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Posted on Jun 1, 2012 in Articles, Editorial | 0 comments

Validate an App: How to Design Your Study and Get Published


Dr Orrin Franko MD2
1Lead App Editor, Journal of Mobile Technology in Medicine, 2Dept of Orthopaedic Surgery, University of California, USA.
Corresponding Author:
Journal MTM 1:2:1-4, 2012

The last two years have demonstrated an exponential growth in the use of smartphones and tablets by medical professionals, a trend that has led to medical apps developed specifically for patients and physicians.1-71. Azark R. Smartphone apps for your practice. CDS Rev 2011;104:12-13.
2. Bhansali R, Armstrong J. Smartphone applications for pediatric anesthesia. Paediatr Anaesth 2012;22:400-404.
3. Franko OI. Smartphone apps for orthopaedic surgeons. Clin Orthop Relat Res 2011;469:2042-2048.
4. Franko OI, Bhola S. iPad apps for orthopedic surgeons. Orthopedics 2011;34:978-981.
5. Oehler RL, Smith K, Toney JF. Infectious diseases resources for the iPhone. Clin Infect Dis 2010;50:1268-1274.
6. Rosser BA, Eccleston C. Smartphone applications for pain management. J Telemed Telecare 2011;17:308-312.
7. Franko OI, Tirrell TF. Smartphone App Use Among Medical Providers in ACGME Training Programs. J Med Syst 2011.
Not surprisingly, because most app developers are unverified sources of medical information, recent publications have emphasized the importance of peer-review validation.7-107. Franko OI, Tirrell TF. Smartphone App Use Among Medical Providers in ACGME Training Programs. J Med Syst 2011.
8. Boulos MN, Wheeler S, Tavares C, Jones R. How smartphones are changing the face of mobile and participatory healthcare: an overview, with example from eCAALYX. Biomed Eng Online 2011;10:24.
9. Hamilton AD, Brady RR. Medical Professional Involvement in Smartphone Apps in Dermatology. Br J Dermatol 2012.
10. Kabachinski J. Mobile medical apps changing healthcare technology. Biomed Instrum Technol 2011;45:482-486.
  In addition to safety concerns, the validation of mobile apps in the health care setting provides an opportunity for younger physicians, often medical students and residents, to contribute to the medical community by demonstrating the efficacy and validity of these new technologies.  However, many trainees and practicing physicians are unfamiliar with scientific validation methodology.  This editorial outlines a structure that can be used to assist with the design, execution, and publication of a validation study for mobile technology.

Validation refers to proving a tool’s ability to report the absolute “truth” as much as it can be measured.  Various forms of validity exist that, when combined, allow a tool to be considered “valid” by the medical community.  To clarify various forms of validation, I will share examples from the current literature, which can serve as guides for providers interested in designing a study of their own.

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Posted on Jun 1, 2012 in Articles, Editorial | 0 comments

Principles of Security for the use of Mobile Technology in Medicine

Dr Chandrashan Perera MBBS1,2
1Editor-In-Chief, Journal of Mobile Technology in Medicine, 2Austin Hospital, Melbourne, Australia
Corresponding Author:
Journal MTM 1:2:5-7, 2012

The rapid uptake of mobile technologies has allowed a number of innovations in the medical field1Luanrattana R, Win KT, Fulcher J, Iverson D. Mobile technology use in medical education. J Med Syst. 2012 Feb.;36(1):113–22.,2Zurovac D, Talisuna AO, Snow RW. Mobile phone text messaging: tool for malaria control in Africa. PLoS Med. 2012 Feb.;9(2):e1001176. .  However, as with any new technology, there are a number of security concerns that need to be acknowledged and addressed in order for these technologies to be implemented safely3Fernando JIE. Clinical software on personal mobile devices needs regulation. Med J Aust. 2012 Apr. 17;196(7):437. .  This is of particular significance in the medical realm where confidentiality of patient data needs to be preserved.  Whilst data security is considered a more sensitive topic with evolving technologies, it is important to also consider the security benefits provided by mobile technologies.

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Posted on Jun 1, 2012 in Articles, Letters | 0 comments

An experience of the virtual desktop: a surgical perspective

Dr Pamela Boekel MBBS1
1Austin Hospital, Heidelberg, Australia
Corresponding Author:
Journal MTM 1:2:8-10, 2012

With the advent of mobile technology, the interface in which the clinician can view medical imaging and electronic records is more accessible than ever1Citrix. Making the iPad work for healthcare. In: Inc CS, editor. Fort Lauterdale, USA2010.. The Citrix Receiver™ provides a secure platform for clinicians to access a virtual desktop, linked to the hospital server, via their mobile tablet device or laptop computer.  This technology was born out of the need for mobile offices dedicated for the clinician, and has since been adopted by medical professionals in many centres as a means for offsite access to hospital electronic medical records (EMR).  With the nascent boom of health informatics and ‘tele-medicine’ due to the birth of mobile devices, we are continuously in the pursuit towards improving the efficacy and timeliness of healthcare delivery as well as ensuring patient safety.  Citrix ReceiverTM is but one example and it is currently in use amongst the Orthopaedic registrars at the Austin Hospital in metropolitan Melbourne, Victoria.

