Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record ...Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record following the concept of narrative evidence-based medicine.Methods:The information was searched from Pubmed,Embase,CBMdisc,CNKI.A preliminary agreement was reached by referring to the principles of narrative medicine and advises given by experts of digestive system and evidence-based medicine in both Traditional Chinese Medicine and Western Medicine.Result:This research is a useful attempt to discuss the establishment of doctor-patient co-operated evidence-based medical record guided by the direction of narrative evidence-based medicine.Reflection and outlook:Doctor-patient co-operated medical record can be a key factor of the curative effect evaluation methodology system of integrated therapy of Tradition Chinese Medicine and Western Medicine on spleen and stomach diseases.展开更多
Electronic medical record (EMR) containing rich biomedical information has a great potential in disease diagnosis and biomedical research. However, the EMR information is usually in the form of unstructured text, whic...Electronic medical record (EMR) containing rich biomedical information has a great potential in disease diagnosis and biomedical research. However, the EMR information is usually in the form of unstructured text, which increases the use cost and hinders its applications. In this work, an effective named entity recognition (NER) method is presented for information extraction on Chinese EMR, which is achieved by word embedding bootstrapped deep active learning to promote the acquisition of medical information from Chinese EMR and to release its value. In this work, deep active learning of bi-directional long short-term memory followed by conditional random field (Bi-LSTM+CRF) is used to capture the characteristics of different information from labeled corpus, and the word embedding models of contiguous bag of words and skip-gram are combined in the above model to respectively capture the text feature of Chinese EMR from unlabeled corpus. To evaluate the performance of above method, the tasks of NER on Chinese EMR with “medical history” content were used. Experimental results show that the word embedding bootstrapped deep active learning method using unlabeled medical corpus can achieve a better performance compared with other models.展开更多
With the rapid development of information technology,the electronifi-cation of medical records has gradually become a trend.In China,the population base is huge and the supporting medical institutions are numerous,so ...With the rapid development of information technology,the electronifi-cation of medical records has gradually become a trend.In China,the population base is huge and the supporting medical institutions are numerous,so this reality drives the conversion of paper medical records to electronic medical records.Electronic medical records are the basis for establishing a smart hospital and an important guarantee for achieving medical intelligence,and the massive amount of electronic medical record data is also an important data set for conducting research in the medical field.However,electronic medical records contain a large amount of private patient information,which must be desensitized before they are used as open resources.Therefore,to solve the above problems,data masking for Chinese electronic medical records with named entity recognition is proposed in this paper.Firstly,the text is vectorized to satisfy the required format of the model input.Secondly,since the input sentences may have a long or short length and the relationship between sentences in context is not negligible.To this end,a neural network model for named entity recognition based on bidirectional long short-term memory(BiLSTM)with conditional random fields(CRF)is constructed.Finally,the data masking operation is performed based on the named entity recog-nition results,mainly using regular expression filtering encryption and principal component analysis(PCA)word vector compression and replacement.In addi-tion,comparison experiments with the hidden markov model(HMM)model,LSTM-CRF model,and BiLSTM model are conducted in this paper.The experi-mental results show that the method used in this paper achieves 92.72%Accuracy,92.30%Recall,and 92.51%F1_score,which has higher accuracy compared with other models.展开更多
Background： The usage of modem technology in healthcare record system is now a must throughout the world. However, many doctors and nurses has been reporting facing numerous challenges and obstacles in the implementa...Background： The usage of modem technology in healthcare record system is now a must throughout the world. However, many doctors and nurses has been reporting facing numerous challenges and obstacles in the implementation. The aim of the present study is to determine the prevalence of depression, anxiety and stress among doctors and nurses who utilize EMR （electronic medical record） and its associated factor. Methods： A comparative cross-sectional study was conducted ~om January till April 2012 among doctors and nurses in two public tertiary hospitals in Johor in which one of them uses EMR and the other one still using the MMR （manual medical record） system. Data was collected using self-administered validated Malay version of DASS-21 （Depression, Anxiety, and Stress Scales-21） items questionnaire. It comprises of socio-demographic and occupational characteristics. Findings： There were 130 respondents with a response rate of 91% for EMR and 123 respondents with a response rate of 86% for MMR. The mean （SD） age of respondents in EMR and MMR groups were 34.7 （9.42） and 29.7 （6.15） respectively. The mean （SD） duration of respondents using EMR was 46.1 （35.83） months. The prevalence of depression, anxiety and stress among respondents using EMR were 6.9%, 25.4% and 12.3%. There were no significant difference between the study groups related to the depression, anxiety and stress scores. In multivariable analysis, the significant factors associated with depression among respondents using EMR was age （OR 1.10, 95% CI 1.02, 1.19）. The significant factors associated with stress among respondents using EMR was marital status （OR 3.33, 95% CI 1.10, 10.09） and borderline significant was computer skill course （OR 2.94, 95% CI 0.98, 8.78）. Conclusion： The prevalence of depression, anxiety and stress of those who uses EMR were within acceptable range. Age, marital status and computer skill are the identified factor associated with the depression and stress level which need to be considered in its implementation.展开更多
