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  • 1.
    Nordqvist, Ola
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). Region Kalmar County, Sweden.
    Lönnbom Svensson, Ulrika
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för kemi och biomedicin (KOB).
    Brundin, Lars
    County Hospital Kalmar, Sweden;Linköping university, Sweden.
    Wanby, Pär
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). County Hospital Kalmar, Sweden.
    Carlsson, Martin
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). County Hospital Kalmar, Sweden.
    Adherence to risk management guidelines for drugs which cause vitamin D deficiency – big data from the Swedish health system2019Ingår i: Drug, Healthcare and Patient Safety, ISSN 1179-1365, E-ISSN 1179-1365, Vol. 11, s. 19-28Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Several medications are known to cause vitamin D deficiency. The aim of this study is to describe vitamin D testing and supplementation in patients using these “risk medications”, thereby assessing adherence to medical guidelines.Patients and methods: A database with electronic health records for the population in a Swedish County (≈240,000 inhabitants) was screened for patients prescribed the pre-defined “risk medications” during a 2-year period (2014–2015). In total, 12,194 patients were prescribed “risk medications” pertaining to one of the three included pharmaceutical groups. Vitamin D testing and concomitant vitamin D supplementation, including differences between the included pharmaceutical groups, was explored by matching personal identification numbers.Results: Corticosteroids were prescribed to 10,003 of the patients, antiepileptic drugs to 1,101, and drugs mainly reducing vitamin D uptake to 864. Two hundred twenty-six patients were prescribed >1 “risk medication”. Seven hundred eighty-seven patients (6.5%) had been tested during the 2-year period. There were no differences regarding testing frequency between groups. Concomitant supplements were prescribed to 3,911 patients (32.1%). It was more common to be prescribed supplements when treated with corticosteroids. Vitamin D supplementation was more common among tested patients in all three groups. Women were tested and supplemented to a higher extent. The mean vitamin D level was 69 nmol/L. Vitamin D deficiency was found in 24.1% of tested patients, while 41.3% had optimal levels. It was less common to be deficient and more common to have optimal levels among patients prescribed corticosteroids.Conclusion: Adherence to medical guidelines comprising testing and supplementation of patients prescribed drugs causing vitamin D deficiency needs improvement in Sweden.

  • 2.
    Dressler, Danny
    et al.
    AIMO AB, Sweden.
    Liapota, Pavlo
    Softwerk AB, Sweden.
    Löwe, Welf
    Linnéuniversitetet, Fakulteten för teknik (FTK), Institutionen för datavetenskap och medieteknik (DM).
    Data Driven Human Movement Assessment2019Ingår i: Intelligent Decision Technologies 2019: Proceedings of the 11th KES International Conference on Intelligent Decision Technologies (KES-IDT 2019), Volume 2 / [ed] Ireneusz Czarnowski; Robert Howlett; Lakhmi C. Jain, Springer, 2019, s. 317-327Konferensbidrag (Refereegranskat)
    Abstract [en]

    Quality assessment of human movements has many of applications in diagnosis and therapy of musculoskeletal insufficiencies and high performance sport. We suggest five purely data driven assessment methods for arbitrary human movements using inexpensive 3D sensor technology. We evaluate their accuracy by comparing them against a validated digitalization of a standardized human-expert-based assessment method for deep squats. We suggest the data driven method that shows high agreement with this baseline method, requires little expertise in the human movement and no expertise in the assessment method itself. It allows for an effective and efficient, automatic and quantitative assessment of  arbitrary human movements.

