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PubMedDate not supplied

In the palm of your hand.

The explosive growth of handheld personal digital assistants (PDAs) in health care has been nothing short of amazing. What applications--business and clinical--do these devices have in medicine, and what is their potential? PDAs are simple and intuitive; their applications require minimal interaction time, so they have minimal impact on work flow: the investment is small; and the lightweight form is relatively nonintrusive during a patient encounter. The devices are being used to capture charges for medical services at the point of care. Encounter capture, online prescription writing and other applications will soon come on the scene. This article discusses current and possible future uses for PDAs in health care, interfaces with other technologies and security concerns.

Computer Peripherals↗
PubMed2002

Patient empowerment and the asymmetry of knowledge.

eHealth consumers know more, expect more and demand more. The Inteernet has the potential of being a major influence on them by opening up vast opportunities for information transparency and access and the sharing of information which is essential to healthcare practice. But, these vast opportunities also pose numerous obstacles, such as the lack of common terminology or terminology standardization, the uncertain quality and reliability of the information on the Internet, the public's health literacy and the digital divide. A gradual and progressive shift from exclusive to shared knowledge and responsibility can be achieved by patient/physician collaboration.

Humans↗
PubMed2006

A 24-hour dental plaque prevention study with a stannous fluoride dentifrice containing hexametaphosphate.

Recently, a novel antibacterial fluoride dentifrice containing stannous fluoride and sodium hexametaphosphate (CrestPRO-HEALTH) was introduced. A digital plaque image analysis (DPIA) technique was used to quantify in situ plaque formation in a population carrying out a phased intervention protocol that included: (1) an initial treatment regimen including toothbrushing with standard sodium fluoride dentifrice in conventional bid brushing, (2) a second treatment regimen where a modified hygiene regimen was applied using standard sodium fluoride dentifrice including a period of 24 hours of non-brushing, and (3) a third treatment regimen where the 24-hour non-brushing regimen was continued using the antimicrobial stannous fluoride/sodium hexametaphosphate dentifrice. The quantitative evaluation of plaque formation was assessed in morning measurements following either standard evening hygiene (treatment period 1) or 24 hours since brushing (treatment periods 2 and 3). Post-brushing plaque measurements were also taken in each treatment regimen. Sixteen subjects completed all three treatment regimens with no side effects or oral complaints. Morning plaque coverage in treatment period 1 was 13.3%. Plaque coverage significantly increased in treatment period 2 when pre-bedtime brushing was discontinued, with 24-hour growth covering 18.4% of the dentition. Intervention of the antimicrobial stannous fluoride/hexametaphosphate dentifrice in treatment period 3 provided significant inhibition of plaque regrowth over 24 hours (15.2% coverage, a 17% reduction vs. sodium fluoride dentifrice control). These results support the strong retention and lasting antimicrobial efficacy of high stabilized stannous fluoride/sodium hexametaphosphate dentifrices.

Adult↗
PubMed1987

Home health-care: accuracy, calibration, exhaust, and failure rate comparisons of digital blood pressure monitors.

This study provides a detailed comparison of 22 digital, blood pressure monitors intended for home use. Blood pressure and pulse-rate readings from each electronic monitor were compared with concurrent measures obtained using the mercury column and auscultation. Correlation coefficients and linear regressions were performed to evaluate accuracy. Separate analyses of variance were used to determine significant calibration errors for each model. The results showed considerable disparity among available home monitors under controlled testing conditions. Variables associated with accuracy and home use by the layperson are discussed.

Adolescent↗
PubMedDate not supplied

Teleradiology in southern Sweden--a tool for reorganization of health care and for education.

The county organization, including health care, is reorganized in the province of Scania in southern Sweden. As part of the restructuring of health care, a program for digitalization of the departments of diagnostic imaging, as well as for teleradiology, has been set up. Standards for network, radiology information systems, and workstations have been settled, and teleradiology links both for on-call consultations and for on-line consultations day-time have been implemented, mainly running at 10 Mb/s. Further digitalization and implementation of teleradiology is planned for the nearest years. Parallel to this, a video conference system including several disciplines, hospitals and health care levels in the whole of southern Sweden has been implemented. The links are now also used for education, both in the province and internationally.

Computer-Assisted Instruction↗
PubMed1994

The Employee Health Care Value Survey: round one.

In a groundbreaking arrangement, a consortium of large employers--the Xerox, GTE, and Digital Equipment Corporations--launched the Employee Health Care Value Survey during fall 1993. Completed by 24,306 employees, this survey was used to develop comparable methods for assessing corporate health care benefit strategies. It also enabled fair comparisons of thirty-two health plans across the country on more than sixty criteria. Variation in performance among plans was substantial, with managed care plans--particularly prepaid group practices and individual practice associations (IPAs)--recording the most favorable rankings on disenrollment, overall satisfaction, and other measures of "bottom-line performance." Variation in enrollees' health among plans was more modest, with indemnity enrollees posing a somewhat greater illness burden to their plans than enrollees of other plan types. The employers and evaluated health plans are now using the results for multiple purposes, including quality improvement initiatives, employee-based plan performance reports, employee contribution strategies, and health promotion programs.

