scholarly journals A computer-based guideline implementation system for cardiac rehabilitation screening

Author(s):  
R. Goud ◽  
N. Peek ◽  
A.M. Strijbis ◽  
P.A. de Clercq ◽  
A. Hasman
2011 ◽  
Vol 19 (3) ◽  
pp. 504-514 ◽  
Author(s):  
Mariëtte M van Engen-Verheul ◽  
Hareld MC Kemps ◽  
Nicolette F de Keizer ◽  
Irene M Hellemans ◽  
Rick Goud ◽  
...  

Background: Despite all available evidence of its effectiveness, cardiac rehabilitation and secondary prevention (CRSP) is still insufficiently implemented in current clinical practice. Based on an analysis of implementation problems, recently the Dutch clinical algorithm for the assessment of patient’s CRSP needs was revised. The purpose of this paper is to describe the revision process and its results to improve CRSP guideline implementation. Methods: The National Institute for Health and Clinical Excellence (NICE) guidelines manual for conducting guideline revisions was followed. Information on the use of the algorithm in practice was collected from electronic medical records and by conducting semi-structured interviews. Next, an expert advisory group identified the problems for use in daily practice and defined the scope for the revision. A multidisciplinary guideline development group subsequently wrote the revised algorithm. Results: A large variation in assessed patient needs was observed between CRSP clinics. Assessment based on clinical judgement was found to be a source of practice variation and is therefore avoided in the revised algorithm. It was decided to add assessment instruments for anxiety and depression, cardiovascular risk factors, stress, attitude of partner and lifestyle parameters. Conclusion: The Dutch clinical algorithm for assessing patient needs for CRSP was revised using a combination of patient data from routine practice, knowledge from academic experts and experience from field experts. The revised algorithm is a practical tool consisting of assessment instruments to improve CRSP guideline adherence in the Netherlands. This algorithm may also be useful for other Western countries to organize their CRSP needs assessment procedure.


2010 ◽  
Vol 19 (6) ◽  
pp. e15-e15 ◽  
Author(s):  
R. S. Fernandez ◽  
P. Davidson ◽  
R. Griffiths ◽  
Y. Salamonson

1999 ◽  
Vol 38 (03) ◽  
pp. 148-153 ◽  
Author(s):  
G.J Corb ◽  
Y. Liaw ◽  
C.A. Brandt ◽  
R.N. Shiffman

AbstractClinical practice guidelines provide a means of directing medical care towards clinically appropriate and cost-effective interventions. A direct relationship exists between the integration of a guideline into clinical workflow and the effectiveness of the guideline in influencing clinicians’ behavior. Computer-based guideline implementations, used at the point-of-care, accomplish this integration. Employing object-oriented technologies, we propose a framework of reusable components for the development of guideline implementation systems. We have identified eight information management services that are common to such systems. Our framework integrates these services and their respective reusable components into clinical workflow to promote the development of comprehensive guideline implementation systems, which should ultimately enhance guideline compliance and the overall quality of care.


Author(s):  
M. Marko ◽  
A. Leith ◽  
D. Parsons

The use of serial sections and computer-based 3-D reconstruction techniques affords an opportunity not only to visualize the shape and distribution of the structures being studied, but also to determine their volumes and surface areas. Up until now, this has been done using serial ultrathin sections.The serial-section approach differs from the stereo logical methods of Weibel in that it is based on the Information from a set of single, complete cells (or organelles) rather than on a random 2-dimensional sampling of a population of cells. Because of this, it can more easily provide absolute values of volume and surface area, especially for highly-complex structures. It also allows study of individual variation among the cells, and study of structures which occur only infrequently.We have developed a system for 3-D reconstruction of objects from stereo-pair electron micrographs of thick specimens.


Author(s):  
Nestor J. Zaluzec

The Information SuperHighway, Email, The Internet, FTP, BBS, Modems, : all buzz words which are becoming more and more routine in our daily life. Confusing terminology? Hopefully it won't be in a few minutes, all you need is to have a handle on a few basic concepts and terms and you will be on-line with the rest of the "telecommunication experts". These terms all refer to some type or aspect of tools associated with a range of computer-based communication software and hardware. They are in fact far less complex than the instruments we use on a day to day basis as microscopist's and microanalyst's. The key is for each of us to know what each is and how to make use of the wealth of information which they can make available to us for the asking. Basically all of these items relate to mechanisms and protocols by which we as scientists can easily exchange information rapidly and efficiently to colleagues in the office down the hall, or half-way around the world using computers and various communications media. The purpose of this tutorial/paper is to outline and demonstrate the basic ideas of some of the major information systems available to all of us today. For the sake of simplicity we will break this presentation down into two distinct (but as we shall see later connected) areas: telecommunications over conventional phone lines, and telecommunications by computer networks. Live tutorial/demonstrations of both procedures will be presented in the Computer Workshop/Software Exchange during the course of the meeting.


1973 ◽  
Vol 37 (8) ◽  
pp. 27-31
Author(s):  
HA Brody ◽  
LF Lucaccini ◽  
M Kamp ◽  
R Rozen

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