decision support

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    Error in algorithm to assess risk (and inform prescription of statins)

Error in algorithm to assess risk (and inform prescription of statins)

Computer error may have led to incorrect prescribing of statins to thousands of patients

BMJ 2016;353:i2742

 
Thousands of patients in England may have been incorrectly prescribed or taken off statins because of a major IT glitch.

The Medicines and Healthcare Products Regulatory Agency (MHRA) has launched an investigation after a fault was discovered with the digital QRISK2 calculator in SystmOne, run by […]

‘Genomic data are inherently computable’, or the opportunities and challenges for using genomic information in health care systems

Genomics is at the forefront of clinical decision support because the
data are inherently computable and therefore could be provided as supporting
information at the point of care, […].
Clinical decision support provides a better opportunity for physicians and
patients to use genomic data than either could have when the information
is solely contained in paper format. Validating the algorithms that are
being used to […]

A decision support tool for warfarin prescribing

Anna-Karin Hamberg, Jacob Hellman, Jonny Dahlberg, E Niclas Jonsson and Mia Wadelius (2015)
A Bayesian decision support tool for efficient dose individualization of warfarin in adults and children
BMC Medical Informatics and Decision Making 2015, 15:7
http://www.biomedcentral.com/1472-6947/15/7

Based on population based Pharmacokinetic-pharmacodynamic (PK/PD) model of warfarin.
The tool is developed in Java.
“.. user enters information on body weight, age, baseline and target INR, and […]

On decision support: use of drug interaction databases

A survey with 1871 respondents, ‘75% from drug prescribing professionals (n = 1402) or pharmacists (n = 469)’

“74% of the prescribers stated that the information provided by SFINX make them change their prescribing or ongoing treatment ‘sometimes’ or more often (Figure 2). The most common action was to change the choice of drug (73%) followed by informing the patient […]

February 4th, 2015|Clinical use|0 Comments|

On genetics and electronic health record

A Special Issue of the Genetics in Medicine journal on genetics and electronic health record

Volume 15, Issue 10 (October 2013)
http://www.nature.com/gim/journal/v15/n10/index.html

Among others, in this issue:

Integration of genomics into the electronic health record: mapping terra incognita
Joseph L. Kannry MD and Marc S. Williams MD
http://www.nature.com/gim/journal/v15/n10/full/gim2013102a.html

“… To date, no commercial EHR system has been described that systematically integrates genetic or genomic […]

Pharmacogenetics test lab embedded in ePrescribing, for personalised medicine?

“Pharmacogenetics (PG) examines inherited or acquired variations in genes that dictate drug response, disposition, or toxicity and explores how these variations can be used to optimize medication therapy”…

Lab tests are done before the prescription; the CPOE alerts the doctor if the test is positive.

Perhaps an example of enhancing traditional CPOE/ePrescriing systems with personalised medicine?

Goldspiel BR, Flegel WA, DiPatrizio […]