Consumer Behavior↗
PubMed1995

Are self-reports of smoking rate biased? Evidence from the Second National Health and Nutrition Examination Survey.

This study determined evidence for digit preference in self-reports of smoking in the Second National Health and Nutrition Examination Survey (NHANES II). Subjects were 4275 adult smokers. Self-reports of smoking showed a marked degree of digit preference, with the vast majority of smokers reporting in multiples of 10 cigarettes per day. When number per day was compared to an objective measure of smoking exposure (carboxyhemoglobin; n = 2070) the distribution was found to be significantly assymetrical. Analysis of the distribution of COHb and various levels of number per day indicates that the differences in distribution are not due to variability in COHb. Heavier smokers, Caucasians, and those with less education were more likely to report a digit preference than lighter smokers. African-Americans, and those with more education. Results suggest that self-reports of number of cigarettes per day may be biased towards round numbers (particularly 20 cigarettes per day). Implications for assessment of smoking behavior are discussed.

Adolescent↗
PubMed2004

Self-reported health of residents of the Mississippi Delta.

The rural Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi has a large economically and socially disadvantaged population at high risk for health problems. Their health status is poorly understood as they are not well represented in national health surveys. A random-digit-dialing telephone survey was conducted in 2000, with 2,236 respondents representing residents of 36 counties along the Mississippi River. Self-reported chronic conditions, health status, and obesity (derived from weight and height) were compared with the nationally representative Continuing Survey of Food Intake of Individuals. High cholesterol, diabetes, and hypertension were significantly higher than in the national sample. Obesity was strikingly higher in Delta children (27.9% versus 16.2%) of all ages and in Delta adults (33.9% versus 17.3%). Controlling for age, income, and gender, African Americans were at particular risk for obesity, hypertension, and diabetes. A public health crisis appears to exist in the Delta given the high prevalence health problems.

Adolescent↗
PubMed2002

[Analysis of the extent of harm from digitally modulated mobile telephone rays].

In the public discussion regarding the health risks of mobile phone system radiation, it is emphasized that the pulse slope of digital modulation, as defined in the GSM-Standard, will cause biological effects. In contrast, the high field strength of broadcasting and television radiation is not considered to be relevant. This paper compares quantitatively the slope of the digital GSM pulses with that of the synchronizing pulse of the television signal. The result shows clearly that the pulse spectrum of the television signal contains that of the GSM signal; in addition, the synchronizing impulse of television exhibits a much steeper slope. Considering the countrywide normal radiation intensities of television and mobile phone systems, it can be stated that the worldwide exposure to the common television signals over more than 50 years can disprove the contention of adverse biological health effects of the pulse slope of digitally modulated radiofrequency.

Humans↗
PubMed2026

Cost-Effectiveness of Electronic Patient-Reported Outcome Measure Interventions in Cancer: Systematic Review and Parameter Extraction for Economic Modeling.

BACKGROUND: Complex digital interventions that integrate electronic patient-reported outcome measures (ePROM) into clinical practice in cancer have the potential to improve quality of life, increase survival, and reduce health resource use and costs. Such systems can help patients with cancer self-manage chemotherapy symptoms, reduce clinicians' workloads through automated decision support, and resolve problems earlier. However, more research on the cost-effectiveness of ePROM monitoring is needed. OBJECTIVE: This paper comprises two complementary components: (1) a systematic literature review summarizing and evaluating the quantitative and qualitative evidence related to the cost-effectiveness of ePROM monitoring and (2) a health economic model parameter extraction. We also conducted supplementary targeted searches and scoping to provide context to our findings. METHODS: We searched Ovid (including MEDLINE and Embase), Scopus, and the International Health Technology Assessment Database for original English-language papers published on or before March 2025 using search strings that combined terms related to ePROMs, health economics, and cancer/oncology. We included papers reporting health economic-related outcomes for ePROM interventions designed for adult cancer populations and excluded screening tools and conference abstracts. RESULTS: We included 34 publications from 27 unique studies and identified and analyzed 26 ePROM-integrated interventions within these. Most (23/26) of the included interventions explicitly described some form of alert handling and automated decision support based on remote ePROM monitoring. Of the 34 publications, 5 presented full cost-effectiveness analysis results, of which 3 were highly uncertain and lacked clear differences in costs and health outcomes between ePROMs and standard care; conversely, 2 presented strong evidence of cost-effectiveness due to quality-of-life improvements, reduced hospitalizations, and potentially more autonomy in health-related travel (eg, ePROM-monitored patients can drive or walk to the hospital instead of using taxis or ambulances). A further 5 publications reported partial health economic results (eg, cost-consequence and budget impact), of which 1 detected no difference in strategies; in contrast, 4 reported lower health resource use and costs of ePROMs, mainly due to hospitalization reductions. Overall, 12 of the 27 studies included a qualitative component but mostly focused on user experience and design-related themes; only 2 of these addressed economic-specific themes (eg, changes in workflow and resource use due to ePROM implementation and integration), indicating some potential for time saving due to ePROM monitoring. CONCLUSIONS: Some ePROM-integrated interventions demonstrated cost-effectiveness in cancer care, but the evidence base remains limited. Where evidence does exist, cost-effectiveness appears driven by reduced hospitalization and improved quality of life. Qualitative research within the included studies rarely addressed economic questions. We provide a detailed parameter extraction for use in future economic modeling and recommend research priorities, including quantitative mapping of ePROM symptom data onto health resource use patterns, and qualitative work exploring how ePROM implementation affects clinical workloads and patient-perspective costs.

