Growing adoption of health information technologies is allowing healthcare providers to capture and store enormous amounts of patient data. In order to effectively use this data to improve healthcare outcomes and processes, clinicians need to identify the relevant measures and apply the correct analysis methods for the type of data at hand. In this dissertation, we present various data mining and statistical methods that could be applied to the type of datasets that are found in healthcare research. We discuss the process of identification of appropriate measures and statistical tools, the analysis and validation of mathematical models, and the interpretation of results to improve healthcare quality and safety. We illustrate the application of statistics and data mining techniques on three real-world healthcare datasets. In the first chapter, we develop a new method to assess hydration status using breath samples. Through analysis of the more than 300 volatile organic compounds contained in human breath, we aim to identify markers of hydration. In the second chapter, we evaluate the impact of the implementation of an electronic medical record system on the rate of inpatient medication errors and adverse drug events. The objective is to understand the impact on patient safety of different information technologies in a specific environment (inpatient pediatrics) and to provide recommendations on how to correctly analyze count data with a large amount of zeros. In the last chapter, we develop a mathematical model to predict the probability of developing post-operative nausea and vomiting based on patient demographics and clinical history, and to identify the group of patients at high-risk.

Background: The incidence of postoperative nausea and vomiting (PONV) can be reduced by dexamethasone. Single dose administration may cause elevated blood glucose levels in obese adults. No data are available for children. Objective: The aim was to evaluate perioperative blood glucose changes related to body weight in children who received dexamethasone. Methods: This prospective observational study included 62 children. All patients received total intravenous anesthesia and a single dose of dexamethasone (0.15mg/kg, maximum 8mg). Blood glucose levels were measured up to 6 hours. Standard deviation scores (SDS) were calculated using age- and gender-specific BMI percentiles, p<0.05. Results: 62 children (11.5±2.9years, median SDS 0.43, 29% overweight/obese) were included. Blood glucose level increased from 5.52±0.52 to 6.74±0.84mmol/l 6h after dexamethasone without correlation to the BMI-SDS. Conclusions: This study shows an increase of perioperative blood glucose (normoglycemic ranges) after single dose of dexamethasone but no BMI-dependent effect in children. Therefore, low-dose dexamethasone may be used in obese children for PONV prophylaxis.

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