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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: Recent advances in computer technology offer to the medical profession specialized tools for gathering medical data, processing power, as well as fast storing and retrieving capabilities. Artificial intelligence (AI), an emerging field of computer science is studying the issues of human problem solving and decision making. Furthermore, rule-based systems and knowledge-based systems that are other fields of AI have been adopted by many scientists in an effort to develop intelligent medical diagnostic systems. In this study artificial neural networks (ANN) are introduced as a tool for building an intelligent diagnostic system; the system does not attempt to replace the physician…from being the decision maker but to enhance ones facilities for reaching a correct decision. An integrated diagnostic system for assessing certain neuromuscular disorders is used in this study as an example for demonstrating the proposed methodology. The diagnostic system is composed of modules that independently provide numerical data to the system from the clinical examination of a patient, and from various laboratory tests that are performed. The examination procedure has been standardized by developing protocols for each specialized area, in cooperation with experts in the area. At the conclusion of the clinical examination and laboratory tests, data in the form of a numerical vector represents a medical examination snapshot of the subject. Artificial neural network (ANN) models were developed using the unsupervised self-organizing feature maps algorithm. Data from 71 subjects were collected. The ANN models were trained with the data from 41 subjects, and tested with the data from the remaining 30 subjects. Two sets of models were developed; those trained with the data from only the clinical examinations; and those trained by combining the clinical and the laboratory test data. The diagnostic yield that was obtained for the unknown cases is in the region of 73 to 93% for the models trained with only the clinical data, and in the region of 73 to 100% for those trained by combining both the clinical and laboratory data. The pictorial representation of the diagnostic models through the self organized two dimensional feature maps provide the physician with a friendly human–computer interface and a comprehensive tool that can be used for further observations, for example in monitoring disease progression of a subject.
Abstract: We set out a protocol for giving a computerised medical decision system the label of expert-system meaning that its responses are of the same standard as those of an expert. We apply it to the validation of an expert-system, MENINGE, which is applied to diagnosis of meningitis in children. The proposed protocol can be widely used since it doesn't refer to the existence of correct responses for therapy or diagnosis, and since it involves simple statistical computations. First this validation rests on a comparison of agreement among experts and among physicians new to medical practice. Secondly, the agreement of the…system with the experts is compared to the agreement of the system with physicians new to medical practice. In order to perform this comparison we recommend a standard agreement measure, the choice of which is an important issue in this paper.
Abstract: One of the major factors for the resistance of physicians to the use of computers in their workplace is the computer keyboard. Many physicians cannot type and do not want to type. Furthermore, working on a computer keyboard does not allow them to maintain eye contact with patients, an important success factor for any physician-patient encounter. One possible solution to the problem is to tap the friendly data input interface that is provided by pen-based computers. These devices facilitate data entry with the support of stylus-based touch screen entries, handwriting recognition and use of gestures for word and character editing.…They are also unobtrusive and should serve as an excellent data entry interface tool for a clinic-based electronic medical record system. This paper reviews the current pen-based technology and describes two proven applications in healthcare.
Abstract: Pressure infusion devices (PID) are used in trauma hospitals and in military applications to enhance rapid fluid replacement of hypovolemic shocked patients. This work presents a simple inexpensive technique for evaluation of the performance characteristics of pressure infusors. Pressure–volume and volume–time curves of pneumatic and spring-activated infusors have been derived for pressurized infusion with various output resistances. Three indices of performance are suggested for evaluation of pressure infusors: the energy to discharge fluid from the bag, efficiency index and time required to empty 50% of the bag.
Abstract: For magnetic stimulation the desired electromagnetic field is produced by a magnetic coil to affect biological tissue and thereby to stimulate it for neurological diagnosis. The coil geometry determines the strength and the duration of the induced electric field in the volume of interest for a given stimulator: The aim of our work is to establish a relationship between the coil geometry and the strength as well as duration of the induced electric field. The calculated results show that there exists an optimal coil geometry for stimulating a given volume of the biological tissues. Our numerical calculation is restricted to…an excitable tissue 15 mm below the lower plane of the coil.
Keywords: Coil parameter, Magnetic stimulation, Neurological diagnosis
Abstract: By means of a simple and inexpensive system, the computer aided densitometric image analysis (CADIA), we can now evaluate on X-ray film the effect of long term bone remodelling after total hip arthroplasties (THA). The results of CADIA system applied to the historical archive are burdened by a not always acceptable significance. The main source of error is the variance of radiological parameters. An attempt to retrieve the historical archive, that is of every X-ray film obtained out of any radiological control protocol, can be carried out with the bone density ratio representation. We have evaluated three different specimens with…bone density ratio analysis: cementless group (96 cases), cemented group (59 cases) and non prosthetized femurs group (51 cases) as a control, all groups were followed up for more than 24 months. Ratios showed up different behaviour among the three specimens, confirming clinical evidence of a lower bone remodelling for cemented THA.
Keywords: Total hip arthroplasty, Bone remodelling, Densitometry, Image analysis