This document provides an overview of how computers and interactive health applications can help doctors share information and clinical understanding with patients. It discusses the case of Ms. Patel, who met with her doctor and genetics clinic team to discuss her family history of breast cancer and 30% lifetime risk of also developing breast cancer. The team created a genogram to visualize her family history and risks. The document then discusses the benefits of interactive tools for improving patient understanding, reducing uncertainty, and better supporting patients. It provides some examples of how images, videos and other multimedia can help explain clinical information to patients during consultations.
Nicholas Tenhue completed his Master's degree in MSc ICT Innovation at University College London, this document is his thesis on Making Sense of Risk by Visualizing Complex Health Data.
Find out more about Nicholas at http://nicholastenhue.com
Data Visuallization for Decision Making - Intel White PaperNicholas Tenhue
Clinicians must analyze large amounts of patient data from various sources to assess health and develop treatment plans. This process is becoming more complex with new sources of data. The study explored creating data visualization tools to help clinicians make sense of growing data volumes and varieties. Participants provided feedback on prototype tools, identifying challenges and beneficial design approaches. The tools showed potential to improve the speed and accuracy of healthcare decisions by making implicit thought processes more explicit.
Tablets show potential for mobile radiology applications like teleradiology. While tablets have high-quality displays, various technical factors must be considered for clinical radiology use, including display size and resolution, software viewers, bandwidth, and data security. Early experiences indicate tablets can accurately read emergency cases remotely but may have limitations for primary diagnostic interpretation. Further standards and regulations are needed as mobile radiology evolves.
The document discusses several topics related to imaging in healthcare:
1) Stage 2 MU requirements call for remote viewing of patient records and images to increase access for physicians and patients. Patient portals may play a larger role in remote monitoring programs for chronic conditions.
2) Clinical decision support and CPOE are now required to improve safety, eliminate errors, and justify expensive tests. VNAs can enable remote access via mobile devices.
3) The future is moving from hospital-centric, episodic, fee-for-service care to being more patient-centric, continuous, and value-based with an emphasis on wellness in addition to sickness.
4) Data liquidity, or ensuring the
TCGC The Clinical Genome Conference 2015Nicole Proulx
Bio-IT World and Cambridge Healthtech Institute are again proud to host the Fourth Annual TCGC: The Clinical Genome Conference, inviting stakeholders impacting clinical genomics to share new findings and solutions for advancing the applications of clinical genome medicine.
The document discusses emerging technologies including wearables, augmented reality, and virtual reality and their potential applications in healthcare and medical education. Wearables like smartwatches can help monitor patient health outside of clinical settings. Augmented reality shows promise for enhancing medical education by allowing interactive 3D models and remote teaching. Virtual reality could transform surgical training by enabling realistic simulations, but high-fidelity systems present technical challenges around software, hardware, and costs. These technologies offer opportunities to improve patient care and address shortages in medical education and training.
1. Ms Smith developed symptomatic renal impairment that may have been avoided if her underlying medical issues were properly diagnosed and treated earlier at multiple points in her care.
2. Ensuring appropriate follow-up and continuity of care between primary care physicians and specialists can help reduce risks for patients with chronic conditions like Ms Smith.
3. Integrating medical records electronically across different parts of a healthcare system can improve information sharing, guide treatment according to best practices, and ultimately enhance patient outcomes.
Nicholas Tenhue completed his Master's degree in MSc ICT Innovation at University College London, this document is his thesis on Making Sense of Risk by Visualizing Complex Health Data.
Find out more about Nicholas at http://nicholastenhue.com
Data Visuallization for Decision Making - Intel White PaperNicholas Tenhue
Clinicians must analyze large amounts of patient data from various sources to assess health and develop treatment plans. This process is becoming more complex with new sources of data. The study explored creating data visualization tools to help clinicians make sense of growing data volumes and varieties. Participants provided feedback on prototype tools, identifying challenges and beneficial design approaches. The tools showed potential to improve the speed and accuracy of healthcare decisions by making implicit thought processes more explicit.
Tablets show potential for mobile radiology applications like teleradiology. While tablets have high-quality displays, various technical factors must be considered for clinical radiology use, including display size and resolution, software viewers, bandwidth, and data security. Early experiences indicate tablets can accurately read emergency cases remotely but may have limitations for primary diagnostic interpretation. Further standards and regulations are needed as mobile radiology evolves.
The document discusses several topics related to imaging in healthcare:
1) Stage 2 MU requirements call for remote viewing of patient records and images to increase access for physicians and patients. Patient portals may play a larger role in remote monitoring programs for chronic conditions.
2) Clinical decision support and CPOE are now required to improve safety, eliminate errors, and justify expensive tests. VNAs can enable remote access via mobile devices.
3) The future is moving from hospital-centric, episodic, fee-for-service care to being more patient-centric, continuous, and value-based with an emphasis on wellness in addition to sickness.
4) Data liquidity, or ensuring the
TCGC The Clinical Genome Conference 2015Nicole Proulx
Bio-IT World and Cambridge Healthtech Institute are again proud to host the Fourth Annual TCGC: The Clinical Genome Conference, inviting stakeholders impacting clinical genomics to share new findings and solutions for advancing the applications of clinical genome medicine.
The document discusses emerging technologies including wearables, augmented reality, and virtual reality and their potential applications in healthcare and medical education. Wearables like smartwatches can help monitor patient health outside of clinical settings. Augmented reality shows promise for enhancing medical education by allowing interactive 3D models and remote teaching. Virtual reality could transform surgical training by enabling realistic simulations, but high-fidelity systems present technical challenges around software, hardware, and costs. These technologies offer opportunities to improve patient care and address shortages in medical education and training.
1. Ms Smith developed symptomatic renal impairment that may have been avoided if her underlying medical issues were properly diagnosed and treated earlier at multiple points in her care.
2. Ensuring appropriate follow-up and continuity of care between primary care physicians and specialists can help reduce risks for patients with chronic conditions like Ms Smith.
3. Integrating medical records electronically across different parts of a healthcare system can improve information sharing, guide treatment according to best practices, and ultimately enhance patient outcomes.
