OBJECTIVE: To determine the differences between the patient's and physicians' views of the effects of internet health information on the physician-patient relationship. METHODS: An online survey was carried out with 25 items developed by revising the questionnaire of Direct-to-Consumer Advertising to accommodate the internet health information. The respondents were 671 patients who were active participants in online patient communities and 493 physicians who were the professors of medical schools and practicing physicians. RESULTS: Most of the patients were positive toward the Internet Health Information saying that it gives them advice from a doctor with self-confidence, allows them to follow their doctor's directions well, obtain more medical treatment after retrieving the information, etc. In contrast, physicians perceived that the internet health information may have variety of negative effects, such as increasing the healthcare cost, unnecessary clinic visits and undermining of the doctor-patient relationship. There were significant differences in the perspectives between the physicians and patients. CONCLUSION: It will be necessary to ensure experts provide internet health information, which will have beneficial effects on the quality of care, physician-patient relationship, and health service utilization.
Ambulatory Care ; Surveys and Questionnaires ; Dietary Sucrose ; Health Care Costs ; Health Services ; Humans ; Internet ; Schools, Medical

The Korean law on medicine was amended in 2003 to introduce new provisions for telemedicine, electronic medical record, and electronic prescription. However, this has not satisfied the realities of the increased demand on medical services and related technology development, resulting in calls for a legislative amendment. In this regard, recent active promotion projects and the advance notice proposing a new amendment by the Ministry of Health, Welfare, and Family Affairs have raised the need for active discussions on telemedicine because the current law on medicine and its amendment do not adequately address the individual privacy protection aspect in the telemedicine environment. In this regard, this study examines current domestic and foreign legal systems on telemedicine and privacy protection, drawing and reviewing subjects to be discussed for individual privacy protection in telemedicine, and proposes plans that may improve Korea's legal system. The domestic and foreign literature on telemedicine and privacy protection was reviewed, recent legislations on telemedicine and views of interest groups were considered, and expert opinions were collected. In addition, the main discussions on privacy protection in telemedicine were identified and reviewed, including information ownership, the scope of privacy protection, the right to review and request correction, and privacy protection matters related to foreign patients. The recent amendment to tele medicine contains a provision only on penalties for privacy protection violations. The main discussions in this study on privacy protection are expected to be reflected in future amendments to enforcement rules and sub-ordinances such as the enforcement ordinance.
Electronic Health Records ; Electronic Prescribing ; Expert Testimony ; Humans ; Jurisprudence ; Ownership ; Privacy ; Public Opinion ; Telemedicine

No abstract available.
Delivery of Health Care ; Informatics

OBJECTIVE: Personal Digital Assistants (PDAs) have the potential to improve clinical trial data collection; however, most current PDA-based clinical data collection systems typically collect and store data in the offline mode, and then transfer the data to an operational database. The purpose of this study was to explore the usefulness of a wireless clinical data collection system for an irritable bowel syndrome trial compared with the traditional paper based data collection. METHODS: We have developed a PDA-based data capture system for clinical trials, and tested it in a double-blind trial. Sixty four patients with irritable bowel syndrome were randomly selected and divided into a control group that used the standard paper report forms (CRF) and an intervention group that used the electronic report forms (e-CRF), daily for five weeks. There were 630 data sets consisting of six questions each, and thus 3,570 data points total were collected. RESULTS: The response rate of the control group was significantly higher than that of the intervention group. However, the completeness of the response in the intervention group was higher and the number of input errors per person for the PDA group was lower than in the paper group. CONCLUSION: A PDA based electronic diary improved the response rate and decreased input errors in an IBS trial. We conclude that mobile devices can be very useful, especially when the proposed design and connectivity aspects have been taken into account.
Cellular Phone ; Computers, Handheld ; Data Collection ; Electronics ; Electrons ; Humans ; Irritable Bowel Syndrome

OBJECTIVE: The goal of this study was to develop a novel pupil and iris segmentation algorithm. We evaluated segmentation performance based on a fractal model. Two methods were compared: Daugman's and our new proposed method. METHODS: We received 200 anterior segment images with 3,872x2,592 pixels. Here we present an active contour model that accurately detects pupil boundaries in order to improve the performance of segmentation systems. We propose a method that uses iris segmentation based on a fractal model. We compared the performance of Daugman's method and the proposed new method and statistically analyzed the results. RESULTS: We manually compared segmentation with the Daugman's method and the new proposed method. The findings showed that the proposed segmentation accuracy was about 2.5 percent higher than Daugman's method. There was a significant difference (p<0.05) between the under and over data between the two methods. CONCLUSION: The results of this study show that the new proposed method was more accurate than the conventional method for the measurement of segmentation of the eye by CAD (Computer-aided Diagnosis).
Eye ; Fractals ; Iris ; Pupil

