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At least 217 records · Page 12Linked to original sources
PubMed1992

An electronic medical record system with direct data-entry and research capabilities.

The transfer of medical records from a paper system to a computer-based system is inevitable. However, the widespread acceptance of electronic medical records has been delayed by problems such as high cost, inefficiency, data entry errors and poor physician acceptance. We have developed a database system that has overcome these difficulties and now serves as an electronic medical record. Our system has been in use for a year and a half, and currently contains information on over two thousand patients. The database provides an electronic radiation oncology chart containing patients' demographic information, technical treatment data and dictated reports. All dictated notes are captured, including consultation notes, treatment summaries, on-treatment visits, letters and follow up reports. The system provides data validation upon entry, required few additional software or hardware purchases, and allows for efficient retrieval of data. Unlike other database systems which require the hiring of data entry clerks to input the data, ours combines transcription and data entry. The database runs on a local area network of computers and uses a commercially available relational database package. It makes extensive use of mouse interface features such as pull-down menus, pop-up lists, buttons, multi-page forms, and scrolling fields, making the system easy to use with minimal training. Many custom features are built in, such as help screens, control functions, audit trails, and a system that keeps track of each patient's referring and other relevant physicians. For research purposes, the system has the capability to perform survival analyses on arbitrary user-defined subsets of patients. Data may also be exported transparently to statistical packages for other types of analyses.

Data Display↗
PubMed2004

MITIS: a WWW-based medical system for managing and processing gynecological-obstetrical-radiological data.

In this paper a World Wide Web (WWW)-based medical system, called MITIS, is designed and developed for the management and processing of obstetrical, gynecological and radiological medical data. The system records all the necessary medical information in terms of patient data, examinations, and operations and provides the user-expert with advanced image processing tools for the manipulation, processing and storage of ultrasound and mammographic images. The system can be installed in a hospital's Local Area Network (LAN) where it can access picture archival and communication systems (PACS) servers (if available), or any other server within the radiology department, for image archiving and retrieval, based on the digital imaging and communication in medicine (DICOM) 3.0 protocol, over TCP/IP and also it is accessible to external physicians via the hospital's Internet connection. MITIS is composed as a set of independent WWW modules (ISAPI server extension dlls) and a Win32 application (COM+ server) for mammography image processing and evaluation.

Algorithms↗
PubMed2004

A multichannel telemetry system for single unit neural recordings.

We present the design, testing, and evaluation of a 16 channel wearable telemetry system to facilitate multichannel single unit recordings from freely moving test subjects. Our design is comprised of (1) a 16-channel analog front end board to condition and sample signals derived from implanted neural electrodes, (2) a digital board for processing and buffering the digitized waveforms, and (3) an index-card sized 486 PC equipped with an IEEE 802.11b wireless ethernet card. Digitized data (up to 12 bits of resolution at 31.25k samples/s per channel) is transferred to the PC and sent to a nearby host computer on a wireless local area network. Up to 12 of the 16 channels were transmitted simultaneously for sustained periods at a range of 9 m. The device measures 5.1 cm x 8.1 cm x 12.4 cm, weighs 235 g, and is powered from rechargeable lithium ion batteries with a lifespan of 45 min at maximum transmission power. The device was successfully used to record signals from awake, chronically implanted macaque and owl monkeys.

Action Potentials↗
PubMed2006

Continuous EEG-SEP monitoring of severely brain injured patients in NICU: methods and feasibility.