This document provides an overview of clinical trial accrual challenges and discusses how social media could potentially help address some of these challenges. It summarizes the National Clinical Trials Network (NCTN) and reviews major accrual barriers experienced by institutions, investigators, and patients. These include a lack of trial awareness, preference for standard care over trials, and concerns about side effects. The document then describes NCI's use of Twitter to promote NCTN trials and poses questions about how social media could enhance awareness of cancer clinical trials.
jlme article final on NGS coverage n reimb issues w pat deverkaJennifer Dreyfus
The document discusses the challenges of obtaining coverage and reimbursement for clinical next generation sequencing (NGS) from both public and private health payers. It outlines the evidentiary standards payers use to evaluate new diagnostic tests, including requirements for analytic validity, clinical validity, and clinical utility. However, establishing these standards is difficult for NGS given limitations in analytical validation methods, lack of proficiency testing, and the technology's rapid advancement. Additionally, while regulatory approval for market entry requires less evidence than reimbursement decisions, demand for NGS often outpaces evidence development. The document argues more collaboration is needed between developers and payers to strengthen evidence standards and facilitate clinical integration of NGS.
PACS (Picture Archive and Communication Systems) are digital systems used to store, view, and manage diagnostic imaging studies. They allow for faster access to images compared to traditional film, which can improve patient care. While initial implementation of PACS is costly, studies have shown cost savings from reduced lost images, repeated exams, and shorter hospital stays. PACS integrate with other hospital information systems and allow multiple providers to view images simultaneously from different locations. This improves care coordination and patient discussions. Overall, PACS aim to make healthcare delivery more effective and efficient through electronic access and sharing of diagnostic images.
1) HPC is being used in healthcare to quickly diagnose cancer through genomic analysis and to develop new drug therapies through simulations.
2) Pathwork Diagnostics uses cloud-based HPC to develop models that can diagnose cancer in months rather than years.
3) GNS Healthcare applies HPC to reverse engineer disease models and simulate new drug targets for conditions like cancer and diabetes.
In this work, we describe the field research, design, and comparative deployment of a multimodal medical imaging user interface for breast screening. The main contributions described here are threefold: 1) The design of an advanced visual interface for multimodal diagnosis of breast cancer (BreastScreening); 2) Insights from the field comparison of Single-Modality vs Multi-Modality screening of breast cancer diagnosis with 31 clinicians and 566 images; and 3) The visualization of the two main types of breast lesions in the following image modalities: (i) MammoGraphy (MG) in both Craniocaudal (CC) and Mediolateral oblique (MLO) views; (ii) UltraSound (US); and (iii) Magnetic Resonance Imaging (MRI).
Learning, Training, Classification, Common Sense and Exascale ComputingJoel Saltz
In this talk, I will describe work my group has carried out in development of deep learning methods that target semantic segmentation and object identification tasks in terapixel Pathology datasets and for satellite data. I will describe what we have been able to achieve, how this work can generalize to additional types of problems and will outline how exascale computing could be used to transform and integrate our methods and pipelines. I will then go on to outline broad research program in exascale computing and deep learning that promises to identify common deep learning methods for previously disparate large and extreme scale data tasks.
Twenty Years of Whole Slide Imaging - the Coming Phase ChangeJoel Saltz
I surveyed the development of Digital Pathology methodology beginning with the 1997 virtual microscope prototype at Hopkins (PMC2233368) to current tools, methods and algorithms designed to display, analyze and classify whole slide imaging data. I will describe the capabilities of current methods, describe how these methods are likely to evolve and how they will be likely to impact Pathology research and practice.
Contemporary Memo, Merging technologies in the workforceWarren Sprecher
The document proposes using virtual reality technology for medical training at the University of Washington Medical School. It summarizes research showing virtual reality training results in faster procedures, fewer errors, and better outcomes for patients. The author urges adopting virtual reality to improve how students learn procedures and treat mental health conditions like PTSD. Virtual reality could help minimize the increase in patient deaths that occurs when new medical residents start each July. As virtual reality technology advances further, it will likely become an essential tool for medical education.
Presentation "The Impact of All Data on Healthcare"
Keith Perry
Associate VP & Deputy CIO
UT MD Anderson Cancer Center
With continuing advancement in both technology and medicine, the drive is on to make all data meaningful to drive medical discovery and create actionable outcomes. With tools and capabilities to capture more data than ever before, the challenge becomes linking existing structured and unstructured clinical data with genomic data to increase the industry’s analytical footprint.
Learning Objectives:
∙ Discuss the need to make all data meaningful in order to speed discovery of new knowledge
∙ Provide examples of an analytical direction that supports evolution in medicine
∙ Expose the challenges facing the industry with respect to ~omits
Support & information for radiotherapy patients: how can social media help?KimMeeking
Slides from my presentation looking at social media for patient benefit and also for healthcare professionals in the field of cancer and radiation therapy.
Presented at the UK Radiological and Radiation Oncology Congress (UKRCO), Liverpool, July 2nd 2018
St. Vincent's Hospital implemented McKesson's clinical solutions including their electronic medical record, clinical data repository, pharmacy information system, medication administration system, and clinical documentation system to improve patient safety and access to information. This integrated clinicians with real-time patient data at the point of care. It helped reduce medication errors through automated dispensing cabinets, clinical alerts, and computerized physician order entry. These solutions supported St. Vincent's goals of safer, higher quality, and more efficient care through improved access to patient information for clinicians.
This project describes methods for recruiting and retaining adolescent and young adult (AYA) oncology patients in psychosocial research studies at a single institution. Key methods included:
1) Monitoring clinic schedules and patient wards daily to identify eligible patients and approach them during appointments to minimize interference.
2) Using a dedicated research assistant to have greater coverage of clinics and flexibility in approaching patients.
3) Collecting multiple contact methods and an alternate contact to facilitate retention through regular reminders via phone, email, and in-person.
4) Carefully tracking patients in databases helped with retention rates averaging over 80% at follow-up timepoints up to a year later despite the challenges of this patient group.
Charles River’s Corporate Vice President, William
BarBo, and Director Patrick mcconville discuss the
benefits of preclinical imaging for the discovery process.
This study assessed the impact of health sciences libraries, information services, and librarians on patient care. A survey of over 13,000 health professionals found that:
1) 75% said library resources definitely or probably changed patient care;
2) 95% said library-provided information resulted in better clinical decisions and higher quality care;
3) Library resources like journals, PubMed, and UpToDate were used by 40-46% of respondents.
This document provides an overview and introduction to the textbook "Digital Radiography: Physical Principles and Quality Control" by Euclid Seeram. It includes a dedication to the author's granddaughters, as well as forewords from experts in the field praising the author's expertise and ability to explain complex concepts. The preface outlines updates and new content in the second edition, including additional chapters on topics such as the standardized exposure indicator, digital tomosynthesis, and medical imaging informatics. The purpose and organization of the textbook are also summarized.
