Fang Y .
Sociotechnical feasibility of natural language processing-driven tools in clinical trial eligibility prescreening for Alzheimer's disease and related dementias.
J Am Med Inform Assoc 2024 Apr 19; 31(5):1062-73. doi: 10.1093/jamia/ocae032..
Keywords: Dementia, Neurological Disorders, Health Information Technology (HIT), Research Methodologies
Barton HJ, Maru A, Leaf MA
Academic detailing as a health information technology implementation method: supporting the design and implementation of an emergency department-based clinical decision support tool to prevent future falls.
This study investigated the effectiveness of academic detailing, a method involving personalized education sessions with clinicians, in implementing a machine learning-based clinical decision support (CDS) tool designed to prevent future falls in elderly emergency department patients. Through qualitative analysis of interviews with clinicians who had encountered the CDS tool, researchers identified several factors influencing its use, including aspects of the tool's design, clinicians' understanding of the tool and referral process, the fast-paced emergency department environment, clinicians' perception of patient fall risk, and the complexity of the referral process. Academic detailing sessions allowed for real-time clarification of misconceptions and demonstration of the tool's functionality, highlighting its potential as a valuable strategy for supporting the implementation and optimization of health information technologies. Additionally, insights gained from these sessions can inform both immediate adjustments to the implementation process and long-term redesign of the tool to better align with clinicians' needs and workflows.
AHRQ-funded; HS027735.
Citation: Barton HJ, Maru A, Leaf MA .
Academic detailing as a health information technology implementation method: supporting the design and implementation of an emergency department-based clinical decision support tool to prevent future falls.
JMIR Hum Factors 2024 Apr 18; 11:e52592. doi: 10.2196/52592..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Implementation, Emergency Department, Falls, Prevention
He Z, Bhasuran B, Jin Q
Quality of answers of generative large language models versus peer users for interpreting laboratory test results for lay patients: evaluation study.
This study compared the quality of answers of generative large language models (LLMs) versus peer users for interpreting laboratory test results for lay patients. The authors collected laboratory test result-related Q&A data from Yahoo! Answers and selected 53 Q&A pairs for this study. Using the LangChain framework and ChatGPT web portal, they generated responses to the 53 questions from 5 LLMs: GPT-4, GPT-3.5, LLaMA 2, MedAlpaca, and ORCA_mini. They assessed the similarity of their answers using standard Q&A similarity-based evaluation metrics. They used an LLM-based evaluator to judge whether a target model had higher quality in terms of relevance, correctness, helpfulness, and safety than the baseline model. They performed a manual evaluation with medical experts for all the responses to 7 selected questions on the same 4 aspects. They used GPT-4 output as the reference answer and found the responses from GPT-3 were the most similar, followed by those from LLaMA 2, ORCA_mini, and MedAlpaca. Human answers from Yahoo data were scored the lowest. They also identified a number of ways to improve the quality of LLM responses.
AHRQ-funded; HS029969.
Citation: He Z, Bhasuran B, Jin Q .
Quality of answers of generative large language models versus peer users for interpreting laboratory test results for lay patients: evaluation study.
J Med Internet Res 2024 Apr 17; 26:e56655. doi: 10.2196/56655..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Foer D, Rubins DM, Nguyen V
Utilization of electronic health record sex and gender demographic fields: a metadata and mixed methods analysis.
An assessment of electronic health record (EHR) metadata revealed that while all patients had a "Legal Sex" entry as mandated, completion rates for "Gender Identity" and "Sex Assigned at Birth" were only 20% and 19%, respectively. Notably, 321,185 patients experienced changes in these fields over time, with administrators initiating the majority of changes. Provider utilization varied significantly by subspecialty, with identified barriers including system limitations and individual perceptions. This study underscores the need for improved accuracy and consistency in sex and gender data collection in EHRs, as well as greater awareness and standardized workflows among providers to ensure appropriate utilization of these fields.
AHRQ-funded; HS028916.
Citation: Foer D, Rubins DM, Nguyen V .
Utilization of electronic health record sex and gender demographic fields: a metadata and mixed methods analysis.