Introduction: Today, information technology is considered as an important national development principle in each country which is applied in different fields. Health care as a whole and the hospitals could be regarded...Introduction: Today, information technology is considered as an important national development principle in each country which is applied in different fields. Health care as a whole and the hospitals could be regarded as a field and organizations with most remarkable IT applications respectively. Although different benchmarks and frameworks have been developed to assess different aspects of Hospital Information Systems (HISs) by various researchers, there is not any suitable reference model yet to benchmark HIS in the world. Electronic Medical Record Adoption Model (EMRAM) has been currently presented and is globally well-known to benchmark the rate of HIS utilization in the hospitals. Notwithstanding, this model has not been introduced in Iran so far. Methods: This research was carried out based on an applied descriptive method in three private hospitals of Isfahan—one of the most important provinces of Iran—in the year 2015. The purpose of this study was to investigate IT utilization stage in three selected private hospitals. Conclusion: The findings revealed that HIS is not at the center of concern in studied hospitals and is in the first maturity stage in accordance with EMRAM. However, hospital managers are enforced and under the pressure of different beneficiaries including insurance companies to improve their HIS. Therefore, it could be concluded that these types of hospitals are still far away from desirable conditions and need to enhance their IT utilization stage significantly.展开更多
1|DEVELOPMENT AND ADOPTION OF EHR IN THE UNITED STATES At present,health-care systems in the United States face enormous challenges in providing quality care,characterized by safe,effective,efficient,patientcentered,t...1|DEVELOPMENT AND ADOPTION OF EHR IN THE UNITED STATES At present,health-care systems in the United States face enormous challenges in providing quality care,characterized by safe,effective,efficient,patientcentered,timely,and equitable care while containing health-care costs[1,2].To understand and address patients'increasingly complicated health-care needs,we need safe access to quality information that is characterized by integrity,reliability,and accuracy[3],and establish mutually beneficial relationships among a multidisciplinary team of professionals[4].Traditional paper-based clinical workflow produces many issues such as illegible handwriting,inconvenient access,the possibility of computational prescribing errors,inadequate patient hand-offs,and drug administration errors.These problems can lead to medical errors,omissions,and duplications and,ultimately,poor patient outcomes and compromised quality of care[2].展开更多
Patients with colorectal cancer (CRC) can have chemotherapy with oxaliplatin postoperatively. Oxaliplatin can cause acute and chronic neurotoxicity. It is important to be aware of neurotoxic side effects so they can b...Patients with colorectal cancer (CRC) can have chemotherapy with oxaliplatin postoperatively. Oxaliplatin can cause acute and chronic neurotoxicity. It is important to be aware of neurotoxic side effects so they can be documented and action taken at an early stage. The study aimed to identify and explore neurotoxic side effects documented in the medical records of patients with colorectal cancer treated with oxaliplatin-based adjuvant chemotherapy. Data in this study were medical records;presenting documentation about patients treated at the University Hospital in the south of Sweden between 2009 and 2010. A summative content analysis approach was used to explore the neurotoxic side effects. Identification and quantification of the content of medical records were carried out by using a study-specific protocol. “Cold sensitivity” and “tingling in the hands” were the most frequently documented neurotoxicity-related terms in the medical records. This identification was followed by interpretation. Three categories were identified in the interpretive part of the study: acute, chronic, and degree of neurotoxicity. The results show the importance of awareness of neurotoxic side effects so that they can be documented and action taken at an early stage. The documentation could be more reliable if patient-reported structured measurements were used, combined with free descriptions in the medical records. Being able to follow the progression of the symptoms during and after treatment would improve patient’s safety and also quality of life. The protocol that we developed and used in this review of medical records may be helpful to structure the documentation in the electronic system for documentation of neurotoxicity side effects.展开更多
Objective:To explore the core drug of Tian-shi Ye(1666 C.E.–1745 C.E.,a famous medical experts in Qing Dynasty)for treating exogenous cough and its mechanism of action.Methods:The database of prescriptions for treati...Objective:To explore the core drug of Tian-shi Ye(1666 C.E.–1745 C.E.,a famous medical experts in Qing Dynasty)for treating exogenous cough and its mechanism of action.Methods:The database of prescriptions for treating exogenous cough was established in Clinical Guide to Medical Records,and the complex network was constructed with frequency analysis and Gephi 0.9.2 software to obtain the core drug for exogenous cough,and the network of traditional Chinese medicine-component-disease-target regulation was constructed through network pharmacology to reveal the potential mechanism.Results:Xingren(Amygdalus Communis Vas)is the core drug for the treatment of exogenous cough in the“Clinical Guidelines and Medical Records”.It contains 19 active ingredients and forms 27 traditional Chinese medicine-disease targets for the treatment of acute bronchitis.Kyoto Encyclopedia of Genes and Genomes analysis involving 114 pathways,including arachidonic acid metabolism pathways,peroxidase pathways,estrogen metabolism pathways,and tryptophan metabolism pathways are the main signal pathways involved.Conclusion:Xingren(Amygdalus Communis Vas)-acute bronchitis has a multi-molecule,multi-target,and multi-pathway,and may be regulating the arachidonic acid metabolism pathway,peroxidase pathway,estrogen metabolism pathway,and tryptophan metabolism pathway.Such interventions as various biological processes in the body play a role in the treatment of acute bronchitis.展开更多
Medical record information system engineering technology is used to set professor Wang Yongyan5s medical record as the master system, and model the disease, syndrome, treatment and prescription. According to the exper...Medical record information system engineering technology is used to set professor Wang Yongyan5s medical record as the master system, and model the disease, syndrome, treatment and prescription. According to the experience of doctors, we will combine them according to the procedure of ＂problem-solution＂, to study Professor Wang＇s treatment experience and his clinical thinking.展开更多
