78 FR 16448 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee will hold its fifth...) on Medical Diagnostic Equipment Accessibility Standards. DATES: The Committee will meet on March 26...

Modeling paradigms for medical diagnostic decision support: a survey and future directions.

PubMed

Wagholikar, Kavishwar B; Sundararajan, Vijayraghavan; Deshpande, Ashok W

2012-10-01

Use of computer based decision tools to aid clinical decision making, has been a primary goal of research in biomedical informatics. Research in the last five decades has led to the development of Medical Decision Support (MDS) applications using a variety of modeling techniques, for a diverse range of medical decision problems. This paper surveys literature on modeling techniques for diagnostic decision support, with a focus on decision accuracy. Trends and shortcomings of research in this area are discussed and future directions are provided. The authors suggest that-(i) Improvement in the accuracy of MDS application may be possible by modeling of vague and temporal data, research on inference algorithms, integration of patient information from diverse sources and improvement in gene profiling algorithms; (ii) MDS research would be facilitated by public release of de-identified medical datasets, and development of opensource data-mining tool kits; (iii) Comparative evaluations of different modeling techniques are required to understand characteristics of the techniques, which can guide developers in choice of technique for a particular medical decision problem; and (iv) Evaluations of MDS applications in clinical setting are necessary to foster physicians' utilization of these decision aids.

Diagnostic techniques and treatments for internal disorders of Koi (Cyprinus carpio).

PubMed

Saint-Erne, Nicholas

2010-09-01

The most common problems that occur in koi involve external pathogens and environmental conditions. Techniques for external fish examination and water quality analysis have been well described in the veterinary literature. However, there are also some internal disorders of koi, such as gas bladder abnormalities affecting the fish's buoyancy, neoplasia, egg binding (roe retention), and spinal disorders that can be diagnosed with common veterinary medical procedures. Diagnostic techniques along with available treatments for these disorders are presented in this article. Copyright 2010 Elsevier Inc. All rights reserved.

Novel diagnostic techniques for celiac disease.

PubMed

Kurppa, Kalle; Taavela, Juha; Saavalainen, Päivi; Kaukinen, Katri; Lindfors, Katri

2016-07-01

The diagnosis of celiac disease has long been based on the demonstration of gluten-induced small-bowel mucosal damage. However, due to the constantly increasing disease prevalence and limitations in the histology-based criteria there is a pressure towards more serology-based diagnostics. The serological tools are being improved and new non-invasive methods are being developed, but the constantly refined endoscopic and histologic techniques may still prove helpful. Moreover, growing understanding of the disease pathogenesis has led researchers to suggest completely novel approaches to celiac disease diagnostics regardless of disease activity. In this review, we will elucidate the most recent development and possible future innovations in the diagnostic techniques for celiac disease.

Biomedical visual data analysis to build an intelligent diagnostic decision support system in medical genetics.

PubMed

Kuru, Kaya; Niranjan, Mahesan; Tunca, Yusuf; Osvank, Erhan; Azim, Tayyaba

2014-10-01

In general, medical geneticists aim to pre-diagnose underlying syndromes based on facial features before performing cytological or molecular analyses where a genotype-phenotype interrelation is possible. However, determining correct genotype-phenotype interrelationships among many syndromes is tedious and labor-intensive, especially for extremely rare syndromes. Thus, a computer-aided system for pre-diagnosis can facilitate effective and efficient decision support, particularly when few similar cases are available, or in remote rural districts where diagnostic knowledge of syndromes is not readily available. The proposed methodology, visual diagnostic decision support system (visual diagnostic DSS), employs machine learning (ML) algorithms and digital image processing techniques in a hybrid approach for automated diagnosis in medical genetics. This approach uses facial features in reference images of disorders to identify visual genotype-phenotype interrelationships. Our statistical method describes facial image data as principal component features and diagnoses syndromes using these features. The proposed system was trained using a real dataset of previously published face images of subjects with syndromes, which provided accurate diagnostic information. The method was tested using a leave-one-out cross-validation scheme with 15 different syndromes, each of comprised 5-9 cases, i.e., 92 cases in total. An accuracy rate of 83% was achieved using this automated diagnosis technique, which was statistically significant (p<0.01). Furthermore, the sensitivity and specificity values were 0.857 and 0.870, respectively. Our results show that the accurate classification of syndromes is feasible using ML techniques. Thus, a large number of syndromes with characteristic facial anomaly patterns could be diagnosed with similar diagnostic DSSs to that described in the present study, i.e., visual diagnostic DSS, thereby demonstrating the benefits of using hybrid image processing

Diagnostic Imaging in the Medical Support of the Future Missions to the Moon

NASA Technical Reports Server (NTRS)

Sargsyan, Ashot E.; Jones, Jeffrey A.; Hamilton, Douglas R.; Dulchavsky, Scott A.; Duncan, J. Michael

2007-01-01

This viewgraph presentation is a course that reviews the diagnostic imaging techniques available for medical support on the future moon missions. The educational objectives of the course are to: 1) Update the audience on the curreultrasound imaging in space flight; 2) Discuss the unique aspects of conducting ultrasound imaging on ISS, interplanetary transit, ultrasound imaging on ISS, interplanetary transit, and lunar surface operations; and 3) Review preliminary data obtained in simulations of medical imaging in lunar surface operations.

Medical image computing for computer-supported diagnostics and therapy. Advances and perspectives.

PubMed

Handels, H; Ehrhardt, J

2009-01-01

Medical image computing has become one of the most challenging fields in medical informatics. In image-based diagnostics of the future software assistance will become more and more important, and image analysis systems integrating advanced image computing methods are needed to extract quantitative image parameters to characterize the state and changes of image structures of interest (e.g. tumors, organs, vessels, bones etc.) in a reproducible and objective way. Furthermore, in the field of software-assisted and navigated surgery medical image computing methods play a key role and have opened up new perspectives for patient treatment. However, further developments are needed to increase the grade of automation, accuracy, reproducibility and robustness. Moreover, the systems developed have to be integrated into the clinical workflow. For the development of advanced image computing systems methods of different scientific fields have to be adapted and used in combination. The principal methodologies in medical image computing are the following: image segmentation, image registration, image analysis for quantification and computer assisted image interpretation, modeling and simulation as well as visualization and virtual reality. Especially, model-based image computing techniques open up new perspectives for prediction of organ changes and risk analysis of patients and will gain importance in diagnostic and therapy of the future. From a methodical point of view the authors identify the following future trends and perspectives in medical image computing: development of optimized application-specific systems and integration into the clinical workflow, enhanced computational models for image analysis and virtual reality training systems, integration of different image computing methods, further integration of multimodal image data and biosignals and advanced methods for 4D medical image computing. The development of image analysis systems for diagnostic support or

Munchausen Syndrome by Proxy: medical diagnostic criteria.

PubMed

Rosenberg, Donna Andrea

2003-04-01

Medical diagnostic criteria for Munchausen Syndrome by Proxy are presented. The strength of the known facts may vary from case to case, and thus there may be different degrees of diagnostic conviction. Therefore, diagnostic criteria for a definitive diagnosis, and a possible diagnosis of Munchausen Syndrome by Proxy are provided. Because the gathering of evidence in a case may, ultimately, diminish or exclude the diagnosis of Munchausen Syndrome by Proxy, diagnostic criteria for the inconclusive determination and the definitely excluded diagnosis are also enunciated.

Tacit knowledge and visual expertise in medical diagnostic reasoning: implications for medical education.

PubMed

Heiberg Engel, Peter Johan

2008-01-01

Much education--especially at the university level--has been criticized for having primarily dealt with explicit knowledge, i.e. those aspects of mental activities, which are verbal and conscious. Furthermore, research in medical diagnostic reasoning has been criticized for having focused on the specialty of intern medicine, while specialties with other skills, i.e. perceptive skills within pathology and radiology, have been ignored. To show that the concept of tacit knowledge is important in medical education-at all levels and in medical diagnostic reasoning. Describing how tacit knowledge according to Michael Polany, is experienced and expressed in day-to-day life, it is shown that there is a tacit dimension to all knowledge. Reviewing recent literature on medical diagnostic reasoning, it is shown that tacit knowledge is recognized in connection with concepts such as "non-analytical reasoning" and "dual process of reasoning." It is important that educators are trained in how explicit and implicit knowledge is attained and that tacit knowledge is included in educational programmes of all medical specialties.

Munchausen Syndrome by Proxy: Medical Diagnostic Criteria.

ERIC Educational Resources Information Center

Rosenberg, Donna Andrea

2003-01-01

Medical diagnostic criteria for Munchausen Syndrome by Proxy (a persistent fabrication by one individual of illness in another) are presented. Since the strength of the known facts may vary from case to case, diagnostic criteria are given for a definitive diagnosis, a possible diagnosis, an inconclusive determination, and the definitely excluded…

Understanding the medical and nonmedical value of diagnostic testing.

PubMed

Lee, David W; Neumann, Peter J; Rizzo, John A

2010-01-01

To develop a framework for defining the potential value of diagnostic testing, and discuss its implications for the health-care delivery system. We reviewed the conceptual and empirical literature related to the valuing of diagnostic tests, and used this information to create a framework for characterizing their value. We then made inferences about the impact of this framework on health insurance coverage, health technology assessment, physician-patient relationships, and public health policy. Three dimensions can effectively classify the potential value created by diagnostic tests: 1) medical value (impact on treatment decisions); 2) planning value (affect on patients' ability to make better life decisions); and 3) psychic value (how test information affects patients' sense of self). This comprehensive framework for valuing diagnostics suggests that existing health technology assessments may systematically under- or overvalue diagnostics, leading to potentially incorrect conclusions about cost-effectiveness. Further, failure to account for all value dimensions may lead to distorted payments under a value-based health-care system. The potential value created by medical diagnostics incorporates medical value as well as value associated with well-being and planning. Consideration of all three dimensions has important implications for technology assessment and value-based payment.

Hypergraph Based Feature Selection Technique for Medical Diagnosis.

PubMed

Somu, Nivethitha; Raman, M R Gauthama; Kirthivasan, Kannan; Sriram, V S Shankar

2016-11-01

The impact of internet and information systems across various domains have resulted in substantial generation of multidimensional datasets. The use of data mining and knowledge discovery techniques to extract the original information contained in the multidimensional datasets play a significant role in the exploitation of complete benefit provided by them. The presence of large number of features in the high dimensional datasets incurs high computational cost in terms of computing power and time. Hence, feature selection technique has been commonly used to build robust machine learning models to select a subset of relevant features which projects the maximal information content of the original dataset. In this paper, a novel Rough Set based K - Helly feature selection technique (RSKHT) which hybridize Rough Set Theory (RST) and K - Helly property of hypergraph representation had been designed to identify the optimal feature subset or reduct for medical diagnostic applications. Experiments carried out using the medical datasets from the UCI repository proves the dominance of the RSKHT over other feature selection techniques with respect to the reduct size, classification accuracy and time complexity. The performance of the RSKHT had been validated using WEKA tool, which shows that RSKHT had been computationally attractive and flexible over massive datasets.

Plasmonic SERS nanochips and nanoprobes for medical diagnostics and bio-energy applications

NASA Astrophysics Data System (ADS)

Ngo, Hoan T.; Wang, Hsin-Neng; Crawford, Bridget M.; Fales, Andrew M.; Vo-Dinh, Tuan

2017-02-01

The development of rapid, easy-to-use, cost-effective, high accuracy, and high sensitive DNA detection methods for molecular diagnostics has been receiving increasing interest. Over the last five years, our laboratory has developed several chip-based DNA detection techniques including the molecular sentinel-on-chip (MSC), the multiplex MSC, and the inverse molecular sentinel-on-chip (iMS-on-Chip). In these techniques, plasmonic surface-enhanced Raman scattering (SERS) Nanowave chips were functionalized with DNA probes for single-step DNA detection. Sensing mechanisms were based on hybridization of target sequences and DNA probes, resulting in a distance change between SERS reporters and the Nanowave chip's gold surface. This distance change resulted in change in SERS intensity, thus indicating the presence and capture of the target sequences. Our techniques were single-step DNA detection techniques. Target sequences were detected by simple delivery of sample solutions onto DNA probe-functionalized Nanowave chips and SERS signals were measured after 1h - 2h incubation. Target sequence labeling or washing to remove unreacted components was not required, making the techniques simple, easy-to-use, and cost effective. The usefulness of the techniques for medical diagnostics was illustrated by the detection of genetic biomarkers for respiratory viral infection and of dengue virus 4 DNA.

77 FR 67595 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-13

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY.... SUMMARY: The Medical Diagnostic Equipment Accessibility Standards Advisory Committee (Committee) will hold... Equipment Accessibility Standards. DATES: The Committee will meet on December 3, 2012, from 10:00 a.m. to 5...

Noninvasive Medical Diagnostics & Treatment Using Ultrasonics

NASA Technical Reports Server (NTRS)

Bar-Cohen, Y.; Siegel, R.; Grandia, W.

1998-01-01

In parallel to the industrial application of NDE to flaw detection and material property determination, the medical community has succesfully adapted such methods to the noninvasaive diagnostics and treatment of many conditions and disorders of the human body.

MO-F-204-00: Preparing for the ABR Diagnostic and Nuclear Medical Physics Exams

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and

The potential of high resolution melting analysis (hrma) to streamline, facilitate and enrich routine diagnostics in medical microbiology.

PubMed

Ruskova, Lenka; Raclavsky, Vladislav

2011-09-01

Routine medical microbiology diagnostics relies on conventional cultivation followed by phenotypic techniques for identification of pathogenic bacteria and fungi. This is not only due to tradition and economy but also because it provides pure culture needed for antibiotic susceptibility testing. This review focuses on the potential of High Resolution Melting Analysis (HRMA) of double-stranded DNA for future routine medical microbiology. Search of MEDLINE database for publications showing the advantages of HRMA in routine medical microbiology for identification, strain typing and further characterization of pathogenic bacteria and fungi in particular. The results show increasing numbers of newly-developed and more tailor-made assays in this field. For microbiologists unfamiliar with technical aspects of HRMA, we also provide insight into the technique from the perspective of microbial characterization. We can anticipate that the routine availability of HRMA in medical microbiology laboratories will provide a strong stimulus to this field. This is already envisioned by the growing number of medical microbiology applications published recently. The speed, power, convenience and cost effectiveness of this technology virtually predestine that it will advance genetic characterization of microbes and streamline, facilitate and enrich diagnostics in routine medical microbiology without interfering with the proven advantages of conventional cultivation.

Raman spectroscopy for medical diagnostics--From in-vitro biofluid assays to in-vivo cancer detection.

PubMed

Kong, Kenny; Kendall, Catherine; Stone, Nicholas; Notingher, Ioan

2015-07-15

Raman spectroscopy is an optical technique based on inelastic scattering of light by vibrating molecules and can provide chemical fingerprints of cells, tissues or biofluids. The high chemical specificity, minimal or lack of sample preparation and the ability to use advanced optical technologies in the visible or near-infrared spectral range (lasers, microscopes, fibre-optics) have recently led to an increase in medical diagnostic applications of Raman spectroscopy. The key hypothesis underpinning this field is that molecular changes in cells, tissues or biofluids, that are either the cause or the effect of diseases, can be detected and quantified by Raman spectroscopy. Furthermore, multivariate calibration and classification models based on Raman spectra can be developed on large "training" datasets and used subsequently on samples from new patients to obtain quantitative and objective diagnosis. Historically, spontaneous Raman spectroscopy has been known as a low signal technique requiring relatively long acquisition times. Nevertheless, new strategies have been developed recently to overcome these issues: non-linear optical effects and metallic nanoparticles can be used to enhance the Raman signals, optimised fibre-optic Raman probes can be used for real-time in-vivo single-point measurements, while multimodal integration with other optical techniques can guide the Raman measurements to increase the acquisition speed and spatial accuracy of diagnosis. These recent efforts have advanced Raman spectroscopy to the point where the diagnostic accuracy and speed are compatible with clinical use. This paper reviews the main Raman spectroscopy techniques used in medical diagnostics and provides an overview of various applications. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Exploring the Case for a Global Alliance for Medical Diagnostics Initiative

PubMed Central

Mugambi, Melissa L.; Palamountain, Kara M.; Gallarda, Jim; Drain, Paul K.

2017-01-01

In recent years, the private and public sectors have increased investments in medical diagnostics for low- and middle-income countries (LMICs). Despite these investments, numerous barriers prevent the adoption of existing diagnostics and discourage the development and introduction of new diagnostics in LMICs. In the late 1990s, the global vaccine community had similar challenges, as vaccine coverage rates stagnated and the introduction of new vaccines was viewed as a distraction to delivering existing vaccines. To address these challenges, the international community came together and formed the Global Alliance for Vaccines Initiative (GAVI). Sixteen years after the formation of GAVI, we see evidence of a healthier global vaccine landscape. We discuss how GAVI’s four guiding principles (product, health systems strengthening, financing and market shaping) might apply to the advancement of medical diagnostics in LMICs. We present arguments for the international community and existing organizations to establish a Global Alliance for Medical Diagnostics Initiative (GAMDI). PMID:28134750

Medical diagnostics with mobile devices: Comparison of intrinsic and extrinsic sensing.

PubMed

Kwon, L; Long, K D; Wan, Y; Yu, H; Cunningham, B T

2016-01-01

We review the recent development of mobile detection instruments used for medical diagnostics, and consider the relative advantages of approaches that utilize the internal sensing capabilities of commercially available mobile communication devices (such as smartphones and tablet computers) compared to those that utilize a custom external sensor module. In this review, we focus specifically upon mobile medical diagnostic platforms that are being developed to serve the need in global health, personalized medicine, and point-of-care diagnostics. Copyright © 2016 Elsevier Inc. All rights reserved.

The future of novel diagnostics in medical mycology.

PubMed

Teles, Fernando; Seixas, Jorge

2015-04-01

Several fungal diseases have become serious threats to human health and life, especially upon the advent of human immunodeficiency virus/AIDS epidemics and of other typical immunosuppressive conditions of modern life. Accordingly, the burden posed by these diseases and, concurrently, by intensive therapeutic regimens against these diseases has increased worldwide. Existing and available rapid tests for point-of-care diagnosis of important fungal diseases could enable the limitations of current laboratory methods for detection and identification of medically important fungi to be surpassed, both in low-income countries and for first-line diagnosis (screening) in richer countries. As with conventional diagnostic methods and devices, former immunodiagnostics have been challenged by molecular biology-based platforms, as a way to enhance the sensitivity and shorten the assay time, thus enabling early and more accurate diagnosis. Most of these tests have been developed in-house, without adequate validation and standardization. Another challenge has been the DNA extraction step, which is especially critical when dealing with fungi. In this paper, we have identified three major research trends in this field: (1) the application of newer biorecognition techniques, often applied in analytical chemistry; (2) the development of new materials with improved physico-chemical properties; and (3) novel bioanalytical platforms, allowing fully automated testing. Keeping up to date with the fast technological advances registered in this field, primarily at the proof-of-concept level, is essential for wise assessment of those that are likely to be more cost effective and, as already observed for bacterial and viral pathogens, may provide leverage to the current tepid developmental status of novel and improved diagnostics for medical mycology. © 2015 The Authors.

Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil.

PubMed

Chojniak, Rubens; Carneiro, Dominique Piacenti; Moterani, Gustavo Simonetto Peres; Duarte, Ivone da Silva; Bitencourt, Almir Galvão Vieira; Muglia, Valdair Francisco; D'Ippolito, Giuseppe

2017-01-01

To map the different methods for diagnostic imaging instruction at medical schools in Brazil. In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution.

Medical physics: some recollections in diagnostic X-ray imaging and therapeutic radiology.

PubMed

Gray, J E; Orton, C G

2000-12-01

Medical physics has changed dramatically since 1895. There was a period of slow evolutionary change during the first 70 years after Roentgen's discovery of x rays. With the advent of the computer, however, both diagnostic and therapeutic radiology have undergone rapid growth and changes. Technologic advances such as computed tomography and magnetic resonance imaging in diagnostic imaging and three-dimensional treatment planning systems, stereotactic radiosurgery, and intensity modulated radiation therapy in radiation oncology have resulted in substantial changes in medical physics. These advances have improved diagnostic imaging and radiation therapy while expanding the need for better educated and experienced medical physics staff.

Boosting medical diagnostics by pooling independent judgments

PubMed Central

Kurvers, Ralf H. J. M.; Herzog, Stefan M.; Hertwig, Ralph; Krause, Jens; Carney, Patricia A.; Bogart, Andy; Argenziano, Giuseppe; Zalaudek, Iris; Wolf, Max

2016-01-01

Collective intelligence refers to the ability of groups to outperform individual decision makers when solving complex cognitive problems. Despite its potential to revolutionize decision making in a wide range of domains, including medical, economic, and political decision making, at present, little is known about the conditions underlying collective intelligence in real-world contexts. We here focus on two key areas of medical diagnostics, breast and skin cancer detection. Using a simulation study that draws on large real-world datasets, involving more than 140 doctors making more than 20,000 diagnoses, we investigate when combining the independent judgments of multiple doctors outperforms the best doctor in a group. We find that similarity in diagnostic accuracy is a key condition for collective intelligence: Aggregating the independent judgments of doctors outperforms the best doctor in a group whenever the diagnostic accuracy of doctors is relatively similar, but not when doctors’ diagnostic accuracy differs too much. This intriguingly simple result is highly robust and holds across different group sizes, performance levels of the best doctor, and collective intelligence rules. The enabling role of similarity, in turn, is explained by its systematic effects on the number of correct and incorrect decisions of the best doctor that are overruled by the collective. By identifying a key factor underlying collective intelligence in two important real-world contexts, our findings pave the way for innovative and more effective approaches to complex real-world decision making, and to the scientific analyses of those approaches. PMID:27432950

Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil

PubMed Central

Chojniak, Rubens; Carneiro, Dominique Piacenti; Moterani, Gustavo Simonetto Peres; Duarte, Ivone da Silva; Bitencourt, Almir Galvão Vieira; Muglia, Valdair Francisco; D'Ippolito, Giuseppe

2017-01-01

Objective To map the different methods for diagnostic imaging instruction at medical schools in Brazil. Materials and Methods In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Results Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. Conclusion The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution. PMID:28298730

77 FR 39656 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

...-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards Advisory Committee AGENCY... Diagnostic Equipment Accessibility Standards. DATES: The first meeting of the committee will be held at a... Equipment Accessibility Standards. See 77 FR 14706 (March 13, 2012). Section 510 of the Rehabilitation Act...

The future of medical diagnostics: review paper

PubMed Central

2011-01-01

While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation. Their accuracy, expressed as sensitivity and specificity, are reported in a number of studies suggests that they have a potential for cost effective, real-time, in situ diagnosis. We review the Third Scientific Meeting of the Head and Neck Optical Diagnostics Society held in Congress Innsbruck, Innsbruck, Austria on the 11th May 2011. For the first time the HNODS Annual Scientific Meeting was held in association with the International Photodynamic Association (IPA) and the European Platform for Photodynamic Medicine (EPPM). The aim was to enhance the interdisciplinary aspects of optical diagnostics and other photodynamic applications. The meeting included 2 sections: oral communication sessions running in parallel to the IPA programme and poster presentation sessions combined with the IPA and EPPM posters sessions. PMID:21861912

Email for communicating results of diagnostic medical investigations to patients.

PubMed

Meyer, Barbara; Atherton, Helen; Sawmynaden, Prescilla; Car, Josip

2012-08-15

As medical care becomes more complex and the ability to test for conditions grows, pressure on healthcare providers to convey increasing volumes of test results to patients is driving investigation of alternative technological solutions for their delivery. This review addresses the use of email for communicating results of diagnostic medical investigations to patients. To assess the effects of using email for communicating results of diagnostic medical investigations to patients, compared to SMS/ text messaging, telephone communication or usual care, on outcomes, including harms, for health professionals, patients and caregivers, and health services. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (OvidSP) (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010), and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists and contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies of interventions using email for communicating results of any diagnostic medical investigations to patients, and taking the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two review authors independently assessed the titles and abstracts of retrieved citations. No studies were identified for inclusion. Consequently, no data collection or analysis was possible. No studies met the inclusion criteria, therefore there are no results to report on the use of email for communicating results of diagnostic medical

Rocket engine diagnostics using qualitative modeling techniques

NASA Technical Reports Server (NTRS)

Binder, Michael; Maul, William; Meyer, Claudia; Sovie, Amy

1992-01-01

Researchers at NASA Lewis Research Center are presently developing qualitative modeling techniques for automated rocket engine diagnostics. A qualitative model of a turbopump interpropellant seal system was created. The qualitative model describes the effects of seal failures on the system steady state behavior. This model is able to diagnose the failure of particular seals in the system based on anomalous temperature and pressure values. The anomalous values input to the qualitative model are generated using numerical simulations. Diagnostic test cases include both single and multiple seal failures.

System theory in medical diagnostic devices: an overview.

PubMed

Baura, Gail D

2006-01-01

Medical diagnostics refers to testing conducted either in vitro or in vivo to provide critical health care information for risk assessment, early diagnosis, treatment, or disease management. Typical in vivo diagnostic tests include the computed tomography scan, magnetic resonance imaging, and blood pressure screening. Typical in vitro diagnostic tests include cholesterol, Papanicolaou smear, and conventional glucose monitoring tests. Historically, devices associated with both types of diagnostics have used heuristic curve fitting during signal analysis. However, since the early 1990s, a few enterprising engineers and physicians have used system theory to improve their core processing for feature detection and system identification. Current applications include automated Pap smear screening for detection of cervical cancer and diagnosis of Alzheimer's disease. Future applications, such as disease prediction before symptom onset and drug treatment customization, have been catalyzed by the Human Genome Project.

Rocket engine diagnostics using qualitative modeling techniques

NASA Technical Reports Server (NTRS)

Binder, Michael; Maul, William; Meyer, Claudia; Sovie, Amy

1992-01-01

Researchers at NASA Lewis Research Center are presently developing qualitative modeling techniques for automated rocket engine diagnostics. A qualitative model of a turbopump interpropellant seal system has been created. The qualitative model describes the effects of seal failures on the system steady-state behavior. This model is able to diagnose the failure of particular seals in the system based on anomalous temperature and pressure values. The anomalous values input to the qualitative model are generated using numerical simulations. Diagnostic test cases include both single and multiple seal failures.

[Advances of Molecular Diagnostic Techniques Application in Clinical Diagnosis.

PubMed

Ying, Bin-Wu

2016-11-01

Over the past 20 years,clinical molecular diagnostic technology has made rapid development,and became the most promising field in clinical laboratory medicine.In particular,with the development of genomics,clinical molecular diagnostic methods will reveal the nature of clinical diseases in a deeper level,thus guiding the clinical diagnosis and treatments.Many molecular diagnostic projects have been routinely applied in clinical works.This paper reviews the advances on application of clinical diagnostic techniques in infectious disease,tumor and genetic disorders,including nucleic acid amplification,biochip,next-generation sequencing,and automation molecular system,and so on.

Laser optoacoustic tomography for medical diagnostics: principles

NASA Astrophysics Data System (ADS)

Oraevsky, Alexander A.; Esenaliev, Rinat O.; Jacques, Steven L.; Tittel, Frank K.

1996-04-01

This paper is to describe principles of laser optoacoustic tomography for medical diagnostics. Two types of imaging modes are presented. The first is the tomography in transmission mode, which utilizes detection of stress transients transmitted from the laser-excited volume toward the depth through thick layers of tissue. The second is the tomography in reflection mode which utilizes detection of stress transients generated in superficial tissue layer and reflected back toward tissue surface. To distinguish the two modes, we have abbreviated them as (1) laser optoacoustic tomography in transmission mode, LOATT, and (2) time-resolved stress detection tomography of light absorption, TRSDTLA, in reflection mode where emphasis is made on high spatial resolution of images. The basis for laser optoacoustic tomography is the time-resolved detection of laser-induced transient stress waves, selectively generated in absorbing tissues of diagnostic interest. Such a technique allows one to visualize absorbed light distribution in turbid biological tissues irradiated by short laser pulses. Laser optoacoustic tomography can be used for detection of tissue pathological changes that result in either increased concentration of various tissue chromophores such as hemoglobin or in development of enhanced microcirculation in diseased tissue. Potential areas of applications are diagnosis of cancer, brain hemorrhages, arterial atherosclerotic plaques, and other diseased tissues. In addition, it can provide feedback information during medical treatments. Both LOATT and TRSDTLA utilize laser excitation of biological tissues and sensitive detection of laser-induced stress waves. Optical selectivity is based upon differences in optical properties of pathologically different tissues. Sensitivity comes from stress generation under irradiation conditions of temporal stress confinement. The use of sensitive wide-band lithium niobate acoustic transducers expands limits of laser optoacoustic

Noncontact techniques for diesel engine diagnostics using exhaust waveform analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gore, D.A.; Cooke, G.J.

1987-01-01

RCA Corporation's continuing efforts to develop noncontact test techniques for diesel engines have led to recent advancements in deep engine diagnostics. The U.S. Army Tank-Automotive Command (TACOM) has been working with RCA for the development of new noncontact sensors and test techniques which use these sensors in conjunction with their family of Simplified Test Equipment (STE) to perform vehicle diagnostics. The STE systems are microprocessor-based maintenance tools that assist the Army mechanic in diagnosing malfunctions in both tactical and combat vehicles. The test systems support the mechanic by providing the sophisticated signal processing capabilities necessary for a wide range ofmore » diagnostic testing including exhaust waveform analysis.« less

Emerging applications of fluorescence spectroscopy in medical microbiology field.

PubMed

Shahzad, Aamir; Köhler, Gottfried; Knapp, Martin; Gaubitzer, Erwin; Puchinger, Martin; Edetsberger, Michael

2009-11-26

There are many diagnostic techniques and methods available for diagnosis of medically important microorganisms like bacteria, viruses, fungi and parasites. But, almost all these techniques and methods have some limitations or inconvenience. Most of these techniques are laborious, time consuming and with chances of false positive or false negative results. It warrants the need of a diagnostic technique which can overcome these limitations and problems. At present, there is emerging trend to use Fluorescence spectroscopy as a diagnostic as well as research tool in many fields of medical sciences. Here, we will critically discuss research studies which propose that Fluorescence spectroscopy may be an excellent diagnostic as well as excellent research tool in medical microbiology field with high sensitivity and specificity.

Optoelectronic tweezers for medical diagnostics

NASA Astrophysics Data System (ADS)

Kremer, Clemens; Neale, Steven; Menachery, Anoop; Barrett, Mike; Cooper, Jonathan M.

2012-01-01

Optoelectronic tweezers (OET) allows the spatial patterning of electric fields through selected illumination of a photoconductive surface. This enables the manipulation of micro particles and cells by creating non-uniform electrical fields that then produce dielectrophoretic (DEP) forces. The DEP responses of cells differ and can produce negative or positive (repelled or attracted to areas of high electric field) forces. Therefore OET can be used to manipulate individual cells and separate different cell types from each other. Thus OET has many applications for medical diagnostics, demonstrated here with work towards diagnosing Human African Trypanosomiasis, also known as sleeping sickness.

Integrated Artificial Intelligence Approaches for Disease Diagnostics.

PubMed

Vashistha, Rajat; Chhabra, Deepak; Shukla, Pratyoosh

2018-06-01

Mechanocomputational techniques in conjunction with artificial intelligence (AI) are revolutionizing the interpretations of the crucial information from the medical data and converting it into optimized and organized information for diagnostics. It is possible due to valuable perfection in artificial intelligence, computer aided diagnostics, virtual assistant, robotic surgery, augmented reality and genome editing (based on AI) technologies. Such techniques are serving as the products for diagnosing emerging microbial or non microbial diseases. This article represents a combinatory approach of using such approaches and providing therapeutic solutions towards utilizing these techniques in disease diagnostics.

Paper-based sample-to-answer molecular diagnostic platform for point-of-care diagnostics.

PubMed

Choi, Jane Ru; Tang, Ruihua; Wang, ShuQi; Wan Abas, Wan Abu Bakar; Pingguan-Murphy, Belinda; Xu, Feng

2015-12-15

Nucleic acid testing (NAT), as a molecular diagnostic technique, including nucleic acid extraction, amplification and detection, plays a fundamental role in medical diagnosis for timely medical treatment. However, current NAT technologies require relatively high-end instrumentation, skilled personnel, and are time-consuming. These drawbacks mean conventional NAT becomes impractical in many resource-limited disease-endemic settings, leading to an urgent need to develop a fast and portable NAT diagnostic tool. Paper-based devices are typically robust, cost-effective and user-friendly, holding a great potential for NAT at the point of care. In view of the escalating demand for the low cost diagnostic devices, we highlight the beneficial use of paper as a platform for NAT, the current state of its development, and the existing challenges preventing its widespread use. We suggest a strategy involving integrating all three steps of NAT into one single paper-based sample-to-answer diagnostic device for rapid medical diagnostics in the near future. Copyright © 2015 Elsevier B.V. All rights reserved.

A review of rapid prototyping (RP) techniques in the medical and biomedical sector.

PubMed

Webb, P A

2000-01-01

The evolution of rapid prototyping (RP) technology is briefly discussed, and the application of RP technologies to the medical sector is reviewed. Although the use of RP technology has been slow arriving in the medical arena, the potential of the technique is seen to be widespread. Various uses of the technology within surgical planning, prosthesis development and bioengineering are discussed. Some possible drawbacks are noted in some applications, owing to the poor resolution of CT slice data in comparison with that available on RP machines, but overall, the methods are seen to be beneficial in all areas, with one early report suggesting large improvements in measurement and diagnostic accuracy as a result of using RP models.

A comparative study of electrical probe techniques for plasma diagnostics

NASA Technical Reports Server (NTRS)

Szuszczewicz, E. P.

1972-01-01

Techniques for using electrical probes for plasma diagnostics are reviewed. Specific consideration is given to the simple Langmuir probe, the symmetric double probe of Johnson and Malter, the variable-area probe of Fetz and Oeschsner, and a floating probe technique. The advantages and disadvantages of each technique are discussed.

Modern Approach to Medical Diagnostics - the Use of Separation Techniques in Microorganisms Detection.

PubMed

Chylewska, Agnieszka; Ogryzek, M; Makowski, Mariusz

2017-10-23

New analytical and molecular methods for microorganisms are being developed on various features of identification i.e. selectivity, specificity, sensitivity, rapidity and discrimination of the viable cell. The presented review was established following the current trends in improved pathogens separation and detection methods and their subsequent use in medical diagnosis. This contribution also focuses on the development of analytical and biological methods in the analysis of microorganisms, with special attention paid to bio-samples containing microbes (blood, urine, lymph, wastewater). First, the paper discusses microbes characterization, their structure, surface, properties, size and then it describes pivotal points in the bacteria, viruses and fungi separation procedure obtained by researchers in the last 30 years. According to the above, detection techniques can be classified into three categories, which were, in our opinion, examined and modified most intensively during this period: electrophoretic, nucleic-acid-based, and immunological methods. The review covers also the progress, limitations and challenges of these approaches and emphasizes the advantages of new separative techniques in selective fractionating of microorganisms. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

An Interview with Medical Diagnostics Scientist Bernhard Weigl

ERIC Educational Resources Information Center

Sullivan, Megan

2010-01-01

Medical diagnostics help us evaluate a range of disorders, such as cancer and infectious diseases. In the United States and other developed countries, doctors have access to advanced equipment and laboratories that provide reliable diagnoses. As a result, when we are sick, we feel confident that we will get the treatment we need. Unfortunately,…

20 CFR 220.179 - Exceptions to medical improvement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... on new or improved diagnostic or evaluative techniques the annuitant's impairment(s) is not as... methodologies and advances in medical and other diagnostic or evaluative techniques have given, and will...

20 CFR 220.179 - Exceptions to medical improvement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... on new or improved diagnostic or evaluative techniques the annuitant's impairment(s) is not as... methodologies and advances in medical and other diagnostic or evaluative techniques have given, and will...

20 CFR 220.179 - Exceptions to medical improvement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... on new or improved diagnostic or evaluative techniques the annuitant's impairment(s) is not as... methodologies and advances in medical and other diagnostic or evaluative techniques have given, and will...

20 CFR 220.179 - Exceptions to medical improvement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... on new or improved diagnostic or evaluative techniques the annuitant's impairment(s) is not as... methodologies and advances in medical and other diagnostic or evaluative techniques have given, and will...

20 CFR 220.179 - Exceptions to medical improvement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... on new or improved diagnostic or evaluative techniques the annuitant's impairment(s) is not as... methodologies and advances in medical and other diagnostic or evaluative techniques have given, and will...

A Hybrid Neural Network-Genetic Algorithm Technique for Aircraft Engine Performance Diagnostics

NASA Technical Reports Server (NTRS)

Kobayashi, Takahisa; Simon, Donald L.

2001-01-01

In this paper, a model-based diagnostic method, which utilizes Neural Networks and Genetic Algorithms, is investigated. Neural networks are applied to estimate the engine internal health, and Genetic Algorithms are applied for sensor bias detection and estimation. This hybrid approach takes advantage of the nonlinear estimation capability provided by neural networks while improving the robustness to measurement uncertainty through the application of Genetic Algorithms. The hybrid diagnostic technique also has the ability to rank multiple potential solutions for a given set of anomalous sensor measurements in order to reduce false alarms and missed detections. The performance of the hybrid diagnostic technique is evaluated through some case studies derived from a turbofan engine simulation. The results show this approach is promising for reliable diagnostics of aircraft engines.

National variation of ADHD diagnostic prevalence and medication use: health care providers and education policies.

PubMed

Fulton, Brent D; Scheffler, Richard M; Hinshaw, Stephen P; Levine, Peter; Stone, Susan; Brown, Timothy T; Modrek, Sepideh

2009-08-01

Attention-deficit hyperactivity disorder (ADHD) diagnostic prevalence and medication use vary across U.S. census regions, but little is known about state-level variation. The purpose of this study was to estimate this variation across states and examine whether a state's health care provider characteristics and education policies are associated with this variation. Logistic regression models were estimated with 69,505 children aged four to 17 from the state-stratified and nationally representative 2003 National Survey of Children's Health, conducted by the Centers for Disease Control and Prevention. Diagnostic prevalence was higher in the South (odds ratio [OR]=1.42, p<.001) than in the West; among children with ADHD diagnoses, medication use was higher in the South (OR=1.60, p<.01) and the Midwest (OR=1.53, p<.01) versus the West. On these measures, several states differed from the U.S. averages, including some states that, on the basis of the regional patterns found above, would not be expected to differ: Michigan had a high diagnostic prevalence; Vermont, South Dakota, and Nebraska had low diagnostic prevalences; and Connecticut, New Jersey, and Kentucky had low medication rates. Both diagnosis and medication status were associated with the number, age, and type of physicians within a state, particularly pediatricians. However, state education policies were not significantly associated with either diagnostic prevalence or medication rates. To better understand the association between a state's health care provider characteristics and both diagnostic prevalence and medication use, it may be fruitful to examine the content of provider continuing education programs, including the recommendations of major health professional organization guidelines to treat ADHD.

Emergency physician perceptions of medically unnecessary advanced diagnostic imaging.

PubMed

Kanzaria, Hemal K; Hoffman, Jerome R; Probst, Marc A; Caloyeras, John P; Berry, Sandra H; Brook, Robert H

2015-04-01

The objective was to determine emergency physician (EP) perceptions regarding 1) the extent to which they order medically unnecessary advanced diagnostic imaging, 2) factors that contribute to this behavior, and 3) proposed solutions for curbing this practice. As part of a larger study to engage physicians in the delivery of high-value health care, two multispecialty focus groups were conducted to explore the topic of decision-making around resource utilization, after which qualitative analysis was used to generate survey questions. The survey was extensively pilot-tested and refined for emergency medicine (EM) to focus on advanced diagnostic imaging (i.e., computed tomography [CT] or magnetic resonance imaging [MRI]). The survey was then administered to a national, purposive sample of EPs and EM trainees. Simple descriptive statistics to summarize physician responses are presented. In this study, 478 EPs were approached, of whom 435 (91%) completed the survey; 68% of respondents were board-certified, and roughly half worked in academic emergency departments (EDs). Over 85% of respondents believe too many diagnostic tests are ordered in their own EDs, and 97% said at least some (mean = 22%) of the advanced imaging studies they personally order are medically unnecessary. The main perceived contributors were fear of missing a low-probability diagnosis and fear of litigation. Solutions most commonly felt to be "extremely" or "very" helpful for reducing unnecessary imaging included malpractice reform (79%), increased patient involvement through education (70%) and shared decision-making (56%), feedback to physicians on test-ordering metrics (55%), and improved education of physicians on diagnostic testing (50%). Overordering of advanced imaging may be a systemic problem, as many EPs believe a substantial proportion of such studies, including some they personally order, are medically unnecessary. Respondents cited multiple complex factors with several potential high

Medical diagnostics for indoor mold exposure.

PubMed

Hurraß, Julia; Heinzow, Birger; Aurbach, Ute; Bergmann, Karl-Christian; Bufe, Albrecht; Buzina, Walter; Cornely, Oliver A; Engelhart, Steffen; Fischer, Guido; Gabrio, Thomas; Heinz, Werner; Herr, Caroline E W; Kleine-Tebbe, Jörg; Klimek, Ludger; Köberle, Martin; Lichtnecker, Herbert; Lob-Corzilius, Thomas; Merget, Rolf; Mülleneisen, Norbert; Nowak, Dennis; Rabe, Uta; Raulf, Monika; Seidl, Hans Peter; Steiß, Jens-Oliver; Szewszyk, Regine; Thomas, Peter; Valtanen, Kerttu; Wiesmüller, Gerhard A

2017-04-01

In April 2016, the German Society of Hygiene, Environmental Medicine and Preventative Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin (GHUP)) together with other scientific medical societies, German and Austrian medical societies, physician unions and experts has provided an AWMF (Association of the Scientific Medical Societies) guideline 'Medical diagnostics for indoor mold exposure'. This guideline shall help physicians to advise and treat patients exposed indoors to mold. Indoor mold growth is a potential health risk, even without a quantitative and/or causal association between the occurrence of individual mold species and health effects. Apart from the allergic bronchopulmonary aspergillosis (ABPA) and the mycoses caused by mold, there is only sufficient evidence for the following associations between moisture/mold damages and different health effects: Allergic respiratory diseases, asthma (manifestation, progression, exacerbation), allergic rhinitis, exogenous allergic alveolitis and respiratory tract infections/bronchitis. In comparison to other environmental allergens, the sensitizing potential of molds is estimated to be low. Recent studies show a prevalence of sensitization of 3-10% in the total population of Europe. The evidence for associations to mucous membrane irritation and atopic eczema (manifestation, progression, exacerbation) is classified as limited or suspected. Inadequate or insufficient evidence for an association is given for COPD, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis, and cancer. The risk of infections from indoor molds is low for healthy individuals. Only molds that are capable to form toxins can cause intoxications. The environmental and growth conditions and especially the substrate determine whether toxin formation occurs, but indoor air concentrations are always very low. In the case of indoor moisture/mold damages, everyone can be affected by odor effects and

[The diagnostic value of medical thoracoscopy for unexplained pleural effusion].

PubMed

Jiang, Shu-juan; Mu, Xiao-yan; Zhang, Song; Su, Li-li; Ma, Wei-xia

2013-05-01

To explore the endoscopic features of patients with unexplained pleural effusion, and to evaluate the diagnostic value of medical thoracoscopy. A retrospective analysis of 2380 patients with unexplained pleural effusion (1320 males and 1060 females; age 15-94 years) in Shandong Provincial Hospital from 1992 to 2011 were performed .The diagnosis was confirmed by medical thoracoscopy. The endoscopic findings of malignant pleural effusion mostly showed nodules of varying sizes. The nodules could be grape-like, cauliflower-like, fused into masses, or diffused small nodules . The appearance of cancerous nodules was more diversified compared to tuberculous nodules. Tuberculous pleurisy was manifested as diffuse pleural congestion and miliary changes, multiple small gray-white nodules, fibrin deposition and adhesion in the pleural cavity, pleural thickening and loculation . The pathological diagnosis was as follows: pleural metastases in 899 (37.8%), primary pleural mesothelioma in 439 (18.4%), tuberculous pleurisy in 514 (21.6%), non-specific inflammation in 226 (9.5%), empyema in 190 (8.0%), hepatic pleural effusion in 36 (1.5%) and pleural effusion of unknown causes in 76 (3.2%) cases. The diagnostic positive rate of medical thoracoscopy was 96.8%. No serious complications were observed. Medical thoracoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.

History of diagnostics in dermatovenerology on Medical Faculty in Prague.

PubMed

Kruzicová, Z

2009-01-01

The article deals with the history of diagnostics in dermatovenerology on Medical Faculty in Prague from 1875 to 1910. Medical Reports of General Hospital in Prague from those years were used as the source of data. Three dermatologic and venereal diagnoses from years 1875, 1881, 1885, 1890, 1895, 1899, 1906 and 1910 were used for a statistic comparison. The article also contains short description of institutional background of dermatovenerology in Prague during this period.

Improvement of Railroad Roller Bearing Test Procedures & Development of Roller Bearing Diagnostic Techniques. Volume 2.

DOT National Transportation Integrated Search

1982-04-01

A comprehensive review of existing basic diagnostic techniques applicable to the railcar roller bearing defect and failure problem was made. Of the potentially feasible diagnostic techniques identified, high frequency vibration was selected for exper...

Diagnostic Reasoning across the Medical Education Continuum.

PubMed

Smith, C Scott; Hill, William; Francovich, Chris; Morris, Magdalena; Robbins, Bruce; Robins, Lynne; Turner, Andrew

2014-07-15

We aimed to study linguistic and non-linguistic elements of diagnostic reasoning across the continuum of medical education. We performed semi-structured interviews of premedical students, first year medical students, third year medical students, second year internal medicine residents, and experienced faculty (ten each) as they diagnosed three common causes of dyspnea. A second observer recorded emotional tone. All interviews were digitally recorded and blinded transcripts were created. Propositional analysis and concept mapping were performed. Grounded theory was used to identify salient categories and transcripts were scored with these categories. Transcripts were then unblinded. Systematic differences in propositional structure, number of concept connections, distribution of grounded theory categories, episodic and semantic memories, and emotional tone were identified. Summary concept maps were created and grounded theory concepts were explored for each learning level. We identified three major findings: (1) The "apprentice effect" in novices (high stress and low narrative competence); (2) logistic concept growth in intermediates; and (3) a cognitive state transition (between analytical and intuitive approaches) in experts. These findings warrant further study and comparison.

Diagnostic delay in psychogenic seizures and the association with anti-seizure medication trials.

PubMed

Kerr, Wesley T; Janio, Emily A; Le, Justine M; Hori, Jessica M; Patel, Akash B; Gallardo, Norma L; Bauirjan, Janar; Chau, Andrea M; D'Ambrosio, Shannon R; Cho, Andrew Y; Engel, Jerome; Cohen, Mark S; Stern, John M

2016-08-01

The average delay from first seizure to diagnosis of psychogenic non-epileptic seizures (PNES) is over 7 years. The reason for this delay is not well understood. We hypothesized that a perceived decrease in seizure frequency after starting an anti-seizure medication (ASM) may contribute to longer delays, but the frequency of such a response has not been well established. Time from onset to diagnosis, medication history and associated seizure frequency was acquired from the medical records of 297 consecutive patients with PNES diagnosed using video-electroencephalographic monitoring. Exponential regression was used to model the effect of medication trials and response on diagnostic delay. Mean diagnostic delay was 8.4 years (min 1 day, max 52 years). The robust average diagnostic delay was 2.8 years (95% CI: 2.2-3.5 years) based on an exponential model as 10 to the mean of log10 delay. Each ASM trial increased the robust average delay exponentially by at least one third of a year (Wald t=3.6, p=0.004). Response to ASM trials did not significantly change diagnostic delay (Wald t=-0.9, p=0.38). Although a response to ASMs was observed commonly in these patients with PNES, the presence of a response was not associated with longer time until definitive diagnosis. Instead, the number of ASMs tried was associated with a longer delay until diagnosis, suggesting that ASM trials were continued despite lack of response. These data support the guideline that patients with seizures should be referred to epilepsy care centers after failure of two medication trials. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Comparison of diagnostic performances among bronchoscopic sampling techniques in the diagnosis of peripheral pulmonary lesions.

