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1.
Clin J Sport Med ; 30(5): e139-e142, 2020 09.
Article in English | MEDLINE | ID: mdl-30358616

ABSTRACT

OBJECTIVE: To explore differences in baseline King-Devick Test (KD) completion time between 2 testing modalities: (1) spiral-bound paper cards (cards) and (2) iPad application (iPad). DESIGN: Cross-sectional cohort analysis. SETTING: National Collegiate Athlete Association (NCAA) institutions. PARTICIPANTS: Student athletes from 13 women's and 11 men's collegiate sports who completed KD baseline testing as part of their first year in the Concussion Assessment, Research and Education (CARE) Consortium from 2014 to 2016 (n = 2003, 52.2% male). INDEPENDENT VARIABLES: King-Devick Test modalities; cards or iPad. MAIN OUTCOME MEASURE: Baseline KD completion time (seconds). RESULTS: Mean baseline KD completion time of the iPad modality group [42.8 seconds, 95% confidence interval (CI), 42.1-43.3] was 2.8 seconds (95% CI, 2.1-3.4) greater than the cards group (40.0 seconds, 95% CI, 39.7-40.3) (t(1, 1010.7) = -8.0, P < 0.001, Cohen's d = 0.41). CONCLUSIONS: Baseline KD performance is slower when tested on an iPad than when tested on spiral-bound paper cards. The 2 KD modalities should not be used interchangeably in concussion assessments because differences in the modalities can lead to time differences similar in magnitude to those used to indicate concussion. From a research perspective, modality may influence interpretation and/or synthesis of findings across studies.


Subject(s)
Athletic Injuries/physiopathology , Brain Concussion/physiopathology , Neuropsychological Tests , Time Factors , Athletes , Confidence Intervals , Cross-Sectional Studies , Female , Humans , Male , Minicomputers/statistics & numerical data , Neuropsychological Tests/statistics & numerical data , Outcome Assessment, Health Care , Paper , Students , Young Adult
2.
Cochrane Database Syst Rev ; (7): MR000042, 2015 Jul 27.
Article in English | MEDLINE | ID: mdl-26212714

ABSTRACT

BACKGROUND: Self-administered survey questionnaires are an important data collection tool in clinical practice, public health research and epidemiology. They are ideal for achieving a wide geographic coverage of the target population, dealing with sensitive topics and are less resource-intensive than other data collection methods. These survey questionnaires can be delivered electronically, which can maximise the scalability and speed of data collection while reducing cost. In recent years, the use of apps running on consumer smart devices (i.e., smartphones and tablets) for this purpose has received considerable attention. However, variation in the mode of delivering a survey questionnaire could affect the quality of the responses collected. OBJECTIVES: To assess the impact that smartphone and tablet apps as a delivery mode have on the quality of survey questionnaire responses compared to any other alternative delivery mode: paper, laptop computer, tablet computer (manufactured before 2007), short message service (SMS) and plastic objects. SEARCH METHODS: We searched MEDLINE, EMBASE, PsycINFO, IEEEXplore, Web of Science, CABI: CAB Abstracts, Current Contents Connect, ACM Digital, ERIC, Sociological Abstracts, Health Management Information Consortium, the Campbell Library and CENTRAL. We also searched registers of current and ongoing clinical trials such as ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform. We also searched the grey literature in OpenGrey, Mobile Active and ProQuest Dissertation & Theses. Lastly, we searched Google Scholar and the reference lists of included studies and relevant systematic reviews. We performed all searches up to 12 and 13 April 2015. SELECTION CRITERIA: We included parallel randomised controlled trials (RCTs), crossover trials and paired repeated measures studies that compared the electronic delivery of self-administered survey questionnaires via a smartphone or tablet app with any other delivery mode. We included data obtained from participants completing health-related self-administered survey questionnaire, both validated and non-validated. We also included data offered by both healthy volunteers and by those with any clinical diagnosis. We included studies that reported any of the following outcomes: data equivalence; data accuracy; data completeness; response rates; differences in the time taken to complete a survey questionnaire; differences in respondent's adherence to the original sampling protocol; and acceptability to respondents of the delivery mode. We included studies that were published in 2007 or after, as devices that became available during this time are compatible with the mobile operating system (OS) framework that focuses on apps. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data from the included studies using a standardised form created for this systematic review in REDCap. They then compared their forms to reach consensus. Through an initial systematic mapping on the included studies, we identified two settings in which survey completion took place: controlled and uncontrolled. These settings differed in terms of (i) the location where surveys were completed, (ii) the frequency and intensity of sampling protocols, and (iii) the level of control over potential confounders (e.g., type of technology, level of help offered to respondents). We conducted a narrative synthesis of the evidence because a meta-analysis was not appropriate due to high levels of clinical and methodological diversity. We reported our findings for each outcome according to the setting in which the studies were conducted. MAIN RESULTS: We included 14 studies (15 records) with a total of 2275 participants; although we included only 2272 participants in the final analyses as there were missing data for three participants from one included study.Regarding data equivalence, in both controlled and uncontrolled settings, the included studies found no significant differences in the mean overall scores between apps and other delivery modes, and that all correlation coefficients exceeded the recommended thresholds for data equivalence. Concerning the time taken to complete a survey questionnaire in a controlled setting, one study found that an app was faster than paper, whereas the other study did not find a significant difference between the two delivery modes. In an uncontrolled setting, one study found that an app was faster than SMS. Data completeness and adherence to sampling protocols were only reported in uncontrolled settings. Regarding the former, an app was found to result in more complete records than paper, and in significantly more data entries than an SMS-based survey questionnaire. Regarding adherence to the sampling protocol, apps may be better than paper but no different from SMS. We identified multiple definitions of acceptability to respondents, with inconclusive results: preference; ease of use; willingness to use a delivery mode; satisfaction; effectiveness of the system informativeness; perceived time taken to complete the survey questionnaire; perceived benefit of a delivery mode; perceived usefulness of a delivery mode; perceived ability to complete a survey questionnaire; maximum length of time that participants would be willing to use a delivery mode; and reactivity to the delivery mode and its successful integration into respondents' daily routine. Finally, regardless of the study setting, none of the included studies reported data accuracy or response rates. AUTHORS' CONCLUSIONS: Our results, based on a narrative synthesis of the evidence, suggest that apps might not affect data equivalence as long as the intended clinical application of the survey questionnaire, its intended frequency of administration and the setting in which it was validated remain unchanged. There were no data on data accuracy or response rates, and findings on the time taken to complete a self-administered survey questionnaire were contradictory. Furthermore, although apps might improve data completeness, there is not enough evidence to assess their impact on adherence to sampling protocols. None of the included studies assessed how elements of user interaction design, survey questionnaire design and intervention design might influence mode effects. Those conducting research in public health and epidemiology should not assume that mode effects relevant to other delivery modes apply to apps running on consumer smart devices. Those conducting methodological research might wish to explore the issues highlighted by this systematic review.


