Evaluation of TELEDERM for dermatological services in rural and remote areas.

OBJECTIVE: This paper describes the Web-based decision support system (TELEDERM) that provides medical services to rural and remote general practitioners (GPs), and presents qualitative results on the usefulness and usability of the system obtained from trials in the GoldFields, Western Australia. METHODS: Diagnostic methods and other functions were developed to assist medical practitioners, who may not be familiar with aspects of decision support systems, to diagnose patients with dermatological problems. GPs in rural and remote areas took part in a trial to assess the usefulness of TELEDERM in clinical situations. In evaluating and assessing a number of the system's characteristics, questionnaires, seminars and interviews were used. RESULTS AND CONCLUSIONS: Feedback concerning the usefulness of TELEDERM shows that 67% of the GPs found the system useful or very useful, and 25% found the system somewhat useful. In terms of its usability, 83% found the system easy to use. The responses concerning the user interface and interactivity of TELEDERM are encouraging as 92% of the GPs found the text easy to read, 84% were happy with the appearance of the interface, and 84% found the system easy to navigate. 89% indicated that they are likely to use the system again. An issue with such systems is the reluctance of GPs to use them, even given that the development was quite sensitive to the needs of the GPs and the consultants, e.g. by streamlining the query process and emphasising that the system is a support tool and not a replacement.

Dynamic knowledge validation and verification for CBR teledermatology system.

OBJECTIVE: Case-based reasoning has been of great importance in the development of many decision support applications. However, relatively little effort has gone into investigating how new knowledge can be validated. Knowledge validation is important in dealing with imperfect data collected over time, because inconsistencies in data do occur and adversely affect the performance of a diagnostic system. METHODS: This paper consists of two parts. First, it describes methods that enable the domain expert, who may not be familiar with machine learning, to interactively validate knowledge base of a Web-based teledermatology system. The validation techniques involve decision tree classification and formal concept analysis. Second, it describes techniques to discover unusual relationships hidden in the dataset for building and updating a comprehensive knowledge base, because the diagnostic performance of the system is highly dependent on the content thereof. Therefore, in order to classify different kinds of diseases, it is desirable to have a knowledge base that covers common as well as uncommon diagnoses. RESULTS AND CONCLUSION: Evaluation results show that the knowledge validation techniques are effective in keeping the knowledge base consistent, and that the query refinement techniques are useful in improving the comprehensiveness of the case base.

Gronuflex adhesive compression bandage.

Adequate compression bandaging to reduce lower leg venous hypertension by improving the function of the calf muscle pump is the most important aspect of treating ambulatory patients with venous ulceration. Conventional methods of providing compression, such as paste bandages with other outer forms of support, have been used for many years, but are associated with a number of problems. These include the need for more than one bandage as well as being messy in application and removal, which increases nursing time. Patient discomfort frequently leads to a lack of compliance. In addition to the time spent on bandaging, lack of improvement of skin condition necessitates additional time and cost with the need to apply emollient or other medicaments as part of the therapeutic regimen of patients with venous ulcers.