J Am Med Inform Assoc 2024 Apr 3; 31(4):910-18. doi: 10.1093/jamia/ocae016..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Bouchelle Z, Menko SG, Yazdani M
Parent perspectives on documentation and sharing of health-related social needs data.
This survey aimed to examine parents of pediatric patients’ preferences regarding how health-related social needs (HRSN) screening program data are documented and shared. The authors conducted semi-structured interviews with parents of hospitalized children participating in an HRSN screening program at a quaternary care children's hospital. Interviews were then coded to identify emergent themes. A total of 20 parents were interviewed with all being female, 55% identifying as Black or African American and 20% identifying as Hispanic or Latino. Parents expressed comfort with electronic health record documentation of HRSN data and the use of ICD-10 Revision Z codes as long as this information was used to provide families with meaningful support. Most parents viewed social workers and medical teams as being the most appropriate recipients of the data, with few parents feeling comfortable with HRSN data being shared with payors. Parents wanted transparency around HRSN data sharing, with many expressing concerns that documentation and sharing of HRSN data could lead to unwanted or unsafe disclosures or result in child welfare referrals.
AHRQ-funded; HS028555.
Citation: Bouchelle Z, Menko SG, Yazdani M .
Parent perspectives on documentation and sharing of health-related social needs data.
Hosp Pediatr 2024 Apr; 14(4):308-16. doi: 10.1542/hpeds.2023-007478..
Keywords: Children/Adolescents, Screening, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bybee SG, Sharareh N, Guo JW
A secondary data analysis of technology access as a determinant of health and impediment in social needs screening and referral processes.
A study of social needs screening and referral interventions in an emergency department setting found that of 453 patients with unmet social needs requesting assistance, only 21% were successfully connected with community service specialists. Contact preferences varied among patients, with the majority preferring telephone outreach. However, preferences differed based on age, specific needs, outreach success, and changes in emergency department utilization. This suggests that traditional communication methods may not be effective for reaching the most vulnerable patients who experience unstable access to phones or the internet. Further research is needed to determine whether communication preferences can serve as an indicator of unmet needs and to adapt social needs interventions for better accessibility among these high-risk populations.
AHRQ-funded; HS026505.
Citation: Bybee SG, Sharareh N, Guo JW .
A secondary data analysis of technology access as a determinant of health and impediment in social needs screening and referral processes.
AJPM Focus 2024 Apr; 3(2):100189. doi: 10.1016/j.focus.2024.100189..
Keywords: Health Information Technology (HIT), Social Determinants of Health
Tai-Seale M, Baxter SL, Vaida F
AI-generated draft replies integrated into health records and physicians' electronic communication.
The objective of this quality improvement (QI) study was to investigate association between generative artificial intelligence (GenAI) drafted replies for patient messages and physician time spent on answering messages and length of replies. Primary care physicians in an academic health system were randomized to an immediate activation group and a delayed activation group. Results showed that GenAI-drafted replies were associated with significantly increased read time and reply length, no change in reply time, and some perceived benefits. Participants recognized GenAI's value and suggested areas for improvement. The authors noted that rigorous empirical tests were necessary to examine GenAI's performance and that future studies should examine patient experience and compare multiple GenAIs, including those with medical training.
AHRQ-funded; HS029770.
Citation: Tai-Seale M, Baxter SL, Vaida F .
AI-generated draft replies integrated into health records and physicians' electronic communication.
JAMA Netw Open 2024 Apr; 7(4):e246565. doi: 10.1001/jamanetworkopen.2024.6565..
Keywords: Health Information Technology (HIT), Communication, Electronic Health Records (EHRs)
Kalwani NM, Osmanlliu E, Parameswaran V
Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic.
Researchers conducted a retrospective cohort study to examine trends in telemedicine use and visit volumes across cardiology subspecialties during the early months of the COVID-19 pandemic. Data from patients with ambulatory visits at a multispecialty cardiovascular center in Northern California were analyzed. Results showed that telemedicine visits increased dramatically during the COVID period; usage was above 75% of visits in all cardiology subspecialties in April 2020, stabilizing at rates ranging from over 95% (electrophysiology) to under 25% (heart transplant and vascular medicine). Visit volumes were below pre-COVID levels from March to May 2020, but exceeded pre-COVID levels after June 2020. The researchers concluded that telemedicine can be used to deliver a significant proportion of outpatient cardiovascular care and may increase access to care in cardiology clinics.
