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Evaluation of spoken dialogue technology for real-time health data collection.

BACKGROUND: A real-time assessment of patients' experiences is an important methodology for studies in health care, quality of life, behavioral sciences, and new drug and treatment development. Ecological momentary assessment is a methodology that allows for real-time assessment of experience and behavior in a subject's natural environment. Recently, electronic data collection techniques have been introduced, including systems utilizing interactive voice response. OBJECTIVE: The objective of this project was evaluation of spoken dialogue methodology for real-time data collection of information from patients for health, behavioral, and lifestyle studies and monitoring. While the management of the data collection process was Internet-based, this additional eHealth communication channel was based on over-the-phone natural language conversation with a dialogue system utilizing automated speech recognition technology. For this study we implemented a dialogue system for patients' assessment and monitoring of chronic pain. METHODS: Experimental evaluation of usability of the Pain Monitoring Voice Diary was performed with 24 volunteers. The volunteers were asked to contribute 10 sessions with the system over a period of 2 weeks; in practice, the number of sessions per subject ranged from 1 to 20. The subjects were asked to either relate to pain episodes in their past while answering the system's questions, or use as a guidance one of nine provided medical scenarios compiled by a pain specialist, ranging from migraines and back pain to post-surgical pain (knee injury) and cancer- and chemotherapy-related afflictions. RESULTS: From 24 volunteers, we collected a total of 177 dialogue sessions: 171 sessions were completed, while the caller hung up in the other 6 sessions. There were a total of 2437 dialogue turns, where a dialogue turn corresponds to one system prompt and one user utterance. The data capture rate, measuring the percentage of slots filled automatically, was 98%, while the other 2% were flagged for transcription. Among the utterances sent to transcription, where the user had opted for the "none of those" option, 70% corresponded to the "type of pain" slot, 20% to the "symptoms" slot, and 10% to the "body part" slot, indicating that those are the grammars with the highest out-of-vocabulary rate. CONCLUSIONS: The results of this feasibility study indicated that desired accuracy of data can be achieved with a high degree of automation (98% in the study) and that the users were indeed capable of utilizing the flexible interface, the sessions becoming more and more efficient as users' experience increased, both in terms of session duration and avoidance of troublesome dialogue situations.

Adaptation, Psychological↗

A model for multidisciplinary data collection for cervical metastasis.

A system for multidisciplinary data collection for metastatic neck disease is discussed. Information from 87 neck dissections and 3218 lymph nodes is reported to illustrate the strength of the model. Clinical (endoscopic) assessment under general anesthesia, surgical assessment during the neck dissection, and radiographic (computed tomographic scan) assessment were compared with the pathological evaluation. All disciplines stratified the necks by region and node size. This model provides an effective stratagem for multi-institutional studies.

Data Collection↗

Can we monitor socioeconomic inequalities in health? A survey of U.S. health departments' data collection and reporting practices.

OBJECTIVE: To evaluate the potential for and obstacles to routine monitoring of socioeconomic inequalities in health using U.S. vital statistics and disease registry data, the authors surveyed current data collection and reporting practices for specific socioeconomic variables. METHODS: In 1996 the authors mailed a self-administered survey to all of the 55 health department vital statistics offices reporting data to the National Center for Health Statistics (NCHS) to determine what kinds of socioeconomic data they collected on birth and death certificates and in cancer, AIDS, and tuberculosis (TB) registries and what kinds of socioeconomic data were routinely reported in health department publications. RESULTS: Health departments routinely obtained data on occupation on death certificates and in most cancer registries. They collected data on educational level for both birth and death certificates. None of the databases collected information on income, and few obtained data on employment status, health insurance carrier, or receipt of public assistance. When socioeconomic data were collected, they were usually not included in published reports (except for mothers educational level in birth certificate data). Obstacles cited to collecting and reporting socioeconomic data included lack of resources and concerns about the confidentiality and accuracy of data. All databases, however, included residential addresses, suggesting records could be geocoded and linked to Census-based socioeconomic data. CONCLUSIONS: U.S. state and Federal vital statistics and disease registries should routinely collect and publish socioeconomic data to improve efforts to monitor trends in and reduce social inequalities in health.

Birth Certificates↗

Using the Internet for data collection in nursing research.

This article examines how the internet may be used as a tool for data collection in nursing research. An overview of the demographic composition of the Internet population is outlined and discussed as a constraint on the type of research that can be undertaken using the Internet. Methods of data collection such as e-mail and WWW questionnaires are discussed as well as the possibility of virtual focus groups. Some of the difficulties and advantages that may confront the researcher wishing to undertake research using the Internet are outlined.

