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BackgroundResearch networking systems hold great promise for helping biomedical scientists identify collaborators with the expertise needed to build interdisciplinary teams. Although efforts to date have focused primarily on collecting and aggregating information, less attention has been paid to the design of end-user tools for using these collections to identify collaborators. To be effective, collaborator search tools must provide researchers with easy access to information relevant to their collaboration needs. ObjectiveThe aim was to study user requirements and preferences for research networking system collaborator search tools and to design and evaluate a functional prototype. MethodsPaper prototypes exploring possible interface designs were presented to 18 participants in semistructured interviews aimed at eliciting collaborator search needs. Interview data were coded and analyzed to identify recurrent themes and related software requirements. Analysis results and elements from paper prototypes were used to design a Web-based prototype using the D3 JavaScript library and VIVO data. Preliminary usability studies asked 20 participants to use the tool and to provide feedback through semistructured interviews and completion of the System Usability Scale (SUS). ResultsInitial interviews identified consensus regarding several novel requirements for collaborator search tools, including chronological display of publication and research funding information, the need for conjunctive keyword searches, and tools for tracking candidate collaborators. Participant responses were positive (SUS score: mean 76.4%, SD 13.9). Opportunities for improving the interface design were identified. ConclusionsInteractive, timeline-based displays that support comparison of researcher productivity in funding and publication have the potential to effectively support searching for collaborators. Further refinement and longitudinal studies may be needed to better understand the implications of collaborator search tools for researcher workflows.

Background As biomedical research projects become increasingly interdisciplinary and complex, collaboration with appropriate individuals, teams, and institutions becomes ever more crucial to project success. While social networks are extremely important in determining how scientific collaborations are formed, social networking technologies have not yet been studied as a tool to help form scientific collaborations. Many currently emerging expertise locating systems include social networking technologies, but it is unclear whether they make the process of finding collaborators more efficient and effective. Objective This study was conducted to answer the following questions: (1) Which requirements should systems for finding collaborators in biomedical science fulfill? and (2) Which information technology services can address these requirements? Methods The background research phase encompassed a thorough review of the literature, affinity diagramming, contextual inquiry, and semistructured interviews. This phase yielded five themes suggestive of requirements for systems to support the formation of collaborations. In the next phase, the generative phase, we brainstormed and selected design ideas for formal concept validation with end users. Then, three related, well-validated ideas were selected for implementation and evaluation in a prototype. Results Five main themes of systems requirements emerged: (1) beyond expertise, successful collaborations require compatibility with respect to personality, work style, productivity, and many other factors (compatibility); (2) finding appropriate collaborators requires the ability to effectively search in domains other than your own using information that is comprehensive and descriptive (communication); (3) social networks are important for finding potential collaborators, assessing their suitability and compatibility, and establishing contact with them (intermediation); (4) information profiles must be complete, correct, up-to-date, and comprehensive and allow fine-grained control over access to information by different audiences (information quality and access); (5) keeping online profiles up-to-date should require little or no effort and be integrated into the scientist’s existing workflow (motivation). Based on the requirements, 16 design ideas underwent formal validation with end users. Of those, three were chosen to be implemented and evaluated in a system prototype, “Digital|Vita”: maintaining, formatting, and semi-automated updating of biographical information; searching for experts; and building and maintaining the social network and managing document flow. Conclusions In addition to quantitative and factual information about potential collaborators, social connectedness, personal and professional compatibility, and power differentials also influence whether collaborations are formed. Current systems only partially model these requirements. Services in Digital|Vita combine an existing workflow, maintaining and formatting biographical information, with collaboration-searching functions in a novel way. Several barriers to the adoption of systems such as Digital|Vita exist, such as potential adoption asymmetries between junior and senior researchers and the tension between public and private information. Developers and researchers may consider one or more of the services described in this paper for implementation in their own expertise locating systems.

