Medical informatics = Medecine et informatique最新文献_第7页

Interactive educational simulators in diabetes care. 糖尿病护理中的交互式教育模拟器。

Medical informatics = Medecine et informatique Pub Date : 1997-01-01 DOI: 10.3109/14639239709089834

E D Lehmann

{"title":"Interactive educational simulators in diabetes care.","authors":"E D Lehmann","doi":"10.3109/14639239709089834","DOIUrl":"https://doi.org/10.3109/14639239709089834","url":null,"abstract":"Since the Diabetes Control and Complications Trial demonstrated the substantial benefits of tight glycaemic control there has been renewed interest in the application of information technology (IT) based techniques for improving the day-to-day care of patients with diabetes mellitus. Computer-based educational approaches have a great deal of potential for patients use, and may offer a means of training more health-care professionals to deliver such improved care. In this article the potential role of IT in diabetes education is reviewed, focusing in particular on the application of compartmental models in both computer-based interactive simulators and educational video games. Close attention is devoted to practical applications-available today-for use by patients, their relatives, students and health-care professionals. The novel features and potential benefits of such methodologies are highlighted and some of the limitations of currently available software are discussed. The need for improved graphical user interfaces, and for further efforts to evaluate such programs and demonstrate an educational benefit from their use are identified as hurdles to their more widespread application. The review concludes with a look to the future and the type of modelling features which should be provided in the next generation of interactive diabetes simulators and educational video games.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"22 1","pages":"47-76"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239709089834","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20129202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 57

Controlling blood glucose: insights from an engineering control systems perspective. 控制血糖:从工程控制系统角度的见解。

Medical informatics = Medecine et informatique Pub Date : 1997-01-01 DOI: 10.3109/14639239709089831

D R Worthington

{"title":"Controlling blood glucose: insights from an engineering control systems perspective.","authors":"D R Worthington","doi":"10.3109/14639239709089831","DOIUrl":"https://doi.org/10.3109/14639239709089831","url":null,"abstract":"In order to discern areas of potential improvement in various aspects of glycaemic control for patients with insulin dependent (type 1) diabetes mellitus, blood glucose control is analysed in the light of general engineering feedback control systems theory. This approach is based on models of the system being controlled, using appropriate control strategies. The models presently used for glycaemic control are analysed from this perspective, revealing certain limitations that they impose on the control strategies that use them. Current type 1 diabetes regimens are evaluated for the ease with which they may be analysed mathematically, suggesting areas where improvements in control may be effected by simplifying calculation of appropriate insulin quantities. A new model of undergraded insulin action, derived from established insulin action profiles, along with a control strategy which flexibly extends the basal/bolus regimen using patient-specific parameters, is proposed. This may provide the information needed to enable prediction of expected glycaemia several hours into the future, thereby enabling earlier corrective action to be taken should it fail outside the target range, and in turn potentially reduce the degree and frequency of both hyperglycaemia and hypoglycaemia.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"22 1","pages":"5-19"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239709089831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20129340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Comparison of parametrized models for computer-based estimation of diabetic patient glucose response. 计算机估计糖尿病患者血糖反应的参数化模型的比较。

Medical informatics = Medecine et informatique Pub Date : 1997-01-01 DOI: 10.3109/14639239709089832

J S Naylor, A S Hodel, A M Albisser, J H Evers, J H Strickland, D A Schumacher

引用次数: 12

DIABNET: a qualitative model-based advisory system for therapy planning in gestational diabetes. DIABNET:一个定性的基于模型的咨询系统，用于妊娠期糖尿病的治疗计划。

Medical informatics = Medecine et informatique Pub Date : 1996-10-01 DOI: 10.3109/14639239608999295

M E Hernando, E J Gómez, F del Pozo, R Corcoy

{"title":"DIABNET: a qualitative model-based advisory system for therapy planning in gestational diabetes.","authors":"M E Hernando, E J Gómez, F del Pozo, R Corcoy","doi":"10.3109/14639239608999295","DOIUrl":"https://doi.org/10.3109/14639239608999295","url":null,"abstract":"An intelligent decision support system for the analysis of home monitoring data and therapy planning in gestational diabetes is presented. The paper describes the integration of qualitative and quantitative reasoning modules within the DIABNET advisory system. The system kernel is a qualitative model of the physiological processes involved in the glucose metabolism of this type of diabetic patient. A causal probabilistic network (CPN) has been used to represent the qualitative model in order to manage uncertain and missing monitoring data. The DIABNET inputs are the patient's available ambulatory monitoring data, and the output is a dietary and insulin therapy adjustment that includes initiation of insulin therapy, quantitative insulin dose changes and qualitative diet and schedule modifications. Over periods of up to seven days, monitoring data are analysed by the CPN to detect any diet or insulin therapy items which may require modification. The qualitative insulin needs are translated into a quantitative proposal in line with the characteristics of the patient and the modification strategies usually used by doctors. The first evaluation of the system has been accomplished, the encouraging results of which are also presented.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"21 4","pages":"359-74"},"PeriodicalIF":0.0,"publicationDate":"1996-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239608999295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20126347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 25