The pleasures and pitfalls of rendering interpretations in layperson’s languageApparao Mukkamala
The pleasures and pitfalls of rendering interpretations in layperson’s language https://www.radiologybusiness.com/topics/imaging-informatics/pleasures-and-pitfalls-rendering-interpretations-laypersons-language
The document provides information about the SPIE Medical Imaging conference to be held February 15-20, 2014 in San Diego, California. It calls for submissions of abstracts by August 12, 2013 on topics related to medical imaging technologies and their biomedical applications. The conference will cover all aspects of medical imaging including physics, image processing, computer-aided diagnosis, image-guided procedures, and various imaging modalities. Authors are encouraged to present their latest research on imaging physics, systems, applications, and image analysis.
1) The document discusses the Future Health department at KU Leuven which conducts research in health decision support for professionals, patients, and policymakers.
2) The department takes an interdisciplinary approach and focuses on using data mining, IT, and software design to extract appropriate information from clinical, biomedical, and other health data sources to provide decision support.
3) The goal is to enable better, more cost effective healthcare by providing personalized decision support that is evidence-based, user-centered, and looks ahead to future needs.
Ms. Amulya Patel uses the internet to research her risk of breast cancer after her mother's diagnosis. She finds many resources online, including patient portals and medical literature, but may have difficulty interpreting information without professional help. The document describes how electronic tools can provide initial information for health issues, but a consultation is still beneficial for personalized risk assessment and advice. Online information prompted Ms. Patel to ask her family about their cancer history, finding a strong familial link, so she sought a genetics expert's opinion. While the internet can satisfy some health questions, patients may need a doctor's expertise to properly interpret data.
This document summarizes key aspects of clinical review and use of health informatics in patient assessment. It discusses 1) using open questions rather than closed questions to understand the patient's reason for visiting, 2) considering symptoms and non-verbal cues to form an initial hypothesis, 3) gathering a medical history over time to understand recurring issues, 4) reviewing records such as laboratory results, prescriptions, and family history to inform the diagnosis, and 5) the importance of coding clinical data for storage and communication between healthcare providers and systems.
This document summarizes an article about how clinical informatics tools can help make patient consultations more efficient. It discusses how computers can help clinicians obtain relevant patient information, assess the patient's status, and take effective management steps. It also explains how recording consultation data can produce useful information to improve local healthcare services and inform broader health system policies. The document provides a flow chart outlining the acute asthma management process in emergency departments for children over 5 years old.
This document provides an overview of clinical trial accrual challenges and discusses how social media could potentially help address some of these challenges. It summarizes the National Clinical Trials Network (NCTN) and reviews major accrual barriers experienced by institutions, investigators, and patients. These include a lack of trial awareness, preference for standard care over trials, and concerns about side effects. The document then describes NCI's use of Twitter to promote NCTN trials and poses questions about how social media could enhance awareness of cancer clinical trials.
jlme article final on NGS coverage n reimb issues w pat deverkaJennifer Dreyfus
The document discusses the challenges of obtaining coverage and reimbursement for clinical next generation sequencing (NGS) from both public and private health payers. It outlines the evidentiary standards payers use to evaluate new diagnostic tests, including requirements for analytic validity, clinical validity, and clinical utility. However, establishing these standards is difficult for NGS given limitations in analytical validation methods, lack of proficiency testing, and the technology's rapid advancement. Additionally, while regulatory approval for market entry requires less evidence than reimbursement decisions, demand for NGS often outpaces evidence development. The document argues more collaboration is needed between developers and payers to strengthen evidence standards and facilitate clinical integration of NGS.
PACS (Picture Archive and Communication Systems) are digital systems used to store, view, and manage diagnostic imaging studies. They allow for faster access to images compared to traditional film, which can improve patient care. While initial implementation of PACS is costly, studies have shown cost savings from reduced lost images, repeated exams, and shorter hospital stays. PACS integrate with other hospital information systems and allow multiple providers to view images simultaneously from different locations. This improves care coordination and patient discussions. Overall, PACS aim to make healthcare delivery more effective and efficient through electronic access and sharing of diagnostic images.
1) HPC is being used in healthcare to quickly diagnose cancer through genomic analysis and to develop new drug therapies through simulations.
2) Pathwork Diagnostics uses cloud-based HPC to develop models that can diagnose cancer in months rather than years.
3) GNS Healthcare applies HPC to reverse engineer disease models and simulate new drug targets for conditions like cancer and diabetes.
In this work, we describe the field research, design, and comparative deployment of a multimodal medical imaging user interface for breast screening. The main contributions described here are threefold: 1) The design of an advanced visual interface for multimodal diagnosis of breast cancer (BreastScreening); 2) Insights from the field comparison of Single-Modality vs Multi-Modality screening of breast cancer diagnosis with 31 clinicians and 566 images; and 3) The visualization of the two main types of breast lesions in the following image modalities: (i) MammoGraphy (MG) in both Craniocaudal (CC) and Mediolateral oblique (MLO) views; (ii) UltraSound (US); and (iii) Magnetic Resonance Imaging (MRI).
Learning, Training, Classification, Common Sense and Exascale ComputingJoel Saltz
In this talk, I will describe work my group has carried out in development of deep learning methods that target semantic segmentation and object identification tasks in terapixel Pathology datasets and for satellite data. I will describe what we have been able to achieve, how this work can generalize to additional types of problems and will outline how exascale computing could be used to transform and integrate our methods and pipelines. I will then go on to outline broad research program in exascale computing and deep learning that promises to identify common deep learning methods for previously disparate large and extreme scale data tasks.
Twenty Years of Whole Slide Imaging - the Coming Phase ChangeJoel Saltz
I surveyed the development of Digital Pathology methodology beginning with the 1997 virtual microscope prototype at Hopkins (PMC2233368) to current tools, methods and algorithms designed to display, analyze and classify whole slide imaging data. I will describe the capabilities of current methods, describe how these methods are likely to evolve and how they will be likely to impact Pathology research and practice.
Contemporary Memo, Merging technologies in the workforceWarren Sprecher
The document proposes using virtual reality technology for medical training at the University of Washington Medical School. It summarizes research showing virtual reality training results in faster procedures, fewer errors, and better outcomes for patients. The author urges adopting virtual reality to improve how students learn procedures and treat mental health conditions like PTSD. Virtual reality could help minimize the increase in patient deaths that occurs when new medical residents start each July. As virtual reality technology advances further, it will likely become an essential tool for medical education.
Presentation "The Impact of All Data on Healthcare"
Keith Perry
Associate VP & Deputy CIO
UT MD Anderson Cancer Center
With continuing advancement in both technology and medicine, the drive is on to make all data meaningful to drive medical discovery and create actionable outcomes. With tools and capabilities to capture more data than ever before, the challenge becomes linking existing structured and unstructured clinical data with genomic data to increase the industry’s analytical footprint.
