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PubMed1988

Activities of and time spent by the project dietitian in implementing a custom-designed decision support system for a computer.

Part 1 of this study involved development and implementation of a prototype of Interactive Foodservice Decision Assist Methods (IFDAM) software. A 1-day menu from the Health Center of Methodist Health Services, Inc., which included 161 menu items and 181 ingredients, composed the data base. The prototype was used to test transfer procedures from the mainframe computer at the university to the one at the hospital and to test the program and train users. Three supporting documents were written. The Procedure Manual described methodology for data collection and use of IFDAM at the Health Center. The Data-Entry Manual explained the use of the microcomputer for entering information into IFDAM. The User Manual illustrated the command structure of IFDAM. Part 2 of the study included the addition of data from five cost centers, which were serviced from the central production facility of the Health Center. Six-week-cycle menus and all ingredient files in the foodservice were incorporated into the data base. The data totaled 998 menu items and 660 ingredients. Time spent by the project dietitian on development of data bases and support manuals, completion of data forms, data entry and transfer, conferences, and training totaled 362.10 hours and 898.75 hours in Parts 1 and 2, respectively. The project required 30 months to complete. Problems, classified as equipment, program, or personnel, delayed implementation.

Data Collection↗
PubMed1998

Knowledge-based visualization of time-oriented clinical data.

We describe a domain-independent framework (KNAVE) specific to the task of interpretation, summarization, visualization, explanation, and interactive exploration in a context-sensitive manner through time-oriented raw clinical data and the multiple levels of higher-level, interval-based concepts that can be abstracted from these data. The KNAVE exploration operators, which are independent of any particular clinical domain, access a knowledge base of temporal properties of measured data and interventions that is specific to the clinical domain. Thus, domain-specific knowledge underlies the domain-independent semantics of the interpretation, visualization, and exploration processes. Initial evaluation of the KNAVE prototype by a small number of users with variable clinical and informatics training has been encouraging.

Artificial Intelligence↗
PubMed2006

A randomized, controlled, prospective study validating the acquisition of percutaneous renal collecting system access skills using a computer based hybrid virtual reality surgical simulator: phase I.

PURPOSE: The need to develop new methods of surgical training combined with advances in computing has led to the development of sophisticated virtual reality surgical simulators. The PERC Mentortrade mark is designed to train the user in percutaneous renal collecting system access puncture. We evaluated and established face, content and construct validation of the simulator in this task. MATERIALS AND METHODS: A total of 63 trainees underwent baseline testing on the simulator, consisting of percutaneous renal puncture followed by the introduction of a guidewire into the collecting system. Subjects were then randomized to an intervention arm, in which they underwent 2, 30-minute training sessions on the simulator, and a control arm, in which no further training was given, followed by repeat testing. Performance was assessed using a global rating scale and by virtual reality derived parameters. RESULTS: There were no significant differences between the 2 groups with respect to baseline measures. Subjects who underwent training with the simulator demonstrated significant improvement in objective and subjective parameters compared to their baseline performance and compared to the untrained control group. Spearman rank correlations demonstrated a significant relationship between multiple parameters of the objective and subjective data. CONCLUSIONS: Training on the simulator improves virtual reality skills. It may allow trainees to develop the basic skills necessary to perform percutaneous renal collecting system access. Face and content validity were demonstrated and construct validity was supported by establishing convergent validity.

Computer Simulation↗
PubMed1995

Computer conversion & user group participation.

A small, hand-held computer seemed to be the answer to many challenges of home care automation. When users came together to discuss their success and problems, their combined attention only improved the product and helped them use it more effectively.

Community Health Nursing↗
PubMedDate not supplied

Virtual reality and medicine--from the cockpit to the operating room: are we there yet?

Teaching medicine to medical students, physicians in training and nurses is a challenging task that has remained unchanged for decades. The airline industry has achieved a great deal of safety and quality in a technically challenging environment. Many believe that their outstanding achievement is due to team training and crew resource management using simulators and dedicated training programs. Many experts in the medical profession believe that adopting the same strategies in teaching medical students and trainees could achieve significant reductions in medical errors and improve the quality of patient care. This article explores the role of teaching medicine using virtual reality in a multitude of medical specialties and outlines the use of simulation training at Saint Louis University.

Education, Medical↗
PubMed2006

Brain-computer interfaces for 1-D and 2-D cursor control: designs using volitional control of the EEG spectrum or steady-state visual evoked potentials.

