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Biomedical subjects

W H Young

Publications and source records attributed to W H Young.

6 recordsLinked to original sources
PubMed1997

Computerized ventilator data selection: artifact rejection and data reduction.

OBJECTIVE: To determine acceptable strategies for automated data acquisition and artifact rejection from computerized ventilators using the Medical Information Bus. DESIGN: Medical practitioners were surveyed to establish 'clinically important' ventilator events. A prospective study involving frequent data collection from ventilators was also conducted. SUBJECTS: Data from 10 adult patients were collected every 10 seconds from a Puritan Bennett 7200A ventilator for a total of 617.1 hours. INTERVENTIONS: Twelve different computerized data selection and artifact algorithms were tested and evaluated. MEASUREMENTS AND MAIN RESULTS: Data derived from 12 data selection algorithms were compared with each other and with data manually charted by respiratory therapists into a computerized charting system. Ventilator setting data collected by the algorithms, such as FIO2, reduced the amount of data collected to about 25% compared to manually charted data. The amount of data collected for measured parameters, such as tidal volume, from the ventilator had large variability and many artifacts. Automated data capture and selection generally increased the amount of data collected compared to manual charting, for example for the 3 minute median the increase was a modest 1.2 times. CONCLUSION: Computerized methods for collecting ventilator setting data were relatively straightforward and more-efficient than manual methods. However, the method for automated selection and presentation of observed measured parameters is much more difficult. Based on the findings and analysis presented here, the authors recommend recording ventilator setting data after they have existed for three minutes and measured parameters using a three minute median data selection strategy. Such an algorithm rejected most artifacts, required minimal computational time, had minimal time-delay, and provided clinically acceptable data acquisition. The results presented here are but a starting point in developing automated ventilator data selection strategies.

Adult↗
PubMed1992

Digital electronic communication between ICU ventilators and computers and printers.

UNLABELLED: Although many modern ICU ventilators offer the option of electronic communication, most of these systems are not used because there is a huge communication gap between the ventilator and the computer it might be connected to. When such systems are now used, a large part of what is communicated is artifactual and misleading. We need to overcome both legal and knowledge barriers in the effort to provide seamless communication between ventilators and computers. With regard to the specific issues raised in this paper, here are our answers. Issue #1: Is it essential to have a digital electronic communication port on an ICU ventilator? ANSWER: No, it is not essential. The purpose of the mechanical ventilator is to support pulmonary ventilation by supplying gas and pressure. There is no vital role for digital communication in the gas-delivery function of the ventilator; however, in the future it will be essential to have effective electronic communication in order to guarantee accurate and timely charting. Issue #2: What impact does electronic communication between a ventilator and a computer have on patient outcome? ANSWER: Our preliminary data show that electronic communication can reduce the number of charting errors and can improve the timeliness of data entry. However, there is little evidence, other than anecdotal, that this has any impact on patient outcome. Automated charting has been shown to reduce the time spent on charting. This time-savings could be used to increase time spent in direct patient care, but there is no conclusive evidence that this occurs. In fact, one report on computerized charting systems indicates that the result is less time spent in direct patient care. Issue #3: If electronic communication is to be effective in the future, how should these interfaces be configured for mechanical ventilation? ANSWER: We recommend an optimal algorithm for automated respiratory care charting that has been suggested. Sampling frequency: Sample data from the ventilator every 10 seconds. Ventilator-setting changes: Report every new setting if change lasts more than 3 minutes. Measured respiratory care data: Filter raw MIB-collected data with a 3-minute moving-median filter. Report one filtered value every hour for each variable. In addition, use a threshold table (Table 3) to define significant events. Report changes that remain above threshold more than 3 minutes. Report all measured respiratory-care data 1 minute following any ventilator-mode changes.

Computer Communication Networks↗
PubMed1984

Program relationships of community hospitals and medical schools in CME.

In this paper, the authors report on a nationwide study that examined continuing medical education (CME) "programmatic linkages" between medical schools and community hospitals. Data were gathered to answer two major questions. To what extent are U.S. medical schools currently involved with community hospitals in providing cosponsored, accredited CME programs on an ongoing basis for hospital staffs? How do such programs differ one from the other? Data obtained indicated that a majority (70 percent) of the medical schools have CME programmatic linkages with community hospitals and that these relationships were viewed as very positive and beneficial.

Education, Medical, Continuing↗