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PubMedDate not supplied

Telepathology applications of the Internet multimedia electronic mail.

Telepathology is based on the sharing of medical images coming from the microscope, and comprises different applications: intra-operative telediagnosis, second opinion teleconsultation, reference case archives, remote data and image processing, quality assessment. Since the Internet is available worldwide, it can be of interest to define which of these tasks can be performed by means of some telepathology method based on it. This paper focuses particularly on the use of Internet multimedia electronic mail for exchanging multimedia cases. To test the validity of the proposed approach for transmission of multimedia cases, the first step is to evaluate its diagnostic accuracy. Trials involving the transmission of 299 cases have been carried out between two departments of Pathology in Italy (at the University of Udine and at the City Hospital of Trento, respectively) in order to evaluate the diagnostic accuracy as well as the time needed for acquisition and transmission. First results show that good diagnostic agreement can be reached, but the time needed for transmission, generally low, is not sufficiently affordable to be adopted in those cases where time is important. In particular, telepathology through multimedia e-mail can be adopted for second opinion consultation, remote image processing, quality assessment and continuing education possibly by means of software that integrates acquisition and delivery of cases with HIS functionalities.

Evaluation Studies as Topic↗
PubMed1994

The multimedia textbook. A revolutionary tool for pediatric education.

Textbooks are now available via computers. These new electronic or multimedia textbooks appears similar to conventional books but differ in function. In addition to text and images, they contain video and audio clips and allow readers to interact with the content. Multimedia textbooks contain digital media, can be quickly and inexpensively updated and repurposed for lectures and handouts, and are available on-line via computer networks for distance learning. We present the concept of computer-generated multimedia text-books; describe their creation by an easy-to-use, sophisticated authoring system; and describe the underlying instructional design approach to guide future authors of multimedia textbooks.

Computer-Assisted Instruction↗
PubMed1989

A multimedia medical communication link between a radiology department and an emergency department.

The most critical aspect of a radiologist's work is communicating his findings to the attending physician responsible for the patient's care. This is also the part of the process that is least well organized and the most subject to failure. At the University of Ottawa Medical Communications Research Centre we are investigating technical means to improving communications between radiologists and attending physicians. We first introduce the radiology communication service problem and show why it is essentially a multimedia communication problem. We then briefly describe a multimedia communication system designed and implemented by our research team. The multimedia system consists of several work stations linked by the Hospital's local area network (LAN). Each physician work station comprises a Compaq 386/20-Mhz microcomputer with 16 Mbytes of RAM, a 500-Mbyte image disk, and an image memory that drives a 1,000-line monochrome monitor. The images are digitized using a Konica laser-based film digitizer (2430 by 2000 10-bit pixels for a standard chest radiograph). The multimedia file server manager station is built around a PC-AT compatible with a Northern Telecom Meridian SL-1ST digital PBX and a Meridian Mail digital voice messaging system. This last device is used to store voice data and is linked via the PBX to the workstations' digital telephones. A Sytek 6,000 LAN links all work stations to the file server. All data, image, and graphic information is transmitted via this network, while the twisted pair connections linking the digital PBX to the telephone sets are used for transmitting voice data.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMed1996

CD-ROM multimedia. The step before virtual reality.

Applications developed using key multimedia elements are finding their way into a number of training and information exchange environments including the laparoscopy training market. Emerging multimedia-based applications range from procedural information for patients to interactive CD-ROM-based applications used to train highly skilled surgeons. These products are designed with a high level of interactivity that allows the surgeon to plan a surgical procedure, review detailed patient information and then merge that information into the surgical planning process. Using this new technology, a surgeon now has the ability to review CD-ROM-based course materials and efficiently meet continuing education requirements. The factor found most limiting in the development of multimedia-based applications for laparoscopy training is generally not the technology, but the limits placed on the technology because of one's reluctance to think beyond what is accepted as the norm. Properly implemented, multimedia applications developed for laparoscopy training reduce the cost and time associated with learning new materials, assist a user in retaining more of the information reviewed, and in many cases make the learning experience much more enjoyable.

Audiovisual Aids↗
PubMed1995

Multimedia clinical examination: the time honoured art and science mirrored digitally.

