Subjects -> MEDICAL SCIENCES (Total: 8359 journals)
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    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
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    - MEDICAL SCIENCES (2268 journals)
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    - SPORTS MEDICINE (78 journals)
    - SURGERY (393 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (150 journals)

MEDICAL SCIENCES (2268 journals)            First | 1 2 3 4 5 6 7 8 | Last

Showing 201 - 400 of 3562 Journals sorted alphabetically
Audiology - Communication Research     Open Access   (Followers: 10)
Auris Nasus Larynx     Full-text available via subscription  
Australasian Journal of Ultrasound in Medicine (AJUM)     Hybrid Journal  
Australian Coeliac     Full-text available via subscription   (Followers: 1)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Journal of Medical Science     Full-text available via subscription   (Followers: 2)
Autopsy and Case Reports     Open Access  
Avicenna     Open Access   (Followers: 3)
Avicenna Journal of Clinical Medicine     Open Access  
Avicenna Journal of Medicine     Open Access   (Followers: 1)
Bangabandhu Sheikh Mujib Medical University Journal     Open Access   (Followers: 1)
Bangladesh Journal of Anatomy     Open Access   (Followers: 2)
Bangladesh Journal of Bioethics     Open Access  
Bangladesh Journal of Medical Biochemistry     Open Access   (Followers: 4)
Bangladesh Journal of Medical Education     Open Access   (Followers: 2)
Bangladesh Journal of Medical Microbiology     Open Access   (Followers: 4)
Bangladesh Journal of Medical Physics     Open Access   (Followers: 1)
Bangladesh Journal of Medical Science     Open Access  
Bangladesh Journal of Medicine     Open Access   (Followers: 1)
Bangladesh Journal of Physiology and Pharmacology     Open Access  
Bangladesh Journal of Scientific Research     Open Access   (Followers: 1)
Bangladesh Medical Journal     Open Access  
Bangladesh Medical Journal Khulna     Open Access  
Basal Ganglia     Hybrid Journal  
Basic Sciences of Medicine     Open Access   (Followers: 2)
Batı Karadeniz Tıp Dergisi / Medical Journal of Western Black Sea     Open Access  
Baylor University Medical Center Proceedings     Hybrid Journal  
BBA Clinical     Open Access  
BC Medical Journal     Free  
Benha Medical Journal     Open Access  
Beni-Suef University Journal of Basic and Applied Sciences     Open Access   (Followers: 4)
Bijblijven     Hybrid Journal  
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Bio-Algorithms and Med-Systems     Hybrid Journal   (Followers: 2)
BioDiscovery     Open Access   (Followers: 2)
Bioelectromagnetics     Hybrid Journal   (Followers: 2)
Bioelectronic Medicine     Open Access   (Followers: 1)
Bioengineering & Translational Medicine     Open Access  
Bioethics     Hybrid Journal   (Followers: 17)
Bioethics Research Notes     Full-text available via subscription   (Followers: 14)
Biologics in Therapy     Open Access  
Biology of Sex Differences     Open Access   (Followers: 2)
Biomarker Research     Open Access   (Followers: 3)
Biomarkers in Medicine     Hybrid Journal   (Followers: 2)
BioMed Research International     Open Access   (Followers: 4)
Biomédica     Open Access  
Biomedical & Life Sciences Collection     Full-text available via subscription   (Followers: 3)
Biomedical and Biotechnology Research Journal     Open Access   (Followers: 1)
Biomedical Engineering     Hybrid Journal   (Followers: 17)
Biomedical Engineering and Computational Biology     Open Access   (Followers: 13)
Biomedical Engineering Letters     Hybrid Journal   (Followers: 6)
Biomedical Engineering Research     Open Access   (Followers: 7)
Biomedical Informatics Insights     Open Access   (Followers: 8)
Biomedical Journal     Open Access   (Followers: 3)
Biomedical Materials     Hybrid Journal   (Followers: 7)
Biomedical Microdevices     Hybrid Journal   (Followers: 8)
Biomedical Optics Express     Open Access   (Followers: 6)
Biomedical Photonics     Open Access  
Biomedical Reports     Full-text available via subscription  
Biomedical Research Reports     Full-text available via subscription   (Followers: 2)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Biomedical Science and Engineering     Open Access   (Followers: 7)
BioMedicine     Open Access  
Biomedicine Hub     Open Access  
Biomedicines     Open Access   (Followers: 1)
Biomedika     Open Access  
Biomolecular and Health Science Journal     Open Access   (Followers: 1)
Biophysics Reports     Open Access  
BioPsychoSocial Medicine     Open Access   (Followers: 8)
Biosalud     Open Access  
Biostatistics & Epidemiology     Hybrid Journal   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BIRDEM Medical Journal     Open Access   (Followers: 1)
Birth Defects Research     Hybrid Journal  
Birth Defects Research Part A : Clinical and Molecular Teratology     Hybrid Journal   (Followers: 3)
Birth Defects Research Part C : Embryo Today : Reviews     Hybrid Journal  
BJR|Open     Open Access  
BJS Open     Open Access   (Followers: 1)
Black Sea Journal of Health Science     Open Access  
BLDE University Journal of Health Sciences     Open Access  
Blickpunkt Medizin     Hybrid Journal  
BMC Biomedical Engineering     Open Access  
BMC Medical Ethics     Open Access   (Followers: 21)
BMC Medical Research Methodology     Open Access   (Followers: 9)
BMC Medicine     Open Access   (Followers: 13)
BMC Obesity     Open Access   (Followers: 8)
BMC Proceedings     Full-text available via subscription   (Followers: 1)
BMC Research Notes     Open Access   (Followers: 4)
BMC Sports Science, Medicine and Rehabilitation     Open Access   (Followers: 34)
BMH Medical Journal     Open Access   (Followers: 2)
BMI Journal : Bariátrica & Metabólica Iberoamericana     Open Access  
BMJ     Hybrid Journal   (Followers: 1744)
BMJ Case Reports     Hybrid Journal   (Followers: 26)
BMJ Evidence-Based Medicine     Hybrid Journal   (Followers: 2)
BMJ Global Health     Open Access   (Followers: 3)
BMJ Innovations     Hybrid Journal   (Followers: 6)
BMJ Leader     Hybrid Journal  
BMJ Open     Open Access   (Followers: 42)
BMJ Open Quality     Open Access   (Followers: 19)
BMJ Open Science     Open Access   (Followers: 1)
BMJ Sexual & Reproductive Health     Hybrid Journal   (Followers: 2)
BMJ Surgery, Interventions, & Health Technologies     Open Access  
Bodine Journal     Open Access  
Boletín del Consejo Académico de Ética en Medicina     Open Access  
Boletín del ECEMC     Open Access  
Boletin Médico de Postgrado     Open Access  
Boletín Médico del Hospital Infantil de México     Open Access  
Bone     Hybrid Journal   (Followers: 18)
Bone and Tissue Regeneration Insights     Open Access   (Followers: 2)
Bone Marrow Research     Open Access   (Followers: 2)
Bone Reports     Open Access  
Bosnian Journal of Basic Medical Sciences     Open Access  
Bozok Tıp Dergisi / Bozok Medical Journal     Open Access  
Brachytherapy     Full-text available via subscription   (Followers: 6)
Brain and Development     Full-text available via subscription   (Followers: 5)
Brain Connectivity     Hybrid Journal   (Followers: 5)
Brain Impairment     Full-text available via subscription   (Followers: 2)
Brazilian Journal of Medical and Biological Research     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
Brazilian Journal of Pain (BrJP)     Open Access  
Brazilian Journal of Physical Therapy     Open Access   (Followers: 1)
Breastfeeding Review     Full-text available via subscription   (Followers: 18)
British Journal of Biomedical Science     Full-text available via subscription   (Followers: 7)
British Journal of General Practice     Full-text available via subscription   (Followers: 38)
British Journal of Hospital Medicine     Full-text available via subscription   (Followers: 16)
British Medical Bulletin     Hybrid Journal   (Followers: 6)
Buddhachinaraj Medical Journal     Open Access  
Bulletin Amades     Open Access  
Bulletin de la Société de pathologie exotique     Hybrid Journal   (Followers: 1)
Bulletin of Legal Medicine     Open Access  
Bulletin of Medical Sciences     Open Access  
Bulletin of the History of Medicine     Full-text available via subscription   (Followers: 18)
Bulletin of the Menninger Clinic     Full-text available via subscription  
Bulletin of The Royal College of Surgeons of England     Free  
Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products     Open Access  
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz     Hybrid Journal   (Followers: 6)
Burapha Journal of Medicine     Open Access  
Burns     Hybrid Journal   (Followers: 10)
Cadernos de Naturologia e Terapias Complementares     Open Access   (Followers: 1)
Calcified Tissue International     Hybrid Journal   (Followers: 2)
Canadian Bulletin of Medical History     Hybrid Journal  
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Pain     Open Access   (Followers: 2)
Canadian Journal of Rural Medicine     Full-text available via subscription   (Followers: 1)
Canadian Medical Association Journal     Open Access   (Followers: 17)
Canadian Medical Education Journal     Open Access   (Followers: 10)
Canadian Prosthetics & Orthotics Journal     Open Access  
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Cardiac Electrophysiology Clinics     Full-text available via subscription   (Followers: 1)
Care Management Journals     Hybrid Journal   (Followers: 5)
Case Reports     Open Access  
Case Reports in Acute Medicine     Open Access  
Case Reports in Clinical Medicine     Open Access   (Followers: 1)
Case Reports in Clinical Nutrition     Open Access   (Followers: 1)
Case Reports in Medicine     Open Access   (Followers: 2)
Case Reports in Transplantation     Open Access  
Case Reports in Vascular Medicine     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Study and Case Report     Open Access   (Followers: 5)
CBU International Conference Proceedings     Open Access   (Followers: 3)
Cell & Bioscience     Open Access   (Followers: 6)
Cell Adhesion & Migration     Open Access   (Followers: 9)
Cell and Molecular Response to Stress     Full-text available via subscription   (Followers: 2)
Cell and Tissue Transplantation and Therapy     Open Access   (Followers: 2)
Cell Cycle     Full-text available via subscription   (Followers: 6)
Cell Death and Differentiation     Hybrid Journal   (Followers: 7)
Cell Death Discovery     Open Access   (Followers: 1)
Cell Health and Cytoskeleton     Open Access   (Followers: 1)
Cell Medicine     Open Access   (Followers: 6)
Cell Research     Hybrid Journal   (Followers: 8)
Cell Transplantation     Open Access   (Followers: 4)
CEN Case Reports     Hybrid Journal  
Central African Journal of Medicine     Full-text available via subscription  
Ceylon Journal of Medical Science     Open Access  
Ceylon Medical Journal     Open Access  
Chattagram Maa-O-Shishu Hospital Medical College Journal     Open Access  
Chiang Mai Medical Journal     Open Access  
ChiangRai Medical Journal     Open Access  
Chimerism     Full-text available via subscription  
Chinese Journal of Integrative Medicine     Hybrid Journal   (Followers: 3)
Chinese Journal of Natural Medicines     Full-text available via subscription   (Followers: 1)
Chinese Medical Journal     Open Access   (Followers: 10)
Chinese Medical Record English Edition     Hybrid Journal  
Chinese Medical Sciences Journal     Full-text available via subscription   (Followers: 2)
Chinese Medicine     Open Access   (Followers: 2)
Chinese Medicine     Open Access   (Followers: 4)
Chisholm Health Ethics Bulletin     Full-text available via subscription   (Followers: 1)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Chronic Diseases and Translational Medicine     Open Access  
Chronic Illness     Hybrid Journal   (Followers: 6)
Chronic Wound Care Management and Research     Open Access   (Followers: 4)
Chronobiology International     Hybrid Journal   (Followers: 3)
ChronoPhysiology and Therapy     Open Access  
Chulalongkorn Medical Bulletin     Open Access  
Chulalongkorn Medical Journal     Open Access  
Ciencia e Innovación en Salud     Open Access  
Ciencia e Investigación Medico Estudiantil Latinoamericana     Open Access  
Ciencias Clínicas     Open Access  

