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Items 1 to 10 of about 36
1. Sintchenko V, Coiera EW: Which clinical decisions benefit from automation? A task complexity approach. Int J Med Inform; 2003 Jul;70(2-3):309-16
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Which clinical decisions benefit from automation? A task complexity approach.
  • OBJECTIVE: To describe a model for analysing complex medical decision making tasks and for evaluating their suitability for automation.
  • METHOD: Assessment of a decision task's complexity in terms of the number of elementary information processes (EIPs) and the potential for cognitive effort reduction through EIP minimisation using an automated decision aid.
  • RESULTS: The model consists of five steps:.
  • (1) selection of the domain and relevant tasks;.
  • (2) evaluation of the knowledge complexity for tasks selected;.
  • (3) identification of cognitively demanding tasks;.
  • (4) assessment of unaided and aided effort requirements for this task accomplishment; and (5) selection of computational tools to achieve this complexity reduction.
  • The model is applied to the task of antibiotic prescribing in critical care and the most complex components of the task identified.
  • Decision aids to support these components can provide a significant reduction of cognitive effort suggesting this is a decision task worth automating.
  • CONCLUSION: We view the role of decision support for complex decision to be one of task complexity reduction, and the model described allows for task automation without lowering decision quality and can assist decision support systems developers.
  • [MeSH-major] Artificial Intelligence. Automation. Cognition. Decision Making, Computer-Assisted. Decision Support Systems, Clinical. Models, Theoretical
  • [MeSH-minor] Humans. Mental Processes

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  • (PMID = 12909183.001).
  • [ISSN] 1386-5056
  • [Journal-full-title] International journal of medical informatics
  • [ISO-abbreviation] Int J Med Inform
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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2. Coiera EW, Vickland V: Is relevance relevant? User relevance ratings may not predict the impact of Internet search on decision outcomes. J Am Med Inform Assoc; 2008 Jul-Aug;15(4):542-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is relevance relevant? User relevance ratings may not predict the impact of Internet search on decision outcomes.
  • OBJECTIVE: A common measure of Internet search engine effectiveness is its ability to find documents that a user perceives as 'relevant'.
  • This study sought to test whether user provided relevance ratings for documents retrieved by an Internet search engine correlate with the decision outcome after use of a search engine.
  • DESIGN: 227 university students were asked to answer four randomly assigned consumer health questions, then to conduct an Internet search on one of two randomly assigned search engines of different performance, and to again answer the question.
  • MEASUREMENTS: Participants were asked to provide a relevance score for each document retrieved as well as a pre and post search answer to each question.
  • RESULTS: User relevance rankings had little or no predictive power.
  • Relevance rankings were unable to predict whether the user of a search engine could correctly answer a question after search and could not differentiate between two search engines with statistically different performance in the hands of users.
  • Only when users had strong prior knowledge of the questions, and the decision task was of low complexity, did relevance appear to have modest predictive power.
  • CONCLUSIONS: User provided relevance rankings taken in isolation seem to be of limited to no value when designing a search engine that will be used in a general-purpose setting.
  • Relevance rankings may have a place in situations in which experts provide rankings, and decision tasks are of complexity commensurate with the abilities of the raters.
  • A more natural metric of search engine performance may be a user's ability to accurately complete a task, as this removes the inherent subjectivity of relevance rankings, and provides a direct and repeatable outcome measure which directly correlates with the performance of the search technology in the hands of users.
  • [MeSH-major] Decision Making. Information Storage and Retrieval / standards. Internet
  • [MeSH-minor] Humans. Medical Informatics

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  • [Cites] Stud Health Technol Inform. 2001;84(Pt 1):348-52 [11604761.001]
  • [Cites] Int J Med Inform. 2003 Jul;70(2-3):309-16 [12909183.001]
  • [Cites] JAMA. 1998 Oct 21;280(15):1347-52 [9794316.001]
  • [Cites] J Med Internet Res. 2008;10(1):e2 [18244893.001]
  • [Cites] J Am Med Inform Assoc. 2005 May-Jun;12(3):315-21 [15684126.001]
  • [Cites] J Med Internet Res. 2005;7(5):e52 [16403716.001]
  • [Cites] J Am Med Inform Assoc. 2005 May-Jun;12(3):296-8 [15684123.001]
  • (PMID = 18436902.001).
  • [ISSN] 1067-5027
  • [Journal-full-title] Journal of the American Medical Informatics Association : JAMIA
  • [ISO-abbreviation] J Am Med Inform Assoc
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2442252
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3. Coiera EW, Kidd MR, Haikerwal MC: A call for national e-health clinical safety governance. Med J Aust; 2012 Apr 16;196(7):430-1
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A call for national e-health clinical safety governance.
  • [MeSH-major] Clinical Governance. Internet / standards. Medical Informatics / standards. Patient Safety / legislation & jurisprudence
  • [MeSH-minor] Australia. Humans

