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PubMed2005

International comparison of the definition and the practical application of health technology assessment.

OBJECTIVES: Health Technology Assessment (HTA) is defined as a policy research approach that examines the short- and long-term social consequences of the application or use of technology. Internationally different institutions have translated this definition to local contexts. In Denmark, HTA is comprehensive with focus on four aspects of the problem in question (technology [clinical evidence], economy, patient, and organization). The objective of this study is to study how the application of HTA differs across leading countries and to study the extent to which Danish HTA reports differ from foreign HTAs. METHODS: A sample of 433 HTA reports published in the period 1989--2002 by eleven leading institutions or agencies in Denmark and eight other countries were reviewed. We looked at the characteristics of the HTA with respect to focus on the four main aspects and the manner in which each aspect has been approached. RESULTS: The study shows health technology procedures to be the most common type of health technology assessed in HTAs and literature review to be the most often used method of analysis. Policy recommendations are only present in approximately half of the HTA reports. CONCLUSIONS: In the HTAs one generally sees a great focus on the clinical aspect of health technologies, leaving the economic, the patient-related, and the organizational aspect much more unanalyzed. The Danish HTAs generally have a wider scope than HTAs produced in other countries and tend to focus more frequently on patient-related and organizational dimensions.

Denmark↗

PubMed2004

Environmental implications of wireless technologies: news delivery and business meetings.

Wireless information technologies are providing new ways to communicate, and are one of several information and communication technologies touted as an opportunity to reduce society's overall environmental impacts. However, rigorous system-wide environmental impact comparisons of these technologies to the traditional applications they may replace have only recently been initiated, and the results have been mixed. In this paper, the environmental effects of two applications of wireless technologies are compared to those of conventional technologies for which they can substitute. First, reading newspaper content on a personal digital assistant (PDA) is compared to the traditional way of reading a newspaper. Second, wireless teleconferencing is compared to business travel. The results show that for both comparisons wireless technologies create lower environmental impacts. Compared to reading a newspaper, receiving the news on a PDA wirelessly results in the release of 32-140 times less CO2, several orders of magnitude less NOx and SOx, and the use of 26-67 times less water. Wireless teleconferencing results in 1-3 orders of magnitude lower CO2, NOx, and SO2 emissions than business travel.

Commerce↗

PubMed2002

Measuring the economic returns from successful NASA life sciences technology transfers.

Since 1958 NASA has invested approximately $3.7 billion in life sciences R&D in the support of the successful human space flight program. There are numerous studies documenting the spin-off technologies that can be traced to NASA research and development activities. Most of these studies describe the technologies and their uses; however only a few measure the economic impact of the spin-offs and most of these are benefit/cost studies that tend to overstate benefits or underestimate costs. This study takes a different approach, measuring only economic impacts to the companies that developed successful spin-off products from NASA life sciences investments. A personal interview was conducted with each company and the benefits are conservatively estimated as the value-added by the NASA technology to the company's output and the amount of additional private R&D stimulated by the NASA R&D. This pilot study of fifteen companies, using a very conservative measurement technique, found a large return to companies that have successfully commercialized NASA life sciences spin-off products. Value-added benefits totaled over $1.5 billion and a NASA R&D total investment in these 15 technologies of $64 million was found to stimulate an additional $200 million in private R&D. The study also found that the largest benefits were from products developed and marketed by large companies, primarily because these companies had the financial and marketing resources to work on a scale unavailable to smaller companies. Many of the small companies reported very profitable product-lines as well as documented evidence of benefits extending to the commercial users of their products. However, the smaller companies often lacked either the ability or the desire to expand into much larger scale production. NASA and other government technology transfer programs may be overlooking an opportunity to enlarge the economic benefits from their spin-off technologies. When a federal R&D grant or contract ends, the formal relationship between the agency and the company also usually ends. However, the companies continue to use the prior connection to NASA for advertising and for developing new business partners. One recommendation of this study is for NASA to be more proactive with "alumni" companies and to help open additional financial and marketing doors for these companies.