Background Science has developed from a solitary pursuit into a team-based collaborative activity and, more recently, into a multidisciplinary research enterprise. The increasingly collaborative character of science, mandated by complex research questions and problems that require many competencies, requires that researchers lower the barriers to the creation of collaborative networks of experts, such as communities of practice (CoPs). Objectives The aim was to assess the information needs of prospective members of a CoP in an emerging field, dental informatics, and to evaluate their expectations of an e-community in order to design a suitable electronic infrastructure. Methods A Web-based survey instrument was designed and administered to 2768 members of the target audience. Benefit expectations were analyzed for their relationship to (1) the respondents’ willingness to participate in the CoP and (2) their involvement in funded research. Two raters coded the respondents’ answers regarding expected benefits using a 14-category coding scheme (Kappa = 0.834). Results The 256 respondents (11.1% response rate) preferred electronic resources over traditional print material to satisfy their information needs. The most frequently expected benefits from participation in the CoP were general information (85% of respondents), peer networking (31.1%), and identification of potential collaborators and/or research opportunities (23.2%). Conclusions The competitive social-information environment in which CoPs are embedded presents both threats to sustainability and opportunities for greater integration and impact. CoP planners seeking to support the development of emerging biomedical science disciplines should blend information resources, social search and filtering, and visibility mechanisms to provide a portfolio of social and information benefits. Assessing benefit expectations and alternatives provides useful information for CoP planners seeking to prioritize community infrastructure development and encourage participation.

Introduction: Implementation of research findings in clinical practice often is not realized or only partially achieved, and if so, with a significant delay. Learning health systems (LHSs) hold promise to overcome this problem by embedding clinical research and evidence‐based best practices into care delivery, enabling innovation and continuous improvement. Implementing an LHS is a complex process that requires participation and resources of a wide range of stakeholders, including healthcare leaders, clinical providers, patients and families, payers, and researchers. Engaging these stakeholders requires communicating clear, tangible value propositions. Existing models identify broad categories of benefits but do not explicate the full range of benefits or ways they can manifest in different organizations. Methods: To develop such a framework, a working group with representatives from six Clinical and Translational Science Award (CTSA) hubs reviewed existing literature on LHS characteristics, models, and goals; solicited expert input; and applied the framework to their local LHS experiences. Results: The Framework of LHS Benefits includes six categories of benefits (quality, safety, equity, patient satisfaction, reputation, and value) relevant for a range of stakeholders and defines key concepts within each benefit. Applying the framework to five LHS case examples indicated preliminary face validity across varied LHS approaches and revealed three dimensions in which the framework is relevant: defining goals of individual LHS projects, facilitating collaboration based on shared values, and establishing guiding tenets of an LHS program or mission. Conclusion: The framework can be used to communicate the value of an LHS to different stakeholders across varied contexts and purposes, and to identify future organizational priorities. Further validation will contribute to the framework's evolution and support its potential to inform the development of tools to evaluate LHS impact. [ABSTRACT FROM AUTHOR]

Conducted a measurement study to validate a preliminary survey for dental students which contained five subscales: computer use, information resource use, computer knowledge, capabilities of computer systems, and effects of computers on dental practice. Found that all survey scales except computer use were unidimensional; computer use required a two-factor solution that distinguished between clinical and nonclinical uses of computers. (EV)

Evaluates Temple University (Pennsylvania) dental school's five-year (1992-97) plan for development of academic computing, including promotion of faculty computer literacy, student computer literacy, and computer-assisted instruction. All goals except implementation of computer-aided instruction have been met. Findings have implications for the goals of the 1998-2003 plan and for institutional support of academic computing initiatives. (Author/MSE)