Learning Objectives:
∙ Discuss the need to make all data meaningful in order to speed discovery of new knowledge
∙ Provide examples of an analytical direction that supports evolution in medicine
∙ Expose the challenges facing the industry with respect to ~omits
Support & information for radiotherapy patients: how can social media help?KimMeeking
Slides from my presentation looking at social media for patient benefit and also for healthcare professionals in the field of cancer and radiation therapy.
Presented at the UK Radiological and Radiation Oncology Congress (UKRCO), Liverpool, July 2nd 2018
St. Vincent's Hospital implemented McKesson's clinical solutions including their electronic medical record, clinical data repository, pharmacy information system, medication administration system, and clinical documentation system to improve patient safety and access to information. This integrated clinicians with real-time patient data at the point of care. It helped reduce medication errors through automated dispensing cabinets, clinical alerts, and computerized physician order entry. These solutions supported St. Vincent's goals of safer, higher quality, and more efficient care through improved access to patient information for clinicians.
This project describes methods for recruiting and retaining adolescent and young adult (AYA) oncology patients in psychosocial research studies at a single institution. Key methods included:
1) Monitoring clinic schedules and patient wards daily to identify eligible patients and approach them during appointments to minimize interference.
2) Using a dedicated research assistant to have greater coverage of clinics and flexibility in approaching patients.
3) Collecting multiple contact methods and an alternate contact to facilitate retention through regular reminders via phone, email, and in-person.
4) Carefully tracking patients in databases helped with retention rates averaging over 80% at follow-up timepoints up to a year later despite the challenges of this patient group.
Charles River’s Corporate Vice President, William
BarBo, and Director Patrick mcconville discuss the
benefits of preclinical imaging for the discovery process.
This study assessed the impact of health sciences libraries, information services, and librarians on patient care. A survey of over 13,000 health professionals found that:
1) 75% said library resources definitely or probably changed patient care;
2) 95% said library-provided information resulted in better clinical decisions and higher quality care;
3) Library resources like journals, PubMed, and UpToDate were used by 40-46% of respondents.
This document provides an overview and introduction to the textbook "Digital Radiography: Physical Principles and Quality Control" by Euclid Seeram. It includes a dedication to the author's granddaughters, as well as forewords from experts in the field praising the author's expertise and ability to explain complex concepts. The preface outlines updates and new content in the second edition, including additional chapters on topics such as the standardized exposure indicator, digital tomosynthesis, and medical imaging informatics. The purpose and organization of the textbook are also summarized.
The pleasures and pitfalls of rendering interpretations in layperson’s languageApparao Mukkamala
The pleasures and pitfalls of rendering interpretations in layperson’s language https://www.radiologybusiness.com/topics/imaging-informatics/pleasures-and-pitfalls-rendering-interpretations-laypersons-language
The document provides information about the SPIE Medical Imaging conference to be held February 15-20, 2014 in San Diego, California. It calls for submissions of abstracts by August 12, 2013 on topics related to medical imaging technologies and their biomedical applications. The conference will cover all aspects of medical imaging including physics, image processing, computer-aided diagnosis, image-guided procedures, and various imaging modalities. Authors are encouraged to present their latest research on imaging physics, systems, applications, and image analysis.
1) The document discusses the Future Health department at KU Leuven which conducts research in health decision support for professionals, patients, and policymakers.
2) The department takes an interdisciplinary approach and focuses on using data mining, IT, and software design to extract appropriate information from clinical, biomedical, and other health data sources to provide decision support.
3) The goal is to enable better, more cost effective healthcare by providing personalized decision support that is evidence-based, user-centered, and looks ahead to future needs.
Ms. Amulya Patel uses the internet to research her risk of breast cancer after her mother's diagnosis. She finds many resources online, including patient portals and medical literature, but may have difficulty interpreting information without professional help. The document describes how electronic tools can provide initial information for health issues, but a consultation is still beneficial for personalized risk assessment and advice. Online information prompted Ms. Patel to ask her family about their cancer history, finding a strong familial link, so she sought a genetics expert's opinion. While the internet can satisfy some health questions, patients may need a doctor's expertise to properly interpret data.
This document summarizes key aspects of clinical review and use of health informatics in patient assessment. It discusses 1) using open questions rather than closed questions to understand the patient's reason for visiting, 2) considering symptoms and non-verbal cues to form an initial hypothesis, 3) gathering a medical history over time to understand recurring issues, 4) reviewing records such as laboratory results, prescriptions, and family history to inform the diagnosis, and 5) the importance of coding clinical data for storage and communication between healthcare providers and systems.
This document summarizes an article about how clinical informatics tools can help make patient consultations more efficient. It discusses how computers can help clinicians obtain relevant patient information, assess the patient's status, and take effective management steps. It also explains how recording consultation data can produce useful information to improve local healthcare services and inform broader health system policies. The document provides a flow chart outlining the acute asthma management process in emergency departments for children over 5 years old.
The Indian Parliament passed the Companies Bill 2013, replacing the previous Companies Act of 1956. The new law aims to modernize corporate regulation in India and promote business-friendly initiatives. It provides for greater transparency, accountability, and protection of minority shareholders and investors. Some key changes include allowing more members in private companies, introducing one-person companies, mandatory CSR spending for large companies, restrictions on related party transactions and loans to directors, and establishing a new National Company Law Tribunal to handle corporate matters instead of the High Court. The new law is expected to facilitate business while improving governance.
This document summarizes key concepts around using clinical data and informatics tools to improve healthcare services. It discusses how data from multiple sources can be linked and analyzed to provide intelligence to decision-makers. However, issues around data protection, privacy and ensuring data is used appropriately must be addressed. Effective presentation of data is important so clinicians view it as valid and are motivated to change practices. Feedback of performance data can improve quality when done constructively and by considering the local context.
1) The document discusses the promise and potential perils of eHealth technologies like remote monitoring devices, virtual assistants, and personalized health records.
2) Factors driving eHealth include patient demand for convenient access to information, the ability to link separate health services, and using technology to address issues like staff shortages.
3) Potential benefits include improved patient information and choice, better communication between providers, and links to vetted external health resources. However, issues around privacy and control of personal data still need solutions.
This document summarizes key concepts around using clinical data and informatics tools to improve healthcare services. It discusses how data from multiple sources can be linked and analyzed to provide intelligence to decision-makers. However, issues around data protection, privacy and ensuring data is used appropriately must be addressed. Effective presentation of data is important so clinicians view it as valid and are motivated to change practices. Feedback of performance data can improve quality when done constructively and by considering the local context.
