Biomedical subjects
W V Slack
Publications and source records attributed to W V Slack.
The handheld calculator.
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ClinQuery: searching a large clinical database.
We designed a user-friendly computer program that permits physicians to use clinical and demographic descriptors to search a hospital's clinical database for purposes of patient care, teaching, and research. For example, the user can identify all admissions in which diabetic ketoacidosis was diagnosed, the serum bicarbonate level was under 12 mmol/liter, and the length of stay exceeded 7 days. Once particular admissions have been identified, all data stored in the computerized record can be displayed. Authorized persons can also request the patient's complete medical record for further study. Over a 5-year period, 895 doctors, nurses, medical students, and hospital administrators used Clin-Query to search the clinical database of Boston's Beth Israel Hospital 3724 times. They displayed detailed information on 72,489 patients and requested the complete medical record 5477 times. Responses to a computer-based questionnaire indicated that 16% of the searches were performed for patient care, 38% for clinical research, 16% for teaching and education, 12% for hospital administration, and 18% for general exploration. We conclude that physicians and allied personnel will repeatedly examine and analyze aggregate clinical information when they are provided with the appropriate tools.
A brief treatise on the academic committee.
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Computer-based support for clinical decision making.
Although computers are now commonly used for financial purposes in hospitals and physicians' offices, most physicians do not routinely use them in patient care. And in hospitals where laboratory data are provided on computer terminals, the displays are often difficult to use and programs that offer assistance in interpreting the data are usually unavailable. We have developed decision support programs that are widely used with the clinical computing system at our hospital. This paper describes the programs and how the clinicians use them.
Computer-assisted soliloquy as an approach to psychotherapy.
Schools of talking therapy generally consider the doctor-patient relationship to be essential to the therapeutic process. Yet studies reveal that the presence of a therapist can sometimes inhibit frank disclosure and that patients will speak alone, in the absence of a therapist, about matters of importance to them. We have programmed a computer interview to facilitate soliloquy and have studied its effectiveness. Encouraged by the computer, subjects talked into a microphone first about anxiety-provoking circumstances and then about relaxation. Both mean heart rate and State anxiety scores fell significantly between the beginning and the end of the interview.
Neural networks in plants?
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Type 1 and type 2 administrators.
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The computer and the doctor-patient relationship.
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The soul of a new system: a modern parable.
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Role of computing in patient care in two hospitals.
This report describes two hospital-wide clinical computing systems that assist physicians, nurses, medical students, and other clinicians in the care of their patients. From any of the video-display terminals located throughout the hospitals (666 at Beth Israel Hospital and 1250 at Brigham and Women's Hospital, both in Boston), clinicians can obtain results from the clinical laboratories; read diagnostic reports from the clinical departments; view lists of medications used during hospitalization and prescriptions filled in the outpatient pharmacy; request delivery of a patient's chart; request consultation on approaches to therapy; perform bibliographic retrieval of the MEDLINE database; and read, write, retract, edit, and forward electronic mail. During a one-week study period, 1737 clinicians at Beth Israel Hospital used one or more of the options in the clinical information system 58,757 times. During the same week, 2262 clinicians at Brigham and Women's Hospital used one or more of their options 89,101 times. The large amount of use by clinicians, who could, if they so desired, rely on printed reports or telephone calls to obtain their clinical information, suggests that a reliable, comprehensive, and easy-to-use computer system can contribute substantially to the quality of patient care.
Departmental and laboratory computing in two hospitals.
This report describes the departmental and laboratory use of integrated, hospital-wide computing systems at Beth Israel and Brigham and Women's hospitals in Boston. The systems have an important role in the admitting, outpatient, and medical records departments; in the clinical departments (blood bank, cardiology, neurophysiology, pathology, radiology, and pharmacy); in the clinical laboratories; and at Brigham and Women's Hospital, in the financial departments. Information that is collected in the computers from these departments and laboratories is available for viewing by clinicians at terminals located throughout each hospital and is used in compiling charges for each patient's account. The programs are heavily used. During a one-week study period, 742 departmental and laboratory workers at Beth Israel Hospital filed or edited information in patients' computerized records 137,526 times. During the same week, 984 departmental and laboratory workers at Brigham and Women's Hospital filed or edited information 293,367 times. After the computing systems were introduced, the time required to collect unpaid bills decreased substantially at both hospitals.
Remembrance, thanks, and welcome.
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Measurement of intelligence: misplaced trust and the lure of prophecy.
A careful look at studies of "intelligence" and "aptitude" tests belies the contention that these tests measure heritable attributes. Rather, they are achievement tests that measure learned abilities. When stripped of the aura of "intelligence" and "aptitude" and compared with other indexes of accomplishment, they are poor predictors of future performance. Furthermore, when promulgated as measures of cognitive potential, they are socially harmful, particularly to disadvantaged children.