Linked Life Data

11079889

Source:http://linkedlifedata.com/resource/pubmed/id/11079889

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:dateCreated
2001-1-10
pubmed:abstractText
The management of carotid artery stenosis is an art evolving into a science, increasingly informed by clinical trials of medical management versus carotid endarterectomy (CEA). Ideas about optimal management depend on the confluence of patient-specific variables, surgical expertise, and the state of medical knowledge. In this complex and progressing setting, an up-to-date decision support system could help physicians apply the latest evidence to patient care. Carotid ultrasonography (US) studies provide an excellent opportunity to aid in the therapy of carotid stenosis. We developed a Carotid US Report Enhancement (CURE) to augment carotid US reports with treatment-specific prognostic information and patient-specific portions of the American Heart Association's 1998 guideline for the management of carotid artery stenosis. In the process of designing and implementing the CURE software, we encountered and eventually solved a variety of problems. The first problem was that US test was not always precise enough to distinguish between a moderate and mild carotid stenosis. Likewise, the standard US reports did not elucidate several technical problems that decreased the reliability of the US result. Third, although 17 of 18 physicians agreed to receive the CURE reports, they requested non-incriminating wording. Fourth, vascular surgeons supervising the US laboratories were reluctant to support the CURE report if they thought it would be construed as prompting self-referral. Finally, information about some comorbid conditions (e.g. a history of atrial fibrillation) could not be obtained reliably from the patients. The result of responding to these problems is a decision support program that is increasingly robust, able to detect many of its own limitations, and capable of integrating data from multiple sources. A randomized controlled trial now in progress will evaluate the clinical impact of the CURE program.
pubmed:commentsCorrections
http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-10628477, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-1929682, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-6658954, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-8160224, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-8266381, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-8637102, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-8790077, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-8869049, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-9054277, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-9480580, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-9508223, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-9811916, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-9811920, http://linkedlifedata.com/resource/pubmed/commentcorrection/11079889-9831572
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
1531-605X
pubmed:author
pubmed:issnType
Print
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
280-4
pubmed:dateRevised
2009-11-18
pubmed:meshHeading
pubmed:year
2000
pubmed:articleTitle
Development and implementation of a decision support system for carotid artery stenosis: the Carotid Ultrasound Report Enhancement (CURE).
pubmed:affiliation
Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, USA. gageb@msnotes.wustl.edu
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't