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Use of Electronic Health Records, Disease Registries, and Health Insurance Databases in Ophthalmology
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Rachel Marjorie Wei Wen Tseng, Grace May Chuang, Zhi Da Soh, Yih-Chung Tham
Countries such as the USA, Germany, and the UK are actively contributing their EHRs to different data registries. Table 1.1 summarizes the ophthalmic data registries currently available. First, the Intelligent Research In Sight (IRIS) registry is known to be the first established ophthalmic clinical registry in the USA (7). The purpose of IRIS is to aid clinical performance from screening to follow-up and care interventions using participants’ EHR data, including patient demographics, past medical history, diagnoses, and medications (7). Secondly, the Smart Eye database (SMEYEDAT) registry was established in Germany as a real-time ophthalmology data warehouse that combines patients’ health records and imaging data for all types of ocular diseases and conditions (8). Thirdly, the Sight Outcomes Research Collaborative (SOURCE) registry is a US-based registry which is built upon an EHR consortium of several academic medical centers in the USA (i.e., University of Michigan Kellogg Eye Center, Stanford University Byers Eye Institute, Moran Eye Center, etc.) (9). Data such as patient demographics, billing codes, imaging data, and diagnostic tests were included in this registry (9). On the other hand, the Save Sight Registry is a culmination of different registries (of different countries), including the Fight Retinal Blindness Registry and Fight Tumour Blindness Registry. The Fight Retinal Blindness Registry in particular focuses on ocular diseases that affect the retina, such as diabetic retinopathy (DR) and retinal vein occlusion.
Domestic Violence and Abuse
Published in James Matheson, John Patterson, Laura Neilson, Tackling Causes and Consequences of Health Inequalities, 2020
IRIS is an evidence-based training, referral and support programme for general practice. It is a collaboration between primary care and a local DVA specialist organisation, usually from the voluntary and community sector. IRIS DVA training is usually jointly delivered by a GP and the IRIS specialist domestic abuse worker, the Advocate Educator (AE) to the whole GP practice. The training includes the evidence base for the health impacts of DVA, learning how to ask, respond, risk assess, refer and record DVA safely. Consenting patients are referred to the IRIS AE who sees the patient in their own practice, enhancing safety and confidentiality.
Case 85: Fever and Cough (Part 2)
Published in Layne Kerry, Janice Rymer, 100 Diagnostic Dilemmas in Clinical Medicine, 2017
Patients with IRIS are usually managed by specialist HIV or infectious diseases physicians. In severe cases, corticosteroid treatment may be considered, although this will increase the risk of developing further infections. Anti-retroviral therapy is usually continued during IRIS, although in certain cases, particularly in patients with cryptococcal meningitis, this may be adjusted or even stopped.
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2021
David A. Bellows, Noel C. Y. Chan, John J. Chen, Hui-Chen Cheng, Peter W. MacIntosh, Jenny A. Nij Bijvank, Michael S. Vaphiades, Konrad P. Weber, Sui H. Wong
The authors conducted a retrospective registry study to characterise the prevalence and clinical patterns of ophthalmic immune-related adverse events (OirAEs) among patients receiving cancer immunotherapy. They collected data from electronic health records of IRIS Registry participating ophthalmology practices. A total of 3,123 patients were identified to receive immune checkpoint inhibitors (ICIs, including anti-CTLA-4, anti-PD-1, and anti-PDL1 therapy), 112 of whom developed an OirAE. Incidence rates for anterior uveitis were 3,740 per 100,000 among all ICIs. OirAEs rates among patients on ICI therapy were much greater compared to baseline ocular complication rates in the general registry population (incidence rate ratio [IRR] of anterior uveitis, intermediate/posterior/panuveits were 13.9, 43.0 respectively). Patients with a prior history of ocular inflammatory condition showed high recurrence rates of OirAEs after initiating ICIs. The authors suggested that early coordination with ophthalmic subspecialist care is important for patients initiating ICI therapy, as rates of OirAEs are higher than general population, especially for patients with a previous history of uveitis or autoimmune ocular disease.
Pilot Evaluation of Preservice Teacher Training to Improve Preparedness and Confidence to Address Student Mental Health
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2020
Jennifer Greif Green, Rebecca S. Levine, Rachel Oblath, Kathleen H. Corriveau, Melissa K. Holt, Glenn Albright
In order to use an immediate posttest following the Kognito training, the study design required a training for the control group that was of comparable length and style. Therefore, the control group completed a training from the IRIS Center, an organization housed at Vanderbilt University that provides online resources to support the use of effective evidence-based practices and interventions for students, with a particular focus on students with disabilities (available at http://iris.peabody.vanderbilt.edu). Participants in the current study completed the module: Accommodations: Instructional and Testing Supports for Students with Disabilities. In this interactive training, participants learn the definition of accommodations, review primary types of accommodations (presentation, response, setting, and timing/scheduling), and learn how accommodations could be presented on Individualized Education Plans. The training consists of text, audio, links to resources, and includes examples of how to use accommodations with students with learning, intellectual, and physical disabilities. The IRIS training was chosen because (a) it was thought to be relevant and useful for preservice teachers in the control group, (b) it was a similar duration to the Kognito intervention, (c) it was online and interactive, and (d) it was not specifically related to mental health, thus we did not anticipate that the training would contaminate the study results.
Successful treatment of cytomegalovirus encephalitis post TCR-alpha-beta/CD19 depleted haploidentical stem cell transplant by unmanipulated donor lymphocyte infusions
Published in Pediatric Hematology and Oncology, 2019
Neha Rastogi, Satya Prakash Yadav
Although inflammation is a beneficial host response, restoration of immunity during treatment of infections, particularly if restoration is abrupt and rapid, has the potential to promote excessive inflammatory pathology and tissue damage. The ensuing clinical entity is termed as IRIS.6 IRIS was initially described in acquired immune deficiency syndrome patients. It is characterized by paradoxical worsening of an existing infection or disease process or appearance of a new infection/disease process soon after initiation of antiretroviral therapy and immune reconstitution.7 Since, post HSCT there is a state of immunodeficiency and DLI results in sudden rapid increase in the number of lymphocytes reconstituting the immunity, we find the clinical scenario present in our patient favoring the diagnosis of IRIS. Usually corticosteroids are the treatment for IRIS.6,7 Our patient responded well to steroids and recovered fully from IRIS with normal vision and sensorium,