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Gamma-ray spectrometry data collection and reduction by simple computing systems.

The review summarizes the present state of the involvement of relatively small computing devices in the collection and processing of gamma-ray spectrum data. An economic and utilitarian point of view has been chosen with regard to data collection in order to arrive at practically valuable conclusions in terms of feasibility of possible configurations with respect to their eventual application. A unified point of view has been adopted with regard to data processing by developing an information theoretical approach on a more or less intuitive level in an attempt to remove the largest part of the virtual disparity between the several processing methods described in the literature. A synoptical introduction to the most important mathematical methods has been incorporated, together with a detailed theoretical description of the concept gamma-ray spectrum. In accordance with modern requirements, the discussions are mainly oriented towards high-resolution semiconductor detector-type spectra. The critical evaluation of the processing methods reviewed is done with respect to a set of predefined criteria. Smoothing, peak detection, peak intensity determination, overlapping peak resolving and detection and upper limits are discussed in great detail. A preferred spectrum analysis method combining powerful data reduction properties with extreme simplicity and speed of operation is suggested. The general discussion is heavily oriented towards activation analysis application, but other disciplines making use of gamma-ray spectrometry will find the material presented equally useful. Final conclusions are given pointing to future developments and shifting their centre of gravity towards improving the quality of the measurements rather than expanding the use of tedious and sophisticated mathematical techniques requiring the limits of available computational power.

Activation Analysis

Patient-data collection system used during medical operations after the 1994 San Fernando Valley-Northridge earthquake.

INTRODUCTION: In large disasters, such as earthquakes and hurricanes, rapid, adequate, and documented medical care and distribution of patients are essential. METHODS: After a major (magnitude 6.7 Richter scale) earthquake occurred in Southern California, nine disaster medical assistance teams and two Veterans Administration (VA) buses with VA personnel responded to staff four medical stations, 19 disaster-assistance centers, and two mobile vans. All were under the supervision of the medical support unit (MSU) and its supervising officer. This article describes the patient-data collection system used. All facilities used the same patient-encounter forms, log sheets, and medical treatment forms. Copies of these records accompanied the patients during every transfer. Centers for Disease Control and Prevention data classifications were used routinely. The MSU collected these forms twice each day so that all facilities had access to updated patient flow information. RESULTS: Through the use of these methods, more than 11,000 victims were treated, transferred, and their cases tracked during a 12-day period. CONCLUSIONS: Use of this system by all federal responders to a major disaster area led to organized care for a large number of victims. Factors enhancing this care were the simplicity of the forms, the use of the forms by all federal responders, a central data collection point, and accessibility of the data at a known site available to all agencies every 12 hours.

California

A program evaluation of classroom data collection with bar codes.

A technology incorporating bar code symbols and hand-held optical scanners was evaluated for its utility for routine data collection in a special education classroom. A different bar code symbol was created for each Individualized Educational Plan objective, each type of response occurrence, and each student in the first author's classroom. These symbols were organized by activity and printed as data sheets. The teacher and paraprofessionals scanned relevant codes with scanners when the students emitted targeted behaviors. The codes, dates, and approximate times of the scans were retained in the scanner's electronic memory until they could be transferred by communication software to a computer file. The data from the computer file were organized weekly into a printed report of student performance using a program written with commercially available database software. Advantages, disadvantages, and costs of using the system are discussed.

Child

Use of a viewdata system to collect data from a multicentre clinical trial in anaesthesia.

The interactive electronic information storage and transmission system PRESTEL was assessed as a method of recording and collecting patient record forms from a multicentre trial in anaesthesia. PRESTEL terminals were provided in anaesthetic centres around Britain and all data handled by this public viewdata service, which connects users by telephone to a central computer. The trial was of a new analgesic supplement, alfentanil, and confirmed more rapid recovery of patients as compared with that after traditional anaesthesia with halothane. Advantages of the system were manifold and included reducing the need for the trial monitor to visit the trialist, an electronic "mailbox," confidentiality, and the ability immediately to identify violations of study protocol. No participant found the system too difficult to use, though the small keyboard was a source of complaint. Despite the initial cost of the system its utility vastly outweighs traditional methods of data collection.

Adjuvants, Anesthesia

[Data collection in anesthesia. Experiences with the inauguration of a new information system].