We have developed and tested two electroencephalogram (EEG)-based brain-computer interfaces (BCI) for users to control a cursor on a computer display. Our system uses an adaptive algorithm, based on kernel partial least squares classification (KPLS), to associate patterns in multichannel EEG frequency spectra with cursor controls. Our first BCI, Target Practice, is a system for one-dimensional device control, in which participants use biofeedback to learn voluntary control of their EEG spectra. Target Practice uses a KPLS classifier to map power spectra of 62-electrode EEG signals to rightward or leftward position of a moving cursor on a computer display. Three subjects learned to control motion of a cursor on a video display in multiple blocks of 60 trials over periods of up to six weeks. The best subject's average skill in correct selection of the cursor direction grew from 58% to 88% after 13 training sessions. Target Practice also implements online control of two artifact sources: 1) removal of ocular artifact by linear subtraction of wavelet-smoothed vertical and horizontal electrooculograms (EOG) signals, 2) control of muscle artifact by inhibition of BCI training during periods of relatively high power in the 40-64 Hz band. The second BCI, Think Pointer, is a system for two-dimensional cursor control. Steady-state visual evoked potentials (SSVEP) are triggered by four flickering checkerboard stimuli located in narrow strips at each edge of the display. The user attends to one of the four beacons to initiate motion in the desired direction. The SSVEP signals are recorded from 12 electrodes located over the occipital region. A KPLS classifier is individually calibrated to map multichannel frequency bands of the SSVEP signals to right-left or up-down motion of a cursor on a computer display. The display stops moving when the user attends to a central fixation point. As for Target Practice, Think Pointer also implements wavelet-based online removal of ocular artifact; however, in Think Pointer muscle artifact is controlled via adaptive normalization of the SSVEP. Training of the classifier requires about 3 min. We have tested our system in real-time operation in three human subjects. Across subjects and sessions, control accuracy ranged from 80% to 100% correct with lags of 1-5 s for movement initiation and turning. We have also developed a realistic demonstration of our system for control of a moving map display (http://ti.arc.nasa.gov/).

Algorithms↗
PubMed2005

The digital pen and paper. Evaluation and acceptance of a new data acquisition device in clinical settings.

OBJECTIVES: To evaluate the efficiency and acceptance of digital pen and paper technology for real-time clinical data acquisition. METHODS: A prospective interventional unblinded study involving consecutive patients in two clinical settings during a defined time-frame was proposed. The first trial was designed as a stress test to evaluate acceptance in a workload-intensive environment. Acceptance was assessed using observations and a satisfaction questionnaire. The second trial was intended to determine the reliability of data acquisition in a controlled environment. Reliability was assessed by comparing the performance of the digital pen against scanner analysis and a double human blinded acquisition. RESULTS: Overall, users were satisfied with the use of the digital pen (median 3 on a Likert-scale (-5, 5)). Without any specific user training, successful data acquisition was greater than 80%. Use of this technology required less adaptation than standard computer devices, and was easy to learn and use. Ergonomic problems shaded the perception of the technology by inducing an increased cognitive load. Digitalized data was missing either because of a bug or due to lack of data validation. The reliability obtained with the digital pen was significantly lower to that obtained with the scanner. CONCLUSIONS: Natural technology such as the digital pen proved to be a good tool in stressful clinical environments without interfering with the normal workload or increasing the time for data acquisition. However, in order to improve quality of data acquisition, designing acquisition forms specifically for the use of digital pens is of paramount importance.

Anesthesia, Obstetrical↗
PubMed1998

Barriers to rural physician use of a digital health sciences library.

BACKGROUND: Rural physicians need access to quality medical information, but accessing information is difficult in rural settings. Digital health sciences libraries (DHSLs) offer the potential to make information more accessible to rural physicians. A telemedicine network was deployed to six rural hospitals in Iowa. Computers were installed allowing access to a DHSL and training sessions were held. The purpose of this study was to examine the barriers to use of a DHSL by rural physicians. METHODS: Approximately one year after deployment of the telemedicine network, physicians were surveyed using a modified critical incident technique. RESULTS: Seventy percent of the eligible physicians responded and 33% had used the DHSL. Primary barriers included insufficient training, being too time consuming to use, and distance of computers from physicians' practice sites. Non-DHSL users cited the difficulty of using the DHSL as their greatest barrier, while DHSL users cited the quality of the information resources. CONCLUSIONS: This study identifies a number of barriers that exist to rural physicians use of a DHSL. Potential solutions to these barriers are discussed. DHSLs will finally reach their potential when they can be delivered by easy to use handheld computers seamlessly integrated into the rural physician's workflow.

