Semantic representation of evidence-based medical guidelines provides the support for the data inter-operability and has been found many applications in the medical domain. In this paper, we describe a semantic repres...Semantic representation of evidence-based medical guidelines provides the support for the data inter-operability and has been found many applications in the medical domain. In this paper, we describe a semantic representation approach of evidence-based medical guidelines, which is based on the Semantic Web Technology standards. We discuss several use cases of that semantic representation of evidence-based medical guideline, and show that they are potentially useful for medical applications.展开更多
BACKGROUND Significant gaps in guideline-directed medical therapy(GDMT)for heart failure(HF)stem from shortages of cardiologists and advanced HF providers,as well as a lack of optimal HF management knowledge among hos...BACKGROUND Significant gaps in guideline-directed medical therapy(GDMT)for heart failure(HF)stem from shortages of cardiologists and advanced HF providers,as well as a lack of optimal HF management knowledge among hospitalists.This study compared the impact of optimal medical therapy in HF(OMT-HF)certification on GDMT implementation and patient outcomes between an intervention group(IG)of hospitalists and a standard-of-care comparison group(SOC-CG).METHODS This study was implemented from November 2022 to May 2023.Hospitalized car-diology patients with HF and left ventricular ejection fraction≤40%were rando-mized to IG or SOC-CG.Exclusion criteria included patients in cardiogenic shock,unable to consent,or at high risk.Follow-up was at 30 days post-discharge.Diffe-rences between groups were analyzed using Fisher’s exact test for categorical va-riables and Wilcoxon rank-sum or unpaired t-test for continuous variables.Chan-ges in Minnesota Living with Heart Failure Questionnaire(MLWHFQ)scores were evaluated using a paired t-test.RESULTS IG patients had lower readmission rates[9(42.85%)vs 11(17.46%),P=0.03]and a decreased trend in mortality 30-day post discharge.IG patients also showed greater mean improvements in total(-27.03±24.59 vs-5.85±23.52,P<0.001),physical(-13.8±12.3 vs-2.71±11.16,P<0.001)and emotional(-4.76±8.10 vs-1.42±5.98)dimensions on the MLWHFQ compared to SOC-CG,however,change in emotional dimension did not reach statistical significance.CONCLUSION Hospitalist OMT-HF certification may lead to better 30-day outcomes in hospitalized HF patients including quality of life,mortality and readmission rates.Larger prospective studies are warranted to validate these findings.展开更多
基金Supported by the European Commission under the 7th Framework EURECA Project(FP7-ICT-2011-7,288048)the Key Projects of National Social Science Foundation of China(11ZD&189)the Natural Science Foundation of Hubei Province(2014CFB247)
文摘Semantic representation of evidence-based medical guidelines provides the support for the data inter-operability and has been found many applications in the medical domain. In this paper, we describe a semantic representation approach of evidence-based medical guidelines, which is based on the Semantic Web Technology standards. We discuss several use cases of that semantic representation of evidence-based medical guideline, and show that they are potentially useful for medical applications.
基金Supported by Houston Methodist DeBakey Heart and Vascular Center Grant.
文摘BACKGROUND Significant gaps in guideline-directed medical therapy(GDMT)for heart failure(HF)stem from shortages of cardiologists and advanced HF providers,as well as a lack of optimal HF management knowledge among hospitalists.This study compared the impact of optimal medical therapy in HF(OMT-HF)certification on GDMT implementation and patient outcomes between an intervention group(IG)of hospitalists and a standard-of-care comparison group(SOC-CG).METHODS This study was implemented from November 2022 to May 2023.Hospitalized car-diology patients with HF and left ventricular ejection fraction≤40%were rando-mized to IG or SOC-CG.Exclusion criteria included patients in cardiogenic shock,unable to consent,or at high risk.Follow-up was at 30 days post-discharge.Diffe-rences between groups were analyzed using Fisher’s exact test for categorical va-riables and Wilcoxon rank-sum or unpaired t-test for continuous variables.Chan-ges in Minnesota Living with Heart Failure Questionnaire(MLWHFQ)scores were evaluated using a paired t-test.RESULTS IG patients had lower readmission rates[9(42.85%)vs 11(17.46%),P=0.03]and a decreased trend in mortality 30-day post discharge.IG patients also showed greater mean improvements in total(-27.03±24.59 vs-5.85±23.52,P<0.001),physical(-13.8±12.3 vs-2.71±11.16,P<0.001)and emotional(-4.76±8.10 vs-1.42±5.98)dimensions on the MLWHFQ compared to SOC-CG,however,change in emotional dimension did not reach statistical significance.CONCLUSION Hospitalist OMT-HF certification may lead to better 30-day outcomes in hospitalized HF patients including quality of life,mortality and readmission rates.Larger prospective studies are warranted to validate these findings.
