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<p>Breast cancer is one of the most common diseases diagnosed in women over the world. The balanced iterative reducing and clustering using hierarchies (BIRCH) has been widely used in many applications. However, clustering the patient records and selecting an optimal threshold for the hierarchical clusters still a challenging task. In addition, the existing BIRCH is sensitive to the order of data records and influenced by many numerical and functional parameters. Therefore, this paper proposes a unique BIRCH-based algorithm for breast cancer clustering. We aim at transforming the medical records using the breast screening features into sub-clusters to group the subject cases into malignant or benign clusters. The basic BIRCH clustering is firstly fed by a set of normalized features then we automate the threshold initialization to enhance the tree-based sub-clustering procedure. Additionally, we present a thorough analysis on the performance impact of tuning BIRCH with various relevant linkage functions and similarity measures. Two datasets of the standard breast cancer wisconsin (BCW) benchmarking collection are used to evaluate our algorithm. The experimental results show a clustering accuracy of 97.7% in 0.0004 seconds only, thereby confirming the efficiency of the proposed method in clustering the patient records and making timely decisions.</p>

Background:According to amended legislation implemented in Norway in 2010, personnel in healthcare services for adults are obligated to identify patients' minor children and to assess the family situation. Health personnel is also obligated to contribute to adequate support to families affected by parental mental illness or substance use disorders. The intention behind the amendment was to support and protect children of mentally ill parents, as they are at risk of developing problems of their own. The aim of the present study was to evaluate health personnel's practice during the years 2010-2020, more specifically; (a) to what extent children of patients with mental illness and substance use disorders are registered in patient records, and (b) to what extent activities relating to the assessment and support of patients' minor children are documented in patient records.Method:The participants in the study are patients admitted to Division for Mental Health and Substance Use at the University Hospital of North Norway in the years 2010–2020. The data was drawn from patient records during October 2021.Results:The registration of patients' minor children is considerably strengthened since the introduction of the new Norwegian Health Personnel Act in 2010, and estimates show that 56% of patients' minor children are identified. However, only 31% of cases where patients have identified minor children this result in health personnel performing activities to support the children.Discussion:Based on the rising proportion of identified minor children throughout the 10-year period, it seems evident that the dissemination efforts have contributed to the development of some new skills among health personnel. However, compared with the national estimation that 35% of mentally ill and substance abusing patients have minor children, a large proportion of children remains unidentified. After identification, there seem to still be a long way to go before minor children are systematically offered support. Different solutions to strengthen the implementation of new skills in clinical practice, to ensure the identification of minor children and provision of necessary support for them is discussed.

The eHealthMonitor: a survey on the use of eHealth in health care professionals and patients The idea behind eHealth is to manage patient records more efficiently and to communicate more easily with other health care providers or patients. However, the implementation of eHealth has not always gone smoothly, leading to dissatisfaction of the health care providers, who should use the applications. Therefore, it is important to monitor the use, satisfaction and attitudes of health care providers towards eHealth applications and the digitisation of health care. To this end, the eHealthMonitor was established. This article discusses the results of the first eHealthMonitor, which focused on 5 target groups of health care providers (general practitioners, specialists, pharmacists, nurses and caretakers) and patients. Each target group was invited to complete a specific online survey from October until December 2019. A total of 9.428 respondents were reached.

Abstract Purpose Data quality is essential for all types of research, including health registers. However, data quality is rarely reported. We aimed to assess the accuracy of data in a national spine register (NORspine) and its agreement with corresponding data in electronic patient records (EPR). Methods We compared data in NORspine registry against data in (EPR) for 474 patients operated for spinal stenosis in 2015 and 2016 at four public hospitals, using EPR as the gold standard. We assessed accuracy using the proportion correctly classified (PCC) and sensitivity. Agreement was quantified using Kappa statistics or interaclass correlation coefficient (ICC). Results The mean age (SD) was 66 (11) years, and 54% were females. Compared to EPR, surgeon-reported perioperative complications displayed weak agreement (kappa (95% CI) = 0.51 (0.33–0.69)), PCC of 96%, and a sensitivity (95% CI) of 40% (23–58%). ASA classification had a moderate agreement (kappa (95%CI) = 0.73 (0.66–0.80)). Comorbidities were underreported in NORspine. Perioperative details had strong to excellent agreements (kappa (95% CI) ranging from 0.76 ( 0.68–0.84) to 0.98 (0.95–1.00)), PCCs between 93% and 99% and sensitivities (95% CI) between 92% (0.84–1.00%) and 99% (0.98–1.00%). Patient-reported variables (height, weight, smoking) had excellent agreements (kappa (95% CI) between 0.93 (0.89–0.97) and 0.99 (0.98–0.99)). Conclusion Compared to electronic patient records, NORspine displayed weak agreement for perioperative complications, moderate agreement for ASA classification, strong agreement for perioperative details, and excellent agreement for height, weight, and smoking. NORspine underreported perioperative complications and comorbidities when compared to EPRs. Patient-recorded data were more accurate and should be preferred when available.

