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At least 55 records · Page 3Linked to original sources

Recording of ECG signals on a portable MiniDisc recorder for time and frequency domain heart rate variability analysis.

Analysis of heart rate variability (HRV) is a non-invasive technique useful for investigating autonomic function in both humans and animals. It has been used for research into both behaviour and physiology. Commercial systems for human HRV analysis are expensive and may not have sufficient flexibility for appropriate analysis in animals. Some heart rate monitors have the facility to provide inter-beat interval (IBI), but verification following collection is not possible as only IBIs are recorded, and not the raw electrocardiogram (ECG) signal. Computer-based data acquisition and analysis systems such as Po-Ne-Mah and Biopac offer greater flexibility and control but have limited portability. Many laboratories and veterinary surgeons have access to ECG machines but do not have equipment to record ECG signals for further analysis. The aim of the present study was to determine whether suitable HRV data could be obtained from ECG signals recorded onto a MiniDisc (MD) and subsequently digitised and analysed using a commercial data acquisition and analysis package. ECG signals were obtained from six Thoroughbred horses by telemetry. A split BNC connecter was used to allow simultaneous digitisation of analogue output from the ECG receiver unit by a computerised data acquisition system (Po-Ne-Mah) and MiniDisc player (MZ-N710, Sony). Following recording, data were played back from the MiniDisc into the same input channel of the data acquisition system as previously used to record the direct ECG. All data were digitised at a sampling rate of 500 Hz. IBI data were analysed in both time and frequency domains and comparisons between direct recorded and MiniDisc data were made using Bland-Altman analysis. Despite some changes in ECG morphology due to loss of low frequency content (primarily below 5 Hz) following MiniDisc recording, there was minimal difference in IBI or time or frequency domain analysis between the two recording methods. The MiniDisc offers a cost-effective approach to intermediate recording of ECG signals for subsequent HRV analysis and also provides greater flexibility than use of human Holter systems.

Algorithms↗

Electronic patient records and their benefit for patient care. Findings from the Section on Patient Records.

OBJECTIVES: To summarize current excellent research in the field of patient records. METHOD: Synopsis of the articles selected for the IMIA Yearbook 2006. RESULTS: Current research in the field of patient records analyses users' needs and attitudes as well as the potential and limitations of electronic patient record systems. Particular topics are the questions physicians have when assessing patients during ward rounds, the timeliness of results when ordered electronically, the quality of documenting haemophilia home therapy, attitudes towards patient access to health records and adequate strategies for record linkage in dependence on the intended purpose. CONCLUSIONS: The best paper selection of articles on patient records shows examples of excellent research on methods used for the management of patient records and for processing their content as well as assessing the potential, limitations of and user attitudes towards electronic patient record systems. Computerized patient records are mature, so that they can contribute to high quality patient care and efficient patient management.

Awards and Prizes↗

Differential recording of upper and lower cervical N13 responses and their contribution to scalp recorded responses in median nerve somatosensory evoked potentials.

To distinguish the different origins of cervical N13 potentials in median nerve somatosensory evoked potentials (SSEPs), cervical N13 potentials were recorded by two different montages. The abnormal patterns of the SSEPs were compared to the abnormal evoked spinal cord responses (ESCPs) recorded from posterior epidural space in 13 patients with various cervical lesions. SSEPs from the posterior cervical surface were recorded from the mid-cervical level with anterior neck reference (Cv5-AN) and from the upper cervical level with inion reference (Cv2-IN). Scalp responses were recorded from the parietal region contralateral to the stimulating side with non-cephalic reference (shoulder contralateral to stimulating side). ESCPs were recorded from the posterior epidural space using catheter electrodes or needle electrodes inserted into the ligamentum flavum. Lower cervical N13 (LC-N13) recorded from the Cv5-AN montage showed similar latency to upper cervical N13 (UC-N13) recorded from the Cv2-IN montage. The latency of the early part of the P13-P14 complex in the scalp montage was similar to that of the UC-N13 and the negative peak latency of the ESCPs recorded at the C2-3 level. Attenuation of the LC-N13 and relatively preserved UC-N13 and P13-P14 were characteristic in patients with cervical syringomyelia and compression cervical myelopathy at the mid-cervical levels. Attenuation of the UC-N13 with normal LC-N13 was characteristic in patients with cervical spondylotic myelopathy who showed conduction blockade of the ESCPs at the C3-4 level. In a patient with schwannoma at the C1-2 level, conduction blockade of the ESCPs was observed at the C1-2 level. P13 was normal but P14 was prolonged. UC-N13 and P13 latencies were similar to the negative peak latency of the ESCPs at the C2-3 level. We demonstrated that two different cervical N13 potentials can be recorded by two different montages and they represent different behavior in various spinal cord lesions. In addition, at least the early part of the P13-P14 complex originates in the upper cervical region. To distinguish two different cervical N13, it is useful to detect not only the cervical pathology but also the symptomatic cervical cord compression level in patients with cervical myelopathy.

Adult↗

Use of tape-recorded food records in assessing children's dietary intake.

