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Databases are an increasingly important part of the everyday life of all healthcare professionals. This straightforward practical guide to creating and using databases is closely tailored to the needs of healthcare practitioners. It covers design and implementation including simple data modelling, normalisation, tables, forms, queries and reports and shows how a database can be integrated with a word processor to produce letters for mailing. The easy to use step-by-step format guides the reader through the text in a user-friendly style by showing what actually appears on the computer and by making extensive use of screen shots, toolbar icons, mouse and keyboard actions. This clear and concise approachable book is designed for all general practitioners, practice managers and nurses, clinical governance and audit staff, doctors, nurses and other hospital staff, and staff involved in research and development - who need have no prior knowledge of databases.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
This book trains the next generation of scientists representing different disciplines to leverage the data generated during routine patient care. It formulates a more complete lexicon of evidence-based recommendations and support shared, ethical decision making by doctors with their patients. Diagnostic and therapeutic technologies continue to evolve rapidly, and both individual practitioners and clinical teams face increasingly complex ethical decisions. Unfortunately, the current state of medical knowledge does not provide the guidance to make the majority of clinical decisions on the basis of evidence. The present research infrastructure is inefficient and frequently produces unreliable results that cannot be replicated. Even randomized controlled trials (RCTs), the traditional gold standards of the research reliability hierarchy, are not without limitations. They can be costly, labor intensive, and slow, and can return results that are seldom generalizable to every patient population. Furthermore, many pertinent but unresolved clinical and medical systems issues do not seem to have attracted the interest of the research enterprise, which has come to focus instead on cellular and molecular investigations and single-agent (e.g., a drug or device) effects. For clinicians, the end result is a bit of a “data desert” when it comes to making decisions. The new research infrastructure proposed in this book will help the medical profession to make ethically sound and well informed decisions for their patients.
This book allows readers to gain an in-depth understanding of the role of real-world data in pharmacoepidemiology, and highlights the strengths and limitations of the respective databases with regard to pharmacoepidemiological research. Over the past decade, the increasing use of real-world data in pharmacoepidemiological research has been accompanied by a growing recognition of the value of real-world evidence in clinical and regulatory decision-making. Electronic healthcare databases allow analyses of drug and vaccine utilization in routine care after approval, as well as investigations of their comparative effectiveness and safety. They are especially useful for the identification of rare risks and rare drug exposures over long periods of time, and as such sustainably extend the basis for drug safety research. This book provides an introduction to the role of real-world data in pharmacoepidemiological research and the main developments in the last 15 years. It also offers a comprehensive overview of the general classification characteristics of databases, together with their strengths and limitations, and a detailed description of 21 individual databases, written by professionals who work with or maintain them.
Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
Bernadette Mazurek Melnyk and Ellen Fineout-Overholt are creators of the ARCC (Advancing Research and Clinical practice through close Collaboration) Model, an innovative strategy for implementing and sustaining evidence-based practice in healthcare systems. The ARCC Model is cited as an exemplar of education in evidence-based practice in the Board on Health Care Services and the Institute of Medicine's book, Health Professions Education: A Bridge to Quality. "McInyk and Fineout-Overholt's book should be required reading in all graduate programs. Their text has provided a blueprint for the future of nursing practice and a rigorously substantiated and clearly described means for clinicians, educators, and administrators to participate in improving quality of care." Janet D. Allan, PhD, RN, FAAN Dean and Professor University of Maryland School of Nursing "Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice has been instrumental in developing a culture of evidence-based practice at Barnes-Jewish Hospital. It is fundamental to our curriculum provided to all levels of staff, from new graduate nurses to the highest levels of hospital leadership." Dr. Patricia Potter, RN, PhD, FAAN, Dr. Gail Rea, RN, PhD, CNE, Dr. Karen Balakas, RN, PhD, CNE, Jennifer Williams, MSN, RN, ACNS-BC, Elizabeth Pratt, MSN, RN, ACNS-BC Evidence Equals Excellence group at Barnes-Jewish Hospital and Barnes-Jewish School of Nursing at Goldfarb Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice is an exemplary text that spans the continuum of nursing