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MedFetch

08/09/2012
MedFetch is a free service that I find amazing.  If you have access to a medical library for full text articles it is even more amazing.

The service aggregates your primary literature searches and reading into a nice format.  It is not perfect and it does require some up front set up that is not trivial.  Honing in on your search and interests are key.  Since my search is fairly specific, I do not get daily emails but periodic ones with some terrific information.  Check out the pearls below. 

The service is built and maintained by a really delightful physician in MA that does this on the side.  He is very open to new features and ideas.  Check it out and see what you think.  

———- Forwarded message ———-
From: MedFetch <alerts-noreply@medfetch.com>
Date: Thu, Aug 9, 2012 at 7:00 AM
Subject: MedFetch: INFORMATICS, CLINICAL DECISION SUPPORT, ME…
To: john.poikonen@gmail.com


New results from your MedFetch Daily Alert.

SEARCH TERMS: INFORMATICS, CLINICAL DECISION SUPPORT, MEDICATIONS
RSS Feed: http://www.medfetch.com/rs/47205

There were 2 new results. You can see all 306 results on the web.


1. Int J Med Inform 2012(Apr); 81(4): 232-43.
   Prescribers' interactions with medication alerts at the point of prescribing: A multi-method, in situ investigation of the human-computer interaction.
  Russ AL, Zillich AJ, McManus MS, Doebbeling BN, Saleem JJ  
  Department of Veterans Affairs, Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA.

  • DOI: 10.1016/j.ijmedinf.2012.01.002
  • View PDF | Full Text Link Out via EZ Proxy if enabled. | Link Out via NCBI/PubMed.gov | Comments |

    PURPOSE: Few studies have examined prescribers' interactions with medication alerts at the point of prescribing. We conducted an in situ, human factors investigation of outpatient prescribing to uncover factors that influence the prescriber-alert interaction and identify strategies to improve alert design.
    METHODS: Field observations and interviews were conducted with outpatient prescribers at a major Veterans Affairs Medical Center. Physicians, clinical pharmacists, and nurse practitioners were recruited across five primary care clinics and eight specialty clinics. Prescribers were observed in situ as they ordered medications for patients and resolved alerts. Researchers collected 351 pages of typed notes across 102 hours of observations and interviews. An interdisciplinary team identified emergent themes via inductive qualitative analysis.
    RESULTS: Altogether, 320 alerts were observed among 3 0 prescribers and their interactions with 146 patients. Qualitative analysis uncovered 44 emergent themes and 9 overarching factors, which were organized into a framework that describes the prescriber-alert interaction. Prescribers' ability to act on alerts was impeded by the alert interface, which did not adequately support all prescriber types.
    CONCLUSIONS: This empiric study produced a novel framework for understanding the prescriber-alert interaction. Results revealed key components of the alert interface that influence prescribers and indicate a need for more universal design. Actionable design recommendations are presented and may be used to enhance alert design and patient safety. Published by Elsevier Ireland Ltd.
    2. Clin J Am Soc Nephrol 2012(Apr); 7(4): 565-72.
       A cluster randomized trial of an enhanced eGFR prompt in chronic kidney disease.
      Manns B, Tonelli M, Culleton B, Faris P, McLaughlin K, Chin R, Gooch K, McAlister FA, Taub K, Thorlacius L, Krause R, Kearns M, Hemmelgarn B, Alberta Kidney Disease Network  
      Department of Medicine, University of Calgary, Alberta, Canada. Braden.Manns@albertahealthservices.ca

  • DOI: 10.2215/CJN.12391211
  • View PDF | View PDF | Full Text Link Out via EZ Proxy if enabled. | Link Out via NCBI/PubMed.gov | Comments |

    BACKGROUND AND OBJECTIVES: Despite reporting estimated GFR (eGFR), use of evidence-based interventions in CKD remains suboptimal. This study sought to determine the effect of an enhanced eGFR laboratory prompt containing specific management recommendations, compared with standard eGFR reporting in CKD.
    DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A cluster randomized trial of a standard or enhanced eGFR laboratory prompt was performed in 93 primary care practices in Alberta, Canada. Although all adult patients with CKD (eGFR <60 ml/min per 1.73 m(2)) were included, medication data were only available for elderly patients (aged ≥66 years). The primary outcome, the proportion of patients with diabetes or proteinuria receiving an angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB), was assessed in elderly CKD patients.
    RESULTS: There were 5444 e lderly CKD patients with diabetes or proteinuria who were eligible for primary outcome assessment, irrespective of baseline ACEi/ARB use. ACEi/ARB use in the subsequent year was 77.1% and 76.9% in the standard and enhanced prompt groups, respectively. In the subgroup of elderly patients with an eGFR <30 ml/min per 1.73 m(2), ACEi/ARB use was higher in the enhanced prompt group. Among 22,092 CKD patients, there was no difference in the likelihood of a composite clinical outcome (death, ESRD, doubling of serum creatinine, or hospitalization for myocardial infarction, heart failure, or stroke) over a median of 2.1 years.
    CONCLUSIONS: In elderly patients with CKD and an indication for ACEi/ARB, an enhanced laboratory prompt did not increase use of these medications.

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