Objective: To determine whether preventive dental visits are associated with fewer subsequent nonpreventive dental visits and lower dental expenditures. Data Sources: Indiana Medicaid enrollment and claims data (2015–2018) and the Area Health Resource File. Study Design: A repeated measures design with individual and year fixed effects examining the relationship between preventive dental visits (PDVs) and nonpreventive dental visits (NPVs) and dental expenditures. Data Collection/Extraction Methods: Not applicable. Principal Findings: Of 28,152 adults (108,349 observation‐years) meeting inclusion criteria, 36.0% had a dental visit, 27.8% a PDV, and 22.1% a NPV. Compared to no PDV in the prior year, at least one was associated with fewer NPVs (β = −0.13; 95% CI –0.12, −0.11), lower NPV expenditures (β = −$29.12.53; 95% CI –28.07, −21.05), and lower total dental expenditures (−$70.12; 95% –74.92, −65.31), as well as fewer PDVs (β = −0.24; 95% CI –0.26, −0.23). Conclusions: Our findings suggest that prior year PDVs are associated with fewer subsequent NPVs and lower dental expenditures among Medicaid‐enrolled adults. Thus, from a public insurance program standpoint, supporting preventive dental care use may translate into improved population oral health outcomes and lower dental costs among certain low‐income adult populations, but barriers to consistent utilization of PDV prohibit definitive findings. [ABSTRACT FROM AUTHOR]

BACKGROUND: Heated humidified high-flow nasal cannula (HFNC) is a respiratory support device historically used in pediatrics for infants with bronchiolitis. No large-scale analysis has determined the current frequency or demographic distribution of HFNC use in children. The objective of this study was to determine the frequency and correlates of HFNC use in children presenting to the hospital for asthma, bronchiolitis, or pneumonia. METHODS: This longitudinal observational study was based on electronic health record data from a large regional health information exchange, the Indiana Network for Patient Care (INPC). Subjects were age 0--18 y with recorded hospital encounters at an INPC hospital between 2010--2019 with International Classification of Diseases codes for bronchiolitis, asthma, or pneumonia. Annual proportions of HFNC use among all hospital encounters were assessed using generalized additive models. Log-binomial regression models were used to identify correlates of incident HFNC use and determine risk ratios of specific subjects receiving HFNC. RESULTS: The study sample included 242,381 unique subjects with 412,712 hospital encounters between 2010--2019. The 10-y period prevalence of HFNC use was 2.54% (6,155/242,381) involving 7,974 encounters. Hospital encounters utilizing HFNC increased by 400%, from 326 in 2010 to 1,310 in 2019. This increase was evenly distributed across all 3 diagnostic categories (bronchiolitis, asthma, and pneumonia). Sex, race, age, and ethnicity all significantly influenced the risk of HFNC use. Over the 10-y period, the percentage of all hospital encounters using HFNC increased from 1.11% in 2010 to 3.15% in 2018. Subjects with multiple diagnoses had significantly higher risk of receiving HFNC. CONCLUSIONS: The use of HFNC in children presenting to the hospital with common respiratory diseases has increased substantially over the past decade and is no longer confined to treating infants with bronchiolitis. Demographic and diagnostic factors significantly influenced the frequency of HFNC use. [ABSTRACT FROM AUTHOR]

Purpose: To conduct a systematic review to identify studies that assessed the association between CYP2C19 polymorphisms and clinical outcomes in peripheral artery disease (PAD) patients who took clopidogrel. Methods: We systematically searched Ovid EMBASE, PubMed, and Web of Science from November 1997 (inception) to September 2020. We included observational studies evaluating how CYP2C19 polymorphism is associated with clopidogrel's effectiveness and safety among patients with PAD. We extracted relevant information details from eligible studies (e.g., study type, patient population, study outcomes). We used the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) Tool to assess the risk of bias for included observational studies. Results: The outcomes of interest were the effectiveness and safety of clopidogrel. The effectiveness outcomes included clinical ineffectiveness (e.g., restenosis). The safety outcomes included bleeding and death related to the use of clopidogrel. We identified four observational studies with a sample size ranging from 50 to 278. Outcomes and comparison groups of the studies varied. Three studies (75%) had an overall low risk of bias. All included studies demonstrated that carrying CYP2C19 loss of function (LOF) alleles was significantly associated with reduced clinical effectiveness and safety of clopidogrel. Conclusions: Our systematic review showed an association between CYP2C19 LOF alleles and reduced functions of clopidogrel. The use of CYP2C19 testing in PAD patients prescribed clopidogrel may help improve the clinical outcomes. However, based on the limited evidence, there is a need for randomized clinical trials in PAD patients to test both the effectiveness and safety outcomes of clopidogrel. [ABSTRACT FROM AUTHOR]

A usability assessment of four commercial dental computer-based patient record systems finds that the range for correctly completed tasks for these software was 16 to 64 percent and incomplete tasks stood at 9 to 47 percent. The findings reveal significant usability problems for novice users which could potentially reduce system adoption.