BACKGROUND: Dietary assessment among children is particularly problematic when techniques are dependent on memory skills or advanced cognitive development. OBJECTIVE: The current study explored the use of self-report by tape recorders to document children's dietary intake immediately upon consumption, and compared this method with the traditional, interviewer-guided recall technique. In addition, the influence of body fatness and sociodemographic characteristics on the accuracy of recall and tape-recorded food records was determined. RESEARCH METHODS AND PROCEDURES: The sample included 30 black and white children aged 6.5 to 11.6 years (x = 9.5). Energy intake (EI), measured by six 24-hour food records (three for each method), was compared with total energy expenditure calculated by the doubly labeled water technique. Paired t tests, correlation analyses, and multiple regression analyses were performed. RESULTS: The analyses revealed poor validity of the tape recorder method (x misreporting score = -1.13+/-2.62 MJ/day, r for total energy expenditure and EI = -0.06, p = 0.74). Estimates of EI differed significantly between the tape recorder and recall methods (p<0.01). The traditional recall method was confirmed as a valid estimate of energy intake (x misreporting score = 0.04+/-2.38 MJ/day), although demonstrating a modest correlation with TEE (r = 0.32, p = 0.08). Although no significant predictors of misreporting using the recall method were identified in the multivariate analyses, older children and children with higher adiposity were more likely to misreport using the tape recorder method. DISCUSSION: The results suggest that the use of the tape recorder for estimating EI does not result in accurate assessments among children, although this technique may be useful for specific subgroups (i.e., younger and leaner children).

Black People↗

Eyetrack (ET) vs the conventional paper record (CPR): a study comparing the accuracy and speed of data retrieval from glaucoma patient records.

PURPOSE: To compare patient data retrieval between electronic patient record systems (Eyetrack) and conventional paper records (CPRs). METHODS: A total of 20 long term glaucoma patient records held on Eyetrack were randomised into two collections with 10 CPRs and 10 Eyetrack records in each collection. The Eyetrack records of one collection were the CPRs of the other collection and vice versa. Four doctors, as two groups, were assessed on a separate collection of records. The time taken to answer 10 questions and the accuracy were assessed. Comparison was made of the answers between the two formats. A month later each group was assessed on the 10 CPRs of the other collection. An expert Eyetrack user was assessed on only the 20 Eyetrack notes. Comparison was made between the 20 CPRs the doctors were assessed on and the 20 eyetrack records. RESULTS: In the first comparison, the mean time for all the doctors to answer the questions on a CPR was 324.4(+/-106.0) s compared to 104.8(+/-34.0) s for Eyetrack(Mann-Whitney, P<0.01). Mean accuracy for a CPR was 84.0%(+/-13.0%) compared to 98.0%(+/-4.0%) for Eyetrack(Mann-Whitney, P<0.01). Comparing the expert Eyetrack user with the CPR showed a mean time for Eyetrack of 96.6(+/-34.8) s compared with 283.7(+/-63.9) s for CPR(Mann-Whitney, P<0.0001). Mean accuracy for Eyetrack was 97.5%(+/-7.2%) compared to 82.0%(+/-8.7%) for CPRs(Mann-Whitney, P<0.0001). CONCLUSIONS: An improvement of 3 min 40 s per record was observed with Eyetrack. Accuracy was also improved. Similar results were also found comparing an expert Eyetrack user with CPRs.

Glaucoma↗

Automating the recording and improving the presentation of the anesthesia record.

Although anesthesia records have been kept for over a hundred years, there is still discussion of their value and content. Two uses of the record are widely accepted: (1) review after the anesthetic event (as in medicolegal disputes), and (2) support of patient care during the delivery of an anesthetic. Although the anesthetic record is mandatory in much of the world, there is not a single standard for its format. Automating the generation and presentation of the record will enhance its value and help develop a consensus as to content. Merely automating the steps used to produce the manually generated record does not realize the full benefit of automation. For maximum benefit, the primary goal of automation should be to support the uses of the record. Specific techniques that are discussed include increasing time resolution, optimizing the type and location of input and display equipment, and tailoring the human interface. Particular attention is paid to the issue of how much detail is acceptable in the record, how to use visual cues to present detail properly, how to exclude extraneous detail, and how to avoid misleading presentations (erroneous interpretation of the data). Specific elements discussed include line width, the use of color, presentation of gradients, statistical summaries, contexts for reporting data, graphical techniques for increasing data content, and pictorial presentations. Current records are more often confusing because presented information is inconsistently displayed or irrelevant than because too much information is offered, and automation can ameliorate this problem.

Anesthesiology↗

Effect of a low-cost intervention on recording body mass index in patients' records.

PURPOSE: Evaluate the effectiveness of body mass index (BMI) tables placed in exam rooms as an intervention to encourage providers to calculate and record BMI scores in patients' medical records. DESIGN: In a prospective cohort design, medical record data for 276 adult patients at a federally funded community health center in New England were examined from August 2000 to August 2002 following the intervention. METHODS: Prominent, multicolored, laminated BMI tables were posted in the exam rooms of one of the study site's three primary health care teams. Medical record data collected included documentation of BMI calculation in medical records, documentation of an obesity diagnosis, and inclusion of heights and current weights. Frequency distributions were calculated; chi-square tests were used to identify associations. FINDINGS: In contrast to the comparison teams, patients on the intervention team were more likely to have BMI recorded in the medical record. A statistically significant increase in the diagnosis of obesity was observed throughout the health center after the intervention. CONCLUSIONS: Posting BMI tables in exam rooms contributed to increased BMI documentation in patients' medical records.

Adult↗

The PEN & PAD medical record model: development of a nursing record for hospital-based care of the elderly.

The PEN & PAD Medical Record model describes a framework for an information model, designed to meet the requirements of an electronic medical record. This model has been successfully tested in a computer-based record system for General Practitioners as part of the PEN & PAD (GP) Project. Experiences of using the model for developing computer-based nursing records are reported. Results show that there are some problems with directly applying the model to the nursing domain. Whilst the main purpose of the nursing record is to document and communicate a patient's care, it has several other, possibly incompatible, roles. Furthermore, the structure and content of the information contained within the nursing record is heavily influenced by the need for the nursing profession to visibly demonstrate the philosophical frameworks underlying their work. By providing new insights into the professional background of nursing records, this work had highlighted the need for nurses to clarify and make explicit their uses of information, and also provided them with some tools to assist in this task.

Aged↗