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At least 757 records · Page 42Linked to original sources
PubMed2000

Smart care technologies: meeting whose needs?

Recent funding programmes supporting research and development in telecare have argued for a shift in perspective from a technology-driven approach to one that is needs-led. While this is in the interests of both users and technologists, achieving this goal is not straightforward. This paper outlines some of the conceptual, methodological and practical problems that potentially constrain a needs-led approach and illustrates the emergent issues with a case study of the development of an intelligent home monitoring system to support the independent living of older people. The research indicates clear differences between users and technologists in the way problems, needs and requirements are understood and defined. This in turn has consequences for the way assistive technologies are developed and implemented.

Health Services Research↗
PubMed2000

Safety and risk issues in using telecare.

The increasing adoption of technology to support independent living at home through the extended use of community alarms and, ultimately, second-generation telecare systems poses some safety problems. The implications of any failure of the technology must be addressed in order to provide a safe and reliable care service. The risks of using home-based technology can be assessed by standard techniques under three categories: environmental factors; human factors; and technological factors. A safety classification system for telecare devices is proposed leading to a range of design guidelines which represent good practice. An example of the use of these design principles is a prototype second-generation telecare system, MIDAS, which is currently undergoing trials. In order to reduce the risks associated with device failure, the system incorporates distributed intelligence, built-in self-testing and redundancy. Potentially hazardous situations can therefore be controlled.

Accidental Falls↗
PubMed2001

Narrative interpretations for clinical laboratory evaluations: an overview.

As the clinical laboratory test menu has significantly expanded in volume and complexity, there is a rapidly growing need by clinicians for narrative interpretations of complex studies that resemble those provided in anatomic pathology and radiology. In this report, the impact of advice on laboratory test selection and interpretation is presented with regard to providing adequate quality of care, reducing medical error, and reducing the cost for health care. In addition, past and current attempts to address the physician's need for advice on laboratory test selection and interpretation are also described. These include curbside consultations, intelligent laboratory information systems, and medical information from the Internet. Each is presented with examples from the literature and with its advantages and disadvantages for practicing clinicians confronting large, expensive test menus and the results of esoteric assays.

Clinical Laboratory Information Systems↗
PubMed2006

Prescribing errors resulting in adverse drug events: how can they be prevented?

As approximately 19% of medical errors occurring in hospitals are related to medication errors, reduction of these is one of the major goals to be achieved by healthcare providers. Medication errors may occur at different levels: i) prescribing; ii) transcription; iii) dispensing; and iv) administration. Whereas errors in transcription can be significantly reduced by computerised physician order systems, improvement of prescribing appears to be a much larger problem. Continuous support by ward pharmacists may be feasible in some hospitals, but not in the setting of ambulatory prescribing. Much hope relies on computerised physician order systems with a knowledge database for interactions, warnings on allergies and other intelligent alerts. However, these systems still have some shortcomings and it has not yet convincingly been shown that the use of this technology really improves patient safety.

Clinical Pharmacy Information Systems↗
PubMed2000

Automatic control of a robot camera for broadcasting based on cameramen's techniques and subjective evaluation and analysis of reproduced images.

With the goal of achieving an intelligent robot camera system that can take dynamic images automatically through humanlike, natural camera work, we analyzed how images were shot, subjectively evaluated reproduced images, and examined effects of camerawork, using camera control technique as a parameter. It was found that (1) A high evaluation is obtained when human-based data are used for the position adjusting velocity curve of the target; (2) Evaluation scores are relatively high for images taken with feedback-feedforward camera control method for target movement in one direction; (3) Keeping the target within the image area using the control method that imitates human camera handling becomes increasingly difficult when the target changes both direction and velocity and becomes bigger and faster, and (4) The mechanical feedback method can cope with rapid changes in the target's direction and velocity, constantly keeping the target within the image area, though the viewer finds the image rather mechanical as opposed to humanlike.

Algorithms↗
PubMedDate not supplied

Incorporating user and dialogue models into the interface design of an intelligent patient monitor.

A user and dialogue modelling approach is proposed for the development of user interfaces for intelligent patient monitoring systems. Illustrative models and dialogues are developed and simple examples of user interfaces for a monitor system based upon these are presented. The user model and dialogue method is also used to evaluate some interface techniques from the literature.

Anesthesiology↗
PubMedDate not supplied

[Analysis of intracranial pressure signals using artificial neural networks].

