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At least 1,153 records · Page 64Linked to original sources
PubMedDate not supplied

Technologies for measuring HIV-1 drug resistance.

Drug resistance testing significantly improves response to antiretroviral treatment in HIV-1-infected patients, therefore it has recently been implemented into current guidelines for the management of antiretroviral therapy. Knowledge about technologies for measuring drug resistance is important for several reasons: (a) differences exist between different technologies and also between assays based on the same technology; (b) the results of resistance testing are strongly dependent on the reliability and precision of the technology used; and (c) technical aspects have to be considered for a clinically relevant interpretation of drug resistance. The spectrum of genotypic and phenotypic technologies as well as the technical quality is increasing, which shifts the emphasis to the interpretation of resistance profiles. The interpretation is based on the knowledge of drug resistance-associated mutations as well as correlations between genotype and phenotype and clinical response, which are incorporated into rules-based systems. Bioinformatic techniques are used to generate mathematical models for the prediction of drug resistance from genotype. Both approaches are converging toward the prediction of clinical response. Because therapy response is dependent on many additional variables, further efforts are required for the generation of a large clinical database. This will be the basis of a prediction system that will optimize the antiretroviral therapy for each individual patient.

Anti-HIV Agents↗
PubMed1997

Cost-effectiveness of evaluating the new technologies.

The problem of evaluating cost-effectiveness claims is complex and not readily solved. However, such evaluation represents an important direction for technology assessment as resources become more scarce. Neumann et al.'s analysis (1996) represents one solution to the relatively simple problem of pharmacoeconomic studies. In addition, Fryback and Thornbury included a useful method for approaching the cost-effectiveness of all medical technologies. I note that the cost-effectiveness cutoff of $50,000 per quality-adjusted life year is an incremental one, meaning that new technology must be substantially more cost-effective than older technology. This is currently not the case where incremental improvements over previous technology are often quite small. Interested readers are referred to standard tests in the field, including Drummond, Stoddart, and Torrance (1987), Eisenberg (1986), and Sox, Blatt, Higgins, and Marton (1988).

Cost-Benefit Analysis↗
PubMedDate not supplied

Medicare's next voyage: encouraging physicians to adopt health information technology.

Although there is growing consensus that health information technology (HIT) will be critical to improving health care quality and reducing costs, physicians' investments in technology remain limited. As the largest single U.S. purchaser of health care services, Medicare has the power to promote physician adoption of HIT. The Centers for Medicare and Medicaid Services should clarify its technology objectives, engage the physician community, shape the development of standards and technology certification criteria, and adopt concrete payment systems to promote adoption of meaningful technology that furthers the interests of Medicare beneficiaries.

Diffusion of Innovation↗
PubMedDate not supplied

Competition and new technology.

Most real medical spending growth is accounted for by beneficial but costly new technology. This paper argues that a missing dimension of our concepts of competition among health plans is a focus on their policy toward new technology. In principle, plans could choose to move rapidly or slowly, inclusively or selectively, toward adopting new technologies, broadly defined. These policies would affect the rates of growth of their premiums, and consumers could choose among plans depending on both the technology policy and premium growth. Legal impediments, physician resistance, and membership turnover are all possible obstacles. Further thought should be given to making technology policy an explicit dimension of plan competition.

Diffusion of Innovation↗
PubMed2004

Gene expression quantitation technology summary.

Scientists routinely talk and write about gene expression and the abundance of transcripts, but in reality they extrapolate this information from the various measurements that a variety of different technologies provide. Indeed, there are many reasons why applying different technologies to the problem of transcript abundance may give different results, owing to an incomplete understanding of the gene in question or from shortcomings in the applications of the technologies. There are nine basic considerations for making a technology choice for quantitating gene expression that will impact the overall outcome: architecture, specificity, sensitivity, sample requirement, coverage, throughput, cost, reproducibility, and data management. These considerations will be discussed in the context of available technologies.

Computational Biology↗
PubMed2003

The technologically well-equipped dental office.

