Die Ophthalmologie最新文献

Background: The increasing bureaucratic burden in everyday clinical practice impairs doctor-patient communication (DPC). Effective use of digital technologies, such as automated semantic speech recognition (ASR) with automated extraction of diagnostically relevant information can provide a solution.

Objective: The aim was to determine the extent to which ASR in conjunction with semantic information extraction for automated documentation of the doctor-patient dialogue (ADAPI) can be integrated into everyday clinical practice using the IVI routine as an example and whether patient care can be improved through process optimization.

Methods: In a prospective monocentric study at the Sulzbach Eye Clinic, 50 patients were included in the period from 2020 to 2022. As part of a project funded by the "Zentrale Initiative des Mittelstandes" (ZIM), a demonstrator was developed with the consortium partners and integrated into the hospital information system (HIS). For qualitative and quantitative evaluation, a survey of patients was carried out using a questionnaire before and after implementation of the ADAPI module, supplemented by a determination of acceptance and possible time saving for users.

Results: The ADAPI module was successfully integrated into the HIS. The documentation of the findings and connection of the subsequent processes could be automated. An improvement in the DPC was reported for 13/50 patients (26%). The majority 35/50 (70%) did not notice any subjective change. The average duration of the conversation in the area of conventional documentation was 4.46 min (1-10 min) and 3.9 min with ADAPI (1-10 min).

Conclusion: With respect to the quality of the conversation within the DPC, no relevant differences could be shown with both types of documentation; however, larger case numbers and other areas of application still need to be evaluated. In the long term, the use of automated documentation solutions will sustainably improve the efficiency, completeness and consistency of clinical documentation.

Background: Orbital lymphomas are the most frequently occurring malignant tumor entities in this region. They are less frequently also localized in the ocular adnexa and show a high entity-specific heterogeneity regarding the treatment and prognosis.

Objective: This article gives an overview of the heterogeneity of symptoms of orbital lymphoma and lymphoma of the ocular adnexa and focuses on new systemic options for treatment of this disease.

Material and methods: For this article a systematic search of the PubMed databank was carried out and the practical knowledge of the authors was taken into account.

Results and conclusion: Orbital lymphoma and lymphoma of the ocular adnexa show a high variability in the clinical symptoms and therefore require a comprehensive ophthalmological examination of the affected patients. Histopathologically assisted diagnostics after an incisional biopsy are essential for the classification into the various lymphoma entities. This is necessary for developing and carrying out a targeted treatment concept consisting of local and systemic treatment modalities. Especially for the new systemic treatment approaches, in addition to the histopathological classification of the lymphoma entity it is also necessary to analyze the molecular features in order to efficiently implement the new highly specific medications. Finally, a close interdisciplinary cooperation of all disciplines involved is absolutely necessary for the best possible treatment, including ophthalmology, hemato-oncology, radiotherapy, radiology, pathology and psycho-oncology. Depending on the localization of the tumor, inclusion of otorhinolaryngology, oral and maxillofacial surgery and/or neurosurgery can be necessary.

The works of Julius Hirschberg (1843-1925), especially his "History of ophthalmology" are even now still worth reading and indispensable for those who are interested in the history of the discipline ophthalmology. In addition to his scientific achievements in the field of ophthalmology, he was particularly concerned with international understanding and is therefore more current than ever before.