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  • (PMID = 22509862.001).
  • [ISSN] 1326-5377
  • [Journal-full-title] The Medical journal of Australia
  • [ISO-abbreviation] Med. J. Aust.
  • [Language] eng
  • [Publication-type] Editorial; Research Support, Non-U.S. Gov't
  • [Publication-country] Australia
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4. Vickland V, Chilko N, Draper B, Low LF, O'Connor D, Brodaty H: Individualized guidelines for the management of aggression in dementia - Part 2: appraisal of current guidelines. Int Psychogeriatr; 2012 Jul;24(7):1125-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Individualized guidelines for the management of aggression in dementia - Part 2: appraisal of current guidelines.
  • BACKGROUND: Individualized guidelines have the potential to offer clinicians assistance in decision-making at the point of consultation to improve health outcomes for patients.
  • This project aims to develop individualized guidelines for the management of aggression in dementia.
  • At an earlier stage, we developed a map of concepts to consider when managing aggression.
  • The purpose of the current study is to appraise paper-based guidelines for their representation of these concepts.
  • METHODS: Two reviewers used a four-point scale (absent, weak, moderate, strong) to rate the guidelines on their representation of concepts relating to the patient, the aggression and dementia disorder, the treatment, and the guidelines themselves.
  • Consensus was reached on inconsistent scores.
  • RESULTS: Sixteen guidelines published since 2005 were evaluated for their representation of 13 key concepts.
  • Pharmacological and non-pharmacological interventions were strongly represented overall in the guidelines, in conjunction with a consideration of the individual characteristics of the patients and their environment.
  • Recommendations based on the presentation of the aggressive symptoms, goals of treatment, and theory of the cause of the aggression were moderately represented in the guidelines.
  • Recommendations for the principles of restraint use and emergency treatment, as well as a consideration of the personal history of the patient, were poorly represented.
  • Only 6 of 16 guidelines gave details of the expected review.
  • CONCLUSION: Concepts important to the management of aggression in dementia are missing in the majority of published guidelines on dementia.
  • This limits the ability of these tools to guide clinical practice effectively.

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  • (PMID = 22420860.001).
  • [ISSN] 1741-203X
  • [Journal-full-title] International psychogeriatrics
  • [ISO-abbreviation] Int Psychogeriatr
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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5. Vickland V, McDonnell G, Werner J, Draper B, Low LF, Brodaty H: A computer model of dementia prevalence in Australia: foreseeing outcomes of delaying dementia onset, slowing disease progression, and eradicating dementia types. Dement Geriatr Cogn Disord; 2010;29(2):123-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A computer model of dementia prevalence in Australia: foreseeing outcomes of delaying dementia onset, slowing disease progression, and eradicating dementia types.
  • BACKGROUND: A computer model was designed to test hypothetical scenarios regarding dementia prevalence in Australia (2001-2040).
  • METHODS: The study implemented 3 scenarios: delaying dementia onset, slowing disease progression and, in a previously unpublished experiment, eradicating dementia types.
  • Sensitivity analysis and parameter variation were the main methods of experimentation.
  • RESULTS: The model predicts that delaying dementia onset by 5 years will reduce the 2040 prevalence by 37%.
  • An onset delay of 2 years, introduced in 2010, will reduce the 2040 prevalence by 16%.
  • Slowing disease progression increases the 2040 prevalence by 4-7%.
  • Total eradication of Alzheimer's disease (currently approximately 50% of all dementia cases) in 2020 will decrease the 2040 prevalence by 42%.
  • CONCLUSION: Computer modeling of future scenarios and interventions helps health and aged care planners understand the likely challenges society will face with the ageing of the world's population.
  • [MeSH-major] Dementia / epidemiology
  • [MeSH-minor] Age Factors. Aged. Australia / epidemiology. Computer Simulation. Disease Progression. Female. Forecasting. Humans. Male. Models, Statistical. Population. Software. Treatment Outcome

