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Yang Y, Qian QY, Yang XY, Li DS, Chen DS, Shen M. Measurement of non-invasive cardiac output during cycling exercise in ischemic stroke inpatients: A pilot study. Technol Health Care 2024; 32:215-228. [PMID: 37302050 DOI: 10.3233/thc-220823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Cardiac dysfunction accompanies acute ischemic stroke and affects the effective implementation of early rehabilitation interventions. There is a lack of reference hemodynamic data on cardiac function in the subacute phase of ischemic stroke. OBJECTIVE In this study, we aimed to identify appropriate cardiac parameters for exercise training utilizing a pilot study. METHODS We used a transthoracic electrical bioimpedance non-invasive cardiac output measurement (NICOM) device to monitor cardiac function in real time for two groups [i.e., subacute ischemic stroke inpatients group (n= 10) and healthy control group (n= 11)] using a cycling exercise experiment. The parameters of both groups were compared to highlight the cardiac dysfunction in the subacute phase in patients with ischemic stroke. RESULTS We considered stroke volume index (SVI) and systemic vascular resistance index (SVRi) as the primary outcomes, and there was significant intragroup difference (stroke group: P< 0.001; control group: P< 0.001, using one-way ANOVA) and significant intergroup difference at each individual time segment (P< 0.01, using independent t-test). Among the secondary outcomes, i.e., cardiac index (CI), ejection fraction (EF), end-diastolic volume (EDV), and cardiac contraction index (CTI), we found significant intergroup differences in CI, EF, and CTI scores (P< 0.01, using independent t-test). Significant interaction with respect to time and group were seen only in the SVRi and CI scores (P< 0.01, using two-way ANOVA). There was no significant inter- or intra-group differences in EDV scores. CONCLUSION SVRI, SVI, and CI values highlight cardiac dysfunction in stroke patients the most. At the same time, these parameters suggest that cardiac dysfunction in stroke patients may be closely related to the increased peripheral vascular resistance caused by infarction and the limitation of myocardial systolic function.
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Affiliation(s)
- Ying Yang
- Department of Rehabilitation Medicine, People's Hospital of Longhua, Shenzhen, Guangdong, China
- Department of Rehabilitation Medicine, People's Hospital of Longhua, Shenzhen, Guangdong, China
| | - Qiu-Yang Qian
- Department of Rehabilitation Medicine, People's Hospital of Longhua, Shenzhen, Guangdong, China
- Department of Rehabilitation Medicine, People's Hospital of Longhua, Shenzhen, Guangdong, China
| | - Xiao-Yan Yang
- Department of Rehabilitation Medicine, People's Hospital of Longhua, Shenzhen, Guangdong, China
| | - De-Sheng Li
- Department of Rehabilitation Medicine, People's Hospital of Longhua, Shenzhen, Guangdong, China
| | - De-Sheng Chen
- Department of Rehabilitation Medicine, People's Hospital of Longhua, Shenzhen, Guangdong, China
| | - Mei Shen
- Department of Rehabilitation Medicine, People's Hospital of Longhua, Shenzhen, Guangdong, China
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2
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Zhang M, Du H, Ma X, Zhao W. Effect evaluation of new dressing URGOTULRANGE in the treatment of pressure injury. Technol Health Care 2024; 32:143-150. [PMID: 37248926 DOI: 10.3233/thc-220604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Pressure injury (PI) is a local injury of the skin and/or soft tissue located at the bone caused by medical or other equipment and is common in long-term bedridden patients. OBJECTIVE To investigate the clinical effect of Urgotul foam dressing in the treatment of stage 3 ∼ 4 PI and deep tissue PI. METHODS A total of 38 patients with stage 3 ∼ 4 PI and deep tissue PI admitted to Jinan Central Hospital from January 2016 to December 2018 were selected and randomly divided into a control group (dressing change plus silver ion cream dressing) and an observation group (dressing change plus Urgotul Absorb non-border foam dressing), with 19 cases in each group. After 4 weeks of treatment, the pain intensity during dressing change and the treatment efficacy for PI wounds were compared between the two groups. RESULTS There were no differences in gender (P= 0.740), age (P= 0.130), single wound area (P= 0.673), consultation department (P= 0.972), stage (P= 0.740), presence of undermining (P= 0.721), deep tissue PI (P= 0.721), and systemic antibiotic therapy (P= 1.000) between the two groups, which were comparable. The treatment effect of the observation group was better than that of the control group (P= 0.003), and the pain score of the observation group was lower than that of the control group (P< 0.001). CONCLUSION Urgotul Absorb non-border foam dressing has a good effect in the treatment of stage 3 ∼ 4 PI and deep tissue PI and can relieve patients' pain, and is thus worth promoting.