Computer Communication Networks↗

[The vignette as a strategy for data collection in nursing research].

With a view to verifying, quantifying and analyzing the use of vignettes as a strategy for data collection, the authors investigated how this strategy has been used for research data collection, in the MEDLINE and LILACS systems, in the period from 1966 to 2000. Five hundred eighty-two research works were found, 57 (9.8%) of which were published in nursing journals or contained studies about nursing professionals and/or students. Among these, 4 (7.0%) were published in the 1980s; 49 (86%) in the 1990s and 4 (7.0%) in 2000. The study proposals were: to explore attitude/behavior 20 (35.1%); to explore knowledge/attitude/behavior 14 (24.6%); to evaluate 12 (21.1%); to explore knowledge level 6 (10.5%); to conduct methodological studies 3 (5.3%) and to attribute responsibility 2 (3.5%). The prevailing theme was nursing care. The United States of America presented 34 (59.6%) publications, while the United Kingdom presented 16 (28.1%). One work was found which originated from Latin America.

Data Collection↗

How do we collect data for surveillance of wound infection?

The surveillance of surgical wound infection (SWI) may be undertaken for a number of purposes which include evaluating changes in practice, studying the epidemiology of SWI and for assessing the quality of health care. Purchasers require this information from providers as an indicator of the quality of care. Surveillance of SWI can also have a role in audit, by setting standards and comparing observed practice with agreed standards. The level of SWI can be the standard, and the collection, analysis and interpretation of data (undertaken during surveillance) could be the means for measuring the standard. In a surveillance programme, data collection is often the most time consuming and difficult element and requires considerable planning. Initially, the data to be collected should be defined. This will be influenced by the purposes of surveillance, the ways the events (SWI) are defined, the data required to produce meaningful analyses and criteria used for identifying the patient. After the data has been defined, data collection methods should be chosen. The importance of assessing the accuracy and limitations of data collection methods in local settings is stressed. Only then is it possible to be sure that the data is a reliable basis on which to base decisions which promote the quality of health care.

Data Collection↗

European surveillance of antimicrobial consumption (ESAC): data collection performance and methodological approach.

BACKGROUND: Europe is a continent with strong public healthcare systems, but diverging antibiotic policies and resistance patterns. AIMS: To describe the performance and methodological approach in a retrospective data collection effort (1997-2001), through an international network of surveillance systems, aiming to collect publicly available, comparable and reliable data on antibiotic use in Europe. METHODS: A central multidisciplinary management team co-ordinated a network of national representatives, liasing with national data providers and bodies responsible for antibiotic policy. The data collected were screened for bias, using a checklist. We focused on detection bias in sample and census data; errors in assigning medicinal product packages to the Anatomical Therapeutic Chemical Classification (ATC); errors in calculations of defined daily doses (DDD) per package; bias by over-the-counter sales and parallel trade; and bias in ambulatory care (AC)/hospital care (HC) mix. Datasets were corrected after national feedback, and classified as valid; valid but with minor bias; not valid. RESULTS: Of the 31 participating countries, 21 countries delivered AC data suitable for cross-national comparison (14 for all 5 years). Of these, 17 countries provided data on a quarterly basis for at least 1 year. For HC, 14 countries were able to deliver valid data (nine for all 5 years). A valid estimate of the total exposure of national populations to human antibiotic consumption could be made in 17 countries. CONCLUSION: In cross-national comparisons of antibiotic consumption in Europe, methodological rigour in correcting for various sources of bias and checking the validity of ATC/DDD assignment is needed.

Anti-Bacterial Agents↗

Comparison of 180 degrees and 360 degrees data collection in thallium-20 1 imaging using single-photon emission computerized tomography (SPECT): concise communication.

