Incomplete Recording Research Articles

The impact of cosmetic tourism across one year on an NHS breast surgery unit

BackgroundThis is a review of patients managed by our single-site breast surgery service for complications of cosmetic surgeries performed abroad and within the UK, across September 2022-2023. MethodsA retrospective review of outpatient clinic and emergency theatre lists was used to identify patients; data was collected from their electronic records. Results25 patients (23 female) were identified, 20 had surgery abroad. Turkey was the most common destination that patients travelled to (n=15), with bilateral breast augmentation being the most common procedure (n=15). Post-operative infection and wound dehiscence (n=10 and n=8 respectively) were the most common complications; 72% (n=18) of patients presented within 8 weeks of their surgery. There was incomplete recording of surgical details including precise date (recorded for 48%), clinic name (8%), and name of the surgeon (0%). 17 microbiological samples were sent, with 11 resulting in a named organism - Staphylococcus Aureus was most common (n=5). 17 (68%) cases were treated conservatively, without radiological or surgical interventions. When surgical management occurred (n=6), it was for removal of breast implants (n=5) or evacuation of haematoma (n=1). The cost of managing these complications was at least £37,000. ConclusionComplications from cosmetic tourism present more commonly to the NHS than those resulting from private surgery performed in the UK. This has significant financial implications for the NHS. More accurate recording of relevant data, engagement in audits, and disseminating findings may help raise awareness of the risks and complications of cosmetic surgery performed abroad.

An Archival Framework for Sharing of Cultural Heritage 3D Survey Data: OpenHeritage3D.org

Abstract. Photogrammetry and LiDAR have become increasingly accessible methods for documentation of Cultural Heritage sites. Academic and government agencies recognize the utility of high-resolution 3D models supporting long-term asset management through visualization, conservation planning, and change detection. Though detailed models can be created with increasing ease, their potential for future use can be constrained by a lack of accompanying topographic data, data collector skill level, and incomplete recording of the key metadata and paradata which make such survey data useful to future endeavors. In this paper, informed by various international survey organizations and data archives, we present a framework to record and communicate Cultural Heritage - focusing on architectures based on 3D metric survey - to first describe the data and metadata which should be included by surveyors to enable data usage and to communicate the expected utility of this data.

Pattern of Ultrasonographic Prescriptions and Findings in Rural Northern India: A Mixed Methods Study

Abstract Background: Ultrasonography (USG) is used extensively across countries to diagnose and manage diseases. However, the existing USG services must be utilised rationally and effectively. Aim: Understanding the pattern of USG prescriptions and findings is important for improving the quality of healthcare services delivered by any healthcare system. Patients and Methods: A mixed methods study was conducted at a rural sub-district hospital in northern India to assess the pattern and completeness of prescriptions and USG findings and explore the patient and doctor-related factors influencing the USG prescription practices. Results: Of the 505 patients studied, 324 (64.2%) were females. The median age was 32 years (interquartile range: 24–45 years). The availability of complete medical history and clinical examination recording was 471 (85.7%) and 145 (28.7%), respectively. The indication for USG was mentioned in 436 (86.3%) prescriptions. Of the total, 251 (49.7%) had abnormal ultrasound findings. The abnormal finding was significantly high amongst patients (a) aged 45–59 years (P = 0.015) and (b) referred from surgery, paediatrics and other outpatient departments (P = 0.001) after adjustment to other factors. Patient-related factors such as non-harmfulness, free availability, reassurance of normality and health system/provider-level factors such as absence or low awareness of guidelines and changed clinical practice were the reasons for the current pattern of USG prescriptions. Conclusion: Although the medical history is better recorded, the incomplete recording of clinical examination needs improvement. Placing a guideline for prescribing USG, imposing nominal user fees and patient education and counselling can be tested for effectively utilising the USG services. Further, tracking the change in clinical management following the USG in Indian setting is the need of the hour.

