13 results on '"Pretschner, Dietrich P."'
Search Results
2. An e-consent-based shared EHR system architecture for integrated healthcare networks
- Author
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Bergmann, Joachim, Bott, Oliver J., Pretschner, Dietrich P., and Haux, Reinhold
- Published
- 2007
- Full Text
- View/download PDF
3. virtX - a computer based system for training the intrasurgical use of mobile image intensifier systems
- Author
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Pretschner, Dietrich Peter, Stürmer, Klaus Michael, Raab, Björn, Lörchner, Andre, Kimmel, Robert, Grobe, Jan-Henrik, Ahrens, Christoph Alexander, Teistler, Michael, Duwenkamp, Christopher, Wagner, Markus, Bott, Oliver Johannes, and Dresing, Klaus
- Subjects
virtual radiography ,C-arm ,computer based training ,orthopaedic surgery ,trauma surgery ,Computer applications to medicine. Medical informatics ,R858-859.7 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Background and objectives: Currently the correct intrasurgical positioning and adjustment of mobile X-ray image intensifiers (C-arm) can be learned theoretically through the use of textbooks, the practical training with the device itself suffers from the lack of visual feedback, i.e. radiographs corresponding to the adjustment of the C-arm. This leads to the question, whether the training of correct operation and adjustment of a C-arm in different operation scenarios can be supported by a C-arm simulation system being part of a CBT system (Computer Based Training). Methods: In co-operation with physicians from accident surgery and radiology the computer-based training system virtX was developed. virtX confronts the user with different exercises of C-arm adjustment and evaluates their execution and the results. These tasks can be created with the help of an authoring tool and can be accomplished by the trainee in different modes: a pure virtual mode and a combined virtual-real mode. In the pure virtual mode the user controls the virtual C-arm in a virtual operating theatre via the graphic-interactive virtX user interface. In the virtual-real mode however the position and orientation of a real C-arm are detected and mapped onto the virtual C-arm. At any time during the completion of an exercise the user can produce a close-to-reality, virtual radiograph and can control all parameters, like the positions of the apertures, X-ray intensity, etc. virtX was used on a three-day course for OR personnel with 120 participants and evaluated using questionnaires.Results: 79 of the participants returned a questionnaire. The average age of the 62 female and 15 male participants (two n.s.) was 34 ± 9 years, their professional experience was 8.3 ± 7.6 years. 18 persons (23%) indicated to work occasionally with a C-arm, 61 (77%) worked regularly with it. Over 83% of the interviewed participants considered virtX a useful addition to the conventional C-arm training. With an acceptance of 91% of the participants the virtual radiography was judged particularly important for understanding C-arm functioning. With 84% acceptance the combined virtual-real mode also got a comparatively high rating. Conclusion: The evaluation results show a high degree of acceptance of the virtX system as a substantial enhancement of conventional C-arm training.
- Published
- 2006
4. Virtual tomography: a new approach to efficient human-computer interaction for medical imaging
- Author
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Teistler, Michael, primary, Bott, Oliver J., additional, Dormeier, Jochen, additional, and Pretschner, Dietrich P., additional
- Published
- 2003
- Full Text
- View/download PDF
5. Virtual tomography: a new approach to efficient human-computer interaction for medical imaging.
- Author
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Teistler, Michael, Bott, Oliver J., Dormeier, Jochen, and Pretschner, Dietrich P.
- Published
- 2003
- Full Text
- View/download PDF
6. Elastodynamic Shape Modeler: A Tool for Defining the Deformation Behavior of Virtual Tissues
- Author
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Radetzky, Arne, primary, Nürnberger, Andreas, additional, and Pretschner, Dietrich P., additional
- Published
- 2000
- Full Text
- View/download PDF
7. Simulation of elastic tissues in virtual medicine using neuro-fuzzy systems
- Author
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Radetzky, Arne, primary, Nuernberger, Andreas, additional, and Pretschner, Dietrich P., additional
- Published
- 1998
- Full Text
- View/download PDF
8. Simulation of elastic tissues in virtual medicine using neuro-fuzzy systems.
- Author
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Radetzky, Arne, Nuernberger, Andreas, and Pretschner, Dietrich P.
