ABSTRACT
BACKGROUND: Adverse sensitivity (e.g., allergy and intolerance) information is a critical component of any electronic health record system. While several standards exist for structured entry of adverse sensitivity information, many clinicians record this data as free text. OBJECTIVES: This study aimed to 1) identify and compare the existing common adverse sensitivity information models, and 2) to evaluate the coverage of the adverse sensitivity information models for representing allergy information on a subset of inpatient and outpatient adverse sensitivity clinical notes. METHODS: We compared four common adverse sensitivity information models: Health Level 7 Allergy and Intolerance Domain Analysis Model, HL7-DAM; the Fast Healthcare Interoperability Resources, FHIR; the Consolidated Continuity of Care Document, C-CDA; and OpenEHR, and evaluated their coverage on a corpus of inpatient and outpatient notes (n = 120). RESULTS: We found that allergy specialists' notes had the highest frequency of adverse sensitivity attributes per note, whereas emergency department notes had the fewest attributes. Overall, the models had many similarities in the central attributes which covered between 75% and 95% of adverse sensitivity information contained within the notes. However, representations of some attributes (especially the value-sets) were not well aligned between the models, which is likely to present an obstacle for achieving data interoperability. Also, adverse sensitivity exceptions were not well represented among the information models. CONCLUSIONS: Although we found that common adverse sensitivity models cover a significant portion of relevant information in the clinical notes, our results highlight areas needed to be reconciled between the standards for data interoperability.
Subject(s)
Documentation , Electronic Health Records , Models, Theoretical , Reference StandardsABSTRACT
Anxiety sensitivity (AS), the fear of anxiety-related sensations, has been posited to be a cognitive risk factor for the development of anxiety disorders but has been understudied in youth. The purpose of the present investigations was to evaluate relations between AS and panic symptoms in nonreferred children and adolescents. In Study 1, (N = 113, mean age, 13.98). scores on the Childhood Anxiety Sensitivity Index (CASI) predicted the experience of uncued panic attacks after controlling for general anxiety and depression, although the total variance accounted for was small. In Study 2 (N = 52; mean age, 9.48), the Panic/ Agoraphobia subscale of the Spence Children's Anxiety Scale was used as the criterion variable. CASI score again predicted panic symptoms after controlling for trait anxiety and depression. Identification of a risk factor for panic attacks and panic disorder in youth will have important implications for etiologic theory, intervention, and prevention.
Subject(s)
Anxiety Disorders/diagnosis , Panic Disorder/diagnosis , Referral and Consultation , Adolescent , Anxiety Disorders/psychology , Child , Cognition Disorders/diagnosis , Cognition Disorders/epidemiology , Cognition Disorders/etiology , Female , Humans , Male , Neuropsychological Tests , Panic Disorder/psychology , Sensitivity and Specificity , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To develop prevention and treatment modalities for eye injuries, ophthalmologists require epidemiological data on the various types of eye injuries. This study sought to define eye injury patterns in the U.S. armed forces. METHOD: Data on patterns of eye injury in the armed forces were obtained through voluntary reporting by U.S. military ophthalmologists throughout the world. The reporting format was standardized with the U.S. Eye Injury Registry initial and follow-up report forms. The data were analyzed for significant injury patterns. RESULTS: Data on 112 patients were submitted, representing a broad range of the military population. Data on a total of 96 patients with a 6-month follow-up were analyzed in this study. Immediately after injury, 43% of the patients were noted to have poor vision (worse than 20/200). After treatment, only 20% were noted to have poor vision. Patients lost an average of 21.6 days of work after a severe eye injury. CONCLUSION: An eye injury is a traumatic and potentially debilitating event. The loss of visual acuity can be drastic, resulting in an extensive recovery period.