UNLABELLED: In many institutions information systems are used to process off-line anaesthesia data for invoices, statistical purposes, and quality assurance. Information systems are also increasingly being used to improve process control in order to reduce costs. Most of today's systems were created when information technology and working processes in anaesthesia were very different from those in use today. Thus, many institutions must now replace their computer systems but are probably not aware of how complex this change will be. Modern information systems mostly use client-server architecture and relational data bases. Substituting an old system with a new one is frequently a greater task than designing a system from scratch. This article gives the conclusions drawn from the experience obtained when a large departmental computer system is redesigned in an university hospital. METHODS: The new system was based on a client-server architecture and was developed by an external company without preceding conceptual analysis. Modules for patient, anaesthesia, surgical, and pain-service data were included. Data were analysed using a separate statistical package (RS/1 from Bolt Beranek), taking advantage of its powerful precompiled procedures. RESULTS: Development and introduction of the new system took much more time and effort than expected despite the use of modern software tools. Introduction of the new program required intensive user training despite the choice of modem graphic screen layouts. Automatic data-reading systems could not be used, as too many faults occurred and the effort for the user was too high. However, after the initial problems were solved the system turned out to be a powerful tool for quality control (both process and outcome quality), billing, and scheduling. The statistical analysis of the data resulted in meaningful and relevant conclusions. CONCLUSIONS: Before creating a new information system, the working processes have to be analysed and, if possible, made more efficient; a detailed programme specification must then be made. A servicing and maintenance contract should be drawn up before the order is given to a company. Time periods of equal duration have to be scheduled for defining, writing, testing and introducing the program. Modern client-server systems with relational data bases are by no means simpler to establish and maintain than previous mainframe systems with hierarchical data bases, and thus, experienced computer specialists need to be close at hand. We recommend collecting data only once for both statistics and quality control. To verify data quality, a system of random spot-sampling has to be established. Despite the large investments needed to build up such a system, we consider it a powerful tool for helping to solve the difficult daily problems of managing a surgical and anaesthesia unit.

Anesthesia

Application of computers in diabetes care--a review. I. Computers for data collection and interpretation.

The paper reviews the contribution of information technology (IT) to diabetes care. An appraisal of this topic with respect to insulin-dependent (type 1) diabetic patients is carried out in view of the landmark findings of the Diabetes Control and Complications Trial (DCCT) which has demonstrated that maintaining tight blood glucose control can delay the onset and slow the progression of the later life complications of diabetes. The review starts with the clinical background and the main features of the control schema in which diabetic patients receive insulin therapy. An overview is then provided of recent IT initiatives in diabetes care, and the application of IT techniques to assist in the diagnosis and characterization of patients with diabetes mellitus is considered. The role of IT approaches for short-term glycaemic control is discussed and the utilization of computers for collecting, viewing and interpreting home monitoring blood glucose data is reviewed; both quantitative and qualitative techniques being considered. In the second paper the role of decision support tools for planning insulin therapy using clinical algorithms, hand-held devices, knowledge-based approaches, telemedicine techniques and interactive simulations is reviewed, and the validation and clinical evaluation of these tools is discussed. The likely impact of the routine clinical application of implantable/non-invasive blood glucose monitoring devices is also considered. Finally, the application of computers as teaching tools is reviewed and the ways in which such educational approaches might be applied for disseminating the benefits of the DCCT trial more widely are discussed.

Blood Glucose Self-Monitoring

Reporting errors in time-to-pregnancy data collected with a short questionnaire. Impact on power and estimation of fecundability ratios.

Few tools exist in reproductive epidemiology for studying adverse effects on fertility. Data on time to pregnancy (the number of menstrual cycles required to conceive) can be used to estimate fecundability ratios, a sensitive endpoint for identifying factors associated with reduced fertility. Time-to-pregnancy data can be collected in detailed interviews. The accuracy of data collected on brief, self-administered questionnaires is not known. In a study of occupational exposures to dental assistants conducted in 1987-1988, 523 women provided time-to-pregnancy data both on a short, mailed questionnaire and in a detailed telephone interview. The correlation between the two measures was 0.82. Assuming that the detailed data were accurate, reporting errors in data from the short form were distributed nondifferentially with respect to most covariates of interest in fecundability analyses. Simulation studies were conducted to estimate bias and loss of power from the misclassification. Bias was toward the null. Substantial power was lost in detecting weak exposures. However, exposures that reduce fecundability by 50 percent (equivalent to adding about three cycles to the median time to pregnancy) could still be detected with 80 percent power in samples of about 100 women (half of them exposed to a possible toxin). The authors conclude that time-to-pregnancy data collected with a few self-administered questions can be useful in a variety of epidemiologic studies, including occupational and environmental surveillance programs.

Bias

Problems of case finding and data collection in ambulatory care settings.

The experience gained in a four-year ambulatory care study suggests that major problems of patient care data collection include: 1) Difficulties in obtaining listings of patients by diagnosis/condition that accurately reflect the actual practice experience; 2) Inaccurate coding or identification of the reason for patient visits; and 3) Inability to find the medical record within the system. Data presented here suggest there are certain regularities in completion rates characteristic of research sites and of diagnostic categories.

Adult

[Technical investigation of cerebral blood flow measurements using the Patlak Plot method--a contrivance for positioning of the gamma camera at data collection in radionuclide angiography].

The time-activity curve for the aortic arch obtained from radionuclide angiography (RNA) is handled as an input function parameter according to the method of Matsuda et al., which determines regional cerebral blood flow non-invasively. The data are collected from a frontal view of the thorax captured by RNA by their method, however we encountered a case in which it was difficult to identify aortic arch in the data collection from the frontal view. The precise identification of the aortic arch was implemented when the RNA data were collected from the left anterior oblique view of the thorax. No significant difference was noted in the measured values between the data collection from the frontal view and from the left anterior oblique view. Our method seems to be useful modification of the Patlak plot method.

Aged

Data collection efforts in New England.

