Characterizing stroke lesions using digital templates and lesion quantification tools in a web-based imaging informatics system for a large-scale stroke rehabilitation clinical trial

2015 ◽  
Author(s):  
Ximing Wang ◽  
Matthew Edwardson ◽  
Alexander Dromerick ◽  
Carolee Winstein ◽  
Jing Wang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Stroke Rehabilitation ◽  
Large Scale ◽  
Imaging Informatics ◽  
Web Based ◽  
Informatics System

Abstract 2379: A Comprehensive Imaging Informatics System with Decision-Support Tools for the Interdisciplinary Comprehensive Arm Rehabilitation Trial

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Carolee J Winstein ◽  
Brent Liu ◽  
Alexander Dromerick ◽  
Andrew Butler ◽  
Steven Wolf ◽  
...  
Keyword(s):  
Decision Support ◽  
Large Scale ◽  
Imaging Informatics ◽  
Imaging Biomarkers ◽  
Decision Support Tools ◽  
Imaging Data ◽  
Web Based ◽  
Informatics System ◽  
Arm Rehabilitation ◽  
Support Tools

BACKGROUND: Stroke is one of the major causes of death and disability in America. The Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) project aims to compare a theoetically-defensible, evidence-based arm therapy, Accelerated Skill Acquisition Program, with traditional therapies. Imaging of the brain provides evidence of the location and severity of the stroke lesion. Researchers can analyze selected images acquired prior to enrollment and perform knowledge discovery of correlation between the size and location of the lesion and specific rehabilitation outcomes. However, large-scale trials such as ICARE encounter challenges for integrating imaging data from multiple healthcare institutions across the country. The ICARE project has 7 clinical sites distributed across the country, with more than 160 patients randomized thus far, tens of gigabytes of imaging data are involved. Therefore, we propose to develop a web-based system with tools that can support imaging and informatics related data within such a randomized controlled trial and allow for tele-consultation and collaboration. EVALUATION: The system includes a database and file storage system, a Health Insurance Portability and Accountability Act (HIPAA)-compliant anonymizer, a web-based Graphical User Interface (GUI) and decision-support tools such as lesion quantifying tools and image analysis. The GUI allows users to upload, search and review the images, patient information and annotations. The HIPAA-compliant anonymizer will anonymize any private information according to HIPAA. The lesion quantifying tool will help clinicians to measure, quantify, and characterize the size of lesion and evaluate the rehabilitation progress. The system will be used within 7 clinical sites and evaluated by researchers in the ICARE trial. DISCUSSION: The system allows for tele-consultation and is facilitated through the development of a thin-client image viewing application. Clinicians and researchers across the country can manage the imaging data, make and store annotations, measure the lesion size, and collaborate to identify the imaging biomarkers that would ultimately enhance the existing ICARE clinical trial database. Moreover, the anonymizer tool can be used not only for imaging data in this rehabilitation trial, but also for other data from multi-site clinical trials since most studies are required to be anonymized. CONCLUSION: A comprehensive imaging informatics system for a large-scale controlled stroke rehabilitation trial is developed. Physicians and clinical researchers are able to collect, organize and analyze stroke cases efficiently and effectively across multiple sites.

Randomized trial of a web-based intervention to address barriers to clinical trials.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6500-6500 ◽  
Author(s):  
Neal J. Meropol ◽  
Terrance Lynn Albrecht ◽  
Yu-Ning Wong ◽  
Al Bowen Benson ◽  
Joanne S. Buzaglo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Clinical Trials ◽  
Randomized Trial ◽  
Large Scale ◽  
College Education ◽  
Phase Iii ◽  
Post Intervention ◽  
Web Based ◽  
Attitudinal Barriers