OBJECTIVE: The most widely used method for quantifying new blood vessel growth in tumor angiogenesis is the determination of microvessel density, which is reported to be associated with tumor progression and metastasis, and a prognostic indicator of patient outcome. In this study, we propose a method for the determination of microvessel density by image analysis, to improve the accuracy and the objectivity of determination of the microvessel density. METHODS: Four-micron-thick tissue sections of renal cell carcinoma samples were stained immunohistochemically for CD34. The regions with a high degree of vascularization were selected by an expert for digitization. Each image was digitized as a 24-bits/pixel image file with a resolution of 640x480 pixels. First, segmentation of the microvessels based on pixel classification using color features in hybrid color space was performed. After use of a correction process for microvessels with discontinuities and separation of touching microvessels, we counted the number of microvessels for the microvessel density measurement. RESULTS: The result was evaluated by comparison with manual quantification of the same images. The comparison revealed that our computerized microvessel quantification was highly correlated with manual counting by a pathologist. CONCLUSION: The results indicate that our method is better than the conventional computerized image analysis methods.
Blood Vessels ; Carcinoma, Renal Cell ; Chimera ; Diagnosis, Computer-Assisted ; Glycosaminoglycans ; Humans ; Microvessels ; Neoplasm Metastasis

OBJECTIVE: Cadaver's sectioned images with high resolution and real color could be used as the source of realistic three-dimensional images. If the sectioned images are registered to a patient's MRIs, three-dimensional images with high resolution and real color that fit the patient, can be produced; the three-dimensional images enable realistic virtual surgery for the patient. The objective of this study was to verify the registration of a cadaver's sectioned images to a patient's head MRIs. METHODS: The sectioned images of the heads of cadaver were associated with segmented images selected at 3 mm intervals. The patient had his head MR scanned at 3 mm intervals; the MRIs were segmented. Software to register the cadaver's sectioned images to the patient's MRIs was developed. On this software, the corresponding dots were identified on both the sectioned images and the MRIs either manually or automatically using segmented images. RESULTS: The registered sectioned images corresponded to the patient's MRIs. Both manual and automatic registrations were satisfied. CONCLUSION: Further study is needed for registering sectioned images to actual patients.
Cadaver ; Head ; Humans ; Imaging, Three-Dimensional

OBJECTIVE: This aim of this study was to evaluate the quality and agreement of electronic medical records with paper-based medical records. METHODS: Data was collected from the paper-based medical records generated during 2004 and electronic medical records during 2007, in patients hospitalized for arterial fibrillation. The categories evaluated included the chief complaint, history of present illness, past illness, medication history, admission history, family history, allergies, smoking history, and drinking history in admission record. RESULTS: The electronic medical records scored higher for: the existence of a medical record, level of information in the medical record and agreement of information. However, there were some categories of disagreement between the information from doctors and nurses, and there were several categories with no record by doctors or nurses. CONCLUSION: The results of this study confirmed that the quality of the electronic medical record is better than that of paper-based medical with regard to: the existence of the record, level and agreement of information. However, there are discrepancies in the information contained within both types of records.
Drinking ; Electronic Health Records ; Electronics ; Electrons ; Hospital Information Systems ; Humans ; Hypersensitivity ; Medical Records ; Smoke ; Smoking

OBJECTIVE: Post-marketing surveillance (PMS) is an adverse events monitoring practice of pharmaceutical drugs on the market. Traditional PMS methods are labor intensive and expensive to perform, because they are largely based on manual work including phone-calling, mailing, or direct visits to relevant subjects. The objective of this study was to develop and validate a PMS methodology based on the clinical data warehouse (CDW). METHODS: We constructed a archival DB using a hospital information system and a refined CDW from three different hospitals. Fluoxetine hydrochloride, an antidepressant, was selected as the target monitoring drug. Corrected QT prolongation on ECG was selected as the target adverse outcome. The Wilcoxon signed rank test was performed to analyze the difference in the corrected QT interval before and after the target drug administration. RESULTS: A refined CDW was successfully constructed from three different hospitals. Table specifications and an entity-relation diagram were developed and are presented. A total of 13 subjects were selected for monitoring. There was no statistically significant difference in the QT interval before and after target drug administration (p=0.727). CONCLUSION: The PMS method based on CDW was successfully performed on the target drug. This IT-based alternative surveillance method might be beneficial in the PMS environment of the future.
Electrocardiography ; Fluoxetine ; Hospital Information Systems ; Postal Service ; Retrospective Studies

Recently, many hospitals have been adopting clinical data warehouses (CDW) as well as electronic medical records. These new hospital information systems are inevitably introducing very large amounts of clinical data that might be useful for further analysis. However, the electronic clinical data in the CDW are usually byproducts of clinical practice rather than the product of research. Therefore, they include inconsistent and sometimes erroneous information that might not have the specific context of the clinical situations. Data miners usually have various academic backgrounds such as electronics, informatics, statistics, biomedicine, and public health. If the complex situations surrounding the clinical data are not well understood, investigators performing data mining in clinical fields may have problems assessing the information they are confronted with. Here, we would like to introduce some basic concepts on the principles of data mining in clinical fields including legal and ethical considerations as well as technical concerns.
Machine Learning ; Data Mining ; Electronic Health Records ; Electronics ; Electrons ; Hospital Information Systems ; Humans ; Informatics ; Public Health ; Research Personnel