Acute Stroke Registry Planning Experiences.

BACKGROUND: Stroke is a serious health threat around the world, particularly in developing countries. As a preventive action, disease registries have long been used in developed countries. Based on the globally accepted evidence, disease registries have an impressive positive impact on different dimensions of health care systems. In order to develop an acute stroke registry, acute stroke registry planning experiences in the world are assessed in this paper. METHODS: There were 4 main factors in the planning phase to be assessed: determination of goal, scope, registration type, and consideration of technical aspects. Electronic databases were examined to find 27 relevant English-language articles focusing on acute stroke registry development. Based on the literature review, the main data sets and care quality measures of acute stroke registries were identified. RESULTS: The main purposes of developing an acute stroke registry are improvement of care quality, epidemiology assessment, and evaluation of health care system outcomes. Most of the registries focus on improving care quality. The number of multicenter, Web-based, and prospective registries were significantly higher than other types of registries. Only 1 of the registry systems implemented clinical support tools. Among 12 data sets identified to be considered as registry, 7 were highly used. Among the 14 care quality measures in acute ischemic stroke, the mostly used measure was the rate of early thrombolytic therapy. CONCLUSION: Establishment of a Web-based, prospective registry system for the acute phase of stroke seems useful for monitoring the rate of early thrombolytic therapy. The establishment of a clinical guideline-based support tool for diagnosis of patients' eligibility for thrombolytic treatment is suggested. As observed in this research, time is a very important factor in care quality improvement, particularly in the acute phase of stroke, for achievement of a more qualified care and a more serious surveillance on prehospital and hospital emergency systems.

Smart Acute Stroke Quality Registry Design-Data Elements Identification.

INTRODUCTION: Stroke is one of the most important health problems around the world. Care quality improvement in the acute phase is significantly influential on stroke prognosis. An acute stroke quality registry that is integrated with a guideline-based support tool is a powerful system for measuring and improving care quality. As the first step in registry system design, the goal of this study was to identify relative data elements. METHODS: A list of common data elements taken from the National Institute of Neurological Disorders and Stroke and a list of data elements for paper-based medical records were first evaluated, then compared with each other. In parallel, a literature review was conducted to explore the main data elements in acute stroke registries. Considering quality improvement as the main purpose, a second study was undertaken to identify the measures of acute stroke care quality. For guideline-based smart diagnosis of patients' eligibility for thrombolytic treatment (as a clinical support tool), clinical guidelines of the American Heart Association were assessed, and appropriate eligibility criteria were identified. Finally, a questionnaire was prepared based on the identified data elements. The questionnaire was distributed among 17 neurology physicians for identification of essential data elements (minimum data sets). RESULTS: Patient-centric data elements were identified and classified into 3 categories: (1) data elements identified based on acute stroke care quality measures; (2) data elements for diagnosis of patients' eligibility for tissue plasminogen activator treatment based on clinical guidelines; and (3) essential data elements based on paper medical records. After duplication removal, the 3 categories of data elements were integrated. Finally, essential data elements were identified using the neurology clinical experts' survey. CONCLUSION: Compared to traditional disease registries, quality improvement registries cover much more detailed data elements. Integration of medical record data elements with care quality measures, as well as guideline-based criteria, results in a powerful source of data for more exact studies and analysis by clinical support tools. Identifying essential data elements as a mandatory part of the system helps with more accurate data entry, and can also be considered a ready-to-use item for other relative systems.

The Evaluation of a Web-Based Stroke Quality Registry System.

Quality registry systems are very useful and have many benefits for clinical experts. Assessing the user experience while working with such a system is one of the most important steps in their development. An evaluation of the quality of the user experience allows designers to improve the system's usability and efficiency. Various usability engineering approaches may be used to analyze and improve the functionality of a Web-based registry system. User experience questionnaires (UEQs) are a reliable and validated tool that have been used to evaluate many systems. The UEQ questionnaire can be linked to the system and users can evaluate the system online. Thus, the gathering of questionnaire data can be a continuous process, allowing for ongoing analysis of the quality of the user experience, leading to a more user-friendly system. Our research focused on the evaluation phase of registry system development and indicated how we can evaluate the quality of the user experience of a registry system. In this paper, a Web-based stroke quality registry system was evaluated through a usability assessment methodology with a UEQ. The results may be applicable to other registry systems.

The Usage of Association Rule Mining to Identify Influencing Factors on Deafness After Birth.

BACKGROUND: Providing complete and high quality health care services has very important role to enable people to understand the factors related to personal and social health and to make decision regarding choice of suitable healthy behaviors in order to achieve healthy life. For this reason, demographic and clinical data of person are collecting, this huge volume of data can be known as a valuable resource for analyzing, exploring and discovering valuable information and communication. This study using forum rules techniques in the data mining has tried to identify the affecting factors on hearing loss after birth in Iran. MATERIALS AND METHODS: The survey is kind of data oriented study. The population of the study is contained questionnaires in several provinces of the country. First, all data of questionnaire was implemented in the form of information table in Software SQL Server and followed by Data Entry using written software of C # .Net, then algorithm Association in SQL Server Data Tools software and Clementine software was implemented to determine the rules and hidden patterns in the gathered data. FINDINGS: Two factors of number of deaf brothers and the degree of consanguinity of the parents have a significant impact on severity of deafness of individuals. Also, when the severity of hearing loss is greater than or equal to moderately severe hearing loss, people use hearing aids and Men are also less interested in the use of hearing aids. CONCLUSION: In fact, it can be said that in families with consanguineous marriage of parents that are from first degree (girl/boy cousins) and 2(nd) degree relatives (girl/boy cousins) and especially from first degree, the number of people with severe hearing loss or deafness are more and in the use of hearing aids, gender of the patient is more important than the severity of the hearing loss.