Medical record coding plays an important role in hospital management and the improvement of medical record coding quality is quite important to hospital management.The professional qualities of medical record coders s...Medical record coding plays an important role in hospital management and the improvement of medical record coding quality is quite important to hospital management.The professional qualities of medical record coders significantly affect the improvement of coding quality.At present,Medical record coders lack in professional knowledge,clinical knowledge and disease classification knowledge.In order to improve the quality of medical record coding,medical record coders should receive regular professional training,and hospital management departments should strengthen the monitoring of the quality of medical record coding.When encountering problems in the process of coding,medical record coders should take the initiative to consult and learn from clinicians.At the same time,medical record coders should cultivate a sense of responsibility,which can continuously improve their professional qualities and achieve the objective of improving the quality of medical record coding.展开更多
Objective: the experiment will strengthen the result analysis for the management of archived medical records in the pharmacy department, better put forward suggestions for the development of the work of the pharmacy d...Objective: the experiment will strengthen the result analysis for the management of archived medical records in the pharmacy department, better put forward suggestions for the development of the work of the pharmacy department, cooperate with the work content of the pharmacy department, clinical department and medical record management room, and improve the rationality of medication for patients. Methods: taking the archived medical records of the experimental pharmacy department as the main body of the investigation, the medication situation of 300 archived medical records from July 2019 to June 2020 was intercepted in the time period, and the medication situation was timely fed back to the clinical department. Results: from the perspective of all medical records, there were 7 unreasonable medical records and 11 dissenting medical records, which were caused by faulty medical orders. In addition, the number of unreasonable medical orders in the first half of 2020 was significantly lower than that in the second half of 2019, indicating that the medical orders were more accurate after the strengthening of comment management. In the cases that did not conform to the guidelines for clinical application of antibiotics, there were 2 cases of irrational prophylactic drug use, 3 cases of unindicated drug use and 2 cases of unsuitable usage and dosage. Conclusions: to strengthen the comment management of archived medical records is conducive to ensuring the medication safety of patients, and the problems found can be discussed centrally, thus improving the participation of pharmacists and strengthening the connection between departments.展开更多
Objective: to study and analyze the value of medical record quality management in the continuous improvement of medical quality. Methods: 30 cases were included in our hospital from May 2021 to June 2022. From May 202...Objective: to study and analyze the value of medical record quality management in the continuous improvement of medical quality. Methods: 30 cases were included in our hospital from May 2021 to June 2022. From May 2021 to May 2021,15 cases and 15 cases from January 2022 to June 2022 were included in the control group;The quality management quality, writing quality and quality control of the two groups were evaluated. Results: study group patients management quality, writing quality, quality control patients management quality score is higher than the control group, patients writing quality assessment of grade A is higher than the control group, patients homepage, admission records, hospital records, discharge records, the incidence of quality control defects are lower than the control group, the difference has statistical significance (P 0.05). Conclusion: the application of medical record quality management has an outstanding value in improving the quality of medical record management, writing quality and quality control quality.展开更多
The goal of this research was to develop a digital system that could allow managing electronic medical records (EMRs) codified under specifications of the Health Level 7/Clinical Document Architecture (HL7/CDA) intern...The goal of this research was to develop a digital system that could allow managing electronic medical records (EMRs) codified under specifications of the Health Level 7/Clinical Document Architecture (HL7/CDA) international standard, and saving them in a portable digital storage device called iButton?. To this end, an USB-based hardware interface for reading and storing EMRs in iButtons was designed and implemented. In addition, a software application for invoking read/write operations on stored EMRs and showing their content on a graphical user interface was also developed, following the Extreme Programming (XP) software development methodology and using Visual Basic .NET as programming language. Tests conducted on the hardware interface showed that it was able to recognize any iButton type, reading and writing data on them as well. Moreover, the system helped in creating empty EMRs in conformance with the HL7/CDA standard, adding and viewing information, and updating it in the iButton. This system offers an easy way for managing and visualizing medical records codified in HL7/CDA, and allows patients to take their updated medical history with them everywhere.展开更多
Surgical site infections(SSIs)are the most common healthcare-related infections in patients with lung cancer.Constructing a lung cancer SSI risk prediction model requires the extraction of relevant risk factors from l...Surgical site infections(SSIs)are the most common healthcare-related infections in patients with lung cancer.Constructing a lung cancer SSI risk prediction model requires the extraction of relevant risk factors from lung cancer case texts,which involves two types of text structuring tasks:attribute discrimination and attribute extraction.This article proposes a joint model,Multi-BGLC,around these two types of tasks,using bidirectional encoder representations from transformers(BERT)as the encoder and fine-tuning the decoder composed of graph convolutional neural network(GCNN)+long short-term memory(LSTM)+conditional random field(CRF)based on cancer case data.The GCNN is used for attribute discrimination,whereas the LSTM and CRF are used for attribute extraction.The experiment verified the effectiveness and accuracy of the model compared with other baseline models.展开更多
