AMIA Informatics 2010 Year in Review
A compendium of notable publications and events in the field of biomedical informatics, November 2009 - October 2010
by
Daniel Masys, M.D.
Professor and Chair
Dept. of Biomedical Informatics

Professor of Medicine
Vanderbilt University School of Medicine
Presented here are the citations and events from the 2010 Year in Review session at the AMIA Symposium, Washington DC, on Tuesday November 16, 2010 at 8:30. 

 Notable new literature in Clinical Informatics
Topic Areas

Computerized Clinical Decision Support

For Providers
  1. Atlas SJ, et al. A Cluster-Randomized Trial of a Primary Care Informatics-Based System for Breast Cancer Screening. J Gen Intern Med. 2010 Sep 15. [Epub ahead of print]
  2. Herasevich V et al.  Limiting ventilator-induced lung injury through individual electronic medical record surveillance.Crit Care Med. 2010 Oct 14. [Epub ahead of print]
  3. Co JP et al. Electronic health record decision support and quality of care for children with ADHD.  Pediatrics. 2010 Aug;126(2):239-46. Epub 2010 Jul 19.
  4. Longhurst CA et al. Decrease in hospital-wide mortality rate after implementation of a commercially sold computerized physician order entry system. Pediatrics. 2010 Jul;126(1):14-21. Epub 2010 May 3.
  5. Schnipper JL et al.  Effects of a computerized order set on the inpatient management of hyperglycemia: a cluster-randomized controlled trial. Endocr Pract. 2010 Mar-Apr;16(2):209-18.
  6. Riggio JM et al.  Effectiveness of a clinical-decision-support system in improving compliance with cardiac-care quality measures and supporting resident training. Acad Med. 2009 Dec;84(12):1719-26.
  7. Ledwich LJ et al. Improved influenza and pneumococcal vaccination in rheumatology patients taking immunosuppressants using an electronic health record best practice alert. Arthritis Rheum. 2009 Nov 15;61(11):1505-10.
  8. Hug BL, et al. Adverse drug event rates in six community hospitals: and the potential impact of computerized physician order entry for prevention. J Gen Intern Med 2010;25(1):31-38.

For Patients
  1. Fals-Stewart W, Lam WK. Computer-assisted cognitive rehabilitation for the treatment of patients with substance use disorders: a randomized clinical trial. Exp Clin Psychopharmacol. 2010 Feb;18(1):87-98.
  2. Schinke SP et al. Computer-delivered, parent-involvement intervention to prevent substance use among adolescent girls. Prev Med. 2009 Nov;49(5):429-35. Epub 2009 Aug 12.

Unintended consequenes of decision support systems
  1. Strom BL et al.  Unintended effects of a computerized physician order entry nearly hard-stop alert to prevent a drug interaction: a randomized controlled trial. Arch Intern Med. 2010 Sep 27;170(17):1578-83.
  2. Other
    3. Persell SD et al. Frequency of inappropriate medical exceptions to quality measures. Ann Intern Med. 2010 Feb 16;152(4):225-31.


Studies showing no statistically significant difference with CDSS intervention vs. alternatives
  1. Xu C et al.  A randomized controlled trial of an interactive voice response telephone system and specialist nurse support for childhood asthma management. J Asthma. 2010 Sep;47(7):768-73.
  2. Williams LK et al.   A cluster-randomized trial to provide clinicians inhaled corticosteroid adherence information for their patients with asthma. J Allergy Clin Immunol. 2010 Aug;126(2):225-31, 231.e1-4. Epub 2010 May 31.
  3. Strom BL et al.  Randomized clinical trial of a customized electronic alert requiring an affirmative response compared to a control group receiving a commercial passive CPOE alert: NSAID--warfarin co-prescribing as a test case. J Am Med Inform Assoc. 2010 Jul-Aug;17(4):411-5.
  4. Walsh MN et al.  Electronic health records and quality of care for heart failure. Am Heart J. 2010 Apr;159(4):635-642.e1.
  5. Singh H et al.  Notification of abnormal lab test results in an electronic medical record: do any safety concerns remain? Am J Med. 2010 Mar;123(3):238-44.
  6. Tamblyn R et al. Increasing the detection and response to adherence problems with cardiovascular medication in primary care through computerized drug management systems: a randomized controlled trial. Med Decis Making. 2010 Mar-Apr;30(2):176-88. Epub 2009 Aug 12.
  7. Maclean CD. The Vermont diabetes information system: a cluster randomized trial of a population based decision support system. J Gen Intern Med. 2009 Dec;24(12):1303-10. Epub 2009 Oct 28.


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Telemedicine

Diabetes
  1. Stone RA et al.  Active care management supported by home telemonitoring in veterans with type 2 diabetes: the DiaTel randomized controlled trial. Diabetes Care. 2010 Mar;33(3):478-84. Epub 2009 Dec 15.


Psychiatric conditions
  1. Pyne JM et al. Cost-effectiveness analysis of a rural telemedicine collaborative care intervention for depression. Arch Gen Psychiatry. 2010 Aug;67(8):812-21.
  2. Kroenke K et al.  Effect of telecare management on pain and depression in patients with cancer: a randomized trial. JAMA. 2010 Jul 14;304(2):163-71.
  3. Morland LA et al.  Telemedicine for anger management therapy in a rural population of combat veterans with posttraumatic stress disorder: a randomized noninferiority trial. J Clin Psychiatry. 2010 Jul;71(7):855-63. Epub 2010 Jan 26.
  4. Wiegand B et al.  Efficacy of a comprehensive program for reducing stress in women: a prospective, randomized trial. Curr Med Res Opin. 2010 Apr;26(4):991-1002.

