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CONTEXT To ensure interpretability and replicability of clinical experiments, methods must be adequately explicit and should elicit the same decision from different clinicians who comply with the study protocol. OBJECTIVE The objective of this study was to determine whether clinician compliance with protocol recommendations exceeds 90%. DESIGN We(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)
OBJECTIVE The aim of this study was to assess, using a Web-based format, third-year medical students' pediatric knowledge and perceptions of game playing with faculty facilitation compared with self-study computerized flash cards. METHODS This study used a repeated-measures experimental design with random assignment to a game group or self-study group.(More)
Paper-based clinical practice standards usually pertain to a single diagnosis or clinical condition. When a computerized provider order entry system applies multiple paper-based practice standards to one patient, it generates an order list containing redundant orders. Nurses respond to redundant orders on the basis of their level of nursing expertise with(More)
Unnecessary variation in clinical care and clinical research reduces our ability to determine what healthcare interventions are effective. Reducing this unnecessary variation could lead to further healthcare quality improvement and more effective clinical research. We have developed and used electronic decision support tools (eProtocols) to reduce(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)
The Arden Syntax is an HL7 standard language for representing medical knowledge as logic statements. Despite nearly 2 decades of availability, Arden Syntax has not been widely used. This has been attributed to the lack of a generally available compiler to implement the logic, to Arden's complex syntax, to the challenges of mapping local data to data(More)
OBJECTIVE To characterize the clinical course, therapies, and outcomes of children with fatal and near-fatal asthma admitted to pediatric intensive care units (PICUs). STUDY DESIGN This was a retrospective chart abstraction across the 8 tertiary care PICUs of the Collaborative Pediatric Critical Care Research Network (CPCCRN). Inclusion criteria were(More)
PURPOSE Although pediatric intensivists claim to embrace lung protective ventilation for acute lung injury (ALI), ventilator management is variable. We describe ventilator changes clinicians made for children with hypoxemic respiratory failure, and evaluate the potential acceptability of a pediatric ventilation protocol. METHODS This was a retrospective(More)
BACKGROUND Results of randomized controlled trials (RCTs) provide high-level evidence for evidence-based practice (EBP). The quality of RCTs has a substantial influence on providing reliable knowledge for EBP. Little is known about the quality of RCT reporting in cancer nursing. OBJECTIVE The aim of this study was to assess the quality of reporting in(More)