PubMed

Boonsarngsuk, Viboon; Kanoksil, Wasana; Laungdamerongchai, Sarangrat

2015-04-01

There are many sampling techniques dedicated to radial endobronchial ultrasound (R-EBUS) guided flexible bronchoscopy (FB). However, data regarding the diagnostic performances among bronchoscopic sampling techniques is limited. This study was conducted to compare the diagnostic yields among bronchoscopic sampling techniques in the diagnosis of peripheral pulmonary lesions (PPLs). A prospective study was conducted on 112 patients who were diagnosed with PPLs and underwent R-EBUS-guided FB between Oct 2012 and Sep 2014. Sampling techniques-including transbronchial biopsy (TBB), brushing cell block, brushing smear, rinsed fluid of brushing, and bronchoalveolar lavage (BAL)-were evaluated for the diagnosis. The mean diameter of the PPLs was 23.5±9.5 mm. The final diagnoses included 76 malignancies and 36 benign lesions. The overall diagnostic yield of R-EBUS-guided bronchoscopy was 80.4%; TBB gave the highest yield among the 112 specimens: 70.5%, 34.8%, 62.5%, 50.0% and 42.0% for TBB, brushing cell block, brushing smear, rinsed brushing fluid, and BAL fluid (BALF), respectively (P<0.001). TBB provided high diagnostic yield irrespective of the size and etiology of the PPLs. The combination of TBB and brushing smear achieved the maximum diagnostic yield. Of 31 infectious PPLs, BALF culture gave additional microbiological information in 20 cases. TBB provided the highest diagnostic yield; however, to achieve the highest diagnostic performance, TBB, brushing smear and BAL techniques should be performed together.

A Clinicopathological Study of Various Oral Cancer Diagnostic Techniques

PubMed Central

Ulaganathan, G.; Mohamed Niazi, K. Thanvir; Srinivasan, Soundarya; Balaji, V. R.; Manikandan, D.; Hameed, K. A. Shahul; Banumathi, A.

2017-01-01

Oral cancer is one of the most commonly occurring malignant tumors in the head and neck regions with high incident rate and mortality rate in the developed countries than in the developing countries. Generally, the survival rate of cancer patients may increase when diagnosed at early stage, followed by prompt treatment and therapy. Recently, cancer diagnosis and therapy design for a specific cancer patient have been performed with the advanced computer-aided techniques. The responses of the cancer therapy could be continuously monitored to ensure the effectiveness of the treatment process that hardly requires diagnostic result as quick as possible to improve the quality and patient care. This paper gives an overview of oral cancer occurrence, different types, and various diagnostic techniques. In addition, a brief introduction is given to various stages of immunoanalysis including tissue image preparation, whole slide imaging, and microscopic image analysis. PMID:29284926

Fluorescence Lifetime Techniques in Medical Applications

PubMed Central

Marcu, Laura

2012-01-01

This article presents an overview of time-resolved (lifetime) fluorescence techniques used in biomedical diagnostics. In particular, we review the development of time-resolved fluorescence spectroscopy (TRFS) and fluorescence lifetime imaging (FLIM) instrumentation and associated methodologies which allows for in vivo characterization and diagnosis of biological tissues. Emphasis is placed on the translational research potential of these techniques and on evaluating whether intrinsic fluorescence signals provide useful contrast for the diagnosis of human diseases including cancer (gastrointestinal tract, lung, head and neck, and brain), skin and eye diseases, and atherosclerotic cardiovascular disease. PMID:22273730

21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

Code of Federal Regulations, 2014 CFR

2014-04-01

... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within or...

21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

Code of Federal Regulations, 2011 CFR

2011-04-01

... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within or...

21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

Code of Federal Regulations, 2013 CFR

2013-04-01

... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within or...

21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

Code of Federal Regulations, 2012 CFR

2012-04-01

... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within or...

21 CFR 1000.50 - Recommendation for the use of specific area gonad shielding on patients during medical diagnostic...

Code of Federal Regulations, 2010 CFR

2010-04-01

... shielding on patients during medical diagnostic x-ray procedures. 1000.50 Section 1000.50 Food and Drugs... shielding on patients during medical diagnostic x-ray procedures. Specific area gonad shielding covers an... that may cause genetic mutations during many medical x-ray procedures in which the gonads lie within or...

42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Procedural Terminology published by the American Medical Association. (vii) Diagnostic tests performed by a... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Procedural Terminology published by the American Medical Association. (vii) Diagnostic tests performed by a... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

[Forensic-medical diagnostics of doping cases in sports].

PubMed

Khodasevich, L S; Kuzin, S G; Khodasevich, A L

2013-01-01

The present review of the literature is focused on the problem of forensic-medical diagnostics of doping cases in sports, with special reference to the main classes of pharmaceutical products forbidden for use by the International Olympic Committee. The main causes of death among the athletes as a result of using doping substances are considered. Much attention is given to adverse reactions induced by long-time intake of anabolic steroids many of which can be identified at autopsy.

New diagnostic technique for the study of turbulent boundary-layer separation

NASA Technical Reports Server (NTRS)

Horstman, C. C.; Owen, F. K.

1974-01-01

Description of a diagnostic technique for determining the unsteady character of turbulent boundary-layer separation. The technique uses thin platinum films mounted flush with the model surface. Voltages from these films provide measurements related to the flow character above the film. For illustration, results obtained by this technique are presented for the interaction of a hypersonic shock wave and a turbulent boundary layer, with and without separation.

A Statistical Evaluation of the Diagnostic Performance of MEDAS-The Medical Emergency Decision Assistance System

PubMed Central

Georgakis, D. Christine; Trace, David A.; Naeymi-Rad, Frank; Evens, Martha

1990-01-01

Medical expert systems require comprehensive evaluation of their diagnostic accuracy. The usefulness of these systems is limited without established evaluation methods. We propose a new methodology for evaluating the diagnostic accuracy and the predictive capacity of a medical expert system. We have adapted to the medical domain measures that have been used in the social sciences to examine the performance of human experts in the decision making process. Thus, in addition to the standard summary measures, we use measures of agreement and disagreement, and Goodman and Kruskal's λ and τ measures of predictive association. This methodology is illustrated by a detailed retrospective evaluation of the diagnostic accuracy of the MEDAS system. In a study using 270 patients admitted to the North Chicago Veterans Administration Hospital, diagnoses produced by MEDAS are compared with the discharge diagnoses of the attending physicians. The results of the analysis confirm the high diagnostic accuracy and predictive capacity of the MEDAS system. Overall, the agreement of the MEDAS system with the “gold standard” diagnosis of the attending physician has reached a 90% level.

Diagnostic reasoning techniques for selective monitoring

NASA Technical Reports Server (NTRS)

Homem-De-mello, L. S.; Doyle, R. J.

1991-01-01

An architecture for using diagnostic reasoning techniques in selective monitoring is presented. Given the sensor readings and a model of the physical system, a number of assertions are generated and expressed as Boolean equations. The resulting system of Boolean equations is solved symbolically. Using a priori probabilities of component failure and Bayes' rule, revised probabilities of failure can be computed. These will indicate what components have failed or are the most likely to have failed. This approach is suitable for systems that are well understood and for which the correctness of the assertions can be guaranteed. Also, the system must be such that changes are slow enough to allow the computation.

On the diagnostic emulation technique and its use in the AIRLAB

NASA Technical Reports Server (NTRS)

Migneault, Gerard E.

1988-01-01

An aid is presented for understanding and judging the relevance of the diagnostic emulation technique to studies of highly reliable, digital computing systems for aircraft. A short review is presented of the need for and the use of the technique as well as an explanation of its principles of operation and implementation. Details that would be needed for operational control or modification of existing versions of the technique are not described.

Design of point-of-care (POC) microfluidic medical diagnostic devices

NASA Astrophysics Data System (ADS)

Leary, James F.

2018-02-01

Design of inexpensive and portable hand-held microfluidic flow/image cytometry devices for initial medical diagnostics at the point of initial patient contact by emergency medical personnel in the field requires careful design in terms of power/weight requirements to allow for realistic portability as a hand-held, point-of-care medical diagnostics device. True portability also requires small micro-pumps for high-throughput capability. Weight/power requirements dictate use of super-bright LEDs and very small silicon photodiodes or nanophotonic sensors that can be powered by batteries. Signal-to-noise characteristics can be greatly improved by appropriately pulsing the LED excitation sources and sampling and subtracting noise in between excitation pulses. The requirements for basic computing, imaging, GPS and basic telecommunications can be simultaneously met by use of smartphone technologies, which become part of the overall device. Software for a user-interface system, limited real-time computing, real-time imaging, and offline data analysis can be accomplished through multi-platform software development systems that are well-suited to a variety of currently available cellphone technologies which already contain all of these capabilities. Microfluidic cytometry requires judicious use of small sample volumes and appropriate statistical sampling by microfluidic cytometry or imaging for adequate statistical significance to permit real-time (typically < 15 minutes) medical decisions for patients at the physician's office or real-time decision making in the field. One or two drops of blood obtained by pin-prick should be able to provide statistically meaningful results for use in making real-time medical decisions without the need for blood fractionation, which is not realistic in the field.

Advanced Laser-Based Techniques for Gas-Phase Diagnostics in Combustion and Aerospace Engineering.

PubMed

Ehn, Andreas; Zhu, Jiajian; Li, Xuesong; Kiefer, Johannes

2017-03-01

Gaining information of species, temperature, and velocity distributions in turbulent combustion and high-speed reactive flows is challenging, particularly for conducting measurements without influencing the experimental object itself. The use of optical and spectroscopic techniques, and in particular laser-based diagnostics, has shown outstanding abilities for performing non-intrusive in situ diagnostics. The development of instrumentation, such as robust lasers with high pulse energy, ultra-short pulse duration, and high repetition rate along with digitized cameras exhibiting high sensitivity, large dynamic range, and frame rates on the order of MHz, has opened up for temporally and spatially resolved volumetric measurements of extreme dynamics and complexities. The aim of this article is to present selected important laser-based techniques for gas-phase diagnostics focusing on their applications in combustion and aerospace engineering. Applicable laser-based techniques for investigations of turbulent flows and combustion such as planar laser-induced fluorescence, Raman and Rayleigh scattering, coherent anti-Stokes Raman scattering, laser-induced grating scattering, particle image velocimetry, laser Doppler anemometry, and tomographic imaging are reviewed and described with some background physics. In addition, demands on instrumentation are further discussed to give insight in the possibilities that are offered by laser flow diagnostics.

Cultivating Medical Intentionality: The Phenomenology of Diagnostic Virtuosity in East Asian Medicine.

PubMed

Kim, Taewoo

2017-03-01

This study examines the perceptual basis of diagnostic virtuosity in East Asian medicine, combining Merleau-Ponty's phenomenology and an ethnographic investigation of Korean medicine in South Korea. A novice, being exposed to numerous clinical transactions during apprenticeship, organizes perceptual experience that occurs between him or herself and patients. In the process, the fledgling practitioner's body begins to set up a medically-tinged "intentionality" interconnecting his or her consciousness and medically significant qualities in patients. Diagnostic virtuosity is gained when the practitioner embodies a cultivated medical intentionality. In the process of becoming a practitioner imbued with virtuosity, this study focuses on the East Asian notion of "Image" that maximizes the body's perceptual capacity, and minimizes possible reductions by linguistic re-presentation. "Image" enables the practitioner to somatically conceptualize the core notions of East Asian medicine, such as Yin-Yang, and to use them as an embodied litmus as the practitioner's cultivated body instinctively conjures up medical notions at clinical encounters. In line with anthropological critiques of reductionist frameworks that congeal human existential and perceptual vitality within a "scientific" explanatory model, this article attempts to provide an example of various knowing and caring practices, institutionalized external to the culture of science.

Efficient Privacy-Enhancing Techniques for Medical Databases

NASA Astrophysics Data System (ADS)

Schartner, Peter; Schaffer, Martin

In this paper, we introduce an alternative for using linkable unique health identifiers: locally generated system-wide unique digital pseudonyms. The presented techniques are based on a novel technique called collision-free number generation which is discussed in the introductory part of the article. Afterwards, attention is payed onto two specific variants of collision-free number generation: one based on the RSA-Problem and the other one based on the Elliptic Curve Discrete Logarithm Problem. Finally, two applications are sketched: centralized medical records and anonymous medical databases.

A survey of GPU-based medical image computing techniques

PubMed Central

Shi, Lin; Liu, Wen; Zhang, Heye; Xie, Yongming

2012-01-01

Medical imaging currently plays a crucial role throughout the entire clinical applications from medical scientific research to diagnostics and treatment planning. However, medical imaging procedures are often computationally demanding due to the large three-dimensional (3D) medical datasets to process in practical clinical applications. With the rapidly enhancing performances of graphics processors, improved programming support, and excellent price-to-performance ratio, the graphics processing unit (GPU) has emerged as a competitive parallel computing platform for computationally expensive and demanding tasks in a wide range of medical image applications. The major purpose of this survey is to provide a comprehensive reference source for the starters or researchers involved in GPU-based medical image processing. Within this survey, the continuous advancement of GPU computing is reviewed and the existing traditional applications in three areas of medical image processing, namely, segmentation, registration and visualization, are surveyed. The potential advantages and associated challenges of current GPU-based medical imaging are also discussed to inspire future applications in medicine. PMID:23256080

A Review of Diagnostic Techniques for ISHM Applications

NASA Technical Reports Server (NTRS)

Patterson-Hine, Ann; Biswas, Gautam; Aaseng, Gordon; Narasimhan, Sriam; Pattipati, Krishna

2005-01-01

System diagnosis is an integral part of any Integrated System Health Management application. Diagnostic applications make use of system information from the design phase, such as safety and mission assurance analysis, failure modes and effects analysis, hazards analysis, functional models, fault propagation models, and testability analysis. In modern process control and equipment monitoring systems, topological and analytic , models of the nominal system, derived from design documents, are also employed for fault isolation and identification. Depending on the complexity of the monitored signals from the physical system, diagnostic applications may involve straightforward trending and feature extraction techniques to retrieve the parameters of importance from the sensor streams. They also may involve very complex analysis routines, such as signal processing, learning or classification methods to derive the parameters of importance to diagnosis. The process that is used to diagnose anomalous conditions from monitored system signals varies widely across the different approaches to system diagnosis. Rule-based expert systems, case-based reasoning systems, model-based reasoning systems, learning systems, and probabilistic reasoning systems are examples of the many diverse approaches ta diagnostic reasoning. Many engineering disciplines have specific approaches to modeling, monitoring and diagnosing anomalous conditions. Therefore, there is no "one-size-fits-all" approach to building diagnostic and health monitoring capabilities for a system. For instance, the conventional approaches to diagnosing failures in rotorcraft applications are very different from those used in communications systems. Further, online and offline automated diagnostic applications are integrated into an operations framework with flight crews, flight controllers and maintenance teams. While the emphasis of this paper is automation of health management functions, striking the correct balance between

Molecular diagnostics in medical microbiology: yesterday, today and tomorrow.

PubMed

van Belkum, Alex

2003-10-01

Clinical microbiology is clearly on the move, and various new diagnostic technologies have been introduced into laboratory practice over the past few decades. However, Henri D Isenberg recently stated that molecular biology techniques promised to revolutionise the diagnosis of infectious disease, but that, to date, this promise is still in its infancy. Molecular diagnostics have now surpassed these early stages and have definitely reached puberty. Currently, a second generation of automated molecular approaches is already within the microbiologists' reach. Quantitative amplification tests in combination with genomics, transcriptomics, proteomics and related methodologies will pave the way to further enhancement of innovative microbial detection and identification.

Relativity Screens for Misvalued Medical Services: Impact on Noninvasive Diagnostic Radiology.

PubMed

Rosenkrantz, Andrew B; Silva, Ezequiel; Hawkins, C Matthew

2017-11-01

In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services. The frequency of having ever undergone a screen was compared between the two groups. Screened radiology codes were further evaluated regarding the RVU impact of subsequent revaluation. Of noninvasive diagnostic radiology codes, 46.0% (201 of 437) were screened versus 22.2% (1,460 of 6,575) of remaining codes (P < .001). Most common screens for which radiology codes were identified as potentially misvalued were (1) high expenditures (27.5%) and (2) high utilization (25.6%). The modality and body region most likely to be identified in a screen were CT (82.1%) and breast (90.9%), respectively. Among screened radiology codes, work RVUs, practice expense RVUs, and nonfacility total RVUs decreased in 20.3%, 65.9%, and 75.3%, respectively. All screened CT, MRI, brain, and spine codes exhibited decreased total RVUs. Policymakers' ongoing search for potentially misvalued medical services has disproportionately impacted noninvasive diagnostic radiology services, risking the introduction of unintended or artificial shifts in physician practice. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Performance of physical examination skills in medical students during diagnostic medicine course in a University Hospital of Northwest China.

PubMed

Li, Yan; Li, Na; Han, Qunying; He, Shuixiang; Bae, Ricard S; Liu, Zhengwen; Lv, Yi; Shi, Bingyin

2014-01-01

This study was conducted to evaluate the performance of physical examination (PE) skills during our diagnostic medicine course and analyze the characteristics of the data collected to provide information for practical guidance to improve the quality of teaching. Seventy-two fourth-year medical students were enrolled in the study. All received an assessment of PE skills after receiving a 17-week formal training course and systematic teaching. Their performance was evaluated and recorded in detail using a checklist, which included 5 aspects of PE skills: examination techniques, communication and care skills, content items, appropriateness of examination sequence, and time taken. Error frequency and type were designated as the assessment parameters in the survey. The results showed that the distribution and the percentage in examination errors between male and female students and among the different body parts examined were significantly different (p<0.001). The average error frequency per student in females (0.875) was lower than in males (1.375) although the difference was not statistically significant (p = 0.167). The average error frequency per student in cardiac (1.267) and pulmonary (1.389) examinations was higher than in abdominal (0.867) and head, neck and nervous system examinations (0.917). Female students had a lower average error frequency than males in cardiac examinations (p = 0.041). Additionally, error in examination techniques was the highest type of error among the 5 aspects of PE skills irrespective of participant gender and assessment content (p<0.001). These data suggest that PE skills in cardiac and pulmonary examinations and examination techniques may be included in the main focus of improving the teaching of diagnostics in these medical students.

Defining and Measuring Diagnostic Uncertainty in Medicine: A Systematic Review.

PubMed

Bhise, Viraj; Rajan, Suja S; Sittig, Dean F; Morgan, Robert O; Chaudhary, Pooja; Singh, Hardeep

2018-01-01

Physicians routinely encounter diagnostic uncertainty in practice. Despite its impact on health care utilization, costs and error, measurement of diagnostic uncertainty is poorly understood. We conducted a systematic review to describe how diagnostic uncertainty is defined and measured in medical practice. We searched OVID Medline and PsycINFO databases from inception until May 2017 using a combination of keywords and Medical Subject Headings (MeSH). Additional search strategies included manual review of references identified in the primary search, use of a topic-specific database (AHRQ-PSNet) and expert input. We specifically focused on articles that (1) defined diagnostic uncertainty; (2) conceptualized diagnostic uncertainty in terms of its sources, complexity of its attributes or strategies for managing it; or (3) attempted to measure diagnostic uncertainty. We identified 123 articles for full review, none of which defined diagnostic uncertainty. Three attributes of diagnostic uncertainty were relevant for measurement: (1) it is a subjective perception experienced by the clinician; (2) it has the potential to impact diagnostic evaluation-for example, when inappropriately managed, it can lead to diagnostic delays; and (3) it is dynamic in nature, changing with time. Current methods for measuring diagnostic uncertainty in medical practice include: (1) asking clinicians about their perception of uncertainty (surveys and qualitative interviews), (2) evaluating the patient-clinician encounter (such as by reviews of medical records, transcripts of patient-clinician communication and observation), and (3) experimental techniques (patient vignette studies). The term "diagnostic uncertainty" lacks a clear definition, and there is no comprehensive framework for its measurement in medical practice. Based on review findings, we propose that diagnostic uncertainty be defined as a "subjective perception of an inability to provide an accurate explanation of the patient

Topical medication instillation techniques for glaucoma

PubMed Central

Xu, Li; Wang, Xuemei; Wu, Meijing

2017-01-01

Background Glaucoma is a leading cause of irreversible blindness worldwide and the second most common cause of blindness after cataracts. The primary treatment for glaucoma aims to lower intraocular pressure (IOP) with the use of topical medicines. Topical medication instillation techniques, such as eyelid closure and nasolacrimal occlusion when instilling drops, have been proposed as potential methods to increase ocular absorption and decrease systemic absorption of the drops. Objectives To investigate the effectiveness of topical medication instillation techniques compared with usual care or another method of instillation of topical medication in the management of glaucoma or ocular hypertension. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 12), MEDLINE Ovid (1946 to 8 December 2016), Embase Ovid (1947 to 8 December 2016), PubMed (1948 to 8 December 2016), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 8 December 2016), International Pharmaceutical Abstracts Database (1970 to 8 December 2016), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) (last searched 13 May 2013), ClinicalTrials.gov (www.clinicaltrials.gov) (searched 8 December 2016) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en) (searched 8 December 2016). We did not use any date or language restrictions in the electronic searches for trials. Selection criteria We included randomized controlled trials which had compared any topical medication instillation technique with usual care or a different method of instillation of topical medication. Data collection and analysis Two review authors independently screened records from the searches for eligibility, assessed the risk of bias, and extracted data. We followed methods recommended by Cochrane. Main results We identified two trials

SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weir, V; Zhang, J

Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medicalmore » physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department.« less

Endoscopic Ultrasound-guided Specimen Collection and Evaluation Techniques Affect Diagnostic Accuracy.

PubMed

Bang, Ji Young; Navaneethan, Udayakumar; Hasan, Muhammad K; Hawes, Robert; Varadarajulu, Shyam

2018-03-11

Outcomes of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) evaluation vary with technique, needles, and methods of specimen evaluation. We performed a direct comparison of diagnostic yields of EUS-FNA samples collected using different gauge needles (22- vs 25-gauge), with or without suction. We performed a randomized controlled study of 352 patients with suspected pancreatic masses, referred for EUS-FNA at a tertiary referral center. Patients were randomly assigned to 22-gauge needles with or without suction or 25-gauge needles with or without suction. Specimens were evaluated offsite by cell block and rapid onsite cytologic evaluation (ROSE). Final diagnoses were made based on histologic analyses or 12-month follow-up evaluations. The primary outcome was diagnostic adequacy of cell blocks. Secondary outcomes were operating characteristics of ROSE and EUS-FNA, number of passes required for accurate onsite diagnosis, and amount of blood in specimens. The final diagnoses were malignancy (81.5% of patients) and benign disease (17.0% of patients); 1.4% of patients were lost during follow up. Cell block, ROSE, and EUS-FNA led to diagnostic accuracies of 71.9%, 95.5%, and 96.6%, respectively. A 22-gauge needle with suction was associated with more passes for adequate onsite diagnosis (P = .003) and specimens contained more blood (P = .01). Diagnostic accuracy of specimens collected by transduodenal EUS-FNA was lower with 22-gauge needles with suction compared to other techniques (P = .004). In a randomized trial of patients undergoing EUS-FNA for pancreatic masses, samples collected with 22-gauge vs 25-gauge needles performed equally well for offsite specimen evaluation. Use of suction appears to increase number of passes needed and specimen bloodiness. Specimen collection techniques should be individualized based on method of evaluation. ClinicalTrials.gov no: NCT02424838. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

Capillary waveguide optrodes: an approach to optical sensing in medical diagnostics

NASA Astrophysics Data System (ADS)

Lippitsch, Max E.; Draxler, Sonja; Kieslinger, Dietmar; Lehmann, Hartmut; Weigl, Bernhard H.

1996-07-01

Glass capillaries with a chemically sensitive coating on the inner surface are used as optical sensors for medical diagnostics. A capillary simultaneously serves as a sample compartment, a sensor element, and an inhomogeneous optical waveguide. Various detection schemes based on absorption, fluorescence intensity, or fluorescence lifetime are described. In absorption-based capillary waveguide optrodes the absorption in the sensor layer is analyte dependent; hence light transmission along the inhomogeneous waveguiding structure formed by the capillary wall and the sensing layer is a function of the analyte concentration. Similarly, in fluorescence-based capillary optrodes the fluorescence intensity or the fluorescence lifetime of an indicator dye fixed in the sensing layer is analyte dependent; thus the specific property of fluorescent light excited in the sensing layer and thereafter guided along the inhomogeneous waveguiding structure is a function of the analyte concentration. Both schemes are experimentally demonstrated, one with carbon dioxide as the analyte and the other one with oxygen. The device combines optical sensors with the standard glass capillaries usually applied to gather blood drops from fingertips, to yield a versatile diagnostic instrument, integrating the sample compartment, the optical sensor, and the light-collecting optics into a single piece. This ensures enhanced sensor performance as well as improved handling compared with other sensors. waveguide, blood gases, medical diagnostics.

Health Technology Assessment for Molecular Diagnostics: Practices, Challenges, and Recommendations from the Medical Devices and Diagnostics Special Interest Group.

PubMed

Garfield, Susan; Polisena, Julie; S Spinner, Daryl; Postulka, Anne; Y Lu, Christine; Tiwana, Simrandeep K; Faulkner, Eric; Poulios, Nick; Zah, Vladimir; Longacre, Michael

2016-01-01

Health technology assessments (HTAs) are increasingly used to inform coverage, access, and utilization of medical technologies including molecular diagnostics (MDx). Although MDx are used to screen patients and inform disease management and treatment decisions, there is no uniform approach to their evaluation by HTA organizations. The International Society for Pharmacoeconomics and Outcomes Research Devices and Diagnostics Special Interest Group reviewed diagnostic-specific HTA programs and identified elements representing common and best practices. MDx-specific HTA programs in Europe, Australia, and North America were characterized by methodology, evaluation framework, and impact. Published MDx HTAs were reviewed, and five representative case studies of test evaluations were developed: United Kingdom (National Institute for Health and Care Excellence's Diagnostics Assessment Programme, epidermal growth factor receptor tyrosine kinase mutation), United States (Palmetto's Molecular Diagnostic Services Program, OncotypeDx prostate cancer test), Germany (Institute for Quality and Efficiency in Healthcare, human papillomavirus testing), Australia (Medical Services Advisory Committee, anaplastic lymphoma kinase testing for non-small cell lung cancer), and Canada (Canadian Agency for Drugs and Technologies in Health, Rapid Response: Non-invasive Prenatal Testing). Overall, the few HTA programs that have MDx-specific methods do not provide clear parameters of acceptability related to clinical and analytic performance, clinical utility, and economic impact. The case studies highlight similarities and differences in evaluation approaches across HTAs in the performance metrics used (analytic and clinical validity, clinical utility), evidence requirements, and how value is measured. Not all HTAs are directly linked to reimbursement outcomes. To improve MDx HTAs, organizations should provide greater transparency, better communication and collaboration between industry and HTA

42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... in the 80000 series of the Current Procedural Terminology published by the American Medical... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

42 CFR 410.32 - Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Procedural Terminology published by the American Medical Association. (3) Levels of supervision. Except where... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.32 Diagnostic x-ray tests, diagnostic laboratory...

A diagnostic analysis of the VVP single-doppler retrieval technique

NASA Technical Reports Server (NTRS)

Boccippio, Dennis J.

1995-01-01

A diagnostic analysis of the VVP (volume velocity processing) retrieval method is presented, with emphasis on understanding the technique as a linear, multivariate regression. Similarities and differences to the velocity-azimuth display and extended velocity-azimuth display retrieval techniques are discussed, using this framework. Conventional regression diagnostics are then employed to quantitatively determine situations in which the VVP technique is likely to fail. An algorithm for preparation and analysis of a robust VVP retrieval is developed and applied to synthetic and actual datasets with high temporal and spatial resolution. A fundamental (but quantifiable) limitation to some forms of VVP analysis is inadequate sampling dispersion in the n space of the multivariate regression, manifest as a collinearity between the basis functions of some fitted parameters. Such collinearity may be present either in the definition of these basis functions or in their realization in a given sampling configuration. This nonorthogonality may cause numerical instability, variance inflation (decrease in robustness), and increased sensitivity to bias from neglected wind components. It is shown that these effects prevent the application of VVP to small azimuthal sectors of data. The behavior of the VVP regression is further diagnosed over a wide range of sampling constraints, and reasonable sector limits are established.

[The Offer of Medical-Diagnostic Self-Tests on German Language Websites: Results of a Systematic Internet Search].

PubMed

Kuecuekbalaban, P; Schmidt, S; Muehlan, H

2018-03-01

The aim of the current study was to provide an overview of medical-diagnostic self-tests which can be purchased without a medical prescription on German language websites. From September 2014 to March 2015, a systematic internet research was conducted with the following search terms: self-test, self-diagnosis, home test, home diagnosis, quick test, rapid test. 513 different self-tests for the diagnostics of 52 diverse diseases or health risks were identified, including chronic diseases (e. g. diabetes, chronic disease of the kidneys, liver, and lungs), sexually transmitted diseases (e. g. HIV, chlamydia, gonorrhea), infectious diseases (e. g. tuberculosis, malaria, Helicobacter pylori), allergies (e. g. house dust, cats, histamine) and cancer as well as tests for the diagnostics of 12 different psychotropic substances. These were sold by 90 companies in Germany and by other foreign companies. The number of medical-diagnostic self-tests which can be bought without a medical prescription on the Internet has increased enormously in the last 10 years. Further studies are needed for the identification of the determinants of the use of self-tests as well as the impact of the application on the experience and behavior of the user. © Georg Thieme Verlag KG Stuttgart · New York.

A preface on advances in diagnostics for infectious and parasitic diseases: detecting parasites of medical and veterinary importance.

PubMed

Stothard, J Russell; Adams, Emily

2014-12-01

There are many reasons why detection of parasites of medical and veterinary importance is vital and where novel diagnostic and surveillance tools are required. From a medical perspective alone, these originate from a desire for better clinical management and rational use of medications. Diagnosis can be at the individual-level, at close to patient settings in testing a clinical suspicion or at the community-level, perhaps in front of a computer screen, in classification of endemic areas and devising appropriate control interventions. Thus diagnostics for parasitic diseases has a broad remit as parasites are not only tied with their definitive hosts but also in some cases with their vectors/intermediate hosts. Application of current diagnostic tools and decision algorithms in sustaining control programmes, or in elimination settings, can be problematic and even ill-fitting. For example in resource-limited settings, are current diagnostic tools sufficiently robust for operational use at scale or are they confounded by on-the-ground realities; are the diagnostic algorithms underlying public health interventions always understood and well-received within communities which are targeted for control? Within this Special Issue (SI) covering a variety of diseases and diagnostic settings some answers are forthcoming. An important theme, however, throughout the SI is to acknowledge that cross-talk and continuous feedback between development and application of diagnostic tests is crucial if they are to be used effectively and appropriately.

Performance of Physical Examination Skills in Medical Students during Diagnostic Medicine Course in a University Hospital of Northwest China

PubMed Central

Li, Yan; Li, Na; Han, Qunying; He, Shuixiang; Bae, Ricard S.; Liu, Zhengwen; Lv, Yi; Shi, Bingyin

2014-01-01

This study was conducted to evaluate the performance of physical examination (PE) skills during our diagnostic medicine course and analyze the characteristics of the data collected to provide information for practical guidance to improve the quality of teaching. Seventy-two fourth-year medical students were enrolled in the study. All received an assessment of PE skills after receiving a 17-week formal training course and systematic teaching. Their performance was evaluated and recorded in detail using a checklist, which included 5 aspects of PE skills: examination techniques, communication and care skills, content items, appropriateness of examination sequence, and time taken. Error frequency and type were designated as the assessment parameters in the survey. The results showed that the distribution and the percentage in examination errors between male and female students and among the different body parts examined were significantly different (p<0.001). The average error frequency per student in females (0.875) was lower than in males (1.375) although the difference was not statistically significant (p = 0.167). The average error frequency per student in cardiac (1.267) and pulmonary (1.389) examinations was higher than in abdominal (0.867) and head, neck and nervous system examinations (0.917). Female students had a lower average error frequency than males in cardiac examinations (p = 0.041). Additionally, error in examination techniques was the highest type of error among the 5 aspects of PE skills irrespective of participant gender and assessment content (p<0.001). These data suggest that PE skills in cardiac and pulmonary examinations and examination techniques may be included in the main focus of improving the teaching of diagnostics in these medical students. PMID:25329685

Improved Signal Processing Technique Leads to More Robust Self Diagnostic Accelerometer System

NASA Technical Reports Server (NTRS)

Tokars, Roger; Lekki, John; Jaros, Dave; Riggs, Terrence; Evans, Kenneth P.

2010-01-01

The self diagnostic accelerometer (SDA) is a sensor system designed to actively monitor the health of an accelerometer. In this case an accelerometer is considered healthy if it can be determined that it is operating correctly and its measurements may be relied upon. The SDA system accomplishes this by actively monitoring the accelerometer for a variety of failure conditions including accelerometer structural damage, an electrical open circuit, and most importantly accelerometer detachment. In recent testing of the SDA system in emulated engine operating conditions it has been found that a more robust signal processing technique was necessary. An improved accelerometer diagnostic technique and test results of the SDA system utilizing this technique are presented here. Furthermore, the real time, autonomous capability of the SDA system to concurrently compensate for effects from real operating conditions such as temperature changes and mechanical noise, while monitoring the condition of the accelerometer health and attachment, will be demonstrated.

Diagnostic Machine Learning Models for Acute Abdominal Pain: Towards an e-Learning Tool for Medical Students.

PubMed

Khumrin, Piyapong; Ryan, Anna; Judd, Terry; Verspoor, Karin

2017-01-01

Computer-aided learning systems (e-learning systems) can help medical students gain more experience with diagnostic reasoning and decision making. Within this context, providing feedback that matches students' needs (i.e. personalised feedback) is both critical and challenging. In this paper, we describe the development of a machine learning model to support medical students' diagnostic decisions. Machine learning models were trained on 208 clinical cases presenting with abdominal pain, to predict five diagnoses. We assessed which of these models are likely to be most effective for use in an e-learning tool that allows students to interact with a virtual patient. The broader goal is to utilise these models to generate personalised feedback based on the specific patient information requested by students and their active diagnostic hypotheses.

Tapping into the wisdom in the room: results from participant discussion at the 7th International Conference on Diagnostic Error in Medicine facilitated by a World Café technique.

PubMed

Cosby, Karen S; Zipperer, Lorri; Balik, Barbara

2015-09-01

The patient safety literature is full of exhortations to approach medical error from a system perspective and seek multidisciplinary solutions from groups including clinicians, patients themselves, as well as experts outside the traditional medical domain. The 7th annual International Conference on Diagnostic Error in Medicine sought to attract a multispecialty audience, and attempted to capture some of the conversations by engaging participants in a World Café, a technique used to stimulate discussion and preserve insight gained during the conference. We present the ideas generated in this session, discuss them in the context of psychological safety, and demonstrate the application of this novel technique.

Source Book of Educational Materials for Diagnostic Medical Ultrasound. Radiological Health Series.

ERIC Educational Resources Information Center

Pijar, Mary Lou, Comp; And Others

This report is a compilation of educational materials that are available in the field of diagnostic medical ultrasound. Materials, which include publications, audiovisual aids, and teaching aids, are listed under the following categories: abdominal imaging; anatomy and physiology; anatomy and embryology; bioeffects; cardiology and vasculature;…

An accurate automated technique for quasi-optics measurement of the microwave diagnostics for fusion plasma

NASA Astrophysics Data System (ADS)

Hu, Jianqiang; Liu, Ahdi; Zhou, Chu; Zhang, Xiaohui; Wang, Mingyuan; Zhang, Jin; Feng, Xi; Li, Hong; Xie, Jinlin; Liu, Wandong; Yu, Changxuan

2017-08-01

A new integrated technique for fast and accurate measurement of the quasi-optics, especially for the microwave/millimeter wave diagnostic systems of fusion plasma, has been developed. Using the LabVIEW-based comprehensive scanning system, we can realize not only automatic but also fast and accurate measurement, which will help to eliminate the effects of temperature drift and standing wave/multi-reflection. With the Matlab-based asymmetric two-dimensional Gaussian fitting method, all the desired parameters of the microwave beam can be obtained. This technique can be used in the design and testing of microwave diagnostic systems such as reflectometers and the electron cyclotron emission imaging diagnostic systems of the Experimental Advanced Superconducting Tokamak.

How 3D immersive visualization is changing medical diagnostics

NASA Astrophysics Data System (ADS)

Koning, Anton H. J.

2011-03-01

Originally the only way to look inside the human body without opening it up was by means of two dimensional (2D) images obtained using X-ray equipment. The fact that human anatomy is inherently three dimensional leads to ambiguities in interpretation and problems of occlusion. Three dimensional (3D) imaging modalities such as CT, MRI and 3D ultrasound remove these drawbacks and are now part of routine medical care. While most hospitals 'have gone digital', meaning that the images are no longer printed on film, they are still being viewed on 2D screens. However, this way valuable depth information is lost, and some interactions become unnecessarily complex or even unfeasible. Using a virtual reality (VR) system to present volumetric data means that depth information is presented to the viewer and 3D interaction is made possible. At the Erasmus MC we have developed V-Scope, an immersive volume visualization system for visualizing a variety of (bio-)medical volumetric datasets, ranging from 3D ultrasound, via CT and MRI, to confocal microscopy, OPT and 3D electron-microscopy data. In this talk we will address the advantages of such a system for both medical diagnostics as well as for (bio)medical research.

A comparison of the millon behavioral medical diagnostic and millon behavioral health inventory with medical populations.

PubMed

Wise, Edward A; Streiner, David L

2010-12-01

There is a lack of normative data on broadband omnibus types of personality tests with medical populations. In fact, the only two tests normed on medical populations are the Millon Behavioral Medicine Diagnostic (MBMD) and the Millon Behavioral Health Inventory (MBHI). The internal consistency, test-retest reliabilities, and validity studies of these instruments are reviewed and compared in an effort to aid clinicians in discerning their relative psychometric strengths and weaknesses. Due to the lack of validity studies with the MBMD and the fact that reliability limits the ceiling of validity coefficients, the MBMD has yet to meet the challenges it was designed to meet. Implications for practice are addressed. © 2010 Wiley Periodicals, Inc.

A traditionally administered short course failed to improve medical students' diagnostic performance. A quantitative evaluation of diagnostic thinking.

PubMed

Noguchi, Yoshinori; Matsui, Kunihiko; Imura, Hiroshi; Kiyota, Masatomo; Fukui, Tsuguya

2004-05-01

Quite often medical students or novice residents have difficulty in ruling out diseases even though they are quite unlikely and, due to this difficulty, such students and novice residents unnecessarily repeat laboratory or imaging tests. To explore whether or not a carefully designed short training course teaching Bayesian probabilistic thinking improves the diagnostic ability of medical students. Ninety students at 2 medical schools were presented with clinical scenarios of coronary artery disease corresponding to high, low, and intermediate pretest probabilities. The students' estimates of test characteristics of exercise stress test, and pretest and posttest probability for each scenario were evaluated before and after the short course. The pretest probability estimates by the students, as well as their proficiency in applying Bayes's theorem, were improved in the high pretest probability scenario after the short course. However, estimates of pretest probability in the low pretest probability scenario, and their proficiency in applying Bayes's theorem in the intermediate and low pretest probability scenarios, showed essentially no improvement. A carefully designed, but traditionally administered, short course could not improve the students' abilities in estimating pretest probability in a low pretest probability setting, and subsequently students remained incompetent in ruling out disease. We need to develop educational methods that cultivate a well-balanced clinical sense to enable students to choose a suitable diagnostic strategy as needed in a clinical setting without being one-sided to the "rule-in conscious paradigm."

Do Anesthetic Techniques Influence the Threshold for Glomerular Capillary Hemorrhage Induced in Rats by Contrast-Enhanced Diagnostic Ultrasound?

PubMed

Miller, Douglas L; Lu, Xiaofang; Fabiilli, Mario; Dou, Chunyan

2016-02-01

Glomerular capillary hemorrhage can be induced by ultrasonic cavitation during contrast-enhanced diagnostic ultrasound (US) exposure, an important nonthermal US bioeffect. Recent studies of pulmonary US exposure have shown that thresholds for another nonthermal bioeffect of US, pulmonary capillary hemorrhage, is strongly influenced by whether xylazine is included in the specific anesthetic technique. The objective of this study was to determine the influence of xylazine on contrast-enhanced diagnostic US-induced glomerular capillary hemorrhage. In this study, anesthesia with ketamine only was compared to ketamine plus xylazine for induction of glomerular capillary hemorrhage in rats by 1.6-MHz intermittent diagnostic US with a microsphere contrast agent (similar to Definity; Lantheus Medical Imaging, Inc, North Billerica, MA). Glomerular capillary hemorrhage was measured as a percentage of glomeruli with hemorrhage found in histologic sections for groups of rats scanned at different peak rarefactional pressure amplitudes. There was a significant difference between the magnitude of the glomerular capillary hemorrhage between the anesthetics at 2.3 MPa, with 45.6% hemorrhage for ketamine only, increasing to 63.2% hemorrhage for ketamine plus xylazine (P < .001). However, the thresholds for the two anesthetic methods were virtually identical at 1.0 MPa, based on linear regression of the exposure response data. Thresholds for contrast-enhanced diagnostic US-induced injury of the microvasculature appear to be minimally affected by anesthetic methods. © 2016 by the American Institute of Ultrasound in Medicine.

Photoionization sensors for non-invasive medical diagnostics

NASA Astrophysics Data System (ADS)

Mustafaev, Aleksandr; Rastvorova, Iuliia; Khobnya, Kristina; Podenko, Sofia

2016-09-01

The analysis of biomarkers can help to identify the significant number of diseases: lung cancer, tuberculosis, diabetes, high levels of stress, psychosomatic disorders etc. To implement continuous monitoring of the state of human health, compact VUV photoionization detector with current-voltage measurement is designed by Saint-Petersburg Mining University Plasma Research Group. This sensor is based on the patented method of stabilization of electric parameters - CES (Collisional Electron Spectroscopy). During the operation at atmospheric pressure VUV photoionization sensor measures the energy of electrons, produced in the ionization with the resonance photons, whose wavelength situated in the vacuum ultraviolet (VUV). A special software was developed to obtain the second-order derivative of the I-U characteristics, taken by the VUV sensor, to construct the energy spectra of the characteristic electrons. VUV photoionization detector has an unique set of parameters: small size (10*10*1 mm), low cost, wide range of recognizable molecules, as well as accuracy, sufficient for using this instrument for the medical purposes. This device can be used for non-invasive medical diagnostics without compromising the quality of life, for control of environment and human life. Work supported by Foundation for Assistance to Small Innovative Enterprises in Science and Technology.

Ultrasound Metrology in Mexico: a round robin test for medical diagnostics

NASA Astrophysics Data System (ADS)

Amezola Luna, R.; López Sánchez, A. L.; Elías Juárez, A. A.

2011-02-01

This paper presents preliminary statistical results from an on-going imaging medical ultrasound study, of particular relevance for gynecology and obstetrics areas. Its scope is twofold, firstly to compile the medical ultrasound infrastructure available in cities of Queretaro-Mexico, and second to promote the use of traceable measurement standards as a key aspect to assure quality of ultrasound examinations performed by medical specialists. The experimental methodology is based on a round robin test using an ultrasound phantom for medical imaging. The physician, using its own ultrasound machine, couplant and facilities, measures the size and depth of a set of pre-defined reflecting and absorbing targets of the reference phantom, which simulate human illnesses. Measurements performed give the medical specialist an objective feedback regarding some performance characteristics of their ultrasound examination systems, such as measurement system accuracy, dead zone, axial resolution, depth of penetration and anechoic targets detection. By the end of March 2010, 66 entities with medical ultrasound facilities, from both public and private institutions, have performed measurements. A network of medical ultrasound calibration laboratories in Mexico, with traceability to The International System of Units via national measurement standards, may indeed contribute to reduce measurement deviations and thus attain better diagnostics.

Examining Shifts in Medical Students' Microanalytic Motivation Beliefs and Regulatory Processes during a Diagnostic Reasoning Task

ERIC Educational Resources Information Center

Cleary, Timothy J.; Dong, Ting; Artino, Anthony R., Jr.

2015-01-01

This study examined within-group shifts in the motivation beliefs and regulatory processes of second-year medical students as they engaged in a diagnostic reasoning activity. Using a contextualized assessment methodology called self-regulated learning microanalysis, the authors found that the 71 medical student participants showed statistically…

Medical thoracoscopy: a useful diagnostic tool for undiagnosed pleural effusion.

PubMed

Agarwal, Abhishek; Prasad, Rajendra; Garg, Rajiv; Verma, S K; Singh, Abhijeet; Husain, N

2014-01-01

We aimed to assess the role of medical thoracoscopy in patients with undiagnosed pleural effusion. Patiens presenting with pleural effusion underwent three pleural aspirations. Patients in whom pleural fluid analysis was inconclusive underwent closed pleural biopsy for diagnostic confirmation. Patients in whom closed pleural biopsy was incolcusive underwent medical thoracoscopy using a rigid thoracoscope with a viewing angle of zero degrees was done under local anaesthesia and sedation with the patient lying in lateral decubitus position with the affected side up. Biopsy specimens from parietal pleura were obtained under direct vision and were sent for histopathological examination. Of the 128 patients with pleural effusion who were studied, pleural fluid examination established the diagnosis in 81 (malignancy 33, tuberculosis 33, pyogenic 14 and fungal 1); 47 patients underwent closed pleural biopsy and a diagnosis was made in 28 patients (malignancy 24, tuberculosis 4). The remaining 19 patients underwent medical thoracoscopy and pleural biopsy and the aetiological diagnosis could be confirmed in 13 of the 19 patients (69%) (adenocarcinoma 10, poorly differentiated carcinoma 2 and mesothelioma 1). Medical thoracoscopy is a useful tool for the diagnosis of pleural diseases. The procedure is safe with minimal complications.

An evaluation of children's metered-dose inhaler technique for asthma medications.

PubMed

Burkhart, Patricia V; Rayens, Mary Kay; Bowman, Roxanne K

2005-03-01

Regardless of the medication delivery system, health care providers need to teach accurate medication administration techniques to their patients, educate them about the particular nuances of the prescribed delivery system (eg, proper storage), and reinforce these issues at each health encounter. A single instruction session is not sufficient to maintain appropriate inhaler techniques for patients who require continued use. Providing written steps for the administration technique is helpful so that the patient can refer to them later when using the medication. The National Heart, Lung, and Blood Institute's "Practical Guide for the Diagnosis and Management of Asthma" recommends that practitioners follow these steps for effective inhaler technique training when first prescribing an inhaler: 1. Teach patients the steps and give written instruction handouts. 2. Demonstrate how to use the inhaler step-by-step. 3. Ask patients to demonstrate how to use the inhaler. Let the patient refer to the handout on the first training. Then use the handout asa checklist to assess the patient's future technique. 4. Provide feedback to patients about what they did right and what they need to improve. Have patients demonstrate their technique again, if necessary. The last two steps should be performed (ie, demonstration and providing feedback on what patients did right and what they need to improve) at every subsequent visit. If the patient makes multiple errors, it is advisable to focus on improving one or two key steps at a time. With improvements in drug delivery come challenges, necessitating that practitioners stay current with new medication administration techniques. Teaching and reinforcing accurate technique at each health care encounter are critical to help ensure medication efficacy for patients with asthma. Since one fifth of children in the study performed incorrect medication technique even after education, checklists of steps for the correct use of inhalation devices

Photoacoustic sensor for medical diagnostics

NASA Astrophysics Data System (ADS)

Wolff, Marcus; Groninga, Hinrich G.; Harde, Hermann

2004-03-01

The development of new optical sensor technologies has a major impact on the progress of diagnostic methods. Of the permanently increasing number of non-invasive breath tests, the 13C-Urea Breath Test (UBT) for the detection of Helicobacter pylori is the most prominent. However, many recent developments, like the detection of cancer by breath test, go beyond gastroenterological applications. We present a new detection scheme for breath analysis that employs an especially compact and simple set-up. Photoacoustic Spectroscopy (PAS) represents an offset-free technique that allows for short absorption paths and small sample cells. Using a single-frequency diode laser and taking advantage of acoustical resonances of the sample cell, we performed extremely sensitive and selective measurements. The smart data processing method contributes to the extraordinary sensitivity and selectivity as well. Also, the reasonable acquisition cost and low operational cost make this detection scheme attractive for many biomedical applications. The experimental set-up and data processing method, together with exemplary isotope-selective measurements on carbon dioxide, are presented.

