Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2001
3D visualization and stereographic techniques for medical research and education.
While computers have been able to work with true 3D models for a long time, the same does not apply to the users in common. Over the years, a number of 3D visualization techniques have been developed to enable a scientist or a student, to see not only a flat representation of an object, but also an approximation of its Z-axis. In addition to the traditional flat image representation of a 3D object, at least four established methodologies exist: Stereo pairs. ⋯ While the system requires very expensive hardware, it solves some of the more important problems mentioned above, such as the capacity to use higher frame rates and the ability to display images to a large audience. Mednet has instigated a research project which uses reconstructed models from the central nervous system (human brain and basal ganglia, cortex, dendrites and dendritic spines) and peripheral nervous system (nodes of Ranvier and axoplasmic areas). The aim is to modify the models to fit the different visualization techniques mentioned above and compare a group of users perceived degree of 3D for each technique.
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Stud Health Technol Inform · Jan 2001
Structured data entry of clinical information for documentation and data collection.
Routine databases containing large amounts of clinical data represent a tremendous opportunity for the evaluation of health care practices and outcomes. However, data collected for administrative purposes has limitations in content, accuracy and completeness. ⋯ We developed a structured data entry method, the Clinical Data Framework (CDF), which has been used to support the capture of clinical information by clinicians in the normal process of care delivery. A study of the CDF over a two month period showed that it improved the accuracy of completeness of data collection over a coding method which was based on selection of ICD-9-CM codes.
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In today's ICUs clinicians routinely integrate huge numbers of discrete data points to arrive at a coherent picture of their patients' status. Often the clinician must obtain those data elements from many devices, which makes the problem more difficult. Because presenting data visually amplifies cognition by capitalizing on well-known human perceptual capabilities, it is not surprising that a growing body of research is directed at the effective presentation of visual information in clinical displays. ⋯ We recently used CWA to analyze the information needs for interactive graphical displays that will integrate and represent data in structures that help clinicians visualize a patient's physiological status. We found that the analysis was an effective way to identify information needs at multiple levels. Based on our experience, CWA is a generic methodology that is highly applicable to medical informatics.
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Implementing telehealth applications represents a substantial investment of resources, which is one reason why success is of great interest. Many research and evaluation studies have investigated measures of successful telehealth systems. However, the term "telehealth" represents a wide range of variables including clinical application, characteristics of the information being transmitted, temporal relationships of data transfer and the organizational context. ⋯ Less is known about the relationship among these variables and whether the findings around one variable are generalizable to other settings or applications. For example, organizational support may be essential for successful provider-patient interactions via videoconference, which result in higher quality of life. A conceptual framework would assist in accumulating this type of evidence and supporting more advanced research efforts.
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Stud Health Technol Inform · Jan 2001
Sharable computer-based clinical practice guidelines: rationale, obstacles, approaches, and prospects.
Clinical practice guideline automation at the point of care is of growing interest, yet most guidelines are authored in unstructured narrative form. Computer-based execution depends on a formal structured representation, and also faces a number of other challenges at all stages of the guideline lifecycle: modeling, authoring, dissemination, implementation, and update. This is because of the multiplicity of conceptual models, authoring tools, authoring approaches, intended applications, implementation platforms, and local interface requirements and operational constraints. ⋯ Because of limitations in what can be done by a single team with finite resources, however, and the variety of additional perspectives that need to be accommodated, the InterMed team has determined that further development of a shared representation would be best served as an open process in which the world community is engaged. Under the auspices of the HL7 Decision Support Technical Committee, a GLIF Special Interest Group has been established, which is intended to be a forum for collaborative refinement and extension of a standard representation that can support the needs of the guideline lifecycle. Significant areas for future work will need to include demonstrations of effective means for incorporating guide-lines at point of care, reconciliation of functional requirements of different models and identification of those most important for supporting practical implementation, im-proved means for authoring and management of complexity, and methods for automatically analyzing and validating syntax, semantics, and logical consistency of guidelines.