Search PubMed⌕ Search

Biomedical subjects

M S Frank

Publications and source records attributed to M S Frank.

At least 19 recordsLinked to original sources
PubMed2001

Integrating digital educational content created and stored within disparate software environments: an extensible markup language (XML) solution in real-world use.

OBJECTIVE: To provide a standardized and scaleable mechanism for exchanging digital radiologic educational content between software systems that use disparate authoring, storage, and presentation technologies. MATERIALS/METHODS: Our institution uses two distinct software systems for creating educational content for radiology. Each system is used to create in-house educational content as well as commercial educational products. One system is an authoring and viewing application that facilitates the input and storage of hierarchical knowledge and associated imagery, and is capable of supporting a variety of entity relationships. This system is primarily used for the production and subsequent viewing of educational CD-ROMS. Another software system is primarily used for radiologic education on the world wide web. This system facilitates input and storage of interactive knowledge and associated imagery, delivering this content over the internet in a Socratic manner simulating in-person interaction with an expert. A subset of knowledge entities common to both systems was derived. An additional subset of knowledge entities that could be bidirectionally mapped via algorithmic transforms was also derived. An extensible markup language (XML) object model and associated lexicon were then created to represent these knowledge entities and their interactive behaviors. Forward-looking attention was exercised in the creation of the object model in order to facilitate straightforward future integration of other sources of educational content. XML generators and interpreters were written for both systems. RESULTS: Deriving the XML object model and lexicon was the most critical and time-consuming aspect of the project. The coding of the XML generators and interpreters required only a few hours for each environment. Subsequently, the transfer of hundreds of educational cases and thematic presentations between the systems can now be accomplished in a matter of minutes. The use of algorithmic transforms results in nearly 100% transfer of context as well as content, thus providing "presentation-ready" outcomes. CONCLUSION: The automation of knowledge exchange between dissimilar digital teaching environments magnifies the efforts of educators and enriches the learning experience for participants. XML is a powerful and useful mechanism for transfering educational content, as well as the context and interactive behaviors of such content, between disparate systems.

Computer Storage Devices↗
PubMed2001

Integrating digital teaching-file systems with off-the-shelf presentation software to facilitate speaker-led conferences.

OBJECTIVE: Develop methods for automated transfer of images and associated text from a teaching-file repository into presentation material for speaker-led conferences. MATERIALS/METHODS: Our institution uses a Microsoft Windows (Microsoft Corp, Redmond, WA) software application to maintain a digital teaching-file database that can store and retrieve content in a case-centric fashion. Virtually any number of images can be stored with any given case. Cases and their associated images can be retrieved via a module that supports searches by American College of Radiology (ACR) code and by free-text Boolean queries on the history, findings, diagnosis, and discussion components of a case. In addition to the software system serving directly as an interactive teaching tool, the digital teaching file itself serves as an image repository and resource for attending radiologists who create their own presentations and lectures. To better support this use, software modules were developed for interprocess communication and automated creation of Powerpoint slides. These modules are fully integrated with the teaching-file software application. A single image or a set of selected images can be automatically made into individual slides with two mouse clicks. Images are automatically centered and optimally sized. A slide title is automatically rendered from the user's preference of the case history or diagnosis (stored with the case), or via the entry of freeform text. We describe the programming techniques that are used, as well as how several features of the operating system and Powerpoint itself can be integrated with a customized software application to facilitate this objective. RESULTS: The creation of presentation-ready Powerpoint slides is fully automated from within our teaching-file application, and the time required to create a presentation compared to the conventional method of manually seeking and inserting files from within Powerpoint itself, on a per-slide basis, is drastically reduced. The benefits are magnified by having all imagery stored within an organized and searchable database system so that desired images can be easily located. CONCLUSION: A digital teaching-file system can serve as a useful image repository for purposes ancillary to direct computerized instruction. Software that supports these uses, such as the automated creation of presentation material for speaker-led conferences, facilitates the radiologist's role as an educator.

Computer-Assisted Instruction↗
PubMed2001

Beyond the electronic textbook model: software techniques to make on-line educational content dynamic.