Biological Science Disciplines↗

PubMed2001

Postmodern negotiations with medical technology: the role of midwifery clients in the new midwifery in Canada.

In 1994, after more than a century of uncertain legal status, the Province of Ontario legalized midwifery and incorporated midwives into the formal health care system. Midwifery is now accessible and publicly funded for all women experiencing "normal" uncomplicated pregnancy and birth. Yet midwifery's move from the margins into the mainstream health care system has brought many new challenges. Midwives must now contend with an expanded scope of practice; they use more medical technology both to fulfill their professional obligations and to respond to the choices of women. This and an increased accessibility to a wider clientele seem to work against midwifery as a critical, low-tech alternative to "technocratic birth." In this article, through re-telling and analyzing women's narratives of pregnancy and birth, I explore the role of midwifery clients in re-shaping midwifery's relationship to medical technology. Steering away from essentialist explanations that hold that women are either inherently opposed to technology by virtue of their closeness to nature or wholly oppressed by technology and the systems within which it is imbedded, my analysis focuses on women's agency (on what women do rather than on what is done to them). My study suggests that women act pragmatically both with regard to biomedical technology and to midwifery. I argue that women's negotiations with medical technology have been instrumental in re-shaping midwifery as a postmodern phenomenon.

Biomedical Technology↗

PubMed2026

Effectiveness and usability of artificial intelligence-powered assistive technologies in Supporting daily activities of children with cerebral palsy: a systematic review.

BACKGROUND: Cerebral Palsy (CP) is the main cause of motor disabilities in childhood, necessitating innovative approaches to rehabilitation and assistive technology (AT). Simultaneously, artificial intelligence (AI) is increasingly being integrated into devices to create more adaptive, personalized, and effective AT. This systematic review aimed to evaluate the effectiveness and usability of AI-powered assistive technologies designed to support daily activities and rehabilitation in children with CP. MATERIALS AND METHODS: Five databases, including Scopus, Web of Science, PubMed, Embase, and IEEE Xplore, were systematically searched, and 23 articles were included in the final analysis. Articles were identified, selected, and categorized into emerging thematic areas based on the primary function and application of the technology. RESULTS: Five key thematic topics were identified: 1) AI-driven motor rehabilitation and gait training for functional mobility; 2) intelligent assessment and monitoring systems for clinical decision support; 3) AI-supported communication, social interaction, and intention recognition tools; 4) gamified and virtual reality-based interventions to enhance engagement and usability; and 5) smart assistive systems supporting daily living and independent mobility. The findings demonstrate a strong trend toward the application of AI technologies in personalized, engaging, and data-driven interventions for children with CP. However, the field is predominantly in the proof-of-concept stage, with limitations including small sample sizes, lack of long-term clinical validation, challenges in user-centered design, and usability for children with CP. CONCLUSION: AI-powered assistive technologies hold significant potential for transforming the care of children with CP by enabling highly personalized and engaging interventions. To actualize this potential, future work must realize that practical application remains challenging owing to limited clinical validation, technological integration, and usability barriers for children with CP. Future research must prioritize user-centered design and multidisciplinary collaboration to ensure that AI and robotic advancements improve the usability and quality of life for children with CP.

Humans↗

PubMedDate not supplied

Receptivity to new technology among older adults.

PURPOSE: Both absolute and relative increases in the older adult population are occurring concurrently with the growth of high technology. Technological devices offer sophisticated solutions to some of the problems associated with ageing. This study borrows from the health utilization literature in order to develop and test a model for understanding receptivity to specific technological products by older adults. RESULTS: Receptivity is directly influenced by predispositional, need and social support factors, as well as by one's level of concern for problems that could be alleviated through the use of technology. Hierarchical regression equations reveal that this latter variable, concern, has the strongest influence on receptivity, while need factors display strong indirect effects. Those with unsatisfactory contact with others are also more receptive, suggesting that the lack of social support acts as a need factor. Contrary to past research, women are more receptive to technology than men. CONCLUSIONS: The results indicate that new technology geared toward enhancing the quality of life of seniors in their homes would be welcomed by many.