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Affiliation(s)
- Mengmeng Zhang
- Department of Burns and Plastic Surgery, Central Hostpital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Hongxia Du
- Department of Nursing, Central Hostpital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiaoxia Ma
- Department of Digestive Endoscopy, Central Hostpital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Wenxing Zhao
- Department of Burns and Plastic Surgery, Central Hostpital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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3
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Yuan Y, Chen J, Wang X, Song J. Application of a rehabilitation management strategy based on symptom management theory in postoperative functional exercises in patients with lower extremity arteriosclerosis obliterans. Technol Health Care 2024; 32:63-73. [PMID: 37248923 DOI: 10.3233/thc-220478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Lower extremity arteriosclerosis obliterans (ASO) is the most common occlusive disease of the peripheral blood vessels. OBJECTIVE To explore the application effect of symptom management-based rehabilitation strategy in postoperative functional exercises in patients with lower extremity ASO. METHODS The researchers selected 136 patients that underwent lower extremity ASO surgery for the first time in their department from January to September 2020. Patients were divided into a control group (n= 68) and an experimental group (n= 68). The control group implemented routine discharge rehabilitation education and continuous nursing. On this basis, the experimental group applied the symptom management theory to the rehabilitation management strategy to compare the degree of pain, the ankle-brachial index, self-care ability and quality of life between the two groups before and after the intervention. RESULTS Three months (P= 0.045) and six months (P=0.013) after discharge, the experimental group's degree of pain was significantly lower than that of the control group. At one month (P= 0.019), three months (P= 0.003) and six months (P= 0.000) after discharge, the experimental group recovered significantly better than the control group. At six months after discharge, the self-care ability, mood status and physical pain of the experimental group were significantly higher than in the control group (P< 0.05). CONCLUSION The rehabilitation management strategy, which is based on symptom management theory, can effectively improve the symptoms, quality of life and self-efficacy of ASO patients in continuous care. This nursing strategy is worthy of clinical promotion.
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Affiliation(s)
- Youyuan Yuan
- Department of Interventional Therapy for Tumor and Vascular Disease, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Jiaqi Chen
- Department of Interventional Therapy for Tumor and Vascular Disease, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Xueqi Wang
- Department of Interventional Therapy for Tumor and Vascular Disease, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Jialu Song
- Nursing Department, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
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4
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Alataş E, Tanyıldızı Kökkülünk H, Tanyıldızı H, Alcın G. Treatment prediction with machine learning in prostate cancer patients. Comput Methods Biomech Biomed Engin 2023:1-9. [PMID: 38148626 DOI: 10.1080/10255842.2023.2298364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/16/2023] [Indexed: 12/28/2023]
Abstract
There are various treatment modalities for prostate cancer, which has a high incidence. In this study, it is aimed to make predictions with machine learning in order to determine the optimal treatment option for prostate cancer patients. The study included 88 male patients diagnosed with prostate cancer. Independent variables were determined as Gleason scores, biopsy, PSA, SUVmax, and age. Prostate cancer treatments, which are dependent variables, were determined as hormone therapy(n = 30), radiotherapy(n = 28) and radiotherapy + hormone therapy(n = 30). Machine learning was carried out in the Python with SVM, RF, DT, ETC and XGBoost. Metrics such as accuracy, ROC curve, and AUC were used to evaluate the performance of multi-class predictions. The model with the highest number of successful predictions was the XGBoost. False negative rates for hormone therapy, radiotherapy, and radiotherapy + hormone therapy treatments were, respectively, 12.5, 33.3, and 0%. The accuracy values were computed as 0.61, 0.83, 0.83, 0.72 and 0.89 for SVM, RF, DT, ETC and XGBoost, respectively. The three features that had the greatest influence on the treatment model prediction for prostate cancer with XGBoost were biopsy, Gleason score (3 + 3), and PSA level, respectively. According to the AUC, ROC and accuracy, it was determined that the XGBoost was the model that made the best estimation of prostate cancer treatment. Among the variables biopsy, Gleason score, and PSA level are identified as key variables in prediction of treatment.
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Affiliation(s)
- Emre Alataş
- Management Information Systems, Faculty of Economics and Administrative Sciences, Beykent University, Istanbul, Turkey
- Management Information Systems, Institute of Science and Technology, Kadir Has University, Istanbul, Turkey
| | | | - Hilal Tanyıldızı
- International Trade and Finance, Faculty of Economics and Administrative Sciences, Beykent University, Istanbul, Turkey
- Business Administration, Institute of Social Sciences, Istanbul University, Istanbul, Turkey
| | - Goksel Alcın
- Department of Nuclear Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey
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5
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Abd Rahman NH, Mohamad Zaki MH, Hasikin K, Abd Razak NA, Ibrahim AK, Lai KW. Predicting medical device failure: a promise to reduce healthcare facilities cost through smart healthcare management. PeerJ Comput Sci 2023; 9:e1279. [PMID: 37346641 PMCID: PMC10280478 DOI: 10.7717/peerj-cs.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/15/2023] [Indexed: 06/23/2023]
Abstract
Background The advancement of biomedical research generates myriad healthcare-relevant data, including medical records and medical device maintenance information. The COVID-19 pandemic significantly affects the global mortality rate, creating an enormous demand for medical devices. As information technology has advanced, the concept of intelligent healthcare has steadily gained prominence. Smart healthcare utilises a new generation of information technologies, such as the Internet of Things (loT), big data, cloud computing, and artificial intelligence, to completely transform the traditional medical system. With the intention of presenting the concept of smart healthcare, a predictive model is proposed to predict medical device failure for intelligent management of healthcare services. Methods Present healthcare device management can be improved by proposing a predictive machine learning model that prognosticates the tendency of medical device failures toward smart healthcare. The predictive model is developed based on 8,294 critical medical devices from 44 different types of equipment extracted from 15 healthcare facilities in Malaysia. The model classifies the device into three classes; (i) class 1, where the device is unlikely to fail within the first 3 years of purchase, (ii) class 2, where the device is likely to fail within 3 years from purchase date, and (iii) class 3 where the device is likely to fail more than 3 years after purchase. The goal is to establish a precise maintenance schedule and reduce maintenance and resource costs based on the time to the first failure event. A machine learning and deep learning technique were compared, and the best robust model for smart healthcare was proposed. Results This study compares five algorithms in machine learning and three optimizers in deep learning techniques. The best optimized predictive model is based on ensemble classifier and SGDM optimizer, respectively. An ensemble classifier model produces 77.90%, 87.60%, and 75.39% for accuracy, specificity, and precision compared to 70.30%, 83.71%, and 67.15% for deep learning models. The ensemble classifier model improves to 79.50%, 88.36%, and 77.43% for accuracy, specificity, and precision after significant features are identified. The result concludes although machine learning has better accuracy than deep learning, more training time is required, which is 11.49 min instead of 1 min 5 s when deep learning is applied. The model accuracy shall be improved by introducing unstructured data from maintenance notes and is considered the author's future work because dealing with text data is time-consuming. The proposed model has proven to improve the devices' maintenance strategy with a Malaysian Ringgit (MYR) cost reduction of approximately MYR 326,330.88 per year. Therefore, the maintenance cost would drastically decrease if this smart predictive model is included in the healthcare management system.
