Technology in Medicine

I

By : Khaled H. AlkhodariSupervisor : Dr. Jehad H. Hammad

Contents

• Introduction• Operating Systems• Apps:– BNF 69– DynaMed– Medscape– دواءٌ

• Databases:– Hinari– EBSCO-DynaMed– Others

In late 2010, Microsoft executive Stephen Elop became CEO at the then independent smartphone-maker Nokia.

He concluded that Nokia's persistence in keeping its own smartphone platform,

Symbian, was a mistake — he compared its strategy to a "burning platform" in a

memo in February 2011.

Use them WELL

Visual Reality

Are MMA included in research?

• Alzheimer disease : GPS

• Using smartphones connected via Bluetooth to a single-lead electrocardiograph (ECG) device.

• Stroke: accelerometer can be used to interpret gait and balance of patients.

AliveCor Mobile ECG 113$

715$

• DM1 Pt.:A self-adjusting insulin calculator ,digital diary for long and short-acting insulin doses based on their doctor’s prescription, tailored to nutritional intake and physical activity.

• sleep apnea:single-lead ECGproviding a possible alternative to costly and labor-intensive polysomnography

A study in 2010 claimed that >60% of physicians surveyed felt that

Epocrates helped to reduce medical errors

Percentage frequency of use of different categories of medical apps within the junior doctor group

Percentage frequency of use of different categories of medical apps within the medical student group

• UpToDate – an evidence-based clinical smartphone tool – provides the most recent clinical evidence and includes

more than 9,000 physicians’ topics, 5,000 drug topics, practice change updates, etc.

– This application is very useful in the practice of EBM at the bedside

– is very useful for the integration of test results with clinical information

• six applications providing common laboratory test information including reference values and interpretation, causes for abnormal (increased or decreased) values, and laboratory unit conversions. – Palm LabDX, – Normal Lab Values,– Lab Unit Converter, – Labs 360o, – Davis’s Laboratory and Diagnostic Tests,– Pocket Guide to Diagnostic Tests

• Smartphones can also be applied in the process of diagnosis and treatment using software application.

• A simple smartphone application for eye-care professionals is a visual acuity test. – EyeChart is an iPhone application that includes the

Snellen eye chart to measure visual acuity – A similar application is EyePhone, which includes a

distance E-test, near visual acuity test, color test, Amsler grid, and pupil gauge test

Drug Reference Applications

• six applications are: Skyscape’s RxDrugs, Epocrates, Medscape, SafeMed Pocket, FDA drugs, and DrugDoses.net.

• Epocrates was cited as the most common

• Epocrates and Skyscape’s RxDrugs, another drug reference can check multiple drug-drug interaction at the same time

• FDA Drugs, which includes package inserts or official labels of FDA-approved prescription and over-the-counter drugs, shares this functionality and also searches by active ingredients

Number of Healthcare Applications per OS Platform Discussed in this Study

Examples of MMAs the FDA regulates

1. Mobile apps that use a sensor or to measure and display ECG2. apps that use a sensor attached to the mobile or in it (e.g.,

microphone and speaker) to electronically amplify sounds associated with the heart, arteries and veins and other internal organs (i.e., an electronic stethoscope)

3. Apps measure physiological parameters during cardiopulmonary resuscitation (CPR) and give feedback about the quality of CPR being delivered.

4. Apps record, view, or analyze eye movements for use in the diagnosis of balance disorders (i.e., nystagmograph).

5. App produce controlled levels of test tones and signals intended for use in conducting diagnostic hearing evaluations and assisting in the diagnosis of possible otologic disorders (i.e., an audiometer)

6. Measure the degree of tremor caused by certain diseases (i.E., A tremor transducer).

7. Measure physiological parameters (e.G., Limb movement, electrical activity of the brain (EEG)) during sleep and are intended for use in diagnosis of specific diseases or conditions such as sleep apnea.

8. Measure blood oxygen saturation for diagnosis of specific disease or condition.

9. Potential blood donor and record and/or transmit the responses to those questions for a blood collection facility to use in determining blood donor eligibility prior to collection of blood or blood components

10. Measure blood glucose levels11. To treat acne, reduce wrinkles, or remove hair

12. Audiometer to allow healthcare providers to determine hearing loss at different frequencies.

13. Analyze an image of a skin lesion using mathematical algorithms, such as fractal analysis, and provide the user with an assessment of the risk of the lesion

14. Alter the function or settings of an infusion pump.

15. Control or change settings of an implantable neuromuscular stimulator

16. Calibrate, control, or change settings of a cochlear implant.

17. Control the inflation or deflation of a blood-pressure cuff.

18. Calibrate hearing aids and assess the electroacoustic frequency and sound intensity

19. Mobile apps that connect to a nursing central station and display medical device data to a physician’s mobile platform for review

20. Mobile apps that connect to bedside (or cardiac) monitors and transfer the data to a central viewing station for display and active patient monitoring.

21. Mobile apps that connect to a perinatal monitoring system and transfer uterine contraction and fetal heart rate data to another display to allow for remote monitoring of labor progress.

22. Mobile apps that are intended to display images for diagnostic review may be regulated as a picture archiving and communications system

211 app nearly

79% android=3118% IOS =71% others=1

Android IOS Others

Pharmacology in your pocket instead of memorizing texts

BNF British National Formulary.

• New edition /6m (Mar-Sep)• The first was on 1949 , Today 71th ed.• BNF Publications are published jointly by the– British Medical Association – The Royal Pharmaceutical Society.

• They are independent resources that do not market medicines.

• Content includes:– Guidance on the drug management of common conditions.– Details of medicines with special reference to their uses, cautions,

contra-indications, side-effects, doses, and relative costs.– Guidance on prescribing, monitoring, dispensing, and

administering medicines.

