SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A universal soft-art complex tentatively named Arm-Stomatolog, covering all sections of dentistry, has been developed. It is based on individual programs in dentistry, making use of high-level algorithmic languages fitted to modern operation systems and permitting block-to-block fitting of individual programs to unite them in a complex.
Epidemiologists are under considerable pressure to acknowledge the presence of measurement error in the determination of risk factors. Repeatability and validation studies are often prescribed in conjunction with epidemiological studies. We describe some practical uses for repeatability and validation study data, in terms of correcting risk estimates for measurement error. Commonly available methods are described, with their advantages and shortcomings. A user-friendly computer program to carry out the analyses described accompanies the paper.
Explore the source record for details and available documents.
In order to conform to the rigid German legislation on data privacy and security we developed a new concept of data flow and data storage for population-based cancer registries. A special trusted office generates a pseudonym for each case by a cryptographic procedure. This office also handles the notification of cases and communicates with the reporting physicians. It passes pseudonymous records to the registration office for permanent storage. The registration office links the records according to the pseudonyms. Starting from a requirements analysis we show how to construct the pseudonyms; we then show that they meet the requirements. We discuss how the pseudonyms have to be protected by cryptographic and organizational means. A pilot study showed that the proposed procedure gives acceptable synonym and homonym error rates. The methods described are not restricted to cancer registration and may serve as a model for comparable applications in medical informatics.
Medical activity is characterized by its complexity. Professional guidelines and good wills do not suffice to improve efficiently performances of decisions taken by health care workers, medical doctors and administrators. The evaluation medical activity is a necessity for assisted decision making. The finality of evaluation has to be specified, its methods must be adapted, so that it is accepted by the medical community. In this framework, data processing can be a tremendous way to improve continuously the efficiency of the health care system.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Clinical practice guidelines are being touted as a cure for the tension between health care cost and quality. Rather than being just a means of controlling clinicians, guidelines also offer the chance to improve the quality of care by reducing practice variation and adherence to standards of good care. To be operationalized via computers, guidelines must be accepted by the clinicians, who must fully intend to follow them. They must be timely and use available data with minimal additional data entry by clinicians. Finally, they should have a measurable effect and be shown to improve care processes and/or outcomes.
A patient's quality of life is difficult to assess. Most methods designed to evaluate quality of life for clinical trials are time consuming, subject to varied interpretation among patients and assessors, and apply scales with only a limited relationship to utility theory. We have developed a HyperCard program, incorporating animated graphics, to (1) improve the speed of collection and collation of data, (2) improve understanding between patients and assessors, and (3) incorporate utility theory-based assessments. We assessed the quality of life of 25 patients with end-stage renal disease receiving hemodialysis using a traditional paper-based presentation and, eight months later, repeated the assessment with a computer-assisted presentation. Each presentation incorporated five techniques for evaluating quality of life: the Campbell Index of Well-being, the Kaplan-Bush Index of Well-being, categorical scaling, standard gamble, and time tradeoff. The computer program improved the speed of collation of data for statistical analysis, provided a consistent interface among patients for utility assessments, and showed stable reporting of patient's well-being. These findings suggest that further development of computer-assisted assessments of patients' quality of life for clinical trials is warranted.
BACKGROUND: The methods and characteristics of clinical data gathered at the initial steps of development of a computerized system to aid medical diagnosis are reported. The objectives of the study were as follows: to describe the overall method and to set a framework for developing an intellectual model of the medical diagnosis procedure. MATERIAL AND METHODS: A structured medical interview and physical examination using an informatic program on PC compatible portable computers were completed in a sample 1,238 patients attending the outpatient clinics of our institution. Data obtained were compared with information in the patient's medical record taking as reference pattern the record of physicians in charge of the patients. Diagnosis were codified according to WHO International Classification of Diseases (ICD-9-CM). RESULTS: The distribution of symptoms and signs corresponding to the different organs and systems was analyzed. Each subdivision afforded a range of 1.3 to 3.9 abnormal findings per patient. A total of 3,571 diagnoses were codified for the whole group 1,238 patients with a mean (standard deviation) of 3 (2) diagnoses per patient (range 0-12). The distribution of diagnostic groups varied depending on the consideration of the main diagnosis or the concomitant diagnoses that defined the patient's clinical context. The most frequent main diagnoses included tumors, cardiovascular diseases, gastrointestinal disorders, and genitourinary tract diseases. CONCLUSIONS: As shown by results obtained in a sample of 1,238 patients, there is a very complex situation in clinical practice due to the simultaneous occurrence of several clinical patterns. This finding should be taken into account when developing clinical decision making support systems. The use of a structured medical interview or a structured and standard medical visit may be an adequate tool to clarify this matter and to contribute to standardization of clinical concepts and situations.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Over the past 20 years, computer simulation has become an invaluable third leg of research in the physical sciences, adding to the traditional tools of theoretical studies and experimental observation. Simulation can give far more accurate pictures than can be provided by theoretical analysis, and show processes that are difficult to observe in detail. Recently, this invaluable tool has been successfully applied to medicine, where the systems tend to be more complex, requiring more computer power. The results are likely to be as far reaching as they have been in physics and chemistry.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Few kinds of technology have had as broad an impact on the recent affairs of humanity as have information technologies. The appearance and rapid spread in the past several years of innovations such as the Internet's World Wide Web and the emergence of computer networks connecting tens to hundreds of millions of people worldwide have occurred with startling rapidity. These global events portend substantial changes in the delivery of health care, the conduct of biomedical research, and the undergraduate, graduate, and continuing education of health professionals. This report will attempt to succinctly review the following: (1) the characteristics of modern information technologies and recent trends that are most relevant to medical education and to the world in which future practitioners, researchers, and educators will live and work; (2) the implications of these technologies for the development of educational goals (in other words, the specific information technology skills that future health professionals will need); (3) the issues associated with the use of these technologies in the process of education; and (4) implications for near-term action by University of California medical schools and academic medical centers.