scholarly journals Simulation of Abnormal Physiological Signals in a Phantom for Bioengineering Education

2020 ◽  
Vol 16 (14) ◽  
pp. 107
Author(s):  
Hélder Vieira ◽  
Nelson Costa ◽  
Joaquim Fernando Almeida Alves ◽  
Luís Pinto Coelho
Keyword(s):  
Decision Making ◽  
Medical Devices ◽  
Healthcare Professionals ◽  
Daily Life ◽  
Physiological Signals ◽  
Diagnostic Process ◽  
Decision Making Process ◽  
Non Invasive ◽  
Health Related ◽  
Electrocardiogram Ecg

In clinical practice and in particular in the diagnostic process, the assessment of cardiac and respiratory functions is supported by electrocardiogram and auscultation. These exams are non-invasive, quick and inexpensive to perform and easy to interpret. For these reasons, this type of assessment is a constant in the daily life of a clinician and the information obtained is central to the decision making process. Therefore, it is essential that during their training, students of health-related subjects acquire skills in the acquisition and evaluation of the referred physiological signals. Simulation, considering the technological possibilities of today, is an excellent preparation tool since it exposes trainees to near real contexts but without the associated risks. Hence, the simulation of physiological signals plays an important role in the education of healthcare professionals, bioengineering professionals and also in the development and calibration of medical devices. This paper describes a project to develop synchronized electrocardiogram (ECG), phonocardiogram (PCG) and breathing sounds simulators that aims to improve an existing phantom simulator. The developed system allows, in an integrated way, to generate normal and pathological signals, being contemplated several distinct pathologies. For engineering education, it is also possible to simulate the introduction of signal disturbances or hardware malfunctions.

Improving the Decision-Making Process in a Hospital Environment With New Interactive Visualization Methods

2020 ◽  
Vol 9 (1) ◽  
pp. 13-24
Author(s):  
Cristiana Neto ◽  
Diana Ferreira ◽  
António Abelha
Keyword(s):  
Decision Making ◽  
Medical Errors ◽  
Healthcare Professionals ◽  
Hospital Environment ◽  
Diagnostic Process ◽  
Decision Making Process ◽  
Test Results ◽  
Adequate Treatment ◽  
Efficient Access ◽  
Visualization Process

A large number of medical errors occurring in hospitals happen in the diagnostic process, such as the use of outmoded tests and the failure to perform on test results, leading to delays in the diagnosis. Thus, fast and efficient access to the patients' exams and test results is essential to provide them adequate treatment. This need demands solving problems that exist during this process of consulting the results in order to reduce clinical risk. Therefore, an analysis of the problems in the visualization process of the exams in Centro Hospitalar do Porto was carried out, leading to the development of a new platform - AIDA-MCDT, whose main objective was to fill the gaps verified, making the access to exams' results more efficient and intuitive. This platform has significantly improved the system's usability, including several features designed to help healthcare professionals make decisions more quickly and securely.

Exploring ethical aspects of elective surgery patients’ decision-making experiences

2012 ◽  
Vol 20 (6) ◽  
pp. 672-683 ◽  
Author(s):  
Mei-Ling Lin ◽  
Chuen-Teng Huang ◽  
Hsien-Hsien Chiang ◽  
Ching-Huey Chen
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Healthcare Professionals ◽  
Elective Surgery ◽  
Phenomenological Approach ◽  
Healthcare Personnel ◽  
Decision Making Process ◽  
Ethical Aspects ◽  
Southern Taiwan ◽  
Colaizzi's Method

The practice of respecting patients’ autonomy is rooted in the healthcare professionals’ empathy for patients’ situations, without which appropriate supports to the patients during the informed consent process may be remarkably moderated. The purpose of this study was to explore elective surgery patients’ experiences during their decision-making process. This research was conducted using a phenomenological approach, and the data analysis was guided by Colaizzi’s method. A total of 17 participants were recruited from a hospital in southern Taiwan. Two major themes emerged from the analyses: (a) a voluntary yet necessary alternative—to undergo a surgery and (b) alternatives compelled by the unalterable decision—the surgery. It was concluded that unless healthcare professionals can empathize with the distressed situation of their patients who are facing elective surgery, the practice of informed consent may become merely a routine. Nurses can be the best advocates for patients and facilitators to enhance communication between patients and healthcare personnel.