  • 3.
    Hagelbäck, Johan
    et al.
    Linnéuniversitetet, Fakulteten för teknik (FTK), Institutionen för datavetenskap och medieteknik (DM).
    Lincke, Alisa
    Linnéuniversitetet, Fakulteten för teknik (FTK), Institutionen för datavetenskap och medieteknik (DM).
    Löwe, Welf
    Linnéuniversitetet, Fakulteten för teknik (FTK), Institutionen för datavetenskap och medieteknik (DM).
    Rall, Eduard
    AIMO AB.
    On the Agreement of Commodity 3D Cameras2019Ingår i: 23rd International Conference on Image Processing, Computer Vision, & Pattern Recognition (IPCV'19: July 29 - August 1, 2019, USA), CSREA Press, 2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    The advent of commodity 3D sensor technol- ogy has, amongst other things, enabled the efficient and effective assessment of human movements. Machine learning approaches do not rely manual definitions of gold standards for each new movement. However, to train models for the automated assessments of a new movement they still need a lot of data that map recorded movements to expert judg- ments. As camera technology changes, this training needs to be repeated if a new camera does not agree with the old one. The present paper presents an inexpensive method to check the agreement of cameras, which, in turn, would allow for a safe reuse of trained models regardless of the cameras. We apply the method to the Kinect, Astra Mini, and Real Sense cameras. The results show that these cameras do not agree and that the models cannot be reused without an unacceptable decay in accuracy. However, the suggested method works independent of movements and cameras and could potentially save effort when integrating new cameras in an existing assessment environment.

  • 4.
    Dressler, Danny
    et al.
    AIMO AB, Sweden.
    Liapota, Pavlo
    Softwerk AB, Sweden.
    Löwe, Welf
    Linnéuniversitetet, Fakulteten för teknik (FTK), Institutionen för datavetenskap och medieteknik (DM).
    Towards an automated assessment of musculoskeletal insufficiencies2019Ingår i: Intelligent Decision Technologies 2019: Proceedings of the 11th KES International Conference on Intelligent Decision Technologies (KES-IDT 2019), Volume 1 / [ed] Ireneusz Czarnowski; Robert Howlett; Lakhmi C. Jain, Springer, 2019, s. 251-261Konferensbidrag (Refereegranskat)
    Abstract [en]

    The paper suggests a quantitative assessment of human movements using inexpensive 3D sensor technology and evaluates its accuracy by comparing it with human expert assessments. The two assessment methods show a high agreement. To achieve this, a novel sequence alignment algorithm was developed that works for arbitrary time series.

  • 5.
    Hagelbäck, Johan
    et al.
    Linnéuniversitetet, Fakulteten för teknik (FTK), Institutionen för datavetenskap och medieteknik (DM).
    Liapota, Pavlo
    Softwerk AB.
    Lincke, Alisa
    Linnéuniversitetet, Fakulteten för teknik (FTK), Institutionen för datavetenskap och medieteknik (DM).
    Löwe, Welf
    Linnéuniversitetet, Fakulteten för teknik (FTK), Institutionen för datavetenskap och medieteknik (DM).
    Variants of Dynamic Time Warping and their Performance in Human Movement Assessment2019Ingår i: 21st International Conference on Artificial Intelligence (ICAI'19: July 29 - August 1, 2019, las Vegas, USA), CSREA Press, 2019Konferensbidrag (Refereegranskat)
    Abstract [en]

    The advent of commodity 3D sensor technology enabled, amongst other things, the efficient and effective assessment of human movements. Statistical and machine learning approaches map recorded movement instances to expert scores to train models for the automated assessment of new movements. However, there are many variations in selecting the approaches and setting the parameters for achieving good performance, i.e., high scoring accuracy and low response time. The present paper researches the design space and the impact of sequence alignment on accuracy and response time. More specifically, we introduce variants of Dynamic Time Warping (DTW) for aligning the phases of slow and fast movement instances and assess their effect on the scoring accuracy and response time. Results show that an automated stripping of leading and trailing frames not belonging to the movement (using one DTW variant) followed by an alignment of selected frames in the movements (based on another DTW variant) outperforms the original DTW and other suggested variants thereof. Since these results are independent of the selected learning approach and do not rely on the movement specifics, the results can help improving the performance of automated human movement assessment, in general.

  • 6.
    Stevenson-Ågren, Jean
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). University of Sheffield, UK.
    Israelsson, Johan
    Linnéuniversitetet, Fakulteten för teknik (FTK), Sjöfartshögskolan (SJÖ). Kalmar County Hospital ; Linköping University.
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Bath, Peter
    University of Sheffield, UK.
    Factors influencing the quality of vital signs data in electronic health records: a qualitative study2018Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 5-6, s. 1276-1286Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives

    To investigate reasons for inadequate documentation of vital signs in an electronic health record.

