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PubMed2006

[The curriculum Health Technology Assessment (HTA)].

Information derived from Health Technology Assessment (HTA) reports is increasingly used for decision-making in healthcare. The production of HTA reports requires well-qualified interdisciplinarily working specialists who are not yet available in sufficient number. The German HTA Society and the German Network for Evidence Based Medicine have now developed an HTA curriculum which may serve as a basis for training courses for users of HTA information as well as HTA authors. Structure and content of the curriculum were inspired by internationally established training courses. However, the specific aspects of technology regulation and decision-making in the healthcare systems of German-speaking countries are emphasised. The curriculum is subdivided into a total of 11 modules. These include principles of HTA, status and regulation of technologies, priority setting, management of knowledge and information, methods of conducting HTA reports and project management. In the next step, the application of the curriculum into an Internet-based training course is planned.

Biomedical Technology↗
PubMed1999

Health care technology: nursing's challenge and opportunity.

The growth in health care technology is ubiquitous and has far reaching consequences both for users and providers. This paper explores how health care technology affects ours lives, presents the challenges inherent in its use, and also identifies some of the opportunities that it provides nurses.

Biomedical Technology↗
PubMedDate not supplied

Technowave 2010: hospitals compete on high-tech care.

The medical arms race is back. Hospitals are competing vigorously around new technology, spending millions on da Vinci surgical systems, Gamma knives, and high-tech heart implants. Many new technologies require large investments in specialized facilities and technology, pushing up capital investment and health costs. But other technologies have migrated from the inpatient to the outpatient, pushing costs down with shorter inpatient stays and rapid recoveries, like arthroscopic surgery.

Biomedical Technology↗
PubMed2004

SUM: a new way to incorporate mismatch probe measurements.

Affymetrix's high-density oligonucleotide arrays offer an exciting technology in biomedical research. With more and more statistical involvement in every step of the process, there has been a constant effort to make sure that the expression data are appropriately extracted in the first place. According to Affymetrix GeneChip technology, each gene is represented by 11-20 oligo probe pairs; the challenge is how to extract one meaningful number, expression, from the 11-20 pairs of numbers. More specifically, there is first a need to differentiate the components of specific binding, nonspecific binding, and optical background noise in both PM and MM probes, and then an expression measure that is proportional to the true abundance of transcripts is to be derived. A new method, SUM, which sums up PM and MM values and then follows a process similar to that of RMA, is considered. The performance of SUM is investigated and compared to the three most popular methods, MAS5, dChip, and RMA. The assessments are based on a well-controlled experiment dataset that is publicly available. The results show that in several respects the performance of SUM is comparable to that of RMA and dChip, and all three of these methods show some advantages over MAS5. There is some evidence showing that SUM has higher differential sensitivity than other methods in certain situations.

Algorithms↗
PubMed2002

Integrating pharmacogenomics into drug development.

The first observations of inherited differences in drug effects in the 1950s led to the recognition of a genetic basis for drug response. With the development of genetics and molecular biology, it became clear that certain drug responses could be associated with specific genetic variations or polymorphisms. There are now examples of polymorphisms that affect response to drugs ranging from common analgesics to chemotherapeutics. The goal of pharmacogenetics is to identify polymorphisms that can serve as predictive markers of drug response. This review summarizes how existing pharmacogenomic technologies can be applied advantageously throughout drug development to bring drugs successfully to market along with diagnostic tests that ensure their appropriate use.

Biomedical Technology↗
PubMed2001

Semiconducting biomaterials: current status and future perspectives.

The ability to truly interface living cells with intelligent semiconducting biomaterials will launch new post-digital technology involving biologically interfaced medical devices. This article examines the potential of porous silicon for use in cell-interfaced electronic devices.

Biomedical Technology↗
PubMed2001

Telehealth technology: consequences for structure through use.

In recent years the focus of ICTs in healthcare has changed from the â back office' to the front end of patient care. These changes have been brought about by a number of factors including the potential of technologies, pressures for modernisation and administrative reforms, including blurring of the boundaries between different organisations (within and beyond the health sector), and which break down traditional barriers between administration of health services and the practice of medicine In this paper we explore in particular how technology is implicated in such changes, focussing on the consequences of the use of the new telehealth technologies, as seen in a set of linked case studies from an inner city borough in London. The paper addresses the way these technologies, through routine use, become (or not) resources and rules that embody new structures for health care.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Future of computer implant technology and intelligent human-machine systems.

Linking the human nervous system and brain directly to a computer opens up innumerable possibilities, not only in the future world of medicine, but also as a potential way of technically evolving all humans. This, however, presents something of an ethical problem. Nevertheless, the only way to actually find out what is realistically possible and what is not is to carry out practical experimentation using implant technology and to witness the results. This chapter describes the most recent self-experimentation trials carried out by the author and his team.

Biomedical Technology↗
PubMed2004

How acceptable are innovative health-care technologies? A survey of public beliefs and attitudes in England and Wales.

