scholarly journals Design of an Interactive Web Application for Teaching Uncertainty Interpretations of Clinical Tests

2021 ◽  
Author(s):  
Sebastian Neher ◽  
Lorenz A. Kapsner ◽  
Hans-Ulrich Prokosch ◽  
Dennis Toddenroth
Keyword(s):  
Medical Students ◽  
Web Application ◽  
Clinical Decision ◽  
Local Learning ◽  
Interactive Software ◽  
Potential Utility ◽  
Software Module ◽  
Future Developments ◽  
Negative Results ◽  
Clinical Investigations

Background: Assessing the uncertainty of diagnostic findings is essential for advising patients. Previous research has demonstrated the difficulty of computing the expected correctness of positive or negative results, although clinical decision support (CDS) tools promise to facilitate adequate interpretations. Objectives: To teach the potential utility of CDS tools to medical students, we designed an interactive software module that computes and visualizes relevant probabilities from typical inputs. Methods: We reviewed the literature on recommended graphical approaches and decided to support contingency tables, plain table formats, tree diagrams, and icon arrays. Results: We implemented these functions in a single-page web application, which was configured to complement our local learning management system where students also access interpretation tasks. Conclusion: Our technical choices promoted a rapid implementation. We intend to explore the utility of the tool during some upcoming courses. Future developments could also model a more complex clinical reality where the likelihood of alternative diagnoses is estimated from sets of clinical investigations.

ANALYZING AND IMPROVING WEB APPLICATION QUALITY USING DESIGN PATTERNS

2012 ◽  
Vol 2 (2) ◽  
pp. 112-116
Author(s):  
Shikha Bhatia ◽  
Mr. Harshpreet Singh
Keyword(s):  
Web Application ◽  
Design Pattern ◽  
Design Patterns ◽  
Web Applications ◽  
Past Research ◽  
Software Systems ◽  
Interactive Software ◽  
Web Based ◽  
Software Application ◽  
Execution Speed

With the mounting demand of web applications, a number of issues allied to its quality have came in existence. In the meadow of web applications, it is very thorny to develop high quality web applications. A design pattern is a general repeatable solution to a generally stirring problem in software design. It should be noted that design pattern is not a finished product that can be directly transformed into source code. Rather design pattern is a depiction or template that describes how to find solution of a problem that can be used in many different situations. Past research has shown that design patterns greatly improved the execution speed of a software application. Design pattern are classified as creational design patterns, structural design pattern, behavioral design pattern, etc. MVC design pattern is very productive for architecting interactive software systems and web applications. This design pattern is partition-independent, because it is expressed in terms of an interactive application running in a single address space. We will design and analyze an algorithm by using MVC approach to improve the performance of web based application. The objective of our study will be to reduce one of the major object oriented features i.e. coupling between model and view segments of web based application. The implementation for the same will be done in by using .NET framework.

scholarly journals An Interactive Web Application for the Statistical Analysis of Continuous Glucose Monitoring Data in Epidemiological Studies

2021 ◽  
pp. 193229682098557
Author(s):  
Alysha M. De Livera ◽  
Jonathan E. Shaw ◽  
Neale Cohen ◽  
Anne Reutens ◽  
Agus Salim
Keyword(s):  
Continuous Glucose Monitoring ◽  
Web Application ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Epidemiological Studies ◽  
Interactive Software ◽  
Web Based ◽  
Software Applications ◽  
Visualization Of Data ◽  
User Friendly

Motivation: Continuous glucose monitoring (CGM) systems are an essential part of novel technology in diabetes management and care. CGM studies have become increasingly popular among researchers, healthcare professionals, and people with diabetes due to the large amount of useful information that can be collected using CGM systems. The analysis of the data from these studies for research purposes, however, remains a challenge due to the characteristics and large volume of the data. Results: Currently, there are no publicly available interactive software applications that can perform statistical analyses and visualization of data from CGM studies. With the rapidly increasing popularity of CGM studies, such an application is becoming necessary for anyone who works with these large CGM datasets, in particular for those with little background in programming or statistics. CGMStatsAnalyser is a publicly available, user-friendly, web-based application, which can be used to interactively visualize, summarize, and statistically analyze voluminous and complex CGM datasets together with the subject characteristics with ease.