Celiac disease(CD)is a common autoimmune disorder where gluten ingestion triggers an immune response,damaging the small intestine in genetically pre-disposed individuals.Affecting around 1%of the global population,CD ...Celiac disease(CD)is a common autoimmune disorder where gluten ingestion triggers an immune response,damaging the small intestine in genetically pre-disposed individuals.Affecting around 1%of the global population,CD presents with diverse symptoms,including gastrointestinal issues like diarrhea and extraintestinal conditions such as anemia and osteoporosis,often complicating diagnosis.Advances in serology,histology,and genetic testing,such as HLA-DQ2/DQ8 analysis,have improved diagnostic accuracy.Precision medicine is transforming CD management by integrating genetic,clinical,and lifestyle data to enable risk prediction,personalized therapies,and improved outcomes.Tools like machine learning enhance early diagnosis,dietary management,and drug discovery,while electronic medical records support comprehensive patient pro-filing and disease monitoring.These technologies facilitate personalized health-care delivery tailored to individual patient profiles.展开更多
Recently,numerous estimation issues have been solved due to the developments in data-driven artificial neural networks(ANN)and graph neural networks(GNN).The primary limitation of previous methodologies has been the d...Recently,numerous estimation issues have been solved due to the developments in data-driven artificial neural networks(ANN)and graph neural networks(GNN).The primary limitation of previous methodologies has been the dependence on data that can be structured in a grid format.However,physiological recordings often exhibit irregular and unordered patterns,posing a significant challenge in conceptualising them as matrices.As a result,GNNs which comprise interactive nodes connected by edges whose weights are defined by anatomical junctions or temporal relationships have received a lot of consideration by leveraging implicit data that exists in a biological system.Additionally,our study incorporates a structural GNN to effectively differentiate between different degrees of infection in both the left and right hemispheres of the brain.Subsequently,demographic data are included,and a multi-task learning architecture is devised,integrating classification and regression tasks.The trials used an authentic dataset,including 800 brain x-ray pictures,consisting of 560 instances classified as moderate cases and 240 instances classified as severe cases.Based on empirical evidence,our methodology demonstrates superior performance in classification,surpassing other comparison methods with a notable achievement of 92.27%in terms of area under the curve as well as a correlation coefficient of 0.62.展开更多
Ye Tianshi was a renowned expert in classical formulas during the Qing Dynasty.He created the Light Bitterness and Mild Pungency Method,which is formulated based on the compatibility of“Xing(bitter almond),Kou(Fructu...Ye Tianshi was a renowned expert in classical formulas during the Qing Dynasty.He created the Light Bitterness and Mild Pungency Method,which is formulated based on the compatibility of“Xing(bitter almond),Kou(Fructus amomi rotundus),Ju(tangerine peel),and Jie(platycodon root)”.This method regulates the dispersion and descent of lung Qi to dispel warm-heat pathogens and smooth the Qi movement of the triple energizer.In the treatment of lung system diseases,Ye classified them into two major categories based on etiology and pathogenesis:excess syndrome of nutrient-defense and deficiency syndrome of nutrient-defense.When discussing the treatment of cough caused by phlegm-fluid retention,he frequently referred to Synopsis of the Golden Chamber and attached great importance to summarizing and absorbing the academic thoughts of predecessors.As an accomplished expert in classical formulas,Ye Tianshi followed the academic essence of Xuanyuan and Qi Bo(founders of TCM theory)and respected the principles of Zhang Zhongjing’s classical formulas,integrating these theories in a coherent manner.With his masterful application of classical formulas to achieve remarkable curative effects,Ye’s academic viewpoints on treating lung system diseases still exert a profound influence on the modern clinical diagnosis and treatment of related diseases.展开更多
A case of amyotrophic cervical spondylosis was healed by using acupuncture in combination with electroacupuncture, needling was carried out on fengchi（风池 GB 20）, Tianzhu （天柱 BE 10）, Dazhui （大椎 GV 14）, Jian...A case of amyotrophic cervical spondylosis was healed by using acupuncture in combination with electroacupuncture, needling was carried out on fengchi（风池 GB 20）, Tianzhu （天柱 BE 10）, Dazhui （大椎 GV 14）, Jianjing （肩井GB 21）, Zhiyang （至阳 GV 9）, Jianzhen （肩贞SI 9）, Jianyu （肩髃 El 15）, Shousanli （手三里LI 10）, Houxi （后溪SI 3）, Kunlun （昆仑 BE 60） and Shugu （束骨 BL 65）. BL 10 on the left side and LI 10 on the right side, GB 20 on the right side and GV 9 were connected for electroacupuncture, once a day, 12 treatments as one treatment course, a interval of 5 days was set between two treatment courses, and totally 6 treatment courses were carried out. The patient was clinically healed after the treatment and the disease did not recur during the follow-up for six months.展开更多
In the digital era,electronic medical record(EMR)has been a major way for hospitals to store patients’medical data.The traditional centralized medical system and semi-trusted cloud storage are difficult to achieve dy...In the digital era,electronic medical record(EMR)has been a major way for hospitals to store patients’medical data.The traditional centralized medical system and semi-trusted cloud storage are difficult to achieve dynamic balance between privacy protection and data sharing.The storage capacity of blockchain is limited and single blockchain schemes have poor scalability and low throughput.To address these issues,we propose a secure and efficient medical data storage and sharing scheme based on double blockchain.In our scheme,we encrypt the original EMR and store it in the cloud.The storage blockchain stores the index of the complete EMR,and the shared blockchain stores the index of the shared part of the EMR.Users with different attributes can make requests to different blockchains to share different parts according to their own permissions.Through experiments,it was found that cloud storage combined with blockchain not only solved the problem of limited storage capacity of blockchain,but also greatly reduced the risk of leakage of the original EMR.Content Extraction Signature(CES)combined with the double blockchain technology realized the separation of the privacy part and the shared part of the original EMR.The symmetric encryption technology combined with Ciphertext-Policy Attribute-Based Encryption(CP–ABE)not only ensures the safe storage of data in the cloud,but also achieves the consistency and convenience of data update,avoiding redundant backup of data.Safety analysis and performance analysis verified the feasibility and effectiveness of our scheme.展开更多
