A web application for follow-up of results from a mobile device test battery for parkinson’s disease patients

Background: A test battery consisting of self-assessments and motor tests (tapping and spiral drawing) was developed for a hand computer with touch screen in a telemedicine setting. Objectives: To develop and evaluate a web-based system that delivers decision support information to the treating clinical staff for assessing PD symptoms in their patients based on the test battery data. Methods: The test battery is currently being used in a clinical trial (DAPHNE, EudraCT No. 2005-002654-21) by sixty five patients with advanced Parkinson’s disease (PD) on 9991 test occasions (four tests per day during in all 362 week-long test periods) at nine clinics around Sweden. Test results are sent continuously from the hand unit over a mobile net to a central computer and processed with statistical methods. They are summarized into scores for different dimensions of the symptom state and an ‘overall test score’ reflecting the overall condition of the patient during a test period. The information in the web application is organized and presented graphically in a way that the general overview of the patient performance per test period is emphasized. Focus is on the overall test score, symptom dimensions and daily summaries. In a recent preliminary user evaluation, the web application was demonstrated to the fifteen study nurses who had used the test battery in the clinical trial. At least one patient per clinic was shown. Results: In general, the responses from nurses were positive. They claimed that the test results shown in the system were consistent with their own clinical observations. They could follow complications, changes and trends within their patients. Discussion: In conclusion, the system is able to summarise the various time series of motor test results and self-assessments during test periods and present them in a useful manner. Its main contribution is a novel and reliable way to capture and easily access symptom information from patients’ home environment. The convenient access to current symptom profile as well as symptom history provides a basis for individualized evaluation and adjustment of treatments.

En applikationsinfrastruktur för massutskick av e-post

In today's society it is becoming more and more important with direct marketing. Some of the direct marketing is done through e-mail, in which companies see an easy way to advertise himself. I did this thesis work at WebDoc Systems. They have a product that creates web documents directly in your browser, also called CMS. The CMS has a module for sending mass e-mail, but this module does not function properly and WebDoc Systems customers are dissatisfied with that part of the product. The problem with the module was that sometimes it didn't send the e-mail, and that it was not possible to obtain some form of follow-up information on the e-mail. The goal of this work was to develop a Web service that could easily send e-mail to many receivers, just as easily be able to view statistics on how mailing has gone. The first step was to do a literature review to get a good picture of available programming platforms, but also to be able create a good application infrastructure. The next step was to implement this design and improve it over time by using an iterative development methodology. The result was an application infrastructure that consists of three main parts and a plugin interface. The parts that were implemented were a Web service application, a Web application and a Windows service application. The three elements cooperate with each other and share a database, and plugins.

Teknik för en flerskiktadwebbapplikation

The report analyses if some common problems can be avoided by using modern technology. As a reference system “Fartygsrapporteringssystemet” is used. It is an n-tier web application built with modern technology at time, 2003-2004. The aim is to examine whether ASP.Net MVC, Windows Communication Foundation, Workflow Foundation and SQL Server 2005 Service Broker can be used to create an n-tier web application which also communicate with other systems and facilitate automated testing. The report describes the construction of a prototype in which the presentation layer uses ASP.Net MVC to separate presentation and business logic. Communication with the business layer is done through the Windows Communication Foundation. Hard coded processes are broken out and dealt with by Workflow Foundation. Asynchronous communication with other systems is done by using Microsoft SQL Server 2005 Service Broker. The results of the analysis is that these techniques can be used to create a n-tier web application, but that ASP.Net MVC, which at present only available in a preview release, is not sufficiently developed yet.

Identification of cause of impairment in spiral drawings, using non-stationary feature extraction approach

Parkinson’s disease is a clinical syndrome manifesting with slowness and instability. As it is a progressive disease with varying symptoms, repeated assessments are necessary to determine the outcome of treatment changes in the patient. In the recent past, a computer-based method was developed to rate impairment in spiral drawings. The downside of this method is that it cannot separate the bradykinetic and dyskinetic spiral drawings. This work intends to construct the computer method which can overcome this weakness by using the Hilbert-Huang Transform (HHT) of tangential velocity. The work is done under supervised learning, so a target class is used which is acquired from a neurologist using a web interface. After reducing the dimension of HHT features by using PCA, classification is performed. C4.5 classifier is used to perform the classification. Results of the classification are close to random guessing which shows that the computer method is unsuccessful in assessing the cause of drawing impairment in spirals when evaluated against human ratings. One promising reason is that there is no difference between the two classes of spiral drawings. Displaying patients self ratings along with the spirals in the web application is another possible reason for this, as the neurologist may have relied too much on this in his own ratings.

User perspectives on the Swedish Maternal Health Care Register

Background: Established in 1999, the Swedish Maternal Health Care Register (MHCR) collects data on pregnancy, birth, and the postpartum period for most pregnant women in Sweden. Antenatal care (ANC) midwives manually enter data into the Web-application that is designed for MHCR. The aim of this study was to investigate midwives? experiences, opinions and use of the MHCR. Method: A national, cross-sectional, questionnaire survey, addressing all Swedish midwives working in ANC, was conducted January to March 2012. The questionnaire included demographic data, preformed statements with six response options ranging from zero to five (0 = totally disagree and 5 = totally agree), and opportunities to add information or further clarification in the form of free text comments. Parametric and non-parametric methods and logistic regression analyses were applied, and content analysis was used for free text comments. Results: The estimated response rate was 53.1%. Most participants were positive towards the Web-application and the included variables in the MHCR. Midwives exclusively engaged in patient-related work tasks perceived the register as burdensome (70.3%) and 44.2% questioned the benefit of the register. The corresponding figures for midwives also engaged in administrative supervision were 37.8% and 18.5%, respectively. Direct electronic transfer of data from the medical records to the MHCR was emphasised as significant future improvement. In addition, the midwives suggested that new variables of interest should be included in the MHCR ? e.g., infertility, outcomes of previous pregnancy and birth, and complications of the index pregnancy. Conclusions: In general, the MHCR was valued positively, although perceived as burdensome. Direct electronic transfer of data from the medical records to the MHCR is a prioritized issue to facilitate the working situation for midwives. Finally, the data suggest that the MHCR is an underused source for operational planning and quality assessment in local ANC centres.