    Background

    Monitoring vital signs is crucial to detecting and responding to patient deterioration. The ways in which vital signs are documented in electronic health records have received limited attention in the research literature. A previous study revealed that vital signs in an electronic health record were incomplete and inconsistent.

    Design

    Qualitative study.

    Methods

    Qualitative study. Data were collected by observing (68 hr) and interviewing nurses (n = 11) and doctors (n = 3), and analysed by thematic analysis to examine processes for measuring, documenting and retrieving vital signs in four clinical settings in a 353-bed hospital.

    Results

    We identified two central reasons for inadequate vital sign documentation. First, there was an absence of firm guidelines for observing patients’ vital signs, resulting in inconsistencies in the ways vital signs were recorded. Second, there was a lack of adequate facilities in the electronic health record for recording vital signs. This led to poor presentation of vital signs in the electronic health record and to staff creating paper “workarounds.”

    Conclusions

    This study demonstrated inadequate routines and poor facilities for vital sign documentation in an electronic health record, and makes an important contribution to knowledge by identifying problems and barriers that may occur. Further, it has demonstrated the need for improved facilities for electronic documentation of vital signs.

    Relevance to clinical practice

    Patient safety may have been compromised because of poor presentation of vital signs. Thus, our results emphasised the need for standardised routines for monitoring patients. In addition, designers should consult the clinical end-users to optimise facilities for electronic documentation of vital signs. This could have a positive impact on clinical practice and thus improve patient safety.

  • 7.
    Johansson Östbring, Malin
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). Kalmar County Council.
    Eriksson, Tommy
    Malmö University;Norwegian University of Sciences and Technology, Norway.
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Hellström, Lina
    Kalmar County Council.
    Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Intervention Development and Protocol for the Process Evaluation2018Ingår i: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 7, nr 1, s. 1-12, artikel-id e21Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Trials of complex interventions are often criticized for being difficult to interpret because the effects of apparently similar interventions vary across studies dependent on context, targeted groups, and the delivery of the intervention. The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a randomized controlled trial (RCT) of an intervention aimed at improving pharmacological secondary prevention. Guidelines for the development and evaluation of complex interventions have recently highlighted the need for better reporting of the development of interventions, including descriptions of how the intervention is assumed to work, how this theory informed the process evaluation, and how the process evaluation relates to the outcome evaluation.

    OBJECTIVE: This paper aims to describe how the intervention was designed and developed. The aim of the process evaluation is to better understand how and why the intervention in the MIMeRiC trial was effective or not effective.

    METHODS: The research questions for evaluating the process are based on the conceptual model of change processes assumed in the intervention and will be analyzed by qualitative and quantitative methods. Quantitative data are used to evaluate the medication review in terms of drug-related problems, to describe how patients' beliefs about medicines are affected by the intervention, and to evaluate the quality of motivational interviewing. Qualitative data will be used to analyze whether patients experienced the intervention as intended, how cardiologists experienced the collaboration and intervention, and how the intervention affected patients' overall experience of care after coronary heart disease.

    RESULTS: The development and piloting of the intervention are described in relation to the theoretical framework. Data for the process evaluation will be collected until March 2018. Some process evaluation questions will be analyzed before, and others will be analyzed after the outcomes of the MIMeRiC RCT are known.

    CONCLUSIONS: This paper describes the framework for the design of the intervention tested in the MIMeRiC trial, development of the intervention from the pilot stage to the complete trial intervention, and the framework and methods for the process evaluation. Providing the protocol of the process evaluation allows prespecification of the processes that will be evaluated, because we hypothesize that they will determine the outcomes of the MIMeRiC trial. This protocol also constitutes a contribution to the new field of process evaluations as made explicit in health services research and clinical trials of complex interventions.

