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Menzies O.H.,Auckland City Hospital | Thwaites J.,The Princess Margaret Hospital
New Zealand Medical Journal | Year: 2012

Aim To gather information about handheld computing hardware and software usage by hospital based doctors in New Zealand (NZ). Method An online tool (SurveyMonkey™) was used to conduct the survey from 27 June to 10 September 2010. Distribution of the survey was via an email to all NZ District Health Boards (DHBs). Results There were 850 responses. About half of respondents (52%) used a personal digital assistant (PDA), 90% using it at least once daily. Usage varied greatly between DHBs (27-100%), perhaps related to institutional support. Among PDA users, the most common applications were the non-clinical; Scheduler (95%), Contacts (97%), and Tasks (83%). Users felt PDAs helped considerably with organisation and time saving. For non-users there were a range of barriers to usage, cost being a large factor. Another major barrier identified by both users and non-users was lack of organisational integration and support. Conclusions Half of survey respondents used a PDA. PDA usage of responders from different DHBs varied considerably. Perceived barriers to PDA use included cost and lack of institutional support. A collaborative approach between clinical leadership and Information Technology teams to address barriers may result in increased utility and usage of PDAs in the NZ health system. © NZMA.

Xu M.,Hong Kong Baptist University | Tian X.Y.,Hong Kong Baptist University | Leung K.S.-Y.,Hong Kong Baptist University | Lee K.C.,The Princess Margaret Hospital | And 10 more authors.
Birth Defects Research Part B - Developmental and Reproductive Toxicology | Year: 2012

BACKGROUND: Psoralea corylifolia L. (PC) was commonly used to treat miscarriages clinically. The aim of this study was to examine its embryotoxicity in mice and embryonic stem cells (ESCs). METHODS: Quality control of PC extract including reference marker compounds, pesticide residues, and heavy metals was authenticated with HPLC, Gas chromatography-mass spectrometry (GC-MS), and inductively coupled plasma-mass spectrometry. Pregnant mice were randomly assigned into five groups and dosed with distilled water (G1), PC extract of 2 (G2), 4 (G3), or 8 g/kg/day (G4), and vitamin A (G5). Meanwhile, half maximal inhibitory concentration values for ESCs and 3T3 cells were identified in a cytotoxicity assay, and apoptosis in neuroepithelium was assessed by transmission electron microscopy. RESULTS: In the G4 group, a statistically significant decrease in the total fetus, live fetus, and gravid uterine weight, and increase in the resorbed fetus, postimplantation loss, and neuroepithelial apoptosis as well as maternal liver-weight were found (p < 0.05). CONCLUSIONS: PC extracts at 8 g/kg/day might cause fetal toxicity and maternal liver damage in mice, although it did not cause typical malformation and ESC's cytotoxicity in this experiment. Our data suggested that high dosage and long-term administration of PC preparations may not be safe for pregnant women. © 2012 Wiley Periodicals, Inc.

Warren C.,The Princess Margaret Hospital | Gilchrist N.,The Princess Margaret Hospital | Coates M.,Christchurch Hospital | Frampton C.,University of Otago | And 3 more authors.
ANZ Journal of Surgery | Year: 2012

Background: Recent reports have suggested that a certain type of subtrochanteric and diaphyseal femoral fractures maybe associated with bisphosphonate (BP) therapy. We assessed the association between BP use in atypical and typical femoral fractures in a retrospective study and also looked at the rate of coding errors. Methods: All cases between July 2003 and June 2008 with International Classification of Disease, 10th revision discharge codes for femoral fractures (S72.2 subtrochanteric and S72.3 fracture of shaft of femur) were reviewed. Cases were excluded if there was significant trauma, underlying bone disease or coding error. The remaining cases' films were assessed by an independent, blinded, single radiologist to assess for atypical features (thickened cortices, transverse fractures, medial cortical spike) with additional exclusion criteria of periprosthetic fractures and bone pathology. Odds ratios were calculated comparing BP use in atypical and typical fractures. Results: Six atypical fractures were found in the study period. Compared with the 65 typical fractures, there was an association between BP use and atypical fractures (odds ratio 5.5) but it did not reach statistical significance (0.97-31). Atypical femoral fractures accounted for <0.1% of total fracture admissions during this period. There was a 20% rate of miscoding. Conclusion: This study shows a nonsignificant trend towards alendronate/BP use and atypical femoral fractures compared with typical femoral fractures. These fractures were rare <0.1% and the benefit and treatment of osteoporosis with BPs currently seems likely to outweigh the perceived risks. Individual case and radiology review is important as coding errors were frequent. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Wong K.,University of Toronto | Huang S.H.,Radiation Medicine Program | O'Sullivan B.,University of Toronto | Lockwood G.,The Princess Margaret Hospital | And 9 more authors.
Radiotherapy and Oncology | Year: 2010

Background and purpose: To assess the completeness and accuracy of stage and outcome data in the Anthology of Outcomes (AOs), a prospective point-of-care physician-collected electronic data system for patients at the Princess Margaret Hospital. Material and methods: A random sample of 10% of the AO cases registered between July 2003 and December 2005 was drawn. An audit was conducted of the AO data compared with chart review and cancer registry. Results: The AO system was applied first to a head and neck (HN) cancer patient cohort. From 1152 HN cases, 120 were audited. TNM stage was recorded in all cases. Discrepancy was found between the AO and primary data sources in 3-13% of cases. Physician review showed a 3% error rate in overall stage recorded in the AO. Sixty-two outcomes in 43 patients were found on chart review. No outcomes were incorrectly recorded in the AO. Nineteen (31%) outcomes in 17 patients were missed in the AO. Conclusions: Our experience has demonstrated the feasibility of real-time outcome recording at point-of-care. New processes needed to improve the completeness of capture of patient outcomes in the AO have more recently been introduced. This successful system has been expanded to other disease sites. © 2010 Elsevier Ireland Ltd. All rights reserved.

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