Adult↗
PubMed2004

Conversion of EEG activity into cursor movement by a brain-computer interface (BCI).

The Wadsworth electroencephalogram (EEG)-based brain-computer interface (BCI) uses amplitude in mu or beta frequency bands over sensorimotor cortex to control cursor movement. Trained users can move the cursor in one or two dimensions. The primary goal of this research is to provide a new communication and control option for people with severe motor disabilities. Currently, cursor movements in each dimension are determined 10 times/s by an empirically derived linear function of one or two EEG features (i.e., spectral bands from different electrode locations). This study used offline analysis of data collected during system operation to explore methods for improving the accuracy of cursor movement. The data were gathered while users selected among three possible targets by controlling vertical [i.e., one-dimensional (1-D)] cursor movement. The three methods analyzed differ in the dimensionality of the cursor movement [1-D versus two-dimensional (2-D)] and in the type of the underlying function (linear versus nonlinear). We addressed two questions: Which method is best for classification (i.e., to determine from the EEG which target the user wants to hit)? How does the number of EEG features affect the performance of each method? All methods reached their optimal performance with 10-20 features. In offline simulation, the 2-D linear method and the 1-D nonlinear method improved performance significantly over the 1-D linear method. The 1-D linear method did not do so. These offline results suggest that the 1-D nonlinear or the 2-D linear cursor function will improve online operation of the BCI system.

Adult↗
PubMed2002

Using mixed reality, force feedback and tactile augmentation to improve the realism of medical simulation.

This paper describes an application of a display approach which uses chromakey techniques to composite real and computer-generated images allowing a user to see his hands and medical instruments collocated with the display of virtual objects during a medical training simulation. Haptic feedback is provided through the use of a PHANTOM force feedback device in addition to tactile augmentation, which allows the user to touch virtual objects by introducing corresponding real objects in the workspace. A simplified catheter introducer insertion simulation was developed to demonstrate the capabilities of this approach.

Biomechanical Phenomena↗
PubMed1999

Occupational stress in human computer interaction.

There have been a variety of research approaches that have examined the stress issues related to human computer interaction including laboratory studies, cross-sectional surveys, longitudinal case studies and intervention studies. A critical review of these studies indicates that there are important physiological, biochemical, somatic and psychological indicators of stress that are related to work activities where human computer interaction occurs. Many of the stressors of human computer interaction at work are similar to those stressors that have historically been observed in other automated jobs. These include high workload, high work pressure, diminished job control, inadequate employee training to use new technology, monotonous tasks, por supervisory relations, and fear for job security. New stressors have emerged that can be tied primarily to human computer interaction. These include technology breakdowns, technology slowdowns, and electronic performance monitoring. The effects of the stress of human computer interaction in the workplace are increased physiological arousal; somatic complaints, especially of the musculoskeletal system; mood disturbances, particularly anxiety, fear and anger; and diminished quality of working life, such as reduced job satisfaction. Interventions to reduce the stress of computer technology have included improved technology implementation approaches and increased employee participation in implementation. Recommendations for ways to reduce the stress of human computer interaction at work are presented. These include proper ergonomic conditions, increased organizational support, improved job content, proper workload to decrease work pressure, and enhanced opportunities for social support. A model approach to the design of human computer interaction at work that focuses on the system "balance" is proposed.

Boredom↗
PubMed1985

Computers and veterinary practice in the United Kingdom.

The results of a survey of 103 computers being used by veterinary surgeons in the United Kingdom are presented. Details of the hardware and software in use are given as well as the costs, time taken to change to computerisation and the ease of implementing such a changeover. The problems that arose with hardware, software, supply companies and staff are summarised. Details are presented about after sales service contracts, office staff training, user opinions as to overall cost effectiveness, and advice offered to colleagues considering changing to computerisation.

Computers↗
PubMed1989

[The use of a computer for the diagnosis of comatose states in diabetics (a differential diagnostic algorithm)].

An algorithm for differential diagnosis of comatose conditions in patients with diabetes mellitus has been devised. The algorithm is intended for the general practitioner and non-specialized department. The algorithm uses the minimum of the crucial signs of comatose conditions, ensuring their diagnosis under the conditions of any hospital. The algorithm can be applied to the recognition of the typical variants of comatose conditions in a "pure" form. The amount of algorithm steps is minimized. The program of differential diagnosis is written in the Fokal language and realized on the computer "Elektronika BK 0010". The program is run in the dialogue mode. The algorithm is used in clinical practice and in the training process, with its efficacy being independent of the professional skills of the user.

Algorithms↗
PubMed2005

A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users.

