The future of laboratory medicine - A 2014 perspective.

Predicting the future is a difficult task. Not surprisingly, there are many examples and assumptions that have proved to be wrong. This review surveys the many predictions, beginning in 1887, about the future of laboratory medicine and its sub-specialties such as clinical chemistry and molecular pathology. It provides a commentary on the accuracy of the predictions and offers opinions on emerging technologies, economic factors and social developments that may play a role in shaping the future of laboratory medicine

Factors associated with appropriate inhaler use in patients with COPD - lessons from the REAL survey

The authors thank Clarice Field (PhD) and Paul McKiernan (PhD) of Novartis for providing medical writing support, which was funded by Novartis AG, Basel, Switzerland, in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3). Pankaj Goyal and Joao Mendes, Novartis Pharma AG, Basel, contributed to the design and conceptualization of study. The survey was designed by PDD, London, United Kingdom, and GfK Switzerland AG, Basel, Switzerland. The survey was conducted by GfK Switzerland AG, Basel, Switzerland, and sponsored by Novartis Pharma AG, Basel, Switzerland.Peer reviewedPublisher PD

Visualizing pain data for wheelchair users: A ubiquitous approach

Copyright @ 2005 Rinton PressWe describe a wireless enabled solution for the vizualisation of pain data. Our approach uses pain drawings to record spatial location and type of pain and enables data collection with appropriate time stamping, thus providing a means for the seldom-recorded (but often attested) time-varying nature of pain, with consequential impact on monitoring the effectiveness of patient treatment regimes. Moreover, since the implementation platform of our solution is that of a Personal Digital Assistant (PDA), data collection takes place ubiquitously, providing back pain sufferers with mobility problems (such as wheelchair users) with a convenient means of logging their pain data and of seamlessly uploading it to a hospital server using WiFi technology. Stakeholder results show that, notwithstanding problems related to PDA data input, our approach is generally perceived to be an easy to use and convenient solution to the challenges of anywhere/anytime data collection

Use of nonintrusive sensor-based information and communication technology for real-world evidence for clinical trials in dementia

Cognitive function is an important end point of treatments in dementia clinical trials. Measuring cognitive function by standardized tests, however, is biased toward highly constrained environments (such as hospitals) in selected samples. Patient-powered real-world evidence using information and communication technology devices, including environmental and wearable sensors, may help to overcome these limitations. This position paper describes current and novel information and communication technology devices and algorithms to monitor behavior and function in people with prodromal and manifest stages of dementia continuously, and discusses clinical, technological, ethical, regulatory, and user-centered requirements for collecting real-world evidence in future randomized controlled trials. Challenges of data safety, quality, and privacy and regulatory requirements need to be addressed by future smart sensor technologies. When these requirements are satisfied, these technologies will provide access to truly user relevant outcomes and broader cohorts of participants than currently sampled in clinical trials

M-health review: joining up healthcare in a wireless world

In recent years, there has been a huge increase in the use of information and communication technologies (ICT) to deliver health and social care. This trend is bound to continue as providers (whether public or private) strive to deliver better care to more people under conditions of severe budgetary constraint

MyAirCoach: The use of home-monitoring and mHealth systems to predict deterioration in asthma control and the occurrence of asthma exacerbations; Study protocol of an observational study

© Published by the BMJ Publishing Group Limited. Introduction Asthma is a variable lung condition whereby patients experience periods of controlled and uncontrolled asthma symptoms. Patients who experience prolonged periods of uncontrolled asthma have a higher incidence of exacerbations and increased morbidity and mortality rates. The ability to determine and to predict levels of asthma control and the occurrence of exacerbations is crucial in asthma management. Therefore, we aimed to determine to what extent physiological, behavioural and environmental data, obtained by mobile healthcare (mHealth) and home-monitoring sensors, as well as patient characteristics, can be used to predict episodes of uncontrolled asthma and the onset of asthma exacerbations. Methods and analysis In an 1-year observational study, patients will be provided with mHealth and home-monitoring systems to record daily measurements for the first-month (phase I) and weekly measurements during a follow-up period of 11 months (phase II). Our study population consists of 150 patients, aged ≥18 years, with a clinician's diagnosis of asthma, currently on controller medication, with uncontrolled asthma and/or minimally one exacerbation in the past 12 months. They will be enrolled over three participating centres, including Leiden, London and Manchester. Our main outcomes are the association between physiological, behavioural and environmental data and (1) the loss of asthma control and (2) the occurrence of asthma exacerbations. Ethics This study was approved by the Medical Ethics Committee of the Leiden University Medical Center in the Netherlands and by the NHS ethics service in the UK. Trial registration number NCT02774772

Disease surveillance and patient care in remote regions: an exploratory study of collaboration among healthcare professionals in Amazonia

The development and deployment of information technology, particularly mobile tools, to support collaboration between different groups of healthcare professionals has been viewed as a promising way to improve disease surveillance and patient care in remote regions. The effects of global climate change combined with rapid changes to land cover and use in Amazonia are believed to be contributing to the spread of vector-borne emerging and neglected diseases. This makes empowering and providing support for local healthcare providers all the more important. We investigate the use of information technology in this context to support professionals whose activities range from diagnosing diseases and monitoring their spread to developing policies to deal with outbreaks. An analysis of stakeholders, their roles and requirements, is presented which encompasses results of fieldwork and of a process of design and prototyping complemented by questionnaires and targeted interviews. Findings are analysed with respect to the tasks of diagnosis, training of local healthcare professionals, and gathering, sharing and visualisation of data for purposes of epidemiological research and disease surveillance. Methodological issues regarding the elicitation of cooperation and collaboration requirements are discussed and implications are drawn with respect to the use of technology in tackling emerging and neglected diseases

Recording of time-varying back-pain data: A wireless solution

Chronic back pain is a debilitating experience for a considerable proportion of the adult population, with a significant impact on countries’ economies and health systems. While there has been increasing anecdotal evidence to support the fact that for certain categories of patients (such as wheelchair users), the back pain experienced is dynamically varying with time, there is a relative scarcity of data to support and document this observation, with consequential impact upon such patients’ treatment and care. Part of the reason behind this state of affairs is the relative difficulty in gathering pain measurements at precisely defined moments in time. In this paper,we describe a wireless-enabled solution that collects both questionnaire and diagrammatic, visual-based data, via a pain drawing, which overcomes such limitations, enabling seamless data collection and its upload to a hospital server using existing wireless fidelity technology. Results show that it is generally perceived to be an easy-to-use and convenient solution to the challenges of anywhere/anytime data collection