Browsing by Author "Weshler, Jason"
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- ItemAngina on the Palm: randomized controlled pilot trial of Palm PDA software for referrals for cardiac testing.(2006-08-23) Greiver, Michelle; Drummond, Neil; White, David; Weshler, Jason; Moineddin, Rahim; ,OBJECTIVE Personal digital assistants PDAs are popular with physicians in 2003 33 of Canadian doctors reported using them in their practices We do not know however whether using a PDA changes the behaviour of practising physicians We studied the effectiveness of a PDA software application to help family physicians diagnose angina among patients with chest pain DESIGN Prospective randomized controlled pilot trial using a cluster design SETTING Primary care practices in the Toronto area PARTICIPANTS Eighteen family physicians belonging to the North Toronto Primary Care Research Network Nortren or recruited from a local hospital INTERVENTIONS We randomized physicians to receive a Palm PDA which included the angina diagnosis software or to continue conventional care Physicians prospectively recorded the process of care for patients aged 30 to 75 presenting with suspected angina over 7 months MAIN OUTCOME MEASURES Did the process of care for patients with suspected angina improve when their physicians had PDAs and software The primary outcomes we looked at were frequency of cardiac stress test orders for suspected angina and the appropriateness of referral for cardiac stress testing at presentation and for nuclear cardiology testing after cardiac stress testing Secondary outcome was referrals to cardiologists RESULTS The software led to more overall use of cardiac stress testing 81 vs 50 The absolute increase was 31 P 007 95 confidence interval CI 8 to 58 There was a trend toward more appropriate use of stress testing 48 6 with the PDA vs 28 6 control an increase of 20 P 284 95 CI 11 54 to 51 4 There was also a trend toward more appropriate use of nuclear cardiology following cardiac stress testing 63 0 vs 45 5 an absolute increase of 17 5 P 400 95 CI 13 9 to 48 9 Referrals to cardiologists did not increase 38 2 with the PDA vs 40 9 P 869 CONCLUSION A PDA based software application can lead to improved care for patients with suspected angina seen in family practices this finding requires confirmation in a larger study
- ItemSurgical procedure logging with use of a hand-held computer.(2002-10-21) Fischer, Sandra; Lapinsky, Stephen E; Weshler, Jason; Howard, Frazer; Rotstein, Lorne E; Cohen, Zane; Stewart, Thomas EOBJECTIVE To evaluate the feasibility of incorporating hand held computing technology in a surgical residency program by means of hand held devices for surgical procedure logging linked through the Internet to a central database SETTING Division of General Surgery University of Toronto DESIGN A survey of general surgery residents METHODS The 69 residents in the general surgery training program received hand held computers with preinstalled medical programs and a program designed for surgical procedure logging Procedural data were uploaded via the Internet to a central database Survey data were collected regarding previous computer use as well as previous procedure logging methods MAIN OUTCOME MEASURE Utilization of the procedure logging system RESULTS After a 5 month pilot period 38 of surgical residents were using the procedure logging program successfully and on a regular basis Program use was higher among more junior trainees Analysis of the database provided valuable information on individual trainees hospital programs and supervising surgeons data that would assist in program development CONCLUSIONS Hand held devices can be implemented in a large division of general surgery to provide a reference database and a procedure logging platform However user acceptance is not uniform and continued training and support are necessary to increase acceptance The procedure database provides important information for optimizing trainees educational experience