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T. Elizabeth Workman

Bio: T. Elizabeth Workman is an academic researcher from George Washington University. The author has contributed to research in topics: Information needs & Automatic summarization. The author has an hindex of 8, co-authored 21 publications receiving 292 citations. Previous affiliations of T. Elizabeth Workman include National Institutes of Health & University of Utah.

Papers
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Journal ArticleDOI
TL;DR: Clinicians' lack of time and doubt that a useful answer exists were the main barriers to information seeking and technology-based solutions should enable clinicians to track their questions and provide just-in-time access to high-quality evidence in the context of patient care decision making.
Abstract: Importance In making decisions about patient care, clinicians raise questions and are unable to pursue or find answers to most of them. Unanswered questions may lead to suboptimal patient care decisions. Objective To systematically review studies that examined the questions clinicians raise in the context of patient care decision making. Data Sources MEDLINE (from 1966), CINAHL (from 1982), and Scopus (from 1947), all through May 26, 2011. Study Selection Studies that examined questions raised and observed by clinicians (physicians, medical residents, physician assistants, nurse practitioners, nurses, dentists, and care managers) in the context of patient care were independently screened and abstracted by 2 investigators. Of 21 710 citations, 72 met the selection criteria. Data Extraction and Synthesis Question frequency was estimated by pooling data from studies with similar methods. Main Outcomes and Measures Frequency of questions raised, pursued, and answered and questions by type according to a taxonomy of clinical questions. Thematic analysis of barriers to information seeking and the effects of information seeking on decision making. Results In 11 studies, 7012 questions were elicited through short interviews with clinicians after each patient visit. The mean frequency of questions raised was 0.57 (95% CI, 0.38-0.77) per patient seen, and clinicians pursued 51% (36%-66%) of questions and found answers to 78% (67%-88%) of those they pursued. Overall, 34% of questions concerned drug treatment, and 24% concerned potential causes of a symptom, physical finding, or diagnostic test finding. Clinicians’ lack of time and doubt that a useful answer exists were the main barriers to information seeking. Conclusions and Relevance Clinicians frequently raise questions about patient care in their practice. Although they are effective at finding answers to questions they pursue, roughly half of the questions are never pursued. This picture has been fairly stable over time despite the broad availability of online evidence resources that can answer these questions. Technology-based solutions should enable clinicians to track their questions and provide just-in-time access to high-quality evidence in the context of patient care decision making. Opportunities for improvement include the recent adoption of electronic health record systems and maintenance of certification requirements.

175 citations

Journal ArticleDOI
TL;DR: The Interaction Flow in Serendipitous Knowledge Discovery (IF‐SKD) model is a theoretical structure that accommodates iterative, evolving search interests, and can potentially serve as the foundation for future literature‐based discovery applications.
Abstract: Several researchers have studied serendipitous knowledge discovery in information-seeking behavior. Electronic data in the form of semantic predications have a potential role in literature-based discovery, which can be guided by serendipitous knowledge discovery research findings. We sought to model information-seeking behavior within the context of serendipitous knowledge discovery by leveraging existing research. These efforts were done with an eye for a potential literature-based discovery application that utilizes semantic predications. We performed a literature search, reviewed the results, and applied the findings in developing a model for serendipitous knowledge discovery as an information-seeking behavior. The literature review indicated four important themes in serendipitous knowledge discovery: iteration, change or clarification, a seeker's prior knowledge, and the role of information organization and presentation. The Interaction Flow in Serendipitous Knowledge Discovery (IF-SKD) model includes these themes, and accommodates iterative, evolving search interests. Output can be presented in a manner to enhance short-term memory conceptualization and connections with prior knowledge. Although the IF-SKD model is currently a theoretical structure, its utility is demonstrated through replicating a literature-based discovery event, using a documented search method within the model's steps. The IF-SKD model can potentially serve as the foundation for future literature-based discovery applications.

24 citations

Journal ArticleDOI
TL;DR: Examination of complementary and alternative medicine information-seeking behaviors and preferences from short- to long-term cancer survival, including goals, motivations, and information sources showed that CAM usage did not change significantly between 2004 and 2015.
Abstract: Objective: The research examined complementary and alternative medicine (CAM) information-seeking behaviors and preferences from short- to long-term cancer survival, including goals, motivations, and information sources. Methods: A mixed-methods approach was used with cancer survivors from the “Assessment of Patients’ Experience with Cancer Care” 2004 cohort. Data collection included a mail survey and phone interviews using the critical incident technique (CIT). Results: Seventy survivors from the 2004 study responded to the survey, and eight participated in the CIT interviews. Quantitative results showed that CAM usage did not change significantly between 2004 and 2015. The following themes emerged from the CIT: families’ and friends’ provision of the initial introduction to a CAM, use of CAM to manage the emotional and psychological impact of cancer, utilization of trained CAM practitioners, and online resources as a prominent source for CAM information. The majority of participants expressed an interest in an online information-sharing portal for CAM. Conclusion: Patients continue to use CAM well into long-term cancer survivorship. Finding trustworthy sources for information on CAM presents many challenges such as reliability of source, conflicting information on efficacy, and unknown interactions with conventional medications. Study participants expressed interest in an online portal to meet these needs through patient testimonials and linkage of claims to the scientific literature. Such a portal could also aid medical librarians and clinicians in locating and evaluating CAM information on behalf of patients.