Aged↗

PubMed1994

The regulatory environment past and future--incentive or impediment to developments in food science and technology: a perspective from FDA.

The best system for protecting public health is one that involves two layers of control before food reaches the consumer. The first layer of control is the industry's clear responsibility to prepare food that is safe. The second layer of control is the monitoring that is provided by government to ensure that the industry is doing its job and is in fact producing safe food. While some may view this "second layer" as an impediment in the development and marketing of new technologies, there is another way to look at the "regulatory environment". The regulatory environment itself, is not an impediment to the development of food science and technology. The regulatory environment, with all its components--scientists, consumers, industry, and Congress--defines "safety" within the context of today's technology, scientific capability, and tolerance level of the lay public. The entire regulatory environment serves to guide the development of food science and technology by providing signposts, in the form of scientifically sound regulatory decisions. The scientific basis of these decisions becomes building blocks on which to rest further refinement of the technology, product, ingredient, or packaging material or on which research in related technologies or research in innovative directions can build. This scientific groundwork becomes very important as more and more companies move away from having self-contained research laboratories toward using commercial laboratories and academic institutions, as well as participating in cooperative research endeavors to meet food safety and product development research needs.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1991

Overview and update of the Superfund Innovative Technology Evaluation (SITE) Demonstration Program.

The Superfund Innovative Technology Evaluation (SITE) Program is now in its sixth year of demonstrating technologies applicable to Superfund sites. The SITE Program, conducted by the U.S. Environmental Protection Agency's Risk Reduction Engineering Laboratory, is intended to accelerate the use of new and innovative treatment processes as well as evaluate innovative measurement and monitoring techniques. Within the SITE Program, the Demonstration Program and the Emerging Technologies Program are responsible for innovative/alternative waste treatment technology development. Separate and parallel activities are progressing for development and evaluation of measuring and monitoring technologies as well as technology transfer operations.

Environmental Pollution↗

PubMed2004

Preventing medication errors with smart infusion technology.

PURPOSE: Processes that pharmacists can use to identify high-risk areas and drugs that require special focus in error-prevention efforts are discussed, with emphasis on the need for i.v. medication error prevention. SUMMARY: Pharmacists can help determine where best to focus medication safety efforts and innovative technology by identifying areas that pose the greatest risk of harm to a patient, such as medications, administration routes, patient care areas, and diagnosis-related groups. Delivery of i.v. medications via infusion devices has traditionally not been a major concern for pharmacists. The introduction of "smart" infusion technology has changed that paradigm by requiring pharmacist involvement in defining minimum and maximum doses for continuous and bolus infusions used within a health care facility. This technology provides a software filter to prevent key-stroke errors in programming infusion devices for delivery of i.v. drugs, as well as a new source of data with which to measure medication errors at the bedside. Implementation of smart infusion technology at Vanderbilt University Medical Center appeared to prevent errors involving heparin. In addition to having an immediate positive impact at the bedside, the technology was relatively easy to implement. CONCLUSION: Smart infusion systems represent an innovative technology that can provide an additional layer of protection at the point of care to help avert i.v. drug errors and prevent patient harm.

Biomedical Technology↗

PubMed2002

Managed care, medical technology, and the well-being of society.

