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At least 19 recordsLinked to original sources
PubMed1989

Evaluation of the use of standardized recommendation forms in admissions in radiologic technology, medical technology, and dietetics.

The continuing decline in the number of applicants to allied health educational programs combined with the need to ensure that graduates are competent has made essential the development of reliable predictors that more fully assess the potential of all individuals in the restricted applicant pool. The letter of recommendation is the most commonly requested information that relates to personal qualities in college applicants, but little research has been conducted on the value of this predictor. The purpose of this study was to retroactively review how attribute ratings in letters of recommendation submitted on standardized forms (N = 500) related to the source of the reference and the admission status of students applying to allied health educational programs. Results indicated that some attribute ratings distinguish between students and some do not, that standardized forms can be refined by elimination of items that failed to distinguish students, that ratings vary significantly by type of rater, and that the relationship between rating scores and admission status supports the efficacy of the standardized recommendation forms.

Allied Health Personnel↗
PubMed1983

Policy implications of the diffusion and control of medical technology.

Medical technology has become a controversial national policy issue, largely because of rapidly rising national health expenditures and their relation to medical technology. These costs are increasingly viewed in relation to benefits or effectiveness. Attempts to control medical technology, to consider benefits in relation to costs, have largely been regulatory, and have failed to ameliorate cost rises. This failure has stimulated consideration of the reimbursement system as a controlling device. The Medicare program already has developed a rather formal process for making reimbursement decisions based on technology assessments. However, fundamental reform of the reimbursement system seems necessary to counter perverse incentives built into payment. Recent proposals to shift to prospective payment is an example of such a change. However, the basically private nature of the health care system and the limited leverage of the Medicare program limits the power of the federal government to make change.

Communication↗
PubMed2002

The ethics of applying new medical technologies.

Medical technology itself, including minimally invasive surgery, has no morals; our morality revolves around when and how we use technology. This often involves the individual clinician's assessment of their own abilities and an awareness of two aspects of the technology: its proven efficacy and its safety. Is technology outpacing knowledge? Or do physicians adopt new technologies in a responsible way with good motives? No one knows for sure. Technological progress in medicine has been a mixed blessing. The only ethical element involved in the use of new technologies over which individual medical practitioners have control, is that of user proficiency with the device, procedure, or drug, and the related information they provide to their patients when obtaining their consent for its use. New technologies fall into two broad categories: evolutionary, the most common, and revolutionary, which occur sporadically and may completely change the face of medical care. The learning curve for all new technologies can be steep. So, when should physicians be permitted to use these new technologies without supervision? Who is responsible for setting and monitoring standards for new technologies? With the moving target of medical technological innovation, individual practitioners are primarily responsible for the ethical use of new (to them) technologies. It is physicians' ethics that govern their use of new technologies, being certain that they have the requisite training and experience to use the modality, and that the intervention is safe for their patients. Institutional practitioner credentialing at the local level, despite its faults, will often be the primary control over a technology's use. What will ultimately govern the use of new technologies is the ethics (if they exist) of healthcare institutions and individual practitioners, as well as patient need. This is simply another reason why ethics education is vital for physicians-and other health practitioners and healthcare administrators.

Attitude of Health Personnel↗
PubMed2003

Living and dying with medical technology.

Medical technology is a two-edged sword, capable of saving and improving life but also of ending and harming life. Finding the right stance toward technology requires great balance and sensitivity. It has seductive powers because of its expected benefits, the social and professional pressures to use it, and a frequent confusion that results from confusing the sanctity and value of human life with a supposed imperative always to use technology. The aim of good critical care medicine should be to establish a meaningful tension, particularly in the care of those patients threatened with death, between the aim of preserving life, on the one hand, and making possible a peaceful death, on the other. Any automatic bias in favor of using technology will threaten that latter possibility.

Critical Care↗
PubMed1993

[Economic and structural aspects of modern medical technology].

Medical techniques are one of the few innovative factors that can improve the efficiency and economics of the health services. However, as illustrated for the example of Germany, the outlay and subsequent costs for expensive technical appliances in medicine account for only 1% of the total expenditure for health. But they provide the potential for improved quality and lower costs for the health service and the economy in general. The availability of modern medical technology is indispensable for research, health care, education, and training in medicine. Further innovative aspects arise. The digital images obtained by various methods (Fig. 13) can be collected by image archiving and communication systems (20), mutually related, and indexed for morphological and functional information, thus opening improved strategies for therapy. Major challenges are awaiting all of us.

Germany↗
PubMed1990

Priority setting in medical technology and medical practice assessment.

