Neonatal Intensive Care Workflow Analysis Informing NEC-Zero Clinical Decision Support Design

Gephart, Sheila M.; Tolentino, D. Anthony; Quinn, Megan; Wyles, Christina

doi:10.1097/cin.0000000000000929

Cited by 2 publications

(5 citation statements)

References 22 publications

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“…For this reason, we sought to examine whether other clinical factors could be considered to “put the story” together around NEC timely recognition to improve its clinical utility. Ultimately, we did not show improvement to GutCheck NEC by adding other “scores,” although in the interim we found it more necessary to structure NEC communication in addition to providing a risk score 19,26…”

Section: Discussionmentioning

confidence: 81%

“…17 NEC risk assessment is rarely consistent and is complicated by varying understanding about NEC risk among clinicians. 18,19 Although the most commonly described risk factor for NEC is premature birth with very low birth weight, other risk factors have been described. 14,20 To avoid failed rescue from NEC, risk scores have been developed to assess NEC risk and have begun to be integrated into practice.…”

Section: Background and Significancementioning

confidence: 99%

“…Ultimately, we did not show improvement to GutCheck NEC by adding other "scores," although in the interim we found it more necessary to structure NEC communication in addition to providing a risk score. 19,26…”

Section: Implications For Practicementioning

confidence: 99%

“…NEC risk assessment is rarely consistent and is complicated by varying understanding about NEC risk among clinicians 18,19. Although the most commonly described risk factor for NEC is premature birth with very low birth weight, other risk factors have been described 14,20.…”

Section: Background and Significancementioning

confidence: 99%

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Prediction of GutCheckNEC and Its Relation to Severity of Illness and Measures of Deterioration in Necrotizing Enterocolitis

Gephart¹,

Fleiner²,

Msowoya³

et al. 2023

Advances in Neonatal Care

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Background: Necrotizing enterocolitis (NEC) risk has been shown to arise from multiple sources and risk awareness may be supported using bedside tools. Purpose: The purpose of this research was to examine the extent to which GutCheckNEC was associated with scores for clinical deterioration, severity of illness, and clinical outcome, and further to examine how scores might improve NEC prediction. Methods: A retrospective, correlational case-control study with infant data from 3 affiliated neonatal intensive care units was conducted. Results: Of 132 infants (44 cases, 88 controls), most were 28 weeks of gestation at birth and less (74%). Median age at NEC onset was 18 days (range: 6-34 days), with two-thirds diagnosed before 21 days. At 68 hours of life, higher GutCheckNEC scores were associated with NEC requiring surgery or resulting in death (relative risk ratio [RRR] = 1.06, P = .036), associations that persisted at 24 hours prior to diagnosis (RRR = 1.05, P = .046), and at the time of diagnosis (RRR = 1.05, P = .022) but showed no associations for medical NEC. GutCheckNEC scores were significantly correlated with pediatric early warning scores (PEWS) (r > 0.30; P < .005) and SNAPPE-II scores (r > 0.44, P < .0001). Increasing numbers of clinical signs and symptoms were positively associated with GutCheckNEC and PEWS at the time of diagnosis (r = 0.19, P = .026; and r = 0.25, P = .005, respectively). Implications for Practice and Research: GutCheckNEC provides structure to streamline assessment and communication about NEC risk. Yet, it is not intended to be diagnostic. Research is needed on how GutCheckNEC impacts timely recognition and treatment.

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Section: Discussionmentioning

confidence: 81%

Section: Background and Significancementioning

confidence: 99%

Section: Implications For Practicementioning

confidence: 99%

Section: Background and Significancementioning

confidence: 99%

See 2 more Smart Citations

Prediction of GutCheckNEC and Its Relation to Severity of Illness and Measures of Deterioration in Necrotizing Enterocolitis

Gephart¹,

Fleiner²,

Msowoya³

et al. 2023

Advances in Neonatal Care

Self Cite

View full text Add to dashboard Cite

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“…These tools assist in managing patient data, monitoring vital signs, and coordinating care among healthcare professionals. Such optimization not only improves the quality of care but also reduces the burden on healthcare providers ( 21 – 24 ). These examples illustrate how clinical informatics is revolutionizing healthcare by harnessing data-driven approaches to enhance patient outcomes across a wide range of medical specialties.…”

Section: Incidence/prevalence Of Bpd and Why It Is A Priority For Imp...mentioning

confidence: 99%

A clinical informatics approach to bronchopulmonary dysplasia: current barriers and future possibilities

Moreira,

Husain,

Knake

et al. 2024

Front. Pediatr.

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Bronchopulmonary dysplasia (BPD) is a complex, multifactorial lung disease affecting preterm neonates that can result in long-term pulmonary and non-pulmonary complications. Current therapies mainly focus on symptom management after the development of BPD, indicating a need for innovative approaches to predict and identify neonates who would benefit most from targeted or earlier interventions. Clinical informatics, a subfield of biomedical informatics, is transforming healthcare by integrating computational methods with patient data to improve patient outcomes. The application of clinical informatics to develop and enhance clinical therapies for BPD presents opportunities by leveraging electronic health record data, applying machine learning algorithms, and implementing clinical decision support systems. This review highlights the current barriers and the future potential of clinical informatics in identifying clinically relevant BPD phenotypes and developing clinical decision support tools to improve the management of extremely preterm neonates developing or with established BPD. However, the full potential of clinical informatics in advancing our understanding of BPD with the goal of improving patient outcomes cannot be achieved unless we address current challenges such as data collection, storage, privacy, and inherent data bias.

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Neonatal Intensive Care Workflow Analysis Informing NEC-Zero Clinical Decision Support Design

Cited by 2 publications

References 22 publications

Prediction of GutCheckNEC and Its Relation to Severity of Illness and Measures of Deterioration in Necrotizing Enterocolitis

Prediction of GutCheckNEC and Its Relation to Severity of Illness and Measures of Deterioration in Necrotizing Enterocolitis

A clinical informatics approach to bronchopulmonary dysplasia: current barriers and future possibilities

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