The LeRC rail accelerators: Test designs and diagnostic techniques

NASA Technical Reports Server (NTRS)

Zana, L. M.; Kerslake, W. R.; Sturman, J. C.; Wang, S. Y.; Terdan, F. F.

1983-01-01

The feasibility of using rail accelerators for various in-space and to-space propulsion applications was investigated. A 1 meter, 24 sq mm bore accelerator was designed with the goal of demonstrating projectile velocities of 15 km/sec using a peak current of 200 kA. A second rail accelerator, 1 meter long with a 156.25 sq mm bore, was designed with clear polycarbonate sidewalls to permit visual observation of the plasma arc. A study of available diagnostic techniques and their application to the rail accelerator is presented. Specific topics of discussion include the use of interferometry and spectroscopy to examine the plasma armature as well as the use of optical sensors to measure rail displacement during acceleration. Standard diagnostics such as current and voltage measurements are also discussed.

Infrared Imaging Tools for Diagnostic Applications in Dermatology.

PubMed

Gurjarpadhye, Abhijit Achyut; Parekh, Mansi Bharat; Dubnika, Arita; Rajadas, Jayakumar; Inayathullah, Mohammed

Infrared (IR) imaging is a collection of non-invasive imaging techniques that utilize the IR domain of the electromagnetic spectrum for tissue assessment. A subset of these techniques construct images using back-reflected light, while other techniques rely on detection of IR radiation emitted by the tissue as a result of its temperature. Modern IR detectors sense thermal emissions and produce a heat map of surface temperature distribution in tissues. Thus, the IR spectrum offers a variety of imaging applications particularly useful in clinical diagnostic area, ranging from high-resolution, depth-resolved visualization of tissue to temperature variation assessment. These techniques have been helpful in the diagnosis of many medical conditions including skin/breast cancer, arthritis, allergy, burns, and others. In this review, we discuss current roles of IR-imaging techniques for diagnostic applications in dermatology with an emphasis on skin cancer, allergies, blisters, burns and wounds.

Medical Products Research

NASA Technical Reports Server (NTRS)

1982-01-01

Ventrex Laboratories, Inc. develops, manufactures and markets a line of medical diagnostic assays based on biochemical techniques, in particular immunochemical techniques. Their products are sold worldwide to hospitals and medical laboratories for use in testing blood samples and other biological fluids. Analysis of a patient's body fluids, compared with normal values, aids a physician in confirming or otherwise diagnosing a suspected disease condition. NERAC's rapid information retrieval has provided Ventrex invaluable up-to-date information, and has permitted large scale savings. NERAC's service was particularly important in the development of a new product in the company's Ventre/Sep line, which is used in radioimmunoassays.

DXplain: a Web-based diagnostic decision support system for medical students.

PubMed

London, S

1998-01-01

DXplain is a diagnostic decision support program, with a new World Wide Web interface, designed to help medical students and physicians formulate differential diagnoses based on clinical findings. It covers over 2000 diseases and 5000 clinical manifestations. DXplain suggests possible diagnoses, and provides brief descriptions of every disease in the database. Not all diseases are included, nor does DXplain take into account preexisting conditions or the chronological sequence of clinical manifestations. Despite these limitations, it is a useful educational tool, particularly for problem-based learning (PBL) cases and for students in clinical rotations, as it fills a niche not adequately covered by MEDLINE or medical texts. The system is relatively self-explanatory, requiring little or no end-user training. Medical libraries offering, or planning to offer, their users access to Web-based materials and resources may find this system a valuable addition to their electronic collections. Should it prove popular with the local users, provision of access may also establish or enhance the library's image as a partner in medical education.

Electromagnetic Nanoparticles for Sensing and Medical Diagnostic Applications

PubMed Central

Vegni, Lucio

2018-01-01

A modeling and design approach is proposed for nanoparticle-based electromagnetic devices. First, the structure properties were analytically studied using Maxwell’s equations. The method provides us a robust link between nanoparticles electromagnetic response (amplitude and phase) and their geometrical characteristics (shape, geometry, and dimensions). Secondly, new designs based on “metamaterial” concept are proposed, demonstrating great performances in terms of wide-angle range functionality and multi/wide behavior, compared to conventional devices working at the same frequencies. The approach offers potential applications to build-up new advanced platforms for sensing and medical diagnostics. Therefore, in the final part of the article, some practical examples are reported such as cancer detection, water content measurements, chemical analysis, glucose concentration measurements and blood diseases monitoring. PMID:29652853

Photonic Diagnostic Technique For Thin Photoactive Films

NASA Technical Reports Server (NTRS)

Thakoor, Sarita

1996-01-01

Photonic diagnostic technique developed for use in noninvasive, rapid evaluation of thin paraelectric/ferroelectric films. Method proves useful in basic research, on-line monitoring for quality control at any stage of fabrication, and development of novel optoelectronic systems. Used to predict imprint-prone memory cells, and to study time evolution of defects in ferroelectric memories during processing. Plays vital role in enabling high-density ferroelectric memory manufacturing. One potential application lies in use of photoresponse for nondestructive readout of polarization memory states in high-density, high-speed memory devices. In another application, extension of basic concept of method makes possible to develop specially tailored ferrocapacitor to act as programmable detector, wherein remanent polarization used to modulate photoresponse. Large arrays of such detectors useful in optoelectronic processing, computing, and communication.

Oral Hygiene Practices and Teeth Cleaning Techniques Among Medical Students

PubMed Central

Fatima, Syeda H; Ghazanfar, Haider; Haq, Sana; Khan, Najeeb A; Mehmood, Moeez; Ghazanfar, Ali

2017-01-01

Objectives Oral health is essential for general health and quality of life. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infections and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity to bite, chew, smile, and speak; it affects psychosocial well-being too. The objective of our study was to assess teeth cleaning techniques and oral hygiene practices among medical students. Methods The data of the study were collected in two stages. The first stage involved the administration of a self-constructed questionnaire among medical students. In the second step, the students were asked to demonstrate their teeth cleaning techniques on a model. A standard teeth cleaning checklist was used to evaluate the students. The students were then given the checklist and a video on teeth cleaning techniques was shown to them. The data obtained was analyzed on IBM's statistical package for the social sciences (SPSS) version 21.  Results Out of a total of 444 students, 256 (57.7 percent) were males while 188 (42.3 percent) were females. About 254 (57.2 percent) participants were preclinical medical students while 190 (42.8 percent) were clinical year medical students. A majority of medical students used medium consistency toothbrushes (177; 39.9 percent) and soft consistency toothbrushes (137; 30.9 percent). Most medical students (248; 55.9 percent) brushed two times a day while 163 (36.7 percent) brushed only one time. About 212 (47.7 percent) of the medical students used mouthwash along with a toothbrush while only 36 (8.1 percent) used floss along with a toothbrush. About 157 participants (35.4 percent) changed their toothbrush once in two months while 132 (26.7 percent) changed their toothbrush once in three months. The mean duration that participants brushed their teeth was 134.99 ± 69.01 seconds. Conclusion Medical students were found to have a faulty teeth

Comparing Noun Phrasing Techniques for Use with Medical Digital Library Tools.

ERIC Educational Resources Information Center

Tolle, Kristin M.; Chen, Hsinchun

2000-01-01

Describes a study that investigated the use of a natural language processing technique called noun phrasing to determine whether it is a viable technique for medical information retrieval. Evaluates four noun phrase generation tools for their ability to isolate noun phrases from medical journal abstracts, focusing on precision and recall.…

The Role of the Medical Physicist in Radiation Protection in Hospitals.

ERIC Educational Resources Information Center

Harrison, R. M.

1989-01-01

Described is the role of the medical physicist in five areas of medical application, including radiotherapy, nuclear medicine, diagnostic radiology, environmental radioactivity, and dosimetry and personal monitoring. The management contribution of the medical physicist is discussed. Provided are two examples of new techniques influencing radiation…

The US Navy’s Helicopter Integrated Diagnostics System (HIDS) Program: Power Drive Train Crack Detection Diagnostics and Prognostics Life Usage Monitoring and Damage Tolerance; Techniques, Methodologies, and Experiences

DTIC Science & Technology

2000-02-01

HIDS] Program: Power Drive Train Crack Detection Diagnostics and Prognostics ife Usage Monitoring and Damage Tolerance; Techniques, Methodologies, and...and Prognostics , Life Usage Monitoring , and Damage Tolerance; Techniques, Methodologies, and Experiences Andrew Hess Harrison Chin William Hardman...continuing program and deployed engine monitoring systems in fixed to evaluate helicopter diagnostic, prognostic , and wing aircraft, notably on the A

Behavior Change Techniques in Apps for Medication Adherence: A Content Analysis.

PubMed

Morrissey, Eimear C; Corbett, Teresa K; Walsh, Jane C; Molloy, Gerard J

2016-05-01

There are a vast number of smartphone applications (apps) aimed at promoting medication adherence on the market; however, the theory and evidence base in terms of applying established health behavior change techniques underpinning these apps remains unclear. This study aimed to code these apps using the Behavior Change Technique Taxonomy (v1) for the presence or absence of established behavior change techniques. The sample of apps was identified through systematic searches in both the Google Play Store and Apple App Store in February 2015. All apps that fell into the search categories were downloaded for analysis. The downloaded apps were screened with exclusion criteria, and suitable apps were reviewed and coded for behavior change techniques in March 2015. Two researchers performed coding independently. In total, 166 medication adherence apps were identified and coded. The number of behavior change techniques contained in an app ranged from zero to seven (mean=2.77). A total of 12 of a possible 96 behavior change techniques were found to be present across apps. The most commonly included behavior change techniques were "action planning" and "prompt/cues," which were included in 96% of apps, followed by "self-monitoring" (37%) and "feedback on behavior" (36%). The current extent to which established behavior change techniques are used in medication adherence apps is limited. The development of medication adherence apps may not have benefited from advances in the theory and practice of health behavior change. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Imaging techniques used in the diagnostic workup of acute venous thromboembolic disease.

PubMed

Tilve-Gómez, A; Rodríguez-Fernández, P; Trillo-Fandiño, L; Plasencia-Martínez, J M

Early diagnosis is one of the most important factors affecting the prognosis of pulmonary embolism (PE); however, the clinical presentation of PE is often very unspecific and it can simulate other diseases. For these reasons, imaging tests, especially computed tomography angiography (CTA) of the pulmonary arteries, have become the keystone in the diagnostic workup of PE. The wide availability and high diagnostic performance of pulmonary CTA has led to an increase in the number of examinations done and a consequent increase in the population's exposure to radiation and iodinated contrast material. Thus, other techniques such as scintigraphy and venous ultrasonography of the lower limbs, although less accurate, continue to be used in certain circumstances, and optimized protocols have been developed for CTA to reduce the dose of radiation (by decreasing the kilovoltage) and the dose of contrast agents. We describe the technical characteristics and interpretation of the findings for each imaging technique used to diagnose PE and discuss their advantages and limitations; this knowledge will help the best technique to be chosen for each case. Finally, we comment on some data about the increased use of CTA, its clinical repercussions, its "overuse", and doubts about its cost-effectiveness. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Pleural tuberculosis: medical thoracoscopy greatly increases the diagnostic accuracy

PubMed Central

Mori, Pier Anselmo; Majori, Maria; Anghinolfi, Miriam; Silini, Enrico Maria; Gnetti, Letizia; Motta, Federica; Larini, Sandra; Montecchini, Sara; Pisi, Roberta; Calderaro, Adriana

2018-01-01

Our objective was to evaluate the efficacy of a standardised work-up in the diagnosis of pleural tuberculosis (TB) that included fibreoptic bronchoscopy and medical thoracoscopy. A consecutive series of 52 pleural TB patients observed during the period 2001–2015 was evaluated retrospectively. 20 females, mean (range) age 39.7 (18–74) years, and 32 males, mean (range) age 45.75 (21–83) years, were included (28 non-EU citizens (53.8%)). The diagnosis of TB infections was established by identification (using stains, culture or molecular tests) of Mycobacterium tuberculosis in the pleura, sputum and/or bronchial specimens, or by evidence of caseous granulomas on pleural biopsies. Patients with and without lung lesions were considered separately. The diagnostic yield of the microbiological tests on pleural fluid was 17.3% (nine out of 52 patients). Among the 18 patients with lung lesions, bronchial samples (washing, lavage or biopsy) were positive in 50% of cases (nine patients). Cultures of pleural biopsies were positive in 63% of cases (29 out of 46 patients); pleural histology was relevant in all patients. Without pleural biopsy, a diagnosis would have been reached in 15 out of 52 patients (28.6%) and in four of them only following culture at 30–40 days. An integrated diagnostic work-up that includes all the diagnostic methods of interventional pulmonology is required for a diagnosis of pleural TB. In the majority of patients, a diagnosis can be reached only with pleural biopsy. PMID:29318136

On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians.

PubMed

Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir

2013-01-01

We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

From a genetic innovation to mass health programmes: the diffusion of Down's Syndrome prenatal screening and diagnostic techniques in France.

PubMed

Vassy, Carine

2006-10-01

Down's Syndrome prenatal diagnostic and screening techniques have spread widely in France over the last 30 years and are now part of the routine clinical practice of prenatal care. These techniques, which originated in the field of genetics, ultrasonography and biochemistry, were the first to provide the possibility of choosing the features of the foetus, or at least to reject some of its characteristics. They lead to new norms of healthy foetuses and a progressive acceptance of medical abortions. The aim of this paper is to understand how the use of these tests has been generalised in France despite scientific controversies about their risks and ethical questioning about a potential renewal of eugenics. It analyses the representations of public needs that have been articulated by key players in the scientific and medical fields. This research explores political and administrative decision making processes to understand how progressively widening public access to prenatal testing has been organised and funded. The results highlight the scientific and political role of biomedical researchers, the forms of involvement of health authorities and politicians, and the passive participation of the vast majority of the users. The paper also examines the characteristics of the French health system that facilitated the generalised use of the technology.

Towards intelligent diagnostic system employing integration of mathematical and engineering model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Isa, Nor Ashidi Mat

as well as mathematical model of clustering technique have been widely used in developing the medical diagnostic systems. The selected features will be classified using mathematical models that embedded engineering theory such as artificial intelligence, support vector machine, neural network and fuzzy-neuro system. These classifiers will provide the diagnostic results without human intervention. Among many publishable researches, several prototypes have been developed namely NeuralPap, Neural Mammo, and Cervix Kit. The former system (NeuralPap) is an automatic intelligent diagnostic system for classifying and distinguishing between the normal and cervical cancerous cells. Meanwhile, the Cervix Kit is a portable Field-programmable gate array (FPGA)-based cervical diagnostic kit that could automatically diagnose the cancerous cell based on the images obtained during sampling test. Besides the cervical diagnostic system, the Neural Mammo system is developed to specifically aid the diagnosis of breast cancer using a fine needle aspiration image.« less

Towards intelligent diagnostic system employing integration of mathematical and engineering model

NASA Astrophysics Data System (ADS)

Isa, Nor Ashidi Mat

2015-05-01

as mathematical model of clustering technique have been widely used in developing the medical diagnostic systems. The selected features will be classified using mathematical models that embedded engineering theory such as artificial intelligence, support vector machine, neural network and fuzzy-neuro system. These classifiers will provide the diagnostic results without human intervention. Among many publishable researches, several prototypes have been developed namely NeuralPap, Neural Mammo, and Cervix Kit. The former system (NeuralPap) is an automatic intelligent diagnostic system for classifying and distinguishing between the normal and cervical cancerous cells. Meanwhile, the Cervix Kit is a portable Field-programmable gate array (FPGA)-based cervical diagnostic kit that could automatically diagnose the cancerous cell based on the images obtained during sampling test. Besides the cervical diagnostic system, the Neural Mammo system is developed to specifically aid the diagnosis of breast cancer using a fine needle aspiration image.

Cognitive balanced model: a conceptual scheme of diagnostic decision making.

PubMed

Lucchiari, Claudio; Pravettoni, Gabriella

2012-02-01

Diagnostic reasoning is a critical aspect of clinical performance, having a high impact on quality and safety of care. Although diagnosis is fundamental in medicine, we still have a poor understanding of the factors that determine its course. According to traditional understanding, all information used in diagnostic reasoning is objective and logically driven. However, these conditions are not always met. Although we would be less likely to make an inaccurate diagnosis when following rational decision making, as described by normative models, the real diagnostic process works in a different way. Recent work has described the major cognitive biases in medicine as well as a number of strategies for reducing them, collectively called debiasing techniques. However, advances have encountered obstacles in achieving implementation into clinical practice. While traditional understanding of clinical reasoning has failed to consider contextual factors, most debiasing techniques seem to fail in raising sound and safer medical praxis. Technological solutions, being data driven, are fundamental in increasing care safety, but they need to consider human factors. Thus, balanced models, cognitive driven and technology based, are needed in day-to-day applications to actually improve the diagnostic process. The purpose of this article, then, is to provide insight into cognitive influences that have resulted in wrong, delayed or missed diagnosis. Using a cognitive approach, we describe the basis of medical error, with particular emphasis on diagnostic error. We then propose a conceptual scheme of the diagnostic process by the use of fuzzy cognitive maps. © 2011 Blackwell Publishing Ltd.

Two-layer Lab-on-a-chip (LOC) with passive capillary valves for mHealth medical diagnostics.

PubMed

Balsam, Joshua; Bruck, Hugh Alan; Rasooly, Avraham

2015-01-01

There is a new potential to address needs for medical diagnostics in Point-of-Care (PoC) applications using mHealth (Mobile computing, medical sensors, and communications technologies for health care), a mHealth based lab test will require a LOC to perform clinical analysis. In this work, we describe the design of a simple Lab-on-a-chip (LOC) platform for mHealth medical diagnostics. The LOC utilizes a passive capillary valve with no moving parts for fluid control using channels with very low aspect ratios cross sections (i.e., channel width ≫ height) achieved through transitions in the channel geometry via that arrest capillary flow. Using a CO2 laser in raster engraving mode, we have designed and fabricated an eight-channel LOC for fluorescence signal detection fabricated by engraving and combining just two polymer layers. Each of the LOC channels is capable of mixing two reagents (e.g., enzyme and substrate) for various assays. For mHealth detection, we used a mobile CCD detector equipped with LED multispectral illumination in the red, green, blue, and white range. This technology enables the development of low-cost LOC platforms for mHealth whose fabrication is compatible with standard industrial plastic fabrication processes to enable mass production of mHealth diagnostic devices, which may broaden the use of LOCs in PoC applications, especially in global health settings.

Diagnostic Emplotment in Q'eqchi' Maya Medicine.

PubMed

Hatala, Andrew R; Waldram, James B

2017-04-01

Medical diagnosis is a process of illness discrimination, categorization, and identification on the basis of careful observation and is central in biomedicine and many traditional medical systems around the world. Through a detailed analysis of several illness episodes and healer interviews among Maya communities in southern Belize, we observe that the diagnostic processes of traditional Q'eqchi' healers reflect patterns of narrative 'emplotment' that engage not simply the individual patient but also significant spiritual and cosmological forces. Three diagnostic techniques of the Q'eqchi' Maya healers are described and their connections to Maya concepts of personhood and cosmovision are presented. This research fosters an appreciation of how Indigenous knowledge systems shape clinical encounters and healing dramas, widening the spheres of clinical narrative co-construction and dialogue beyond the material and physical contexts implicit within Western clinical encounters.

Surveying Fourth-Year Medical Students Regarding the Choice of Diagnostic Radiology as a Specialty.

PubMed

Arleo, Elizabeth Kagan; Bluth, Edward; Francavilla, Michael; Straus, Christopher M; Reddy, Sravanthi; Recht, Michael

2016-02-01

The aim of this study was to survey fourth-year medical students, both those choosing and those not choosing diagnostic radiology as their specialty, regarding factors influencing their choice of specialty and their perceptions of radiology. A voluntary anonymous online survey hyperlink was sent to 141 US medical schools for distribution to fourth-year students. Topics included demographics, radiology education, specialty choice and influencing factors, and opinions of radiology. A representative sampling (7%) of 2015 fourth-year medical students (n = 1,219; 51% men, 49% women) participated: 7% were applying in radiology and 93% were not. For respondents applying in radiology, the most important factor was intellectual challenge. For respondents applying in nonradiology specialties, degree of patient contact was the most important factor in the decision not to choose radiology; job market was not listed as a top-three factor. Women were less likely than men to apply in radiology (P < .001), with radiology selected by 11.8% of men (56 of 476) and only 2.8% of women (13 of 459). Respondents self-identifying as Asian had a significantly higher (P = .015) likelihood of selecting radiology (19 of 156 [12.2%]) than all other races combined (44 of 723 [6.1%]). Respondents at medical schools with required dedicated medical imaging rotations were more likely to choose radiology as a specialty, but most schools still do not require the clerkship (82%). The reasons fourth-year medical students choose, or do not choose, diagnostic radiology as a specialty are multifactorial, but noncontrollable factors, such as the job market, proved less compelling than controllable factors, such as taking a radiology rotation. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Toxoplasma gondii: history and diagnostic test development.

PubMed

Wyrosdick, Heidi M; Schaefer, John J

2015-12-01

Toxoplasma gondii is a protozoa that causes toxoplasmosis in people and other animals. It is considered one of the most common parasitic infections in the world due to its impressive range of hosts, widespread environmental contamination and the diverse means by which animals can be infected. Despite its ubiquity and numerous ongoing research efforts into both its basic biology and clinical management, many aspects of diagnosis and management of this disease are poorly understood. The range of diagnostic options that is available for veterinary diagnostic investigators are notably more limited than those available to medical diagnosticians, making accurate interpretation of each test result critical. The current review joins other reviews on the parasite with a particular emphasis on the history and continued development of diagnostic tests that are useful for veterinary diagnostic investigations. An understanding of the strengths and shortcomings of current diagnostic techniques will assist veterinary and public health officials in formulating effective treatment and control strategies in diverse animal populations.

Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

PubMed

Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

2017-09-01

Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Signal Detection Techniques for Diagnostic Monitoring of Space Shuttle Main Engine Turbomachinery

NASA Technical Reports Server (NTRS)

Coffin, Thomas; Jong, Jen-Yi

1986-01-01

An investigation to develop, implement, and evaluate signal analysis techniques for the detection and classification of incipient mechanical failures in turbomachinery is reviewed. A brief description of the Space Shuttle Main Engine (SSME) test/measurement program is presented. Signal analysis techniques available to describe dynamic measurement characteristics are reviewed. Time domain and spectral methods are described, and statistical classification in terms of moments is discussed. Several of these waveform analysis techniques have been implemented on a computer and applied to dynamc signals. A laboratory evaluation of the methods with respect to signal detection capability is described. A unique coherence function (the hyper-coherence) was developed through the course of this investigation, which appears promising as a diagnostic tool. This technique and several other non-linear methods of signal analysis are presented and illustrated by application. Software for application of these techniques has been installed on the signal processing system at the NASA/MSFC Systems Dynamics Laboratory.

PREFACE: IX International Conference on Modern Techniques of Plasma Diagnostics and their Application

NASA Astrophysics Data System (ADS)

Savjolov, A. S.; Dodulad, E. I.

2016-01-01

The IX Conference on ''Modern Techniques of Plasma Diagnosis and their Application'' was held on 5 - 7 November, 2014 at National Research Nuclear University MEPhI (NRNU MEPhI). The goal of the conference was an exchange of information on both high-temperature and low-temperature plasma diagnostics as well as deliberation and analysis of various diagnostic techniques and their applicability in science, industry, ecology, medicine and other fields. The Conference also provided young scientists from scientific centres and universities engaged in plasma diagnostics with an opportunity to attend the lectures given by the leading specialists in this field as well as present their own results and findings. The first workshop titled ''Modern problems of plasma diagnostics and their application for control of chemicals and the environment'' took place at Moscow Engineering and Physics Institute (MEPhI) in June 1998 with the support of the Section on Diagnostics of the Council of Russian Academic of Science on Plasma Physics and since then these forums have been held at MEPhI every two years. In 2008 the workshop was assigned a conference status. More than 150 specialists on plasma diagnostics and students took part in the last conference. They represented leading Russian scientific centres (such as Troitsk Institute of Innovative and Thermonuclear Research, National Research Centre ''Kurchatov Institute'', Russian Federal Nuclear Centre - All-Russian Scientific Research Institute of Experimental Physics and others) and universities from Belarus, Ukraine, Germany, USA, Belgium and Sweden. About 30 reports were made by young researchers, students and post-graduate students. All presentations during the conference were broadcasted online over the internet with viewers in Moscow, Prague, St. Petersburgh and other cities. The Conference was held within the framework of the Centre of Plasma, Laser Research and Technology supported by MEPhI Academic Excellence Project (Russian

Cyclotron Production of Medical Radioisotopes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Avila-Rodriguez, M. A.; Zarate-Morales, A.; Flores-Moreno, A.

2010-08-04

The cyclotron production of radioisotopes for medical applications is gaining increased significance in diagnostic molecular imaging techniques such as PET and SPECT. In this regard, radioisotope production has never been easier or more convenient until de introduction of compact medical cyclotrons in the last few decades, which allowed the use of short-lived radioisotopes in in vivo nuclear medicine studies on a routine basis. This review outlines some general considerations about the production of radioisotopes using charged particle accelerators.

Medical capsule robots: A renaissance for diagnostics, drug delivery and surgical treatment.

PubMed

Mapara, Sanyat S; Patravale, Vandana B

2017-09-10

The advancements in electronics and the progress in nanotechnology have resulted in path breaking development that will transform the way diagnosis and treatment are carried out currently. This development is Medical Capsule Robots, which has emerged from the science fiction idea of robots travelling inside the body to diagnose and cure disorders. The first marketed capsule robot was a capsule endoscope developed to capture images of the gastrointestinal tract. Today, varieties of capsule endoscopes are available in the market. They are slightly larger than regular oral capsules, made up of a biocompatible case and have electronic circuitry and mechanisms to capture and transmit images. In addition, robots with diagnostic features such as in vivo body temperature detection and pH monitoring have also been launched in the market. However, a multi-functional unit that will diagnose and cure diseases inside the body has not yet been realized. A remote controlled capsule that will undertake drug delivery and surgical treatment has not been successfully launched in the market. High cost, inadequate power supply, lack of control over drug release, limited space for drug storage on the capsule, inadequate safety and no mechanisms for active locomotion and anchoring have prevented their entry in the market. The capsule robots can revolutionize the current way of diagnosis and treatment. This paper discusses in detail the applications of medical capsule robots in diagnostics, drug delivery and surgical treatment. In diagnostics, detailed analysis has been presented on wireless capsule endoscopes, issues associated with the marketed versions and their corresponding solutions in literature. Moreover, an assessment has been made of the existing state of remote controlled capsules for targeted drug delivery and surgical treatment and their future impact is predicted. Besides the need for multi-functional capsule robots and the areas for further research have also been

[Application of digital design and three-dimensional printing technique on individualized medical treatment].

PubMed

Qin, Mian; Liu, Yaxiong; He, Jiankang; Wang, Ling; Lian, Qin; Li, Dichen; Jin, Zhongmin; He, Sanhu; Li, Gang; Liu, Yanpu; Wang, Zhen

2014-03-01

To summarize the latest research development of the application of digital design and three-dimensional (3-D) printing technique on individualized medical treatment. Recent research data and clinical literature about the application of digital design and 3-D printing technique on individualized medical treatment in Xi'an Jiaotong University and its cooperation unit were summarized, reviewed, and analyzed. Digital design and 3-D printing technique can design and manufacture individualized implant based on the patient's specific disease conditions. And the implant can satisfy the needs of specific shape and function of the patient, reducing dependence on the level of experience required for the doctor. So 3-D printing technique get more and more recognition of the surgeon on the individualized repair of human tissue. Xi'an Jiaotong University is the first unit to develop the commercial 3-D printer and conduct depth research on the design and manufacture of individualized medical implant. And complete technological processes and quality standards of product have been developed. The individualized medical implant manufactured by 3-D printing technique can not only achieve personalized match but also meet the functional requirements and aesthetic requirements of patients. In addition, the individualized medical implant has the advantages of accurate positioning, stable connection, and high strength. So 3-D printing technique has broad prospects in the manufacture and application of individualized implant.

The problem of sexual imbalance and techniques of the self in the Diagnostic and Statistical Manual of Mental Disorders.

PubMed

Flore, Jacinthe

2016-09-01

This article examines the problematization of sexual appetite and its imbalances in the development of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in the twentieth and twenty-first centuries. The dominant strands of historiographies of sexuality have focused on historicizing sexual object choice and understanding the emergence of sexual identities. This article emphasizes the need to contextualize these histories within a broader frame of historical interest in the problematization of sexual appetite. The first part highlights how sexual object choice, as a paradigm of sexual dysfunctions, progressively receded from medical interest in the twentieth century as the clinical gaze turned to the problem of sexual appetite and its imbalances. The second part uses the example of the newly introduced Female Sexual Interest/Arousal Disorder in the DSM-5 to explore how the Manual functions as a technique for taking care of the self. I argue that the design of the Manual and associated inventories and questionnaires paved the way for their interpretation and application as techniques for self-examination. © The Author(s) 2016.

Machine learning techniques for medical diagnosis of diabetes using iris images.

PubMed

Samant, Piyush; Agarwal, Ravinder

2018-04-01

Complementary and alternative medicine techniques have shown their potential for the treatment and diagnosis of chronical diseases like diabetes, arthritis etc. On the same time digital image processing techniques for disease diagnosis is reliable and fastest growing field in biomedical. Proposed model is an attempt to evaluate diagnostic validity of an old complementary and alternative medicine technique, iridology for diagnosis of type-2 diabetes using soft computing methods. Investigation was performed over a close group of total 338 subjects (180 diabetic and 158 non-diabetic). Infra-red images of both the eyes were captured simultaneously. The region of interest from the iris image was cropped as zone corresponds to the position of pancreas organ according to the iridology chart. Statistical, texture and discrete wavelength transformation features were extracted from the region of interest. The results show best classification accuracy of 89.63% calculated from RF classifier. Maximum specificity and sensitivity were absorbed as 0.9687 and 0.988, respectively. Results have revealed the effectiveness and diagnostic significance of proposed model for non-invasive and automatic diabetes diagnosis. Copyright © 2018 Elsevier B.V. All rights reserved.

Interdisciplinary diagnostics in environmental medicine--findings and follow-up in patients with chronic medically unexplained health complaints.

PubMed

Herr, Caroline E; Kopka, Ines; Mach, Jens; Runkel, Bettina; Schill, Wolf-Bernhard; Gieler, Uwe; Eikmann, Thomas F

2004-01-01

In patients attributing their chronic, medically unexplained complaints to environmental factors the greatest challenge is to overcome their disabling belief in toxicogenic explanations. Patients presenting with health complaints that they attributed to environmental causes in an environmental outpatient department (EOPD) within a university medical center in Germany were studied. An interdisciplinary review of previously diagnosed medical conditions, current clinical consultations, personal risk communication and therapeutic advice is presented. Additionally, patient contentedness, complaint development, and belief in environmental attribution in a follow-up interview are given. The open, prospective study comprises 51 patients reporting more than one complaint. Symptoms had lasted for more than 3 years in 63% of the cases. Seventy percent attributed their complaints to more than one environmental cause. The clinical diagnostic procedure reduced the number of prediagnosed clinical conditions by 50%. Numerous foregoing environmental laboratory analyses had overestimated toxicologically relevant findings. These were not confirmed in 80% (8/10) of the cases. In 8% (n = 4) of the patients a relevant environmental or occupational medical condition was found. A mental or behavioral condition was not considered to have first priority in explaining all complaints in 43% (22/51) of the patients. Among these, mostly respiratory or skin-related diseases were found. All patients contacted participated in a follow-up study after a minimum of 21 months. Sixty-seven percent reported having felt that they were taken seriously, 38% felt better after the beginning of the study, and 45% were no longer certain about the importance of the environmental attribution. Since 83% of the patients with a preceding residential diagnosis of MCS or SBS still believed in environmental causes of their complaints in the follow-up study, we conclude that these prediagnoses appear to be a risk for

GIS insulation co-ordination: On-site tests and dielectric diagnostic techniques, a utility point of view

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sabot, A.; Petit, A.; Taillebois, J.P.

1996-07-01

This paper summarizes the Electricite de France experience with insulation co-ordination of GIS. After a review of the insulation co-ordination practice mainly dealing with fast front overvoltage and the one minute AC test, some results of the on-site test procedure applied since 30 years are presented and related to the insulation co-ordination practice. The in-service return of experience dealing with dielectric failures is analyzed then the dielectric diagnostic techniques now available are briefly presented with their possibilities and limitations. According to this survey, the expectations of EDF from these diagnostic techniques as well as the new on-site test and on-linemore » monitoring tendencies at EDF are presented.« less

Variation in Results Release and Patient Portal Access to Diagnostic Test Results at an Academic Medical Center

PubMed Central

Krasowski, Matthew D.; Grieme, Caleb V.; Cassady, Brian; Dreyer, Nicholas R.; Wanat, Karolyn A.; Hightower, Maia; Nepple, Kenneth G.

2017-01-01

Background: Electronic health records (EHRs) are commonplace in industrialized countries. Many hospitals are granting their patients access to their medical information through online patient portals. In this report, we describe a retrospective analysis of patient access to diagnostic test results released through the patient portal (MyChart; Epic, Inc.) at a state academic medical center. Methods: We analyzed 6 months of data for anatomic pathology, clinical laboratory, and radiology test results to evaluate variations in results release (automated vs. manual) and subsequent patient access to the institutional patient portal. During this period, diagnostic test results were released for all patient encounters including inpatient units, outpatient clinics, and the emergency department. Results: Manual results release by providers before automated release time occurred most commonly in the outpatient setting. The highest rates of access of diagnostic test results occurred for outpatients (about 30% overall view rate), females (two times or more compared to males in nearly every age bracket), and 20–45-year-old. Access rates of diagnostic tests in the emergency department or inpatient units were <10% across all populations. Access of diagnostic test results was very low for 12–17-year-old, likely influenced by institutional policies limiting parental proxy access within this pediatric age range. Approximately 20% of outpatient laboratory results were viewed by patients within 8 h of release from the EHR to the patient portal and 10% within 2 h of release. Conclusions: Patient accessing of diagnostic test results were generally higher for females, outpatients, and 20–45-year-old. Approximately, 20% of outpatient results were viewed quickly by patients after release to the EHR. PMID:29226008

Variation in Results Release and Patient Portal Access to Diagnostic Test Results at an Academic Medical Center.

PubMed

Krasowski, Matthew D; Grieme, Caleb V; Cassady, Brian; Dreyer, Nicholas R; Wanat, Karolyn A; Hightower, Maia; Nepple, Kenneth G

2017-01-01

Electronic health records (EHRs) are commonplace in industrialized countries. Many hospitals are granting their patients access to their medical information through online patient portals. In this report, we describe a retrospective analysis of patient access to diagnostic test results released through the patient portal (MyChart; Epic, Inc.) at a state academic medical center. We analyzed 6 months of data for anatomic pathology, clinical laboratory, and radiology test results to evaluate variations in results release (automated vs. manual) and subsequent patient access to the institutional patient portal. During this period, diagnostic test results were released for all patient encounters including inpatient units, outpatient clinics, and the emergency department. Manual results release by providers before automated release time occurred most commonly in the outpatient setting. The highest rates of access of diagnostic test results occurred for outpatients (about 30% overall view rate), females (two times or more compared to males in nearly every age bracket), and 20-45-year-old. Access rates of diagnostic tests in the emergency department or inpatient units were <10% across all populations. Access of diagnostic test results was very low for 12-17-year-old, likely influenced by institutional policies limiting parental proxy access within this pediatric age range. Approximately 20% of outpatient laboratory results were viewed by patients within 8 h of release from the EHR to the patient portal and 10% within 2 h of release. Patient accessing of diagnostic test results were generally higher for females, outpatients, and 20-45-year-old. Approximately, 20% of outpatient results were viewed quickly by patients after release to the EHR.

Diagnostic value of medical history and physical examination of anterior cruciate ligament injury: comparison between primary care physician and orthopaedic surgeon.

PubMed

Geraets, Stijn E W; Meuffels, Duncan E; van Meer, Belle L; Breedveldt Boer, Hans P; Bierma-Zeinstra, Sita M A; Reijman, Max

2015-04-01

Well-designed validity studies on the clinical diagnosis of anterior cruciate ligament (ACL) injury are scarce. Our purpose is to assess the diagnostic value of ACL-specific medical history assessment and physical examination between primary and secondary care medical specialists. Medical history assessment and physical examination were performed by both an orthopaedic surgeon and a primary care physician, both blinded to all clinical information, in a secondary care population. A knee arthroscopy was used as reference standard. A total of 60 participants were divided into an index group with an arthroscopically proven complete ACL rupture and a control group with an arthroscopically proven intact ACL. The orthopaedic surgeon recognized 94 % of the participants with an ACL rupture through a positive medical history combined with a positive physical examination; of the participants with an intact ACL, 16 % were misclassified by the orthopaedic surgeon. The primary care physician recognized 62 % of the participants with an ACL rupture and misclassified 23 % of the participants with an intact ACL. Physical examination appeared to have no additional value for the primary care physician. Combined medical history and physical examination have strong diagnostic value in ACL rupture diagnostics performed by an orthopaedic surgeon, whereas for the primary care physician, only medical history appeared to be of value. For current practice, this could mean that only orthopaedic surgeons can perform an ACL physical examination with accuracy. III.

Academic disintegrity among medical students: a randomised response technique study.

PubMed

Mortaz Hejri, Sameh; Zendehdel, Kazem; Asghari, Fariba; Fotouhi, Akbar; Rashidian, Arash

2013-02-01

Medical students, as tomorrow's doctors, are responsible for their patients' health; cheating may affect their academic knowledge and clinical skills. The main purpose of this study was to investigate the frequency of and attitudes towards academic disintegrity among medical students at Tehran University of Medical Sciences (TUMS). Anonymous questionnaires including questions about various types of academic disintegrity were distributed among medical students during the clerkship and internship phases of the curriculum. Randomised response technique (RRT) was used to maintain the responders' privacy. Because the study design guaranteed the confidentiality of respondents, the TUMS Institutional Review Board declared that formal ethical approval was not required. A total of 124 students were enrolled in this study, of whom 63 were in the clerkship phase and 61 were in the internship phase. Of these respondents, 29% (n = 36) were male. The most frequently reported type of academic disintegrity was found to be 'impersonating an absent student in a class' (93%) and the least frequent to be 'legitimising absences by using bribes' (5%). Only a small number of interns considered 'buying hospital shifts', 'selling hospital shifts', 'impersonating an absent student' and 'helping others to cheat in examinations' as representing academic disintegrity. Approximately one third of participants stated that the RRT increased their confidence in anonymity and 90% of students found the use of RRT not difficult. Academic integrity is widely disrespected in different ways among medical students. Effective policies and interventions are required to control these misbehaviours in future doctors in order to optimise medical practice. Almost all respondents found it not difficult to use the RRT; the technique proved to be an effective and easily applied method of eliciting truthful responses to sensitive questions and represents an alternative to conventional anonymising techniques. �

[Achilles tendon rupture : Current diagnostic and therapeutic standards].

PubMed

Hertel, G; Götz, J; Grifka, J; Willers, J

2016-08-01

A superior life expectancy and an increased activity in the population result in an increase in degenerative diseases, such as Achilles tendon ruptures. The medical history and physical examinations are the methods of choice to diagnose Achilles tendon ruptures. Ultrasound and radiography represent reasonable extended diagnostic procedures. In order to decide on the medical indications for the therapy concept, the advantages and disadvantages of conservative and surgical treatment options have to be weighed up on an indivdual basis. There are explicit contraindications for both treatment options. For the surgical treatment concept open suture techniques, minimally invasive methods and reconstructive procedures are available. The postoperative management of the patient is as important as the choice of surgical technique. With the correct medical indications and supervision of the patient it is possible to achieve extremely satisfying results for the patient with both conservative and surgical treatment options.

A diagnostic technique used to obtain cross range radiation centers from antenna patterns

NASA Technical Reports Server (NTRS)

Lee, T. H.; Burnside, W. D.

1988-01-01

A diagnostic technique to obtain cross range radiation centers based on antenna radiation patterns is presented. This method is similar to the synthetic aperture processing of scattered fields in the radar application. Coherent processing of the radiated fields is used to determine the various radiation centers associated with the far-zone pattern of an antenna for a given radiation direction. This technique can be used to identify an unexpected radiation center that creates an undesired effect in a pattern; on the other hand, it can improve a numerical simulation of the pattern by identifying other significant mechanisms. Cross range results for two 8' reflector antennas are presented to illustrate as well as validate that technique.

GENOSENSE Diagnostics GmbH.

PubMed

Schneeberger, Christian

2004-07-01

GENOSENSE Diagnostics GmbH, a company specialized in preventive genetic diagnostics, has committed itself to applying molecular medical knowledge to realizing the vision of individual, preventive and patient-tailored medicine. GENOSENSE offers a unique line of preventive genomic diagnostic profiles. Each profile focuses on a carefully selected set of polymorphisms associated with particular diseases or physiologic imbalances. GENOSENSE does not only provide the genetic test results, but highly capable medical experts 'translate' the results into a clinical language and assist the customer with established support regarding their medical interpretation. In addition, the company provides academic institutions and pharmaceutical companies with turnkey solutions for research-based projects.

Design of portable ultraminiature flow cytometers for medical diagnostics

NASA Astrophysics Data System (ADS)

Leary, James F.

2018-02-01

Design of portable microfluidic flow/image cytometry devices for measurements in the field (e.g. initial medical diagnostics) requires careful design in terms of power requirements and weight to allow for realistic portability. True portability with high-throughput microfluidic systems also requires sampling systems without the need for sheath hydrodynamic focusing both to avoid the need for sheath fluid and to enable higher volumes of actual sample, rather than sheath/sample combinations. Weight/power requirements dictate use of super-bright LEDs with top-hat excitation beam architectures and very small silicon photodiodes or nanophotonic sensors that can both be powered by small batteries. Signal-to-noise characteristics can be greatly improved by appropriately pulsing the LED excitation sources and sampling and subtracting noise in between excitation pulses. Microfluidic cytometry also requires judicious use of small sample volumes and appropriate statistical sampling by microfluidic cytometry or imaging for adequate statistical significance to permit real-time (typically in less than 15 minutes) initial medical decisions for patients in the field. This is not something conventional cytometry traditionally worries about, but is very important for development of small, portable microfluidic devices with small-volume throughputs. It also provides a more reasonable alternative to conventional tubes of blood when sampling geriatric and newborn patients for whom a conventional peripheral blood draw can be problematical. Instead one or two drops of blood obtained by pin-prick should be able to provide statistically meaningful results for use in making real-time medical decisions without the need for blood fractionation, which is not realistic in the doctor's office or field.

Crossing the Great Divide: Adoption of New Technologies, Therapeutics and Diagnostics at Academic Medical Centers

ERIC Educational Resources Information Center

DeMonaco, Harold J.; Koski, Greg

2007-01-01

The role of new technology in healthcare continues to expand from both the clinical and financial perspectives. Despite the importance of innovation, most academic medical centers do not have a clearly defined process for technology assessment. Recognizing the importance of new drugs, diagnostics and procedures in the care of patients and in the…

Diagnostic techniques in thermal plasma processing, part 2, volume 2

NASA Astrophysics Data System (ADS)

Boulos, M.; Fauchais, P.; Pfender, E.

1986-02-01

Techniques for diagnostics for thermal plasmas are discussed. These include both optical techniques and in-flight measurements of particulate matter. In the core of the plasma, collisional excitation of the various chemical species is so strong that the population of the corresponding quantum levels becomes high enough for net emission from the plasma. In that case, the classical methods of emission spectroscopy may be applied. But in the regions where the temperatures are below 4000K (these regions are of primary importance for plasma processing), the emission from the plasma is no longer sufficient for emission spectroscopy. In this situation, the population of excited levels must be increased by the absorption of the light from an external source. Such sources, as for example pulsed tunable dye lasers, are now commercially available. The use of such new devices leads to various techniques such as laser induced fluorescence (LIF) or Coherent Anti Stockes Raman Spectroscopy (CARS) that can be used for analyzing plasmas. Particle velocity measurements can be achieved by photography and laser Doppler anemometry. Particle flux measurements are typically achieved by collecting particles on a substrate. Particle size measurements are based on intensity of scattered light.

Diagnostic procedures in tularaemia with special focus on molecular and immunological techniques.

PubMed

Splettstoesser, W D; Tomaso, H; Al Dahouk, S; Neubauer, H; Schuff-Werner, P

2005-08-01

Tularaemia is a severe bacterial zoonosis caused by the highly infectious agent Francisella tularensis. It is endemic in countries of the northern hemisphere ranging from North America to Europe, Asia and Japan. Very recently, Francisella-like strains causing disease in humans were described from tropical northern Australia. In the last decade, efforts have been made to develop sensitive and specific immunological and molecular techniques for the laboratory diagnosis of tularaemia and also for the definite identification of members of the species F. tularensis and its four subspecies. Screening for the keyword 'Francisella' a Medline search over the last decade was performed and articles describing diagnostic methods for tularaemia and its causative agent were selected. Besides classical microbiological techniques (cultivation, biochemical profiling, susceptibility testing) several new immunological and molecular approaches to identify F. tularensis have been introduced employing highly specific antibodies and various polymerase chain reaction (PCR)-based methods. Whereas direct antigen detection by enzyme-linked immunosorbent assay (ELISA) or immunofluorescence might allow early presumptive diagnosis of tularaemia, these methods--like all PCR techniques--still await further evaluation. Therefore, diagnosis of tularaemia still relies mainly on the demonstration of specific antibodies in the host. ELISA and immunoblot methods started to replace the standard tube or micro-agglutination assays. However, the diagnostic value of antibody detection in the very early clinical phase of tularaemia is limited. Francisella tularensis is regarded as a 'highest priority' biological agent (category 'A' according to the CDC, Atlanta, GA, USA), thus rapid and reliable diagnosis of tularaemia is required not only for a timely onset of therapy, the handling of outbreak investigations but also for the surveillance of endemic foci. Only very recently, evaluated test kits for

Comparison of immediate effects between two medical stretching techniques on Hamstrings flexibility

PubMed Central

Aye, Thanda; Kuramoto-Ahuja, Tsugumi; Han, Heonsoo; Maruyama, Hitoshi

2017-01-01

[Purpose] The aim of this study was to compare immediate effects between new medical stretching (NMS) and conventional medical stretching (CMS) techniques on Hamstrings flexibility. [Subjects and Methods] Thirteen healthy adult males, with finger floor distance (FFD) less than zero centimeter, without known musculoskeletal and neurological impairment in spine or lower extremities, were included. The subjects were randomly allocated to two groups. The subjects were instructed to perform NMS and CMS (hold for 30 seconds once, twice for each side of lower extremity) for both sides (total two minutes, only one session for one day). The interval between the two techniques was one week. FFD was measured with digital standing trunk flexion meter at the pre-intervention and post-intervention of both techniques. [Results] The mean values of FFD improved at the post-interventions of both techniques. The tests of within subject effects indicated that the main effect of treatment was not significant but the main effect of time was significant and the interaction of treatment and time was also significant. [Conclusion] The results of this study indicated that both medical stretching techniques were effective on Hamstrings flexibility immediately after the intervention and NMS technique was more effective on improving flexibility. PMID:28931979

Comparison of immediate effects between two medical stretching techniques on Hamstrings flexibility.

