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At least 163 records · Page 9Linked to original sources

PubMedDate not supplied

Internet-based prescription of sildenafil: a 2104-patient series.

BACKGROUND: The Internet is becoming increasingly important as a way for patients to acquire medical information and as a means for patient-physician communication. Questions about appropriate use of this new technology have been brought to the fore by the many patients using the Internet to seek sildenafil prescriptions. OBJECTIVE: To present the first description of a physician designed and directed Internet-based prescribing system of sildenafil, together with data covering more than 2,100 patient encounters. METHODS: Retrospective analysis of a large case series from a medical practice that prescribes sildenafil based on medical and sexual histories obtained through a physician designed and directed World Wide Web (WWW) site, compared against patients from clinics at a Midwestern inner city medical center. We compared all 2,104 Internet patients seeking sildenafil prescriptions online between June 14, 1998, and March 1, 1999, with all 36 medical center patients obtaining sildenafil prescriptions during the same period. The outcome measures compared were: completeness of medical record; patient safety as noted by the follow up responses of all patients requesting refills, any comments received by the internet site (webmaster), and patient or physician comments noted in the clinic medical record; satisfaction as noted by the follow up responses of all patients requesting refills, any comments received by the internet site (webmaster), and patient or physician comments noted in the clinic medical record; examinations and laboratory tests. RESULTS: Fifty-six percent of Internet requests came from 46 states, and 44% from eight foreign countries. Of 2,104 requests, 2,100 were granted. Three hundred ten patients have requested medication refills: all reported erections sufficient for intercourse and 69% said their satisfaction exceeded all expectations; none were at all dissatisfied. Side effect rates were comparable to those in the literature. Comparison of the medical history obtained from Internet patients with that recorded in clinic patients' charts revealed that the former was far more complete. No clinic patient received any examination or laboratory test specific for erectile dysfunction or its causes. There were no reported deaths or serious complications in either group. CONCLUSIONS: Internet-based prescription of sildenafil provides the physician with a complete and very detailed medical and sexual history for 100% of patients without denying any information routinely obtained in a direct patient contact setting. Internet-based practice, which may be expected to require far fewer healthcare resources than traditional settings, rates very high in patient satisfaction among patients requesting a refill; no negative comments were received from all other patients. Overall, these data support the safety and effectiveness of Internet prescribing of selected medications.

Commerce↗

PubMedDate not supplied

Use of the Internet by women with breast cancer.

BACKGROUND: Recently, many cancer patients have been using the Internet for information with which to make informed choices. We are not aware of any studies that investigate this Internet use among breast cancer patients or women. OBJECTIVE: We investigate the prevalence and predictors of Internet use for medical information among women with breast cancer. METHODS: We used a cross-sectional design and approached 251 women with breast cancer being treated at a university-based hospital. We successfully interviewed 188 (74.9%), through mailed self-report questionnaires. Medical information was obtained from the hospital tumor registry. We used t tests and chi-square tests to assess differences in Internet use for breast health issues and binary logistic regression to estimate the odds ratio (OR) for predictors of Internet use for breast health issues. RESULTS: In our sample, 41.5% of patients used the Internet for medical information. Internet users differed from nonusers on income level, educational level, and by race/ethnicity. After controlling for the other predictors, Internet users had a higher income (OR = 3.10; 95% CI = 1.09-8.85) and tended to be more educated (OR = 2.59; 95% CI = 0.87-7.74) than nonusers. There was also a suggestion that those of nonwhite ethnicity were less likely to use the Internet (OR = 0.39; 95% CI = 0.14-1.11). Increasing age, length of time since diagnosis, and breast cancer stage had no effect. CONCLUSIONS: A substantial proportion of breast cancer patients used the Internet as a source of information. Patients with higher income or education, and patients of white race/ethnicity are more likely to use the Internet for breast health issues.

Attitude to Computers↗

PubMed2004

The role of the Internet in patient-practitioner relationships: findings from a qualitative research study.