scholarly journals Rational and irrational processes in decision making: An economic perspective

2019 ◽  
Vol 1 (1) ◽  
pp. 51-57
Author(s):  
Maria Liana Lacatus
Keyword(s):  
Decision Making ◽  
Imperfect Information ◽  
Final Section ◽  
Daily Life ◽  
Decision Making Process ◽  
Economic Perspective ◽  
Short Introduction ◽  
Decision Making Processes ◽  
Economic Understanding

The paper presents important issues of decision making processes with an emphasis on rational and irrational components of these processes. After a short introduction outlining the need for a deeper understanding of rational and non-rational factors that affect the decisions people make, the rationality of people decisions in daily life is questioned and the role of non-rational factors such as intuition are analyzed. The economic understanding of the decision making process is presented and principles of rational decision-making are explained. Different methods used and recommended by economists in order to make decisions are presented and applied in different life situations in order to demonstrate their value in daily life. Special emphasis is put on factors such as imperfect information, illusion of control, or risk aversion that may affect the rationality of the decision making processes. In the final section of the paper the concept of bounded rationality is introduced and explained along with new theories in economics that are challenging the classic economic perspective on the decision making process

Depressed Latinx Older Adults’ Shared Decision-Making Preferences

2021 ◽  
Author(s):  
Sara Romero ◽  
Patrick Raue ◽  
Andrew Rasmussen
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Puerto Rican ◽  
Shared Decision Making ◽  
Decision Making Process ◽  
Shared Decision ◽  
Medical Conditions ◽  
Depression Severity ◽  
Related Information ◽  
Health Related

The shared decision-making (SDM) model is the optimal patient-centered approach to reduce racial and ethnic health disparities in primary care settings. This study examined decision-making preferences and the desire to be knowledgeable of health-related information of a multiheritage group of depressed older Latinx primary care patients. The primary aim was to determine differences in treatment preferences for both general medical conditions and depression and desire to be knowledgeable of health-related information between older Puerto Rican adults compared to older non-Puerto Rican Latinx adults. We also examined whether depression severity moderated those relationships. A sample of 178 older Latinx patients were assessed on measures of decision-making preferences, information-seeking desires, and depression severity. Regression models indicated depression severity moderated the relationship between Latinx heritage and decision-making preferences that relate to general medical decisions, but not depression treatment. Specifically, Puerto Ricans with high levels of depression preferred to be more active in making decisions related to general medical conditions compared to non-Puerto Rican patients who preferred less active involvement. There was no difference between groups at low levels of depression as both groups preferred to be similarly active in the decision-making process. This investigation adds to the literature by indicating between-group differences within a Latinx older adult sample regarding decision-making preferences and the desire to be informed of health-related information. Future research is needed to identify other sociocultural characteristics that contribute to this disparity between Latinx heritage groups in their desires to participate in the decision-making process with their primary care provider.

Telecardiology: supporting the decision making process in general practice

1996 ◽  
Vol 2 (1) ◽  
pp. 7-13 ◽  
Author(s):  
D Shanit ◽  
A Cheng ◽  
R A Greenbaum
Keyword(s):  
Decision Making ◽  
Initial Phase ◽  
Daily Practice ◽  
Cost Comparison ◽  
Decision Making Process ◽  
Health Centres ◽  
Cardiac Assessment ◽  
On Line ◽  
Electrocardiogram Ecg ◽  
Ecg Interpretation