PubMed

Aye, Thanda; Kuramoto-Ahuja, Tsugumi; Han, Heonsoo; Maruyama, Hitoshi

2017-09-01

[Purpose] The aim of this study was to compare immediate effects between new medical stretching (NMS) and conventional medical stretching (CMS) techniques on Hamstrings flexibility. [Subjects and Methods] Thirteen healthy adult males, with finger floor distance (FFD) less than zero centimeter, without known musculoskeletal and neurological impairment in spine or lower extremities, were included. The subjects were randomly allocated to two groups. The subjects were instructed to perform NMS and CMS (hold for 30 seconds once, twice for each side of lower extremity) for both sides (total two minutes, only one session for one day). The interval between the two techniques was one week. FFD was measured with digital standing trunk flexion meter at the pre-intervention and post-intervention of both techniques. [Results] The mean values of FFD improved at the post-interventions of both techniques. The tests of within subject effects indicated that the main effect of treatment was not significant but the main effect of time was significant and the interaction of treatment and time was also significant. [Conclusion] The results of this study indicated that both medical stretching techniques were effective on Hamstrings flexibility immediately after the intervention and NMS technique was more effective on improving flexibility.

Towards real-time medical diagnostics using hyperspectral imaging technology

NASA Astrophysics Data System (ADS)

Bjorgan, Asgeir; Randeberg, Lise L.

2015-07-01

Hyperspectral imaging provides non-contact, high resolution spectral images which has a substantial diagnostic potential. This can be used for e.g. diagnosis and early detection of arthritis in finger joints. Processing speed is currently a limitation for clinical use of the technique. A real-time system for analysis and visualization using GPU processing and threaded CPU processing is presented. Images showing blood oxygenation, blood volume fraction and vessel enhanced images are among the data calculated in real-time. This study shows the potential of real-time processing in this context. A combination of the processing modules will be used in detection of arthritic finger joints from hyperspectral reflectance and transmittance data.

Screening for Depression in Medical Settings with the Patient Health Questionnaire (PHQ): A Diagnostic Meta-Analysis

PubMed Central

Richards, David; Brealey, Stephen; Hewitt, Catherine

2007-01-01

Objective To summarize the psychometric properties of the PHQ2 and PHQ9 as screening instruments for depression. Interventions We identified 17 validation studies conducted in primary care; medical outpatients; and specialist medical services (cardiology, gynecology, stroke, dermatology, head injury, and otolaryngology). Electronic databases from 1994 to February 2007 (MEDLINE, PsycLIT, EMBASE, CINAHL, Cochrane registers) plus study reference lists have been used for this study. Translations included US English, Dutch, Italian, Spanish, German and Arabic). Summary sensitivity, specificity, likelihood and diagnostic odds ratios (OR) against a gold standard (DSM-IV) Major Depressive Disorder (MDD) were calculated for each study. We used random effects bivariate meta-analysis at recommended cut points to produce summary receiver–operator characteristic (sROC) curves. We explored heterogeneity with metaregression. Measurements and Main Results Fourteen studies (5,026 participants) validated the PHQ9 against MDD: sensitivity = 0.80 (95% CI 0.71–0.87); specificity = 0.92 (95% CI 0.88–0.95); positive likelihood ratio = 10.12 (95% CI 6.52–15.67); negative likelihood ratio = 0.22 (0.15 to 0.32). There was substantial heterogeneity (Diagnostic Odds Ratio heterogeneity I2 = 82%), which was not explained by study setting (primary care versus general hospital); method of scoring (cutoff ≥ 10 versus “diagnostic algorithm”); or study quality (blinded versus unblinded). The diagnostic validity of the PHQ2 was only validated in 3 studies and showed wide variability in sensitivity. Conclusions The PHQ9 is acceptable, and as good as longer clinician-administered instruments in a range of settings, countries, and populations. More research is needed to validate the PHQ2 to see if its diagnostic properties approach those of the PHQ9. PMID:17874169

Diagnostic value and safety of medical thoracoscopy in tuberculous pleural effusion.

PubMed

Wang, Zhen; Xu, Li-Li; Wu, Yan-Bing; Wang, Xiao-Juan; Yang, Yuan; Zhang, Jun; Tong, Zhao-Hui; Shi, Huan-Zhong

2015-09-01

Differentiating tuberculous pleural effusion from other lymphocytic pleural effusions is often challenging. This retrospective study aimed to assess the efficacy and safety of medical thoracoscopy in patients with suspected tuberculous pleural effusion. Between July 2005 and June 2014, patients with pleural effusions of unknown etiologies underwent medical thoracoscopy in our institute after less invasive means of diagnosis had failed. Demographic, radiographic, procedural, and histological data of patients with tuberculous pleural effusion were analyzed. During this 9-year study, 333 of 833 patients with pleural effusion were confirmed to have tuberculous pleurisy. Under thoracoscopy, we observed pleural nodules in 69.4%, pleural adhesion in 66.7%, hyperemia in 60.7%, plaque-like lesions in 6.0%, ulceration in 1.5% of patients with tuberculous pleurisy. Pleural biopsy revealed the presence of Mycobacterium tuberculosis in the pleural tissue or/and demonstration of caseating granulomas in 330 (99.1%) patients. No serious adverse events were recorded, and the most common minor complication was transient chest pain (43.2%) from the indwelling chest tube. Our data showed that medical thoracoscopy is a simple procedure with high diagnostic yield and excellent safety for the diagnosis of tuberculous pleural effusion. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Effect of Self-Explanation of Pathophysiological Mechanisms of Diseases on Medical Students' Diagnostic Performance

ERIC Educational Resources Information Center

Peixoto, José Maria; Mamede, Sílvia; de Faria, Rosa Malena Delbone; Moura, Alexandre Sampaio; Santos, Silvana Maria Elói; Schmidt, Henk G.

2017-01-01

Self-explanation while diagnosing clinical cases fosters medical students' diagnostic performance. In previous studies on self-explanation, students were free to self-explain any aspect of the case, and mostly clinical knowledge was used. Elaboration on knowledge of pathophysiological mechanisms of diseases has been largely unexplored in studies…

[Improvement of work of chiefs of therapeutic and diagnostic hospital departments--chief medical specialists of military districts (fleet)].

PubMed

Tregubov, V N; Kostiuchenko, A I; Stetsenko, B G

2009-03-01

In now-day conditions, on the background of enlargement and complication of tasks', solved by military health service, it's supervised the increase of significance of qualitative and effective administration by collectives of military-medical organizations. An important role belongs to activity of chiefs of treatment-diagnostic units (centers) of military hospitals. These chiefs in the same time are staff or inorganic medical specialists of military regions (NAVYs).

The Sandtray Technique for Swedish Children 1945-1960: Diagnostics, Psychotherapy and Processes of Individualisation

ERIC Educational Resources Information Center

Nelson, Karin Zetterqvist

2011-01-01

The present article examines the development of a diagnostic and therapeutic technique named The Sandtray at the Erica Foundation, a privately-run child counselling service in Stockholm. Originally it was called The World, developed by the British paediatrician and child psychiatrist Margaret Lowenfeld. In the 1930s it was imported to Sweden,…

Diagnostic Lumbar Puncture

PubMed Central

Doherty, Carolynne M; Forbes, Raeburn B

2014-01-01

Diagnostic Lumbar Puncture is one of the most commonly performed invasive tests in clinical medicine. Evaluation of an acute headache and investigation of inflammatory or infectious disease of the nervous system are the most common indications. Serious complications are rare, and correct technique will minimise diagnostic error and maximise patient comfort. We review the technique of diagnostic Lumbar Puncture including anatomy, needle selection, needle insertion, measurement of opening pressure, Cerebrospinal Fluid (CSF) specimen handling and after care. We also make some quality improvement suggestions for those designing services incorporating diagnostic Lumbar Puncture. PMID:25075138

Diagnostic reasoning strategies and diagnostic success.

PubMed

Coderre, S; Mandin, H; Harasym, P H; Fick, G H

2003-08-01

Cognitive psychology research supports the notion that experts use mental frameworks or "schemes", both to organize knowledge in memory and to solve clinical problems. The central purpose of this study was to determine the relationship between problem-solving strategies and the likelihood of diagnostic success. Think-aloud protocols were collected to determine the diagnostic reasoning used by experts and non-experts when attempting to diagnose clinical presentations in gastroenterology. Using logistic regression analysis, the study found that there is a relationship between diagnostic reasoning strategy and the likelihood of diagnostic success. Compared to hypothetico-deductive reasoning, the odds of diagnostic success were significantly greater when subjects used the diagnostic strategies of pattern recognition and scheme-inductive reasoning. Two other factors emerged as independent determinants of diagnostic success: expertise and clinical presentation. Not surprisingly, experts outperformed novices, while the content area of the clinical cases in each of the four clinical presentations demonstrated varying degrees of difficulty and thus diagnostic success. These findings have significant implications for medical educators. It supports the introduction of "schemes" as a means of enhancing memory organization and improving diagnostic success.

Hadoop-based implementation of processing medical diagnostic records for visual patient system

NASA Astrophysics Data System (ADS)

Yang, Yuanyuan; Shi, Liehang; Xie, Zhe; Zhang, Jianguo

2018-03-01

We have innovatively introduced Visual Patient (VP) concept and method visually to represent and index patient imaging diagnostic records (IDR) in last year SPIE Medical Imaging (SPIE MI 2017), which can enable a doctor to review a large amount of IDR of a patient in a limited appointed time slot. In this presentation, we presented a new approach to design data processing architecture of VP system (VPS) to acquire, process and store various kinds of IDR to build VP instance for each patient in hospital environment based on Hadoop distributed processing structure. We designed this system architecture called Medical Information Processing System (MIPS) with a combination of Hadoop batch processing architecture and Storm stream processing architecture. The MIPS implemented parallel processing of various kinds of clinical data with high efficiency, which come from disparate hospital information system such as PACS, RIS LIS and HIS.

Diagnostic aids: the Surgical Sieve revisited.

PubMed

Chai, Jason; Evans, Lloyd; Hughes, Tom

2017-08-01

Diagnostic errors are well documented in the literature and emphasise the need to teach diagnostic skills at an early stage in medical school to create effective and safe clinicians. Hence, there may be a place for diagnostic aids (such as the Surgical Sieve) that provide a framework for generating ideas about diagnoses. With repeated use of the Surgical Sieve in teaching sessions with students, and prompted by the traditional handheld wheels used in antenatal clinics, we developed the Compass Medicine, a handheld diagnostic wheel comprising three concentric discs attached at the centre. We report a preliminary study comparing the Surgical Sieve and the Compass Medicine in generating differential diagnoses. A total of 48 third-year medical students from Cardiff University participated in a study aimed at measuring the efficacy of diagnostic aids (Surgical Sieve and Compass Medicine) in generating diagnoses. We quantified the effect each aid had on the number of diagnoses generated, and compared the size of the effect between the two diagnostic aids. There may be a place for diagnostic aids that provide a framework for generating ideas about diagnoses RESULTS: The study suggests that both diagnostic aids prompted users to generate a greater number of diagnoses, but there was no significant difference in the size of effect between the two diagnostic aids. We hope that our study with diagnostic aids will encourage the use of robust tools to teach medical students an easily visualised framework for diagnostic thinking. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Horizon 2020 SME-Instrument topic: clinical research for the validation of biomarkers and/or diagnostic medical devices.

PubMed

Sanne, Jean-Luc

2018-06-21

The European Commission released €130 million over 2014, 2015 and 2017 under the EU Framework Program for Research and Innovation, Horizon 2020, to support innovative small and medium-sized enterprises in the diagnostic area. The call topic focused on 'Clinical research for the validation of biomarkers and/or diagnostic medical devices'. It attracted 1194 applicants from all over Europe. The quality of the proposals was high and a large proportion of them were eligible for funding. In the majority, proposals were about in vitro diagnostics and tackled both clinical validation of new biomarkers and device optimization. The proposals dealt with various advanced technologies. One third of the proposers gave priority to the new and promising field of personalized medicine.

Taguchi's technique: an effective method for improving X-ray medical radiographic screen performance.

PubMed

Vlachogiannis, J G

2003-01-01

Taguchi's technique is a helpful tool to achieve experimental optimization of a large number of decision variables with a small number of off-line experiments. The technique appears to be an ideal tool for improving the performance of X-ray medical radiographic screens under a noise source. Currently there are very many guides available for improving the efficiency of X-ray medical radiographic screens. These guides can be refined using a second-stage parameter optimization. based on Taguchi's technique, selecting the optimum levels of controllable X-ray radiographic screen factors. A real example of the proposed technique is presented giving certain performance criteria. The present research proposes the reinforcement of X-ray radiography by Taguchi's technique as a novel hardware mechanism.

Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing

PubMed Central

Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

2015-01-01

Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called “threshold probability” at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today’s clinical practice. PMID:26244571

Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

PubMed

Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

2015-01-01

Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice.

Predictive Modeling of Student Performances for Retention and Academic Support in a Diagnostic Medical Sonography Program

ERIC Educational Resources Information Center

Borghese, Peter; Lacey, Sandi

2014-01-01

As part of a retention and academic support program, data was collected to develop a predictive model of student performances in core classes in a Diagnostic Medical Sonography (DMS) program. The research goal was to identify students likely to have difficulty with coursework and provide supplemental tutorial support. The focus was on the…

21 CFR 890.1850 - Diagnostic muscle stimulator.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1850 Diagnostic... electromyograph machine to initiate muscle activity. It is intended for medical purposes, such as to diagnose...

Diagnostic Techniques to Elucidate the Aerodynamic Performance of Acoustic Liners

NASA Technical Reports Server (NTRS)

June, Jason; Bertolucci, Brandon; Ukeiley, Lawrence; Cattafesta, Louis N., III; Sheplak, Mark

2017-01-01

In support of Topic A.2.8 of NASA NRA NNH10ZEA001N, the University of Florida (UF) has investigated the use of flow field optical diagnostic and micromachined sensor-based techniques for assessing the wall shear stress on an acoustic liner. Stereoscopic particle image velocimetry (sPIV) was used to study the velocity field over a liner in the Grazing Flow Impedance Duct (GFID). The results indicate that the use of a control volume based method to determine the wall shear stress is prone to significant error. The skin friction over the liner as measured using velocity curve fitting techniques was shown to be locally reduced behind an orifice, relative to the hard wall case in a streamwise plane centered on the orifice. The capacitive wall shear stress sensor exhibited a linear response for a range of shear stresses over a hard wall. PIV over the liner is consistent with lifting of the near wall turbulent structure as it passes over an orifice, followed by a region of low wall shear stress.

A technique to improve diagnostic information from fine-needle aspirations: immunohistochemistry on cytoscrape.

PubMed

Skov, Birgit Guldhammer; Kiss, Katalin; Ramsted, Julie; Linnemann, Dorte

2009-04-25

Cytologic examination of fine-needle aspiration (FNA) material is being used increasingly for the diagnosis of pulmonary lesions. Accurate distinction between nonsmall cell lung cancer (NSCLC), including subgroups, and small cell lung cancer and between primary lung cancer and metastases has therapeutic impact. However, the distinction between these groups may be difficult on smears. In this report, the authors describe a simple method, called cytoscrape (CS), which can be used on virtually any smear to produce material useful for ancillary methods, including immunohistochemistry. Aspirates from 47 patients who had possible malignant infiltrates identified on computed tomography scans of the chest were included. Smears were stained by May-Grunwald-Giemsa and Diff-Quick for diagnostic purposes. CS material was obtained by gently scraping cells off the slides. Clots were made, and the sections were stained for thyroid transcription factor-1 (TTF-1) and mucin. The utility of the CS technique was evaluated by assessing the sensitivity and specificity of the method and by quantifying the extra diagnostic information obtained by the method relative to smears alone. Malignant tumor cells in the CS material were identified in 43 aspirates (91%). Both the sensitivity and the specificity for TTF-1 were 100%. The sensitivity for mucin was 60%, and the specificity for mucin was 100%. The diagnoses made on smears were improved by CS in 31 patients (72%), in that more precise separation of subgroups of NSCLC was possible or information on primary tumors was obtained. The CS technique improved the diagnostic information from FNA in a clinically relevant way. The method is simple, quick, and inexpensive. (c) 2009 American Cancer Society.

Use of a microwave diagnostics technique to measure the temperature of an axisymmetric ionized gas flow

NASA Astrophysics Data System (ADS)

Tsel'Sov, Iu. G.; Kondrat'ev, A. S.

1990-12-01

A method is developed for determining the temperature of an ionized gas on the basis of electron-density sounding. This technique is used to measure the cross-sectional temperature distribution of an axisymmetric ionized gas flow using microwave diagnostics.

Diagnostic value of the fluoroscopic triggering 3D LAVA technique for primary liver cancer.

PubMed

Shen, Xiao-Yong; Chai, Chun-Hua; Xiao, Wen-Bo; Wang, Qi-Dong

2010-04-01

Primary liver cancer (PLC) is one of the common malignant tumors. Liver acquisition with acceleration volume acquisition (LAVA), which allows simultaneous dynamic enhancement of the hepatic parenchyma and vasculature imaging, is of great help in the diagnosis of PLC. This study aimed to evaluate application of the fluoroscopic triggering 3D LAVA technique in the imaging of PLC and liver vasculature. The clinical data and imaging findings of 38 adults with PLC (22 men and 16 women; average age 52 years), pathologically confirmed by surgical resection or biopsy, were collected and analyzed. All magnetic resonance images were obtained with a 1.5-T system (General Electrics Medical Systems) with an eight-element body array coil and application of the fluoroscopic triggering 3D LAVA technique. Overall image quality was assessed on a 5-point scale by two experienced radiologists. All the nodules and blood vessel were recorded and compared. The diagnostic accuracy and feasibility of LAVA were evaluated. Thirty-eight patients gave high quality images of 72 nodules in the liver for diagnosis. The accuracy of LAVA was 97.2% (70/72), and the coincidence rate between the extent of tumor judged by dynamic enhancement and pathological examination was 87.5% (63/72). Displayed by the maximum intensity projection reconstruction, nearly all cases gave satisfactory images of branches III and IV of the hepatic artery. Furthermore, small early-stage enhancing hepatic lesions and the parallel portal vein were also well displayed. Sequence of LAVA provides good multi-phase dynamic enhancement scanning of hepatic lesions. Combined with conventional scanning technology, LAVA effectively and safely displays focal hepatic lesions and the relationship between tumor and normal tissues, especially blood vessels.

Virtual reality aided visualization of fluid flow simulations with application in medical education and diagnostics.

PubMed

Djukic, Tijana; Mandic, Vesna; Filipovic, Nenad

2013-12-01

Medical education, training and preoperative diagnostics can be drastically improved with advanced technologies, such as virtual reality. The method proposed in this paper enables medical doctors and students to visualize and manipulate three-dimensional models created from CT or MRI scans, and also to analyze the results of fluid flow simulations. Simulation of fluid flow using the finite element method is performed, in order to compute the shear stress on the artery walls. The simulation of motion through the artery is also enabled. The virtual reality system proposed here could shorten the length of training programs and make the education process more effective. © 2013 Published by Elsevier Ltd.

MO-AB-210-00: Diagnostic Ultrasound Imaging Quality Control and High Intensity Focused Ultrasound Therapy Hands-On Workshop

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrationsmore » with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant

The Role of Flow Diagnostic Techniques in Fan and Open Rotor Noise Modeling

NASA Technical Reports Server (NTRS)

Envia, Edmane

2016-01-01

A principal source of turbomachinery noise is the interaction of the rotating and stationary blade rows with the perturbations in the airstream through the engine. As such, a lot of research has been devoted to the study of the turbomachinery noise generation mechanisms. This is particularly true of fan and open rotors, both of which are the major contributors to the overall noise output of modern aircraft engines. Much of the research in fan and open rotor noise has been focused on developing theoretical models for predicting their noise characteristics. These models, which run the gamut from the semi-empirical to fully computational ones, are, in one form or another, informed by the description of the unsteady flow-field in which the propulsors (i.e., the fan and open rotors) operate. Not surprisingly, the fidelity of the theoretical models is dependent, to a large extent, on capturing the nuances of the unsteady flowfield that have a direct role in the noise generation process. As such, flow diagnostic techniques have proven to be indispensible in identifying the shortcoming of theoretical models and in helping to improve them. This presentation will provide a few examples of the role of flow diagnostic techniques in assessing the fidelity and robustness of the fan and open rotor noise prediction models.

Overuse of diagnostic tools and medications in acute rhinosinusitis in Spain: a population-based study (the PROSINUS study)

PubMed Central

Jaume, Francesca; Quintó, Llorenç; Alobid, Isam; Mullol, Joaquim

2018-01-01

Objectives Acute rhinosinusitis (ARS) has a high incidence. Diagnosis is clinical, and evolution is mostly self-limited. The aim of this study was to describe the sociodemographic characteristics and use of diagnostic tools and medications in patients with ARS. Design This is a prospective observational study in real-life clinical practice. Setting Patients with clinical diagnosis of ARS (n=2610) were included from ear, nose and throat clinics in Spain. A second visit at resolution was done. Participants Patients were classified according to the duration of symptoms: viral ARS (≤10 days), postviral ARS (>10 days, ≤12 weeks) and chronic rhinosinusitis (>12 weeks). Main outcome measures Sociodemographic characteristics, symptoms, disease severity, quality of life (Sino-Nasal Outcome Test-16), used diagnostic tools and medications, and the management performed by primary care physicians (PCPs) and by otorhinolaryngologists (ORLs) were assessed. Results Of the patients 36% were classified as having viral ARS, 63% postviral ARS and 1% as chronic rhinosinusitis. Working in a poorly air-conditioned environment was a risk factor (OR: 2.26, 95% CI 1.27 to 4.04) in developing postviral ARS. A higher number of diagnostic tools (rhinoscopy/endoscopy: 80% vs 70%; plain X-ray: 70% vs 55%; CT scan: 22% vs 12%; P<0.0001) were performed in postviral than viral cases. PCPs performed more X-rays than ORLs (P<0.0001). Patients, more those with postviral than viral ARS, received a high number of medications (oral antibiotics: 76% vs 62%; intranasal corticosteroids: 54% vs 38%; antihistamines: 46% vs 31%; mucolytic: 48% vs 60%; P<0.0001). PCPs prescribed more antibiotics, antihistamines and mucolytics than ORLs (P<0.0068). More patients with postviral than viral ARS reported symptoms of potential complications (1.5% vs 0.4%; P=0.0603). Independently of prescribed medications, quality of life was more affected in patients with postviral (38.7±14.2 vs 36.0±15.3; P=0

The compression and storage method of the same kind of medical images: DPCM

NASA Astrophysics Data System (ADS)

Zhao, Xiuying; Wei, Jingyuan; Zhai, Linpei; Liu, Hong

2006-09-01

Medical imaging has started to take advantage of digital technology, opening the way for advanced medical imaging and teleradiology. Medical images, however, require large amounts of memory. At over 1 million bytes per image, a typical hospital needs a staggering amount of memory storage (over one trillion bytes per year), and transmitting an image over a network (even the promised superhighway) could take minutes--too slow for interactive teleradiology. This calls for image compression to reduce significantly the amount of data needed to represent an image. Several compression techniques with different compression ratio have been developed. However, the lossless techniques, which allow for perfect reconstruction of the original images, yield modest compression ratio, while the techniques that yield higher compression ratio are lossy, that is, the original image is reconstructed only approximately. Medical imaging poses the great challenge of having compression algorithms that are lossless (for diagnostic and legal reasons) and yet have high compression ratio for reduced storage and transmission time. To meet this challenge, we are developing and studying some compression schemes, which are either strictly lossless or diagnostically lossless, taking advantage of the peculiarities of medical images and of the medical practice. In order to increase the Signal to Noise Ratio (SNR) by exploitation of correlations within the source signal, a method of combining differential pulse code modulation (DPCM) is presented.

New perineal injection technique for pudendal nerve infiltration in diagnostic and therapeutic procedures.

PubMed

Weinschenk, Stefan; Hollmann, Markus W; Strowitzki, Thomas

2016-04-01

Pudendal nerve injection is used as a diagnostic procedure in the vulvar region and for therapeutic purposes, such as in vulvodynia. Here, we provide a new, easy-to-perform perineal injection technique. We analyzed 105 perineal injections into the pudendal nerve with a local anesthetic (LA), procaine in 20 patients. A 0.4 × 40 mm needle was handled using a stop-and-go technique while monitoring the patient's discomfort. The needle was placed 1-2 cm laterally to the dorsal introitus. After aspiration, a small amount of LA was applied. After subcutaneous anesthesia, the needle was further advanced step-by-step. Thus, 5 ml could be applied with little discomfort to the patient. Anesthesia in the pudendal target region was the primary endpoint of our analysis. In 93 of 105 injections (88.6 %), complete perineal anesthesia was achieved with a single injection. 12 injections were repeated. These injections were excluded from the analysis. Severity of injection pain, on visual analog scale (VAS) from 0 to 100, was 26.8 (95 % CI 7.2-46.4). Age (β = 0.33, p < 0.01) and the number of previous injections (β = 0.35, p < 0.01) inversely correlated with injection pain. Injection pain and anesthesia were not affected by BMI, the number and the side of previous injections, or order of injection. A reversible vasovagal reaction was common, but no serious adverse effects occurred. Perineal pudendal injection is an effective and safe technique for anesthesia in diagnostic (vulva biopsy) and therapeutic indications (pudendal neuralgia), and regional anesthesia in perinatal settings.

Optical diagnostics of vascular reactions triggered by weak allergens using laser speckle-contrast imaging technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuznetsov, Yu L; Kalchenko, V V; Astaf'eva, N G

2014-08-31

The capability of using the laser speckle contrast imaging technique with a long exposure time for visualisation of primary acute skin vascular reactions caused by a topical application of a weak contact allergen is considered. The method is shown to provide efficient and accurate detection of irritant-induced primary acute vascular reactions of skin. The presented technique possesses a high potential in everyday diagnostic practice, preclinical studies, as well as in the prognosis of skin reactions to the interaction with potentially allergenic materials. (laser biophotonics)

Modern Diagnostic Techniques for the Assessment of Ocular Blood Flow in Myopia: Current State of Knowledge.

PubMed

Grudzińska, Ewa; Modrzejewska, Monika

2018-01-01

Myopia is the most common refractive error and the subject of interest of various studies assessing ocular blood flow. Increasing refractive error and axial elongation of the eye result in the stretching and thinning of the scleral, choroid, and retinal tissues and the decrease in retinal vessel diameter, disturbing ocular blood flow. Local and systemic factors known to change ocular blood flow include glaucoma, medications and fluctuations in intraocular pressure, and metabolic parameters. Techniques and tools assessing ocular blood flow include, among others, laser Doppler flowmetry (LDF), retinal function imager (RFI), laser speckle contrast imaging (LSCI), magnetic resonance imaging (MRI), optical coherence tomography angiography (OCTA), pulsatile ocular blood flowmeter (POBF), fundus pulsation amplitude (FPA), colour Doppler imaging (CDI), and Doppler optical coherence tomography (DOCT). Many researchers consistently reported lower blood flow parameters in myopic eyes regardless of the used diagnostic method. It is unclear whether this is a primary change that causes secondary thinning of ocular tissues or quite the opposite; that is, the mechanical stretching of the eye wall reduces its thickness and causes a secondary lower demand of tissues for oxygen. This paper presents a review of studies assessing ocular blood flow in myopes.

[Application of molecular diagnostic techniques in precision medicine of personalized treatment for colorectal cancer].

PubMed

Fu, Ji; Lin, Guole

2016-01-01

Precision medicine is to customize the treatment options for individual patient based on the personal genome information. Colorectal cancer (CRC) is one of the most common cancer worldwide. Molecular heterogeneity of CRC, which includes the MSI phenotype, hypermutation phenotype, and their relationship with clinical preferences, is believed to be one of the main factors responsible for the considerable variability in treatment response. The development of powerful next-generation sequencing (NGS) technologies allows us to further understand the biological behavior of colorectal cancer, and to analyze the prognosis and chemotherapeutic drug reactions by molecular diagnostic techniques, which can guide the clinical treatment. This paper will introduce the new findings in this field. Meanwhile we integrate the new progress of key pathways including EGFR, RAS, PI3K/AKT and VEGF, and the experience in selective patients through associated molecular diagnostic screening who gain better efficacy after target therapy. The technique for detecting circulating tumor DNA (ctDNA) is introduced here as well, which can identify patients with high risk for recurrence, and demonstrate the risk of chemotherapy resistance. Mechanism of tumor drug resistance may be revealed by dynamic observation of gene alteration during treatment.

Use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus secondary hypertension.

PubMed

Yoon, Esther Y; Cohn, Lisa; Freed, Gary; Rocchini, Albert; Kershaw, David; Ascione, Frank; Clark, Sarah

2014-07-01

To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary versus secondary hypertension. We conducted retrospective cohort analysis of claims data for adolescents and young adults (12-21 years of age) with ≥3 years of insurance coverage (≥11 months/year) in a large private managed care plan during 2003-2009 with diagnosis of primary hypertension or secondary hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and the presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms). The study sample included 1,232 adolescents and young adults; 84% had primary hypertension and 16% had secondary hypertension. The overall prevalence rate of hypertension was 2.6%. One quarter (28%) with primary hypertension had one or more antihypertensive medications, whereas 65% with secondary hypertension had one or more antihypertensive medications. Leading prescribers of antihypertensives for subjects with primary hypertension were primary care physicians (80%), whereas antihypertensive medications were equally prescribed by primary care physicians (43%) and sub-specialists (37%) for subjects with secondary hypertension. The predominant hypertension diagnosis among adolescents and young adults is primary hypertension. Antihypertensive medication use was higher among those with secondary hypertension compared with those with primary hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary versus secondary hypertension. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Studies on the foundation and development of diagnostic ultrasound

PubMed Central

Wagai, Toshio

2007-01-01

In recent years, various types of diagnostic imaging methods, such as CT, MRI, PET and Ultrasound, have been developed rapidly and become indispensable as clinical diagnostic tools. Among these imaging modalities, CT, MRI and PET all apply electromagnetic waves like radiation rays. In contrast, an ultrasound imaging method uses a completely different mechanical pressure wave: “sound”. Ultrasound has various features, including inaudible sound at very high frequencies, which allows its use in medical diagnoses. That is, ultrasound techniques can be applied in transmission, reflection and Doppler methods. Moreover, the sharp directivity of an ultrasound beam can also improve image resolution. Another big advantage of diagnostic ultrasound is that it does not harm the human body or cause any pain to patients. Given these various advantages, diagnostic ultrasound has recently been widely used in diagnosing cancer and cardiovascular disease and scanning fetuses (Fig. 1) as well as routine clinical examinations in hospitals. In this paper, I outline my almost 50-year history of diagnostic ultrasound research, particularly that performed at the early stage from 1950–56. PMID:24367150

MDR-TB screening in a setting with molecular diagnostic techniques: who got tested, who didn't and why?

PubMed Central

Govindarajan, S.; Sharath, B. N.; Tripathy, J. P.; Chinnakali, P.; Kumar, A. M. V.; Muthaiah, M.; Vivekananda, K.; Paulraj, A. K.; Roy, G.

2015-01-01

Setting: The Revised National Tuberculosis Control Programme, Puducherry, India, which has facilities for molecular diagnostic technique. Objective: To determine pre-diagnostic and pre-treatment attrition among presumptive multidrug-resistant tuberculosis (MDR-TB) patients and reasons for attrition. Methods: In this mixed-methods study, the quantitative component consisted of retrospective cohort analysis through record review of all presumptive MDR-TB patients recorded between October 2012 and September 2013. The qualitative component included in-depth interviews with key informants involved in programmatic management of drug-resistant tuberculosis services. Results: Of 341 eligible presumptive MDR-TB patients, pre-diagnostic and pre-treatment attrition was respectively 45.5% (155/341) and 29% (2/7). Patients with extra-pulmonary TB (RR = 2.3), those with human immuno-deficiency and TB co-infection (RR = 1.7), those registered during October–December 2012 (RR = 1.3) and those identified from primary/secondary health centres (RR = 1.8) were less likely to be tested. Themes that emerged during the analysis of the qualitative data were ‘lack of a systematic mechanism to track referrals for culture and drug susceptibility testing’, ‘absence of courier service to transport sputum’, ‘lack of knowledge and ownership among staff of general health system’, ‘shortage of diagnostic kits’ and ‘patient non-adherence’. Conclusion: Despite the introduction of molecular diagnostic techniques, operational issues in MDR-TB screening remain a concern and require urgent attention. PMID:26400385

Personality and Medical Specialty Choice: Technique Orientation versus People Orientation.

ERIC Educational Resources Information Center

Borges, Nicole J.; Osmon, William R.

2001-01-01

Results of the 16 Personality Factor Questionnaire completed by 161 physicians indicated that role consciousness, abstractedness, and tough mindedness differentiated medical specialties (surgeons, anesthesiologists, family practitioners). Results correlated with the use of differences between person orientation and technique orientation to…

Techniques A: continuous waves

NASA Astrophysics Data System (ADS)

Beuthan, J.

1993-08-01

In a vast amount of medical diseases the biochemical and physiological changes of soft tissues are hardly detectable by conventional techniques of diagnostic imaging (x- ray, ultrasound, computer tomography, and MRI). The detectivity is low and the technical efforts are tremendous. On the other hand these pathologic variations induce significant changes of the optical tissue parameters which can be detected. The corresponding variations of the scattered light can most easily be detected and evaluated by infrared diaphanoscopy, even on optical thick tissue slices.

Investigating existing medical CT segmentation techniques within automated baggage and package inspection

NASA Astrophysics Data System (ADS)

Megherbi, Najla; Breckon, Toby P.; Flitton, Greg T.

2013-10-01

3D Computed Tomography (CT) image segmentation is already well established tool in medical research and in routine daily clinical practice. However, such techniques have not been used in the context of 3D CT image segmentation for baggage and package security screening using CT imagery. CT systems are increasingly used in airports for security baggage examination. We propose in this contribution an investigation of the current 3D CT medical image segmentation methods for use in this new domain. Experimental results of 3D segmentation on real CT baggage security imagery using a range of techniques are presented and discussed.

Novel Nonlinear Laser Diagnostic Techniques

DTIC Science & Technology

1993-07-01

a thermometric probe of reactive flows. Since the two-photon pump laser couples a Doppler broadened ground state velocity distribution to the excited...rism, and passed unfocused into an aluminum cell con- in frequency space. Regions for line fitting are found by taining 99% pure NO. The gas mixture...of ASE as a More recently, ASE has prompted interest as an thermometric probe of combustion environments optical diagnostic of combustion environments

Local gray level S-curve transformation - A generalized contrast enhancement technique for medical images.

PubMed

Gandhamal, Akash; Talbar, Sanjay; Gajre, Suhas; Hani, Ahmad Fadzil M; Kumar, Dileep

2017-04-01

Most medical images suffer from inadequate contrast and brightness, which leads to blurred or weak edges (low contrast) between adjacent tissues resulting in poor segmentation and errors in classification of tissues. Thus, contrast enhancement to improve visual information is extremely important in the development of computational approaches for obtaining quantitative measurements from medical images. In this research, a contrast enhancement algorithm that applies gray-level S-curve transformation technique locally in medical images obtained from various modalities is investigated. The S-curve transformation is an extended gray level transformation technique that results into a curve similar to a sigmoid function through a pixel to pixel transformation. This curve essentially increases the difference between minimum and maximum gray values and the image gradient, locally thereby, strengthening edges between adjacent tissues. The performance of the proposed technique is determined by measuring several parameters namely, edge content (improvement in image gradient), enhancement measure (degree of contrast enhancement), absolute mean brightness error (luminance distortion caused by the enhancement), and feature similarity index measure (preservation of the original image features). Based on medical image datasets comprising 1937 images from various modalities such as ultrasound, mammograms, fluorescent images, fundus, X-ray radiographs and MR images, it is found that the local gray-level S-curve transformation outperforms existing techniques in terms of improved contrast and brightness, resulting in clear and strong edges between adjacent tissues. The proposed technique can be used as a preprocessing tool for effective segmentation and classification of tissue structures in medical images. Copyright © 2017 Elsevier Ltd. All rights reserved.

Radiological safety status and quality assurance audit of medical X-ray diagnostic installations in India.

PubMed

Sonawane, A U; Singh, Meghraj; Sunil Kumar, J V K; Kulkarni, Arti; Shirva, V K; Pradhan, A S

2010-10-01

We conducted a radiological safety and quality assurance (QA) audit of 118 medical X-ray diagnostic machines installed in 45 major hospitals in India. The main objective of the audit was to verify compliance with the regulatory requirements stipulated by the national regulatory body. The audit mainly covered accuracy check of accelerating potential (kVp), linearity of tube current (mA station) and timer, congruence of radiation and optical field, and total filtration; in addition, we also reviewed medical X-ray diagnostic installations with reference to room layout of X-ray machines and conduct of radiological protection survey. A QA kit consisting of a kVp Test-O-Meter (ToM) (Model RAD/FLU-9001), dose Test-O-Meter (ToM) (Model 6001), ionization chamber-based radiation survey meter model Gun Monitor and other standard accessories were used for the required measurements. The important areas where there was noncompliance with the national safety code were: inaccuracy of kVp calibration (23%), lack of congruence of radiation and optical field (23%), nonlinearity of mA station (16%) and timer (9%), improper collimator/diaphragm (19.6%), faulty adjustor knob for alignment of field size (4%), nonavailability of warning light (red light) at the entrance of the X-ray room (29%), and use of mobile protective barriers without lead glass viewing window (14%). The present study on the radiological safety status of diagnostic X-ray installations may be a reasonably good representation of the situation in the country as a whole. The study contributes significantly to the improvement of radiological safety by the way of the steps already taken and by providing a vital feed back to the national regulatory body.

The transmission of low frequency medical data using delta modulation techniques.

NASA Technical Reports Server (NTRS)

Arndt, G. D.; Dawson, C. T.

1972-01-01

The transmission of low-frequency medical data using delta modulation techniques is described. The delta modulators are used to distribute the low-frequency data into the passband of the telephone lines. Both adaptive and linear delta modulators are considered. Optimum bit rates to minimize distortion and intersymbol interference are discussed. Vibrocardiographic waves are analyzed as a function of bit rate and delta modulator configuration to determine their reproducibility for medical evaluation.

ICNIRP Statement on Diagnostic Devices Using Non-ionizing Radiation: Existing Regulations and Potential Health Risks.

PubMed

2017-03-01

Use of non-ionizing radiation (NIR) for diagnostic purposes allows non-invasive assessment of the structure and function of the human body and is widely employed in medical care. ICNIRP has published previous statements about the protection of patients during medical magnetic resonance imaging (MRI), but diagnostic methods using other forms of NIR have not been considered. This statement reviews the range of diagnostic NIR devices currently used in clinical settings; documents the relevant regulations and policies covering patients and health care workers; reviews the evidence around potential health risks to patients and health care workers exposed to diagnostic NIR; and identifies situations of high NIR exposure from diagnostic devices in which patients or health care workers might not be adequately protected by current regulations. Diagnostic technologies were classified by the types of NIR that they employ. The aim was to describe the techniques in terms of general device categories which may encompass more specific devices or techniques with similar scientific principles. Relevant legally-binding regulations for protection of patients and workers and organizations responsible for those regulations were summarized. Review of the epidemiological evidence concerning health risks associated with exposure to diagnostic NIR highlighted a lack of data on potential risks to the fetus exposed to MRI during the first trimester, and on long-term health risks in workers exposed to MRI. Most of the relevant epidemiological evidence that is currently available relates to MRI or ultrasound. Exposure limits are needed for exposures from diagnostic technologies using optical radiation within the body. There is a lack of data regarding risk of congenital malformations following exposure to ultrasound in utero in the first trimester and also about the possible health effects of interactions between ultrasound and contrast media.

ICNIRP Statement on Diagnostic Devices Using Non-ionizing Radiation: Existing Regulations and Potential Health Risks

PubMed Central

2017-01-01

Abstract Use of non-ionizing radiation (NIR) for diagnostic purposes allows non-invasive assessment of the structure and function of the human body and is widely employed in medical care. ICNIRP has published previous statements about the protection of patients during medical magnetic resonance imaging (MRI), but diagnostic methods using other forms of NIR have not been considered. This statement reviews the range of diagnostic NIR devices currently used in clinical settings; documents the relevant regulations and policies covering patients and health care workers; reviews the evidence around potential health risks to patients and health care workers exposed to diagnostic NIR; and identifies situations of high NIR exposure from diagnostic devices in which patients or health care workers might not be adequately protected by current regulations. Diagnostic technologies were classified by the types of NIR that they employ. The aim was to describe the techniques in terms of general device categories which may encompass more specific devices or techniques with similar scientific principles. Relevant legally-binding regulations for protection of patients and workers and organizations responsible for those regulations were summarized. Review of the epidemiological evidence concerning health risks associated with exposure to diagnostic NIR highlighted a lack of data on potential risks to the fetus exposed to MRI during the first trimester, and on long-term health risks in workers exposed to MRI. Most of the relevant epidemiological evidence that is currently available relates to MRI or ultrasound. Exposure limits are needed for exposures from diagnostic technologies using optical radiation within the body. There is a lack of data regarding risk of congenital malformations following exposure to ultrasound in utero in the first trimester and also about the possible health effects of interactions between ultrasound and contrast media. PMID:28121732

[The characteristics of medical technologies in emergency medical care hospital].

PubMed

Murakhovskiĭ, A G; Babenko, A I; Bravve, Iu I; Tataurova, E A

2013-01-01

The article analyzes the implementation of major 12 diagnostic and 17 treatment technologies applied during medical care of patients with 12 key nosology forms of diseases in departments of the emergency medical care hospital No 2 of Omsk. It is established that key groups of technologies in the implementation of diagnostic process are the laboratory clinical diagnostic analyses and common diagnostic activities at reception into hospital and corresponding departments. The percentage of this kind of activities is about 78.3% of all diagnostic technologies. During the realization of treatment process the priority technologies are common curative and rehabilitation activities, intensive therapy activities and clinical diagnostic monitoring activities. All of them consist 80.1% of all curative technologies.

[Abdominal ultrasound course an introduction to the ultrasound technique. Physical basis. Ultrasound language].

PubMed

Segura-Grau, A; Sáez-Fernández, A; Rodríguez-Lorenzo, A; Díaz-Rodríguez, N

2014-01-01

Ultrasound is a non-invasive, accessible, and versatile diagnostic technique that uses high frequency ultrasound waves to define outline the organs of the human body, with no ionising radiation, in real time and with the capacity to visual several planes. The high diagnostic yield of the technique, together with its ease of uses plus the previously mentioned characteristics, has currently made it a routine method in daily medical practice. It is for this reason that the multidisciplinary character of this technique is being strengthened every day. To be able to perform the technique correctly requires knowledge of the physical basis of ultrasound, the method and the equipment, as well as of the human anatomy, in order to have the maximum information possible to avoid diagnostic errors due to poor interpretation or lack of information. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

The diagnostic accuracy of three rapid diagnostic tests for typhoid fever at Chittagong Medical College Hospital, Chittagong, Bangladesh.

PubMed

Maude, Rapeephan R; de Jong, Hanna K; Wijedoru, Lalith; Fukushima, Masako; Ghose, Aniruddha; Samad, Rasheda; Hossain, Mohammed Amir; Karim, Mohammed Rezaul; Faiz, Mohammed Abul; Parry, Christopher M

2015-10-01

To determine the diagnostic accuracy of three rapid diagnostic tests (RDTs) for typhoid fever in febrile hospitalised patients in Bangladesh. Febrile adults and children admitted to Chittagong Medical College Hospital, Bangladesh, were investigated with Bact/Alert(®) blood cultures and real-time PCR to detect Salmonella enterica Typhi and Paratyphi A and assays for Rickettsia, leptospirosis and dengue fever. Acute serum samples were examined with the LifeAssay (LA) Test-it™ Typhoid IgM lateral flow assay detecting IgM antibodies against S. Typhi O antigen, CTKBiotech Onsite Typhoid IgG/IgM Combo Rapid-test cassette lateral flow assay detecting IgG and IgM antibodies against S. Typhi O and H antigens and SD Bioline line assay for IgG and IgM antibodies against S. Typhi proteins. In 300 malaria smear-negative febrile patients [median (IQR) age of 13.5 (5-31) years], 34 (11.3%) had confirmed typhoid fever: 19 positive by blood culture for S. Typhi (three blood PCR positive) and 15 blood culture negative but PCR positive for S. Typhi in blood. The respective sensitivity and specificity of the three RDTs in patients using a composite reference standard of blood culture and/or PCR-confirmed typhoid fever were 59% and 61% for LifeAssay, 59% and 74% for the CTK IgM and/or IgG, and 24% and 96% for the SD Bioline RDT IgM and/or IgG. The LifeAssay RDT had a sensitivity of 63% and a specificity of 91% when modified with a positive cut-off of ≥2+ and analysed using a Bayesian latent class model. These typhoid RDTs demonstrated moderate diagnostic accuracies, and better tests are needed. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Urine sampling techniques in symptomatic primary-care patients: a diagnostic accuracy review.

PubMed

Holm, Anne; Aabenhus, Rune

2016-06-08

Choice of urine sampling technique in urinary tract infection may impact diagnostic accuracy and thus lead to possible over- or undertreatment. Currently no evidencebased consensus exists regarding correct sampling technique of urine from women with symptoms of urinary tract infection in primary care. The aim of this study was to determine the accuracy of urine culture from different sampling-techniques in symptomatic non-pregnant women in primary care. A systematic review was conducted by searching Medline and Embase for clinical studies conducted in primary care using a randomized or paired design to compare the result of urine culture obtained with two or more collection techniques in adult, female, non-pregnant patients with symptoms of urinary tract infection. We evaluated quality of the studies and compared accuracy based on dichotomized outcomes. We included seven studies investigating urine sampling technique in 1062 symptomatic patients in primary care. Mid-stream-clean-catch had a positive predictive value of 0.79 to 0.95 and a negative predictive value close to 1 compared to sterile techniques. Two randomized controlled trials found no difference in infection rate between mid-stream-clean-catch, mid-stream-urine and random samples. At present, no evidence suggests that sampling technique affects the accuracy of the microbiological diagnosis in non-pregnant women with symptoms of urinary tract infection in primary care. However, the evidence presented is in-direct and the difference between mid-stream-clean-catch, mid-stream-urine and random samples remains to be investigated in a paired design to verify the present findings.

Intelligent distributed medical image management

NASA Astrophysics Data System (ADS)

Garcia, Hong-Mei C.; Yun, David Y.

1995-05-01

The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.