Thallium-201 imaging using SPECT is being done with 180 degrees (RAO to LPO) data collection in some centers with single-gamma camera systems. Using our SPECT system with two gamma cameras, we have compared the effects of 180 degrees data collection without attenuation correction against 360 degrees collection with attenuation correction, using phantoms and patients. With a heart phantom in a chest phantom, TI-201 activities simulating "normal myocardium," "ischemia," "infarction," and "background" were placed in object contrast ratios (with respect to background) of 5.0, 2.0, and -1.0, respectively. The 180 degrees data gave image contrast ratios of 1.6, 0.2, and -0.8, and the 260 degrees data gave ratios of 1.5, 0.8, and -0.3, respectively. Uniform activity throughout the heart gave similar image contrast with both data-collection methods, but there was more variability with the 180 degrees collection than with 360 degrees collection. Since attenuation correction is available with the 260 degrees collection, the effects of attenuation are seen only on the 180 degrees collection images. In eight patients the image contrasts from the 180 degrees and 260 degrees collections are similar. For our two-camera SPECT system, the 360 degrees collection permits attenuation correction, has less variability in counting statistics, and gives contrast ratios like those of 180 degrees collection.

Coronary Circulation↗

["ARCHIDIA": a system for patients' data collection and computerized filing. Part I. Methodology].

This report describes a computer based program of patient clinical data collection: the ARCHIDIA system. The project relies on descriptive analysis of clinical events according to well defined methodological criteria. This allows the formulation of a concise diagnosis which is, at the same time, exhaustive of all essential information. Two are the basis principles of this methodology: To define, as accurately as possible, the logical steps necessary to elaborate the diagnosis, that is construed by a sequence of codes. To define all the conditions that must be followed so to use any code in a controlled and independent way. These criteria were derived from literature. The major claim of the system is likely to be the introduction of a "common language" between different ICUs. Uniformed diagnostic and clinical criteria are the main source of large data collection for descriptive, analytic and prospective studies. After a one year pilot study performed by 4 ICUs, ARCHIDIA was used, in 1991, by 20 centers from the area of Milan, Pavia, Como, Varese (70% of total) and 4148 patient data were collected. A descriptive analysis will be reported in the following paper.

Electronic Data Processing↗

Large-format imaging plate and weissenberg camera for accurate protein crystallographic data collection using synchrotron radiation.

Off-line and on-line protein data-collection systems using an imaging plate as a detector are described and their components reported. The off-line scanner IPR4080 was developed for a large-format imaging plate ;BASIII' of dimensions 400 x 400 mm and 400 x 800 mm. The characteristics of this scanner are a dynamic range of 10(5) photons pixel(-1), low background noise and high sensitivity. A means of reducing electronic noise and a method for finding the origin of the noise are discussed in detail. A dedicated screenless Weissenberg camera matching IPR4080 with synchrotron radiation was developed and installed on beamline BL6B at the Photon Factory. This camera can attach one or two sheets of 400 x 800 mm large-format imaging plate inside the film cassette by evacuation. The positional reproducibility of the imaging plate on the cassette is so good that the data can be processed by batch job. Data of 93% completeness up to 1.6 A resolution were collected on a single axis rotation and the value of R(merge) becomes 4% from a tetragonal lysozyme crystal using a set of two imaging-plate sheets. Comparing two types of imaging plates, the signal-to-noise ratio of the ST-VIP-type imaging plate is 25% better than that of the BASIII-type imaging plate for protein data collection using 1.0 and 0.7 A X-rays. A new on-line protein data-collection system with imaging plates is specially designed to use synchrotron radiation X-rays at maximum efficiency.

Journal Article↗

Assessing internet survey data collection methods with ethnic nurse shift workers.

An increasing number of ethnic minorities are expected to enter the United States workforce based on projected demographic changes. This includes American Indian/Alaskan Native (AI/AN) nurses. Sociocultural influences on sleep disturbances, sleepiness, and other aspects related to shift-work tolerance are of unrecognized importance. More minority nurses are needed to provide culturally congruent care; however, AI/AN nurses represent less than 1% of nurses located throughout the American workforce. This article aims to verify the feasibility of Internet data collection (Web-based survey) methods and instrument stability as the first part of a two-phase study comparing individual differences and shift-work-related sleep disturbances between AI/AN and White non-Hispanic (WNH) nurses. In the first phase, an Internet survey was used to reach a cross-section of AI/AN and WNH nurses. The on-line survey was composed of accepted shift-work-related instruments. Items estimating sleep disturbances, sociocultural choices, time awareness, polychronicity, morningness/ eveningness, ethnic identity, and demographic questions were asked. The survey was linked to a series of Web pages describing the study purpose, inclusion and exclusion criteria, consent form, Web survey, and the second phase of the study in which subjects were invited to participate in actigraphy measurements. The survey was pilot-tested for error codes, item confusion, length, and completion time. Forced-answer questions were added asking ethnicity, age group, license type, state where licensed, and legal name on nursing license before accessing the survey. Data were saved periodically, cued by the word "continue." The database was located on a secure server and password protected. Nurses were recruited using published articles and printed advertisements, hospital e-mail systems, national nursing organization Web sites (minoritynurse.com; NANAINA.org), nursing Web site discussion groups, snow-balling, and word of mouth. The site was accessed 656 times with the Internet survey being completed by 138 WNH and 56 AI/AN nurses meeting the inclusion criteria. Except for the polychronicity measure (PAI3), instruments measuring time awareness, chronotype, and situational sleepiness achieved acceptable reliability coefficients with Internet data collection. Using pull-down menus would improve questions asking specific times. Internet data collection with different ethnic groups is possible; however, accessing the target population may be difficult. Despite extensive recruitment efforts, few AI/AN nurses participated. Computer literacy and failing to relate to the study's purpose may have limited the interest of the AI/AN nurses. It is possible to recruit nurse shift workers and collect individual difference and sleep disturbance data through the Internet; however, the researcher must remain vigilant throughout the process.

