TY  - BOOK
AU  - Greenes,Robert A.
TI  - Clinical Decision Support: The Road Ahead
SN  - 9780080467696
AV  - RC78.7.D35C55 2007 
U1  - 616.07/5 
PY  - 2006///
CY  - London
PB  - Elsevier Science & Technology
KW  - Clinical medicine -- Decision making -- Data processing
KW  - Diagnosis -- Decision making -- Data processing
KW  - Electronic books
N1  - Front Cover -- Clinical Decision Support -- Copyright Page -- Table of Contents -- Contributors -- Preface -- PART I COMPUTER-BASED CLINICAL DECISION SUPPORT: CONCEPTS AND ORIGINS -- Chapter 1 DEFINITION, SCOPE, AND CHALLENGES -- 1.1 INTRODUCTION -- 1.2 DEFINITION OF COMPUTER-BASED CLINICAL DECISION SUPPORT -- 1.3 FEATURES OF CDS -- 1.4 THE TALE OF A RELATIONSHIP -- 1.5 SCOPE AND PLAN OF THIS BOOK -- REFERENCES -- Chapter 2 A BRIEF HISTORY OF CLINICAL DECISION SUPPORT: TECHNICAL, SOCIAL, CULTURAL, ECONOMIC, AND GOVERNMENTAL PERSPECTIVES -- 2.1 PRIMARY RESEARCH METHODOLOGIES THAT HAVE BEEN PURSUED AND EXTENDED -- 2.2 DRIVING FORCES FOR CDS -- 2.3 CONCLUSION -- REFERENCES -- Chapter 3 FEATURES OF COMPUTER-BASED CLINICAL DECISION SUPPORT -- 3.1 CDS AND THE HUMAN -- 3.2 DESIGN AND STRUCTURE OF CDS -- 3.3 OTHER CONSIDERATIONS -- REFERENCES -- PART II CASE STUDIES AND CURRENT STATUS -- Chapter 4 REGENSTRIEF MEDICAL INFORMATICS: EXPERIENCES WITH CLINICAL DECISION SUPPORT SYSTEMS -- 4.1 INTRODUCTION -- 4.2 HISTORY -- 4.3 CONCLUSION -- REFERENCES -- Chapter 5 PATIENTS, DOCTORS, AND INFORMATION TECHNOLOGY: CLINICAL DECISION SUPPORT AT BRIGHAM AND WOMEN'S HOSPITAL AND PARTNERS -- 5.1 HISTORY -- 5.2 CLINICAL DECISION SUPPORT AND INPATIENT CPOE AT BWH -- 5.3 DECISION SUPPORT DELIVERED USING THE OUTPATIENT ELECTRONIC HEALTH RECORD -- 5.4 OVERARCHING STUDIES -- 5.5 OVERARCHING LESSONS -- 5.6 FUTURE DIRECTIONS -- REFERENCES -- Chapter 6 CASE STUDIES IN CLINICAL DECISION SUPPORT: LDS HOSPITAL EXPERIENCE -- 6.1 INTRODUCTION -- 6.2 TOOLS FOR INFORMATION MANAGEMENT -- 6.3 TOOLS FOR FOCUSING ATTENTION -- 6.4 TOOLS FOR PATIENT-SPECIFIC CONSULTATION -- 6.5 CONCLUSION -- REFERENCES -- Chapter 7 PENETRATION AND AVAILABILITY OF CLINICAL DECISION SUPPORT IN COMMERCIAL SYSTEMS -- 7.1 INTRODUCTION -- 7.2 CDS PENETRATION AND AVAILABILITY IN COMMERCIAL SYSTEMS; 7.3 CLINICAL ALERTING IN 2002 -- 7.4 OBSTACLES TO CDS IN 2002 -- 7.5 WHAT CHANGED SINCE EARLY 2002? -- 7.6 HOW FAR ALONG ARE CDS VENDORS IN 2005? -- 7.7 SELF-REPORTED VENDOR DATA AS OF FEBRUARY 2005 -- 7.8 CONCLUSION -- REFERENCES -- VENDOR WEB SITE REFERENCES -- Chapter 8 LESSONS LEARNED -- 8.1 ACADEMIC PROTOTYPES -- 8.2 STANDARDS AND SHARING OF INTEROPERABLE CONTENT AND TOOLS -- 8.3 USERS -- 8.4 OTHER CONSIDERATIONS -- REFERENCES -- PART III GENERATION AND FORMULATION OF KNOWLEDGE -- Chapter 9 HUMAN-INTENSIVE TECHNIQUES -- 9.1 INTRODUCTION -- 9.2 THEORETICAL BASIS FOR KNOWLEDGE ACQUISITION -- 9.3 COGNITIVE TASK ANALYSIS -- 9.4 COMPUTER-BASED KNOWLEDGE ACQUISITION -- 9.5 CONCLUSION -- REFERENCES -- Chapter 10 GENERATION OF KNOWLEDGE FOR CLINICAL DECISION SUPPORT: STATISTICAL AND MACHINE LEARNING TECHNIQUES -- 10.1 INTRODUCTION -- 10.2 LEARNING FROM DATA -- 10.3 OVERVIEW OF LOGISTIC REGRESSION -- 10.4 OVERVIEW