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At least 1,315 records · Page 73Linked to original sources

Education review: a computer-assisted instructional tool to assist students in developing an epidemiological research proposal.

The development of an epidemiological research proposal can be a difficult assignment for junior health information management students. The article demonstrates how a computer-assisted instructional (CAI) tool was developed to assist students in the development of an epidemiological research proposal. Surveys were conducted to determine where students were having the most problems, information about writing a research proposal was gathered and organized into an appropriate format, appropriate software (Hypercard) was chosen, the final CAI tool (the Research and Grant Writer) was developed, and positive feedback was obtained from junior health information management students using the CAI tool.

Attitude↗

Towards a novel augmented-reality tool to visualize dynamic 3-D anatomy.

Using augmented reality (AR) to teach dynamic 3-D anatomy may impart better understanding of bone dynamics during body movement. We are currently developing an AR tool that will allow superimposition and registration of bone structures on real anatomical counterparts of a human subject. This article describes the application, the problems to be solved, and reports on preliminary developmental studies of a first prototype of the tool. Specifically, studies test approaches to simulating real-time dynamic anatomy, and the feasibility in achieving registration of 3-D anatomical bones on their real counterparts. Such a tool will offer several unique advantages over traditional teaching methods and overcome many of their current limitations.

Anatomy↗

Virtual reality as assessment tool in psychology.

Virtual environments (VEs), offering a new human-computer interaction paradigm, have attracted much attention, in clinical psychology, especially in the treatment of phobias. However, a possible new application of VR in psychology is as assessment tool: VEs can be considered as an highly sophisticated form of adaptive testing. This chapter describes the context of current psychological assessment and underlines possible advantages of a VR based assessment tool. The chapter also details the characteristics of BIVRS, Body Image Virtual Reality Scale, an assessment tool designed to assess cognitive and affective components of body image. It consists of a non-immersive 3D graphical interface through which the patient is able to choose between 9 figures of different size which vary in size from underweight to overweight. The software was developed in two architectures, the first (A) running on a single user desktop computer equipped with a standard virtual reality development software and the second (B) splitted into a server (B1) accessible via Internet and actually running the same virtual ambient as in (A) and a VRML client (B2) so that anyone can access the application.

Computer Graphics↗

Tools from the implementation workbench: a project manager's survival kit.

Change rarely comes easy. There are frequently obstacles of various shapes and sizes throughout the implementation process, and in order to ensure success a project manager must have the right tools and know how to use them. Just as craftspeople master the tools of their trade, so too must project managers--not only if they are to succeed but also if they are to survive. This article focuses on the "how to"--the skill set needed to be a successful project manager. It describes the project management process and reviews some basic but invaluable tools.

Humans↗

Quality management tool for mass casualty emergency responses and disasters.

INTRODUCTION AND BACKGROUND: Quality management (QM) principles generally have not been applied to multi-casualty and disaster situations. Quality management incorporates quality assurance (QA) and quality improvement (QI) supported by a management information system (MIS). Since responders to disasters and multi-casualty incidents generally operate on standing orders and/or protocols, the character of the responses lends itself to quality management methods. Standards and indicators of performance readily can be developed for these situations. OBJECTIVES: 1) to format disaster medical records as data collection instruments; 2) to develop appropriate tools that are easy to use for rapid assessments; 3) to develop a mechanism for determination of causes of injuries; and 4) to develop methods to: a) track patients; b) document response and recovery; and c) document the circumstances associated with the event. METHODS: Model tools using checklists and short, fill-in answers are provided. These tools are designed to be incorporated into the trauma or EMS registries. Emergency medical technicians, nurses, physicians, and medical students scored the same disaster scenario for the functional areas of calling the state of the disaster, triage, and field stabilization. RESULTS: Testing indicated that the checklists are completed in less than one minute, and produce objective data per patient in each functional area evaluated. In one instance, data were compiled for 38 patients from one bus accident in less than 10 minutes. The same data were reproduced, without variation, in the same amount of time, by three different providers of varied professional backgrounds.

