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PubMed2000

An algorithm for cadaver kidney allocation based on a multivariate analysis of factors impacting on cadaver kidney graft survival and function.

The large imbalance between cadaver kidney supply and demand makes the implementation of equitable and effective organ allocation systems an urgent need. This has triggered a revision of the criteria used so far for cadaver kidney allocation within the North Italy Transplant program, not least in the light of the many changes that have occurred recently with respect to broader criteria for admission of patients to the waiting list, donor selection, tissue-typing methods, organ preservation and immunosuppressive protocols. We based the critical revision of our cadaver kidney allocation algorithm on univariate and multivariate analysis of a number of immunological, clinical, social and administrative factors that impacted on the transplant outcome in 2,917 patients transplanted in the 12 transplant centers operating within our organization from 1 January 1990 to 30 September 1997. This analysis indicated that younger donor age, absence of pretransplant transfusions, patient dialysis center and level of HLA match showed statistically significant positive associations with graft survival. Younger donor age and male donor gender showed a statistically significant association with excellent graft function at 4 years. The results of this analysis were used to develop a new computer-assisted version of our adult kidney allocation algorithm. It works in two steps (local pool first, then the entire waiting list) and four levels (0-1 HLA MM, PRA+; 2 HLA MM, PRA+; 0-1 MM, PRA-; 2-4 HLA MM, PRA-); within each level, selection takes into account waiting time and age difference from donor age. The evaluation of 731 transplants allocated in 19 months with the new algorithm, as against 698 transplants allocated in the preceding 19 months according to the previous algorithm, showed a significantly higher proportion of recipients who had been on the waiting list for more than 3 years (33.2% versus 22.6%). The use of the new algorithm was also associated with a significantly increased number of transplanted alloimmunized patients (18.8% versus 9.2% with the previous algorithm) and recipients with 0-1 HLA mismatches (22% versus 14.3%). Furthermore, the number of kidneys used locally has steadily increased. Differences in 6-month graft survival and percentage of patients with excellent function at 6 months were not statistically significant in recipients transplanted with the new versus the previous algorithm. Survivals were 93.7% versus 91.8%. Percentages of patients with excellent renal function were 69.9% and 71.8%, respectively. These preliminary data suggest that the new algorithm improves HLA match and reduces the number of patients on the waiting list for 3 or more years without determining significant modifications of 6-month graft survival and function. Moreover, it facilitates the achievement of a fair local balance between organs retrieved and transplanted, the compliance of operators with objective allocation rules and the documentation of the whole allocation process.

Adult↗
PubMed2002

Initiation of oral anticoagulant therapy in orthopedic and surgical patients: an algorithm compared with routine dosing.

Oral anticoagulant therapy is initiated in most hospitals in The Netherlands by clinicians who routinely dose oral anticoagulants (without using an algorithm). This may explain the low proportion of patients leaving the hospital stabilized. To test this hypothesis this study compared the dosing of acenocoumarol in orthopedic and surgical patients using an algorithm with routine dosing. Because of the routine administration of low molecular weight heparin for at least the first 5 days of acenocoumarol therapy, the study focused on supratherapeutic INR-values during this period. The study included 103 patients and was performed on orthopedic surgery and general surgery wards of a Dutch hospital over 5 months. The patients received acenocoumarol as an oral anticoagulant to prevent venous thromboembolism after general of orthopedic surgery. Patients were randomized into a group routinely dosed by physicians (n=54) and a group dosed using a dosing algorithm (n=49). A patient was defined as stable if he had two consecutive INR values within the range of 2-3 during hospitalization with the first (of the two consecutive INR values within range) having been measured on day 5 or later. The groups did not differ significantly in proportion of patients stabilized, time to stabilization, or length of hospitalization. In the first period (days 1-5) the routine dosing group had significantly more INR values above therapeutic range than the algorithm group, while the algorithm group had more INR values below the therapeutic range. There were two bleeding episodes in the routine dosing group and none in the algorithm group. Despite the lack of differences in stabilization between the two groups, this study suggests an advantage of dosing acenocoumarol using an algorithm in a study population consisting of prophylactically treated, mostly elderly orthopedic patients. The algorithm provides a safe dosing schedule for elderly postoperative patients who use low molecular weight heparin and NSAIDs concomitantly and are thus at high risk for bleeding complications.