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  • (PMID = 20145398.001).
  • [ISSN] 1421-9824
  • [Journal-full-title] Dementia and geriatric cognitive disorders
  • [ISO-abbreviation] Dement Geriatr Cogn Disord
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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6. Vickland V, McDonnell G, Werner J, Draper B, Low LF, Brodaty H: In silico modeling systems: learning about the prevalence and dynamics of dementia through virtual experimentation. Alzheimers Dement; 2011 Jul;7(4):e77-83
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] In silico modeling systems: learning about the prevalence and dynamics of dementia through virtual experimentation.
  • BACKGROUND: Virtual experimentation using computer modeling creates opportunities for researchers who want to better understand disease processes, foresee effects of future demographics, and evaluate combinations of interventions when applied to larger target groups.
  • METHODS: We created a computer model of dementia prevalence consisting of six population groups representing diagnosed and undiagnosed dementia at mild, moderate, and severe levels.
  • Dynamic transitions between these groups corresponded to the gradual progression of disease.
  • The seventh group represented the general population without dementia aged >60 years from which new dementia cases emerged.
  • Through a series of virtual experiments we estimated future changes in the severity-specific prevalence of dementia in Australia.
  • RESULTS: The projected total prevalence of dementia in Australia for year 2040 changed from 742,000 to 986,000 (+33%) and to 433,000 (-42%) when the incidence rate was altered by ±50%.
  • Increasing the transition time between mild and moderate dementia from 5 to 7 years and between moderate to severe from 7 to 9 years increased the prevalence of mild dementia by 23% and decreased the prevalence of severe dementia by 24%.
  • CONCLUSIONS: As computer modeling becomes more accepted, in silico experiments are being routinely performed to update demographic projections.
  • Despite its simplicity, the framework of this model integrates a large pool of knowledge and consists of components which are dynamically interconnected.
  • The computational logic underpins series of assumptions and binds them together with demographic data.
  • [MeSH-major] Computer Simulation. Dementia / epidemiology. Nonlinear Dynamics. User-Computer Interface
  • [MeSH-minor] Age Factors. Age of Onset. Aged. Aged, 80 and over. Australia / epidemiology. Disease Progression. Humans. Male. Prevalence. Sensitivity and Specificity

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  • [Copyright] Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.
  • (PMID = 21784345.001).
  • [ISSN] 1552-5279
  • [Journal-full-title] Alzheimer's & dementia : the journal of the Alzheimer's Association
  • [ISO-abbreviation] Alzheimers Dement
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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7. Vickland V, Chilko N, Draper B, Low LF, O'Connor D, Brodaty H: Individualized guidelines for the management of aggression in dementia - Part 1: key concepts. Int Psychogeriatr; 2012 Jul;24(7):1112-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Individualized guidelines for the management of aggression in dementia - Part 1: key concepts.
  • BACKGROUND: Clinical guidelines have the potential to assist in the management of aggression in dementia.
  • This study aims to develop a conceptual framework for the construction of individualized guidelines for this group.
  • METHODS: A concept map of the topic "How to manage aggression in dementia" was developed by reviewing research papers, clinical guidelines, and gray literature.
  • Titles and abstracts of papers that met search criteria were manually scanned in an iterative process for the extraction of key ideas and terminology commonly used to describe the field.
  • Essential ideas and concepts were recorded on a concept map and hierarchically arranged.
  • The concept map was converted into an interactive PDF document for easy distribution and sharing.
  • RESULTS: Ten key concepts were found to be important when managing aggression in dementia clustered along three major dimensions: Patient, Disorder and Treatment.
  • The dimension Patient was defined by the "Patient's individual characteristics," the "Personal life story," and the "Patient's environment."
  • Disorder was defined by the "Presentation of symptoms" and "Theory of causation."
  • Treatment was defined by "Goals and expectations," "Non-pharmacological interventions," "Pharmacological interventions," "Ethics and Restraint Use," and "Emergency treatment."
  • Concepts relating to clinical guidelines themselves were also included in the interactive map, including "Support from evidence-based medicine," "Regular updates," "Disclosures," and "Usability."
  • CONCLUSION: Managing aggression in dementia requires consideration of a wide range of factors relating to the patient, the dementia and behavioral disturbance, and possible treatment options.
  • An interactive and hierarchical concept map provides a framework to develop individualized clinical guidelines.

