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At least 1,063 records · Page 59Linked to original sources
PubMed2000

Intranet health clinic: Web-based medical support services employing XML.

In this paper, the implementation of an Internet-based telematic service for medical support is presented, which operates in pilot form within the INTRANET HEALTH CLINIC project--a two-year project supported by the European Commission under the Health Telematics Programme. The aim of the application is to offer high quality care to users of health services over inexpensive communication pathways, using Internet-based, interactive communication tools, like remote access to medical records and transmission of multimedia information. The XML technology was employed to achieve customised views on patient data, according to the access rights of different users. Strict security and access control policy were implemented to ensure secure transmission of medical data through the Internet. The system is designed to collaborate with existing clinical patient record systems and to be adjustable to different medical applications. Current pilot implementations are under clinical evaluation and include oncological patients (Greece), Lupus Erythrematosis (Canada), Obstetrics (Belgium) and Chronic Obstructive Pulmonary disease (Spain).

Computer Communication Networks↗
PubMed2000

The teleconsultation service ENDOTEL. Implementation and first experiences.

The multimedia teleconsultation service ENDOTEL launches in May 2000 with its asynchronous component. In the initial phase, three hospitals and four general practitioners use the service to consult a specialist in the domain of gastroenterology and endoscopy. By validation of the patient information, i.e. videos, voice clips, still images and text, the experts can decide the further proceeding, for example, whether a patient shall be transported to a specialized hospital or not (cost-saving). We report about the experiences during the initiation and the first months of operation.

Endoscopy, Gastrointestinal↗
PubMedDate not supplied

The Cerec 3--a quantum leap for computer-aided restorations: initial clinical results.

The Cerec 3 system simplifies and accelerates the fabrication of ceramic inlays, onlays, veneers, and quarter, half, and complete crowns for anterior and posterior teeth. Cerec 3 software simplifies occlusal and functional registration. Proper occlusion is established accurately and quickly; manual adjustment is reduced to a minimum. The separate grinding device, working true to morphologic detail and with fine surface quality, is connected to the optical unit by radio control. Equipped with a laser scanner, it can also be used for indirect application through a standard personal computer. The Cerec 3 system is network and multimedia ready and, in combination with an intraoral color videocamera or a digital radiography unit, can be used for patient education and for user training. The Cerec 3 system thus is a diagnostic, restorative, training, and documentation center for the dental practice.

Adult↗
PubMed2001

LAHYSTOTRAIN development and evaluation of a complex training system for hysteroscopy.

Hysteroscopy has already become an irreplaceable method in gynaecoloic diagnosis and therapy. In the diagnostic case the hysteroscope with a 30 degrees optic is insert transvaginally, in the therapeutic case the resectoscope with a 12 degrees optic is used. The endoscopic intervention requires special surgical skills for endoscope handling and remote instrument control. To acquire these skills currently hands-on training in clinical praxis has become standard, which is linked with higher danger for the women. To overcome current drawbacks of traditional training methods the European project LAHYSTOTRAIN was set up, that tries to combine Virtual Reality (VR), Multimedia (MM) technology, and Intelligent Tutoring Systems (ITS) to develop an alternative training system for hysteroscopic interventions. The first prototype of the LAHYSTOTRAIN demonstrator has been shown on several European conferences. An evaluation of the system was performed, with the idea, to collect feedback and impressions, that should be considered in further developments. This paper presents the LAHYSTOTRAIN prototype and the results of these evaluations.

Artificial Intelligence↗
PubMed2001

Paradigms for recording cognitive brain electrical activity.

Human event-related potentials reflect cognitive processing, and are normally elicited by external events, such as acoustic sounds or visual stimuli. As such they provide an opportunity to study normal and abnormal brain function noninvasively, at sub-second resolution. Advances in multimedia technology permit specialists in informatics and neuropsychology to co-operate in the design and implementation of paradigms, which influence ERP components. The paper illustrates the progression from standard paradigms such as the auditory oddball, which can be used to study memory update through to contingent negative variation and three condition, visual paradigms which can be used to study cognitive and emotional responses. Data from a study investigating the comparative processing of target pictures and words illustrate how external stimuli influence the later cognitive potentials.