Adult↗

NMR data collection and analysis protocol for high-throughput protein structure determination.

A standardized protocol enabling rapid NMR data collection for high-quality protein structure determination is presented that allows one to capitalize on high spectrometer sensitivity: a set of five G-matrix Fourier transform NMR experiments for resonance assignment based on highly resolved 4D and 5D spectral information is acquired in conjunction with a single simultaneous 3D 15N,13C(aliphatic),13C(aromatic)-resolved [1H,1H]-NOESY spectrum providing 1H-1H upper distance limit constraints. The protocol was integrated with methodology for semiautomated data analysis and used to solve eight NMR protein structures of the Northeast Structural Genomics Consortium pipeline. The molecular masses of the hypothetical target proteins ranged from 9 to 20 kDa with an average of approximately 14 kDa. Between 1 and 9 days of instrument time were invested per structure, which is less than approximately 10-25% of the measurement time routinely required to date with conventional approaches. The protocol presented here effectively removes data collection as a bottleneck for high-throughput solution structure determination of proteins up to at least approximately 20 kDa, while concurrently providing spectra that are highly amenable to fast and robust analysis.

Data Collection↗

["ARCHIDIA": a system for patients' data collection and computerized filing. Part II. General description of a caseload].

OBJECTIVE: To describe a population of patients admitted in ICU in an homogeneous urban area by means of a computed system. EXPERIMENTAL DESIGN: Observational study. SETTING: 20 general intensive care units of general and university hospitals. PATIENTS: Patients admitted in ICU from 1-1-1991 to 31-12-1991. 3 centers collected patients only for 6 months, starting on 1-6-1991. MEASUREMENTS: For each patient demographic data, hospitalization data, outcome, diagnosis and diagnostic procedures used during hospitalization according to defined criteria previously described, were collected. Data have been collected on PC using dedicated software. RESULTS: All centers concluded data collection, none abandoned the study. General characteristics of 4148 valuable patients were reported. Age was 52.9 years, SAPS 12.4 and mortality 21.7%. The patients spent 8.7 days in ICU and, when transferred to a general ward, the following hospitalization was 21.5 days. CONCLUSIONS: Data collection demonstrated the project feasibility. It realizes a continue up to date system inside each unit and allows the use of a "common language" and homogeneous methodology between centers.

Adolescent↗

Data collection methods in prospective economic evaluations: how accurate are the results?

OBJECTIVES: Often in economic evaluations a division is made between those studies that have a high level of accuracy versus those that are easily generalized. This interstudy dichotomy is often translated into prospective, randomized controlled trials with high internal validity and observational and modeling studies with a high level of external validity. This article challenges this conventional view and examines intrastudy effects on validity. METHOD: A review and summary of the literature was conducted in order to assess the impact that data collection strategies will have on internal validity. Two scenario models were created in order to gain a preliminary understanding of the magnitude of the problem. RESULTS: Data collection strategies have an impact on the level of internal validity found in an economic evaluation. Comparisons of studies that are prospective in nature is misleading as data collection strategy can lead to different resource and cost estimates even when all other relevant factors are similar. It is possible to shift and improve the level of validity by combining different collection methods. CONCLUSIONS: Instead of viewing internal and external validity as polar opposites, validity should be considered in terms of a continuum within a particular study. The use of proxies to collect resource utilization estimates, the reliance on patient self-reported data, and the method of collecting this type of data all impact the validity of study results. National guidelines for the economic evaluation of agents and devices should consider this issue in more depth, and existing evidence rankings should be adapted to be more appropriate to pharmacoeconomic studies.