  First | 1 2 3 4 5 6 7 8 | Last

Similar Journals
Journal Cover
BMJ Innovations
Journal Prestige (SJR): 0.491
Citation Impact (citeScore): 1
Number of Followers: 6  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Online) 2055-642X
Published by BMJ Publishing Group Homepage  [67 journals]
  • Crowdsourcing designathon: a new model for multisectoral collaboration
    • Authors: Tucker, J. D; Tang, W, Li, H, Liu, C, Fu, R, Tang, S, Cao, B, Wei, C, Tangthanasup, T. M.
      Pages: 46 - 50
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000216
      Issue No: Vol. 4, No. 2 (2018)
       
  • The Social Network: a concept to improve the quality of life for an ageing
           population while reducing loading on the NHS
    • Authors: Andah, E; Ahsan, M, Lee, R, Brewin, E, Ahmed, K.
      Pages: 51 - 53
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000200
      Issue No: Vol. 4, No. 2 (2018)
       
  • Mobile stroke unit triage of patients with a suspected stroke: a novel
           solution to reducing suspected stroke admissions in busy emergency
           departments
    • Authors: Shuaib, A; Amlani, S, Kalashyan, H, Morrison, L, Khan, K, Jickling, G, Buck, B, Butcher, K, Saqqur, M, Jeerakathil, T.
      Pages: 54 - 59
      Abstract: BackgroundEvaluation of patients with a suspected stroke is one of the most common neurological emergencies requiring rapid, comprehensive assessment by the stroke service to determine patient eligibility for timely reperfusion therapies. Prehospital evaluation may help to improve patient selection and reduce avoidable admissions to overcapacity emergency departments.Methods and resultsWe report on our early experience of prehospital triage of patients with a suspected stroke using a mobile stroke unit (MSU) equipped with CT scanner in rural Alberta. During the initial 4 months of operation, 28 patients were evaluated by the team in the MSU. Eight patients were within the time window of thrombolysis and were treated with intravenous tissue plasminogen activator in the MSU. No patients suffered haemorrhage or any other complications. Fourteen patients with multiple aetiologies (stroke mimics 6, transient ischaemic attacks 2, subacute stroke outside thrombolysis window 2, intracranial haemorrhage 3 and cerebral contusion 1) were assessed in the field and transferred to the tertiary hospital. Six patients after assessment and imaging were repatriated back to the local hospital as they were deemed stroke mimics or were outside of the reperfusion window.ConclusionsThe MSU offers a novel approach to performing timely evaluation and treatment of patients with a suspected stroke in rural settings and may help reduce admissions to overcapacity tertiary care facilities.
      Keywords: Diagnostics
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000240
      Issue No: Vol. 4, No. 2 (2018)
       