Brain Mapping↗
PubMed2001

A cognitive approach for designing a computer-based learning tool in dentistry: ODONTOS application.

This work emphasises a cognitive approach to build ODONTOS, a computer-based education system in dentistry. It aims at providing for both instructors and students without any particular knowledge in computer programming; a tool dedicated to dental disease learning. For instructors, it implements for knowledge construction e.g. creating and proposing clinical cases according to student learning style, using multimedia technology. For students it is a tool, which privileges their learning style in order to solve uniform and inflexible learning problem. World Wide Web (WWW) technology has allowed us to offer flexible learning program without any pressure of time and place to student. 13 instructors and 84 students tested the ODONTOS prototype via Internet and answered to the questions related to their habit regarding learning style for the students and knowledge construction for the instructors. Although video data have emerged as an important learning support for the students (82 out of 84), their use in knowledge construction still remains unusual comparative with the use of text and picture (10 out of 13 instructors). It appears that, the integration of video data should be more used by instructors (2 out of 13) while textual data are overwhelmingly used in knowledge construction (13 out of 13). We introduce ODONTOS, and discuss the concrete contributions of this work.

Cognition↗
PubMed2001

Technology as an aid to coping with caring: a usability evaluation of a telematics intervention.

This paper presents evaluation data for an interactive software program designed to provide family carers with information, advice and psychological support by way of feedback of their coping capacity. The multimedia program consists of an information-based package that provides carers with advice on health promotion and relaxation and offers them a range of coping strategies (for example, positive self-talk, assertiveness training and relaxation tapes and videos). The program also includes a carer's self-assessment instrument, designed to provide both family and professional carers with information to assess how family carers are coping with their care-giving role. As part of the usability evaluation, casual users (family carers, professional carers and older people) were invited to test the program and were administered a program evaluation questionnaire measuring quality and efficiency in utility and usability. Quantitative data were analysed by using the Statistical Package for the Social Sciences (SPSS) and qualitative data were analysed by content analysis. Findings indicated that the program is visually pleasant, easily understood, responds quickly and corresponds with user expectations. A number of recommendations are made for improvement of the navigation of the program.

Adaptation, Psychological↗
PubMed2001

Evaluation of a filmless radiology pilot--a preliminary report.

The development of the Multimedia Electronic Medical Record System (MEMRS) promises new opportunities to significantly reduce the routine use of film as the medium for viewing radiological medical images. The effect of this change to digital media on physician workflow and the perceived value and utility of medical images is an area of ongoing investigation. In this study we examined oncology clinicians use of medical images in a MEMRS. We conducted observational studies of clinicians during a filmless radiology pilot study in which a filmless environment was simulated but the actual film was available on request. This observational study was the first step in a comprehensive evaluation designed to elucidate the issues surrounding the implementation of a filmless radiology environment. We identified and examined several of these issues, including physician concern regarding the utility of digital images for clinical use and comparison with film, the need to address the effects of image compression with clinicians, and the workflow changes necessary to incorporate digital image use into a clinical practice.

Attitude of Health Personnel↗
PubMed2001

Cardiac auscultatory recording database: delivering heart sounds through the Internet.

The clinical skill of cardiac auscultation, while known to be sensitive, specific, and inexpensive in screening for cardiac disease among children, has recently been shown to be deficient among residents in training. This decline in clinical skill is partly due to the difficulty in teaching auscultation. Standardization, depth, and breadth of experience has been difficult to reproduce for students due to time constraints and the impracticality of examining large numbers of patients with cardiac pathology. We have developed a web-based multimedia platform that delivers complete heart sound recordings from over 800 different patients seen at the Johns Hopkins Outpatient Pediatric Cardiology Clinic. The database represents more than twenty significant cardiac lesions as well as normal and innocent murmurs. Each patient record is complete with a gold standard echo for diagnostic confirmation and a gold standard auscultatory assessment provided by a pediatric cardiology attending.

