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Biomedical subjects

P P Sher

Publications and source records attributed to P P Sher.

10 recordsLinked to original sources
PubMed1998

Advances in health information technology for patients.

Patients now have access to a wide variety of health-related educational material via computers and other sources. To ensure quality, security, and data integrity, it is likely that these databases of patient health information will become part of the information that HIM professionals manage and coordinate for patient use in the clinical setting. This article describes the health information resources available to patients.

Advance Directives↗
PubMed1988

Knowledge-based automation.

Future technologic advances in microcomputer hardware will allow us to build complex interactive information systems that go far beyond conventional laboratory management functions to address the needs of laboratorians as well as physicians in patient care activities. These systems will use a "local-area network to transmit not only text but also images to workstations throughout a hospital. Unlike current systems driven from a central computer, future systems will decentralize much of the memory and processing to individual workstations." The expansion of software tools for modeling the decision-making process coupled with the development and testing of useful systems in relatively narrow problem domains will help the laboratory construct the necessary knowledge bases for future applications. Such systems will present complex medical data in a useful, informative manner, leading to a more rapid, consistent, and, it is hoped, cost effective decision making process. Utilizing these techniques, laboratory medicine can play a crucial role in fostering the appropriate and logical use of the laboratory.

Artificial Intelligence↗
PubMed1986

Using spreadsheets in the clinical laboratory.

Once the user becomes acquainted with the power of electronic spreadsheet software, it is easy to visualize how it could be of use in the laboratory. Here is an overview of this new tool's current and potential uses and in-depth explanation of one possible application in the laboratory.

Clinical Laboratory Information Systems↗
PubMed1982

Drug interferences with clinical laboratory tests.

The interpretation of clinical laboratory tests is dependent on a host of physiological, environmental and pharmacological factors. At present, it is difficult to determine which of these broad groups is involved when one suspects interference with a clinical laboratory test. Detailed knowledge of the drugs that a patient is consuming is critical in understanding potential interferences. Drugs affect laboratory tests by 2 basic mechanisms: (a) physiological or pharmacological interference, and (b) chemical interference. The major interferences with routine clinical chemistry tests are described in the review which follows. The diversity of therapeutic agents that influence tests, points to the problem of monitoring drug interferences. Awareness of the problem and careful review of drug histories is at present the only realistic method of attempting to minimise the problem. Future use of computer data bases may allow potential drug interferences to be signalled automatically.

Alkaline Phosphatase↗
PubMed1980

Mathematical and computer assisted procedures in clinical decision making.

Numerous mathematical and computer assisted procedures have been developed and tested as aids in clinical decision making. With pressures to curtail unnecessary utilization of diagnostic tests, these models may play an increasingly important role. In practice, additional data may benefit the construction of mathematical models but may not necessarily benefit clinicians. With improvements in computer technology, laboratory medicine is in a strategic position to influence the direction of diagnostic testing and clinical decisions in a more cost effective manner.

Bayes Theorem↗
PubMed1979

An evaluation of the detection capacity of a computer-assisted real-time delta check system.

We developed of computer programs to evaluate the clinical reliability of test results by comparing each new result with previous results for the same patient, and to signal discrepancies in real time. These "delta check" discrepancies are noted, and they must be reviewed by the laboratory staff before results can appear on a patient's record. During a month, I reviewed 1403 such delta check messages and detected 55 (3.9%) that could not be explained on the basis of the patient's clinical condition. Of these, 23 represented true laboratory errors, which were corrected. The recognition of discrepancies before they appear on patients' reports has facilitated the operation of the clinical chemistry laboratory. Mislabeled and otherwise mishandled specimens are discovered before erroneous results appear on a patient's record.

Blood Chemical Analysis↗
PubMed1977

Diagnostic effectiveness of biochemical liver-function tests, as evaluated by discriminant function analysis.

I evaluated the diagnostic value of routinely ordered liver-function tests in 175 biopsy-proven cases of hepatic disease by use of stepwise discriminant analysis. The tests studied-total and "direct" bilirubin, alkaline phosphatase, lactate dehydrogenase, and aspartate aminotransferase-correctly classified 45-73% of cases, depending on the homogeneity of the diagnostic groups. Aspartate aminotransferase and alkaline phosphatase were the best discriminators. When all tests were used in the most homogeneous groups (tumors, cirrhosis, and hepatitis), there was a stepwise improvement in diagnostic accuracy from 51 to 73%.

Alkaline Phosphatase↗
PubMed1977

Computer-assisted quality control in clinical chemistry.

A MUMPS comuter program, which stores and retrieves quality-control data from all automated and manual work-station in the laboratory, has been developed as part of a laboratory information system. Tabular displays, Levey-Jennings charts, and summary statistics are available on a real-time basis. Significant economy over previous manual methods has been observed, and the total quality-control program in the laboratory has become a more active and timely process.

Chemistry, Clinical↗
PubMedDate not supplied

The use of multimedia in the informed consent process.

OBJECTIVE: The goal of the project was to create recommendations and design specifications for a multimedia tool to enhance the informed consent process for clinical trials. The authors focused on the needs of patients with potential cognitive impairment. DESIGN: The authors first performed a needs assessment using focus groups and interviews with health care researchers, institutional review board members, and three groups of patients (who had depression, breast cancer, or schizophrenia). Their feedback was incorporated into the design of a prototype multimedia tool. The design included general modules with information about clinical trials and informed consent as well as trial-specific modules. The authors then used the resulting prototype multimedia tool for informed consent in follow-up focus groups and interviews to obtain feedback on the feasibility and potential effectiveness of using such a tool routinely for clinical trials. RESULTS: The authors showed that it was feasible to adapt a structured multimedia informed consent system to a specific clinical trial and to incorporate techniques to improve the understandability of informed consent content. Patients generally felt the prototype system was useful and could replace the paper document. They felt using the system would be less stressful, because they would have a greater sense of control and could proceed at their own pace. They liked the hierarchic and modular approach to providing information and felt that the use of video made information more understandable. Researchers and institutional review board members also found the system to be valuable in these ways but had concerns about how to review the system for potential biases in presentation and about the legal issues associated with replacing the paper document.

Adult↗