Intracranial pressure (ICP) is influenced by an array of predictable and unpredictable factors. Statistical modelling of this signal has only limited applicability because of the significant load of stochastic components. We tested the efficiency of an alternative approach, based on the methodology of artificial neural networks (ANNs) in the on-line prediction of future values of ICP and in the classification of signal properties. Satisfactory accuracy of forecasting was achieved with the ANNs for a 3-minute prediction horizon, while the prediction quality with autoregressive models of statistical origin was proved unsatisfactory. The results obtained with the ANNs were further improved when signal pre-processing with wavelet transform was employed. Nevertheless, even with the ANN methodology, no sudden breakdowns in the ICP signal (which in this respect might be compared to a "catastrophe") can be forecast with any practical applicability. We therefore applied two ANN algorithms, oriented at classification and discrimination of the global properties of the ICP signal. The neural network was expected to discriminate those sets of signal properties, which were assumed to correspond to certain clinical conditions of the patient. In a "dynamic pattern classification" the network was presented with several sections of ICP records. This was combined with information about the assignment of a given record to one of four arbitrary classes of danger. In this mode no data pre-processing was carried out, in contrast to our second approach, in which the signal was pre-processed with statistical analyses and only these intermediate coefficients were fed to the ANN classifier. The results obtained with both classification methods at their present stage of training were similar and approximated to a 70% rate of judgements consistent with expert scoring. Nevertheless, the method based on the assessment of global parameters of the ICP record seems more promising, because it leaves the possibility of extending the set of training data by information from other diagnostic modalities. The study aims towards the development of a pseudo-intelligent computer expert system, which has would be taught salient links between data extracted from the ICP signal and higher- order data, which contributed to the expert score. Hence the system would be able to make decisions on the basis of a reduced set of input information, available from a standard monitoring modality.

Algorithms↗
PubMedDate not supplied

Review of the development, validation, and application of predictive instruments in interventional cardiology.

Within the last few years, risk assessment has become an integral part of clinical practice, particularly for thoracic surgery and interventional procedures. Risk assessment statistical models are being used in medical decision making, quality improvement tools, and as aids to patient counseling. This literature review was conducted to evaluate the types of predictive models and outcomes measures that have been examined, and methods used in development, validation, and application of these models. A Medline search performed to identify articles (limited to human studies) published in English from 1980 to 1999 resulted in 89 articles, of which 71 were evaluable. Populations studied for model development included patients undergoing coronary artery bypass graft (CABG), percutaneous transluminal coronary revascularization (PTCR), cardiac catheterization, or stenting procedures and patients with angina or stroke. The models were equally developed from a single center versus multicenter and from retrospective databases versus prospective studies. In terms of model perspectives, only three of the models measured cost or cost-effectiveness as the outcome; the remainder considered only clinical outcomes. The most commonly reported types of predictive models were developed using logistic regression and Bayesian techniques, followed by neural networks, rule-based artificial intelligence, simultaneous equation system, and multiple linear regression. Factors to consider when developing or evaluating a predictive model include uniformity of definitions of outcomes, uniformity of definitions of variables, completeness of data, number and frequency of variables, timeliness and source of data, development population characteristics, development and testing (validation) cohorts, and calibration and discrimination. Application of these models to an individual patient can spur quality improvement efforts that can lead to dramatic, system-wide improvements in outcomes.

Cardiovascular Diseases↗
PubMed2002

The technological edge.

A computer-assisted intraoperative imaging system and an intelligent trajectory guide improves the precision of orthopaedic surgery.

Computer Graphics↗
PubMedDate not supplied

Web-based radiology: a future to be created.

The impact of Internet on Medicine and Surgery is certainly remarkable, however the influence it had on Diagnostic Imaging was even stronger. The standardization of digital images acquired by the different medical imaging equipment has further facilitated the diffusion, transmission and communication in radiology within hospitals as well as on WEB. Radiology departments are bound to become "filmless" and with the present "tablet PC" radiological images will be directly transferred to the patient's bed in the relative electronic patient report. For radiology, interactive education could be envisaged with a tutor who guides the student(s) through the network. The Internet is an inexhaustible source of radiologic educational and information material with a number of sites of clinical cases, tutorial and teaching files, journals and magisterial lectures on-line. In a near future, the Internet could be applied in the simulation of clinicoradiologic cases or in applications of artificial intelligence with expert systems to support the solution of most complex cases.

Analog-Digital Conversion↗
PubMed2005

Healthons: errorless healthcare with bionic hugs and no need for quality control.

Errorless, invisible, continuous and infrastructure-free healthcare should become our goal. In order to achieve that goal, we need to rapidly move from current episodic and emergency-driven "healthcare delivery system" to an intelligent and extelligent health environment. That requires introduction of distributed affective Intelligent Caring Creatures (ICCs) consisting of healthons. Healthons are tools combining prevention with diagnosis and treatment based on continuous monitoring and analyzing of vital signs and biochemistry. Unlike humans, who posses only two or three dimensions of thinking, healthons can assure errorless health because of their adaptability, flexibility, and multidimensional reasoning capability. ICCs can do "the right thing" based on (1) state-of-art medical knowledge, (2) data about emotional, physiological, and genetic state of a consumer and (3) moral values of a consumer. The transition to the intelligent health environment based on ICCs requires the solutions to many currently unsolved healthcare problems. This paper lists the unsolved problems (by analogy to mathematical unsolved problems list) and explains why errorless healthcare with bionic hugs and no need for quality control is possible.