Novel Variants of a Histogram Shift-Based Reversible Watermarking Technique for Medical Images to Improve Hiding Capacity

PubMed Central

Tuckley, Kushal

2017-01-01

In telemedicine systems, critical medical data is shared on a public communication channel. This increases the risk of unauthorised access to patient's information. This underlines the importance of secrecy and authentication for the medical data. This paper presents two innovative variations of classical histogram shift methods to increase the hiding capacity. The first technique divides the image into nonoverlapping blocks and embeds the watermark individually using the histogram method. The second method separates the region of interest and embeds the watermark only in the region of noninterest. This approach preserves the medical information intact. This method finds its use in critical medical cases. The high PSNR (above 45 dB) obtained for both techniques indicates imperceptibility of the approaches. Experimental results illustrate superiority of the proposed approaches when compared with other methods based on histogram shifting techniques. These techniques improve embedding capacity by 5–15% depending on the image type, without affecting the quality of the watermarked image. Both techniques also enable lossless reconstruction of the watermark and the host medical image. A higher embedding capacity makes the proposed approaches attractive for medical image watermarking applications without compromising the quality of the image. PMID:29104744

Computer-Aided Diagnostic (CAD) Scheme by Use of Contralateral Subtraction Technique

NASA Astrophysics Data System (ADS)

Nagashima, Hiroyuki; Harakawa, Tetsumi

We developed a computer-aided diagnostic (CAD) scheme for detection of subtle image findings of acute cerebral infarction in brain computed tomography (CT) by using a contralateral subtraction technique. In our computerized scheme, the lateral inclination of image was first corrected automatically by rotating and shifting. The contralateral subtraction image was then derived by subtraction of reversed image from original image. Initial candidates for acute cerebral infarctions were identified using the multiple-thresholding and image filtering techniques. As the 1st step for removing false positive candidates, fourteen image features were extracted in each of the initial candidates. Halfway candidates were detected by applying the rule-based test with these image features. At the 2nd step, five image features were extracted using the overlapping scale with halfway candidates in interest slice and upper/lower slice image. Finally, acute cerebral infarction candidates were detected by applying the rule-based test with five image features. The sensitivity in the detection for 74 training cases was 97.4% with 3.7 false positives per image. The performance of CAD scheme for 44 testing cases had an approximate result to training cases. Our CAD scheme using the contralateral subtraction technique can reveal suspected image findings of acute cerebral infarctions in CT images.

Constructing an Urban Population Model for Medical Insurance Scheme Using Microsimulation Techniques

PubMed Central

Xiong, Linping; Zhang, Lulu; Tang, Weidong; Ma, Yuqin

2012-01-01

China launched a pilot project of medical insurance reform in 79 cities in 2007 to cover urban nonworking residents. An urban population model was created in this paper for China's medical insurance scheme using microsimulation model techniques. The model made it clear for the policy makers the population distributions of different groups of people, the potential urban residents entering the medical insurance scheme. The income trends of units of individuals and families were also obtained. These factors are essential in making the challenging policy decisions when considering to balance the long-term financial sustainability of the medical insurance scheme. PMID:22481973

Development of a High-Pressure Gaseous Burner for Calibrating Optical Diagnostic Techniques

NASA Technical Reports Server (NTRS)

Kojima, Jun; Nguyen, Quang-Viet

2003-01-01

In this work-in-progress report, we show the development of a unique high-pressure burner facility (up to 60 atm) that provides steady, reproducible premixed flames with high precision, while having the capability to use multiple fuel/oxidizer combinations. The highpressure facility has four optical access ports for applying different laser diagnostic techniques and will provide a standard reference flame for the development of a spectroscopic database in high-pressure/temperature conditions. Spontaneous Raman scattering (SRS) was the first diagnostic applied, and was used to successfully probe premixed hydrogen-air flames generated in the facility using a novel multi-jet micro-premixed array burner element. The SRS spectral data include contributions from H2, N2, O2, and H2O and were collected over a wide range of equivalence ratios ranging from 0.16 to 4.9 at an initial pressure of 10-atm via a spatially resolved point SRS measurement with a high-performance optical system. Temperatures in fuel-lean to stoichiometric conditions were determined from the ratio of the Stokes to anti-Stokes scattering of the Q-branch of N2, and those in fuel-rich conditions via the rotational temperature of H2. The SRS derived temperatures using both techniques were consistent and indicated that the flame temperature was approximately 500 K below that predicted by adiabatic equilibrium, indicating a large amount of heat-loss at the measurement zone. The integrated vibrational SRS signals show that SRS provides quantitative number density data in high-pressure H2-air flames.

[Forensic medical diagnostics of intra-vitality of the strangulation mark by morphological methods].

PubMed

Bogomolov, D V; Zbrueva, Yu V; Putintsev, V A; Denisova, O P

2016-01-01

The objective of the present study WaS to overview the current domestic and foreign literature concerning the up-to-date methods employed for the expert evaluation of intra-vitality of the strangulation mark. The secondary objective was to propose the new approaches for addressing this problem. The methods of expert diagnostics with a view to determining the time of infliction of injuries as exemplified by mechanical asphyxia are discussed. It is concluded that immunohistochemical and morphometric studies provide the most promising tools for the evaluation of intra-vitality of the strangulation mark for the purpose of forensic medical expertise.

Diagnostics barriers and innovations in rural areas: insights from junior medical doctors on the frontlines of rural care in Peru.

PubMed

Anticona Huaynate, Cynthia Fiorella; Pajuelo Travezaño, Monica Jehnny; Correa, Malena; Mayta Malpartida, Holger; Oberhelman, Richard; Murphy, Laura L; Paz-Soldan, Valerie A

2015-10-05

Worldwide, rural communities face barriers when accessing health services. In response, numerous initiatives have focused on fostering technological innovations, new management approaches and health policies. Research suggests that the most successful innovations are those involving stakeholders at all levels. However, there is little evidence exploring the opinions of local health providers that could contribute with further innovation development and research. The aims of this study were to explore the perspectives of medical doctors (MDs) working in rural areas of Peru, regarding the barriers impacting the diagnostic process, and ideas for diagnostic innovations that could assist them. Data gathered through three focus group discussions (FGG) and 18 individual semi-structured interviews (SSI) with MDs who had completed their medical service in rural areas of Peru in the last two years were analyzed using thematic analysis. Three types of barriers emerged. The first barrier was the limited access to point of care (POC) diagnostic tools. Tests were needed for: i) the differential diagnosis of malaria vs. pneumonia, ii) dengue vs. leptospirosis, iii) tuberculosis, iv) vaginal infections and cervical cancer, v) neurocysticercosis, and vi) heavy metal toxicity. Ultrasound was needed for the diagnosis of obstetric and intra-abdominal conditions. There were also health system-related barriers such as limited funding for diagnostic services, shortage of specialists, limited laboratory services and access to telecommunications, and lack of institutional support. Finally, the third type of barriers included patient related-barriers to follow through with diagnostic referrals. Ideas for innovations proposed included POC equipment and tests, and telemedicine. MDs at primary health facilities in rural Peru face diagnostic challenges that are difficult to overcome due to a limited access to diagnostic tools. Referrals to specialized facilities are constrained by deficiencies

21 CFR 868.1840 - Diagnostic spirometer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic spirometer. 868.1840 Section 868.1840...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1840 Diagnostic spirometer. (a) Identification. A diagnostic spirometer is a device used in pulmonary function testing to measure the volume of...

The role of modern diagnostic imaging in diagnosing and differentiating kidney diseases in children.

PubMed

Maliborski, Artur; Zegadło, Arkadiusz; Placzyńska, Małgorzata; Sopińska, Małgorzata; Lichosik, Marianna; Jobs, Katarzyna

2018-01-01

Urinary tract diseases are in the group of the most commonly diagnosed medical conditions in pediatric patients. Many diseases with different etiologies are accompanied by pain, fever, hematuria, or urinary tract dysfunction. Those most common ones in children are urinary tract infections and congenital malformation. They can also represent tumors or changes caused by systemic diseases. Clinical tests and even more often additional imaging studies are required to make a proper diagnosis of urinary tract diseases. Just a few decades ago urography, cystography or voiding cystourethrography were the main methods in diagnostic imaging of the urinary tract. Today's imaging methods supported by digital radiographic and fluoroscopy systems, high sensitivity detectors with quantum detection, advanced algorithms eliminating motion artifacts, modern medical imaging monitors with a resolution of three or even eight megapixels significantly differ from conventional radiographic methods. The methods that are currently usually performed are: computed tomography, magnetic resonance imaging, isotopic methods and ultrasonography using elastography and new solutions in Doppler imaging. Modern techniques are currently focused on reducing radiation exposure with better imaging capabilities. The development of these techniques became an essential diagnostic aid in nephrological and urological practice. The aim of this paper is to present the latest solutions that are currently used in the diagnostic imaging of urinary tract diseases.

Evaluation of Programmed Instruction Techniques in Medical Interviewing. Final Report, June 15, 1966 to June 15, 1968.

ERIC Educational Resources Information Center

Adler, Leta McKinney; And Others

Since the medical interview is usually considered to be the basis of all diagnosis and treatment in medicine, this study investigated alternative ways of improving medical interview techniques. To test the hypothesis that the visual (videotape) technique would be more effective than the lecturing or audiotape technique, 12 videotaped interviews…

Estimating the Burden of Pneumococcal Pneumonia among Adults: A Systematic Review and Meta-Analysis of Diagnostic Techniques

PubMed Central

Said, Maria A.; Johnson, Hope L.; Nonyane, Bareng A. S.; Deloria-Knoll, Maria; O′Brien, Katherine L.

2013-01-01

Background Pneumococcal pneumonia causes significant morbidity and mortality among adults. Given limitations of diagnostic tests for non-bacteremic pneumococcal pneumonia, most studies report the incidence of bacteremic or invasive pneumococcal disease (IPD), and thus, grossly underestimate the pneumococcal pneumonia burden. We aimed to develop a conceptual and quantitative strategy to estimate the non-bacteremic disease burden among adults with community-acquired pneumonia (CAP) using systematic study methods and the availability of a urine antigen assay. Methods and Findings We performed a systematic literature review of studies providing information on the relative yield of various diagnostic assays (BinaxNOW® S. pneumoniae urine antigen test (UAT) with blood and/or sputum culture) in diagnosing pneumococcal pneumonia. We estimated the proportion of pneumococcal pneumonia that is bacteremic, the proportion of CAP attributable to pneumococcus, and the additional contribution of the Binax UAT beyond conventional diagnostic techniques, using random effects meta-analytic methods and bootstrapping. We included 35 studies in the analysis, predominantly from developed countries. The estimated proportion of pneumococcal pneumonia that is bacteremic was 24.8% (95% CI: 21.3%, 28.9%). The estimated proportion of CAP attributable to pneumococcus was 27.3% (95% CI: 23.9%, 31.1%). The Binax UAT diagnosed an additional 11.4% (95% CI: 9.6, 13.6%) of CAP beyond conventional techniques. We were limited by the fact that not all patients underwent all diagnostic tests and by the sensitivity and specificity of the diagnostic tests themselves. We address these resulting biases and provide a range of plausible values in order to estimate the burden of pneumococcal pneumonia among adults. Conclusions Estimating the adult burden of pneumococcal disease from bacteremic pneumococcal pneumonia data alone significantly underestimates the true burden of disease in adults. For every case of

Modernizing and transforming medical education at the Kilimanjaro Christian Medical University College.

PubMed

Lisasi, Esther; Kulanga, Ahaz; Muiruri, Charles; Killewo, Lucy; Fadhili, Ndimangwa; Mimano, Lucy; Kapanda, Gibson; Tibyampansha, Dativa; Ibrahim, Glory; Nyindo, Mramba; Mteta, Kien; Kessi, Egbert; Ntabaye, Moshi; Bartlett, John

2014-08-01

The Kilimanjaro Christian Medical University (KCMU) College and the Medical Education Partnership Initiative (MEPI) are addressing the crisis in Tanzanian health care manpower by modernizing the college's medical education with new tools and techniques. With a $10 million MEPI grant and the participation of its partner, Duke University, KCMU is harnessing the power of information technology (IT) to upgrade tools for students and faculty. Initiatives in eLearning have included bringing fiber-optic connectivity to the campus, offering campus-wide wireless access, opening student and faculty computer laboratories, and providing computer tablets to all incoming medical students. Beyond IT, the college is also offering wet laboratory instruction for hands-on diagnostic skills, team-based learning, and clinical skills workshops. In addition, modern teaching tools and techniques address the challenges posed by increasing numbers of students. To provide incentives for instructors, a performance-based compensation plan and teaching awards have been established. Also for faculty, IT tools and training have been made available, and a medical education course management system is now being widely employed. Student and faculty responses have been favorable, and the rapid uptake of these interventions by students, faculty, and the college's administration suggests that the KCMU College MEPI approach has addressed unmet needs. This enabling environment has transformed the culture of learning and teaching at KCMU College, where a path to sustainability is now being pursued.

Review of quantitative ultrasound: envelope statistics and backscatter coefficient imaging and contributions to diagnostic ultrasound

PubMed Central

Oelze, Michael L.; Mamou, Jonathan

2017-01-01

Conventional medical imaging technologies, including ultrasound, have continued to improve over the years. For example, in oncology, medical imaging is characterized by high sensitivity, i.e., the ability to detect anomalous tissue features, but the ability to classify these tissue features from images often lacks specificity. As a result, a large number of biopsies of tissues with suspicious image findings are performed each year with a vast majority of these biopsies resulting in a negative finding. To improve specificity of cancer imaging, quantitative imaging techniques can play an important role. Conventional ultrasound B-mode imaging is mainly qualitative in nature. However, quantitative ultrasound (QUS) imaging can provide specific numbers related to tissue features that can increase the specificity of image findings leading to improvements in diagnostic ultrasound. QUS imaging techniques can encompass a wide variety of techniques including spectral-based parameterization, elastography, shear wave imaging, flow estimation and envelope statistics. Currently, spectral-based parameterization and envelope statistics are not available on most conventional clinical ultrasound machines. However, in recent years QUS techniques involving spectral-based parameterization and envelope statistics have demonstrated success in many applications, providing additional diagnostic capabilities. Spectral-based techniques include the estimation of the backscatter coefficient, estimation of attenuation, and estimation of scatterer properties such as the correlation length associated with an effective scatterer diameter and the effective acoustic concentration of scatterers. Envelope statistics include the estimation of the number density of scatterers and quantification of coherent to incoherent signals produced from the tissue. Challenges for clinical application include correctly accounting for attenuation effects and transmission losses and implementation of QUS on clinical

Statistical innovations in the medical device world sparked by the FDA.

PubMed

Campbell, Gregory; Yue, Lilly Q

2016-01-01

The world of medical devices while highly diverse is extremely innovative, and this facilitates the adoption of innovative statistical techniques. Statisticians in the Center for Devices and Radiological Health (CDRH) at the Food and Drug Administration (FDA) have provided leadership in implementing statistical innovations. The innovations discussed include: the incorporation of Bayesian methods in clinical trials, adaptive designs, the use and development of propensity score methodology in the design and analysis of non-randomized observational studies, the use of tipping-point analysis for missing data, techniques for diagnostic test evaluation, bridging studies for companion diagnostic tests, quantitative benefit-risk decisions, and patient preference studies.

Committee Opinion No. 723: Guidelines for Diagnostic Imaging During Pregnancy and Lactation.

PubMed

2017-10-01

Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient. With few exceptions, radiation exposure through radiography, computed tomography scan, or nuclear medicine imaging techniques is at a dose much lower than the exposure associated with fetal harm. If these techniques are necessary in addition to ultrasonography or magnetic resonance imaging or are more readily available for the diagnosis in question, they should not be withheld from a pregnant patient. Breastfeeding should not be interrupted after gadolinium administration.

Diagnostic Accuracy of Lumbosacral Spine Magnetic Resonance Image Reading by Chiropractors, Chiropractic Radiologists, and Medical Radiologists.

PubMed

de Zoete, Annemarie; Ostelo, Raymond; Knol, Dirk L; Algra, Paul R; Wilmink, Jan T; van Tulder, Maurits W

2015-06-01

A cross-sectional diagnostic accuracy study was conducted in 2 sessions. It is important to know whether it is possible to accurately detect "specific findings" on lumbosacral magnetic resonance (MR) images and whether the results of different observers are comparable. Health care providers frequently use magnetic resonance imaging in the diagnostic process of patients with low back pain. The use of MR scans is increasing. This leads to an increase in costs and to an increase in risk of inaccurately labeling patients with an anatomical diagnosis that might not be the actual cause of symptoms. A set of 300 blinded MR images was read by medical radiologists, chiropractors, and chiropractic radiologists in 2 sessions. Each assessor read 100 scans in round 1 and 50 scans in round 2. The reference test was an expert panel.For all analyses, the magnetic resonance imaging findings were dichotomized into "specific findings" or "no specific findings." For the agreement, percentage agreement and κ values were calculated and for validity, sensitivity, and specificity. Sensitivity analysis was done for classifications A and B (prevalence of 31% and 57%, respectively). The intraobserver κ values for chiropractors, chiropractic radiologists, and medical radiologists were 0.46, 0.49, and 0.69 for A and 0.55, 0.75, and 0.64 for B, respectively.The interobserver κ values were lowest for chiropractors (0.28 for A, 0.37 for B) and highest for chiropractic radiologists (0.50 for A, 0.49 for B).The sensitivities of the medical radiologists, chiropractors, and chiropractic radiologists were 0.62, 0.71, and 0.75 for A and 0.70, 0.74, 0.84 for B, respectively.The specificities of medical radiologists, chiropractic radiologists, and chiropractors were 0.82, 0.77, and 0.70 for A and 0.74, 0.52, and 0.61 for B, respectively. Agreement and validity of MR image readings of chiropractors and chiropractic and medical radiologists is modest at best. This study supports recommendations in

Noninvasive diagnostic techniques in cardiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Verani, M.S.

1983-10-01

Noninvasive cardiology has made notable progress in the last several years. A variety of sophisticated tests are now available to the clinician, providing both anatomic and physiologic information. The result has been an improvement of the level of diagnostic accuracy, which in a final analysis translates into better patient care. Newer tests such as cardiac CAT scan and nuclear magnetic resonance, using incredibly advanced technologies, continue to be investigated and almost certainly will play an important role in cardiovascular diagnosis in year to come.

Can electronic medical images replace hard-copy film? Defining and testing the equivalence of diagnostic tests.

PubMed

Obuchowski, N A

2001-10-15

Electronic medical images are an efficient and convenient format in which to display, store and transmit radiographic information. Before electronic images can be used routinely to screen and diagnose patients, however, it must be shown that readers have the same diagnostic performance with this new format as traditional hard-copy film. Currently, there exist no suitable definitions of diagnostic equivalence. In this paper we propose two criteria for diagnostic equivalence. The first criterion ('population equivalence') considers the variability between and within readers, as well as the mean reader performance. This criterion is useful for most applications. The second criterion ('individual equivalence') involves a comparison of the test results for individual patients and is necessary when patients are followed radiographically over time. We present methods for testing both individual and population equivalence. The properties of the proposed methods are assessed in a Monte Carlo simulation study. Data from a mammography screening study is used to illustrate the proposed methods and compare them with results from more conventional methods of assessing equivalence and inter-procedure agreement. Copyright 2001 John Wiley & Sons, Ltd.

The Application of Whole Cell-Based Biosensors for Use in Environmental Analysis and in Medical Diagnostics

PubMed Central

Gui, Qingyuan; Lawson, Tom; Shan, Suyan; Yan, Lu; Liu, Yong

2017-01-01

Various whole cell-based biosensors have been reported in the literature for the last 20 years and these reports have shown great potential for their use in the areas of pollution detection in environmental and in biomedical diagnostics. Unlike other reviews of this growing field, this mini-review argues that: (1) the selection of reporter genes and their regulatory proteins are directly linked to the performance of celllular biosensors; (2) broad enhancements in microelectronics and information technologies have also led to improvements in the performance of these sensors; (3) their future potential is most apparent in their use in the areas of medical diagnostics and in environmental monitoring; and (4) currently the most promising work is focused on the better integration of cellular sensors with nano and micro scaled integrated chips. With better integration it may become practical to see these cells used as (5) real-time portable devices for diagnostics at the bedside and for remote environmental toxin detection and this in situ application will make the technology commonplace and thus as unremarkable as other ubiquitous technologies. PMID:28703749

Veterinary nurse to medical diagnostic radiographer.

PubMed

Taylor, Nicholas

2017-08-19

Nicholas Taylor is senior diagnostic radiographer at the Great Western Hospital, Swindon, having initially qualified as a veterinary nurse. It was a college lecture that initially sparked his interest in radiography - little did he know where it would lead. British Veterinary Association.

Molecular diagnostics: the changing culture of medical microbiology.

PubMed

Bullman, Susan; Lucey, Brigid; Sleator, Roy D

2012-01-01

Diagnostic molecular biology is arguably the fastest growing area in current laboratory-based medicine. Growth of the so called 'omics' technologies has, over the last decade, led to a gradual migration away from the 'one test, one pathogen' paradigm, toward multiplex approaches to infectious disease diagnosis, which have led to significant improvements in clinical diagnostics and ultimately improved patient care.

Evidence of the preferential use of disease prototypes over case exemplars among early year one medical students prior to and following diagnostic training.

PubMed

Papa, Frank J; Li, Feiming

2015-12-01

Two core dual processing theory (DPT) System I constructs (Exemplars and Prototypes) were used to: 1) formulate a training exercise designed to improve diagnostic performance in year one medical students, and 2) explore whether any observed performance improvements were associated with preferential use of exemplars or prototypes. With IRB approval, 117 year one medical students participated in an acute chest pain diagnostic training exercise. A pre- and post-training test containing the same 27 case vignettes was used to determine if the subjects' diagnostic performance improved via training in both exemplars and prototypes. Exemplar and Prototype theory was also used to generate a unique typicality estimate for each case vignette. Because these estimates produce different performance predictions, differences in the subjects' observed performance would make it possible to infer whether subjects were preferentially using Exemplars or Prototypes. Pre- vs. post-training comparison revealed a significant performance improvement; t=14.04, p<0.001, Cohen's d=1.32. Pre-training, paired t-testing demonstrated that performance against the most typical vignettes>mid typical vignettes: t=4.94, p<0.001; and mid typical>least typical: t=5.16, p<0.001. Post-training, paired t-testing again demonstrated that performance against the most typical vignettes>mid typical: t=2.94, p<0.01; and mid typical>least typical: t=6.64, p<0.001. These findings are more consistent with the performance predictions generated via Prototype theory than Exemplar theory. DPT is useful in designing and evaluating the utility of new approaches to diagnostic training, and, investigating the cognitive factors driving diagnostic capabilities among early medical students.

21 CFR 892.1570 - Diagnostic ultrasonic transducer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic ultrasonic transducer. 892.1570 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1570 Diagnostic ultrasonic transducer. (a) Identification. A diagnostic ultrasonic transducer is a device made of a piezoelectric material...

21 CFR 870.1425 - Programmable diagnostic computer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Programmable diagnostic computer. 870.1425 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1425 Programmable diagnostic computer. (a) Identification. A programmable diagnostic computer is a device that can be...

21 CFR 870.1425 - Programmable diagnostic computer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Programmable diagnostic computer. 870.1425 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1425 Programmable diagnostic computer. (a) Identification. A programmable diagnostic computer is a device that can be...

21 CFR 870.1425 - Programmable diagnostic computer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Programmable diagnostic computer. 870.1425 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1425 Programmable diagnostic computer. (a) Identification. A programmable diagnostic computer is a device that can be...

21 CFR 870.1425 - Programmable diagnostic computer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Programmable diagnostic computer. 870.1425 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1425 Programmable diagnostic computer. (a) Identification. A programmable diagnostic computer is a device that can be...

21 CFR 870.1425 - Programmable diagnostic computer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Programmable diagnostic computer. 870.1425 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1425 Programmable diagnostic computer. (a) Identification. A programmable diagnostic computer is a device that can be...

The role of neurologists and diagnostic tests in the management of distal symmetric polyneuropathy

PubMed Central

Callaghan, Brian C.; Kerber, Kevin A.; Lisabeth, Lynda L.; Morgenstern, Lewis B.; Longoria, Ruth; Rodgers, Ann; Longwell, Paxton; Feldman, Eva L.

2014-01-01

Importance Distal symmetric polyneuropathy (DSP) is a prevalent condition resulting in high costs from diagnostic testing. However, the role of neurologists and diagnostic tests on patient care is unknown. Objective To determine how often neurologists and diagnostic tests influence the diagnosis and management of DSP patients in a community setting. Design We utilized a validated case-capture method (ICD-9 screening technique with subsequent medical chart abstraction) to identify patients with a new DSP diagnosis (retrospective cohort). Using a structured data abstraction process, diagnostic testing, diagnoses rendered (before and after testing), and subsequent management were recorded. Setting Community neurologist’s outpatient offices in Corpus Christi, Texas. Participants Patients meeting the Toronto consensus criteria for probable DSP. Main Outcome Measure Changes in etiology and management after diagnostic testing by neurologists. Results Between 1/1/2010–3/31/2011, we identified 458 DSP patients followed for mean (SD) 435.3 (44.1) days. Neurologists identified a cause of DSP in 63.5% of cases prior to their diagnostic testing. Seventy-one patients (15.5%) had a new DSP cause discovered after testing by neurologists. The most common new diagnoses were pre-diabetes (N=28), B12 deficiency (N=20), diabetes (N=8), and thyroid disease (N=8). Management changes were common (63.1%), usually related to neuropathic pain management (77.5%). Disease modifying management changes occurred in 24.7% with diabetes management (N=45), starting vitamins (N=39), advising diet/exercise (N=33), and adjusting thyroid medications (N=10) the most common. Electrodiagnostic testing and MRIs of the neuroaxis rarely led to management changes. Conclusions and Relevance Neurologists diagnosed the cause of DSP in almost two-thirds of patients prior to their diagnostic testing. Inexpensive blood tests for diabetes, thyroid dysfunction, and B12 deficiency, allowed neurologists to identify

Racial differences in the elderly's use of medical procedures and diagnostic tests.

PubMed Central

Escarce, J J; Epstein, K R; Colby, D C; Schwartz, J S

1993-01-01

OBJECTIVES. This study sought to examine racial differences in the use of medical procedures and diagnostic tests by elderly Americans. METHODS. We used 1986 physician claims data for a 5% national sample of Medicare enrollees aged 65 years and older to study 32 procedures and tests. For each service, we calculated the age- and sex-adjusted rate of use by race and the corresponding White-Black relative risk. RESULTS. Whites were more likely than Blacks to receive 23 services, and for many of these services, the differences in use were substantial. In contrast, Blacks were more likely than Whites to receive seven services. Whites had a particular advantage in access to higher-technology or newer services. Racial differences in use persisted among elders who had Medicaid in addition to Medicare coverage and increased among rural elders. CONCLUSIONS. There are pervasive racial differences in the use of medical services by elderly Americans that cannot be explained by differences in the prevalence of specific clinical conditions. Financial barriers to care do not fully account for these findings. Race may exacerbate the impact of other barriers to access. PMID:8328615

21 CFR 886.1380 - Diagnostic condensing lens.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic condensing lens. 886.1380 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1380 Diagnostic condensing lens. (a) Identification. A diagnostic condensing lens is a device used in binocular indirect ophthalmoscopy (a procedure...

[The evaluation of costs: standards of medical care and clinical statistic groups].

PubMed

Semenov, V Iu; Samorodskaia, I V

2014-01-01

The article presents the comparative analysis of techniques of evaluation of costs of hospital treatment using medical economic standards of medical care and clinical statistical groups. The technique of evaluation of costs on the basis of clinical statistical groups was developed almost fifty years ago and is largely applied in a number of countries. Nowadays, in Russia the payment for completed case of treatment on the basis of medical economic standards is the main mode of payment for medical care in hospital. It is very conditionally a Russian analogue of world-wide prevalent system of diagnostic related groups. The tariffs for these cases of treatment as opposed to clinical statistical groups are counted on basis of standards of provision of medical care approved by Minzdrav of Russia. The information derived from generalization of cases of treatment of real patients is not applied.

Effect of Accreditation on Accuracy of Diagnostic Tests in Medical Laboratories

PubMed Central

Jang, Mi-Ae; Yoon, Young Ahn; Song, Junghan; Kim, Jeong-Ho; Min, Won-Ki; Lee, Ji Sung

2017-01-01

Background Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective. We analyzed the results of the KEQAS to identify significant differences between laboratories with or without KLAP and to determine the impact of laboratory standardization on the accuracy of diagnostic tests. Methods We analyzed KEQAS participant data on clinical chemistry tests such as albumin, ALT, AST, and glucose from 2010 to 2013. As a statistical parameter to assess performance bias between laboratories, we compared 4-yr variance index score (VIS) between the two groups with or without KLAP. Results Compared with the group without KLAP, the group with KLAP exhibited significantly lower geometric means of 4-yr VIS for all clinical chemistry tests (P<0.0001); this difference justified a high level of confidence in standardized services provided by accredited laboratories. Confidence intervals for the mean of each test in the two groups (accredited and non-accredited) did not overlap, suggesting that the means of the groups are significantly different. Conclusions These results confirmed that practice standardization is strongly associated with the accuracy of test results. Our study emphasizes the necessity of establishing a system for standardization of diagnostic testing. PMID:28224767

21 CFR 890.1375 - Diagnostic electromyograph.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Diagnostic electromyograph. 890.1375 Section 890.1375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1375 Diagnostic...

21 CFR 890.1375 - Diagnostic electromyograph.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Diagnostic electromyograph. 890.1375 Section 890.1375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1375 Diagnostic...

21 CFR 890.1375 - Diagnostic electromyograph.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Diagnostic electromyograph. 890.1375 Section 890.1375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1375 Diagnostic...

21 CFR 890.1375 - Diagnostic electromyograph.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic electromyograph. 890.1375 Section 890.1375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1375 Diagnostic...

MO-F-204-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Szczykutowicz, T.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and

MO-F-204-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zambelli, J.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and

MO-F-204-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

DOE Office of Scientific and Technical Information (OSTI.GOV)

McKenney, S.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance of allmore » aspects of clinical medical physics. All parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those unique aspects of the nuclear exam, and how preparing for a second specialty differs from the first. Medical physicists who recently completed each ABR exam portion will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to prepare for Part 2 of the ABR exam by understanding diagnostic and

WE-D-213-00: Preparing for the ABR Diagnostic and Nuclear Medicine Physics Exams

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging

WE-D-213-01: Preparing for Part 1 of the ABR Diagnostic Physics Exam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Simiele, S.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging

WE-D-213-03: Preparing for Part 3 of the ABR Diagnostic Physics Exam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bevins, N.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging

WE-D-213-02: Preparing for Part 2 of the ABR Diagnostic Physics Exam

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zambelli, J.

Adequate, efficient preparation for the ABR Diagnostic and Nuclear Medical Physics exams is key to successfully obtain ABR professional certification. Each part of the ABR exam presents its own challenges: Part I: Determine the scope of basic medical physics study material, efficiently review this material, and solve related written questions/problems. Part II: Understand imaging principles, modalities, and systems, including image acquisition, processing, and display. Understand the relationship between imaging techniques, image quality, patient dose and safety, and solve related written questions/problems. Part III: Gain crucial, practical, clinical medical physics experience. Effectively communicate and explain the practice, performance, and significance ofmore » all aspects of clinical medical physics. All three parts of the ABR exam require specific skill sets and preparation: mastery of basic physics and imaging principles; written problem solving often involving rapid calculation; responding clearly and succinctly to oral questions about the practice, methods, and significance of clinical medical physics. This symposium focuses on the preparation and skill sets necessary for each part of the ABR exam. Although there is some overlap, the nuclear exam covers a different body of knowledge than the diagnostic exam. A separate speaker will address those aspects that are unique to the nuclear exam. Medical physicists who have recently completed each of part of the ABR exam will share their experiences, insights, and preparation methods to help attendees best prepare for the challenges of each part of the ABR exam. In accordance with ABR exam security policy, no recalls or exam questions will be discussed. Learning Objectives: How to prepare for Part 1 of the ABR exam by determining the scope of basic medical physics study material and related problem solving/calculations How to Prepare for Part 2 of the ABR exam by understanding diagnostic and/or nuclear imaging

21 CFR 890.1375 - Diagnostic electromyograph.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1375 Diagnostic..., and to monitor and display the electrical activity produced by nerves, for the diagnosis and prognosis...

Committee Opinion No. 723 Summary: Guidelines for Diagnostic Imaging During Pregnancy and Lactation.

PubMed

2017-10-01

Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient. With few exceptions, radiation exposure through radiography, computed tomography scan, or nuclear medicine imaging techniques is at a dose much lower than the exposure associated with fetal harm. If these techniques are necessary in addition to ultrasonography or magnetic resonance imaging or are more readily available for the diagnosis in question, they should not be withheld from a pregnant patient. Breastfeeding should not be interrupted after gadolinium administration.

VCSEL technology for medical diagnostics and therapeutics

NASA Astrophysics Data System (ADS)

Hibbs-Brenner, M. K.; Johnson, K. L.; Bendett, M.

2009-02-01

In the 1990's a new laser technology, Vertical Cavity Surface Emitting Lasers, or VCSELs, emerged and transformed the data communication industry. The combination of performance characteristics, reliability and performance/cost ratio allowed high data rate communication to occur over short distances at a commercially viable price. VCSELs have not been widely used outside of this application space, but with the development of new attributes, such as a wider range of available wavelengths, the demonstration of arrays of VCSELs on a single chip, and a variety of package form factors, VCSELs can have a significant impact on medical diagnostic and therapeutic applications. One area of potential application is neurostimulation. Researchers have previously demonstrated the feasibility of using 1850nm light for nerve stimulation. The ability to create an array of VCSELs emitting at this wavelength would allow significantly improved spatial resolution, and multiple parallel channels of stimulation. For instance, 2D arrays of 100 lasers or more can be integrated on a single chip less than 2mm on a side. A second area of interest is non-invasive sensing. Performance attributes such as the narrow spectral width, low power consumption, and packaging flexibility open up new possibilities in non-invasive and/or continuous sensing. This paper will suggest ways in which VCSELs can be implemented within these application areas, and the advantages provided by the unique performance characteristics of the VCSEL. The status of VCSEL technology as a function of available wavelength and array size and form factors will be summarized.

Evidence assessing the diagnostic performance of medical smartphone apps: a systematic review and exploratory meta-analysis

PubMed Central

Buechi, Rahel; Faes, Livia; Bachmann, Lucas M; Thiel, Michael A; Bodmer, Nicolas S; Schmid, Martin K; Job, Oliver; Lienhard, Kenny R

2017-01-01

Objective The number of mobile applications addressing health topics is increasing. Whether these apps underwent scientific evaluation is unclear. We comprehensively assessed papers investigating the diagnostic value of available diagnostic health applications using inbuilt smartphone sensors. Methods Systematic Review—MEDLINE, Scopus, Web of Science inclusive Medical Informatics and Business Source Premier (by citation of reference) were searched from inception until 15 December 2016. Checking of reference lists of review articles and of included articles complemented electronic searches. We included all studies investigating a health application that used inbuilt sensors of a smartphone for diagnosis of disease. The methodological quality of 11 studies used in an exploratory meta-analysis was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the reporting quality with the ’STAndards for the Reporting of Diagnostic accuracy studies' (STARD) statement. Sensitivity and specificity of studies reporting two-by-two tables were calculated and summarised. Results We screened 3296 references for eligibility. Eleven studies, most of them assessing melanoma screening apps, reported 17 two-by-two tables. Quality assessment revealed high risk of bias in all studies. Included papers studied 1048 subjects (758 with the target conditions and 290 healthy volunteers). Overall, the summary estimate for sensitivity was 0.82 (95 % CI 0.56 to 0.94) and 0.89 (95 %CI 0.70 to 0.97) for specificity. Conclusions The diagnostic evidence of available health apps on Apple’s and Google’s app stores is scarce. Consumers and healthcare professionals should be aware of this when using or recommending them. PROSPERO registration number 42016033049. PMID:29247099

Novel Biomaterials Used in Medical 3D Printing Techniques

PubMed Central

Tappa, Karthik; Jammalamadaka, Udayabhanu

2018-01-01

The success of an implant depends on the type of biomaterial used for its fabrication. An ideal implant material should be biocompatible, inert, mechanically durable, and easily moldable. The ability to build patient specific implants incorporated with bioactive drugs, cells, and proteins has made 3D printing technology revolutionary in medical and pharmaceutical fields. A vast variety of biomaterials are currently being used in medical 3D printing, including metals, ceramics, polymers, and composites. With continuous research and progress in biomaterials used in 3D printing, there has been a rapid growth in applications of 3D printing in manufacturing customized implants, prostheses, drug delivery devices, and 3D scaffolds for tissue engineering and regenerative medicine. The current review focuses on the novel biomaterials used in variety of 3D printing technologies for clinical applications. Most common types of medical 3D printing technologies, including fused deposition modeling, extrusion based bioprinting, inkjet, and polyjet printing techniques, their clinical applications, different types of biomaterials currently used by researchers, and key limitations are discussed in detail. PMID:29414913

Novel Biomaterials Used in Medical 3D Printing Techniques.

PubMed

Tappa, Karthik; Jammalamadaka, Udayabhanu

2018-02-07

The success of an implant depends on the type of biomaterial used for its fabrication. An ideal implant material should be biocompatible, inert, mechanically durable, and easily moldable. The ability to build patient specific implants incorporated with bioactive drugs, cells, and proteins has made 3D printing technology revolutionary in medical and pharmaceutical fields. A vast variety of biomaterials are currently being used in medical 3D printing, including metals, ceramics, polymers, and composites. With continuous research and progress in biomaterials used in 3D printing, there has been a rapid growth in applications of 3D printing in manufacturing customized implants, prostheses, drug delivery devices, and 3D scaffolds for tissue engineering and regenerative medicine. The current review focuses on the novel biomaterials used in variety of 3D printing technologies for clinical applications. Most common types of medical 3D printing technologies, including fused deposition modeling, extrusion based bioprinting, inkjet, and polyjet printing techniques, their clinical applications, different types of biomaterials currently used by researchers, and key limitations are discussed in detail.

Applying data mining techniques to medical time series: an empirical case study in electroencephalography and stabilometry.

PubMed

Anguera, A; Barreiro, J M; Lara, J A; Lizcano, D

2016-01-01

One of the major challenges in the medical domain today is how to exploit the huge amount of data that this field generates. To do this, approaches are required that are capable of discovering knowledge that is useful for decision making in the medical field. Time series are data types that are common in the medical domain and require specialized analysis techniques and tools, especially if the information of interest to specialists is concentrated within particular time series regions, known as events. This research followed the steps specified by the so-called knowledge discovery in databases (KDD) process to discover knowledge from medical time series derived from stabilometric (396 series) and electroencephalographic (200) patient electronic health records (EHR). The view offered in the paper is based on the experience gathered as part of the VIIP project. Knowledge discovery in medical time series has a number of difficulties and implications that are highlighted by illustrating the application of several techniques that cover the entire KDD process through two case studies. This paper illustrates the application of different knowledge discovery techniques for the purposes of classification within the above domains. The accuracy of this application for the two classes considered in each case is 99.86% and 98.11% for epilepsy diagnosis in the electroencephalography (EEG) domain and 99.4% and 99.1% for early-age sports talent classification in the stabilometry domain. The KDD techniques achieve better results than other traditional neural network-based classification techniques.

Diagnostic Imaging

MedlinePlus

Diagnostic imaging lets doctors look inside your body for clues about a medical condition. A variety of machines and ... and activities inside your body. The type of imaging your doctor uses depends on your symptoms and ...

Reducing beam shaper alignment complexity: diagnostic techniques for alignment and tuning

NASA Astrophysics Data System (ADS)

Lizotte, Todd E.

2011-10-01

Safe and efficient optical alignment is a critical requirement for industrial laser systems used in a high volume manufacturing environment. Of specific interest is the development of techniques to align beam shaping optics within a beam line; having the ability to instantly verify by a qualitative means that each element is in its proper position as the beam shaper module is being aligned. There is a need to reduce these types of alignment techniques down to a level where even a newbie to optical alignment will be able to complete the task. Couple this alignment need with the fact that most laser system manufacturers ship their products worldwide and the introduction of a new set of variables including cultural and language barriers, makes this a top priority for manufacturers. Tools and methodologies for alignment of complex optical systems need to be able to cross these barriers to ensure the highest degree of up time and reduce the cost of maintenance on the production floor. Customers worldwide, who purchase production laser equipment, understand that the majority of costs to a manufacturing facility is spent on system maintenance and is typically the largest single controllable expenditure in a production plant. This desire to reduce costs is driving the trend these days towards predictive and proactive, not reactive maintenance of laser based optical beam delivery systems [10]. With proper diagnostic tools, laser system developers can develop proactive approaches to reduce system down time, safe guard operational performance and reduce premature or catastrophic optics failures. Obviously analytical data will provide quantifiable performance standards which are more precise than qualitative standards, but each have a role in determining overall optical system performance [10]. This paper will discuss the use of film and fluorescent mirror devices as diagnostic tools for beam shaper module alignment off line or in-situ. The paper will also provide an overview

Spectroscopic diagnostics for bacteria in biologic sample

DOEpatents

El-Sayed, Mostafa A.; El-Sayed, Ivan H.

2002-01-01

A method to analyze and diagnose specific bacteria in a biologic sample using spectroscopy is disclosed. The method includes obtaining the spectra of a biologic sample of a non-infected patient for use as a reference, subtracting the reference from the spectra of an infected sample, and comparing the fingerprint regions of the resulting differential spectrum with reference spectra of bacteria in saline. Using this diagnostic technique, specific bacteria can be identified sooner and without culturing, bacteria-specific antibiotics can be prescribed sooner, resulting in decreased likelihood of antibiotic resistance and an overall reduction of medical costs.

Modernizing and Transforming Medical Education at the Kilimanjaro Christian Medical University College

PubMed Central

Lisasi, Esther; Kulanga, Ahaz; Muiruri, Charles; Killewo, Lucy; Fadhili, Ndimangwa; Mimano, Lucy; Kapanda, Gibson; Tibyampansha, Dativa; Ibrahim, Glory; Nyindo, Mramba; Mteta, Kien; Kessi, Egbert; Ntabaye, Moshi; Bartlett, John

2014-01-01

The Kilimanjaro Christian Medical University (KCMU) College and the Medical Education Partnership Initiative (MEPI) are addressing the crisis in Tanzanian health care manpower by modernizing the college’s medical education with new tools and techniques. With a $10 million MEPI grant and the participation of its partner, Duke University, KCMU is harnessing the power of information technology (IT) to upgrade tools for students and faculty. Initiatives in eLearning have included bringing fiber-optic connectivity to the campus, offering campus-wide wireless access, opening student and faculty computer laboratories, and providing computer tablets to all incoming medical students. Beyond IT, the college is also offering wet laboratory instruction for hands-on diagnostic skills, team-based learning, and clinical skills workshops. In addition, modern teaching tools and techniques address the challenges posed by increasing numbers of students. To provide incentives for instructors, a performance-based compensation plan and teaching awards have been established. Also for faculty, IT tools and training have been made available, and a medical education course management system is now being widely employed. Student and faculty responses have been favorable, and the rapid uptake of these interventions by students, faculty, and the college’s administration suggests that the KCMU College MEPI approach has addressed unmet needs. This enabling environment has transformed the culture of learning and teaching at KCMU College, where a path to sustainability is now being pursued. PMID:25072581

READING DIAGNOSTIC APPROACHES.

ERIC Educational Resources Information Center

PURDY, ROBERT J.; AND OTHERS

A DIAGNOSTIC KIT DESIGNED TO HELP CLASSROOM TEACHERS DIAGNOSE READING DIFFICULTIES MORE ADEQUATELY AND MOTIVATE PUPILS MORE EFFECTIVELY IS PRESENTED. SUGGESTIONS ARE APPLICABLE TO LOWER PRIMARY CHILDREN. DIAGNOSTIC TECHNIQUES ARE OUTLINED FOR SUBJECTIVE AND OBJECTIVE OBSERVATION OF LANGUAGE ABILITY, VISUAL PERCEPTION SKILLS, AUDITORY…

Review of Quantitative Ultrasound: Envelope Statistics and Backscatter Coefficient Imaging and Contributions to Diagnostic Ultrasound.

PubMed

Oelze, Michael L; Mamou, Jonathan

2016-02-01

Conventional medical imaging technologies, including ultrasound, have continued to improve over the years. For example, in oncology, medical imaging is characterized by high sensitivity, i.e., the ability to detect anomalous tissue features, but the ability to classify these tissue features from images often lacks specificity. As a result, a large number of biopsies of tissues with suspicious image findings are performed each year with a vast majority of these biopsies resulting in a negative finding. To improve specificity of cancer imaging, quantitative imaging techniques can play an important role. Conventional ultrasound B-mode imaging is mainly qualitative in nature. However, quantitative ultrasound (QUS) imaging can provide specific numbers related to tissue features that can increase the specificity of image findings leading to improvements in diagnostic ultrasound. QUS imaging can encompass a wide variety of techniques including spectral-based parameterization, elastography, shear wave imaging, flow estimation, and envelope statistics. Currently, spectral-based parameterization and envelope statistics are not available on most conventional clinical ultrasound machines. However, in recent years, QUS techniques involving spectral-based parameterization and envelope statistics have demonstrated success in many applications, providing additional diagnostic capabilities. Spectral-based techniques include the estimation of the backscatter coefficient (BSC), estimation of attenuation, and estimation of scatterer properties such as the correlation length associated with an effective scatterer diameter (ESD) and the effective acoustic concentration (EAC) of scatterers. Envelope statistics include the estimation of the number density of scatterers and quantification of coherent to incoherent signals produced from the tissue. Challenges for clinical application include correctly accounting for attenuation effects and transmission losses and implementation of QUS on

GONADAL AND BONE MARROW DOSE IN MEDICAL DIAGNOSTIC RADIOLOGY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mahmoud, K.A.; Mahfouz, M.M.; Mahmoud, M.E.

1961-08-01

Measurements were made of the active mean bone marrow, integral bone marrow, gonadal, and maximum skin doses from diagnostic x-ray procedures used in Cairo University Hospitals. The active mean marrow dose in cervical, dorsal, and lumbar spine diagnostic exposures were: found to be somewhat smaller than those reported by some western couatries. One of the most striking results of the survey was the relatively high values of the urinary tract cases investigated diagnostically; owing to the high incidence of urinary tract Schistosomiasis. The gonadal dose delivered to males and females was found to be almosi negligible for all diagnostic investigationsmore » of the spine, except for the lumbo-dorsal region which was within the range 50 to 500 mrads. It was also found that the gonadal dose was significant in investigations of the lower gastrointestinal tract, gall bladder, and urinary tract. (P.C.H.)« less

21 CFR 874.1925 - Toynbee diagnostic tube.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toynbee diagnostic tube. 874.1925 Section 874.1925...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Diagnostic Devices § 874.1925 Toynbee diagnostic tube. (a) Identification. The toynbee diagnostic tube is a listening device intended to determine the degree of openness of...

21 CFR 874.1925 - Toynbee diagnostic tube.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Toynbee diagnostic tube. 874.1925 Section 874.1925...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Diagnostic Devices § 874.1925 Toynbee diagnostic tube. (a) Identification. The toynbee diagnostic tube is a listening device intended to determine the degree of openness of...

Current audiological diagnostics

PubMed Central

Hoth, Sebastian; Baljić, Izet

2017-01-01

Today’s audiological functional diagnostics is based on a variety of hearing tests, whose large number takes account of the variety of malfunctions of a complex sensory organ system and the necessity to examine it in a differentiated manner and at any age of life. The objective is to identify nature and origin of the hearing loss and to quantify its extent as far as necessary to dispose of the information needed to initiate the adequate medical (conservative or operational) treatment or the provision with technical hearing aids or prostheses. Moreover, audiometry provides the basis for the assessment of impairment and handicap as well as for the calculation of the degree of disability. In the present overview, the current state of the method inventory available for practical use is described, starting from basic diagnostics over to complex special techniques. The presentation is systematically grouped in subjective procedures, based on psychoacoustic exploration, and objective methods, based on physical measurements: preliminary hearing tests, pure tone threshold, suprathreshold processing of sound intensity, directional hearing, speech understanding in quiet and in noise, dichotic hearing, tympanogram, acoustic reflex, otoacoustic emissions and auditory evoked potentials. Apart from a few still existing gaps, this method inventory covers the whole spectrum of all clinically relevant functional deficits of the auditory system. PMID:29279727

Functional Nausea in Children: A Review of the Literature and Need for Diagnostic Criteria

PubMed Central

Russell, Alexandra C.; Stone, Amanda L.; Walker, Lynn S.