Data Collection↗

Benchmarking: one of your CEO's favorite tools.

Benchmarking ranked third in an annual survey by Bain & Co., a Boston-based consulting firm, of the top management tools used around the world. Benchmarking is the only tool in the survey that has consistently risen in popularity over the last five years. Bain & Co. says there is a correlation between financial success and the ways tools such as benchmarking are used.

Benchmarking↗

Using three-dimensional-computerized tomography as a diagnostic tool for temporo-mandibular joint ankylosis: a case report.

Roentgenographic examination has long been a useful diagnostic tool for temporo-mandibular joint (TMJ) disease. The methods include TMJ tomography, panoramic radiography and computerized tomography (CT) scan with or without injection of contrast media. Recently, three-dimensional CT (3D-CT), reconstructed from the two-dimensional image of a CT scan to simulate the soft tissue or bony structure of the real target, was proposed. In this report, a case of TMJ ankylosis due to traumatic injury is presented. 3D-CT was employed as one of the presurgical roentgenographic diagnostic tools. The conventional radiographic examination including panoramic radiography and tomography showed lesions in both sides of the mandible. CT scanning further suggested that the right-sided lesion was more severe than that on the left. With 3D-CT image reconstruction the size and extent of the lesions were clearly observable. The decision was made to proceed with an initial surgical approach on the right side. With condylectomy and condylar replacement using an autogenous costochondral graft on the right side, the range of mouth opening improved significantly. In this case report, 3D-CT demonstrates its advantages as a tool for the correct and precise diagnosis of TMJ ankylosis.

Ankylosis↗

Galen-In-Use: using artificial intelligence terminology tools to improve the linguistic coherence of a national coding system for surgical procedures.

GALEN has developed a language independent common reference model based on a medically oriented ontology and practical tools and techniques for managing healthcare terminology including natural language processing. GALEN-IN-USE is the current phase which applied the modelling and the tools to the development or the updating of coding systems for surgical procedures in different national coding centers co-operating within the European Federation of Coding Centre (EFCC) to create a language independent knowledge repository for multicultural Europe. We used an integrated set of artificial intelligence terminology tools named CLAssification Manager workbench to process French professional medical language rubrics into intermediate dissections and to the Grail reference ontology model representation. From this language independent concept model representation we generate controlled French natural language. The French national coding centre is then able to retrieve the initial professional rubrics with different categories of concepts, to compare the professional language proposed by expert clinicians to the French generated controlled vocabulary and to finalize the linguistic labels of the coding system in relation with the meanings of the conceptual system structure.

Artificial Intelligence↗

Investigating a concept-based tool to enhance the process of curriculum development: an example for healthcare education.

This paper reports on a first exploration carried out in the CoMET (COncept Modelling Environment for Teachers) project to investigate the educational potential of a concept-based toolkit developed in the GALEN project. In particular, on whether such tools can offer a basis to support and enhance healthcare curriculum development. We first adapted part of the toolkit by developing a front-end user friendly interface to access the conceptual knowledge. We then collected data from an empirical study. Preliminary results suggest that the concept-based approach of the CoMET tools is viable and has several potential benefits for educational activities. Directions for further work in the use of the concept-based tool for teaching as well as learning are also discussed.

Artificial Intelligence↗

Post-stroke assessment tool helps providers accurately predict wide range of patient outcomes.

Post-stroke assessment tool predicts patient's recovery and clinical needs. Not all strokes--or stroke patients--are the same. An assessment tool developed at the University of Pennsylvania creates benchmarks for patients undergoing stroke rehabilitation. Read how providers use the tool when patients are admitted to attach a score to each patient based on impairment categories and disabilities, and find out how that score correlates with average length of stay, resource utilization, and clinical outcomes.

