A randomized study of feedback on student write-ups using an electronic portfolio.

Traditional methods allowing medical students and residents to review their work and receive feedback are lacking. We developed a web-based portfolio system that collects all clinical documentation and allows teachers to give feedback electronically. In a randomized control trial, we found that this system significantly increased feedback to students, often exceeding clerkship expectations. Seventy-five percent of students found the system a "valuable teaching tool". Students in control and portfolio groups agreed that the system increased feedback.

Prevalence and Clinical Significance of Discrepancies within Three Computerized Pre-Admission Medication Lists.

Inaccurate records of pre-admission medication exposure have been identified as a major source of medication error. Authors collected records of patients' pre-admission medications: 1) the most recent outpatient medication list ("EMR"), 2) the medication list recorded by admitting providers ("H&P"), and 3) a list generated by a medication reconciliation process conducted by nursing staff ("PAML"). Forty-eight sets of pre-admission records composed of 1087 medication entries were compared to a reference standard generated by trained study staff conducting an independent interview.

The use of a DNA biobank linked to electronic medical records to characterize pharmacogenomic predictors of tacrolimus dose requirement in kidney transplant recipients.

Tacrolimus, an immunosuppressive drug widely prescribed in kidney transplantation, requires therapeutic drug monitoring due to its marked interindividual pharmacokinetic variability and narrow therapeutic index. Previous studies have established that CYP3A5 rs776746 is associated with tacrolimus clearance, blood concentration, and dose requirement. The importance of other drug absorption, distribution, metabolism, and elimination (ADME) gene variants has not been well characterized.

Extracting and integrating data from entire electronic health records for detecting colorectal cancer cases.

Identification of a cohort of patients with specific diseases is an important step for clinical research that is based on electronic health records (EHRs). Informatics approaches combining structured EHR data, such as billing records, with narrative text data have demonstrated utility for such tasks. This paper describes an algorithm combining machine learning and natural language processing to detect patients with colorectal cancer (CRC) from entire EHRs at Vanderbilt University Hospital.

Extracting semantic lexicons from discharge summaries using machine learning and the C-Value method.

Semantic lexicons that link words and phrases to specific semantic types such as diseases are valuable assets for clinical natural language processing (NLP) systems. Although terminological terms with predefined semantic types can be generated easily from existing knowledge bases such as the Unified Medical Language Systems (UMLS), they are often limited and do not have good coverage for narrative clinical text. In this study, we developed a method for building semantic lexicons from clinical corpus.

The Pharmacogenomics Research Network Translational Pharmacogenetics Program: overcoming challenges of real-world implementation.

  • Shuldiner AR, Relling MV, Peterson JF, Hicks JK, Freimuth RR, Sadee W, Pereira NL, Roden DM, Johnson JA, Klein TE, Shuldiner AR, Vesely M, Robinson SW, Ambulos N, Stass SA, Kelemen MD, Brown LA, Pollin TI, Beitelshees AL, Zhao RY, Pakyz RE, Palmer K, Alestock T, O'Neill C, Maloney K, Branham A, Sewell D, Relling MV, Crews K, Hoffman J, Cross S, Haidar C, Baker D, Hicks JK, Bell G, Greeson F, Gaur A, Reiss U, Huettel A, Cheng C, Gajjar A, Pappo A, Howard S, Hudson M, Pui CH, Jeha S, Evans WE, Broeckel U, Altman RB, Gong L, Whirl-Carrillo M, Klein TE, Sadee W, Manickam K, Sweet KM, Embi PJ, Roden D, Peterson J, Denny J, Schildcrout J, Bowton E, Pulley J, Beller M, Mitchell J, Danciu I, Price L, Pereira NL, Weinshilboum R, Wang L, Johnson JA, Nelson D, Clare-Salzler M, Elsey A, Burkley B, Langaee T, Liu F, Nessl D, Dong HJ, Lesko L, Freimuth RR, Chute CG. The Pharmacogenomics Research Network Translational Pharmacogenetics Program: overcoming challenges of real-world implementation. Clinical pharmacology and therapeutics. 2013 Aug;94(94). 207-10. PMID: 23588301 [PubMed] PMCID: PMC3720847 NIHMSID: NIHMS483135.

Development of a natural language processing system to identify timing and status of colonoscopy testing in electronic medical records.

Colorectal cancer (CRC) screening rates are low despite proven benefits. We developed natural language processing (NLP) algorithms to identify temporal expressions and status indicators, such as "patient refused" or "test scheduled." The authors incorporated the algorithms into the KnowledgeMap Concept Identifier system in order to detect references to completed colonoscopies within electronic text. The modified NLP system was evaluated using 200 randomly selected electronic medical records (EMRs) from a primary care population aged >/=50 years.

Extracting timing and status descriptors for colonoscopy testing from electronic medical records.

Colorectal cancer (CRC) screening rates are low despite confirmed benefits. The authors investigated the use of natural language processing (NLP) to identify previous colonoscopy screening in electronic records from a random sample of 200 patients at least 50 years old. The authors developed algorithms to recognize temporal expressions and 'status indicators', such as 'patient refused', or 'test scheduled'.

Integrating existing natural language processing tools for medication extraction from discharge summaries.

To develop an automated system to extract medications and related information from discharge summaries as part of the 2009 i2b2 natural language processing (NLP) challenge. This task required accurate recognition of medication name, dosage, mode, frequency, duration, and reason for drug administration.