Sources

• Summaries of product characteristics (SPCs). The principal.

• Expert advisers.

• Medical and pharmaceutical journals, research papers …

• Systematic reviews databases eg Cochrane.

• Reference sources such as Martindale: The Complete Drug

Reference.

• Pricing information. Provided by the NHS Prescription

Services (from the NHS Business Services Authority).

Martindale: The Complete Drug Reference 38th ed. 2014

• This package contains two hardback volumes (4688pages)

presented in a slipcase with:– Over 6,000 (and over 7,000 online) drug monographs– Over 180,000 (and over 240,000 online) preparations– Over 54,000 reference citations– About 20,000 (and 25,000 online) manufacturers and distributors– Proprietary preparations from 43 countries and regions– Nearly 700 disease reviews, with references from the published

literature– Information to enable identification of medicines, the local

equivalent and the manufacturer– Herbals, diagnostic agents, radiopharmaceuticals, pharmaceutical

excipients, toxins, and poisons as well as drugs and medicines.

publication

For topics in your search

Any thing Blue , you can click on it and read more

Always updated

Medscape

• Medscape is a web resource for physicians and health professionals.

• It features:– peer-reviewed original medical journal articles, – CME (continuing medical education)

– A customized version of the national library of medicine's MEDLINE database

– Daily medical news– Major conference coverage– Drug information—including a drug database (medscape

drug reference, or MDR) and drug interaction checker

For latest news

For Continuing

medical eduction

(CME)

Palestinian Ministry of health & ministry of IT

$$$$$$$$$So What !!

IUG DatabasesIslamic University of Gaza (IUG)

• Set up by WHO together with major publishers.• Enables low- and middle- income countries to gain

access to one of the world's largest collections of biomedical and health literature:

– Up to 15,000 journals (in 30 different languages).

– Up to 47,000 e-books

– Up to 100 other information resources – Now available to health institutions in more than 100

countries

Video

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Level 1 (likely reliable) Representing research results addressing clinical outcomes and meeting an extensive set of quality criteria which minimizes bias.

Level 3 (lacking direct) Evidence

Representing research results addressing clinical outcomes, and using some method of scientific investigation, but not meeting the quality criteria to achieve level 1 evidence labeling.

Level 2 (mid-level) Evidence

Representing reports that are not based on scientific analysis of clinical outcomes. Examples include case series, case reports, expert opinion, and conclusions extrapolated indirectly from scientific studies.

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EBM Journal

EBM FocusThe EBM Focus is a free weekly e-newsletter providing a

concise summary of articles most likely to inform clinical practice.

Resident FocusThe Resident Focus is a free e-newsletter written by medical

residents highlighting recent clinical evidence they find important at the point-of-care.

ArchivesRead past issues of the EBM Focus, Resident Focus

Recent Updates

E- Newsletter

Calculators

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• Cambridge Journals1. Brain Impairment 2. Breast Cancer Online 3. British Journal of Anaesthetic

and Recovery Nursing 4.

Cambridge Quarterly of Healthcare Ethics

5. Canadian Journal of Emergency Medicine

6. Cardiology in the Young 7.

Developmental Medicine & Child Neurology

8. Disaster Medicine and Public Health Preparedness

9. European Journal of Anaesthesiology

10. Expert Reviews in Molecular Medicine

11. Fetal and Maternal Medicine Review

12. Global Health, Epidemiology and Genomics

13. Health Economics, Policy and Law

14. Infection Control & Hospital Epidemiology (formerly Infection Control Volumes 1 (1980) - 8 (1987))

15. International Journal of Disability Management

16. International Journal of Technology Assessment in Health Care

17. Journal of Dentofacial Anomalies and Orthodontics

18. Journal of Diagnostic Radiography and Imaging

19. The Journal of Laryngology & Otology (formerly The Journal of Laryngology, Rhinology, and Otology Volumes 6 (1892) - 35 (1920), The Journal of Laryngology and Rhinology Volumes 1 (1887) - 5 (1891))

20. Journal of Psychiatric Intensive Care

21. Journal of Radiotherapy in Practice

22. Nurse Prescriber 23.

Palliative & Supportive Care

24. Prehospital and Disaster Medicine (formerly Journal of the World Association for Emergency and Disaster Medicine Volumes 1 (1985) - 3 (1987).)

25. Primary Health Care Research & Development

26. Reviews in Clinical Gerontology

some Members of the OpenAthens Federation include:https://auth.athensams.net/list_orgs.php

1. AkzoNobel2. American Medical

Association3. Cambridge University Press4. Cengage Learning5. Department of Health

(Victoria, Australia)6. Department of Veterans

Affairs (USA)7. EBSCO 8. Elsevier9. Emerald Group Publishing10. IEEE 11. Informa Healthcare12. Ingram Digital

Ltd/MyiLibrary13. John Wiley & Sons

14. JSTOR15. LexisNexis 16. Maney Publishing17. McGraw Hill Professional 18. National Institute for

Health and Clinical Excellence (NICE) on behalf of NHS organisations in England

19. Nature Publishing Group 20. New England Journal of

Medicine21. Navy Medicine Information

Systems Support Agency (NAVMISSA)

22. NHS Scotland23. NHS Wales24. Oxford University Press25. Philips Research

26. ProQuest27. Royal Australia and New

Zealand College of28. Ophthalmologists29. Royal Dutch Shell30. SAGE Publications31. Springer32. Taylor & Francis33. Thieme34. Thomson Healthcare 35. Thomson Scientific36. U.S. Army Medical

Department (AMEDD)37. U.S. Army Research

Institute38. US Department of

Defense39. Westlaw40. Wolters Kluwer Health

The End of Part #1