Benchmarking↗

[Program for medicalization of the information systems in France: tool for management and quality assessment?].

OBJECTIVE: We analyzed data reported in the scientific literature to assess how the program for medicalizing information systems employed in France for budget management and allocation could be used to evaluate health care quality. A MANAGEMENT TOOL: In France the PMSI (Programme de Médicalisation des Systèmes d'Information) is used outside health care facilities to plan an allocate health care budgets. Within each facility, it can be used to coordinate external and internal resource allocations. The goal is to medicalize management decisions. Certain methods are based on calculations of total costs per hospital stay and others on the construction of budgets for individual units. A QUALITY ASSESSMENT TOOL: Medical criteria of final outcome of health care, for example mortality, are widely used for inter-hospital comparisons. The PMSI can be a useful tool for monitoring inter-hospital comparisons if three prerequisites are met: comparable data, identification of convenient tracers of care episodes or clinical situations, and multifactorial adjustment to account for variations in rates. The most widely used adjustment factors concern patient characteristics: age, sex, case severity, comorbidity, socio-economic level and hospital characteristics: size and status, number of stays and interventions, emergency and intensive care activity, referral practices.

Delivery of Health Care↗

A web-based research tool for functional genomics of the microcirculation: the leukocyte adhesion cascade.

OBJECTIVE: Currently, microvascular data are almost exclusively deposited in scholarly journals. With the increasing availability of molecular data and the construction of genomic databases, a need arises to organize physiological data in a more accessible format. The microcirculation is a functional system that spans all organ systems and shares certain characteristics of organization with metabolic pathways, which have successfully been organized around genomic information for several prokaryotes. Here, we present a web-based research and teaching tool (http:@hsc.Virginia.EDU/medicine/basic-sci/biomed/l ey/) that covers a small aspect of microcirculatory physiology, the leukocyte adhesion cascade. METHODS: Currently, the site is organized in a flat-text mode with hypertext links to GenBank, Medline, and online journals where available. RESULTS: The web-based research and education tool is useful for graduate student education, and as a research resource for genetic researchers interested in gene function and for physiologists and biomedical engineers interested in the molecular basis of the leukocyte adhesion cascade. Our effort is intended to be a beginning toward a distributed database for the microcirculation (microcirculation physiome. see http://www.bme.jhu.edu/news/microphys). CONCLUSIONS: We invite all microvascular researchers to provide annotations and comments to make the research and teaching tool more useful to the scientific community.

Algorithms↗

Structure and content of 400 CT reports in four teaching hospitals using a new, Windows-based software tool.

PURPOSE: To test a new software tool developed for analysis of radiology reports and to compare CT reports from four different teaching hospitals. MATERIAL AND METHODS: Four hundred CT reports were randomly collected from four Finnish university hospitals. A Windows 3.1-based software tool was developed to make a comparative analysis of the information content of CT reports. The structure of the reports was partly analyzed manually. RESULTS: The new software tool greatly facilitated semiquantitative analysis of the information content of residents' and radiologists' reports. There were some local differences in the length and structure of the reports, the choice of vocabulary and the number of differential diagnoses given, and large differences in the use of an "impression" section. Thorough description of focal lesions was included in less than 50% of the reports from each of the four institutions. CONCLUSION: The variation in well-structured CT reports indicates considerable geographic differences in radiology reporting, which may reflect the long-term influences of a few teachers. Rational application of the communication standards should improve the quality of written radiology reports. Such standards should be emphasized, particularly in teaching hospitals.

Hospitals, Teaching↗

A management tool for controlling the rate of non-acceptable inpatient hospital claims.

This paper demonstrates a tool for substantially improved monitoring of the validity of health insurance claims. Using a Bayesian regression model, we predict the probability of a non-acceptable claim (NAC) for each claim record and the expected number of NACs for any set of claims. When applied to a large set of hospital discharge claims, the tool shows a substantial improvement in the ability to estimate the actual number of NACs in the set. The tool permits ongoing monitoring of claims, more precise control, and a substantial reduction in audit cost in claims administration. It is conceptually applicable to other ongoing quality control systems, where inexpensively obtained information can be used to predict events that are costly to measure directly.