AIMS: To evaluate the feasibility of a continuous neurophysiologic monitoring (electroencephalography (EEG)-somatosensory evoked potentials (SEPs)) in the neuro-intensive care unit (NICU), taking into account both the technical and medical aspects that are specific of this environment. METHODS: We used an extension of the recording software that is routinely used in our unit of clinical neurophysiology. It performs cycles of alternate EEG and SEP recordings. Raw traces and trends are simultaneously displayed. Patient head and stimulator box are placed behind the bed and linked to the ICU monitoring terminal through optic fibers. The NICU staff has been trained to note directly clinical events, main artefacts and therapeutic changes. The hospital local area network (LAN) enables remote monitoring survey. RESULTS: Continuous EEG (CEEG)-SEP monitoring was performed in 44 patients. Problems of needle detachment were seldomly encountered, thanks to the use of a sterile plastic dressing, which covers needles. We never had infection or skin lesions due to needles or the electrical stimulator. The frequent administration of sedative at high doses prevented us from having a clinically valuable EEG in several cases but SEPs were always monitorable, independently of the level of EEG suppression. The diagnosis of seizures and non-epileptic status was based on raw EEG, while quantitative EEG (QEEG) was used to quantify ictal activity as a guide to treatment. CONCLUSIONS: EEG and EP waveforms collected in NICU were of comparable quality to routine clinical measurements and contained the same clinical information. A continuous SEP monitoring in a comatose and sedated patient in NICU is not technically more difficult and potentially less useful than in operating room. This monitoring appears to be feasible provided the observance of some requirement regarding setting, electrodes, montages, personnel integration, consulting and software.

Brain Injuries↗
PubMed2004

Development of a novel SCADA system for laboratory testing.

This document summarizes the supervisory control and data acquisition (SCADA) system that allows communication with, and controlling the output of, various I/O devices in the renewable energy systems and components test facility RESLab. This SCADA system differs from traditional SCADA systems in that it supports a continuously changing operating environment depending on the test to be performed. The SCADA System is based on the concept of having one Master I/O Server and multiple client computer systems. This paper describes the main features and advantages of this dynamic SCADA system, the connections of various field devices to the master I/O server, the device servers, and numerous software features used in the system. The system is based on the graphical programming language "LabVIEW" and its "Datalogging and Supervisory Control" (DSC) module. The DSC module supports a real-time database called the "tag engine," which performs the I/O operations with all field devices attached to the master I/O server and communications with the other tag engines running on the client computers connected via a local area network. Generic and detailed communication block diagrams illustrating the hierarchical structure of this SCADA system are presented. The flow diagram outlining a complete test performed using this system in one of its standard configurations is described.

Journal Article↗
PubMed2003

Telemonitoring of patients at home: a software agent approach.

To address the issue of the increasing social, economical and medical needs of maintaining at home people in loss of autonomy while preserving privacy and quality of life, the authors present a software agent based telemonitoring and alarm raising system. The article describes the overall architecture, the various components of the model, and the methodology that has been used. It specifically addresses the issue of reflecting in the object oriented model of the system various dimensions including: the physical world of in-home bio-signal sensors, the numerical world of software agents and Internet-related technologies, and the medical and social worlds of patients, physicians and caregivers. In the model, the main stream of information goes from the biophysical world of patients at home to the socio-medical world of carers through a chain of devices including in-home sensors, local area network, home computer, remote server, and carers' computers. Each device hosts software agents with different levels of knowledge and complexity. Internet and Java technologies provide the building blocks of the designed telemonitoring software. Laboratory experiments have been realized using a fully equipped 'smart' demonstration home for telecare. The study takes place into a more general research project on 'smart' homes for telecare conducted at the Hospital Centre of Grenoble, France.

Computer Security↗
PubMed2000

A software tool to acquire, synchronise and playback multimedia data: an application in kinesiology.

Assessing the physical condition of the human body frequently requires evaluating different tests performed by different devices. This information has to be analysed simultaneously to derive conclusions, and so a temporal relationship must be established between the data sources. In this paper, synchronisation of the sources of information is achieved by synchronising the clocks of computers connected in a Local Area Network. A clock synchronisation protocol is used and a global time is stamped in each information data flow. During analysis, the time-stamp is used to playback the data in a synchronised way. The proposed system is valid for any medical application in which data synchronisation is needed. However, it has initially been used in a distributed medical environment for analysing electrical muscular activity and lumbar movement. The dual aim is to detect injuries and plan training sessions for athletes. It was specifically used to analyse data generated by: electromyographs; lumbar equipment; and images generated by video cameras. The simple operation of the application and the precision of the synchronisation protocol enabled several interesting medical conclusions to be made.

Electromyography↗
PubMed2000

Reengineering a database for clinical trials management: lessons for system architects.