The growth of managed care could have widespread effects on the structure and functioning of the health care delivery system, potentially influencing all patients, even those not enrolled in managed care plans. One important mechanism by which managed care could have such broad effects is by influencing technology development and adoption. This article examines available literature on the effects of managed care activity on technology adoption and the implications of any effects on patient care, outcomes, and health care costs. Existing literature supports the view that managed care has contributed to slowing the adoption of new technologies, particularly the high-cost, high-profile technologies that have been the focus of the most attention. The literature outlining the effects of managed-care-induced changes in technology adoption on patient care and outcomes is not large, but what literature there is tends not to find negative effects on patient care and outcomes. Specific evidence about costs also is somewhat sparse, but it suggests that managed care has contributed to some reduction in health care spending, although the extent to which savings will persist over time is unclear. Although evidence thus far does not suggest important detrimental effects of managed care on care or outcomes and even indicates some benefit through savings, it should be noted that existing literature has only explored a small number of the many technologies and services that might have been influenced, and there remain issues for the future that deserve vigilance.

Biomedical Technology↗

PubMed2001

Measuring the impact of new technology: an outcomes-based approach.

In the current era of decreasing resources, many healthcare organizations are under increasing pressure to evaluate new technology. Advances and innovations in healthcare technology are instrumental in reshaping the healthcare system and in impacting the practice of medicine, including critical care. Healthcare organizations are faced with the following four questions related to adopting a new technology: 1) Should the organization invest in this technology? 2) What are the associated benefits and risks of the capital investment? 3) What is the impact on patient outcomes as a result of adopting the technology? 4) What is the return on investment to the organization? These issues represent challenging areas for the researcher, clinician, manager, and policy maker. New techniques from the business and outcomes research arenas allow for the development of quantitative and qualitative models to facilitate answering these questions. By integrating business and clinical considerations, these models can impact policy at two levels: 1) by identifying optimal capital expenditure decisions for individual healthcare organizations, it can provide a significant competitive advantage for an organization; and 2) by identifying optimal health policies related to technology at a national and international health level, it can impact the healthcare systems and patient outcomes in a favorable manner.

Cost-Benefit Analysis↗

PubMed1988

Modern technology in the rehabilitation process.

Modern technology gives a variety of new opportunities for severely disabled persons. It is time to start a serious discussion about how these new opportunities can be incorporated in rehabilitation theory and practice. In this article we show how modern technology may support independent life for the severely disabled. And we also discuss how modern technology can be used to change the environment. Removal and prevention of environmental barriers for participation is one main practical rehabilitation method. Modern technology therefore must also be evaluated by its environmental consequences. One important question is: How can modern technology open up more areas of normal participation for the disabled? The research approach is fieldwork, interviews with disabled persons, co-operation with organizations inventing and producing new products, as well as participation in social analysis and environmental change. Two conclusions to date are: (1) There is a wide gap between new technical possibilities and the real life situation of most people with severe disabilities; (2) Modern technology used as aids for people with severe disabilities has a rehabilitative effect only if it is supported by a sufficient social system for transport, security and care.

Activities of Daily Living↗

PubMedDate not supplied

Technology assessment--a survey of the clinical engineer's role within the hospital.

Advancements in technology are vital to improve clinical outcomes within the medical community and, in particular, to healthcare systems. The need for a systematic approach to analyzing, assessing and selecting the best new technology for individual hospitals continues to increase in response to this technological growth. To determine the use of technology assessment, the effectiveness of different methods, and the role of clinical engineers and bioengineers in this process, a survey was conducted of clinical engineering departments throughout the United States. The results reveal that technology assessment programs are widely utilized as a team effort between hospital departments. Clinical engineers are playing a key role within these teams as technology managers.

Attitude of Health Personnel↗

PubMedDate not supplied

A systems approach to purchasing and implementing new technology.

There are many risks associated with purchasing and implementing new technology. The challenge is to reduce these risks to gain maximum benefit from the new technology purchased. In the high-cost world of healthcare, there is little room for wasting time and money related to technology implementation. If the workflow of the current system is not adequately understood before purchasing and implementing a new technology, that technology may mask underlying problems and/or create new ones. The purpose of this article is to present a framework for analyzing the current process or system, identifying the strengths and the areas in need of improvement. A thorough understanding of the problems with the current system and the barriers to change is necessary to ensure the selection of the "right" technology and promote its implementation.