BACKGROUND: Studies suggest that there has been an increase in the use of the Internet by patients in many Western societies. However, despite the many texts available on health and the Internet, not much is known about how much patients actually use the Internet to look up health information in their daily lives. We know little about what meaning this activity has for their experience of health and illness, and for their relationship with health-care practitioners. OBJECTIVE: To explore patients' and practitioners' use of the Internet and to consider whether use of the Internet is changing relationships between patients and health-care practitioners. METHOD: The study used qualitative interviews and observations of patient-practitioner interaction. Our purposive sample of 47 patients (32 women and 15 men) had all had contact with the health services for information/treatment in relation to hormone replacement therapy (HRT)/menopause and Viagra/erectile dysfunction. The setting for the research was in general practitioners' surgeries, specialist clinics and patients' homes in the United Kingdom. Participants reflected a wide range of socio-economic groups, but most were white and British born, which, given the ethnic make-up of the town in which we conducted the research, was not surprising. In addition to patients, we interviewed 10 health-care practitioners (4 consultant doctors, 3 GPs, 2 specialist nurses, and a psychologist) about their own health information seeking practices (HISPs) and those of their patients. RESULTS: Use of the Internet can increase patients' knowledge about their health conditions, although patients in our study were often too overwhelmed by the information available on the Internet to make an informed decision about their own care. Patients have a great deal of trust in their health-care practitioners. Health-care practitioners need to improve their own skills in Internet use. Hype around Internet use by patients appears to exceed the reality of Internet use. CONCLUSIONS: Our qualitative study suggests that use of the Internet is contributing to subtle changes in the relationship between health-care practitioners and their patients, rather than effecting the dramatic transformation some people envisage for it.

Adult↗

PubMed2004

[The relationships of Internet addiction, depression, and suicidal ideation in adolescents].

PURPOSE: This study was done to identify the state of internet addiction and to investigate the relationships among internet addiction, depression and suicidal ideation in adolescents. METHOD: Participants were 1,670 high school students in an urban city. The Internet Addiction Scale was used to measure internet addiction, the DISC-MDD-SQ was used to measure depression, and the Suicidal Ideation Questionnaire-JR was used to measure suicidal ideation. RESULT: 38.1% of participants were perceived to be in the early stages of internet addiction and 1.5% reported heavy addiction. Overall the internet addiction scale score was 37.57(+/-12.52). The differences of internet addiction in sample characteristics were found to be significant in rank in class. The differences in DISC-MDD-SQ and IAS scores among the states of internet addiction were statistically significant. The level of internet addiction correlated positively to the level of depression and suicidal ideation. CONCLUSION: Based upon these findings, there were significant positive correlations among Internet addiction, depression, and suicidal ideation in adolescents. As schools are often the first line for the identification of potential life-threatening behaviors, nurses, especially school-based health professionals, need to be cognizant of measures and procedures for the assessment of Internet addiction, depression, and suicidal ideation.

Adolescent↗

PubMedDate not supplied

Use of the Internet as a medical resource by rural physicians.

BACKGROUND: Internet has become an integral tool for modern physicians, and those not ready to embrace this new technology will be missing a valuable resource. This pilot study reviews rural physicians' usage patterns of the Internet as a medical resource and examines the barriers that might preclude rural providers from using this technology. METHODS: We undertook a questionnaire survey of rural providers in Wyoming, Montana, and Idaho. Information was elicited about the physicians' Internet access, frequency of Internet use, the different Internet categories used, and the barriers they encountered to using the Internet. A background MEDLINE search was performed using the MeSH headings "Internet," "medical informatics," "and rural health." RESULTS: Eighty-five percent of providers had Internet access, and 75% of respondents reported using the Internet either daily or one to four times a week. E-mail was the most frequently used category. The next most frequent categories were on-line literature search, professional organizations, special interest Web sites, clinical reference Web sites, on-line journals, and patient education. Lack of time and having no computer were the most important barriers cited. CONCLUSIONS: Although the findings of this survey suggest that, compared with broader physician populations, rural physicians are using the Internet with the same frequency, their scope of use might be much more limited. Barriers to using the Internet are difficult to determine, but lack of time, hardware, and a sense of need appear to be important factors.