Adult↗
PubMed2001

Structured data management--the design and implementation of a web-based video archive prototype.

In response to the lack of readily available multimedia rich medical knowledge sources to support medical education and patient care, we designed and implemented a web-based video publishing platform. In order to promote the development of high-quality, up-to-date educational content, we have devised a scalable structure that allows online submissions and continuous updating of video and accompanying textual descriptions. Our goal is to enable experts in varied medical domains to collaborate in the construction of a video library using an intuitive web-based interface. Neurologists at Stanford built a well-annotated neurology video collection that initially emphasized childhood and adult movement disorders. The collection may be accessed either as a stand-alone resource or as part of the Stanford Skolar MD, an integrated online medical knowledge provider. This manuscript discusses the design framework and implementation details of structured media content development. We present examples illustrating media data collection, content indexing using UMLS concepts, media storage, and web presentation.

Abstracting and Indexing↗
PubMed2002

The Stanford MediaServer Project: strategies for building a flexible digital media platform to support biomedical education and research.

Medical media collections are growing at a pace that exceeds the value they currently provide as research and educational resources. To address this issue, the Stanford MediaServer was designed to promote innovative multimedia-based application development. The nucleus of the MediaServer platform is a digital media database strategically designed to meet the information needs of many biomedical disciplines. Key features include an intuitive web-based interface for collaboratively populating the media database, flexible creation of media collections for diverse and specialized purposes, and the ability to construct a variety of end-user applications from the same database to support biomedical education and research.

Abstracting and Indexing↗
PubMed2003

Feasibility of a palmtop-based interactive education to promote patient safety.

Institute of Medicine defines "patient safety" as a set of measures taken by healthcare professionals to prevent adverse outcomes from medical errors. Kohn estimated that medical errors are likely to result in a death of 44,000 to 98,000 people in U.S. hospitals each year, making it almost the fifth leading cause of death. The costs of medical errors, made by healthcare professionals, amount to $29 billions annually. Recent studies showed that current system of medical training and continuous education has limited capability in promoting and sustaining awareness of patient safety and medical error issues. Use of Personal Digital Assistants (PDA) has been increasingly widespread among clinical students and residents. Despite significant improvement in PDA functionality, current literature does not provide systematic assessment of potential use of hand-held computing for interactive clinician education. To address these issues, we assessed the feasibility of a PDA-based interactive multimedia tool aimed to provide self-paced patient safety education for clinicians.

Clinical Medicine↗
PubMed2004

Design of interactive health drama built on social realism.

There are many psychosocial aspects of chronic diseases, such as diabetes. Educational multimedia can support patients with chronic diseases and their families by communicating narratives based on social realism. The production of such socio-realistic interactive health dramas requires systematic methods, especially for the identification of significant stories. The aim of this study is to explore the use of self-documentary video in the design of an Interactive Health Drama environment to support diabetic adolescents and their families. In particular, the potential of the self-documentary video for story development in combination with qualitative interviews were explored. The proposed approach, when further developed, is intended to enable all types of chronic disease patients to work with their specific psychosocial problems in a supportive and stimulating environment adapted to their personality and preferences.

Adolescent↗
PubMed2004

The learning unit "Orthodontic set-up" as a new-media module in teaching.

