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At least 559 records · Page 31Linked to original sources
PubMed2001

Development of a Personal Digital Assistant (PDA) based client/server NICU patient data and charting system.

Personal Digital Assistants (PDAs) offer clinicians the ability to enter and manage critical information at the point of care. Although PDAs have always been designed to be intuitive and easy to use, recent advances in technology have made them even more accessible. The ability to link data on a PDA (client) to a central database (server) allows for near-unlimited potential in developing point of care applications and systems for patient data management. Although many stand-alone systems exist for PDAs, none are designed to work in an integrated client/server environment. This paper describes the design, software and hardware selection, and preliminary testing of a PDA based patient data and charting system for use in the University of Washington Neonatal Intensive Care Unit (NICU). This system will be the subject of a subsequent study to determine its impact on patient outcomes and clinician efficiency.

Hospital Information Systems↗
PubMed2002

[Design of MC-III low frequency pulsed strong magnetic fields generator].

In this paper, We designed and accomplished a low frequency pulsed strong magnetic fields generator, which provides a pulsed magnetic field with the intensity range from 0.1-2.5 T and the adjusted time interval of pulse. This device is easy to operate and performs reliably. It can work steady for a long time and has been successful used in the experiments of biological effects of electromagnetics.

Electromagnetic Phenomena↗
PubMed2002

OR automation systems.

An operating room (OR) automation system is a combination of hardware and software designed to address efficiency issues in the OR by controling multiple devices via a common interface. Systems range from the relatively basic--allowing control of a few devices within a single OR--to advanced designs that are capable of not only controlling a wide range of devices within the OR but also exchanging information with remote locations.

Automation↗
PubMed2000

[A new telemedicine system].

A new telemedicine system and its application are introduced in this paper. Many new technologies, such as multiteleconference, multibind of MODEM and ISP, are adopted, which greatly improve the performance of the system.

Computer Communication Networks↗
PubMed2001

[The design of detection circuit for DNA biosensor].

The paper describes the design of a quartz crystal sensor for the detection of DNA hybridization reaction. With the ssDNA as probe on the electrode surface, we can detect the frequency change and show it on the computer display. The design is capable of real time monitoring for frequency change of DNA hybridization reaction.

Biosensing Techniques↗
PubMed2003

Model appropriateness and population pharmacokinetic modeling.

The purpose of this study was to define model appropriateness, identifying the individual elements thereof, and to set out a framework within which model appropriateness could be determined for population pharmacokinetic (PPK) models. Model appropriateness was defined by stating the problem to be solved, with the intended use of the model being the pivotal event. The elements of model appropriateness were identified with the type of model (descriptive vs. predictive) determining which elements of model appropriateness need to be executed. An example is presented to show how model appropriateness is determined for the optimal application of PPK models. It was determined that PPK models are developed to solve problems. Model appropriateness depends on identifying the problem, as well as stating the intended use of the model, and requires evaluation of the model for goodness of fit, reliability, and stability if intended for descriptive purposes; for predictive models, validation would be an additional requirement. Descriptive models are used to explain variability in the pharmacokinetics (PK) of a drug, while predictive models are developed to extrapolate beyond the immediate study population. For those models used for predictive purposes, strong assumptions are made about the relationship to the underlying population from which the data were collected. As an example of determining model appropriateness, a PPK model for 5-fluorocytosine was developed, using NONMEM, version IV. The model was evaluated and validated by the process of percentile bootstrapping. From the PPK model, the range of expected serum concentrations based on two widely used dosing methods (Sanford and the University of California at San Diego [UCSD]) was simulated (Pharsight Trial Designer software). These results indicated that the UCSD method performed well and has the advantage of recommending convenient dosing intervals. In conclusion, considering and applying the principles of model appropriateness to PPK models will result in models that can be applied for their intended use with confidence. Model appropriateness was efficiently established and determined to address the problem of comparing competing dosing strategies.

Adult↗
PubMedDate not supplied

Validation of automated systems--system definition.

A Parenteral Drug Association (PDA) Committee on Software Validation was formed about three years ago to address some of the issues associated with validating automated systems, particularly where all, or part, of the automated system is supplied by outside vendors. A Technical Report that describes a process which emphasizes system definition, a comprehensive system specification, system qualification and ongoing evaluation will issue later this year. The concepts described in this document will be consistent with the PMA's System Development Life Cycle approach which is commonly used for computer system validation. The following article has been developed from the System Definition section of this PDA Technical Report.

