A low-cost ultrasound program leads to increased antenatal clinic visits and attended deliveries at a health care clinic in rural Uganda.

BACKGROUND: In June of 2010, an antenatal ultrasound program to perform basic screening for high-risk pregnancies was introduced at a community health care center in rural Uganda. Whether the addition of ultrasound scanning to antenatal visits at the health center would encourage or discourage potential patients was unknown. Our study sought to evaluate trends in the numbers of antenatal visits and deliveries at the clinic, pre- and post-introduction of antenatal ultrasound to determine what effect the presence of ultrasound at the clinic had on these metrics. METHODS AND FINDINGS: Records at Nawanyago clinic were reviewed to obtain the number of antenatal visits and deliveries for the 42 months preceding the introduction of ultrasound and the 23 months following. The monthly mean deliveries and antenatal visits by category (first visit through fourth return visit) were compared pre- and post- ultrasound using a Kruskal-Wallis one-way ANOVA. Following the introduction of ultrasound, significant increases were seen in the number of mean monthly deliveries and antenatal visits. The mean number of monthly deliveries at the clinic increased by 17.0 (13.3-20.6, 95% CI) from a pre-ultrasound average of 28.4 to a post-ultrasound monthly average of 45.4. The number of deliveries at a comparison clinic remained flat over this same time period. The monthly mean number of antenatal visits increased by 97.4 (83.3-111.5, 95% CI) from a baseline monthly average of 133.5 to a post-ultrasound monthly mean of 231.0, with increases seen in all categories of antenatal visits. CONCLUSIONS: The availability of a low-cost antenatal ultrasound program may assist progress towards Millennium Development Goal 5 by encouraging women in a rural environment to come to a health care facility for skilled antenatal care and delivery assistance instead of utilizing more traditional methods.

Trusted and relevant medical knowledge: the promise of information retrieval in biomedicine.

As the world of medicine becomes increasingly digitized, the Web has become a de facto resource for physicians to quickly glean pertinent clinical information to carry out diagnostic and therapeutic decisions. At present, physicians face the dual challenge of judging the relevance of the information and trusting its Web source. This paper proposes a trust-relevance framework for conceptualizing computer-accessed medical information resources, a set of criteria for evaluating these information resources, and descriptions of a sample of available online resources. It also presents a usable framework for evaluating information retrieval innovations and explains the different capabilities of representative information retrieval tools and applications. By demystifying the concepts associated with information resources, search engines, and retrieval tools, and presenting a reasonable view of current opportunities as well as future possibilities, the authors hope to provide guidance so physicians can more rapidly adopt innovative computer-assisted search tools for acquiring information that facilitate patient care decision-making.

ZebraHunter: searching rare medical diagnoses and retrieving relevant citations.

The clinicopathological conferences and case reports that are published in the medical literature contain rare and complex medical cases that are of general interest to the medical community. We present ZebraHunter, an information retrieval resource that allows clinicians to input clinical findings, search for rare diseases (medical zebras), and fetch the associated citations.