Search results for: patient dosimetry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 388

Search results for: patient dosimetry

358 A Robotic Rehabilitation Arm Driven by Somatosensory Brain-Computer Interface

Authors: Jiewei Li, Hongyan Cui, Chunqi Chang, Yong Hu

Abstract:

It was expected to benefit patient with hemiparesis after stroke by extensive arm rehabilitation, to partially regain forearm and hand function. This paper propose a robotic rehabilitation arm in assisting the hemiparetic patient to learn new ways of using and moving their weak arms. In this study, the robotic arm was driven by a somatosensory stimulated brain computer interface (BCI), which is a new modality BCI. The use of somatosensory stimulation is not only an input for BCI, but also a electrical stimulation for treatment of hemiparesis to strengthen the arm and improve its range of motion. A trial of this robotic rehabilitation arm was performed in a stroke patient with pure motor hemiparesis. The initial trial showed a promising result from the patient with great motivation and function improvement. It suggests that robotic rehabilitation arm driven by somatosensory BCI can enhance the rehabilitation performance and progress for hemiparetic patients after stroke.

Keywords: Robotic rehabilitation arm, brain computer interface (BCI), hemiparesis, stroke, somatosensory stimulation.

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357 A Multilingual Virtual Simulated Patient Framework for Training Primary Health Care Students

Authors: Juan L. Castro, Maria I. NavarroVictor Lopez, Eduardo M. Eisman, Jose M. Zurita

Abstract:

This paper describes the Multilingual Virtual Simulated Patient framework. It has been created to train the social skills and testing the knowledge of primary health care medical students. The framework generates conversational agents which perform in serveral languages as virtual simulated patients that help to improve the communication and diagnosis skills of the students complementing their training process.

Keywords: Medical training, conversational agents, patient modeling.

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356 A Study of Current Maintenance Strategies and the Reliability of Critical Medical Equipment in Hospitals in Relation to Patient Outcomes

Authors: Khelood A. Mkalaf, Peter Gibson, John Flanagan

Abstract:

This study investigates the relationship between the reliability of critical medical equipment (CME) and the effectiveness of CME maintenance management strategies in relation to patient outcomes in 84 public hospitals of a top 20 OECD country. The work has examined the effectiveness of CME maintenance management strategies used by the public hospital system of a large state run health organization. The conceptual framework was designed to examine the significance of the relationship between six variables: (1) types of maintenance management strategies, (2) maintenance services, (3) maintenance practice, (4) medical equipment reliability, (5) maintenance costs and (6) patient outcomes. The results provide interesting insights into the effectiveness of the maintenance strategies used. For example, there appears to be about a 1 in 10 000 probability of failure of anesthesia equipment, but these seem to be confined to specific maintenance situations. There are also some findings in relation to outsourcing of maintenance. For each of the variables listed, results are reported in relation to the various types of maintenance strategies and services. Decision-makers may use these results to evaluate more effective maintenance strategies for their CME and generate more effective patient outcomes.

Keywords: Critical medical equipment, maintenance strategy, patient outcomes, reliability.

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355 A Decision Support System Based on Leprosy Scales

Authors: Dennys Robson Girardi, Hugo Bulegon, Claudia Maria Moro Barra

Abstract:

Leprosy is an infectious disease caused by Mycobacterium Leprae, this disease, generally, compromises the neural fibers, leading to the development of disability. Disabilities are changes that limit daily activities or social life of a normal individual. When comes to leprosy, the study of disability considered the functional limitation (physical disabilities), the limitation of activity and social participation, which are measured respectively by the scales: EHF, SALSA and PARTICIPATION SCALE. The objective of this work is to propose an on-line monitoring of leprosy patients, which is based on information scales EHF, SALSA and PARTICIPATION SCALE. It is expected that the proposed system is applied in monitoring the patient during treatment and after healing therapy of the disease. The correlations that the system is between the scales create a variety of information, presented the state of the patient and full of changes or reductions in disability. The system provides reports with information from each of the scales and the relationships that exist between them. This way, health professionals, with access to patient information, can intervene with techniques for the Prevention of Disability. Through the automated scale, the system shows the level of the patient and allows the patient, or the responsible, to take a preventive measure. With an online system, it is possible take the assessments and monitor patients from anywhere.