BACKGROUND: Information technology, or IT, applications for dental practice continue to develop rapidly. More than 85 percent of all dentists use computers in their offices, and the number of clinical uses for the computer is on the rise. This article discusses the state of the art of several technologies, provides an integrative view of a technologically well-equipped office and offers several guidelines for technology purchasing decisions. CONCLUSIONS: Most administrative applications are relatively mature and are required for the smooth functioning of today's dental offices. Clinical applications--such as dental and medical health histories, charting, digital imaging, diagnostic and treatment applications, and decision support--vary in their degree of maturity. Most Internet applications-such as Internet-based scheduling and e-mail communication with patients--still are an optional adjunct for dental practices. PRACTICE IMPLICATIONS: Practitioners should develop a comprehensive plan for implementing or updating the IT infrastructure in their offices. Issues to be considered in technology purchasing decisions include usability, integration, work flow support, cost-benefit analysis and compliance with standards.

Computers↗
PubMed2005

Pharmaceutical development and clinical effectiveness of a novel gel technology for transdermal drug delivery.

Transdermal gels are designed to deliver sustained drug amounts, resulting in systemically consistent levels. They represent an improvement compared with transdermal delivery by patches because they offer more dosage flexibility, less irritation potential and a better cosmetic appearance. Advanced Transdermal Delivery (ATD) gel technology was developed in order to provide enhanced passive skin permeation of various active drugs for the treatment of many conditions, including hypogonadism, female sexual dysfunction, postmenopausal symptoms, overactive bladder and anxiety. The technology consists of a combination of solvent systems and permeation enhancers enabling systemic drug delivery, and is covered by many patents. Pharmaceutical development of formulations based on the technology allowed optimisation of physicochemical parameters (rheological profile, pH) as well as skin permeation properties (type and concentration of permeation enhancers, thermodynamic activity of the drug). This gel technology has demonstrated to be efficient for many drugs, as shown in the preclinical and clinical pharmacokinetic studies presented in this technology evaluation.

Administration, Cutaneous↗
PubMed1996

[On technology].

Based on conceptions forged in classic Greece, the article affirms the idea of technology as a "way of doing" that is underpinned by forms of organization produced by the society where the technology has emerged and by the knowledge produced in each era. Emphasizing aspects of specific moments in Western history, it goes on to identify relations between technology and science--understood here as the search for maximum rationality. The article questions certain positions which would seem to contend that techno-science contributes to the production of social inequalities and injustice, given a kind of collusion between knowledge and power. In the case of medicine, it is held that modern science has paved the way for ever more efficacious technology for intervention that benefits humankind; furthermore, the failure to solve all of humanity's problems derives much more from the political character of these inequalities than from any specific role that science and technology could play in achieving such a solution.

History, Ancient↗
PubMed2000

Technology for patient care assessment, documentation, and education.

Computer technology plays a big role in health care systems and information management. As technology continues to evolve, its role will become even more prevalent and important. Among the trends seen in technology products are better integration and compatibility of systems and accessories, enhanced performance and speed, smaller size and portability, improved user-friendliness, and affordability. All of these trends favor increased use in the health care environment. Selection of a product requires consideration of the desired goals and needs. An assessment should be made of existing technologies, particularly if interfacing will be required. Furthermore, most products have a life of only 10-18 months due to the rapid development of newer and better technologies.

Humans↗
PubMed1977

An implicit technology of generalization.

Traditionally, discrimination has been understood as an active process, and a technology of its procedures has been developed and practiced extensively. Generalization, by contrast, has been considered the natural result of failing to practice a discrimination technology adequately, and thus has remained a passive concept almost devoid of a technology. But, generalization is equally deserving of an active conceptualization and technology. This review summarizes the structure of the generalization literature and its implicit embryonic technology, categorizing studies designed to assess or program generalization according to nine general headings: Train and Hope; Sequential Modification; Introduce to Natural Maintaining Contingencies; Train Sufficient Exemplars; Train Loosely; Use Indiscriminable Contingencies; Program Common Stimuli; Mediate Generalization; and Train "To Generalize".

Journal Article↗
PubMed2004

Technological advances in high-throughput screening.