To assess the initial phase of a telecardiology diagnostic service for general practitioners GPs , we provided 93 GPs in 26 health centres with direct telephone access to a cardiologist, and equipped them with hand-held, automatic standard 12-lead electrocardiogram ECG transmitters for on-line cardiac consultations and ECG interpretation in their daily practice. Clinical details, reason for consultation and the ECG signal were transmitted from the GPs' practices or the patients' homes. A consultation followed and a full report, including ECG print-out, was then sent to the GP. During an 18-month study period, 2563 consultations were carried out. The system allowed the identification of 479 patients 19 with urgent cardiac problems and the remaining 2084 81 in whom admission or outpatient investigation was unnecessary. Following the study, we distributed a questionnaire asking the GPs to rate the quality, define the use and consider the benefit of the service to their daily practice. We conclude that a telecardiology diagnosis and ECG interpretation service is simple, reliable and efficacious in routine primary care. It offers instant access to cardiac assessment and supports the decision-making process of GPs. A preliminary cost comparison with a conventional referral indicated that a teleconsultation was substantially cheaper. We expect that the future incorporation of teleechocardiography would expand the scope of telecardiology even further and allow comprehensive cardiology consultations.

scholarly journals The Influence of Experiential Knowledge and Societal Perceptions on Decision-Making Regarding Non-Invasive Prenatal Testing (NIPT)

2020 ◽  
Author(s):  
Sophie Montgomery ◽  
Zaneta M. Thayer
Keyword(s):  
Decision Making ◽  
Qualitative Analysis ◽  
Genetic Information ◽  
Prenatal Testing ◽  
Phenomenological Approach ◽  
Experiential Knowledge ◽  
Emotional Impact ◽  
Decision Making Process ◽  
Structured Interviews ◽  
Non Invasive

Abstract Non-invasive prenatal testing (NIPT) allows women to access genetic information about their fetuses without the physical risk inherent to prior testing methods. The advent of NIPT technology has yielded concerns among bioethicists regarding the quality and process of informed consent, as the routinization of this technology could degrade the intentionality of women choosing whether to undergo testing. Prior studies evaluating the NIPT decision-making process have focused on the clinical encounter as the primary environment for acquisition of biomedical information and decision formation. While important, this conceptualization fails to consider how additional sources of knowledge, including both embodied and empathetic experiential knowledge, shape perceptions of risk and the societal use of NIPT. In order to address this issue, qualitative, semi-structured interviews with 25 women who had been offered NIPT were performed. Women were categorized by NIPT use/non-use, as well as whether their described decision-making process was routinized. Qualitative analysis of the data using a phenomenological approach was used to explore themes in the data, develop a framework of NIPT decision-making, and compare the perceptions of women with differential decision-making processes and outcomes. A framework for decision-making regarding NIPT was developed based on three emergent factors: perceptions of the societal use of NIPT, expected emotional impact of genetic information, and perceived utility of genetic information. Qualitative analysis revealed that perceptions of widespread use of NIPT, pervasive societal narratives of NIPT use as progressive and “forward-thinking,” and a perception of information as anxiety-relieving contributed to routinized uptake of NIPT. In contrast, women who displayed a lack of routinization expressed fewer stereotypes regarding the audience for NIPT and relied on communication with their social networks in-person and online to consider how they might use the information provided by NIPT. The findings of this study reveal the societal narratives and perceptions that shape differential decision-making regarding NIPT. Understanding and addressing these perceptions that influence NIPT decision-making, especially routinized uptake of NIPT, is important as the use and scope of this technology increases.

scholarly journals Hyperglycemia Identification Using ECG in Deep Learning Era

Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 6263
Author(s):  
Renato Cordeiro ◽  
Nima Karimian ◽  
Younghee Park
Keyword(s):  
Deep Learning ◽  
Blood Glucose Concentration ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Physiological Signals ◽  
Ecg Signals ◽  
Non Invasive ◽  
Learning Classifier ◽  
Electrocardiogram Ecg ◽  
Smart Wearable

