Scott Cunningham, Technical Consultant, University of DundeeTechnology to Support Population-Based Diabetes Care
'Act like a Startup to Transform Healthcare Innovation'
25th January 2012
We all know that we are living in a world of tremendous change, with new demands on services, less supply of resources, a population with rapidly changing health needs and incredible developments in technology. This talk will share examples of how startups are changing the world in their favour, and will talk about what large organisations can achieve by thinking and acting like a startup.
The talk wasl be delivered by Adil Abrar, the founder of a health startup (buddyapp.org) and Sidekick School, an incubator for other startups.
Assessing and improving hearing with cochlear implants in noisy spaces
29th February 2012
Cochlear implants (CIs) can restore speech understanding in quiet but most implant users complain that noise and reverberation make speech understanding difficult or even impossible. In normal hearing, several mechanisms contribute to our ability to hear out one source in a potpourri of sources. This so called auditory scene analysis uses monaural and binaural cues which are often degraded in electric hearing. I will review our research on auditory scene analysis by CI users with a particular focus on the effect of reverberation on binaural hearing. The results of our studies suggest ways to improve the coding of binaural cues in implants which will be discussed.
Auditory FMRI of the Deaf
22nd March 2012
Stimulability of the auditory system is a prerequisite to successful cochlear implantation (CI). FMRI audiometry and promontory testing can demonstrate the integrity of the auditory system, even in virtually deaf CI candidates irrespective of their subjective hearing. These advanced FMRI applications are, in conjunction with each other and probabilistic tractography of the acoustic radiation, useful to decide i) which ear should host the CI and ii) whether a different device implanted at the brainstem or midbrain level should be considered. This talk illustrates actual decision-makings based on clinical cases.
Virtual agency, embodiment and analgesia in phantom limb pain
28th March 2012
Phantom limb pain (PLP) had been considered due to loss of sensory input and central plasticity, though Ramachandran, following use of a mirror box (Ramachandran and Rogers-Ramachandran, Proc Roy Soc B, 1996, 263, 377-386), suggested that it may result from mismatch between sensory input and motor intention.
Whilst other VR system have been essentially virtual mirrors, with a requirement to imagine moving the amputated limb whilst also moving the remaining one, we have developed a virtual limb, seen on a screen or in a HMD, which moves in real time relation to movement of the amputee’s residual limb [stump] recorded using a magnetic motion sensor. The arm moves to a table and grasps an apple as the subject guides his stump or shoulder forward and medially; a leg plays a base drum. In these pre-recorded tasks controlled by the patient, as they move their residual limb forward, so the screen limb moves; if they stop, so does the animation. This temporal mismatch allows visual feedback of intention or agency.
As patients with severe PLP learnt to move the virtual limb under their own intention, they felt their VR induced limbs move and grasp. With virtual agency and re-embodiment their pain reduced by amounts, on a visual analogue scale, more than can be explained by distraction alone. Though the task soon leads to immersion, VR induced agency and limb ownership in minutes, it does require mental effort and so is tiring. Better, more game like and portable tasks are needed.
This work was supported by The Wellcome Trust.
Cole J, Crowle S, Austwick G and Henderson-Slater D. Exploratory findings in virtual induced agency for phantom limb pain. Disability & Rehabilitation, 2009, 31, 10, 846 – 854.
Developing and using digital health systems for patient care: lessons from 3 decades in the field.
25th April 2012
Thirty years ago the challenges in health informatics were user acceptability, the cost of disk space and lack of suitable coding schemes. Today the challenges are more to do with interoperability, information governance and monitoring outcomes. Progress has been frustratingly slow. I will seek to demonstrate that these problems are not essentially technical, but have much to do with the short-term survival strategies pursued by suppliers and hospitals, which have favoured lock-in over openness. We will not achieve patient-centric computing without some sort of regulator, with financial incentives and penalties, to ensure a level playing field.
Tim Benson founded Abies in 1980; he is author of Principles of Health Interoperability HL7 and SNOMED (Springer 2101). Current projects include leading the TSB-funded miConsent project, which allows patients to give others access to their records; new tools for monitoring health outcomes (howRU) and patient experience (howRwe); and standardised metadata, CDA and XDS specifications for the Wellcome Trust's Sintero platform.
