Friday, May 13, 2016

Clinical Research Oriented Workshop (CROW) Meeting: May 12, 2016

Present:  Marianne Burke, Abigail Crocker, Justine Dee, Nancy Gell, Juvena Hitt, Kairn Kelley, Ben Littenberg, Adam Sprouse-Blum, Connie van Eeghen

Start Up: Who’s who: welcome Abby!

1.                  Discussion: Ben on free text based data base to find missed clinical opportunities
a.       There is some anecdotal evidence that people with radiology studies may show need for services outside the primary reason for the study:
                                                  i.      Boxer fracture (esp if repeated) indicating need for anger management
                                                ii.      Nodules found on one organ when a different organ is the focus of the study
                                              iii.      Screening of smokers for lung cancern that show other fractures, calcification, growths…
b.      Three questions:
                                                  i.      Can we identify punching?
                                                ii.      Can we identify falls?
                                              iii.      Can we identify osteoporosis?
c.       Methods:
                                                  i.      Data set: 2 files of type delimited reports: 2014 and 2015 with diagnosis, text of report, year done, laterality, YOB, sex
1.      Chest CTs of all kinds
2.      All hand films
3.      All wrist films
                                                ii.      Stata process
1.      Identify the date and time fields for each record (AM vs PM)
2.      Identify key words that represent the clinical issues of interest
3.      Identify the location of those key words within the text
a.       Eliminate occurrences preceded with “no” related to those key words if >30 character positions away from key words
4.      For fall study, eliminate if <65 years or if skiing
5.      For osteoporosis study, eliminate “periarticular,” meaning a marker of inflammatory arthritis, not associated with weak bones
6.      Capture the number of times those key words occur and the phrase in which they occurred
7.      Tab by key word (gosh, that was easy)
                                              iii.      Clinical outcomes
1.      5% of hand films indicate punching, fighting, or boxer fracture
2.      2% of films indicate falls
3.      4% of films indicate osteoporosis or osteopenia (did not look for compression fractures which may increase the results)
4.      Note: wrist and hand studies showed more than chest studies
d.      Next steps
                                                  i.      Ask for reports from other film studies; check for errors
                                                ii.      Check for duplicate patients
                                              iii.      Did identified patients get follow up treatment, as identified by the problem list

2.                  Future meetings
a.       Stay with current time of Thursdays at 1:30 until end of August.  After the meeting, Connie sent out a Doodle Poll to request a change to Thursday mornings.

3.                  Next Workshop Meeting(s): Thursdays, 1:30 p.m. – 2:30 p.m., at Given Courtyard South Level 4.   
a.       May 19, 2016: Nancy?
b.      May 26, 2016:(start new time)
c.       June 2, 2016: Amanda and Connie on Rheumatology QI Project on Opioid Prescription Management
d.      June 9, 2016: Adam

Recorder: Connie van Eeghen

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