Nick Guldemond

Integrated personalized diabetes management (IPDM) has emerged as a promising approach to improving outcomes in patients with diabetes mellitus (DM). This care approach emphasizes the integration and coordination of different providers, including physicians, nurses, dietitians, social workers and pharmacists. The goal of IPDM is to provide patients with personalized care that is tailored to their needs. This review addresses the concept of integrated care and the use of technology (including… Meer weergeven

Integrated personalized diabetes management (IPDM) has emerged as a promising approach to improving outcomes in patients with diabetes mellitus (DM). This care approach emphasizes the integration and coordination of different providers, including physicians, nurses, dietitians, social workers and pharmacists. The goal of IPDM is to provide patients with personalized care that is tailored to their needs. This review addresses the concept of integrated care and the use of technology (including data, software applications and artificial intelligence) as well as managerial, regulatory and financial aspects. The implementation and upscaling of digitally enabled IPDM are discussed, with elaboration of successful practices and related evidence. Finally, recommendations are made. It is concluded that the adoption of digitally enabled IPDM on a global level is inevitable, considering the challenges created by an increasing prevalence of patients with DM and the need for better outcomes and improvement of health system sustainability. Minder weergeven

Steele Gray, C., Efimenko, I., Piera-Jiménez, J. and Guldemond, N. (2022), "Guest editorial: Advancing integrated care with digital health innovation issue editorial", Journal of Integrated Care, Vol. 30 No. 4, pp. 277-281. https://doi.org/10.1108/JICA-10-2022-088
Leveraging new opportunities to advance integrated care using digital health
The interest in digital health in the context of integrated care has been growing substantially over the last five years as evidenced through increased… Meer weergeven

Steele Gray, C., Efimenko, I., Piera-Jiménez, J. and Guldemond, N. (2022), "Guest editorial: Advancing integrated care with digital health innovation issue editorial", Journal of Integrated Care, Vol. 30 No. 4, pp. 277-281. https://doi.org/10.1108/JICA-10-2022-088
Leveraging new opportunities to advance integrated care using digital health
The interest in digital health in the context of integrated care has been growing substantially over the last five years as evidenced through increased publication numbers and citations, international conference activities and events, as well as the increasing number of solutions developed and implemented. This interest accelerated when digital health became essential to how health systems responded to the COVID-19 crisis (Webster, 2020; Ferguson et al., 2021; Bhatia et al., 2021; Pérez Sust et al., 2020). Notably (but not necessarily related to the acceleration of digital health use) integrated care was also viewed as a key solution to address diverse needs of populations through the pandemic (Lindner et al., 2020). As countries world-wide continue to recover from the pandemic while building more sustainable and resilient health systems, there remains an opportunity to capitalize on both these trends to help advance the transformation toward digitally-enabled integrated health and social care systems. Minder weergeven

Background: Globally, insomnia remains a highly prevalent public health problem. eHealth presents a novel opportunity to deliver effective, accessible, and affordable insomnia treatments on a population-wide scale. However, there is no quantitative integration of the evidence regarding the effectiveness of eHealth-based psychosocial interventions on insomnia.
Objective: We aimed to evaluate the overall effectiveness and identify the effectiveness of specific factors of… Meer weergeven

Background: Globally, insomnia remains a highly prevalent public health problem. eHealth presents a novel opportunity to deliver effective, accessible, and affordable insomnia treatments on a population-wide scale. However, there is no quantitative integration of the evidence regarding the effectiveness of eHealth-based psychosocial interventions on insomnia.
Objective: We aimed to evaluate the overall effectiveness and identify the effectiveness of specific factors of eHealth.
Conclusions:

eHealth interventions for insomnia are effective in improving sleep and mental health and can be considered a promising treatment for insomnia. Our findings support wider dissemination of eHealth interventions and further promotion in a stepped-care model. Offering blended care could improve treatment effectiveness. Future research needs to elucidate which specific intervention components are most important to reach intervention effectiveness. Blended eHealth interventions may be tailored to benefit people with low socioeconomic status, limited access to health care, or lack of eHealth literacy. Clinical Trial: This study was registered with PROSPERO, CRD42021233241. Minder weergeven

Demographic changes and population aging have been recognized as key priorities to ensure global health and social care systems sustainability. The increase in life expectancy of individuals is a very positive achievement of modern societies, but people’s health in the last decades of life is highly at risk due to the burden of chronic diseases and multimorbidity. Therefore, providing innovative solutions to alleviate the burden of chronic diseases is a demanding need both for individuals and… Meer weergeven

Demographic changes and population aging have been recognized as key priorities to ensure global health and social care systems sustainability. The increase in life expectancy of individuals is a very positive achievement of modern societies, but people’s health in the last decades of life is highly at risk due to the burden of chronic diseases and multimorbidity. Therefore, providing innovative solutions to alleviate the burden of chronic diseases is a demanding need both for individuals and societies. A relevant percentage of chronic conditions in later life is associated with inadequate lifestyles adopted by individuals across the life cycle. Therefore, population education to support adoption of healthy lifestyles, across all ages, is the most immediate and effective way to support good health status of individuals in future generations. In the present chapter (chapter 2), we introduce regional collaborative innovation networks as originators and replicators of innovative good practices to support healthy living and active ageing – European Innovation Partnership on Active and Healthy Aging Reference Sites. Minder weergeven

Breakthrough technologies must contribute to integration across the healthcare delivery
The implementation and up-scaling of integrated digital-enabled person-centred care services is a necessity for better patient outcomes and performance of health systems. Discrete attempts at improvement, whether it is about services, finances, education, legislation or technology aspects, are insufficient and often not successful in making health systems change.
Successful health system change… Meer weergeven

Breakthrough technologies must contribute to integration across the healthcare delivery
The implementation and up-scaling of integrated digital-enabled person-centred care services is a necessity for better patient outcomes and performance of health systems. Discrete attempts at improvement, whether it is about services, finances, education, legislation or technology aspects, are insufficient and often not successful in making health systems change.
Successful health system change requires both a bottom-up and top-down approach: i.e., addressing practical integration and improvement issues at an operational level while aligning higher system aspects like finances, regulation and authorities. The leading principle in this approach is that all actions are aimed at optimising services that anticipate people’s needs. Minder weergeven

Value-based healthcare (VBHC) is a service improvement approach developed at Harvard Business School (HBS) that explores the best practices for reorganizing and coordinating healthcare that aim to achieve the outcomes that are important to patients. An implementation of value-added services for patients diagnosed with age-related macular degeneration (AMD) and macular edema using value-based healthcare (VBHC) was introduced in a Bulgarian ophthalmic clinic. Human resources were freed using… Meer weergeven

Value-based healthcare (VBHC) is a service improvement approach developed at Harvard Business School (HBS) that explores the best practices for reorganizing and coordinating healthcare that aim to achieve the outcomes that are important to patients. An implementation of value-added services for patients diagnosed with age-related macular degeneration (AMD) and macular edema using value-based healthcare (VBHC) was introduced in a Bulgarian ophthalmic clinic. Human resources were freed using time-driven activity-based costing (TDABC) methodology and were then reinvested in patient-related outcome measurement activity. Minder weergeven

Chronic diseases kill 41 million people each year, equivalent to 71 percent of all deaths globally, according to the World Health Organization (WHO). And a third of Europeans have at least one chronic condition. During the COVID-19 pandemic, patients living with chronic diseases have had an increased risk of hospitalization, as well as higher mortality. In some countries, over 90 percent of hospitalized patients who did not survive COVID had accompanying chronic diseases.

