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IMPORTANCE Cardiac biomarker testing is not routinely indicated in the emergency department (ED) because of low utility and potential downstream harms from false-positive results. However, current rates of testing are unknown. OBJECTIVE To determine the use of cardiac biomarker testing overall, as well as stratified by disposition status and selected(More)
BACKGROUND Effective population management of patients with diabetes requires timely recognition. Current case-finding algorithms can accurately detect patients with diabetes, but lack real-time identification. We sought to develop and validate an automated, real-time diabetes case-finding algorithm to identify patients with diabetes at the earliest(More)
BACKGROUND Although timely treatment of sepsis improves outcomes, delays in administering evidence-based therapies are common. PURPOSE To determine whether automated real-time electronic sepsis alerts can: (1) accurately identify sepsis and (2) improve process measures and outcomes. DATA SOURCES We systematically searched MEDLINE, Embase, The Cochrane(More)
RATIONALE, AIMS AND OBJECTIVES To describe primary care providers' (PCP) attitudes about the impact of a mature, commercial electronic health records (EHR) on clinical practice in settings with experience using the system and to evaluate whether a provider's propensity to adopt new technologies is associated with more favourable perceptions. METHOD We(More)
BACKGROUND Despite considerable financial incentives for adoption, there is little evidence available about providers' use and satisfaction with key functions of electronic health records (EHRs) that meet "meaningful use" criteria. METHODS We surveyed primary care providers (PCPs) in 11 general internal medicine and family medicine practices affiliated(More)
BACKGROUND Guidelines and performance measures recommend obtaining blood cultures in selected patients hospitalized with community-acquired pneumonia (CAP). Due to inherent diagnostic uncertainty, there may be spillover effects of these recommendations on other conditions that resemble pneumonia. METHODS Using data from the 2002 to 2010 National Hospital(More)
BACKGROUND Social determinants directly contribute to poorer health, and coordination between healthcare and community-based resources is pivotal to addressing these needs. However, our healthcare system remains poorly equipped to address social determinants of health. The potential of health information technology to bridge this gap across the delivery of(More)
OBJECTIVES To evaluate the risk and predictors of thiazide-induced adverse events (AEs) in multimorbid older adults in real-world clinical settings. DESIGN Observational cohort study. SETTING National Veterans Affairs data from 2007 to 2008. PARTICIPANTS Veterans aged 65 and older newly prescribed a thiazide (N = 1,060) compared with(More)