1) The article discusses health informatics and how it helps doctors make better decisions by improving how patient data and medical knowledge is captured, processed, communicated and applied.
2) It focuses on how information is handled during routine clinical tasks like consultations and covers broader issues related to things like medical record keeping, communicating with colleagues and patients, and keeping clinical knowledge up to date.
3) It explains the differences between actual information, representations of that information, and how individuals may interpret it, noting that information is best captured and represented in a way that helps both human and computer users find and interpret it.
This clinical review document provides an overview of health informatics and discusses key concepts around clinical information including how it is captured, represented, interpreted, stored, and used. It examines these issues through the example of a clinical encounter between Dr. McKay and patient Ms. Smith. The document also discusses where clinical information comes from, how to assess its quality, and the various costs associated with capturing and processing information.
How decision support tools help define clinical problemseduardo guagliardi
1) The document discusses using informatics resources like decision support tools to consider issues beyond a patient's presenting problem during a clinical consultation, including management of continuing problems, opportunistic health promotion, and modification of help-seeking behaviors.
2) It provides an example of how these tools could help in the consultation of a patient, Mr. Evans, who presented with headaches and sleep issues but was also found to have high blood pressure and undisclosed alcohol use, which are relevant to understanding his overall health situation and treating his depression.
3) The document examines how electronic prompts can help bring hidden issues to light and make both doctors and patients aware of all factors that could impact the patient's health, though clinical judgement
Ms. Patel uses the internet to research her risk of breast cancer after her mother's diagnosis. The document discusses how eHealth tools allow people to research health issues without a doctor's consultation. It describes search engines, patient portals, and ways to access medical literature. Risk is often described in complex ways, so many people prefer professional help interpreting information. Guidelines suggest when to see a genetics specialist based on family cancer history.
This document provides definitions for various terms related to health informatics. It defines terms such as algorithm, bioinformatics, clinical coding system, clinical data system, clinical decision tool, communication, database, electronic health record, and medical knowledge. The definitions cover topics such as the use of informatics methods and technologies in research, clinical practice, public health, and consumer health contexts.
This document summarizes how clinical information can help doctors understand patients and their health issues. It provides examples of how a doctor uses a patient's medical history, including prior visits, prescriptions, lab results, and family history to inform their assessment of the patient's current issues. The document also contrasts experienced doctors' hypothetico-deductive approach to less experienced doctors' more exhaustive checklist method. Overall, it discusses how electronic medical records can provide doctors important context to help identify health problems and guide their consultation with patients.
This document provides definitions for various terms related to health informatics. It defines terms such as algorithm, bioinformatics, clinical coding system, clinical data system, clinical decision tool, communication, database, electronic health record, and medical knowledge. The definitions cover topics such as the use of informatics methods and technologies in clinical care, research, public health, and consumer health contexts.
1) The document discusses the promise and potential perils of eHealth technologies like remote monitoring devices, virtual assistants, and personalized health records.
2) Factors driving eHealth include patient demand for convenient access to information, the ability to link separate health services, and using technology to address staffing shortages. However, eHealth may also shift costs to patients and change the role of healthcare providers.
3) Potential benefits of eHealth include improved patient information and choice, better communication between providers, and links to vetted external health resources. However, ensuring privacy and appropriate access to personal health data is also discussed.
This document discusses how essays are classified based on style and subject matter. Essays can be classified into formal or informal styles based on how they are written. They can also be classified based on their subject matter into categories like character sketches, descriptive essays, philosophical essays, editorials, critical essays, scientific essays, semi-narrative essays, and biographical essays based on their content and focus. Effective essays express a vital point, widen the reader's intellectual range, reveal the author's personality, and have an appropriately beautiful style with elements like humor or imagination.
USING DATA MINING TECHNIQUES FOR DIAGNOSIS AND PROGNOSIS OF CANCER DISEASEIJCSEIT Journal
Breast cancer is one of the leading cancers for women in developed countries including India. It is the
second most common cause of cancer death in women. The high incidence of breast cancer in women has
increased significantly in the last years. In this paper we have discussed various data mining approaches
that have been utilized for breast cancer diagnosis and prognosis. Breast Cancer Diagnosis is
distinguishing of benign from malignant breast lumps and Breast Cancer Prognosis predicts when Breast
Cancer is to recur in patients that have had their cancers excised. This study paper summarizes various
review and technical articles on breast cancer diagnosis and prognosis also we focus on current research
being carried out using the data mining techniques to enhance the breast cancer diagnosis and prognosis.
Telemedicine - Moving Beyond the Video VisitHoward Reis
1. Telemedicine is moving beyond video visits to new technologies and patient engagement methods. Recent developments include tele-dermatology businesses, inner-city pediatric telemedicine, cervical cancer screening in developing countries via telepathology, and palliative care services using telehealth.
2. Technical challenges include ensuring quality of care, addressing patient considerations like satisfaction, and overcoming barriers to data-driven medicine and deep learning from medical images.
3. Case studies highlight successful models including a dermatology telehealth startup, an inner-city pediatric telehealth program, cervical cancer screening via remote microscopy, and a palliative care program using telehealth and value-based payments.
Large Language Models, No-Code, and Responsible AI - Trends in Applied NLP in...David Talby
An April 2023 presentation to the AMIA working group on natural language processing. The talk focuses on three current trends in NLP and how they apply in healthcare: Large language models, No-code, and Responsible AI.
1. Ms Smith developed symptomatic renal impairment that may have been avoided if her underlying medical issues were properly diagnosed and treated earlier at multiple points in her care.
2. Ensuring appropriate follow-up and continuity of care between primary and secondary healthcare providers is challenging but important to reduce risks to patients.
3. The integration of clinical records and guidelines across healthcare locations and providers could help improve diagnosis, investigation, referral and follow-up to reduce risks to patients like Ms Smith.
The document discusses integrating genomics data and evidence-based medicine into electronic health records (EHRs) for precision healthcare. It notes the gap between what is known and what is done in healthcare. Integrating genomics could help do the right thing for each patient through pharmacogenomics. However, challenges include representing huge volumes of molecular data in a usable way in EHRs. A three step approach is proposed: 1) get genomic data into EHRs in a structured format, 2) use that data for clinical decision support, 3) evaluate outcomes and continually improve the system.
Technology and data-driven approaches are helping advance our understanding of science and medicine. Deep learning algorithms can analyze large amounts of medical data to identify patterns and make diagnoses. One study found that a deep learning system correctly identified the diagnosis of skin lesions 72% of the time, outperforming board-certified dermatologists who were correct 66% of the time. Initiatives like the Cancer Moonshot aim to apply these types of data-driven approaches and machine learning to make breakthroughs in cancer research, with a goal of accelerating progress by 10 years. These new technologies have potential to transform how doctors learn, practice medicine, and improve patient outcomes.