6500 Background: Cancer patients (pts) have knowledge and attitudinal barriers to participation in clinical trials (CT). We developed PRE-ACT (Preparatory Education About Clinical Trials), a tailored, interactive, web-based intervention to address these barriers and improve preparation for consideration of CT as a treatment option. Methods: We conducted a prospective, randomized, multicenter, phase III clinical trial of PRE-ACT vs. control (general text about CT excerpted from NCI materials). All assessments and interventions were conducted online. Cancer pts >18 years old were enrolled before initial oncologist consultation. Pts completed a baseline assessment including CT knowledge (19-item); CT attitudes (28-item); preparation for decision making (10-item); and validated measures of preferences for shared decision making and quality/length of life. PRE-ACT pts received a summary of their preferences and a list of their top CT barriers. Based on ranking of individual barriers, pts were presented with a video library of 30-90 second clips addressing their top barriers (10 maximum). After the educational intervention a follow up survey reassessed CT barriers and preparation. Results: 1255 pts were randomized; median age 59 (range 20-88); 58% female; 12% non-white / 2% Hispanic; 76.4% some college education. 1081 pts completed baseline and post-intervention assessments. The control and PRE-ACT groups both had improved knowledge, reduced attitudinal barriers, and improved preparation (p<.0001 for all comparisons). PRE-ACT was more effective than control in improving knowledge (p=.0006) and attitudes (p<.0001). Furthermore, pts in the PRE-ACT arm were more satisfied with the amount (p=.002) and format (<.0001) of information, and felt more prepared to consider CT (p=.0003). Conclusions: This large-scale randomized trial of a tailored, web-based, video intervention demonstrates that educational information delivered online before the oncologist visit can significantly reduce knowledge barriers and attitudinal barriers and improve preparation for consideration of clinical trials. Both text and PRE-ACT are effective, with greater improvements and satisfaction in the PRE-ACT group. Clinical trial information: NCT00750009.

Using Web-based Testing for Large-Scale Assessment

2013 ◽  
Author(s):  
Laura S. Hamilton ◽  
Stephen P. Klein ◽  
William Lorie
Keyword(s):  
Large Scale ◽  
Web Based ◽  
Large Scale Assessment ◽  
Scale Assessment

Impact of COVID-19 on Nuclear Medicine in Germany, Austria and Switzerland: An International Survey in April 2020

2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann
Keyword(s):  
Nuclear Medicine ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
Large Scale ◽  
Diagnostic Procedures ◽  
Protective Equipment ◽  
Current Crisis ◽  
Web Based ◽  
Public Versus Private ◽  
The Impact

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

scholarly journals Age impairs mnemonic discrimination of objects more than scenes: A web-based, large-scale approach across the lifespan

Cortex ◽  
2021 ◽  
Vol 137 ◽  
pp. 138-148
Author(s):  
Jeremie Güsten ◽  
Gabriel Ziegler ◽  
Emrah Düzel ◽  
David Berron
Keyword(s):  
Large Scale ◽  
Web Based

scholarly journals Moving Online: A Pilot Clinical Trial of the Changing Talk Online (CHATO) Communication Education for Nursing Home Staff

2020 ◽  
Author(s):  
Kristine N Williams ◽  
Carissa K Coleman ◽  
Yelena Perkhounkova ◽  
Tim Beachy ◽  
Maria Hein ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Nursing Home ◽  
Training Program ◽  
Effective Means ◽  
Posttest Score ◽  
Behavioral Symptoms ◽  
Wait List ◽  
Web Based ◽  
Wait List Control ◽  
Design And Methods

Abstract Background and Objectives Staff-resident communication is a critical part of nursing home (NH) care. Reducing elderspeak and increasing person-centered communication has been shown to reduce behavioral symptoms experienced by persons living with dementia. An online version of a successful classroom-based communication-training program that reduced staff elderspeak and resident behavioral symptoms was evaluated. The objective of this study was to establish feasibility and determine the preliminary effects of the online program in preparation for a national pragmatic clinical trial. Research Design and Methods Seven NHs were randomized to immediate intervention or wait-list control conditions. The NHs were provided with the web-based training program that staff individually accessed. Primary outcomes were knowledge scores and communication ratings of a video-recorded interaction, using pre- to post-training comparisons. Results Knowledge increased from a mean pretest score of 61.9% (SD=20.0) to a mean posttest score of 84.6% (SD=13.5) for the combined group. Knowledge significantly improved between Time 1 and Time 2 for the immediate intervention participants (p&lt;.001), but not for the wait-list control participants (p=.091), and this difference was statistically significant (p&lt;.001). Ability to recognize ineffective, inappropriate, non-person-centered, and elderspeak communication improved after training (p&lt;.001). The magnitude of improvement in communication recognition was comparable to that of the original classroom format. Discussion and Implications The adapted communication intervention was feasible and improved knowledge and communication. Online instruction can improve access to quality education and is an effective means to improve dementia care by overcoming barriers to in-person training.

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