Computer Systems↗
PubMed2003

A platform to develop and to improve effectiveness of online computable guidelines.

The quality criteria of guidelines are identified. Taking these criteria into account we have built a platform to improve computable guideline effectiveness and facilitate their production. Our implementation is based on the GLIF Model (GuideLine Interchange Format). We have designed software components to edit, test, index, perform and present guidelines in a user-friendly Web architecture. These components are based on XML specifications in order to preserve their shareability and their re-usability. Several guidelines have been developed using our approach. We discuss the advantages of such an implementation and future evolutions so as to improve guideline integration within the clinician's workflow.

Decision Support Systems, Clinical↗
PubMed2003

New Jersey experiment. Eight hospitals will participate in CMS 'gainsharing' project, in which doctors can earn bonuses of up to 25% on Medicare fees.

A CMS project will let doctors earn bonuses for helping hospitals cut inpatient costs, using software designed by Michael Kalison, left. But not everyone is excited about the plan, including U.S. Rep. Pete Stark, the California Democrat who championed the physician self-referral legislation the CMS is waiving for the program.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1992

Picture archiving and communication systems in the United States.

Picture archiving and communication systems (PACS) are expected to replace film in the years to come. PACS acquire, store, transmit, and display medical images. Although there are several clinical PACS in operation today, there are significant problems slowing their introduction. PACS are limited in spatial and contrast resolution and the workstation's displays present difficulties due to low light levels, slow image presentation, and poorly designed software. Standard interfaces are still lacking for most of the imaging equipment currently in use, making connections to these devices nearly impossible. Cost is a major issue as well. Yet limited implementations, often called mini-PACS, offer advantages such as faster image presentation to radiologists and referring physicians, reduced portable retake rates, the capability for viewing images at home off-hours, and transmission from remote sites. More development is needed for interfaces with the radiology information system and for sophisticated network and image management.

Radiology Information Systems↗
PubMedDate not supplied

[Assessment of function recovery in patients with total knee prosthesis].

The aim of this study was to analyse the evolution of motor performance in a group of patients who underwent surgical knee replacement. We also assessed patient satisfaction at 3 and 9 months after the operation. Sixty-two patients (40 women, 22 men, mean age 72.4 years) underwent isokinetic evaluation associated with surface EMG. All the patients had undergone a total prosthetic knee joint replacement for arthrosis, and had followed a standardised 30-day rehabilitation program at our centre for recovery of knee joint function, strengthening of the flexor-extensor muscles and restoration of ambulation as best as possible. Each of these patients underwent isokinetic evaluations 3 months and 9-10 months after their operation. The isokinetic test consisted of carrying out 5 flexion-extensions of the knee at an angular velocity of 60 degrees/second, followed by an endurance test of 30 repetitions of flexion-extension of the knee at 120 degrees/second. This isokinetic test provided data on extensor strength and flexor strength; furthermore, specifically designed software allowed simultaneous visualisation of the surface EMG tracing, torque and joint excursion. The first analysis showed a macroscopic decrease in the strength of the flexor-extensor muscles of the knee. This muscle weakness was clearly evident 3 months after the operation and was particularly pronounced for the extensor muscles of the operated limb compared with the muscles of contralateral, unoperated limb. Muscle weakness was still present 9 months after the operation although there had been a considerable improvement compared with 6 months previously; the imbalance in the flexor/extensor ratio, which differed from that in the contralateral, unoperated limb, was noted to be still present. The surface EMG demonstrated persistent myoelectrical activity in the flexors even when the extensor activity was predominant: this is an expression of imbalance between agonists-antagonists. A questionnaire administered to the patients about their satisfaction with the operation revealed that 9 months after the surgery 23 patients still complained of continuous joint pain with increased loads, 27 complained of frequent pain with load-bearing and only 12 no longer complained of any disturbance, manifesting full satisfaction with the operation. Total knee replacement is thus a valid treatment in those cases in which degenerative joint disease necessitates a radical solution. Nevertheless, dissatisfaction with the operation is common, and may be due to persistence of joint pain and incomplete joint recovery of joint function or muscle strength. In our series of patients, we found that although there was progressive recovery of strength of both the flexor and extensor muscles, a considerable imbalance remained between the operated and unoperated limbs; this finding was also confirmed by the surface EMG investigation.

Aged↗
PubMed2004

Embedding clinical indicators into nursing documentation.