The present study examines the extent to which computer-assisted learning units provided independently of place and time are used in self-study as a supplement to the classical classroom instruction of dental students. Indications as to whether such teaching modules improve training in orthodontics should be obtained from this. Attention was focussed on the implementation and evaluation of the "Orthodontic set-up" teaching module, which can be accessed in the Internet and Intranet of the university. The didactic arrangement offered classical university courses in parallel (four lectures on the subjects of occlusion, function, diagnostics, and therapy) in addition to the electronically communicated teaching contents. In addition, intensive supervision during the production of the set-up was guaranteed. The use of this multimedia learning concept was in general assessed positively by 63 surveyed students in the 2002/03 winter semester. The results revealed on the one hand the intensity of use and features of the acquisition of knowledge (use types), and on the other hand, in terms of professional relevance, the contents were found to be well explained, didactically attractive, and understandably presented. However, numerous drawbacks were also mentioned (technical and time problems; qualification deficits). The experience gained in this project should encourage more future investment in the development of alternative university didactic models.

Computer-Assisted Instruction↗
PubMed2004

The concept of a clinical round as a virtual, interactive web-based, e-learning model for interdisciplinary teaching.

The demonstration of patient case reports in the course of a clinical round is an essential part of teaching medicine and dentistry. However, suitable live patients with particular problems are not always available at a time when teaching is taking place. This project therefore had the objective of establishing a web-based, virtual e-learning concept for demonstrating case reports independent of time and place, with the possibility of an interactive examination, diagnosis, and interdisciplinary therapy decision making for medical and dental students. Anonymized case reports of diseases in the oral and maxillofacial region and the interdisciplinary treatment were digitized and prepared in a web-based format. The technical aspect was based on connecting flash modules with videos and animation, and monitoring through HTML and Javascript. Due to the modular concept and the programming used, the learning environment was independent of platform and open. Independent formats (.swf, .avi, .mpeg, etc.) were integrated into the individual modules. According to a hierarchic decision system, the user was guided interactively to the diagnosis through a differential diagnostic exclusion process. Sound was digitized and integrated in mp3 compressed form in the 3D models for lip-synchronous speech output. The speech output was connected with a virtual 3D tutor that acted in an advisory capacity in reaching a diagnosis and determining therapy. Further sources of information and literature with abstracts or pdf files of the subject-related publications were inserted to ensure that the teaching was objective. To conclude the virtual clinical round, a check on learning success was conducted in the form of a multimedia multiple choice test.

Computer-Assisted Instruction↗
PubMed2002

[A computer processing system for bronchoscopes images].

A new equipment of a computer multimedia system combined with a bronchoscope is presented here, which is able to provide active images with a high definition, image capture, synchronized video recording and playback during bronchoscopy. Its operation is easy and its quality is reliable. It is an advanced product for endoscopies and is worth while to be applied to clinical application.

Algorithms↗
PubMed2005

Obstacles to Implementing an Execution Engine for Clinical Guidelines Formalized in GLIF.

This article is on obstacles we faced when developing an executable representation of guidelines formalized the Guideline Interchange Format (GLIF). The GLIF does not fully specify the representation of guidelines at the implementation level as it is focused mainly on the description of guideline's logical structure. Our effort was to develop an executable representation of guidelines formalized in GLIF and to implement a pilot engine, which will be able to process such guidelines. The engine has been designed as a component of the MUltimedia Distributed Record system version 2 (MUDR(2)). When developing executable representation of guidelines we paid special attention to utilisation of existing technologies to achieve the highest reusability.Main implementation areas, which are not fully covered by GLIF, are a data model and an execution language. Concerning the data model we have decided to use MUDR(2)'s native data model for this moment and to keep watching the standardisation of a virtual medical record to implement it in execution engine in the near future. When developing the execution language, first of all we have specified necessities, which the execution language ought to meet. Then we have considered some of the most suitable candidates: Guideline Execution Language (GEL), GELLO, Java and Python. Finally we have chosen GELLO although it does not completely cover all required areas. The main GELLO's advantage is that it is a proposed HL7 standard. In this paper we show some of the most important disadvantages of GELLO as an executable language and how we have solved them.

Decision Making, Computer-Assisted↗