In the recent years, multimedia has exhibited a tremendous presence in the personal computer market and it has exerted an influence in our homes and teaching institutions as well. To define it very simply, a multimedia PC is a personal computer capable of producing images and sound of reasonable quality by means of software toggles. This paper presents an Asymetrix Multimedia Toolbook application entitled Multimedia Clinical Examination (MCE) which harnesses the ability of affordable computers to create and display a variety of audiovisual media to supplement 'bed-side teaching' of elementary clinical methods which includes history taking and physical examination. MCE comprises a history taking module which helps in keeping track of the possible differential diagnoses and a physical examination module which shows digital videos of appropriate examination steps. The application runs on the Microsoft Windows platform.

Audiovisual Aids↗
PubMed1996

The use of multimedia computer-based patient records in ambulatory care.

The use of a multimedia computer-based patient record (CPR) within ambulatory care is a topic that has not achieved widespread understanding or acceptance. However, if the topic is divided into its parts, multimedia and computer-based patient record, it reflects both highly recognizable and desirable goals that most health care organizations are undertaking. Multimedia technology is quickly maturing. In addition, the goal of attaining a CPR is of primary interest to most health care organizations. It is inevitable that these two technologies will eventually become synergistic. This article presents the case for a multimedia ambulatory CPR and describes one example of this happy marriage.

Ambulatory Care Information Systems↗
PubMed1999

Teaching medical students cancer risk reduction nutrition counseling using a multimedia program.

BACKGROUND AND OBJECTIVES: There are many barriers to medical students receiving education about the linkage between nutrition and cancer, including the lack of role models and teachers and insufficient curricular time. We tested the use of a multimedia program as a possible solution to teaching diet-risk assessment and counseling skills. METHODS: Images of Cancer Prevention, The Nutrition Link is a CD-ROM multimedia program that was developed and evaluated by 147 medical students. Pre-use and post-use surveys, computer log files, and recorded response sessions were used to determine the learner's 1) ease in using the program, 2) attitudes about the treatment of the content, 3) knowledge gain, and 4) attitudes about the role of physicians in nutrition assessment and counseling for cancer risk reduction. RESULTS: Students improved their knowledge of dietary guidelines for cancer risk reduction and made positive changes in their attitudes toward the role of physicians in dietary counseling. However, most students reported that they would not use the program unless it was required that they do so. CONCLUSIONS: The multimedia program was successful; it affected students' knowledge and attitudes concerning nutrition as a modifiable risk factor for some cancers. In addition, the design and delivery of the multimedia product was positively reviewed by the students for ease of access, message design, individualized instruction, and flexibility. Despite these favorable ratings, it was not clear that students would use the program unless required to do so.

Health Knowledge, Attitudes, Practice↗
PubMed1992

Multimedia for clinical education in myocardial perfusion imaging.

Interactive multimedia has many advantages as a presentation medium for diagnostic imaging case studies, particularly for teaching digital imaging techniques such as myocardial perfusion imaging. Multimedia documents may incorporate interactive audiovisual presentations, sophisticated diagnostic images, anatomical illustrations, and text in medical instructional materials. The article describes a multimedia teaching atlas of SPECT and planar myocardial perfusion imaging delivered on Apple Macintosh II microcomputers, and discusses some of the advantages of delivering medical educational materials with interactive multimedia techniques.

Computer-Assisted Instruction↗
PubMed1995

Multimedia cardiac catheterization record document system.

In this paper, we present the design and implementation of a multimedia cardiac catheterization record (CCR) system. A traditional CCR contains medical report, electrocardiograms, X-ray images, and possibly video sequences for angiograms. The physicians found it difficult to access and manage these multimedia information easily. Current advances in multimedia technology has made possible the authoring, storage and presentation of these medical information in a systematic and easily-accessible way. This paper discusses the background and rationale that led to the design and implementation of a cost-effective multimedia medical document system framework and prototype.

Cardiac Catheterization↗
PubMed1997

Filmless multimedia display following cardiac catheterization.