However, health… Meer weergeven

Chronic diseases kill 41 million people each year, equivalent to 71 percent of all deaths globally, according to the World Health Organization (WHO). And a third of Europeans have at least one chronic condition. During the COVID-19 pandemic, patients living with chronic diseases have had an increased risk of hospitalization, as well as higher mortality. In some countries, over 90 percent of hospitalized patients who did not survive COVID had accompanying chronic diseases.

However, health systems have largely been set up to treat acute conditions, not chronic. “For the last 150 or 200 years, we have been building fragmented care,” said Rafael Bengoa, co-director of the Bilbao Institute for Health and Strategy, and member of the Expert Group for Integrated Care and Digital Health Europe (EGIDE) in Spain. “In Europe, we have excellent acute care but weak chronic care and no continuity of care. We have to change this to address the chronic disease epidemic.”

A major contribution to integrated care can come from increased use of data. To facilitate this, the European Commission wants to establish a general European Health Data Space (EHDS), which will be built on the basis of strong data governance, data quality and interoperability. It will therefore enable greater exchange and access to different types of health data — such as electronic health records, genomics data and data from patient registries. Minder weergeven

The Advisory Board identified barriers to NCD care during the COVID-19 pandemic in four areas: lack of NCD management guidelines; disruption to integrated care and shift from hospital-based NCD care to more community and primary level care; infodemics and a lack of reliable health information for patients and HCPs on how to manage NCDs; lack of availability, training, standardization, and regulation of digital health tools. Multistakeholder partnerships can promote swift changes to NCD… Meer weergeven

The Advisory Board identified barriers to NCD care during the COVID-19 pandemic in four areas: lack of NCD management guidelines; disruption to integrated care and shift from hospital-based NCD care to more community and primary level care; infodemics and a lack of reliable health information for patients and HCPs on how to manage NCDs; lack of availability, training, standardization, and regulation of digital health tools. Multistakeholder partnerships can promote swift changes to NCD prevention and patient care. Intra- and inter-communication between all stakeholders should be facilitated involving all players in the development of clinical guidelines and digital health tools, health and social care restructuring, and patient support in the short-, medium- and long-term future. A comprehensive response to NCDs should be delivered to improve patient outcomes by providing strategic, scientific, and economic support. Minder weergeven

This book constitutes the revised, selected and extended papers of the 6th International Conference on Communication Technologies for Ageing Well and e-Health, ICT4AWE 2020, held in Prague, Czech Republic, in May 2020. Due to the COVID-19 pandemic the conference was held online. The 7 full papers presented were carefully reviewed and selected from 50 submissions. The papers present most recent research on best practices, innovation and technical improvements in the fields of age and health… Meer weergeven

This book constitutes the revised, selected and extended papers of the 6th International Conference on Communication Technologies for Ageing Well and e-Health, ICT4AWE 2020, held in Prague, Czech Republic, in May 2020. Due to the COVID-19 pandemic the conference was held online. The 7 full papers presented were carefully reviewed and selected from 50 submissions. The papers present most recent research on best practices, innovation and technical improvements in the fields of age and health care, education, psychology, social coordination and ambient assisted living. Minder weergeven

Digital Health Interventions for Diabetes: Re-defining value and values for a connected system” is a
report by the Economist Intelligence Unit, commissioned by Roche. The report looks into some of the
critical factors and evidence that make the case for placing digital health interventions at the centre
of diabetes care (we define ‘digital health interventions’ broadly to include any complex intervention
that is in part supported by connecting digital technologies, such as… Meer weergeven

Digital Health Interventions for Diabetes: Re-defining value and values for a connected system” is a
report by the Economist Intelligence Unit, commissioned by Roche. The report looks into some of the
critical factors and evidence that make the case for placing digital health interventions at the centre
of diabetes care (we define ‘digital health interventions’ broadly to include any complex intervention
that is in part supported by connecting digital technologies, such as smartphones, websites, text
messaging or proprietary monitoring or delivery devices). Guided by end-user requirements and a
formal assessment of the existing definitions of value, we take a forward view of how outcomes could
be improved by using digital technologies to better connect people to each other and to the system. Minder weergeven

Integrated diabetes systems, comprising horizontal and vertical integration, present an opportunity to reduce the fragmentation of care, ultimately increasing the efficiency and effectiveness of diabetes services. The following calls to action are based on a scorecard benchmarking the level of service, IT and financial integration in 28 European countries, plus discussions with experts in diabetes management and integrated services

The Digital Diabetes Index benchmarks the readiness of ten European countries to deploy digital interventions, focusing on digital technologies used to care and treat people with Type 1 and Type 2 diabetes. The findings of this research indicate five key enablers of access to digital diabetes tools, here we provide a summary of those enablers and how they can be leveraged to improve access to digital diabetes tools with the aim of improving outcomes for people with diabetes. The EIU research… Meer weergeven

The Digital Diabetes Index benchmarks the readiness of ten European countries to deploy digital interventions, focusing on digital technologies used to care and treat people with Type 1 and Type 2 diabetes. The findings of this research indicate five key enablers of access to digital diabetes tools, here we provide a summary of those enablers and how they can be leveraged to improve access to digital diabetes tools with the aim of improving outcomes for people with diabetes. The EIU research team comprised Elly Vaughan and Rob Cook. Minder weergeven

The Expert Group for Integrated Care and Digital Health Europe (EGIDE) – a group of experts supported by Sanofi, whose objective is to enhance chronic disease management through integrated patient pathways and digitalisation of health – presented its Policy Paper on ‘Putting people at the centre – Integrated care for chronic diseases in Europe’ during a webinar hosted by Pascal Arimont, Member of the European Parliament from the European People’s Party (EPP), on 10 November.