Keywords: Leprosy, Medical Informatics, Decision SupportSystem, Disability.

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354 Designing a Patient Monitoring System Using Cloud and Semantic Web Technologies

Authors: Chryssa Thermolia, Ekaterini S. Bei, Stelios Sotiriadis, Kostas Stravoskoufos, Euripides G.M. Petrakis

Abstract:

Moving into a new era of healthcare, new tools and devices are developed to extend and improve health services, such as remote patient monitoring and risk prevention. In this concept, Internet of Things (IoT) and Cloud Computing present great advantages by providing remote and efficient services, as well as cooperation between patients, clinicians, researchers and other health professionals. This paper focuses on patients suffering from bipolar disorder, a brain disorder that belongs to a group of conditions called affective disorders, which is characterized by great mood swings. We exploit the advantages of Semantic Web and Cloud Technologies to develop a patient monitoring system to support clinicians. Based on intelligently filtering of evidence-knowledge and individual-specific information we aim to provide treatment notifications and recommended function tests at appropriate times or concluding into alerts for serious mood changes and patient’s nonresponse to treatment. We propose an architecture as the back-end part of a cloud platform for IoT, intertwining intelligence devices with patients’ daily routine and clinicians’ support.

Keywords: Bipolar disorder, intelligent systems patient monitoring, semantic web technologies, IoT.

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353 Patient Perspectives on Telehealth during the Pandemic in the United States

Authors: Manal Sultan Alhussein, Xiang Michelle Liu

Abstract:

Telehealth is an advanced technology using digital information and telecommunication facilities that provide access to health services from a distance. It slows the transmission factor of COVID-19, especially for elderly patients and patients with chronic diseases during the pandemic. Therefore, understanding patient perspectives on telehealth services and the factors impacting their option of telehealth service will shed light on the measures that healthcare providers can take to improve the quality of telehealth services. This study aimed to evaluate perceptions of telehealth services among different patient groups and explore various aspects of telehealth utilization in the United States during the COVID-19 pandemic. An online survey distributed via social media platforms was used to collect research data. In addition to the descriptive statistics, both correlation and regression analyses were conducted to test research hypotheses. The empirical results highlighted that the factors such as accessibility to telehealth services and the type of specialty clinics that the patients required play important roles in the effectiveness of telehealth services they received. However, the results found that patients’ waiting time to receive telehealth services and their annual income did not significantly influence their desire to select receiving healthcare services via telehealth. The limitations of the study and future research directions are discussed.

Keywords: Telehealth, patient satisfaction, pandemic, healthcare, remote patient monitor.

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352 GSM Based Smart Patient Monitoring System

Authors: Ayman M. Mansour

Abstract:

In this paper, we propose an intelligent system that is used for monitoring the health conditions of patients. Monitoring the health condition of patients is a complex problem that involves different medical units and requires continuous monitoring especially in rural areas because of inadequate number of available specialized physicians. The proposed system will improve patient care and drive costs down comparing to the existing system in Jordan. The proposed system will be the start point to faster and improve the communication between different units in the health system in Jordan. Connecting patients and their physicians beyond hospital doors regarding their geographical area is an important issue in developing the health system in Jordan. The ability of making medical decisions, the quality of medical is expected to be improved.

Keywords: GSM, SMS, Patient, Monitoring system, Fuzzy Logic, Multi-agent system.