Enhancing Financial Technology Operations: A Comprehensive Evaluation Using COBIT 2019 Framework

This research aims to enhance information technology (IT) governance in a financial technology company by focusing on peer-to-peer lending services. The main challenges faced by the company involve a lack of system design details, leading to post-implementation imperfections and negative impacts on business process performance, including unnecessary delays and adjustments. The lack of transparency in system evaluation is also a hindrance caused by incomplete recording of test results. Therefore, this research aims to address these challenges by utilizing the COBIT 2019 framework. The study employs a qualitative approach, utilizing data obtained through interviews and literature studies supported by the COBIT Tool Kit. The analysis is conducted on three main objectives: security management, solution identification, and IT change management, to identify disparities between the current status and desired targets. The analysis results highlight the need for improvements in specific aspects, including the lack of system design details, more precise information in the change process, and deficiencies in recording test results. Recommendations for improvement involve the development of more detailed guidelines for system design, enhanced documentation of changes, and improvements in testing instructions and result reporting. Additionally, recommendations focus on enhancing capabilities through proactive evaluation, refining security plans, developing more adaptive solution acquisition strategies, and improving testing practices. Thus, this research underscores the importance of strategic improvements within the IT and Information Systems governance framework to shape a more effective and transparent operational environment in Financial Technology companies.

Incomplete recording of race/colour in health information systems in Brazil: time trend, 2009-2018.

This ecological study of time trends and multiple groups evaluated incompleteness in the race/colour field of Brazilian health information system records and the related time trend, 2009-2018, for the diseases and disorders most prevalent in the black population. The Romero and Cunha (2006) classification was applied in order to examine incompleteness using secondary data from Brazil's National Notifiable Diseases System, Hospital Information System and Mortality Information System, by administrative regions of Brazil, while percentage underreporting and time trend were calculated using simple linear regression models with Prais-Winsten correction (p-value<0.05). All records scored poorly except those for mortality from external causes (excellent), tuberculosis (good) and infant mortality (fair). An overall downward trend was observed in percentage incompleteness. Analysis by region found highest mean incompleteness in the North (30.5%), Northeast (33.3%) and Midwest (33.0%) regions. The Southeast and Northeast regions showed the strongest downward trends. The findings intended to increase visibility on the implications of the race/color field for health equity.

Development of a novel labour monitoring tool: Improving labour care quality in the Indian setting.

Efficient care by labour monitoring tools manages labour, identifies the abnormalities and avoids the fatalities. Various studies are being undertaken by the researchers to understand the limited use of these therapeutic tools. The present study aimed to develop a novel labour monitoring instrument after understanding the barriers and enablers of the currently used tools and using it in the health setting for improving clinical outcomes. Methodological research design was adopted to develop the novel tool. Item pool was generated by literature review, focus group discussions and retrospective observations of the partographs. Developed tool was evaluated by various experts by undergoing three rounds and was found to be reliable in terms of stability and equivalency. After undergoing pilot runs by researcher and nurses, tool was found to be feasible and understandable. The developed novel labour monitoring tool was used on 200 intranatal women. Focus group discussions revealed various barriers in the current labour tools, such as lack of clarity, complexity, staff shortage, workload etc. Retrospective observation of filled partographs revealed the incomplete recording of the components of the partograph. The prepared first draft underwent rigorous review by the experts. The prepared novel tool, after being used on 200 intranatal women resulted in 90% of normal vaginal deliveries. Duration of 1st stage of labour was around 5 hours. A novel labour monitoring tool was developed after methodological approach resulting in adequate monitoring and improved labour outcomes.

Development of urinary diary mobile application and evaluation in patients with urinary incontinence.

To develop a feasible smartphone urinary diary application (UDA), and evaluate reliability and patient acceptability as a collection, calculation, and sharing tool. We developed the UDA for smartphones, which collects voiding, leakage, fluid intake, and grade of urgency data. A two-way cross-sectional study was conducted with 60 participants, participants split into two groups. Thirty participants completed UDA for 3 days either preceded or followed by a standard paper diary. We assessed the paper app reliability of the UDA with the Kappa variable and internal correlation coefficient (ICC). 29 (96.6%) participants completed the 3-day UDA in the first phase, 92.6% in the second phase, in comparison to 90% and 79.4% in paper form, respectively. Incomplete variable recording was observed at 10.3%-20% in the UDA group in comparison to 33.3%-34.8 % in the PF group. Of the 48 participants who experienced both diaries, 40 (83.3%) preferred the UDA. Paper app correlation was good to very good with ICC ranging from 0.60 to 0.90 for all variables (p < 0.001). Kappa values for incontinence, stress incontinence, urge incontinence, and increased frequency were 0.95, 0.94, 0.82 0.87, and 0.54; respectively (p < 0.001). The performance of developed smartphone UDA is comparable with and highly correlated with paper form with most users finding the app feasible. Convergent validity with urinary incontinence and other lower urinary tract dysfunctions is required.