Subject(s)
Cell Phone/statistics & numerical data , Minicomputers/statistics & numerical data , Mobile Applications/statistics & numerical data , Surveys and Questionnaires/standards , Data Accuracy , Humans , Text Messaging/statistics & numerical data , Time Factors
3.
J Lab Autom ; 18(4): 264-8, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23592569

ABSTRACT

Electronic laboratory notebooks (ELNs) are increasingly replacing paper notebooks in life science laboratories, including those in industry, academic settings, and hospitals. ELNs offer significant advantages over paper notebooks, but adopting them in a predominantly paper-based environment is usually disruptive. The benefits of ELN increase when they are integrated with other laboratory informatics tools such as laboratory information management systems, chromatography data systems, analytical instrumentation, and scientific data management systems, but there is no well-established path for effective integration of these tools. In this article, we review and evaluate some of the approaches that have been taken thus far and also some radical new methods of integration that are emerging.


Subject(s)
Automation, Laboratory/instrumentation , Clinical Laboratory Information Systems/instrumentation , Electrical Equipment and Supplies , Minicomputers/statistics & numerical data , Minicomputers/trends , Animals , Electronics, Medical/trends , Humans , Research
4.
J Digit Imaging ; 25(5): 628-34, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22562174

ABSTRACT

Tablet computers such as the iPad, which have a large format, improved graphic display resolution and a touch screen interface, may have an advantage compared to existing mobile devices such as smartphones and laptops for viewing radiological images. We assessed their potential for emergency radiology teleconsultation by reviewing multi-image CT and MRI studies on iPad tablet computers compared to Picture Archival and Communication Systems (PACS) workstations. Annonymised DICOM images of 79 CT and nine MRI studies comprising a range of common on-call conditions, reported on full-featured diagnostic PACS workstation by one Reporting Radiologist, were transferred from PACS to three iPad tablet computers running OsiriX HD v 2.02 DICOM software and viewed independently by three reviewing radiologists. Structured documentation was made of major findings (primary diagnosis or other clinically important findings), minor findings (incidental findings), and user feedback. Two hundred and sixty four readings (88 studies read by three reviewing radiologists) were compared, with 3.4 % (nine of 264) major discrepancies and 5.6 % (15 of 264) minor discrepancies. All reviewing radiologists reported favorable user experience but noted issues with software stability and limitations of image manipulation tools. Our results suggest that emergency conditions commonly encountered on CT and MRI can be diagnosed using tablet computers with good agreement with dedicated PACS workstations. Shortcomings in software and application design should be addressed if the potential of tablet computers for mobile teleradiology is to be fully realized.