AHRQ-funded; HS026128.
Citation: Kalwani NM, Osmanlliu E, Parameswaran V .
Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic.
J Telemed Telecare 2024 Apr; 30(3):543-48. doi: 10.1177/1357633x211073428..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Cardiovascular Conditions, Ambulatory Care and Surgery
Walker DM, Hefner JL, MacEwan SR
Differences by race in outcomes of an in-person training intervention on use of an inpatient portal: a secondary analysis of a randomized clinical trial.
The objective of this study was to compare differences in effectiveness of patient training and portal functionality interventions implemented to increase portal use among racial groups. This secondary analysis used data from a randomized clinical trial. Findings indicated that providing in-person training or robust portal functionality did not narrow the divide between Black participants and White participants with respect to portal use. The authors concluded that health systems may need to consider intentional interventions that address underlying issues which contribute to this inequity.
AHRQ-funded; HS024379; HS024091.
Citation: Walker DM, Hefner JL, MacEwan SR .
Differences by race in outcomes of an in-person training intervention on use of an inpatient portal: a secondary analysis of a randomized clinical trial.
JAMA Netw Open 2024 Apr; 7(4):e245091. doi: 10.1001/jamanetworkopen.2024.5091..
Keywords: Racial and Ethnic Minorities, Electronic Health Records (EHRs), Health Information Technology (HIT), Education: Patient and Caregiver
Liu T, Zhu Z, Holmgren AJ
National trends in billing patient portal messages as e-visit services in traditional Medicare.
This study examined trends in billing patient portal messages in traditional Medicare. In 2020 the Centers for Medicare & Medicaid Services introduced online digital evaluation and management (E&M) codes for clinicians to address patient concerns asynchronously through patient portal messages. The authors identified e-visit services for 100% Medicare fee-for-service population from 2020 through 2022. Billing for e-visit services reached a peak of 728 monthly encounters per 100,000 beneficiaries during the initial onset of the COVID pandemic and stabilized to approximately 90 monthly encounters per 100,000 beneficiaries. Primary care provided billing more frequently than other specialties, accounting for over 50% of all billed e-visits during the study period. Fewer beneficiaries lived in rural areas compared with beneficiaries using telehealth and in-person care, but otherwise shared similar demographic characteristics. Hypertension was the most common diagnosis (21%), followed by diabetes (2.3%) and COVID-19 (2%).
AHRQ-funded; HS028397.
Citation: Liu T, Zhu Z, Holmgren AJ .
National trends in billing patient portal messages as e-visit services in traditional Medicare.
Health Affairs Scholar 2024 Apr; 2(4):qxae040. doi: 10.1093/haschl/qxae040..
Keywords: Telehealth, Health Information Technology (HIT), Medicare, COVID-19
Yellowlees PM, Burke MM, Gonzalez AD
Patient and provider satisfaction with asynchronous versus synchronous telepsychiatry in primary care: a secondary mixed-methods analysis of a randomized controlled trial.
This mixed-methods study was a secondary analysis of patients' and primary care providers' (PCPs) satisfaction from a randomized clinical trial that compared asynchronous telepsychiatry (ATP) with synchronous telepsychiatry (STP). Patients and PCPs completed a satisfaction survey and provided unstructured feedback about their experiences with either ATP or STP. Patients expressed overall satisfaction with both STP and ATP, although patients in ATP reported more concerns about the process. PCPs showed no preference for STP or ATP, and reported implementing psychiatrists' recommendations for both groups when recommendations were made.
AHRQ-funded; HS021477.
Citation: Yellowlees PM, Burke MM, Gonzalez AD .
Patient and provider satisfaction with asynchronous versus synchronous telepsychiatry in primary care: a secondary mixed-methods analysis of a randomized controlled trial.
Telemed J E Health 2024 Apr; 30(4):e1049-e63. doi: 10.1089/tmj.2023.0238..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care, Behavioral Health
Apathy NC, Zabala G, Gomes K
Telemedicine and in-person visit modality mix and electronic health record use in primary care.