The Methodist Healthcare System of San Antonio audits completeness and accuracy of nursing assessments. Between 1996 and 2001, regardless of software enhancements and education, completeness of risk assessments hovered at 80% or less. Accuracy of risk scores were in question due to paste functionality. In review, it became apparent that many risk assessment indicators were already an intrinsic part of nursing systems assessment. This project embedded weighted indicators invisibly within systems assessment. Risk scores then automatically calculate and display. This approach decreased documentation queries and increased accuracy of risk assessments. Results were validated using concurrent manual review. Skin assessment demonstrated a 96% accuracy rate with 100% completeness of documentation. Fall assessment resulted in a 2.5% miss rate and 100% completeness of record. 100% of high risk patients identified had appropriate care plan problems. Recommendations are to further explore embedded indicators in software design. The study demonstrated a) decrease in nursing documentation queries b) increase in completeness of record c) increase in accuracy of record and d) increase in accuracy of care plan.

Accidental Falls↗
PubMed1992

Computed tomography measurement of acetabular cup anteversion and retroversion in total hip arthroplasty.

In a clinical study conducted between March 1983 and July 1987, computed tomography of the hip was employed with specially designed software in 20 patients after 23 total hip arthroplasties (THAs). Three patients had bilateral THAs. Computed tomography was performed in the routine manner, except that the image was reconstructed utilizing software that eliminated the metallic artifacts. The angle of the acetabular cup is determined on a display console. The cursor is turned on, one pole of the cup is marked, and when the second moving cursor is positioned on the opposite pole, the angle is shown and measured on the console. This technique has been indispensable for accurate measurement of the angle of inclination of the acetabular cup and in treatment planning in patients with a dislocating total hip prosthesis.

Acetabulum↗
PubMedDate not supplied

Development of a computer software for easy storage and analysis of fibreoptic bronchoscopy data.

OBJECTIVE: To develop a simple software for management of fibreoptic bronchoscopy records. METHODS: After identification of the specific needs at our hospital, a software was developed. A graphical interface with structured data entry related to patient information and diagnosis, bronchoscopic findings and specimens obtained, and their reports were envisaged. After initial construction, the software was tested over a four-week period. The software was put to routine use after necessary corrections, and validated over the next few months through actual data entry. RESULTS: The software has various modules for input and modification of data, as well as for generation of reports, and can work both on stand-alone personal computers and on networks. With little practice, residents soon became adept at entering details correctly and quickly. The slightly increased time of data entry into the computer was more than made up by uniform and complete report generation. The database component was evaluated by analyzing 1000 consecutive records entered over a 14-month period, and no discrepancies were observed. CONCLUSION: A user-friendly software providing uniform and complete data entry regarding fibreoptic bronchoscopic procedures was developed.

Bronchoscopy↗
PubMedDate not supplied

Computerized image analysis of nails affected by fungal infection: evaluation using digital photographs and manually defined areas.

Despite the relevant increase in clinical trials on the efficacy of various systemic and/or topical antifungal agents in onychomycosis therapy, the evaluation of the results is largely subjective. The aim of this study was to set up and ensure an objective, reproducible and reliable method to measure nail plate involvement in onychomycosis. In order to validate a specifically designed software for the computerized image analysis of affected areas of the nail, standardized clinical pictures of onychomycosis were prepared by six different clinicians using a sample of 11 affected nails. Diseased areas and total nail plates were measured both on the clinical pictures and on their drawings traced by the different clinicians on transparent tapes adhering to sample nails. The computerized procedure was undertaken by a trained operator who was not a dermatologist. The variation coefficients of measurements on clinical pictures (automatically detected) and on drawings were compared. In addition, the agreement between automatic evaluation and drawing was evaluated by means of Bland-Altman analysis. To consider the effect of possible variations linked to different operators using the computerized method, 11 clinical pictures (one for each clinical case considered) were selected and submitted to computerized image analysis by six different trained operators. The computerized detection of affected nail areas showed a coefficient of variation (vc=8.5%) lower than that observed on drawings (vc=14.7%). The two methods showed appreciable agreement, as demonstrated by Bland-Altman plot. The coefficient of variation of image analysis conducted by six different operators was very low for the total area calculation (vc=0.9%) and acceptable for pathological area detection (vc=4.8%). Based on the results obtained, we conclude that automatic evaluation is a reliable and helpful method for the measurement of the clinical involvement of the nail plate in onychomycosis and for the evaluation of therapies, since it can increase the objectivity and reproducibility of data. However, in a minority of difficult cases, expert dermatological evaluation is needed.

Humans↗