Application of information technology in clinical diabetes care--a special issue. Part 1. Databases, algorithms and decision support. 信息技术在糖尿病临床护理中的应用——专题第1部分。数据库，算法和决策支持。

Medical informatics = Medecine et informatique Pub Date : 1996-10-01 DOI: 10.3109/14639239608999287

E D Lehmann

引用次数: 29

UTOPIA: a consultation system for visit-by-visit diabetes management. 乌有之乡:一种针对糖尿病患者的就诊管理咨询系统。

Medical informatics = Medecine et informatique Pub Date : 1996-10-01 DOI: 10.3109/14639239608999294

T Deutsch, A V Roudsari, H J Leicester, T Theodorou, E R Carson, P H Sönksen

引用次数: 34

Randomized controlled pilot trial of a hand-held patient-oriented, insulin regimen optimizer. 一种手持式面向患者的胰岛素方案优化器的随机对照试验。

Medical informatics = Medecine et informatique Pub Date : 1996-10-01 DOI: 10.3109/14639239608999292

R R Holman, A D Smale, E Pemberton, A Riefflin, J L Nealon

{"title":"Randomized controlled pilot trial of a hand-held patient-oriented, insulin regimen optimizer.","authors":"R R Holman, A D Smale, E Pemberton, A Riefflin, J L Nealon","doi":"10.3109/14639239608999292","DOIUrl":"https://doi.org/10.3109/14639239608999292","url":null,"abstract":"A robust, hand-held, patient-oriented insulin regimen optimizer (POIRO) has been developed. Relevant information is entered by selecting appropriate items from choices displayed on a touch-sensitive screen rather than a conventional keyboard. All data items are recorded, together with their time and date of entry, and may be recalled at any time with glucose values displayed graphically to provide an overview of glycaemic control. When requested, an integral, hybrid, statistical and rule-based expert system program uses all available data to suggest an optimum insulin dose within physician determined, pre-set limits. POIRO has been formally evaluated in a randomized crossover pilot trial, comparing two 3 week periods with and without decision support, in six patients with type 1 diabetes. Mean (SE) pre-prandial blood glucose levels were significantly lower during the period when decision support was available (7.5 (0.4) versus 8.9 (0.4) mmol/l, p = 0.015) with no increase in the frequency or severity of hypoglycaemia. The device, which was well received by the patients, may offer a relatively inexpensive method of providing expert diabetic advice at a distance. The persistence of improved glycaemic control, even after decision support was switched off, suggests the device could be used intermittently by patients and may have educational value.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"21 4","pages":"317-26"},"PeriodicalIF":0.0,"publicationDate":"1996-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239608999292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20126429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

Application of database systems in diabetes care. 数据库系统在糖尿病护理中的应用。

Medical informatics = Medecine et informatique Pub Date : 1996-10-01 DOI: 10.3109/14639239608999288

P G Kopelman, A J Sanderson

引用次数: 26

DIABCARD--an application of a portable medical record for persons with diabetes. DIABCARD——用于糖尿病患者的便携式医疗记录的应用。

Medical informatics = Medecine et informatique Pub Date : 1996-10-01 DOI: 10.3109/14639239608999289

R Engelbrecht, C Hildebrand, E Brugués, A De Leiva, R Corcoy

引用次数: 18

Telemedicine for diabetes care: the DIABTel approach towards diabetes telecare. 糖尿病护理的远程医疗:DIABTel对糖尿病远程护理的方法。

Medical informatics = Medecine et informatique Pub Date : 1996-10-01 DOI: 10.3109/14639239608999290

E J Gómez, F del Pozo, M E Hernando

{"title":"Telemedicine for diabetes care: the DIABTel approach towards diabetes telecare.","authors":"E J Gómez, F del Pozo, M E Hernando","doi":"10.3109/14639239608999290","DOIUrl":"https://doi.org/10.3109/14639239608999290","url":null,"abstract":"Telemedicine is modifying classical health care by providing effective solutions to an increasing number of new situations. This article summarizes the potential benefits made available by this technology in diabetes care, and describes in detail how the new DIABTel Telemedicine Service complements the daily care of diabetic patients. The basic functions of the telemedicine system include telemonitoring of patient's blood glucose data and self-management actions, and remote care from doctors to diabetic patients. The system's architecture comprises two main components: the Medical Workstation, a PC-based system to be used by physicians and nurses in Diabetes Day Centre units in hospitals, and the Patient Unit, a palmtop-computer to be used by patients in their day to day activities. Both components, in an integrated approach, offer tools to doctors and patients for data collection and management, viewing and interpretation modules, data/message exchange services and an interactive glucose/insulin simulator for educational purposes. The DIABTel telemedicine diabetes care procedure aims: (1) to improve communication of the patient with the hospital-based diabetologist, in between the patient's visits to the clinic; (2) to allow doctors to assess the patient's condition on a frequent basis (every week); (3) to help patients with management in the daily care of diabetes, and (4) to provide patients with a service of 'supervised autonomy', to increase patient's independence without decreasing the necessary continual support and supervision from the doctor. Finally, we discuss the practical problems, limitations and vital issues regarding implementation of the telemedicine service.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"21 4","pages":"283-95"},"PeriodicalIF":0.0,"publicationDate":"1996-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239608999290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20126427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 83