2016-01-01

Nausea is common amongst children with functional gastrointestinal disorders and is associated with a high burden of somatic and psychosocial comorbidities in both the short and long-term. Current treatments including medications, phytotherapy, stress-reduction techniques, and gastric electrical stimulation for recalcitrant cases, are reviewed. Functional nausea merits its own diagnostic criteria as a pediatric functional gastrointestinal disorder. PMID:27417243

Fundamentals of materials, techniques and instrumentation for OSL and FNTD dosimetry

NASA Astrophysics Data System (ADS)

Akselrod, M. S.

2013-02-01

The optically stimulated luminescence (OSL) technique has already become a successful commercial tool in personal radiation dosimetry, medical dosimetry, diagnostic imaging, geological and archeological dating. This review briefly describes the history and fundamental principles of OSL materials, methods and instrumentation. The advantages of OSL technology and instrumentation in comparison with thermoluminescent technique are analyzed. Progress in material and detector engineering has allowed new and promising developments regarding OSL applications in the medical field. Special attention is dedicated to Al2O3:C as a material of choice for many dosimetric applications including fiberoptic OSL/RL sensors with diameters as small as 300 μm. A new RL/OSL fiberoptic system has a high potential for in vivo and in vitro dosimetry in both radiation therapy and diagnostic mammography. Different aspects of instrumentation, data processing algorithms, post-irradiation and real-time measurements are described. The next technological breakthrough was done with Fluorescent Nuclear Track detectors (FNTD) that has some important advantages in measuring fast neutron and high energy heavy charge particles that became the latest tool in radiation therapy. New Mg-doped aluminum oxide crystals and novel type of imaging instrumentation for FNTD technology were engineered and successfully demonstrated for occupational and accident dosimetry, for medical dosimetry and radiobiological research.

Helminth parasitic infections of the central nervous system: a diagnostic approach.

PubMed

Othman, Ahmad A; Bruschi, Fabrizio; Ganna, Ahmed A

2014-04-01

Helminth parasitic infections of the central nervous system (CNS) occur worldwide with high prevalence in tropical and subtropical countries. Clinical evaluation of patients is mandatory, and it is convenient to group the clinical manifestations into syndromes: for example space-occupying lesions, meningitis, and encephalitis. The history should focus on residence or travel to endemic areas, diet, activities, intercurrent medical conditions, and associated clinical clues. Direct parasitological diagnosis can be reached by cerebrospinal fluid and cerebral tissue examination either by microscopy, culture, or immunological techniques. Immunodiagnosis by detection of parasite antibodies or antigens in serum could provide indirect evidence of parasitic infections. In addition, various imaging and radiological techniques e.g., computed tomography (CT) scan and magnetic resonance imaging (MRI) complement the diagnostic work-up of CNS diseases. Finally, the helminthic CNS infections of global impact, such as schistosomiasis, neurotoxocariasis, Strongyloides infection, neurotrichinosis, neurocysticercosis, and echinococcosis will be briefly discussed as regards the principal clinical and diagnostic features.

Myasthenia Gravis: Tests and Diagnostic Methods

MedlinePlus

... Focus on MG Newsletter MG Quarterly Test & Diagnostic methods In addition to a complete medical and neurological ... How can I help? About MGFA Test & Diagnostic methods Treatment for MG FAQ's Upcoming Events 2018 MG ...

Molecular diagnostics of neurodegenerative disorders.

PubMed

Agrawal, Megha; Biswas, Abhijit

2015-01-01

Molecular diagnostics provide a powerful method to detect and diagnose various neurological diseases such as Alzheimer's and Parkinson's disease. The confirmation of such diagnosis allows early detection and subsequent medical counseling that help specific patients to undergo clinically important drug trials. This provides a medical pathway to have better insight of neurogenesis and eventual cure of the neurodegenerative diseases. In this short review, we present recent advances in molecular diagnostics especially biomarkers and imaging spectroscopy for neurological diseases. We describe advances made in Alzheimer's disease (AD), Parkinson's disease (PD), Amyotrophic lateral sclerosis (ALS) and Huntington's disease (HD), and finally present a perspective on the future directions to provide a framework for further developments and refinements of molecular diagnostics to combat neurodegenerative disorders.

Nonculture molecular techniques for diagnosis of bacterial disease in animals: a diagnostic laboratory perspective.

PubMed

Cai, H Y; Caswell, J L; Prescott, J F

2014-03-01

The past decade has seen remarkable technical advances in infectious disease diagnosis, and the pace of innovation is likely to continue. Many of these techniques are well suited to pathogen identification directly from pathologic or clinical samples, which is the focus of this review. Polymerase chain reaction (PCR) and gene sequencing are now routinely performed on frozen or fixed tissues for diagnosis of bacterial infections of animals. These assays are most useful for pathogens that are difficult to culture or identify phenotypically, when propagation poses a biosafety hazard, or when suitable fresh tissue is not available. Multiplex PCR assays, DNA microarrays, in situ hybridization, massive parallel DNA sequencing, microbiome profiling, molecular typing of pathogens, identification of antimicrobial resistance genes, and mass spectrometry are additional emerging technologies for the diagnosis of bacterial infections from pathologic and clinical samples in animals. These technical advances come, however, with 2 caveats. First, in the age of molecular diagnosis, quality control has become more important than ever to identify and control for the presence of inhibitors, cross-contamination, inadequate templates from diagnostic specimens, and other causes of erroneous microbial identifications. Second, the attraction of these technologic advances can obscure the reality that medical diagnoses cannot be made on the basis of molecular testing alone but instead through integrated consideration of clinical, pathologic, and laboratory findings. Proper validation of the method is required. It is critical that veterinary diagnosticians understand not only the value but also the limitations of these technical advances for routine diagnosis of infectious disease.

Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.

PubMed

Kahwati, Leila; Viswanathan, Meera; Golin, Carol E; Kane, Heather; Lewis, Megan; Jacobs, Sara

2016-05-04

Interventions to improve medication adherence are diverse and complex. Consequently, synthesizing this evidence is challenging. We aimed to extend the results from an existing systematic review of interventions to improve medication adherence by using qualitative comparative analysis (QCA) to identify necessary or sufficient configurations of behavior change techniques among effective interventions. We used data from 60 studies in a completed systematic review to examine the combinations of nine behavior change techniques (increasing knowledge, increasing awareness, changing attitude, increasing self-efficacy, increasing intention formation, increasing action control, facilitation, increasing maintenance support, and motivational interviewing) among studies demonstrating improvements in adherence. Among the 60 studies, 34 demonstrated improved medication adherence. Among effective studies, increasing patient knowledge was a necessary but not sufficient technique. We identified seven configurations of behavior change techniques sufficient for improving adherence, which together accounted for 26 (76 %) of the effective studies. The intervention configuration that included increasing knowledge and self-efficacy was the most empirically relevant, accounting for 17 studies (50 %) and uniquely accounting for 15 (44 %). This analysis extends the completed review findings by identifying multiple combinations of behavior change techniques that improve adherence. Our findings offer direction for policy makers, practitioners, and future comparative effectiveness research on improving adherence.

A fuzzy optimal threshold technique for medical images

NASA Astrophysics Data System (ADS)

Thirupathi Kannan, Balaji; Krishnasamy, Krishnaveni; Pradeep Kumar Kenny, S.

2012-01-01

A new fuzzy based thresholding method for medical images especially cervical cytology images having blob and mosaic structures is proposed in this paper. Many existing thresholding algorithms may segment either blob or mosaic images but there aren't any single algorithm that can do both. In this paper, an input cervical cytology image is binarized, preprocessed and the pixel value with minimum Fuzzy Gaussian Index is identified as an optimal threshold value and used for segmentation. The proposed technique is tested on various cervical cytology images having blob or mosaic structures, compared with various existing algorithms and proved better than the existing algorithms.

Uncharted territory: measuring costs of diagnostic errors outside the medical record.

PubMed

Schwartz, Alan; Weiner, Saul J; Weaver, Frances; Yudkowsky, Rachel; Sharma, Gunjan; Binns-Calvey, Amy; Preyss, Ben; Jordan, Neil

2012-11-01

In a past study using unannounced standardised patients (USPs), substantial rates of diagnostic and treatment errors were documented among internists. Because the authors know the correct disposition of these encounters and obtained the physicians' notes, they can identify necessary treatment that was not provided and unnecessary treatment. They can also discern which errors can be identified exclusively from a review of the medical records. To estimate the avoidable direct costs incurred by physicians making errors in our previous study. In the study, USPs visited 111 internal medicine attending physicians. They presented variants of four previously validated cases that jointly manipulate the presence or absence of contextual and biomedical factors that could lead to errors in management if overlooked. For example, in a patient with worsening asthma symptoms, a complicating biomedical factor was the presence of reflux disease and a complicating contextual factor was inability to afford the currently prescribed inhaler. Costs of missed or unnecessary services were computed using Medicare cost-based reimbursement data. Fourteen practice locations, including two academic clinics, two community-based primary care networks with multiple sites, a core safety net provider, and three Veteran Administration government facilities. Contribution of errors to costs of care. Overall, errors in care resulted in predicted costs of approximately $174,000 across 399 visits, of which only $8745 was discernible from a review of the medical records alone (without knowledge of the correct diagnoses). The median cost of error per visit with an incorrect care plan differed by case and by presentation variant within case. Chart reviews alone underestimate costs of care because they typically reflect appropriate treatment decisions conditional on (potentially erroneous) diagnoses. Important information about patient context is often entirely missing from medical records. Experimental

Systematic evaluation of a secondary method for measuring diagnostic-level medical ultrasound transducer output power based on a large-area pyroelectric sensor

NASA Astrophysics Data System (ADS)

Zeqiri, B.; Žauhar, G.; Rajagopal, S.; Pounder, A.

2012-06-01

A systematic study of the application of a novel pyroelectric technique to the measurement of diagnostic-level medical ultrasound output power is described. The method exploits the pyroelectric properties of a 0.028 mm thick membrane of polyvinylidene fluoride (PVDF), backed by an acoustic absorber whose ultrasonic absorption coefficient approaches 1000 dB cm-1 at 3 MHz. When exposed to an ultrasonic field, absorption of ultrasound adjacent to the PVDF-absorber interface results in heating and the generation of a pyroelectric output voltage across gold electrodes deposited on the membrane. For a sensor large enough to intercept the whole of the acoustic beam, the output voltage can be calibrated for the measurement of acoustic output power. A number of key performance properties of the method have been investigated. The technique is very sensitive, with a power to voltage conversion factor of typically 0.23 V W-1. The frequency response of a particular embodiment of the sensor in which acoustic power reflected at the absorber-PVDF interface is subsequently returned to the pyroelectric membrane to be absorbed, has been evaluated over the frequency range 1.5 MHz to 10 MHz. This has shown the frequency response to be flat to within ±4%, above 2.5 MHz. Below this frequency, the sensitivity falls by 20% at 1.5 MHz. Linearity of the technique has been demonstrated to within ±1.6% for applied acoustic power levels from 1 mW up to 120 mW. A number of other studies targeted at assessing the achievable measurement uncertainties are presented. These involve: the effects of soaking, the influence of the angle of incidence of the acoustic beam, measurement repeatability and sensitivity to transducer positioning. Additionally, over the range 20 °C to 30 °C, the rate of change in sensitivity with ambient temperature has been shown to be +0.5% °C-1. Implications of the work for the development of a sensitive, traceable, portable, secondary method of ultrasound output power

Medical imaging: examples of clinical applications

NASA Astrophysics Data System (ADS)

Meinzer, H. P.; Thorn, M.; Vetter, M.; Hassenpflug, P.; Hastenteufel, M.; Wolf, I.

Clinical routine is currently producing a multitude of diagnostic digital images but only a few are used in therapy planning and treatment. Medical imaging is involved in both diagnosis and therapy. Using a computer, existing 2D images can be transformed into interactive 3D volumes and results from different modalities can be merged. Furthermore, it is possible to calculate functional areas that were not visible in the primary images. This paper presents examples of clinical applications that are integrated into clinical routine and are based on medical imaging fundamentals. In liver surgery, the importance of virtual planning is increasing because surgery is still the only possible curative procedure. Visualisation and analysis of heart defects are also gaining in significance due to improved surgery techniques. Finally, an outlook is provided on future developments in medical imaging using navigation to support the surgeon's work. The paper intends to give an impression of the wide range of medical imaging that goes beyond the mere calculation of medical images.

Effect of Accreditation on Accuracy of Diagnostic Tests in Medical Laboratories.

PubMed

Jang, Mi Ae; Yoon, Young Ahn; Song, Junghan; Kim, Jeong Ho; Min, Won Ki; Lee, Ji Sung; Lee, Yong Wha; Lee, You Kyoung

2017-05-01

Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective. We analyzed the results of the KEQAS to identify significant differences between laboratories with or without KLAP and to determine the impact of laboratory standardization on the accuracy of diagnostic tests. We analyzed KEQAS participant data on clinical chemistry tests such as albumin, ALT, AST, and glucose from 2010 to 2013. As a statistical parameter to assess performance bias between laboratories, we compared 4-yr variance index score (VIS) between the two groups with or without KLAP. Compared with the group without KLAP, the group with KLAP exhibited significantly lower geometric means of 4-yr VIS for all clinical chemistry tests (P<0.0001); this difference justified a high level of confidence in standardized services provided by accredited laboratories. Confidence intervals for the mean of each test in the two groups (accredited and non-accredited) did not overlap, suggesting that the means of the groups are significantly different. These results confirmed that practice standardization is strongly associated with the accuracy of test results. Our study emphasizes the necessity of establishing a system for standardization of diagnostic testing. © The Korean Society for Laboratory Medicine

Information-Gathering Patterns Associated with Higher Rates of Diagnostic Error

ERIC Educational Resources Information Center

Delzell, John E., Jr.; Chumley, Heidi; Webb, Russell; Chakrabarti, Swapan; Relan, Anju

2009-01-01

Diagnostic errors are an important source of medical errors. Problematic information-gathering is a common cause of diagnostic errors among physicians and medical students. The objectives of this study were to (1) determine if medical students' information-gathering patterns formed clusters of similar strategies, and if so (2) to calculate the…

Screening pregnant women for suicidal behavior in electronic medical records: diagnostic codes vs. clinical notes processed by natural language processing.

PubMed

Zhong, Qiu-Yue; Karlson, Elizabeth W; Gelaye, Bizu; Finan, Sean; Avillach, Paul; Smoller, Jordan W; Cai, Tianxi; Williams, Michelle A

2018-05-29

We examined the comparative performance of structured, diagnostic codes vs. natural language processing (NLP) of unstructured text for screening suicidal behavior among pregnant women in electronic medical records (EMRs). Women aged 10-64 years with at least one diagnostic code related to pregnancy or delivery (N = 275,843) from Partners HealthCare were included as our "datamart." Diagnostic codes related to suicidal behavior were applied to the datamart to screen women for suicidal behavior. Among women without any diagnostic codes related to suicidal behavior (n = 273,410), 5880 women were randomly sampled, of whom 1120 had at least one mention of terms related to suicidal behavior in clinical notes. NLP was then used to process clinical notes for the 1120 women. Chart reviews were performed for subsamples of women. Using diagnostic codes, 196 pregnant women were screened positive for suicidal behavior, among whom 149 (76%) had confirmed suicidal behavior by chart review. Using NLP among those without diagnostic codes, 486 pregnant women were screened positive for suicidal behavior, among whom 146 (30%) had confirmed suicidal behavior by chart review. The use of NLP substantially improves the sensitivity of screening suicidal behavior in EMRs. However, the prevalence of confirmed suicidal behavior was lower among women who did not have diagnostic codes for suicidal behavior but screened positive by NLP. NLP should be used together with diagnostic codes for future EMR-based phenotyping studies for suicidal behavior.

Analysis of questioning technique during classes in medical education.

PubMed

Cho, Young Hye; Lee, Sang Yeoup; Jeong, Dong Wook; Im, Sun Ju; Choi, Eun Jung; Lee, Sun Hee; Baek, Sun Yong; Kim, Yun Jin; Lee, Jeong Gyu; Yi, Yu Hyone; Bae, Mi Jin; Yune, So Jung

2012-06-12

Questioning is one of the essential techniques used by lecturers to make lectures more interactive and effective. This study surveyed the perception of questioning techniques by medical school faculty members and analyzed how the questioning technique is used in actual classes. Data on the perceptions of the questioning skills used during lectures was collected using a self-questionnaire for faculty members (N = 33) during the second semester of 2008. The questionnaire consisted of 18 items covering the awareness and characteristics of questioning skills. Recorded video tapes were used to observe the faculty members' questioning skills. Most faculty members regarded the questioning technique during classes as being important and expected positive outcomes in terms of the students' participation in class, concentration in class and understanding of the class contents. In the 99 classes analyzed, the median number of questions per class was 1 (0-29). Among them, 40 classes (40.4 %) did not use questioning techniques. The frequency of questioning per lecture was similar regardless of the faculty members' perception. On the other hand, the faculty members perceived that their usual wait time after question was approximately 10 seconds compared to only 2.5 seconds measured from video analysis. More lecture-experienced faculty members tended to ask more questions in class. There were some discrepancies regarding the questioning technique between the faculty members' perceptions and reality, even though they had positive opinions of the technique. The questioning skills during a lecture need to be emphasized to faculty members.

Introducing First-Year Medical Students to Early Diagnostic Hypotheses

ERIC Educational Resources Information Center

Taylor, P. J.; And Others

1978-01-01

A method of instruction in gynecology is described that encouraged the formulation of early diagnostic hypotheses, an important part of clinical problem-solving. Students were given a set of clinical clues to help them make broad diagnostic hypotheses. Student ability, results, and student perceptions of the course are provided. (Author/LBH)

Microfluidic-integrated biosensors: prospects for point-of-care diagnostics.

PubMed

Kumar, Suveen; Kumar, Saurabh; Ali, Md Azahar; Anand, Pinki; Agrawal, Ved Varun; John, Renu; Maji, Sagar; Malhotra, Bansi D

2013-11-01

There is a growing demand to integrate biosensors with microfluidics to provide miniaturized platforms with many favorable properties, such as reduced sample volume, decreased processing time, low cost analysis and low reagent consumption. These microfluidics-integrated biosensors would also have numerous advantages such as laminar flow, minimal handling of hazardous materials, multiple sample detection in parallel, portability and versatility in design. Microfluidics involves the science and technology of manipulation of fluids at the micro- to nano-liter level. It is predicted that combining biosensors with microfluidic chips will yield enhanced analytical capability, and widen the possibilities for applications in clinical diagnostics. The recent developments in microfluidics have helped researchers working in industries and educational institutes to adopt some of these platforms for point-of-care (POC) diagnostics. This review focuses on the latest advancements in the fields of microfluidic biosensing technologies, and on the challenges and possible solutions for translation of this technology for POC diagnostic applications. We also discuss the fabrication techniques required for developing microfluidic-integrated biosensors, recently reported biomarkers, and the prospects of POC diagnostics in the medical industry. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

21 CFR 886.1380 - Diagnostic condensing lens.

Code of Federal Regulations, 2010 CFR

2010-04-01

... light from the fundus of the eye. (b) Classification. Class I (general controls). The device is exempt...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1380 Diagnostic condensing lens. (a) Identification. A diagnostic condensing lens is a device used in binocular indirect ophthalmoscopy (a procedure...

Infrared Thermography-based Biophotonics: Integrated Diagnostic Technique for Systemic Reaction Monitoring

NASA Astrophysics Data System (ADS)

Vainer, Boris G.; Morozov, Vitaly V.

A peculiar branch of biophotonics is a measurement, visualisation and quantitative analysis of infrared (IR) radiation emitted from living object surfaces. Focal plane array (FPA)-based IR cameras make it possible to realize in medicine the so called interventional infrared thermal diagnostics. An integrated technique aimed at the advancement of this new approach in biomedical science and practice is described in the paper. The assembled system includes a high-performance short-wave (2.45-3.05 μm) or long-wave (8-14 μm) IR camera, two laser Doppler flowmeters (LDF) and additional equipment and complementary facilities implementing the monitoring of human cardiovascular status. All these means operate synchronously. It is first ascertained the relationship between infrared thermography (IRT) and LDF data in humans in regard to their systemic cardiovascular reactivity. Blood supply real-time dynamics in a narcotized patient is first visualized and quantitatively represented during surgery in order to observe how the general hyperoxia influences thermoregulatory mechanisms; an abrupt increase in temperature of the upper limb is observed using IRT. It is outlined that the IRT-based integrated technique may act as a take-off runway leading to elaboration of informative new methods directly applicable to medicine and biomedical sciences.

Development of advanced strain diagnostic techniques for reactor environments.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fleming, Darryn D.; Holschuh, Thomas Vernon,; Miller, Timothy J.

2013-02-01

The following research is operated as a Laboratory Directed Research and Development (LDRD) initiative at Sandia National Laboratories. The long-term goals of the program include sophisticated diagnostics of advanced fuels testing for nuclear reactors for the Department of Energy (DOE) Gen IV program, with the future capability to provide real-time measurement of strain in fuel rod cladding during operation in situ at any research or power reactor in the United States. By quantifying the stress and strain in fuel rods, it is possible to significantly improve fuel rod design, and consequently, to improve the performance and lifetime of the cladding.more » During the past year of this program, two sets of experiments were performed: small-scale tests to ensure reliability of the gages, and reactor pulse experiments involving the most viable samples in the Annulated Core Research Reactor (ACRR), located onsite at Sandia. Strain measurement techniques that can provide useful data in the extreme environment of a nuclear reactor core are needed to characterize nuclear fuel rods. This report documents the progression of solutions to this issue that were explored for feasibility in FY12 at Sandia National Laboratories, Albuquerque, NM.« less

Hyperspectral fluorescence imaging system for biomedical diagnostics

NASA Astrophysics Data System (ADS)

Martin, Matthew E.; Wabuyele, Musundi B.; Panjehpour, Masoud; Phan, Mary N.; Overholt, Bergein F.; Vo-Dinh, Tuan

2006-02-01

An advanced hyper-spectral imaging (HSI) system has been developed for use in medical diagnostics. One such diagnostic, esophageal cancer is diagnosed currently through biopsy and subsequent pathology. The end goal of this research is to develop an optical-based technique to assist or replace biopsy. In this paper, we demonstrate an instrument that has the capability to optically diagnose cancer in laboratory mice. We have developed a real-time HSI system based on state-of-the-art liquid crystal tunable filter (LCTF) technology coupled to an endoscope. This unique HSI technology is being developed to obtain spatially resolved images of the slight differences in luminescent properties of normal versus tumorous tissues. In this report, an in-vivo mouse study is shown. A predictive measure of cancer for the mice studied is developed and shown. It is hoped that the results of this study will lead to advances in the optical diagnosis of esophageal cancer in humans.

21 CFR 892.1570 - Diagnostic ultrasonic transducer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic ultrasonic transducer. 892.1570 Section 892.1570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1570 Diagnostic ultrasonic transducer...

21 CFR 890.1850 - Diagnostic muscle stimulator.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Diagnostic muscle stimulator. 890.1850 Section 890.1850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1850 Diagnostic...

21 CFR 890.1850 - Diagnostic muscle stimulator.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Diagnostic muscle stimulator. 890.1850 Section 890.1850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1850 Diagnostic...

21 CFR 890.1850 - Diagnostic muscle stimulator.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Diagnostic muscle stimulator. 890.1850 Section 890.1850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1850 Diagnostic...

21 CFR 890.1850 - Diagnostic muscle stimulator.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic muscle stimulator. 890.1850 Section 890.1850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1850 Diagnostic...

Benefit-risk Evaluation for Diagnostics: A Framework (BED-FRAME).

PubMed

Evans, Scott R; Pennello, Gene; Pantoja-Galicia, Norberto; Jiang, Hongyu; Hujer, Andrea M; Hujer, Kristine M; Manca, Claudia; Hill, Carol; Jacobs, Michael R; Chen, Liang; Patel, Robin; Kreiswirth, Barry N; Bonomo, Robert A

2016-09-15

The medical community needs systematic and pragmatic approaches for evaluating the benefit-risk trade-offs of diagnostics that assist in medical decision making. Benefit-Risk Evaluation of Diagnostics: A Framework (BED-FRAME) is a strategy for pragmatic evaluation of diagnostics designed to supplement traditional approaches. BED-FRAME evaluates diagnostic yield and addresses 2 key issues: (1) that diagnostic yield depends on prevalence, and (2) that different diagnostic errors carry different clinical consequences. As such, evaluating and comparing diagnostics depends on prevalence and the relative importance of potential errors. BED-FRAME provides a tool for communicating the expected clinical impact of diagnostic application and the expected trade-offs of diagnostic alternatives. BED-FRAME is a useful fundamental supplement to the standard analysis of diagnostic studies that will aid in clinical decision making. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Remote Skin Tissue Diagnostics In Vivo By Fiber Optic Evanescent Wave Fourier Transform Infrared (FEW-FTIR) Spectroscopy

NASA Astrophysics Data System (ADS)

Kolyakov, Sergei; Afanasyeva, Natalia; Bruch, Reinhard; Afanasyeva, Natalia

1998-05-01

The new method of fiber optical evanescent wave Fourier transform infrared (FEW-FTIR) spectroscopy has been applied to the diagnostics of normal skin tissue, as well as precancerous and cancerous conditions. The FEW-FTIR technique is nondestructive and sensitive to changes of vibrational spectra in the IR region, without heating and damaging human and animal skin tissue. Therefore this method and technique is an ideal diagnostic tool for tumor and cancer characterization at an early stage of development on a molecular level. The application of fiber optic technology in the middle infrared (MIR) region is relatively inexpensive and can be adapted easily to any commercially available tabletop FTIR spectrometers. This method of diagnostics is fast (several seconds), and can be applied to many fields. Noninvasive medical diagnostics of skin cancer and other skin diseases in vivo, ex vivo, and in vitro allow for the development of convenient, remote clinical applications in dermatology and related fields. The spectral variations from normal to pathological skin tissue and environmental influence on skin have been measured.

Evaluation of Chest Ultrasound Integrated Teaching of Respiratory System Physiology to Medical Students

ERIC Educational Resources Information Center

Paganini, Matteo; Bondì, Michela; Rubini, Alessandro

2017-01-01

Ultrasound imaging is a widely used diagnostic technique, whose integration in medical education is constantly growing. The aim of this study was to evaluate chest ultrasound usefulness in teaching respiratory system physiology, students' perception of chest ultrasound integration into a traditional lecture in human physiology, and short-term…

Abdominal Wall Desmoid during Pregnancy: Diagnostic Challenges

PubMed Central

Awwad, Johnny; Hammoud, Nadine; Farra, Chantal; Fares, Farah; Abi Saad, George; Ghazeeri, Ghina

2013-01-01

Background. Desmoids are benign tumors, with local invasive features and no metastatic potential, which have rarely been described to be pregnancy associated. Case. We described the rapid growth of an anterior abdominal wall mass in a 40-year-old pregnant woman. Due to its close proximity to the enlarged uterus, it was misdiagnosed to be a uterine leiomyoma by ultrasound examination. Final tissue diagnosis and radical resection were done at the time of abdominal delivery. Conclusion. Due to the diagnostic limitations of imaging techniques, desmoids should always be considered when the following manifestations are observed in combination: progressive growth of a solitary abdominal wall mass during pregnancy and well-delineated smooth tumor margins demonstrated by imaging techniques. This case emphasizes the importance of entertaining uncommon medical conditions in the differential diagnosis of seemingly common clinical manifestations. PMID:23346436

Hybrid Optical-Ultrasonic Technique for Biomedical Diagnostics

PubMed Central

Marcu, L.; Sun, Y.; Stephens, D.; Park, J.; Farwell, D. G.; Shung, K. K.

2010-01-01

We report the development of a diagnostic system combining time-resolved fluorescence spectroscopy and ultrasound backscatter microscopy and its application in diagnosis of tumors and atherosclerotic disease. This system allows for concurrent evaluation of distinct compositional, functional, and micro-anatomical features of normal and diseased tissues. PMID:21918737

Evaluation and construction of diagnostic criteria for inclusion body myositis

PubMed Central

Mammen, Andrew L.; Amato, Anthony A.; Weiss, Michael D.; Needham, Merrilee

2014-01-01

Objective: To use patient data to evaluate and construct diagnostic criteria for inclusion body myositis (IBM), a progressive disease of skeletal muscle. Methods: The literature was reviewed to identify all previously proposed IBM diagnostic criteria. These criteria were applied through medical records review to 200 patients diagnosed as having IBM and 171 patients diagnosed as having a muscle disease other than IBM by neuromuscular specialists at 2 institutions, and to a validating set of 66 additional patients with IBM from 2 other institutions. Machine learning techniques were used for unbiased construction of diagnostic criteria. Results: Twenty-four previously proposed IBM diagnostic categories were identified. Twelve categories all performed with high (≥97%) specificity but varied substantially in their sensitivities (11%–84%). The best performing category was European Neuromuscular Centre 2013 probable (sensitivity of 84%). Specialized pathologic features and newly introduced strength criteria (comparative knee extension/hip flexion strength) performed poorly. Unbiased data-directed analysis of 20 features in 371 patients resulted in construction of higher-performing data-derived diagnostic criteria (90% sensitivity and 96% specificity). Conclusions: Published expert consensus–derived IBM diagnostic categories have uniformly high specificity but wide-ranging sensitivities. High-performing IBM diagnostic category criteria can be developed directly from principled unbiased analysis of patient data. Classification of evidence: This study provides Class II evidence that published expert consensus–derived IBM diagnostic categories accurately distinguish IBM from other muscle disease with high specificity but wide-ranging sensitivities. PMID:24975859

21 CFR 886.1390 - Flexible diagnostic Fresnel lens.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Flexible diagnostic Fresnel lens. 886.1390 Section... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1390 Flexible diagnostic Fresnel lens. (a) Identification. A flexible diagnostic Fresnel lens is a device that is a very thin lens which has...

Large-scale retrieval for medical image analytics: A comprehensive review.

PubMed

Li, Zhongyu; Zhang, Xiaofan; Müller, Henning; Zhang, Shaoting

2018-01-01

Over the past decades, medical image analytics was greatly facilitated by the explosion of digital imaging techniques, where huge amounts of medical images were produced with ever-increasing quality and diversity. However, conventional methods for analyzing medical images have achieved limited success, as they are not capable to tackle the huge amount of image data. In this paper, we review state-of-the-art approaches for large-scale medical image analysis, which are mainly based on recent advances in computer vision, machine learning and information retrieval. Specifically, we first present the general pipeline of large-scale retrieval, summarize the challenges/opportunities of medical image analytics on a large-scale. Then, we provide a comprehensive review of algorithms and techniques relevant to major processes in the pipeline, including feature representation, feature indexing, searching, etc. On the basis of existing work, we introduce the evaluation protocols and multiple applications of large-scale medical image retrieval, with a variety of exploratory and diagnostic scenarios. Finally, we discuss future directions of large-scale retrieval, which can further improve the performance of medical image analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

SMS-Based Medical Diagnostic Telemetry Data Transmission Protocol for Medical Sensors

PubMed Central

Townsend, Ben; Abawajy, Jemal; Kim, Tai-Hoon

2011-01-01

People with special medical monitoring needs can, these days, be sent home and remotely monitored through the use of data logging medical sensors and a transmission base-station. While this can improve quality of life by allowing the patient to spend most of their time at home, most current technologies rely on hardwired landline technology or expensive mobile data transmissions to transmit data to a medical facility. The aim of this paper is to investigate and develop an approach to increase the freedom of a monitored patient and decrease costs by utilising mobile technologies and SMS messaging to transmit data from patient to medico. To this end, we evaluated the capabilities of SMS and propose a generic communications protocol which can work within the constraints of the SMS format, but provide the necessary redundancy and robustness to be used for the transmission of non-critical medical telemetry from data logging medical sensors. PMID:22163845

What We Do and Do Not Know about Teaching Medical Image Interpretation.

PubMed

Kok, Ellen M; van Geel, Koos; van Merriënboer, Jeroen J G; Robben, Simon G F

2017-01-01

Educators in medical image interpretation have difficulty finding scientific evidence as to how they should design their instruction. We review and comment on 81 papers that investigated instructional design in medical image interpretation. We distinguish between studies that evaluated complete offline courses and curricula, studies that evaluated e-learning modules, and studies that evaluated specific educational interventions. Twenty-three percent of all studies evaluated the implementation of complete courses or curricula, and 44% of the studies evaluated the implementation of e-learning modules. We argue that these studies have encouraging results but provide little information for educators: too many differences exist between conditions to unambiguously attribute the learning effects to specific instructional techniques. Moreover, concepts are not uniformly defined and methodological weaknesses further limit the usefulness of evidence provided by these studies. Thirty-two percent of the studies evaluated a specific interventional technique. We discuss three theoretical frameworks that informed these studies: diagnostic reasoning, cognitive schemas and study strategies. Research on diagnostic reasoning suggests teaching students to start with non-analytic reasoning and subsequently applying analytic reasoning, but little is known on how to train non-analytic reasoning. Research on cognitive schemas investigated activities that help the development of appropriate cognitive schemas. Finally, research on study strategies supports the effectiveness of practice testing, but more study strategies could be applicable to learning medical image interpretation. Our commentary highlights the value of evaluating specific instructional techniques, but further evidence is required to optimally inform educators in medical image interpretation.

Evidence assessing the diagnostic performance of medical smartphone apps: a systematic review and exploratory meta-analysis.

PubMed

Buechi, Rahel; Faes, Livia; Bachmann, Lucas M; Thiel, Michael A; Bodmer, Nicolas S; Schmid, Martin K; Job, Oliver; Lienhard, Kenny R

2017-12-14

The number of mobile applications addressing health topics is increasing. Whether these apps underwent scientific evaluation is unclear. We comprehensively assessed papers investigating the diagnostic value of available diagnostic health applications using inbuilt smartphone sensors. Systematic Review-MEDLINE, Scopus, Web of Science inclusive Medical Informatics and Business Source Premier (by citation of reference) were searched from inception until 15 December 2016. Checking of reference lists of review articles and of included articles complemented electronic searches. We included all studies investigating a health application that used inbuilt sensors of a smartphone for diagnosis of disease. The methodological quality of 11 studies used in an exploratory meta-analysis was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool and the reporting quality with the 'STAndards for the Reporting of Diagnostic accuracy studies' (STARD) statement. Sensitivity and specificity of studies reporting two-by-two tables were calculated and summarised. We screened 3296 references for eligibility. Eleven studies, most of them assessing melanoma screening apps, reported 17 two-by-two tables. Quality assessment revealed high risk of bias in all studies. Included papers studied 1048 subjects (758 with the target conditions and 290 healthy volunteers). Overall, the summary estimate for sensitivity was 0.82 (95 % CI 0.56 to 0.94) and 0.89 (95 %CI 0.70 to 0.97) for specificity. The diagnostic evidence of available health apps on Apple's and Google's app stores is scarce. Consumers and healthcare professionals should be aware of this when using or recommending them. 42016033049. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Uncertainty Management for Diagnostics and Prognostics of Batteries using Bayesian Techniques

NASA Technical Reports Server (NTRS)

Saha, Bhaskar; Goebel, kai

2007-01-01

Uncertainty management has always been the key hurdle faced by diagnostics and prognostics algorithms. A Bayesian treatment of this problem provides an elegant and theoretically sound approach to the modern Condition- Based Maintenance (CBM)/Prognostic Health Management (PHM) paradigm. The application of the Bayesian techniques to regression and classification in the form of Relevance Vector Machine (RVM), and to state estimation as in Particle Filters (PF), provides a powerful tool to integrate the diagnosis and prognosis of battery health. The RVM, which is a Bayesian treatment of the Support Vector Machine (SVM), is used for model identification, while the PF framework uses the learnt model, statistical estimates of noise and anticipated operational conditions to provide estimates of remaining useful life (RUL) in the form of a probability density function (PDF). This type of prognostics generates a significant value addition to the management of any operation involving electrical systems.

Diagnostics of glass fiber reinforced polymers and comparative analysis of their fabrication techniques with the use of acoustic emission

NASA Astrophysics Data System (ADS)

Bashkov, O. V.; Bryansky, A. A.; Panin, S. V.; Zaikov, V. I.

2016-11-01

Strength properties of the glass fiber reinforced polymers (GFRP) fabricated by vacuum and vacuum autoclave molding techniques were analyzed. Measurements of porosity of the GFRP parts manufactured by various molding techniques were conducted with the help of optical microscopy. On the basis of experimental data obtained by means of acoustic emission hardware/software setup, the technique for running diagnostics and forecasting the bearing capacity of polymeric composite materials based on the result of three-point bending tests has been developed. The operation principle of the technique is underlined by the evaluation of the power function index change which takes place on the dependence of the total acoustic emission counts versus the loading stress.

Non-invasive biomedical research and diagnostics enabled by innovative compact lasers

NASA Astrophysics Data System (ADS)

Litvinova, Karina S.; Rafailov, Ilya E.; Dunaev, Andrey V.; Sokolovski, Sergei G.; Rafailov, Edik U.

2017-11-01

For over half a century, laser technology has undergone a technological revolution. These technologies, particularly semiconductor lasers, are employed in a myriad of fields. Optical medical diagnostics, one of the emerging areas of laser application, are on the forefront of application around the world. Optical methods of non- or minimally invasive bio-tissue investigation offer significant advantages over alternative methods, including rapid real-time measurement, non-invasiveness and high resolution (guaranteeing the safety of a patient). These advantages demonstrate the growing success of such techniques. In this review, we will outline the recent status of laser technology applied in the biomedical field, focusing on the various available approaches, particularly utilising compact semiconductor lasers. We will further consider the advancement and integration of several complimentary biophotonic techniques into single multimodal devices, the potential impact of such devices and their future applications. Based on our own studies, we will also cover the simultaneous collection of physiological data with the aid a multifunctional diagnostics system, concentrating on the optimisation of the new technology towards a clinical application. Such data is invaluable for developing algorithms capable of delivering consistent, reliable and meaningful diagnostic information, which can ultimately be employed for the early diagnosis of disease conditions in individuals from around the world.

21 CFR 886.1395 - Diagnostic Hruby fundus lens.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic Hruby fundus lens. 886.1395 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1395 Diagnostic Hruby fundus lens. (a) Identification. A diagnostic Hruby fundus lens is a device that is a 55 diopter lens intended for use in the...

Diagnostic accuracy of magnetic resonance imaging techniques for treatment response evaluation in patients with high-grade glioma, a systematic review and meta-analysis.

PubMed

van Dijken, Bart R J; van Laar, Peter Jan; Holtman, Gea A; van der Hoorn, Anouk

2017-10-01

Treatment response assessment in high-grade gliomas uses contrast enhanced T1-weighted MRI, but is unreliable. Novel advanced MRI techniques have been studied, but the accuracy is not well known. Therefore, we performed a systematic meta-analysis to assess the diagnostic accuracy of anatomical and advanced MRI for treatment response in high-grade gliomas. Databases were searched systematically. Study selection and data extraction were done by two authors independently. Meta-analysis was performed using a bivariate random effects model when ≥5 studies were included. Anatomical MRI (five studies, 166 patients) showed a pooled sensitivity and specificity of 68% (95%CI 51-81) and 77% (45-93), respectively. Pooled apparent diffusion coefficients (seven studies, 204 patients) demonstrated a sensitivity of 71% (60-80) and specificity of 87% (77-93). DSC-perfusion (18 studies, 708 patients) sensitivity was 87% (82-91) with a specificity of 86% (77-91). DCE-perfusion (five studies, 207 patients) sensitivity was 92% (73-98) and specificity was 85% (76-92). The sensitivity of spectroscopy (nine studies, 203 patients) was 91% (79-97) and specificity was 95% (65-99). Advanced techniques showed higher diagnostic accuracy than anatomical MRI, the highest for spectroscopy, supporting the use in treatment response assessment in high-grade gliomas. • Treatment response assessment in high-grade gliomas with anatomical MRI is unreliable • Novel advanced MRI techniques have been studied, but diagnostic accuracy is unknown • Meta-analysis demonstrates that advanced MRI showed higher diagnostic accuracy than anatomical MRI • Highest diagnostic accuracy for spectroscopy and perfusion MRI • Supports the incorporation of advanced MRI in high-grade glioma treatment response assessment.

77 FR 6915 - Medical Diagnostic Equipment Accessibility Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... Israel Deaconess Medical Center (October 22, 2009) accessible facilities and accessible medical equipment... of types of accessible medical equipment required in different types of health care facilities. If... facilities, accessible medical equipment, and auxiliary aids and services; University of Southern California...

Evaluation of Computer-aided Strategies for Teaching Medical Students Prenatal Ultrasound Diagnostic Skills.

PubMed

Amesse, Lawrence S; Callendar, Ealena; Pfaff-Amesse, Teresa; Duke, Janice; Herbert, William N P

2008-09-24

To evaluate whether computer-based learning (CBL) improves newly acquired knowledge and is an effective strategy for teaching prenatal ultrasound diagnostic skills to third-year medical students when compared with instruction by traditional paper-based methods (PBM). We conducted a randomized, prospective study involving volunteer junior (3(rd) year) medical students consecutively rotating through the Obstetrics and Gynecology clerkship during six months of the 2005-2006 academic year. The students were randomly assigned to permuted blocks and divided into two groups. Half of the participants received instruction in prenatal ultrasound diagnostics using an interactive CBL program; the other half received instruction using equivalent material by the traditional PBM. Outcomes were evaluated by comparing changes in pre-tutorial and post instruction examination scores. All 36 potential participants (100%) completed the study curriculum. Students were divided equally between the CBL (n = 18) and PBM (n = 18) groups. Pre-tutorial exam scores (mean+/-s.d.) were 44%+/-11.1% for the CBL group and 44%+/-10.8% for the PBL cohort, indicating no statistically significant differences (p>0.05) between the two groups. After instruction, post-tutorial exam scores (mean+/-s.d.) were increased from the pre-tutorial scores, 74%+/-11% and 67%+/-12%, for students in the CBL and the PBM groups, respectively. The improvement in post-tutorial exam scores from the pre-test scores was considered significant (p<0.05). When post-test scores for the tutorial groups were compared, the CBL subjects achieved a score that was, on average, 7 percentage points higher than their PBM counterparts, a statistically significant difference (p < 0.05). Instruction by either CBL or PBM strategies is associated with improvements in newly acquired knowledge as reflected by increased post-tutorial examination scores. Students that received CBL had significantlyhigher post-tutorial exam scores than those in the

Solar thermal polymerase chain reaction for smartphone-assisted molecular diagnostics.

PubMed

Jiang, Li; Mancuso, Matthew; Lu, Zhengda; Akar, Gunkut; Cesarman, Ethel; Erickson, David

2014-02-20

Nucleic acid-based diagnostic techniques such as polymerase chain reaction (PCR) are used extensively in medical diagnostics due to their high sensitivity, specificity and quantification capability. In settings with limited infrastructure and unreliable electricity, however, access to such devices is often limited due to the highly specialized and energy-intensive nature of the thermal cycling process required for nucleic acid amplification. Here we integrate solar heating with microfluidics to eliminate thermal cycling power requirements as well as create a simple device infrastructure for PCR. Tests are completed in less than 30 min, and power consumption is reduced to 80 mW, enabling a standard 5.5 Wh iPhone battery to provide 70 h of power to this system. Additionally, we demonstrate a complete sample-to-answer diagnostic strategy by analyzing human skin biopsies infected with Kaposi's Sarcoma herpesvirus (KSHV/HHV-8) through the combination of solar thermal PCR, HotSHOT DNA extraction and smartphone-based fluorescence detection. We believe that exploiting the ubiquity of solar thermal energy as demonstrated here could facilitate broad availability of nucleic acid-based diagnostics in resource-limited areas.

Solar thermal polymerase chain reaction for smartphone-assisted molecular diagnostics

PubMed Central

Jiang, Li; Mancuso, Matthew; Lu, Zhengda; Akar, Gunkut; Cesarman, Ethel; Erickson, David

2014-01-01

Nucleic acid-based diagnostic techniques such as polymerase chain reaction (PCR) are used extensively in medical diagnostics due to their high sensitivity, specificity and quantification capability. In settings with limited infrastructure and unreliable electricity, however, access to such devices is often limited due to the highly specialized and energy-intensive nature of the thermal cycling process required for nucleic acid amplification. Here we integrate solar heating with microfluidics to eliminate thermal cycling power requirements as well as create a simple device infrastructure for PCR. Tests are completed in less than 30 min, and power consumption is reduced to 80 mW, enabling a standard 5.5 Wh iPhone battery to provide 70 h of power to this system. Additionally, we demonstrate a complete sample-to-answer diagnostic strategy by analyzing human skin biopsies infected with Kaposi's Sarcoma herpesvirus (KSHV/HHV-8) through the combination of solar thermal PCR, HotSHOT DNA extraction and smartphone-based fluorescence detection. We believe that exploiting the ubiquity of solar thermal energy as demonstrated here could facilitate broad availability of nucleic acid-based diagnostics in resource-limited areas. PMID:24553130

Solar thermal polymerase chain reaction for smartphone-assisted molecular diagnostics

NASA Astrophysics Data System (ADS)

Jiang, Li; Mancuso, Matthew; Lu, Zhengda; Akar, Gunkut; Cesarman, Ethel; Erickson, David

2014-02-01

Nucleic acid-based diagnostic techniques such as polymerase chain reaction (PCR) are used extensively in medical diagnostics due to their high sensitivity, specificity and quantification capability. In settings with limited infrastructure and unreliable electricity, however, access to such devices is often limited due to the highly specialized and energy-intensive nature of the thermal cycling process required for nucleic acid amplification. Here we integrate solar heating with microfluidics to eliminate thermal cycling power requirements as well as create a simple device infrastructure for PCR. Tests are completed in less than 30 min, and power consumption is reduced to 80 mW, enabling a standard 5.5 Wh iPhone battery to provide 70 h of power to this system. Additionally, we demonstrate a complete sample-to-answer diagnostic strategy by analyzing human skin biopsies infected with Kaposi's Sarcoma herpesvirus (KSHV/HHV-8) through the combination of solar thermal PCR, HotSHOT DNA extraction and smartphone-based fluorescence detection. We believe that exploiting the ubiquity of solar thermal energy as demonstrated here could facilitate broad availability of nucleic acid-based diagnostics in resource-limited areas.

An ontology-driven, diagnostic modeling system.

PubMed

Haug, Peter J; Ferraro, Jeffrey P; Holmen, John; Wu, Xinzi; Mynam, Kumar; Ebert, Matthew; Dean, Nathan; Jones, Jason

2013-06-01

To present a system that uses knowledge stored in a medical ontology to automate the development of diagnostic decision support systems. To illustrate its function through an example focused on the development of a tool for diagnosing pneumonia. We developed a system that automates the creation of diagnostic decision-support applications. It relies on a medical ontology to direct the acquisition of clinic data from a clinical data warehouse and uses an automated analytic system to apply a sequence of machine learning algorithms that create applications for diagnostic screening. We refer to this system as the ontology-driven diagnostic modeling system (ODMS). We tested this system using samples of patient data collected in Salt Lake City emergency rooms and stored in Intermountain Healthcare's enterprise data warehouse. The system was used in the preliminary development steps of a tool to identify patients with pneumonia in the emergency department. This tool was compared with a manually created diagnostic tool derived from a curated dataset. The manually created tool is currently in clinical use. The automatically created tool had an area under the receiver operating characteristic curve of 0.920 (95% CI 0.916 to 0.924), compared with 0.944 (95% CI 0.942 to 0.947) for the manually created tool. Initial testing of the ODMS demonstrates promising accuracy for the highly automated results and illustrates the route to model improvement. The use of medical knowledge, embedded in ontologies, to direct the initial development of diagnostic computing systems appears feasible.