This cross-sectional study examined the relationship between daily telemedicine visit share and electronic health record (EHR) usage among primary care physicians (PCPs). The analysis of 67,894 PCP-day observations revealed that days with a mix of telemedicine and in-person visits were associated with a 5.6% to 6.2% increase in EHR-based work, primarily in documentation and medical record review. However, fully telemedicine days did not show a significant association with increased EHR use. This discrepancy with previous findings is attributed to the smaller sample size of fully telemedicine days and higher average visit volume in this study. The increased EHR time on mixed-modality days may be due to multitasking during telemedicine visits. Future research should explore the potential burden of this additional EHR work on PCPs.
AHRQ-funded.
Citation: Apathy NC, Zabala G, Gomes K .
Telemedicine and in-person visit modality mix and electronic health record use in primary care.
JAMA Netw Open 2024 Apr; 7(4):e248060. doi: 10.1001/jamanetworkopen.2024.8060..
Keywords: Telehealth, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Hahn AL, Michaels CL, Khawly G
Comparison of evaluation methods for improving the usability of a Spanish mHealth tool.
The purpose of this study was to compare two usability evaluation methods for adapting an evidence-based mHealth tool from English into Spanish. The authors conducted cognitive interviews and usability assessments using a think-aloud protocol to evaluate the usability of an HIV mHealth application among 40 Spanish-speaking adults with HIV in New York City and in La Romana in the Dominican Republic. Findings highlighted contributions and limitations of including these methods in mHealth usability testing. The authors concluded that future research should employ a multi-method approach that incorporated complementary usability evaluation methods and engaged participants in multiple assessments.
AHRQ-funded; HS028523.
Citation: Hahn AL, Michaels CL, Khawly G .
Comparison of evaluation methods for improving the usability of a Spanish mHealth tool.
Int J Med Inform 2024 Apr; 184:105355. doi: 10.1016/j.ijmedinf.2024.105355.
Keywords: Telehealth, Health Information Technology (HIT)
Simpson RL, Lee JA, Li Y
Medicare meets the cloud: the development of a secure platform for the storage and analysis of claims data.
This case report outlines the development and implementation of Amazon Web Services (AWS) at Emory University to securely store and analyze research data from the Centers for Medicare and Medicaid Services (CMS). Several interdisciplinary teams collaborated and ensured compliance with CMS policy. Results showed successful transition to a cloud-based environment with enhanced security measures and regular review processes. User training addressed cloud computing challenges. Lessons learned from challenges benefited CMS and interdisciplinary teams university-wide.
AHRQ-funded; HS026232.
Citation: Simpson RL, Lee JA, Li Y .
Medicare meets the cloud: the development of a secure platform for the storage and analysis of claims data.
JAMIA Open 2024 Apr; 7(1):ooae007. doi: 10.1093/jamiaopen/ooae007.
Keywords: Medicare, Health Information Technology (HIT)
Jeffery AD, Fabbri D, Reeves RM
Use of noisy labels as weak learners to identify incompletely ascertainable outcomes: a Feasibility study with opioid-induced respiratory depression.
Researchers examined whether ‘noisy’ labels generated from subject matter experts' heuristics using heterogenous data types could provide outcomes labels to a large, observational data set. De-identified electronic health records of over 52,000 post-operative encounters were applied to a data programming paradigm for the development of a machine learning classifier for opioid-induced respiratory depression. All confirmed cases were identified by the classifier. The researchers noted that this finding is encouraging for rare outcomes because it reduces manual reviews needed by excluding visits/patients with low probabilities. They concluded that the application of a data programming paradigm with expert-informed labeling functions might be used for phenotyping clinical phenomena easily ascertainable from highly structured data.
AHRQ-funded; HS026395.
Citation: Jeffery AD, Fabbri D, Reeves RM .
Use of noisy labels as weak learners to identify incompletely ascertainable outcomes: a Feasibility study with opioid-induced respiratory depression.
Heliyon 2024 Mar 15; 10(5):e26434. doi: 10.1016/j.heliyon.2024.e26434..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Hershberger PJ, Pei Y, Bricker DA
Motivational interviewing skills practice enhanced with artificial intelligence: ReadMI.
