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A methodology for evaluating the development of new clinical emergency response technologies: Testing its validity using the case of electron paramagnetic resonance dosimetry.

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Call No.	Ph.D. 2010
Author	Nicolalde, Roberto J.
Title	A methodology for evaluating the development of new clinical emergency response technologies: Testing its validity using the case of electron paramagnetic resonance dosimetry.
Date	2010
Abstract	Background. The development and implementation of emergency response technologies have relied on two independent and rarely integrated processes. Initially, research labs develop technologies without systematic consideration of the special needs associated with large-scale deployment for catastrophic events. Subsequently, the emergency response community tries to adapt the technology for their special needs, thus producing suboptimal technologies. Objective. The overall goal is to design and test a new methodology for the effective development and assessment of a new technology which can improve the speed and ease with which it can be transferred from a basic science laboratory setting to its ultimate implementation in a large-scale disaster context. Methods. The new methodology, the Disaster Technology Assessment Cycle (DTAC), is based on a framework that adapts components from: human factors engineering, emergency response, public health and quality improvement. A case study approach is used to validate and improve DTAC. EPR dosimetry, a method to estimate exposure to radiation, is evaluated across its development. The specific criteria to evaluate DTAC's validity focused on its adequacy to accomplish three goals: (1) improving the design and development of the technology, (2) integrating stakeholders into the assessment process, and (3) identifying and including overarching system factors to ensure its appropriate intended use. Task analysis and process evaluations were based on data obtained from videotaping, surveys of stakeholders, observations by experts, and quantitative questionnaires for volunteers. Results. DTAC as implemented in the case study used three simulation exercises as the main mechanism to integrate (a) all stakeholders into the technology's evaluation and (b) technology-specific research and development. It also provided useful input into refining the DTAC approach to guide future developments of this and other technologies. DTAC resulted in improvements to the technology itself by decreasing the perpatient measuring time, improving patient comfort during measurement, and decreasing the complexity of operating the technology. The simulation exercises established the feasibility of using EPR biodosimetry to triage potential victims of a mass casualty radiological event. Conclusions. DTAC was found to be a valid and useful methodological approach to develop a new technology for use in disaster planning so that it can develop rapidly and effectively to accomplish its ultimate purpose.
Description	xvi, 230 leaves : ill. (some col.) ; 28 cm.
Format	application/pdf
Advisor	Swartz, Harold M., Blike, George T., Flood, Ann Barry, Gougelet, Robert M.
Subject	Electron paramagnetic resonance spectroscopy -- Technological innovations. Radiation dosimetry -- Technological innovations. Emergency management -- Technological innovations.
College	Dartmouth Medical School -- Department of Health Policy and Clinical Practice.
Issuing Body	Dartmouth Dissertations are made available through the Dartmouth Digital Library.
Degree	Thesis (Ph.D.)--Dartmouth College.
Copyright	All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means without permission in writing from the author.
DOI	http://dx.doi.org/10.1349/ddlp.362

Title	Page 1
Format	application/pdf
Issuing Body	Dartmouth Dissertations are made available through the Dartmouth Digital Library.
Degree	Thesis (Ph.D.)--Dartmouth College.
Full Text	A METHODOLOGY FOR EVALUATING THE DEVELOPMENT OF NEW CLINICAL EMERGENCY RESPONSE TECHNOLOGIES: TESTING ITS VALIDITY USING THE CASE OF ELECTRON PARAMAGNETIC RESONANCE DOSIMETRY A Thesis Submitted to the Faculty in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Health Policy and Clinical Practice by Roberto J. Nicolalde DARTMOUTH COLLEGE Hanover, New Hampshire June 3, 2010 Examining Committee: Harold M. Swartz, M.D., Ph.D. (chair) George Blike, M.D. Ann Barry Flood, Ph.D. Robert M. Gougelet, M.D. Brian W. Pogue, Ph.D. Dean of Graduate Studies

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