OBJECTIVE: We describe a working software technology that enables educators to incorporate their expertise and teaching style into highly interactive and Socratic educational material for distribution on the world wide web. MATERIALS/METHODS: A graphically oriented interactive authoring system was developed to enable the computer novice to create and store within a database his or her domain expertise in the form of electronic knowledge. The authoring system supports and facilitates the input and integration of several types of content, including free-form, stylized text, miniature and full-sized images, audio, and interactive questions with immediate feedback. The system enables the choreography and sequencing of these entities for display within a web page as well as the sequencing of entire web pages within a case-based or thematic presentation. Images or segments of text can be hyperlinked with point-and-click to other entities such as adjunctive web pages, audio, or other images, cases, or electronic chapters. Miniature (thumbnail) images are automatically linked to their full-sized counterparts. The authoring system contains a graphically oriented word processor, an image editor, and capabilities to automatically invoke and use external image-editing software such as Photoshop. The system works in both local area network (LAN) and internet-centric environments. An internal metalanguage (invisible to the author but stored with the content) was invented to represent the choreographic directives that specify the interactive delivery of the content on the world wide web. A database schema was developed to objectify and store both this electronic knowledge and its associated choreographic metalanguage. A database engine was combined with page-rendering algorithms in order to retrieve content from the database and deliver it on the web in a Socratic style, assess the recipient's current fund of knowledge, and provide immediate feedback, thus stimulating in-person interaction with a human expert. RESULTS: This technology enables the educator to choreograph a stylized, interactive delivery of his or her message using multimedia components assembled in virtually any order, spanning any number of web pages for a given case or theme. An educator can thus exercise precise influence on specific learning objectives, embody his or her personal teaching style within the content, and ultimately enhance its educational impact. CONCLUSION: The described technology amplifies the efforts of the educator and provides a more dynamic and enriching learning environment for web-based education.

Computer-Assisted Instruction↗
PubMed2001

Empowering radiologic education on the Internet: a new virtual website technology for hosting interactive educational content on the World Wide Web.

OBJECTIVE: We describe a virtual web site hosting technology that enables educators in radiology to emblazon and make available for delivery on the world wide web their own interactive educational content, free from dependencies on in-house resources and policies. MATERIALS/METHODS: This suite of technologies includes a graphically oriented software application, designed for the computer novice, to facilitate the input, storage, and management of domain expertise within a database system. The database stores this expertise as choreographed and interlinked multimedia entities including text, imagery, interactive questions, and audio. Case-based presentations or thematic lectures can be authored locally, previewed locally within a web browser, then uploaded at will as packaged knowledge objects to an educator's (or department's) personal web site housed within a virtual server architecture. This architecture can host an unlimited number of unique educational web sites for individuals or departments in need of such service. Each virtual site's content is stored within that site's protected back-end database connected to Internet Information Server (Microsoft Corp, Redmond WA) using a suite of Active Server Page (ASP) modules that incorporate Microsoft's Active Data Objects (ADO) technology. Each person's or department's electronic teaching material appears as an independent web site with different levels of access--controlled by a username-password strategy--for teachers and students. There is essentially no static hypertext markup language (HTML). Rather, all pages displayed for a given site are rendered dynamically from case-based or thematic content that is fetched from that virtual site's database. The dynamically rendered HTML is displayed within a web browser in a Socratic fashion that can assess the recipient's current fund of knowledge while providing instantaneous user-specific feedback. Each site is emblazoned with the logo and identification of the participating institution. Individuals with teacher-level access can use a web browser to upload new content as well as manage content already stored on their virtual site. Each virtual site stores, collates, and scores participants' responses to the interactive questions posed on line. CONCLUSION: This virtual web site strategy empowers the educator with an end-to-end solution for creating interactive educational content and hosting that content within the educator's personalized and protected educational site on the world wide web, thus providing a valuable outlet that can magnify the impact of his or her talents and contributions.

Computer-Assisted Instruction↗
PubMed2001

Radiofrequency thermal ablation: computer analysis of the size of the thermal injury created by overlapping ablations.

OBJECTIVE: The purpose of this study was to perform a computer analysis of the size of the thermal injury created by overlapping multiple thermal ablation spheres. MATERIALS AND METHODS: A computer-assisted design system was used to create three-dimensional models of a spherical tumor, a spherical tissue volume consisting of the tumor plus a 1-cm tumor-free margin, and individual spherical ablations. These volumes were superimposed in real-time three-dimensional space in different geometric relationships. The effect of the size and geometric configuration of the ablation spheres was analyzed with regard to the ability to ablate the required volume of tissue (tumor plus margin) without leaving untreated areas or interstices. RESULTS: The single-ablation model showed that if a 360-degree 1-cm tumor-free margin is included around the tumor targeted for ablation, radiofrequency ablation devices producing 3-, 4-, and 5-cm ablation spheres can be used to treat 1-, 2-, and 3-cm tumors, respectively. The six-sphere model, in which six ablation spheres are placed in orthogonal planes around the tumor, showed that the largest tumor that may be treated with a 3-cm ablation device is 1.75 cm, whereas 4- and 5-cm ablation spheres can be used to treat tumors measuring 3 and 4.25 cm, respectively. The 14- sphere model showed that addition of eight more spheres to the six-sphere model increased the treatable tumor size to 3, 4.6, or 6.3 cm, depending on the diameter of the ablation sphere used. For treating larger tumors, we found a cylindrical model to be less efficient but easier to control. CONCLUSION: Our computer analysis showed that the size of the composite thermal injury created by overlapping multiple thermal ablation spheres is surprisingly small relative to the number of ablations performed. These results emphasize the need for a methodic tumor ablation strategy.