In this unique study we combined a service #design approach with #HTA techniques. We made an inventory of needs and key issues from a patient perspective throughout the development of the disease (the patient journey) and used economic modelling of the treatment as currently provided in contrast with an optimised scenario where the identified treatment gaps and insufficiencies were anticipated. This is creative multidisciplinary research which we need especially now to make a positive societal… Meer weergeven

In this unique study we combined a service #design approach with #HTA techniques. We made an inventory of needs and key issues from a patient perspective throughout the development of the disease (the patient journey) and used economic modelling of the treatment as currently provided in contrast with an optimised scenario where the identified treatment gaps and insufficiencies were anticipated. This is creative multidisciplinary research which we need especially now to make a positive societal impact #healthpolicy #surgery #improvement European Brain Council Uwe KehlerDr Michela Tinelli Minder weergeven

Personalised healthcare is a shift from one-size-fits-all treatment of disease to maintaining high and healthy quality of life over the lifespan by applying the right health interventions for the right person at the right time. An ideal personalised healthcare system involves the collection and analysis of all meaningful health data at scale and the integrated use of tools and services to tailor prevention, diagnosis, treatment and follow-up to each person, while simultaneously cultivating both… Meer weergeven

Personalised healthcare is a shift from one-size-fits-all treatment of disease to maintaining high and healthy quality of life over the lifespan by applying the right health interventions for the right person at the right time. An ideal personalised healthcare system involves the collection and analysis of all meaningful health data at scale and the integrated use of tools and services to tailor prevention, diagnosis, treatment and follow-up to each person, while simultaneously cultivating both individual and population health. Minder weergeven

Diabetes represents a significant challenge for European health systems. There are 60 million people with diabetes in Europe and diabetes management already represents as much as 10% of overall health budgets—with both figures set to rise. Integrated diabetes systems, comprising horizontal and vertical integration, present an opportunity to reduce the fragmentation of care, ultimately increasing the efficiency and effectiveness of diabetes services. The following calls to action are based on a… Meer weergeven

Diabetes represents a significant challenge for European health systems. There are 60 million people with diabetes in Europe and diabetes management already represents as much as 10% of overall health budgets—with both figures set to rise. Integrated diabetes systems, comprising horizontal and vertical integration, present an opportunity to reduce the fragmentation of care, ultimately increasing the efficiency and effectiveness of diabetes services. The following calls to action are based on a scorecard benchmarking the level of service, IT and financial integration in 28 European countries, plus discussions with experts in diabetes management and integrated services. Minder weergeven

The combination of a service design methodology with economic modelling, applied in a patient lead multi-stakeholder setting, proofed to be a practical and inclusive approach to work jointly on the design of future care models in order to close the treatment gap for different brain diseases in Europe.

This chapter studies living labs as a methodology of user-centric innovation. The focus is on sustainability in healthcare and increasing efficiency, affordability and inclusiveness. The real-life environments are residential homes for elderly people, hospitals and a shopping mall, the latter as an example of increasing accessibility for wheelchairs. The chapter aims to identify critical factors in the performance of living labs, drawing on literature and in-depth case studies in Eindhoven and… Meer weergeven

This chapter studies living labs as a methodology of user-centric innovation. The focus is on sustainability in healthcare and increasing efficiency, affordability and inclusiveness. The real-life environments are residential homes for elderly people, hospitals and a shopping mall, the latter as an example of increasing accessibility for wheelchairs. The chapter aims to identify critical factors in the performance of living labs, drawing on literature and in-depth case studies in Eindhoven and Maastricht (Netherlands), Copenhagen (Denmark) and Montreal (Canada). Important critical factors are: early involvement of users, including feedback from them, and sufficient involvement of a wider network of stakeholders with the required expertise/input. An appropriate selection of promising inventions is also important. A preliminary analysis of network building through living labs found a trend for both local and global networking, with an emphasis on the latter. These findings touch on a leadership challenge for local governments, namely as a ‘connector’ between different local/ regional organizations. Minder weergeven

Various initiatives within Europe are in search of the identification and scaling up of ‘good practices’ within the field of integrated care. However, the operationalisation of a ‘good practice’ seems to be oversimplified or overlooked.

An analysis of best practices across Europe identifies commonalities and success factors to establish good practices for IT-supported ICPs in diabetes care. Building on this, the next step is to identify specific solutions addressing the challenges faced by health care providers in locally implementing IT-supported ICPs for patients with co-morbidities.

Background Restless Legs Syndrome (RLS) (or Willis/Ekbom Disease – WED) is a common neurological disease which is often unrecognized or misdiagnosed. 2.7% of the European population suffer from moderate to severe RLS: an uncontrollable urge to move the legs due to highly unpleasant pain-like sensations, leading to chronic sleep deprivation. Wrong diagnoses and wrong treatments occur due to lack of knowledge and expertise at both the primary and secondary care levels, and as a consequence wrong… Meer weergeven

Background Restless Legs Syndrome (RLS) (or Willis/Ekbom Disease – WED) is a common neurological disease which is often unrecognized or misdiagnosed. 2.7% of the European population suffer from moderate to severe RLS: an uncontrollable urge to move the legs due to highly unpleasant pain-like sensations, leading to chronic sleep deprivation. Wrong diagnoses and wrong treatments occur due to lack of knowledge and expertise at both the primary and secondary care levels, and as a consequence wrong routing of the patient. Minder weergeven

Schizophrenia is a severe mental disorder, which affects 0.8-1.5% of the population. It is a clinically heterogeneous illness with highly variable course, typically episodic. Frequent relapses contribute to neurobiological impairment, functional and social decline, and poor treatment response. Schizophrenia has a substantial impact on patients, their families, caregivers, and society in general. It is one of the top 25 leading causes of disability worldwide, affecting negatively all the aspect… Meer weergeven

Schizophrenia is a severe mental disorder, which affects 0.8-1.5% of the population. It is a clinically heterogeneous illness with highly variable course, typically episodic. Frequent relapses contribute to neurobiological impairment, functional and social decline, and poor treatment response. Schizophrenia has a substantial impact on patients, their families, caregivers, and society in general. It is one of the top 25 leading causes of disability worldwide, affecting negatively all the aspect of a person’s life. Schizophrenia can be effectively managed: in most cases recovery and social reintegration through adequate treatment and care is possible. Minder weergeven

