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Effect of a Voice Recognition System on Paediatric Outpatient Medication Errors

Thesis Info

Author

Migowa, Angela Nyangore

Department

Paediatrics and Child Health (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2013

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728046285

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Background: Medication errors have potential to cause harm and death; especially children who are three times more vulnerable than adults. Risk of medication errors is higher in out- patient settings due to a stressful work environment with less familiarity of individual patients. This problem in sub-Saharan Africa is however largely undetermined. A Voice Recognition System that converts verbal messages into text and stores it in a database in a retrievable format could impact on reduction of medication errors. Objectives: The primary objective was to compare medication prescription and dispensing errors in written prescriptions with those from a Voice Recognition System. Secondary objectives were to determine the types and frequency of medication errors, determinants of medication errors and acceptability of routine use of a Voice Recognition System to make medication prescriptions. Study design: A before -after Intervention study to determine the impact of introduction of a Voice Recognition System on the occurrence of medication errors. Methods: Prescriptions issued from the Paediatric Accident and Emergency Department at Aga Khan University Hospital Nairobi over a six month period were randomly selected and analyzed for errors. Patient‟s bio-data, diagnosis, prescriber‟s specialization and time of prescription were retrieved from outpatient medical records and documented in a standard study tool. A Voice Recognition System was installed and doctors and pharmacists consenting to use Voice Recognition were trained to enhance proficiency in its use. During consultations, doctors enrolled patients who provided written informed consent to have their prescriptions made using Voice Recognition. Prescription and dispensing records were analysed to determine the occurrence of medication errors. Questionnaires were issued to pharmacists and doctors to rate the use of Voice Recognition in the medication process. Results: During the VRS phase the proportion of female patients reviewed were 56.9% compared to 40% in the pre VRS phase. (OR= 0.5 (95% CI 0.37-0.69), P<0.001). The top five conditions diagnosed at the pediatric A&E department were upper respiratory tract infections, urinary tract infections, tonsillitis, pharyngitis and gastroenteritis. Incidence was similar in both pre VRS and VRS phases. (51.5% and 58.3% OR=0.74 (95% CI 0.53-1.01), P=0.063.) Overall, there was a 19.5% reduction in prescription errors from 86.1% in the pre Voice Recognition phase to 69.3% in the Voice Recognition phase (P<0.001). Among prescription errors analysed, there was a 31.9% reduction in omitted drug route (P <0.001) and a 64.8 % reduction in incorrect drug dose (P<0.001). Analysis of dispensing errors revealed the greatest
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فصل سوم: آیاتِ استفہام میں فہم عبادات

ایمان لانے کے بعد انسان پر سب سے پہلے عبادت کا ادا کرنا لازم ہے ہر مذہب میں عبادت کا ایک خاص طریقہ ہوتا ہے جو مخصوص طریقے کے ساتھ ادائیگی کا حکم دیا جاتا ہے اسی طرح اسلام میں بھی نماز، روزہ، حج اور زكوة عبادات کی مختلف طرق ہیں اصل عبادت کی غایت یہ ہے کہ معبود صرف اللہ تبارک وتعالیٰ ہی کو ماننا ، صرف اسی کی عبادت کرنا ہر چیز میں اسی سے مدد طلب کرنا اسی کو حاجت روا اور مشکل کشا سمجھنا اسی کو مالک، خالق اور رب تسلیم کرنا اسی سے التجاء کرنا، ہر چیز کے لئے اسی کو پکارنا اور یہ یقین رکھنا کہ اللہ کے سوا کسی کے دائرہ اختیار میں کوئی چیز نہیں ہے اگر وہ نفع پہنچانا چاہے تو اسے کوئی روکنے والا نہیں ہے اور اگر ضرر پہنچائے تو اس کو کوئی ہٹانے والا نہیں ہے ہر طرح کی عبادت مثلاً قیام، رکوع، سجدہ صرف اسی کے لئے خاص ہے اور کسی اور کے سامنے جھکنا جائز نہیں۔

 انسانوں سے اللہ تعالیٰ نے انکی تخلیق سے پہلے ایک وعدہ لیا تھا جس کا ذکر قرآن مجید میں یوں مذکور ہے:

"اَلَسْتُ بِرَبِّكُمْ، قَالُوْا بَلٰي، شَہِدْنَا"۔[[1]]

" کیا میں تمہارا رب نہیں ہوں؟ اس وقت سب نے یہ کہا کیوں نہیں اے ہمارے رب!"۔

 سب نے اس وقت اللہ کی ربوبیت کا اقرار کیا تھا گویا کہ اللہ تعالیٰ کی ربوبیت کا اقرار و اعتراف انسانوں کی فطرت میں داخل اور انکے وجدان میں شامل ہے۔

اللہ تعالیٰ کی ربوبیت کا مطلب اور اس کا تقاضا کیا ہے ؟اسکے جواب کے بارے میں بشیر احمد لودھی یوں رقمطراز ہیں:

 " انسان ازخود پیدا نہیں...

