PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Technology Assessment, Biomedical”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed2004

Cognitive and usability engineering methods for the evaluation of clinical information systems.

Increasingly healthcare policy and decision makers are demanding evidence to justify investments in health information systems. This demand requires an adequate evaluation of these systems. A wide variety of approaches and methodologies have been applied in assessing the impact of information systems in health care, ranging from controlled clinical trials to use of questionnaires and interviews with users. In this paper we describe methodological approaches which we have applied and refined for the past 10 years for the evaluation of health information systems. The approaches are strongly rooted in theories and methods from cognitive science and the emerging field of usability engineering. The focus is on assessing human computer interaction and in particular, the usability of computer systems in both laboratory and naturalistic settings. The methods described can be a part of the formative evaluation of systems during their iterative development, and can also complement more traditional assessment methods used in summative system evaluation of completed systems. The paper provides a review of the general area of systems evaluation with the motivation and rationale for methodological approaches underlying usability engineering and cognitive task analysis as applied to health information systems. This is followed by a detailed description of the methods we have applied in a variety of settings in conducting usability testing and usability inspection of systems such as computer-based patient records. Emerging trends in the evaluation of complex information systems are discussed.

Biomedical Engineering↗
PubMed2000

Tissue engineering: confronting the transplantation crisis.

Tissue engineering is the development of biological substitutes and/or the fostering of tissue regeneration/remodelling. It is emerging as a technology which has the potential to confront the crisis in transplantation caused by the shortage of donor tissues and organs. With the development of this technology, ther is emerging a new industry which is at the interface of biotechnology and the traditional medical implant field. For this technology and the associated industry to realize their full potential, there are core, enabling technologies that need to be developed. This is the focus of the Georgia Tech/Emory Center for the Engineering of Living Tissues, newly established in the United States, with an Engineering Research Center Award from the National Science Foundation. With the development of these core technologies, tissue engineering will evolve from an art form to a technology based on science and engineering.

Biomedical Engineering↗
PubMed2006

Year 2006 update of the Israel National List of Health Services.

In Israel, updating of the National List of Health Services is performed on a yearly basis by means of a systematic and structured mechanism for almost a decade. The existence of such a mechanism is vital for keeping medicine up to date, since many innovative and breakthrough medical technologies continuously and frequently evolve. The 2006 update is unique in several aspects, relating both to the mechanism and to the decision-making process. In this article we describe notable issues that arose during the current process: modifications to the update mechanism, the four-phase increase in allocated resources to fund the addition of new medical technologies (including the addition of finances at the expense of the 2007 planned budget), and public funding for high-cost therapies. Finally, we discuss the impact of medical advances on healthcare costs and a suggested constant annual addition to the budget.

Biomedical Technology↗
PubMed2006

International diffusion of new health technologies: a ten-country analysis of six health technologies.

OBJECTIVES: The objective of this study was to examine and explain the differential international diffusion of six health innovations. METHODS: A retrospective diffusion study was undertaken of sildenafil, cyclooxygenase-II (COX II) inhibitors, beta interferon, verteporfin, deep brain stimulators, and drug-eluting coronary stents in ten countries-Australia, Canada, Denmark, France, The Netherlands, Norway, Spain, Sweden, Switzerland, and the United Kingdom. We plotted diffusion curves of daily defined doses per quarter, vials or implants per million population, and examined the association between diffusion and five key variables. RESULTS: Canada, Switzerland, and Sweden are generally high users of new technologies; Spain, Denmark, and particularly the United Kingdom are low users. Almost all countries experienced rapid adoption of sildenafil with diffusion to a similar level; there was variable adoption and diffusion of COX II inhibitors, verteporfin, and interferon beta; drug-eluting stents penetrated the market in a similar way in all but one country; and two countries had very different adoption patterns for deep brain stimulators. Above average health spending and the presence of health technology assessment (HTA) or other guidance reports are consistently associated with increased diffusion. Early warning activity and a national coverage decision being taken are more likely to be associated with a reduced diffusion. CONCLUSIONS: The significant differences in diffusion between different countries are not consistent with a neat evidence-based world. The tools available to policy makers to control diffusion (early warning systems, HTA, and a fourth hurdle) play some part in influencing diffusion but need close scrutiny of how successfully they operate.

