Specialized Laboratory Information Systems

Some laboratories or laboratory sections have unique needs that traditional anatomic and clinical pathology systems may not address. A specialized laboratory information system (LIS), which is designed to perform a limited number of functions, may perform well in areas where a traditional LIS falls short. Opportunities for specialized LISs continue to evolve with the introduction of new testing methodologies. These systems may take many forms, including stand-alone architecture, a module integrated with an existing LIS, a separate vendor-supplied module, and customized software. This article addresses the concepts underlying specialized LISs, their characteristics, and in what settings they are found.     

医院影像胶片与报告自助打印设计与应用

介绍了传统的影像胶片与报告流程存在很多问题。通过改进流程,构建虚拟打印服务器网络并推行自助式影像胶片与报告打印服务模式,可缩减患者检查后等候时间,降低影像科报告胶片核对错误率,节省成本并提高影像科的工作效率。     

Palliative systemic therapy and overall survival of 1,395 patients with advanced breast cancer – Results from the prospective German TMK cohort study

Data on treatment and outcome of advanced breast cancer in routine practice are rare, especially concerning recurrent disease, but important to complement the results from clinical trials and to improve the standard of care. We present data on choice of systemic first-line treatment, number of treatment lines, and survival of patients treated by medical oncologists in Germany.1395 patients recruited by 124 sites at start of first-line therapy into the ongoing, prospective German clinical cohort study TMK (Tumour Registry Breast Cancer) between February 2007 and October 2015 were analysed.The median OS was 33.8 months (95% CI 30.2–40.2) for HR-positive/HER2-negative, 38.2 months (95% CI 31.3–43.0) for HER2-positive and 16.8 months (95% CI 11.5–22.0) for triple negative breast cancer. Patients with triple negative tumours more often died before start of a third-line therapy than patients with HR-positive or HER2-positive tumours (44% vs. 25%). Use of taxane-based chemotherapies has increased since 2007, with 65% of all first-line chemotherapy-treatments containing taxanes in 2013–15 (60% HR-positive/HER2-negative, 75% HER2-positive, 56% triple negative). 52% of the patients with HR-positive/HER2-negative tumours received first-line endocrine therapy in 2013–15; when restricted to patients with only non-visceral metastases this percentage increased to 63%.To our knowledge, this is the first cohort study showing systemic first-line therapy for all subtypes of advanced breast cancer. Overall survival in the TMK is comparable to that reported by clinical trials despite the inclusion of older and comorbid patients.     

推进真实世界研究的透明化

真实世界研究近几年在临床需求及相关政策的引导下快速发展,成为医药行业广泛关注的焦点。目前,对真实世界研究的证据强度、偏倚控制及研究价值等关键内容还缺乏深入的探讨。临床研究透明化是实现研究规范性、结果真实性和结论可靠性的重要保障。本文介绍提高真实世界研究透明化的必要性,从真实世界研究方案预注册、统计分析计划的发布、数据清洗方案的制定、结果报告规范和数据共享等方面阐述促进真实世界研究透明化的措施,以期更好控制混杂和偏倚,产出可用于临床相关决策的高质量证据,减少研究浪费。     

某三甲医院1603例药品不良反应报告分析

目的 分析某三甲医院药品不良反应(ADR)发生的规律和特征,加强药品的合理使用.方法 对某院2010年1月—2015年6月上报的1603例药品不良反应报告分别从上报人职业、不良反应的分类、病人性别、年龄、可疑药品的类别、不良反应影响到的系统及其主要的临床表现、药物的给药途径等方面进行统计和分析.结果 在1603例ADR报告中,男性797例,女性806例,男女比例基本持平;其中41~60岁年龄段发生ADR最多,为626例(39.05%);抗菌药物诱发的药品不良反应发生率最高(23.52%),其次为抗肿瘤药物(21.83%);消化系统是ADR最常见累及的系统(25.14%),其次是皮肤及其附件(22.52%).结论 临床用药过程中应密切关注41~60岁年龄段人群的抗菌药物和抗肿瘤药的合理使用与用药安全,以减少或避免ADR的发生.加强对医院医护人员ADR专业知识培训,提高ADR上报率.     

《世界卫生组织狂犬病专家磋商会第三版报告》更新与解读

2018年4月,世界卫生组织(World Health Organization,WHO)公布了《WHO狂犬病专家磋商会第三版报告》,总结和展示了近年来世界范围内在狂犬病免疫、预防、控制和国际间合作等方面的研究结果,在狂犬病病毒学、人类狂犬病防控、人用狂犬病疫苗及狂犬病免疫球蛋白使用、犬狂犬病防控等方面展示了新的证据,提出了新的更改和推荐意见。尤其在狂犬病病毒学、人用狂犬病疫苗和狂犬病免疫球蛋白使用方面进行了较大的修改,重点关注方案的可行性、疫苗接种程序的简化、成本效益的提高,并对以往未涉及的许多细节给出了明确推荐意见。提出到2030年在全球范围内消除由犬传播的人狂犬病病例的战略目标及其实施方案。作者就主要的更新内容进行解读,揭示其临床意义。     

流程再造提升病理报告归档质量

对纸质病理报告归档流程进行再造,充分利用信息技术,省去人工派送环节,使临床医师从归档工作中解脱,方便医患及时查询打印。再造流程实施后,病理报告归档率由改造前的88.24%上升到99.32%,缺失现象明显改善;病理报告接收时间平均缩短1.1个工作日。流程再造为解决病案中病理报告缺失提供了有效路径。     

Compassionate care in radiography recruitment,education and training: A post-Francis Report review of the current literature and patient perspectives

Compassion is elemental in the care of a patient during their medical imaging (MI) procedure and is highly topical in the light of the Francis Report. The patient–practitioner interaction is an amalgam of context, communication and individual differences, and whilst compassion is a term in common parlance in the media, policy and radiographers' professional documents, its meaning and manifestation in radiography recruitment, education and practice are less clearly articulated. A review of the existing literature was undertaken, including a small scale study exploring patients' experiences in diagnostic medical imaging. Themes from the study included communication; competence; emotions; attitudes and relationships, but notably absent was any mention of compassion per se. Radiography research would benefit from further exploratory work into the nature of compassionate patient care in the unique context of the medical imaging encounter; offering an evidence-based contribution to radiography in the light of the Francis Report.