文摘Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record following the concept of narrative evidence-based medicine.Methods:The information was searched from Pubmed,Embase,CBMdisc,CNKI.A preliminary agreement was reached by referring to the principles of narrative medicine and advises given by experts of digestive system and evidence-based medicine in both Traditional Chinese Medicine and Western Medicine.Result:This research is a useful attempt to discuss the establishment of doctor-patient co-operated evidence-based medical record guided by the direction of narrative evidence-based medicine.Reflection and outlook:Doctor-patient co-operated medical record can be a key factor of the curative effect evaluation methodology system of integrated therapy of Tradition Chinese Medicine and Western Medicine on spleen and stomach diseases.
基金the Artificial Intelligence Innovation and Development Project of Shanghai Municipal Commission of Economy and Information (No. 2019-RGZN-01081)。
文摘Electronic medical record (EMR) containing rich biomedical information has a great potential in disease diagnosis and biomedical research. However, the EMR information is usually in the form of unstructured text, which increases the use cost and hinders its applications. In this work, an effective named entity recognition (NER) method is presented for information extraction on Chinese EMR, which is achieved by word embedding bootstrapped deep active learning to promote the acquisition of medical information from Chinese EMR and to release its value. In this work, deep active learning of bi-directional long short-term memory followed by conditional random field (Bi-LSTM+CRF) is used to capture the characteristics of different information from labeled corpus, and the word embedding models of contiguous bag of words and skip-gram are combined in the above model to respectively capture the text feature of Chinese EMR from unlabeled corpus. To evaluate the performance of above method, the tasks of NER on Chinese EMR with “medical history” content were used. Experimental results show that the word embedding bootstrapped deep active learning method using unlabeled medical corpus can achieve a better performance compared with other models.
基金This research was supported by the National Natural Science Foundation of China under Grant(No.42050102)the Postgraduate Education Reform Project of Jiangsu Province under Grant(No.SJCX22_0343)Also,this research was supported by Dou Wanchun Expert Workstation of Yunnan Province(No.202205AF150013).
文摘With the rapid development of information technology,the electronifi-cation of medical records has gradually become a trend.In China,the population base is huge and the supporting medical institutions are numerous,so this reality drives the conversion of paper medical records to electronic medical records.Electronic medical records are the basis for establishing a smart hospital and an important guarantee for achieving medical intelligence,and the massive amount of electronic medical record data is also an important data set for conducting research in the medical field.However,electronic medical records contain a large amount of private patient information,which must be desensitized before they are used as open resources.Therefore,to solve the above problems,data masking for Chinese electronic medical records with named entity recognition is proposed in this paper.Firstly,the text is vectorized to satisfy the required format of the model input.Secondly,since the input sentences may have a long or short length and the relationship between sentences in context is not negligible.To this end,a neural network model for named entity recognition based on bidirectional long short-term memory(BiLSTM)with conditional random fields(CRF)is constructed.Finally,the data masking operation is performed based on the named entity recog-nition results,mainly using regular expression filtering encryption and principal component analysis(PCA)word vector compression and replacement.In addi-tion,comparison experiments with the hidden markov model(HMM)model,LSTM-CRF model,and BiLSTM model are conducted in this paper.The experi-mental results show that the method used in this paper achieves 92.72%Accuracy,92.30%Recall,and 92.51%F1_score,which has higher accuracy compared with other models.
文摘Background： The usage of modem technology in healthcare record system is now a must throughout the world. However, many doctors and nurses has been reporting facing numerous challenges and obstacles in the implementation. The aim of the present study is to determine the prevalence of depression, anxiety and stress among doctors and nurses who utilize EMR （electronic medical record） and its associated factor. Methods： A comparative cross-sectional study was conducted ~om January till April 2012 among doctors and nurses in two public tertiary hospitals in Johor in which one of them uses EMR and the other one still using the MMR （manual medical record） system. Data was collected using self-administered validated Malay version of DASS-21 （Depression, Anxiety, and Stress Scales-21） items questionnaire. It comprises of socio-demographic and occupational characteristics. Findings： There were 130 respondents with a response rate of 91% for EMR and 123 respondents with a response rate of 86% for MMR. The mean （SD） age of respondents in EMR and MMR groups were 34.7 （9.42） and 29.7 （6.15） respectively. The mean （SD） duration of respondents using EMR was 46.1 （35.83） months. The prevalence of depression, anxiety and stress among respondents using EMR were 6.9%, 25.4% and 12.3%. There were no significant difference between the study groups related to the depression, anxiety and stress scores. In multivariable analysis, the significant factors associated with depression among respondents using EMR was age （OR 1.10, 95% CI 1.02, 1.19）. The significant factors associated with stress among respondents using EMR was marital status （OR 3.33, 95% CI 1.10, 10.09） and borderline significant was computer skill course （OR 2.94, 95% CI 0.98, 8.78）. Conclusion： The prevalence of depression, anxiety and stress of those who uses EMR were within acceptable range. Age, marital status and computer skill are the identified factor associated with the depression and stress level which need to be considered in its implementation.