Artificial Intelligence↗
PubMed2006

[Brain white matter lesions of children with phenylketonuria before and after treatment].

OBJECTIVE: To observe brain white matter changes in children with late-treated phenylketonuria (PKU) before and after receiving treatment. METHODS: This study included 19 PKU patients (aged 34-410 weeks) who were administered a low-phenylalanine diet (< 15-50 mg/kg daily) for 8-16 months. The brain MR imaging with spin-echo T1-weighted and T2-weighted sequences in coronal and axial planes was taken before and after treatment. The white matter abnormalities (T2WI high signal intensity) were graded based on the Thompson grading system. Meanwhile the intelligence quotient (IQ) or developmental quotient (DQ) was tested by the Gesell's Intelligence Scale. RESULTS: All 19 PKU patients presented with the brain white matter lesions, manifesting abnormally high T2-signal intensity in the periventricular region around anterior and posterior horns of both lateral ventricles. Different extents of mental retardation were also observed in the 19 patients. The low phenylalanine diet treatment decreased the average grade of abnormal T2-signal intensity from 2.59 to 1.76 (P < 0.05). The mean IQ or DQ improved from 44.8 to 61.6 after treatment (P < 0.05). There was some correlation between the amelioration of brain white matter lesions and IQ or DQ. CONCLUSIONS: The patients with late-treated PKU have a higher occurrence of the brain white matter lesions and mental retardation. A low-phenylalanine diet treatment can partly improve the abnormalities. Brain white matter lesions may play a part in mental retardation.

Brain↗
PubMed1995

[Contemporary strategies and methods of modeling antiparasitic drugs].

Contemporary methods of directed chemotherapy are based on multi-step procedures, which require co-ordinated activities of interdisciplinary teams of biochemists, pharmacologists, geneticists, crystallographers as well as computer scientists. Biochemists select the proper target, such as an enzyme, throughout screening of the biochemical influence of compounds-potential drugs on this target. For further research they use targets with very low inhibition constants (> 10(-6) M). Determination of the relation between therapeutic activity of the compound and modelling of its chemical structure constitutes an important part of the procedure. The most important part of the procedure is the recognition of the primary structure of the target. The two following pathways allow to do that: 1. isolation of DNA and gDNA or cDNA-started cloning of a gene responsible for production of the target protein and then its sequencing. 2. purification and crystallization of the target protein and further computer-aided processing of crystallographic data in order to determine the primary structure. Computational chemistry (C/C) methods are the basic part of the procedure of molecular modelling (M/M) of a target molecule and its interactions with a molecule of the future drug. Data obtained using a technology which engages the C/C and M/M methods not only allow to determine the aminoacid sequence of the target protein in question (e.g. a unique parasite enzyme); they also enable to further speculate on its secondary and tertiary structures. Such structure includes specified number of repeated motifs of alpha-helixes, beta-sheets and loops or turns. Particularly, the "barrel" structure is very common in numerous enzymes. Two following examples of research on target-antiparasitic drug interactions is presented. They are the interaction between phosphoglicerate kinase in Leishmania and drug suramin and malic enzyme of Trichinella and drug closantel. New promising targets for new anti-protozoan drugs (protozoa of Trypanosoma species) include e.g. microbody translocation signal in kinetosom proteins (SKL) or protein blocking the transport of proteins to glycosomes-metabolic centres in Trypanosoma (repetitive groups of QRLQ). Recently, scientists from Arris Pharmaceutical (San Francisco) have considered, employing new data, up to 100 to fully characterize the surface structure of a molecule, using the systems of artificial intelligence.

Anthelmintics↗
PubMed1994

Perinatal research and its support. Corporate contributions at McGill University.

Three technologic projects with potentially patentable end results are slowly evolving in the Department of Obstetrics and Gynecology, McGill University and Royal Victoria Hospital. A tax shelter infusion of a significant amount of venture capital developed opportunities for all three projects over two years. The three projects--fetal heart rate tracing analysis related to fetal outcome, a distributed and intelligent data acquisition system and selected ultrasonic three dimensional imaging--were advanced considerably, and their results are expressed in outline. The effects of such infusions of business support into an environment of sparse research grant support have been extremely encouraging to the investigators, but the department, with its obligations of ongoing research, teaching and patient care, must develop the next steps with care, although one of the projects has been extended by an interested corporation.

Capital Financing↗