Adult↗

PubMed2002

In search of evidence: family practitioners' use of the Internet for clinical information.

PURPOSE: The aim of the study was to determine the extent of use of the Internet for clinical information among family practitioners in New Zealand, their skills in accessing and evaluating this information, and the ways they dealt with patient use of information from the Internet. METHOD: A random sample of members of the Royal New Zealand College of General Practitioners was surveyed to determine their use of the Internet as an information source and their access to MEDLINE. They were asked how they evaluated and applied the retrieved information and what they knew about their patients' use of the Internet. Structured interviews with twelve participants focused in more depth on issues such as the physicians' skills in using MEDLINE and in evaluating retrieved material, their searches for evidence-based information, their understanding of critical appraisal, their patients' use of the Internet, and the ways they handle this use. RESULTS: More than 80% (294/363) of members in the sample completed and returned the questionnaire. Of these, 48.6% reported that they used the Internet to look for clinical information. Gender and age were more significant in determining use than practice type or location. Information was primarily sought on rare diseases, updates on common diseases, diagnosis, and information for patients. MEDLINE was the most frequently accessed source. Search skills were basic, and abstracts were commonly used if the full text of an item was not readily available. Most reported that up to 10% of patients bring information from the Internet to consultations. Both Internet users and non-Internet users encouraged patients to search the Web. Internet users were more likely to recommend specific sites. CONCLUSIONS: Practitioners urgently need training in searching and evaluating information on the Internet and in identifying and applying evidence-based information. Portals to provide access to high-quality, evidence-based clinical and patient information are needed along with access to the full text of relevant items.

Adult↗

PubMed2005

Household computer and Internet access: The digital divide in a pediatric clinic population.

Past studies have noted a digital divide, or inequality in computer and Internet access related to socio-economic class. This study sought to measure how many households in a pediatric primary care outpatient clinic had household access to computers and the Internet, and whether this access differed by socio-economic status or other demographic information. We conducted a phone survey of a population-based sample of parents with children ages 0 to 11 years old. Analyses assessed predictors of having home access to a computer, the Internet, and high-speed Internet service. Overall, 88.9% of all households owned a personal computer, and 81.4% of all households had Internet access. Among households with Internet access, 48.3% had high speed Internet at home. There were significant associations between home computer ownership or Internet access and parental income or education. There was no relationship these factors and high speed Internet access. Over 60% of families with annual household income of $10,000-$25,000, and nearly 70% of families with only a high-school education had Internet access at home. While income and education remain significant predictors of household computer and internet access, many patients and families at all economic levels have access, and might benefit from health promotion interventions using these modalities.

Computers↗

PubMed2003

Filling the gaps in physician communication. The role of the Internet among primary care patients.

BACKGROUND: Millions of people use the Internet as a source for health information yet little is understood about how the use of the Internet for health information is related to the doctor-patient relationship. OBJECTIVE: We conducted the present study to understand the association between one's interest in using the Internet for general and quality-oriented health information and attitudes about one's communications with health care provider(s). DESIGN: Cross-sectional survey. SETTING: Four community-based primary care practices in Rhode Island. MEASUREMENTS: A single self-administered survey included items to measure: interest in using the Internet to look for general and quality-oriented information and a patient's perceptions of the degree to which their doctors over the previous year have: (1) given them information and (2) engaged them in the decision-making process. RESULTS: A total of 300 patients completed the survey. Among patients without Internet access, interest in using the Internet for health related activities was less among patients who felt that their doctor gave less information: Odds ratio 0.83 (95% CI, 0.70-0.98) and greater among patients who felt that their doctor engaged them more in decision making: Odds ratio 1.3 (95% CI, 1.1-1.6). Among patients with Internet access, we found no relationship between interest in using the Internet for health related activities and measures of patient-physician communication or patient-physician decision making. CONCLUSIONS: Interest in using the Internet for health information is greater for those who (1) felt their doctors provided less information and (2) felt their doctors engaged them more in the decision-making process, but this is true only for those without access to the Internet.

