Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2002
The Double Rib Contour Sign (DRCS) in lateral spinal radiographs: aetiologic implications for scoliosis.
All lateral spinal radiographs in idiopathic scoliosis show a DRC sign of the thoracic cage, a radiographic expression of the rib hump. The outline of the convex overlies the contour of the concave ribs. The aim of this study is to assess this DRC sign in children with and without Late Onset Idiopathic Scoliosis (LOIS) with 10 degrees -20 degrees Cobb angle, and to examine whether in scoliosis the deformity of the thorax or that of the spine develops first. ⋯ The DRCS primarily appears because of the rib deformation and secondarily because of the vertebral rotation, as it could be present in straight spines with no vertebral rotation. In all our school-screening referrals, (having ATI > or = 7 degrees), the thorax deformity, in terms of the DRC sign, has already been developed. 70% of these children were scoliotic. The others had a curvature of less than 9 degrees of Cobb angle (10%) or they were children with straight spines (20%) who were followed because of their existing rib hump. The non-scoliotics were 1,5-2 years younger than the ones who had already developed scoliosis, and they had both approximately a "rib index" of 1,5. The DRC sign is present in all referrals. In contrary, there is no scoliotic spine without it, as the DRC sign is always present in scoliotic lateral spinal radiographs with no exception. This observation supports our hypothesis that in idiopathic scoliosis, the deformity of the thorax develops first and then the deformity of the spine follows.
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Stud Health Technol Inform · Jan 2002
Trust me, I'm a patient! The effect of an EHR on my consultation.
A general assumption has been made within the health care community that the introduction of an Electronic Health Record (EHR) is beneficial and improves clinical care. However, it is my contention as both a Health Informatician, and more importantly a patient, that this assumption is not supported by evidence, either scientific or anecdotal. However, to my mind of more importance than this is the complete lack of understanding about how using an EHR effects my consultation. This paper discusses this issue and identifies four lessons to be learned by the EHR community.
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Stud Health Technol Inform · Jan 2002
The significance of correlation of radiographic variables and MOS short-form health survey for clinical decision in symptomatic low back pain patients.
To assess any correlation between SF-36 scores and several lateral roentgenographic variables of the lumbar spine, both in low back pain patients and asymptomatic volunteers. The clinical relevance of the method proposed in this study to make a surgical strategy on the basis of distinct lateral roentgenographic parameters and conversely was assessed by independent radiologists and physicians. ⋯ SF-36 scores were correlated with distinct lateral roentgenographic variables of the lowermost lumbar spine (L4-S1) in low back patients, and of the whole lumbar spine in asymptomatic individuals. Clinical decision should not be taken on the basis of radiological evidence of pathology because clinical decision seems to be more accurate when is taken on the basis of combined SF-36 and roentgenographic data. However, clinical examination is mandatory to SF-36 questionnaire and radiographic analysis.
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Stud Health Technol Inform · Jan 2002
CTM brace effect on scoliotic intervertebral discs using MRI method.
MRI has been clinically only used for investigation of intervertebral disc disorders. In this study, MR images were used and a new 3D modelling of the intervertebral discs was proposed. MRI examination had been performed on fourteen girls presenting an idiopathic scoliosis and wearing a first CTM brace. ⋯ The intervertebral disc informations obtained represented new data in the scoliotic deformation description. But this method was not adapted for a clinical use. The qualitative and quantitative data obtained will help the orthopaedist in the brace design and also the clinician in the scoliosis comprehension.
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Emergency healthcare delivery involves a variety of activities performed from the time of a call to the ambulance service till the time of patient's disposal from the emergency department of a hospital. Workflow systems have recently received considerable attention in the healthcare field since they overcome organizational structures and support collaboration and coordination requirements by automatically routing relevant information where and when needed. In particular, healthcare workflow systems implemented over the Web can form the basis for a collaborative environment by bringing together healthcare professionals who are geographically dispersed and, hence, creating virtual healthcare workgroups organized around patient care. In this paper, a web-based workflow system is presented that was developed to support emergency healthcare processes and to provide an infrastructure for the integration of pre-hospital and in-hospital emergency healthcare.