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Replication studies and diversity, equity, and inclusion strategies are critical to advance the impact of biomedical and health informatics
In this Editorial, I highlight 2 critical issues for advancing the impact of the science and application of biomedical and health informatics methods, processes, and tools: replication studies and diversity, equity, and inclusion. In a previous article inJournal of the American Medical Informatics Association, Coiera et al1 asked if health informatics had a replication crisis and concluded that “taking replication seriously is essential if biomedical and health informatics is to be an evidence-based discipline.” In this issue, Coiera and Tong2 assess the frequency, fidelity, and impact of replication studies in the...
Source: Journal of the American Medical Informatics Association - August 7, 2021 Category: Information Technology Source Type: research

Improving domain adaptation in de-identification of electronic health records through self-training
ConclusionOur work demonstrates an effective self-training framework to boost the domain adaptation performance for the de-identification task for electronic health records. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 7, 2021 Category: Information Technology Source Type: research

To the editor: New approaches toward actionable mobile health evaluation
Hensher et al1 offer an impressive review of the app evaluation space. The scope and depth of their review is a boon to the literature, with great applicability across diverse health domains. However, one concern is that the authors may fall prey to the same issues that they seek to caution readers about. The authors note in the discussion that outcomes of app evaluation systems without scoring “often seemed to be subjective” in a clear subjective statement for which they offer no supporting results or citations. The authors cite our team’s 2018 review article to support their claim that “consistent with previous s...
Source: Journal of the American Medical Informatics Association - August 7, 2021 Category: Information Technology Source Type: research

Misalignment between COVID-19 hotspots and clinical trial sites
This study presents novel metrics to examine the geographic alignment between COVID-19 hotspots and interventional clinical trial sites and evaluate trial access over time during the evolving pandemic. Using temporal COVID-19 case data from USAFacts.org and trial data from ClinicalTrials.gov, US counties were categorized based on their numbers of cases and trials. Our analysis suggests that alignment and access have worsened as the pandemic shifted over time. We recommend strategies and metrics to evaluate the alignment between cases and trials. Future studies are warranted to investigate the impact of the misalignment of ...
Source: Journal of the American Medical Informatics Association - August 5, 2021 Category: Information Technology Source Type: research

Learning decision thresholds for risk stratification models from aggregate clinician behavior
AbstractUsing a risk stratification model to guide clinical practice often requires the choice of a cutoff —called the decision threshold—on the model’s output to trigger a subsequent action such as an electronic alert. Choosing this cutoff is not always straightforward. We propose a flexible approach that leverages the collective information in treatment decisions made in real life to learn refere nce decision thresholds from physician practice. Using the example of prescribing a statin for primary prevention of cardiovascular disease based on 10-year risk calculated by the 2013 pooled cohort equations, we demonstra...
Source: Journal of the American Medical Informatics Association - August 5, 2021 Category: Information Technology Source Type: research

DOPE: D-Optimal Pooling Experimental design with application for SARS-CoV-2 screening
ConclusionDOPE can substantially improve accuracy and throughput over current pooling strategies. Hence, DOPE can facilitate rapid testing and aid the efforts of combating COVID-19 and other future pandemics. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 3, 2021 Category: Information Technology Source Type: research

Patient portal engagement and diabetes management among new portal users in the Veterans Health Administration
ConclusionsWe found consistent use of the patient portal among new portal users to be associated with modest improvements in mean HbA1c and LDL for patients at increased risk at baseline. For patients with type 2 diabetes, self-management supported by online patient portals may help control HbA1c, LDL, and BP. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 2, 2021 Category: Information Technology Source Type: research

The relationship between cybersecurity ratings and the risk of hospital data breaches
ConclusionPolicy makers should continue encouraging acute-care hospitals to proactively invest in security controls that reduce cyber risk. Best practices from other sectors like the financial services sector could provide useful guides and benchmarks for improvement. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 2, 2021 Category: Information Technology Source Type: research

Corrigendum to: Feeling better on hemodialysis:user-centered design requirements for promotingpatient involvement in the prevention of treatmentcomplications
Journal of the American Medical Informatics Association, ocab033,https://doi.org/10.1093/jamia/ocab033 (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 2, 2021 Category: Information Technology Source Type: research

A systematic review of automatic text summarization for biomedical literature and EHRs
ConclusionThis study found that current biomedical text summarization systems have achieved good performance using hybrid methods. Studies on electronic health records summarization have been increasing compared to a previous survey. However, the majority of the works still focus on summarizing literature. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 2, 2021 Category: Information Technology Source Type: research

Electronic consultations and economies of scale: a qualitative study of clinician perspectives on scaling up e-consult delivery
ConclusionsScaling up e-consults in line with the hub-and-spoke model may help pave the way for a centralized and efficient approach to care delivery, but the success of this transformation will depend on healthcare systems ’ ability to evaluate and address barriers to leveraging economies of scale for e-consults. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 2, 2021 Category: Information Technology Source Type: research

Analyzing security issues of android mobile health and medical applications
ConclusionDespite being better aligned with security best practices than non-mHealth apps, mHealth apps are still far from ensuring robust security guarantees. App users, clinicians, technology developers, and policy makers alike should be cognizant of the uncovered security issues and weigh them carefully against the benefits of mHealth apps. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 2, 2021 Category: Information Technology Source Type: research

Shared clinical decision-making on vaccines: out of sight, out of mind
AbstractClinical decision support systems, which provide automated reminders in electronic health systems, are designed to provide physicians and other health professionals support in clinical decision-making. New clinical guidance from the Advisory Committee on Immunization Practices on a new category of recommendations referred to as “shared clinical decision-making” have left providers struggling to interpret how to best implement recommendations for adult vaccines. The issue at hand is how to ensure that a conversation between the patient and provider occurs. While traditional clinical decision support systems have...
Source: Journal of the American Medical Informatics Association - August 2, 2021 Category: Information Technology Source Type: research

Data Consult Service: Can we use observational data to address immediate clinical needs?
ConclusionsWhile the Data Consult Service has the potential to generate evidence and facilitate decision making, only a portion of questions can be answered in real time. Recognizing challenges in patient phenotyping and designing studies along with using validated practices for observational research are mandatory to produce reliable evidence. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 1, 2021 Category: Information Technology Source Type: research

Trading off accuracy and explainability in AI decision-making: findings from 2 citizens ’ juries
ConclusionCitizens may value explainability of AI systems in healthcare less than in non-healthcare domains and less than often assumed by professionals, especially when weighed against system accuracy. The public should therefore be actively consulted when developing policy on AI explainability. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 1, 2021 Category: Information Technology Source Type: research