Smoking cessation

1.     Seidman DF et al. Randomized controlled trial of an interactive internet smoking cessation program with long-term follow-up. Ann Behav Med. 2010 Feb;39(1):48-60.

Telemedicine studies showing no statistically significant difference in health outcomes between intervention group and controls.

  1. Dalta SK, et al. Economic analysis of a tailored behavioral intervention to improve blood pressure control for primary care patients. Am Heart J. 2010 Aug;160(2):257-63
  2. Palmas W et al. Medicare payments, healthcare service use, and telemedicine implementation costs in a randomized trial comparing telemedicine case management with usual care in medically underserved participants with diabetes mellitus (IDEATel). J Am Med Inform Assoc. 2010 Mar-Apr;17(2):196-202.
  3. Watson AJ et al.  A randomized trial to evaluate the efficacy of online follow-up visits in the management of acne. Arch Dermatol. 2010 Apr;146(4):406-11.
  4. Haemmerli K et al.  Internet-based support for infertile patients: a randomized controlled study. J Behav Med. 2010 Apr;33(2):135-46. Epub 2009 Dec 29.
  5. Copeland LA et al. An intervention for VA patients with congestive heart failure.  Am J Manag Care. 2010 Mar;16(3):158-65.
  6. Ollivier L et al. Use of short message service (SMS) to improve malaria chemoprophylaxis compliance after returning from a malaria endemic area. Malar J. 2009 Oct 23;8:236.

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Practice of Informatics

  1. Poon EG et al. Effect of bar-code technology on the safety of medication administration. N Engl J Med 2010;362(18):1698-1707.
  2. Simon SR et. al. Physicians’ use of key functions in electronic health records from 2005 to 2007: a statewide survey.  J Am Med Inform Assoc 2009;16(4):465-470.
  3. Metzger J et al. Mixed results in the safety performance of computerized physician order entry.  Health Aff (Millwood) 2010;29(4):655-663.
  4. Anderson JG et al. Reporting trends in a regional medication error data-sharing system. Health Care Manag Sci. 2010 Mar;13(1):74-83.

 
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  Candidate new literature in Clinical Bioinformatics
Topic Areas


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Human health and disease

  1. NIH Genome-wide Association Study catalog.  As of November 2010 has nearly 1000 GWAS studies on 165 human traits.
  2. Plata G, et al.  Reconstruction and flux-balance analysis of the Plasmodium falciparum metabolic network. Mol Syst Biol. 2010 Sep 7;6:408. They used comp bio to find a potential cure for drug-resistant malaria, identifying a drug approved for other purposes:
  3. Solovyov A, et al.  Host Dependent Evolutionary Patterns and the Origin of 2009 H1N1 Pandemic Influenza. PLoS Curr. 2010 Jan 29:RRN1147
  4. Cadeiras M, et al.  Drawing networks of rejection - a systems biological approach to the identification of candidate genes in heart transplantation. J Cell Mol Med. 2010 May 24.   using comp bio to unravel transplant rejection:
    5.  

Model systems for understanding biology

  1. Barash Y et. al.  Deciphering the splicing code. Nature. 2010 May 6;465(7294):53-9.

The practice of bioinformatics

  1. Eriksson N et al.  Web-based, participant-driven studies yield novel genetic associations for common traits. PLoS Genet. 2010 Jun 24;6(6):e1000993.
  2. Denny J, et al.  PheWAS: demonstrating the feasibility of a phenome-wide scan to discover gene-disease associations. Bioinformatics. 2010 May 1;26(9):1205-10. Epub 2010 Mar 24.

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"Top Five" Notable Events

5. October 27, 2010.  First phase of 1000 genomes project released. Of 180 complete genomes sequence, each has 50-100 variants associated with disease.  “No human carries a perfect set of genes.”

4. AMIA’s profile and impact on national policy continues to grow: ONC, Institute of Medicine, NCVHS

3. ONC funding for informatics R&D flows through SHARPs, BEACONs, state HIE’s, and for Advancing Clinical Decision Support

2. July 28, 2010. Final Rule for Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology published

1. July 13, 2010.  Meaningful Use Final Rule published
 

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Search methodology used to identify potentially high impact literature


Many thanks to Rebecca Jerome, MLS for developing and iteratively refining search profiles for both clinical and bioinformatics for publications with Entrez date Nov 2009 – Oct 2010.

Clinical informatics searching methods: 

  • Clinical trials that included > 100 patients or providers, and those which appear to have the potential for significant clinical impact, e.g. the carvedilol study)
  • Primary PubMed search string:  randomized controlled trial[ptyp] AND (telemedicine[mh] OR informatics[tiab] OR medical informatics[mh])
  • Secondary PubMed search string: randomized[ti] AND (telemedicine[mh] OR informatics[tiab] OR medical informatics[mh])
  • Follow-up with examination of editorials from JAMIA and news sites (e.g. Reuters) to identify 2-3 additional studies

 
Computational biology searching methods:

  • Primary PubMed search string: computational biology[mh] NOT (review[pt] OR letter[pt] OR case reports[pt] OR editorial[pt])
  • Also (genomic[ti] OR genome[ti] OR bioinformatic*[ti]), limited to the core clinical journals.
  • Secondary PubMed search string: computational biology[mh] AND (letter[pt] OR editorial[pt])
  • To see which articles were generating more discussion, follow-up with consideration of key science blogs and news sites
 

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