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None of the arguments that patients have an obligation to participate in medical education are convincing. We believe that patients participate in training largely out of altruism rather than obligation. Where possible, sick patients should be substituted for by healthy patients or simulations.

Numerous commercial technologies for online treatment monitoring (OTM) in radiotherapy (RT) are currently available including electronic portal imaging device (EPID) in vivo dosimetry (IVD), transmission detectors and log files analysis. Despite this, in the UK there exists limited guidance on how to implement and commission a system for clinical use or information about the resources required to set up and maintain a service. A Radiotherapy Special Interest Group working party, established by Institute of Physics and Engineering in Medicine was formed with a view to reassess the current practice for OTM in the UK and an aim to develop consensus guidelines for the implementation of a system. A survey distributed to Heads of Medical Physics at 71 UK RT departments investigated: availability of OTM in the UK; estimates of workload; clinical implementation; methods of analysis; quality assurance; and opinions on future directions. The survey achieved a 76% response rate and demonstrated that OTM is widely supported in the UK, with 87% of respondents indicating all patients should undergo OTM. EPID IVD (EIVD) was the most popular form of OTM. An active EIVD service was reported by 37% of respondents, with 84% believing it was the optimal solution. This demonstrates a steady increase in adoption since 2012. Other forms of OTM were in use but they had only been adopted by a minority of centres. Financial barriers and the increase of staff workload continue to hinder wider implementation in other centres. Device automation and integration is a key factor for successful future adoption and requires support between treatment machine and OTM manufacturers. The survey has provided an updated analysis on the use of OTM methods across the UK. Future guidance is recommended on commissioning, adoption of local tolerances and root-cause analysis strategies to assist departments intending to implement OTM.

In this paper we present a corporate information system for untrained users to search gigabytes of unformatted data using quasi‐natural language and relevance feedback queries. The data can reside on distributed servers anywhere on a wide area network, giving the users access to personal, corporate, and published information from a single interface. Effective queries can be turned into profiles, allowing the system to automatically alert the user when new data are available. The system was tested by twenty executive users located in six cities. Our primary goal in building the system was to determine if the technology and infrastructure existed to make end‐user searching of unstructured information profitable. We found that effective search and user interface technologies for end‐users are available, but network technologies are still a limiting cost factor. As a result of the experiment, we are continuing the development of the system. This article will describe the overall system architecture, the implemented subset, and the lessons learned.

Three-dimensional (3D) computed tomographic reformations have been used successfully as an adjunct to standard axial computed tomography (CT) in the evaluation of disorders affecting areas of complex anatomy. The basic requirements for high-quality 3D reformations are an absence of patient movement and narrow-width transaxial sections. Speed of examination is an important factor in optimizing image quality. One hundred examinations were performed on an IGE CT 9800 scanner. For bone studies, 80 mAs and, for certain soft tissues, 140 or 200 mAs were employed with 120 kVp. The advantages of such a "low-dose" technique are significant reduction in patient skin dose and a faster examination. The main disadvantage is a reduction in signal-to-noise ratio. The image quality obtained in 3D presentations has nevertheless been sufficient to enable all bony abnormalities to be identified. Three-dimensional examinations are now being performed routinely using a dynamic mode and this "low-dose" technique.