evidence to support best practice. Utilizing this text with undergraduate, RN to BSN, and graduate nursing students, it is the ONLY text that demonstrates how to retrieve, read, and analyze evidence whether it is published as an individual study, systematic review, meta-analysis, best practice guideline, or outcomes management report. Students learn how to utilize multiple complex databases and websites as they move through each chapter. And, they experience dissemination of evidence through the development of presentations, publications, posters, and grants. This is truly a remarkable book that embraces evidence as the basis for nursing practice and patient-centered care and safety. Having used this text with more than 1000 students over the past five years, I can honestly say that I have found no other text that facilitates learning and development of clinical judgment that is grounded in valid, reliable, and applicable evidence. This is a keeper! Alice E. Dupler, JD, APRN-BC Clinical Associate Professor Washington State University College of Nursing "I have used the book since I developed the Evidence-based Practice course for our College of Nursing in Fall 2007. It was the first course of its kind at Indiana State University. It has been well received and the preferred course for all nursing graduate students for completion of their final scholarly projects. The text was essential in developing the course and provides the foundation and guidance that the students need to develop their Evidence Based Practice projects...the students love the text!" Susan Eley PhD, RN, FNP-BC Assistant Professor Director FNP Program Indiana State University
Most industries have plunged into data automation, but health care organizations have lagged in moving patients' medical records from paper to computers. In its first edition, this book presented a blueprint for introducing the computer-based patient record (CPR). The revised edition adds new information to the original book. One section describes recent developments, including the creation of a computer-based patient record institute. An international chapter highlights what is new in this still-emerging technology. An expert committee explores the potential of machine-readable CPRs to improve diagnostic and care decisions, provide a database for policymaking, and much more, addressing these key questions: Who uses patient records? What technology is available and what further research is necessary to meet users' needs? What should government, medical organizations, and others do to make the transition to CPRs? The volume also explores such issues as privacy and confidentiality, costs, the need for training, legal barriers to CPRs, and other key topics.
This open access book explores ways to leverage information technology and machine learning to combat disease and promote health, especially in resource-constrained settings. It focuses on digital disease surveillance through the application of machine learning to non-traditional data sources. Developing countries are uniquely prone to large-scale emerging infectious disease outbreaks due to disruption of ecosystems, civil unrest, and poor healthcare infrastructure – and without comprehensive surveillance, delays in outbreak identification, resource deployment, and case management can be catastrophic. In combination with context-informed analytics, students will learn how non-traditional digital disease data sources – including news media, social media, Google Trends, and Google Street View – can fill critical knowledge gaps and help inform on-the-ground decision-making when formal surveillance systems are insufficient.
Modern businesses depend on data for their very survival, creating a need for sophisticated databases and database technologies to help store, organise and transport their valuable data. This updated and expanded, easy-to-read textbook/reference presents a comprehensive introduction to databases, opening with a concise history of databases and of data as an organisational asset. As relational database management systems are no longer the only database solution, the book takes a wider view of database technology, encompassing big data, NoSQL, object and object-relational, and in-memory databases. Presenting both theoretical and practical elements, the new edition also examines the issues of scalability, availability, performance and security encountered when building and running a database in the real world. Topics and features: Presents review and discussion questions at the end of each chapter, in addition to skill-building, hands-on exercises Provides new material on database adaptiveness, integration, and efficiency in relation to data growth Introduces a range of commercial databases and encourages the reader to experiment with these in an associated learning environment Reviews use of a variety of databases in business environments, including numerous examples Discusses areas for further research within this fast-moving domain With its learning-by-doing approach, supported by both theoretical and practical examples, this clearly-structured textbook will be of great value to advanced undergraduate and postgraduate students of computer science, software engineering, and information technology. Practising database professionals and application developers will also find the book an ideal reference that addresses today's business needs.