The influence of narrated group discussions on the interpretational ability of medical students: a prospective observational study

2021 ◽  
Vol 6 (8) ◽  
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
First Year ◽  
Group Discussions ◽  
Prior Literature ◽  
Long Course ◽  
Long Term Impact ◽  
First Year Medical Students

Background: Clinical decision making is predominantly knowledge-based perception, interpretation under terms of uncertainty. It is unclear whether interpretational ability can be improved. We evaluated the effect of a narrated group-discussions course (NGDC) on the interpretational ability of first-year medical students. Objective: To evaluate the effect of our course on first year medical students in respect to: a) their interpretational abilities b) their attitude towards studying literature and the core subjects. Method: Using a pre-post questionnaire, of a semester-long course, among two consecutive classes, the authors evaluated the participant’s interpretational ability and depth of understanding when analyzing four complex passages. Results: Out of 235 students, 146 (62%) responded to both questionnaires. There was a significant increase in the participant’s interpretational ability (P=0.003). ninety one participants (38%) improved their level of understanding in at least one out of the four passages, and 37 participants (25%) improved in two passages. A multivariate analysis revealed that the improvement in the interpretational ability was associated with younger age (P=0.034, CI 95%=0.64-0.98, OR=0.79), positive pre-course attitude and motivation (P<0.001, CI 95%=1.43-3.05, OR=2.09), and lack of a prior literature background (P=0.064, CI 95%=0.17-1.05, OR=0.43). Conclusion: Our data suggests that NGDC may improve and refine interpretational ability. Further studies are required to establish the short- and long-term impact of this change and whether it can be translated into better clinical decision making.

scholarly journals Updated Review of Blood Culture Contamination

2006 ◽  
Vol 19 (4) ◽  
pp. 788-802 ◽  
Author(s):  
Keri K. Hall ◽  
Jason A. Lyman
Keyword(s):  
Health Care ◽  
Decision Support ◽  
Blood Culture ◽  
Infection Control ◽  
Clinical Decision ◽  
Potential Utility ◽  
Diagnostic Uncertainty ◽  
Computer Based ◽  
Clinically Significant ◽  
Care Costs

SUMMARY Blood culture contamination represents an ongoing source of frustration for clinicians and microbiologists alike. Ambiguous culture results often lead to diagnostic uncertainty in clinical management and are associated with increased health care costs due to unnecessary treatment and testing. A variety of strategies have been investigated and employed to decrease contamination rates. In addition, numerous approaches to increase our ability to distinguish between clinically significant bacteremia and contamination have been explored. In recent years, there has been an increase in the application of computer-based tools to support infection control activities as well as provide clinical decision support related to the management of infectious diseases. Finally, new approaches for estimating bacteremia risk which have the potential to decrease unnecessary blood culture utilization have been developed and evaluated. In this review, we provide an overview of blood culture contamination and describe the potential utility of a variety of approaches to improve both detection and prevention. While it is clear that progress is being made, fundamental challenges remain.

scholarly journals XML Data and Knowledge-Encoding Structure for a Web-Based and Mobile Antenatal Clinical Decision Support System: Development Study

10.2196/17512 ◽  
2020 ◽  
Vol 4 (10) ◽  
pp. e17512
Author(s):  
Ever Augusto Torres Silva ◽  
Sebastian Uribe ◽  
Jack Smith ◽  
Ivan Felipe Luna Gomez ◽  
Jose Fernando Florez-Arango
Keyword(s):  
Decision Support ◽  
Antenatal Care ◽  
Clinical Decision Support ◽  
Web Application ◽  
Clinical Care ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Structure Design ◽  
Mobile App ◽  
Clinical Workflow