Adolescent↗

PubMed2005

Internet use by a referral gastroenterology clinic population and their medical information preferences.

BACKGROUND: Internet use is growing rapidly in Iran. However, little is known about the rate of Internet access and Internet use habits of gastroenterology patients and their health information preferences in the country. METHODS: A two-part questionnaire was presented to a convenience sample of 401 consecutive outpatients (mean age: 43.7 years) of a referral gastroenterology clinic in Tehran from February 21 to March 13, 2004. RESULTS: Of all literate patients (92%), 62% self-estimated their disease-related knowledge as nothing to little. The most common sources of information were media (62%) and printed materials (58%). Printed material (57%) and media (35%) were the most preferred means of receiving health information; the Internet was the most preferred means among Internet users and almost all of them were interested in getting online medical services. The cause (65%) and treatment (56%) of disease were the most favorite knowledge topics. Of all patients 28% could use Internet. Males, more educated and younger subjects were more likely to use the Internet. Of the Internet users, 37% had already performed at least one search for medical information. CONCLUSION: Though Internet is not yet a popular means of patient education in Iran, considering the speedy growth of Internet use and its undeniable advantages and prospects in a young country like Iran, it seems wise for private and public health sectors to start more vigorous planning to develop web-based patient education systems run by trusted bodies and encourage and cultivate its use among patients.

Adult↗

PubMed2000

Use of the internet by infertile couples.

OBJECTIVE: To evaluate and compare the extent of Internet use by infertile couples attending a government-funded and a private assisted reproductive technology clinic. DESIGN: A prospective study. SETTING: One private and one public tertiary care fertility clinic in Toronto. PATIENT(S): 250 patients were approached, and 150 (60%) responded. INTERVENTION(S): A self-administered questionnaire on socioeconomic status, fertility history, and computer and Internet use. MAIN OUTCOME MEASURE(S): The extent of Internet use on fertility-related issues was determined, correlated with socioeconomic status and fertility history, and compared between the two clinics. RESULT(S): Higher levels of education, employment, and combined family income characterized patients at the private clinic. A similarly high proportion of patients at both clinics had previous experience with the Internet (mean, 75.3%). Overall, 42% of the total study population and 55.8% of current Internet users had used the Internet for fertility-related issues. Using a logistic regression model, none of the patients' socioeconomic or clinical variables predicted Internet use. Thirty percent of the patients found the Internet helpful in their decision making process. CONCLUSION(S): A considerable proportion of infertile couples from all socioeconomic levels is actively using the Internet with regard to their fertility problems. Health care providers should consider the Internet an important tool for all aspects of their interaction with infertile persons.

Adult↗

PubMed2001

Use of the Internet by patients and their families to obtain genetics-related information.