Integrated Care Pathways (ICPs) are a method for the mutual decision-making and organization of care for a well-defined group of patients during a well-defined period. The aim of a care pathway is to enhance the quality of care by improving patient outcomes, promoting patient safety, increasing patient satisfaction, and optimizing the use of resources. To describe this concept, different names are used, e.g. care pathways and integrated care pathways. Modern information technologies (IT) can… Meer weergeven

Integrated Care Pathways (ICPs) are a method for the mutual decision-making and organization of care for a well-defined group of patients during a well-defined period. The aim of a care pathway is to enhance the quality of care by improving patient outcomes, promoting patient safety, increasing patient satisfaction, and optimizing the use of resources. To describe this concept, different names are used, e.g. care pathways and integrated care pathways. Modern information technologies (IT) can support ICPs by enabling patient empowerment, better management, and the monitoring of care provided by multidisciplinary teams. This study analyses ICPs across Europe, identifying commonalities and success factors to establish good practices for IT-supported ICPs in diabetes care. Minder weergeven

mHealth has the potential to transform the face of health service delivery across the globe. A powerful combination of factors is driving this change. These include rapid advances in mobile technologies and applications, a rise in new opportunities for the integration of mobile health into existing mHealth services, and the continued growth in coverage of mobile cellular networks.

European Observatory on Health Systems and Policies (‎2017)‎. Co-creating health to meet local needs: how to make solutions work for real?. Eurohealth, 23 (‎3)‎, 28 - 30. World Health Organization. Regional Office for Europe. https://apps.who.int/iris/handle/10665/332630

Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS).

IWA 18:2016 provides guidelines for addressing challenges faced by societies that have been unable to adapt to an ageing population. It can also be used by stakeholders as a useful reference at regional or global level. addresses health, care and social challenges (including health care needs, daily living tasks, well-being, combating isolation and keeping safe) to ensure that the needs of individuals continue to be met as they grow older. It also outlines principles related to ethics… Meer weergeven

IWA 18:2016 provides guidelines for addressing challenges faced by societies that have been unable to adapt to an ageing population. It can also be used by stakeholders as a useful reference at regional or global level. addresses health, care and social challenges (including health care needs, daily living tasks, well-being, combating isolation and keeping safe) to ensure that the needs of individuals continue to be met as they grow older. It also outlines principles related to ethics, community-based solutions, integration, person-centred solutions and innovation. Minder weergeven

To move the integration of care processes for diabetes in Europe forward, an expert group was
constituted. The goal of the group’s activities was to develop a recommendation for integrated care
pathways, targeting people with diabetes and comorbidities. Integrated care is an organising principle to achieve the delivery of improved patient care through better coordination of services provided. Integrated care pathways (ICPs) are structured multidisciplinary care plans which detail… Meer weergeven

To move the integration of care processes for diabetes in Europe forward, an expert group was
constituted. The goal of the group’s activities was to develop a recommendation for integrated care
pathways, targeting people with diabetes and comorbidities. Integrated care is an organising principle to achieve the delivery of improved patient care through better coordination of services provided. Integrated care pathways (ICPs) are structured multidisciplinary care plans which detail essential steps in the care of patients with a specific clinical problem. Minder weergeven

Highlights
A classification system, using a common language, has been developed.
The online tool ensures consistency in describing and reporting studies.
The classification system can be modified to accommodate technological development.
The taxonomy will continue to develop iteratively through feedback from users.

Deze verkenning signaleert vanuit de dagelijkse praktijk zorgen over de kwaliteit van de hulpmiddelenzorg, de keuzevrijheid, de productkwaliteit en het toezicht. Het lijkt erop dat de verschillende partijen in het stelsel hun rol in de hulpmiddelenzorg nog niet optimaal invullen. De signalen doen zich voor ondanks het beschikbare instrumentarium van overheidswege, dat de context aangeeft waarbinnen de partijen opereren. Daarbij gaat het onder meer om het toezicht op kwaliteit door de Inspectie… Meer weergeven

Deze verkenning signaleert vanuit de dagelijkse praktijk zorgen over de kwaliteit van de hulpmiddelenzorg, de keuzevrijheid, de productkwaliteit en het toezicht. Het lijkt erop dat de verschillende partijen in het stelsel hun rol in de hulpmiddelenzorg nog niet optimaal invullen. De signalen doen zich voor ondanks het beschikbare instrumentarium van overheidswege, dat de context aangeeft waarbinnen de partijen opereren. Daarbij gaat het onder meer om het toezicht op kwaliteit door de Inspectie van de Gezondheidszorg, duiding van de aanspraak door het Zorginstituut Nederland en toezicht op de markt (en zorgplicht) door de Nederlandse Zorgautoriteit. Ook doen de signalen zich voor ondanks de zorgplicht van de zorgverzekeraars, die enerzijds moeten zorgdragen voor kwalitatief goede zorg en anderzijds waar mogelijk de zorgkosten moeten beheersen. Minder weergeven

Google scholar publication list

“Er is enorm veel enthousiasme over quantified self en wearables, maar we hebben de basis infrastructuur – landelijke uitwisseling van medische gegevens – nog niet op orde. Eigenlijk zijn we nog niet aan de meest basale stappen toegekomen.”

“Het thema van Seneca Congres is interessant want de ontwikkelingen in de gezondheidszorg gaan snel en zijn ingrijpend. De vraag is: blijf je als bestuurder in de lead of maken politieke krachten en triviale partijen die beter anticiperen op de snelle veranderingen, dat onmogelijk?

This Knowledge and Innovation Agenda (KIA) ICT has been created under the auspices of Team ICT. This Team, chaired by René Penning de Vries, has been installed by the Minister of Economic Affairs to stimulate interconnections between the top sectors, to strengthen the industry policy and the let ICT innovations fuel economic growth. According to the Minister: “In the future, ICT will continue to play a major role. Think Big Data, the internet of things, breakthroughs in healthcare, increases in… Meer weergeven

This Knowledge and Innovation Agenda (KIA) ICT has been created under the auspices of Team ICT. This Team, chaired by René Penning de Vries, has been installed by the Minister of Economic Affairs to stimulate interconnections between the top sectors, to strengthen the industry policy and the let ICT innovations fuel economic growth. According to the Minister: “In the future, ICT will continue to play a major role. Think Big Data, the internet of things, breakthroughs in healthcare, increases in serious gaming and e.g. 3D printing, where in a short time an industry of start-ups and suppliers around it arose. The government, business and education together have the task to utilize the opportunities of such developments. In that way the Netherlands remains a forerunner in the world of the digital economy. Rene Penning de Vries will stimulate and boost these developments with his Team ICT. That benefits both the ICT sector and the Netherlands.” Under the umbrella name ‘Dutch Digital Delta’ Team ICT initiated several high-priority activities: a human capital agenda, a branding initiative, and this KIA ICT. Minder weergeven

