药品检验标准资料信息综合管理系统

分析了药品标准资料管理现状和读者需求,论述了药品检验标准资料信息综合管理系统的设计思路和建设过程,评价了药品检验标准资料信息综合管理系统的效果.实践证明,该管理系统解决了以往管理和使用中出现的难题,提高了标准资料管理水平和查找效率,促进了药检事业的发展.     

Lessons learned in detailed clinical modeling at Intermountain Healthcare

Background and objective

Intermountain Healthcare has a long history of using coded terminology and detailed clinical models (DCMs) to govern storage of clinical data to facilitate decision support and semantic interoperability. The latest iteration of DCMs at Intermountain is called the clinical element model (CEM). We describe the lessons learned from our CEM efforts with regard to subjective decisions a modeler frequently needs to make in creating a CEM. We present insights and guidelines, but also describe situations in which use cases conflict with the guidelines. We propose strategies that can help reconcile the conflicts. The hope is that these lessons will be helpful to others who are developing and maintaining DCMs in order to promote sharing and interoperability.

Methods

We have used the Clinical Element Modeling Language (CEML) to author approximately 5000 CEMs.

Results

Based on our experience, we have formulated guidelines to lead our modelers through the subjective decisions they need to make when authoring models. Reported here are guidelines regarding precoordination/postcoordination, dividing content between the model and the terminology, modeling logical attributes, and creating iso-semantic models. We place our lessons in context, exploring the potential benefits of an implementation layer, an iso-semantic modeling framework, and ontologic technologies.

Conclusions

We assert that detailed clinical models can advance interoperability and sharing, and that our guidelines, an implementation layer, and an iso-semantic framework will support our progress toward that goal.     

过敏高风险婴儿罹患过敏性疾病的多因素分析及干预

目的探讨过敏高风险婴儿发生过敏性疾病的危险因素及早期干预措施。方法对具有过敏性疾病家族史(父母一方或双方)的新生儿进行1年的随访,观察过敏性疾病的发生情况。对影响过敏性疾病发生的因素进行单因素分析后,选取有统计学意义的指标,应用logistic逐步回归模型进行统计分析。结果254名婴儿中,有114例在生后1年内出现1种或多种过敏症状。单因素分析中有12项指标具有统计学意义,7项指标入选logistic逐步回归方程,分别为母孕期过敏性疾病发作史(OR=2.523,95%CI为1.263～5.041,P<0.01)、双亲有过敏性疾病史(OR=6.116,95%CI为2.546～14.692,P<0.01)、母亲血清IgE值(OR=2.413,95%CI为1.710～3.404,P<0.01)、被动吸烟(OR=2.778,95%CI为1.402～5.502,P<0.01)、出生后6个月内添加鸡蛋(OR=2.693,95%CI为1.238～5.859,P<0.05)、纯母乳喂养(OR=0.196,95%CI为0.086～0.447,P<0.01)和部分水解配方奶(pHF)喂养(OR=0.099,95%CI为0.038～0.255,P<0.01)。结论妊娠期加强对有过敏史妇女的保护,防止过敏性疾病的复发,避免过敏高风险婴儿过早接触香烟、过早添加鸡蛋,母乳喂养及pHE喂养等综合措施可减少过敏高风险婴儿过敏性疾病的发生。     

606种药品执行标准状况调查

目的：了解我国药品标准现状。方法：对医疗机构临床使用的606种药品生产厂家标明的执行标准进行统计。结果：我国现行的药品标准欠规范,不统一,偏低偏乱。结论：应加快药品标准的科学化、规范化建设,建立以《中国药典》标准为主,部（局）颁标准为辅的药品标准制度。     

Documentation of drug allergy on drug chart in patients presenting for surgery

Background  This study looked into documentation of drug allergy in preoperative patients charts who were presenting for elective surgery to enhance patient safety. Aims and objectives  To determine the rate of completion of drug allergy. Three hundred charts were evaluated for completion of the drug allergy box during January and February 2006. Results  Thirty percent charts were not documented for drug allergy. Conclusion  A multifaceted approach is necessary to address this important aspect to identify drug errors and enhance patient safety.     

中文药品剂型信息的规范化

介绍了中文药品剂型的分类,分析了中文药品剂型数据的特点,探讨了中文药品剂型信息规范化表达的方法,以便于对含义相同但有多种表达形式的中文药品剂型信息进行映射和归一化处理,使药品剂型信息的表达符合规范,提高药事相关系统之间的互操作和用药安全,促进药品信息化进程。     

药品质量标准制定课程的教学实践和体会

目的：在药学本科教学中开设讲授药品质量标准制定新课程。方法：自编教材,采用案例导入法、PBL（problem-based learning,PBL）启发式教学法进行课程讲授。结果：在教学实践应用中紧扣基础内容,选择恰当的案例,学生思维活跃,标准制定能力得到提高。结论：结合药物标准制定的实际工作,紧扣理论课教学,培养了学生的科研创新和标准制定能力,收到了较好的效果。     

医院急救药品来源信息储备模块的研究进展

本文分析了医院实际工作中经常碰到的寻找急救药品时存在的问题,指出了应用计算机技术和数据库技术,通过模块的设计,建立一个具有当地特色的急救药品信息储备系统的重要性。实践表明该系统能及时、准确的提供急救药品的储备分布信息,从源头上把握急救药品信息,提高了药品信息的共享性。     

我国卫生信息管理专业研究生标准化课程体系构建

在文献研究和实证调查的基础上制定了卫生信息管理（HIM）专业研究生标准化课程体系初步框架,采用德尔菲法对初步框架进行专家咨询,得到优化的课程体系框架,有助于促进我国HIM研究生教育的规范发展。该框架包括卫生信息管理模块、医院管理模块,以及信息科学和计算机科学模块三大模块18门课程,并依据布鲁姆教育目标分类理论对课程提出了相应的教学目标。     

Impact Evaluation of CONSORT and STRICTA Guidelines on Reporting Quality for Randomized Controlled Trials of Acupuncture Conducted in China

Objective:To evaluate and compare the reports' qualities of acupuncture randomized controlled trials(RCTs) conducted in China before and after the implementation of two guidelines,i.e.,the Consolidated Standards of Reporting Trials(CONSORT) statement and the Standards for Reporting Interventions in Controlled Trials of Acupuncture(STRICTA).Methods:Proportions of studies that reported CONSORT and STRICTA items were compared for the years before and after implementation of these two guidelines.In addition,the total score of each item's reporting were calculated and reported differences during different date ranges were compared.Results:For CONSORT items(maximum score 8),there was evidence of a slight improvement in reporting between 1994-1995 and 1999-2000 combined(2.5 + 0.6) and 2004-2005 and2009-2010 combined(3.0 ±0.9;difference 0.4,95%confidence interval,0.3 to 0.6,P0.01).For STRICTA items(maximum score 17),there was evidence that a slight improvement in reporting between 1994-1995 and 1999-2000 combined(8.6±2.1) and 2004-2005 and 2009-2010 combined(10.1 ±1.8;difference1.5,95%confidence interval,1.1 to 1.9,P0.01).Conclusion:Quality of reporting for RCTs of acupuncture treatment conducted in China have generally improved since the introduction of the STRICTA and CONSORT guidelines.