In traditional cardiac catheterization laboratories, anatomic images are acquired onto 35-mm cine film and presented in series with related information days, weeks, or months later to an audience of decision-makers. These data are projected onto a convenient light-colored wall or silver screen, while echocardiograms and electrophysiologic data are displayed using small single-user computer monitors. This presentation format is not ideal, because full audience participation is not fostered, image quality may be degraded, and small computer screens can be adequataly visualized only by those individuals immediately in front of them. Modern video multimedia systems now make an ideal data presentation format practical, in which all types of media including digitally acquired angiograms can be displayed in parallel with full annotation, using large diagonal multisync color monitors. This communication discusses how to design a multimedia conference center in which remotely acquired filmless digital images can be displayed and processed together with all other pertinent cardiac multimedia to a large audience.

Cardiac Catheterization↗
PubMed1999

The clinical display of radiologic information as an interactive multimedia report.

We regard the delivery of radiological information as an interactive multimedia report. We use a multimedia report model based on Extensible Markup Language (XML), rather than a traditional workstation model. Others have suggested a similar document-based approach. This display presentation includes image-related and text-based information and may contain interactive components (e.g., window, level and zoom). Using XML as a foundation for this multimedia presentation, we achieve flexibility and platform independence at a lower cost. XML allows for the separation of content and form. Content information, defined as elements (e.g., images, radiologic reports, and demographic information), is treated as independent information objects. The behavior of the elements can be changed for different users and tasks. In addition, by separating format detail from content, the appearance of the elements within the report can be modified. XML does not replace existing standards (i.e., Digital Imaging and Communications in Medicine [DICOM], Transmission Control Protocol/Internet Protocol [TCP/IP]). Instead, it provides a powerful framework that is used in combination with existing standards to allow system designers to modify display characteristics based on user need. We describe our application of XML to the clinical display of radiologic information.

Computer Systems↗
PubMed1998

Multimedia system based on programmed instruction in medical genetics: construction and evaluation.

A multimedia system used as an auxiliary didactic tool for teaching medical genetics, HGEN, is based on non-linear programmed instruction and multimedia. HGEN was implemented in layers for PC compatible using MULTIMEDIA TOOLBOOK and DELPHI. It includes basic medical genetics concepts (inheritance patterns and cytogenetics) and it is based on multiple choice questions with images, diagrams and animations. The student-program interaction occurs by choosing an alternative in a question and receiving a specific answer as feedback and additional information. Links send the students to a glossary, to short descriptions of diseases used as examples, or to references for further studies. In order to evaluate the performance of the HGEN the authors used two questionnaires: (a) about the students' background in using computers; and (b) the system efficiency as a didactic tool, the software quality and user satisfaction. HGEN was used by 63 students from three medical schools and it was considered efficient as a learning tool (100%). Furthermore the implementation of a navigation map for frequencies analysis of followed path enable the study to detect structure and content inadequacies that could be correct for version 1.1 and proved to be an efficient tool to optimize a didactic software.

Computer-Assisted Instruction↗
PubMed1998

Acceptance by Swedish users of a multimedia program for primary and secondary prevention of malignant melanoma.

BACKGROUND: In Sweden, the incidence of malignant melanoma of the skin is rapidly increasing, and the disease is now one of the ten most common tumor types. The objectives were to apply multimedia techniques to increase public knowledge about malignant melanoma and its risk factors, to increase awareness of preventive measures, and to make people more disposed to change their sunbathing habits. METHODS: A trilingual (Swedish, English, and German) multimedia program was developed for two target groups, health care personnel and the general public, with a total of >500 "pages" in each language. User reactions were studied on-site at a municipal pharmacy and library, where the program was available in a kiosk with touch-screen. RESULTS: Practically all 274 users interviewed found the program easy to use and understand. 92% identified one or more of the recommendations given. 66% found the program information "worrying," and 29%--mainly young women-instantly declared that they were going to change their sun-exposure behaviors. No correlation to skin type was found. CONCLUSIONS: A multimedia program of the present design seems to be a useful tool for health promotion.

Adult↗
PubMed1997

Multimedia benchmarking analysis for three risk assessment models: RESRAD, MMSOILS, and MEPAS.