A growing number of smart wearable biosensors are operating in the medical IoT environment and those that capture physiological signals have received special attention. Electrocardiogram (ECG) is one of the physiological signals used in the cardiovascular and medical fields that has encouraged researchers to discover new non-invasive methods to diagnose hyperglycemia as a personal variable. Over the years, researchers have proposed different techniques to detect hyperglycemia using ECG. In this paper, we propose a novel deep learning architecture that can identify hyperglycemia using heartbeats from ECG signals. In addition, we introduce a new fiducial feature extraction technique that improves the performance of the deep learning classifier. We evaluate the proposed method with ECG data from 1119 different subjects to assess the efficiency of hyperglycemia detection of the proposed work. The result indicates that the proposed algorithm is effective in detecting hyperglycemia with a 94.53% area under the curve (AUC), 87.57% sensitivity, and 85.04% specificity. That performance represents an relative improvement of 53% versus the best model found in the literature. The high sensitivity and specificity achieved by the 10-layer deep neural network proposed in this work provide an excellent indication that ECG possesses intrinsic information that can indicate the level of blood glucose concentration.

The Buying Decision-Making Process in the Selection of Device Suppliers in Reproductive Medicine

2021 ◽  
pp. 1-23
Author(s):  
Paulo Botelho Pires ◽  
António Correia Barros ◽  
Filipe Taveira Santos
Keyword(s):  
Decision Making ◽  
Medical Devices ◽  
Reproductive Medicine ◽  
Marketing Strategies ◽  
Decision Makers ◽  
Decision Making Process ◽  
The Third ◽  
Post Purchase ◽  
The Relationship ◽  
Selection Of

This study identifies the criteria underlying the buying decision-making process of medical devices in reproductive medicine. This research had three main objectives. The first one was to translate the criteria mentioned by the decision-makers into theoretical constructs, while the second objective was intended to establish the relationship between the constructs, creating a conceptual model of buying decision-making for medical devices in reproductive medicine. The third objective was to identify suitable business and marketing strategies for such a decision-making process. Four constructs were evaluated in the pre-purchase phase, namely the brand, the product's performance, the training associated with the product, and the price. In the post-purchase phase, decision-makers evaluated the following constructs: service provided by the company, the relationship with the salesperson, and loyalty. Regarding marketing strategies, market-orientation strategy, relationship-marketing strategy, and brand-equity strategy were identified as possible strategies.

Improving the Decision-Making Process in a Hospital Environment With New Interactive Visualization Methods

2021 ◽  
pp. 1001-1014
Author(s):  
Cristiana Neto ◽  
Diana Ferreira ◽  
António Abelha
Keyword(s):  
Decision Making ◽  
Medical Errors ◽  
Interactive Visualization ◽  
Hospital Environment ◽  
Diagnostic Process ◽  
Decision Making Process ◽  
Test Results ◽  
Adequate Treatment ◽  
Efficient Access ◽  
Visualization Process

A large number of medical errors occurring in hospitals happen in the diagnostic process, such as the use of outmoded tests and the failure to perform on test results, leading to delays in the diagnosis. Thus, fast and efficient access to the patients' exams and test results is essential to provide them adequate treatment. This need demands solving problems that exist during this process of consulting the results in order to reduce clinical risk. Therefore, an analysis of the problems in the visualization process of the exams in Centro Hospitalar do Porto was carried out, leading to the development of a new platform - AIDA-MCDT, whose main objective was to fill the gaps verified, making the access to exams' results more efficient and intuitive. This platform has significantly improved the system's usability, including several features designed to help healthcare professionals make decisions more quickly and securely.

Personal perspectives: having the time to observe the patient

2021 ◽  
pp. medethics-2020-107041
Author(s):  
Simon D Taylor-Robinson
Keyword(s):  
Decision Making ◽  
Medical Staff ◽  
Healthcare Professionals ◽  
Decision Making Process ◽  
Medical Culture ◽  
Personal Perspectives ◽  
Unpleasant Experience

Being a medically qualified patient can be an unpleasant experience for a person who is used to making decisions. For the most part, this applies to the vast majority of doctors and other healthcare professionals. Becoming passive and surrendering the decision-making process to others is alien to the medical culture we were taught. However, when as a hospitalised medically qualified patient, one sees fellow patients in difficulty, or deteriorating clinically, unnoticed by medical staff, the question of whether it is ethical to intervene arises. I report my views on this as a largely passive, but still actively thinking patient.

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