Acenocoumarol↗
PubMed2005

Predatory search algorithm with restriction of solution distance.

A variety of methods and algorithms have been developed to solve NP-Hard problems in recent decades. In this paper, we are concerned with a relatively new algorithm based on animal behavioral adaptability and evolutionary computation, namely predatory search. When first introduced, the algorithm was implemented with restrictions based on solution cost as a simplification of distance adopted by search-intensive predators. Our research concentrates on exploring the possibility of using distance to restrict search area. Based on the research of Boese et al. (1994), we propose a type of predatory search algorithm restricted by solution distance (particularly bond distance), and compare it with the original algorithm based on three benchmark traveling salesman problems. The results indicate that both algorithms are suitable for solving the traveling salesman problems, while our proposed algorithm either outperforms or at least matches its predecessor with respect to both the running time and the quality of solutions. In addition, further experiments suggest that there exists a certain relationship between the two algorithms.

Algorithms↗
PubMed1994

The chimeric mapping problem: algorithmic strategies and performance evaluation on synthetic genomic data.

The Human Genome Project requires better software for the creation of physical maps of chromosomes. Current mapping techniques involve breaking large segments of DNA into smaller, more-manageable pieces, gathering information on all the small pieces, and then constructing a map of the original large piece from the information about the small pieces. Unfortunately, in the process of breaking up the DNA some information is lost and noise of various types is introduced; in particular, the order of the pieces is not preserved. Thus, the map maker must solve a combinatorial problem in order to reconstruct the map. Good software is indispensable for quick, accurate reconstruction. The reconstruction is complicated by various experimental errors. A major source of difficulty--which seems to be inherent to the recombination technology--is the presence of chimeric DNA clones. It is fairly common for two disjoint DNA pieces to form a chimera, i.e., a fusion of two pieces which appears as a single piece. Attempts to order chimera will fail unless they are algorithmically divided into their constituent pieces. Despite consensus within the genomic mapping community of the critical importance of correcting chimerism, algorithms for solving the chimeric clone problem have received only passing attention in the literature. Based on a model proposed by Lander (1992a, b) this paper presents the first algorithms for analyzing chimerism. We construct physical maps in the presence of chimerism by creating optimization functions which have minimizations which correlate with map quality. Despite the fact that these optimization functions are invariably NP-complete our algorithms are guaranteed to produce solutions which are close to the optimum. The practical import of using these algorithms depends on the strength of the correlation of the function to the map quality as well as on the accuracy of the approximations. We employ two fundamentally different optimization functions as a means of avoiding biases likely to decorrelate the solutions from the desired map. Experiments on simulated data show that both our algorithm which minimizes the number of chimeric fragments in a solution and our algorithm which minimizes the maximum number of fragments per clone in a solution do, in fact, correlate to high quality solutions. Furthermore, tests on simulated data using parameters set to mimic real experiments show that that the algorithms have the potential to find high quality solutions with real data. We plan to test our software against real data from the Whitehead Institute and from Los Alamos Genomic Research Center in the near future.

Algorithms↗
PubMed1994

A comparison of three electron planning algorithms for a 16 MeV electron beam.

