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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)
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)
The management of patients over a prolonged period of time is a complicated task involving both diagnostic and prognostic reasoning with incomplete and often uncertain knowledge. Various formalisations of this type of task exist, but these often conceal one or more essential ingredients of the problem. This article explores the suitability of partially(More)
OBJECTIVES To study the effect of predefined order sets on the efficiency of computerized medication ordering, and to analyze the effect of different types of usability problems on ordering efficiency. METHODS Crossover study to comparing the efficiency of two methods of ordering (with and without use of predefined order sets) in a laboratory setting(More)