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I have described the results of a telemetering radio capsule which we used in the clinical assessment of digestive disease. This method has many merits which we have never found with other methods. This is one example of the clinical use of medical electronics. Medical electronics provides surgeons with many useful aids to improve diagnosis and treatment of their patients. Medical electronic technics should be used more often.
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The transfer of medical records from a paper system to a computer-based system is inevitable. However, the widespread acceptance of electronic medical records has been delayed by problems such as high cost, inefficiency, data entry errors and poor physician acceptance. We have developed a database system that has overcome these difficulties and now serves as an electronic medical record. Our system has been in use for a year and a half, and currently contains information on over two thousand patients. The database provides an electronic radiation oncology chart containing patients' demographic information, technical treatment data and dictated reports. All dictated notes are captured, including consultation notes, treatment summaries, on-treatment visits, letters and follow up reports. The system provides data validation upon entry, required few additional software or hardware purchases, and allows for efficient retrieval of data. Unlike other database systems which require the hiring of data entry clerks to input the data, ours combines transcription and data entry. The database runs on a local area network of computers and uses a commercially available relational database package. It makes extensive use of mouse interface features such as pull-down menus, pop-up lists, buttons, multi-page forms, and scrolling fields, making the system easy to use with minimal training. Many custom features are built in, such as help screens, control functions, audit trails, and a system that keeps track of each patient's referring and other relevant physicians. For research purposes, the system has the capability to perform survival analyses on arbitrary user-defined subsets of patients. Data may also be exported transparently to statistical packages for other types of analyses.
A two-phase study was conducted to assess the effect of an electronic medication compliance aid on hypertension control and pharmaceutical compliance in ambulatory patients. In Phase I (12 weeks), 36 patients were randomly assigned to a medication vial equipped with a cap containing a digital timepiece that displays the last time the cap was removed. The control group included 34 patients randomly assigned to a standard medication vial. Subjects using the timepiece cap showed an average compliance rate of 95.1%, an average decrease in systolic pressure of 7.6 mm Hg (P = .006), and an average decrease in diastolic pressure of 8.8 mm Hg (P less than .001). Controls had an average compliance rate of 78% and decreases of 2.8 mm Hg and 0.2 mm Hg in systolic and diastolic pressures, respectively. Phase II (12 weeks) combined use of the timepiece cap with other compliance aids: a pocket-size card for recording blood pressure and a blood pressure cuff for self-monitoring. Patients using the timepiece cap and the card had an average compliance rate of 98.7% with mean decreases of 11 mm Hg in systolic pressure (P less than .01) and 7.64 Hg mm in diastolic pressure (P = .0001). The combined use of the cap, the card, and the blood pressure cuff resulted in an average 100.2% compliance rate with mean decreases of 15 mm Hg (P = .0006) and 6.60 mm Hg (P = .0006) in systolic and diastolic pressures, respectively. Results of the two-phase study showed statistically significant increases in medication compliance associated with statistically and clinically significant reductions in blood pressure for all patients using the timepiece cap.
INTRODUCTION: Rapid advances in whole-exome sequencing (WES) have enabled large-scale detection of pathogenic variants. Although hundreds of genes are implicated in hearing loss, up to half of inherited cases remain unsolved, limiting eligibility for gene therapy trials that require genetic diagnosis. Biobanks and electronic medical records (EMRs) offer opportunities to integrate genomic and clinical data at scale and expand the spectrum of hearing loss genes. Despite clinical value, EMRs often lack key information such as inheritance patterns, posing challenges for accurate interpretation. METHODS: WES was performed on DNA samples from 1038 hearing-impaired patients enrolled in the Maccabi Research and Innovation Center Tipa Biobank. Clinical data were extracted from EMRs. Audiograms were available for all cases, although data on age of onset, family history and mode of inheritance were mostly unavailable. We applied a scalable bioinformatics analysis strategy for high-throughput annotation, filtering and prioritisation of WES variants across more than 1000 patients, designed to accommodate incomplete and heterogeneous clinical records. RESULTS: Using this approach, 15% of cases were solved or potentially solved through known or novel variants in established deafness genes. Homozygous variants in novel candidate genes were identified in 3% of cases. Functional characterisation was performed for promising candidate genes to validate their role in the ear. CONCLUSION: These findings demonstrate that WES can determine disease aetiology in large, genetically heterogeneous populations, even in the context of incomplete clinical data. This approach supports large-scale genetic screening and provides a framework for identifying patients who may benefit from emerging gene-based therapies.
First, the paper deals with the fundamental importance of standardisation to manufacturers, users and experts; the special demands made by medical engineering on safety and function are outlined clearly and in detail. The application and significance of standards for the development, testing and approval of medical technical systems are illustrated by means of a unit for the extracorporeal disintegration of renal calculi (lithotripsy), and the principle, technology and use of such a unit are discussed. The paper concludes with the prospects for further development of medical engineering and possible consequences for standardisation work. At the same time, the increasing use of software is addressed in particular. Finally, the present work on standards and directives for Europe in 1992 is referred to once again. With reference to the forthcoming standardisation tasks, with hardly increasing resources, an appeal is made for their optimum use to achieve truly international standardisation.
In the daily routine of an SICU, particularly in cardiac surgery, the nurses are to an increasing extent confronted with problems of connecting and using medical instruments as well as with documentation of the data of these instruments. An increasing number of user errors is to be expected. Use of advanced computer technology can help avoid such errors. In this paper the system 'ALODIN' is presented which is developed in our institutions according to the IEEE standard 'Medical Information Bus' (MIB). ALODIN-I will be part of a CCCS (computerized critical care system) which is installed in the clinic for cardiovascular surgery at Medical School Hannover.