Background Displeasure with the functionality of clinical decision support systems (CDSSs) is considered the primary challenge in CDSS development. A major difficulty in CDSS design is matching the functionality to the desired and actual clinical workflow. Computer-interpretable guidelines (CIGs) are used to formalize medical knowledge in clinical practice guidelines (CPGs) in a computable language. However, existing CIG frameworks require a specific interpreter for each CIG language, hindering the ease of implementation and interoperability. Objective This paper aims to describe a different approach to the representation of clinical knowledge and data. We intended to change the clinician’s perception of a CDSS with sufficient expressivity of the representation while maintaining a small communication and software footprint for both a web application and a mobile app. This approach was originally intended to create a readable and minimal syntax for a web CDSS and future mobile app for antenatal care guidelines with improved human-computer interaction and enhanced usability by aligning the system behavior with clinical workflow. Methods We designed and implemented an architecture design for our CDSS, which uses the model-view-controller (MVC) architecture and a knowledge engine in the MVC architecture based on XML. The knowledge engine design also integrated the requirement of matching clinical care workflow that was desired in the CDSS. For this component of the design task, we used a work ontology analysis of the CPGs for antenatal care in our particular target clinical settings. Results In comparison to other common CIGs used for CDSSs, our XML approach can be used to take advantage of the flexible format of XML to facilitate the electronic sharing of structured data. More importantly, we can take advantage of its flexibility to standardize CIG structure design in a low-level specification language that is ubiquitous, universal, computationally efficient, integrable with web technologies, and human readable. Conclusions Our knowledge representation framework incorporates fundamental elements of other CIGs used in CDSSs in medicine and proved adequate to encode a number of antenatal health care CPGs and their associated clinical workflows. The framework appears general enough to be used with other CPGs in medicine. XML proved to be a language expressive enough to describe planning problems in a computable form and restrictive and expressive enough to implement in a clinical system. It can also be effective for mobile apps, where intermittent communication requires a small footprint and an autonomous app. This approach can be used to incorporate overlapping capabilities of more specialized CIGs in medicine.

Abdominal Pain

2018 ◽  
pp. 327-331
Author(s):  
Elizabeth DeVos
Keyword(s):  
United States ◽  
Signs And Symptoms ◽  
Standard Of Care ◽  
Clinical Decision ◽  
Operative Management ◽  
The United States ◽  
Potential Utility ◽  
Treatment Protocols ◽  
Common Presentation ◽  
Treatment Risks

This case demonstrates a common presentation of appendicitis including frequent signs and symptoms and classic examination findings. Options for diagnostic imaging are reviewed. Clinical decision scores may assist in risk stratification, which may be particularly useful in austere or low-resource settings. The discussion introduces the concept of “antibiotics first” treatment for appendicitis including a discussion of patients who are poor candidates for such treatment, risks for need of future operative management, and proposed treatment protocols. While surgical management remains the standard of care in the United States, this case discusses potential utility for an “antibiotics first” protocol when definitive surgical treatment is not readily available.

Web Application “Congenital Malformations”: Program Effectiveness Evaluation Based on Feedback

2020 ◽  
pp. 6-13
Author(s):  
A.N. Putintsev ◽  
◽  
V.Yu. Voinova ◽  
N.S. Demikova ◽  
A.S. Lapina ◽  
...  
Keyword(s):  
Medical Students ◽  
Web Application ◽  
Congenital Malformations ◽  
Program Effectiveness ◽  
Growth Dynamics ◽  
Repeated Testing ◽  
Additional Tool ◽  
Anonymous Testing ◽  
E Learning ◽  
User Knowledge