High-throughput screening (HTS) is the process of testing a large number of diverse chemical structures against disease targets to identify 'hits'. Compared to traditional drug screening methods, HTS is characterized by its simplicity, rapidness, low cost, and high efficiency, taking the ligand-target interactions as the principle, as well as leading to a higher information harvest. As a multidisciplinary field, HTS involves an automated operation-platform, highly sensitive testing system, specific screening model (in vitro), an abundant components library, and a data acquisition and processing system. Various technologies, especially the novel technologies such as fluorescence, nuclear-magnetic resonance, affinity chromatography, surface plasmon resonance, and DNA microarray, are now available, and the screening of more than 100,000 samples per day is already possible. Fluorescence-based assays include the scintillation proximity assay, time-resolved energy transfer, fluorescence anisotropy, fluorescence correlation spectroscopy, and fluorescence fluctuation spectroscopy. Fluorescence-based techniques are likely to be among the most important detection approaches used for HTS due to their high sensitivity and amenability to automation, giving the industry-wide drive to simplify, miniaturize, and speed up assays. The application of NMR technology to HTS is another recent trend in drug research. One advantage afforded by NMR technology is that it can provide direct information on the affinity of the screening compounds and the binding location of protein. The structure-activity relationship acquired from NMR analysis can sharpen the library design, which will be very important in furnishing HTS with well-defined drug candidates. Affinity chromatography used for library screening will provide the information on the fundamental processes of drug action, such as absorption, distribution, excretion, and receptor activation; also the eluting curve can give directly the possibility of candidate drug. SPR can measure the quantity of a complex formed between two molecules in real-time without the need for fluorescent or radioisotopic labels. SPR is capable of characterizing unmodified biopharmaceuticals, studying the interaction of drug candidates with macromolecular targets, and identifying binding partners during ligand fishing experiments. DNA microarrays can be used in HTS be used to further investigate the expression of biological targets associated with human disease, which then opens new and exciting opportunities for drug discovery. Without doubt, the addition of new technologies will further increase the application of HTS in drug screening and its related fields.

Animals↗
PubMed2001

Technology and archives in radiology research: a sampling analysis of articles published in the AJR and Radiology. American Journal of Roentgenology.

OBJECTIVE: Our aim was to determine the use of advanced technology and archiving and the contribution of countries other than United States in the articles published in the American Journal of Roentgenology (AJR) and Radiology. We analyzed the association of these features with the type of research, the main technical features of the modalities used, and the countries of origin. MATERIALS AND METHODS: We determined the proportion of articles published in 18 randomly selected issues of the AJR and Radiology that required advanced imaging techniques and relied on the analysis of archived data. "Advanced technology" was defined as imaging techniques that serve a purpose other than simple anatomic imaging or that are not widely available because of the high cost of the technology, such as functional imaging and computer programming designed for an individual study or simulation studies. We analyzed the association of these features with the country of origin, the topic, and the methodology used. RESULTS: Sixteen percent of the studies required advanced technology. MR imaging, CT, and sonography were the most frequently used modalities (31%, 27%, and 15% of studies, respectively). Archiving was used in 37% of the studies, and 67% of the original articles were prospective. The articles most commonly originated in North America (67%), Europe (20%), and Asia (12%). CONCLUSION: Only a small percentage of published research studies required advanced technology and approximately one third of the studies used archiving. These results may suggest that other criteria, such as the design of the study, its relevance for daily clinical use, and the originality of the paper, have a major impact on the acceptance of papers in clinically oriented radiology journals.

Periodicals as Topic↗
PubMed2000

Predicting satisfaction with assistive technology for a sample of adults with new spinal cord injuries.

To assess the validity of the Assistive Technology Device Predisposition Assessment-Consumer Form for persons with a new spinal cord injury, 10 men and 10 women completed the scale and the Satisfaction with Life Scale and the Brief Symptom Inventory while in acute rehabilitation. One month postdischarge, subjects completed the Perceived Needs Inventory and rated their satisfaction with assistive technology. Significant positive correlations between items of the Assistive Technology Device Predisposition Assessment and Satisfaction with Life Scale (and their significant negative correlations with scores on the Brief Symptom Inventory-Depression) suggest the selected Assistive Technology Device Predisposition Assessment items measure quality of life (concurrent validity). Only Assistive Technology Device Predisposition Assessment scores predicted satisfied use 1-mo. postdischarge as measured by the Perceived Needs Inventory.