Right partial rainbow refractometry for measuring droplet refractive index and size

Rainbow refractometry can be employed for measuring the parameters of droplets or sprays. Considering the diversity of different measurement environments and droplet components, there are instances in experiments where optics fail to record the complete rainbow signal. To enhance the experimental data utilization, this paper investigates rainbow refractometry using the incomplete rainbow signal on the right side, focusing on its feasibility and accuracy. The concept that defines the incompleteness of the right-sided rainbow signal is termed as the dimensionless right signal partial ratio (RSPR). The study conducts a comprehensive analysis of refractive index, droplet diameter, and size distributions retrieved from the partial rainbow signals simulated by the Lorenz-Mie theory with varying RSPR values. For both partial standard and global rainbows, the critical value of the retrieval error is found to be whether the primary peak of the rainbow is preserved or not, i.e., RSPR = 1. Laboratory experiments verify the feasibility and effectiveness of employing rainbow refractometry with right partial rainbow signals. The study addresses the challenge of incomplete recording of rainbow signals in experiments, and is expected to improve experimental efficiency and data utilization.

Intracoronary ECG ST-segment shift remission time during reactive coronary hyperemia (tau-icECG): a new approach to assess hemodynamic coronary stenosis severity

Abstract Background Coronary pressure-derived fractional flow reserve (FFR) measurements are recommended for hemodynamic coronary stenosis assessment. Given temporary paralysis of the coronary microcirculation during hyperemia, pressure is, in theory, directly related to coronary flow. Pressure drop during hyperemia across a coronary stenosis, thus, provides an estimate of its restrictive effect on flow. FFR during reactive hyperemia induced by a proximal, 1-minute coronary artery balloon occlusion has been shown non-inferior to FFR as obtained by adenosine-induced hyperemia. Intracoronary ECG (icECG) is more sensitive in detecting myocardial ischemia than the surface ECG, and can be easily obtained. Purpose The present study evaluated a novel diagnostic approach based on icECG ST-segment shift remission time for hemodynamic stenosis severity assessment. Methods This was a retrospective observational trial in patients with chronic coronary syndrome, who underwent hemodynamic measurements during a brief coronary occlusion with simultaneous icECG recording during coronary angiography. The icECG recording was used for a beat-to-beat analysis of the ST-segment elevation performed by a previously developed fully autonomous algorithm. The time after release of the 1-minute ostial coronary balloon occlusion when the ST elevation reached 50% of the pre-occlusion (baseline) isoelectric line, i.e., icECG remission half time (τ-icECG; τ=tau), was obtained by the algorithm (Figure1). τ-icECG was evaluated using the simultaneously obtained FFR at a threshold of 0.80 as reference parameter. Results 139 icECGs from 119 patients were analysed, 23 had to be excluded in advance, due to incomplete icECG recording or algorithm failure. A ROC-analysis of τ at a threshold of &amp;gt;8s found it significantly accurate for detecting a hemodynamically relevant coronary stenosis at FFR≤0.80 (area under the ROC-curve 0.618, 95% CI 0.507-0.735, sensitivity 60%, specificity 67%, p=0.037) (Figure2). Conclusion Τ-icECG, a measure of icECG ST-elevation remission time to isoelectricity as obtained during reactive hyperemia FFR accurately detects hemodynamically relevant coronary artery stenoses at a threshold of ≥ 8 seconds.

Release velocity improvement with a new metronome-guided chest compression protocol: preliminary results of the RITMICO study