De organisatie van de zorg kenmerkt zich door een toenemende vraag naar zorg, terwijl er steeds minder middelen beschikbaar zijn. Dit noopt tot het anders organiseren van zorg. Meer aandacht voor preventie waardoor behandelen achteraf minder nodig zal zijn. Inzet van technologie is daarbij onvermijdelijk. De mogelijkheden van consumentenelektronica, informatie en het IoT, kunnen zorg
persoonlijker en efficiënter maken. Dat kan echter alleen als ook de burger en zijn omgeving meer bij het… Meer weergeven

De organisatie van de zorg kenmerkt zich door een toenemende vraag naar zorg, terwijl er steeds minder middelen beschikbaar zijn. Dit noopt tot het anders organiseren van zorg. Meer aandacht voor preventie waardoor behandelen achteraf minder nodig zal zijn. Inzet van technologie is daarbij onvermijdelijk. De mogelijkheden van consumentenelektronica, informatie en het IoT, kunnen zorg
persoonlijker en efficiënter maken. Dat kan echter alleen als ook de burger en zijn omgeving meer bij het organiseren van lokale zorg betrokken raken. Minder weergeven

Knipselmap met verschillende nieuwsberichten over mijn activiteiten :-)

While worldwide several health and wellbeing products and services are being developed to support people to live comfortable and independently in their home environment, widespread adoption of these smart living solutions is still not envisioned. A hindering factor is that users are not aware of possible solutions or where to find them, which could be solved through promoting solutions on shared platforms. Designing such platforms is challenging as multiple stakeholders need to be satisfied and… Meer weergeven

While worldwide several health and wellbeing products and services are being developed to support people to live comfortable and independently in their home environment, widespread adoption of these smart living solutions is still not envisioned. A hindering factor is that users are not aware of possible solutions or where to find them, which could be solved through promoting solutions on shared platforms. Designing such platforms is challenging as multiple stakeholders need to be satisfied and start-up problems need to be overcome. Most theory on platforms is explored in ex-post studies and there is a lack of knowledge on how platforms should be designed and implemented. In this paper, we elicit functional requirements for the design of a multi-sided health and wellbeing platform based on interviews with both end-users and stakeholders. These requirements provide the basis for future design cycles in which, the development and actual implementation of a platform is foreseen. Minder weergeven

MACVIALR (contre les maladies chroniques pour un vieillissement actif en Languedoc Roussillon), reference Site of the European Innovation Parternship on Active and Healthy Ageing (EIP on AHA), EIP on AHA Reference Site Network, European Union Geriatric Medicine Society (EUGMS), International Association of Gerontology and Geriatrics (IAGG), Groupe de recherche (GDR) français sur la longévité et le vieillissement, ECHAlliance, Healthy Ageing Research Center (HARC).

Abstract: The broad… Meer weergeven

MACVIALR (contre les maladies chroniques pour un vieillissement actif en Languedoc Roussillon), reference Site of the European Innovation Parternship on Active and Healthy Ageing (EIP on AHA), EIP on AHA Reference Site Network, European Union Geriatric Medicine Society (EUGMS), International Association of Gerontology and Geriatrics (IAGG), Groupe de recherche (GDR) français sur la longévité et le vieillissement, ECHAlliance, Healthy Ageing Research Center (HARC).

Abstract: The broad concept of Active and Healthy Ageing was proposed by WHO as the process of optimizing opportunities for health to enhance quality of life as people age. It applies to both individuals and population groups. A universal active and healthy ageing definition is not available and may differ depending on the purpose of the definition and/or the questions raised. The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has had a major impact but a definition of Active and Healthy Ageing is urgently needed. A meeting was organised in Montpellier October 2021, 2014 as the annual conference of the EIP on AHA Reference Site MACVIALR (contre les maladies chroniques pour un vieillissement actif en Languedoc Roussillon). The goal of the meeting was to propose an operational definition of Active and Healthy Ageing and tools that may be used for this definition. The current paper gives a summary of the plenary presentations that were given during the meeting. Minder weergeven

European Innovation Partnership on Active and Healthy Ageing
3rd Conference of Partners: Taking stock and focusing on delivery

http://ec.europa.eu/research/innovation-union/index_en.cfm?section=active-healthy-ageing&pg=partners-conference-2014

Ascom has recently launched Ascom Myco, a new solution for integrated workflow intelligence in healthcare. In this interview, Nick Guldemond, Associate Professor, University Medical Centre Utrecht, discusses the importance of intelligent and efficient workflow in the hospital setting and Roel Ottink, Director Product Management and Marketing, Ascom, explains how the Ascom Myco is designed to optimize workflow around nurses and patients.

Ascom has recently launched Ascom Myco, a new solution for integrated workflow intelligence in healthcare. In this interview, Nick Guldemond, Associate Professor, University Medical Centre Utrecht, discusses the importance of intelligent and efficient workflow in the hospital setting and Roel Ottink, Director Product Management and Marketing, Ascom, explains how the Ascom Myco is designed to optimize workflow around nurses and patients.

Hallux valgus deformity is a common musculoskeletal foot disorder with a prevalence of 3.5% in adolescents to 35.7% in adults aged over 65 years. Radiographic measurements of hallux valgus angles (HVA) are considered to be the most reproducible and accurate assessment of HVA. However, in European countries, many podiatrists do not have direct access to radiographic facilities. Therefore, alternative measurements are desired. Such measurements are computerised plantar pressure measurement and… Meer weergeven

Hallux valgus deformity is a common musculoskeletal foot disorder with a prevalence of 3.5% in adolescents to 35.7% in adults aged over 65 years. Radiographic measurements of hallux valgus angles (HVA) are considered to be the most reproducible and accurate assessment of HVA. However, in European countries, many podiatrists do not have direct access to radiographic facilities. Therefore, alternative measurements are desired. Such measurements are computerised plantar pressure measurement and clinical goniometry. The purpose of this study was to establish the agreement of these techniques and radiographic assessments. Minder weergeven

Healthy living is increasingly urgent, since it may help curb our escalating health care costs. ICT (Information and Communication Technology) offers healthy lifestyle support opportunities. Given the dose–response relation between health behaviors and -benefits, an important challenge is: how to motivate participants to large health behavior improvements? We conducted two design and test iterations to add ICT support to traditional face to face coach formats: first web based eDashboarding… Meer weergeven