There has been a continuing debate about the extent to which the public finds health-care technological innovation acceptable. The public's ambivalence about scientific medicine may have been exacerbated, more recently, by developments such as the introduction of the 'new genetics' with their associated ethical and social implications and the claims that public trust in health care and practitioners and, more widely, in society has been eroded. The aim of this paper is to examine public attitudes to a range of innovative health-care technologies to see whether (i) certain technologies are perceived as particularly problematic, and (ii) attitudes to new health-care technologies are associated more broadly with beliefs about science, trust in health care and social trust, and perceptions of the benefits and risks of complementary and alternative medicine versus orthodox (technological) medicine. These questions are examined through a statistical analysis of data collected in a national, postal survey of the adult population (n = 1187) in England and Wales. The results showed public ambivalence about new health-care technologies, although genetic technologies, as a whole, were not seen to be problematic and their acceptability depended on their ability to control serious diseases. However, there was a level of consistency in attitude across the different technologies. Those consistently against new health-care technologies were also more likely to be suspicious of science, and doubtful about the benefits of other established, orthodox technologies (screening; medications) and to have less trust in health and health-care practitioners.

Adolescent↗
PubMed2003

Application of transgenesis in livestock for agriculture and biomedicine.

Microinjection of foreign DNA into pronuclei of a fertilized oocyte has predominantly been used for the generation of transgenic livestock. This technology works reliably, but is inefficient and results in random integration and variable expression patterns in the transgenic offspring. Nevertheless, remarkable achievements have been made with this technology. By targeting expression to the mammary gland, numerous heterologous recombinant human proteins have been produced in large amounts which could be purified from milk of transgenic goats, sheep, cattle and rabbit. Products such as human anti-thrombin III, alpha-anti-trypsin and tissue plasminogen activator are currently in advanced clinical trials and are expected to be on the market within the next few years. Transgenic pigs that express human complement regulating proteins have been tested in their ability to serve as donors in human organ transplantation (i.e. xenotransplantation). In vitro and in vivo data convincingly show that the hyperacute rejection response can be overcome in a clinically acceptable manner by successful employing this strategy. It is anticipated that transgenic pigs will be available as donors for functional xenografts within a few years. Similarly, pigs may serve as donors for a variety of xenogenic cells and tissues. The recent developments in nuclear transfer and its merger with the growing genomic data allow a targeted and regulatable transgenic production. Systems for efficient homologous recombination in somatic cells are being developed and the adaptation of sophisticated molecular tools, already explored in mice, for transgenic livestock production is underway. The availability of these technologies are essential to maintain "genetic security" and to ensure absence of unwanted side effects.

Agriculture↗
PubMed2005

Predicting the impact of new health technologies on average length of stay: development of a prediction framework.

OBJECTIVES: The aim of this study was to develop a framework to predict the impact of new health technologies on average length of hospital stay. METHODS: A literature search of EMBASE, MEDLINE, Web of Science, and the Health Management Information Consortium databases was conducted to identify papers that discuss the impact of new technology on length of stay or report the impact with a proposed mechanism of impact of specific technologies on length of stay. The mechanisms of impact were categorized into those relating to patients, the technology, or the organization of health care and clinical practice. RESULTS: New health technologies have a variable impact on length of stay. Technologies that lead to an increase in the proportion of sicker patients or increase the average age of patients remaining in the hospital lead to an increase in individual and average length of stay. Technologies that do not affect or improve the inpatient case mix, or reduce adverse effects and complications, or speed up the diagnostic or treatment process should lead to a reduction in individual length of stay and, if applied to all patients with the condition, will reduce average length of stay. CONCLUSIONS: The prediction framework we have developed will ensure that the characteristics of a new technology that may influence length of stay can be consistently taken into consideration by assessment agencies. It is recognized that the influence of technology on length of stay will change as a technology diffuses and that length of stay is highly sensitive to changes in admission policies and organization of care.

Biomedical Technology↗
PubMed2003

Blood compatible design of a pulsatile blood pump using computational fluid dynamics and computer-aided design and manufacturing technology.

Thrombus formation is a critical issue when designing a long-term implantable left ventricular assist system (LVAS). Fluid dynamic characteristics of blood flow are one of the main factors that cause thrombus formation. In this study, we optimized the fluid dynamics of a sac blood pump in our LVAS to ensure minimization of shear-related blood damage that could lead to thrombus formation. A pump housing and a sac chamber were designed with computer-aided design (CAD) software, and fluid dynamics were estimated by computational fluid dynamic (CFD) analysis. We adopted distribution of CFD results for qualitative evaluation, and we also tried to estimate normalized index of hemolysis (NIH) from the results of CFD analysis as a quantitative index of optimization for geometry of the blood pump chamber. A prototype model of the optimized blood pump was made using a three-axis computer machine tool by whittling pieces of nonfoamed polyurethane. Shear stress and theoretical NIH in the redesigned model were lower than those in the first model. Area of flow stagnation that was observed in the first model was not seen in the redesigned model. The results demonstrate that application of CAD/CAM technology to design an artificial heart contributes to optimizing a blood pump chamber for the purpose of reducing thrombus formation.

Biomedical Technology↗
PubMed2001

Developing new technology.

The specialty of cardiothoracic surgery should be one of constant innovation. Albert Einstein was a man of vision who said, "Imagination is more important than knowledge." With most technology expected to be obsolete in 5-7 years, thoracic surgeons need to draw from their imaginations to find innovative surgical solutions for the future.

Biomedical Technology↗