OF SOME MACHINE LEARNING MODELS -- 10.5 PREDICTION MODELS IN MEDICINE -- 10.6 CONCLUSION -- REFERENCES -- Chapter 11 EVIDENCE-BASED MEDICINE AND META-ANALYSIS: GETTING MORE OUT OF THE LITERATURE -- 11.1 SYSTEMATIC REVIEWS AND META-ANALYSES -- 11.2 METHODOLOGIES OF SYSTEMATIC REVIEW AND META-ANALYSIS -- 11.3 DEVELOPING A SYSTEMATIC REVIEW PROTOCOL -- 11.4 FORMULATING THE RESEARCH QUESTION -- 11.5 LITERATURE SEARCH -- 11.6 DATA EXTRACTION -- 11.7 ASSESSING THE QUALITY OF STUDIES -- 11.8 COMBINING DATA IN A META-ANALYSIS -- 11.9 EXPLORING HETEROGENEITY WITH SUBGROUP AND META-REGRESSION ANALYSES -- 11.10 ISSUES IN CONDUCTING META-ANALYSES -- 11.11 USES OF SYSTEMATIC REVIEWS AND META-ANALYSES -- 11.12 ACCESSING SYSTEMATIC REVIEWS AND META-ANALYSES AND RELATED PRODUCTS -- 11.13 CONCLUSION -- REFERENCES -- PART IV REPRESENTING THE KNOWLEDGE: STANDARDIZATION EFFORTS -- Chapter 12 DECISION RULES AND EXPRESSIONS -- 12.1 INTRODUCTION; 12.2 PROCEDURAL KNOWLEDGE -- 12.3 KNOWLEDGE AS PRODUCTION RULES -- 12.4 THE HYBRID APPROACH: ARDEN SYNTAX -- 12.5 EXPRESSION LANGUAGES -- 12.6 FUTURE WORK -- 12.7 CONCLUSION -- REFERENCES -- Chapter 13 GUIDELINES AND WORKFLOW MODELS -- 13.1 INTRODUCTION: CLINICAL GUIDELINES AND ALGORITHMS -- 13.2 THE KNOWLEDGE CONTAINED IN CLINICAL GUIDELINES -- 13.3 FORMAL METHODS FOR SPECIFYING CIGS -- 13.4 FROM NARRATIVE TO FORMAL REPRESENTATIONS OF GUIDELINES -- 13.5 INTEGRATION OF GUIDELINES WITH WORKFLOW -- 13.6 METHODS FOR SHARING OF CIG CONTENT -- 13.7 CONCLUSION -- 13.8 RECOMMENDED RESOURCES -- ACKNOWLEDGMENTS -- REFERENCES -- Chapter 14 ONTOLOGIES, VOCABULARIES, AND DATA MODELS -- 14.1 INTRODUCTION -- 14.2 THE NEED FOR CODED DATA -- 14.3 REFERENCING DATA IN DECISION LOGIC -- 14.4 ISSUES OF PRE- AND POSTCOORDINATION -- 14.5 DATA REPRESENTATION USING NAME-VALUE PAIRS -- 14.6 TERMINOLOGY IN THE LIFE CYCLE OF DECISION SUPPORT PROGRAMS -- 14.7 CONTEXTUAL RESTRICTIONS WITHIN THE TERMINOLOGY -- 14.8 WHAT NEEDS TO BE DONE -- REFERENCES -- Chapter 15 GROUPED KNOWLEDGE ELEMENTS -- 15.1 INTRODUCTION -- 15.2 CLINICAL DOCUMENTATION -- 15.3 CURRENT APPROACHES TO CLINICAL DOCUMENTATION -- 15.4 GROUPED KNOWLEDGE ELEMENTS (KEGs) -- 15.5 CONCLUSION -- REFERENCES -- Chapter 16 INFOBUTTONS AND POINT OF CARE ACCESS TO KNOWLEDGE -- 16.1 INTRODUCTION -- 16.2 UNDERSTANDING AND ADDRESSING CLINICIAN INFORMATION NEEDS -- 16.3 LINKING CLINICAL INFORMATION SYSTEMS TO ONLINE RESOURCES -- 16.4 INFOBUTTONS -- 16.5 MANAGING INFOBUTTONS -- 16.6 INFOBUTTON STANDARDIZATION -- 16.7 STANDARDS FOR INFORMATION RESOURCES -- 16.8 CONCLUSION -- RECOMMENDED RESOURCES -- ACKNOWLEDGMENTS -- REFERENCES -- Chapter 17 THE ROLE OF STANDARDS: WHAT WE CAN EXPECT AND WHEN -- 17.1 KEY STANDARDS AND THEIR BENEFITS -- 17.2 HOW IMPORTANT ARE STANDARDS? -- REFERENCES; PART V ORGANIZATIONAL, BUSINESS, AND SOCIAL CHALLENGES -- Chapter 18 ORGANIZATIONAL AND CULTURAL CHANGE CONSIDERATIONS -- 18.1 INTRODUCTION -- 18.2 ORGANIZATIONAL ISSUES RELATED TO CLINICAL DECISION SUPPORT -- 18.3 PLANNING WITH THESE ISSUES IN MIND -- 18.4 DEVELOPMENT, IMPLEMENTATION, AND MODIFICATION -- 18.5 EVALUATION AND MAINTENANCE -- 18.6 CONCLUSION -- RESOURCES -- ACKNOWLEDGMENTS -- REFERENCES -- Chapter 19 MANAGING THE INVESTMENT IN CLINICAL DECISION SUPPORT -- 19.1 INTRODUCTION -- 19.2 KNOWLEDGE MANAGEMENT -- 19.3 ORGANIZATION OF THE EFFORT -- 19.4 KEY IT STRATEGIES AND CONSIDERATIONS -- 19.5 EVALUATION OF THE IMPACT AND VALUE OF KNOWLEDGE MANAGEMENT -- 19.6 CONCLUSION -- REFERENCES -- Chapter 20 LEGAL AND REGULATORY ISSUES RELATED TO THE USE OF CLINICAL SOFTWARE IN HEALTH CARE DELIVERY -- 20.1 INTRODUCTION -- 20.2 LEGAL ISSUES RELATED TO USING EMBEDDED AND FREE-STANDING DECISION SUPPORT SOFTWARE IN CLINICAL SETTINGS -- 20.3 RESPONSIBILITY FOR CDS SOFTWARE AT THE INSTITUTIONAL LEVEL AND POTENTIAL GOVERNMENTAL REGULATION -- 20.4 CONCLUSION -- ACKNOWLEDGMENTS -- REFERENCES -- PART VI KNOWLEDGE MANAGEMENT APPROACHES -- Chapter 21 KNOWLEDGE MANAGEMENT INFRASTRUCTURE: EVOLUTION AT PARTNERS HEALTHCARE SYSTEM -- 21.1 INTRODUCTION -- 21.2 RAPID INNOVATION DISCOVERY AND ADOPTION: KEY INFRASTRUCTURE REQUIREMENTS -- 21.3 KNOWLEDGE ASSET MANAGEMENT INFRASTRUCTURE -- 21.4 CONCLUSION -- REFERENCES -- Chapter 22 THE CLINICAL KNOWLEDGE MANAGEMENT INFRASTRUCTURE OF INTERMOUNTAIN HEALTHCARE -- 22.1 CLINICAL KNOWLEDGE MANAGEMENT AT INTERMOUNTAIN HEALTHCARE -- 22.2 KNOWLEDGE ASSETS -- 22.3 SOFTWARE INFRASTRUCTURE -- ACKNOWLEDGMENTS -- REFERENCES -- Chapter 23 INTEGRATION OF KNOWLEDGE RESOURCES INTO APPLICATIONS TO ENABLE CLINICAL DECISION SUPPORT: ARCHITECTURAL CONSIDERATIONS -- 23.1 INTRODUCTION -- 23.2 TERM DEFINITIONS -- 23.3 KNOWLEDGE INTEGRATION TASKS; 23.4 ARCHITECTURAL CONSIDERATIONS -- 23.5 CASE STUDIES -- 23.6 LESSONS LEARNED FROM MARKET ADOPTION PATTERNS -- 23.7 PROPOSAL FOR A SOA APPROACH TO CLINICAL DECISION SUPPORT -- 23.8 CONCLUSION -- RECOMMENDED RESOURCES -- ACKNOWLEDGMENTS -- REFERENCES -- PART VII THE ROAD AHEAD -- Chapter 24 A PROPOSED STRATEGY FOR OVERCOMING INERTIA -- 24.1 EXISTING APPROACHES NOT WORKING -- 24.2 NEED FOR NEW MECHANISMS -- 24.3 RATIONALE FOR COMMUNAL INFRASTRUCTURE, RESOURCES, AND TOOLS -- 24.4 ORGANIZATION OF PROCESS -- 24.5 OVERVIEW OF STRATEGY -- 24.6 IDENTIFYING KEY SOCIETAL DRIVERS AND SETTING PRIORITIES -- 24.7 FORMALIZING THE THREE LIFE CYCLE PROCESSES -- 24.8 GETTING SPECIFIC: END-TO-END IMPLEMENTATION STARTING WITH HIGH-PRIORITY FOCUS AREA(s) -- 24.9 LOOKING AHEAD: EPILOGUE AS PROLOGUE -- REFERENCES -- INDEX
N2  - This book examines the nature of medical knowledge, how it is obtained, and how it can be used for decision support. It provides complete coverage of computational approaches to clinical decision-making. Chapters discuss data integration into healthcare information systems and delivery to point of care for providers, as well as facilitation of direct to consumer access. A case study section highlights critical lessons learned, while another portion of the work examines biostatistical methods including data mining, predictive modelling, and analysis. This book additionally addresses organizational, technical, and business challenges in order to successfully implement a computer-aided decision-making support system in healthcare delivery
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