Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Digital Health”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed2006

A questionnaire survey of patient preparation and techniques for prostate biopsy among urologists in the Kyushu and Okinawa regions of Japan.

BACKGROUND: We surveyed urologists in the Kyushu and Okinawa regions of Japan regarding their standard approach to patient preparation and their prostate biopsy technique. METHODS: A total of 155 survey questionnaires were prepared and mailed to community and academic urologists in the Kyushu and Okinawa regions. Incidences were derived from the total numbers of responses, by item, divided by the total number of responses per practice type. RESULTS: There were 27 responses from clinics (17.4%), 115 from general hospitals (74.2%), and 13 from university hospitals or cancer centers (8.4%). Most urologists performed biopsy in patients with prostate-specific antigen (PSA) levels greater than 4 ng/ml when digital rectal examination (DRE) and/or transrectal ultrasound (TRUS) results were normal. Of the urologists, 83% reported performing the procedure with hospitalization; 51% of urologists do not advocate enema use, 69% performed the procedure under spinal anesthesia or a sacral block, 53% reported the combined administration of antibiotics orally and intramuscularly or intravenously, 70% used only the transrectal route for prostate biopsy, and 86.5% performed six or more biopsy cores at the initial prostate biopsy session. CONCLUSION: This survey shows substantial variation in the prostate biopsy protocols among urologists in the Kyushu and Okinawa regions in Japan, and suggests that national, evidence-based, guidelines are required, particularly as to antibiotic prophylaxis and the number of biopsy cores.

Anesthesia, Local↗
PubMed2005

DICOM router: an open source toolbox for communication and correction of DICOM objects.

RATIONALE AND OBJECTIVE: Today, the exchange of medical images and clinical information is well defined by the digital imaging and communications in medicine (DICOM) and Health Level Seven (ie, HL7) standards. The interoperability among information systems is specified by the integration profiles of IHE (Integrating the Healthcare Enterprise). However, older imaging modalities frequently do not correctly support these interfaces and integration profiles, and some use cases are not yet specified by IHE. Therefore, corrections of DICOM objects are necessary to establish conformity. The aim of this project was to develop a toolbox that can automatically perform these recurrent corrections of the DICOM objects. MATERIALS AND METHODS: The toolbox is composed of three main components: 1) a receiver to receive DICOM objects, 2) a processing pipeline to correct each object, and 3) one or more senders to forward each corrected object to predefined addressees. The toolbox is implemented under Java as an open source project. The processing pipeline is realized by means of plug ins. One of the plug ins can be programmed by the user via an external eXtensible Stylesheet Language (ie, XSL) file. Using this plug in, DICOM objects can also be converted into eXtensible Markup Language (ie, XML) documents or other data formats. DICOM storage services, DICOM CD-ROMs, and the local file system are defined as input and output channel. RESULTS: The toolbox is used clinically for different application areas. These are the automatic correction of DICOM objects from non-IHE-conforming modalities, the import of DICOM CD-ROMs into the picture archiving and communication system and the pseudo naming of DICOM images. CONCLUSION: The toolbox has been accepted by users in a clinical setting. Because of the open programming interfaces, the functionality can easily be adapted to future applications.

CD-ROM↗
PubMed2006

Librarians, surgeons, and knowledge.

are indicative of the ferment of change brought about by the digital revolution, and of the continuing determination of health information professionals to rise to the challenges involved in supporting surgeons and everyone in the surgical team, as they endeavor to provide the best possible care for their patients. Libraries as we know them have changed, and are changing. The scholarly communications process is also undergoing profound transformation. The authors discuss these changes and their implications for surgeons.

Clinical Competence↗
PubMed1994

Comparison of standardized echography with magnetic resonance imaging to measure extraocular muscle size.