Possible Solution for Managing the Worlds Personal Genetic Data - DNA Guide, ...DNA Compass
World DNA Day and Genome Day, Dalian China 2011
"Possible Solution for Managing the Worlds Genetic Data" given by Alice Rathjen, Founder & President DNA Guide, Inc.
Proposes genetic tests be given a rating for quality of science, medical utility and viewing risk so as to facilitate the flow of genetic information in a responsible manner from the lab to the physician and patient. Explains how technology combined with public policy could enable both privacy and personalized medicine to thrive. Advocates individual ownership over personal genetic data and suggests the genome as a data format could provide the foundation for digital human rights.
tags: DNA, genetic testing, privacy, personalized medicine, FDA regulation
International Journal of Engineering and Science Invention (IJESI) is an international journal intended for professionals and researchers in all fields of computer science and electronics. IJESI publishes research articles and reviews within the whole field Engineering Science and Technology, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
A Review on Data Mining Techniques for Prediction of Breast Cancer RecurrenceDr. Amarjeet Singh
The most common type of cancer in women
worldwide is the Breast Cancer. Breast cancer may be
detected early using Mammograms, probably before it's
spread. Recurrent breast cancer could occur months or years
after initial treatment. The cancer could return within the
same place because the original cancer (local recurrence), or it
may spread to different areas of your body (distant
recurrence). Early stage treatment is done not only to cure
breast cancer however additionally facilitate in preventing its
repetition/recurrence. Data mining algorithms provide
assistance in predicting the early-stage breast cancer that
continually has been difficult analysis drawback. The
projected analysis can establish the most effective algorithm
that predicts the recurrence of the breast cancer and improve
the accuracy the algorithms. Large information like Clump,
Classification, Association Rules, Prediction and Neural
Networks, Decision Trees can be analyzed using data mining
applications and techniques.
Branch: An interactive, web-based tool for building decision tree classifiersBenjamin Good
A crucial task in modern biology is the prediction of complex phenotypes, such as breast cancer prognosis, from genome-wide measurements. Machine learning algorithms can sometimes infer predictive patterns, but there is rarely enough data to train and test them effectively and the patterns that they identify are often expressed in forms (e.g. support vector machines, neural networks, random forests composed of 10s of thousands of trees) that are highly difficult to understand. In addition, it is generally unclear how to include prior knowledge in the course of their construction.
Decision trees provide an intuitive visual form that can capture complex interactions between multiple variables. Effective methods exist for inferring decision trees automatically but it has been shown that these techniques can be improved upon via the manual interventions of experts. Here, we introduce Branch, a new Web-based tool for the interactive construction of decision trees from genomic datasets. Branch offers the ability to: (1) upload and share datasets intended for classification tasks (in progress), (2) construct decision trees by manually selecting features such as genes for a gene expression dataset, (3) collaboratively edit decision trees, (4) create feature functions that aggregate content from multiple independent features into single decision nodes (e.g. pathways) and (5) evaluate decision tree classifiers in terms of precision and recall. The tool is optimized for genomic use cases through the inclusion of gene and pathway-based search functions.
Branch enables expert biologists to easily engage directly with high-throughput datasets without the need for a team of bioinformaticians. The tree building process allows researchers to rapidly test hypotheses about interactions between biological variables and phenotypes in ways that would otherwise require extensive computational sophistication. In so doing, this tool can both inform biological research and help to produce more accurate, more meaningful classifiers.
A prototype of Branch is available at http://biobranch.org/
This document discusses using data mining techniques like association rule mining and improved apriori algorithm with fuzzy logic to develop an expert system that can predict the risk of osteoporosis based on a patient's clinical data and history. It aims to help doctors make more informed decisions early on to prevent osteoporosis. The system would find relationships between various risk factors and diagnose osteoporosis severity to identify at-risk patients before costly tests. Literature on using different algorithms like decision trees and neural networks for medical diagnosis and predicting osteoporosis risk is also reviewed.
Emerging collaboration models for academic medical centers _ our place in the...Rick Silva
- The document discusses emerging collaboration models between academic medical centers and other organizations in the genomics and precision medicine field, as genomic sequencing capabilities advance and more clinical cases are needed to power artificial intelligence platforms. It explores new partnership approaches around data sharing, patient engagement, infrastructure needs, and how academic medical centers can position themselves in this evolving ecosystem.
Breast Cancer Diagnostics with Bayesian NetworksBayesia USA
The Wisconsin Breast Cancer Database (WBCD) is a widely studied (and publicly available) data set from the field of breast cancer diagnostics. The creators of this database, Wolberg, Street, Heisey and Managasarian, made an important contribution with their research towards automating diagnostics with image processing and machine learning.
Beyond the medical field, many statisticians and computer scientists have proposed a wide range of classification models based on WBCD. Such new methods have continuously raised the benchmark in terms of diagnostic performance.
Our white paper now reevaluates the Wisconsin Breast Cancer Database within the framework of Bayesian networks, which, to our knowledge, has not been done before. We demonstrate how the BayesiaLab software can extremely quickly — and simply — create a Bayesian network model that is on par performance-wise with virtually all existing models that have been developed from WBCD over the last 15 years.
Patient engagement in clinical trials Martin Kelly
The document discusses improving patient engagement in clinical trials through digital methods. Only 2-5% of cancer patients currently participate in clinical trials. The top 3 solutions identified to engage patients were: 1) a clinical trial finder for patients to inform them of available trials, 2) virtual clinical trials conducted entirely online, and 3) tools to personalize clinical trials to individual patient needs/preferences. The document reviews several companies providing these types of solutions and proposes an experiment partnering with a CRO to test if a digital intervention increases patient enrollment and retention in a clinical trial compared to a control group without a digital intervention.
Case Study: Advanced analytics in healthcare using unstructured dataDamo Consulting Inc.
This document summarizes a case study on using unstructured data like images to analyze diabetic retinopathy. Retinal images from half a million patients were analyzed using neural networks and computer vision to detect disease patterns. This automated analysis compressed 50 years of clinical experience into 24 hours to more accurately diagnose patients. The results complemented physician expertise. This case study demonstrates the potential of advanced analytics and large datasets to enhance medical diagnosis using unstructured data like images.
Data Mining Techniques In Computer Aided Cancer DiagnosisDatamining Tools
Data mining techniques are used in computer aided cancer diagnosis and detection. They help physicians interpret complex diagnoses, combine information from multiple sources, and provide support for differential diagnosis. Specific techniques like neural networks, decision trees, and cluster detection are used in ALL diagnosis. Data mining can also be applied to detect gastric and breast cancer by analyzing features in images and using case-based reasoning. National Cancer Institute created 3D mind tools to help scientists detect compounds related to cancer and compare their activities.
