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INTRODUCTION The aim of the study was to assess the influence of annual volume and factors related to intensive care unit (ICU) organization on in-hospital mortality among patients admitted to the ICU with severe sepsis. METHODS A retrospective cohort study was conducted using the database of the Dutch National Intensive Care Evaluation (NICE) registry.(More)
PURPOSE Clinical practice guidelines often contain ambiguities, inconsistencies, and logical errors that hamper implementation of these guidelines in practice. As guideline formalization is useful to verify the logical structure, consistency, and completeness of guidelines, several authors have argued that the formalization of guidelines concurrent with(More)
Clinical decision support systems (CDSSs) differ from other health information systems in their aim to directly influence the decision-making behaviour of healthcare professionals. As a result, CDSSs face additional challenges with respect to user acceptance. The objective of this study was to investigate subjective usability of a guideline-based CDSS for(More)
AIMS To assess the effects of multi-disciplinary cardiac rehabilitation (CR) on survival in the full population of patients with an acute coronary syndrome (ACS) and patients that underwent coronary revascularization and/or heart valve surgery. METHODS AND RESULTS Population-based cohort study in the Netherlands using insurance claims database covering(More)
OBJECTIVE To study posttraumatic stress disorder (PTSD) in parents after unexpected pediatric intensive care unit (PICU) treatment of their child and to identify risk factors for its development. METHOD Parents completed PTSD questionnaires 3 and 9 months (N = 190) after PICU treatment. Risk factors included pretrauma data, medical data, social(More)
In intensive care medicine close monitoring of organ failure status is important for the prognosis of patients and for choices regarding ICU management. Major challenges in analyzing the multitude of data pertaining to the functioning of the organ systems over time are to extract meaningful clinical patterns and to provide predictions for the future course(More)
OBJECTIVES To compare two temporal abstraction procedures for the extraction of meta features from monitoring data. Feature extraction prior to predictive modeling is a common strategy in prediction from temporal data. A fundamental dilemma in this strategy, however, is the extent to which the extraction should be guided by domain knowledge, and to which(More)
For effective guideline implementation it is recommended to develop and apply carefully designed implementation strategies and instruments. Computerized decision support systems (CDSSs) are such instruments as they can improve guideline adherence by providing advice at the point of care. To improve the implementation of the Dutch cardiac rehabilitation(More)
Sensitivity analysis is a method to investigate the effects of varying a model's parameters on its predictions. It was recently suggested as a suitable means to facilitate quantifying the joint probability distribution of a Bayesian belief network. This article presents practical experience with performing sensitivity analyses on a belief network in the(More)