Using both standardized echography and high-resolution, surface coil magnetic resonance imaging, we measured the transverse diameter of recti extraocular muscles to evaluate comparative accuracy. Maximum transverse diameter of each rectus muscle in primary gaze was measured in 39 orbits of 20 subjects by using standardized A-scan echography. In the same orbits, we obtained multiple coronal magnetic resonance imaging planes by using a surface coil to span the anteroposterior extent of each orbit. Digital image analysis with the National Institutes of Health Image program was used to measure transverse muscle diameter. Average size for each rectus muscle was similar for the echographic and magnetic resonance imaging techniques. However, linear regressions of individual ultrasound against magnetic resonance imaging measurements showed coefficients of determination (R2) moderate (0.29) for inferior recti muscles and low (< or = 0.11) for other recti muscles. For most recti muscles, significant variability in echographic estimates of muscle width results from factors other than true muscle size. Results indicate that ultrasound measurements of muscle size in individual patients should be interpreted cautiously.

Adolescent↗
PubMed1972

What is a doctor?

Explore the source record for details and available documents.

Analog-Digital Conversion↗
PubMed2004

Implementing a full-feature PACS solution in accordance with the IHE technical framework: the CHILI approach.

RATIONALE AND OBJECTIVES: During the last 4 years, Integrating the Healthcare Enterprise (IHE) has worked in establishing a reliable integrated environment for medical imaging devices and other clinical information systems by using existing industry standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7). Because IHE is organized and driven by professional organizations representing both buyers and vendors, it was able to define a common language for the various health care parties who are involved in the integration process. Thus IHE offers a rigorously organized technical framework that provides a comprehensive guide for a coordinated implementation of information standards. MATERIALS AND METHODS: A multistage plan for incorporating the IHE elements while scaling up general-purpose workstations with teleradiology functionalities to a full-feature picture archiving and communication system (PACS) solution was created. To introduce a pragmatic example, the plan approach was applied to the CHILI workstations (CHILI, Heidelberg, Germany). To implement the proposed plan in making various legacy systems comply with IHE, the effects of available resources and market needs on the plan are discussed. Most implementation challenges and problems were overcome using generic design approaches and well-designed DICOM utilities. RESULTS: On completion of the first stage, the PACS viewer and reporting workstations were IHE-compliant. In addition, the plan facilitates the conformance process while maintaining the planned software development cycle. CONCLUSION: Based on these positive results and the practical experience acquired during the first stage, further stages will be completed to provide the system with the required plug-and-play interoperability among systems from different vendors.

Data Display↗
PubMed2003

Patient knowledge and attitude toward information technology and teledermatology: some tentative findings.

A large proportion of Internet users tend to ask health-related questions. There is evidence of growing interest in the use of information technology in health care delivery. Moreover, patient-driven health care is becoming a reality. We hypothesized that dermatology outpatients would be knowledgeable and capable of participating in teledermatology services. Hence, this study was conducted to evaluate knowledge among teledermatology patients. The survey instrument was composed of 16 close-ended questions. The validity and reliability of the questions were tested in a pilot study. Institutional Review Board approval was obtained. Consecutive patients seen at two dermatology clinics at tertiary care hospitals were recruited for a regular survey. A total of 430 questionnaires were completed. About two-thirds of the patients reported having a computer at home, with Internet access, and also using e-mail regularly. Slightly more than one-half of them used the Internet to search for health-related information. One in 5 patients had digital cameras. More than one-half would consider getting an opinion from their physician or send their skin images to their physician via a secure Internet connection. Based on this cross-sectional survey, dermatology outpatients seem to be accepting of and technologically capable of participating in teledermatology.

Adult↗
PubMed1999

Marital stability after breast cancer.

