Arterial Blood Pressure and Heart Rate Discrepancies Between Handwritten and Computerized Anesthesia Records

Reich, David L.; Wood, Richard K.; Mattar, Raafat; Krol, Marina; Adams, David C.; Hossain, Sabera; Bodian, Carol

doi:10.1213/00000539-200009000-00022

Cited by 102 publications

(45 citation statements)

References 8 publications

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“…20 Two studies have suggested that there is a tendency for nurses to favour normal readings and ignore extreme values resulting in a reduced variability in manually collected values. 21,22 Because physiological values in our studies were validated by nursing or respiratory staff, our data are likely subject to similar bias but we would expect less so than previous studies as data were not generated de novo by the nurses. Both systems had only modest ability to discriminate and most models suffered from poor calibration.…”

Section: Association With and Ability To Discriminate Outcomementioning

confidence: 95%

Neuroanesthesia and Intensive Care Limited ability of SOFA and MOD scores to discriminate outcome: a prospective evaluation in 1,436 patients

Zygun

Laupland

Fick³

et al. 2005

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : The multiple organ dysfunction (MOD) score and sequential organ failure assessment (SOFA) score are measures of organ dysfunction and have been validated based on the association of these scores with mortality. We sought to compare the performance of the SOFA and MOD scores in a large cohort of consecutive multisystem intensive care unit (ICU) patients.M Me et th ho od ds s: : Prospective automated daily measurements of MOD and SOFA scores were performed in 1,436 patients admitted to a multisystem ICU in the Calgary Health Region over a one-year period. Logistic regression modeling techniques were used to describe the association of SOFA and MODS with mortality. Receiver operator characteristic (ROC) curves were used to assess the model's discriminatory ability.R Re es su ul lt ts s: : For ICU and hospital mortality, there was very little practical difference between the SOFA and MOD scores in their ability to discriminate outcome as determined by the area under the ROC. However, compared to previous literature, the discriminatory ability of both scores in this population was weak. As well, the calibration of the models was poor for both scores. The SOFA cardiovascular component score performed better than the MOD cardiovascular component score in the discrimination of both ICU and hospital mortality.C Co on nc cl lu us si io on ns s: : SOFA and MOD scores had only a modest ability to discriminate between survivors and non-survivors. These results question the appropriateness of using organ dysfunction scores as a 'surrogate' for mortality in clinical trials and suggest further work is necessary to better understand the temporal relationship and course of organ failure with mortality. Objectif : Le score de défaillance multiviscérale (DMV) et

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Section: Association With and Ability To Discriminate Outcomementioning

confidence: 95%

Neuroanesthesia and Intensive Care Limited ability of SOFA and MOD scores to discriminate outcome: a prospective evaluation in 1,436 patients

Zygun

Laupland

Fick³

et al. 2005

Can J Anesth/J Can Anesth

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“…[7][8][9][10] These studies predominantly relate to the accuracy of physiological data. In a recent study, completion rates were assessed for six text entry fields on AIMS records, 24 and results showed rates similar to those seen in this study; however, randomized evaluations directly comparing the completeness of text entry data between different methods of recordkeeping are lacking.…”

Section: Discussionmentioning

confidence: 99%

“…6,21 Several studies have compared the accuracy and completeness of physiologic data in handwritten and AIMS records and have found AIMS records to be superior. [7][8][9][10] This is not surprising, as electronic data from physiologic monitors lend themselves to automated capture by an AIMS. It is less clear whether AIMS technology facilitates recording information that can be obtained only by clinical observation.…”

Section: Résumémentioning

confidence: 97%

“…[1][2][3] Automation of this task can reduce the time devoted to completing anesthetic records [4][5][6] while increasing the quality of data contained in them. [7][8][9][10] Anesthesia information management system (AIMS) technology was once the domain of an enthusiastic minority, but use is increasing. 11,12 Published data have reduced concerns about the potential of AIMS to reduce vigilance and increase medico-legal exposure 5,13,14 (although there were more lapses in response to a vigilance task in a recent randomized controlled trial [RCT] in our own institution).…”

Section: Résumémentioning

confidence: 99%

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A randomized comparison between records made with an anesthesia information management system and by hand, and evaluation of the Hawthorne effect

Edwards

Hagen

Hannam

et al. 2013

Can J Anesth/J Can Anesth

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Purpose Anesthesia information management system (AIMS) technology is designed to facilitate high-quality anesthetic recordkeeping. We examined the hypothesis that no difference exists between AIMS and handwritten anesthetic records in regard to the completeness of important information contained as text data. We also investigated the effect of observational research on the completeness of anesthesiologists' recordkeeping. Methods As part of a larger randomized controlled trial, participants were randomized to produce 400 anesthetic records, either handwritten (n = 200) or using an AIMS (n = 200). Records were assessed against a 32-item checklist modified from a clinical guideline. Intravenous agent and bolus recordings were quantified, and data were compared between handwritten and AIMS records. Records produced with intensive research observation during the initial phase of the study (n = 200) were compared with records produced with reduced intensity observation during the final phase of the study (n = 200). Results The AIMS records were more complete than the handwritten records (mean difference 7.1%; 95% confidence interval [CI] 5.6 to 8.6%; P \ 0.0001), with higher completion rates for six individual items on the checklist (P \ 0.0001). Drug annotation data were equal between arms. The records completed early in the study, during a period of more intense observation, were more thorough than subsequent records (87.3% vs 81.6%, respectively; mean difference 5.7%; 95% CI 4.2 to 7.3%; P \ 0.0001). Conclusions The AIMS records were more complete than the handwritten records for 32 predefined items. The potential of observational research to influence professional behaviour in an anesthetic context was confirmed. This trial was registered at the Australian New Zealand Clinical Trials Registry No 12608000068369.

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“…''Smoothing'' vital signs during the recording of manual anesthesia records is a well-described problem, 4 and there is no question in our minds that electronically captured data are superior in quality compared with manually entered data. Nevertheless, these discrepancies raise the issue of how credible electronic records may be when they contain manually entered drug administration or vital signs data.…”

mentioning

confidence: 99%

The limitations of manually entered data in acute care environments

Ehrenfeld

Wanderer

2014

Can J Anesth/J Can Anesth

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Arterial Blood Pressure and Heart Rate Discrepancies Between Handwritten and Computerized Anesthesia Records

Cited by 102 publications

References 8 publications

Neuroanesthesia and Intensive Care Limited ability of SOFA and MOD scores to discriminate outcome: a prospective evaluation in 1,436 patients

Neuroanesthesia and Intensive Care Limited ability of SOFA and MOD scores to discriminate outcome: a prospective evaluation in 1,436 patients

A randomized comparison between records made with an anesthesia information management system and by hand, and evaluation of the Hawthorne effect

The limitations of manually entered data in acute care environments

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