2018 AAPM Annual Meeting
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Session Title: Errors and Data Mining in EMR
Question 1: Approximately what percentage of adverse drug events is identified through voluntary incident reporting in hospital systems:
Reference:Cullen DJ, Bates DW, Small SD, et al. The incident reporting system does not detect adverse drug events: a problem for quality improvement. The Joint Commission Journal on Quality Improvement. 21(10):541-8, 1995.
Choice A:1%
Choice B:5%
Choice C:50%
Choice D:90%
Question 2: An example of a trigger event used in the IHI Global Trigger Tool is:
Reference:Griffin FA, Resar RK. IHI Global Trigger Tool for Measuring Adverse Events (Second Edition). IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2009. (Available on www.IHI.org)
Choice A:Return to surgery.
Choice B:Radiation therapy to the wrong site.
Choice C:Infection one month after release from hospital.
Choice D:Administration of analgesics.
Question 3: Rules-based algorithms in radiation oncology have been used to identify what type of error in the EMR:
Reference:Covington EL, Chen X, Younge KC, et al. Improving treatment plan evaluation with automation. J Appl Clin Med Phys. 17(6):6322-6328, 2016.
Choice A:Prescription approval status.
Choice B:Prescription appropriateness.
Choice C:Scheduling of radiotherapy with chemotherapy.
Choice D:Scheduling for follow-up appointments.
Question 4: Probabilistic machine-learning algorithms in radiation oncology have been used to identify what type of error in the EMR:
Reference:Kalet et al. A Bayesian network models for error detection in radiotherapy plans. Phys Med Biol, 60, 2735-2749, 2015.
Choice A:Prescription approval status
Choice B:Prescription appropriateness
Choice C:Scheduling of radiotherapy with chemotherapy
Choice D:Scheduling for follow-up appointments
Question 5: Clinical information for follow-up notes is typically documented in what manner within the EMR:
Reference:McNutt TR et al., Practical Data Collection and Extraction for Big Data Applications in Radiotherapy. Med Phys, 2018 Feb 15 [Epub ahead of print]
Choice A:Clinical information is documented strictly using the Common Terminology Criteria for Adverse Events (CTCAE) grading system.
Choice B:Clinical information is typically documented as free-text in the form of clinical notes.
Choice C:Clinical information is codified by a system similar to the ICD-10 used for billing.
Choice D:Clinical information is automatically extracted from other medical information systems.
Question 6: Unstructured documentation can cause all of the following except:
Reference:Mayo CS et al. Big data in designing clinical trials: Opportunities and challenges. Front Oncol, 7, 187, 2017.
Choice A:Unwanted transcription errors.
Choice B:Physician recall bias.
Choice C:Increase the difficulty associated with conducting an accurate retrospective chart review.
Choice D:Always provide objective data for statistical analysis.
Question 7: The development of a clinical pathway typically incorporates all of the following except:
Reference:Chawla A et al., Care pathways in US healthcare settings: Current successes and limitations, and future challenges. Am J Manag Care, 22, 53-62, 2016.
Choice A:Published treatment guidelines.
Choice B:Randomized clinical trial results.
Choice C:Anecdotal physician experience.
Choice D:Highest level of evidence for a given subject.
Question 8: Human factors engineering involves:
Reference:The use of human factors methods to identify and mitigate safety issues in radiation therapy, Alvita J. Chan; Mohammad K Islam; Tara Rosewall; David A. Jaffray; Anthony C. Easty; and Joseph A Cafazzo, Radiotherapy and Oncology, Vol 97, pp 596-600, 2010
Choice A:The study of human social responses to patients and to the healthcare environment.
Choice B:The study of human behavior, abilities, and limitations when applied to system design for safe and effective human use.
Choice C:The study of human preferences for a well-defined work day with reasonable performance expectations.
Choice D:The study of how humans understand and retain knowledge of the engineering sciences.
Question 9: Consideration of human factors and ergonomics is very important to healthcare system redesign. The phases of a successful process should include the following:
Reference:A systematic review of human factors and ergonomics (HFE)-based healthcare system redesign for quality of care and patient safety, Anping Xie; and Pascale Carayon, Ergonomics, Vol 58, Issue 1, pp 33-49, 2015
Choice A:Analysis, Implementation, and Evaluation.
Choice B:Analysis, Design, Evaluation, and Discussion.
Choice C:Analysis, Design, Implementation, and Evaluation.
Choice D:Analysis, Design, Implementation, and Disciplinary action.
Question 10: “Mistake-proof” mitigation strategies should include all of the following except:
Reference:Mistake proofing: Changing designs to reduce error, J R Grout, Qual. Saf. Health Care, Vol 15, pp i44-i49, 2006
Choice A:Mistake prevention and detection.
Choice B:Work environments that prevent errors.
Choice C:Designing the process to fail safely.
Choice D:A well-publicized discipline policy for mistakes.
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