Joo Yun Lee

2016 Year-in-Review of Clinical and Consumer Informatics: Analysis and Visualization of Keywords and Topics

Objectives The objective of this study was to review and visualize the medical informatics field over the previous 12 months according to the frequencies of keywords and topics in papers published in the top four journals in the field and in Healthcare Informatics Research (HIR), an official journal of the Korean Society of Medical Informatics. Methods A six-person team conducted an extensive review of the literature on clinical and consumer informatics. The literature was searched using keywords employed in the American Medical Informatics Association year-in-review process and organized into 14 topics used in that process. Data were analyzed using word clouds, social network analysis, and association rules. Results The literature search yielded 370 references and 1,123 unique keywords. ‘Electronic Health Record’ (EHR) (78.6%) was the most frequently appearing keyword in the articles published in the five studied journals, followed by ‘telemedicine’ (2.1%). EHR (37.6%) was also the most frequently studied topic area, followed by clinical informatics (12.0%). However, ‘telemedicine’ (17.0%) was the most frequently appearing keyword in articles published in HIR, followed by ‘telecommunications’ (4.5%). Telemedicine (47.1%) was the most frequently studied topic area, followed by EHR (14.7%). Conclusions The study findings reflect the Korean governments efforts to introduce telemedicine into the Korean healthcare system and reactions to this from the stakeholders associated with telemedicine.

Evaluating test-retest reliability in patient-reported outcome measures for older people: A systematic review

OBJECTIVES This study aimed to evaluate the components of test-retest reliability including time interval, sample size, and statistical methods used in patient-reported outcome measures in older people and to provide suggestions on the methodology for calculating test-retest reliability for patient-reported outcomes in older people. DESIGN This was a systematic literature review. DATA SOURCES MEDLINE, Embase, CINAHL, and PsycINFO were searched from January 1, 2000 to August 10, 2017 by an information specialist. REVIEW METHODS This systematic review was guided by both the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and the guideline for systematic review published by the National Evidence-based Healthcare Collaborating Agency in Korea. The methodological quality was assessed by the Consensus-based Standards for the selection of health Measurement Instruments checklist box B. RESULTS Ninety-five out of 12,641 studies were selected for the analysis. The median time interval for test-retest reliability was 14days, and the ratio of sample size for test-retest reliability to the number of items in each measure ranged from 1:1 to 1:4. The most frequently used statistical methods for continuous scores was intraclass correlation coefficients (ICCs). Among the 63 studies that used ICCs, 21 studies presented models for ICC calculations and 30 studies reported 95% confidence intervals of the ICCs. Additional analyses using 17 studies that reported a strong ICC (>0.09) showed that the mean time interval was 12.88days and the mean ratio of the number of items to sample size was 1:5.37. CONCLUSIONS When researchers plan to assess the test-retest reliability of patient-reported outcome measures for older people, they need to consider an adequate time interval of approximately 13days and the sample size of about 5 times the number of items. Particularly, statistical methods should not only be selected based on the types of scores of the patient-reported outcome measures, but should also be described clearly in the studies that report the results of test-retest reliability.

Development and validation of detailed clinical models for nursing actions in perinatal care

OBJECTIVES The aim of this study was to develop and evaluate detailed clinical models (DCMs) for nursing actions in perinatal care. We propose the use of action-target dyads as entities in DCMs for nursing actions. METHODS We identified action and target concepts, attributes, and value sets by analyzing nursing documentation and reviewing the wider literature, in addition to published standards and models. We developed the DCMs by linking entities, attributes, and value sets. DCMs were classified by action type based on the Clinical Care Classification, and by target type based on the axes of the International Classification for Nursing Practice (ICNP). Attributes in the DCMs were also classified by ICNP axes. The quality of the DCMs was evaluated by domain experts, and their coverage was evaluated by mapping narrative nursing statements. RESULTS Nursing DCMs consisting of 233 entities (dyads comprising 34 action and 212 target concepts), 214 attributes and 541 values were developed. The most frequent action type was hands-on care (43.3%). The focus axis was used most frequently for the targets (51.9%) and attributes (38.8%). The quality scores of the DCMs ranged from 0.80 to 0.96. Most (174/192; 90.6%) of the statements were fully mapped, while 7 (3.7%) were partially mapped and 11 (5.7%) were not mapped. We modified the DCMs in accordance with these results. CONCLUSIONS In total, 240 DCMs were developed with action-target dyads as entities. The DCMs developed in this study could be implemented in an electronic nursing record system to enhance nursing practices and ensure semantic interoperability of nursing data.