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Posted on Jun 1, 2012 in Articles, Original Article | 0 comments

Mobile Technology Usage by Orthopaedic Surgeons and Trainees in Australia

Dr James Churchill MBBS1
1Dept. of Orthopaedics, Western Health, Melbourne, Australia
Corresponding Author:
Journal MTM 1:2:11-15, 2012

Background: The use of smartphones and portable tablet devices is increasingly more common and widespread in Australia. Usage amongst medical professionals is increasing in a number of fields. The purpose of this study was to gain insight into the current and future usage of these devices by orthopaedic surgeons and orthopaedic trainees, in addition to understanding the perceived impact on patient care.

Methods: A survey examining mobile technology usage was administered via email to a number of orthopaedic surgeons and trainees across Australia. Data regarding the respondents’ownership and usage of mobile technology, perceived future usage, and impact on patient care and productivity was collected and analysed.

Results: 97.7% of respondents currently use a smartphone, and 58.1% use a tablet device. The most common work use was for professional contact (78%), viewing journals,online educational resources (68.3%), and viewing radiology (46.3%). Respondents showed a significant interest in the ability to view x-rays and computed tomography (CT) in the future. Overall, surgeons indicated that mobile technology improves patient care and productivity, and they believe they will use it more often in the future.

Conclusion: Mobile technology usage is highly prevalent amongst orthopaedic surgeons and trainees in Australia. These technologies may be used to facilitate improved quality and timely provision of care.

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Posted on Jun 1, 2012 in Articles, Original Article | 0 comments

Accuracy of Mobile Phone Pedometer Technology

Dr Glenn Boyce MBBS1, Dr Gayan Padmasekara MBBS2,Dr Martin Blum FRACS1
1Dept. Orthopaedics, Albury Wodonga Health, Albury, Australia, 2Dept. Orthopaedics, Bendigo Health, Bendigo, Australia
Corresponding Author:
Journal MTM 1:2:16-22, 2012

Background: Moderate to high intensity activity is an important component in weight loss. The ability to use free technology to monitor activity would provide a useful clinical tool.

Methods: Three popular pedometer mobile applications (“iSteps Lite”, “Pedometer Lite” and “Lyr Free”) were compared to a conventional pedometer. Outcome measures included step recording, speed estimate, distance recorded over a fixed distance and steps recorded during car travel.

Results: All devices show inaccuracy in step count and speed estimate at varying intensities of activity. For measurement of 100 steps at medium intensity activity, the range of recorded step counts detected at medium sensitivity was 69.3 to 101.3. Valid and reliable results for step count were seen with the control pedometer and with one program at moderate sensitivity settings for moderate and high intensity activity. The most accurate distance recorded and estimate of speed over a fixed distance was from a program with Global Positioning System (GPS) functionality.

Conclusion: It is possible to determine a step count as accurate as a control pedometer with careful selection of program and calibration. When exercising over a distance, a program with GPS functionality leads to the most accurate determination of speed estimate and distance recorded.

Key words: Pedometer, Accuracy, Mobile Phone, Weight Loss, Technology, Software

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Posted on Jun 1, 2012 in Articles, Original Article | 0 comments

Accuracy of using a tablet device for the use of digital radiology manipulation and measurements

Dr Yasith Edirisinghe MBBS1, Mr Marcus Crossette BaAppSc1
1Southern Health, Clayton, Australia
Journal MTM 1:2:23-27, 2012

Background: Integration of information technology and the birth of e-health has been a phenomenon in the last few decades and currently it is thoroughly embraced. It has been a tampered concept in the past to use portable devices to access digital radiology. However necessary resolution and processing capabilities have not been available to meet the demands. With the integration of high-resolution tablet devices and easy access touch software, we are now at a point where this concept can finally become a reality. As part of this feasibility analysis we have conducted a small experiment to assess tablet devices and its ability to manipulate and gain measurements of complex high-resolutioncomputed tomography (CT)images.

Methods: A human skeleton foot was put through an advanced 320 slice dynamic CT scanner. The obtained DICOM data was manipulated and distance measurements were taken using Osirix software between 2 very distinguishable points. The same 2 points were identified on the skeleton and the distances were measured precisely using calipers.

Results: When measuring distances using defined anatomical landmarks on a real skeleton and the CT scan on the iPad, the measurements correlated to within 1mm, with a mean percentage error of 1.3%. The tablet device image processing capability was very user friendly and ergonomic. However the software processing capability of the tablet was limited to simple distance measurements. The processing speed was inferior to a laptop and 3D reconstructions were not possible with the current software.

Conclusion: Tablet devices have reached the complexity needed to be an excellent portable digital radiology access point. However at the moment this remains as a concept envisioned but not applied. This concept currently is limited by the processing capability and the software design of these devices. This is undoubtedly going to change with the further advancement of tablet technology and its software.

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Posted on Jun 1, 2012 in Articles, Case report | 0 comments

Video Multimedia Messaging System (MMS) supporting referral for an acute subdural haemorrhage: A case report

Dr Kristy Scandrett MBBS1
1Dept. Neurosurgery, St Vincent’s Hospital, Fitzroy, Australia
Corresponding Author:
Journal MTM 1:2:28-30, 2012

Neurosurgery is a specialised field of medicine restricted to major metropolitan tertiary hospitals.  A number of neurosurgical conditions are high acuity medical problems which may require rapid diagnosis and treatment.  Peripheral hospitals need to convey not only clinical, but also radiological information rapidly and accurately to the receiving neurosurgical unit. We describe a case report of the use of video MMS to aid in the referral of a 60 year old man with an acute on chronic subdural haemorrhage to a neurosurgical unit, expediting the transfer and definitive management of this patient.

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