Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2008
The posterior skeletal thorax: rib-vertebral angle and axial vertebral rotation asymmetries in adolescent idiopathic scoliosis.
The deformity of the ribcage in thoracic adolescent idiopathic scoliosis (AIS) is viewed by most as being secondary to the spinal deformity, though a few consider it primary or involved in curve aggravation. Those who consider it primary ascribe pathogenetic significance to rib-vertebra angle asymmetry. In thoracic AIS, supra-apical rib-vertebra angle differences (RVADs) are reported to be associated with the severity of the Cobb angle. ⋯ RVADs are largest at two and three vertebral levels above the apex where they correlate significantly and positively with Cobb angle and AVT but not AVR. In right thoracic AIS, the cause(s) of the RVA asymmetries is unknown: it may result from trunk muscle imbalance, or from ribs adjusting passively within the constraint of the fourth column of the spine to increasing spinal curvature from whatever cause. Several possible mechanisms may drive axial vertebral rotation including, biplanar spinal asymmetry, relative anterior spinal overgrowth, dorsal shear forces in the presence of normal vertebral axial rotation, asymmetry of rib linear growth, trunk muscle imbalance causing rib-vertebra angle asymmetry weakening the spinal rotation-defending system of bipedal gait, and CNS mechanisms.
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Stud Health Technol Inform · Jan 2008
Comparative StudyPre-post evaluation of physicians' satisfaction with a redesigned electronic medical record system.
Physicians' acceptance of Electronic Medical Record Systems (EMRs) is closely related to their usability. Knowledge about end-users' opinions on usability of an EMR system may contribute to planning for the next phase of the usability cycle of the system. A demand for integration of new functionalities, such as computerized order entry and an electronic patient status led to redesign of our EMR system, which had been in use for over 8 years at the Academic Medical Center of Amsterdam. ⋯ Though overall user satisfaction was relatively high for both EMR systems, screen layout and interaction structure proved less easy to work with in the newer EMR system. The new EMR system however was more appreciated because of its enhanced functionality, capabilities and likeable user-interface. The results point to a number of actions that might be useful in future usability improvement efforts of our EMR system and other EMRs.
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Stud Health Technol Inform · Jan 2008
An automated personalised intervention algorithm for remote patient monitoring.
An automated personalised intervention algorithm was developed to determine when and if patients with chronic disease in a remote monitoring programme required intervention for management of their condition. The effectiveness of the algorithm has so far been evaluated on 29 patients. It was found to be particularly effective in monitoring newly diagnosed patients, patients requiring a change in medication as well as highlighting those that were not conforming to their medication. Our approach indicates that RPM used with the intervention algorithm and a clinical protocol can be effective in a primary care setting for targeting those patients that would most benefit from monitoring.
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Stud Health Technol Inform · Jan 2008
Case ReportsOur experience with virtual craniomaxillofacial surgery: planning, transference and validation.
Clinical application of virtual craniomaxillofacial surgery (VCMS) planning is demonstrated with four typical cases. An integral component to success is transferring the surgical plan to the operating environment within a reasonable time frame through the design and fabrication of surgical guides and implants.
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Stud Health Technol Inform · Jan 2008
The relationship between hip flexion/extension and the sagittal curves of the spine.
The objective of this study was to develop a finite element model (FEM) in order to study the relationship between hip flexion/extension and the sagittal curves of the spine. A previously developed FEM of the spine, rib cage and pelvis personalized to the 3D reconstructed geometry of a patient using biplanar radiographs was adapted to include the lower limbs including muscles. ⋯ Additional simulations showed that the hamstrings and gluteal muscles were responsible for the transmission of hip flexion to pelvic rotation with the legs straight and flexed respectively, and the important influence of knee bending on lordosis modulation during lower limb positioning. The knowledge gained through this study is intended to be used to improve operative patient positioning.