Humans↗
PubMed2000

The availability and distribution of dentists in rural ZIP codes and primary care health professional shortage areas (PC-HPSA) ZIP codes: comparison with primary care providers.

OBJECTIVE: This paper maps dentists, primary care physicians, physician assistants, nurse practitioners, and nurse midwives in rural areas and rural areas meeting criteria as underserved for primary health care. METHODS: Computer-based mapping was used to localize health care provider groups by five-digit ZIP code. For each rural and each rural primary care health professional shortage area (PC-HPSA) ZIP code, the number of providers in each group was determined. The different combinations of providers were determined. RESULTS: All providers in rural areas were present at levels substantially lower than national averages, particularly in PC-HPSA areas. Dentists were approximately equal in number to primary care physicians in rural areas and the largest group in PC-HPSAs. Approximately 75 percent of rural residents lived in ZIP code areas with dentists available. Over 5.8 million rural residents and over 50 percent of rural PC-HPSA residents had no providers available in their ZIP code areas. CONCLUSIONS: Rural areas continue to have a short supply of primary care providers and dentists. Dentists were present in many areas where primary care provider presence was absent or very low. These data, including those relating to provider co-presence, can be used to develop strategies to overcome health care access problems due to provider shortages.

Dentists↗
PubMed1992

Optical technology: making the simulator portable.

Optical disc technology can be either analog or digital. Analog (videodiscs) simulation programs are available for the allied health professions educator to incorporate into the curriculum. Digital optical discs, currently available in three formats, follow standards that have been adopted by the International Standards Organization. The formats differ in the amount of information they can accommodate and their practical use in the health professions curriculum.

Computer Simulation↗
PubMed2026

Precision medicine in mental health: applications, challenges, and recommendations.

Mental disorders represent a major and growing public health challenge in Europe and worldwide, characterised by marked clinical, biological, and functional heterogeneity, that limits the effectiveness of current diagnostic and therapeutic approaches. In recent years, advances in precision medicine have initiated a paradigm shift in psychiatry, offering new opportunities to improve prevention, prediction, diagnosis, treatment selection, and long-term management by integrating biological, psychological, social, and environmental information.This EPA Guidance Paper provides an overview of the current state of precision medicine in mental health and outlines its potential clinical, scientific, and policy implications. We review key advances in genomics, epigenetics, neuroimaging, transcriptomics, digital technologies, and artificial intelligence, highlighting their relevance across the full clinical pathway, from risk prediction and early detection to treatment personalisation and monitoring. We also examine major barriers to implementation, including limited biomarker validation, insufficient representativeness of research populations, ethical and regulatory challenges, data protection concerns, and inequalities in access across healthcare systems.Based on the available evidence, we propose strategic recommendations to support the responsible and equitable integration of precision approaches into mental health care in Europe. These include strengthening translational research, promoting multidisciplinary collaboration, updating regulatory and ethical frameworks, enhancing professional training, and prioritising mental health within national and European research and health agendas. By addressing these challenges, precision psychiatry has the potential to contribute to more effective, person-centred, and sustainable mental health care, while supporting innovation, reducing stigma, and improving outcomes for patients and society.

Humans↗
PubMed2006

Mental health and related disability among workers: a population-based study.

BACKGROUND: In past decades, the nature of work has undergone significant changes including increased psychological demands and job instability. A stressful psychosocial work environment has been shown to have adverse effects on workers' mental and physical health. This goal of this study is to estimate the prevalence of psychiatric syndromes and related disability in a population-based sample of employed adults and investigate associations between psychiatric syndromes and related disability. METHODS: A random-digit dial provincial wide mental health survey was conducted in Alberta, Canada (n = 5,383). The telephone interview included the Mini International Neuropsychiatric Interview (MINI) and the World Health Organization's Disability Assessment Schedule (WHO-DAS-II). In this analysis, participants who were currently employed were included (n = 4,149). RESULTS: In this population, 6.2% had had at least one MINI-defined psychiatric diagnosis with clinically significant interference. Without consideration of the clinical interference criterion, the prevalence of psychiatric syndromes was higher (33.5%). Psychiatric syndromes were strongly associated with disability. A dose-response relationship between the number of diagnoses and disability was found. CONCLUSIONS: Interventional strategies in the workplace should focus on mental disorders at both the clinical and sub-clinical levels.

Adult↗