This paper describes the process of enhancing Trial/DB, a database system for clinical studies management. The system's enhancements have been driven by the need to maximize the effectiveness of developer personnel in supporting numerous and diverse users, of study designers in setting up new studies, and of administrators in managing ongoing studies. Trial/DB was originally designed to work over a local area network within a single institution, and basic architectural changes were necessary to make it work over the Internet efficiently as well as securely. Further, as its use spread to diverse communities of users, changes were made to let the processes of study design and project management adapt to the working styles of the principal investigators and administrators for each study. The lessons learned in the process should prove instructive for system architects as well as managers of electronic patient record systems.

Clinical Trials as Topic↗
PubMed2000

Design and evolution of the data management systems in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.

This paper describes the design and evolution of the data management systems developed in support of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. These systems span platforms from stand-alone computers to distributed systems on local area networks to mainframes. Allowing all of these systems to share appropriate information electronically introduces integration, synchronization, testing, and support challenges. For each platform, applications were developed to handle data entry, editing, trial management, reporting, telecommunications, and data sharing. Approaches to issues such as level of data access, integration with other, existing applications, and handling the expansion of the protocol are discussed.

Colorectal Neoplasms↗
PubMedDate not supplied

[Analog gamma camera digitalization computer system].

OBJECTIVE: Digitalization of analogue gamma cameras systems, using special acquisition boards in microcomputers and appropriate software for acquisition and processing of nuclear medicine images is described in detail. MATERIAL AND METHODS: Microcomputer integrated systems interconnected by means of a Local Area Network (LAN) and connected to several gamma cameras have been implemented using specialized acquisition boards. The PIP software (Portable Image Processing) was installed on each microcomputer to acquire and preprocess the nuclear medicine images. A specialized image processing software has been designed and developed for these purposes. This software allows processing of each nuclear medicine exam, in a semiautomatic procedure, and recording of the results on radiological films. RESULTS: . A stable, flexible and inexpensive system which makes it possible to digitize, visualize, process, and print nuclear medicine images obtained from analogue gamma cameras was implemented in the Nuclear Medicine Division. Such a system yields higher quality images than those obtained with analogue cameras while keeping operating costs considerably lower (filming: 24.6%, fixing 48.2% and developing 26%.) CONCLUSIONS: Analogue gamma camera systems can be digitalized economically. This system makes it possible to obtain optimal clinical quality nuclear medicine images, to increase the acquisition and processing efficiency, and to reduce the steps involved in each exam.

Computers↗
PubMed2000

Postimplant analysis of transperineal interstitial permanent prostate brachytherapy: evidence for a learning curve in the first year at a single institution.