- Published
- 1998
- Full Text
- View/download PDF
9. Simulation based cost-benefit analysis of a telemedical system for closed-loop insulin pump therapy of diabetes.
- Author
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Hasman, Arie, Haux, Reinhold, van der Lei, Johan, De Clercq, Etienne, Roger-France, Francis, Bott, Oliver J., Hoffmann, Ina, Bergmann, Joachim, Kosche, Patrick, von Ahn, Christian, Mattfeld, Dirk C., Schnell, Oliver, and Pretschner, Dietrich P.
- Abstract
Background: INCA (Intelligent Control Assistant for Diabetes) is a project funded by the EU with the objective to improve diabetes therapy by creating a personal closed loop system interacting with telemedical remote control. Cost-benefit analyses of such systems are needed to decide on the introduction of telemedical systems such as the INCA system to routine care. Objective: To identify and apply suitable methods for a cost-benefit analysis from the perspective of the payor for health services (i.e. a health insurance company). Methods: For the cost analysis MOSAIK-M was used, a method and tool that supports health information systems analysis and design. Two MOSAIK-M models were created during the INCA project. Both, the “As is”-model of conventional insulin pump based diabetes care, and the “To be”-model of the INCA system were parameterised with cost values. With both models a period of one year was simulated to determine the yearly costs of diabetes management and treatment for a patient who does not suffer from diabetes related complications yet. The HbA1c-value was chosen as effectiveness parameter for diabetes therapy. To determine the probability of developing complications and their probable duration the Archimedes-Model was used. It was parameterised with selected HbA1c-values anticipating the effect of INCA. The simulation results in form of years of disease within a 30-years time frame were multiplied with corresponding treatment costs from the KoDiM study. Results: The yearly costs of conventional insulin pump treatment for a 19 year old diabetes type 1 patient with no complications are 5,907 euro (German health care system). Using the INCA system would raise the yearly costs by 7,348 euro. Almost all (98.53%) of the additional costs are generated by the continuous blood glucose measurement device. HbA1c-decreases from 7% (conventional treatment) to 6.5%, 6%, and 5.8 % would produce yearly savings (benefit) concerning the treatment of complications of 100.50 euro, 189.20 euro and 221.82 euro. Conclusions: The selected approach produces an estimation of a lower bound for cost savings. Further work is needed to improve the approximation and to include indirect and intangible costs. The INCA approach would be cost efficient from the chosen perspective, only if the costs of system operation were notably lowered. [ABSTRACT FROM AUTHOR]
- Published
- 2006
10. An eConsent-based System Architecture Supporting Cooperation in Integrated Healthcare Networks.
- Author
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Bergmann, Joachim, Bott, Oliver J., Hoffmann, Ina, and Pretschner, Dietrich P.
- Abstract
Objectives: The economical need for efficient healthcare leads to cooperative shared care networks. A virtual electronic health record is required, which integrates patient related information but reflects the distributed infrastructure and restricts access only to those health professionals involved into the care process. Our work aims on specification and development of a system architecture fulfilling these requirements to be used in concrete regional pilot studies. Methods: Methodical analysis and specification have been performed in a healthcare network using the formal method and modelling tool MOSAIK-M. The complexity of the application field was reduced by focusing on the scenario of thyroid disease care, which still includes various interdisciplinary cooperation. Results: Result is an architecture for a secure distributed electronic health record for integrated care networks, specified in terms of a MOSAIK-M-based system model. The architecture proposes business processes, application services, and a sophisticated security concept, providing a platform for distributed document-based, patient-centred, and secure cooperation. A corresponding system prototype has been developed for pilot studies, using advanced application server technologies. The architecture combines a consolidated patient-centred document management with a decentralized system structure without needs for replication management. An eConsent-based approach assures, that access to the distributed health record remains under control of the patient. Conclusion: The proposed architecture replaces message-based communication approaches, because it implements a virtual health record providing complete and current information. Acceptance of the new communication services depends on compatibility with the clinical routine. Unique and cross-institutional identification of a patient is also a challenge, but will loose significance with establishing common patient cards. [ABSTRACT FROM AUTHOR]
- Published
- 2005
11. Entwurf und Realisierung eines Ergonomie-Mock-Ups unter Verwendung von Methoden der Virtuellen Realität
- Author
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Schrader, Kai and Pretschner, Dietrich P.