Abstract Introduction Annually, emergency medical services treat over 350’000 out-of-hospital cardiac arrests in the U.S. and over 25’000 in Europe. Outcomes vary widely, according also to the quality of the CardioPulmonary Resuscitation (CPR) provided. Recently, it was demonstrated how, on top of the compression phase, chest release phase is also important to obtain an adequate heart and brain perfusion. However, no studies describe how to ameliorate this parameter during resuscitation. Purpose We investigated if a modified metronome-guided procedure might improve chest compression release velocity during CPR simulation on standard manikin, compared to the standard procedure. Methods We developed a double-click metronome for CPR: the first click corresponds to chest compression and the second to the end of chest release. Volunteers with different levels of expertise in CPR and with a valid BLS-D certification have been included in the study. Each subject performed two CPR manikin simulations following a 4-min protocol with the standard and the modified metronome (Figure 1), in a random order. An Automated External Defibrillator (AED) equipped with pads allowed continuous measurement of CPR quality during simulations. Three CPR parameters have been measured: compression depth, rate and release velocity. CPR simulation was guided only by the external metronome, all audio prompts from the AED were silenced. The two procedures have been compared, in terms of CPR quality, using Wilcoxon signed-ranks test. Impact of subject-specific factors on the difference in CPR quality has been evaluated using stepwise regression. Results 151 volunteers were included in the study, 23 of them have been excluded due to incomplete data recording. Comparison between the two procedures (Figure 2) showed a significant increase of median chest compression depth (p&amp;lt;&amp;lt;0.001) and release velocity (p&amp;lt;0.05) with the modified metronome. Percentage of compressions within the optimal range was significantly higher for compression depth (p&amp;lt;0.05) and significantly lower for compression rate (p&amp;lt;0.01) with the modified metronome. Chest compression release velocity difference was not statistically significant (p=0.20). No significant impact of sex, age and level of expertise was observed. Conclusions The double-click metronome significantly increased CPR quality in terms of both compression depth and release velocity. The decrease of compressions within the optimal rate range in the modified procedure could be due to lack of familiarity with the new rhythm and needs further evaluation. Our study represents the first trial trying to improve chest compression release velocity. Demonstrating the efficacy of this procedure could pave the way to clinical trials in real resuscitations to confirm the potential impact on the outcome of out-of-hospital cardiac arrest.Study protocolComparison between the two procedures

Assessing adherence to National Institute for Health and Care Excellence dementia assessment and diagnosis guidelines in adults with intellectual disability: a retrospective cohort study

PurposeThis study aims to evaluate the dementia assessment and diagnosis care provided to adults with intellectual disability. The authors selected recommendations from the National Institute for Health and Care Excellence (NICE) standards which could be evidenced in clinical notes and aimed to identify characteristics which may be associated with improved adherence to these recommendations.Design/methodology/approachThe study population was adults with an intellectual disability who were diagnosed with dementia between January 2019 and December 2022 by a UK-based intellectual disability service. Data to demonstrate adherence to selected recommendations and demographic and clinical characteristics were extracted from electronic patient records.FindingsThe authors identified 41 individuals. A mean of six of the eight recommendations were adhered to. There was low adherence with structural imaging to support dementia subtype diagnosis (9 individuals, 22%). This may be linked with the low percentage of people diagnosed with vascular dementia (1 individual, 2%) despite a national figure of 20%. No demographic or clinical characteristics were associated with level of adherence recorded. The authors found incomplete recording of diagnostic clinical coding in electronic patient records. This may disadvantage this population, as they cannot be readily identified for post diagnostic support or resource allocation.Originality/valueTo the best of the authors’ knowledge, this is the first study to examine adherence to these NICE guidelines in this population.

Effects of Aquatic Interventions on Physical Health Indicators in People with Intellectual Disabilities: A Review.

Exercise in water is widely used for improving the physical capacities of people with intellectual disabilities (IDs). In this review, we examined the results of studies on the effects of water interventions on functional abilities, as well as the physiological and biochemical status of people with IDs. We considered studies in the PubMed, MEDLINE, Scopus, Google Scholar, and Research Gate databases which were published between 2010 and 31 December 2022. Based on our inclusion criteria, 15 studies were selected for review. We found incomplete recording of data on the intensity and timing of physical activity. There was also wide variation in the terminology used to describe physical abilities. The study results suggested that aquatic interventions brought about improvements in endurance and strength; however, conflicting data were found with respect to balance and body mass index, and there were few data on biomarkers related to stress and brain health. Further research with more accurate training load data and a more common fitness terminology is needed. Lastly, traditional swimming should probably be considered as an aquatic intervention.

