Ebook: HTI Open Access Collection 1

Purpose:

To investigate the correlative factors of vision regression after Implantable Collamer Lens (ICL) surgery from the perspective of binocular vision and to develop a predictive model for the refractive change over the long term.

Methods:

This was a prospective study of 30 subjects (60 implants), who underwent ICL surgery at Guangdong General Hospital. Corrected distance visual acuity, uncorrected distance visual acuity, spherical equivalent (SE), axial length and binocular examination using virtual reality were analyzed before, 1 month and 1 year after the surgery.

Results:

Mean SE was (-12.01 ± 0.86) D preoperatively, (-0.44 ± 0.13)D 1 month postoperatively and (-0.97 ± 0.15)D 1 year postoperatively. The average regression 1 year postoperatively (-0.53 ± 0.25D of SE) was significant (P = 0.01). Mean axial length at the base line and 1 year after the surgery was (28.35 ± 0.39) mm and (28.91 ± 0.57) mm. The regression was correlated with the binocular equilibrium difference (r = 0.553, P = 0.002), and the degree of perceptual eye position shift, especially the horizontal shift (r = -0.620, P = 0.000). The important variables relevant to myopic regression were preoperative horizontal perceptual eye position shift (B = -0.007, P = 0.001) and binocular equilibrium difference (B = 0.146, P = 0.012).

Conclusion:

Perceptual eye position deviation and the binocular equilibrium difference could cause binocular gazing instability, and the unstable retinal image created a ‘micro retinal-defocus phenomena’, leading to an elongation of the axial length and resulting in myopic regression after ICL surgery.

Clinical decision support system (CDSS) plays an essential role nowadays and CDSS for treatment provides clinicians with the clinical evidence of candidate prescriptions to assist them in making patient-specific decisions. Therefore, it is essential to find a partition of patients such that patients with similar clinical conditions are grouped together and the preferred prescriptions for different groups are diverged. A comprehensive clinical guideline often provides information of patient partition. However, for most diseases, the guideline is not so detailed that only limited circumstances are covered. This makes it challenging to group patients properly. Here we proposed an approach that combines clinical guidelines with medical data to construct a nested decision tree for patient partitioning and treatment recommendation. Compared with pure data-driven decision tree, the recommendations generated by our model have better guideline adherence and interpretability. The approach was successfully applied in a real-world case study of patients with hyperthyroidism.

Electronic patient data use and handling are critical issues in terms of privacy, confidentiality, security, and the Health Insurance Portability and Accountability Act (HIPAA) regulations. The risks associated with electronic patient data are not limited to identity theft but rather include a person’s social, economic, and psychological well-being. However, there have not been many studies that have focused on the associated risk factors that could lead to these situations. This paper identifies those risks related to electronic patient data breaches by means of a grounded theory approach and develops a systemic risk management plan that enables engineering managers and risk managers to more effectively and efficiently overcome risks associated with electronic patient data.

Patient portals can have positive consequences in the empowerment of people with depression by raising awareness about their condition. Patient portals are important yet challenging technologies in the field of mental health care. We conducted a scoping review aiming to investigate some important characteristics and features of the mental health websites and related patient portal services for the target audience including people with depression. For this purpose, two reviewers independently entered the keywords in the popular search engines including Google, Yahoo, and Bing in April 2019, in order to find mental health websites that provide patient portal service targeting depression. Examination of the inclusion and exclusion criteria led finally to the selection of 31 websites. We found out that some features of patient portals including the online questionnaires, messaging between the patient and the healthcare provider, and medication refill were more consistent with the areas on which the mental healthcare providers focus, and thus can be effective in improving the progression of these areas. It is essential for patient portal providers to put more focus on expressing the patient portal’s features and objectives on their websites. Besides, it is also necessary to conduct further research to investigate the obstacles and facilitators of the interactive features of the patient portals in the field of mental health care, particularly depression.