Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2008
Computer-assisted Cobb angle measurement on posteroanterior radiographs.
The Cobb angle method is the gold standard to assess severity of scoliosis. A computer-aided method was developed to provide a semi-automatic Cobb angle measurement during a scoliosis clinic. This study was to evaluate the reliability and accuracy of the developed method. ⋯ For each curve type, the inter-method, inter-observer, and intra-observer variability were analyzed by Intraclass correlation coefficients (ICC[2,1]). The ICC values were higher than 0.90 in all these types. The developed method was reliable to measure the Cobb angle and was not dependent on the curve type.
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Stud Health Technol Inform · Jan 2008
Comparative StudySagittal alignment correction of the thoracolumbar junction in idiopathic scoliosis by in situ bending technique.
A long thoracolumbar sagittal rectitude is sometimes present in adolescent idiopathic scoliosis. The purpose of this study was to identify typical patterns, by comparing frontal plane deformities and vertebral rotation leading to this rectitude. Surgical thoracolumbar alignment correction by three-dimensional in situ bending of rods was then analyzed. ⋯ In situ bending realizes a stepwise correction of the three-dimensional deformity at different levels. An accurate preoperative analysis is mandatory to achieve an adequate sagittal balance, frontal curve correction and vertebral derotation simultaneously. The determined patterns of thoracolumbar rectitude are helpful to plan surgical correction accurately.
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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
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
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.