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Affiliation(s)
- Noorul Husna Abd Rahman
- Department of Biomedical Engineering, Universiti Malaya, Lembah Pantai, Wilayah Persekutuan Kuala Lumpur, Malaysia
- Engineering Services Division, Ministry of Health, Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia
| | - Muhammad Hazim Mohamad Zaki
- Department of Biomedical Engineering, Universiti Malaya, Lembah Pantai, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Khairunnisa Hasikin
- Department of Biomedical Engineering, Universiti Malaya, Lembah Pantai, Wilayah Persekutuan Kuala Lumpur, Malaysia
- Center of Intelligent Systems for Emerging Technology (CISET), Faculty of Engineering, Universiti Malaya, Lembah Pantai, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Nasrul Anuar Abd Razak
- Department of Biomedical Engineering, Universiti Malaya, Lembah Pantai, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Ayman Khaleel Ibrahim
- Faculty of Computing and Informatics, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Khin Wee Lai
- Department of Biomedical Engineering, Universiti Malaya, Lembah Pantai, Wilayah Persekutuan Kuala Lumpur, Malaysia
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6
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Jonathan J, Barakabitze AA. ML technologies for diagnosing and treatment of tuberculosis: a survey. HEALTH AND TECHNOLOGY 2023. [DOI: 10.1007/s12553-023-00727-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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7
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Badnjevic A, Deumic A, Trakic A, Pokvic LG. A novel method for conformity assessment testing of mechanical ventilators for post-market surveillance purposes. Technol Health Care 2023; 31:367-376. [PMID: 36530109 DOI: 10.3233/thc-229012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Mechanical ventilators are medical devices used in intensive care units when patients are in need of mechanical aid to facilitate the process of breathing. As the function of breathing is the exchange of gases, the mechanical ventilator takes over that function while the patient is incapable to spontaneous breathing. As these devices are used to maintain the life of patents, their performance must be ensured and there cannot be significant deviations in the volumes and pressure of gases they introduce to the patient. The new Medical Device Regulation (MDR) defines medical device post-market surveillance (PMS) as performed by independent, third-party, notified bodies more strategically in hope to improve traceability of device performance. However, there is still an apparent gap in terms of standardised conformity assessment testing methods. OBJECTIVE This paper proposes a novel method for conformity assessment testing of mechanical ventilators for post-market surveillance purposes. METHOD The method was developed on the basis of metrology characteristics of mechanical ventilators and evaluation of their vital safety and performance parameters. In addition to the evaluation of essential safety and visual integrity of mechanical ventilators, their performance in terms of volume of oxygen delivered to the patient as well as the flow and pressure of the delivered gas is evaluated. RESULTS The developed method was validated between 2018 and 2021 in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of mechanical ventilators as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION A standardized approach in conformity assessment testing of mechanical ventilators during PMS, besides increasing reliability of the devices, is the first step in digital transformation of management of these devices in healthcare institutions opening possibility for use of artificial intelligence.
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Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,International Federation of Medical and Biological Engineering (IFMBE), Sarajevo, Bosnia and Herzegovina
| | - Amar Deumic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina
| | - Ammar Trakic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
| | - Lejla Gurbeta Pokvic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
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8
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Badnjevic A, Deumic A, Softic A, Pokvic LG. A novel method for conformity assessment testing of patient monitors for post-market surveillance purposes. Technol Health Care 2023; 31:327-337. [PMID: 36530105 DOI: 10.3233/thc-229008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patient monitors are medical devices used to monitor vital parameters such as heart rate, respiratory rate, blood pressure, blood oxygen saturation, and body temperature during inpatient treatment. As such, patient monitors provide physicians with information necessary to adjust the treatment as well as evaluate the overall status and recovery of the patient. Measurements made by intrinsic sensors of patient monitors must be compliant and provide reliable readings in order to ensure safety and optimal quality of care to the patients. OBJECTIVE This paper proposes a novel method for conformity assessment testing of patient monitors in healthcare institutions for post-market surveillance purposes. METHOD The method was developed on the basis of metrology characteristics of sensors used to monitor vital parameters observed by patient monitors and evaluation of their vital safety and performance parameters. In addition to the evaluation of essential safety and visual integrity of patient monitors, their performance in terms of accuracy of the readings is evaluated. RESULTS The developed method was validated between 2018 and 2021 in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of patient monitors as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION A standardized approach in conformity assessment testing of patient monitors during PMS, besides increasing reliability of the devices, is the first step in digital transformation of management of these devices in healthcare institutions opening possibility for use of artificial intelligence.