  • Remote biomonitoring of temperatures in mothers and newborns: design,
           development and testing of a wearable sensor device in a tertiary-care
           hospital in southern India
    • Authors: Mony, P. K; Thankachan, P, Bhat, S, Rao, S, Washington, M, Antony, S, Thomas, A, Nagarajarao, S. C, Rao, H, Amrutur, B.
      Pages: 60 - 67
      Abstract: ObjectiveNewer technologies such as wearables, sensors, mobile telephony and computing offer opportunities to monitor vital physiological parameters and tackle healthcare problems, thereby improving access and quality of care. We describe the design, development and testing of a wearable sensor device for remote biomonitoring of body temperatures in mothers and newborns in southern India.MethodsBased on client needs and technological requirements, a wearable sensor device was designed and developed using principles of ‘social innovation’ design. The device underwent multiple iterations in product design and engineering based on user feedback, and then following preclinical testing, a techno-feasibility study and clinical trial were undertaken in a tertiary-care teaching hospital in Bangalore, India. Clinical trial phases I and IIa for evaluation of safety and efficacy were undertaken in the following sequence: 7 healthy adult volunteers; 18 healthy mothers; 3 healthy babies; 10 stable babies in the neonatal care intensive unit and 1 baby with morbidities. Time-stamped skin temperature readings obtained at 5 min intervals over a 1-hour period from the device secured on upper arms of mothers and abdomen of neonates were compared against readings from thermometers used routinely in clinical practice.ResultsDevices were comfortably secured on to adults and neonates, and data were efficiently transmitted via the gateway device for secure storage and retrieval for analysis. The mean skin temperatures in mothers were lower than the axillary temperatures by 2°C; and in newborns, there was a precision of –0.5°C relative to axillary measurements. While occasional minimal adverse events were noted in healthy volunteers, no adverse events were noted in mothers or neonates.ConclusionsThis proof-of-concept study shows that this device is promising in terms of feasibility, safety and accuracy (with appropriate calibration) with potential for further refinements in device accuracy and pursuit of further phases of clinical research for improved maternal and neonatal health.
      Keywords: Open access
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2016-000153
      Issue No: Vol. 4, No. 2 (2018)
       
  • Peer influence as a driver of technological innovation in the UK National
           Health Service: a qualitative study of clinicians experiences and
           attitudes
    • Authors: Greszczuk, C; Mughal, F, Mathew, R, Rashid, A.
      Pages: 68 - 74
      Abstract: BackgroundAccelerating innovation to improve quality is a key policy target for healthcare systems around the world. Effectively influencing individuals’ behaviour is crucial to the success of innovation initiatives. This study explores UK clinicians’ lived experiences of, and attitudes towards, clinical peers endorsing healthcare innovations.MethodsQualitative interviews with UK-based clinicians in one of two groups: (1) clinicians working in ‘front-line’ service provision and (2) clinicians in strategic leadership roles within health institutions. Participants were identified through purposive sampling, and participated in semistructured telephone interviews. Thematic analysis was used to identify and analyse themes in the data.Results17 participants were recruited: eight clinicians from front-line UK healthcare settings and nine clinicians in leadership roles. Two major themes were identified from the interviews: power and trust. Participants recognised and valued peers’ powerful influence, exerted in person via social networks and routine work-related activities. Peers were implicitly trusted, although often on condition of their credibility and deservingness of respect, supporting evidence and absence of conflict of interest. While the groups shared similar views, they diverged on the subject of institutions, felt to be powerful by strategic leaders yet scarcely mentioned by front-line clinicians.ConclusionsUK clinicians view peers as a powerful and trustworthy source to promote innovative technologies. Policies that aim to support this process should seek to control the wider conditions that nurture peer-to-peer influence. Further research into interpersonal influence in health settings may improve implementation of change initiatives.
      Keywords: Editor's choice, Health IT, systems and process innovations
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000208
      Issue No: Vol. 4, No. 2 (2018)
       
  • Temporal prediction of in-hospital falls using tensor factorisation
    • Authors: Wang, H; Zhang, Q, So, H.-Y, Kwok, A, Wong, Z. S.-Y.
      Pages: 75 - 83
      Abstract: In-hospital fall incidence is a critical indicator of healthcare outcome. Predictive models for fall incidents could facilitate optimal resource planning and allocation for healthcare providers. In this paper, we proposed a tensor factorisation-based framework to capture the latent features for fall incidents prediction over time. Experiments with real-world data from local hospitals in Hong Kong demonstrated that the proposed method could predict the fall incidents reasonably well (with an area under the curve score around 0.9). As compared with the baseline time series models, the proposed tensor based models were able to successfully identify high-risk locations without records of fall incidents during the past few months.
      Keywords: Open access, Health IT, systems and process innovations
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000221
      Issue No: Vol. 4, No. 2 (2018)
       
  • Two-day home blood pressure monitoring may offer an alternative to
           costlier methods
    • Authors: Devereux, G; Gibney, D, Fadhlillah, F, Brown, P, Macey, N, Rudland, S.
      Pages: 84 - 90
      Abstract: BackgroundKey benefits of home-based blood pressure measurements are the potential to reduce the risk of ‘white coat hypertension’, encouraging patients to take ownership of their condition and be more actively involved in their long-term condition care, and to move work out of the doctor’s office.AimTo assess whether performing 20 resting blood pressure measurements over a 2-day period would provide a reliable, stable representation of patients’ resting systolic and diastolic blood pressure. Following clinician recommendation, each participant completed the Stowhealth home blood pressure monitoring procedure.MethodOne thousand and forty-five participants (mean age 66±13 years, 531 women and 514 men) completed the procedure, of 10 resting measurements per day, for 2 days (20 resting systolic and diastolic blood pressure readings in total). All measurements were made using automated oscillometric monitors.ResultsWithin-patient coefficient of variation for the entire participant cohort was 8% for systolic blood pressure (cohort mean 141±11 mm Hg), and 8% for diastolic blood pressure (cohort mean 79±6 mm Hg). There were no significant differences between the first and second day, for either systolic (142±1vs 141±1 mm Hg, respectively, p>0.05) or diastolic blood pressures (79±1vs 78±1 mm Hg, respectively, p>0.05 in both cases).ConclusionThe overall duration of home blood pressure monitoring may be able to be reduced to just 48 hours. This method would offer meaningful time saving for patients, and financial and time benefits for doctors and their surgery administration.
      Keywords: Health IT, systems and process innovations
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000247
      Issue No: Vol. 4, No. 2 (2018)
       
  • New device for intraoperative blood suction avoiding turbulences
    • Authors: Friedrich, M. G; Bougioukas, I, Wenig, P, Vormfelde, S, Tirilomis, T.
      Pages: 91 - 97
      Abstract: IntroductionBleeding during surgery is common. Increased bleeding may disturb procedure, induces haemodynamic instability and results in need for blood transfusion. Allogenic blood transfusions increase mortality and morbidity, especially risk of infections, pulmonary and renal complications, as well as thromboembolic events. Autotransfusion is in many cases a solution but forced suction may destroy or alter blood cells because of turbulences, shear forces and contact of the blood to extrinsic surfaces. The aim of the study was the analysis of turbulence profile and development of a new suction device reducing (or avoiding) turbulences.MethodsWe registered turbulences with a microphone placed in different positions within the blood suction during surgery and analysed the spectrum. Then, we modified the circuit adding signals from optical sensors and pressure transducer to avoid air mixing and tight suction. Finally, we created the algorithm for the suction circuit regulating individualised suction modes.ResultsWe developed a new suction system based on a roller pump. We used a piezo sensor and registered the acoustic signals. The optimal position for this element was into the suction handle. After filtering the signal and further processing, we used it for regulation of the roller pump. Additionally, an optical sensor minimises air mixing due to further regulation of motor speed. Finally, a negative pressure transducer gives in case of tight suction information to the circuit stopping motor speed and equalising pressure by opening a valve before suctions starts again. The algorithm allows various suction modes in an individualised manner for specific situations in operating field.ConclusionsWe developed a new blood suction device based on a roller pump. The system is turbulence-controlled and its algorithm allows several individualised suction modes. Additional features avoid tight suction and reduce air mixing.
      Keywords: Surgery, Assistive technologies
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000201
      Issue No: Vol. 4, No. 2 (2018)
       