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351 Localization of Anatomical Landmarks in Head CT Images for Image to Patient Registration

Authors: M. Ovinis, D. Kerr, K. Bouazza-Marouf, M. Vloeberghs

Abstract:

The use of anatomical landmarks as a basis for image to patient registration is appealing because the registration may be performed retrospectively. We have previously proposed the use of two anatomical soft tissue landmarks of the head, the canthus (corner of the eye) and the tragus (a small, pointed, cartilaginous flap of the ear), as a registration basis for an automated CT image to patient registration system, and described their localization in patient space using close range photogrammetry. In this paper, the automatic localization of these landmarks in CT images, based on their curvature saliency and using a rule based system that incorporates prior knowledge of their characteristics, is described. Existing approaches to landmark localization in CT images are predominantly semi-automatic and primarily for localizing internal landmarks. To validate our approach, the positions of the landmarks localized automatically and manually in near isotropic CT images of 102 patients were compared. The average difference was 1.2mm (std = 0.9mm, max = 4.5mm) for the medial canthus and 0.8mm (std = 0.6mm, max = 2.6mm) for the tragus. The medial canthus and tragus can be automatically localized in CT images, with performance comparable to manual localization, based on the approach presented.

Keywords: Anatomical Landmarks, CT, Localization.

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350 IOT Based Process Model for Heart Monitoring Process

Authors: Dalyah Y. Al-Jamal, Maryam H. Eshtaiwi, Liyakathunisa Syed

Abstract:

Connecting health services with technology has a huge demand as people health situations are becoming worse day by day. In fact, engaging new technologies such as Internet of Things (IOT) into the medical services can enhance the patient care services. Specifically, patients suffering from chronic diseases such as cardiac patients need a special care and monitoring. In reality, some efforts were previously taken to automate and improve the patient monitoring systems. However, the previous efforts have some limitations and lack the real-time feature needed for chronic kind of diseases. In this paper, an improved process model for patient monitoring system specialized for cardiac patients is presented. A survey was distributed and interviews were conducted to gather the needed requirements to improve the cardiac patient monitoring system. Business Process Model and Notation (BPMN) language was used to model the proposed process. In fact, the proposed system uses the IOT Technology to assist doctors to remotely monitor and follow-up with their heart patients in real-time. In order to validate the effectiveness of the proposed solution, simulation analysis was performed using Bizagi Modeler tool. Analysis results show performance improvements in the heart monitoring process. For the future, authors suggest enhancing the proposed system to cover all the chronic diseases.

Keywords: Business process model and notation, cardiac patient, cardiac monitoring, heart monitoring, healthcare, internet of things, remote patient monitoring system, process model, telemedicine, wearable sensors.

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349 Assessment of Occupational Exposure and Individual Radio-Sensitivity in People Subjected to Ionizing Radiation

Authors: Oksana G. Cherednichenko, Anastasia L. Pilyugina, Sergey N.Lukashenko, Elena G. Gubitskaya

Abstract:

The estimation of accumulated radiation doses in people professionally exposed to ionizing radiation was performed using methods of biological (chromosomal aberrations frequency in lymphocytes) and physical (radionuclides analysis in urine, whole-body radiation meter, individual thermoluminescent dosimeters) dosimetry. A group of 84 "A" category employees after their work in the territory of former Semipalatinsk test site (Kazakhstan) was investigated. The dose rate in some funnels exceeds 40 μSv/h. After radionuclides determination in urine using radiochemical and WBC methods, it was shown that the total effective dose of personnel internal exposure did not exceed 0.2 mSv/year, while an acceptable dose limit for staff is 20 mSv/year. The range of external radiation doses measured with individual thermo-luminescent dosimeters was 0.3-1.406 µSv. The cytogenetic examination showed that chromosomal aberrations frequency in staff was 4.27±0.22%, which is significantly higher than at the people from non-polluting settlement Tausugur (0.87±0.1%) (р ≤ 0.01) and citizens of Almaty (1.6±0.12%) (р≤ 0.01). Chromosomal type aberrations accounted for 2.32±0.16%, 0.27±0.06% of which were dicentrics and centric rings. The cytogenetic analysis of different types group radiosensitivity among «professionals» (age, sex, ethnic group, epidemiological data) revealed no significant differences between the compared values. Using various techniques by frequency of dicentrics and centric rings, the average cumulative radiation dose for group was calculated, and that was 0.084-0.143 Gy. To perform comparative individual dosimetry using physical and biological methods of dose assessment, calibration curves (including own ones) and regression equations based on general frequency of chromosomal aberrations obtained after irradiation of blood samples by gamma-radiation with the dose rate of 0,1 Gy/min were used. Herewith, on the assumption of individual variation of chromosomal aberrations frequency (1–10%), the accumulated dose of radiation varied 0-0.3 Gy. The main problem in the interpretation of individual dosimetry results is reduced to different reaction of the objects to irradiation - radiosensitivity, which dictates the need of quantitative definition of this individual reaction and its consideration in the calculation of the received radiation dose. The entire examined contingent was assigned to a group based on the received dose and detected cytogenetic aberrations. Radiosensitive individuals, at the lowest received dose in a year, showed the highest frequency of chromosomal aberrations (5.72%). In opposite, radioresistant individuals showed the lowest frequency of chromosomal aberrations (2.8%). The cohort correlation according to the criterion of radio-sensitivity in our research was distributed as follows: radio-sensitive (26.2%) — medium radio-sensitivity (57.1%), radioresistant (16.7%). Herewith, the dispersion for radioresistant individuals is 2.3; for the group with medium radio-sensitivity — 3.3; and for radio-sensitive group — 9. These data indicate the highest variation of characteristic (reactions to radiation effect) in the group of radio-sensitive individuals. People with medium radio-sensitivity show significant long-term correlation (0.66; n=48, β ≥ 0.999) between the values of doses defined according to the results of cytogenetic analysis and dose of external radiation obtained with the help of thermoluminescent dosimeters. Mathematical models based on the type of violation of the radiation dose according to the professionals radiosensitivity level were offered.

Keywords: Biodosimetry, chromosomal aberrations, ionizing radiation, radiosensitivity.

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348 Thyroids Dose Evaluation and Calculation of Backscatter Factors for Co-60 Irradiations

Authors: D. Kısınma, A. B. Tugrul

Abstract:

The aim of the study is evaluation of absorbed doses for thyroids by using neck phantoms. For this purpose, it was arranged the irradiation set with different phantoms. Three different materials were used for phantom materials as, water, parafine and wood. The phantoms were three different dimensions for simulation of different ages and human race for each material. Co-60 gammao source was used for irradiation and the experimental procedure applied rigorously with narrow beam geometry.  As the results of the experiments the relative radiation doses are evaluated for therapic applications for thyroids and backscattering factors were calculated and shown that water, parafine and wood can appropriate for phantom material with the converge values of backscattering factors.

Keywords: Co-60, Dosimetry, phantom, thyroids.

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347 A Novel Approach to Handle Uncertainty in Health System Variables for Hospital Admissions

Authors: Manisha Rathi, Thierry Chaussalet

Abstract:

Hospital staff and managers are under pressure and concerned for effective use and management of scarce resources. The hospital admissions require many decisions that have complex and uncertain consequences for hospital resource utilization and patient flow. It is challenging to predict risk of admissions and length of stay of a patient due to their vague nature. There is no method to capture the vague definition of admission of a patient. Also, current methods and tools used to predict patients at risk of admission fail to deal with uncertainty in unplanned admission, LOS, patients- characteristics. The main objective of this paper is to deal with uncertainty in health system variables, and handles uncertain relationship among variables. An introduction of machine learning techniques along with statistical methods like Regression methods can be a proposed solution approach to handle uncertainty in health system variables. A model that adapts fuzzy methods to handle uncertain data and uncertain relationships can be an efficient solution to capture the vague definition of admission of a patient.