  • 8.
    Johansson Östbring, Malin
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). Kalmar County Council.
    Eriksson, Tommy
    Malmö University;Norweigan University of Sciences and Technology, Norway.
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Hellström, Lina
    Kalmar County Council.
    Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Protocol for a Randomized Controlled Trial Investigating Effects on Clinical Outcomes, Adherence, and Quality of Life2018Ingår i: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 7, nr 2, s. 1-15, artikel-id e57Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Preventive treatment goals for blood pressure and cholesterol levels continue to be unmet for many coronary patients. The effect of drug treatment depends on both its appropriateness and the patients' adherence to the treatment regimen. There is a need for adherence interventions that have a measurable effect on clinical outcomes.

    OBJECTIVE: This study aims to evaluate the effects on treatment goals of an intervention designed to improve patient adherence and treatment quality in secondary prevention of coronary heart disease. A protocol for the prespecified process evaluation of the trial is published separately.

    METHODS: The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a prospective, randomized, outcomes-blinded trial designed to compare individualized follow-up by a clinical pharmacist using motivational interviewing (MI) and medication review with standard follow-up. Patients were randomized to 2 groups after stratification according to their beliefs about medicines. After standard follow-up at the cardiology clinic, patients in the intervention group are seen individually by a clinical pharmacist 2 to 5 times as required over 7 months, at the clinic. The pharmacist reviews each patient's medication and uses MI to manage any problems with prescribing and adherence. The primary study outcome is the proportion of patients who have reached the treatment goal for low-density lipoprotein cholesterol by 12 months after discharge. Secondary outcomes are the effects on patient adherence, systolic blood pressure, disease-specific quality of life, and health care use.

    RESULTS: The protocol for this study was approved by the Regional Ethics Committee, Linköping, in 2013. Enrollment started in October 2013 and ended in December 2016 when 417 patients had been included. Follow-up data collection will conclude in March 2018. Publication of the primary and secondary outcome results from the MIMeRiC trial is anticipated in 2019.

    CONCLUSIONS: The MIMeRiC trial will assess the effectiveness of an intervention involving medication reviews and individualized support. The results will inform the continued development of support for this large group of patients who use preventive medicines for lifelong treatment. The design of this adherence intervention is based on a theoretical framework and is the first trial of an intervention that uses beliefs about medicines to individualize the intervention protocol.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT02102503; https://clinicaltrials.gov/ct2/show/NCT02102503 (Archived by WebCite at http://www.webcitation.org/6x7iUDohy).

  • 9.
    Stevenson-Ågren, Jean
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). University of Sheffield, UK.
    Israelsson, Johan
    Kalmar County Hospital.
    Nilsson, Gunilla
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Bath, Peter A.
    University of Sheffield, UK.
    Vital sign documentation in electronic records: the development of workarounds2018Ingår i: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 24, nr 2, s. 206-215Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Workarounds are commonplace in health care settings. An increase in the use of electronic health records (EHR) has led to an escalation of workarounds as health care professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in EHR has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient’s condition. We examined work flow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of hand-written notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and to ensure patients safety.

  • 10.
    Ericson, Lisa
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Hovstadius, Bo
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Carlsson, Martin
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). Kalmar County Hospital.
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Wanby, Pär
    Kalmar County Hospital.
    A cost analysis of systematic vitamin D supplementation in the elderly versus supplementation based on assessed requirements2017Ingår i: Journal of Aging Research and Healthcare, ISSN 2474-7785, Vol. 2, nr 2, s. 13-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Hypovitaminosis D is common among older people and treatment with vitamin D is associated with reduced risk of falls and fractures. This paper provides a cost analysis of assessing the vitamin D status of and providing the pharmaceuticals for elderly citizens in Kalmar County, Sweden (population approximately 230,000). Four hypothetical interventions were analyzed: (a) systematic vitamin D/calcium supplementation to all elderly (≥75 years), (b) assessment of vitamin D status in elderly and supplementation to those with insufficient levels, (c) systematic vitamin D/calcium supplementation to all nursing-home residents, and (d) assessment of vitamin D status in nursing-home residents and supplementation to those with insufficient levels. The calculations were based on an estimated reduction in overall costs due to the assessed number of hip fractures after vitamin D/calcium supplementation. The annual net economic benefit of vitamin D/calcium supplementation was estimated at (a) €304,000, (b) €860,000, (c) €755,000, and (d) €740,000. The provision of systematic vitamin D supplementation to nursing-home residents would provide a substantial net economic benefit to society and assessment of the vitamin D status before starting supplementation does not seem to be necessary. Although assessment of all elderly citizens would be more comprehensive, the true proportion with insufficient vitamin D levels in the general population is uncertain and to reaching consensus on the most advantageous daily vitamin D intake, vitamin D blood levels are necessary. Also, systematic supplementation to all elderly would result in other outcomes that could be worth the cost, but that remains to be evaluated.