Computer Simulation↗
PubMed1998

Embodying medical expertise in decision support systems for health care management: techniques and benefits.

Health care providers and payers are faced with ever-increasing pressures to lower costs, improve quality, and maximize profits. As medical information technology evolves, more medically related data are being collected, stored electronically within a data warehouse, and made available for decision support in the pursuit of lower costs and higher quality in health care. The article describes how medical expertise can be captured and integrated into decision support systems to improve awareness and predictability of disease and disease-associated financial risk within a population of patients, ultimately providing patient-centric and provider-centric opportunities to improve health and decrease costs. The concept of medical logic engineering is introduced.

Cost Control↗
PubMed1995

Opinion: a prototype for a computerized national mammography registry and tracking system using telecommunications and the Internet.

In this report, we analyze the feasability and discuss the potential benefits of using currently available technology for the wide-area registration and tracking of mammography patients. In our prototype, three dissimilar computer systems transmitted mammographic data (demographics and the results of mammograms) in a standardized format to a central data repository. Two of the three systems were dedicated computerized mammography systems and one was a general-purpose radiology information system. High-speed modems and the Internet were used to connect with the central repository, which could be queried in real time by remote users. Our results indicated that a busy mammography practice, using the slowest transmission method we tested (14-kilobaud modem), could transmit several days of mammographic data to a central repository in a matter of minutes. To implement systems that provide nation-wide mammographic tracking and follow up, more in-depth planning, development, and testing are necessary.

Computer Communication Networks↗
PubMed1995

CT of the lungs in patients with pulmonary emphysema.

Pulmonary emphysema is a pathological diagnosis. The clinical diagnosis of emphysema can be difficult because correlations between results of lung function tests and the extent of emphysema are poor. Features of chronic bronchitis or asthma may overlap with emphysema, making the clinical diagnosis more challenging. Nonetheless, the diagnosis of pulmonary emphysema can be made with relative confidence on the basis of clinical and radiological criteria. Despite not detecting mild emphysema and underestimating the severity of disease, CT--and high-resolution CT in particular--is the best noninvasive modality for detecting or corroborating pulmonary emphysema. This review focuses on several important aspects of pulmonary emphysema: (1) the definition and pathological characterization, (2) techniques of CT imaging, (3) CT findings and their correlation with pathophysiological data, and (4) quantification with CT.

Humans↗
PubMed1995

Chest computed tomography display preferences. Survey of thoracic radiologists.

RATIONALE AND OBJECTIVES: The authors conducted a survey of dedicated thoracic radiologists and tabulated their preferences for reconstruction algorithm, display, and photography of computed tomography (CT) scans of the chest. METHODS: Data were derived from a mail survey of 343 active members of the Society of Thoracic Radiology and based on a set of 20 questions about the display and photography of chest CT scans. The response rate was 35.4%. RESULTS: There were 119 usable replies from 31 states and 8 countries. Although there was considerable variation, the questionnaire indicates that the "typical" dedicated thoracic radiologist, regardless of practice setting, uses a standard reconstruction algorithm for chest CT and prints images on a laser imager using the "sharp" setting with a 12-on-1 format. Window settings for evaluating the lung are window-width 1500 HU and window-level -600 HU. Window settings for evaluating the mediastinum are window-width 350 HU and window-level 40 HU. CONCLUSIONS: Although there is wide variation in the preferences used to display and photograph chest CT scans, most thoracic radiologists have similar display preferences.

Algorithms↗
PubMed1995

Use of data in a radiology information system for labeling computed radiographs: an interface to connect the two systems.

Computers have greatly facilitated the processing and storage of radiologic information. Manufacturers of radiology information systems (RISs) are gradually incorporating options for interfacing their products with other computers (e.g., hospital information systems). However, a growing need exists to also interface RISs with digital radiologic equipment so that images (e.g., computed radiographs of the chest and skeleton) are automatically labeled with identification data. Such connectivity would eliminate redundant work by technologists, decrease errors in the labeling of images, and increase the consistency of patients' data within a radiology department. Unfortunately, the rapid advances in digital technology, combined with the lack of a well-defined standard for the transfer of demographic information between dissimilar systems, have delayed development of these interfaces. We have developed a widely applicable method to automatically transfer patients' demographic data from an RIS to a commercially available computed radiography system. A personal computer is configured with inexpensive programmable telecommunications software to create an interactive gateway, which eliminates the need for redundant data entry (compared with entering data once on the RIS and again on the stand-alone computed radiography system), and thus also decreases errors in the labeling of images.

