Studies in Health Technology and Informatics

Second Life (SL) is emerging as a repository of health information. The purpose of this study was to determine the number of places and groups that offer specific health information in SL. A retrospective analysis of SL places and groups was conducted for cancer. Findings indicate that more cancer information is available from groups than specific places in SL. All current and future cancer information will need to be evaluated for reliability and efficacy.

In the CONQUEST Quality Management System, assessment and improvement of the quality of treatment process and outcome is done by introducing a Clinical Quality Management Support System. Initially the treatment of breast cancer was chosen to illustrate the potential benefits of introducing quality management in the treatment process. The main objective of the CONQUEST Quality Management System is to provide a flexible framework for supplying quality management of the treatment process and enable comparison of clinical results, despite differences in the local best clinical practice guidelines used in the participating treatment centres.

Health information provides the foundation for all decision making in healthcare whether clinical at the bed side, or at a national government level. This information is generally collected as part of systems which support administrative or clinical workflow and practice. This chapter describes the many and varied features of systems such as electronic health records (EHRs), how they fit with health information systems and how they collectively manage information flow. Systems engineering methods and tools are described together with their use to suit the health industry. This focuses on the need for suitable system architectures and semantic interoperability. These concepts and their relevance to the health industry are explained. The relationship and requirements for appropriate data governance in these systems is also considered.

This paper describes the role of simulation involving end-users in Health Informatics. Simulation has long been established as a widely accepted method in clinical skills training. During the last decade simulation has also gained a place in the development and evaluation of clinical information systems. Simulation is especially well suited for the evaluation of human factors and organizational aspects in relation to application of information systems. In full-scale simulation tests it is possible to evaluate socio-technical interaction. A near to real life experience can be achieved by creating high fidelity environments. The paper discusses how simulation may be used during the lifecycle of clinical information systems, and the requirements on simulation fidelity in various situations. We recommend that simulation should get a more prominent role in the design and evaluation of clinical information systems.

This paper is concerned with how the future information needs of the medical community should be met. The current dominant belief within medicine is that these information needs should be met from bespoke research studies. The necessity of this approach is far from certain. Health organisations worldwide are currently investing vast resources into centralising and amalgamating every day patient data. Is there a future for these Electronic Medical Records in informing medical decisions? This paper describes the challenges to be met in using both research studies and every day patient data to inform medical decisions. It then describes an ongoing practical project to evaluate these information sources' ability to meet the information needs of cancer care decision makers. Details of background, methodology and initial promising results are presented.

To support the ongoing development of software-based surgical simulation systems, work is underway to acquire the mechanical properties of living tissue. When such simulations include force feedback, visco-elastic properties must be evaluated over a range of frequencies relevant to human perception and motor control. A minimally invasive instrument has been developed which can perform normal indentation on solid organs, and apply and measure deformations over a frequency range from DC to approximately 100Hz. Measurement performance was validated on a series of objects and materials with known properties, and the device was subsequently used in in vivo tests on porcine liver. Results of these validation tests as well as the data extracted from the in vivo experiments are presented. Testing in ongoing, and will be expanded to more completely characterize liver, as well as porcine spleen and other solid organ tissues. While these animal tissue property tests are valuable in and of themselves, they pave the way for the development of instruments and experimental protocols suitable for the measurement of human tissue properties.

Unlabelled: There is low evidence on the possible efficacy of exercises to treat idiopathic scoliosis, graded as C by the existing Italian Guidelines. Our aim was to verify if exercises quality has an effect on results. Design: Prospective controlled study on idiopathic scoliosis patients that performed only exercises to avoid progression. Treatment: SEAS Group make exercises according to the protocol SEAS.02 (Scientific Exercises Approach to Scoliosis, version 2002). The CONT Group performed exercises at a local structure according to different protocols preferred by the treating therapists. Population. SEAS: 48 patients (37 females), 12.5+/-2.2 years, 15.1 degrees +/-5.7 degrees Cobb (degrees C), 9.0 degrees +/-3.3 degrees Bunnell (degrees B). The difference in the number of braced patients within the first year has been almost statistically significant (P=0.07): 1 in SEAS vs. 5 in CONT. Cobb degrees improved with treatment (P<0.05) only in the SEAS group. Clinical results (variation of at least 5 degrees C or 2 degrees B) were better in SEAS than CONT. Not all exercises for scoliosis have the same efficacy: this study proves the short term efficacy of SEAS.02 when compared to usual care.

