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PubMed1999

Comparison of literature searches on quality and costs for health technology assessment using the MEDLINE and EMBASE databases.

Biomedical databases are an important source of information for health technology assessment. However, there is considerable variation in the costs of accessing commercial databases. We sought to measure the quality, amount of overlap, and costs of information retrieved from two of the main database sources--MEDLINE and EMBASE. Librarians at two health technology assessment agencies ran a total of eight literature searches on various medical technologies, using both databases. All search results were independently reviewed by two researchers. The researchers were asked to identify relevant references and to rank each of these according to a level of evidence scale. The results were tabulated to show the number of references identified by each database, the number of relevant references ranked by level of evidence, and the number of these references that were unique to one or the other database. The cost of retrieving references from each source was also calculated. Each database contained relevant references not available in the other. Because of the longer time lag for indexing in MEDLINE, many of the references that originally appeared to be unique to EMBASE were subsequently available in MEDLINE as well. Since our study was conducted, MEDLINE has been made available worldwide, free of charge, via the Internet. Hence, the cost difference between the databases is now even greater. However, notwithstanding the costs, it appears that literature searches that rely on only one or the other database will inevitably miss pertinent information.

Abstracting and Indexing↗
PubMed2002

Assessing the learning curve effect in health technologies. Lessons from the nonclinical literature.

INTRODUCTION: Many health technologies exhibit some from of learning effect, and this represents a barrier to rigorous assessment. It has been shown that the statistical methods used are relatively crude. Methods to describe learning curves in fields outside medicine, for example, psychology and engineering, may be better. METHODS: To systematically search non-health technology assessment literature (for example, PsycLit and Econlit databases) to identify novel statistical techniques applied to learning curves. RESULTS: The search retrieved 9,431 abstracts for assessment, of which 18 used a statistical technique for analyzing learning effects that had not previously been identified in the clinical literature. The newly identified methods were combined with those previously used in health technology assessment, and categorized into four groups of increasing complexity: a) exploratory data analysis; b) simple data analysis; c) complex data analysis; and d) generic methods. All the complex structured data techniques for analyzing learning effects were identified in the nonclinical literature, and these emphasized the importance of estimating intra- and interindividual learning effects. CONCLUSION: A good dividend of more sophisticated methods was obtained by searching in nonclinical fields. These methods now require formal testing on health technology data sets.

Biomedical Technology↗
PubMedDate not supplied

Technology assessment--a survey of the clinical engineer's role within the hospital.

Advancements in technology are vital to improve clinical outcomes within the medical community and, in particular, to healthcare systems. The need for a systematic approach to analyzing, assessing and selecting the best new technology for individual hospitals continues to increase in response to this technological growth. To determine the use of technology assessment, the effectiveness of different methods, and the role of clinical engineers and bioengineers in this process, a survey was conducted of clinical engineering departments throughout the United States. The results reveal that technology assessment programs are widely utilized as a team effort between hospital departments. Clinical engineers are playing a key role within these teams as technology managers.

Attitude of Health Personnel↗
PubMed2007

Intraoperative neurophysiological monitoring technology: recent advances and evolving uses.

Intraoperative neurophysiological monitoring has evolved over the last 25 years to become an important component of many types of orthopedic and neurosurgical procedures. From its foundations in VIII cranial nerve surgeries and scoliosis corrections surgeries, intraoperative neurophysiological monitoring has expanded to incorporate nearly all spine procedures and many involving the brain and brainstem. Fundamental to this growth in the use of intraoperative neurophysiological monitoring has been the development of the technology used to perform the neurophysiological tests. Advancements in electronics and computer technology have resulted in significant improvements in the capacity, ease of use, quality and reliability of the equipment as well as the quality of and control over the acquired data. These technological advancements have resulted in remarkable improvements in not only the quality and availability of intraoperative neurophysiological monitoring, but also, as a consequence, patient care, and have arguably propelled the expansion of the use that intraoperative neurophysiological monitoring has seen over the last 10 years.

Biomedical Technology↗
PubMedDate not supplied

Diagnostic ultrasound.

Explore the source record for details and available documents.

Biomedical Engineering↗
PubMed2003

Advanced clinical engineering workshops in Central America.

Over the past ten years the American College of Clinical Engineering has conducted numerous Advanced Clinical Engineering Workshops in developing countries around the world. Most of the recent workshops have been conducted in Latin America and the Caribbean in cooperation with the Pan American Health Organization, an affiliate of the World Health Organization. This presentation describes workshop objectives and topics. It also describes the author's participation in workshops conducted in Costa Rica (2002) and El Salvador (2003).

Biomedical Engineering↗
PubMed2005

Technology strategy and the balance sheet: 3 points to consider.

Most hospitals use technology strategically to differentiate themselves from their competition. The rapid rate of change in healthcare technologies necessitates development of a technology life-cycle management program. Having access to flexible sources of capital appropriate to each category of technology assets allows liabilities and assets to be matched on a "balanced" balance sheet.

Accounting↗
PubMed2004

Biomedical applications of optical imaging.

Developments in imaging offer real-time visualisation of biological processes at the cellular and molecular level. This article considers how micro- and nanotechnology may enhance the application of optical imaging for in vivo and in vitro diagnostics.

Biomedical Engineering↗
PubMed1995

Clinical engineering helps reduce equipment costs.

Clinical engineering involves, among other activities, managing equipment repair and maintenance activities, assessing technology needs and potential equipment acquisitions, training users, negotiating service contracts, and optimizing patient-care equipment utilization. Effective clinical engineering programs can help healthcare organizations reduce the high cost of acquiring and maintaining patient care equipment.

Biomedical Engineering↗
PubMed1994

Women, health, and medical technology.

New medical technologies are often developed and diffused in health care without societal assessments or setting of priorities. This article discusses the driving forces behind the development of new technologies and asks how women as users and providers of health services can gain influence on the process. Technologies used in pregnancy and childbirth are discussed to reveal different interests in their development and use and to discuss the role of industry in the development of new medical technologies in general.

Biomedical Research↗
PubMed1996

Bioelectrical impedance analysis in body composition measurement: National Institutes of Health Technology Assessment Conference Statement.

The objective of this conference was to provide physicians with a responsible assessment of bioelectrical impedance analysis (BIA) technology for body composition measurement. Participants were a non-Federal, nonadvocate, 13-member panel representing the fields of nutrition, pediatrics, surgery, public health, biomedical engineering, epidemiology, and biostatistics. In addition, 20 experts in nutrition, pediatrics, metabolism, biomedical engineering, physiology, and epidemiology presented data to the panel and a conference audience of 220. The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The panel concluded that BIA provides a reliable estimate of total body water under most conditions. It can be a useful technique for body composition analysis in healthy individuals and in those with a number of chronic conditions such as mild-to-moderate obesity, diabetes mellitus, and other medical conditions in which major disturbances of water distribution are not prominent. BIA values are affected by numerous variables including body position, hydration status, consumption of food and beverages, ambient air and skin temperature, recent physical activity, and conductance of the examining table. Reliable BIA requires standardization and control of these variables. A specific, well-defined procedure for performing routine BIA measurements is not practiced. Therefore, the panel recommends that a committee of appropriate scientific experts and instrument manufacturers be formed with the goal of setting instrument standards and procedural methods.

Body Composition↗