An interactive videodisc program for low back pain patients. (1/52)

Decisions about back pain treatment are often made in the presence of both physician and patient uncertainty. Therefore, we developed a computerized, interactive video program to help patients make informed decisions about undergoing low back surgery. Program development was guided by the shared decision-making model, a comprehensive literature synthesis, information from administrative databases, and focus groups of patients and physicians. Core segments are tailored to each patient's age and diagnosis; and include a narrative, excerpts from patient interviews, animated graphics illustrating spinal anatomy, and tabular summaries of the benefits and risks of both surgical and non-surgical treatment. As part of a multifocal information dissemination effort, interactive videodiscs were placed in five medical facilities in two Washington State counties. Patients (N = 239) who viewed the video program completed short evaluation forms. The majority rated the video's understandability (84%) and interest (64%) as very good or excellent. Most patients felt the amount of information provided was appropriate (75%) and over half (56%) believed the discussion of surgical versus non-surgical treatment was completely balanced. Fewer patients (17%) remained undecided about therapy after watching the program than before (29%). We conclude that interactive videodisc technology offers substantial promise as a means of involving patients in their own medical decision making.  (+info)

Randomized, controlled trial of an interactive videodisc decision aid for patients with ischemic heart disease. (2/52)

OBJECTIVE: To determine the effect of the Ischemic Heart Disease Shared Decision-Making Program (IHD SDP) an interactive videodisc designed to assist patients in the decision-making process involving treatment choices for ischemic heart disease, on patient decision-making. DESIGN: Randomized, controlled trial. SETTING: The Toronto Hospital, University of Toronto, Toronto, Ontario, Canada. PARTICIPANTS: Two hundred forty ambulatory patients with MEASUREMENTS AND MAIN RESULTS: The primary outcome was patient satisfaction with the decision-making process. This was measured using the 12-item Decision-Making Process Questionnaire that was developed and validated in a randomized trial of the benign prostatic hyperplasia SDP. Secondary outcomes included patient knowledge (measured using 20 questions about knowledge deemed necessary for an informed treatment decision), treatment decision, patient-angiographer agreement on decision, and general health scores. Outcomes were measured at the time of treatment decision and/or at 6 months follow-up. Shared decision-making program scores were similar for the intervention and control group (71% and 70%, respectively; 95% confidence interval [CI] for 1% difference, -3% to 7%). The intervention group had higher knowledge scores (75% vs 62%; 95% CI for 13% difference, 8% to 18%). The intervention group chose to pursue revascularization less often (58% vs 75% for the controls; 95% CI for 17% difference, 4% to 31%). At 6 months, 52% of the intervention group and 66% of the controls had undergone revascularization (95% CI for 14% difference, 0% to 28%). General health and angina scores were not different between the groups at 6 months. Exposure to the IHD SDP resulted in more patient-angiographer disagreement about treatment decisions. CONCLUSIONS: There was no significant difference in satisfaction with decision-making process scores between the IHD SDP and usual practice groups. The IHD SDP patients were more knowledgeable, underwent less revascularization (interventional therapies), and demonstrated increased patient decision-making autonomy without apparent impact on quality of life.  (+info)

Pacemaker troubleshooting: improved efficacy using a new diagnostic digital Holter recording system. (3/52)

Asymptomatic dysfunction of cardiac pacing systems is not uncommonly detected using long-term ambulatory monitoring techniques. We report two patients with atrial and ventricular sensing abnormalities noted only on Holter monitoring. Multiple empirical attempts at pacemaker reprogramming based on deductive analysis of the pacing anomaly were unsuccessful. Through the use of a new digital recording system that allowed collection of surface electrocardiographic data, intracardiac electrograms, and Marker Channel data a correct diagnosis was made (pacing lead insulation failure). This new recording system has the advantage of significantly improving diagnostic sensitivity and resulting in cost savings.  (+info)

Tackling children's road safety through edutainment: an evaluation of effectiveness. (4/52)

The burgeoning market in electronic media has encouraged a trend toward 'edutainment', where entertaining, media-based materials are used to facilitate educational outcomes. In this study, we evaluated the effectiveness of a video that has recently been released by a popular children's entertainment group to help tackle Britain's poor record on children's road safety. We wished to determine whether the video had an impact on either children's knowledge or parents' awareness of pedestrian skills, when used in a standard home-based fashion. A total of 120 families participated, all of whom had children 5 years of age. Half the families received videos at the beginning of the study, while the other half served as a control group against which to measure change in the treatment group. Data were gathered at baseline and again 1 month later, using a series of tailored questionnaire items. A robust pattern of null findings indicated that the video, when used in this casual fashion, had no educational impact on either parents or children. Crucially, however, parents strongly believed that it had. The discussion explores the implications of such a mismatch and highlights similarities with outcomes of other health education interventions.  (+info)