The Region of Punjab: A Sufi Perspective With Particular Focus on Chishtiya Sufism

Medieval Punjab was amongst the first regions of South Asia to encounter the substantial impact of early Sufi mystics. This article aims to investigate the history of the Punjab from a Sufi perspective with particular focus on Chishtiya Sufism and its generous role in diverting the local community center of attention. For that, the prominent Chishti Sufi Dargahs of Baba Farid Ganj Shaker in Pakpattan is selected. The study tries to investigate Dargahs’ impact on the socio-cultural and religious set up of the Medieval Punjab. How did it influence another important religion of the region i.e. Sikh belief, paper tried to highlight this impact as well.

Identification of Temporal Specificity and Focus Time Estimation in News Documents

Time is deemed as paramount aspect in Information Retrieval (IR) and it pro foundly influence the interpretation as well as the users intention and expectation. The temporal patterns in a document or collection of documents plays a central role in the effectiveness of IR systems. The accurate discernment plays an immense role in persuading the time-based intention of a user. There exists a plethora of documents on the web wherein most on them contain the divergent temporal pat terns. Assimilation of these temporal patterns in IR is referred to as Temporal Information Retrieval (TIR). The comprehension of TIR systems is requisite to address the temporal intention of a user in an efficient manner. For time specific queries (i.e. query for an event), the relevant document must relate to the time period of the event. To attenuate the problem, the IR systems must: determine whether the document is temporal specific (i.e. focusing on single time period) and determine the focus time (to which the document content refers) of the documents. This thesis exploits the temporal features of the news documents to improve the retrieval effectiveness of IR systems.As best to our knowledge, this thesis is the pioneer study that focuses on the problem of temporal specificity in news docu ments. This thesis defines and evaluate novel approaches to determine the tem poral specificity in news documents. Thereafter, these approaches are utilized to classify news documents into three novel temporal classes. Furthermore, the study also considers 24 implicit temporal features of news documents to classify in to; a) High Temporal Specificity (HTS), b) Medium Temporal Specificity (MTS), and c) Low Temporal Specificity (LTS) classes. For such classification, Rule-based and Temporal Specificity Score (TSS) based classification approaches are proposed. In the former approach, news documents are classified using a proposed set of rules that are based on temporal features. The later approach classifies news documents based on a TSS score using the temporal features. The results of the proposed approaches are compared with four Machine Learning classification algorithms: Bayes Net, Support Vector Machine (SVM),Random Forest and Decision Tree. x The outcomes of the study indicate that the proposed rule-based classifier outper forms the four algorithms by achieving 82% accuracy, whereas TSS classification achieves 77% accuracy. In addition, to determine the focus time of news documents, the thesis contem plates the temporal nature of news documents. The type and structure of doc uments influence the performance of focus time detection methods. This thesis propose different splitting methods to split the news document into three logical sections by scrutinizing the inverted pyramid news paradigm. These methods in clude: the Paragraph based Method (PBM), the Words Based Method (WBM), the Sentence Based Method (SBM), and the Semantic Based Method (SeBM). Temporal expressions in each section are assigned weights using a linear regres sion model. Finally, a scoring function is used to calculate the temporal score for each time expression appearing in the document. Afterwards, these temporal expressions are ranked on the basis of their temporal score, where the most suit able expression appears on top. Two evaluation measures are used to evaluate the performance of proposed framework, a) precision score (P@1, P@2) and average error years. Precision score at position 1 (P@1) and position 2 (P@2) represent the correct estimation of focus at the top 2 positions in the ranked list of focus time whereas, average error year is the distance between the estimated year and the actual focus year of news document. The effectiveness of proposed method is evaluated on a diverse dataset of news related to popular events; the results re vealed that the proposed splitting methods achieved an average error of less than 5.6 years, whereas the SeBM achieved a high precision score of 0.35 and 0.77 at positions 1 and 2 respectively. The overall findings presented in this thesis demonstrate that the valuable tempo ral insights of documents can be used to enhance the performance of IR systems. The time aware information retrieval systems can adopt these findings to satisfy the user expectation for temporal queries.