  • 11.
    Ericson, Lisa
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Hammar, Tora
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Schönström, Nils
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Stakeholder consensus on the purpose of clinical evaluation of electronic health records is required2017Ingår i: Health Policy and Technology, ISSN 2211-8837, E-ISSN 2211-8845, Vol. 6, nr 2, s. 152-160Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To explore the purpose and performance of clinical evaluation of electronic health records (EHRs) among stakeholders in order to identify any need for regulatory actions or guidelines.

    Methods

    This was a qualitative study of information collected in semi-structured interviews (n=28) of representatives of the five largest EHR vendors in Sweden, healthcare provider IT managers, users, and representatives of national authorities.

    Results

    We found a difference between the stated purpose of clinical evaluation of EHRs by the authorities and the perception of the purpose by the vendors, IT managers, and the users. The respondents gave divergent answers about the medical purpose of the application: e.g. availability of data, overview and documentation, patient safety, process efficiency, decision support, a working tool, and an aid to communication and follow-up. Several vendors found it difficult to put the term clinical evaluation in its specific context, instead referring to literature reviews, risk analyses, risk-management processes, acceptance tests, test facilities, pilot tests, and proven experience.

    Conclusions

    Stakeholders need to agree on a mutually acceptable, consistent method to guide regulatory decisions. The lack of consensus regarding the purpose and performance of clinical evaluation of EHRs could impact negatively on a safe and efficient documentation in healthcare. Thus, there is a need for more consistent use of terms and concepts in, and a more systematic approach to, clinical evaluation of EHRs. To ensure that the implementation of IT in healthcare meets expectations, delivers the desired outcome, and does not create new problems, it should be evaluated.

  • 12.
    Carlsson, Martin
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). Kalmar County Hospital.
    Wanby, Pär
    Kalmar County Hospital.
    Brudin, Lars
    Linköping University;Kalmar County Hospital.
    Lexne, Erik
    Kalmar County Hospital.
    Mathold, Karin
    Kalmar County Hospital.
    Nobin, Rebecca
    Kalmar County Hospital.
    Ericson, Lisa
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Nordqvist, Ola
    Kalmar County Council.
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Older Swedish Adults with High Self-Perceived Health Show Optimal 25-Hydroxyvitamin D Levels Whereas Vitamin D Status Is Low in Patients with High Disease Burden2016Ingår i: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 8, nr 11, artikel-id 717Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH) D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH) D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people >= 75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy. Only 13% of the 169 controls were vitamin D deficient (S-25(OH) D) < 50 nmol/L), in contrast with 49% of orthopedic patients with hip fractures (n = 133), 31% of stroke patients (n = 122), 39% of patients visiting the hospital's emergency department >= 4 times a year (n = 81), and 75% of homebound adult residents in long-term care nursing homes (n = 51). The mean vitamin D concentration of the healthy control group (74 nmol/L) was similar to a suggested optimal level based on physiological data and mortality studies, and much higher than that of many officially recommended cut-off levels for vitamin D deficiency (< 50 nmol/L). The present study provides a basis for planning and implementing public guidelines for the screening of vitamin D deficiency and vitamin D treatment for frail elderly patients.

  • 13.
    Stevenson-Ågren, Jean
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). University of Sheffield, UK.
    Israelsson, Johan
    Kalmar County Hospital, Sweden.
    Nilsson, Gunilla
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Bath, Peter
    University of Sheffield, UK.
    Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest2016Ingår i: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 22, nr 1, s. 21-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPACTM Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety. 

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