PURPOSE: We report results of a comparison of three electron planning algorithms, an Age-Diffusion Pencil beam algorithm and two (2-D) and three dimensional (3-D) Hogstrom pencil beam algorithms, using simple 2 x 2 cm air and hard bone inhomogeneities and a complex anthropomorphic head and neck phantom. METHODS AND MATERIALS: The simple inhomogeneities have variable dimensions outside the plane of calculation to test the effects of out of plane scattering on 2-D algorithms, compared with dose measured by film below the inhomogeneity in the dose fall-off range. Comparisons are also made of a parotid treatment field for 16 MeV electrons, and the dose measured by high sensitivity thermoluminescent dosimeters in the head and neck phantom. RESULTS: Behind the simple inhomogeneities, the electron algorithms are found to underestimate the dose behind the air cavity by up to 40% and overestimated the dose behind bone by up to 30%. In the head phantom, the presence of inhomogeneities also presents problems for the algorithms, with overestimations of dose of up to 20% found behind bone-tissue interfaces, apparently due to shielding by high density bone. Overestimations of up to 17% are also found beside interfaces parallel to the beam. Underestimations of dose of up to 10% are found on the beam-side of interfaces, due to under-prediction of backscattered electrons. All three investigated algorithms underestimate the dose by up to 20% behind extreme surface curvature. One algorithm is found to underestimate the dose in the falloff region while another overestimates the dose around the 90% isodose. CONCLUSION: Clinicians should be aware of the limitations of their planning systems.

Algorithms↗
PubMed1993

A tutorial introduction to stochastic simulation algorithms for belief networks.

Belief networks combine probabilistic knowledge with explicit information about conditional independence assumptions. A belief network consists of a directed acyclic graph in which the nodes represent variables and the edges express relationships of conditional dependence. When information about one variable's state is given to the network in the form of evidence, an update algorithm computes the posterior marginal probability distributions for the remaining variables in the network. Many algorithms for performing this inference task have been proposed. Exact algorithms report precise results for some classes of networks, but take exponential time (in the number of nodes) both in the worst case and for many interesting networks. Stochastic simulation algorithms estimate the posterior marginal probability distribution for many graph topologies that would require exponential time when using an exact algorithm. Nonetheless, for some belief networks, stochastic simulation algorithms are also known to have exponential worst case performance. This article describes at a tutorial level several stochastic simulation algorithms for belief networks, and illustrates them on some simple examples. In addition, the theoretical and empirical performance of the algorithms is briefly surveyed.

Algorithms↗
PubMed2006

Algorithms and collaborative-care systems for depression: are they effective and why? A systematic review.

BACKGROUND: Treatment algorithms and collaborative-care systems are systematic treatment approaches that are designed to improve outcomes by enhancing the quality of care. During the last decade, algorithm research has evolved as a new branch of clinical research that evaluates the clinical and economic impact of algorithm-guided treatment in primary and psychiatric care of patients with depressive disorders. METHODS: This article discusses the rationale of algorithm development, their risks and limitations, and important elements in their implementation in clinical practice. It further reviews the available studies that have evaluated algorithm-guided treatment for depression. RESULTS: Recent studies show that compared with treatment as usual, the use of algorithms and collaborative-care approaches in the care of depressed patients enhances treatment outcomes by modifying practice procedures and treatment processes. CONCLUSIONS: Treatment algorithms and collaborative-care systems clearly increase the efficacy of applied treatments in the care of depressed patients. However, to what extent the enhanced outcomes are a result of diligent measurement-based care or of the specific treatment steps that are used remains to be resolved. Valid clinical or pharmacogenetic predictors of response are needed to further tailor specific algorithms to individual patients.

Algorithms↗
PubMed2006

Algorithm architectures for patient dependent seizure detection.

