Brian Marein, John Devereux
A comment on "Height and the standard of living in Puerto Rico from the Spanish Enlightenment to annexation by the United States, 1770-1924"
Economics and human biology
clinical decisionmaking complex cognitive process relies interpretation large variety data different sources involves use knowledge bases scientific recommendations representation clinical data plays key role speed efficiency interpretation addition increasing use clinical decision support systems cdsss provides assistance clinicians practice allowing improve patient outcomes pediatric intensive care unit picu clinicians must process high volumes data deal evergrowing workloads use multiple systems daily assess patients status adjust health care plan including electronic health records ehr clinical systems eg laboratory imaging pharmacy connected devices eg bedside monitors mechanical ventilators intravenous pumps syringes clinicians rely mostly judgment ability trace relevant data decisionmaking circumstances lack optimal data structure adapted visual representation hinder clinicians cognitive processes clinical decisionmaking skills study designed prototype optimize representation clinical data collected existing sources eg ehr clinical systems devices via structure supports integration homedeveloped cdss picu study based analyzing end user needs clinical workflow first observed clinical activities picu secure better understanding workflow terms staff tasks use ehr typical work shift second conducted interviews 11 clinicians different staff categories eg intensivists fellows nurses nurse practitioners compile needs decision support third structured data design prototype illustrates proposed representation used brain injury care scenario validate relevance integrated data utility main functionalities clinical context fourth held design meetings 5 clinicians present revise adapt prototype meet needs created structure 3 levels abstractionunit level patient level system levelto optimize clinical data representation display efficient patient assessment provide flexible platform host internally developed cdss subsequently designed preliminary prototype based structure data representation structure allows prioritizing patients via criticality indicators assessing conditions using personalized dashboard monitoring courses based evolution clinical values research required define model concepts criticality problem recognition evolution furthermore feasibility tests conducted ensure user satisfaction