This study seeks to assist in setting priorities for assessing medical practices and technologies when assessment resources are scarce. It develops an objective index of expected gain from technology assessment, using modified DRG-level data on hospitalizations in NY State. The index uses standard economic concepts to combine measures of resource use, the coefficient of variation in use rates across regions, and the rate at which the incremental value of a medical intervention changes as its rate of use changes, providing a dollar-valued welfare loss from variations. For the entire US in 1987, the highest index occurred for coronary artery bypass graft ($0.95 billion per year), but most of the high-index interventions were nonsurgical, including hospitalizations for psychosis ($0.74 billion per year), cardiac catheterization ($0.62 billion per year), chronic obstructive lung disease ($0.55 billion per year), angina pectoris ($0.46 billion per year), adult gastroenteritis ($0.38 billion per year), adult pneumonia ($0.32 billion per year) and medical back problems ($0.28 billion per year). The top 25 interventions create an annual welfare loss of exceeding $7 billion. The present value of convincingly assessing the correct way to use these interventions sums many years of annual gains from eliminating these welfare losses. The gains from eliminating unexplained variation in medical practices appear greatly larger than costs of necessary studies.

Bias↗
PubMed2003

Decision making in acquiring medical technologies in Israeli medical centers: a preliminary study.

OBJECTIVE: This preliminary study had two objectives: a) charting the considerations relevant to decisions about acquisition of new medical technology at the hospital level; and b) creating a basis for the development of a research tool that will examine the function of the Israeli health system in assessment of new medical technologies. METHODS: A comprehensive literature review and in-depth interviews with decision makers at different levels allowed formulation of criteria considered by decision makers when they decide to purchase and use (or disallow the use) of new medical technology. The resulting questionnaire was sent to medical center directors, along with a letter explaining the goals of the study. The questionnaire included 31 possible considerations for decision making concerning the acquisition of new medical technology by medical centers. The interviewees were asked to indicate the relevance of each consideration in the decision-making process. RESULTS: The most relevant criteria for the adoption of new technologies related to the need for a large capital investment, clinical efficacy of the technology as well as its influence on side effects and complication rates, and a formal approval by the Ministry of Health. Most interviewees stated that pressures exerted by the industry, by patients, or by senior physicians in the hospital are less relevant to decision making. Very small and usually not statistically significant differences in the ranking of hospital directors were found according to the hospitals' ownership, size, or location. CONCLUSIONS: The present study is a basis for a future study that will map and describe the function of hospital decision makers within the area of new technology assessment and the decision-making process in the adoption of new healthcare technologies.

Academic Medical Centers↗
PubMed1995

Curriculum of medical informatics and medical technology in the medical faculty.

1. CURRICULUM DESCRIPTION. Twenty years ago, our faculty organized several lessons in a physiology course to inform students about computers. Recently, new courses in informatics were established. In their first year, students take a compulsory course (15 hours=h) of basic computer science (computers databases, networking, and basic non-medical computer software). A special elective course in medical informatics (30h) can be taken in the 4th year (about 20% of students pass tis course). This course includes the following lessons: computers in medicine (2h), scientific information (4h), classification in medicine (2h- including ICD, SNOMED etc.), computer support of clinical decision (2h-calculation principles with demonstration), artificial intelligence (2h), statistical software (2h), hospital information systems (2h), software for practitioners (2h), biosignal and image analysis (4th), computers in pharmacology (2h), computer simulation (2h), support of metabolic care (2h-consultations, risk calculations), and laboratory information systems (2h). The same course, though slightly differences, is used for paramedical students (occupational therapy, health education, and nursing). Medical technology was established in a three year curriculum courses in the 1st year include common courses in electronic devices (60 h), computers and programming (120 h), biophysics (90 h), biomechanics (30 h), and different medical courses (500 h). For the 2nd and 3rd year, 75% of the courses (700 h per year) are technical e.g., medical devices, information systems, signal and picture analysis, laboratory technique, and data protection. 2. CONCLUSION AND PERSPECTIVES. Students of medicine, and some paramedical studies, are able to use computer in their profession after having taken these courses. Bachelors of medical technology find application in biomedical research, hospitals, and medical technology firms.

Curriculum↗
PubMed2000

Assessing medical technologies in development. A new paradigm of medical technology assessment.

OBJECTIVE: Our study aims to provide a practical contribution to the field of medical technology assessment within a new paradigm. This paradigm indicates the need for more comprehensive technology assessments in the development stage of a new technology. METHOD: We introduce a method, based on Saaty's Analytic Hierarchy Process, which quantitatively supports discussions between the various actors that shape the technology's development and diffusion. These discussions focus on technical, medical, social, and economical requirements relevant to the design and diffusion of the new technology. DISCUSSION: In contrast to more traditional technology assessments, our method encompasses the perspectives of the diverse actors in the social context of technology development and diffusion. It influences their decision making on technology design and diffusion in order to improve this technology's later clinical as well as social effectiveness.

Decision Support Techniques↗
PubMed1994

Women, health, and medical technology.

New medical technologies are often developed and diffused in health care without societal assessments or setting of priorities. This article discusses the driving forces behind the development of new technologies and asks how women as users and providers of health services can gain influence on the process. Technologies used in pregnancy and childbirth are discussed to reveal different interests in their development and use and to discuss the role of industry in the development of new medical technologies in general.

Biomedical Research↗