Healthy living is increasingly urgent, since it may help curb our escalating health care costs. ICT (Information and Communication Technology) offers healthy lifestyle support opportunities. Given the dose–response relation between health behaviors and -benefits, an important challenge is: how to motivate participants to large health behavior improvements? We conducted two design and test iterations to add ICT support to traditional face to face coach formats: first web based eDashboarding. Next: integrating existing best of breed mobile smart phone apps (mApps) in the coach relationship. We extract several design lessons regarding: how to design for a motivational virtuous circle, and when do Web or mApps add benefits for users? An important finding is that eCoach solutions add more value when part of an overall health coach relationship. For the future, we anticipate more intelligent mobile applications for health behavior tracking and feedback, plus an increasing role for mApps in health provisioning. Minder weergeven

We leven in een unieke tijd: dankzij het internet kunnen we samenwerken op een schaal en een manier die tot voor kort onmogelijk was. Daardoor kunnen we veel beter gebruik maken van ieders talenten, ideeën, kennis, creativiteit en mankracht. Samen zijn we slimmer. Dat wordt ook wel de ‘wisdom of crowds’ genoemd. Daarmee kunnen we onze kwaliteit van leven verbeteren, elkaar helpen, maatschappelijke vraagstukken aanpakken en betere producten en diensten maken. De technologische ontwikkelingen… Meer weergeven

We leven in een unieke tijd: dankzij het internet kunnen we samenwerken op een schaal en een manier die tot voor kort onmogelijk was. Daardoor kunnen we veel beter gebruik maken van ieders talenten, ideeën, kennis, creativiteit en mankracht. Samen zijn we slimmer. Dat wordt ook wel de ‘wisdom of crowds’ genoemd. Daarmee kunnen we onze kwaliteit van leven verbeteren, elkaar helpen, maatschappelijke vraagstukken aanpakken en betere producten en diensten maken. De technologische ontwikkelingen gaan snel: 3D-printing, Big Data, sensoren en kunstmatige intelligentie zijn bezig aan een snelle opmars. Deze geven een nieuwe impuls aan de ‘wisdom of crowds’. Het boek ‘Samen slimmer’ duidt die belangrijkste technologische ontwikkelingen van de komende decennia en laat in aansprekende toekomstbeelden de maatschappelijke betekenis ervan zien: hoe zorg, onderwijs, innovatie en democratie hierdoor blijvend van karakter kunnen veranderen. Minder weergeven

Deze uitgave Care is een weergave van de Tiende Jan Brouwer Conferentie, gehouden
op 24 januari 2014 in het Hodshon Huis te Haarlem. De conferentie stond onder
voorzitterschap van Prof. dr. P. Schnabel en is georganiseerd door de Koninklijke
Hollandsche Maatschappij der Wetenschappen en het Jan Brouwer Fonds. Het
was de tiende conferentie in een reeks over de implicaties van demografische
veranderingen en generatiebeleid.

The notion of self care is gaining growing acceptance in health systems across Europe. Yet little is known about how the public perceives self care. The Self Care Barometer, the first of its kind, will provide a benchmark for future surveys, allowing us to track trends citizens’ attitudes and appetite for self care. The research will be conducted every two years.

TNS Global carried out the fieldwork on behalf of Epposi, with ten countries participating: Denmark, Spain, Italy, Scotland… Meer weergeven

The notion of self care is gaining growing acceptance in health systems across Europe. Yet little is known about how the public perceives self care. The Self Care Barometer, the first of its kind, will provide a benchmark for future surveys, allowing us to track trends citizens’ attitudes and appetite for self care. The research will be conducted every two years.

TNS Global carried out the fieldwork on behalf of Epposi, with ten countries participating: Denmark, Spain, Italy, Scotland, Finland, France, Netherlands, Germany, Slovakia and Poland.
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Via gezondheidsprogramma’s kunnen organisaties hun medewerkers aansporen om gezonder te leven. Dat leidt niet alleen tot productievere werknemers, het helpt ook de gezondheidszorg betaalbaar te houden. Tezelfdertijd vergrijst de samenleving, en in het bijzonder de werkenden, in een snel tempo. In Europa zijn er twee keer meer vijftigjarigen dan er 25-jarigen zijn. Anderzijds dwingt de economische crisis bedrijven en organisaties om de kosten te bedwingen. Is het dan wel rendabel om nu te… Meer weergeven

Via gezondheidsprogramma’s kunnen organisaties hun medewerkers aansporen om gezonder te leven. Dat leidt niet alleen tot productievere werknemers, het helpt ook de gezondheidszorg betaalbaar te houden. Tezelfdertijd vergrijst de samenleving, en in het bijzonder de werkenden, in een snel tempo. In Europa zijn er twee keer meer vijftigjarigen dan er 25-jarigen zijn. Anderzijds dwingt de economische crisis bedrijven en organisaties om de kosten te bedwingen. Is het dan wel rendabel om nu te investeren in een duurzaam gezondheidsbeleid? Belang van én voor het bedrijf Nick Guldemond, professor en programmadirecteur Gezondheid aan de TU Delft, schetst de sociaaleconomische context waarom investeren in een gezondheidsbeleid op bedrijfsniveau nodig is: “In 2050 zullen er in de EU maar 2 werkenden zijn per persoon op rust. Vanuit een economisch perspectief is dat een enorme uitdaging, omdat de afhankelijkheid met het ouder worden almaar toeneemt. Met het toenemen van de leeftijd neemt immers ook de kans op chronische ziekten toe. Bovendien stijgt de levensverwachting in EU landen maar dat gaat niet gepaard met een groei van de gezonde levensjaren.
Ook door de toenemende krapte op de arbeidsmarkt is het van belang dat bedrijven hun werknemers zo gezond mogelijk houden. Vitale medewerkers zijn bovendien productiever en dat komt de bedrijfsresultaten ten goede. Bedrijven hebben een rol te spelen in het betaalbaar houden van de gezondheidszorg: Het huidige gezondheidszorgsysteem is curatief georiënteerd en zeer sterk geprofessionaliseerd. En bijgevolg zeer duur. Vandaag bedragen de zorgkosten per Nederlander zo’n 5000 euro per jaar. Bij een ongewijzigd beleid loopt dit in 2040 op tot 25.000 euro: dat belemmert de economische groei. Het geld dat geïnvesteerd wordt in de gezondheidszorg, kan immers niet meer geïnvesteerd worden in economische groei. “We moeten van een medisch curatief model waarin zorginstituten een grote rol spelen, naar een sociaal gezondheidsperspectief. Minder weergeven

Inclusive Society: Health and Wellbeing in the Community, and Care at Home. 11th International Conference on Smart Homes and Health Telematics, ICOST 2013, Singapore, June 19-21, 2013. Proceedings

