PubMed Health⌕ Search

Biomedical subjects

S M Finkelstein

Publications and source records attributed to S M Finkelstein.

45 records · Page 3Linked to original sources

Considerations for the design of a Web-based clinical monitoring and educational system for elderly patients.

Designing a Web system for elderly patients requires attention to the users' functional impairments and inexperience with computers. The authors reviewed published guides for the design of Web-based clinical systems for elderly patients and identified additional design considerations that have not been reported in the literature. The resulting recommendations are related to the system interface, the training and support of users, and the content of Web pages. The recommendations can be used as design objectives for Web-based systems for elderly patients, which emphasize system usability and aim to optimize patients' error-free use of these systems.

Aged↗

Monitoring progress after lung transplantation from home-patient adherence.

A paperless electronic spirometer/diary instrument has been employed in a home monitoring programme for lung and heart-lung transplant patients at the University of Minnesota. The monitoring programme is part of a long term study to develop a system which will detect the earliest signs of developing rejection or infection in the transplanted organs. It is based on patient daily self-measurements of standard spirometry, vital signs, and symptoms recorded at home and transmitted weekly to the study data center over the telephone using a modern built into the instrument. This report summarizes adherence behaviour for 41 subjects enrolled in the study over a 12 month period. The number of subjects from whom home data has been received each week was used to measure adherence at the subject level. The number of records received each week measured adherence at the daily recording level. A data record consists of a daily set of spirometry, vital signs, and symptom values from a given subject. Approximately 82% of subjects transmitted records each week, over the 52 week review period. There was an average of 4.5 records received each week from each subject. Transmitted records had missing vital sign or symptom items in less than 2% of cases, spirometry data was always present. This evaluation showed than lung transplant recipients are willing and able to use a home-monitoring instrument, and that basic spirometry, data entry, and data transmission can be performed satisfactorily.

Adolescent↗

Computer-aided real-time acquisition of physiological data: technical design and selection constraints.

For many years, physiological investigations have utilized the power and speed of analogue, digital and hybrid computers. Complex protocols often require the recording of large amounts of data in short periods, typically with simultaneous fine control of multiple experimental variables. Current systems often include data analysis in the same program which controls data acquisition. Although this is convenient from a package point of view, acquisition and analysis routines have different and sometimes conflicting purposes and requirements. This paper examines acquisition of continuous physiological signals by small dedicated computers in an attempt to separate these processes and to provide guidelines for computer selection, design and development.

Animals↗

Automated noninvasive determination of mixed venous pCO2.

The determination of mixed venous pCO2 is desirable for assessing the metabolic and respiratory status of a patient. A totally automated, laboratory computer-controlled noninvasive system has been developed to determine mixed venous pCO2 by an equilibrium rebreathing method or by an exponential compartmental analysis for cases in which equilibrium is not achieved. A gas mixture is charged to a 2-liter anesthesia bag contained in a thermostatically controlled chamber used to maintain the temperature at 37 degrees C. This feature improves upon past rebreathing methods and eliminates water vapor as a variable in gas composition measurement. This bag is connected to a rebreathing circuit controlled by a minicomputer. The subject breathes from a mouthpiece attached to a two-way valve and rebreathes the gas mixture for a period of 30 seconds. Inspirate and expirate hoses are placed in the rebreathing bag to ensure a more uniform gas distribution than is generally found in rebreathing systems. Exchange of CO2 takes place between lungs and rebreathing bag, and the concentration of CO2 is continuously monitored by a mass spectrometer. After a period of time, the concentration of CO2 in the rebreathing bag, the alveoli, and the mixed venous blood come into equilibrium, demonstrated by a plateau on the record of CO2 concentration vs. time. Compartmental analysis predicts the mixed venous pCO2 even if an equilibrium is not established. This feature is a significant benefit of this new method, eliminating problems associated with establishing an equilibrium, such as gas mixture volume adjustment, recirculation, and poor ventilation. The predicted value agrees with the equilibrium valve for cases in which equilibrium is reached.(ABSTRACT TRUNCATED AT 250 WORDS)

Automation↗

Evaluation methodology for selection of computerized clinical ECG interpretation systems.

An evaluation procedure used in the selection of a commercial, turn-key computerized system for processing electrocardiograms in a university hospital is described. Within this framework, the processing of ECGs includes data acquisition, pattern recognition, measurement, interpretation, storage, and report generation. The overall objective of this search is to select a system that will improve the quality of ECG services without adversely affecting patient costs.

Computers↗

Reliability and validity of spirometry measurements in a paperless home monitoring diary program for lung transplantation.

OBJECTIVE: To demonstrate that home spirometry measurements are reliable and valid and can be used as part of a home measurement monitoring system by lung transplant recipients. DESIGN: Longitudinal, observational. SETTING: University medical center. SUBJECTS: Eighteen patients who have undergone lung transplantation; age range was 24 to 63 years (mean of 49.5 years). OUTCOME MEASURES: Reliability and validity of forced expiratory volume at 1 second (FEV1) and forced vital capacity (FVC). INTERVENTION: Recording of spirometry, vital signs, and symptom measures at home each day by use of a paperless electronic diary/spirometer instrument. RESULTS: Day-to-day variability as measured by the standard deviation ranged from 0.013 L to 0.202 L for FVC and 0.015 L to 0.117 L for FEV1. The correlation between the two best forced expiratory maneuvers on any given day was 0.98 for both FVC and FEV1, with percent differences between the measurements of 2% for FVC and 3% for FEV1. The correlation between measurements performed in the pulmonary function laboratory and measurements done by the patient at home on the same day was 0.94 for FVC and 0.99 for FEV1. CONCLUSIONS: This evaluation demonstrated that home measurements are both reliable (i.e., repeatable) and valid when compared with the "gold standard" of the pulmonary function laboratory. The home monitoring program has been well accepted by patients, is easy to use, and provides data comparable to that collected during clinic visits.

Adult↗