Subject(s)
Magnetic Resonance Imaging/methods , Minicomputers/statistics & numerical data , Multidetector Computed Tomography/methods , Teleradiology/instrumentation , Cohort Studies , Computers, Handheld/statistics & numerical data , Databases, Factual , Emergencies , Female , Humans , Male , Medical Audit , Remote Consultation/methods , Retrospective Studies , Sensitivity and Specificity , User-Computer Interface
5.
Schizophr Bull ; 36(6): 1131-9, 2010 Nov.
Article in English | MEDLINE | ID: mdl-19429846

ABSTRACT

BACKGROUND: Psychosis has been repeatedly suggested to be affected by increases in stress and arousal. However, there is a dearth of evidence supporting the temporal link between stress, arousal, and psychosis during "real-world" functioning. This paucity of evidence may stem from limitations of current research methodologies. Our aim is to the test the feasibility and validity of a novel methodology designed to measure concurrent stress and arousal in individuals with psychosis during "real-world" daily functioning. METHOD: Twenty patients with psychosis completed a 36-hour ambulatory assessment of stress and arousal. We used experience sampling method with palm computers to assess stress (10 times per day, 10 AM → 10 PM) along with concurrent ambulatory measurement of cardiac autonomic regulation using a Holter monitor. The clocks of the palm computer and Holter monitor were synchronized, allowing the temporal linking of the stress and arousal data. We used power spectral analysis to determine the parasympathetic contributions to autonomic regulation and sympathovagal balance during 5 minutes before and after each experience sample. RESULTS: Patients completed 79% of the experience samples (75% with a valid concurrent arousal data). Momentary increases in stress had inverse correlation with concurrent parasympathetic activity (ρ = -.27, P < .0001) and positive correlation with sympathovagal balance (ρ = .19, P = .0008). Stress and heart rate were not significantly related (ρ = -.05, P = .3875). CONCLUSION: The findings support the feasibility and validity of our methodology in individuals with psychosis. The methodology offers a novel way to study in high time resolution the concurrent, "real-world" interactions between stress, arousal, and psychosis. The authors discuss the methodology's potential applications and future research directions.


Subject(s)
Arousal , Heart Rate , Individuality , Parasympathetic Nervous System/physiopathology , Psychotic Disorders/physiopathology , Stress, Psychological/physiopathology , Sympathetic Nervous System/physiopathology , Adult , Electrocardiography, Ambulatory/methods , Feasibility Studies , Female , Humans , Male , Minicomputers/statistics & numerical data , Psychotic Disorders/psychology , Reproducibility of Results , Sampling Studies , Time Factors
6.
Acad Med ; 66(4): 232-4, 1991 Apr.
Article in English | MEDLINE | ID: mdl-2012656

ABSTRACT

The National Board of Medical Examiners (NBME) has been developing new tests to be administered using computers. As these tests near readiness for use, logistical issues of test administration have become important. In 1989-1990, in order to plan for the implementation of computer-based testing in NBME examinations of the future, the authors, under the auspices of the NBME, conducted a telephone survey of knowledgeable individuals at the 143 LCME-accredited medical schools in the United States and Canada to gauge the numbers and types of microcomputers and workstations available for students' use at these schools. The findings, based on the responses of all the schools surveyed, are reported.


Subject(s)
Minicomputers/supply & distribution , Schools, Medical , Students, Medical , Canada , Humans , Minicomputers/statistics & numerical data , Schools, Medical/statistics & numerical data , United States
8.
Comput Healthc ; 12(1): 18-9, 22, 1991 Jan.
Article in English | MEDLINE | ID: mdl-10108602

ABSTRACT

By the end of 1989, one of every three hospitals over 100 beds was using six or more software vendors, according to industry consultant Sheldon Dorenfest. This situation mandated that software and hardware solutions "talk to each other," and has made a difference in the healthcare market share of top hardware suppliers.


Subject(s)
Computers, Mainframe/statistics & numerical data , Industry/statistics & numerical data , Minicomputers/statistics & numerical data , Purchasing, Hospital/trends , Software/statistics & numerical data , Data Collection , United States
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