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200 adult respiratory distress syndrome patients were included in a prospective multicenter randomized trial to determine the efficacy of computerized decision support. The study was done in 10 medical centers across the United States. There was no significant difference in survival between the two treatment groups (mean 2 = 0.49 p = 0.49) or in ICU length(More)
(SPRC). The authors would like to extend their appreciation to all the participants in the HASI Evaluation for the time and effort devoted to the project. The authors would also like to acknowledge the contribution of the HASI Reference Group for their direction. v Executive Summary This report presents the summary findings of the second phase of a(More)
It is notoriously difficult to quantify the kinematic behaviour of vertebral segments in the assessment and localization of mechanical disorders of the spine. This paper describes the use of an image processor and an X-ray machine with image intensifier for the measurement of lumbar spine angular rotation and instantaneous centres of rotation in the coronal(More)
BACKGROUND The dynamic role of the trunk musculature, with respect to stability, has not been fully explored to date. The purpose of this study was, using a transient and multi-directional perturbation, to: (1) quantify the tonic level of activity in the superficial trunk musculature prior to any perturbation; (2) quantify the phasic activity in those same(More)
Clinical decision support systems (CDS) can interpret detailed treatment protocols for ICU care providers. In open-loop systems, clinicians can decline protocol recommendations. We capture their reasons for declining as part of ongoing, iterative protocol validation and refinement processes. Even though our protocol was well-accepted by clinicians overall,(More)
PURPOSE Implementation of evidence-based techniques, such as explicit computerized protocols, has achieved limited success among clinicians. In this study, we describe the development and validation of an instrument for assessing clinicians' perceptions about use of explicit computerized protocols. METHODS Qualitative assessment of semi-structured(More)
We describe the use of a frame-based knowledge representation to construct an adequately-explicit bedside clinical decision support application for ventilator weaning. The application consists of a data entry form, a knowledge base, an inference engine, and a patient database. The knowledge base contains database queries, a data dictionary, and decision(More)
INTRODUCTION Both patient- and context-specific factors may explain the conflicting evidence regarding glucose control in critically ill patients. Blood glucose variability appears to correlate with mortality, but this variability may be an indicator of disease severity, rather than an independent predictor of mortality. We assessed blood glucose(More)
INTRODUCTION We evaluated the feasibility of using an electronic protocol developed for research use (Research-eProtocol-insulin) for blood glucose management in usual intensive care unit clinical practice. METHODS We implemented the rules of Research-eProtocol-insulin in the electronic medical record of the Intermountain Healthcare hospital system(More)