OBJECTIVE: The goal of this work is to determine whether improved performance (compared to patient independent algorithms) can be achieved by an algorithm, developed on the fly, that requires no user input beyond the identification of the first one or two seizures in the record. METHODS: The previously developed AutoLearn algorithm, which employs the probabilistic neural network (PNN), is tested on 209 seizures obtained from the epilepsy monitoring unit (EMU) or ambulatory recordings. A construction algorithm is used to compare a variety of algorithm architectures and factors. The Taguchi design of experiments (DoE) method is employed find the significant factors without resorting to a full factorial design. RESULTS: Architectures that train a single PNN per channel and use segmentation to identify ranges of similar activity are preferred. The two best architectures are insensitive to the levels of any of the other factors tested. The training time for the algorithm is less than 1s, and approximately 2 min are required to find the seizures in an 8 h record. CONCLUSIONS: The final algorithm, which requires no input from the user other than the marking of the first seizure in a record, performs as well or better than the 3 seizure detectors on EMU and ambulatory records. The algorithm performs nearly as well as human experts on the EMU records. SIGNIFICANCE: The described method can be used to identify unusual seizures (or other patterns) that will be missed by the current generation of seizure detectors. We expect that the methods developed here will also aid the development of patient independent seizure detectors that can improve their performance over time by incorporating new examples.

Algorithms↗
PubMed2004

The clinical implications of the collapsed cone planning algorithm.

AIMS: The accuracy of computer treatment planning systems is important in achieving clinically acceptable dose distributions. The pencil beam (PB) algorithm on Helax-TMS is currently used for all clinical treatment planning at the two centres involved in this study. However, it has been shown that the Helax-TMS collapsed cone (CC) algorithm is more accurate in regions of heterogeneity, such as the thorax, and head and neck. The aim of this study was to show the actual dose delivered to the patient when treating with a Helax-TMS PB plan, by using the corresponding Helax-TMS CC plan as the reference standard. MATERIALS AND METHODS: Thirty PB treatment plans (for lung and oesophageal treatments) were recalculated using the CC algorithm, and plans were then compared. RESULTS: The number of monitor units required to deliver the prescription dose differed between algorithms, by up to 3.4%. In most cases, the CC algorithm calculated more monitor units than the PB, indicating under-dosage at the prescription point during treatment. The dose distributions also seemed less homogeneous when calculated using the CC algorithm. The minimum dose to the planning target volume (PTV) was lower than the PB plan suggested in every case, by up to 23.2%. ICRU homogeneity requirements (i.e. a minimum 95% of the prescription dose in the PTV) were not met in any of the cases. Even with some attempts at optimisation, conformance to these requirements was difficult. CONCLUSION: The CC algorithm has several factors limiting its suitability for routine clinical use. However, it is an important milestone in radiotherapy treatment planning, and should be used to show expected changes in computer planned dose distributions with new accurate dose algorithms. It is worthwhile considering dose homogeneity requirements well before the advent of anticipated Monte Carlo-based models.

Algorithms↗
PubMed2006

Comparison of different stomatal conductance algorithms for ozone flux modelling.

A multiplicative and a semi-mechanistic, BWB-type [Ball, J.T., Woodrow, I.E., Berry, J.A., 1987. A model predicting stomatal conductance and its contribution to the control of photosynthesis under different environmental conditions. In: Biggens, J. (Ed.), Progress in Photosynthesis Research, vol. IV. Martinus Nijhoff, Dordrecht, pp. 221-224.] algorithm for calculating stomatal conductance (g(s)) at the leaf level have been parameterised for two crop and two tree species to test their use in regional scale ozone deposition modelling. The algorithms were tested against measured, site-specific data for durum wheat, grapevine, beech and birch of different European provenances. A direct comparison of both algorithms showed a similar performance in predicting hourly means and daily time-courses of g(s), whereas the multiplicative algorithm outperformed the BWB-type algorithm in modelling seasonal time-courses due to the inclusion of a phenology function. The re-parameterisation of the algorithms for local conditions in order to validate ozone deposition modelling on a European scale reveals the higher input requirements of the BWB-type algorithm as compared to the multiplicative algorithm because of the need of the former to model net photosynthesis (A(n)).

Algorithms↗
PubMed2005

Improved detection of acute myocardial infarction using a diagnostic algorithm based on calculated epicardial potentials.