OBJECTIVE: To characterize use of the Internet by patients and their families referred to general genetics clinics. PATIENTS AND METHODS: We developed a survey to assess Internet use among patients visiting urban and rural clinics in Colorado and Wyoming. One hundred eighty-nine surveys were distributed to patients and their family members visiting outpatient general genetics clinics in spring 2000. The 8-page anonymous survey instrument asked about use of the Internet to obtain genetics-related information (GRI). All participants were asked whether a physician or health professional had referred them to the Internet for GRI. Subjects who had previously used the Internet to search for GRI were asked to rate whether they considered the GRI they encountered to be accurate, inaccurate, easy to understand, confusing, or trustworthy. RESULTS: One hundred fifty-seven surveys (83%) were returned (52% urban; 48% rural). Ninety (60%) of 149 respondents were at the clinic for a new-patient visit, and 59 (40%) were follow-up visits. All respondents were older than 17 years; 141 (91%) of 155 respondents were the patient's parent or guardian. Seventy-three (47%) of 155 respondents had searched the Internet for GRI prior to their clinic visit. The patients and families themselves initiated the majority of such efforts; only 8 (5%) of 148 respondents had been referred to a site on the World Wide Web by a physician. Interestingly, 136 (92%) of 147 respondents indicated that they would be likely to visit a Web site that was recommended by a geneticist. The most compelling reasons for searching the Internet for GRI were to get information in layperson's terms (60/131 [46%]); to get information about treatment (16/131 [12%]); and to get information about genetic research (16/131 [12%]). Among respondents who reported visiting GRI Web sites, 24 (41%) of 58 agreed that information was confusing or difficult to understand, 35 (53%) of 66 agreed that information was accurate and trustworthy, and 44 (77%) of 57 agreed that using the Internet was a positive experience. CONCLUSION: Internet use among patients referred to general genetics clinics and their family members appears to be widespread. Respondents reported that they found some of the information confusing and questioned its accuracy. Referral to Web sites by physicians was reported rarely, although the majority of respondents said they would visit a Web site recommended by a genetics physician. Further studies are needed to establish the accuracy of Internet information and how best to integrate and/or accommodate the data into the genetics clinic.

Adult↗

PubMed2003

Internet use by patients with prostate cancer undergoing radiotherapy.

OBJECTIVES: To analyze the amount of Internet use, type of Internet use, and factors that predict Internet use by patients with prostate cancer. METHODS: A questionnaire evaluating the use of the Internet was given to 295 patients undergoing radiotherapy for prostate cancer in three different settings: an academic center (AC), a Veterans Affairs center (VA), and a community hospital. The study included 171 AC patients (58%), 104 VA patients (35%), and 20 community hospital patients (7%). RESULTS: The response rate to the questionnaire was greater than 99%. Overall, 128 (43%) of 295 patients had a home computer. This differed among the institutions, with 64% of AC patients and only 5% of VA patients having a home computer (P <0.0001). Overall, 94 (32%) of 295 patients used the Internet to access cancer information, with 48% of AC patients and 8% of VA patients using the Internet (P <0.0001). Seventeen percent of black patients (n = 113) had a home computer compared with 62% of white patients (n = 175; P <0.0001). Equal access to computers did not influence Internet use because, among those patients who had access to computers, black patients used the Internet less than did white patients (32% versus 61%, P <0.0001). Men 65 years of age or younger were more likely to use the Internet (45%) than those older than 65 years (28%; P = 0.004). Patients used many sites to access different types of information. CONCLUSIONS: A significant number of patients with prostate cancer access the Internet to obtain cancer information. Urologists and radiation oncologists should be familiar with this important resource to help patients access appropriate material.

Academic Medical Centers↗

PubMedDate not supplied

Psychiatric features of individuals with problematic internet use.

BACKGROUND: Problematic internet use has been described in the psychological literature as 'internet addiction' and 'pathological internet use'. However, there are no studies using face-to-face standardized psychiatric evaluations to identify behavioral characteristics, psychiatric comorbidity or family psychiatric history of individuals with this behavior. METHODS: Twenty individuals with problematic internet use were evaluated. Problematic internet use was defined as (1) uncontrollable, (2) markedly distressing, time-consuming or resulting in social, occupational or financial difficulties and (3) not solely present during hypomanic or manic symptoms. Evaluations included a semistructured interview about subjects' internet use, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (SCID-IV), family psychiatric history and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) modified for internet use. RESULTS: All (100%) subjects' problematic internet use met DSM-IV criteria for an impulse control disorder (ICD) not otherwise specified (NOS). All 20 subjects had at least one lifetime DSM-IV Axis I diagnosis in addition to their problematic internet use (mean+/-SD=5.1+/-3.5 diagnoses); 14 (70.0%) had a lifetime diagnosis of bipolar disorder (with 12 having bipolar I disorder). LIMITATIONS: Methodological limitations of this study included its small sample size, evaluation of psychiatric diagnoses by unblinded investigators, and lack of a control group. CONCLUSIONS: Problematic internet use may be associated with subjective distress, functional impairment and Axis I psychiatric disorders.