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Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,International Federation of Medical and Biological Engineering (IFMBE), Sarajevo, Bosnia and Herzegovina
| | - Amar Deumic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina
| | - Adna Softic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
| | - Lejla Gurbeta Pokvic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
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9
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Badnjevic A, Deumic A, Biskovic D, Pokvic LG. A novel method for conformity assessment testing of dialysis machines for post-market surveillance purposes. Technol Health Care 2023; 31:357-365. [PMID: 36530108 DOI: 10.3233/thc-229011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Dialysis machines are used regularly in healthcare practice. They are classified as a type of medical device with moderate and high risk therefore significant requirements are placed on their safety and performance every time they are used on patients. The new Medical Device Regulation (MDR) defines medical device post-market surveillance (PMS) as performed by independent, third-party, notified bodies more strategically in hope to improve traceability of device performance. However, there is still an apparent gap in terms of standardised conformity assessment testing methods. OBJECTIVE This paper proposes a novel evidence-based method for conformity assessment testing of dialysis machines for post-market surveillance purposes. METHOD The novel method is developed according to the International Organisation of Legal Metrology (OIML) guidelines and is to be used for the purpose of conformity assessment testing of Dialysis machines with respect to their metrological characteristics during PMS. RESULTS The developed method was validated between 2018 and 2021 in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of dialysis machines as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION A standardized approach in conformity assessment testing of dialysis machines during PMS, besides increasing reliability of the devices, is the first step in digital transformation of management of these devices in healthcare institutions opening possibility for use of artificial intelligence.
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Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,International Federation of Medical and Biological Engineering (IFMBE), Sarajevo, Bosnia and Herzegovina
| | - Amar Deumic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina
| | - Dusanka Biskovic
- Faculty of Electrical Engineering, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Lejla Gurbeta Pokvic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
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10
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Badnjevic A, Deumic A, Smajlhodzic-Deljo M, Pokvic LG. A novel method for conformity assessment testing of infusion and perfusion pumps for post-market surveillance purposes. Technol Health Care 2023; 31:347-355. [PMID: 36530107 DOI: 10.3233/thc-229010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Introduction of fluids, medicaments and nutrients into the human body during hospitalization is fundamental for treatment and healing of patients. Fluids are introduced by means of infusion pumps while nutrients and medicaments are introduced by perfusion pumps. It is of vital importance for these devices to deliver exact amounts of the aforementioned substances as significant deviations can result in severe patient harm. Therefore it is important to effectively monitor their performance and prevent failures. OBJECTIVE This paper proposes a novel method for conformity assessment testing of infusion and perfusion pumps for post-market surveillance purposes. METHOD The method was developed on the basis of metrology characteristics of the devices. In addition to the evaluation of essential safety and visual integrity of infusion and perfusion pumps, their performance in terms of delivered volumes was assessed and monitored. RESULTS The developed method was validated between 2018 and 2021 in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of infusion and perfusion pumps as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION A standardized approach in conformity assessment testing of infusion and perfusion pumps during PMS, besides increasing reliability of the devices, is the first step in digital transformation of management of these devices in healthcare institutions opening possibility for use of artificial intelligence.
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Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,International Federation of Medical and Biological Engineering (IFMBE), Sarajevo, Bosnia and Herzegovina
| | - Amar Deumic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina
| | - Merima Smajlhodzic-Deljo
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
| | - Lejla Gurbeta Pokvic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
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11
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Badnjevic A, Magjarevic R, Mrdjanovic E, Pokvic LG. A novel method for conformity assessment testing of electrocardiographs for post-market surveillance purposes. Technol Health Care 2023; 31:307-315. [PMID: 36502354 DOI: 10.3233/thc-229006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Monitoring cardiac parameters is the fundamental aspect of every diagnostic process and is facilitated by electrocardiography (ECG) devices. This way, continuous state-of-the-art performance of ECG devices can be ensured. The new Medical Device Regulation (MDR) defines medical device post-market surveillance (PMS) as performed by independent, third-party, notified bodies more strategically in hope to improve traceability of device performance. However, there is still an apparent gap in terms of standardised conformity assessment testing methods. OBJECTIVE This paper proposes a novel method for conformity assessment testing of ECG devices for post-market surveillance purposes. METHOD The method was developed on the basis of International Organisation of Legal Metrology (OIML) guidelines and applied in healthcare institutions from 2018 to 2021. RESULTS The developed method was validated in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of the ECG device as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION A standardized approach in conformity assessment testing of ECG devices during PMS, besides increasing reliability of the devices, is the first step in the digital transformation of the management of these devices in healthcare institutions opening possibility for use of artificial intelligence.