PURPOSE: The utilization of transperineal interstitial permanent prostate brachytherapy (TIPPB) is increasing in the United States. Quality assessment of TIPPB is in its infancy, and to date, dosimetric analyses have only been reported from centers with a large experience in prostate brachytherapy. The purpose of this report is to critically analyze the dosimetric coverage achieved following TIPPB in the first 63 cases performed by a multidisciplinary group of investigators with no prior experience with TIPPB. METHODS AND MATERIALS: The information in this report concerns the first 63 men treated with TIPPB alone at our institution between September 1997 and September 1998. All men were treated similarly, adapting the methods described by Blasko and Grimm. All men were treated with 125I. The prescription dose was 144 Gy according to the TG43 formalism. TIPPB was performed jointly by a radiation oncologist and a urologist. One month following TIPPB, all men underwent a computed tomography (CT) scan of the pelvis according to a protocol using 3-mm abutting slices. CT images were transferred by a local area network to a commercially available treatment planning system and dose-volume histograms were calculated with 0.5-mm pixel spacing. A variety of dosimetric endpoints were examined. A single measure of dose homogeneity, the dose-homogeneity index (DHI), is defined as the volume within the prostate that receives 100-150% of the prescription dose (144-216 Gy) divided by the volume within the prostate that receives 100% of the prescription dose (144 Gy). Three measures of target (prostate) dosimetric coverage are provided. C100 is defined as the percentage of the prostate volume defined on postimplant CT that receives at least 100% of the prescription dose. C90 and C80 are similar but represent the percentage of the prostate volume that receive 90% and 80% of the prescription dose, respectively. Statistical analyses were performed using commercially available computer software. To investigate any changes with time the first 30 cases (group 1) are compared to cases 31-63 (group 2). All p-values are two-sided. RESULTS: The mean C100, C90, and C80 for all 63 patients were 80.7% (SD 10.1), 85.1% (SD 10.2), and 89.3% (SD 9.5). The quantifiers of implant adequacy were all improved in the most recent 33 patients compared to the first 30 patients, (group 1: C100, 75.8% [SD 12.2], C90 79.9% [SD 11.4], C80 84.3% [SD 11.1]; group 2: C100, 85.2 [SD 7.0], C90 89.9% [SD 5.8], C80 93.8% [SD 4.2]; p<0.001). The mean DHI was 0.538 SD (0.124). A multivariate model incorporating a number of variables (ultrasound volume, CT volume, total activity, activity/ seed, implant number) with C100 as the dependent variable found that the implant number was the only statistically significant predictor of C100 (p = 0.0001). Using C90 and C80 as the dependent variable produced similar results (C90, p = 0.0001; C80, p = 0.0001). CONCLUSION: In this single institution experience with the first 63 men receiving TIPPB by a multidisciplinary group of investigators, there is evidence for a learning curve. All quantifiers of implant adequacy improved as clinicians gained experience. In the most recent group of patients, quantifiers of implant adequacy are similar to those reported from other groups with significantly more experience with TIPPB.

Aged↗
PubMed1997

Automating and improving the data quality of a nursing department quality management program at a university hospital.

BACKGROUND: The development and implementation of a relational database program for nursing quality management at a university hospital was stimulated by a lack of consistent data management and analysis tools in the existing noncomputerized program. PROGRAM DEVELOPMENT AND IMPLEMENTATION: An initial software prototype implemented in the critical care service included data collection instruments for five areas: medication errors, patient falls, returns to an intensive care unit within 48 hours, hospital-acquired skin breakdown, and unplanned extubations. Access to the database was limited and paper reports only were disseminated on a scheduled basis. In a second phase, the database is being deployed throughout the nursing department using a local area network. Nurse managers will enter and interact with the quality database online and have access to graphics, reports, and action plan development. POSSIBLE ERRORS: A wide range of potential errors influences decisions on how to collect, store, retrieve, and process quality management data. Each type of error affects the nurse manager's ability to identify significant patterns or trends that are amenable to intervention. There is no right way of constructing and implementing a quality improvement database; only an optimum balance between cost, complexity, and efficacy. SUMMARY AND CONCLUSIONS: Initial feedback from end uses has been positive. A three-year experience with a personal computer database suggests that the personal computer-based information technology is appropriate for small to medium applications and can support departmentwide CQI efforts. A case scenario using simulated data is included to illustrate the use of computerized reports in assessing and taking action on an increase in falls.

Accidental Falls↗
PubMed1996

Engineering for quality in the postanesthesia care unit: an outcomes approach.

For the past 18 months, we have been monitoring three categories of outcome indicators. This process has aided us in decreasing overall patient length of stay (LOS) and improved the quality of care we provide our PACU patients. Using a local area network (LAN) computer program, we track the following: a set of sentinel indicators, a set of proximate clinical outcome indicators, and a set of system indicators based on nonclinical issues that prolong PACU LOS. The LAN computer program links the surgical scheduling department, OR, and PACU, and aids in accurately compiling and collating data. Quality improvement tools to facilitate further scrutiny of processes and aspects of care felt to be of particular relevance to perioperative nursing have also been developed. We are entering an era in which external accrediting agencies and third-party payers are placing an increasing emphasis on measuring and optimizing patient outcomes. This overall program will position the PACU at an advantage in meeting such challenges.

Humans↗
PubMed2000

Power of heterogeneous computing as a vehicle for implementing E(3) medical decision support systems.

