Using Clinical Decision Intelligence Applications to Improve Pathways For Earlier Detection Of Underrecognized Cognitive Disorders.

Cost estimates for care for those with dementia and other cognitive impairments are rising globally, estimated to reach US $1 trillion by 2025. Lack of specialized personnel, infrastructure, diagnostic capabilities, and healthcare access impedes the timely identification of patients progressing to dementia, particularly in underserved populations. International healthcare infrastructure may be unable to handle existing cases in addition to a sudden increase due to undiagnosed cognitive impairment and dementia. Healthcare bioinformatics offers a potential route for quicker access to healthcare services; however, a better preparedness plan must be implemented now if expected demands are to be met. The most critical consideration for implementing artificial intelligence/machine learning (AI/ML) -driven clinical decision intelligence applications (CDIA) is ensuring patients and practitioners take action on the information provided.

Pilot trial of IOM duty hour recommendations in neurology residency programs: unintended consequences.

OBJECTIVE: To study the potential effect of the 2008 Institute of Medicine (IOM) work duty hour (WDH) recommendations on neurology residency programs. METHODS: This study evaluated resident sleepiness, personal study hours, quality of life, and satisfaction and faculty satisfaction during a control month using the Accreditation Council for Graduate Medical Education WDH requirements and during an intervention month using the IOM WDH recommendations. Resident participation in both schedules was mandatory, but both resident and faculty participation in the outcome measures was voluntary. RESULTS: Thirty-four residents (11 postgraduate year [PGY]-4, 9 PGY-3, and 14 PGY-2) participated. End-of-work shift sleepiness, mean weekly sleep hours, personal study hours, and hours spent in lectures did not differ between the control and intervention months. Resident quality of life measured by the Maslach Burnout Inventory declined for 1 subscore in the intervention month (p = 0.03). Resident education satisfaction declined during the intervention month for issues related to continuity of care, patient hand-offs, and knowledge of their patients. Faculty satisfaction declined during the intervention month, without a decline in quality of life. CONCLUSIONS: The results from 3 residency programs suggest that the IOM WDH recommendations may negatively affect neurology resident education. This study was limited by the short duration of implementation, negative bias against the IOM recommendations, and inability to blind faculty. Additional study of the IOM WDH recommendations is warranted before widespread implementation.

Incremental limb hypometria.

To find out if patients with right hemisphere strokes (RHD) demonstrate a form of progressive or incremental limb hypometria (ILH), 11 RHD patients and eight matched controls were tested by having them draw a series of horizontal lines while blindfolded. Unlike controls, six RHD patients displayed an incremental decrease in the length of lines they drew, a sign of ILH. ILH might be a common source of disability and hinder rehabilitation efforts.