Recording early deaths following emergency department visits in inpatient data: An observational study using data of 16 German hospitals

ObjectiveIn German hospital emergency departments (EDs), no definite reimbursement rules exist for patients who die within 24 hours after arrival. Our study aimed to assess whether these cases were recorded and billed as inpatient stays. Furthermore, characteristics of patients who die within 24 hours following arrival at the ED were investigated for all ED visits, as well as for the subgroup of ED visits with an ED diagnosis or inpatient principal diagnosis of acute myocardial infarction. MethodsThis study was part of the INDEED project, which aimed to explore utilization and trans-sectoral patterns of care for patients treated in EDs in Germany. The study population includes ED visits of adult patients in 2016 in 16 German hospitals participating in the project. In the data set of combined ED, inpatient, and outpatient treatment information early deaths were classified as patients who died in the ED or in the hospital within 24 hours after arrival. Characteristics of visits followed by early death were analyzed descriptively. Mode of billing as inpatient or outpatient was validated by identifying corresponding billing information using linked inpatient and outpatient data. ResultsIn 2016, 454,747 ED visits of adult patients occurred in the participating hospitals and 42.8% resulted in inpatient admission. Among these inpatients 8,317 (4.3%) died during the overall hospital stay, and 1,302 (0.7%) died within 24 hours following arrival. The proportion of early deaths among all deaths in patients with a diagnosis of acute myocardial infarction was higher (27%) compared to the overall patient population (16%). Although all cases of early death were classified as inpatients the corresponding inpatient data was missing in 1.9% of all early deaths and in 3.4% of early deaths with a diagnosis of acute myocardial infarction. Outpatient billing information suggesting that these cases were billed as outpatients, was found in 0.3% of all early deaths and in 0.8 to 1.7% of early deaths with a diagnosis of acute myocardial infarction, respectively. ConclusionIn-hospital mortality might be biased by incomplete recording of early deaths in inpatient data. However, the proportion of patients with early death who were billed as outpatients was marginal in the investigated study population of 16 hospitals. Although the study results are limited by restricted generalizability and subpar data quality, this finding indicates that early deaths might be almost completely recorded in German inpatient data. Nevertheless, data quality should be enhanced by establishing general billing rules for cases with a short treatment duration due to early death.

Continuous Monitoring Versus Intermittent Auscultation of Wheezes in Patients Presenting With Acute Respiratory Distress

BackgroundAuscultation for an extended period of time using a wearable stethoscope enables objective computerized analysis and longitudinal assessment of lung sounds. However, this auscultation method differs from bedside auscultation in that clinicians are not present to optimize the quality of auscultation. No prior studies have compared these two auscultation methods. ObjectiveThe aim of this study was to compare intermittent auscultation using a conventional stethoscope with continuous auscultation using a wearable stethoscope for wheeze detection in patients who present with acute respiratory distress. MethodsPatients presenting to the emergency department with acute respiratory distress were enrolled. The Strados Remote Electronic Stethoscope Platform (RESP™) was used for continuous auscultation, and intermittent auscultation was performed using a U.S. Food and Drug Administration–cleared electronic stethoscope. A recording was made with an electronic stethoscope. Subsequently, continuous recording was made using RESP™, which continued until the patient was admitted or discharged from the emergency department. The number of captured wheezes in each recording was counted and validated by two board-certified physicians. ResultsFrom May 2018 to May 2019, 43 patients were enrolled in the study. Three patients were excluded from analysis due to incomplete audio recording data. The mean length of recording was 62.3 min for continuous auscultation and 0.7 min for intermittent auscultation; 77.5% (31 of 40) of intermittent recordings contained wheezes, in contrast to 85% (34 of 40) of continuous recordings. ConclusionsExtending the duration of auscultation using a wearable stethoscope in a noisy clinical environment showed comparable performance to standard of care intermittent auscultation in identifying patients who have wheezes.

Development and Testing Requirements for an Integrated Maternal and Child Health Information System in Iran: A Design Thinking Case Study.

