Assessment of 3 standards-based clinical decision support (CDS) tools in an academic electronic health record using Clinical Quality Language, CDS Hooks, and Fast Healthcare Interoperability Resources: a retrospective evaluation.

Objectives: To evaluate clinical decision support (CDS) of varying complexities and care settings represented using Health Information Technology (HIT) standards-Clinical Quality Language (CQL) for representing clinical logic and Fast Healthcare Interoperability Resources (FHIR) for health information exchange.

Materials And Methods: This Institutional Review Board-approved, retrospective study was performed at an academic medical center (January 1, 2023-December 31, 2023). Recommendations extracted from patient-centered outcomes guidelines were translated into standardized syntax (SNOMED CT) and representations (CQL, FHIR).

Impact of a Clinical Decision Support System on CT Pulmonary Angiography Yield and Utilization in Hospitalized Patients.

Purpose: The aims of this study were to determine whether point-of-order clinical decision support (CDS) based on the Wells criteria improves CT pulmonary angiography (CTPA) yield and utilization in hospitalized patients in an enterprise-wide health system and to identify yield-related factors.

Methods: This retrospective, institutional review board-approved, cross-sectional study in an urban, multi-institution health system included hospitalized patients undergoing CTPA 12 months before and after CDS implementation (entire cohort). The χ test was used to compare pulmonary embolism (PE) yield in patients in whom providers overrode versus followed CDS alerts after CDS implementation.

Reducing Intravenous Contrast Utilization for CT: A Health System-Wide Intervention With Sustained Impact.

Objective: To determine the volume of intravenous iodinated contrast media used for CT before, during, and after the global iohexol shortage over a total of 17 months at a multisite health system.

Methods: This retrospective study included all patients who underwent CT at a large health system with 12 sites. Standardized contrast doses for 13 CT examinations were implemented May 23, 2022.

CT Pulmonary Angiogram Clinical Pretest Probability Tool: Impact on Emergency Department Utilization.

Objective: Currently, CT pulmonary angiogram (CTPA) for evaluating acute pulmonary embolism (PE) in emergency departments (EDs) is overused and with low yields. The goal of this study is to assess the impact of an evidence-based clinical decision support (CDS) tool, aimed at optimizing appropriate use of CTPA for evaluating PE.

Methods: The study was performed at EDs in a large health care system and included nine academic and community hospitals.

You cannot fight the pressure: Structural rearrangements of active pharmaceutical ingredients under magic angle spinning.

Although solid-state nuclear magnetic resonance (NMR) is a versatile analytical tool to study polymorphs and phase transitions of pharmaceutical molecules and products, this work summarizes examples of spontaneous and unexpected (and unwanted) structural rearrangements and phase transitions (amorphous-to-crystalline and crystalline-to-crystalline) under magic angle spinning (MAS) conditions, some of them clearly being due to the pressure experienced by the samples. It is widely known that such changes can often be detected by X-ray powder diffraction (XRPD); here, the capability of solid-state NMR experiments with a special focus on H- C frequency-switched Lee-Goldburg heteronuclear correlation (FSLG HETCOR)/MAS NMR experiments to detect even subtle changes on a molecular level not observable by conventional 1D NMR experiments or XRPD is presented. Furthermore, it is shown that a polymorphic impurity combined with MAS can induce a crystalline-to-crystalline phase transition.