Currently, Internet resources are widely used in medical education, becoming one of the key tools of e-learning. We have developed a web application for congenital malformations and anomalies for medical students as an additional tool for self-learning. The web application contains two components: multimedia descriptions of congenital malformations, including images, animations, videos and interactive graphical tests; and the knowledge control module. It is important to evaluate effectiveness of web application and to improve the quality of the resources. We sought to evaluate the effectiveness of a web application by analyzing user knowledge dynamics and use the information to improve content. The anonymous testing involved 260 users – doctors, medical students and teachers. Using the longitudinal method of the study, we analyzed the dynamics of the group-averaged rate of correct responses after repeated testing attempts. The results showed differences in the initial level of knowledge of users, and the results of medical students’ tests in dynamics were improved more than the results of doctors. The initial value of the percentage of correct responses to the control questions and the growth dynamics of this indicator after repeated attempts are important indicators for assessing the usefulness of a particular question. For developers, this information, based on objective indicators, has proved useful for improving the educational resource.

Conclusions

2009 ◽  
pp. 323-358
Author(s):  
Roberto Paiano ◽  
Anna Lisa Guido ◽  
Andrea Pandurino
Keyword(s):  
Information Systems ◽  
Web Application ◽  
Future Developments ◽  
Web Information ◽  
Web Information Systems ◽  
The Web

In this chapter, we briefly summarize the results achieved in this book, and we will provide some indications on possible future developments. In the book’s coverage, we mainly focus on the design and on the development of complex Web information systems that are information systems that aim to manage, in an explicit way, the design of the processes inside the Web application as support for them.

scholarly journals Effectiveness of the clinical decision support tool ESR eGUIDE for teaching medical students the appropriate selection of imaging tests: randomized cross-over evaluation

2020 ◽  
Vol 30 (10) ◽  
pp. 5684-5689 ◽  
Author(s):  
Torsten Diekhoff ◽  
Franz Kainberger ◽  
Laura Oleaga ◽  
Marc Dewey ◽  
Elke Zimmermann
Keyword(s):  
Decision Support ◽  
Medical Students ◽  
Clinical Decision Support ◽  
Imaging Modality ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Support Tool ◽  
Clinical Scenarios ◽  
Group A ◽  
Clinical Decision Support Tool

Abstract Objectives To evaluate ESR eGUIDE—the European Society of Radiology (ESR) e-Learning tool for appropriate use of diagnostic imaging modalities—for learning purposes in different clinical scenarios. Methods This anonymized evaluation was performed after approval of ESR Education on Demand leadership. Forty clinical scenarios were developed in which at least one imaging modality was clinically most appropriate, and the scenarios were divided into sets 1 and 2. These sets were provided to medical students randomly assigned to group A or B to select the most appropriate imaging test for each scenario. Statistical comparisons were made within and across groups. Results Overall, 40 medical students participated, and 31 medical students (78%) answered both sets. The number of correctly chosen imaging methods per set in these 31 paired samples was significantly higher when answered with versus without use of ESR eGUIDE (13.7 ± 2.6 questions vs. 12.1 ± 3.2, p = 0.012). Among the students in group A, who first answered set 1 without ESR eGUIDE (11.1 ± 3.2), there was significant improvement when set 2 was answered with ESR eGUIDE (14.3 ± 2.5, p = 0.013). The number of correct answers in group B did not drop when set 2 was answered without ESR eGUIDE (12.4 ± 2.6) after having answered set 1 first with ESR eGUIDE (13.0 ± 2.7, p = 0.66). Conclusion The clinical decision support tool ESR eGUIDE is suitable for training medical students in choosing the best radiological imaging modality in typical scenarios, and its use in teaching radiology can thus be recommended. Key Points • ESR eGUIDE improved the number of appropriately selected imaging modalities among medical students. • This improvement was also seen in the group of students which first selected imaging tests without ESR eGUIDE. • In the student group which used ESR eGUIDE first, appropriate selection remained stable even without the teaching tool.

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