文摘Introduction: Today, information technology is considered as an important national development principle in each country which is applied in different fields. Health care as a whole and the hospitals could be regarded as a field and organizations with most remarkable IT applications respectively. Although different benchmarks and frameworks have been developed to assess different aspects of Hospital Information Systems (HISs) by various researchers, there is not any suitable reference model yet to benchmark HIS in the world. Electronic Medical Record Adoption Model (EMRAM) has been currently presented and is globally well-known to benchmark the rate of HIS utilization in the hospitals. Notwithstanding, this model has not been introduced in Iran so far. Methods: This research was carried out based on an applied descriptive method in three private hospitals of Isfahan—one of the most important provinces of Iran—in the year 2015. The purpose of this study was to investigate IT utilization stage in three selected private hospitals. Conclusion: The findings revealed that HIS is not at the center of concern in studied hospitals and is in the first maturity stage in accordance with EMRAM. However, hospital managers are enforced and under the pressure of different beneficiaries including insurance companies to improve their HIS. Therefore, it could be concluded that these types of hospitals are still far away from desirable conditions and need to enhance their IT utilization stage significantly.
基金funded by the Organized Research and Creative Activities(ORCA)Program at the University of Houston-Downtown(PI:Song Ge)。
文摘1|DEVELOPMENT AND ADOPTION OF EHR IN THE UNITED STATES At present,health-care systems in the United States face enormous challenges in providing quality care,characterized by safe,effective,efficient,patientcentered,timely,and equitable care while containing health-care costs[1,2].To understand and address patients'increasingly complicated health-care needs,we need safe access to quality information that is characterized by integrity,reliability,and accuracy[3],and establish mutually beneficial relationships among a multidisciplinary team of professionals[4].Traditional paper-based clinical workflow produces many issues such as illegible handwriting,inconvenient access,the possibility of computational prescribing errors,inadequate patient hand-offs,and drug administration errors.These problems can lead to medical errors,omissions,and duplications and,ultimately,poor patient outcomes and compromised quality of care[2].
基金Linköping University Hospital Swedish Society of Nursing
文摘Patients with colorectal cancer (CRC) can have chemotherapy with oxaliplatin postoperatively. Oxaliplatin can cause acute and chronic neurotoxicity. It is important to be aware of neurotoxic side effects so they can be documented and action taken at an early stage. The study aimed to identify and explore neurotoxic side effects documented in the medical records of patients with colorectal cancer treated with oxaliplatin-based adjuvant chemotherapy. Data in this study were medical records;presenting documentation about patients treated at the University Hospital in the south of Sweden between 2009 and 2010. A summative content analysis approach was used to explore the neurotoxic side effects. Identification and quantification of the content of medical records were carried out by using a study-specific protocol. “Cold sensitivity” and “tingling in the hands” were the most frequently documented neurotoxicity-related terms in the medical records. This identification was followed by interpretation. Three categories were identified in the interpretive part of the study: acute, chronic, and degree of neurotoxicity. The results show the importance of awareness of neurotoxic side effects so that they can be documented and action taken at an early stage. The documentation could be more reliable if patient-reported structured measurements were used, combined with free descriptions in the medical records. Being able to follow the progression of the symptoms during and after treatment would improve patient’s safety and also quality of life. The protocol that we developed and used in this review of medical records may be helpful to structure the documentation in the electronic system for documentation of neurotoxicity side effects.
文摘Objective:To explore the core drug of Tian-shi Ye(1666 C.E.–1745 C.E.,a famous medical experts in Qing Dynasty)for treating exogenous cough and its mechanism of action.Methods:The database of prescriptions for treating exogenous cough was established in Clinical Guide to Medical Records,and the complex network was constructed with frequency analysis and Gephi 0.9.2 software to obtain the core drug for exogenous cough,and the network of traditional Chinese medicine-component-disease-target regulation was constructed through network pharmacology to reveal the potential mechanism.Results:Xingren(Amygdalus Communis Vas)is the core drug for the treatment of exogenous cough in the“Clinical Guidelines and Medical Records”.It contains 19 active ingredients and forms 27 traditional Chinese medicine-disease targets for the treatment of acute bronchitis.Kyoto Encyclopedia of Genes and Genomes analysis involving 114 pathways,including arachidonic acid metabolism pathways,peroxidase pathways,estrogen metabolism pathways,and tryptophan metabolism pathways are the main signal pathways involved.Conclusion:Xingren(Amygdalus Communis Vas)-acute bronchitis has a multi-molecule,multi-target,and multi-pathway,and may be regulating the arachidonic acid metabolism pathway,peroxidase pathway,estrogen metabolism pathway,and tryptophan metabolism pathway.Such interventions as various biological processes in the body play a role in the treatment of acute bronchitis.