Personal informatics apps that promote healthy consumption share similar aims, but vary in the means they adopt to meet them. The adopted means reflect different stances. Stances are the positions that designers implicitly take on a range of issues, such as personal information, freedom of choice and responsibility. Judgments on values such as privacy, autonomy and accountability underlie these stances. We argue for the use of stances as a tool to design personal informatics apps for healthy… Meer weergeven

Personal informatics apps that promote healthy consumption share similar aims, but vary in the means they adopt to meet them. The adopted means reflect different stances. Stances are the positions that designers implicitly take on a range of issues, such as personal information, freedom of choice and responsibility. Judgments on values such as privacy, autonomy and accountability underlie these stances. We argue for the use of stances as a tool to design personal informatics apps for healthy consumption. Making stances explicit and exploring alternate stances can help designers and stakeholders analyze means and their consequences, and identify and explore alternative approaches. This can better align app’s approaches with users' values, improving ethical acceptability, adoption and long-term use. We examine a number of apps, identify the implicit stances they take, and propose next steps toward using stances as a design tool. Minder weergeven

Worldwide, healthcare systems are considered unsustainable due to an increase in demand for care and an associated rise in healthcare costs. Ageing of societies and the growth of populations with chronic conditions are making a paradigm shift in western healthcare systems necessary. The Chronic Care Model (CCM) provides a framework for healthcare change, including a prominent role for the community and patients’ self-management. Information and communication technology (ICT) is indispensable to… Meer weergeven

Worldwide, healthcare systems are considered unsustainable due to an increase in demand for care and an associated rise in healthcare costs. Ageing of societies and the growth of populations with chronic conditions are making a paradigm shift in western healthcare systems necessary. The Chronic Care Model (CCM) provides a framework for healthcare change, including a prominent role for the community and patients’ self-management. Information and communication technology (ICT) is indispensable to accomplish the model’s objectives. The role of ICT in the provision of care is discussed as an opportunity to facilitate the application of the CCM and improve healthcare in general. Minder weergeven

This study aims to investigate the reproducibility of a tri axial gyroscope in measurement of anteflexion, abduction and related rotations in the impaired shoulder.
58 patients with either subacromial impingement (27) or osteoarthritis of the shoulder (31) participated. Active anteflexion, abduction and related rotations were measured with a tri axial gyroscope according to a test retest protocol. Severity of shoulder impairment and patient perceived pain were assessed by the DASH and VAS… Meer weergeven

This study aims to investigate the reproducibility of a tri axial gyroscope in measurement of anteflexion, abduction and related rotations in the impaired shoulder.
58 patients with either subacromial impingement (27) or osteoarthritis of the shoulder (31) participated. Active anteflexion, abduction and related rotations were measured with a tri axial gyroscope according to a test retest protocol. Severity of shoulder impairment and patient perceived pain were assessed by the DASH and VAS. VAS scores were recorded before and after testing.
In two out of three hospitals patients with osteoarthritis (n=31) were measured, in the third hospital patients with subacromial impingement (n=27). There were significant differences among hospitals for the VAS and DASH scores measured before and after testing. The mean differences between the test and retest means for anteflexion were -6 degrees (affected side), 9 (contralateral side) and for abduction 15 degrees (affected side) and 10 degrees (contralateral side). Bland & Altman plots showed that the confidence intervals for the mean differences fall within -6 up to 15 degrees, individual test - retest differences could exceed these limits. A simulation according to 'Generalizability Theory' produces very good coefficients for anteflexion and related rotation as a comprehensive measure of reproducibility. Optimal reproducibility is achieved with 2 repetitions for anteflexion.
Measurements were influenced by patient perceived pain. Differences in VAS and DASH might be explained by different underlying pathology. These differences in shoulder pathology however did not alter the reproducibility of testing. The use of a tri axial gyroscope is a simple non invasive and reproducible method for the recording of shoulder anteflexion and abduction. Movements have to be repeated twice for reproducible results.
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The development of medical clusters is high on the agenda of many policymakers in the European Union. Constructing medical clusters may draw on the presence of living labs of different kinds in the regions involved. Living labs are practical environments for innovation aiming at a better mix and match between stakeholders for co-development and reduction of time-to-market through an early involvement of user groups. Living lab settings range from delimited environments for co-creation and… Meer weergeven

The development of medical clusters is high on the agenda of many policymakers in the European Union. Constructing medical clusters may draw on the presence of living labs of different kinds in the regions involved. Living labs are practical environments for innovation aiming at a better mix and match between stakeholders for co-development and reduction of time-to-market through an early involvement of user groups. Living lab settings range from delimited environments for co-creation and development, like a city quarter, a hospital, creative workshop or university campus, to local and regional networks and platforms of open innovation. Participants in living labs are typically universities, research institutes, user groups, small and large firms, nonprofit institutions (like most public hospitals) and local/regional authorities. Accordingly, living labs find themselves in a dynamic multi-actor situation that needs to be dealt with,
both in their design and management. The focus of this paper is on living labs for healthcare innovation and on potentials for cluster development. Healthcare is under pressure as a consequence of the aging population, and fast increasing population with chronic conditions and shortage of resources. The paper identifies critical factors in the design of medical living labs and speculates on the role of living labs in the construction
of clusters based on a single case study. Minder weergeven

The development of medical clusters is high on the agenda of many policymakers in the European Union. Constructing medical clusters may draw on the presence of living labs of different kinds in the regions involved. Living labs are practical environments for innovation aiming at a better mix and match between stakeholders for co-development and reduction of time-to-market through an early involvement of user groups. Living lab settings range from delimited environments for co-creation and… Meer weergeven

The development of medical clusters is high on the agenda of many policymakers in the European Union. Constructing medical clusters may draw on the presence of living labs of different kinds in the regions involved. Living labs are practical environments for innovation aiming at a better mix and match between stakeholders for co-development and reduction of time-to-market through an early involvement of user groups. Living lab settings range from delimited environments for co-creation and development, like a city quarter, a hospital, creative workshop or university campus, to local and regional networks and platforms of open innovation. Participants in living labs are typically universities, research institutes, user groups, small and large firms, non-profit institutions (like most public hospitals) and local/regional authorities. Accordingly, living labs find themselves in a dynamic multi-actor situation that needs to be dealt with, both in their design and management. The focus of this paper is on living labs for health care innovation and on potentials for cluster development. Health care is under pressure as a consequence of the aging population, and fast increasing population with chronic conditions and shortage of resources. The paper identifies critical factors in the design of medical living labs and speculates on the role of living labs in the construction of clusters based on a single case study. Minder weergeven

Aanleiding voor de evaluatie van het Erasmus Bio Medical Fund (EBMF) is een vraag van B&W Rotterdam of een investering in een fonds de juiste manier is om de sector Medisch en Zorg in de gemeente Rotterdam te stimuleren. Deze vraag werd ook mede ingegeven door de plannen voor oprichting van een tweede fonds, EBMF II. Het OBR heeft namens de heer van Rijn, aan de heer Guldemond en heer Oey (TU Delft) gevraagd de evaluatie van het EBMF uit te voeren.

