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Biomedical subjects

A Hasman

Publications and source records attributed to A Hasman.

At least 145 records · Page 8Linked to original sources
PubMed1987

Automation of the patient history--evaluation of ergonomic aspects.

In this study it was investigated in quantitative terms how patient reactions were on automated history-taking. The study is part of a comprehensive project, in which also physicians participated in the validation of such computerized medical records. In total 99 patients, visiting the outpatient clinic of Internal Medicine for the first time, took part in this in-depth study, in which they could express themselves via an interactive and modified terminal and keyboard. The questionnaire that was used in the system contains 28 different screens. Patient complaints are entered together with data on frequency, severity, onset, and duration. The patient may indicate his physical complaints on a stylized picture of the human body. Of the 99 patients, 67 answered the full questionnaire, and another 16 the main part. On the average, 66 min were needed. Younger patients do complete the history in a significantly shorter time than older patients, resulting in relatively more completed histories for the younger group. Quick patients answered on the average 3.5 questions per minute, the slow patients only 2.5. This was strongly correlated with patient familiarization, that has also been investigated: patients who had a quick familiarization were able to finish within 50 min. Patients who needed no help at all in using the system had even answering rates of 3.9/min.

Adult↗
PubMed1987

Heterogeneity of stage II glottic carcinoma and its therapeutic implications.

The heterogeneity of glottic carcinoma results in variable loco-regional control probabilities from 40 to 80%. These widely different results may be due to two prognostic parameters of the tumor: the mobility of the vocal cord and the volume of the tumor. On the other hand radiation dose and technique may influence the treatment results. Stringent work-up has been prospectively undertaken in 156 patients with Stage II glottic carcinoma since 1974 through 1983 in the Academic Hospital of the Free University in Amsterdam. Several subgroups were defined from the beginning to indicate one or both of these prognostic factors. All were treated with a high quality accurate radiation therapy program delivering high dose to all patients with worse prognostic factors and even higher dosages to voluminous tumors with impaired mobility of a cord or slowly regressing tumors. The latter was individually judged for each patient towards the end of the treatment period. The loco-regional control probability of around 80% for all the subgroups irrespective of the prognostic factors indicate that the heterogeneity of Stage II glottic cancer may be influenced by high dosages of quality controlled radiotherapy. Thus results hitherto reported in literature may be further improved by the dose-schedules outlined here.

Adult↗
PubMed1987

Radiation therapy for advanced (T3T4N0-N3M0) laryngeal carcinoma: the need for a change of strategy: a radiotherapeutic viewpoint.

Since 1974 through 1984, 137 selected patients with loco-regionally advanced carcinoma of the larynx (T3T4 N0-N3) were treated primarily with quality controlled high dose megavoltage radiation therapy with salvage surgery in reserve. This policy of treatment has yielded 67% loco-regional control probability with primary radiotherapy and 85% with salvage surgery at 3 years. Fourteen patients (14/38) had moderate to severe complications after salvage surgery. The quality of life of the patients successfully treated by radiation therapy is obviously and unquestionably better. Primary radiotherapy with salvage surgery in reserve should be accepted as the strategy of choice in at least a selected group of patients with advanced laryngeal carcinoma.

Aged↗
PubMed1986

Appraisal of computerized medical histories: comparisons between computerized and conventional records.

Automated patient histories in internal medicine have been compared with written medical records by investigating the diagnostic statements that were generated for both types of records by three internists. Also the intra and interobserver variability was evaluated. In addition, the opinion of the internists about the usability of the different records was investigated. To have a fair comparison, the written record was transcribed to a computerized form and also offered to the internists. Each internist evaluated in total 72 records (from 18 patients) and altogether 529 diagnostic hypotheses were generated. The intraobserver agreement was for the written record 55%, for the automated history 46% and for the transcribed record 38%. Interobserver agreement was 23.5%, the agreement between the automated patient history and the written record was 24%, between the former and the transcribed record it was 36%.

Computer Systems↗
PubMed1986

A data management system to assist hypertension treatment in primary health care.

A data management system has been developed with respect to the treatment of hypertension and other cardiovascular risk factors. With this data management system as a tool, cooperation between the general practitioner and a specialist physician could be implemented. The system was successfully tested in a group-practice of two general practitioners. Individual follow-up became more tangible. Observations in the patients as a group warranted a modest opinion about hypertension management in view of the number of undetected hypertensives, the number of drop-outs, and the failures in treatment. The set-up functioned satisfactorily. Further application of the system on a wider scale is feasible. Improvement of treatment by a cautiously operating specialist physician is within reach of general practice, even if health care is not regionalized.