文摘Medical record information system engineering technology is used to set professor Wang Yongyan5s medical record as the master system, and model the disease, syndrome, treatment and prescription. According to the experience of doctors, we will combine them according to the procedure of ＂problem-solution＂, to study Professor Wang＇s treatment experience and his clinical thinking.
文摘Medical record coding plays an important role in hospital management and the improvement of medical record coding quality is quite important to hospital management.The professional qualities of medical record coders significantly affect the improvement of coding quality.At present,Medical record coders lack in professional knowledge,clinical knowledge and disease classification knowledge.In order to improve the quality of medical record coding,medical record coders should receive regular professional training,and hospital management departments should strengthen the monitoring of the quality of medical record coding.When encountering problems in the process of coding,medical record coders should take the initiative to consult and learn from clinicians.At the same time,medical record coders should cultivate a sense of responsibility,which can continuously improve their professional qualities and achieve the objective of improving the quality of medical record coding.
文摘Objective: the experiment will strengthen the result analysis for the management of archived medical records in the pharmacy department, better put forward suggestions for the development of the work of the pharmacy department, cooperate with the work content of the pharmacy department, clinical department and medical record management room, and improve the rationality of medication for patients. Methods: taking the archived medical records of the experimental pharmacy department as the main body of the investigation, the medication situation of 300 archived medical records from July 2019 to June 2020 was intercepted in the time period, and the medication situation was timely fed back to the clinical department. Results: from the perspective of all medical records, there were 7 unreasonable medical records and 11 dissenting medical records, which were caused by faulty medical orders. In addition, the number of unreasonable medical orders in the first half of 2020 was significantly lower than that in the second half of 2019, indicating that the medical orders were more accurate after the strengthening of comment management. In the cases that did not conform to the guidelines for clinical application of antibiotics, there were 2 cases of irrational prophylactic drug use, 3 cases of unindicated drug use and 2 cases of unsuitable usage and dosage. Conclusions: to strengthen the comment management of archived medical records is conducive to ensuring the medication safety of patients, and the problems found can be discussed centrally, thus improving the participation of pharmacists and strengthening the connection between departments.
文摘Objective: to study and analyze the value of medical record quality management in the continuous improvement of medical quality. Methods: 30 cases were included in our hospital from May 2021 to June 2022. From May 2021 to May 2021,15 cases and 15 cases from January 2022 to June 2022 were included in the control group;The quality management quality, writing quality and quality control of the two groups were evaluated. Results: study group patients management quality, writing quality, quality control patients management quality score is higher than the control group, patients writing quality assessment of grade A is higher than the control group, patients homepage, admission records, hospital records, discharge records, the incidence of quality control defects are lower than the control group, the difference has statistical significance (P 0.05). Conclusion: the application of medical record quality management has an outstanding value in improving the quality of medical record management, writing quality and quality control quality.
文摘The goal of this research was to develop a digital system that could allow managing electronic medical records (EMRs) codified under specifications of the Health Level 7/Clinical Document Architecture (HL7/CDA) international standard, and saving them in a portable digital storage device called iButton?. To this end, an USB-based hardware interface for reading and storing EMRs in iButtons was designed and implemented. In addition, a software application for invoking read/write operations on stored EMRs and showing their content on a graphical user interface was also developed, following the Extreme Programming (XP) software development methodology and using Visual Basic .NET as programming language. Tests conducted on the hardware interface showed that it was able to recognize any iButton type, reading and writing data on them as well. Moreover, the system helped in creating empty EMRs in conformance with the HL7/CDA standard, adding and viewing information, and updating it in the iButton. This system offers an easy way for managing and visualizing medical records codified in HL7/CDA, and allows patients to take their updated medical history with them everywhere.
基金the Special Project of the Shanghai Municipal Commission of Economy and Information Technology for Promoting High-Quality Industrial Development(No.2024-GZL-RGZN-02011)the Shanghai City Digital Transformation Project(No.202301002)the Project of Shanghai Shenkang Hospital Development Center(No.SHDC22023214)。
文摘Surgical site infections(SSIs)are the most common healthcare-related infections in patients with lung cancer.Constructing a lung cancer SSI risk prediction model requires the extraction of relevant risk factors from lung cancer case texts,which involves two types of text structuring tasks:attribute discrimination and attribute extraction.This article proposes a joint model,Multi-BGLC,around these two types of tasks,using bidirectional encoder representations from transformers(BERT)as the encoder and fine-tuning the decoder composed of graph convolutional neural network(GCNN)+long short-term memory(LSTM)+conditional random field(CRF)based on cancer case data.The GCNN is used for attribute discrimination,whereas the LSTM and CRF are used for attribute extraction.The experiment verified the effectiveness and accuracy of the model compared with other baseline models.
