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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: This technical note describes a new robotic workstation for neurological rehabilitation, shortly named Braccio di Ferro. It has been designed by having in mind the range of forces and the frequency bandwidth that characterize the interaction between a patient and a physical therapist, as well as a number of requirements that we think are essential for allowing a natural haptic interaction: back-driveability, very low friction and inertia, mechanical robustness, the possibility to operate in different planes, and an open software environment, which allows the operator to add new functionalities and design personalized rehabilitation protocols. Braccio di Ferro is an open…system and, in the spirit of open source design, is intended to foster the dissemination of robot therapy. Moreover, its combination of features is not present in commercially available systems.
Abstract: Image fusion is a process of combining information from multiple sensors. It is a useful tool implemented in the treatment planning programme of Gamma Knife Radiosurgery. In this paper we evaluate advanced image fusion algorithms for Matlab® platform and head images. We develop nine level grayscale image fusion methods: average, principal component analysis (PCA), discrete wavelet transform (DWT) and Laplacian, filter – subtract – decimate (FSD), contrast, gradient, morphological pyramid and a shift invariant discrete wavelet transform (SIDWT) method in Matlab® platform. We test these methods qualitatively and quantitatively. The quantitative criteria we use are the Root Mean…Square Error (RMSE), the Mutual Information (MI), the Standard Deviation (STD), the Entropy (H), the Difference Entropy (DH) and the Cross Entropy (CEN). The qualitative are: natural appearance, brilliance contrast, presence of complementary features and enhancement of common features. Finally we make clinically useful suggestions.
Abstract: Current studies conclude that clinical decision support systems can help reduce serious medical errors. The importance of Causal Probabilistic Networks (CPNs) for constructing such systems is already well-known. However, the computational complexity of probabilistic inference, which results in unacceptably high response times, can hinder acceptance and integration into clinician workflow. This paper investigates the optimization and parallelization potential of complex CPN-based medical decision support systems and evaluates the results of implementing a parallel, high performance version of an existing decision support system concerning proper antibiotic treatment therapy. Furthermore, it discusses distributed computing techniques for making multiple high performance decision support…systems available at the time and location of decision making, by exploiting computing resources residing inside, as well as outside the hospital walls optimally.
Abstract: Continuous, remote monitoring of patients' healthcare condition, as this can be reflected by crucial vital signs supervision, is a key demand in modern healthcare provision. Towards the accomplishment of this requirement, the traditional solution of cabled sensors appears to have clear limitations and this is one of the ultimate causes of the proliferation of wireless medical sensor networks during last years. The modern trend towards this direction is the formulation of patient Personal Area Networks (pPANs), consisting of a wireless infrastructure of medical sensors, attached to patient's body, which lays the path for incessant telemonitoring of the person in mind,…without discomforting them. The nature of data that these networks are set to handle, as well as the particular demands that patient telemonitoring services raise, necessitate for a thorough analysis of the design requirements of pPAN communication protocols, in order to outflank possible disadvantages appearing in protocols for different types of wireless sensor networks, without putting aside simplicity and feasibility factors. In the context of this paper, we intend to outline the most important requirements and design issues of a pPAN communication protocol, having as compass the main attributes of the most commonly used medical sensors and the typical functionality of these networks.
Keywords: Patient personal area networks, medical sensors, communication protocol requirements
Abstract: Objectives: The purpose of this study is to assess the cost-effectiveness (net costs per life year gained) of telemedical devices for pre-clinical traffic accident emergency rescue in Germany. Methods: Two equipment versions of a telemedical device are compared from a societal perspective with the baseline in Germany, i.e. the non-application of telemedicine in emergency rescues. The analysis is based on retrospective statistical data covering a period of 10 years with discounted costs not adjusted for inflation. Due to the uncertainty of data, certain assumptions and estimates were necessary. The outcome is measured in terms of “life years gained”…by reducing therapy-free intervals and improvements in first-aid provided by laypersons. Results: The introduction of the basic equipment version, “Automatic Accident Alert”, is associated with net costs per life year gained of €247,977 (at baseline assumptions). The full equipment version of the telemedical device would lead to estimated net costs of €239,524 per life year gained. Multi-way sensitivity-analysis with best and worst case scenarios suggests that decreasing system costs would disproportionately reduce total costs, and that rapid market penetration would largely increase the system’s benefit, while simultaneously reducing costs. Conclusion: The net costs per life year gained in the application of the two versions of the telemedical device for pre-clinical emergency rescue of traffic accidents are estimated as quite high. However, the implementation of the device as part of a larger European co-ordinated initiative is more realistic.
Keywords: Cost-benefit analysis, telemedicine, emergency medical services, ambulances, traffic accidents