BACKGROUND: The belief that husbands desert wives who have breast cancer is not uncommon and may be a source of stress for women confronting this disease. To assess the validity of this belief, we examined the role of breast cancer as a determinant of marital breakdown by comparing the frequencies of marital breakdown among women with breast cancer and among control women from Quebec City and surrounding regions. METHODS: Secondary analyses were performed on data collected from women who were newly diagnosed with nonmetastatic breast cancer in 1984 or during the period from 1990 through 1992 and then interviewed 3 months, 18 months, and 8 years after diagnosis (1984 cohort) or interviewed 2 weeks, 3 months, and 12 months after diagnosis (1990-1992 cohort). Population-based control subjects (four groups) were recruited through random-digit dialing and from participants in the Quebec Health Surveys for 1987 and 1992. Eligible subjects were those who were living with a spouse at the time of interview and those who reported divorce or separation in the time periods examined. Marital breakdown in the past 12 months and 5 years and current marital satisfaction and adjustment were assessed. All P values are two-sided. RESULTS: Marital breakdown was never higher in women with breast cancer than in control women. Among women with breast cancer, low marital satisfaction within 3 months of diagnosis predicted further marital difficulties (a breakdown-P = .02 at 12-month interview and P = .01 at 18-month interview; low marital satisfaction- P<.0001 at 12-month interview and P = .005 at 18-month interview). CONCLUSIONS: For the times studied, breast cancer does not appear to be associated with marital breakdown among Quebec women. Marital difficulties occurred mainly among the small proportion of women who probably already had marital difficulties when diagnosed.

Adult↗
PubMed1983

Neuroma formation following digital amputations.

One hundred consecutive patients with 144 digital amputations performed at the University of Colorado Health Sciences Center between 1978 and 1980 were retrospectively reviewed. In this group, four patients demonstrated painful amputation stumps. Two of these were treated by surgical excision of neuromas and two patients, who had more vague complaints, were treated by desensitization which decreased the sensitivity of their stumps and allowed them to return to work. It is felt that this low incidence of painful neuromas and amputation stumps is due to the positive postoperative effort to send patients back to work as soon as possible, allowing them to perform their own therapy and thereby minimizing their disability and tendency to develop pain problems.

Adult↗
PubMed2004

Cleansing, moisturizing, and sun-protection regimens for normal skin, self-perceived sensitive skin, and dermatologist-assessed sensitive skin.

Acquiring or maintaining healthy skin requires a multifunctional approach: mild cleansing, moisturizing, and sun protection. The clinical benefits of a daily, healthy facial skin-care regimen comprising a mild cleanser and moisturizer were evaluated on normal skin, self-perceived sensitive skin, and dermatologist-assessed sensitive skin for a period of up to 4 weeks. Subjects with normal, healthy skin were photographed with a calibrated, high-resolution digital camera, and the average improvement in overall health was calculated using image morphing and facial averaging techniques, following a 2-week period of product application. In a second study that included subjects with self-assessed sensitive facial skin, changes in skin hydration, skin dryness, and skin sensitivity (determined by means of a lactic acid sting test and subject self-assessment) were monitored during a 3-week regimen of mild cleansing and moisturizing with products designed for sensitive skin. The third study involved dermatologist-assessed highly sensitive skin patients (mostly rosacea with an atopic background in some cases). These patients underwent a 4-week skin-care regimen involving mild cleansing and moisturizing. In all three studies, significant improvements in skin health/quality were observed by means of expert assessments, instrumental evaluations, and subjective self-assessment.

Adolescent↗
PubMedDate not supplied

An informatics infrastructure is essential for evidence-based practice.

The contention of the author is that an informatics infrastructure is essential for evidenced-based practice. Five building blocks of an informatics infrastructure for evidence-based practice are proposed: 1) standardized terminologies and structures, 2) digital sources of evidence, 3) standards that facilitate health care data exchange among heterogeneous systems, 4) informatics processes that support the acquisition and application of evidence to a specific clinical situation, and 5) informatics competencies. Selected examples illustrate how each of these building blocks supports the application of evidence to practice and the building of evidence from practice. Although a number of major challenges remain, medical informatics can provide solutions that have the potential to decrease unintended variation in practice and health care errors.

Evidence-Based Medicine↗
PubMed2005

Prostate cancer: correlation of MR imaging and MR spectroscopy with pathologic findings after radiation therapy-initial experience.