The authors developed a software-based training tool, Real-time Assessment of Dialogue in Motivational Interviewing (ReadMI), to advance the skills acquisition of medical students learning the MI approach. Third-year medical students in their Family Medicine clerkship participated in a 90-minute MI training session; intervention group students received both facilitator feedback and ReadMI metrics, while control group students received only facilitator feedback. Both groups improved their MI approach, but those in the intervention group used significantly more open-ended questions, fewer closed-ended questions, and had a higher ratio of open to closed questions. The authors concluded that MI skills practice can be gained with relatively small investment of student time, and that artificial intelligence can be used for both measuring MI skill acquisition and as an instructional aid.
AHRQ-funded; HS026548.
Citation: Hershberger PJ, Pei Y, Bricker DA .
Motivational interviewing skills practice enhanced with artificial intelligence: ReadMI.
BMC Med Educ 2024 Mar 5; 24(1):237. doi: 10.1186/s12909-024-05217-4..
Keywords: Health Information Technology (HIT), Education: Academic
Bratches RWR, Onsando W, Puga F
Family caregiver comfort with telehealth technologies: differences by race and ethnicity in a cross-sectional survey.
This study’s objective was to analyze a demographically representative survey of U.S. family caregivers to understand the level of comfort using telehealth technologies among family caregivers. The authors conducted a secondary analysis of survey data collected during the COVID-19 pandemic in 2020. Likert-style questions were used to determine the level of caregiver comfort using computers, smartphones, and tablets. There was a total of 340 caregivers included in the analysis. Compared with non-Hispanic white caregivers, Asian caregivers had higher odds (odds ratio [OR] 3.1) of expressing comfort using computers; black caregivers (OR 0.46) and Hispanic caregivers (OR 0.36) expressed lower odds of comfort using smartphones; and Asian caregivers had higher odds (OR 4.64) of expressing comfort using tablets.
AHRQ-funded; HS013852.
Citation: Bratches RWR, Onsando W, Puga F .
Family caregiver comfort with telehealth technologies: differences by race and ethnicity in a cross-sectional survey.
Telemed J E Health 2024 Mar; 30(3):685-91. doi: 10.1089/tmj.2023.0314..
Keywords: Telehealth, Health Information Technology (HIT), Caregiving, Racial and Ethnic Minorities
Levander XA, VanDerSchaaf H, Barragán VG
The role of human-centered design in healthcare innovation: a digital health equity case study.
This article described a human-centered design (HCD) approach to developing solutions to health care delivery technology issues that may exacerbate existing disparities. HCD used collaborative, team-based, and empathetic approaches focused on end-user experiences. The authors shared lessons learned about implementing HCD into clinical care settings and how HCD can result in developing site-specific, patient-centered innovations to address disparities and to improve digital health equity.
AHRQ-funded; HS026370.
Citation: Levander XA, VanDerSchaaf H, Barragán VG .
The role of human-centered design in healthcare innovation: a digital health equity case study.
J Gen Intern Med 2024 Mar; 39(4):690-95. doi: 10.1007/s11606-023-08500-0..
Keywords: Telehealth, COVID-19, Health Information Technology (HIT)
Molloy MJ, Zackoff M, Gifford A
Usability testing of situation awareness clinical decision support in the intensive care unit.
Researchers conducted a mixed-methods usability evaluation of an automated clinical decision support (CDS) tool previously implemented in pediatric intensive care units (PICUs) to promote shared situation awareness among medical teams to prevent safety events within children's hospitals. The site for this study was a large, urban, quaternary, free-standing children's hospital in the Midwestern U.S. PICU staff, including physicians, advanced practice providers, nurses, and respiratory therapists, completed a system usability scale, while ten participants underwent think-aloud usability testing. The overall median usability score was 87.5; participant responses and observations from think-aloud testing highlighted positive aspects of learnability and clear display of complex, easily accessible information. The researchers concluded that the tool demonstrated good usability in the critical care setting.
AHRQ-funded; HS026975.
Citation: Molloy MJ, Zackoff M, Gifford A .
Usability testing of situation awareness clinical decision support in the intensive care unit.
Appl Clin Inform 2024 Mar; 15(2):327-34. doi: 10.1055/a-2272-6184..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Intensive Care Unit (ICU), Critical Care