  • Comparative evaluation of a novel solar powered low-cost ophthalmoscope
           (Arclight) by eye healthcare workers in Malawi
    • Authors: Blundell, R; Roberts, D, Fioratou, E, Abraham, C, Msosa, J, Chirambo, T, Blaikie, A.
      Pages: 98 - 102
      Abstract: This study compared a novel low-cost solar powered direct ophthalmoscope called the Arclight with a traditional direct ophthalmoscope (TDO). After appropriate training, 25 Malawian eye healthcare workers were asked to examine 12 retinal images placed in a teaching manikin head with both the Arclight ophthalmoscope and a traditional direct ophthalmoscope (Keeler Professional V.2.8). Participants were scored on their ability to identify clinical signs, to make a diagnosis and how long they took to make a diagnosis. They were also asked to score each ophthalmoscope for ‘ease of use’. Statistically significant differences were found in favour of the Arclight in the number of clinical signs identified, correct diagnoses made and ease of use. The ophthalmoscopes were equally effective as a screening tool for diabetic retinopathy, and there was no statistically difference in time to diagnosis. The authors conclude that the Arclight offers an easy to use, low cost alternative to the traditional direct ophthalmoscope to meet the demands for screening and diagnosis of visually impairing eye disorders in low-income and middle-income countries.
      Keywords: Open access, Medical devices
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000225
      Issue No: Vol. 4, No. 2 (2018)
       
  • From Malawi to Middlesex: the case of the Arbutus Drill Cover System as an
           
    • Authors: Prime, M; Attaelmanan, I, Imbuldeniya, A, Harris, M, Darzi, A, Bhatti, Y.
      Pages: 103 - 110
      Abstract: BackgroundMusculoskeletal disease is one of the leading clinical and economic burdens of the UK health system, and the resultant demand for orthopaedic care is only set to increase. One commonly used and one of the most expensive hardware in orthopaedic surgery is the surgical drill and saw. Given financial constraints, the National Health Service (NHS) needs an economic way to address this recurring cost. We share evidence of one frugal innovation with potential for contributing to the NHS’ efficiency saving target of £22 billion by 2020.MethodsExploratory case study methodology was used to develop insights and understanding of the innovations potential for application in the NHS. Following a global search for potential frugal innovations in surgery, the Arbutus Drill Cover System was identified as an innovation with potential to deliver significant cost savings for the NHS in the UK.ResultsThe Arbutus Drill Cover System is up to 94% cheaper than a standard surgical drill available in the UK. Clinical and laboratory tests show that performance, safety and usability are as good as current offerings in high-income countries and significantly better than hand drills typically used in low-and-middle-income countries. The innovation meets all regulatory requirements to be a medical device in the Europe and North America.ConclusionsThe innovation holds promise in reducing upfront and life span costs for core equipment used in orthopaedic surgery without loss of effectiveness or safety benchmarks. However, the innovation needs to navigate complicated and decentralised procurement processes and clinicians and healthcare leaders need to overcome cognitive bias.
      Keywords: Medical devices
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000233
      Issue No: Vol. 4, No. 2 (2018)
       
  • Regulations for the development of deep technology applications in
           healthcare urgently needed to prevent abuse of vulnerable patients
    • Authors: Gunasekeran; D. V.
      Pages: 111 - 112
      PubDate: 2018-04-06T03:39:16-07:00
      DOI: 10.1136/bmjinnov-2017-000242
      Issue No: Vol. 4, No. 2 (2018)
       
  • Electronic consultations: a new art in clinical communication'
    • Authors: Gishen, F; Gostelow, N.
      Pages: 1 - 4
      PubDate: 2018-02-14T03:09:46-08:00
      DOI: 10.1136/bmjinnov-2017-000218
      Issue No: Vol. 4, No. 1 (2018)
       
  • Correction: Systematic review of innovation design contests for health:
           spurring innovation and mass engagement
    • Pages: 4 - 4
      PubDate: 2018-02-14T03:09:46-08:00
      DOI: 10.1136/bmjinnov-2017-000203corr1
      Issue No: Vol. 4, No. 1 (2018)
       
  • Instant messaging applications in healthcare: are we harnessing their
           potential'
    • Authors: Chari, A; Gane, S. B.
      Pages: 5 - 8
      Keywords: Communication
      PubDate: 2018-02-14T03:09:46-08:00
      DOI: 10.1136/bmjinnov-2017-000197
      Issue No: Vol. 4, No. 1 (2018)
       
  • Atlas table: a dynamic innovative support device for the coming obesity
           epidemic
    • Authors: Smart, A; Bercu, Z. L, Shekhani, H, Newsome, J, Martin, J. G.
      Pages: 9 - 14
      Abstract: With obesity rates increasing rapidly, the Atlas table, a modular table overlay, was developed to address the unmet medical need of the inability of current interventional tables to support patients weighing more than 450 lbs. Current procedural tables have a posted weight limit of 500 lbs. In practice, this limit is 450 lbs due to the permanent installation of a 50 lb dye injector at the foot of the table. Instability is reported in patients in the range of 250–450 lbs, resulting in the need to modify how the table is placed over the base. Additional weight and mobility limitations exist due to the cantilever beam design of the existing table that allows movement of the C-arm fluoroscope to move around the entire table. A clinical device should bear all of the weight of an 800 lb patient, without failing during emergency chest compressions, which makes the weight capacity necessary 1200 lbs. This must be accomplished without obstructing the movement of the C-arm of the existing table or requiring a more than 2% increase in radiation. Our table overlay design features a lightweight, radiolucent tabletop and four modular height-adjusting legs that move with the existing table and do not require separate controls. The legs clamp to the radiolucent tabletop securely but not permanently so that they can be moved when needed, with buttons that swing out and cause the table to raise or lower by being trigger by contact from the existing table. The proposed design safely holds and lifts 1200 lbs.
      Keywords: Diagnostics, Medical devices
      PubDate: 2018-02-14T03:09:46-08:00
      DOI: 10.1136/bmjinnov-2017-000227
      Issue No: Vol. 4, No. 1 (2018)
       
  • Usage-driven problem design for radical innovation in healthcare
    • Authors: Lame, G; Yannou, B, Cluzel, F.
      Pages: 15 - 23
      Abstract: While the diffusion and evaluation of healthcare innovations receive a lot of attention, the early design stages are less studied and potential innovators lack methods to identify where new innovations are necessary and to propose concepts relevant to users. To change this, we propose a structured methodology, Radical Innovation Design (RID), which supports designers who want to work on the unstated needs of potential end users in order to create superior value. In this article, the first part of RID is introduced with its two subprocesses: Problem Design and Knowledge Design. In this first period, RID guides innovators to systematically explore users’ problems and evaluate which ones are most pressing in terms of innovation, taking into account existing solutions. The result is an ambition perimeter, composed of a set of value buckets, that is, important usage situations where major problems are experienced and the current solutions provide little or no relief. The methodology then moves on to Solution Design and Business Design (which are not detailed in this article) to address the value buckets identified. With its emphasis on problem exploration, RID differs from methods based on early prototyping. The RID methodology has been validated in various industrial sectors and is well-adapted for healthcare innovation. To exemplify the methodology, we present a case study in dental imagery performed by 10 students in 8 weeks. This example demonstrates how RID favours efficiency in Problem Design and allows designers to explore unaddressed and sometimes undeclared user needs.
      Keywords: Medical devices
      PubDate: 2018-02-14T03:09:46-08:00
      DOI: 10.1136/bmjinnov-2016-000149
      Issue No: Vol. 4, No. 1 (2018)
       
