Effectiveness of the Use of Standardized Vocabularies on Epilepsy Patient Cohort Generation / 대한의료정보학회지

Objectives@#This study investigated the effectiveness of using standardized vocabularies to generate epilepsy patient cohorts with local medical codes, SNOMED Clinical Terms (SNOMED CT), and International Classification of Diseases tenth revision (ICD-10)/Korean Classification of Diseases-7 (KCD-7). @*Methods@#We compared the granularity between SNOMED CT and ICD-10 for epilepsy by counting the number of SNOMED CT concepts mapped to one ICD-10 code. Next, we created epilepsy patient cohorts by selecting all patients who had at least one code included in the concept sets defined using each vocabulary. We set patient cohorts generated by local codes as the reference to evaluate the patient cohorts generated using SNOMED CT and ICD-10/KCD-7. We compared the number of patients, the prevalence of epilepsy, and the age distribution between patient cohorts by year. @*Results@#In terms of the cohort size, the match rate with the reference cohort was approximately 99.2% for SNOMED CT and 94.0% for ICD-10/KDC7. From 2010 to 2019, the mean prevalence of epilepsy defined using the local codes, SNOMED CT, and ICD-10/KCD-7 was 0.889%, 0.891% and 0.923%, respectively. The age distribution of epilepsy patients showed no significant difference between the cohorts defined using local codes or SNOMED CT, but the ICD-9/KCD-7-generated cohort showed a substantial gap in the age distribution of patients with epilepsy compared to the cohort generated using the local codes. @*Conclusions@#The number and age distribution of patients were substantially different from the reference when we used ICD-10/KCD-7 codes, but not when we used SNOMED CT concepts. Therefore, SNOMED CT is more suitable for representing clinical ideas and conducting clinical studies than ICD-10/KCD-7.

Potentials of Smart dynamometer use for clinical and self-management of rehabilitation in breast cancer survivors: a feasibility study

The aim of this study was to examine the feasibility of the Smart dynamometer as a rehabilitation exercise device in a daily care by comparing with the existing medical devices. We used and analyzed clinical and measurement data of breast cancer survivors who have used Smart dynamometer during their rehabilitation after breast cancer surgery. The Smart dynamometer was compared with the two existing devices of Takei dynamometer and surface electromyography (sEMG) that were used in routine care, respectively. Three key components of the rehabilitation exercise devices were analyzed to validate the feasibility of the Smart dynamometer: grip strength, reaction time, and grip endurance time. Pearson's correlation analysis was performed to compare the statistical significance between the devices. The data of 12 and 15 female breast cancer patients were analyzed for comparing the Smart dynamometer with Takei dynamometer and sEMG, respectively. There was a very weak correlation between the maximum values from the Takei and the Smart dynamometers in the affected and non-affected arms of breast cancer patients (r = 0.5321, 0.4733). Comparisons of 3 features between the Smart dynamometer and sEMG showed that there were strong positive correlations for both reaction time and endurance time in the affected and non-affected arms (r > 0.9). The feasibility of the Smart dynamometer for the possible use in a daily rehabilitation exercise was partially verified. Moreover, since the Smart dynamometer was highly correlated with time-related variables, it was important and significant to measure both grip strength and time-related information.

Validation of the mobile wireless digital automatic blood pressure monitor using the cuff pressure oscillometric method, for clinical use and self-management, according to international protocols

The purpose of this study was to evaluate the accuracy of a mobile wireless digital automatic blood pressure monitor for clinical use and mobile health (mHealth). In this study, a manual sphygmomanometer and a digital blood pressure monitor were tested in 100 participants in a repetitive and sequential manner to measure blood pressure. The guidelines for measurement used the Korea Food & Drug Administration protocol, which reflects international standards, such as the American National Standard Institution/Association for the Advancement of Medical Instrumentation SP 10: 1992 and the British Hypertension Society protocol. Measurements were generally consistent across observers according to the measured mean ± SD, which ranged in 0.1 ± 2.6 mmHg for systolic blood pressure (SBP) and 0.5 ± 2.2 mmHg for diastolic blood pressure (DBP). For the device and the observer, the difference in average blood pressure (mean ± SD) was 2.3 ± 4.7 mmHg for SBP and 2.0 ± 4.2 mmHg for DBP. The SBP and DBP measured in this study showed accurate measurements that satisfied all criteria, including an average difference that did not exceed 5 mmHg and a standard deviation that did not exceed 8 mmHg. The mobile wireless digital blood pressure monitor has the potential for clinical use and managing one's own health.

Laboratory Environment Monitoring: Implementation Experience and Field Study in a Tertiary General Hospital / 대한의료정보학회지

OBJECTIVES: To successfully introduce an Internet of Things (IoT) system in the hospital environment, this study aimed to identify issues that should be considered while implementing an IoT based on a user demand survey and practical experiences in implementing IoT environment monitoring systems. METHODS: In a field test, two types of IoT monitoring systems (on-premises and cloud) were used in Department of Laboratory Medicine and tested for approximately 10 months from June 16, 2016 to April 30, 2017. Information was collected regarding the issues that arose during the implementation process. RESULTS: A total of five issues were identified: sensing and measuring, transmission method, power supply, sensor module shape, and accessibility. CONCLUSIONS: It is expected that, with sufficient consideration of the various issues derived from this study, IoT monitoring systems can be applied to other areas, such as device interconnection, remote patient monitoring, and equipment/environmental monitoring.

Establishing a Personal Health Record System in an Academic Hospital: One Year's Experience / 가정의학회지

BACKGROUND: Personal health records (PHRs) are web based tools that help people to access and manage their personalized medical information. Although needs for PHR are increasing, current serviced PHRs are unsatisfactory and researches on them remain limited. The purpose of this study is to show the process of developing Seoul National University Bundang Hospital (SNUBH)'s own PHR system and to analyze consumer's use pattern after providing PHR service. METHODS: Task force team was organized to decide service range and set the program. They made the system available on both mobile application and internet web page. The study enrolled PHR consumers who assessed PHR system between June 2013 and June 2014. We analyzed the total number of users on a monthly basis and the using pattern according to each component. RESULTS: The PHR service named Health4U has been provided from June 2013. Every patient who visited SNUBH could register Health4U service and view their medical data. The PHR user has been increasing, especially they tend to approach via one way of either web page or mobile application. The most frequently used service is to check laboratory test result. CONCLUSION: For paradigm shift toward patient-centered care, there is a growing interest in PHR. This study about experience of establishing and servicing the Health4U would contribute to development of interconnected PHR.