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Structured entry and reporting in medicine remains an elusive goal. Poor adoption of clinical structured entry for documentation results in part from the inherent complexity of entering patient histories, which are generally unstructured. The authors have developed a structured entry tool that has been adopted by practicing physicians for documentation of(More)
Relative (or receiver) operating characteristic (ROC) curves are a graphical representation of the relationship between sensitivity and specificity of a laboratory test over all possible diagnostic cutoff values. Laboratory medicine has been slow to adopt the use of ROC curves for the analysis of diagnostic test performance. In this tutorial, we discuss the(More)
We used two standard methods (the common percentile and the log-power gaussian transformation) and two novel methods (weighted percentile and smoothed spline interpolation) to estimate the 2.5th and 97.5th percentiles of 1000 sets of data from eight diverse distributional forms, generated by Monte Carlo simulation. For each distributional form we derived an(More)
Richard E. Clark in his widely published comprehensive studies and meta-analyses of the literature on computer assisted instruction (CAI) has decried the lack of carefully controlled research, challenging almost every study which shows the computer-based intervention to result in significant post-test proficiency gains over a non-computer-based(More)
BACKGROUND Current practices of reporting critical laboratory values make it challenging to measure and assess the timeliness of receipt by the treating physician as required by The Joint Commission's 2008 National Patient Safety Goals. METHODS A multidisciplinary team of laboratorians, clinicians, and information technology experts developed an(More)
This project tested the importance of enhanced information transfer of home monitoring results to health care providers. The study tested whether computer-assisted communication of medical information between the chronic care patient and the physician can result in health care benefit. The information tools were constructed/adapted as a test of this(More)
The thesis that an integrated telecommunications/reporting system would affect diabetic prognosis was tested. Over fifteen months a double crossover study compared traditional diaries versus graphical display of telecommunicated blood glucose data. Significant drops in glycohemoglobin were observed in both groups during the telecommunications period, while(More)
The evolution of test performance analysis should include the long-term costs and benefits associated with testing. Evolutionary laboratory techniques to achieve this include introduction of a new methodological technique, a multivariate extension to a current analytical technique, receiver-operating characteristic (ROC) curve analysis (MultiROC analysis).(More)
Iliad 4.0 and QMR 2.03 are computer-based diagnostic knowledge bases that can play many roles in decision support and other areas of medical practice, but neither appears ready to assume the role of an expert diagnostic consultant. In contrast to human experts, these programs have problems related to recognition of their own limitations, interpretation of(More)