Antihypertensive Agents↗
PubMed1985

A computer program for the analysis of serial electrocardiograms from patients who suffered a myocardial infarction.

A program is described, which compares serial ECG recordings of patients, who suffered a myocardial infarction. The comparison of the ECGs is based on the measurements, delivered by the Modular ECG/VCG Interpretation System. The two most recent ECGs are compared and a trend analysis based on all ECG recordings of the patient is performed. The criteria in the comparison program are based, among others, on data obtained from a combined cardiological and respiratory survey in The Netherlands in 1973 and 1976.

Computers↗
PubMed1983

Reproducibility of ejection fraction measurements by gated equilibrium blood pool scintigraphy.

The reproducibility of ejection fraction measurements has been studied using gated equilibrium blood pool scintigraphy. The use of appropriate statistical tests is proposed and commented upon. The intra-observer variability for our group of patients has a standard deviation of 6.4%, the interobserver variability of 3.2% and sequential studies done on the same and different days give standard deviations (due to "time" alone) of 1.0% and 1.9%, respectively. Different factors and sources involved in variability are mentioned. Variability values reported in the literature are discussed.

Adult↗
PubMed1983

Training in medical informatics.

A course is described for the training of medical students in medical informatics (other terms: computational medicine, medical computing). The philosophy behind the course is that there are several modes or levels of human interaction in working with computers, running from registrative functions to assistance at diagnosis and therapy. The course, which consists of five full days, contains lessons in the areas of medical data bases, hospital information systems, medical records, biological signal analysis, computer-assisted diagnosis making, and patient simulation by CAI. Each group of two students has a terminal available, connected to a mini- and/or a microcomputer. The microprocessor takes care of signal analysis and the minicomputer is available for data base construction and interactive operations. The article describes the purposes and contents of all different lessons of this course.

Computer-Assisted Instruction↗
PubMed1982

Training in medical informatics. The use of computers for diagnostic purposes.

Part of a blockcourse on medical informatics is presented; this course is intended for medical students. It is shown how medical students are introduced to the study of the role of computers for diagnostic purposes. The course consists of an oral presentation which introduces the student to the subject, and of practical work on systems in order to more fully comprehend the topics explained in the oral part of the blockcourse. In the oral presentation the student is introduced to various concepts that are used in computer-aided diagnosis. A critical review of the possibilities of computer use for diagnostic purposes is given. A system is presented, with which the student can work interactively. It consists of a database of patients, referred to the hospital because of suspected congenital heart disorder. Bayes' rule and diagnostic tree decision schemes are available to the student to acquaint himself with the subject. The ways he can work with this system are explained. The course is given regularly (every 4 months) to medical students and is well appreciated.

Computers↗
PubMed1981

Piece-wise EEG analysis: an objective evaluation.

In this paper, a method is described to evaluate EEGs by means of a piece-wise analysis. The procedure involves the recursive computation of a 5th-order autoregressive model by means of a Kalman filter. As an illustration the result of applying this method to sleep recordings is described in this paper. Also, an objective comparison of this method with a more conventional approach (based on analyzing 30-s intervals), and with adaptive segmentation (Praetorius et al., 1977) was carried out using the same data. The results obtained indicate that our method is useful in extracting elementary patterns from an EEG and that the piece-wise analysis approach is to be favored over more conventional techniques.

Computers↗
PubMed1979

A data storage and retrieval system for clinical research.

A data storage and retrieval system is presented that can be used for clinical research studies. The system is designed in such a way that the programs are independent of the application. It can be used by non-computer experts via a simple query language. Since it is bulit up in a modular way extensions can be easily made. The system is implemented on a PDP 11/70 under FORTRAN.

Computers↗
PubMed1978

Dose response in radiotherapy for glottic carcinoma.

All consecutive patients with glottic squamous cell carcinoma treated primarily by radiotherapy from 1965 through 1974 have been analyzed to reveal response of the primary tumor in relation to the dose. This study appears to indicate presence of dose response for all stages of the primary lesions (T) of the glottic carcinoma except for the smallest ones namely TIS, T1a and T1b. The total number of advanced tumors is small and selected. But they tend to indicate presence of dose response. Out of 15 selected patients with T3 and T4 glottic tumors, 5 (33%) had attained local control by primary radiotherapy; two had distant metastasis at onset of therapy, while 5 (33%) needed salvage surgery for control of the residual or recurrent disease. The ultimate success rate is 66% (10 out of 15) for the patients with advanced tumors treated with a conservative approach. An ongoing study indicates similar, if not better preliminary results with high dose radiotherapy.

Adult↗