Scott Cunningham, Technical Consultant, University of DundeeTechnology to Support Population-Based Diabetes Care
30th April 2012
Scottish Care Information - Diabetes Collaboration (SCI-DC) is a web-based clinical information system, supporting the care of people with diabetes. This session will show how SCI-DC supports NHS Scotland's Healthcare Quality Strategy and its six dimensions of quality. The data presented will outline the effect of diabetes care on process and long-term outcomes, explain how it has been used to highlight areas for clinical improvement and how it has influenced recommendations for national health care policy and planning. Areas of ‘secondary use’ will be discussed including epidemiological research and how patients are now accessing their own records.
Beyond the audiogram: hearing-aid outcomes in older adults
30th May 2012
The relationship between sensitivity to temporal fine structure information and hearing aid outcomes was investigated in 75 older adults over the first six-months of hearing aid provision. Prior to receiving hearing aids, participants completed a short test to determine their sensitivity to TFS , part one of the Glasgow Hearing Aid Benefit Profile (GHABP: ), and the Speech, Spatial and Qualities of Hearing (SSQ-A: ). Follow-up appointments were conducted three and six months post hearing-aid fitting and comprised of a speech reception task, the GHABP part two, the Speech Spatial and Qualities of Hearing: Benefit (SSQ-B: ), and the International Outcome Inventory for Hearing Aid Outcomes (IOI-HA: ). GHABP self-report scores were not associated with age or hearing loss; pre-defined situations on the GHABP tended to underestimate the degree of difficulty and handicap experienced by patients pre-fitting compared to the self-nominated situations. SSQ-A self-report scores were moderately associated with degree of hearing loss. This suggests that either the breadth of situations covered by SSQ-A or the range of scores available make it more sensitive to the impact of hearing loss on a patient’s life than the GHABP. Sensitivity to TFS was weakly associated with age, but not with hearing loss or GHABP self-reports. This indicates that impairments to TFS information are fairly independent of age and hearing loss. Two thirds of participants were found to have good sensitivity to TFS; listeners with good sensitivity to TFS rated their hearing abilities higher at pre-fitting (SSQ-A) than those with poor sensitivity to TFS. At the follow-up visits, participants with good sensitivity to TFS showed a small advantage for identifying speech in noise on the SRT task over listeners with poor sensitivity to TFS, but also reported experiencing significantly poorer spatial processing abilities (SSQ-B) than those with poor sensitivity to TFS. The clinical identification of a patient’s ability to process TFS information at an early stage in the treatment pathway could prove useful in managing expectations about hearing aid outcomes.
Designing digital interventions: Applying theories and methods from health psychology
27th June 2012
People often behave in ways that harm their health because the short-term rewards are more powerful than the perceived longer-term benefits. Interventions to change such behaviours have had modest effects (NICE, 2007). Interventions will be strengthened by:
Better application of behaviour change theory, more precise specification of content in terms of behaviour change techniques developing methods for responsively intervening “in the moment” and using “optimisation” study designs.
Digital interventions present enormous opportunities advancing the field by allowing tailored “real time” interventions and optimisation designs. If the potential of such opportunities is to be maximised, these opportunities must be underpinned by behavioural science.
This talk will outline the contribution of behavioural science in relation to three studies:
1. Identifying the ‘active ingredients’ within Txt2stop, a mobile phone messaging intervention that doubled smoking cessation (Free et al, Lancet, 2011)
2. Applying behaviour change theory and evidence-based behaviour change techniques to developing StopAdvisor, an interactive, internet-based smoking cessation intervention (Michie et al, in press)
3. Using mobile phone technology to sense the user's activities, mood, location, and who they are with or talking to, and online social networks to collect information about users' attitudes and social contacts. UBhave will use this to deliver the right kind of messages to users at the right time, depending on what the user is doing and feeling (http://ubhave.org/).
Click here for a video of the presentation
Dr. Philip Scott, Senior Lecturer, School of Computing, Portsmouth University
A systematic review of health informatics measurement variables and instruments
Health informatics is a relatively immature discipline in which theory is given insufficient attention (Scott, Briggs, Wyatt & Georgiou, 2011; Wyatt, 1996) and which “does not have a well-established tradition of ‘variables worth measuring’ or proven instruments for measuring them” (Friedman, Wyatt & Owens, 2006).Standardized and well-understood outcome variables and instruments are needed to enable consistent study design, analysis and reporting and to facilitate subsequent systematic reviews. Without an established catalogue of outcome variables and instruments, health informatics evaluations will continue to re-invent artefacts and methods and the evidence base in the field will continue to be weak and inconclusive (Clamp & Keen, 2006; Scott, 2010).The consideration of theoretical constructs will help to address the need for a stronger conceptual foundation for the discipline (Brennan, 2008; Friedman, 2009).A systematic review of health informatics measurement variables and instruments is underway in the Centre for Healthcare Modelling and Informatics at the University of Portsmouth This study seeks to build upon and update the work by Friedman & Abbas, 2003.The presentation will report progress to date, including the methods and preliminary results. The discussion will also explore the alleged ‘paradigm war’ in health informatics evaluation and the incommensurable worldviews the ‘sides’ are claimed to represent (Greenhalgh, Russell, Ashcroft & Parsons, 2011).
