Journal of clinical monitoring and computing
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J Clin Monit Comput · May 1999
Inter observer variability of the transcranial Doppler ultrasound technique: impact of lack of practice on the accuracy of measurement.
Published data on the observer variability with the transcranial doppler (TCD) ultrasound are limited by the use of the product moment correlation coefficient. This study was designed to quantify the intra and inter observer variability with the TCD in terms of the intra class correlation coefficient (ICC) and to assess the impact of lack of practice on the observer variability and the accuracy of data generated. ⋯ A high level of observer agreement is possible with the TCD for measurement of cerebral blood flow velocities. Lack of regular practice with the system reduces the accuracy of measurements and impacts on both measured and calculated indices.
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J Clin Monit Comput · May 1999
Problem-based learning in residency education: a novel implementation using a simulator.
We developed a problem-based learning exercise with a full-scale human patient simulator to teach residents the emergency management and differential diagnosis of acute intraoperative hypotension. ⋯ Exercises on a full-scale patient simulator are a natural extension of problem-based learning. Recent research in learning theory provides the rationale for this teaching modality's potential as a learning tool.
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J Clin Monit Comput · May 1999
Point-of-care and standard laboratory coagulation testing during cardiovascular surgery: balancing reliability and timeliness.
The use of point-of-care technology has increased faster than efforts to validate its effectiveness compared to standard laboratory testing modalities. To address this issue with a current point-of-care coagulation system (HEMOCHRON Jr, International Technidyne Corporation (ITC), Edison, NJ), we designed a study to test the hypothesis that data obtained from point-of-care coagulation equipment correlates with data obtained from standard laboratory coagulation equipment. One of the potential advantages gained using point-of-care testing is the ability to obtain more rapid results. To address this issue, turnaround time, defined as the elapsed time (in minutes) from when the sample was acquired from the patient until the investigators knew the results, was also determined. ⋯ The results from this study population reveal that data obtained from point-of-care prothrombin time, international normalized ratio and activated partial thromboplastin time results correlate with results obtained from standard laboratory coagulation testing. The value of obtaining reliable results in a timely fashion offers a potential advantage for point-of-care testing in dinical situations, such as in the operating room, where saving time may translate into financial savings.
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J Clin Monit Comput · May 1999
Optimal sequencing of urgent surgical cases. Scheduling cases using operating room information systems.
Optimal sequencing of urgent cases (i.e., selecting which urgent case should be performed first and which second) may enhance patient safety, increase patient satisfaction with timeliness of surgery, and minimize surgeons' complaints. Before determining the optimal sequence of urgent cases, an operating room (OR) suite must identify the primary scheduling objective to be satisfied when prioritizing pending urgent cases. ⋯ We provide mathematical structure which can be used to program a computerized surgical services information system to assist in optimizing the sequence of urgent cases. We use an example to illustrate that the optimal sequence varies depending on the scheduling objective chosen.