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Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Ratko Magjarevic
- Faculty of Electrical Engineering and Computing Zagreb, University of Zagreb, Zagreb, Croatia.,International Federation of Medical and Biological Engineering (IFMBE), Zagreb, Croatia
| | - Emina Mrdjanovic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
| | - Lejla Gurbeta Pokvic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
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12
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Badnjevic A, Spahic L, Jordamovic NB, Pokvic LG. A novel method for conformity assessment testing of infant incubators for post-market surveillance purposes. Technol Health Care 2023; 31:389-399. [PMID: 36530111 DOI: 10.3233/thc-229014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Premature born infants or infants born sick require immediate medical attention and decreasing the stress imposed onto their body by the environment. Infant incubators provide an enclosed environment that can be controlled to fit the needs of the infant. As such, their performance must be consistent and without significant deviations. The only manner to ensure this is by post-market surveillance (PMS) focused on evaluation of both safety and performance. The new Medical Device Regulation (MDR) defines medical device post-market surveillance (PMS) as performed by independent, third-party, notified bodies more strategically in hope to improve traceability of device performance. However, there is still an apparent gap in terms of standardised conformity assessment testing methods. OBJECTIVE This paper proposes a novel method for conformity assessment testing of infant incubators for post-market surveillance purposes. METHOD The method was developed based on guidelines for devices providing measurements laid out by the International Organisation of Legal Metrology (OIML). The methodology was validated during a four year period in healthcare institutions of all levels. RESULTS The developed method was validated between 2018 and 2021 in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of infant incubators as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION A standardized approach in conformity assessment testing of infant incubators during PMS, besides increasing reliability of the devices, is the first step in digital transformation of management of these devices in healthcare institutions opening possibility for use of artificial intelligence.
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Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,International Federation of Medical and Biological Engineering (IFMBE), Sarajevo, Bosnia and Herzegovina
| | - Lemana Spahic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
| | - Naida Babic Jordamovic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
| | - Lejla Gurbeta Pokvic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
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Badnjevic A, Deumic A, Dzemic Z, Pokvic LG. A novel method for conformity assessment testing of anaesthesia machines for post-market surveillance purposes. Technol Health Care 2023; 31:377-387. [PMID: 36530110 DOI: 10.3233/thc-229013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Anaesthesia machines, as moderate to high-risk medical devices intended for use on patients during surgical procedures must be safe and reliable with traceable performance every time they are used in healthcare practice. The new Medical Device Regulation (MDR) defines medical device post-market surveillance (PMS) as performed by independent, third-party, notified bodies more strategically in hope to improve traceability of device performance. However, there is still an apparent gap in terms of standardised conformity assessment testing methods. OBJECTIVE This paper proposes a novel evidence-based method for conformity assessment testing of anaesthesia machines for post-market surveillance purposes. METHOD The novel method is developed according to the International Organisation of Legal Metrology (OIML) guidelines and is to be used for the purpose of conformity assessment testing of anaesthesia machines with respect to their technical and metrological characteristics during PMS. RESULTS The developed method was validated between 2018 and 2021 in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of anaesthesia machines as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION A standardized approach in conformity assessment testing of anaesthesia machines during PMS, besides increasing reliability of the devices, is the first step in digital transformation of management of these devices in healthcare institutions opening possibility for use of artificial intelligence.
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Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,International Federation of Medical and Biological Engineering (IFMBE), Sarajevo, Bosnia and Herzegovina
| | - Amar Deumic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina
| | - Zijad Dzemic
- Institute of Metrology of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Lejla Gurbeta Pokvic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
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14
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Badnjevic A, Deumic A, Imamovic E, Pokvic LG. A novel method for conformity assessment testing of defibrillators for post-market surveillance purposes. Technol Health Care 2023; 31:317-325. [PMID: 36530104 DOI: 10.3233/thc-229007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Defibrillators are medical devices (MDs) used in the most critical situations, hence their performance must be ensured at all times. This requires defibrillators to be subjected to regular performance assessments after they have been placed on the market. The new Medical Device Regulation (MDR) defines medical device post-market surveillance (PMS) as performed by independent, third-party, notified bodies more strategically in hope to improve traceability of device performance. However, there is still an apparent gap in terms of standardised conformity assessment testing methods. OBJECTIVE This paper proposes a novel evidence-based method for conformity assessment testing of defibrillators. METHOD The proposed method is developed in accordance with the International Organisation of Legal Metrology (OIML) guidelines and is intended to be used for conformity assessment testing of defibrillators for post-market surveillance purposes. RESULTS The developed method was validated from 2018 to 2021 in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of defibrillators as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION A standardized approach in conformity assessment testing of defibrillators during PMS, besides increasing reliability of the devices, is the first step in the digital transformation of the management of these devices in healthcare institutions opening possibility for use of artificial intelligence.