Brennan, P. F. (2008). Standing in the shadows of theory. J Am Med Inform Assoc, 15(2), 263-264. Clamp, S., & Keen, J. (2006). Electronic health records: is the evidence base any use? Proceedings of Healthcare Computing.
Friedman,C. P. (2009). A "fundamental theorem" of biomedical informatics. J Am Med Inform Assoc, 16(2), 169-170. doi:10.1197/jamia.M3092
Friedman, C. P., & Abbas, U. L. (2003). Is medical informatics a mature science? A review of measurement practice in outcome studies of clinical systems. Int J Med Inform, 69(2-3), 261-272.
Friedman, C. P., Wyatt, J. C., & Owens, D. K. (2006). Evaluation and technology assessment. In E. H. Shortliffe & J. Cimino (Eds.), Biomedical informatics. Computer applications in health care and biomedicine. (3rd ed.). New York, NY: Springer.
Greenhalgh, T., Russell, J., Ashcroft, R. E., & Parsons, W. (2011). Why national eHealth programs need dead philosophers: Wittgensteinian reflections on policymakers' reluctance to learn from history. Milbank Q, 89(4), 533-563. doi:10.1111/j.1468-0009.2011.00642.xScott, P. J. (2010). Health informatics - where's the evidence? Health Informatics Now, 5(1), 10-12. http://www.bcs.org/upload/pdf/hinow-autumn-2010.pdf
Scott, P. J., Briggs, J. S., Wyatt, J. C., & Georgiou, A. (2011). How Important is Theory in Health Informatics? A Survey of the UK Health Informatics Academic Community. Studies in Health Technology and Informatics, 169, 223-227. doi:10.3233/978-1-60750-806-9-223Wyatt, J. (1996). Medical informatics, artefacts or science? Methods Inf Med, 35(3), 197-200.
Professor Norbert Noury, Institute of Technology, University of Lyon
Health Smart Homes – Ambient Intelligence is measuring our actimetry”
During the past centuries Humans deeply modified their relationship to their housings. With the improvements in communication technologies, humans are nomads again but still await for more services from their living place as comfort, security, wellness and also health services. This living place becomes witness of our lives, rhythms of activities, habits, tastes and wishes. The « Health Smart Home » concept initiated numerous research projects. With accessible sensors and algorithms, researchers discovered regular patterns in activities, relationships between night and day activity levels, information from periods of inactivity. The automatic recognition of the daily activities will further help to detect loss of autonomy in fragile people.
Norbert Noury (SM, IEEE) is an expert in smart sensors and systems for Health, Ambient Assisted Living environments and Ubiquitous Health monitoring systems.
He received a MSc Electronics (Grenoble Polytechnic Institute,1985) and a PhD in Applied Physics (Grenoble University, 1992). From 1985 to 1993, he worked in various industrial companies then joined University of Grenoble where he founded a new research team (AFIRM, 2000) on the topic of Health Smart Homes.
Norbert Noury is a Full Professor at the University of Lyon. He guided 25 PhD students, authored over 200 scientific papers (39 journal papers, 96 communications, 18 patents, 16 book chapters). He is a recognized expert at the European Commission and serves on the executive committee of the French Research Group “ICT for Health”. Pr. Norbert Noury was involved in the organizing committees of several international conferences.
Adriana Lukas, Media Influencer, The Big Blog Company
"What's in the numbers - health revolution or technology fad?"
Quantified Self or self-hacking is a trend and a community of people tracking an activity or aspect of their lives, whether it's health, well-being or productivity, using various technologies to capture and analyse their data. Several of the issues facing the movement are the ease of data collection, analysis & visualisation, privacy, security and data ownership, the balance between individual and aggregate data.
The current media coverage oscillates between what they see as a quaint obsession with numbers and excessive self-obsession. Are they right or is the ability of individuals to record and analyse data a new enlightenment?