Adult↗

PubMed2000

Differences between Internet samples and conventional samples of men who have sex with men: implications for research and HIV interventions.

The Internet is becoming a new erotic oasis for obtaining sex online or in person. We reviewed the literature on cybersex and compared differences in data from samples of homosexually active men obtained on identical questionnaires from a conventional written questionnaire, distributed through the mailing and contact lists of a large national gay organization in Sweden, and through the same organization's website and chat room. A total of 716 written questionnaires and 678 Internet questionnaires were obtained. The Internet sample was younger, more likely to live in small towns or cities, live with parents or a girlfriend, and have lower formal education. They are less likely to have previous sexual experience solely with other men (one in three of the Internet sample vs. 1 in 14 of the written sample defined themselves as bisexual) and more likely to visit erotic oases such as bathhouses, video clubs and erotic movie houses. They also visited Internet chat rooms more frequently (86% of the Internet sample vs. 50% of the written sample). One third of the Internet sample wanted the opportunity to talk with an expert about HIV compared with a quarter of the written sample. Sexual practices between the two samples were generally similar, although the Internet sample reported significantly less body contact, kissing, hugging, mutual masturbation, and more condom use for anal intercourse with steady partners. Over four times as many of the Internet samples reported sex with women in the past year as the written sample. These data indicate that Internet data collection is feasible and that this mode of data collection, despite the nonrandom and self-selected nature of both types of samples, is likely to be more significantly oriented toward the young, geographically more isolated, and more behaviorally and self-identified bisexual respondent than conventionally distributed written questionnaires.

Adult↗

PubMed1999

Internet use in radiology: results of a nationwide survey.

PURPOSE: To determine the number of radiologists who currently have Internet access, their use patterns on the Internet for Radiology purposes, the web sites they would recommend, and the potential site access to the Internet that they would like to see in the future. In addition, this study analyzed the best way to find nationwide radiological sites and their content. MATERIALS AND METHODS: In a nationwide survey, 854 Austrian radiologist were asked to fill out and return a questionnaire about Internet access, current problems, current and future use, which web site they recommend, and about the use of e-mail. Next, the available nationwide radiological sites were searched with seven major search engines using 37 different keywords, as well as by category search, and by searching for links on the homepages of the radiological departments of all Universities of Austria. Then, the offered information of the founded pages was classified in categories. RESULTS: Of the 210 (24.6%) radiologists who returned the questionnaire, 154 (73%) had Internet access. Time expenditure was considered the main problem using the Internet. The Internet was used for literature research by 69% of the radiologists with Internet access, for e-mail by 60%, and for congress information by 57%. In future, 43% would like to read electronic journals more often and 39% would like to use the web more intensively for scientific congresses. At the present time, we found 17 radiological web sites in Austria. The most promising way to find these sites was to use the search engines Alta Vista and Hotbot. Fifteen (88%) sites offered information for patients, seven (41%) for radiologists, five (29%) for students, and four (24%) for researchers. SUMMARY: Many radiologists in Austria already have Internet access, although time expenditure was considered the main problem with Internet use. Survey responses showed a need for electronic journals. To our point of view, Universities and radiological societies are urged to publish journals electronically on the Web. Alta Vista and Hotbot were the best search engines for radiological sites in our setting, and a careful reading of the specific search engine's instructions is recommended. In our experience, Web pages with clear structure, small file size, precise HTML keyword editing, and page titles, facilitate more accurate discovery of specific sites. In addition, there seems to be a need for regular publication of reviewed radiological link collections and the establishment of standards for teleconsulting.

Austria↗

PubMed2002

A comparison of Internet usage between two residency programs in the United Kingdom and the United States.

