基于Web2．0技术的病案质控信息化探讨

目的探索Web2．0技术在构建医院病案质量控制与评价体系中的应用。方法论证和引入Web2．0技术的Wiki、SNS、RSS等多个元素,在“大质控观”下将病案质控的各个要素、角色、流程纳入“医院病案质量控制与评价平台”。结果基本实现“全员”参与质控、“全过程”的质量教育和“全天候”的病案信息综合服务。结论基于Web2．0技术的“医院病案质量控制与评价平台”建设方案投资小,建设周期短,使用门槛低,保障前期软件投资,达到质量管理功能的整体升级,值得推广。     

虚拟医院结构及其实现技术

Internet网络技术的不断发展为实施不受时间和地域限制的交互式技能学习和指导提供了平台。提出的虚拟医院是一个学习和训练医疗救治技术和紧急救治过程等的交互式信息模拟平台,通过虚拟医院提供的医疗诊断救治练习和模拟训练平台,可以帮助医务人员提高和改善诊断治疗技术,学习新的诊疗救治和手术技术,以便更好地救治伤病员。同时,为患者提供一个医院就诊检查模拟过程,从而节省就医时间,提高就医效率。它还可为家庭患者提供医疗和健康技术指导。     

基于WEBSERVICE的疾病预防控制空间信息服务研究

空间信息服务在疾病预防控制领域是一个新的尝试,也是我国卫生行业信息化发展的必然趋势,Web Service技术本身的优势为空间信息服务提供了一个具有实际应用价值的解决方案,也为疾病预防控制数据资源的集成与共享提供了一个新的思路。针对疾病预防控制数据信息的空间特点,探讨了Web Service技术支持下的疾病预防控制空间信息服务的模式与技术实现框架。     

基于Webservice系统集成技术在医学资源信息共享平台中的应用

利用XML和WebService技术,建设依托于天津医科大学校园网的医学资源信息共享和服务平台。并具体介绍了建设该平台的设计思路、网络架构、功能划分及安全策略。通过该平台,可以实现各机构间信息的互联互通。并在数据安全性、完整性及资源共享方面得到较大改善,最大限度满足医疗部门的信息需求。     

Methods for evaluating the benefit and harms of deprescribing in observational research using routinely collected data

Deprescribing is defined as “the planned and supervised process of dose reduction or stopping of medication that might be causing harm, or no longer be of benefit”. Barriers to deprescribing include healthcare professional fear and lack of guidance. These may stem from limited available evidence on benefits and harms of deprescribing medications commonly used among older persons. Advances in pharmacoepidemiology and causal inference methods to evaluate comparative effectiveness and safety of prescribing medications have yet to be considered for deprescribing medication. This paper discusses select methods and how they can be applied to deprescribing research, using case studies of benzodiazepines and low-dose acetylsalicylic acid (aspirin). Target trial emulation involves the explicit application of design principles from randomised controlled trials to observational studies. Several design aspects, including defining eligibility criteria and time zero, require additional considerations for deprescribing studies. The active comparator new user design also presents challenges, including selection of an appropriate comparator. This paper discusses these aspects, and others, in relation to deprescribing studies. Furthermore, methods proposed to control for confounding, in particular, the prior event rate ratio and propensity scores, are discussed. Introduction of billing codes or mechanisms for accurately determining when deprescribing has occurred would enhance the ability to conduct research using routinely collected data. Although the approaches discussed in this paper may strengthen observational studies of deprescribing, their use may be best suited to certain scenarios or research questions, where randomised controlled trials may be less feasible.     

Alternative and Complementary Medicine Web Resources for Autoimmune Diseases

Abstract

Autoimmune diseases affect over 14 million Americans, who may frequently search for alternative or complementary treatment methods aimed at reducing the debilitation associated with chronic disease. Included in this column is a select list of Web-based resources that explore the use of alternative and complementary medicine for autoimmune diseases.     

Hospice Code of Ethics

The usefulness and limitations of bibliographic database software is discussed. As an excellent example of how this medium can be used, the electronic database on palliative care developed by Dr. Nathan Cherny that is available on the World Wide Web is described.     

Causal modeling of panic disorder theories

We compare a variety of theories of panic disorder using a neutral framework: causal modeling. The framework requires identification of key constructs and specification of their interaction. Biological, cognitive, and behavioral elements of the theory have to be clearly distinguished, as do critical past events and current trigger conditions. The theories compared were drawn from the psycho-dynamic, cognitive, and neurobiological literature. We conclude that there are substantive differences among the cognitive theories and between the biological theories reviewed. However, cognitive and biological theories appear to be compatible in principle. It is not clear whether substantive differences among theories are due to the existence of subtypes of PD or due to the predominance of multifactorial cause. It is argued that current treatment methods imply particular theories, and that particular patterns of success and failure can be understood in relation to theory through the methods we have employed.     

Expert Knowledge in Palliative Care on the World Wide Web: Palliativedrugs.Org

ABSTRACT.?

In my last Internet-related article, I speculated that social networking would be the coming wave in the effort to share knowledge among experts in various disciplines. At the time I did not know that a palliative care site on the World Wide Web (WWW), palliativedrugs.com, already provided the infrastructure for sharing expert knowledge in the field. The Web site is an excellent traditional formulary but it is primarily devoted to “unlicensed” (“off-label”) use of medications in palliative care, something we in the specialty often do with little to support our interventions except shared knowledge and experience. There is nothing fancy about this Web site. In a good way, its format is a throwback to Web sites of the 1990s. In only the loosest sense can one describe it as “multimedia.” Yet, it provides the perfect forum for expert knowledge and is a “must see” resource. Its existing content is voluminous and reliable, filtered and reviewed by renowned clinicians and educators in the field. Although its origin and structure were not specifically designed for social or professional networking, the Web site's format makes it a natural way for practitioners around the world to contribute to an ever-growing body of expertise in palliative care.     

基于互联网的开放式数字医学影像资料库的构建

传统的医学影像管理系统，比如图像存档与通讯系统（PACS），都是基于专用的工作站和封闭式的体系结构。近年来，因特网技术的蓬勃发展使得医学影像数据的共享和分布式存储成为可能。本文提出基于因特网应用技术构建开放式数字影像资料库的体系结构和实现模式，结合PACS系统模式对他们各自的特点进行了对比，并给出了其实现的思路。