Keywords: Admission, Fuzzy, Regression, Uncertainty

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346 Video-Based System for Support of Robot-Enhanced Gait Rehabilitation of Stroke Patients

Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

Abstract:

We present a dedicated video-based monitoring system for quantification of patient’s attention to visual feedback during robot assisted gait rehabilitation. Two different approaches for eye gaze and head pose tracking are tested and compared. Several metrics for assessment of patient’s attention are also presented. Experimental results with healthy volunteers demonstrate that unobtrusive video-based gaze tracking during the robot-assisted gait rehabilitation is possible and is sufficiently robust for quantification of patient’s attention and assessment of compliance with the rehabilitation therapy.

Keywords: Video-based attention monitoring, gaze estimation, stroke rehabilitation, user compliance.

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345 Characterization of HD-V2 Gafchromic Film for Measurement of Spatial Dose Distribution from Alpha Particle of 5.5 MeV

Authors: A. Aydarous, M. El Ghazaly

Abstract:

The purpose of this study was to investigate the response of the newly released Gafchromic HD-V2 film for alpha particle of 5.5 MeV. Gafchromic HD-V2 was exposed to alpha particles of energy 5 MeV from 241Am for different durations. Then the films were scanned with a flatbed scanner. The dose response curve up to 2200 Gy has been achieved. The film’s reproducibility and sensitivity were evaluated. The results obtained show that the net optical density increases almost exponentially with the increase in the exposure time, and it becomes saturated after prolonged exposure times. The red channel shows the highest sensitivity, with a value of 4 x 10-3 Gy-1 at netOD of 0.4. The inter-film reproducibility was measured and the relative uncertainty found was 1.7 %, 2.1 % and 2.3 % for grey, red and green channels, respectively.

Keywords: Alpha dosimetry, 241Am, Gafchromic film.

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344 Attitudes of Gratitude: An Analysis of 30 Cancer Narratives Published by Leading U.S. Cancer Care Centers

Authors: Maria L. McLeod

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This study examines the ways in which cancer patient narratives are portrayed and framed on the websites of three leading U.S. cancer care centers – The University of Texas MD Anderson Cancer Center in Houston, Memorial Sloan Kettering Cancer Center in New York, and Seattle Cancer Care Alliance. Thirty patient stories, 10 from each cancer center website blog, were analyzed using qualitative and quantitative textual analysis of unstructured data, documenting common themes and other elements of story structure and content. Patient narratives were coded using grounded theory as the basis for conducting emergent qualitative research. As part of a systematic, inductive approach to collecting and analyzing data, recurrent and unique themes were examined and compared in terms of positive and negative framing, patient agency, and institutional praise. All three of these cancer care centers are teaching hospitals, with university affiliations, that emphasize an evidence-based scientific approach to treatment that utilizes the latest research and cutting-edge techniques and technology. The featured cancer stories suggest positive outcomes based on anecdotal narratives as opposed to the science-based treatment models employed by the cancer centers. An analysis of 30 sample stories found skewed representation of the “cancer experience” that emphasizes positive outcomes while minimizing or excluding more negative realities of cancer diagnosis and treatment. The stories also deemphasize patient agency, instead focusing on deference and gratitude toward the cancer care centers, which are cast in the role of savior.  

Keywords: Cancer framing, cancer narratives, survivor stories, patient narratives.

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343 A Lossless Watermarking Based Authentication System For Medical Images

Authors: Samia Boucherkha, Mohamed Benmohamed

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In this paper we investigate the watermarking authentication when applied to medical imagery field. We first give an overview of watermarking technology by paying attention to fragile watermarking since it is the usual scheme for authentication.We then analyze the requirements for image authentication and integrity in medical imagery, and we show finally that invertible schemes are the best suited for this particular field. A well known authentication method is studied. This technique is then adapted here for interleaving patient information and message authentication code with medical images in a reversible manner, that is using lossless compression. The resulting scheme enables on a side the exact recovery of the original image that can be unambiguously authenticated, and on the other side, the patient information to be saved or transmitted in a confidential way. To ensure greater security the patient information is encrypted before being embedded into images.

