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At least 613 records · Page 34Linked to original sources
PubMed2006

Use of a personal digital assistant for managing antibiotic prescribing for outpatient respiratory tract infections in rural communities.

OBJECTIVE: To assess the acceptability and usage of a standalone personal digital assistant (PDA)-based clinical decision-support system (CDSS) for the diagnosis and management of acute respiratory tract infections (RTIs) in the outpatient setting. DESIGN: Observational study performed as part of a larger randomized trial in six rural communities in Utah and Idaho from January 2002 to March 2004. Ninety-nine primary care providers received a PDA-based CDSS for use at the point-of-care, and were asked to use the tool with at least 200 patients with suspected RTIs. MEASUREMENTS: Clinical data were collected electronically from the devices at periodic intervals. Providers also completed an exit questionnaire at the end of the study period. RESULTS: Providers logged 14,393 cases using the CDSS, the majority of which (n=7624; 53%) were from family practitioners. Overall adherence with CDSS recommendations for the five most common diagnoses (pharyngitis, otitis media, sinusitis, bronchitis, and upper respiratory tract infection) was 82%. When antibiotics were prescribed (53% of cases), adherence with the CDSS-recommended antibiotic was high (76%). By logistic regression analysis, the odds of adherence with CDSS recommendations increased significantly with each ten cases completed (P=0.001). Questionnaire respondents believed the CDSS was easy to use, and most (44/65; 68%) did not believe it increased their encounter time with patients, regardless of prior experience with PDAs. CONCLUSION: A standalone PDA-based CDSS for acute RTIs used at the point-of-care can encourage better outpatient antimicrobial prescribing practices and easily gather a rich set of clinical data.

Ambulatory Care↗
PubMed2006

Feasibility of an electronic diary in clinical burnout.

Electronic diaries overcome important drawbacks of retrospective reports and capture fluctuations of psychological states and behavior. This study represents the first use of this method in clinically burned-out participants and aims to establish its feasibility concerning participant acceptability, compliance, and reactivity in this sample. Electronic diary measurement of burnout symptoms was performed 5 times a day for 2 weeks in 60 burned-out participants on sick leave and in 40 healthy controls. The method was well accepted, compliance was high (81%-96%), and no reactivity effect was found on the recording of burnout symptoms. We conclude that the electronic diary employed is accurate, reliable, and a promising tool in capturing key symptoms and their fluctuations in clinical burnout.

Adult↗
PubMed2005

Utilization and value of personal digital assistants on an epidemiology final examination.

BACKGROUND: The utility of personal digital assistants (PDAs) in basic science medical education is uncertain. DESCRIPTION: Student outcomes on an epidemiology course final examination for academic years 2003 and 2004 were examined. Students were given permission to use PDAs on the final examination, and self-selected whether these instruments were used. Performance on the examination based on use of a PDA and whether students thought it was useful for the examination was compared. EVALUATION: A total of 389 students took the final examination, with an 88% response rate to the survey questions. No statistically significant differences were found on final examination scores. No trends toward significance were found on analyses of the total examination, specific topical domains, or on specific questions where a PDA might be expected to be especially useful. CONCLUSIONS: From this study, it can be concluded that use of PDAs and whether students thought they might be helpful had no measurable effect on performance on an epidemiology final examination. Further delineation of the possible use of PDAs in a basic science course and on the final examination is indicated.

Computers, Handheld↗
PubMed2006

Preclinical preceptorships in medical school: can curricular objectives be met in diverse teaching settings?

BACKGROUND: Although preclinical preceptorships for medical students during the first 2 years are now common, little is known about how well the curricular objectives can be met in clinical training sites. PURPOSE: To evaluate whether a clinical encounter system can help align preclinical preceptorship experiences with the core curriculum. METHODS: Using a PDA documentation system, 27 students collected student-preceptor-patient encounter information on all patients (N = 2,953) during a 2-year clinical training course. We compared Years 1 and 2 teaching and learning processes, common symptoms seen, and counseling skills performed and examined how well these clinical experiences aligned with the curricular goals. RESULTS: The majority of encounters in Year 1 involved the student observing the preceptor perform a history (47%) or physical exam (40%). In Year 2, there was a shift to student and preceptor both participating in the history (Year 1, 12%; Year 2, 24%; p = .004) and physical exam (Year 1, 34%; Year 2, 47%; p = .002). Cardiovascular; pulmonary; and head, eyes, ears, nose, and throat examinations were most common in Year 1 and increased in Year 2. Genitourinary, gynecologic, and neurological examinations occurred least often, and only the neurological examinations increased significantly in Year 2. Overall, at least 75% of students could find opportunities in Years 1 and 2 to achieve the majority of curricular goals. CONCLUSIONS: Knowing what students experience at their preceptor sites is vital for clinical skills course evaluation. Student-preceptor-patient encounter data should be used to complement other course evaluations to aid curriculum planning and decrease variability in student experiences.

Computers, Handheld↗
PubMed2006

The time-varying influences of peer and family support on adolescent daily positive and negative affect.

