Studies in health technology and informatics
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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
Image registration assists novice operators in ultrasound assessment of abdominal trauma.
Transcutaneous ultrasound imaging may be used to detect abdominal hemorrhage in the field setting. The Focused Assessment with Sonography for Trauma (FAST) examination was developed to characterize blunt abdominal trauma and has been shown to be effective for assessing penetrating trauma as well. However, it is unlikely that a minimally trained operator could perform a diagnostic examination. ⋯ The operator will be directed through the examination by prompts from a computer system or outside expert, potentially with knowledge of the anatomy of the injured patient. The key elements of the tele-operated FAST exam capability have been demonstrated; the exam is performed with real-time guidance from anatomic images registered to the body. It appears likely that Image Registration will assist hemorrhage detection at the point of injury or in the initial evaluation by a trauma response team.
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While telemedicine is now well established in many areas of medical practice, it is only beginning to create impact in some of the more complex medical applications such as critical care. New systems based on advanced technologies such as the Virtual Critical Care Unit and the eICU have recently successfully demonstrated the provision of critical care services from a distance in emergency and intensive care respectively. These specialties make particular demands on a telemedicine system, and studies in computer supported collaborative work as well as studies of work practices suggest that there is a minimum threshold of technology complexity for supporting such applications. ⋯ Other systems rely on complex physiological models. These approaches exemplify two trends in telemedicine systems of the future, with enhanced immersiveness creating a high sense of presence, and ready access to structured patient-specific data providing assistance to decision support. The future of telemedicine technology may see a convergence of these two trends.
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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.
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Stud Health Technol Inform · Jan 2008
From guidelines to careflows: modelling and supporting complex clinical processes.
Research on computer interpretable clinical guidelines has largely focused on individual points of care rather than processes of care. Whether we consider simple aids like clinical alerts and reminders or more sophisticated data interpretation and decision-making, guideline developers tend to focus on specific tasks rather than processes like care plans and pathways which are extended in time. ⋯ We also briefly discuss the distinct theoretical frameworks which have grown up around them, notably Petri nets for workflow modelling and mathematical logics for guidelines. We conclude that these offer complementary views of clinical processes and that a key research challenge is find a way of unifying them.