Phenotype analysis of early risk factors from electronic medical records improves image-derived diagnostic classifiers for optic nerve pathology

NASA Astrophysics Data System (ADS)

Chaganti, Shikha; Nabar, Kunal P.; Nelson, Katrina M.; Mawn, Louise A.; Landman, Bennett A.

2017-03-01

We examine imaging and electronic medical records (EMR) of 588 subjects over five major disease groups that affect optic nerve function. An objective evaluation of the role of imaging and EMR data in diagnosis of these conditions would improve understanding of these diseases and help in early intervention. We developed an automated image processing pipeline that identifies the orbital structures within the human eyes from computed tomography (CT) scans, calculates structural size, and performs volume measurements. We customized the EMR-based phenome-wide association study (PheWAS) to derive diagnostic EMR phenotypes that occur at least two years prior to the onset of the conditions of interest from a separate cohort of 28,411 ophthalmology patients. We used random forest classifiers to evaluate the predictive power of image-derived markers, EMR phenotypes, and clinical visual assessments in identifying disease cohorts from a control group of 763 patients without optic nerve disease. Image-derived markers showed more predictive power than clinical visual assessments or EMR phenotypes. However, the addition of EMR phenotypes to the imaging markers improves the classification accuracy against controls: the AUC improved from 0.67 to 0.88 for glaucoma, 0.73 to 0.78 for intrinsic optic nerve disease, 0.72 to 0.76 for optic nerve edema, 0.72 to 0.77 for orbital inflammation, and 0.81 to 0.85 for thyroid eye disease. This study illustrates the importance of diagnostic context for interpretation of image-derived markers and the proposed PheWAS technique provides a flexible approach for learning salient features of patient history and incorporating these data into traditional machine learning analyses.

Chest Ultrasound Integrated Teaching of Respiratory System Physiology to Medical Students: A First Experience

ERIC Educational Resources Information Center

Paganini, M.; Rubini, A.

2015-01-01

Ultrasound imaging is a useful diagnostic technique that has spread among several different medical specialties within the last few years. Initially restricted to radiology, cardiology, obstetrics, and gynecology, today it is widely used by many specialists, especially in critical care. New graduate physicians will need to be comfortable with…

21 CFR 892.1770 - Diagnostic x-ray tube mount.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Diagnostic x-ray tube mount. 892.1770 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1770 Diagnostic x-ray tube mount. (a) Identification. A diagnostic x-ray tube mount is a device intended to support and to position the diagnostic x...

21 CFR 892.1770 - Diagnostic x-ray tube mount.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic x-ray tube mount. 892.1770 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1770 Diagnostic x-ray tube mount. (a) Identification. A diagnostic x-ray tube mount is a device intended to support and to position the diagnostic x...

21 CFR 892.1770 - Diagnostic x-ray tube mount.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic x-ray tube mount. 892.1770 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1770 Diagnostic x-ray tube mount. (a) Identification. A diagnostic x-ray tube mount is a device intended to support and to position the diagnostic x...

21 CFR 892.1770 - Diagnostic x-ray tube mount.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Diagnostic x-ray tube mount. 892.1770 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1770 Diagnostic x-ray tube mount. (a) Identification. A diagnostic x-ray tube mount is a device intended to support and to position the diagnostic x...

21 CFR 892.1770 - Diagnostic x-ray tube mount.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Diagnostic x-ray tube mount. 892.1770 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1770 Diagnostic x-ray tube mount. (a) Identification. A diagnostic x-ray tube mount is a device intended to support and to position the diagnostic x...

The use of pre-natal diagnostic techniques for sex selection: the Indian scene.

PubMed

Kusum

1993-04-01

The use of pre-natal diagnostic techniques only for sex determination followed by termination of pregnancy on a finding of female foetus, is an atrocious and unethical practice. The bias against a female has been stretched further back: from cradle to grave, it is now from womb to the grave. One cannot however ignore the conditions of the society which breed and encourage such practices. A girl suffers neglect and discrimination right from childhood; she is tortured, harassed and maltreated after marriage. At the work place she is exploited. A widow or a divorcee is looked down upon by the family and the society. All these things make her life miserable and not worth existence....

Ultrasound Detection of Soft Tissue Abscesses Performed by Non-Physician U.S. Army Medical Providers Naïve to Diagnostic Sonography.

PubMed

LaDuke, Mike; Monti, Jon; Cronin, Aaron; Gillum, Bart

2017-03-01

Patients commonly present to emergency rooms and primary care clinics with cellulitic skin infections with or without abscess formation. In military operational units, non-physician medical personnel provide most primary and initial emergency medical care. The objective of this study was to determine if, after minimal training, Army physician assistants and medics could use portable ultrasound (US) machines to detect superficial soft tissue abscesses. This was a single-blinded, randomized, prospective observational study conducted over the course of 2 days at a military installation. Active duty military physician assistants and medics with little or no US experience were recruited as participants. They received a short block of training on abscess detection using both clinical examination skills (inspection/palpation) and US examination. The participants were then asked to provide a yes/no answer regarding abscess presence in a chicken tissue model. Results were analyzed to assess the participants' abilities to detect abscesses, compare the diagnostic accuracy of their clinical examinations with their US examinations, and assess how often US results changed treatment plans initially on the basis of clinical examination findings alone. 22 participants performed a total of 220 clinical examinations and 220 US scans on 10 chicken tissue abscess models. Clinical examination for abscess detection yielded a sensitivity of 73.5% (95% confidence interval [CI], 65.3-80.3%) and a specificity of 77.2% (95% CI, 67.4-84.9%), although US examination for abscess detection yielded a sensitivity of 99.2% (95% CI, 95.4-99.9%) and a specificity of 95.5% (95% CI, 88.5-98.6%). Clinical examination yielded a diagnostic accuracy of 75.0% (95% CI, 68.9-80.3) although US examination yielded a diagnostic accuracy of 97.7% (95% CI, 94.6-99.2%), a difference in accuracy of 22.7% favoring US (p < 0.01). US changed the diagnosis in 56 of 220 cases (25.4% of all cases, p = 0.02). Of these 56

[Cognitive errors in diagnostic decision making].

PubMed

Gäbler, Martin

2017-10-01

Approximately 10-15% of our diagnostic decisions are faulty and may lead to unfavorable and dangerous outcomes, which could be avoided. These diagnostic errors are mainly caused by cognitive biases in the diagnostic reasoning process.Our medical diagnostic decision-making is based on intuitive "System 1" and analytical "System 2" diagnostic decision-making and can be deviated by unconscious cognitive biases.These deviations can be positively influenced on a systemic and an individual level. For the individual, metacognition (internal withdrawal from the decision-making process) and debiasing strategies, such as verification, falsification and rule out worst-case scenarios, can lead to improved diagnostic decisions making.

Mobile diagnostics: next-generation technologies for in vitro diagnostics.

PubMed

Shin, Joonchul; Chakravarty, Sudesna; Choi, Wooseok; Lee, Kyungyeon; Han, Dongsik; Hwang, Hyundoo; Choi, Jaekyu; Jung, Hyo-Il

2018-03-26

The emergence of a wide range of applications of smartphones along with advances in 'liquid biopsy' has significantly propelled medical research particularly in the field of in vitro diagnostics (IVD). Herein, we have presented a detailed analysis of IVD, its associated critical concerns and probable solutions. It also demonstrates the transition in terms of analytes from minimally invasive (blood) to non-invasive (urine, saliva and sweat) and depicts how the different features of a smartphone can be integrated for specific diagnostic purposes. This review basically highlights recent advances in the applications of smartphone-based biosensors in IVD taking into account the following factors: accuracy and portability; quantitative and qualitative analysis; and centralization and decentralization tests. Furthermore, the critical concerns and future direction of diagnostics based on smartphones are also discussed.

Methacholine challenge test: diagnostic characteristics in asthmatic patients receiving controller medications.

PubMed

Sumino, Kaharu; Sugar, Elizabeth A; Irvin, Charles G; Kaminsky, David A; Shade, Dave; Wei, Christine Y; Holbrook, Janet T; Wise, Robert A; Castro, Mario

2012-07-01

The methacholine challenge test (MCT) is commonly used to assess airway hyperresponsiveness, but the diagnostic characteristics have not been well studied in asthmatic patients receiving controller medications after the use of high-potency inhaled corticosteroids became common. We investigated the ability of the MCT to differentiate participants with a physician's diagnosis of asthma from nonasthmatic participants. We conducted a cohort-control study in asthmatic participants (n= 126) who were receiving regular controller medications and nonasthmatic control participants (n= 93) to evaluate the sensitivity and specificity of the MCT. The overall sensitivity was 77% and the specificity was 96% with a threshold PC(20) (the provocative concentration of methacholine that results in a 20% drop in FEV(1)) of 8 mg/mL. The sensitivity was significantly lower in white than in African American participants (69% vs 95%, P= .015) and higher in atopic compared with nonatopic (82% vs 52%, P= .005). Increasing the PC(20) threshold from 8 to 16 mg/mL did not noticeably improve the performance characteristics of the test. African American race, presence of atopy, and lower percent predicted FEV(1) were associated with a positive test result. The utility of the MCT to rule out a diagnosis of asthma depends on racial and atopic characteristics. Clinicians should take into account the reduced sensitivity of the MCT in white and nonatopic asthmatic patients when using this test for the diagnosis of asthma. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Diagnostic testing for Giardia infections.

PubMed

Heyworth, Martin F

2014-03-01

The traditional method for diagnosing Giardia infections involves microscopic examination of faecal specimens for Giardia cysts. This method is subjective and relies on observer experience. From the 1980s onwards, objective techniques have been developed for diagnosing Giardia infections, and are superseding diagnostic techniques reliant on microscopy. Detection of Giardia antigen(s) by immunoassay is the basis of commercially available diagnostic kits. Various nucleic acid amplification techniques (NAATs) can demonstrate DNA of Giardia intestinalis, and have the potential to become standard approaches for diagnosing Giardia infections. Of such techniques, methods involving either fluorescent microspheres (Luminex) or isothermal amplification of DNA (loop-mediated isothermal amplification; LAMP) are especially promising.

Diagnostic imaging and radiation exposure in inflammatory bowel disease.

PubMed

Zakeri, Nekisa; Pollok, Richard C G

2016-02-21

Diagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease (IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentially harmful cumulative levels of ionising radiation in their lifetime, increasing malignant potential in a population already at risk. In this review we explore the proportion of IBD patients exposed to high cumulative radiation doses, the risk factors associated with higher radiation exposures, and we compare conventional diagnostic imaging with newer radiation-free imaging techniques used in the evaluation of patients with IBD. While computed tomography (CT) performs well as an imaging modality for IBD, the effective radiation dose is considerably higher than other abdominal imaging modalities. It is increasingly recognised that CT imaging remains responsible for the majority of diagnostic medical radiation to which IBD patients are exposed. Magnetic resonance imaging (MRI) and small intestine contrast enhanced ultrasonography (SICUS) have now emerged as suitable radiation-free alternatives to CT imaging, with comparable diagnostic accuracy. The routine use of MRI and SICUS for the clinical evaluation of patients with known or suspected small bowel Crohn's disease is to be encouraged wherever possible. More provision is needed for out-of-hours radiation-free imaging modalities to reduce the need for CT.

[Diagnostic and formative assessment of competencies at the beginning of undergraduate medical internship].

PubMed

Martínez-González, Adrián; Lifshitz-Guinzberg, Alberto; Trejo-Mejía, Juan Andrés; Torruco-García, Uri; Fortoul-van der Goes, Teresa I; Flores-Hernández, Fernando; Peña-Balderas, Jorge; Martínez-Franco, Adrián Israel; Hernández-Nava, Alejandro; Elena-González, Diana; Sánchez-Mendiola, Melchor

2017-01-01

Research on diagnostic and formative assessment competencies during undergraduate medical training is scarce in Latin America. To assess the level of clinical competence of students at the beginning of their medical internship in a new curriculum. This was an observational cross-sectional study in UNAM Faculty of Medicine students in Mexico City: a formative assessment of the second class of Curriculum 2010 students as part of the integral evaluation of the program. The assessment had two components: theoretical and practical. We assessed 577 students (65.5%) of the 880 total population that finished the 9th semester of Curriculum 2010. The written exam consisted of 232 items, with a mean of 61.0 ± 19.6, a difficulty index of 0.61, and Cronbach's alpha of 0.89. The mean of the objective structured clinical examination (OSCE) was 62.2 ± 16.8, with a mean Cronbach's alpha of 0.51. Results were analyzed by knowledge area and exam stations. The overall results provide evidence that students achieve sufficiently the competencies established in the curriculum at the beginning of the internship, that they have the necessary foundation for learning new and more complex information, and integrate it with existing knowledge to achieve significant learning and continue their training.

Integrating nursing diagnostic concepts into the medical entities dictionary using the ISO Reference Terminology Model for Nursing Diagnosis.

PubMed

Hwang, Jee-In; Cimino, James J; Bakken, Suzanne

2003-01-01

The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process.

Integrating Nursing Diagnostic Concepts into the Medical Entities Dictionary Using the ISO Reference Terminology Model for Nursing Diagnosis

PubMed Central

Hwang, Jee-In; Cimino, James J.; Bakken, Suzanne

2003-01-01

Objective: The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. Design and Measurements: The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. Results: The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Conclusions: Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process. PMID:12668692

Managing complex processing of medical image sequences by program supervision techniques

NASA Astrophysics Data System (ADS)

Crubezy, Monica; Aubry, Florent; Moisan, Sabine; Chameroy, Virginie; Thonnat, Monique; Di Paola, Robert

1997-05-01

Our objective is to offer clinicians wider access to evolving medical image processing (MIP) techniques, crucial to improve assessment and quantification of physiological processes, but difficult to handle for non-specialists in MIP. Based on artificial intelligence techniques, our approach consists in the development of a knowledge-based program supervision system, automating the management of MIP libraries. It comprises a library of programs, a knowledge base capturing the expertise about programs and data and a supervision engine. It selects, organizes and executes the appropriate MIP programs given a goal to achieve and a data set, with dynamic feedback based on the results obtained. It also advises users in the development of new procedures chaining MIP programs.. We have experimented the approach for an application of factor analysis of medical image sequences as a means of predicting the response of osteosarcoma to chemotherapy, with both MRI and NM dynamic image sequences. As a result our program supervision system frees clinical end-users from performing tasks outside their competence, permitting them to concentrate on clinical issues. Therefore our approach enables a better exploitation of possibilities offered by MIP and higher quality results, both in terms of robustness and reliability.

When Medicine Meets Engineering—Paradigm Shifts in Diagnostics and Therapeutics

PubMed Central

Wang, Hann; Silva, Aleidy; Ho, Chih-Ming

2013-01-01

During the last two decades, the manufacturing techniques of microfluidics-based devices have been phenomenally advanced, offering unlimited potential for bio-medical technologies. However, the direct applications of these technologies toward diagnostics and therapeutics are still far from maturity. The present challenges lay at the interfaces between the engineering systems and the biocomplex systems. A precisely designed engineering system with narrow dynamic range is hard to seamlessly integrate with the adaptive biological system in order to achieve the design goals. These differences remain as the roadblock between two fundamentally non-compatible systems. This paper will not extensively review the existing microfluidic sensors and actuators; rather, we will discuss the sources of the gaps for integration. We will also introduce system interface technologies for bridging the differences to lead toward paradigm shifts in diagnostics and therapeutics. PMID:26835672

21 CFR 886.1390 - Flexible diagnostic Fresnel lens.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1390 Flexible diagnostic Fresnel lens. (a) Identification. A flexible diagnostic Fresnel lens is a device that is a very thin lens which has its surface a concentric series of increasingly refractive zones. The device is intended to be applied...

Reliability of measuring sciatic and tibial nerve movement with diagnostic ultrasound during a neural mobilisation technique.

PubMed

Ellis, Richard; Hing, Wayne; Dilley, Andrew; McNair, Peter

2008-08-01

Diagnostic ultrasound provides a technique whereby real-time, in vivo analysis of peripheral nerve movement is possible. This study measured sciatic nerve movement during a "slider" neural mobilisation technique (ankle dorsiflexion/plantar flexion and cervical extension/flexion). Transverse and longitudinal movement was assessed from still ultrasound images and video sequences by using frame-by-frame cross-correlation software. Sciatic nerve movement was recorded in the transverse and longitudinal planes. For transverse movement, at the posterior midthigh (PMT) the mean value of lateral sciatic nerve movement was 3.54 mm (standard error of measurement [SEM] +/- 1.18 mm) compared with anterior-posterior/vertical (AP) movement of 1.61 mm (SEM +/- 0.78 mm). At the popliteal crease (PC) scanning location, lateral movement was 6.62 mm (SEM +/- 1.10 mm) compared with AP movement of 3.26 mm (SEM +/- 0.99 mm). Mean longitudinal sciatic nerve movement at the PMT was 3.47 mm (SEM +/- 0.79 mm; n = 27) compared with the PC of 5.22 mm (SEM +/- 0.05 mm; n = 3). The reliability of ultrasound measurement of transverse sciatic nerve movement was fair to excellent (Intraclass correlation coefficient [ICC] = 0.39-0.76) compared with excellent (ICC = 0.75) for analysis of longitudinal movement. Diagnostic ultrasound presents a reliable, noninvasive, real-time, in vivo method for analysis of sciatic nerve movement.

Capturing and displaying microscopic images used in medical diagnostics and forensic science using 4K video resolution - an application in higher education.

PubMed

Maier, Hans; de Heer, Gert; Ortac, Ajda; Kuijten, Jan

2015-11-01

To analyze, interpret and evaluate microscopic images, used in medical diagnostics and forensic science, video images for educational purposes were made with a very high resolution of 4096 × 2160 pixels (4K), which is four times as many pixels as High-Definition Video (1920 × 1080 pixels). The unprecedented high resolution makes it possible to see details that remain invisible to any other video format. The images of the specimens (blood cells, tissue sections, hair, fibre, etc.) are recorded using a 4K video camera which is attached to a light microscope. After processing, this resulted in very sharp and highly detailed images. This material was then used in education for classroom discussion. Spoken explanation by experts in the field of medical diagnostics and forensic science was also added to the high-resolution video images to make it suitable for self-study. © 2015 The Authors. Journal of Microscopy published by John Wiley & Sons Ltd on behalf of Royal Microscopical Society.

Sportsmen’s Groin—Diagnostic Approach and Treatment With the Minimal Repair Technique

PubMed Central

Muschaweck, Ulrike; Berger, Luise Masami

2010-01-01

Context: Sportsmen’s groin, also called sports hernia and Gilmore groin, is one of the most frequent sports injuries in athletes and may place an athletic career at risk. It presents with acute or chronic groin pain exacerbated with physical activity. So far, there is little consensus regarding pathogenesis, diagnostic criteria, or treatment. There have been various attempts to explain the cause of the groin pain. The assumption is that a circumscribed weakness in the posterior wall of the inguinal canal, which leads to a localized bulge, induces a compression of the genital branch of the genitofemoral nerve, considered responsible for the symptoms. Methods: The authors developed an innovative open suture repair—the Minimal Repair technique—to fit the needs of professional athletes. With this technique, the circumscribed weakness of the posterior wall of the inguinal canal is repaired by an elastic suture; the compression on the nerve is abolished, and the cause of the pain is removed. In contrast with that of common open suture repairs, the defect of the posterior wall is not enlarged, the suture is nearly tension free, and the patient can return to full training and athletic activity within a shorter time. The outcome of patients undergoing operations with the Minimal Repair technique was compared with that of commonly used surgical procedures. Results: The following advantages of the Minimal Repair technique were found: no insertion of prosthetic mesh, no general anesthesia required, less traumatization, and lower risk of severe complications with equal or even faster convalescence. In 2009, a prospective cohort of 129 patients resumed training in 7 days and experienced complete pain relief in an average of 14 days. Professional athletes (67%) returned to full activity in 14 days (median). Conclusion: The Minimal Repair technique is an effective and safe way to treat sportsmen’s groin. PMID:23015941

Applying Toyota production system techniques for medication delivery: improving hospital safety and efficiency.

PubMed

Newell, Terry L; Steinmetz-Malato, Laura L; Van Dyke, Deborah L

2011-01-01

The inpatient medication delivery system used at a large regional acute care hospital in the Midwest had become antiquated and inefficient. The existing 24-hr medication cart-fill exchange process with delivery to the patients' bedside did not always provide ordered medications to the nursing units when they were needed. In 2007 the principles of the Toyota Production System (TPS) were applied to the system. Project objectives were to improve medication safety and reduce the time needed for nurses to retrieve patient medications. A multidisciplinary team was formed that included representatives from nursing, pharmacy, informatics, quality, and various operational support departments. Team members were educated and trained in the tools and techniques of TPS, and then designed and implemented a new pull system benchmarking the TPS Ideal State model. The newly installed process, providing just-in-time medication availability, has measurably improved delivery processes as well as patient safety and satisfaction. Other positive outcomes have included improved nursing satisfaction, reduced nursing wait time for delivered medications, and improved efficiency in the pharmacy. After a successful pilot on two nursing units, the system is being extended to the rest of the hospital. © 2010 National Association for Healthcare Quality.

Mining balance disorders' data for the development of diagnostic decision support systems.

PubMed

Exarchos, T P; Rigas, G; Bibas, A; Kikidis, D; Nikitas, C; Wuyts, F L; Ihtijarevic, B; Maes, L; Cenciarini, M; Maurer, C; Macdonald, N; Bamiou, D-E; Luxon, L; Prasinos, M; Spanoudakis, G; Koutsouris, D D; Fotiadis, D I

2016-10-01

In this work we present the methodology for the development of the EMBalance diagnostic Decision Support System (DSS) for balance disorders. Medical data from patients with balance disorders have been analysed using data mining techniques for the development of the diagnostic DSS. The proposed methodology uses various data, ranging from demographic characteristics to clinical examination, auditory and vestibular tests, in order to provide an accurate diagnosis. The system aims to provide decision support for general practitioners (GPs) and experts in the diagnosis of balance disorders as well as to provide recommendations for the appropriate information and data to be requested at each step of the diagnostic process. Detailed results are provided for the diagnosis of 12 balance disorders, both for GPs and experts. Overall, the reported accuracy ranges from 59.3 to 89.8% for GPs and from 74.3 to 92.1% for experts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Diagnostic techniques for measurement of aerodynamic noise in free field and reverberant environment of wind tunnels

NASA Technical Reports Server (NTRS)

El-Sum, H. M. A.; Mawardi, O. K.

1973-01-01

Techniques for studying aerodynamic noise generating mechanisms without disturbing the flow in a free field, and in the reverberation environment of the ARC wind tunnel were investigated along with the design and testing of an acoustic antenna with an electronic steering control. The acoustic characteristics of turbojet as a noise source, detection of direct sound from a source in a reverberant background, optical diagnostic methods, and the design characteristics of a high directivity acoustic antenna. Recommendations for further studies are included.

21 CFR 886.1395 - Diagnostic Hruby fundus lens.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1395 Diagnostic Hruby fundus lens. (a) Identification. A diagnostic Hruby fundus lens is a device that is a 55 diopter lens intended for use in the examination of the vitreous body and the fundus of the eye under slitlamp illumination and magnification. (b...

Recent Developments in Synthetic Carbohydrate-Based Diagnostics, Vaccines, and Therapeutics.

PubMed

Fernández-Tejada, Alberto; Cañada, F Javier; Jiménez-Barbero, Jesús

2015-07-20

Glycans are everywhere in biological systems, being involved in many cellular events with important implications for medical purposes. Building upon a detailed understanding of the functional roles of carbohydrates in molecular recognition processes and disease states, glycans are increasingly being considered as key players in pharmacological research. On the basis of the important progress recently made in glycochemistry, glycobiology, and glycomedicine, we provide a complete overview of successful applications and future perspectives of carbohydrates in the biopharmaceutical and medical fields. This review highlights the development of carbohydrate-based diagnostics, exemplified by glycan imaging techniques and microarray platforms, synthetic oligosaccharide vaccines against infectious diseases (e.g., HIV) and cancer, and finally carbohydrate-derived therapeutics, including glycomimetic drugs and glycoproteins. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Non-invasive, photonics-based diagnostic, imaging, monitoring, and light delivery techniques for the recognition, quantification and treatment of malignant and chronic inflammatory conditions

NASA Astrophysics Data System (ADS)

Davies, N.; Davies-Shaw, D.; Shaw, J. D.

2007-02-01

We report firsthand on innovative developments in non-invasive, biophotonic techniques for a wide range of diagnostic, imaging and treatment options, including the recognition and quantification of cancerous, pre-cancerous cells and chronic inflammatory conditions. These techniques have benefited from the ability to target the affected site by both monochromatic light and broad multiple wavelength spectra. The employment of such wavelength or color-specific properties embraces the fluorescence stimulation of various photosensitizing drugs, and the instigation and detection of identified fluorescence signatures attendant upon laser induced fluorescence (LIF) phenomena as transmitted and propagated by precancerous, cancerous and normal tissue. In terms of tumor imaging and therapeutic and treatment options, we have exploited the abilities of various wavelengths to penetrate to different depths, through different types of tissues, and have explored quantifiable absorption and reflection characteristics upon which diagnostic assumptions can be reliably based and formulated. These biophotonic-based diagnostic, sensing and imaging techniques have also benefited from, and have been further enhanced by, the integrated ability to provide various power levels to be employed at various stages in the procedure. Applications are myriad, including non-invasive, non destructive diagnosis of in vivo cell characteristics and functions; light-based tissue analysis; real-time monitoring and mapping of brain function and of tumor growth; real time monitoring of the surgical completeness of tumor removal during laser-imaged/guided brain resection; diagnostic procedures based on fluorescence life-time monitoring, the monitoring of chronic inflammatory conditions (including rheumatoid arthritis), and continuous blood glucose monitoring in the control of diabetes.

Towards first principle medical diagnostics: on the importance of disease-disease and sign-sign interactions

NASA Astrophysics Data System (ADS)

Ramezanpour, Abolfazl; Mashaghi, Alireza

2017-07-01

A fundamental problem in medicine and biology is to assign states, e.g. healthy or diseased, to cells, organs or individuals. State assignment or making a diagnosis is often a nontrivial and challenging process and, with the advent of omics technologies, the diagnostic challenge is becoming more and more serious. The challenge lies not only in the increasing number of measured properties and dynamics of the system (e.g. cell or human body) but also in the co-evolution of multiple states and overlapping properties, and degeneracy of states. We develop, from first principles, a generic rational framework for state assignment in cell biology and medicine, and demonstrate its applicability with a few simple theoretical case studies from medical diagnostics. We show how disease-related statistical information can be used to build a comprehensive model that includes the relevant dependencies between clinical and laboratory findings (signs) and diseases. In particular, we include disease-disease and sign-sign interactions and study how one can infer the probability of a disease in a patient with given signs. We perform comparative analysis with simple benchmark models to check the performances of our models. We find that including interactions can significantly change the statistical importance of the signs and diseases. This first principles approach, as we show, facilitates the early diagnosis of disease by taking interactions into accounts, and enables the construction of consensus diagnostic flow charts. Additionally, we envision that our approach will find applications in systems biology, and in particular, in characterizing the phenome via the metabolome, the proteome, the transcriptome, and the genome.

Prenatal Diagnosis Procedures and Techniques to Obtain a Diagnostic Fetal Specimen or Tissue: Maternal and Fetal Risks and Benefits.

PubMed

Wilson, R Douglas; Gagnon, Alain; Audibert, François; Campagnolo, Carla; Carroll, June

2015-07-01

-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical speciality societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Health benefits, side effects, and risks: Patient informed consent, knowledge translation, genetic prenatal risk assessment, anxiety relief, anxiety creation, advocacy, understanding or limitation for fetal testing, pregnancy management choice, pregnancy complication or loss, timely and improved care for birth of a neonate with recognized morbidity. Recommendations 1. The health care provider should counsel the at-risk pregnant woman on the different levels of genetic fetal testing in order for her to have a clear understanding and expectation of the level of testing and type of results that are offered. (III-B) 2. As part of the informed consent process, the health care provider should review with the at-risk pregnant woman the risks and benefits of in utero genetic diagnostic techniques associated with fetal genetic testing options. (III-A) 3. During risk/benefit counselling, the health care provider should advise that the best estimate of the pregnancy loss rate related to: a.amniocentesis is 0.5% to 1.0% (range 0.17 to 1.53%) (I) b.chorionic villus sampling is 0.5% to 1.0% (I) and c.cordocentesis or percutaneous umbilical blood sampling is 1.3% for fetuses with no anomalies and 1.3% to 25% for fetuses with single or multiple anomalies or intrauterine growth restriction. (II-2A).

21 CFR 801.119 - In vitro diagnostic products.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false In vitro diagnostic products. 801.119 Section 801...) MEDICAL DEVICES LABELING Exemptions From Adequate Directions for Use § 801.119 In vitro diagnostic products. A product intended for use in the diagnosis of disease and which is an in vitro diagnostic...

21 CFR 801.119 - In vitro diagnostic products.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false In vitro diagnostic products. 801.119 Section 801...) MEDICAL DEVICES LABELING Exemptions From Adequate Directions for Use § 801.119 In vitro diagnostic products. A product intended for use in the diagnosis of disease and which is an in vitro diagnostic...

Handheld Diagnostic Device Delivers Quick Medical Readings

NASA Technical Reports Server (NTRS)

2014-01-01

To monitor astronauts' health remotely, Glenn Research Center awarded SBIR funding to Cambridge, Massachusetts-based DNA Medical Institute, which developed a device capable of analyzing blood cell counts and a variety of medical biomarkers. The technology will prove especially useful in rural areas without easy access to labs.

Measurement Techniques for Flow Diagnostic in ITAM Impulse Wind Tunnels

DTIC Science & Technology

2010-04-01

time of wind - tunnel operation, so that oscillations caused by initial shock loads could decay and a comparatively long time period with constant flow...Flow Diagnostic in ITAM Impulse Wind Tunnels 7 - 4 RTO-EN-AVT-186 A strain-gauge pressure probe is an elastic element (membrane) in a sealed...Diagnostic in ITAM Impulse Wind Tunnels RTO-EN-AVT-186 7 - 5 probes are individually calibrated. Piezoelectric pressure gauges are based

Effects of optical diagnostic techniques on the accuracy of laminar flame speeds measured from Bunsen flames: OH* chemiluminescence, OH-PLIF and acetone/kerosene-PLIF

NASA Astrophysics Data System (ADS)

Wu, Yi; Modica, Vincent; Yu, Xilong; Li, Fei; Grisch, Frédéric

2018-01-01

The effects of optical diagnostic techniques on the accuracy of laminar flame speed measured from Bunsen flames were investigated. Laminar flame speed measurements were conducted for different fuel/air mixtures including CH4/air, acetone/air and kerosene (Jet A-1)/air in applying different optical diagnostic techniques, i.e. OH* chemiluminescence, OH-PLIF and acetone/kerosene-PLIF. It is found that the OH* chemiluminescence imaging technique cannot directly derive the location of the outer edge of the fresh gases and it is necessary to correct the position of the OH* peak to guarantee the accuracy of the measurements. OH-PLIF and acetone/kerosene-PLIF respectively are able to measure the disappearance of the fresh gas contour and the appearance of the reaction zone. It shows that the aromatic-PLIF technique gives similar laminar flame speed values when compared with those obtained from corrected OH* chemiluminescence images. However, discrepancies were observed between the OH-PLIF and the aromatic-PLIF techniques, in that OH-PLIF slightly underestimates laminar flame speeds by up to 5%. The difference between the flame contours obtained from different optical techniques are further analysed and illustrated with 1D flame structure simulation using detailed kinetic mechanisms.

Assessment of Diagnostic Value of Single View Dynamic Technique in Diagnosis of Developmental Dysplasia of Hip: A Comparison with Static and Dynamic Ultrasond Techniques

PubMed Central

Alamdaran, Seyed Ali; Kazemi, Sahar; Parsa, Ali; Moghadam, Mohammad Hallaj; Feyzi, Ali; Mardani, Reza

2016-01-01

Background: Developmental dysplasia of hip (DDH) is a common childhood disorder, and ultrasonography examination is routinely used for screening purposes. In this study, we aimed to evaluate a modified combined static and dynamic ultrasound technique for the detection of DDH and to compare with the results of static and dynamic ultrasound techniques. Methods: In this cross-sectional study, during 2013- 2015, 300 high-risk infants were evaluated by ultrasound for DDH. Both hips were examined with three techniques: static, dynamic and single view static and dynamic technique. Statistical analysis was performed using SPSS version 11.5. Results: Patients aged 9 days to 83 weeks. 75% of the patients were 1 to 3 months old. Among 600 hip joints, about 5% were immature in static sonography and almost all of them were unstable in dynamic techniques. 0.3% of morphologically normal hips were unstable in dynamic sonography and 9% of unstable hips had normal morphology. The mean β angle differences in coronal view before and after stress maneuver was 14.43±5.47° in unstable hips. Single view static and dynamic technique revealed that all cases with acetabular dysplasia, instability and dislocation, except two dislocations, were detected by dynamic transverse view. For two cases, Ortolani maneuver showed femoral head reversibility in dislocated hips. Using single view static and dynamic technique was indicative and applicable for detection of more than 99% of cases. Conclusion: Single view static and dynamic technique not only is a fast and easy technique, but also it is of high diagnostic value in assessment of DDH. PMID:27847852

MO-DE-BRA-05: EUTEMPE-RX: Combining E-Learning and Face-To-Face Training to Build Expert Knowledge, Skills and Competences for Medical Physicists in Diagnostic and Interventional Radiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bosmans, H; Van Peteghem, N; Creten, S

Purpose: In 2013, the EURATOM authorities of the European Commission decided to support the Horizon2020 project submission ‘EUTEMPE-RX’ that aimed for a new set of course modules to train medical physicists in diagnostic and interventional radiology to expert level with small group deep learning. Each module would consist of 2 phases: an e-learning and a face-to-face phase, each phase requiring typically 40h of participant time. Methods: The European Federation (EFOMP) and 13 European partners, all of them selected for their excellent scientific and/or educational skills, led the 12 course modules. A quality manual ensured the quality of course content andmore » organization. Educational workshops familiarized the teachers with e-learning techniques and methods for assessment. Content was set in accordance with the EC document RP174 that lists learning outcomes in terms of knowledge, skills and competences (KSCs) for different specialties and levels of medical physics. Surveys for stake holder satisfaction were prepared. Results: Today the course modules are being realized. The modules cover most of the KSCs in RP174 document. Teachers have challenged the participants with unique tasks: case studies in medical physics leadership, Monte Carlo simulation of a complete x-ray imaging chain, development of a task specific QA protocol, compilation of optimization plans, simulation tasks with anthropomorphic breast models, etc. Participants undertook practical sessions in modern hospitals and visited a synchrotron facility, a calibration lab, screening organizations, etc. Feedback form quality surveys was very positive and constructive. A sustainability plan has been worked out. Conclusion: The modules have enabled the participants to develop their KSCs and cope with challenges in medical physics. The sustainability plan will be implemented to continue the unique combined e-learning and face to face training at high level training in diagnostic and interventional

Molecular diagnostics of periodontitis.

PubMed

Korona-Głowniak, Izabela; Siwiec, Radosław; Berger, Marcin; Malm, Anna; Szymańska, Jolanta

2017-01-28

The microorganisms that form dental plaque are the main cause of periodontitis. Their identification and the understanding of the complex relationships and interactions that involve these microorganisms, environmental factors and the host's health status enable improvement in diagnostics and targeted therapy in patients with periodontitis. To this end, molecular diagnostics techniques (both techniques based on the polymerase chain reaction and those involving nucleic acid analysis via hybridization) come increasingly into use. On the basis of a literature review, the following methods are presented: polymerase chain reaction (PCR), real-time polymerase chain reaction (real-time PCR), 16S rRNA-encoding gene sequencing, checkerboard and reverse-capture checkerboard hybridization, microarrays, denaturing gradient gel electrophoresis (DGGE), temperature gradient gel electrophoresis (TGGE), as well as terminal restriction fragment length polymorphism (TRFLP) and next generation sequencing (NGS). The advantages and drawbacks of each method in the examination of periopathogens are indicated. The techniques listed above allow fast detection of even small quantities of pathogen present in diagnostic material and prove particularly useful to detect microorganisms that are difficult or impossible to grow in a laboratory.

A New Diagnostic Mechanism of Instruction: A Dynamic, Real-Time and Non-Interference Quantitative Measurement Technique for Adaptive E-Learning

ERIC Educational Resources Information Center

Hsu, Pi-Shan; Chang, Te-Jeng; Wu, Ming-Hsiung

2009-01-01

The level of learners' expertise has been used as a metric and diagnostic mechanism of instruction. This metric influences mental effort directly according to the applications of cognitive load theory. Cognitive efficiency, an optimal measurement technique of expertise, was developed by Kalyuga and Sweller to replace instructional efficiency in…

Single molecule real-time (SMRT) sequencing comes of age: applications and utilities for medical diagnostics

PubMed Central

Ardui, Simon; Ameur, Adam; Vermeesch, Joris R; Hestand, Matthew S

2018-01-01

Abstract Short read massive parallel sequencing has emerged as a standard diagnostic tool in the medical setting. However, short read technologies have inherent limitations such as GC bias, difficulties mapping to repetitive elements, trouble discriminating paralogous sequences, and difficulties in phasing alleles. Long read single molecule sequencers resolve these obstacles. Moreover, they offer higher consensus accuracies and can detect epigenetic modifications from native DNA. The first commercially available long read single molecule platform was the RS system based on PacBio's single molecule real-time (SMRT) sequencing technology, which has since evolved into their RSII and Sequel systems. Here we capsulize how SMRT sequencing is revolutionizing constitutional, reproductive, cancer, microbial and viral genetic testing. PMID:29401301

Cancer Risks Associated with External Radiation From Diagnostic Imaging Procedures

PubMed Central

Linet, Martha S.; Slovis, Thomas L.; Miller, Donald L.; Kleinerman, Ruth; Lee, Choonsik; Rajaraman, Preetha; de Gonzalez, Amy Berrington

2012-01-01

The 600% increase in medical radiation exposure to the US population since 1980 has provided immense benefit, but potential future cancer risks to patients. Most of the increase is from diagnostic radiologic procedures. The objectives of this review are to summarize epidemiologic data on cancer risks associated with diagnostic procedures, describe how exposures from recent diagnostic procedures relate to radiation levels linked with cancer occurrence, and propose a framework of strategies to reduce radiation from diagnostic imaging in patients. We briefly review radiation dose definitions, mechanisms of radiation carcinogenesis, key epidemiologic studies of medical and other radiation sources and cancer risks, and dose trends from diagnostic procedures. We describe cancer risks from experimental studies, future projected risks from current imaging procedures, and the potential for higher risks in genetically susceptible populations. To reduce future projected cancers from diagnostic procedures, we advocate widespread use of evidence-based appropriateness criteria for decisions about imaging procedures, oversight of equipment to deliver reliably the minimum radiation required to attain clinical objectives, development of electronic lifetime records of imaging procedures for patients and their physicians, and commitment by medical training programs, professional societies, and radiation protection organizations to educate all stakeholders in reducing radiation from diagnostic procedures. PMID:22307864

Measurements and Diagnostics of Diamond Films and Coatings

NASA Technical Reports Server (NTRS)

Miyoshi, Kazuhisa; Wu, Richard L. C.

1999-01-01

The commercial potential of chemical-vapor-deposited (CVD) diamond films has been established and a number of applications have been identified through university, industry, and government research studies. This paper discusses the methodologies used for property measurement and diagnostic of CVD diamond films and coatings. Measurement and diagnostic techniques studied include scanning electron microscopy, transmission electron microscopy, atomic force microscopy, stylus profilometry, x-ray diffraction, electron diffraction, Raman spectroscopy, Rutherford backscattering, elastic recoil spectroscopy, and friction examination. Each measurement and diagnostic technique provides unique information. A combination of techniques can provide the technical information required to understand the quality and properties of CVD diamond films, which are important to their application in specific component systems and environments. In this study the combination of measurement and diagnostic techniques was successfully applied to correlate deposition parameters and resultant diamond film composition, crystallinity, grain size, surface roughness, and coefficient of friction.

The Handbook of Medical Image Perception and Techniques

NASA Astrophysics Data System (ADS)

Samei, Ehsan; Krupinski, Elizabeth

2014-07-01

Peter Ayton; Part V. Optimization and Practical Issues: 25. Optimization of 2D and 3D radiographic systems Jeff Siewerdson; 26. Applications of AFC methodology in optimization of CT imaging systems Kent Ogden and Walter Huda; 27. Perceptual issues in reading mammograms Margarita Zuley; 28. Perceptual optimization of display processing techniques Richard Van Metter; 29. Optimization of display systems Elizabeth Krupinski and Hans Roehrig; 30. Ergonomic radiologist workplaces in the PACS environment Carl Zylack; Part VI. Epilogue: 31. Future prospects of medical image perception Ehsan Samei and Elizabeth Krupinski; Index.

The Handbook of Medical Image Perception and Techniques

NASA Astrophysics Data System (ADS)

Samei, Ehsan; Krupinski, Elizabeth

2009-12-01

Peter Ayton; Part V. Optimization and Practical Issues: 25. Optimization of 2D and 3D radiographic systems Jeff Siewerdson; 26. Applications of AFC methodology in optimization of CT imaging systems Kent Ogden and Walter Huda; 27. Perceptual issues in reading mammograms Margarita Zuley; 28. Perceptual optimization of display processing techniques Richard Van Metter; 29. Optimization of display systems Elizabeth Krupinski and Hans Roehrig; 30. Ergonomic radiologist workplaces in the PACS environment Carl Zylack; Part VI. Epilogue: 31. Future prospects of medical image perception Ehsan Samei and Elizabeth Krupinski; Index.

Review of medical discharge summaries and medical documentation in a metropolitan hospital: impact on diagnostic-related groups and Weighted Inlier Equivalent Separation.

PubMed

Chin, N; Perera, P; Roberts, A; Nagappan, R

2013-07-01

Accurate and comprehensive clinical documentation is crucial for effective ongoing patient care, follow up and to optimise case mix-based funding. Each Diagnostic Related Group (DRG) is assigned a 'weight', leading to Weighted Inlier Equivalent Separation (WIES), a system many public and private hospitals in Australia subscribe to. To identify the top DRG in a general medical inpatient service, the completeness of medical discharge documentation, commonly missed comorbidities and system-related issues and subsequent impact on DRG and WIES allocation. One hundred and fifty completed discharge summaries were randomly selected from the top 10 medical DRG in our health service. From a detailed review of the clinical documentation, principal diagnoses, associated comorbidities and complications, where appropriate, the DRG and WIES were modified. Seventy-two (48%) of the 150 reviewed admissions resulted in a revision of DRG and WIES equivalent to an increase of AUD 142,000. Respiratory-based DRG generated the largest revision of DRG and WIES, while 'Cellulitis' DRG had the largest relative change. Twenty-seven per cent of summaries reviewed necessitated a change in coding with no subsequent change in DRG allocation or WIES. Acute renal failure, anaemia and electrolyte disturbances were the most commonly underrepresented entities in clinical discharge documentation. Seven patients had their WIES downgraded. Comprehensive documentation of principal diagnosis/diagnoses, comorbidities and their complications is imperative to optimal DRG and WIES allocation. Regular meetings between clinical and coding staff improve the quality and timeliness of medical documentation, ensure adequate communication with general practitioners and lead to appropriate funding. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

[Dealing with diagnostic uncertainty in general practice].

PubMed

Wübken, Magdalena; Oswald, Jana; Schneider, Antonius

2013-01-01

In general, the prevalence of diseases is low in primary care. Therefore, the positive predictive value of diagnostic tests is lower than in hospitals where patients are highly selected. In addition, the patients present with milder forms of disease; and many diseases might hide behind the initial symptom(s). These facts lead to diagnostic uncertainty which is somewhat inherent to general practice. This narrative review discusses different sources of and reasons for uncertainty and strategies to deal with it in the context of the current literature. Fear of uncertainty correlates with higher diagnostic activities. The attitude towards uncertainty correlates with the choice of medical speciality by vocational trainees or medical students. An intolerance of uncertainty, which still increases as medicine is making steady progress, might partly explain the growing shortage of general practitioners. The bio-psycho-social context appears to be important to diagnostic decision-making. The effect of intuition and heuristics are investigated by cognitive psychologists. It is still unclear whether these aspects are prone to bias or useful, which might depend on the context of medical decisions. Good communication is of great importance to share uncertainty with the patients in a transparent way and to alleviate shared decision-making. Dealing with uncertainty should be seen as an important core component of general practice and needs to be investigated in more detail to improve the respective medical decisions. Copyright © 2013. Published by Elsevier GmbH.

Medical Physicists and AAPM

NASA Astrophysics Data System (ADS)

Amols, Howard

2006-03-01

The American Association of Physicists in Medicine (AAPM), a member society of the AIP is the largest professional society of medical physicists in the world with nearly 5700 members. Members operate in medical centers, university and community hospitals, research laboratories, industry, and private practice. Medical physics specialties include radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. The majority of AAPM members are based in hospital departments of radiation oncology or radiology and provide technical support for patient diagnosis and treatment in a clinical environment. Job functions include support of clinical care, calibration and quality assurance of medical devices such as linear accelerators for cancer therapy, CT, PET, MRI, and other diagnostic imaging devices, research, and teaching. Pathways into a career in medical physics require an advanced degree in medical physics, physics, engineering, or closely related field, plus clinical training in one or more medical physics specialties (radiation therapy physics, imaging physics, or radiation safety). Most clinically based medical physicists also obtain certification from the American Board of Radiology, and some states require licensure as well.

New Diagnostic Aides for Melanoma

PubMed Central

Ferris, Laura K.; Harris, Ryan J.

2012-01-01

Synopsis Detection of melanoma at an early stage is crucial to improving survival rates in melanoma. Accurate diagnosis by current techniques including dermatoscopy remains difficult, and new tools are needed to improve our diagnostic abilities. This article discusses recent advances in diagnostic techniques including confocal scanning laser microscopy, MelaFind, Siascopy, noninvasive genomic detection, as well as other future possibilities to aid in diagnosing melanoma. Advantages and barriers to implementation of the various technologies are discussed as well. PMID:22800557

Robotic automation of medication-use management.

PubMed

Enright, S M

1993-11-01

In the October 1993 issue of Physician Assistant, we published "Robots for Health Care," the first of two articles on the medical applications of robotics. That article discussed ways in which robots could help patients with manipulative disabilities to perform activities of daily living and hold paid employment; transfer patients from bed to chair and back again; add precision to the most exacting surgical procedures; and someday carry out diagnostic and therapeutic techniques from within the human body. This month, we are pleased to offer an article by Sharon Enright, an authority on pharmacy operations, who considers how an automated medication-management system that makes use of bar-code technology is capable of streamlining drug dispensing, controlling safety, increasing cost-effectiveness, and ensuring accurate and complete record-keeping.

Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology

PubMed Central

Naik, Aanand Dinkar; Rao, Raghuram; Petersen, Laura Ann

2008-01-01

Diagnostic errors are poorly understood despite being a frequent cause of medical errors. Recent efforts have aimed to advance the "basic science" of diagnostic error prevention by tracing errors to their most basic origins. Although a refined theory of diagnostic error prevention will take years to formulate, we focus on communication breakdown, a major contributor to diagnostic errors and an increasingly recognized preventable factor in medical mishaps. We describe a comprehensive framework that integrates the potential sources of communication breakdowns within the diagnostic process and identifies vulnerable steps in the diagnostic process where various types of communication breakdowns can precipitate error. We then discuss potential information technology-based interventions that may have efficacy in preventing one or more forms of these breakdowns. These possible intervention strategies include using new technologies to enhance communication between health providers and health systems, improve patient involvement, and facilitate management of information in the medical record. PMID:18373151

Doctoral theses in diagnostic imaging: a study of Spanish production between 1976 and 2011.

PubMed

Machan, K; Sendra Portero, F

2018-05-15

To analyze the production of doctoral theses in diagnostic imaging in Spain in the period comprising 1976 through 2011 with the aim of a) determining the number of theses and their distribution over time, b) describing the production in terms of universities and directors, and c) analyzing the content of the theses according to the imaging technique, anatomic site, and type of research used. The TESEO database was searched for "radiología" and/or "diagnóstico por imagen" and for terms related to diagnostic imaging in the title of the thesis. A total of 1036 theses related to diagnostic imaging were produced in 37 Spanish universities (mean, 29.6 theses/year; range, 4-59). A total of 963 thesis directors were identified; 10 of these supervised 10 or more theses. Most candidates and directors were men, although since the 2000-2001 academic year the number of male and female candidates has been similar. The anatomic regions most often included in diagnostic imaging theses were the abdomen (22.5%), musculoskeletal system (21.8%), central nervous system (16.4%), and neck and face (15.6%). The imaging techniques most often included were ultrasonography in the entire period (25.5%) and magnetic resonance imaging in the last 5 years. Most theses (63.8%) were related to clinical research. Despite certain limitations, the TESEO database makes it possible to analyze the production of doctoral theses in Spain effectively. The annual mean production of theses in diagnostic imaging is higher than in other medical specialties. This analysis reflects the historic evolution of imaging techniques and research in radiology as well as the development of Spanish universities. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Evaluation of a diagnostic flow chart applying medical thoracoscopy, adenosine deaminase and T-SPOT.TB in diagnosis of tuberculous pleural effusion.

PubMed

He, Y; Zhang, W; Huang, T; Wang, X; Wang, M

2015-10-01

To evaluate a diagnostic flow chart applying medical thoracoscoy (MT), adenosine deaminase (ADA) and T-SPOT.TB in diagnosis of tuberculous pleural effusion (TPE) at a high TB burden country. 136 patients with pleural effusion (PE) were enrolled and divided into TPE and Non-TPE group. MT (histology), PE ADA and T-SPOT.TB were conducted on all patients. ROC analysis was performed for the best cut-off value of PE ADA in detection of TPE. The diagnostic flow chart applying MT, ADA and T-SPOT.TB was evaluated for improving the limitations of each diagnostic method. ROC analysis showed that the best cut-off value of PE ADA was 30U/L. The sensitivity and specificity of these tests were calculated respectively to be: 71.4% (58.5%-81.6%) and 100% (95.4-100.0%) for MT, 92.9% (83.0-97.2%) and 68.8% (57.9-77.9%) for T-SPOT.TB, and 80.0% (69.6-88.1%) and 92.9% (82.7-98.0%) for PE ADA. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value and negative predictive value of the diagnostic flow chart were 96.4% (87.9-99.0%), 96.3% (89.6-98.7%), 25.714, 0.037, 97.4 and 94.9, respectively. The diagnostic flow chart applying MT, ADA and T-SPOT.TB is an accurate and rapid diagnostic method in detection of TPE.

WE-AB-206-01: Diagnostic Ultrasound Imaging Quality Assurance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zagzebski, J.

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environmentmore » with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.« less

Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions.

PubMed

Makris, D; Scherpereel, A; Leroy, S; Bouchindhomme, B; Faivre, J-B; Remy, J; Ramon, P; Marquette, C-H

2007-06-01

The present study prospectively evaluated the diagnostic yield and safety of electromagnetic navigation-guided bronchoscopy biopsy, for small peripheral lung lesions in patients where standard techniques were nondiagnostic. The study was conducted in a tertiary medical centre on 40 consecutive patients considered unsuitable for straightforward surgery or computed tomography (CT)-guided transthoracic needle aspiration biopsy, due to comorbidities. The lung lesion diameter was mean+/-sem 23.5+/-1.5 mm and the depth from the visceral-costal pleura was 14.9+/-2 mm. Navigation was facilitated by an electromagnetic tracking system which could detect a position sensor incorporated into a flexible catheter advanced through a bronchoscope. Information obtained during bronchoscopy was superimposed on previously acquired CT data. Divergence between CT data and data obtained during bronchoscopy was calculated by the system's software as a measure of navigational accuracy. All but one of the target lesions was reached and the overall diagnostic yield was 62.5% (25-40). Diagnostic yield was significantly affected by CT-to-body divergence; yield was 77.2% when estimated divergence was diagnostic yield of transbronchial biopsies without additional fluoroscopic guidance, and may be useful in the early diagnosis of lung cancer, particularly in nonoperable patients.

Diagnostic imaging and radiation exposure in inflammatory bowel disease

PubMed Central

Zakeri, Nekisa; Pollok, Richard CG

2016-01-01

Diagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease (IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentially harmful cumulative levels of ionising radiation in their lifetime, increasing malignant potential in a population already at risk. In this review we explore the proportion of IBD patients exposed to high cumulative radiation doses, the risk factors associated with higher radiation exposures, and we compare conventional diagnostic imaging with newer radiation-free imaging techniques used in the evaluation of patients with IBD. While computed tomography (CT) performs well as an imaging modality for IBD, the effective radiation dose is considerably higher than other abdominal imaging modalities. It is increasingly recognised that CT imaging remains responsible for the majority of diagnostic medical radiation to which IBD patients are exposed. Magnetic resonance imaging (MRI) and small intestine contrast enhanced ultrasonography (SICUS) have now emerged as suitable radiation-free alternatives to CT imaging, with comparable diagnostic accuracy. The routine use of MRI and SICUS for the clinical evaluation of patients with known or suspected small bowel Crohn’s disease is to be encouraged wherever possible. More provision is needed for out-of-hours radiation-free imaging modalities to reduce the need for CT. PMID:26900282

21 CFR 892.1760 - Diagnostic x-ray tube housing assembly.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Diagnostic x-ray tube housing assembly. 892.1760... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1760 Diagnostic x-ray tube housing assembly. (a) Identification. A diagnostic x-ray tube housing assembly is an x-ray generating tube encased...

21 CFR 892.1700 - Diagnostic x-ray high voltage generator.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Diagnostic x-ray high voltage generator. 892.1700... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1700 Diagnostic x-ray high voltage generator. (a) Identification. A diagnostic x-ray high voltage generator is a device that is intended to...

21 CFR 892.1760 - Diagnostic x-ray tube housing assembly.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Diagnostic x-ray tube housing assembly. 892.1760... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1760 Diagnostic x-ray tube housing assembly. (a) Identification. A diagnostic x-ray tube housing assembly is an x-ray generating tube encased...

21 CFR 892.1700 - Diagnostic x-ray high voltage generator.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Diagnostic x-ray high voltage generator. 892.1700... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1700 Diagnostic x-ray high voltage generator. (a) Identification. A diagnostic x-ray high voltage generator is a device that is intended to...

21 CFR 892.1760 - Diagnostic x-ray tube housing assembly.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Diagnostic x-ray tube housing assembly. 892.1760... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1760 Diagnostic x-ray tube housing assembly. (a) Identification. A diagnostic x-ray tube housing assembly is an x-ray generating tube encased...

21 CFR 892.1610 - Diagnostic x-ray beam-limiting device.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Diagnostic x-ray beam-limiting device. 892.1610... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1610 Diagnostic x-ray beam-limiting device. (a) Identification. A diagnostic x-ray beam-limiting device is a device such as a collimator, a...

21 CFR 892.1610 - Diagnostic x-ray beam-limiting device.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic x-ray beam-limiting device. 892.1610... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1610 Diagnostic x-ray beam-limiting device. (a) Identification. A diagnostic x-ray beam-limiting device is a device such as a collimator, a...

21 CFR 892.1700 - Diagnostic x-ray high voltage generator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic x-ray high voltage generator. 892.1700... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1700 Diagnostic x-ray high voltage generator. (a) Identification. A diagnostic x-ray high voltage generator is a device that is intended to...

21 CFR 892.1610 - Diagnostic x-ray beam-limiting device.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Diagnostic x-ray beam-limiting device. 892.1610... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1610 Diagnostic x-ray beam-limiting device. (a) Identification. A diagnostic x-ray beam-limiting device is a device such as a collimator, a...

21 CFR 892.1610 - Diagnostic x-ray beam-limiting device.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic x-ray beam-limiting device. 892.1610... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1610 Diagnostic x-ray beam-limiting device. (a) Identification. A diagnostic x-ray beam-limiting device is a device such as a collimator, a...

21 CFR 892.1610 - Diagnostic x-ray beam-limiting device.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Diagnostic x-ray beam-limiting device. 892.1610... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1610 Diagnostic x-ray beam-limiting device. (a) Identification. A diagnostic x-ray beam-limiting device is a device such as a collimator, a...

21 CFR 892.1700 - Diagnostic x-ray high voltage generator.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Diagnostic x-ray high voltage generator. 892.1700... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1700 Diagnostic x-ray high voltage generator. (a) Identification. A diagnostic x-ray high voltage generator is a device that is intended to...

21 CFR 892.1760 - Diagnostic x-ray tube housing assembly.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic x-ray tube housing assembly. 892.1760... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1760 Diagnostic x-ray tube housing assembly. (a) Identification. A diagnostic x-ray tube housing assembly is an x-ray generating tube encased...

21 CFR 892.1700 - Diagnostic x-ray high voltage generator.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic x-ray high voltage generator. 892.1700... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1700 Diagnostic x-ray high voltage generator. (a) Identification. A diagnostic x-ray high voltage generator is a device that is intended to...

21 CFR 892.1760 - Diagnostic x-ray tube housing assembly.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic x-ray tube housing assembly. 892.1760... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1760 Diagnostic x-ray tube housing assembly. (a) Identification. A diagnostic x-ray tube housing assembly is an x-ray generating tube encased...

Multi-method automated diagnostics of rotating machines

NASA Astrophysics Data System (ADS)

Kostyukov, A. V.; Boychenko, S. N.; Shchelkanov, A. V.; Burda, E. A.

2017-08-01

The automated machinery diagnostics and monitoring systems utilized within the petrochemical plants are an integral part of the measures taken to ensure safety and, as a consequence, the efficiency of these industrial facilities. Such systems are often limited in their functionality due to the specifics of the diagnostic techniques adopted. As the diagnostic techniques applied in each system are limited, and machinery defects can have different physical nature, it becomes necessary to combine several diagnostics and monitoring systems to control various machinery components. Such an approach is inconvenient, since it requires additional measures to bring the diagnostic results in a single view of the technical condition of production assets. In this case, we mean by a production facility a bonded complex of a process unit, a drive, a power source and lines. A failure of any of these components will cause an outage of the production asset, which is unacceptable. The purpose of the study is to test a combined use of vibration diagnostics and partial discharge techniques within the diagnostic systems of enterprises for automated control of the technical condition of rotating machinery during maintenance and at production facilities. The described solutions allow you to control the condition of mechanical and electrical components of rotating machines. It is shown that the functionality of the diagnostics systems can be expanded with minimal changes in technological chains of repair and operation of rotating machinery. Automation of such systems reduces the influence of the human factor on the quality of repair and diagnostics of the machinery.

Pre-diagnostic Clinical Presentations and Medical History Prior to the Diagnosis of Inflammatory Bowel Disease in Children.

PubMed

Kwon, Yong Hoon; Kim, Yong Joo

2013-09-01

The clinical presentations of inflammatory bowel disease (IBD) prior to diagnosis are so diverse or vague that many of them waste time before final diagnosis. This study was undertaken to know the medical history of the pediatric patients until the final diagnosis could be reached. The medical records of all pediatric patients who were diagnosed with IBD (Crohn's disease [CD] in 14 children, ulcerative colitis [UC] in 17) during the last 13 years were reviewed. We investigated the length of the diagnostic time lag, chief clinical presentation, and any useful laboratory predictor among the routinely performed examinations. Indeterminate colitis was not included. The mean ages of children at the final diagnosis was similar in both diseases. As for the pre-clinical past history of bowel symptoms in CD patients, 5 were previously healthy, 9 had had 1-3 gastrointestinal (GI) symptoms, weight loss, bloody stool, anemia and rectal prolapse. With UC, 9 were previously healthy, 8 had had 1-3 GI symptoms, bloody stool, anorexia. The average diagnostic time lag with CD was 3.36 months, and with UC 2.2 months. Body mass index (BMI) and the initial basic laboratory data (white blood cell, hemoglobin, mean corpuscular volume, serum albumin, and serum total protein) were lower in CD, statistically significant only in BMI. IBD shows diverse clinical symptoms before its classical features, making the patients waste time until diagnosis. It is important to concern possibility of IBD even in the mildly sick children who do not show the characteristic symptoms of IBD.

MEDIC: medical embedded device for individualized care.

PubMed

Wu, Winston H; Bui, Alex A T; Batalin, Maxim A; Au, Lawrence K; Binney, Jonathan D; Kaiser, William J

2008-02-01

Presented work highlights the development and initial validation of a medical embedded device for individualized care (MEDIC), which is based on a novel software architecture, enabling sensor management and disease prediction capabilities, and commercially available microelectronic components, sensors and conventional personal digital assistant (PDA) (or a cell phone). In this paper, we present a general architecture for a wearable sensor system that can be customized to an individual patient's needs. This architecture is based on embedded artificial intelligence that permits autonomous operation, sensor management and inference, and may be applied to a general purpose wearable medical diagnostics. A prototype of the system has been developed based on a standard PDA and wireless sensor nodes equipped with commercially available Bluetooth radio components, permitting real-time streaming of high-bandwidth data from various physiological and contextual sensors. We also present the results of abnormal gait diagnosis using the complete system from our evaluation, and illustrate how the wearable system and its operation can be remotely configured and managed by either enterprise systems or medical personnel at centralized locations. By using commercially available hardware components and software architecture presented in this paper, the MEDIC system can be rapidly configured, providing medical researchers with broadband sensor data from remote patients and platform access to best adapt operation for diagnostic operation objectives.

Diagnostic value of medical thoracoscopy in malignant pleural effusion induced by non-Hodgkin's lymphoma

PubMed Central

Wang, Zhen; Wu, Yan-Bing; Xu, Li-Li; Jin, Mu-Lan; Diao, Xiao-Li; Wang, Xiao-Juan; Tong, Zhao-Hui; Shi, Huan-Zhong

2017-01-01

Malignant pleural effusion (MPE) appears in up to 20% of patients with non-Hodgkin's lymphoma (NHL). The present study aimed to assess the efficacy of medical thoracoscopy (MT) in the diagnosis of patients with MPE induced by NHL. Between July 2005 and June 2014, 833 patients with pleural effusions of unknown etiology underwent MT in Beijing Chaoyang Hospital (Beijing, China), where diagnostic thoracocentesis or/and blind pleural biopsy had failed to yield an answer. Demographic, radiographic, thoracoscopic, histological and immunophenotyping data of 10 NHL patients with MPE were then retrospectively analyzed. Under medical thoracoscopy, pleural nodules (in n=6 patients), hyperemia (n=5), plaque-like lesions (n=4), pleural thickening (n=3), cellulose (n=3), ulcer (n=2), adhesion (n=2), and scattered hemorrhagic spots (n=1) were observed on the surface of parietal pleura. Histopathological and immunohistochemical analysis of pleural biopsy samples led to a correct diagnosis of B-cell NHL in 7 patients and T-lymphoblastic NHL in 2 patients. Data from the present study demonstrated that pleural biopsy through MT achieved a definite diagnosis of NHL in 9 out of 10 (90%) patients with MPE induced by NHL. Therefore, MT is a useful method for diagnosing MPE induced by NHL. PMID:29344253

Diagnostic value of medical thoracoscopy in malignant pleural effusion induced by non-Hodgkin's lymphoma.

PubMed

Wang, Zhen; Wu, Yan-Bing; Xu, Li-Li; Jin, Mu-Lan; Diao, Xiao-Li; Wang, Xiao-Juan; Tong, Zhao-Hui; Shi, Huan-Zhong

2017-12-01

Malignant pleural effusion (MPE) appears in up to 20% of patients with non-Hodgkin's lymphoma (NHL). The present study aimed to assess the efficacy of medical thoracoscopy (MT) in the diagnosis of patients with MPE induced by NHL. Between July 2005 and June 2014, 833 patients with pleural effusions of unknown etiology underwent MT in Beijing Chaoyang Hospital (Beijing, China), where diagnostic thoracocentesis or/and blind pleural biopsy had failed to yield an answer. Demographic, radiographic, thoracoscopic, histological and immunophenotyping data of 10 NHL patients with MPE were then retrospectively analyzed. Under medical thoracoscopy, pleural nodules (in n=6 patients), hyperemia (n=5), plaque-like lesions (n=4), pleural thickening (n=3), cellulose (n=3), ulcer (n=2), adhesion (n=2), and scattered hemorrhagic spots (n=1) were observed on the surface of parietal pleura. Histopathological and immunohistochemical analysis of pleural biopsy samples led to a correct diagnosis of B-cell NHL in 7 patients and T-lymphoblastic NHL in 2 patients. Data from the present study demonstrated that pleural biopsy through MT achieved a definite diagnosis of NHL in 9 out of 10 (90%) patients with MPE induced by NHL. Therefore, MT is a useful method for diagnosing MPE induced by NHL.

A design and implementation methodology for diagnostic systems

NASA Technical Reports Server (NTRS)

Williams, Linda J. F.

1988-01-01

A methodology for design and implementation of diagnostic systems is presented. Also discussed are the advantages of embedding a diagnostic system in a host system environment. The methodology utilizes an architecture for diagnostic system development that is hierarchical and makes use of object-oriented representation techniques. Additionally, qualitative models are used to describe the host system components and their behavior. The methodology architecture includes a diagnostic engine that utilizes a combination of heuristic knowledge to control the sequence of diagnostic reasoning. The methodology provides an integrated approach to development of diagnostic system requirements that is more rigorous than standard systems engineering techniques. The advantages of using this methodology during various life cycle phases of the host systems (e.g., National Aerospace Plane (NASP)) include: the capability to analyze diagnostic instrumentation requirements during the host system design phase, a ready software architecture for implementation of diagnostics in the host system, and the opportunity to analyze instrumentation for failure coverage in safety critical host system operations.

The future of medical diagnostics: large digitized databases.

PubMed

Kerr, Wesley T; Lau, Edward P; Owens, Gwen E; Trefler, Aaron

2012-09-01

The electronic health record mandate within the American Recovery and Reinvestment Act of 2009 will have a far-reaching affect on medicine. In this article, we provide an in-depth analysis of how this mandate is expected to stimulate the production of large-scale, digitized databases of patient information. There is evidence to suggest that millions of patients and the National Institutes of Health will fully support the mining of such databases to better understand the process of diagnosing patients. This data mining likely will reaffirm and quantify known risk factors for many diagnoses. This quantification may be leveraged to further develop computer-aided diagnostic tools that weigh risk factors and provide decision support for health care providers. We expect that creation of these databases will stimulate the development of computer-aided diagnostic support tools that will become an integral part of modern medicine.

Improving the diagnostic workup of hyponatremia in the setting of kidney disease: a continuing medical education (CME) initiative.

PubMed

Golestaneh, Ladan; Neugarten, Joel; Southern, William; Kargoli, Faraj; Raff, Amanda

2017-03-01

Hyponatremia is a common electrolyte disorder and is associated with mortality. We examined the frequency of appropriate testing in response to an episode of inpatient hyponatremia in a large urban hospital to better inform our educational intervention. We then evaluated the impact of a live CME activity with a focus on CKD- and ESRD-associated hyponatremia physiology, on diagnostic practices of audience hospitalist attendings. We performed a retrospective database analysis of all patients admitted to Montefiore Medical Center in 2014 to examine the performance of hospital staff in response to hyponatremia across all CKD stages. We then did a comparative analysis of diagnostic workup orders for hyponatremic patients admitted to audience members of a live CME activity in the 4 months prior as compared to the 4 months after the activity. The prevalence of hyponatremia was 27% in a cohort of hospitalized patients: 41% of these hyponatremia inpatients had CKD, and 11.4% had ESRD. Overall less than 10% of patients had orders written for serum and urine osmolality without a differential pattern based on CKD or ESRD diagnosis. Among the patients admitted to the CME audience hospitalists, urine/serum osmolality and urine sodium orders occurred infrequently overall and did not differ after vs. before the lecture. The frequency of appropriate diagnostic orders written in response to an episode of hyponatremia was very low and did not vary based on degree of CKD. A CME activity with an emphasis on the role of CKD/ESRD in diagnostic accuracy did not improve the order quality in a group of audience hospitalists. Efforts to improve the diagnostic workup of hyponatremia with concomitant kidney disease are crucial to proper management of these patients.

Current practice in laboratory diagnostics of autoimmune diseases in Croatia. 
Survey of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

PubMed

Kuna, Andrea Tešija; Đerek, Lovorka; Kozmar, Ana; Drvar, Vedrana

2016-10-15

With the trend of increasing incidence of autoimmune diseases, laboratories are faced with exponential growth of the requests for tests relating the diagnosis of these diseases. Unfortunately, the lack of laboratory personnel experienced in this specific discipline of laboratory diagnostic, as well as an unawareness of a method limitation often results in confusion for clinicians. The aim was to gain insight into number and type of Croatian laboratories that perform humoral diagnostics with the final goal to improve and harmonize laboratory diagnostics of autoimmune diseases in Croatia. In order to get insight into current laboratory practice two questionnaires, consisting of 42 questions in total, were created. Surveys were conducted using SurveyMonkey application and were sent to 88 medical biochemistry laboratories in Croatia for the first survey. Out of 33 laboratories that declared to perform diagnostic from the scope, 19 were selected for the second survey based on the tests they pleaded to perform. The survey comprised questions regarding autoantibody hallmarks of systemic autoimmune diseases while regarding organ-specific autoimmune diseases was limited to diseases of liver, gastrointestinal and nervous system. Response rate was high with 80 / 88 (91%) laboratories which answered the first questionnaire, and 19 / 19 (1.0) for the second questionnaire. Obtained results of surveys indicate high heterogeneity in the performance of autoantibody testing among laboratories in Croatia. Results indicate the need of creating recommendations and algorithms in order to harmonize the approach to laboratory diagnostics of autoimmune diseases in Croatia.

Applying Diagnostics to Enhance Cable System Reliability (Cable Diagnostic Focused Initiative, Phase II)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hartlein, Rick; Hampton, Nigel; Perkel, Josh

2016-02-01

The Cable Diagnostic Focused Initiative (CDFI) played a significant and powerful role in clarifying the concerns and understanding the benefits of performing diagnostic tests on underground power cable systems. This project focused on the medium and high voltage cable systems used in utility transmission and distribution (T&D) systems. While many of the analysis techniques and interpretations are applicable to diagnostics and cable systems outside of T&D, areas such as generating stations (nuclear, coal, wind, etc.) and other industrial environments were not the focus. Many large utilities in North America now deploy diagnostics or have changed their diagnostic testing approach asmore » a result of this project. Previous to the CDFI, different diagnostic technology providers individually promoted their approach as the “the best” or “the only” means of detecting cable system defects.« less

[Pediatric radiological diagnostics in suspected child abuse].

PubMed

Erfurt, C; Hahn, G; Roesner, D; Schmidt, U

2009-10-01

Advanced and specialized radiological diagnostics are essential in the case of clinical suspicion of pediatric injuries to the head, thorax, abdomen, and extremities when there is no case history or when "battered child syndrome" is assumed on the basis of inadequate trauma. In particular, the aim of this sophisticated diagnostic procedure is the detection of lesions of the central nervous system (CNS) in order to initiate prompt medical treatment. If diagnostic imaging shows typical findings of child abuse, accurate documented evidence of the diagnostic results is required to prevent further endangerment of the child's welfare.

Statistical physics of medical diagnostics: Study of a probabilistic model.

PubMed

Mashaghi, Alireza; Ramezanpour, Abolfazl

2018-03-01

We study a diagnostic strategy which is based on the anticipation of the diagnostic process by simulation of the dynamical process starting from the initial findings. We show that such a strategy could result in more accurate diagnoses compared to a strategy that is solely based on the direct implications of the initial observations. We demonstrate this by employing the mean-field approximation of statistical physics to compute the posterior disease probabilities for a given subset of observed signs (symptoms) in a probabilistic model of signs and diseases. A Monte Carlo optimization algorithm is then used to maximize an objective function of the sequence of observations, which favors the more decisive observations resulting in more polarized disease probabilities. We see how the observed signs change the nature of the macroscopic (Gibbs) states of the sign and disease probability distributions. The structure of these macroscopic states in the configuration space of the variables affects the quality of any approximate inference algorithm (so the diagnostic performance) which tries to estimate the sign-disease marginal probabilities. In particular, we find that the simulation (or extrapolation) of the diagnostic process is helpful when the disease landscape is not trivial and the system undergoes a phase transition to an ordered phase.

Statistical physics of medical diagnostics: Study of a probabilistic model

NASA Astrophysics Data System (ADS)

Mashaghi, Alireza; Ramezanpour, Abolfazl

2018-03-01

We study a diagnostic strategy which is based on the anticipation of the diagnostic process by simulation of the dynamical process starting from the initial findings. We show that such a strategy could result in more accurate diagnoses compared to a strategy that is solely based on the direct implications of the initial observations. We demonstrate this by employing the mean-field approximation of statistical physics to compute the posterior disease probabilities for a given subset of observed signs (symptoms) in a probabilistic model of signs and diseases. A Monte Carlo optimization algorithm is then used to maximize an objective function of the sequence of observations, which favors the more decisive observations resulting in more polarized disease probabilities. We see how the observed signs change the nature of the macroscopic (Gibbs) states of the sign and disease probability distributions. The structure of these macroscopic states in the configuration space of the variables affects the quality of any approximate inference algorithm (so the diagnostic performance) which tries to estimate the sign-disease marginal probabilities. In particular, we find that the simulation (or extrapolation) of the diagnostic process is helpful when the disease landscape is not trivial and the system undergoes a phase transition to an ordered phase.

Converting Radiology Operations in a Six-Hospital Healthcare System from Film-Based to Digital: Another Leadership Role for the Diagnostic Medical Physicist

NASA Astrophysics Data System (ADS)

Arreola, Manuel M.; Rill, Lynn N.

2004-09-01

As medical facilities across the United States continue to convert their radiology operations from film-based to digital environments, partially accomplished and failed endeavors are frequent because of the lack of competent and knowledgeable leadership. The diagnostic medical physicist is, without a doubt, in a privileged position to take such a leadership role, not only because of her/his understanding of the basics principles of new imaging modalities, but also because of her/his inherent participation in workflow design and educational/training activities. A well-structured approach by the physicist will certainly lead the project to a successful completion, opening, in turn, new opportunities for the medical physicist to become an active participant in the decision-making process for an institution.

The suitability of Tedlar bags for breath sampling in medical diagnostic research.

PubMed

Steeghs, Marco M L; Cristescu, Simona M; Harren, Frans J M

2007-01-01

Tedlar bags are tested for their suitability for breath sampling for medical diagnostic purposes. Proton-transfer reaction-mass spectrometry was used to monitor the changes in composition of various mixtures contained in custom-made black-layered Tedlar bags. Characteristic ions at m/z 88 and 95 amu reflect considerable pollution from the bag material. The pollutant found on m/z 88 amu is most probably N,N-dimethylacetamide, a latent solvent used in the production of Tedlar film. Gas composition losses during filling were found to range from 5 to 47%, depending on the compound. Once stored, the half-lives of methanol, acetaldehyde, acetone, isoprene, benzene, toluene and styrene were estimated between 5 and 13 days. Losses from breath samples (52 h after filling) were found to be less than 10%. No observable decrease was found for ethylene over 3 days, using laser-based photoacoustic detection. For the use of Tedlar bags, a standardized protocol is advised, where the time point of analysis is fixed for all samples and should be kept as close as possible to the time of sampling.

A mathematical model for the virus medical imaging technique

NASA Astrophysics Data System (ADS)

Fioranelli, Massimo; Sepehri, Alireza

In this paper, we introduce a mathematical model for the virus medical imaging (VMI). In this method, first, by proposing a mathematical model, we show that there are two types of viruses that each of them produce one type of signal. Some of these signals can be received by males and others by females. Then, we will show that in the VMI technique, viruses can communicate with cells, interior to human’s body via two ways. (1) Viruses can form a wire that passes the skin and reaches to a special cell. (2) Viruses can communicate with viruses interior to body in the wireless form and send some signals for controlling evolutions of cells interior to human’s body.

Remote skin tissue diagnostics in vivo by fiber optic evanescent wave Fourier transform infrared (FEW-FTIR) spectroscopy

NASA Astrophysics Data System (ADS)

Afanasyeva, Natalia I.; Kolyakov, Sergei F.; Butvina, Leonid N.

1998-04-01

The new method of fiber-optical evanescent wave Fourier transform IR (FEW-FTIR) spectroscopy has been applied to the diagnostics of normal tissue, as well as precancerous and cancerous conditions. The FEW-FTIR technique is nondestructive and sensitive to changes of vibrational spectra in the IR region, without heating and damaging human and animal skin tissue. Therefore this method and technique is an ideal diagnostic tool for tumor and cancer characterization at an early stage of development on a molecular level. The application of fiber optic technology in the middle IR region is relatively inexpensive and can be adapted easily to any commercially available tabletop FTIR spectrometers. This method of diagnostics is fast, remote, and can be applied to many fields Noninvasive medical diagnostics of skin cancer and other skin diseases in vivo, ex vivo, and in vitro allow for the development convenient, remote clinical applications in dermatology and related fields. The spectral variations from normal to pathological skin tissue and environmental influence on skin have been measured and assigned in the regions of 850-4000 cm-1. The lipid structure changes are discussed. We are able to develop the spectral histopathology as a fast and informative tool of analysis.

Diagnostics of wear in aeronautical systems

NASA Technical Reports Server (NTRS)

Wedeven, L. D.

1979-01-01

The use of appropriate diagnostic tools for aircraft oil wetted components is reviewed, noting that it can reduce direct operating costs through reduced unscheduled maintenance, particularly in helicopter engine and transmission systems where bearing failures are a significant cost factor. Engine and transmission wear modes are described, and diagnostic methods for oil and wet particle analysis, the spectrometric oil analysis program, chip detectors, ferrography, in-line oil monitor and radioactive isotope tagging are discussed, noting that they are effective over a limited range of particle sizes but compliment each other if used in parallel. Fine filtration can potentially increase time between overhauls, but reduces the effectiveness of conventional oil monitoring techniques so that alternative diagnostic techniques must be used. It is concluded that the development of a diagnostic system should be parallel and integral with the development of a mechanical system.

Computational techniques for ECG analysis and interpretation in light of their contribution to medical advances

PubMed Central

Mincholé, Ana; Martínez, Juan Pablo; Laguna, Pablo; Rodriguez, Blanca

2018-01-01

Widely developed for clinical screening, electrocardiogram (ECG) recordings capture the cardiac electrical activity from the body surface. ECG analysis can therefore be a crucial first step to help diagnose, understand and predict cardiovascular disorders responsible for 30% of deaths worldwide. Computational techniques, and more specifically machine learning techniques and computational modelling are powerful tools for classification, clustering and simulation, and they have recently been applied to address the analysis of medical data, especially ECG data. This review describes the computational methods in use for ECG analysis, with a focus on machine learning and 3D computer simulations, as well as their accuracy, clinical implications and contributions to medical advances. The first section focuses on heartbeat classification and the techniques developed to extract and classify abnormal from regular beats. The second section focuses on patient diagnosis from whole recordings, applied to different diseases. The third section presents real-time diagnosis and applications to wearable devices. The fourth section highlights the recent field of personalized ECG computer simulations and their interpretation. Finally, the discussion section outlines the challenges of ECG analysis and provides a critical assessment of the methods presented. The computational methods reported in this review are a strong asset for medical discoveries and their translation to the clinical world may lead to promising advances. PMID:29321268

Diagnostic accuracy of three biopsy techniques in 117 dogs with intra-nasal neoplasia.

PubMed

Harris, B J; Lourenço, B N; Dobson, J M; Herrtage, M E

2014-04-01

To determine if nasal biopsies taken at rhinoscopy are more accurate for diagnosing neoplasia than biopsies taken blindly or using advanced imaging for guidance. A retrospective study of 117 dogs with nasal mass lesions that were divided into three groups according to the method of nasal biopsy collection; advanced imaging-guided, rhinoscopy-guided and blind biopsy. Signalment, imaging and rhinoscopic findings, and histopathological diagnosis were compared between groups. The proportion of first attempt biopsies confirming neoplasia were determined for each group. There were no statistically significant differences in the proportion of biopsies that confirmed neoplasia obtained via advanced imaging-guided, rhinoscopy-guided or blind biopsy techniques. In dogs with a high index of suspicion of nasal neoplasia, blind biopsy may be as diagnostic as rhinoscopy-guided biopsy. Repeated biopsies are frequently required for definitive diagnosis. © 2014 British Small Animal Veterinary Association.

Compression techniques in tele-radiology

NASA Astrophysics Data System (ADS)

Lu, Tianyu; Xiong, Zixiang; Yun, David Y.

1999-10-01

This paper describes a prototype telemedicine system for remote 3D radiation treatment planning. Due to voluminous medical image data and image streams generated in interactive frame rate involved in the application, the importance of deploying adjustable lossy to lossless compression techniques is emphasized in order to achieve acceptable performance via various kinds of communication networks. In particular, the compression of the data substantially reduces the transmission time and therefore allows large-scale radiation distribution simulation and interactive volume visualization using remote supercomputing resources in a timely fashion. The compression algorithms currently used in the software we developed are JPEG and H.263 lossy methods and Lempel-Ziv (LZ77) lossless methods. Both objective and subjective assessment of the effect of lossy compression methods on the volume data are conducted. Favorable results are obtained showing that substantial compression ratio is achievable within distortion tolerance. From our experience, we conclude that 30dB (PSNR) is about the lower bound to achieve acceptable quality when applying lossy compression to anatomy volume data (e.g. CT). For computer simulated data, much higher PSNR (up to 100dB) is expectable. This work not only introduces such novel approach for delivering medical services that will have significant impact on the existing cooperative image-based services, but also provides a platform for the physicians to assess the effects of lossy compression techniques on the diagnostic and aesthetic appearance of medical imaging.

New Diagnostic, Launch and Model Control Techniques in the NASA Ames HFFAF Ballistic Range

NASA Technical Reports Server (NTRS)

Bogdanoff, David W.

2012-01-01

This report presents new diagnostic, launch and model control techniques used in the NASA Ames HFFAF ballistic range. High speed movies were used to view the sabot separation process and the passage of the model through the model splap paper. Cavities in the rear of the sabot, to catch the muzzle blast of the gun, were used to control sabot finger separation angles and distances. Inserts were installed in the powder chamber to greatly reduce the ullage volume (empty space) in the chamber. This resulted in much more complete and repeatable combustion of the powder and hence, in much more repeatable muzzle velocities. Sheets of paper or cardstock, impacting one half of the model, were used to control the amplitudes of the model pitch oscillations.

Extending battery life: A low-cost practical diagnostic technique for lithium-ion batteries

NASA Astrophysics Data System (ADS)

Merla, Yu; Wu, Billy; Yufit, Vladimir; Brandon, Nigel P.; Martinez-Botas, Ricardo F.; Offer, Gregory J.

2016-11-01

Modern applications of lithium-ion batteries such as smartphones, hybrid & electric vehicles and grid scale electricity storage demand long lifetime and high performance which typically makes them the limiting factor in a system. Understanding the state-of-health during operation is important in order to optimise for long term durability and performance. However, this requires accurate in-operando diagnostic techniques that are cost effective and practical. We present a novel diagnosis method based upon differential thermal voltammetry demonstrated on a battery pack made from commercial lithium-ion cells where one cell was deliberately aged prior to experiment. The cells were in parallel whilst being thermally managed with forced air convection. We show for the first time, a diagnosis method capable of quantitatively determining the state-of-health of four cells simultaneously by only using temperature and voltage readings for both charge and discharge. Measurements are achieved using low-cost thermocouples and a single voltage measurement at a frequency of 1 Hz, demonstrating the feasibility of implementing this approach on real world battery management systems. The technique could be particularly useful under charge when constant current or constant power is common, this therefore should be of significant interest to all lithium-ion battery users.

Development of a neural network technique for KSTAR Thomson scattering diagnostics.

PubMed

Lee, Seung Hun; Lee, J H; Yamada, I; Park, Jae Sun

2016-11-01

Neural networks provide powerful approaches of dealing with nonlinear data and have been successfully applied to fusion plasma diagnostics and control systems. Controlling tokamak plasmas in real time is essential to measure the plasma parameters in situ. However, the χ 2 method traditionally used in Thomson scattering diagnostics hampers real-time measurement due to the complexity of the calculations involved. In this study, we applied a neural network approach to Thomson scattering diagnostics in order to calculate the electron temperature, comparing the results to those obtained with the χ 2 method. The best results were obtained for 10 3 training cycles and eight nodes in the hidden layer. Our neural network approach shows good agreement with the χ 2 method and performs the calculation twenty times faster.

Watermarking of ultrasound medical images in teleradiology using compressed watermark

PubMed Central

Badshah, Gran; Liew, Siau-Chuin; Zain, Jasni Mohamad; Ali, Mushtaq

2016-01-01

Abstract. The open accessibility of Internet-based medical images in teleradialogy face security threats due to the nonsecured communication media. This paper discusses the spatial domain watermarking of ultrasound medical images for content authentication, tamper detection, and lossless recovery. For this purpose, the image is divided into two main parts, the region of interest (ROI) and region of noninterest (RONI). The defined ROI and its hash value are combined as watermark, lossless compressed, and embedded into the RONI part of images at pixel’s least significant bits (LSBs). The watermark lossless compression and embedding at pixel’s LSBs preserve image diagnostic and perceptual qualities. Different lossless compression techniques including Lempel-Ziv-Welch (LZW) were tested for watermark compression. The performances of these techniques were compared based on more bit reduction and compression ratio. LZW was found better than others and used in tamper detection and recovery watermarking of medical images (TDARWMI) scheme development to be used for ROI authentication, tamper detection, localization, and lossless recovery. TDARWMI performance was compared and found to be better than other watermarking schemes. PMID:26839914

Medical students benefit from the use of ultrasound when learning peripheral IV techniques.

PubMed

Osborn, Scott R; Borhart, Joelle; Antonis, Michael S

2012-03-06

Recent studies support high success rates after a short learning period of ultrasound IV technique, and increased patient and provider satisfaction when using ultrasound as an adjunct to peripheral IV placement. No study to date has addressed the efficacy for instructing ultrasound-naive providers. We studied the introduction of ultrasound to the teaching technique of peripheral IV insertion on first- and second-year medical students. This was a prospective, randomized, and controlled trial. A total of 69 medical students were randomly assigned to the control group with a classic, landmark-based approach (n = 36) or the real-time ultrasound-guided group (n = 33). Both groups observed a 20-min tutorial on IV placement using both techniques and then attempted vein cannulation. Students were given a survey to report their results and observations by a 10-cm visual analog scale. The survey response rate was 100%. In the two groups, 73.9% stated that they attempted an IV previously, and 63.7% of students had used an ultrasound machine prior to the study. None had used ultrasound for IV access prior to our session. The average number of attempts at cannulation was 1.42 in either group. There was no difference between the control and ultrasound groups in terms of number of attempts (p = 0.31). In both groups, 66.7% of learners were able to cannulate in one attempt, 21.7% in two attempts, and 11.6% in three attempts. The study group commented that they felt they gained more knowledge from the experience (p < 0.005) and that it was easier with ultrasound guidance (p < 0.005). Medical students feel they learn more when using ultrasound after a 20-min tutorial to place IVs and cannulation of the vein feels easier. Success rates are comparable between the traditional and ultrasound teaching approaches.

Fundamentals of Materials, Techniques, and Instrumentation for OSL and FNTD Dosimetry

NASA Astrophysics Data System (ADS)

Akselrod, M. S.

2011-05-01

The optically stimulated luminescence (OSL) technique has already become a successful commercial tool in personal radiation dosimetry, medical dosimetry, diagnostic imaging, geological and archeological dating. This review briefly describes the history and fundamental principles of OSL materials, methods and instrumentation. The advantages of OSL technology and instrumentation in comparison with thermoluminescent technique are analyzed. Progress in material and detector engineering has allowed new and promising developments regarding OSL applications in the medical field. Special attention is dedicated to Al2O3:C as a material of choice for many dosimetric applications. Different aspects of OSL theory, materials optical and dosimetric properties, instrumentation, and data processing algorithms are described. The next technological breakthrough was done with Fluorescent Nuclear Track Detectors (FNTD) that have some important advantages in measuring fast neutron and high energy heavy charge particles that have become the latest tool in radiation therapy. New Mg-doped aluminum oxide crystals and novel type of imaging instrumentation for FNTD technology are discussed with regard to application in mixed neutron-gamma fields, medical dosimetry and radiobiological research.

[Combination of endoscopic methods in diagnostics and surgical treatment of perforative duodenal ulcer].

PubMed

Timofeev, M E; Shapoval'yants, S G; Mikhalev, A I; Fedorov, E D; Konyukhov, G V

2016-01-01

To present the results of perforative duodenal ulcer surgical management using combination of endoscopic methods. The study included 279 patients with perforative duodenal ulcer who were operated for the period from 1996 to 2012. Diagnostics and medical tactics were based on developed in our clinic algorithm that includes use of both esophagogastroduodenoscopy and laparoscopy. Presented technique confirmed correct diagnosis, defined medical tactics and choice of surgery in 100% of cases. 67 patients had contraindications for laparoscopic suturing and underwent conventional operations. Herewith postoperative complications and death were observed in 25 (37.3%) and 9 (13.4%) patients respectively. Laparoscopic suturing was performed in 212 patients. Complications were diagnosed in 19 (8.9%) cases including 8 (3.7%) intraoperative and 11 (5.2%) postoperative. Deaths were absent.

Virtual reality on the web: the potentials of different methodologies and visualization techniques for scientific research and medical education.

PubMed

Kling-Petersen, T; Pascher, R; Rydmark, M

1999-01-01

Academic and medical imaging are increasingly using computer based 3D reconstruction and/or visualization. Three-dimensional interactive models play a major role in areas such as preclinical medical education, clinical visualization and medical research. While 3D is comparably easy to do on a high end workstations, distribution and use of interactive 3D graphics necessitate the use of personal computers and the web. Several new techniques have been demonstrated providing interactive 3D via a web browser thereby allowing a limited version of VR to be experienced by a larger majority of students, medical practitioners and researchers. These techniques include QuickTimeVR2 (QTVR), VRML2, QuickDraw3D, OpenGL and Java3D. In order to test the usability of the different techniques, Mednet have initiated a number of projects designed to evaluate the potentials of 3D techniques for scientific reporting, clinical visualization and medical education. These include datasets created by manual tracing followed by triangulation, smoothing and 3D visualization, MRI or high-resolution laserscanning. Preliminary results indicate that both VRML and QTVR fulfills most of the requirements of web based, interactive 3D visualization, whereas QuickDraw3D is too limited. Presently, the JAVA 3D has not yet reached a level where in depth testing is possible. The use of high-resolution laserscanning is an important addition to 3D digitization.

Critical evaluation of fine needle aspiration cytology as a diagnostic technique in bone tumors and tumor-like lesions.

PubMed

Chakrabarti, Sudipta; Datta, Alok Sobhan; Hira, Michael

2012-01-01

Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

WE-AB-206-00: Diagnostic QA/QC Hands-On Workshop

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environmentmore » with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.« less

The IDEA Assessment Tool: Assessing the Reporting, Diagnostic Reasoning, and Decision-Making Skills Demonstrated in Medical Students' Hospital Admission Notes.

PubMed

Baker, Elizabeth A; Ledford, Cynthia H; Fogg, Louis; Way, David P; Park, Yoon Soo

2015-01-01

Construct: Clinical skills are used in the care of patients, including reporting, diagnostic reasoning, and decision-making skills. Written comprehensive new patient admission notes (H&Ps) are a ubiquitous part of student education but are underutilized in the assessment of clinical skills. The interpretive summary, differential diagnosis, explanation of reasoning, and alternatives (IDEA) assessment tool was developed to assess students' clinical skills using written comprehensive new patient admission notes. The validity evidence for assessment of clinical skills using clinical documentation following authentic patient encounters has not been well documented. Diagnostic justification tools and postencounter notes are described in the literature (1,2) but are based on standardized patient encounters. To our knowledge, the IDEA assessment tool is the first published tool that uses medical students' H&Ps to rate students' clinical skills. The IDEA assessment tool is a 15-item instrument that asks evaluators to rate students' reporting, diagnostic reasoning, and decision-making skills based on medical students' new patient admission notes. This study presents validity evidence in support of the IDEA assessment tool using Messick's unified framework, including content (theoretical framework), response process (interrater reliability), internal structure (factor analysis and internal-consistency reliability), and relationship to other variables. Validity evidence is based on results from four studies conducted between 2010 and 2013. First, the factor analysis (2010, n = 216) yielded a three-factor solution, measuring patient story, IDEA, and completeness, with reliabilities of .79, .88, and .79, respectively. Second, an initial interrater reliability study (2010) involving two raters demonstrated fair to moderate consensus (κ = .21-.56, ρ =.42-.79). Third, a second interrater reliability study (2011) with 22 trained raters also demonstrated fair to moderate agreement

[MRI diagnostics of bone marrow oedema and its significance for the forensic medical evaluation of the injuries to bones and articulations].

PubMed

Fetisov, V A; Kulinkovich, K Yu

The objective of the present study was the analysis of the publications in the literature dealing with radiological methods employed for the diagnostics of injuries to and diseases of the bones and articulations as well as the role of bone marrow oedema in the development of these conditions in the specific context of the problems facing forensic medical expertise. The main results of the domestic and foreign authors concerning MRI-based investigations into the nature of injuries and other pathological changes in bones and articulations during different periods after their development are discussed with the major emphasis placed on diagnostics of bone marrow oedema. Magnetic resonance visualization of this diagnostic feature and the related manifestations of the above conditions in many cases provides an indisputable evidence of the damage whereas the discovery of its distribution to and localization in the bone structures makes it possible to elucidate the sources of this condition, such as a blow, torsional stress, stretching, etc., and its underlying mechanisms. The character and the mode of distribution of the signal from a bone marrow oedema under various conditions of visualization allow to carry out differential diagnostics of the damage prescription period of up to 1.5 months.

Some Cognitive Components of the Diagnostic Thinking Process.

ERIC Educational Resources Information Center

Gale, Janet

1982-01-01

Identifies 14 cognitive components of the diagnostic thinking process in clinical problem solving. Analyzes the differences between medical students, hospital house officers, and hospital registrars in London, England, on the relative use of such thinking processes. Suggests that diagnostic thinking processes cannot be incorporated into medical…

21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Diagnostic electromyograph needle electrode. 890.1385 Section 890.1385 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890...

21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Diagnostic electromyograph needle electrode. 890.1385 Section 890.1385 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890...

21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Diagnostic electromyograph needle electrode. 890.1385 Section 890.1385 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890...

21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Diagnostic electromyograph needle electrode. 890.1385 Section 890.1385 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890...

21 CFR 890.1385 - Diagnostic electromyograph needle electrode.

Code of Federal Regulations, 2012 CFR