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Data mining techniques are used in computer aided cancer diagnosis and detection. They help physicians interpret complex diagnoses, combine information from multiple sources, and provide support for differential diagnosis. Specific techniques like neural networks, decision trees, and cluster detection are used in ALL diagnosis. Data mining can also be applied to detect gastric cancer using single nucleotide polymorphism information. It helps organize healthcare claims data to detect cancer patterns and evaluate treatment efficacy. New applications of data mining and neural networks are also helping detect cancers like breast cancer sooner.
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How computers can help to share understanding with patients
1. Clinical review
ABC of health informatics
How computers can help to share understanding with patients
Frank Sullivan, Jeremy C Wyatt
In the second article of this series (BMJ 2005;331:625-7) Ms
This is the fifth in a series of 12 articles
Patel found a lot of material on the internet and spoke to family
A glossary of terms is available at http://bmj.com/cgi/
members about their health and the causes of death of some content/full/331/7516/566/DC1
family members. Ms Patel discussed this information with her
general practitioner (GP), who then referred Ms Patel to a
clinical genetics centre. The genetics clinic team converted Ms
Patel’s understanding of the situation into a genogram using
Risk Assessment in Genetics software (RAGs).
A cancer registry was used to find the cause of death of Ms
Patel’s older sister because she had died overseas. By integrating
multiple sources of information the genetics clinic team could
Ms Amulya Patel is a 48 year old accountant whose
advise Ms Patel that her lifetime risk of developing breast cancer mother and possibly two sisters have had breast cancer.
was about 30%, and that she would probably benefit from Because of her family history, clinical examination and
further investigation. If Ms Patel was investigated and shown to mammography were undertaken. Mammography
carry the BRCA1 gene, the risk estimate for Ms Patel’s nieces indicated an area of microcalcification in the upper outer
would be higher. quadrant of her left breast
Before doctors introduce information to patients they
should determine the way in which patients want to look for
information, discover their level of knowledge on the subject,
elicit any specific concerns they have, and find out the
information that they need. Interactive health communication
applications, such as decision support tools and websites, give
Mother 62
doctors and patients additional ways to share understanding of Breast cancer
patients’ reasons for consulting, and they can then work
together to solve patients’ problems. The benefits to patients of
using interactive health communication applications include a ?
better understanding of their health problems, reduced
Sister 51 Ms Patel Brother Sister 45
uncertainty, and the feeling that they are getting better support ? Cancer 48 52 Breast cancer
from their carers.
Many of these tools are new and unfamiliar to patients and
doctors. The best way to use them to achieve better outcomes
for patients during the time available in consultations remains Daughter Daughter
25 28
to be established. Research indicates that patients would like to
be directed to a high quality interactive health communication
A patient’s view of risk, presented as a three generation genogram
application at diagnosis, and at any decision point thereafter (E
Murray, personal communication, 2004).
Access to images, audio, and animation
The mammogram, like other clinical images, is available as hard
Patient information
copy or as an archived picture delivered to the desktop of any
clinician authorised to view it. The image may be presented Patients need information to
x Understand what is wrong
with extra material to help explain the nature of the problem. x Gain a realistic idea of prognosis
Archived images are more likely to be available than a film, and x Make the most of consultations
serial display of archived copies allows comparison. x Understand the processes and likely outcomes of
Many patients like explanation in the form of a diagram or tests and treatment
in simple, often anatomical, terms. Some patients, however, x Help in self care
prefer more detailed descriptions (for example, pathological x Learn about available services and sources of
help
explanations) of what is happening to their body. This
x Provide reassurance and help
information can be provided by clinicians on their computer x Help others understand
screens, using digitised slide libraries, CD Roms, or material on x Legitimise their concerns and the need to seek
websites. help
x Learn how to prevent further illness
x Identify further information and self help groups
Multimedia information retrieval x Identify the best healthcare providers
Large documents can be stored and transferred rapidly over
electronic and optical fibre networks. These documents may
include pictures, sound, video, or computer programs, such as
892 BMJ VOLUME 331 15 OCTOBER 2005 bmj.com
2. Clinical review
simulators. Textbooks, journal articles, clinical guidelines, image
libraries, and material designed for patient education are
increasingly becoming available electronically. Discussing
individual electronic health records and relevant reference
material with patients is preferable to discussing general
information about their problem. If Ms Patel and her surgeon
are discussing whether she may need a lumpectomy or a simple
mastectomy, then the ability to view a relevant image and brief
text making the comparison will probably be more effective
than a comprehensive treatise on all the possible procedures. In lumpectomy, the surgeon removes the In simple mastectomy, the surgeon
breast cancer and some normal tissue removes the whole breast. Some lymph
around it. Often, some of the lymph nodes under the arm may also be
Risk prediction tools nodes under the arm are removed. removed.
During the discussion of a potentially serious problem like Comparison of lumpectomy and mastectomy—simple diagrams with brief
breast cancer, the issue of prognosis will probably arise. Until text can be effective in consultations. Adapted from http://medem.com/
recently prognostication has been largely implicit, and it was medlb/article_detaillb.cfm?article_ID=ZZZSOTZD38C&sub_cat=57
based on the clinical experience of similar patients with the
same kind of problems and comorbidities. In a few cases (such
as head injury or seriously ill patients in the intensive care unit)
accurate, well calibrated clinical prediction rules like the
Glasgow coma scale are available. Databases that contain
information about patients with known characteristics are being
developed, and this information is available across a range of
specialties to augment clinicians’ experience with the type of
problem they are dealing with.
