Technology in medicine

Technology
in Medicine
I
By : Khaled H. Alkhodari
Supervisor : Dr. Jehad H. Hammad

Contents
• Introduction
• Operating Systems
• Apps:
– BNF 69
– DynaMed
– Medscape
– ٌ‫دواء‬
• 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.

• 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 ECG
2. 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 levels
11. 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

79% android=31
18% IOS =7
1% 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.

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

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

IUG Databases
Islamic 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

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.
1

EBM Journal
EBM Focus
The EBM Focus is a free weekly e-newsletter providing a
concise summary of articles most likely to inform clinical
practice.
Resident Focus
The Resident Focus is a free e-newsletter written by medical
residents highlighting recent clinical evidence they find
important at the point-of-care.
Archives
Read past issues of the EBM Focus, Resident Focus

• Cambridge Journals
1. 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
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
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. AkzoNobel
2. American Medical
Association
3. Cambridge University Press
4. Cengage Learning
5. Department of Health
(Victoria, Australia)
6. Department of Veterans
Affairs (USA)
7. EBSCO
8. Elsevier
9. Emerald Group Publishing
10. IEEE
11. Informa Healthcare
12. Ingram Digital
Ltd/MyiLibrary
13. John Wiley & Sons
14. JSTOR
15. LexisNexis
16. Maney Publishing
17. 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
Medicine
21. Navy Medicine Information
Systems Support Agency
(NAVMISSA)
22. NHS Scotland
23. NHS Wales
24. Oxford University Press
25. Philips Research
26. ProQuest
27. Royal Australia and New
Zealand College of
28. Ophthalmologists
29. Royal Dutch Shell
30. SAGE Publications
31. Springer
32. Taylor & Francis
33. Thieme
34. Thomson Healthcare
35. Thomson Scientific
36. U.S. Army Medical
Department (AMEDD)
37. U.S. Army Research
Institute
38. US Department of
Defense
39. Westlaw
40. Wolters Kluwer Health

Technology in medicine

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Editor's Notes