Adult↗
PubMed1996

Outcomes of assistive technology use on quality of life.

The results from many research efforts on the use of assistive devices are reviewed and summarized. Further, conceptual and methodological issues related to the use and abandonment of assistive technologies are discussed. Overall, this review should be helpful to professionals making device recommendations, documenting the need for a device, and assessing short- and long-term device utilization. The available literature lends support to a model of matching person and technology that considers environments of device use, characteristics of the user's preferences and expectations, and device features and functions. To ensure that assistive technologies enhance users' quality of life, future emphases should focus on consumer involvement in the selection and evaluation of appropriate assistive technology, and ways to make technologies more widely available and affordable.

Communication Devices for People with Disabilities↗
PubMed2003

The use of information technology in large animal veterinary education.

To facilitate large animal veterinary education, information technology has to connect the classroom to the farm. Technology needs to be portable, durable, and cost-effective. Dairy production medicine was one of the first areas in veterinary medicine to use computers to manage large sets of milk production-related data. Now equine practice has embraced technology in almost every diagnostic imaging methodology. The personal desktop assistant (PDA) has allowed students to take large volumes of information with them during clinical rotations. The technology is advancing so quickly that it is difficult to keep up with new software and hardware developments, let alone purchase the most current versions. This article reviews information technology as it is used in large animal practice and, consequently, in large animal veterinary education.

Animals↗
PubMed1999

Distance education: has technology become a threat to the academy?

Recent discussions regarding technology-assisted distance education have given rise both to enthusiastic predictions about how this form of instruction will transform higher educational institutions and to widespread fears about the threats that this technology poses to the student-teacher relationship and to the profession of university teacher in general. A review of opinions regarding distance education and computer technology in academia suggests a continuum of positions, ranging from the expectation that dramatic and even cataclysmic changes will lead to the eventual dissolution of the university to an envisioning of only minor changes in the academy's objectives and methods. In the present paper, this continuum is used as an organizing scheme to present the positions of several well-known advocates for and against the use of distance education and information technology. It is argued that the accreditation process will ultimately determine the degree to which distance education replaces traditional classroom instruction and that this process can be influenced by faculty involvement in decisions about the use of technology in the classroom.

Accreditation↗
PubMedDate not supplied

Information technology and the clinical laboratory. Agenda for the '90s.

The innovative use of information technology will be an essential response to the intense pressures and challenges health-care institutions face entering the final decade of the 20th century. Those pressures will affect the clinical laboratory and will result in significant use of improved information technology. The implications for laboratory management are significant. Changes in work methods, human resource needs, knowledge of information technology, and even laboratory organization will refocus the manager's attention. Routine, day-to-day activities that consumed the manager's attention will be handled automatically; long-range strategic planning, quests for productivity, and quality improvements will become more important and demanding. This article reviews current and evolving innovations in information technology and projects their impact on the clinical laboratory. Hardware, software, and communications technologies are examined. The effects on the laboratory, its manager, and the hospital are discussed.

Clinical Laboratory Information Systems↗
PubMedDate not supplied

Reclaiming our moral tradition. Catholic teaching calls us to accept the limits of medical technology.

The success of science and medical technology has led to medical brinkmanship, pushing aggressive treatment as far as it can go. But medicine lacks the precision necessary for such brinkmanship to succeed, and the resulting cycle of expectation and disappointment in technology has, in part, led to an increasing acceptance of euthanasia and assisted suicide, linked closely with advocacy for patient autonomy. At the opposite extreme lies medical vitalism, which refers to attempts to preserve the patient's life in and of itself without any significant hope for recovery. The Catholic moral tradition offers a middle ground, well expressed in the 1994 Ethical and Religious Directives for Catholic Health Care Services. The tradition does not deny the good of technology or state that some lives are not worth living. Rather, it calls us to accept the fact that medical technology has limits. In reclaiming this tradition, we reclaim the naturalness of death. Reclaiming the tradition has practical consequences for the use of life-prolonging technology at the end of life and for end-of-life decision making. These can be placed in three broad categories: the Christian understanding of care, the ambiguity inherent in end-of-life decision making, and the task of Christian formation.

Catholicism↗