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Biomedical subjects

J W Senders

Publications and source records attributed to J W Senders.

9 recordsLinked to original sources

On the complexity of medical devices and systems.

How does one design something that is complex? Or something that is simple? Why should one try to reduce or increase complexity? What is complexity? There are a large number of different uses of the word, including many in mathematics and physics. Most of these are not useful in attempting to fit the word to the problems of the design of systems and devices for medicine. In this paper the concept has been defined to apply to health care, which has led to some conclusions about the future development of medical systems and devices.

Delivery of Health Care↗

Providing a sensory basis for models of visual information acquisition.

Our major goal is to account for some simple digit-recall data with a theory that integrates two models from two scientific traditions. The random-sampling model, founded in the memory and attention literature, holds that (1) stimulus features are randomly sampled throughout the course of stimulus presence and (2) proportion correct recall is equal to the ratio of sampled features to total features. The linear-filter model, founded in the vision and sensation literature, holds that the initial stages of the visual system act as a low-pass temporal filter on the input stimulus, resulting in a time-varying sensory response in the nervous system. We report two experiments in which a variable-duration, masked, four-digit string had to be immediately recalled. Experiment 1 was designed principally to replicate past data confirming the basic random-sampling model. Like others, we were able to confirm the model only by endowing it with an additional processing-delay assumption: that feature sampling does not begin until the stimulus has been physically present for some minimal duration. Experiment 2 was an extension of Experiment 1 in which the target stimulus was preceded, 250 msec prior to its onset, by a 50-msec pre-presentation of the same stimulus called a prime. The Experiment 2 results allowed the following conclusions. First, the initial processing delay found in Experiment 1 is immutably tied to stimulus onset; that is, if there are two stimulus onsets, separated even briefly in time, there are two associated processing delays. Second, processing rate is essentially unaffected by the prime's presentation. Third, being presented with a 50-msec prime is equivalent, in terms of memory performance, to increasing unprimed stimulus duration by approximately 30 msec; the prime can thus said to be worth 30 msec of additional exposure duration. This third conclusion seems superficially paradoxical, in the sense that one would expect that having seen a 50-msec prime would be equivalent to increasing exposure duration by at least the same 50 msec. However, both the initial processing delays and the 30-msec prime's worth are natural consequences of our theory that conjoins the random-sampling model with the linear-filter model.

Adult↗

Theory and analysis of typical errors in a medical setting.

Medical error is not a medical but rather a behavioral matter. In this article, the differences between errors and accidents are discussed in a theoretical manner. A discussion of some useful taxonomies is followed by suggestions on how to talk about an error. In brief, one must distinguish between the "mode" of a particular error (whether, for example, it is an omission or a substitution), the "expression" of the error (what is actually done in the work environment), and the "consequence" of the error (accident or discovery). Finally, there are suggestions about what can be done about errors and accidents. Some remedies are behavioral and depend on training in self-detection of error. Others depend on changes in the engineering and design of medical systems. The use of controlled vocabulary in prescription writing and in the communication of medical orders is strongly recommended.

Accidents↗

Detecting, correcting, and interrupting errors.

The author gives a brief introduction of some theoretical issues and suggests that understanding of errors made in medical settings could be improved by giving up the custom of blaming people who make errors and, instead, attempting to gather as much information as possible. A good database of errors that have not injured patients may help us avoid injury at a later time. Some practical suggestions are offered for minimizing the effect of errors, even if their frequency cannot be reduced.

Data Collection↗