BACKGROUND: New methods for detecting myocardial infarction in patients with suspected acute coronary syndromes are needed particularly in an era where the majority of patients with myocardial infarction present with non-diagnostic 12-lead electrocardiograms (ECG). We compared a novel epicardial diagnostic algorithm using epicardial potentials from the 80-lead body surface map with other electrocardiographic techniques in detection of myocardial infarction. METHODS: Between February 1999 and February 2001, consecutive patients (n=427) with ischemic type chest pain had an initial 12-lead ECG and body surface map recorded. Detecting myocardial infarction using an epicardial algorithm was first performed in a training set (n=213) and tested in a validation set of patients (n=214). The results from this epicardial algorithm in myocardial infarction detection were compared with the physician's interpretation of the 12-lead ECG, the body surface map algorithm (PRIME) and physician's interpretation of the body surface map. RESULTS: Myocardial infarction occurred in 205 patients (creatine kinase >or=2x upper limit of normal with creatine kinase-MB >or=7% CK). The physician's interpretation of the 12-lead ECG identified 122 with myocardial infarction (sensitivity 60%, specificity 99%), the body surface map algorithm 137 (sensitivity 67%, specificity 89%), the physician's interpretation of the body surface map 153 (sensitivity 75%, specificity 91%) and the epicardial algorithm 158 (sensitivity 77% specificity 99%). Combining the physician's interpretation of the 12-lead ECG with the epicardial algorithm increased significantly the detection of myocardial infarction (sensitivity 85%, specificity 98%, p<0.001) compared with the 12-lead ECG. CONCLUSIONS: An epicardial algorithm based on epicardial potentials increases significantly the detection of myocardial infarction particularly among those with non-diagnostic 12-lead ECG's.

Aged↗
PubMed2004

Added value of new acute coronary syndrome computer algorithm for interpretation of prehospital electrocardiograms.

A new computerized acute coronary syndrome (ACS) computer algorithm has been developed with the aim of improving the electrocardiographic detection of acute myocardial ischemia and infarction in the emergency department (ED). The purpose of this study was to determine the added value of the new ACS algorithm in assisting ED physicians to obtain a more accurate diagnosis in patients with ACS. The new algorithm combines a rule-based decision tree, which uses well-known clinical criteria and a data-centered neural network model for more robust pattern recognition. Input parameters of the neural network model consist of morphology features of derived Frank X, Y, Z waveforms and the patient's gender and age. The neural network model was trained with electrocardiograms obtained from documented acute myocardial infarction patients at the Mayo Clinic who were a part of a research ACS database, which includes electrocardiograms (ECGs) of more than 5,000 individuals at hospital admission (1st ECG in the ED). The test set portion of the study was conducted in 2 steps: 1) One emergency physician and 1 cardiologist classified 1,902 clinically correlated out-of-hospital ECGs without seeing the interpretation statement from the algorithm into 1 of the following categories: 1) acute myocardial infarction, acute ischemia, or nonischemic; 2) After 9 months, the same 2 physicians classified the same group of ECGs but with the interpretation statement of the algorithm printed on the tracing. The results demonstrated that with the assistance of the new algorithm, the emergency physician and cardiologist improved their sensitivity of interpreting acute myocardial infarction by 50% and 26%, respectively, without a loss of specificity. The new algorithm also improved the emergency physician's acute ischemia interpretation sensitivity by 53% and still maintained a reasonable specificity (91%). The new ACS algorithm provides added value for improving acute ischemia and infarction detection in the ED.

Age Factors↗
PubMedDate not supplied

A fast reconstruction algorithm for electron microscope tomography.