Keywords: Medical Imaging, Invertible Watermarking, Authentication, Integrity.

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342 A Brain Controlled Robotic Gait Trainer for Neurorehabilitation

Authors: Qazi Umer Jamil, Abubakr Siddique, Mubeen Ur Rehman, Nida Aziz, Mohsin I. Tiwana

Abstract:

This paper discusses a brain controlled robotic gait trainer for neurorehabilitation of Spinal Cord Injury (SCI) patients. Patients suffering from Spinal Cord Injuries (SCI) become unable to execute motion control of their lower proximities due to degeneration of spinal cord neurons. The presented approach can help SCI patients in neuro-rehabilitation training by directly translating patient motor imagery into walkers motion commands and thus bypassing spinal cord neurons completely. A non-invasive EEG based brain-computer interface is used for capturing patient neural activity. For signal processing and classification, an open source software (OpenVibe) is used. Classifiers categorize the patient motor imagery (MI) into a specific set of commands that are further translated into walker motion commands. The robotic walker also employs fall detection for ensuring safety of patient during gait training and can act as a support for SCI patients. The gait trainer is tested with subjects, and satisfactory results were achieved.

Keywords: Brain Computer Interface (BCI), gait trainer, Spinal Cord Injury (SCI), neurorehabilitation.

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341 Internet of Health Things as a Win-Win Solution for Mitigating the Paradigm Shift inside Senior Patient-Physician Shared Health Management

Authors: Marilena Ianculescu, Adriana Alexandru

Abstract:

Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: Health management, Internet of Health Things, remote monitoring, senior patient.

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340 A Study on the Leadership Behavior, Safety Culture, and Safety Performance of the Healthcare Industry

Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

Abstract:

Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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339 Using Knowledge Management and Visualisation Concepts to Improve Patients and Hospitals Staff Workflow

Authors: A. A. AlRasheed, A. Atkins, R. Campion

Abstract:

This paper focuses on using knowledge management and visualisation concepts to improve the patients and hospitals employee’s workflow. Hospitals workflow is a complex and complicated process and poor patient flow can put both patients and a hospital’s reputation at risk, and can threaten the facility’s financial sustainability. Healthcare leaders are under increased pressure to reduce costs while maintaining or increasing patient care standards. In this paper, a framework is proposed to help improving patient experience, staff satisfaction, and operational efficiency across hospitals by using knowledge management based visualisation concepts. This framework is using real-time visibility to track and monitor location and status of patients, staff, rooms, and medical equipment.

Keywords: Knowledge management, visualisation, patients, hospitals, healthcare workers, workflow, improvements.

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338 Evaluation of the Analytic for Hemodynamic Instability as A Prediction Tool for Early Identification of Patient Deterioration

Authors: Bryce Benson, Sooin Lee, Ashwin Belle

Abstract:

Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: Clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring.

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337 Patient Support Program in Pharmacovigilance: Foster Patient Confidence and Compliance

Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

Abstract:

The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: Drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance.

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336 PET/CT Patient Dosage Assay

Authors: Gulten Yilmaz, A. Beril Tugrul, Mustafa Demir, Dogan Yasar, Bayram Demir, Bulent Buyuk

Abstract:

A Positron Emission Tomography (PET) is a radioisotope imaging technique that illustrates the organs and the metabolisms of the human body. This technique is based on the simultaneous detection of 511 keV annihilation photons, annihilated as a result of electrons annihilating positrons that radiate from positron-emitting radioisotopes that enter biological active molecules in the body. This study was conducted on ten patients in an effort to conduct patient-related experimental studies. Dosage monitoring for the bladder, which was the organ that received the highest dose during PET applications, was conducted for 24 hours. Assessment based on measuring urination activities after injecting patients was also a part of this study. The MIRD method was used to conduct dosage calculations for results obtained from experimental studies. Results obtained experimentally and theoretically were assessed comparatively.

