In this paper, we propose a design and implementation of an embedded digital stethoscope that uses the adaptive noise cancellation filter and the Type I Chebyshev IIR bandpass filter to reduce the noise of the heart sound We integrate a traditional stethoscope, two microphones, an amplifier, an analog to digital conversion, a DSP board, and embedded board First, the system acquits the heart sound, amplify, digitize, and input into the DSP board for noise reduction by using of the adaptive noise cancellation and the IIR bandpass filter Then, the preprocessed heart sound signals are send into the embedded board for the LCD displaying and the interface to PC Overall, we design the digital filter, interface circuit, displaying driver, graphical user interface The prototype system integration of the hardware and software modules shows the stable operation with a range of adjustments

The embedded digital stethoscope uses the adaptive noise cancellation filter and the type I Chebyshev IIR bandpass filter to reduce the noise of the heart sound

Many branches of the healthcare industry are being influenced by information and communication technology (ICT). Clinical trials are not an exception. Despite this fact, more than 75% of clinical trials data are being collected on paper records. Recent ICT advances, such as broad acceptance of Internet Technology which are rapidly improving electronic data collection (EDC) tools, however, may soon reduce this percentage of "paper" supported clinical trials. In this paper, we present our Web-based EDC system designed to support a small-scale research-oriented clinical trial for establishing standard operating procedures (SOP) for electrochemotherapy with a new medical device, named Cliniporator. The definition of the SOP can only be based on a comprehensive analysis of collected data and results of clinical trial. Therefore, it is necessary to record treatment efficiency and, in this respect, to carefully follow and collect treatment parameters. We thus established central database and the Web application for filling database with data submitted by users from distant medical centers across Europe. Also, we enabled transmitting of data stored on the local Cliniporator medical devices to the central database as well as submitting of tumor images and marking of tumor nodules on interactive human map developed in Macromedia Flash. We provided users with dynamically generated basic statistics, and, several times during data collection process, we performed statistical data analysis. In order to assure high quality of data in a database, we included several mechanisms: automatic data validation, digital signatures, the form completeness notification system, e-mail alerting of completed forms, and "check tables." After 13 months of using the systems, we performed a simple usability evaluation of the system by asking users to answer to a questionnaire, and here we present the results. With this paper, we try to share our experience and encourage others to exploit Internet and Web technologies to improve clinical trials data collection, follow up, and data analysis

/pdf/web-based-electronic-data-collection-system-to-support-tasmxew7ks.pdf

Web-Based Electronic Data Collection System to Support Electrochemotherapy Clinical Trial

Medical information systems are not designed for clinical trials using clinical imaging. This paper presents a conceptual model for clinical trials based on medical imaging from two complementary points of view: a technical model and a business model. A Web information system (WIS) for supporting multicenter clinical trials has been designed to implement the proposed model. We show that our approach overcomes the actual limitations by facilitating medical image management in the context of clinical trials or cooperative research

Web-PACS for Multicenter Clinical Trials

A database for medical image management

Background: Open source (OS) software is continuously gaining recognition and use in the biomedical domain, for example, in health informatics and bioinformatics.
Objectives: Given the mission critical nature of applications in this domain and their potential impact on patient safety, it is important to understand to what degree and how effectively biomedical OS developers perform standard quality assurance (QA) activities such as peer reviews and testing. This would allow the users of biomedical OS software to better understand the quality risks, if any, and the developers to identify process improvement opportunities to produce higher quality software.
Methods: A survey of developers working on biomedical OS projects was conducted to examine the QA activities that are performed. We took a descriptive approach to summarize the implementation of QA activities and then examined some of the factors that may be related to the implementation of such practices.
Results: Our descriptive results show that 63% (95% CI, 54-72) of projects did not include peer reviews in their development process, while 82% (95% CI, 75-89) did include testing. Approximately 74% (95% CI, 67-81) of developers did not have a background in computing, 80% (95% CI, 74-87) were paid for their contributions to the project, and 52% (95% CI, 43-60) had PhDs. A multivariate logistic regression model to predict the implementation of peer reviews was not significant (likelihood ratio test = 16.86, 9 df, P = .051) and neither was a model to predict the implementation of testing (likelihood ratio test = 3.34, 9 df, P = .95).
Conclusions: Less attention is paid to peer review than testing. However, the former is a complementary, and necessary, QA practice rather than an alternative. Therefore, one can argue that there are quality risks, at least at this point in time, in transitioning biomedical OS software into any critical settings that may have operational, financial, or safety implications. Developers of biomedical OS applications should invest more effort in implementing systemic peer review practices throughout the development and maintenance processes. [J Med Internet Res 2007;9(2):e8]

https://www.ruor.uottawa.ca/bitstream/10393/12904/4/El_Emam_Khaled_2007_A_survey_of_quality_assurance_practices.pdf

A Survey of Quality Assurance Practices in Biomedical Open Source Software Projects

Collection and organization of data in clinical trials requires a sophisticated information management system. An ideal system should be easily accessible over web-technology and should provide high security of data. When deciding for a solution meanwhile even mid- and big-sized companies also evaluate open-source platforms against pure commercial solutions as the use of open-source products seems to get more and more feasible: early open-source disadvantages like limited support and limited user-friendliness seem to disappear. With this work the authors intended to discuss a basic scheme for which software and strategy to choose: objective was to develop a scorecard for decision support with parameters of the trial, user-needs, scale/dimension of the trial, financial budget, IT-resources and long term objectives of the companies IT-strategy. The scorecard can be obtained free from the authors.

http://www.cinc.org/Proceedings/2003/pdf/371.pdf

Open source or commercial products for electronic data capture in clinical trials? a scorecard comparison

Beside regular seminars the Department for Internal Medicine at the Heart Center Leipzig uses Bedside-Teaching and Problem-Oriented Learning (POL) to teach medical students. The advantages of those teaching methods consist in their ability to foster active student inquiry and critical thinking. To have the chance to record interesting cases and reuse them for later seminars and case-presentations, the department uses the PC/WWW-Platform KASUS (Elsner et al.) [1]. Acquiring a case and implementing it into the KASUS database for future use is achieved with a system consisting of a Palm-Computer (Palm V(R)), a digital Camera and a digital Stethoscope (Stethos(R)). Sharing the cases with other groups learning in the POL-format is possible with the KASUS ONLINE application and the WWW-based "Studentencafe", which allows students and doctors to share and discuss cases in different forums.

Sharing cardiology cases with students and doctors over the WWW: the Kasus-platform at the Heart Center Leipzig

Especially in Cardiologic Multicentre Studies the collection, organization and statistical analysis of study data requires a sophisticated information support system. An ideal system should be easy accessible and should provide high security. For this reason Remote-Data-Entry is seen as the most promising future technology. Remote-Data-Entry is the method of collecting Data from different Sites remotely via an Interface emulation or in most cases a browser and writing it into a central database, where the data can be processed and distributed. This way of (Inter)net-based clinical data management is ideal for data entry from distributed locations that have little or no computer infrastructure. A still remaining lack of a system only with simple sewer-browser-user interaction is the missing possibility to verify source data and track Data bedside. For this reason our system integrates Palm-Devices, a Long-Term-ECG-Recorder and Fax-to-Mail Services for direct source- and bedside datacapture.

A real-time monitoring tool for multicentre studies in cardiology

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Open source or commercial products for electronic data capture in clinical trials? a scorecard comparison

Sharing cardiology cases with students and doctors over the WWW: the Kasus-platform at the Heart Center Leipzig

A real-time monitoring tool for multicentre studies in cardiology