Management of child health care can be negatively affected by incomplete recording, low data quality, and lack of data integration of health management information systems to support decision making and public health program needs. Given the importance of identifying key determinants of child health via capturing and integrating accurate and high-quality information, we aim to address this gap through the development and testing requirements for an integrated child health information system. A five-phase design thinking approach including empathizing, defining, ideation, prototyping, and testing was applied. We employed observations and interviews with the health workers at the primary health care network to identify end-users' challenges and needs using tools in human-centered design and focus group discussion. Then, a potential solution to the identified problems was developed as an integrated maternal and child health information system (IMCHIS) prototype and tested using Software Quality Requirements and Evaluation Model (SQuaRE) ISO/IEC 25000. IMCHIS was developed as a web-based system with 74 data elements and seven maternal and child health care requirements. The requirements of "child disease" with weight (0.26), "child nutrition" with weight (0.20), and "prenatal care" with weight (0.16) acquired the maximum weight coefficient. In the testing phase, the highest score with the weight coefficient of 0.48 and 0.73 was attributed to efficiency and functionality characteristics, focusing on software capability to fulfill the tasks that meet users' needs. Implementing a successful child health care system integrates both maternal and child health care information systems to track the effect of maternal conditions on child health and support managing performance and optimizing service delivery. The highest quality score of IMCHIS in efficiency and functionality characteristics confirms that it owns the capability to identify key determinants of child health.

Complementary food introduction practices in infants with intestinal failure.

Oral intake in infants with intestinal failure (IF) may be limited due to intolerance or feeding difficulties. Guidelines for the introduction of semisolid or solid complementary foods (CFs) to infants with IF do not exist. CF intake and caloric contribution from CF is difficult to assess due to malabsorption and incomplete recording. The aim of this study was to identify institutional approaches to introducing CF to infants with IF. The American Society for Parenteral and Enteral Nutriton (ASPEN) Pediatric Intestinal Failure Section Registered Dietitian/Nutritionist (RDN) working group designed a 10-question online cloud-based survey to assess group member practice related to the introduction of CF to infants with IF. Twenty-six surveys were completed. Thirteen (50%) RDNs recommend introduction of CF between 4 and 6 months of age. Nineteen (76%) recommend adding pureed foods to gastrostomy tube feedings. Seventeen (65%) follow standard infant feeding practice guidelines with half citing the American Academy of Pediatrics. Approximately half (44%) recommend introducing vegetables first and the majority (80%) recommend delaying the introduction of fruits. The vast majority (92%) recommend specific foods to minimize stool output including green beans, bananas, infant cereals, and meats/protein. Institutional practices related to the introduction of CF to infants with IF vary. Similarities with first food choice and foods to avoid were observed. Evidenced-based practice guidelines for the introduction of CF to infants with IF need to be established to determine best practices for reducing stool output, encouraging weaning from parenteral nutrition, and achieving enteral autonomy.

Incidence of hospital contacts with acute kidney injury after initiation of second-generation antipsychotics in older adults: a Danish population-based cohort study

PurposeTo investigate the association between acute kidney injury (AKI) and use of second-generation antipsychotics (SGA) in older adults.MethodsIn a population-based cohort study using Danish national registries, new users of SGAs (aged ≥ 65) were identified during 2005–2015. Each SGA user was matched to 10 population controls on age, sex, and the SGA initiation date. The outcome was incident AKI within 90 days after the index date. Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs), adjusting for potential confounders.ResultsIn the study, 36,581 new SGA users and 365,810 controls were included. The 90-day incidence rate of AKI was 4.38 and 1.70 per 1000 person-years among SGA users and controls, respectively, corresponding to a crude HR of 2.57 (1.79–3.68). The fully adjusted HR (aHR) was 1.43 (0.89–2.27) for all SGAs. The risk differed among individual drugs with aHRs for olanzapine 3.50 (1.20–10.23), quetiapine 1.62 (0.81–3.26), and risperidone 0.68 (0.28–1.64). In sensitivity analyses, the aHR declined to 1.24 (0.95–1.61) at 1-year follow-up.ConclusionsOlanzapine use was associated with a significantly increased 90-day AKI risk. For quetiapine, the risk was elevated but not significant, and risperidone had no association. CIs were wide and confounder adjustment largely impacted the estimates. Main limitations included residual confounding and incomplete recording of AKI diagnoses.