The Lyon school has proposed a preparation to brace wearing through an intensive mobilization in order to obtain a better reduction of the braced scoliotic curve. Our aim was to verify this hypothesis. A prospective controlled study on consecutive patients having idiopathic scoliosis with brace management. Results after 5 months of brace wearing were reviewed by radiographic examination without the brace. SEAS Group exercises according to the protocol SEAS.02 (Scientific Exercises Approach to Scoliosis, version 2002); CONT Group various type of exercises. Population. 110 patients (34 females), 13.5+/-2.4 years, 31.1 degrees +/-11.1 degrees Cobb (degrees C), 14.4 degrees +/-6.0 degrees Bunnell (degrees B). All parameters improved at follow-up in both groups. SEAS had better results than CONT for degrees C. Clinical results (variations of at least 5 degrees C and 2 degrees B) were better in SEAS than CONT. This study proves the efficacy of SEAS.02 exercises preparatory for bracing. Bracing demonstrated its short term efficacy.

This paper tries to synthesize the discussion of a seminar on medical informatics educational tasks held in May 1998 in Sinaia, Romania, within the frame of the Tempus-Phare Project CME-02555-96 entitled "Know How Transfer from University to Industry" and coordinated by the University of Medicine and Pharmacy Timisoara, Romania. Special emphasis was paid to particular features of medical education requirements in East European countries, with particular reference to Romania.

The determination of the number of beds needed for a hospital department is a complex problem that try to take into account efficiency, forecasting of needs, appropriateness of stays. Health authority used methods based on ratios that do not take into account local specificities and use rather to support an economic decision. On the other side, the models developed are too specific to be applied to all type of hospital department. Moreover, all the solutions depend on the LoS (Length of Stay). We have developed a non parametric method to solve this problem. This modelisation was successfully tested in teaching and non teaching hospitals, for an Intensive Care Unit, two Internal Medicine and a surgical departments. A software easy to use was developed, working on Windows available on our website www.sante.univ-nantes.fr/med/stat/.

The International Classification for Nursing Practice (ICNP) Programme focuses on terminology for nursing practice and acknowledges that nursing practice is not static but changing and dynamic. A number of major revisions were made to the Beta 2 to develop the ICNP Version 1.0. Although the Beta 2 Version functioned to compare and combine data from different sources, there were many recommendations for improvement. In this paper, we examined the ICNP Version 1.0 and identified the changes from the Beta 2 Version. A major change was the use of new technology for development of the ICNP Version 1.0 using description logics. Another change to the new version is the single classification structure that was refined into representation of a 7 Axis Model. The new coding system and new guidelines for composing statements that were developed using an International Organization for Standardization (ISO) Standard are also discussed.

At CT 2007, we presented NeuroVR (http://www.neurovr.org), a free virtual reality platform based on open-source software. The software allows non-expert users to adapt the content of 14 pre-designed virtual environments to the specific needs of the clinical or experimental setting. Following the feedbacks of the 700 users who downloaded the first version, we developed a new version - NeuroVR 1.5 - that improves the possibility for the therapist to enhance the patient's feeling of familiarity and intimacy with the virtual scene, by using external sounds, photos or videos. The key characteristics that make NeuroVR suitable for most clinical applications are the high level of control of the interaction with the tool, and the enriched experience provided to the patient. Actually, NeuroVR is used in the assessment and treatment of Obesity, Alcohol Abuse, Anxiety Disorders, Generalized Anxiety Disorders, and Cognitive Rehabilitation.

NeuroVR 1.5 is a cost-free virtual reality platform based on open-source components, allowing professionals to easily modify a virtual world, to best suit the needs of the clinical setting. The goal of the present project is to extend the functionalities of this platform by allowing users to interact with the virtual environment by using gestures detected by a webcam. To this end, we used CamSpace Beta 7, a cost-free and user-friendly computer vision technology. We describe how this integrated approach can be used to implement cognitive and motor training programs, involving partial or full-body movements.

At MMVR 2007 we presented NeuroVR (http://www.neurovr.org) a free virtual reality platform based on open-source software. The software allows non-expert users to adapt the content of 14 pre-designed virtual environments to the specific needs of the clinical or experimental setting. Following the feedbacks of the 700 users who downloaded the first version, we developed a new version - NeuroVR 1.5 - that improves the possibility for the therapist to enhance the patient's feeling of familiarity and intimacy with the virtual scene, by using external sounds, photos or videos. Specifically, the new version now includes full sound support and the ability of triggering external sounds and videos using the keyboard. The outcomes of different trials made using NeuroVR will be presented and discussed.

The paper addresses the issue of device management system design for software agents compliant with IEEE 1073 device communication standard. Based on middleware architecture the device control layer represents a universal versatile object-oriented application-programming interface. The approach presented in the paper allows to implement plug-and-play integration and interoperability of medical acquisition devices within the medical device system be means of common middleware services. Adherence to Medical Data Information Base nomenclature, component part of IEEE 1073 communication standard, adds necessary consistency to presented component-based infrastructure.