STUDY OBJECTIVE: To survey the pattern of use and availability of the Internet among anesthesia residents. DESIGN: Survey questionnaire. SETTING: University hospital. MEASUREMENTS: A postal questionnaire of Internet attitudes and usage was sent to trainees in Anesthesiology in two training programs: the University of New Mexico, Albuquerque, NM (UNM) and the North West Regional Health Authority, Manchester, UK (NWR). A repeat questionnaire was sent to nonresponders after 4 weeks. Telephone interviews were conducted with hospital administration to determine availability and cost of the Internet. MAIN RESULTS: Response rates were 67% (82/122) from the NWR and 83% (25/31) from UNM. Compared with NWR, residents at UNM used the Internet longer for general (median 3 vs. 2 yrs; p < 0.001) and medical (median 2 vs. 1.2 yrs; p < 0.001) purposes. All (31/31) UNM trainees and 73% (89/122) of NWR trainees had Internet access. More NWR trainees who had Internet access at work (60/61; 98%) used it for medically related purposes than those without work access (17/21, 81%; p < 0.001). More UNM trainees (19/25; 76%) accessed web sites other than those of official national organizations than did NWR trainees (40/82, 49%; p = 0.046). Approximately 75% of all trainees access web sites of the Association of Anesthetists and Royal College of Anesthetists (in the NWR) the American Society of Anesthesiologists (ASA) and American Board of Anesthesiology (in UNM) and online journals. The most popular sites were GASNET (Global Anesthesiology Server Network; NWR) and ASA (American Society of Anesthesiologists; UNM). Both UNM and NWR trainees perceived the Internet as supplying useful and accurate information. CONCLUSIONS: If the reported survey results are representative of Internet use among anesthesia residents in the United States and UK, Internet access at work is associated with greater Internet use for medical purposes, perhaps in part because residents perceive it to be a convenient and accurate resource.

Adult↗

PubMed2003

Can the Internet be used as a medium to evaluate knee angle?

Telemedicine promises to revolutionize medical care delivery in rural and remote areas. The ability to accurately evaluate physical impairment via the Internet is important to the possible future provision of Internet-based physiotherapy. This study evaluated the reliability and validity of assessing knee range of motion via the Internet. Two therapists evaluated knee angle on a single subject via two methods of assessment: the Internet and the traditional method (face-to-face). Nine random positions of the knee were chosen with the principal examiner performing 20 face-to-face and two sets of 20 Internet measures in each position (n=540). The secondary therapist performed Internet assessments only. The Internet connection was established at a readily available speed of 17 kbit/s. The Internet-based goniometer was found to be a valid tool for measuring both knee flexion and extension angles. It was shown to possess both high intra and inter-rater reliability. Difference average plots of the scores verified the consistency of measurement between both modes of assessment. The successful evaluation of the physical outcome measure of knee range of motion via the Internet assists the further development of Internet-based physiotherapy applications.

Analysis of Variance↗

PubMed2004

Patients and the Internet: a demographic study of a cohort of orthopaedic out-patients.

The Internet is a rich source of medical information but relatively few studies have evaluated its use by patients who seek medical information. The purpose of this study is to assess the demographics of Internet access and attitudes towards the Internet in a cohort of orthopaedic out-patients. Four hundred and three patients attending the orthopaedic outpatient fracture clinic completed a questionnaire consisting of six divisions including personal information, facility to access the Internet and their attitudes towards the information retrieved. Fifty per cent of the patients accessed the Internet, either from home or office and the maximum usage being in the younger age group. Twenty-nine per cent of the patients were aware of the medical information available through the Internet. 19% patients would like to have a consultation through the Internet, the maximum being in the middle-aged group. 70% of those patients who accessed the medical information reported that the Internet information was different than that obtained at consultation with the doctor at the out-patient clinic. This study reveals that the Internet use by patients is still limited. If an increased percentage of medical conditions is to be addressed through the Internet, involving patient information, on-line consultations, prescriptions and referrals, then a substantial amount of patient education and training is required

Access to Information↗