  • Characterisation of the aortic pulse profile of a radial artery
           applanation tonometry device in patients with aortic stenosis
    • Authors: Ngiam, N; Shen, X, Tan, B. Y.-Q, Oinuma, S, Lee, G. K, Kong, W. K, Poh, K.-K.
      Pages: 24 - 28
      Abstract: BackgroundAortic stenosis (AS) is commonly associated with myocardial and systemic arterial dysfunction. We use a radial artery applanation tonometry (B-Pro) device to characterise the arterial pulse profile of patients with AS and compare them against controls.MethodsThe B-Pro device was applied on the left radial artery of 117 consecutive patients, where 21 patients had AS. Baseline clinical and echocardiographic characteristics were compared. Differences in arterial pulse pressure profile were quantified by means of univariate and multivariable analyses.ResultsThe group with AS was older (74±14 vs 62±14 years, P
      Keywords: Medical devices
      PubDate: 2018-02-14T03:09:46-08:00
      DOI: 10.1136/bmjinnov-2017-000210
      Issue No: Vol. 4, No. 1 (2018)
       
  • Use of 3D printing to create a bespoke repair of a Percutaneous Endoscopic
           Gastrostomy (PEG) tube in patient unfit for surgical replacement
    • Authors: OSullivan, K. J; OSullivan, A. G, Power, N, Gillick, J, Dunne, C. P, OSullivan, L, Linnane, B.
      Pages: 29 - 31
      Abstract: We report a case of three-dimensional (3D) printing being used to solve a difficult bedside clinical problem and avoidance of substantial risk associated with alternative solutions. A 15-year-old male with advanced cystic fibrosis developed a small (~1mm) linear tear in his Percutaneous Endoscopic Gastrostomy (PEG) tube, approximately 40 mm from the skin surface. The patient’s advanced condition precluded replacement of the PEG tube under general anaesthetic. Attempts to manage the tear with adhesive tapes yielded limited success. 3D printing was used to create a bespoke sealing device overnight, rectifying the leak and allowing enteral feeding to recommence unimpeded. The device is functioning well, several months post-discharge of the patient.
      Keywords: Palliative care, Medical devices
      PubDate: 2018-02-14T03:09:46-08:00
      DOI: 10.1136/bmjinnov-2017-000246
      Issue No: Vol. 4, No. 1 (2018)
       
  • Innovation for the future of Irish MedTech industry: retrospective
           qualitative review of impact of BioInnovate Irelands clinical fellows
    • Authors: McGloughlin, E. K; Anglim, P, Keogh, I, Sharif, F.
      Pages: 32 - 38
      Abstract: Clinicians have historically been integral in innovating and developing technology in medicine and surgery. In recent years, however, in an increasingly complex healthcare system, a doctor with innovative ideas is often left behind. Transition from idea to bedside now entails significant hurdles, which often go unrecognised at the outset, particularly for first-time innovators. The BioInnnovate Ireland process, based on the Stanford Biodesign Programme (Identify, Invent and Implement), aims to streamline the process of innovation within the MedTech sector. These programmes focus on needs-based innovation and enable multidisciplinary teams to innovate and collaborate more succinctly. In this preliminary study, the authors aimed to examine the impact of BioInnovate Ireland has had on the clinicians involved and validate the collaborative process. To date, 13 fellows with backgrounds in clinical medicine have participated in the BioInnovate programme. Ten of these clinicians remain involved in clinical innovation projects with four of these working on Enterprise Ireland funded commercialisation grants and one working as chief executive officer of a service-led start-up, Strive. Of these, five also remain engaged in clinical practice on a full or part-time basis. The clinicians who have returned to full-time clinical practice have used the process and learning of the programme to influence their individual clinical areas and actively seek innovative solutions to meet clinical challenges. Clinicians, in particular, describe gaining value from the BioInnovate programme in areas of ‘Understanding Entrepreneurship’ and ‘Business Strategy’. Further study is needed into the quantitative impact on the ecosystem and impact to other stakeholders.
      Keywords: Open access, Health IT, systems and process innovations
      PubDate: 2018-02-14T03:09:46-08:00
      DOI: 10.1136/bmjinnov-2016-000184
      Issue No: Vol. 4, No. 1 (2018)
       
  • Accelerated in vitro model for occlusion of biliary stents: investigating
           the role played by dietary fibre
    • Authors: Surwase, S; Balakrishnan, H, Acharya, S. K, Makharia, G. K, Kumaraswamy, G, Prasad, B. L. V.
      Pages: 39 - 45
      Abstract: BackgroundTo develop a new accelerated in vitro model that has implications for investigating the mechanism of biliary stent occlusion and help in the development of new materials that can alleviate this problem.MethodsWe employ a combination of reconstituted animal bile, bacteria and cellulose fibres optimised to reproducibly generate accelerated occlusion of stents, and produce occlusions that closely mimic those found in clinical studies.ResultsOur model affords repeatable, highly accelerated occlusion (within 2–3 days, compared with between about a week to 2 months in previous models). Our results highlight the role of dietary fibre in blockage of stents and demonstrate their importance in the onset of occlusion.ConclusionsThis accelerated model may have implications for developing biliary stents with enhanced patency.
      Keywords: Editor's choice, Assistive technologies
      PubDate: 2018-02-14T03:09:46-08:00
      DOI: 10.1136/bmjinnov-2017-000209
      Issue No: Vol. 4, No. 1 (2018)
       
  • Wearable technology in an international telementoring setting during
           surgery: a feasibility study
    • Authors: Meijer, H. A. W; Sanchez Margallo, J. A, Sanchez Margallo, F. M, Goslings, J. C, Schijven, M. P.
      Pages: 189 - 195
      Abstract: BackgroundTelemedicine holds promise for improving access to care. Telementoring—defined as mentoring by means of telecommunication and computer networks—can be used for remote education of healthcare professionals. Furthermore, it is rapidly establishing itself as a valuable asset in medicine and education. This paper aims to establish a financially and practically feasible, stable telementoring network using wearables for sterile and hands-free remote control, to be used during surgical procedures.MethodsTwo stand-alone computer systems, located at an academic hospital in the Netherlands and at a surgical research facility in Spain, were connected using TeamViewer software allowing for remote, hands-free controlling of radiological images using Myo gesture control armband. The operating surgeon consulted the remote surgeon through an audio, video and desktop sharing system during a live surgical procedure on a single porcine model. The system was analysed for feasibility and connection quality.ResultsThe sensors used were commercially available and relatively cheap, with the integrating computer system being responsible for the majority of costs. A successful connection was established without any downtime and with only a minor time lag, not interfering with the telementoring procedures. The operating surgeon effectively consulted with and was mentored by the remote surgeon, through video, audio and the desktop sharing system, using the wearable sensors.ConclusionsThis proof of principle shows the feasibility of using an internet-based remote desktop sharing system in combination with wearable sensors and TedCube technology for telementoring purposes during surgical procedures.
      Keywords: Assistive technologies
      PubDate: 2017-11-14T03:44:31-08:00
      DOI: 10.1136/bmjinnov-2016-000166
      Issue No: Vol. 3, No. 4 (2017)
       