- Subjects
doctoral thesis ,ddc:0 ,ddc:00 ,ddc:004 - Abstract
In dieser Arbeit werden Möglichkeiten der Verwendung von Virtual Reality-Methoden zu Zwecken der ergonomischen Fahrzeuggestaltung untersucht. Es wird exemplarisch ein Ergonomie-Mock-Up aufgebaut, das einen ähnlich vollständigen Innenraumeindruck eines Automobils ermöglicht, wie dieses bisher nur durch aufwendige physikalische Aufbauten erreichbar war. Speziell Ergonomieanalysen mit subjektiver Bewertung von Sichtbedingungen, Bedieninteraktionen, Tätigkeitsabläufen bis hin zu einfachen Fahrszenarien werden durchführbar. Es gilt zunächst geeignete Komponenten zu wählen: Eine sog. Sitzkiste ermöglicht haptische Wahrnehmung. Sie gibt den Innenraum des darzustellenden Automobils vereinfacht wieder und kann Bedienelemente aufnehmen. Ein Head-Mounted Display dient der Grafik- und Audiowiedergabe. Es blockiert die Sicht auf die reale Versuchsumgebung. Durch die Verwendung eines 3D-Menschmodells kann der Benutzer trotzdem seine Körperhaltung sehen. Zur Nachführung des Menschmodells kommt ein optisches Trackingsystem zum Einsatz. Eine Fahrsimulation wird durch die Kopplung von Sensorikkomponenten mit einer Fahrdynamik-Software ermöglicht Der Systementwurf ist in drei Ebenen gegliedert: Der Kommunikationsentwurf erlaubt eine systemnahe Kopplung. Geometrie-, Sound- und Haptikentwurf definieren Modelle einer virtuellen Szene. Der Interaktionsentwurf verknüpft die Komponenten auf logischer Ebene miteinander. Echtzeit- und Einsatzfähigkeit des entstandenen Ergonomie-Mock-Ups werden getestet., This work inspects existing VR-methods for their use in the field of ergonomic car design. For this reason an ergonomic mock-up is built up. The mock-up enables the sort of impression of the automobile’s interior which had previously only been possible through very elaborate physical models. In particular ergonomic investigations which subjectively evaluate visual conditions, user interaction and operation procedures and simple driving scenarios can be carried out. Suitable components had to be selected: Haptic perception is made possible via a so-called seat box which provides a simplified version of the interior of the vehicle and which can contain various control elements. A head-mounted display provides graphics and audio rendering. It blocks off the view of the actual test environment. By using a 3D human model, the user can still perceive his body as a graphical echo. An optical tracking system is used to record his movements. The coupling of sensory components from the seat box with a driving dynamics software finally enables a driving simulation to be carried out. The system design has been structured in three layers: The communication design allows connecting the components at system level. The geometry, sound and haptic design define models of the virtual environment. The interaction design connects the components at a logical level. Finally the author tests the real-time performance and usability of the developed ergonomic mock-up.
- Published
- 2003
12. Zur Architektur Vorgangsunterstützender Informationssysteme im Krankenhaus: Der Leistungsprozess im Krankenhaus und seine informationstechnische Unterstützung
- Author
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Bott, Oliver and Pretschner, Dietrich P.