Choice Behavior↗

PubMed2003

Technology and medical practice.

One of the most significant developments in healthcare over the past 25 years has been the widespread deployment of information and communication technologies. These technologies have had a wide-ranging impact on the organisation of healthcare, on professional practice and on patients' experience of illness and its management. In this paper we discuss the ways in which Sociology of Health and illness has provided a forum for the analysis of these new technologies in healthcare. We review a range of relevant research published in the Journal; papers that address such issues as dehumanisation and emotional labour, professional practice and identity, and the social and institutional shaping of technology. Despite these important initiatives, we suggest that information and communication technologies in healthcare remain relatively under-explored within the Journal and, more generally, by the sociology of health and illness and point to developments in cognate areas which may have some bearing upon the analysis of technology in action.

Bibliometrics↗

PubMed2002

Study design for concurrent development, assessment, and implementation of new diagnostic imaging technology.

With current constraints on health care resources and emphasis on value for money, new diagnostic imaging technologies must be assessed and their value demonstrated. The state of the art in the field of diagnostic imaging technology assessment advocates a hierarchical step-by-step approach. Although rigorous, such a hierarchical assessment is time-consuming, and, given the current rapid advances in technology, results are often too late to influence management and policy decisions. The purpose of this article is to discuss a study design in which development, assessment, and implementation of new diagnostic imaging technology take place concurrently in one integrated process. An empirically based pragmatic study design is proposed for imaging technology assessment. To minimize bias and enable comparison with current technology, a randomized controlled design is used whenever feasible and ethical. Outcome measures should reflect the clinical decision-making process based on imaging information and acceptance of the new test. Outcome measures can include additional imaging studies requested, costs of diagnostic work-up and treatment, physicians' confidence in therapeutic decision making, recruitment rate, and patient outcome measures related to the clinical problem. The key feature of the proposed study design is analysis of trends in outcome measures over time.

Decision Making↗

PubMed2003

Technology in the teaching of neuroscience: enhanced student learning.

The primary motivation for integrating any form of education technology into a particular course or curriculum should always be to enhance student learning. However, it can be difficult to determine which technologies will be the most appropriate and effective teaching tools. Through the alignment of technology-enhanced learning experiences with a clear set of learning objectives, teaching becomes more efficient and effective and learning is truly enhanced. In this article, I describe how I have made extensive use of technology in two neuroscience courses that differ in structure and content. Course websites function as resource centers and provide a forum for student interaction. PowerPoint presentations enhance formal lectures and provide an organized outline of presented material. Some lectures are also supplemented with interactive CD-ROMs, used in the presentation of difficult physiological concepts. In addition, a computer-based physiological recording system is used in laboratory sessions, improving the hands-on experience of group learning while reinforcing the concepts of the research method. Although technology can provide powerful teaching tools, the enhancement of the learning environment is still dependent on the instructor. It is the skill and enthusiasm of the instructor that determines whether technology will be used effectively.

CD-ROM↗

PubMed1998

Current and future impact of technology on physiology education.

There are at least three areas in which technology can impact education: teaching, learning, and assessment. Teaching, when viewed as communication of information, has been transformed by the technology revolution. Word processing, multimedia, distance learning, and access to the World Wide Web are some prominent examples. The impact of technology on learning, defined as knowledge or skill acquired by instruction or study, has been less dramatic, in part because of our limited understanding of cognitive processes. Some forms of assessment, the collection of evidence of learning, have benefited from technology, such as item analysis of multiple-choice questions. To be effective, the focus on instruction must start with the learner and, from there, consider what should be done to enhance learning. An emphasis on what is technologically appropriate, rather than what is technologically possible, will improve the quality of both teaching and learning.

Curriculum↗