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Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,International Federation of Medical and Biological Engineering (IFMBE), Sarajevo, Bosnia and Herzegovina
| | - Amar Deumic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina
| | - Elma Imamovic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
| | - Lejla Gurbeta Pokvic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
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15
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Badnjevic A, Deumic A, Ademovic A, Pokvic LG. A novel method for conformity assessment testing of therapeutic ultrasounds for post-market surveillance purposes. Technol Health Care 2023; 31:339-346. [PMID: 36530106 DOI: 10.3233/thc-229009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Therapeutic ultrasounds are medical devices used for treatment of conditions such muscle spasms, joint contractures or general muscle pain. Their function relies in the delivery of ultrasonic pulses that generate heat in tissue thus relieving the symptoms of aforementioned conditions. Accuracy of the delivered pulses directly affects the quality and effectiveness of the treatment and has to be ensured throughout the utilization of the therapeutic ultrasound in practice. The new Medical Device Regulation (MDR) defines medical device post-market surveillance (PMS) as performed by independent, third-party, notified bodies more strategically in hope to improve traceability of device performance. However, there is still an apparent gap in terms of standardised conformity assessment testing methods. OBJECTIVE This paper proposes a novel method for conformity assessment testing of therapeutic ultrasounds for post-market surveillance purposes. METHOD The method was developed based on metrology characteristics of therapeutic ultrasounds and includes visual, electrical safety and performance inspections of therapeutic ultrasounds to ensure that both safety and treatment reliability are achieved. RESULTS The developed method was validated between 2018 and 2021 in healthcare institutions of all levels. The results obtained during validation suggest that conformity assessment testing of therapeutic ultrasounds as a method used during PMS contributes to significant improvement in devices' accuracy and reliability. CONCLUSION A standardized approach in conformity assessment testing of therapeutic ultrasounds during PMS, besides increasing reliability of the devices, is the first step in digital transformation of management of these devices in healthcare institutions opening possibility for use of artificial intelligence.
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Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,International Federation of Medical and Biological Engineering (IFMBE), Sarajevo, Bosnia and Herzegovina
| | - Amar Deumic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Medical Device Inspection Laboratory, Verlab Ltd., Sarajevo, Bosnia and Herzegovina
| | - Azra Ademovic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
| | - Lejla Gurbeta Pokvic
- Verlab Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina
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16
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Senirkentli GB, İnce Bingöl S, Ünal M, Bostancı E, Güzel MS, Açıcı K. Machine learning based orthodontic treatment planning for mixed dentition borderline cases suffering from moderate to severe crowding: An experimental research study. Technol Health Care 2023; 31:1723-1735. [PMID: 36970921 DOI: 10.3233/thc-220563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Pedodontists and general practitioners may need support in planning the early orthodontic treatment of patients with mixed dentition, especially in borderline cases. The use of machine learning algorithms is required to be able to consistently make treatment decisions for such cases. OBJECTIVE This study aimed to use machine learning algorithms to facilitate the process of deciding whether to choose serial extraction or expansion of maxillary and mandibular dental arches for early treatment of borderline patients suffering from moderate to severe crowding. METHODS The dataset of 116 patients who were previously treated by senior orthodontists and divided into two groups according to their treatment modalities were examined. Machine Learning algorithms including Multilayer Perceptron, Linear Logistic Regression, k-nearest Neighbors, Naïve Bayes, and Random Forest were trained on this dataset. Several metrics were used for the evaluation of accuracy, precision, recall, and kappa statistic. RESULTS The most important 12 features were determined with the feature selection algorithm. While all algorithms achieved over 90% accuracy, Random Forest yielded 95% accuracy, with high reliability values (kappa = 0.90). CONCLUSION The employment of machine learning methods for the treatment decision with or without extraction in the early treatment of patients in the mixed dentition can be particularly useful for pedodontists and general practitioners.
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Affiliation(s)
| | | | - Metehan Ünal
- Computer Engineering Department, Faculty of Engineering, Ankara University, Ankara, Turkey
| | - Erkan Bostancı
- Computer Engineering Department, Faculty of Engineering, Ankara University, Ankara, Turkey
| | - Mehmet Serdar Güzel
- Computer Engineering Department, Faculty of Engineering, Ankara University, Ankara, Turkey
| | - Koray Açıcı
- Artificial Intelligence and Data Engineering Department, Faculty of Engineering, Ankara University, Ankara, Turkey
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17
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Critical Device Reliability Assessment in Healthcare Services. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:3136511. [PMID: 36860328 PMCID: PMC9970731 DOI: 10.1155/2023/3136511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 04/05/2022] [Indexed: 02/22/2023]
Abstract
Medical device reliability is the ability of medical devices to endure functioning and is indispensable to ensure service delivery to patients. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) technique was employed in May 2021 to evaluate existing reporting guidelines on medical device reliability. The systematic searching is conducted in eight different databases, including Web of Science, Science Direct, Scopus, IEEE Explorer, Emerald, MEDLINE Complete, Dimensions, and Springer Link, with 36 articles shortlisted from the year 2010 to May 2021. This study aims to epitomize existing literature on medical device reliability, scrutinize existing literature outcomes, investigate parameters affecting medical device reliability, and determine the scientific research gaps. The result of the systematic review listed three main topics on medical device reliability: risk management, performance prediction using Artificial Intelligence or machine learning, and management system. The medical device reliability assessment challenges are inadequate maintenance cost data, determining significant input parameter selection, difficulties accessing healthcare facilities, and limited age in service. Medical device systems are interconnected and interoperating, which increases complexity in assessing their reliability. To the best of our knowledge, although machine learning has become popular in predicting medical device performance, the existing models are only applicable to selected devices such as infant incubators, syringe pumps, and defibrillators. Despite the importance of medical device reliability assessment, there is no explicit protocol and predictive model to anticipate the situation. The problem worsens with the unavailability of a comprehensive assessment strategy for critical medical devices. Therefore, this study reviews the current state of critical device reliability in healthcare facilities. The present knowledge can be improved by adding new scientific data emphasis on critical medical devices used in healthcare services.