Australia↗
PubMed1986

Teaching biomedical policy to undergraduates.

Biomedical choices are emerging as critical policy issues of the 1980s. Political pressures for cost containment, trends toward corporate medicine, and continuing problems of access and equity ensure biomedical issues a prominent place on the policy agenda. Students of political science should be familiar with the array of biomedical technologies that currently are challenging the tenets of medicine as well as the capacity of political institutions to resolve the resulting policy dilemmas. Based on this, a course in biomedical policy is overdue. This article outlines a course which is designed to clarify the public policy dimensions of biomedicine and develop analytical skills in the students so that they can better cope with these issues of public and personal importance. It describes some of the approaches and methods that I have found useful and summarizes a few of the problems one might expect to encounter in teaching biomedical policy.

Bioethical Issues↗
PubMed2004

Systems theory and the ethics of human enhancement: a framework for NBIC convergence.

Representatives from government and the private sector recommend a major, cooperative initiative directed toward using NBIC (nano-, bio-, info-, and cogno-) technologies for human enhancement. By appropriately seeding the convergence of NBIC domains, they believe that the rate of development can be both accelerated and simultaneously channeled to avoid adverse risk and advance human good. However, to accomplish these goals, leaders of the convergence efforts identified as a major intellectual barrier the "development of a hierarchical architecture for integrating science across many scales, disciplines, and data modalities." Such a holistic framework requires a radical rethinking of the nature of science and engineering, and, beyond this, is also necessary for addressing their normative ethical and societal implications. In the first part of this essay, I consider the claim that a new view of science and engineering is needed. After reviewing the central features of a classical view of science, I consider aspects of the nano-revolution, showing why the classical conception is inappropriate and how a systems-oriented perspective is responsive to the character of this new science. I then consider how both science and engineering are transformed, calling into question older dichotomies between pure and applied domains. With the reworking of this distinction comes opportunities for rethinking the relation between science and the humanities more generally, which is necessary if we are to more appropriately address normative ethical aspects of the convergence initiative. After providing this groundwork for the needed hierarchical architecture, I consider a useful example of how a systems perspective might guide NBIC convergence. In the 1960s-1990s George Engel advocated a systems-theoretic model as an alternative to a more reductionistic "biomedical model" in medicine, and he did it for the exact same reasons as those advocated by the leaders of the NBIC convergence; namely, it embodies a more appropriate notion of science and enables one to address ethical aspects of medicine that were insufficiently addressed in the older model. By reviewing Engel's "biopsychosocial model" we can learn important lessons for developing the needed NBIC framework. I close by extending Engel's model so that it addresses all areas of enhancement envisioned as a part of NBIC convergence, and then identify areas where future research is still needed.

Biomedical Enhancement↗
PubMed2006

Is technological change in medicine always worth it? The case of acute myocardial infarction.

We examine Medicare costs and survival gains for acute myocardial infarction (AMI) during 1986-2002. As David Cutler and Mark McClellan did in earlier work, we find that overall gains in post-AMI survival more than justified the increases in costs during this period. Since 1996, however, survival gains have stagnated, while spending has continued to increase. We also consider changes in spending and outcomes at the regional level. Regions experiencing the largest spending gains were not those realizing the greatest improvements in survival. Factors yielding the greatest benefits to health were not the factors that drove up costs, and vice versa.

Acute Disease↗
PubMed2002

[More care for a limited budget; a case for a better use of the efficiency criteria].

A systematic consideration of the cost-effectiveness in decisions concerning the financing and implementation of healthcare technologies would contribute to the efficiency of the Dutch healthcare system. This consideration applies to the initial decision to finance a project, the periodic testing of this on the basis of practice data and the policy to promote a cost-effective approach in daily practice (via practice guidelines). Bearing in mind that the government has decided to allocate few additional resources to healthcare, it should undertake measures to ensure the systematic use of such information in these steps. The National Institute for Clinical Excellence (NICE) in the United Kingdom can serve as an example, where broadly supported guidelines are drawn up with systematic attention for the cost-effectiveness and the implications for healthcare. Within this context the question arises as to whether a Dutch variant of NICE is needed.