21 citations

Journal ArticleDOI
TL;DR: Several medications dispensed to pediatric patients in this analysis are in conflict with Food and Drug Administration warnings, suggesting that there is potential risk in current sedation and analgesia practice that could be reduced with practice changes to improve efficacy and minimize risks.
Abstract: Objectives To describe the pharmaceutical management of sedation, analgesia, and neuromuscular blockade medications administered to children in ICUs. Design A retrospective analysis using data extracted from the national database Health Facts. Setting One hundred sixty-one ICUs in the United States with pediatric admissions. Patients Children in ICUs receiving medications from 2009 to 2016. Exposure/intervention Frequency and duration of administration of sedation, analgesia, and neuromuscular blockade medications. Measurements and main results Of 66,443 patients with a median age of 1.3 years (interquartile range, 0-14.5), 63.3% (n = 42,070) received nonopioid analgesic, opioid analgesic, sedative, and/or neuromuscular blockade medications consisting of 83 different agents. Opioid and nonopioid analgesics were dispensed to 58.4% (n = 38,776), of which nonopioid analgesics were prescribed to 67.4% (n = 26,149). Median duration of opioid analgesic administration was 32 hours (interquartile range, 7-92). Sedatives were dispensed to 39.8% (n = 26,441) for a median duration of 23 hours (interquartile range, 3-84), of which benzodiazepines were most common (73.4%; n = 19,426). Neuromuscular-blocking agents were dispensed to 17.3% (n = 11,517) for a median duration of 2 hours (interquartile range, 1-15). Younger age was associated with longer durations in all medication classes. A greater proportion of operative patients received these medication classes for a longer duration than nonoperative patients. A greater proportion of patients with musculoskeletal and hematologic/oncologic diseases received these medication classes. Conclusions Analgesic, sedative, and neuromuscular-blocking medications were prescribed to 63.3% of children in ICUs. The durations of opioid analgesic and sedative medication administration found in this study can be associated with known complications, including tolerance and withdrawal. Several medications dispensed to pediatric patients in this analysis are in conflict with Food and Drug Administration warnings, suggesting that there is potential risk in current sedation and analgesia practice that could be reduced with practice changes to improve efficacy and minimize risks.

18 citations

Journal ArticleDOI
TL;DR: A detailed overview of the Spark system illustrates how methodologies in design and retrieval functionality enable production of semantic predication graphs tailored to evoke Serendipitous Knowledge Discovery in users.

17 citations


Cited by
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Journal ArticleDOI
01 Jan 2001

250 citations

Journal ArticleDOI
TL;DR: Future NLP studies should concentrate on the investigation of symptoms and symptom documentation in EHR free-text narratives, and efforts should be undertaken to examine patient characteristics and make symptom-related NLP algorithms or pipelines and vocabularies openly available.

224 citations

Journal ArticleDOI
TL;DR: This article summarizes and addresses objections and challenges related to competency-based medical education, which should not be viewed as a fixed doctrine, but rather as a set of evolving concepts, principles, tools, and approaches that can enable important reforms in medical education that enable the best outcomes for patients.
Abstract: Although medical education has enjoyed many successes over the last century, there is a recognition that health care is too often unsafe and of poor quality. Errors in diagnosis and treatment, communication breakdowns, poor care coordination, inappropriate use of tests and procedures, and dysfunctional collaboration harm patients and families around the world. These issues reflect on our current model of medical education and raise the question: Are physicians being adequately prepared for twenty-first century practice? Multiple reports have concluded the answer is "no." Concurrent with this concern is an increasing interest in competency-based medical education (CBME) as an approach to help reform medical education. The principles of CBME are grounded in providing better and safer care. As interest in CBME has increased, so have criticisms of the movement. This article summarizes and addresses objections and challenges related to CBME. These can provide valuable feedback to improve CBME implementation and avoid pitfalls. We strongly believe medical education reform should not be reduced to an "either/or" approach, but should blend theories and approaches to suit the needs and resources of the populations served. The incorporation of milestones and entrustable professional activities within existing competency frameworks speaks to the dynamic evolution of CBME, which should not be viewed as a fixed doctrine, but rather as a set of evolving concepts, principles, tools, and approaches that can enable important reforms in medical education that, in turn, enable the best outcomes for patients.

167 citations

Journal ArticleDOI
TL;DR: This is the first systematic review of text summarization in the biomedical domain and identified research gaps and provides recommendations for guiding future research on biomedicalText summarization.

165 citations

Proceedings Article
02 Apr 2005
TL;DR: The Extended Abstracts portion of this disc includes submissions from all conference venues except Papers, and a formal record of the discussions, demonstrations, and debates that will occur during the conference.
Abstract: On behalf of the Technical Program Committee, welcome to the CHI 2005 conference DVD! The Extended Abstracts portion of this disc includes submissions from all conference venues except Papers (which you can find in the Conference Proceedings section). Here you will find a formal record of the discussions, demonstrations, and debates that will occur during the conference. Highlights include: short papers from the Late-Breaking Results venue, videos of demonstrations from our new Interactivity Chamber, case studies in innovation and excellence from the Design Expo, a forum for best practices in HCI, ideas that are controversial, innovative, or "hard-to-publish" from alt.chi, position papers from the Development Consortium, which looks at SIGCHI's role in serving an increasingly multidisciplinary membership, and panels and SIGs that reflect on the foundations of our discipline, and look forward at issues affecting the community today, with topics ranging from outsourcing to the CHI Papers process. You will also find brief summaries from Workshop organizers, Doctoral Consortium participants, Student Competition teams, and Late Breaking Results posters. If you are viewing this disc at the conference, we invite you to interact with these authors during the Highlights on Posters sessions on Wednesday and Thursday in the Commons; check your conference program for more information.On a personal note: bringing together such a large and diverse program is no small task, and I am grateful to the dedication of our venue chairs and Web master - from developing the Calls for Participation and handling the submission/review process, to dealing with my endless requests for information and scheduling conference sessions. Many, many thanks for volunteering your efforts for over a year to make this conference happen!

163 citations