A computer system of PCs, workstations, minicomputers etc. connected together via a local area network or wide area network represents a large pool of computational power. Our aim is to use this power for the implementation of an E(3) (efficiency, effectiveness, efficacy) medical decision support system, which can be based on different models, the best providing an explanation together with an accurate and reliable response. One of the most viable among models is decision trees, already used for many medical decision-making purposes. In this paper, we present a parallel implementation of a genetic algorithm on a heterogeneous computing system for the induction of decision trees with the application on solving the mitral valve prolapse syndrome. Our approach can be considered as a good choice for different real-world decision making, with respect to the advantages of our model, especially the great computational power.

Algorithms↗
PubMed1998

Providing dermatological photographs using the multimedia extension of the international computer database for radiation accident case histories.

The World Health Organisation (WHO) Radiation Emergency Medical Preparedness (REMPAN) centres have built up the International Computer Database for Radiation Accident Case Histories (ICDREC) to document the medical treatment of acute radiation syndrome (ARS) patients. Images play an increasing role as complementary information beside text and numerical data in medicine. In particular, retrieval and display of digitised skin photographs serve to improve patient care, medical education and scientific analysis concerning the cutaneous radiation syndrome (CRS). The ICDREC has been built up as a client/server system. Particular focus has been set on using commercial off-the-shelf software components. All the medical data including the multimedia data are stored in a relational database system. The database can be accessed by inexpensive personal computers in the physician's workplace. Retrieval of one photograph via local area network (LAN) requires approximately 3 s. Authorised institutions can access the database via the Internet. The current state of the ICDREC multimedia component is illustrated with the skin lesion treatment of a Chernobyl patient. An example is given on how the workflow in a dermatology department is supported by the ICDREC.

Databases, Factual↗
PubMed1994

Knowledge data base system for twins study.

The medical research on twins, carried out at the Gregor Mendel Institute for Medical Genetics and Twin Study in Rome over the past four decades, has resulted in a vast collection of clinical paper records. A challenge was presented by the need for a more secure method of storage to preserve this enormously valuable historical and scientific patrimony and to render its contents more easily accessible for research purposes. We met the challenge by planning and developing the computerization of this material. New concepts, currently being explored in biomedical informatics, were applied to build a Knowledge Data Base System, using a fourth-generation language (SQL). This architecturally innovative computer system enables its users to manipulate data supplied, rather than just simply storing it. Based on heuristic relational criteria between variables and parameters, the system is employed to solve problems of sibling design analysis typically arising from twins' records, but is also equipped to meet future data base requirements. Another feature of the system is its users' ability to pull off data in the form of regular automated reports, which are distributed through a Local Area Network (LAN). Through a Bulletin Board System (BBS) and modem, any scientist (outside as well as within the Institute) is thus able to access data and exchange scientific information.

Data Collection↗
PubMed2002

A filter that prevents the spread of mail-attachment-type Trojan horse computer worms.

The malicious code "W32/Sircam" is spread via e-mail and potentially through the file space shared by local area networks. Such Trojan-horse-type computer worms easily penetrate Internet firewalls and propagate via the "backdoor" to other computers. Once a malicious code, such as "W32/Sircam," has been executed on a system, it may reveal or delete confidential data, such as clinical records. In order to protect against the leakage of clinical records, we devised a mail filter that successfully prevents the spread of mail containing this malicious code. It is significant that neither access control nor packet filtering is guaranteed to prevent the spread of this mail-attachment-type Trojan horse computer worm.

Computer Communication Networks↗
PubMed2001

Attributions of the "causes" of group performance as an alternative explanation of the relationship between organizational citizenship behavior and organizational performance.

The purpose of this study was to examine the possibility that feedback regarding team performance may influence team members' reports of organizational citizenship behaviors. Ninety-five teams of business students (N = 412) participated in a labor-scheduling simulation over a local area network. Teams were provided with false negative, false positive, or neutral feedback regarding their performance. Results support the hypothesis that the perception of 2 forms of organizational citizenship behavior (helping behavior and civic virtue) in work groups may, in part. be a function of the nature of the performance feedback that group members receive. However, negative feedback appears to play a more critical role than positive feedback in this attributional process. Possible reasons for these findings, as well as their implications, are discussed.

Adult↗