BACKGROUND: Hip fracture patients often have an impaired nutritional status at the time of fracture, which can result in a higher complication rate, prolonged rehabilitation time and increased mortality. A study was designed to evaluate the effect of nutritional intervention on nutritional status, functional status, total length of stay, postoperative complications and cost-effectiveness.
METHODS: Open-labelled, multi-centre, randomized controlled trial in hip fracture patients aged 55 years… Meer weergeven

BACKGROUND: Hip fracture patients often have an impaired nutritional status at the time of fracture, which can result in a higher complication rate, prolonged rehabilitation time and increased mortality. A study was designed to evaluate the effect of nutritional intervention on nutritional status, functional status, total length of stay, postoperative complications and cost-effectiveness.
METHODS: Open-labelled, multi-centre, randomized controlled trial in hip fracture patients aged 55 years and above. The intervention group receives dietetic counselling (by regular home visits and telephone calls) and oral nutritional supplementation for three months after surgery. The control group receives usual dietetic care as provided by the hospital. Outcome assessment is performed at three and six months after hip fracture.
DISCUSSION: Patient recruitment has started in July 2007 and has ended in December 2009. First results are expected in 2011. Minder weergeven

Snijden in een virtuele 3D-patient, waarbij je niet aileen ziet wat je doet, maar ook voelt hoe de scalpel door de huid heen gaat. Met deze nieuwe techniek kunnen studenten, artsen in opleiding en chirurgen een ingewikkelde ingreep eerst oefenen, voor ze de echte operatie uitvoeren.

In book: Plantar pressure, diabetes and amputation: studies on etiological, diagnostic and therapeutical aspects, Chapter: Plantar pressure measurement, Publisher: Maastricht University, Editors: N.A. Guldemond, pp.27-68 DOI: 10.13140/RG.2.1.4958.5042

The Medical Field Lab organization is the single point of contact for both public and private initiatives wishing to develop a concept for the market. Any idea, problem or
need is screened by a multidisciplinary team, after which a flyer of high potential ideas is disseminated throughout a worldwide network of companies, engineers, researchers and physicians. The consortium of interested parties is assembled in a secure ‘meet & greet’ setting where agreements are made as a prerequisite for a… Meer weergeven

The Medical Field Lab organization is the single point of contact for both public and private initiatives wishing to develop a concept for the market. Any idea, problem or
need is screened by a multidisciplinary team, after which a flyer of high potential ideas is disseminated throughout a worldwide network of companies, engineers, researchers and physicians. The consortium of interested parties is assembled in a secure ‘meet & greet’ setting where agreements are made as a prerequisite for a free exchange of ideas. Innovation scenarios are created through
guided brainstorm sessions, which lead up to the eventual project plan. Minder weergeven

In order to become more innovative, companies that operate in the Smart Living domain increasingly initiate and participate in networked business environments that transcend industry boundaries. Inter-organizational collaboration is often characterized by conflicting strategic interests and incoherent operational business processes and procedures. Although many scholars and practitioners use stakeholder analysis to gain insight into the actors’ relationships and interactions, existing… Meer weergeven

In order to become more innovative, companies that operate in the Smart Living domain increasingly initiate and participate in networked business environments that transcend industry boundaries. Inter-organizational collaboration is often characterized by conflicting strategic interests and incoherent operational business processes and procedures. Although many scholars and practitioners use stakeholder analysis to gain insight into the actors’ relationships and interactions, existing literature on stakeholder analysis focuses mainly on high-level strategic analysis, often limited to a conceptual and static understanding of stakeholder interests. In this paper, it is argued that a ‘true’ understanding of stakeholders can be achieved by looking at their interactions and interdependencies at a more detailed level. This study uses a conceptual framework from the service innovation and business model domain, the VIP framework, to extend stakeholder analysis by including an analysis of their dynamic interactions and processes. The qualitative evaluation of the framework’s application in illustrative design cases shows that this extension provides additional insights into stakeholders, and their potential operational conflicts and critical dependencies. By making these conflicts and interdependencies explicit, products and services are potentially easier to implement and commercialize. Minder weergeven

Normal pressure hydrocephalus (NPH) is a brain disorder, which affects mainly people above the age of 65. NPH prevalence is over 5% in elderly. Moreover, it is also estimated that 5% to 10% of patients with dementia, including Alzheimer’s disease, are actually effected by NPH. Given NPH is an age related disorder, the number of NPH cases is expected to grow as the population ages.

BACKGROUND:

The purpose of this study was to evaluate the inter- and intra-observer reliability and accuracy of sonographic (US) acromiohumeral distance (AHD) measurement for both experienced and novice operators in US in patients suffering from subacromial impingement syndrome.

METHOD:

A total of 43 patients (50 shoulders) diagnosed with subacromial impingement syndrome were recruited from an orthopedic outpatient clinic. The US measurement of AHD was obtained… Meer weergeven

BACKGROUND:

The purpose of this study was to evaluate the inter- and intra-observer reliability and accuracy of sonographic (US) acromiohumeral distance (AHD) measurement for both experienced and novice operators in US in patients suffering from subacromial impingement syndrome.

METHOD:

A total of 43 patients (50 shoulders) diagnosed with subacromial impingement syndrome were recruited from an orthopedic outpatient clinic. The US measurement of AHD was obtained consecutively in a neutral position and in a 60 degrees abduction position. A total of 300 blinded measurements were taken.

RESULT:

In the neutral abduction group the intra- observer interclass correlation coefficient (ICC) was 0.94 for the experienced operator and 0.92 for the novice operator. The inter-observer ICC was 0.70 and the accuracy was 1.1 mm. In the 60 degrees abduction group, the intra-observer ICC was 0.90 for the experienced operator and 0.87 for the novice operator. The inter-observer ICC was 0.64 and the accuracy was 1.4 mm. All ICCs were significant at a level of p < 0.0001.

CONCLUSION:

The inaccuracy of the method was 1 mm regardless of the experience of the observer. US AHD measurement in patients with shoulder complaints is not as accurate as reported in healthy subjects. This may have important implications for the clinical use of this parameter.
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