We have implemented a Fast Fourier Summation algorithm for tomographic reconstruction of three-dimensional biological data sets obtained via transmission electron microscopy. We designed the fast algorithm to reproduce results obtained by the direct summation algorithm (also known as filtered or R-weighted backprojection). For two-dimensional images, the new algorithm scales as O(N(theta)M log M)+O(MN log N) operations, where N(theta) is the number of projection angles and M x N is the size of the reconstructed image. Three-dimensional reconstructions are constructed from sequences of two-dimensional reconstructions. We demonstrate the algorithm on real data sets. For typical sizes of data sets, the new algorithm is 1.5-2.5 times faster than using direct summation in the space domain. The speed advantage is even greater as the size of the data sets grows. The new algorithm allows us to use higher order spline interpolation of the data without additional computational cost. The algorithm has been incorporated into a commonly used package for tomographic reconstruction.

Algorithms↗
PubMed2005

An optimisation algorithm for determination of treatment margins around moving and deformable targets.

PURPOSE: Determining treatment margins for inter-fractional motion of moving and deformable clinical target volumes (CTVs) remains a major challenge. This paper describes and applies an optimisation algorithm designed to derive such margins. MATERIAL AND METHODS: The algorithm works by expanding the CTV, as determined from a pre-treatment or planning scan, to enclose the CTV positions observed during treatment. CTV positions during treatment may be obtained using, for example, repeat CT scanning and/or repeat electronic portal imaging (EPI). The algorithm can be applied to both individual patients and to a set of patients. The margins derived will minimise the excess volume outside the envelope that encloses all observed CTV positions (the CTV envelope). Initially, margins are set such that the envelope is more than adequately covered when the planning CTV is expanded. The algorithm uses an iterative method where the margins are sampled randomly and are then either increased or decreased randomly. The algorithm is tested on a set of 19 bladder cancer patients that underwent weekly repeat CT scanning and EPI throughout their treatment course. RESULTS: From repeated runs on individual patients, the algorithm produces margins within a range of +/-2 mm that lie among the best results found with an exhaustive search approach, and that agree within 3mm with margins determined by a manual approach on the same data. The algorithm could be used to determine margins to cover any specified geometrical uncertainty, and allows for the determination of reduced margins by relaxing the coverage criteria, for example disregarding extreme CTV positions, or an arbitrarily selected volume fraction of the CTV envelope, and/or patients with extreme geometrical uncertainties. CONCLUSION: An optimisation approach to margin determination is found to give reproducible results within the accuracy required. The major advantage with this algorithm is that it is completely empirical, and it is therefore particularly useful for CTVs where the geometrical uncertainties are difficult to model, such as the bladder.

Algorithms↗
PubMed2001

Quantitative comparison of algorithms for tracking single fluorescent particles.

Single particle tracking has seen numerous applications in biophysics, ranging from the diffusion of proteins in cell membranes to the movement of molecular motors. A plethora of computer algorithms have been developed to monitor the sub-pixel displacement of fluorescent objects between successive video frames, and some have been claimed to have "nanometer" resolution. To date, there has been no rigorous comparison of these algorithms under realistic conditions. In this paper, we quantitatively compare specific implementations of four commonly used tracking algorithms: cross-correlation, sum-absolute difference, centroid, and direct Gaussian fit. Images of fluorescent objects ranging in size from point sources to 5 microm were computer generated with known sub-pixel displacements. Realistic noise was added and the above four algorithms were compared for accuracy and precision. We found that cross-correlation is the most accurate algorithm for large particles. However, for point sources, direct Gaussian fit to the intensity distribution is the superior algorithm in terms of both accuracy and precision, and is the most robust at low signal-to-noise. Most significantly, all four algorithms fail as the signal-to-noise ratio approaches 4. We judge direct Gaussian fit to be the best algorithm when tracking single fluorophores, where the signal-to-noise is frequently near 4.

Algorithms↗
PubMed2004

Enhancing vision care integration: 2. Implementation of practice algorithms.