Abstract Background Leishmaniasis is a parasitic zoonotic disease caused by the Leishmania parasites genus. The estimation of this disease is very important to inform the health care policymakers and the governments to applied proper health and economic policies. Thus, this study aimed, to find out the frequency and distribution of human leishmaniasis in West Kordofan state, based on sex and age during 5 years- Sudan. Methods Five years retrospective study from 2016 through 2020 was carried out using local hospital records of leishmaniasis patients. The age and gender of each patient were recorded. The collected data were analysed using STATA package version 16. Results A total of 162,443 patient records from 2016 to 2020 were retrieved. Of these, 4.39% were found to be positive for leishmaniasis. The disease has been more common in males (65.3%) than in females (, 34.7%). The highest reported prevalence (6.58%) was in patients 15-44 years old, which was, and the lowest prevalence (1.95%) was among patients in ≥65-year-old. Conclusion The current study indicates that leishmaniasis is endemic in the study area even though the numbers of patients in the five consecutive years were varying. Besides, the disease was common in males and adults.

Abstract Background Healthcare-associated infections remain a preventable cause of patient harm in healthcare. Full documentation of adherence to evidence-based best practices for each patient can support monitoring and promotion of infection prevention measures. Thus, we reviewed the extent, nature, and determinants of the documentation of infection prevention (IP) standards in patients with HAI. Methods We reviewed the electronic patient records (EMRs) of patients included in four annual point-prevalence studies 2013-2016 who developed a device- or procedure-related HAI (catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated infection (VAP), surgical site infection (SSI)). We examined the documentation quality of mandatory preventive measures published as institutional IP standards. Additionally, we undertook semi-structured interviews with healthcare providers and a two-step inductive (grounded theory) and deductive (Theory of Planned Behaviour) content analysis. Results Of overall 2972 surveyed patients, 249 patients developed 272 healthcare-associated infections (8.4%). Of these, 116 patients met the inclusion criteria, classified as patients with CAUTI, CLABSI, VAP, SSI in 21 (18%), 7 (6%), 10 (9%), 78 (67%) cases, respectively. We found a documentation of the IP measures in electronic medical records (EMR) in 432/1308 (33%) cases. Documentation of execution existed in the study patients’ EMR for CAUTI, CLABSI, VAP, SSI, and overall, in 27/104 (26%), 26/151 (17%), 46/122 (38%), 261/931 (28%), and 360/1308 (28%) cases, respectively, and documentation of non-execution in 2/104 (2%), 3/151 (2%), 0/122 (0%), 67/931 (7%), and 72/1308 (6%) cases, respectively. Healthcare provider attitude, subjective norm, and perceived behavioural control indicated reluctance to document IP standards. Conclusions EMRs rarely included conclusive data about IP standards adherence. Documentation had to be established indirectly through data captured for other reasons. It can be projected that a mandatory institutional documentation protocol and technically automated documentation would be necessary to alleviate this shortcoming in patient safety documentation.

PurposeThe aim of Copenhagen Hospital Biobank-Cardiovascular Disease Cohort (CHB-CVDC) is to establish a cohort that can accelerate our understanding of CVD initiation and progression by jointly studying genetics, diagnoses, treatments and risk factors.ParticipantsThe CHB-CVDC is a large genomic cohort of patients with CVD. CHB-CVDC currently includes 96 308 patients. The cohort is part of CHB initiated in 2009 in the Capital Region of Denmark. CHB is continuously growing with ~40 000 samples/year. Patients in CHB were included in CHB-CVDC if they were above 18 years of age and assigned at least one cardiovascular diagnosis. Additionally, up-to 110 000 blood donors can be analysed jointly with CHB-CVDC. Linkage with the Danish National Health Registries, Electronic Patient Records, and Clinical Quality Databases allow up-to 41 years of medical history. All individuals are genotyped using the Infinium Global Screening Array from Illumina and imputed using a reference panel consisting of whole-genome sequence data from 8429 Danes along with 7146 samples from North-Western Europe. Currently, 39 539 of the patients are deceased.Findings to dateHere, we demonstrate the utility of the cohort by showing concordant effects between known variants and selected CVDs, that is, >93% concordance for coronary artery disease, atrial fibrillation, heart failure and cholesterol measurements and 85% concordance for hypertension. Furthermore, we evaluated multiple study designs and the validity of using Danish blood donors as part of CHB-CVDC. Lastly, CHB-CVDC has already made major contributions to studies of sick sinus syndrome and the role of phytosterols in development of atherosclerosis.Future plansIn addition to genetics, electronic patient records, national socioeconomic and health registries extensively characterise each patient in CHB-CVDC and provides a promising framework for improved understanding of risk and protective variants. We aim to include other measurable biomarkers for example, proteins in CHB-CVDC making it a platform for multiomics cardiovascular studies.

This article aims to describe some of the potential risks of orthodontic treatment which when neglected can lead to a malpractice lawsuit.In orthodontic practice,categories vary from informed consent or negligent non-disclosure,failure to diagnose,to gross negligence.This study focuses on creating awareness about the importance of informed consent before orthodontic procedure to avoid legal issues.Orthodontic failures do occur sometimes but it should be identified earlier and rectified.Consent should be seen as a process and any discussions should be fully and legibly recorded in the patient records. Key words: Malpractice, informed consent, hazards of orthodontic treatment, Negligence.