Biomedical Technology↗
PubMed2004

Wireless body area networks for healthcare: the MobiHealth project.

The forthcoming wide availability of high bandwidth public wireless networks will give rise to new mobile health care services. Towards this direction the MobiHealth project has developed and trialed a highly customisable vital signals' monitoring system based on a Body Area Network (BAN) and an m-health service platform utilizing next generation public wireless networks. The developed system allows the incorporation of diverse medical sensors via wireless connections, and the live transmission of the measured vital signals over public wireless networks to healthcare providers. Nine trials with different health care cases and patient groups in four different European countries have been conducted to test and verify the system, the service and the network infrastructure for its suitability and the restrictions it imposes to mobile health care applications.

Biomedical Technology↗
PubMedDate not supplied

[Technology assessment and operating procedures for the technological resources in the new Community Health Service].

INTRODUCTION: The main purpose of this contribution is to set today's situation of technology assessment and point to some organizing and integrative ways with the evolution concern ASL (Local Health Firm). PATIENTS AND METHODS: We outline main critical processes that fix correct management of technological resource thought data available in national and international literature. We single out more common methods to quantify, evaluate, control and manage biomedical technologies. RESULTS: We expound decisional process that lead Viterbo ASL (Local Health Firm) to a progressive controll of tecnological resource and its management after aggregation of the five USL (Local Health Units) that constituted Viterbo ASL and describe procedures assumed. CONCLUSIONS: We underline the importance of full and complete information in business and decisional process. Inside the complexity of italian view, we outline an organizative solution with a low economic impact and with a high technical content.

Decision Making, Organizational↗
PubMed2006

Engineering challenges of BioNEMS: the integration of microfluidics, micro- and nanodevices, models and external control for systems biology.

Systems biology, i.e. quantitative, postgenomic, postproteomic, dynamic, multiscale physiology, addresses in an integrative, quantitative manner the shockwave of genetic and proteomic information using computer models that may eventually have 10(6) dynamic variables with non-linear interactions. Historically, single biological measurements are made over minutes, suggesting the challenge of specifying 10(6) model parameters. Except for fluorescence and micro-electrode recordings, most cellular measurements have inadequate bandwidth to discern the time course of critical intracellular biochemical events. Micro-array expression profiles of thousands of genes cannot determine quantitative dynamic cellular signalling and metabolic variables. Major gaps must be bridged between the computational vision and experimental reality. The analysis of cellular signalling dynamics and control requires, first, micro- and nano-instruments that measure simultaneously multiple extracellular and intracellular variables with sufficient bandwidth; secondly, the ability to open existing internal control and signalling loops; thirdly, external BioMEMS micro-actuators that provide high bandwidth feedback and externally addressable intracellular nano-actuators; and, fourthly, real-time, closed-loop, single-cell control algorithms. The unravelling of the nested and coupled nature of cellular control loops requires simultaneous recording of multiple single-cell signatures. Externally controlled nano-actuators, needed to effect changes in the biochemical, mechanical and electrical environment both outside and inside the cell, will provide a major impetus for nanoscience.

Animals↗
PubMedDate not supplied

The evolution of biomedical equipment technology.

This feature article presents an overview of how the biomedical equipment technology field developed. It begins with some of the early medical equipment breakthroughs, such as the discovery of X rays. The article then traces the key role of the military in electronic technology design, leading to the concept of specially trained individuals to maintain medical equipment. The Technical Education Research Center is discussed, along with the evolution of BMET schools. Formal BMET education had a strong advocate in Ralph Nader, whose concerns about electrical safety in hospitals supported the need for trained technicians to test medical equipment. BMET certification, BMET careers, and Clinical Engineering are discussed. The article concludes with some speculation on healthcare reform and its possible effect on the biomedical equipment profession.

Biomedical Engineering↗