Local Area Networks↗
PubMed1995

Value of on-line informational databases in a radiology department.

Radiologists and ancillary personnel in a radiology department frequently access a variety of paper-based information during their workday to facilitate decision making. This information can be as mundane as telephone numbers and work schedules or as important as a detailed emergency procedure for treating a patient with a severe contrast reaction. We have installed some hierarchical, textual database systems on the same computer that runs our radiology information system. Several different databases are maintained, including protocol manuals, emergency procedures, and a directory of telephone and pager numbers. This information is accessible from any terminal connected to our radiology information system and from any personal computer connected to our department's local area network or terminal server. Advantages include decreased costs from the photocopying, consumption, and distribution of paper; ubiquitous access for all users to a single source of information; faster and more powerful ways to access data than paper-based media provide; decreased risk of inadvertently using information from an obsolete document; and convenience in maintaining computerized versus paper-based information. Because we use software that is either free or that came with our computer's operating system, no additional software costs were involved.

Online Systems↗
PubMed1995

CT mosaic pattern of lung attenuation: distinguishing different causes.

Areas of variable lung attenuation in a lobular or multilobular distribution are occasionally seen on CT or high-resolution CT scans of the lungs [1], although never as a normal finding. This mosaic pattern of lung attenuation presents a challenge to the radiologist when deciding which are the abnormal regions of lung--those of low attenuation, those of high attenuation, or both. We have observed three categories of disease known to cause a CT mosaic pattern of lung attenuation: small-airway disease, vascular lung disease, and infiltrative disease. Diseases from each of these categories can cause similar patterns of mosaic lung attenuation on CT scans. However, it is sometimes possible to distinguish among these categories by using additional CT findings. We illustrate the known causes of a CT mosaic pattern of lung attenuation and highlight distinguishing features.

Aged↗
PubMed1994

Integrating a digital dictation system with a network data base for creating and managing radiologic teaching files.

RATIONALE AND OBJECTIVES: A method for facilitating the creation and management of radiologic teaching files is described. METHODS: A digital dictation system was integrated with a personal computer data base. The data base is maintained with user-friendly, graphically oriented software. Radiologists can dictate any examination for the teaching file from any dictation station in the department with minimal interruption of their clinical activities. The data base resides on a file server, thus providing department-wide access for radiologists and students. RESULTS: Attending radiologists and residents have responded favorably to the system. Maintenance and retrieval of teaching files are facilitated by using a computer for otherwise tedious aspects of information management. Data are stored in a well-organized manner, thus increasing the value of the teaching file while reducing redundant data entry. CONCLUSION: Computer technology can facilitate the maintenance of radiologic teaching files. Radiology departments that have a convenient, department-wide method for entering cases--such as a digital dictation system and existing computer network--are ideal for the technique that we describe.

Humans↗
PubMed1994

Evaluation of a combined two- and three-dimensional compression method using human visual characteristics to yield high-quality 10:1 compression of cranial computed tomography scans.

RATIONALE AND OBJECTIVES: The compression of cranial computed tomography scans was improved by using independent intra- and interframe compression techniques. METHODS: For intraframe compression, an image was decomposed into four subimages, one subimage was chosen as a reference subimage, and three of the subimages were predicted from the reference subimage. The prediction error was encoded with a classified vector quantizer (CVQ) based on human visual perception characteristics. Interframe redundancy is exploited by a displacement estimated interslice (DEI) algorithm that encodes the differences between reference subimages from adjacent slices. This combined DEI/CVQ method was subjectively evaluated by 13 radiologists under a blinded protocol, and was compared to the CVQ method alone, the DEI method alone, the original images, and to a standard intraframe discrete cosine transform (DCT) compression method. RESULTS: Only the combined DEI/CVQ method at 10:1 compression was not scored significantly different from the original images. At 15:1 compression, the DEI/CVQ method was scored significantly better than the 10:1 DCT and any other 15:1 compression methods. CONCLUSIONS: Compressed image quality is enhanced by exploiting inter- and intraframe redundancy, and by modeling some characteristics of human visual perception. The DEI/CVQ method is well-suited for progressive transmission, and thus, holds potential in teleradiology as well as picture archiving and communications systems.

Analysis of Variance↗