The time-varying influences of peer and family support on adolescent daily mood were explored among youth transitioning from middle school to high school (8th to 9th grade, N = 268) as compared to youth transitioning from 10th to 11th grade (N = 240). Real-time measures of daily positive and negative affect (ecological momentary assessments) were collected via palmtop computers at baseline, 6 months, and 12 months. Participants rated 12 mood adjectives in response to 5 to 7 random prompts per day for 7 consecutive days. Perceived peer and family support were assessed via self-report. Mixed-effects regression analyses revealed significant grade by time by peer support interactions for positive and negative mood, with the younger cohort showing greater increases in the relation between peer support and affect over time than the older cohort. Family support did not interact with cohort or time.

Adolescent↗
PubMed2005

Predicting menstrual migraine with a home-use fertility monitor.

A home-use fertility monitor was used to time perimenstrual prophylaxis in 27 women with menstrual or menstrually related migraine. Cycle length variability was mostly caused by follicular phase variability; the postovulatory luteal phase was relatively constant. The monitor accurately identified ovulation in >90% of cycles, enabling prediction of menstruation and precise timing of perimenstrual prophylaxis. Ninety-seven percent of women found the monitor useful in predicting menstrual migraine attacks.

Adult↗
PubMed2005

A comparison of paper with electronic patient-completed questionnaires in a preoperative clinic.

UNLABELLED: In this unblinded randomized control trial we compared electronic self-administered Pre-Admission Adult Anesthetic Questionnaires (PAAQ) using touchscreen technology with pen and paper. Patients were recruited in the Pre-assessment Clinic if they had completed a PAAQ in the surgeon's office. Patients were randomized to study PAAQ using paper, hand-held computer (PDA), touchscreen desktop computer (kiosk), or tablet. Patients also completed a preference and satisfaction survey. The main outcome measures were percent agreement between the prestudy and study PAAQ and time to completion. Only six of the 366 patients approached refused to participate. The median time to completion of the PAAQ was shortest on the kiosk (2.3 min) and longest on the PDA (3.2 min) (chi2 = 14.5; P = 0.002). The mean agreement between the prestudy and the study PAAQ was approximately 94% across all study arms. The proportion of participants expressing comfort before and after completing the PAAQ increased from 10% to 97% on the computerized arms and from 60% to 64% on the paper arm. Touchscreen computer technology is an accurate, efficient platform for patient-administered PAAQ. Patients expressed comfort using the technology and preference for computerized versus paper for future questionnaires. IMPLICATIONS: Self-administered electronic health questionnaires using touchscreen computer technology are an accurate means of collecting patient information in the preoperative setting and can provide a valuable basis for an electronic perioperative patient record. Patients expressed comfort and satisfaction with this method of questionnaire completion.

Adolescent↗
PubMed2004

A study of the use of hand-held devices in an emergency department.

In a project conducted in 2002 and 2003, the use of hand-held computing devices was examined in a hospital emergency department in Western Australia. Personal digital assistants (PDAs) were used for the wireless development. The study addressed three major issues: development methodology, communication between the mobile devices and existing databases, and user interfaces. The software was tested by about 20 health-care staff, including nurses, doctors, administration staff, information technology staff and front-desk receptionists. The wireless development proved a valuable experience for everyone involved. The product is currently undergoing rigorous testing to meet the standards of the healthcare industry.

Communication↗
PubMed2005

A Web-based mobile asthma management system.

Continuous recording of daily symptoms constitutes an effective means of managing asthma patients. Daily management reduces the costs associated with hospitalization and improves the quality of patient care. We have implemented a Web-based mobile asthma management system. We used a pocket PC, mobile phone and desktop computer. The recorded items and individualized prescriptions were structured using Extensible Mark-up Language (XML) DTD (Data Type Definition). The mobile Web form was automatically adjusted to fit the different display resolutions of the terminal devices. The system provided reliable exchange of all relevant information between a doctor and the asthma patient using wireless mobile transmission. E-mail and Short Messaging Service (SMS) were used to send messages to patients, for example in the case of an automatically determined patient alert. Patients could obtain customized instructions according to their daily personal symptoms, peak expiratory flow (PEF), medications and activity restriction. The daily graph of PEF and the graphs of symptoms and medication were particularly useful for asthma patient control and self-awareness of the progress of the disease.

Asthma↗
PubMed2005

Preferences of general practitioners regarding an application running on a personal digital assistant in acute stroke care.

An application was developed to optimize information exchange in acute stroke care, with which general practitioners (GPs) could consult hospital emergency units. However, it was difficult to obtain clear preferences from GPs regarding the functional requirements of the information to be transferred or the architecture of the application. Thirteen GPs volunteered to take part in the study. The GPs used a personal digital assistant in their daily work for a period of six weeks when visiting stroke patients during their evening, night and weekend shifts. A conjoint analysis was conducted to obtain the least and most preferred characteristics of the application, to facilitate implementation on a larger scale. The main outcome was that GPs preferred the decision-support facilities and the presence of information about the patient's medical history.

Adult↗
PubMed2005

Wearable devices for telemedicine applications.