Feasibility of interactive videodisc technology to teach minority youth about preventing HIV infection. (5/52)

Hispanic and African American adolescents are more likely than white Anglo youth to harbor misconceptions about acquired immunodeficiency syndrome (AIDS) and are also more likely to engage in intravenous drug use and sexual intercourse. This paper describes the development of an AIDS prevention curriculum that uses an interactive videodisc program to teach skills for interventions. Focus group and expert panel studies yielded suggests for intervention vignettes and scenes relevant to Hispanic and African American adolescents. The authors then developed and produced a sample curriculum, specifically designed for Hispanic youth. Content was designed to build knowledge, attitudes, and skills in handling situations where young persons are at risk for human immunodeficiency virus (HIV) infection. The feasibility of the finished pilot product was tested with adolescents and with professionals who serve ethnic and racial minority youth. Adults and Hispanic adolescent viewers rated the videodisc as enjoyable, interesting, and likely to achieve positive effects with the intended target population. Findings suggest that the interactive videodisc is a useful way to interest and help Hispanic adolescents learn ways of reducing their risk of contracting and spreading HIV infection through lifestyle practices. This developmental research in the use of interactive videodisc also provides a basis for further investigation.  (+info)

Preliminary evaluation of learning via the AI/LEARN/Rheumatology interactive videodisc system. (6/52)

AI/LEARN/Rheumatology is a level three videodisc system to teach clinical observational skills in three important diseases: rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. The AI/LEARN software was developed on an independent authoring system called GALE designed for MS-DOS based computers. The purpose of this paper is to present preliminary data about the efficacy of teaching by the use of an interactive videodisc system as evaluated by examinations centered upon disease-oriented learning objectives and by attitude questionnaires. We tested the efficacy of the AI/LEARN/Rheumatology system using both medical students and residents taking the rheumatology elective. Data collected were on learning, attitudes, and ranking of curricular elements of the rotation. We kept records on the student time and search path through the interactive videodisc system. Control data were collected during 1990, before the AI/LEARN/Rheumatology program was available. Data for the treatment groups were collected during 1991 and 1992, while the trainees used the AI/LEARN/Rheumatology system. The basic difference between the control year and the treatment year curricula was the substitution of AI/LEARN/Rheumatology for three hours of lecture covering the three target diseases. AI/LEARN/Rheumatology was as effective as traditional methods of instruction as measured by scores on a multiple choice test. Student and resident learning was related to the time spent on the system. Students and residents ranked the AI/LEARN/Rheumatology system as the single most helpful learning tool in their 8 week rheumatology block, ranking it above the examination of patients.  (+info)

A multipurpose teaching workstation using expert systems, CD ROM and interactive laserdisc. (7/52)

This demonstration shows a multipurpose workstation used in a clinical teaching application which combines currently available software suitable for clinical diagnosis and teaching. The medical software includes QMR, Scientific American Medicine, the Slice of Life and generic video laserdisc authoring software developed at the University of Ottawa. The system allows a clinical instructor either in an individual or in a small group teaching setting on a ward or in a classroom, to access high quality differential diagnosis information via QMR, which is then supplemented by the text components of Scientific American Medicine on CD ROM, with video laserdisc of the appropriate anatomy, imagery and pathology provided by one of the various laserdiscs. The generic authoring software allows the instructor or students to construct subject related tutorial or testing modules either with or without video laserdisc support. The workstation uses DESQview as the multitasking environment to control the various resources. This program allows easy transfer from one application to another and allows for marking and pasting of text material into a study document. DESQview can also be used to script a specific learning sequence. The demonstration will show the interaction required to study a specific clinical problem and how this can be made into a meaningful multimedia experience with hardcopy for study purposes.  (+info)

Interactive videodisc calorimetry simulations for exercise physiology laboratories. (8/52)

Six interactive videodisc lessons for college-level exercise physiology classes were developed. The six lessons were written using TenCore for the IBM M-Motion technology. The focus of the laboratories is on exercise metabolism measured by indirect calorimetry. The six lessons are as follows. 1) Environmental measures: determines whether conditions are favorable for exercise. Dry bulb, wet bulb, and black globe temperatures are obtained to calculate relative humidity, STPD gas volumes, and the wet bulb-globe temperature index. 2) Basal metabolism: emphasizes the mechanics of calculating energy expenditure through indirect calorimetry. Lying, sitting, and exercise metabolism are compared. 3) Submaximal metabolism: compares the energy cost of walking a mile and running a mile. Steady-state exercise, oxygen debt, and oxygen deficit are explored. 4) Maximal metabolism: assesses maximal oxygen consumption using the Bruce protocol. 5) Hormonal responses to prolonged exercise: demonstrates the effect of hormonal levels on %fat and %carbohydrate utilization during 1 h of exercise. 6) Metabolic responses to supramaximal exercise: estimates anaerobic power using the Wingate test.  (+info)