  • New technical solution to minimise noise exposure for surgical staff: the
           'silent operating theatre optimisation system
    • Authors: Friedrich, M. G; Boos, M, Pagel, M, Thormann, T, Berakdar, A, Russo, S, Tirilomis, T.
      Pages: 196 - 205
      Abstract: The increasing number of technical equipment in the operating room (OR) is resulting in significantly higher noise levels. The more complex and sophisticated the surgical procedure is, the more essential it is for all team members of the OR to work together in a harmonious fashion to process and manage their demanding team tasks. With increasing noise in OR, the risk of more frequent errors also increases. The reduction of noise production in the OR is possible but limited. The aim of this study was to develop a device that reduces ambient noise for the operating team without hindering their ability to communicate.We developed a new communication technology set-up for the OR to meet all needed requirements. All members of the operating team are issued headsets with microphones. The headsets filter out background noises (active and passive noise cancelling) and the microphones enable interactive communication among and between OR subgroups through targeted information selection (signal selection). Any remaining background noise is overshadowed by music, which is quiesced by direct speech into the microphone (ducking). Information flow is programmed on a digital workstation, providing each team member a selection of acoustic signals from the OR on their bidirectional headset. A complex matrix of connections in this audio technology allows a predefined communication structure. These procedures were assembled in the Silent Operating Theatre Optimisation System (SOTOS). The technical specifications and user interface are described. A pilot study in 2015 using the SOTOS in cardiac surgery showed very positive feedback from the participating operating team members. Further studies focusing on communicational psychology perspective and physiological reaction are recommended.
      Keywords: Assistive technologies, Communication
      PubDate: 2017-11-14T03:44:31-08:00
      DOI: 10.1136/bmjinnov-2016-000188
      Issue No: Vol. 3, No. 4 (2017)
       
  • A priori consent within pragmatic randomised controlled trials: a
           web-based survey of statin use in primary care
    • Authors: Semprini, A; Hills, T, Braithwaite, I, Weatherall, M, Beasley, R.
      Pages: 206 - 211
      Abstract: BackgroundClinical research methodology is evolving with the advent of pragmatic randomised controlled trials (PRCTs). Novel approaches for informed consent in PRCTs are needed.ObjectiveTo explore public opinion about different ways of giving informed consent for PRCTs.DesignWeb-based survey assessing acceptability of three PRCT consent scenarios for statin use.SettingCommunity-based study.Participants678 (12%) adults responded to an open-access web-based survey.MeasurementsParticipant-rated acceptability of three different options for giving informed consent for a PRCT testing two commonly prescribed, effective treatments: statins for hyperlipidaemia. Option A was written informed consent given a priori for a specific study, with verbal confirmation of consent at time of randomisation. Option B was written informed, general consent a priori for multiple comparative effectiveness studies, with verbal confirmation for a specific study at time of randomisation. Option C was written informed consent for a specific study at time of randomisation.ResultsAcceptability was higher for option A (475/529 (89.9%)) and B (441/487 (90.6%)) compared with C (339/481 (70.5%)). The estimates of differences in paired proportions were A versus C, 19.4% (95% CI 14.4 to 24.5), p
      Keywords: Health IT, systems and process innovations, Informed consent
      PubDate: 2017-11-14T03:44:31-08:00
      DOI: 10.1136/bmjinnov-2017-000193
      Issue No: Vol. 3, No. 4 (2017)
       
  • The search for the holy grail: frugal innovation in healthcare from
           low-income or middle-income countries for reverse innovation to developed
           countries
    • Authors: Bhatti, Y. A; Prime, M, Harris, M, Wadge, H, McQueen, J, Patel, H, Carter, A. W, Parston, G, Darzi, A.
      Pages: 212 - 220
      Abstract: The healthcare sector stands to benefit most from frugal innovation, the idea that more can be done for less for many more people, globally. As a first step for health systems to leverage new approaches to offset escalating health expenditures and to improve health outcomes, the most relevant frugal innovations have to be found. The Institute of Global Health Innovation was commissioned by the US-based Commonwealth Fund to identify frugal innovations from around the world that could, if transferred to the USA, offer approaches for expanding access to care and dramatically lower costs. Our global scan was motivated by the need to extend the list of frugal innovations in healthcare beyond the impressive but oft-repeated examples such as GE’s MAC 400, a US$800 portable ECG machine, Narayana’s US$1500 cardiac surgery and Aravind’s US$30 cataract surgery. Our search involved (1) scanning innovation databases, (2) refining frameworks to identify frugal innovations and evaluate their reverse potential and (3) developing in-depth case studies. From 520 possible innovations, we shortlisted 16 frugal innovations that we considered as frugal and with potential for reverse diffusion into high-income country health systems. Our global search was narrowed down to three care delivery models for case analysis: The Brazilian Family Health Strategy around community health workers; Singapore-based GeriCare@North use of telemedicine and Brazil’s Saude Crianca community involvement and citizenship programme. We share core features of the three frugal innovations and outline lessons for practitioners, scholars and policymakers seeking to lower healthcare costs while increasing access and quality.
      Keywords: Health IT, systems and process innovations
      PubDate: 2017-11-14T03:44:31-08:00
      DOI: 10.1136/bmjinnov-2016-000186
      Issue No: Vol. 3, No. 4 (2017)
       
  • Initial assessment of device mechanism of action and patient acceptance of
           a novel medical device: feasibility study of vaginal bowel control therapy
           for the treatment of faecal incontinence
    • Authors: Sokol; E. R.
      Pages: 221 - 226
      Abstract: BackgroundSuccessful development of a novel medical device requires an early understanding of anatomical feasibility and acceptance by both patient and clinician. In the absence of acceptable artificial anatomical test models, short-term evaluation with controlled observation in a small number of patients can be pursued to demonstrate initial feasibility. The vaginal bowel control (VBC) system, a non-surgical device for faecal incontinence (FI), is difficult to evaluate in artificial models. In-person usage was required to understand the potential for a vaginal insert to provide comfortable, dynamic rectal occlusion.MethodsThis prospective, open-label study was conducted at a single urogynaecology practice at an academic medical centre with 13 female subjects ≥18 years with self-reported FI. The VBC therapy consists of a vaginal insert and pressure-regulated pump. The vaginal insert includes a balloon that, when inflated, creates an occlusion of the rectum. Subjects’ FI symptoms were collected in a baseline questionnaire. The investigator fitted subjects with multiple sizes of VBC inserts and evaluated the fit, position and degree of rectal occlusion. Subject comfort levels were assessed throughout the fitting process with a verbal response and on a subject questionnaire using a 10-point scale (1=no discomfort, 10=extremely uncomfortable). The insert was returned at the end of the study visit.ResultsThe majority of the rectum was occluded in 77% of patients. Furthermore, comfort scores during insertion (2.1±2.0), inflation (3.3±2.6) and ambulation (2.6±2.0) states indicated minor discomfort with 42% of women indicating no discomfort in any states. No adverse events were reported.ConclusionsPilot evaluation of an early VBC system design and its delivery during a single study visit provided evidence for effectiveness, patient comfort and ease of use of a novel VBC for FI in women. This first-in-woman study confirmed feasibility of VBC and informed continued product development and subsequent clinical research.
      Keywords: Editor's choice, Medical devices
      PubDate: 2017-11-14T03:44:31-08:00
      DOI: 10.1136/bmjinnov-2016-000173
      Issue No: Vol. 3, No. 4 (2017)
       