- Subjects
doctoral thesis ,ddc:0 ,ddc:00 ,ddc:004 - Abstract
Medizinische Dokumentation steht in engem Zusammenhang mit medizinischem Handeln: sie 'spiegelt' die Aktivitäten des medizinischen Personals unter Einbeziehung ihrer informativen Resultate. Die Idee, Medizinische Dokumentation zu unterstützen, indem die zugrunde liegenden medizinischen Aktivitäten bzw. der medizinische Prozess durch Rechnersysteme unterstützt werden, liegt nahe. Grundgedanke hierbei ist, den medizinischen Prozess mit Mitteln der Informationstechnik derart zu 'begleiten', dass die Medizinische Dokumentation als 'Nebenprodukt' der Ausführung der Aktivitäten möglichst automatisch entsteht. Hierzu existieren eine Reihe von Ansätzen. Doch selbst der konsequenteste Ansatz, Workflow-Management-Technologie zur Unterstützung medizinischer Prozesse einzusetzen, führte bislang nicht zu den gewünschten Resultaten. Die Hauptgründe liegen in der Komplexität der organisatorischen Strukturen und der Dynamik der Prozesse im medizinischen Umfeld, die mit den existierenden Meta-Modellen nur unzureichend abgebildet werden können. Um die Ursachen der Probleme bisheriger Ansätze der Prozessunterstützung im medizinischen Umfeld und insbesondere im Krankenhaus zu verstehen, wird ein analytisches Meta-Modell des klinischen Prozesses entwickelt. Darüber hinaus wird auf Grundlage des Meta-Modells ein Referenzmodell einer Architektur für vorgangsunterstützende Informationssysteme im medizinischen Umfeld entwickelt, dessen zentrale Eigenschaft die Virtualisierung des medizinischen Prozesses ist. Für zentrale Anwendungen der Systemarchitektur werden Prototypen der Benutzerschnittstellen vorgestellt, die von medizinischem Personal evaluiert worden sind, um die Eignung des Konzepts zu überprüfen., Medical documentation is closely related to medical acting: it 'mirrors' the activities of healthcare professionals including their informative results. To facilitate medical documentation by supporting the underlying activities respectively the clinical process with information technology in a way that drops off the resulting documentation more or less automatically as a by-product of performing the activities is an obvious idea. Accordingly a lot of approaches have been developed. But even the most resolute approach of using Workflow-Management-Technology does not lead to satisfactory results. Main reasons are the complexity of organizational structures and the dynamic nature of processes in health care that both cannot be represented sufficiently with the meta models underlying these approaches. To understand the reasons for the unsuccessfulness of former approaches, an analytical meta model of the clinical process is developed. Moreover a reference model of an architecture of an information system to support and optimize the clinical process is derived, that integrates this developed meta model and thus virtualizes the clinical process. Prototypes of user-interfaces are presented, that have been evaluated by clinical personnel to proof the suitability of the system architecture.
- Published
- 2001
13. Simulation based cost-benefit analysis of a telemedical system for closed-loop insulin pump therapy of diabetes.
- Author
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Bott OJ, Hoffmann I, Bergmann J, Kosche P, von Ahn C, Mattfeld DC, Schnell O, and Pretschner DP
- Subjects
- Cost-Benefit Analysis, Europe, Humans, Diabetes Mellitus therapy, Insulin Infusion Systems economics, Telemedicine
- Abstract
Background: INCA (Intelligent Control Assistant for Diabetes) is a project funded by the EU with the objective to improve diabetes therapy by creating a personal closed loop system interacting with telemedical remote control. Cost-benefit analyses of such systems are needed to decide on the introduction of telemedical systems such as the INCA system to routine care., Objective: To identify and apply suitable methods for a cost-benefit analysis from the perspective of the payor for health services (i.e. a health insurance company)., Methods: For the cost analysis MOSAIK-M was used, a method and tool that supports health information systems analysis and design. Two MOSAIK-M models were created during the INCA project. Both, the "As is"-model of conventional insulin pump based diabetes care, and the "To be"-model of the INCA system were parameterised with cost values. With both models a period of one year was simulated to determine the yearly costs of diabetes management and treatment for a patient who does not suffer from diabetes related complications yet. The HbA1c-value was chosen as effectiveness parameter for diabetes therapy. To determine the probability of developing complications and their probable duration the Archimedes-Model was used. It was parameterised with selected HbA1c-values anticipating the effect of INCA. The simulation results in form of years of disease within a 30-years time frame were multiplied with corresponding treatment costs from the KoDiM study., Results: The yearly costs of conventional insulin pump treatment for a 19 year old diabetes type 1 patient with no complications are 5,907 euro (German health care system). Using the INCA system would raise the yearly costs by 7,348 euro. Almost all (98.53%) of the additional costs are generated by the continuous blood glucose measurement device. HbA1c-decreases from 7% (conventional treatment) to 6.5%, 6%, and 5.8 % would produce yearly savings (benefit) concerning the treatment of complications of 100.50 euro, 189.20 euro and 221.82 euro., Conclusions: The selected approach produces an estimation of a lower bound for cost savings. Further work is needed to improve the approximation and to include indirect and intangible costs. The INCA approach would be cost efficient from the chosen perspective, only if the costs of system operation were notably lowered.
- Published
- 2006
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