Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2008
Optimizing a head-tracked stereo display system to guide hepatic tumor ablation.
Radio frequency ablation is a minimally invasive intervention that introduces -- under 2D ultrasound guidance and via a needle-like probe -- high-frequency electrical current into non-resectable hepatic tumors. These recur mostly on the periphery, indicating errors in probe placement. Hypothesizing that a contextually correct 3D display will aid targeting and decrease recurrence, we have developed a prototype guidance system based on a head-tracked 3D display and motion-tracked instruments. ⋯ Initial candidates were an augmented reality see-through head-mounted display and a virtual reality "fish tank" system. We describe the system requirements and explain how we arrived at the final decision. We show the operational guidance system in use on phantoms and animals.
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Stud Health Technol Inform · Jan 2008
The contextual nature of usability and its relevance to medical informatics.
We report from three usability evaluations of health information systems that illustrate the value of seeing usability as a context dependent property of a product. We show how the definition of usability in ISO 9241-11 can be used as a guiding principle in the evaluation, specification and design of such systems. The contextual view on usability is particularly important for health information systems because of their great diversity concerning user groups, tasks, and work environments.
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Stud Health Technol Inform · Jan 2008
Intensive care telemedicine: evaluating a model for proactive remote monitoring and intervention in the critical care setting.
Historically, telemedicine has focused on the application of traditional physician-to-patient (and physician-to-physician) interactions enhanced by two-way video and audio capability. This "one-on-one" interaction via a telemedicine link can dramatically extend a physician's or other caregiver's geographic range and availability. However, this same telemedicine model is most often implemented "on-demand" for a specified time-limited encounter. ⋯ Multiple challenges remain before remote ICU systems become more broadly accepted and applied. These include cost of implementation of the system, resistance to the system by ICU physicians and nurses, and integration of data systems and clinical information into the remote electronic ICU model. In this chapter, we will provide background information on error reduction theory and the role of the remote ICU model, review current data supporting use of the remote ICU system, address the current obstacles to effective implementation, and look to the future of the field for solutions to these challenges.
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Stud Health Technol Inform · Jan 2008
Randomized Controlled TrialTransfer of systematic computer game training in surgical novices on performance in virtual reality image guided surgical simulators.
We report on a pilot study that investigates the transfer effect of systematic computer game training on performance in image guided surgery. In a group of 22 surgical novices, subjects were matched and randomized into one group training with a 3-D first person shooter (FPS) game and one group training with a 2-D non-FPS game. We also included a control group. ⋯ Furthermore subjects who underwent systematic FPS game training performed better in the MIST-VR than those training with a 2-D game. Our findings indicate a transfer effect and that experience of video games are important for training outcome in simulated surgical procedures. Video game training can become useful when designing future skills training curricula for surgeons.
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Stud Health Technol Inform · Jan 2008
Improving pain & symptom management for advanced cancer patients with a clinical decision support system.
In palliative medicine, healthcare providers aim to provide end-of-life cancer patients with a plan of care to minimize pain and manage symptoms, while providing psychosocial and educational support to patients and their families. Unfortunately, it has been reported that patients often experience unnecessary suffering due to ineffective symptom management as they near end-of-life. ⋯ In this paper, we present a unique clinical decision support system that incorporates case-based reasoning and evidence-based standards of care. It is anticipated that this user-friendly, web-based CBR system will improve decision making for pain and symptom management for end-of-life cancer patients.