AIMS: To examine the effect of two workstation and postural interventions on the incidence of musculoskeletal symptoms among computer users. METHODS: Randomised controlled trial of two distinct workstation and postural interventions (an alternate intervention and a conventional intervention) among 376 persons using computer keyboards for more than 15 hours per week. The incidence of neck/shoulder symptoms and hand/arm symptoms during six months of follow up among individuals in the intervention groups was compared to the incidence in computer users who did not receive an intervention (comparison group). For individuals in the intervention groups, study staff adjusted workstations, where possible, and trained individuals to assume the intervention postures. Individuals reported musculoskeletal symptoms in a weekly diary. Participants who reported discomfort intensity of 6 or greater on a 0-10 visual analogue scale or who reported musculoskeletal symptoms requiring use of analgesic medication were considered symptomatic. RESULTS: There were no significant differences in the incidence of musculoskeletal symptoms among the three intervention groups. Twenty two (18.5%) participants in the alternate intervention group, 25 (20.2%) in the conventional intervention group, and 25 (21.7%) in the comparison group developed incident arm or hand symptoms. Thirty eight (33.3%) participants in the alternate intervention group, 36 (31.0%) in the conventional intervention group, and 33 (30.3%) in the comparison group developed incident neck or shoulder symptoms. Compliance with all components of the intervention was attained for only 25-38% of individuals, due mainly to the inflexibility of workstation configurations. CONCLUSIONS: This study provides evidence that two specific workplace postural interventions are unlikely to reduce the risk of upper extremity musculoskeletal symptoms among computer users.

Adolescent↗
PubMed1996

A haptic interface for virtual simulation of endoscopic surgery.

Virtual reality can be described as a convincingly realistic and naturally interactive simulation in which the user is given a first person illusion of being immersed within a computer generated environment While virtual reality systems offer great potential to reduce the cost and increase the quality of medical training, many technical challenges must be overcome before such simulation platforms offer effective alternatives to more traditional training means. A primary challenge in developing effective virtual reality systems is designing the human interface hardware which allows rich sensory information to be presented to users in natural ways. When simulating a given manual procedure, task specific human interface requirements dictate task specific human interface hardware. The following paper explores the design of human interface hardware that satisfies the task specific requirements of virtual reality simulation of Endoscopic surgical procedures. Design parameters were derived through direct cadaver studies and interviews with surgeons. Final hardware design is presented.

Computer Simulation↗
PubMed2006

NeuroPred: a tool to predict cleavage sites in neuropeptide precursors and provide the masses of the resulting peptides.

NeuroPred is a web application designed to predict cleavage sites at basic amino acid locations in neuropeptide precursor sequences. The user can study one amino acid sequence or multiple sequences simultaneously, selecting from several prediction models and optional, user-defined functions. Logistic regression models are trained on experimentally verified or published cleavage data from mollusks, mammals and insects, and amino acid motifs reported to be associated with cleavage. Confidence interval limits of the probabilities of cleavage indicate the precision of the predictions; these predictions are transformed into cleavage or non-cleavage events according to user-defined thresholds. In addition to the precursor sequence, NeuroPred accepts user-specified cleavage information, providing model accuracy statistics based on observed and predicted cleavages. Neuropred also computes the mass of the predicted peptides, including user-selectable post-translational modifications. The resulting mass list aids the discovery and confirmation of new neuropeptides using mass spectrometry techniques. The NeuroPred application, manual, reference manuscripts and training sequences are available at http://neuroproteomics.scs.uiuc.edu/neuropred.html.

Animals↗
PubMed1997

Validation of EGSITE2, a mixed integer program for deducing objective site models for experimental binding data.

EGSITE2 represents a substantial advance in a long series of methods for calculating receptor site models given only specific binding data. Compared to our most recently reported technique, EGSITE [Schnitker et al. J. Comput.-Aided Mol. Des. 1997, 11, 93-110] the user no longer has to simplify the structures of the molecules in the training set by clustering the atoms into a few superatoms. The only remaining source of subjectivity is the user's choice of compounds for the training set, which can be surprisingly few in number. Then EGSITE2 automatically produces typically several different models that explain the observed binding without outliers. The models are remarkably simple but have substantial predictive power for any sort of test compound, with an estimation of the uncertainty of the prediction. Validation of the method is reported for four standard test cases: triazines and pyrimidines binding to dihydrofolate reductase, steroids binding to corticosteroid-binding globulin and to testosterone-binding globulin, and peptides binding to angiotensin-converting enzyme.

Algorithms↗

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