BACKGROUND: Appropriate access to the best quality of vision care is enhanced when patients receive eye care services from the right professional, at the right time, and in the right place. In the preceding article the authors describe the development of two patient-centred vision care algorithms for the multidisciplinary management of diabetic retinopathy and red eye. Subsequently, a questionnaire survey was done to determine ophthalmologist, optometrist and general practitioner (GP) familiarity with and acceptance of the vision care algorithms. METHODS: The survey was conducted in the summer of 2001 among all ophthalmologists, optometrists and GPs registered with their respective professional body in Nova Scotia to assess their knowledge and acceptance of the diabetes mellitus and red eye algorithms. They were also asked to indicate their preferred method(s) of education and dissemination regarding these and future algorithms. RESULTS: Of the 740 practising GPs in Nova Scotia, 188 completed the questionnaire, for a response rate of 25.4%. The corresponding figures for optometrists and ophthalmologists were 73.6% (53/72) and 43.5% (20/46) respectively. Most of all three types of clinicians practise in Halifax County. More than 80% of the optometrists and ophthalmologists were aware of the algorithms, but less than 50% of the GPs were aware of them. A large majority of respondents in all three groups (77% to 98%) indicated that they were comfortable using the diabetes and red eye algorithms as presented. INTERPRETATION: Ophthalmologists, optometrists and GPs indicated an understanding of and willingness to use the diabetes and red eye algorithms. However, they were not unanimous regarding the choice of implementation method. Therefore, six different strategies for implementing the vision care algorithms are currently being used and are described in the paper.

Algorithms↗
PubMed1999

Reflex testing I: algorithm for lipid and lipoprotein measurement in coronary heart disease risk assessment.

We reviewed the current literature in order to construct a reflex testing algorithm that maximizes clinical utility and cost-effectiveness of lipid and lipoprotein testing. The algorithm was based on the 2nd Report of the National Cholesterol Education Program Adult Treatment Panel guidelines for use of total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C, and published reports describing the clinical use of apolipoprotein B and lipoprotein (a). The success of this algorithm was tested in a low-risk general and a high-risk hyperlipidemic patient population. Lipid data and non-lipid risk factors were obtained from a national database and from patients seen at two lipid clinics. A total of 16,968 individuals from the National Health and Nutrition Examination Survey III database comprised the low-risk group, and 239 patients examined in the Hartford Hospital and Washington University Lipid Clinics comprised the high-risk group. We found a solid scientific base to support the NCEP guidelines and reasonable support for limited testing of apoB and Lp(a). According to the algorithm, the direct LDL-C assay was deemed unnecessary in 98% and 91% of low- and high-risk subjects, respectively, if one assumes that the Friedewald equation is adequate with TG < or = 4.00 g/l. With a more conservative cutoff of TG < or = 2.50 g/l, the algorithm canceled 92% and 81% of direct LDL tests, respectively. The algorithm also limited TG to 20 and 64%, apoB to 6 and 20%, and Lp(a) to 15 and 56%, of low- and high-risk groups, respectively. Use of a comprehensive, reflex algorithm for coronary heart disease risk assessment will substantially reduce the utilization of laboratory services without diminishing the clinical value of these tests. The algorithm will prevent the overuse of certain expensive tests (direct LDL) while promoting the limited use of underutilized tests [apoB and Lp(a)].

Adult↗
PubMed2002

On the use of genetic algorithms for response surface modeling in high-performance liquid chromatography and their combination with the Microsoft Solver.

Four genetic algorithms--the classical, Haupt's, Brunetti's and a modification of the classical algorithm suggested in the present paper--are examined when they are used for the modeling of response surfaces in high-performance liquid chromatography (HPLC). We found that the best results are obtained from our modification and the worst by Haupt's algorithm. The classical genetic algorithm gives satisfactory results, better than those of Brunetti's algorithm. We also ascertained that all genetic algorithms may get stuck in a local minimum other than the global one, except for our modification, which can be considered to approach a global method. Finally, the time needed for the optimization of a genetic algorithm and the combination of a genetic algorithm with a non-linear least-squares routine are considered and discussed.

Algorithms↗