Christopher A. Harle
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View article: Protocol for a Single-Arm Pilot Clinical Trial: Developing and Evaluating a Machine Learning Opioid Prediction & Risk-Stratification E-Platform (DEMONSTRATE)
Protocol for a Single-Arm Pilot Clinical Trial: Developing and Evaluating a Machine Learning Opioid Prediction & Risk-Stratification E-Platform (DEMONSTRATE) Open
Background/Objectives: The Developing and Evaluating a Machine Learning Opioid Prediction & Risk-Stratification E-Platform (DEMONSTRATE) trial aims to assess the usability, acceptability, feasibility, and effectiveness of implementing a ma…
View article: Performance of 4 Methods to Assess Health-Related Social Needs
Performance of 4 Methods to Assess Health-Related Social Needs Open
Importance Organizations use health-related social needs (HRSN) information to identify patients in need of referrals, to increase clinician awareness, to improve analytics, and for quality reporting. Objective To contrast the performance …
View article: Organizational readiness for implementing clinical decision support tools in chronic pain care: a mixed methods evaluation
Organizational readiness for implementing clinical decision support tools in chronic pain care: a mixed methods evaluation Open
Introduction Clinical decision support (CDS) tools have the potential to enhance treatment outcomes in chronic pain care, yet their successful implementation depends on the readiness of both providers and clinical staff. The purpose of thi…
View article: Integrating a risk prediction score in a clinical decision support to identify patients with health-related social needs in the emergency department
Integrating a risk prediction score in a clinical decision support to identify patients with health-related social needs in the emergency department Open
Objectives To improve the identification of patients with health-related social needs (HRSNs) in the emergency department (ED), we developed and integrated a risk prediction score into an existing Fast Healthcare Interoperability Resources…
View article: Primary Care Clinician Perspectives on Older Adult Chronic Pain Management and Clinical Decision Support: Qualitative Study
Primary Care Clinician Perspectives on Older Adult Chronic Pain Management and Clinical Decision Support: Qualitative Study Open
Background Chronic pain management in older adults can be challenging for primary care clinicians due to comorbidities, side effects, and complicated guideline recommendations. Clinical decision support systems (CDSSs) may improve care by …
View article: Research informatics and the COVID-19 pandemic: Challenges, innovations, lessons learned, and recommendations
Research informatics and the COVID-19 pandemic: Challenges, innovations, lessons learned, and recommendations Open
The recipients of NIH's Clinical and Translational Science Awards (CTSA) have worked for over a decade to build informatics infrastructure in support of clinical and translational research. This infrastructure has proved invaluable for sup…
View article: Effectiveness of a clinical decision support system with prediction modeling to identify patients with health-related social needs in the emergency department: Study protocol
Effectiveness of a clinical decision support system with prediction modeling to identify patients with health-related social needs in the emergency department: Study protocol Open
Introduction Health-related social needs (HRSNs) encompass various non-medical risks from a patient’s life circumstances. The emergency department (ED) is a crucial yet challenging setting for addressing patient HRSNs, a clinical decision …
View article: Primary Care Clinician Perspectives on Older Adult Chronic Pain Management and Clinical Decision Support (Preprint)
Primary Care Clinician Perspectives on Older Adult Chronic Pain Management and Clinical Decision Support (Preprint) Open
BACKGROUND Chronic pain management in older adults can be challenging for primary care clinicians because of comorbidities, side effects, and complicated guideline recommendations. Clinical decision support systems (CDSS) can enhance guid…
View article: Development and validation of computable social phenotypes for health-related social needs
Development and validation of computable social phenotypes for health-related social needs Open
Objective Measurement of health-related social needs (HRSNs) is complex. We sought to develop and validate computable phenotypes (CPs) using structured electronic health record (EHR) data for food insecurity, housing instability, financial…
View article: Using human factors methods to mitigate bias in artificial intelligence-based clinical decision support
Using human factors methods to mitigate bias in artificial intelligence-based clinical decision support Open
Objectives To highlight the often overlooked role of user interface (UI) design in mitigating bias in artificial intelligence (AI)-based clinical decision support (CDS). Materials and Methods This perspective paper discusses the interdepen…
View article: Comparing the performance of screening surveys versus predictive models in identifying patients in need of health-related social need services in the emergency department
Comparing the performance of screening surveys versus predictive models in identifying patients in need of health-related social need services in the emergency department Open
Background Health-related social needs (HRSNs), such as housing instability, food insecurity, and financial strain, are increasingly prevalent among patients. Healthcare organizations must first correctly identify patients with HRSNs to re…
View article: A Clinical Decision Support System for Addressing Health-Related Social Needs in Emergency Department: Defining End User Needs and Preferences
A Clinical Decision Support System for Addressing Health-Related Social Needs in Emergency Department: Defining End User Needs and Preferences Open