Bayes Theorem↗

Galen: a third generation terminology tool to support a multipurpose national coding system for surgical procedures.

GALEN has developed a new generation of terminology tools based on a language independent concept reference model using a compositional formalism allowing computer processing and multiple reuses. During the 4th framework program project Galen-In-Use we applied the modelling and the tools to the development of a new multipurpose coding system for surgical procedures (CCAM) in France. On one hand we contributed to a language independent knowledge repository for multicultural Europe. On the other hand we support the traditional process for creating a new coding system in medicine which is very much labour consuming by artificial intelligence tools using a medically oriented recursive ontology and natural language processing. We used an integrated software named CLAW to process French professional medical language rubrics produced by the national colleges of surgeons into intermediate dissections and to the Grail reference ontology model representation. From this language independent concept model representation on one hand we generate controlled French natural language to support the finalization of the linguistic labels in relation with the meanings of the conceptual system structure. On the other hand the classification manager of third generation proves to be very powerful to retrieve the initial professional rubrics with different categories of concepts within a semantic network.

Abstracting and Indexing↗

Development and validation of an improving prescribing in the elderly tool.

OBJECTIVE: To apply recently published consensus panel guidelines to a series of hospital inpatient charts to develop and validate a brief screening tool for potentially inappropriate prescriptions in the elderly. SETTING: A 400-bed acute care hospital in London, Ontario. METHODS: Three hundred and sixty-one consecutive inpatient charts, 185 from a clinical teaching unit (CTU) and 176 from a geriatric assessment unit (GAU) were examined for potentially inappropriate prescriptions as listed by McLeod et al. The potentially inappropriate prescribing practices detected were used to develop the Improving Prescribing in the Elderly Tool (IPET). Construct validity was examined by looking for a predicted difference in the rate of potentially inappropriate prescriptions between the CTU and the GAU. Interrater reliability was determined by applying the IPET to a new series of 100 charts. RESULTS: Forty-two of 361 individuals (12.5%) had 45 potentially inappropriate prescriptions representing 14 different potential drug/disease interactions; these were used to construct the IPET. A demonstrated difference in the rate of potentially inappropriate prescriptions between the CTU and GAU indicated construct validity. The interrater reliability of the IPET (kappa) when applied to a new series of 100 charts was 1.0. INTERPRETATION: The IPET is a brief, reliable and valid tool based on the published literature that may be used to screen for potentially inappropriate prescriptions in the elderly.

Aged↗

Health-risk-assessment tools used to predict costs in defined populations.

With the Balanced Budget Act of 1997 mandating that the Health Care Financing Administration (HCFA) implement risk-adjusted payment mechanisms for Medicare managed care plans (Medicare + Choice) by January 2000, risk-adjustment tools will play an important role in future capitated reimbursement. This is because there is growing evidence that healthier-than-average beneficiaries select Medicare + Choice. The risk adjustment that HCFA has adopted is initially based on primary inpatient diagnosis from hospitalizations in the previous year. Other payers are likely to adopt similar payment mechanisms. This article reviews nineteen risk-adjustment research papers, including the tool adopted for Medicare + Choice, some of which are likely to form the basis for subsequent HCFA risk-adjustment methods. In general, claims-based models are more powerful in predicting total costs than survey-based or demographics-based models. Survey-based models, although expensive and not as powerful claims-based models, can be used when claims data are unavailable. One of the most popular survey-based tools, SF-36, is likely to become increasingly important because HCFA will be using it to measure quality outcomes from Medicare + Choice plans and will make the results public. All of the models reviewed have limitations, but can be expected to be building blocks for future risk-based capitated reimbursement.

Aged↗