This paper is one in a series that describes results of a benchmarking analysis initiated by the Department of Energy (DOE) and the United States Environmental Protection Agency (EPA). An overview of the study is provided in a companion paper by Laniak et al. presented in this journal issue. The three models used in the study--RESRAD (DOE), MMSOILS (EPA), and MEPAS (DOE)--represent analytically-based tools that are used by the respective agencies for performing human exposure and health risk assessments. Both single media and multimedia benchmarking scenarios were developed and executed. In this paper, the multimedia scenario is examined. That scenario consists of a hypothetical landfill that initially contained uranium-238 and methylene chloride. The multimedia models predict the fate of these contaminants, plus the progeny of uranium-238, through the unsaturated zone, saturated zone, surface water, and atmosphere. Carcinogenic risks are calculated from exposure to the contaminants via multiple pathways. Results of the tests show that differences in model endpoint estimates arise from both differences in the models' mathematical formulations and assumptions related to the implementation of the scenarios.

Air Pollutants, Radioactive↗
PubMedDate not supplied

Content preauthoring: preparing medical imaging information for multimedia authoring and quizzing.

Recent advances in multimedia development software and related hardware have given professionals and nonprofessionals tremendous power and flexibility to create multimedia education and training programs. Nevertheless, content organization remains a key and often neglected component of program development. Content preauthoring puts findings, diagnoses, differential diagnoses, and other standard radiologic concepts into a format that fosters logical program layout, centralized remediation, record keeping, decreased data entry, a variety of user levels, easy addition of cases, and linkage to a question-generating program. The goal of content preauthoring is to organize radiologic material into a hierarchical or spreadsheet-based structure that provides a logical basis for software design. By separating content design from software authoring, both processes become more manageable. This approach is applicable to visually oriented topics that focus on identification. The highly structured, goal-oriented nature of the method makes it particularly suitable for newcomers to multimedia authoring.

Authorship↗
PubMed1997

Assisting maxillofacial surgery by using multimedia VR techniques.

Multimedia and VR technologies are examined as regards their potentiality for medicine, specifically for maxillofacial surgery. The goal is to achieve a surgical procedure of better quality as well as a more interesting way of imparting medical knowledge. Close cooperation with the Maxillofacial and Plastic Surgery Department of the University Hospital Benjamin Franklin (UKBF) ensures the suitability of the material for the user. Doctors give regular feedback on the 3D human-computer interface, graphics and interaction devices because they are crucial for the implementation of multimedia and VR systems in medicine. Before implementing a VR or multimedia application, the technical possibilities should be explored in depth. Therefore, a VR tested for 3D input and output devices has been established at the Technical University of Berlin to assess the advantages and technical restrictions of commercially available and self-made devices. Parts of the VR tested are currently being transferred to the Medical Informatics Department of the UKBF, where the usefulness of various 3D input and output devices for different medical applications in a real clinical environment will be evaluated.

Computer Simulation↗
PubMed1997

Understanding surgery: multimedia comes to theatre.

Educational technology is well established within Schools of Nursing, however there are few computer based learning packages within the clinical environment. It was felt within the Operating Services Directorate, Royal Hallamshire Hospital, that the development of a multimedia package would enhance and complement existing teaching methods. This paper describes the theory behind the choice of a multimedia presentation and its development within the operating theatres. The package, concentrating on general surgery, has been developed by two experienced theatre nurses and a graphic designer. This has resulted in a structured but flexible, fun package which is relevant to all learners within the operating theatre environment and allied healthcare fields. The feedback obtained from users within the clinical area has reinforced the project team's original feeling that multimedia is a highly appropriate resource for clinical education.

Computer Graphics↗
PubMed1996

Extending the multimedia patient record across the wide area network.

The Dept. of Veterans Affairs is developing and testing a wide area medical network with multimedia capabilities for coordination and consolidation of medical services across locations. The system is composed of multimedia information systems at individual medical centers connected by a high speed wide area network. The DHCP Imaging System, which has been in clinical use for six years, provides storage management and workstation acquisition and display of the multimedia data. Teleconsulting capability using a variety of mechanisms' is being prototyped and tested to meet medical staffing and consultation needs.

Computer Communication Networks↗