Handheld Computing in Medicine

Fischer, Sandra E.; Stewart, Thomas E.; Mehta, Sangeeta; Wax, Randy S.; Lapinsky, Stephen E.

doi:10.1197/jamia.m1180

Cited by 263 publications

(171 citation statements)

References 31 publications

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“…There are also speciality-specific applications for personal digital assistants. 9 Computer applications have been used to set up database registries 10 and in the general function of various clinics such as hand injury clinics, dermatology and orthopaedics. 11 In urology, computers have been used for automated classification in uroflowmetry and simultaneous pressure-flow studies.…”

Section: Discussionmentioning

confidence: 99%

Computerised triage in a prostate assessment clinic

Rajkumar

Small

Conn

2004

Prostate Cancer Prostatic Dis

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An MS Office package has been developed to score IPSS, take a patient history, compare flows with nomograms and decide on interim management. This is based on these scores, residual volume and laboratory results. A clearly formatted GP letter is produced. The patient uses a touch screen to answer questions on the IPSS and other medical history. These questions and responses are stored in Excel spread sheets. Clinic staff then enter results of flow studies, urinalysis, U&E and PSA. Excel Visual Basic creates a detailed printout for the notes and the MS Office mail merge facility creates a summary printout, which also serves as a letter to the GP. Excel allows embedding of formulae and program code to implement the rules for management. Based on these rules, the program either generates a request for an urgent appointment in the clinic or recommends the use of either an alpha blocker (if not contraindicated by medical history) or 5 alpha reductase inhibitors in the interim period before they are reviewed in clinic. A total of 139 patients have been seen and the computer decisions compared with those of a consultant urologist. Agreement was found in 106, disagreement in 33. However, 21 of the 33 involved computer oversensitivity to flow results. We do not anticipate difficulty improving this and are investigating using an artificial neural network. Of the other 12 patients, the urologist departed from the fixed rules for IPSS, creatinine, PSA and residual urine when only one variable was slightly abnormal. To conclude, this novel user-friendly system shows great potential in the management of prostate outpatients. Some tuning is needed, with particular respect to uroflow results.

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Section: Discussionmentioning

confidence: 99%

Computerised triage in a prostate assessment clinic

Rajkumar

Small

Conn

2004

Prostate Cancer Prostatic Dis

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“…18,19 Based on the conclusion that the use of electronic diaries could potentially increase patient compliance and improve patient satisfaction, they recommended further studies to determine exactly which patients can benefit most from using PDAs. 17 In a recent comprehensive and systematic review of published papers on the use of PDAs in medicine, Fisher et al 21 also echoed the same sentiments that only a few papers have provided evidence-based information about the use of PDAs in medicine.…”

mentioning

confidence: 98%

Incorporating PDA Use in Diabetes Self-Care: A Central Texas Primary Care Research Network (CenTexNet) Study

Forjuoh¹,

Reis²,

Couchman³

et al. 2007

The Journal of the American Board of Family Medicine

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Introduction:We investigated the feasibility of incorporating the use of the personal digital assistant (PDA) in diabetes self-care in primary care.Methods: Adults with type 2 diabetes whose last measured HbA1c value was 8.0% or greater were recruited from 4 family practice clinics. A trained research assistant provided one-on-one training on the use of a loaned PDA preinstalled with Diabetes Pilot software.Results: Of 550 potential subjects invited for participation, only 98 (17.8%) called to schedule an orientation visit. However, 18 were never contacted when the recruitment goal was reached. Of the remaining 80 respondents, 43 (53.8%) met all study inclusion criteria. Participants' mean age was 55.2 years (SD ‫؍‬ 10.1). The majority were female (62.8%) and white (62.8%), 83.7% had at least some college education, and most reported an income of $30,000 to $69,999. The mean baseline HbA1c was 10.0% (SD ‫؍‬ 1.5). Major challenges of concern to the practicing family physician included few subjects agreeing to participate even though it was free, subjects who agreed to participate being generally different from those who decided not to participate, some PDAs not returned, and the relatively high cost of the intervention.Conclusions: Attempts to incorporate PDA use in diabetes self-care may be significantly challenging, although feasible. We identified several challenges and suggest strategies to overcome them.

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“…Developed by medical informatic graduate students nowadays intends by sixth version, presenting a MS-Windows Desktop, a handheld Windows Compact Edition-based (Fischer et al, 2003) and a web interface for data collect. The task of protocol building have only a desktop interface, because our experiences with handheld to large user interaction necessary to make the knowledge tree using this interface was not good; the same occurred with browsers, that forcing to develop an applet or other way for better interaction.…”

Section: The Sinpe Systemmentioning

confidence: 99%