文摘Celiac disease(CD)is a common autoimmune disorder where gluten ingestion triggers an immune response,damaging the small intestine in genetically pre-disposed individuals.Affecting around 1%of the global population,CD presents with diverse symptoms,including gastrointestinal issues like diarrhea and extraintestinal conditions such as anemia and osteoporosis,often complicating diagnosis.Advances in serology,histology,and genetic testing,such as HLA-DQ2/DQ8 analysis,have improved diagnostic accuracy.Precision medicine is transforming CD management by integrating genetic,clinical,and lifestyle data to enable risk prediction,personalized therapies,and improved outcomes.Tools like machine learning enhance early diagnosis,dietary management,and drug discovery,while electronic medical records support comprehensive patient pro-filing and disease monitoring.These technologies facilitate personalized health-care delivery tailored to individual patient profiles.
文摘Recently,numerous estimation issues have been solved due to the developments in data-driven artificial neural networks(ANN)and graph neural networks(GNN).The primary limitation of previous methodologies has been the dependence on data that can be structured in a grid format.However,physiological recordings often exhibit irregular and unordered patterns,posing a significant challenge in conceptualising them as matrices.As a result,GNNs which comprise interactive nodes connected by edges whose weights are defined by anatomical junctions or temporal relationships have received a lot of consideration by leveraging implicit data that exists in a biological system.Additionally,our study incorporates a structural GNN to effectively differentiate between different degrees of infection in both the left and right hemispheres of the brain.Subsequently,demographic data are included,and a multi-task learning architecture is devised,integrating classification and regression tasks.The trials used an authentic dataset,including 800 brain x-ray pictures,consisting of 560 instances classified as moderate cases and 240 instances classified as severe cases.Based on empirical evidence,our methodology demonstrates superior performance in classification,surpassing other comparison methods with a notable achievement of 92.27%in terms of area under the curve as well as a correlation coefficient of 0.62.
文摘Ye Tianshi was a renowned expert in classical formulas during the Qing Dynasty.He created the Light Bitterness and Mild Pungency Method,which is formulated based on the compatibility of“Xing(bitter almond),Kou(Fructus amomi rotundus),Ju(tangerine peel),and Jie(platycodon root)”.This method regulates the dispersion and descent of lung Qi to dispel warm-heat pathogens and smooth the Qi movement of the triple energizer.In the treatment of lung system diseases,Ye classified them into two major categories based on etiology and pathogenesis:excess syndrome of nutrient-defense and deficiency syndrome of nutrient-defense.When discussing the treatment of cough caused by phlegm-fluid retention,he frequently referred to Synopsis of the Golden Chamber and attached great importance to summarizing and absorbing the academic thoughts of predecessors.As an accomplished expert in classical formulas,Ye Tianshi followed the academic essence of Xuanyuan and Qi Bo(founders of TCM theory)and respected the principles of Zhang Zhongjing’s classical formulas,integrating these theories in a coherent manner.With his masterful application of classical formulas to achieve remarkable curative effects,Ye’s academic viewpoints on treating lung system diseases still exert a profound influence on the modern clinical diagnosis and treatment of related diseases.
文摘A case of amyotrophic cervical spondylosis was healed by using acupuncture in combination with electroacupuncture, needling was carried out on fengchi（风池 GB 20）, Tianzhu （天柱 BE 10）, Dazhui （大椎 GV 14）, Jianjing （肩井GB 21）, Zhiyang （至阳 GV 9）, Jianzhen （肩贞SI 9）, Jianyu （肩髃 El 15）, Shousanli （手三里LI 10）, Houxi （后溪SI 3）, Kunlun （昆仑 BE 60） and Shugu （束骨 BL 65）. BL 10 on the left side and LI 10 on the right side, GB 20 on the right side and GV 9 were connected for electroacupuncture, once a day, 12 treatments as one treatment course, a interval of 5 days was set between two treatment courses, and totally 6 treatment courses were carried out. The patient was clinically healed after the treatment and the disease did not recur during the follow-up for six months.
基金the Natural Science Foundation of Heilongjiang Province of China under Grant No.LC2016024Natural Science Foundation of the Jiangsu Higher Education Institutions Grant No.17KJB520044Six Talent Peaks Project in Jiangsu Province No.XYDXX–108.
文摘In the digital era,electronic medical record(EMR)has been a major way for hospitals to store patients’medical data.The traditional centralized medical system and semi-trusted cloud storage are difficult to achieve dynamic balance between privacy protection and data sharing.The storage capacity of blockchain is limited and single blockchain schemes have poor scalability and low throughput.To address these issues,we propose a secure and efficient medical data storage and sharing scheme based on double blockchain.In our scheme,we encrypt the original EMR and store it in the cloud.The storage blockchain stores the index of the complete EMR,and the shared blockchain stores the index of the shared part of the EMR.Users with different attributes can make requests to different blockchains to share different parts according to their own permissions.Through experiments,it was found that cloud storage combined with blockchain not only solved the problem of limited storage capacity of blockchain,but also greatly reduced the risk of leakage of the original EMR.Content Extraction Signature(CES)combined with the double blockchain technology realized the separation of the privacy part and the shared part of the original EMR.The symmetric encryption technology combined with Ciphertext-Policy Attribute-Based Encryption(CP–ABE)not only ensures the safe storage of data in the cloud,but also achieves the consistency and convenience of data update,avoiding redundant backup of data.Safety analysis and performance analysis verified the feasibility and effectiveness of our scheme.
