Utilization of laboratory resources: developments in knowledge-based ordering systems

Boon-Falleur, L; Sokal, Étienne; Peters, Margaret; Otte, Jean-Bernard; Ketelslegers, Jean‐Marie; Wilde, Edwin; Hasman, Andreas

doi:10.1016/0020-7101(95)01118-x

Cited by 9 publications

(17 citation statements)

References 5 publications

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“…Evaluation is key in understanding if the implemented knowledge application system is indeed functioning as an effective aid in the diagnosis process, and if so, how effective and useful it is. In that regard, researchers have reported on extensive field studies, which involve comparing the diagnoses provided by the KMS to those suggested by clinicians [Berner and Maisiak, 1999;Berner et al, 1999;Bonis et al, 2008;Boonfalleur et al, 1995;Bruning et al, 1997;Edwards et al, 1995;Hu et al, 2006;Innis, 1997;Korpinen et al, 1994;Kotzke and Pretschner, 1992;Leitich et al, 2001;Lejbkowicz et al, 2002;Martin, 2001;Moens, 1992;Moens et al, 1992;Molino et al, 2000;Ridderikhoff and vanHerk, 1997]. Overall, these results indicate that KMS certainly enhances the clinical practitioners' diagnostic capability, resulting in an improved overall diagnostic accuracy.…”

Section: Figure 3 Distribution Of Articles In Knowledge Application mentioning

confidence: 98%

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Wills¹,

Sarnikar²,

El‐Gayar³

et al. 2010

CAIS

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Knowledge Management (KM) has emerged as a possible solution to many of the challenges facing U.S. and international healthcare systems. These challenges include concerns regarding the safety and quality of patient care, critical inefficiency, disparate technologies and information standards, rapidly rising costs and clinical information overload. In this paper, we focus on clinical knowledge management systems (CKMS) research. The objectives of the paper are to evaluate the current state of knowledge management systems diffusion in the clinical setting, assess the present status and focus of CKMS research efforts, and identify research gaps and opportunities for future work across the medical informatics and information systems disciplines. The study analyzes the literature along two dimensions: (1) the knowledge management processes of creation, capture, transfer, and application, and (2) the clinical processes of diagnosis, treatment, monitoring and prognosis. The study reveals that the vast majority of CKMS research has been conducted by the medical and health informatics communities. Information systems (IS) researchers have played a limited role in past CKMS research. Overall, the results indicate that there is considerable potential for IS researchers to contribute their expertise to the improvement of clinical process through technologybased KM approaches.

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Section: Figure 3 Distribution Of Articles In Knowledge Application mentioning

confidence: 98%

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Wills¹,

Sarnikar²,

El‐Gayar³

et al. 2010

CAIS

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“…A short time after its introduction, the enthusiasm of junior doctors for the concept resulted in a system with different protocols being installed within the renal transplant unit of the same hospital (5). The software was extended as part of an EEC project (6), to permit multilingual operation, and has since been operational in a pediatric liver transplant unit in Belgium (7,8). For the past three years the system has also been the platform for a Department of Health (UK) project to investigate the use of investigation protocols within acute general medicine, which resulted in the system being installed in three other district general hospitals in the UK.…”

Section: History and Clinical Functionalitymentioning

confidence: 99%

Incorporation of the Arden Syntax within the Reimplementation of a Closed-Loop Decision Support System

McCauley

Young

Clark

et al. 1996

Computers and Biomedical Research

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“…As discussed herein, using chart review in a "reliable and unbiased" fashion 27 is difficult given the limitations of physician documentation. Several studies avoided medical record review by using clinical data documented on laboratory requisitions, 81,84,106,114,127 although none of these studies validated these data. Despite the potential problems with medical record review, only 4 studies used 2 or more reviewers and compared their abstraction results.…”

Section: Commentmentioning

confidence: 99%

Do We Know What Inappropriate Laboratory Utilization Is?

Walraven¹,

Naylor²

1998

JAMA

314

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Objective.-Laboratory utilization has steadily increased, and some studies suggest inappropriate utilization. Therefore, we wished to assess studies that measure inappropriate laboratory use in light of methodological criteria.Design.-Systematic review of published studies. Data Sources.-MEDLINE, HEALTHSTAR, and EMBASE databases were searched from 1966 to September 1997 using a broad and inclusive strategy with no language restriction. In addition, the references of all retrieved studies and 3 textbooks on diagnostic testing were hand-searched.Study Selection.-All studies that provided and applied criteria for inappropriate laboratory use.Data Extraction.-Studies were categorized based on whether the criteria were implicit (objective criteria for inappropriate utilization not provided or very broad) or explicit. Guidelines for evaluation were applied to each study by a single reviewer.Data Synthesis.-Forty-four eligible studies were identified. Eleven studies used implicit criteria for inappropriate laboratory utilization and contained small numbers of patients or physicians. Most did not adequately assess the reliability of the implicit criteria. Thirty-three studies used explicit criteria based on the appropriateness of test choice, frequency, and timing, as well as the probability of a positive result. There were large variations in the estimates of inappropriate laboratory use (4.5%-95%). Evidence supporting the explicit criteria was frequently weak by the standards suggested for therapeutic maneuvers, but was nonetheless compelling based on principles of physiology, pharmacology, and probability.Conclusions.-Many studies identify inappropriate laboratory use based on implicit or explicit criteria that do not meet methodological standards suggested for audits of therapeutic maneuvers. Researchers should develop alternative evidentiary standards for measuring inappropriateness of laboratory test use.

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Utilization of laboratory resources: developments in knowledge-based ordering systems

Cited by 9 publications

References 5 publications

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Incorporation of the Arden Syntax within the Reimplementation of a Closed-Loop Decision Support System

Do We Know What Inappropriate Laboratory Utilization Is?

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