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Thomas C Bailey

Publications and source records attributed to Thomas C Bailey.

21 records · Page 2Linked to original sources

Implementing a commercial rule base as a medication order safety net.

A commercial rule base was used to identify drug orders exceeding standard dosage limits at a university hospital. Initially, there were substantial numbers of clinically insignificant alerts. A method for altering the commercial rule base will be implemented to increase rule specificity for problematic drugs. With minor modifications, commercial rule bases can be used to rapidly create a safety net that screens drug orders for excessive dosages, while preserving the rule architecture for more finely tuned clinical decision support.

Drug Therapy, Computer-Assisted↗

Prospective use of molecular typing of Mycobacterium tuberculosis by use of restriction fragment-length polymorphism in a public tuberculosis-control program.

We performed a prospective, community-based evaluation of molecular typing of Mycobacterium tuberculosis isolates as a method for tuberculosis (TB) control. We performed restriction fragment-length polymorphism (RFLP) analysis of the insertion sequences IS6110 and pTBN12 for isolates recovered from 61 of 62 patients with culture-positive TB in St. Louis during 12 months. Twenty-four (39%) of the 61 patients were infected with an isolate with an RFLP pattern that was shared with >/=1 other isolate, and 11 (46%) also had epidemiologic links with patients in their cluster of cases. One case each of laboratory cross-contamination and occupational transmission were discovered. The patients in clusters were more likely to be younger, black, United States-born, to have substance abuse problems, and to live in poorer areas. A predictive algorithm for molecular identification of clusters had a sensitivity and a specificity of 75%. This study allowed the TB-control program in St. Louis to be redirected toward the affected subpopulations.

Adult↗

Implementation of an automated guideline monitor for secondary prevention of acute myocardial infarction.

Clinical practice guidelines can be used to help improve health care quality, but they are often not optimally implemented. Practice enabling and reinforcing techniques, such as clinical reminders and academic detailing are effective methods for translating guidelines into practice. Following a study showing that we could improve adherence to secondary prevention guidelines for acute myocardial infarction (AMI) using computerized alerts and academic detailing, we implemented an automated monitor to accomplish the same goal in a less labor-intensive manner. This paper describes the implementation of this production application.

Drug Therapy, Computer-Assisted↗