Wearable medical devices can provide both continuous monitoring and ubiquitous treatment. Challenges in this area include the need for a low-power/power-saving design to extend battery life and to reduce the size of the battery itself. This is followed by size and weight restrictions to meet patient expectations of what is 'wearable', the biocompatibility of all outer housings and the final assembly concept. Two examples of wearable medical device are described: a wrist-wearable telemedicine monitor for heart patients (AMON) and a generic belt-integrated computing platform for home and hospital use (QBIC). The electrocardiogram (ECG), the blood oxygen saturation (SpO2) sensor and the blood pressure meter of the AMON device were tested with 29 subjects. The sensors were found to be functional, but as expected the data processing algorithms will need some fine-tuning. The prototype QBIC demonstrates a size reduction of 30-50% in relation to comparable devices.

Computers, Handheld↗
PubMed2006

Design and implementation of an electronic data recording and processing system for physics quality control checks in external beam radiotherapy.

Quality control (QC) of external beam radiotherapy equipment ensures that commissioning performance is maintained. Paper based data recording is still used for QC, but this is resource intensive in terms of data calculation and processing. Electronic systems of data recording have many advantages; for example, they facilitate the analysis of data on a regular basis, allowing the user to examine the "health" of each machine; they help review and audit local frequencies of each check and can possibly predict component failure. They also allow for secure calculation of results and automatic charting for routine trend analysis. Initially, data recording at our centre was paper-based for daily, weekly and monthly checks. This paper system has been successfully replaced with an electronic system for QC data recording and processing for linear accelerators and superficial units. The system makes use of personal digital assistants and networked laptops for online recording of data, and networked desktop PCs for offline work. The systems of data recording have been designed using the power of macros within Microsoft Excel, which automatically calculate each QC parameter and charts the data recorded for long-term analysis of trends. As of the beginning of 2006, these systems have been fully implemented. The benefits of implementing such a system are numerous, for example, central storage, backup and archiving of data, for greater security and reducing operator errors in calculations. Other benefits are discussed within the paper. In the future, we hope to develop similar systems of data recording for QC checks on other radiotherapy equipment.

Computers, Handheld↗
PubMed2003

Implementing PDA technology in a medical library: experiences in a hospital library and an academic medical center library.

Personal digital assistants (PDAs) have grown from being a novelty in the late 1990s to an essential tool for healthcare professionals in the 2000s. This paper describes the experiences of a librarian who implemented PDA technology first in a hospital library, and then at an academic medical center library. It focuses on the role of the library in supporting PDA technology and resources. Included are programmatic issues such as training for library staff and clinicians, and technical issues such as Palm and Windows operating systems. This model could be used in either a hospital or academic health sciences library.

Academic Medical Centers↗
PubMed2004

Family practice clerkship information seminars:the role of the health sciences library.

This article will describe the New Jersey Medical School (NJMS) Family Medicine clerkship's Information Seminars for thirdyear medical students, conducted by the faculty and staff of the Department of Family Medicine and by librarians at the University of Medicine and Dentistry of New Jersey's (UMDNJ) George F. Smith Library of the Health Sciences. Content of the information seminars will be briefly described, as well as the renewed focus on the library through the incorporation of evidence-based medicine concepts into practice.

Clinical Clerkship↗
PubMed2005

PDA power at the bedside.

George Washington University's Himmelfarb Health Sciences Library was investigating adding PDA resources to the collection when a medical education grant was received. Funds were used for a pilot project to compare PDA use by third-year medical students (MSIII), fourth-year medical students (MSIV), second-year physician assistant (PAII) students, and residents in the clinical setting. The PDA Committee evaluated various titles by the following criteria: both Palm and PocketPC operating systems compatibility, ease of use, depth of information, product cost, and a wide target audience. Griffith's 5 Minute Clinical Consult by Skyscape was selected. Library registration was required to receive the software and PDA downloading instructions. A short, Web-based questionnaire was developed to evaluate the product's use in the clinical setting. A low response rate of 74 questionnaires (23% of participants) was received and analyzed in March 2004. As additional funding becomes available, PDA software will be seriously considered as additions to the collection.

Computers, Handheld↗
PubMed2005

Implementation of the Clinical Encounters Tracking system at the Indiana University School of Medicine.

The Indiana University School of Medicine (IUSM) Office of Medical Education &Student Services directed the IUSM Educational Technology Unit to develop a Clinical Encounters Tracking system in response to the Liaison Committee on Medical Education's (LCME) updated accreditation standards. A personal digital assistant (PDA) and centralized database server solution was implemented. Third-year medical students are required to carry a PDA on which they record clinical encounter experiences during all clerkship clinical rotations. Clinical encounters data collected on the PDAs are routinely uploaded to the central server via the PDA HotSyncing process. Real-time clinical encounter summary reports are accessed in the school's online curriculum management system: ANGEL. The resulting IUSM Clinical Encounters Tracking program addresses the LCME accreditation standard which mandates the tracking of medical students' required clinical curriculum experiences.

Accreditation↗