Papers by Ashley Colletti
The Journal of Emergency Medicine
Current Diabetes Reports
Purpose of review Outpatient and perioperative therapeutic decision making for patients with diab... more Purpose of review Outpatient and perioperative therapeutic decision making for patients with diabetes involves increasingly complex medical-decision making due to rapid advances in knowledge and treatment modalities. We sought to review mobile decision support tools available to clinicians for this essential and increasingly difficult task, and to highlight the development and implementation of novel mobile applications for these purposes. Recent findings We found 211 mobile applications related to diabetes from the search, but only five were found to provide clinical decision support for outpatient diabetes management and none for perioperative decision support. Summary We found a dearth of tools for clinicians to navigate these tasks. We highlight key aspects for effective development of future diabetes decision support. These include just-in-time availability, respect for the five rights of clinical decision support, and integration with clinical workflows including the electronic medical record. Keywords Clinical decision support for diabetes • Mobile decision support for diabetes • Diabetes management • Diabetes treatment recommendations • Perioperative diabetes management This article is part of the Topical collection on Health Care Delivery Systems and Implementation in Diabetes
Applied Clinical Informatics, 2017
Summary Background: Real-time clinical decision support (CDS) integrated with anesthesia informat... more Summary Background: Real-time clinical decision support (CDS) integrated with anesthesia information management systems (AIMS) can generate point of care reminders to improve quality of care. Objective: To develop, implement and evaluate a real-time clinical decision support system for anesthetic management of pediatric traumatic brain injury (TBI) patients undergoing urgent neurosurgery. Methods: We iteratively developed a CDS system for pediatric TBI patients undergoing urgent neurosurgery. The system automatically detects eligible cases and evidence-based key performance indicators (KPIs). Unwanted clinical events trigger and display real-time messages on the AIMS computer screen. Main outcomes were feasibility of detecting eligible cases and KPIs, and user acceptance. Results: The CDS system was triggered in 22 out of 28 (79%) patients. The sensitivity of detecting continuously sampled KPIs reached 93.8%. For intermittently sampled KPIs, sensitivity and specificity reached 90.9% and 100%, respectively. 88% of providers reported that CDS helped with TBI anesthesia care. Conclusions: CDS implementation is feasible and acceptable with a high rate of case capture and appropriate generation of alert and guidance messages for TBI anesthesia care.
What is already known-Timely, high-quality care is associated with decreased mortality in childre... more What is already known-Timely, high-quality care is associated with decreased mortality in children with traumatic brain injury-Clinical decision support can improve guideline adherence during anesthesia care What this article adds-Clinical decision support for pediatric traumatic brain injury anesthesia care is feasible and may improve traumatic brain injury guideline adherence. Clinical decision support was reliably activated during anesthesia care for pediatric trauma patients undergoing neurosurgery for traumatic brain injury. Improved adherence to some process measures and a reduction in duration of most second insults was observed. Clinical decision support has the potential to improve traumatic brain injury outcomes.
Intraoperative antibiotic redosing compliance and the extended postoperative recovery period: oft... more Intraoperative antibiotic redosing compliance and the extended postoperative recovery period: often overlooked areas that may reduce surgical site infections
Pediatric Anesthesia
What is already known Maintaining a therapeutic plasma level of prophylactic antibiotics throug... more What is already known Maintaining a therapeutic plasma level of prophylactic antibiotics throughout surgical procedures is important for prevention of surgical site infections in pediatric patients. Given evolving antibiotic redosing recommendations, traditional methods for ensuring reliable intraoperative redose compliance may be ineffective. What this article adds Countermeasures integrated into the electronic anesthesia record are effective in improving pediatric anesthesiologists' compliance with institutional guidelines for redosing of surgical prophylactic antibiotics.
Lab Chip, 2008
We introduce a novel on-chip microparticle focusing technique using standing surface acoustic wav... more We introduce a novel on-chip microparticle focusing technique using standing surface acoustic waves (SSAW). Our method is simple, fast, dilution-free, and applicable to virtually any type of microparticle. { Electronic supplementary information (ESI) available: Fabrication process of the device ; PDMS microchannel and SAW substrate alignment ; real-time video of fluorescent polystyrene beads focusing inside a microchannel. See
Computers in Biology and Medicine, 2011
To determine the impact of mechanical heterogeneity on the distribution of regional flows and pre... more To determine the impact of mechanical heterogeneity on the distribution of regional flows and pressures in the injured lung, we developed an anatomic model of the canine lung comprised of an asymmetric branching airway network which can be stored as binary tree data structure. The entire tree can be traversed using a recursive flow divider algorithm, allowing for efficient computation of acinar flow and pressure distributions in a mechanically heterogeneous lung. These distributions were found to be highly dependent on ventilation frequency and the heterogeneity of tissue elastances, reflecting the preferential distribution of ventilation to areas of lower regional impedance.
We introduce a novel on-chip microparticle focusing technique using standing surface acoustic wav... more We introduce a novel on-chip microparticle focusing technique using standing surface acoustic waves (SSAW). Our method is simple, fast, dilution-free, and applicable to virtually any type of microparticle. { Electronic supplementary information (ESI) available: Fabrication process of the device ; PDMS microchannel and SAW substrate alignment ; real-time video of fluorescent polystyrene beads focusing inside a microchannel. See
Image-Based Computational Modeling of the Human Circulatory and Pulmonary Systems, 2010
The function of the mammalian respiratory system is the facilitation the transfer of gas exchange... more The function of the mammalian respiratory system is the facilitation the transfer of gas exchange between the organism's environment and its internal transport medium, the blood. Evolutionary processes have optimized the anatomic structure of the lung as a tree-like branching network of airways terminating in thinwalled elastic ducts and alveoli, where this gas exchange occurs. Both dissipative and elastic properties of the respiratory system contribute to its unique static and dynamic mechanical behavior. In this chapter, we will explore the various structural and functional relationships of the respiratory system, and review several computational and modeling analyses that provide insight into the pathophysiology of common respiratory diseases. Particular emphasis is placed on studies that utilize imaging to help understand and/or validate the distributed regional nature of lung function.
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Papers by Ashley Colletti