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18
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Xu S, Zhang T, Sheng T, Liu J, Sun M, Luo L. Cost supervision mining from EMR based on artificial intelligence technology. Technol Health Care 2022; 31:1077-1091. [PMID: 36617803 DOI: 10.3233/thc-220608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND To effectively monitor medical insurance funds in the era of big data, the study tries to construct an inpatient cost rationality judgement model by designing a virtuous cycle of inpatient cost supervision information system and exploring a complete set of inpatient cost supervision methods. OBJECTIVE To lay the foundation for applying artificial intelligence (AI) technology in medical insurance cost control supervision and provide feasible paths and available tools for medical insurance cost control managers. METHODS By way of collecting and cleaning electronic medical record (EMR) data from 2016 to 2018 of a city in East China, focusing on basic patient information and cost information, and using a combination of machine learning modeling and information system construction, the study tries to form a feasible inpatient cost supervision method and operation path. RESULTS The set of the regulatory method, applied in nursing homes of a city in East China, is compelling. The accuracy rates of rationality judgement in different main diseases are stable up to 80%, the false positive rate is steady within 10%, and rehabilitation fee days of hospitalization, and the number of complications are important factors affecting the rationality of the inpatient cost. CONCLUSION The model construction and optimization method combining machine learning and information system can make practical cost rationality judgement on medical institution's inpatient cost data, which can directly reflect the key influencing factors of relevant inpatient costs, and achieve the effect of guiding medical behavior and improving the efficiency of medical insurance fund use.
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Affiliation(s)
- Site Xu
- School of Public Health, Fudan University, Shanghai, China.,Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,School of Public Health, Fudan University, Shanghai, China
| | - Tiantian Zhang
- School of Public Health, Fudan University, Shanghai, China.,School of Public Health, Fudan University, Shanghai, China
| | - Tao Sheng
- School of Computer Science and Technology, Fudan University, Shanghai, China
| | - Jiaxing Liu
- School of Software, Fudan University, Shanghai, China
| | - Mu Sun
- Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Li Luo
- School of Public Health, Fudan University, Shanghai, China
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19
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Badnjevic A. Evidence-based maintenance of medical devices: Current shortage and pathway towards solution. Technol Health Care 2022; 31:293-305. [PMID: 36502353 DOI: 10.3233/thc-229005] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Almir Badnjevic
- Verlab Research Institute, Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy, University of Sarajevo, Bosnia and Herzegovina
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20
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Badnjević A, Pokvić LG, Deumić A, Bećirović LS. Post-market surveillance of medical devices: A review. Technol Health Care 2022; 30:1315-1329. [PMID: 35964220 DOI: 10.3233/thc-220284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Medical devices (MDs) represent the backbone of the modern healthcare system. Considering their importance in daily medical practice, the process of manufacturing, marketing and usage has to be regulated at all levels. Harmonized evidence-based conformity assessment of MDs during PMS relying on traceability of medical device measurements can contribute to higher reliability of MD performance and consequently to higher reliability of diagnosis and treatments. OBJECTIVE This paper discusses issues within MD post-market surveillance (PMS) mechanisms in order to set a path to harmonization of MD PMS. METHODS Medline (1980-2021), EBSCO (1991-2021), and PubMed (1980-2021) as well as national and international legislation and standard databases along with reference lists of eligible articles and guidelines of relevant regulatory authorities such as European Commission, Food and Drug Administration were searched for relevant information. Journal articles that contain information regarding PMS methodologies concerning stand-alone medical devices. National and international legislation, standards and guidelines concerning the topic. RESULTS The search strategy resulted in 2282 papers. Out of those only 24 articles satisfied the eligibility criteria and were finally included in the review. Papers were grouped per categories: medical device registry, medical device adverse event reporting, and medical device performance evaluation. In addition to journal articles, national and international legislation, standards, and guidelines were reviewed to assess the state of PMS in different regions of the world. CONCLUSION Although the regulatory framework prescribes PMS of medical devices, the process itself is not harmonized with international standards. Particularly, conformity assessment of MDs, as an important part of PMS, is not measured and managed in a traceable, evidence-based manner. The lack of harmonization within PMS results in an environment of increased adverse events involving MDs and overall mistrust in medical device diagnosis and treatment results.