A prototype of a 3D dental record for patients can retrieve images and radiographs, give a flexible view of teeth, soft tissue and bone, give access to patient's historical data, and focus on a single tooth. Test users accepted the initial design of the 3D dental record, but further research needs to be conducted before going into practice.

The article evaluates dental practice management softwares to measure their usability and detect the areas that need more clarification.

Mandatory continuing education (CE) is the requirement for relicensure of dentists in the United States. Computer based methods are adopted for earning CE credits. A survey is conducted to evaluate how the computer-based CE methods are regulated. The statistical data relating to number of CE hours required by jurisdiction is also provided in this context.

The National Health Information Infrastructure (NHII) improves the effectiveness, efficiency and overall quality of health in the United States by establishing a national, electronic information network for health care. It is concluded that dentistry should become an active participant in the NHII and work to ensure that the needs of dental patients and the profession are met.

The level of integration of different IT-related products for dental practice is reviewed and the consequences for work flow and ergonomics are analyzed. The practical examples for different levels of integration among dental technology products are identified.

Dentists should develop a plan for upgrading the computer systems in their offices. Most dentists use a computer for patient accounts, billing, and processing insurance forms. Fewer have an Internet connection in their office or use e-mail to communicate with patients. Digital imaging and decision support programs are other information technologies dentists may wish to implement.

Most of the dental Internet portals available as of 2000 offer a wide range of services but none offers every service that a dental office may need. This was the conclusion of researchers who evaluated Dentaltown, Dentalxchange, E-dental, Net32, and Rdental. Internet portals are web sites that offer professional services to particular groups of people.

The role of computers in dentistry is reviewed. Uses include office automation, digital X-rays, decision support tools, online bibliographic databases, fabrication of dental materials, computer-assisted learning, online education, and analysis of research data.

Dentists should keep up to date on how computers can impact their practice. Many routine office activities can be automated, such as ordering supplies, sending appointment reminders and monitoring finances. Computers can be used to manage research data and identify the best treatments. Patient records can also be computerized. Computer-aided instruction will benefit dental students. Dentists still need to be careful not to adopt technology for its own sake.

Many dentists use the Internet to keep up with advances in dental research and to communicate with other dentists. This was the finding of a survey of 314 dentists who regularly participated in the Internet Dental Forum, an Internet discussion list for dentists. Although most used the Internet at home and at the office, only 5% used it in the treatment area. Some used the Internet to answer patients' questions or to provide patients with information. However, most used it to keep up with dental research and to reduce their feeling of professional isolation.

Continuing dental education (CDE) courses on the Internet can help dentists maintain their clinical skills, but the fees charged and educational credits offered should be standardized. Researchers evaluated 157 online dental courses offered by 32 organizations. Most providers were universities or companies. Locating the sites was difficult, and most did not specify the dental boards that accepted the credits offered, the authors of the course, or the last date they were updated. Courses offered from 3 minutes to 2 hours of CDE credit, and charged $0-25 per credit hour.

The Internet is widely used by dental professionals and students for consultation, education, purchasing, and research. An international survey of 825 dentists, dental staff, and students found that 42% of dental offices use online services, 48% transmit insurance data electronically, and 20% use electronic mail. Eighty percent of survey respondents believed that the Internet was a useful dental resource.

The School of Dentistry of Temple University decided to develop an expert system to improve its scheduling of students' clinical rotations in seven dental clinics. Through the system, the school also hoped to come up with a schedule which would meet all the academic and training needs of students. The resulting expert system, a scheduler in the rule-based artificial intelligence language Prolog, successfully created schedules which met all user requirements. It allowed the school to save up to 19 person-days for schedule development and helped reduce the costs associated with the task.