Keywords: PET/CT, TLD, MIRD, Dose measurement, Patient doses.

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335 Hospital Based Electrocardiogram Sensor Grid

Authors: Suken Nayak, Aditya Kambli, Bharati Ingale, Gauri Shukla

Abstract:

The technological concepts such as wireless hospital and portable cardiac telemetry system require the development of physiological signal acquisition devices to be easily integrated into the hospital database. In this paper we present the low cost, portable wireless ECG acquisition hardware that transmits ECG signals to a dedicated computer.The front end of the system obtains and processes incoming signals, which are then transmitted via a microcontroller and wireless Bluetooth module. A monitoring purpose Bluetooth based end user application integrated with patient database management module is developed for the computers. The system will act as a continuous event recorder, which can be used to follow up patients who have been resuscitatedfrom cardiac arrest, ventricular tachycardia but also for diagnostic purposes for patients with arrhythmia symptoms. In addition, cardiac information can be saved into the patient-s database of the hospital.

Keywords: ECG, Bluetooth communication, monitoring application, patient database

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334 The Impact of Web Based Education on Cancer Patients’ Clinical Outcomes

Authors: F. Arıkan, Z. Karakus

Abstract:

Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: Cancer Patients, E-Learning, Nursing, Web Based Education.

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333 Privacy Issues in Pervasive Healthcare Monitoring System: A Review

Authors: Rusyaizila Ramli, Nasriah Zakaria, Putra Sumari

Abstract:

Privacy issues commonly discussed among researchers, practitioners, and end-users in pervasive healthcare. Pervasive healthcare systems are applications that can support patient-s need anytime and anywhere. However, pervasive healthcare raises privacy concerns since it can lead to situations where patients may not be aware that their private information is being shared and becomes vulnerable to threat. We have systematically analyzed the privacy issues and present a summary in tabular form to show the relationship among the issues. The six issues identified are medical information misuse, prescription leakage, medical information eavesdropping, social implications for the patient, patient difficulties in managing privacy settings, and lack of support in designing privacy-sensitive applications. We narrow down the issues and chose to focus on the issue of 'lack of support in designing privacysensitive applications' by proposing a privacy-sensitive architecture specifically designed for pervasive healthcare monitoring systems.

Keywords: Human Factors, Pervasive Healthcare, PrivacyIssues

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332 Case Study: Oncological Management of a Patient with Papillary Thyroid Cancer

Authors: A. Taqaddas

Abstract:

The following case study presents the management of stage III Differentiated Thyroid Cancer (DTC) patient in an NHS hospital in London, UK during period of 2004-2005.

Keywords: Differentiated Thyroid Cancer, Oncological Management, Papillary, Thyroid Cancer, Stage III.

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331 Research on Applying the Continuity Care Document to Generate a Medical Record with Entry Level

Authors: Hsing-Yi Kao, Der-Ming Liou

Abstract:

Transferring patient information between medical care sites is necessary to deliver better patient care and to reduce medical cost. So developing of electronic medical records is an important trend for the world.The Continuity of Care Document (CCD) is product of collaboration between CDA and CCR standards. In this study, we will develop a system to generate medical records with entry level based on CCD template module.

Keywords: Continuity Care Document, medical record, entrylevel

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330 Improving Health Care and Patient Safety at the ICU by Using Innovative Medical Devices and ICT Tools: Examples from Bangladesh

Authors: Mannan Mridha, Mohammad S. Islam

Abstract:

Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: Accidents reporting system, patient car and safety, safe medical devices.

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329 The Relevance of Data Warehousing and Data Mining in the Field of Evidence-based Medicine to Support Healthcare Decision Making

Authors: Nevena Stolba, A Min Tjoa

Abstract:

Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.

Keywords: data mining, data warehousing, decision-support systems, evidence-based medicine.

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