Search

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Objectives: The aging of the population creates pressure on the healthcare systems in various ways. A massive increase of chronic disease conditions and age-related illness are predicted as the dominant forces driving the future health care. The objective of this paper is to present future research demands in pervasive healthcare with the goal to meet the healthcare challenges by paving the way for a pervasive, user-centered and preventive healthcare model., Methods: This paper presents recent methodological approaches and proposes future research topics in three areas: i) pervasive, continuous and reliable long-term monitoring systems; ii) prevention through pervasive technology as a key element to maintain lifelong wellness; and iii) design and evaluation methods for ubiquitous, patient-centric technologies., Results: Pervasive technology has been identified as a strong asset for achieving the vision of user-centered preventive healthcare. In order to make this vision a reality, new strategies for design, development and evaluation of technology have to find a common denominator and consequently interoperate. Moreover, the potential of pervasive healthcare technologies offers new opportunities beyond traditional disease treatment and may play a major role in prevention, e.g. motivate healthy behavior and disease prevention throughout all stages of life. In this sense, open challenges in future research have to be addressed such as the variability of health indicators between individuals and the manner in which relevant health indicators are provided to the users in order to maximize their motivation to mitigate or prevent unhealthy behaviors. Additionally, collecting evidence that pervasive technology improves health is seen as one of the toughest challenges. Promising approaches are recently introduced, such as "clinical proof-of-concept" and balanced observational studies., Conclusions: The paper concludes that pervasive healthcare will enable a paradigm shift from the established centralized healthcare model to a pervasive, user-centered and preventive overall lifestyle health management. In order to provide these new opportunities everywhere, anytime and to anyone, future research in the fields of pervasive sensing, pervasive prevention and evaluation of pervasive technology is inevitably needed.

Background: Though the knowledge about the risk of elevated intraocular pressure for pathogenesis for development and progress of glaucoma is more than 400 years old. It took another 300 years before by means of tonometry this elevation could be quantified. After discussion of the key words it is our aim to demonstrate the latest trends in tonometry, specifically by use of modern electronics for instrument design., Materials: Goldmann was the founder of the "applanation tonometry", measuring the corelation of applanated area and applied force. Here, the next step was the development of instruments, measuring independent of position or gravity to allow application also at the lying patient. Electronic area detection was the next step to avoid examinor's error. Also important was the introduction of automatic UV-desinfection to avoid contamination of the other eye or other patients. Other tonometers control the force applied by an inductive method, which also allows application independent of position. Airpuff-tonometry uses completely different measuring principles - the resulting change of corneal curvature indicates the intraocular pressure. The impedance principle is applied even through the closed eye lid. The shock waves resulting shall be measured. Direct application of a surface sensor incorporated into a concave surface contact body shall allow direct measurement of intraocular pressure independent of corneal thickness, curvature, astigmatism. This method has been tried for more than 20 years. Also exposition of the eye to count waves of different frequency was an early attempt. Here also change of reflectivity is used to calculate intraocular pressure., Conclusions: Even after use of modern electronic technology the precision of many of these new devices does not lead to better results. This specifically is shown by modern calibration methods.

During the last decade there has been a wealth of papers discussing the development of scoring systems in medicine, some of which have led to fully operational computer-aided diagnostic systems. In this paper we sketch the development of a simple scoring system for one of the more common rheumatic diseases, rheumatoid arthritis (RA) using a two-tier model, independence Bayes' followed by logistic discrimination. The scoring system gives reasonably well calibrated probability estimates of RA which suggests ways in which the development of computerised systems in rheumatology might be approached.