Amid growing demands for statistical compilations about home care, the eight state home care associations of the National Association for Home Care's Region I ventured into the arena of data collection. What have they learned?

Data Collection

[Study of improving professional training: effect on data collection].

In this study, 30 nurses who worked and studied in one ward were divided into three groups. They accepted one of the three measures for training, that is, lecture, teach by demonstration, and pre-practice and after practice discussion. The quality of data collecting process and data records for everyone have been checked. Result showed the quality of three groups got progress by training and the group of discussion was the best. The progress was increasing obviously with time of work and education.

Education, Nursing, Continuing

Chemotherapy administration and data collection in an EORTC collaborative group--can we trust the results?

As part of a phase II study of the EORTC Soft Tissue and Bone Sarcoma Group, 15 centres took part in a programme to evaluate the quality of treatment delivered and data collected. The centres were visited and facilities for treatment and data management were reviewed. Source data in randomly selected patient hospital records were compared with information which had previously been completed on case record forms and returned to the EORTC Data Centre. The review included 71% of the patients entered into the study and 76% of the treatment cycles. Chemotherapy was prepared by nurses or clinicians in 58% and by pharmacists in 42% of the centres and was administered by specialist nurses in 67% of the hospitals. 8776 items were checked with source data. 3.4% were incorrect, 0.2% were missing and 30% could not be verified as correct (mainly related to the lack of recording of toxicity data in hospital records). The mean doses of chemotherapy delivered and treatment intervals were those stipulated in the protocol but 21% of the cycles were delayed for avoidable reasons. Several modifications to the procedures for running chemotherapy trials were suggested by this survey including the use of a systematic checklist for recording toxicity and chemotherapy administration and the development of quality assurance programmes in other collaborative groups and single centres to ensure that published results are credible.

Adult

Valve data collection: problems and pitfalls.

Since 1981, the Department of Medical Physics and Clinical Engineering at the University of Sheffield has been responsible for the organization, management and data collection associated with the largest multicentre heart valve implant patient follow-up study in the Western world. At the present time, the database comprises information on over 16,000 valve implants, which have been provided by 57 surgeons working at 22 centres in the UK. All this data is available for in-depth statistical analysis. Over 30 individual valve models presently are included in the Study and these can be categorized into five main types: ball, disc, porcine, pericardial and homograft. Analysis includes descriptive statistics as well as valuable information on the various performances of the different valves. Survival and event-free survival graphs are obtained by actuarial methods and individual valve types can be studied in depth in terms of freedom from thromboembolic complications and valve dysfunction. Whilst this approach provides interesting and valuable survival data, it does not take account of the wide variation in prognostic factors which occur within large groups of patients. This latter problem can be addressed by the use of proportional hazards analysis and this paper provides details of this approach and typical results obtained from the use of this method. These include the comparative performances of the major types of valves currently in use in terms of the event-free survival of the patients.

Adolescent

Quality control of dietary data collection in the CARDIA study.

The Coronary Artery Risk Development in (Young) Adults (CARDIA) Study developed and implemented quality control (QC) measures to minimize misclassification associated with dietary data. Manual and automated data inspection were used to monitor quality. Of the 5111 participants who completed a dietary history, 717 (14%) had dietary forms reviewed and 153 (3%) had the interview audiotaped. Results show that for the 717 forms reviewed, the overall form completion error rate was 0.22% and the "critical" error rate (i.e., those errors impacting on nutrient computations) was 0.12%. The proportion of forms free of any type of error increased over time (p less than 0.0001). The discrepancy rate in recording and interviewing methods as estimated from the 153 audiotaped interviews was 0.7%. Inter-interviewer differences were small as indicated by the audiotaped interviews and the proportion of error-free forms completed by interviewers. The results indicate that the dietary data collected in CARDIA were completely and accurately recorded for use in analysis.

Adolescent

International Collaborative Effort (ICE) on birthweight; plurality; and perinatal and infant mortality. I: Methods of data collection and analysis.

This paper describes the collection and analysis of data by a group of international collaborators (International Collaborative Effort on Perinatal and Infant Mortality) interested in comparative studies on birthweight distributions and reproductive outcome. This is the first of a series of reports on the results of these studies. It gives an account of the countries or states involved, and the collection and characteristics of the data. The countries and states included sixteen of the United States, plus England and Wales, Denmark, Bavaria and North Rhine-Westphalia from the Federal Republic of Germany, Israel, Japan, Norway, Scotland, and Sweden. The data comprised birthweight distributions in 500-gram groups for all births and for singletons separately, for livebirths, stillbirths, first week deaths and, where available, late neonatal and infant deaths, from 1970 up to 1985.

Birth Weight

Validity of injury data collected by interview: a study of men born in 1913 and 1923.

An investigation of the validity of anamnestic injury data with special reference to head injuries, was performed, as part of an epidemiological population study of middle aged men. Injury data collected by interview were checked against control data from an emergency department, covering a 7-year period. About 65% of head injuries in the control data set, and 60% of all types of injuries were reported. Injury severity, alcohol intoxication, ambulance transportation and recall period were factors which tended to influence the reporting frequency.

Aged