Background Health-related social needs (HRSNs) are the unmet social and economic needs (e.g., housing instability) that affect individuals' health and well-being. HRSNs are associated with more emergency department (ED) visits, longer stay…
View article: Association between Opioid–Benzodiazepine Trajectories and Injurious Fall Risk among US Medicare Beneficiaries
Association between Opioid–Benzodiazepine Trajectories and Injurious Fall Risk among US Medicare Beneficiaries Open
Background/Objectives: Concurrent opioid (OPI) and benzodiazepine (BZD) use may exacerbate injurious fall risk (e.g., falls and fractures) compared to no use or use alone. Yet, patients may need concurrent OPI-BZD use for co-occurring cond…
View article: Association between Opioid–Benzodiazepine Trajectories and Injurious Fall Risk among US Medicare Beneficiaries
Association between Opioid–Benzodiazepine Trajectories and Injurious Fall Risk among US Medicare Beneficiaries Open
Background/Objectives: Concurrent opioid (OPI) and benzodiazepine (BZD) use may exacerbate injurious fall risk (e.g., falls and fractures) compared to no use or use alone. Yet, patients may need concurrent OPI-BZD use for co-occurring cond…
View article: Acceptance of Automated Social Risk Scoring in the Emergency Department: Clinician, Staff, and Patient Perspectives
Acceptance of Automated Social Risk Scoring in the Emergency Department: Clinician, Staff, and Patient Perspectives Open
Introduction: Healthcare organizations are under increasing pressure from policymakers, payers, and advocates to screen for and address patients’ health-related social needs (HRSN). The emergency department (ED) presents several challenges…
View article: Association between Opioid-Benzodiazepine Trajectories and Injurious Fall Risk among US Medicare Beneficiaries
Association between Opioid-Benzodiazepine Trajectories and Injurious Fall Risk among US Medicare Beneficiaries Open
Background/Objectives: Concurrent opioid (OPI) and benzodiazepine (BZD) use may exacerbate falls/fractures risk compared to no use or use alone. Yet, patients may need concurrent OPI-BZD use for co-occurring conditions (e.g., pain and anxi…
View article: Comparative effectiveness of dual vs. single-action antidepressants on HIV clinical outcomes in HIV-infected people with depression
Comparative effectiveness of dual vs. single-action antidepressants on HIV clinical outcomes in HIV-infected people with depression Open
Objective: Depression is highly prevalent among people living with HIV/AIDS (PLWHA) and has deleterious effects on HIV clinical outcomes. We examined changes in depression symptoms, viral suppression, and CD4 + T cells/μl among PLWHA diagn…
View article: Machine learning-based prediction models for home discharge in patients with COVID-19: Development and evaluation using electronic health records
Machine learning-based prediction models for home discharge in patients with COVID-19: Development and evaluation using electronic health records Open
Objective This study aimed to develop and validate predictive models using electronic health records (EHR) data to determine whether hospitalized COVID-19-positive patients would be admitted to alternative medical care or discharged home. …
View article: Evolving availability and standardization of patient attributes for matching
Evolving availability and standardization of patient attributes for matching Open
Variation in availability, format, and standardization of patient attributes across health care organizations impacts patient-matching performance. We report on the changing nature of patient-matching features available from 2010–2020 acro…
View article: Examining primary care provider experiences with using a clinical decision support tool for pain management
Examining primary care provider experiences with using a clinical decision support tool for pain management Open
Objective To evaluate primary care provider (PCP) experiences using a clinical decision support (CDS) tool over 16 months following a user-centered design process and implementation. Materials and Methods We conducted a qualitative evaluat…
View article: Management of Fall Risk Among Older Adults in Diverse Primary Care Settings
Management of Fall Risk Among Older Adults in Diverse Primary Care Settings Open
Objectives Falls are persistent among community-dwelling older adults despite existing prevention guidelines. We described how urban and rural primary care staff and older adults manage fall risk and factors important to integration of com…
View article: Accuracy of Electronic Health Record Food Insecurity, Housing Instability, and Financial Strain Screening in Adult Primary Care
Accuracy of Electronic Health Record Food Insecurity, Housing Instability, and Financial Strain Screening in Adult Primary Care Open
This study assesses the accuracy of electronic health record–based screening questionnaires about social risk factors using external single-domain questionnaires as a comparator.
View article: Usability Testing of an Interoperable Computerized Clinical Decision Support Tool for Fall Risk Management in Primary Care
Usability Testing of an Interoperable Computerized Clinical Decision Support Tool for Fall Risk Management in Primary Care Open
Background Falls are a widespread and persistent problem for community-dwelling older adults. Use of fall prevention guidelines in the primary care setting has been suboptimal. Interoperable computerized clinical decision support systems h…
View article: Enhancing an enterprise data warehouse for research with data extracted using natural language processing
Enhancing an enterprise data warehouse for research with data extracted using natural language processing Open
Objective: This study aims to develop a generalizable architecture for enhancing an enterprise data warehouse for research (EDW4R) with results from a natural language processing (NLP) model, which allows discrete data derived from clinica…