Problems with information retrieval
during consultations
Although much information is at hand, it is often difficult to
find the most clinically relevant items. Studies measuring the
use of information resources during consultations showed
individual clinicians accessed the resources only a few times a
month. To encourage clinicians to make more use of these
information resources, other approaches to information
retrieval during the encounter are being studied.
x Email or telephone access to a human searcher—An example The Finprog study uses data on a large number of patients with breast
is the ATTRACT question answering service for clinicians cancer to allow an individualised prediction of survival for a new patient by
matching their disease profile to that of other patients whose outcomes are
working in Wales known. From the website www.finprog.org
x Human annotation—This approach uses links between
relevant documents and a selected set of common queries that
are manually assigned by a peer group (for example, by all the
breast surgeons in Scotland or a group of radiologists in New
Problems with real time searches during
England) for mutual reference
consultations
x Case based reasoning—A generic approach to problem
solving developed by researchers in the field of artificial x Time is spent composing and typing queries for
each resource
intelligence. Problems are solved by adapting new solutions to
x Indexing vocabularies are designed by and for
similar problems that have already been solved librarians and are inconsistent and non-intuitive
x Automatic query construction—Information from an for clinicians
electronic medical record is used to construct the query, x Search programs and their displays are designed
partially or fully. Approaches include interactive user selection for research and educational purposes, not for
of terms, automatic recognition of MeSH index terms in the use at the point of care
x No provision for system initiative; that is,
text of medical records, and developing generic queries that can
clinicians can only find what they choose to look
be filled in with terms from the record for. A relevant document may exist in the clinical
x Search by navigation—In this approach it is possible to trials resource, but if the doctor thinks that
search for information by traversing links between information finding a clinical trial is unlikely, then that
items rather than constructing a query. Fixed links may be resource will not be searched
organised in a hierarchical menu or as hypertext. Links may x Although many clinical situations occur often, it is
also be created dynamically to reflect the changing needs of the difficult to reuse or share retrieval success
x Managing and updating the information
user. resources is an extra responsibility for the doctor
Computers in a consultation
The computer screen requires more attention than notes on
paper, and clinicians spend less time interacting with the patient
BMJ VOLUME 331 15 OCTOBER 2005 bmj.com 893
3. Clinical review
when they use information resources during consultations.
Further reading
Despite this, doctors who use computers during their
consultations are viewed favourably by patients. Research is x Emery J, Walton R, Coulson A, Glasspool D, Ziebland S, Fox J. A
qualitative evaluation of computer support for recording and
needed to investigate how additional electronic information
interpreting family histories of breast and ovarian cancer in
resources can be integrated into the consultation, given that a primary care (RAGs) using simulated cases. BMJ 1999;319:32-6
patient centred consultation style is desirable. x Murray E, Burns J, See-Tai S, Lai R, Nazareth I. Interactive Health
Communication Applications for people with chronic disease.
Cochrane Database Syst Rev 2004;(4):CD4274
After the consultation x Jones R, Pearson J, McGregor S, Cawsey AJ, Barret A, Craig N, et al.
Randomised trial of personalised computer based information for
It may be difficult, or impossible, to share understanding of all cancer patients. BMJ 1999;319:1241-7
important issues with a patient during the limited time available x Schmidt H.G. Norman GR, Boshuizen HPA. A cognitive
in many clinical environments. Difficult, embarrassing, or perspective on medical expertise: theory and implications. Academic
additional questions may occur to the patient after leaving the medicine 1990;65:611-21
x Jennett B, Teasdale G, Braakman R, Minderhoud J, Knill-Jones R.
clinic. Written material (preprinted or produced during the
Predicting outcome in ndividual patients after severe head injury.
consultation), audiotapes of the consultation, or an email with Lancet 1976;1:1031-4
relevant website links for the patient may provide another x Hersh WR, Hickam DH. How well do physicians use electronic
chance for them or their carers to revisit the issues or extend a information retrieval systems? A framework for investigation and
line of inquiry that was partially dealt with in the consultation. systematic review. JAMA 1998;280:1347-52
x Brassey J, Elwyn G, Price C, Kinnersley P. Just in time information
for clinicians: a questionnaire evaluation of the ATTRACT project.
Summary BMJ 2001;322:529-30
x Ridsdale L, Hudd S. Computers in the consultation: the patient’s
One of the most attractive features of integrating multimedia view. Br J Gen Pract 1994;44:367-9
information into the consultation is that the process educates x Dickinson D, Raynor DKT. Ask the patients—they may want to
know more than you think. BMJ 2003;327:861
and empowers patient and doctor. Jointly, they retain control
x Lundin J, Lundin M, Isola J, Joensuu H. A web-based system for
over the conduct and conclusions of the encounter. In individualised survival estimation in breast cancer. BMJ
particular, bringing information to the point of care allows the 2003;326:29
patient to participate in decision making, and encourages them
to learn from the doctor’s expertise in interpreting and critically
appraising information, rather than depending on the doctor’s
memory and powers of recall.
At present sources of relevant, well prepared, evidence based
material are insufficient. Systematic reviews and other Frank Sullivan is NHS Tayside professor of research and development
assessments of health technology could be amended to include in general practice and primary care, and Jeremy C Wyatt is professor
of health informatics, University of Dundee.
sections presenting information for patients on the choices of
treatment that they have, with input from relevant patient groups. The series will be published as a book by Blackwell Publishing in
spring 2006.
Guidance from NICE (the National Institute for Health and
Clinical Excellence) always includes a detailed information leaflet, Competing interests: None declared.
but this can only be as evidence based as the available research
BMJ 2005;331:892–4
allows. Some patients will prefer to discuss their problems during
consultations with a doctor they trust, but audiovisual aids can
help that process during and after the consultation.
One hundred years ago
Bedside books
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occasion of the death of Professor Nothnagel, Pastor Johanny literal sense.. . . When reading is deliberately used as a means of
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a volume of Schiller’s poems was found beside him open at Das whole, we think poetry of the sublime order the best for the
Ideal und das Leben. Probably most men, except such as go in purpose.. . . For reading during convalescence literature that
terror of their wives, read in bed, but the custom is generally felt, cheers but not inebriates should be prescribed. Writers whose
even by those who are its slaves, to require some excuse.. . . As a style like that of George Meredith puts a constant strain on the
rule, Wilkie Collins and other masters of plot-weaving should be understanding of the reader, or like that of Mr Maurice Hewlett
avoided, as likely to murder sleep; Richardson, of whom Johnson irritates by its artificial glitter, or like that of Marie Corelli annoys
said that anyone who should read him for the story would hang by its frothy impertinence, are all alike contraindicated. Literature
himself, is the great exemplar of bedside authors.. . . Our own of a kind that depresses the mind or fills it with gloom should be
preference is for a writer whom long acquaintance has made so banished from the sick room. Ibsen, Zola, Maxim Gorki, and
familiar that he can be dipped into at random with the certainty Dostoiewsky should therefore be left to persons of robust mental
of finding something which is always better than one’s digestion who can sup full of literary horrors without suffering
remembrance. Having reached the period of old fogeydom, Scott, from nightmare. For convalescents the best reading is that which
Dickens, and Thackeray are our favourites. . . . Sterne is too jerky carries them out of themselves, and helps them to maintain a
to be restful, and the greater classics must be approached with an healthy interest in life.
earnestness of devotion which bed scarcely helps to foster. The (BMJ 1905;ii:200)
894 BMJ VOLUME 331 15 OCTOBER 2005 bmj.com