Search bioRxiv⌕ Search
Home/Archive/bioRxiv

bioRxiv · 10.1101/473272

Guiding Interoperable Electronic Health Records Through Patient Sharing Networks

Clarke, J. M.·Warren, L.·Arora, S.·Barahona, M.·Darzi, A.
View original source ↗Export metadata ↓

Abstract

Effective sharing of clinical information between care providers is a critical component of a safe, efficient health system. National data sharing systems may be costly, politically contentious and do not reflect local patterns of care delivery. This study examines hospital attendances in England from 2013 to 2015 to identify instances of patient sharing between hospitals. Of 19.6 million patients receiving care from 155 hospital care provider, 130 million presentations were identified. On 14.7 million occasions (12%), patients attended a different hospital to the one they attended on their previous interaction. A network of hospitals was constructed based on the frequency of patient sharing between hospitals which was partitioned using the Louvain algorithm into 10 distinct data-sharing communities, improving the continuity of data sharing in such instances from 0% to 65-95%. Locally implemented data-sharing communities of hospitals may achieve effective accessibility of clinical information without a large-scale national interoperable information system.

Source connections

Explore related subjects

epidemiologyPreprint

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Clarke, J. M., Warren, L., Arora, S., Barahona, M., Darzi, A.. 2018-11-19. Guiding Interoperable Electronic Health Records Through Patient Sharing Networks. https://doi.org/10.1101/473272

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related preprints

bioRxiv2018

Adherence to Iron and Folic Acid Supplement and Associated Factors among Antenatal Care Attendant Mothers In Lay Armachiho Health Centers, Northwest, Ethiopia, 2017

BackgroundIron deficiency is the leading nutrient deficiency in the world affecting the lives of more than 2 billion people, accounting to over 30% of the worlds population. Pregnant women are particularly at high risk of iron and folic acid deficiency.\n\nObjectiveThe aim of this study was to assess Adherence to Iron and folic acid supplement during pregnancy and its associated factors among pregnant women attending antenatal care.\n\nMethodsInstitution based cross-sectional study was employed from February 2016 to March 2017. Systematic random sampling technique was used to select the study participants. Data was collected using a structured and pretested interviewer-administered questionnaire. Bivariable and multivariable logistic regression analysis were used to identify associated factors with Adherence to prenatal iron and folic acid supplement among pregnant women. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance. Those variables with a p-value less than 0.05 had been considered as significant.\n\nResultAdherence to Iron and folic acid was 28.7% with 95% C.I. (24.3, 33.6%). Educational status of mothers(AOR= 9.27 (95%CI: 2.47, 34.71), Educational status of husband (AOR= 0.31(95% CI: 0.11,0.88), Mothers who had a family size of four(AOR=3.70(1.08,12.76), Mothers who had family size of five and above (AOR= 4.88(95% CI: 1.20, 19.85),Mothers who had 25003500 birr household average monthly income (AOR= 0.46(95% CI: 0.24,0.89), Mothers who had registered at 17-24weeks with (AOR=0.40(95% CI: 0.22-0.74), registered at 25-28weeks (AOR=0.20(95% CI 0.10, 0.41), Mothers who had collected their iron and folic acid started at first visit at first month of pregnancy and duration of iron and folic acid is taken (AOR= 2.42(95% CI:1.05, 5.58) had significant association with iron and folic acid adherence.\n\nConclusion and recommendationAdherence of Iron and folic acid was relatively low. Maternal and husband education status, family size, registration time, economic status and first visit in the first month with duration of iron and folic acid taken were factors significantly associated with adherence to iron and folic acid supplement. Educating pregnant mothers, improving economic status, early ANC registration can improve adherence to iron and folic acid supplement.

epidemiology↗
bioRxiv2018

A generic multi-level stochastic modelling framework in computational epidemiology

There is currently an overwhelming increased interest in predictive biology and computational modelling. The development of reliable, reproducible and revisable simulation models in computational life sciences is often pointed out as a challenging issue. Population dynamics, including epidemiology, has not yet developed a language to formalize complex models in a univocal and automatable way, hence hindering the capability to implement in short time reliable, revisable and expert-friendly models intended for realistic mechanistic simulations. In epidemiology specifically, models aim not only at understanding pathogen spread but also at assessing control measures at several scales. To achieve this goal efficiently, best software practices should be supported by Artificial Intelligence methods to handle experts knowledge. The framework EMULSION presented here intends to both tackle multiple modelling paradigms in epidemiology and facilitate the automation of model design. We therefore built both a domain-specific language (DSL) for the modular description of complex epidemiological models, and a generic simulation engine designed to embed existing modelling paradigms within a homogeneous architecture based on adaptive software agents. The diversity of concerns (biology, economics, human activities) involved in real pathosystems requires an explicit, comprehensive and intelligible way to describe epidemiological models, to involve experts without computer science skills throughout the modelling, simulation and output analysis steps. This approach was applied to compare hypotheses in modelling a zoonosis (Q fever), to study its transmission dynamics within and between cattle herds at a regional scale, and to assess the contribution of transmission pathways. Separating model description from the simulation engine allowed epidemiologists to be involved in assumption revision, while guaranteeing very few code modifications. We assessed the added value of EMULSION by applying the DSL and the simulation engine to a concrete disease. Future extensions of EMULSION towards a broader range of epidemiological concerns will reduce significantly the time required to design and assess models and control measures against endemic and epidemic diseases. Ultimately, we believe this effort is a major lever to increase scientists preparedness to face emerging threats for public health and provide rapid, reliable, and reasoned assessments of control measures.

epidemiology↗
bioRxiv2018

Consequences of measurement error in qPCR telomere data: A simulation study

The qPCR method provides an inexpensive, rapid method for estimating relative average telomere length across a set of biological samples. Like all laboratory methods, it involves some degree of measurement error. The estimation of relative telomere length is done subjecting the actual measurements made (the Cq values for telomere and a control gene) to non-linear transformations and combining them into a ratio. Here, we use computer simulations, supported by mathematical analysis, to explore how errors in measurement affect qPCR estimates of relative telomere length, both in cross-sectional and longitudinal data. We show that errors introduced at the level of Cq values are magnified when the TS ratio is calculated. If the errors at the Cq level are normally distributed and independent of telomere length, those in the TS ratio are positively skewed and proportional to telomere length. The repeatability of the TS ratio declines abruptly with increasing error in measurement of the telomere sequence and/or the control gene. In simulated longitudinal data, measurement error alone can produce a pattern of low correlation between successive measures of telomere length, coupled with a strong dependency of the rate of change on initial telomere length. Our results illustrate the importance of control of measurement error: a small increase in error in Cq values can have large consequences for the power and interpretability of qPCR estimates of relative telomere length. They also illustrate the importance of characterising the measurement error that exists in each dataset--coefficients of variation are generally unhelpful, and researchers should report standard deviations of Cq values and/or repeatabilities of TS ratios--and allowing for the known effects of measurement error when interpreting patterns of TS ratio change over time.

epidemiology↗