PURPOSE: To prospectively evaluate magnetic resonance (MR) imaging and MR spectroscopy for depiction of local prostate cancer recurrence after external-beam radiation therapy, with step-section pathologic findings as the standard of reference. MATERIALS AND METHODS: Study received institutional approval, and written informed consent was obtained. Study was compliant with Health Insurance Portability and Accountability Act. Sextant biopsy, digital rectal examination, MR imaging, MR spectroscopy, and salvage radical prostatectomy with step-section pathologic examination were performed in nine patients with increasing prostate-specific antigen levels after external-beam radiation therapy. MR imaging criterion for tumor was a focal nodular region of reduced signal intensity at T2-weighted imaging. MR spectroscopic criteria for tumor were voxels with choline (Cho) plus creatine (Cr) to citrate (Cit) ratio ([Cho + Cr]/Cit) of at least 0.5 or voxels with detectable Cho and no Cit in the peripheral zone. Sensitivity and specificity of sextant biopsy, digital rectal examination, MR imaging, and MR spectroscopy were determined by using a prostate sextant as the unit of analysis. For feature analysis, MR imaging and MR spectroscopic findings were correlated with step-section pathologic findings. RESULTS: MR imaging and MR spectroscopy showed estimated sensitivities of 68% and 77%, respectively, while sensitivities of biopsy and digital rectal examination were 48% and 16%, respectively. MR spectroscopy appears to be less specific (78%) than the other three tests, each of which had a specificity higher than 90%. MR spectroscopic feature analysis showed that a metabolically altered benign gland could be falsely identified as tumor by using MR spectroscopic criteria; further analysis of MR spectroscopic features did not lead to improved MR spectroscopic criteria for recurrent tumor. CONCLUSION: In summary, MR imaging and MR spectroscopy may be more sensitive than sextant biopsy and digital rectal examination for sextant localization of cancer recurrence after external-beam radiation therapy.

Humans↗
PubMedDate not supplied

Willingness to pay per quality-adjusted life year in a study of knee osteoarthritis.

BACKGROUND: Determining whether a particular medical intervention is cost-effective requires that a threshold of cost per benefit gained be established. As debate continues over the appropriate threshold, we present measures of willingness to pay (WTP) per quality-adjusted life year (QALY) for own health and 2 hypothetical osteoarthritis scenarios. METHODS: One hundred ninety-three persons, located through random digit dialing in Harris County, Texas, completed face-to-face interviews collecting demographic information and health preferences using visual analog scale, time tradeoff, standard gamble, and WTP methodologies. RESULTS: The mean WTP/QALY for all methods was lower (range, $1221-$5690/QALY) than many estimates from revealed preference studies and lower than the oft-cited arbitrary cutoff of $50 000. WTP/QALY was highest when participants were judging their personal health improvements as opposed to hypothetical scenarios. There were some significant differences in WTP/QALY across elicitation methodologies for the same scenario. Demographic characteristics were not associated with WTP/QALY measures. CONCLUSIONS: The health states and improvements in health evaluated here do not contain a risk of mortality, unlike many situations in which WTP/QALY has been previously evaluated. The lower WTP/QALY values found here may indicate that the presence of a mortality risk reduction substantially increases stated WTP/QALY. Appropriate thresholds for cost-effectiveness may be dependent on the context of a situation, including risk of mortality.

Adult↗
PubMed2026

Transcranial Photobiomodulation Variables Assessment Battery: Development and Validation.

Transcranial photobiomodulation (tPBM) response variability is partly driven by biophysical characteristics such as skin tone and hair properties that attenuate photon penetration, and by lifestyle factors including sleep quality, alcohol use, and nicotine consumption that disrupt the mitochondrial and vascular pathways on which tPBM acts. To date, no validated self-report tool exists to capture these moderators systematically. To address this gap, the tPBM Variables Assessment Battery was developed and psychometrically evaluated. It integrates adapted versions of established measures (Brief Pittsburgh Sleep Quality Index, E-cigarette Dependence Scale, Hair Scale Assessment PRO, Monk Skin Tone Scale, and Heaviness of Smoking Index), validated wellbeing evaluators (Ryff's Psychological Wellbeing), and custom measures (Hairstyle Classification, Hair Color Classification). Face and content validity met recommended expert thresholds, internal consistency was acceptable across adapted subscales, and criterion validity analyses confirmed meaningful associations between the lifestyle components and PROMIS-10 global health outcomes. The battery is low-burden, digitally deployable, and psychometrically defensible, offering a practical tool for characterizing the variables most likely to moderate tPBM response in home-use studies.

Humans↗