Journal Article↗

Study design in qualitative research--2: Sampling and data collection strategies.

In two prior papers in our series on qualitative research [Frankel & Devers (2000a, 2000b) Qualitative research: a consumer's guide, Education for Health, 13, 113-123; Frankel & Devers (2000) Study design in qualitative research-1: developing research questions and assessing research needs, Education for Health, 13, 251-261], we examine two critical issues in qualitative research design: sampling, including identifying and negotiating access to research sites and subjects, and data collection and management. We describe these two key steps in the qualitative research design process, discuss challenges that often emerge when pursuing these steps, and provide guidelines for addressing them. Qualitative research most often uses "purposive," rather than random, sampling strategies. A good understanding of these sampling strategies and why they are used is central to designing a credible qualitative study. In addition, given the real-world context in which most qualitative research is carried out, identifying and negotiating access to research sites and subjects are critical parts of the process. We also provide suggestions for developing and maintaining productive and mutually satisfying research relationships with sites and subjects. Finally, data collection and management are often neglected subjects in qualitative research. We offer practical advice on how to collect and manage qualitative data, including factors to consider when deciding how structured the data collection process should be, the pros and cons of audio- and/or videotaping compared with note-taking, and tips for writing up field notes and document management. A forthcoming, final paper in the series will focus on qualitative data analysis and the publication of qualitative research results.

Journal Article↗

Web-based classroom data collection in ADHD: a best practices case study.

BACKGROUND: Best practices research identifies and disseminates effective clinical strategies developed and refined by clinicians for their practices. As opposed to the content of health care, medical students and residents are typically not trained in the process of its provision. This paper illustrates a best practices approach to development of a Web-based classroom data collection method to improve medication management in attention deficit hyperactivity disorder (ADHD). OBJECTIVES: 1) To increase Primary Care Physician (PCP) awareness of the process of best practices research, and; 2) to highlight the use of the World Wide Web as a tool for integration of care of children with ADHD. METHODS: Based on the review of a large national study in ADHD, the key ingredients for the best pharmacotherapy practices were identified. The lessons from the literature were adapted for local practice using the framework and steps for best practices outlined by Mold and Gregory. A conceptual model of managing information provided by parents/caregivers and teachers to PCPs was developed. Several steps were identified, including Web-based classroom behavioral data collection by a care manager and feedback reports to PCPs from a child psychiatrist based on the data collected. This model is currently being tested. CONCLUSION: Our preliminary experience suggests that a best practices approach has potential applications to a variety of primary care settings in South Dakota. We encourage PCPs to consider best practice strategies for their own practices. The practice-based research network (Rush Net) being developed by the Center for Rural Health Improvement of the University of South Dakota School of Medicine's Department of Family Medicine can be helpful in this regard.

Attention Deficit Disorder with Hyperactivity↗

High-throughput sample handling and data collection at synchrotrons: embedding the ESRF into the high-throughput gene-to-structure pipeline.

An automatic data-collection system has been implemented and installed on seven insertion-device beamlines and a bending-magnet beamline at the ESRF (European Synchrotron Radiation Facility) as part of the SPINE (Structural Proteomics In Europe) development of an automated structure-determination pipeline. The system allows remote interaction with beamline-control systems and automatic sample mounting, alignment, characterization, data collection and processing. Reports of all actions taken are available for inspection via database modules and web services.

Data Collection↗

[Research on real-time data collection and demonstration system for acupuncture manipulation].

OBJECTIVE: To apply the real-time data collection and demonstration system for acupuncture manipulation to quantitative analysis of acupuncture manipulation for acupuncture teaching and research. METHODS: The real-time observation and analysis of parameter changes of acupuncture manipulation were implemented by this system. RESULTS: During the course of lifting and thrusting manipulation, the needle body moved in a uniform variable motion, and the action force was still kept while the arrival of Qi was achieved. During the course of twirling manipulation, the variations of twirling number and radian caused the changes of resistance moment, and this reaction was related to the body response. During the course of rotating and shaking manipulation, the radius for rotating and shaking was related to such factors as the force, the action point and the direction. CONCLUSION: The real-time data collection and demonstration system for acupuncture manipulation can provide a new experimental method for quantitative data analysis, standardized research and teaching demonstration of acupuncture.

Acupuncture↗