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Affiliation(s)
- Almir Badnjević
- Faculty of Pharmacy.,Verlab, Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy
| | - Lejla Gurbeta Pokvić
- Verlab, Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,International Federation on Medical and Biological Engineering (IFMBE), Sarajevo, Bosnia and Herzegovina.,European Alliance for Medical and Biological Engineering and Science (EAMBES), Sarajevo, Bosnia and Herzegovina.,, Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy
| | - Amar Deumić
- , Sarajevo, Bosnia and Herzegovina.,Verlab, Medical Device Inspection Laboratory, Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy
| | - Lemana Spahić Bećirović
- Verlab, Research Institute for Biomedical Engineering, Medical Devices and Artificial Intelligence, Sarajevo, Bosnia and Herzegovina.,, Sarajevo, Bosnia and Herzegovina.,Faculty of Pharmacy
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21
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Parida PK, Dora L, Swain M, Agrawal S, Panda R. Data science methodologies in smart healthcare: a review. HEALTH AND TECHNOLOGY 2022. [DOI: 10.1007/s12553-022-00648-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Zamzam AH, Al-Ani AKI, Wahab AKA, Lai KW, Satapathy SC, Khalil A, Azizan MM, Hasikin K. Prioritisation Assessment and Robust Predictive System for Medical Equipment: A Comprehensive Strategic Maintenance Management. Front Public Health 2021; 9:782203. [PMID: 34869194 PMCID: PMC8637834 DOI: 10.3389/fpubh.2021.782203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/25/2021] [Indexed: 01/25/2023] Open
Abstract
The advancement of technology in medical equipment has significantly improved healthcare services. However, failures in upkeeping reliability, availability, and safety affect the healthcare services quality and significant impact can be observed in operations' expenses. The effective and comprehensive medical equipment assessment and monitoring throughout the maintenance phase of the asset life cycle can enhance the equipment reliability, availability, and safety. The study aims to develop the prioritisation assessment and predictive systems that measure the priority of medical equipment's preventive maintenance, corrective maintenance, and replacement programmes. The proposed predictive model is constructed by analysing features of 13,352 medical equipment used in public healthcare clinics in Malaysia. The proposed system comprises three stages: prioritisation analysis, model training, and predictive model development. In this study, we proposed 16 combinations of novel features to be used for prioritisation assessment and prediction of preventive maintenance, corrective maintenance, and replacement programme. The modified k-Means algorithm is proposed during the prioritisation analysis to automatically distinguish raw data into three main clusters of prioritisation assessment. Subsequently, these clusters are fed into and tested with six machine learning algorithms for the predictive prioritisation system. The best predictive models for medical equipment's preventive maintenance, corrective maintenance, and replacement programmes are selected among the tested machine learning algorithms. Findings indicate that the Support Vector Machine performs the best in preventive maintenance and replacement programme prioritisation predictive systems with the highest accuracy of 99.42 and 99.80%, respectively. Meanwhile, K-Nearest Neighbour yielded the highest accuracy in corrective maintenance prioritisation predictive systems with 98.93%. Based on the promising results, clinical engineers and healthcare providers can widely adopt the proposed prioritisation assessment and predictive systems in managing expenses, reporting, scheduling, materials, and workforce.
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Affiliation(s)
- Aizat Hilmi Zamzam
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.,Engineering Services Department, Ministry of Health Malaysia, Putrajaya, Malaysia
| | | | - Ahmad Khairi Abdul Wahab
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Khin Wee Lai
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Suresh Chandra Satapathy
- School of Computer Engineering, Kalinga Institute of Industrial Technology, Deemed to Be University, Bhubaneswar, India
| | - Azira Khalil
- Faculty of Science and Technology, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Muhammad Mokhzaini Azizan
- Department of Electrical and Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Khairunnisa Hasikin
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
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23
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Zamzam AH, Abdul Wahab AK, Azizan MM, Satapathy SC, Lai KW, Hasikin K. A Systematic Review of Medical Equipment Reliability Assessment in Improving the Quality of Healthcare Services. Front Public Health 2021; 9:753951. [PMID: 34646808 PMCID: PMC8503610 DOI: 10.3389/fpubh.2021.753951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022] Open
Abstract
Medical equipment highly contributes to the effectiveness of healthcare services quality. Generally, healthcare institutions experience malfunctioning and unavailability of medical equipment that affects the healthcare services delivery to the public. The problems are frequently due to a deficiency in managing and maintaining the medical equipment condition by the responsible party. The assessment of the medical equipment condition is an important activity during the maintenance and management of the equipment life cycle to increase availability, performance, and safety. The study aimed to perform a systematic review in extracting and categorising the input parameters applied in assessing the medical equipment condition. A systematic searching was undertaken in several databases, including Web of Science, Scopus, PubMed, Science Direct, IEEE Xplore, Emerald, Springer, Medline, and Dimensions, from 2000 to 2020. The searching processes were conducted in January 2020. A total of 16 articles were included in this study by adopting Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The review managed to classify eight categories of medical equipment reliability attributes, namely equipment features, function, maintenance requirement, performance, risk and safety, availability and readiness, utilisation, and cost. Applying the eight attributes extracted from computerised asset maintenance management system will assist the clinical engineers in assessing the reliability of medical equipment utilised in healthcare institution. The reliability assessment done in these eight attributes will aid clinical engineers in executing a strategic maintenance action, which can increase the equipment's availability, upkeep the performance, optimise the resources, and eventually contributes in providing effective healthcare service to the community. Finally, the recommendations for future works are presented at the end of this study.
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Affiliation(s)
- Aizat Hilmi Zamzam
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia.,Engineering Services Department, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Ahmad Khairi Abdul Wahab
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Mokhzaini Azizan
- Department of Electrical and Electronic Engineering, Faculty of Engineering and Built Environment, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Suresh Chandra Satapathy
- School of Computer Engineering, Kalinga Institute of Industrial Technology, Deemed to Be University, Bhubaneswar, India
| | - Khin Wee Lai
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Khairunnisa Hasikin
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
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24
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Čaušević A, Hasković E, Eminović I, Fočak M, Mešić A, Lutvikadić I, Pokvić LG, Badnjević A. Hemolytic effect of Vipera ammodytes subspecies venom and it’s cytogenotoxicity on the human lymphocites. HEALTH AND TECHNOLOGY 2021. [DOI: 10.1007/s12553-021-00558-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Badnjević A. Editorial to the special issue on CMBEBIH 2019: biomedical engineering - share the vision. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-020-00407-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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