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  • (PMID = 22414460.001).
  • [ISSN] 1741-203X
  • [Journal-full-title] International psychogeriatrics
  • [ISO-abbreviation] Int Psychogeriatr
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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8. Runciman WB, Coiera EW, Day RO, Hannaford NA, Hibbert PD, Hunt TD, Westbrook JI, Braithwaite J: Towards the delivery of appropriate health care in Australia. Med J Aust; 2012 Jul 16;197(2):78-81
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Towards the delivery of appropriate health care in Australia.
  • [MeSH-major] Delivery of Health Care / standards. Guideline Adherence. Quality Assurance, Health Care / methods. Quality Indicators, Health Care
  • [MeSH-minor] Access to Information. Australia. Medical Records. Practice Guidelines as Topic

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  • [CommentIn] Med J Aust. 2012 Jul 16;197(2):67-8 [22794036.001]
  • (PMID = 22794043.001).
  • [ISSN] 1326-5377
  • [Journal-full-title] The Medical journal of Australia
  • [ISO-abbreviation] Med. J. Aust.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
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9. Chenoweth L, Vickland V, Stein-Parbury J, Jeon YH, Kenny P, Brodaty H: Computer modeling with randomized-controlled trial data informs the development of person-centered aged care homes. Neurodegener Dis Manag; 2015 Oct;5(5):403-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Computer modeling with randomized-controlled trial data informs the development of person-centered aged care homes.
  • AIM: To answer questions on the essential components (services, operations and resources) of a person-centered aged care home (iHome) using computer simulation.
  • MATERIALS & METHODS: iHome was developed with AnyLogic software using extant study data obtained from 60 Australian aged care homes, 900+ clients and 700+ aged care staff.
  • Bayesian analysis of simulated trial data will determine the influence of different iHome characteristics on care service quality and client outcomes.
  • Interim results: A person-centered aged care home (socio-cultural context) and care/lifestyle services (interactional environment) can produce positive outcomes for aged care clients (subjective experiences) in the simulated environment.
  • CONCLUSION: Further testing will define essential characteristics of a person-centered care home.
  • [MeSH-major] Health Services Research / statistics & numerical data. Homes for the Aged / statistics & numerical data. Models, Statistical. Nursing Homes / statistics & numerical data. Patient-Centered Care / statistics & numerical data. Randomized Controlled Trials as Topic / statistics & numerical data
  • [MeSH-minor] Aged. Australia. Humans

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  • (PMID = 26477894.001).
  • [ISSN] 1758-2032
  • [Journal-full-title] Neurodegenerative disease management
  • [ISO-abbreviation] Neurodegener Dis Manag
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Keywords] NOTNLM ; aged care home / computer simulation / older people / person-centred / personhood / wellbeing
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10. Vickland V, Rogers C, Craig A, Tran Y: Electrodermal activity as a possible physiological marker for acupuncture. Complement Ther Clin Pract; 2008 May;14(2):83-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Electrodermal activity as a possible physiological marker for acupuncture.
  • Change in amplitude of skin potential is one of the physiological indicators of electrodermal activity (EDA) and has been associated with the onset of a variety of sensory, cognitive and emotional stimuli.
  • This study investigated the EDA physiological response to manual acupuncture.
  • A group of 60 healthy female volunteers were recruited into the study of which 30 were randomly assigned to a control group (no acupuncture) and 30 to the experimental group (received acupuncture).
  • The experimental group attended three sessions in which acupuncture intervention consisting of unilateral manual stimulation of acupuncture points LU7 and KD6.
  • Results showed that the insertion, stimulation and withdrawal of the acupuncture needles were associated with significant changes in EDA.
  • The insertion of the needle was associated with the highest change in skin potential while the three consecutive manipulations of the needles showed a decline in EDA amplitude, thought to be consistent with physiological habituation.
  • Anxiety level and previous familiarity with acupuncture did not influence outcomes.
  • It is postulated that the change in EDA during needle insertion is non-specific to the type and the function of acupuncture points; however, EDA response may be associated with the precise location of the acupuncture point.
  • If further studies confirm such findings, then EDA may become a valuable physiological marker for the acupuncture phenomenon.
  • [MeSH-major] Acupuncture Points. Acupuncture Therapy / methods. Galvanic Skin Response / physiology
  • [MeSH-minor] Adolescent. Adult. Anxiety / complications. Anxiety / psychology. Electrophysiology. Female. Humans. Needles

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  • (PMID = 18396251.001).
  • [ISSN] 1744-3881
  • [Journal-full-title] Complementary therapies in clinical practice
  • [ISO-abbreviation] Complement Ther Clin Pract
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] England
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