  • Systematic review of innovation design contests for health: spurring
           innovation and mass engagement
    • Authors: Pan, S. W; Stein, G, Bayus, B, Tang, W, Mathews, A, Wang, C, Wei, C, Tucker, J. D.
      Pages: 227 - 237
      Abstract: We undertook a systematic review evaluating the effectiveness and cost of health-focused innovation design contests. We followed Cochrane guidance and systematically searched eight databases. Articles were included if they reported an open contest focused on improving health, required participants submit finished design solutions and contained a prize structure. We searched 3579 citations, identifying 29 health-focused innovation design contests which collectively received 15494 contest submissions. Contests solicited submissions worldwide (7) and exclusively from North America (13), Asia (4), Africa (2), Australia (2) and Europe (1). Submissions per contest ranged from 3 to 11354 (median of 73). Contest entrants were tasked with helping develop health promotion messages (HPM) (25) and improve predictive clinical models, protocols and/or algorithms (4). Two types of contests emerged—those focused on high-quality, innovative outcomes and those focused on the process of mass community engagement. All outcome-oriented contests had innovation design contest solutions equivalent or superior to the comparator (100%; 7/7). Two of two studies found that innovation design contests saved money (100%; 2/2). Five of seven process-oriented contests concluded the contest improved at least one health indicator (71%; 5/7). Innovation design contests are an effective way to solicit innovative solutions to health problems and spur mass community engagement.
      PubDate: 2017-11-14T03:44:31-08:00
      DOI: 10.1136/bmjinnov-2017-000203
      Issue No: Vol. 3, No. 4 (2017)
       
  • WhatsApp Doc'
    • Authors: OSullivan, D. M; OSullivan, E, OConnor, M, Lyons, D, McManus, J.
      Pages: 238 - 239
      PubDate: 2017-11-14T03:44:31-08:00
      DOI: 10.1136/bmjinnov-2017-000239
      Issue No: Vol. 3, No. 4 (2017)
       
  • Challenges on the medical front due to individualisation of medical
           equipment in ageing developed countries, and proposed solutions
    • Authors: Kobayashi, T; Maita, H, Kato, H.
      Pages: 127 - 129
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2017-000191
      Issue No: Vol. 3, No. 3 (2017)
       
  • The use of Microsoft Excel as an electronic database for handover and
           coordination of patients with trauma in a District General Hospital
    • Authors: Bakti, N. I; Williamson, M, Sehjal, R, Thilagarajah, M.
      Pages: 130 - 136
      Abstract: Communication between healthcare professionals is a key aspect in patient safety especially when dealing with patients with musculoskeletal trauma. The change of junior doctors’ working patterns within the last decade and a multidisciplinary approach has resulted in more healthcare professionals being involved in any one patient’s care. A robust handover and communication tool is essential in ensuring patients’ safety and to allow efficient service coordination. We compared the use of a simple traditional template-based handover system with an electronic interactive database developed using Microsoft Excel specifically designed as a handover tool and to coordinate acute trauma referrals to the orthopaedic department in our hospital. We compared the adequacy and accessibility of patient details and clinical information as well as assessing these systems as tools to facilitate coordination of patients with trauma. Data from both handover systems were collected prospectively over the period of 12 weeks and analysed for the degree of missing information based on the General Medical Council and British Medical Association guidelines for safe handover. A questionnaire was also handed to members of the multidisciplinary team to assess their impression of each handover system on coordination and management of the trauma service. Our study showed a significant reduction in missing information in the electronic database handover system in multiple domains (p
      Keywords: Health IT, systems and process innovations
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2016-000182
      Issue No: Vol. 3, No. 3 (2017)
       
  • Paediatric neurorehabilitation: finding and filling the gaps through the
           use of the Institute for Manufacturing strategic roadmapping method
    • Authors: Hamilton, C; Maw, A, Gill, A, Brahmbhatt, M, Phaal, R, Pickard, J.
      Pages: 137 - 143
      Abstract: IntroductionAcquired brain injury (ABI) is a major cause of morbidity and mortality in childhood. Specialist rehabilitation services are often situated far from families and local services may be non-standardised and fragmented. A strategic level of understanding is needed to improve patient care and outcomes. Roadmapping techniques are commonly used in industry settings to discover and present a systematic understanding of structures; however, they are rarely used in the healthcare setting. With continuing pressures on healthcare systems worldwide, they provide an effective method for examining services.MethodsThe Institute for Manufacturing (IfM) strategic roadmapping method was used to identify areas of difficulty and opportunities in paediatric neurorehabilitation. Participants included stakeholders from a wide range of professions and sectors who have input with children after ABI.ResultsDelegates identified a range of ‘layers’ covering trends, drivers, current experience and unmet needs. From these layers, four priorities were identified and further expanded.These included: ‘access to medical and therapy expertise close(r) to home’, ‘shared understanding across family, school and health’, ‘family and professional awareness of resources and support’ and ‘establishing a centre for rehabilitation technology evaluation, advice and co-ordination of services and research’.ConclusionThe IfM strategic roadmapping method identified and developed key areas for development in the field of paediatric neurological rehabilitation. Healthcare professionals looking at strategic level difficulties should strongly consider the use of such systematic tools when evaluating areas of practice.
      Keywords: Neurology, Health IT, systems and process innovations
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2017-000202
      Issue No: Vol. 3, No. 3 (2017)
       
  • Telementoring with project ECHO: a pilot study in Europe
    • Authors: Ni Cheallaigh, C; OLeary, A, Keating, S, Singleton, A, Heffernan, S, Keenan, E, Robson, L, Sears, J, Moloney, J, Arora, S, Bergin, C, Norris, S, On behalf of the Irish Hepatitis C Outcomes Research Network
      Pages: 144 - 151
      Abstract: The Extension of Community Healthcare Outcomes (ECHO) project is a novel educational intervention designed in New Mexico to transfer subspecialty knowledge about hepatitis C virus (HCV) to primary care providers, thereby increasing patient access to HCV care. The ECHO model has been shown to deliver educational benefits and to result in good treatment outcomes for HCV-infected individuals in the USA; however, this approach has not been assessed in a European setting.We sought to evaluate the feasibility, acceptability and implementation of the ECHO model in Ireland using a pilot study. We present a descriptive review of recruitment, participation, retention and cost of the intervention as well as a qualitative review of the views of participants on the barriers, benefits and acceptability of the ECHO model. In the original Project ECHO in New Mexico, geographical distance posed the greatest barrier to accessing HCV care. In Ireland, people who inject drugs (PWID) were identified by interviewees as the main group facing barriers to accessing specialist HCV care. State-employed doctors and nurses caring for large numbers of HCV-infected PWID in opiate substitution treatment centres and homeless hostels were successfully recruited to participate in the project. Self-employed general practitioners did not participate, due mainly to a lack of time and the absence of reimbursement for participation. Practitioners who participated in the pilot reported benefits to themselves and their patients and would like to continue to participate in similar multidisciplinary, multisite educational interventions in the future.
      Keywords: Open access, Health IT, systems and process innovations
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2016-000141
      Issue No: Vol. 3, No. 3 (2017)
       