Due to the rapid growth of information available about individual patients, most physicians suffer from information overload and inefficiencies when they review patient information in health information technology systems. In this paper, we present a novel hybrid dynamic and multi-collaborative filtering method to improve information retrieval from electronic health records. This method recommends relevant information from electronic health records to physicians during patient visits. It models information search dynamics using a Markov model. It also leverages the key idea of collaborative filtering, originating from Recommender Systems, for prioritizing information based on various similarities among physicians, patients and information items. We tested this new method using electronic health record data from the Indiana Network for Patient Care, a large, inter-organizational clinical data repository maintained by the Indiana Health Information Exchange. Our experimental results demonstrated that, for top-5 recommendations, our method was able to correctly predict the information in which physicians were interested in 46.7% of all test cases. For top-1 recommendations, the corresponding figure was 24.7%. In addition, the new method was 22.3% better than the conventional Markov model for top-1 recommendations. [ABSTRACT FROM AUTHOR]

Abstract Background A major challenge in designing useful clinical information systems in dentistry is to incorporate clinical evidence based on dentists' information needs and then integrate the system seamlessly into the complex clinical workflow. However, little is known about the actual information needs of dentists during treatment sessions. The purpose of this study is to identify general dentists' information needs and the information sources they use to meet those needs in clinical settings so as to inform the design of dental information systems. Methods A semi-structured interview was conducted with a convenience sample of 18 general dentists in the Pittsburgh area during clinical hours. One hundred and five patient cases were reported by these dentists. Interview transcripts were coded and analyzed using thematic analysis with a constant comparative method to identify categories and themes regarding information needs and information source use patterns. Results Two top-level categories of information needs were identified: foreground and background information needs. To meet these needs, dentists used four types of information sources: clinical information/tasks, administrative tasks, patient education and professional development. Major themes of dentists' unmet information needs include: (1) timely access to information on various subjects; (2) better visual representations of dental problems; (3) access to patient-specific evidence-based information; and (4) accurate, complete and consistent documentation of patient records. Resource use patterns include: (1) dentists' information needs matched information source use; (2) little use of electronic sources took place during treatment; (3) source use depended on the nature and complexity of the dental problems; and (4) dentists routinely practiced cross-referencing to verify patient information. Conclusions Dentists have various information needs at the point of care. Among them, the needs for better visual representation and patient-specific evidence-based information are mostly unmet. While patient records and support staff remain the most used information sources, electronic sources other than electronic dental records (EDR) are rarely utilized during patient visits. For future development of dental information or clinical decision-support systems, developers should consider integrating high-quality, up-to-date clinical evidence into comprehensive and easily accessible EDRs as well as supporting dentists' resource use patterns as identified in the study.

Although clopidogrel is a frequently used antiplatelet medication to treat and prevent atherothrombotic disease, clinicians must balance its clinical effectiveness with the potential side effect of bleeding. However, many previous studies have evaluated beneficial and adverse factors separately. The objective of our study was to perform a comprehensive meta‐analysis of studies of clopidogrel's clinical effectiveness and/or risk of bleeding in order to identify and assess all reported risk factors, thus helping clinicians to balance patient safety with drug efficacy. We analyzed randomized controlled trials (RCTs) of maintenance use in four stages: search for relevant primary articles; abstract and full article screening; quality assessment and data extraction; and synthesis and data analysis. Screening of 7,109 articles yielded 52 RCTs that met the inclusion criteria. Twenty‐seven risk factors were identified. "Definite risk factors" were defined as those with aggregated odds ratios (ORs) > 1 and confidence intervals (CIs) > 1 if analyzed in more than one study. Definite risk factors for major bleeding were concomitant aspirin use (OR 2.83, 95% CI 2.04–3.94) and long duration of clopidogrel therapy (> 6 months) (OR 1.74, 95% CI 1.21–2.50). Dual antiplatelet therapy, extended clopidogrel therapy, and high maintenance dose (150 mg/day) of clopidogrel were definite risk factors for any bleeding. Reduced renal function, both mild and severe, was the only definite risk factor for clinical ineffectiveness. These findings can help clinicians predict the risks and effectiveness of clopidogrel use for their patients and be used in clinical decision support tools. [ABSTRACT FROM AUTHOR]