P018 Are hospital-only specialist drugs being flagged in primary care records - a step closer toward patient safety

Abstract Background/Aims Rheumatologists prescribe many hospital-only medications (also known as red category prescriptions) including biologicals, chemotherapy such as cyclophosphamide, subcutaneous methotrexate and bosentan. The use of these medicines should be clearly communicated to primary care who should record this information in the patient’s electronic record to reduce the risk of a primary care clinician prescribing an incompatible medication and thus avoiding any potentially severe adverse events. It is also important to provide a complete list of medication when a patient is admitted to hospital acutely or referred to another department. Reflecting on a recent fatal incident, where a patient receiving subcutaneous methotrexate was prescribed trimethoprim by her GP and developed neutropaenic sepsis, our team was prompted to assess whether hospital-only prescriptions in our rheumatology cohort of patients are being flagged as a red drug in the GP system. Our objective was to determine if non-GP prescribed red drugs/hospital-only prescribed medications are being recorded in the patient’s primary care medication record. Methods We randomly selected 100 patients who attended the rheumatology day case unit from March 2021 to June 2021. We checked the newly available regional electronic patient record which contains information on medications listed on the primary care record, to see if the red drug was recorded in this record. We also recorded a patient’s age, gender, rheumatological diagnosis and the name of the hospital-only medication. Results Alarmingly, 50% of hospital-only medications were unflagged in the GP record system raising concerns about patient safety. 75% of the patients evaluated were female and their mean age was 56 (standard deviation 16.3). 61% were diagnosed with an inflammatory arthritis, of which rheumatoid arthritis was the commonest. Patients with CTD and vasculitis accounted for 39% of the population. 11% were receiving chemotherapy, 92% biologics and 12% subcutaneous methotrexate. A biological therapy was missed out more frequently compared with other categories. Conclusion A very high number of GP records did not have the hospital-only/red flag drugs recorded. This is a potential significant risk. The risk needs to be reduced by better communication between secondary care and primary care. Secondary care clinicians working in our trust can now check that the hospital only medication is correctly recorded on the GP prescribing system. If it is not recorded, then it needs to be highlighted to the GP practice in discharge letters and clinic letters. We hypothesise that this incomplete recording is not unique to our trust but a wider problem which needs to be addressed urgently to avoid preventable deaths. We propose that organisations ensure information about medicines prescribed elsewhere is reviewed on the GP clinical system at least annually, even if there are no changes to the medication. We as clinicians need to put patient safety first as an integral part of professionalism. Disclosure L. Rajagopala: None. A. Jain: None. S.Z. Chowdhury: None. D.A.E. Gamage: None. Y.A.A. Ali: None. B. Griffiths: None.

Data-Driven Approach for Resistivity Prediction Using Artificial Intelligence

Abstract Formation resistivity is crucial for petrophysics and formation evaluation. Laboratory measurements and/or well logging can be used to provide resistivity data. Laboratory measurements are time-consuming and costly, limiting their use. Furthermore, certain log records may be missing in some segments for a variety of reasons, including instrument failure, poor hole conditions, and data loss due to storage and incomplete recording. The purpose of this study is to apply support vector machines (SVM), and functional networks (FN) to introduce intelligent models for formation resistivity prediction using other available logging parameters. The well logs include gamma ray, density, neutron, and sonic data. The predictive models were built using a data collection of roughly 4300 data points collected from vertical sections of complex reservoirs. For model training and testing, the data set was split at random in a 70:30 ratio. The predictive models were validated using a different set of data (around 1300 points) that had not been seen by the model. The models predicted the target with a good correlation coefficient (R) of around 0.93 and accepted root-mean-squared error (RMSE) of 0.3 for training and testing. The suggested methods for estimating formation resistivity from available logging parameters are shown to be reliable in this study. Resistivity prediction can fill the missing gaps in log tracks and may save money by removing resistivity logs running in all offset wells in the same field.

A novel gradient-based matching via voting technique for vision-based structural displacement measurement

The effectiveness of vision-sensing system for field applications in remote measurements of structural displacement can be adversely affected by environmental factors, leading to an incomplete recording of a moving feature target in recorded video frames. The result is a non-ideal solution using traditional template matching techniques, which presents significant challenges for accurate measurements. This paper proposes a novel gradient-based matching via voting (GMV) technique to overcome environmental and operational conditions and provide reliable tracking of moved targets with different degrees of feature loss. When evaluating the region similarity between the template and a subset (called the overlapping region) of video frames in which the moved target is located to obtain a similarity score of the subset, the traditional template matching does not ascribe weights to the similarity at the pixel level, whereas GMV uses a voting scheme to weight all the pixel similarities. Three experiments were used to test GMV, evaluating its tracking accuracy and verifying its robustness with different levels of target feature loss based on a comparison with two commonly used template matching techniques. GMV proved to be capable of retrieving accurate displacement data with a high degree of accuracy, even for a moved target with up to 90% feature losses.