  • Engaging patients through an iBooks-based patient portal tutorial
    • Authors: Leisy, H; Ahmad, M, Guevara, G, Smith, R. T.
      Pages: 152 - 156
      Abstract: IntroductionPatient portals or personal health records allow patients to access their health information and communicate with their physician’s office outside of their clinic visit. As such, their use has been observed to increase patient engagement and decrease administrative costs. Despite these advantages, patient adoption and successful use of patient portals remains low. Here we assess the feasibility and efficacy of an iBooks-based tutorial in increasing comfort and compliance with personal health record use.MethodsWe created and published a 5-min iBooks-based tutorial describing our institution’s patient portal features. We administered the tutorial, along with presurvey and postsurvey, to ophthalmology clinic patients.ResultsOf 70 participants, 50% had already registered for our institution’s patient portal. Registered patients had viewed labs (74%, n=26) and messaged providers (57%, n=20) but rarely used other features such as scheduling appointments (17%, n=6) or requesting refills (26%, n=9). After the tutorial, comfort levels in knowledge on how to use portal features increased by 20%–80%, depending on portal feature and registration status. Main barriers to portal usage were preference for telephone-based communication (26%, n=18) and knowledge of portal existence (21%, n=15). The majority (86%, n=60) agreed the tutorial would increase their utilisation of the patient portal.ConclusionTutorials increase knowledge and awareness of patient portal features, allowing these features to be fully used. An iBooks-based approach allows patients to successfully access and use tutorial content outside of the clinic.
      Keywords: Health IT, systems and process innovations
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2016-000140
      Issue No: Vol. 3, No. 3 (2017)
       
  • Does this treatment work for me' The patients role in assessing
           medical care
    • Authors: Neuhauser, D. V; Chu, J.
      Pages: 157 - 162
      Abstract: Randomised clinical trials are designed to determine whether a particular treatment is appropriate to make a significant difference to the health of a defined population and to aid its approval for use. For an accurate, cheap and simple assessment to see if a treatment benefits an individual person, all that is needed is a pen, paper, simple pocket calculator and daily recording of a few variables. It requires the ability to read and write and to understand addition and division. Factorial design of experiments is used to show the impact of several variables and their interaction on the person’s health status. An example of a 75-year-old man with an enlarged prostate is used here to illustrate this approach. This person was able to understand and reduce side effects, lower the costs of medication by 83% and improve measured health status by 28%. A multivariate model for this person was then created with about 450 person-days of data.
      Keywords: Diagnostics, Open access, Diagnostics
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2016-000177
      Issue No: Vol. 3, No. 3 (2017)
       
  • Real-time data capture with electronic cigarettes for smoking cessation
           programme: a cloud platform for behavioural research
    • Authors: Lam, M. W. Y; Leung, N. W. Y, Bat, B. K, Leung, G. K. S, Tsoi, K. K. F.
      Pages: 163 - 166
      Abstract: Tobacco smoking is a major risk factor for many chronic diseases, which led to the popularity of electronic cigarette (e-cigarette) and showed to be an effective tool for tobacco smoking cessation. However, existing studies on e-cigarette use were based on users’ self-reported data. Detailed and accurate e-cigarette use records can be used to better understand e-cigarette use behaviour and design appropriate tobacco smoking cessation plan. Therefore, a platform for real-time data capture, transmission and cloud storage of e-cigarette usage is suggested to address these issues.The application of cloud platform for data transfer, storage and analysis on medical research is still at a novel stage. In this study, a cloud-based infrastructure is established for data collection and storage of captured e-cigarette use behaviour; it consists of an e-cigarette, a smartphone, a smartphone application (APP) and a cloud server. Whenever the e-cigarette is inhaled, the time and number of puff will be transmitted to the APP through Bluetooth signal and then uploaded and stored to the cloud through the internet-connected smartphone. The flow of data transmission is performed automatically. E-cigarette smoking history can be recalled in real time and presented in the APP.This remote cloud platform provides efficient analytical performance on a huge volume of data with high velocity of data creation. The sufficient data accuracy and completeness of e-cigarette use records help to better understand the behaviour and safety of e-cigarette usage and to plan an effective tobacco smoking cessation programme.
      Keywords: Assistive technologies
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2016-000137
      Issue No: Vol. 3, No. 3 (2017)
       
  • Indian medical device sector: insights from patent filing trends
    • Authors: Markan, S; Verma, Y.
      Pages: 167 - 175
      Abstract: In this study, patent application filing trends in India for the last decade (2005–2014) were analysed to understand the medical device patent filing profile. As India is the key emerging market with huge market potential, this study was also undertaken to identify the top medical device companies filing patents in India, the niche technology domains with maximum filings, key gaps in medical device innovation profile and scope for business opportunities. It was observed that patent application filings in the medical device sector during the last 5 years (2009–2013) contributed only to 2% of the total patent applications filed, which may be attributed to nascent medical device sector and lack of Intellectual Property (IP) awareness or funding support for IP filings. The analysis shows increasing trends in medical device patent applications in India, with major share of patent applications being filed from the USA. The Indian applications in this sector contributed only to 17% of the total patent application filings in the last decade. Although foreign players dominate the medical device sector, this study indicates that though at a small scale, Indian applicants are actively filing patents in all key domains of the medical device sector. With the enabling environment being provided by the Government of India with recent policy initiatives such as Startup India, Make in India, 100% Foreign Direct Investment (FDI)and so on and support to start-ups for IP filings, the Indian medical device industry is expected to witness aggressive IP filing and innovation trends and is poised to grow exponentially targeting US$50 billion industry by 2025.
      Keywords: Editor's choice, Medical devices
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2016-000131
      Issue No: Vol. 3, No. 3 (2017)
       
  • Autonomic components of Complex Regional Pain Syndrome (CRPS) are
           favourably affected by Electrical Twitch-Obtaining Intramuscular
           Stimulation (ETOIMS): effects on blood pressure and heart rate
    • Authors: Chu, J; Bruyninckx, F, Neuhauser, D. V.
      Pages: 176 - 187
      Abstract: IntroductionFavourable pain relief results on evoking autonomous twitches at myofascial trigger points with Electrical Twitch Obtaining Intramuscular Stimulation (ETOIMS).AimTo document autonomic nervous system (ANS) dysfunction in Complex Regional Pain Syndrome (CRPS) from blood pressure (BP) and pulse/heart rate changes with ETOIMS.Methods and materialsA patient with persistent pain regularly received serial ETOIMS sessions of 60, 90, 120 or ≥150 min over 24 months. Outcome measures include BP: systolic, diastolic, pulse pressure and pulse/heart rate, pre-session/immediate-post-session summed differences (SDPPP index), and pain reduction. His results were compared with that of two other patients and one normal control. Each individual represented the following maximal elicitable twitch forces (TWF) graded 1–5: maximum TWF2: control subject; maximum TWF3: CRPS patient with suspected ANS dysfunction; and maximum TWF4 and TWF5: two patients with respective slow-fatigue and fast-fatigue twitches who during ETOIMS had autonomous twitching at local and remote myotomes simultaneously from denervation supersensitivity. ETOIMS results between TWFs were compared using one-way analysis of variance test.ResultsThe patients showed immediate significant pain reduction, BP and pulse/heart rate changes/reduction(s) except for diastolic BP in the TWF5 patient. TWF2 control subject had diastolic BP reduction with ETOIMS but not with rest. Linear regression showed TWF grade to be the most significant variable in pain reduction, more so than the number of treatments, session duration and treatment interval. TWF grade was the most important variable in significantly reducing outcome measures, especially pulse/heart rate. Unlike others, the TWF3 patient had distinctive reductions in SDPPP index.ConclusionsMeasuring BP and pulse/heart rate is clinically practical for alerting ANS dysfunction maintained CRPS. SDPPP index (≥26) and pulse/heart rate (≥8) reductions with almost every ETOIMS treatment, plus inability to evoke autonomous twitches due to pain-induced muscle hypertonicity, are pathognomonic of this problem.
      Keywords: Open access, Neurology, Medical devices
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2016-000163
      Issue No: Vol. 3, No. 3 (2017)
       
  • Thank you to our reviewers 2016
    • Pages: 188 - 188
      PubDate: 2017-09-21T06:59:58-07:00
      DOI: 10.1136/bmjinnov-2017-reviewer
      Issue No: Vol. 3, No. 3 (2017)
       
 
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