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PubMed2005

Automation in future air traffic management: effects of decision aid reliability on controller performance and mental workload.

Future air traffic management concepts envisage shared decision-making responsibilities between controllers and pilots, necessitating that controllers be supported by automated decision aids. Even as automation tools are being introduced, however, their impact on the air traffic controller is not well understood. The present experiments examined the effects of an aircraft-to-aircraft conflict decision aid on performance and mental workload of experienced, full-performance level controllers in a simulated Free Flight environment. Performance was examined with both reliable (Experiment 1) and inaccurate automation (Experiment 2). The aid improved controller performance and reduced mental workload when it functioned reliably. However, detection of a particular conflict was better under manual conditions than under automated conditions when the automation was imperfect. Potential or actual applications of the results include the design of automation and procedures for future air traffic control systems.

Accidents, Aviation↗
PubMed2005

Adaptive automation of human-machine system information-processing functions.

The goal of this research was to describe the ability of human operators to interact with adaptive automation (AA) applied to various stages of complex systems information processing, defined in a model of human-automation interaction. Forty participants operated a simulation of an air traffic control task. Automated assistance was adaptively applied to information acquisition, information analysis, decision making, and action implementation aspects of the task based on operator workload states, which were measured using a secondary task. The differential effects of the forms of automation were determined and compared with a manual control condition. Results of two 20-min trials of AA or manual control revealed a significant effect of the type of automation on performance, particularly during manual control periods as part of the adaptive conditions. Humans appear to better adapt to AA applied to sensory and psychomotor information-processing functions (action implementation) than to AA applied to cognitive functions (information analysis and decision making), and AA is superior to completely manual control. Potential applications of this research include the design of automation to support air traffic controller information processing.

Adult↗
PubMed2005

Cervical screening programmes: can automation help? Evidence from systematic reviews, an economic analysis and a simulation modelling exercise applied to the UK.

OBJECTIVES: To assess the effectiveness and cost-effectiveness of adding automated image analysis to cervical screening programmes. DATA SOURCES: Searching of all major electronic databases to the end of 2000 was supplemented by a detailed survey for unpublished UK literature. METHOD: Four systematic reviews were conducted according to recognised guidance. The review of 'clinical effectiveness' included studies assessing reproducibility and impact on health outcomes and processes in addition to evaluations of test accuracy. A discrete event simulation model was developed, although the economic evaluation ultimately relied on a cost-minimisation analysis. RESULTS: The predominant finding from the systematic reviews was the very limited amount of rigorous primary research. None of the included studies refers to the only commercially available automated image analysis device in 2002, the AutoPap Guided Screening (GS) System. The results of the included studies were debatably most compatible with automated image analysis being equivalent in test performance to manual screening. Concerning process, there was evidence that automation does lead to reductions in average slide processing times. In the PRISMATIC trial this was reduced from 10.4 to 3.9 minutes, a statistically significant and practically important difference. The economic evaluation tentatively suggested that the AutoPap GS System may be efficient. The key proviso is that credible data become available to support that the AutoPap GS System has test performance and processing times equivalent to those obtained for PAPNET. CONCLUSIONS: The available evidence is still insufficient to recommend implementation of automated image analysis systems. The priority for action remains further research, particularly the 'clinical effectiveness' of the AutoPap GS System. Assessing the cost-effectiveness of introducing automation alongside other approaches is also a priority.

Automation↗
PubMed1995

Automation and the future practice of pharmacy--changing the focus of pharmacy.

Automation technology offers great potential in pharmacy practice. To realize the full benefits of the potential inherent in automation systems, it is necessary to understand basic concepts of automation and to realize that automation is simply a tool to help achieve the goals of practice. The goal of pharmacy practice is pharmaceutical care. Through using the techniques of reengineering, pharmacies can be redesigned with the help of automation to facilitate the accomplishment of that goal. Essential to achieving that goal is the necessity to change the focus of pharmacy from distribution to pharmaceutical care. Reengineering and automation are the tools to help make that change in focus.

Automation↗
PubMed2000

Development of standards for laboratory automation.

In clinical laboratories, the installation of total laboratory automation systems and/or modular systems has grown dramatically in the 1990s, particularly in the US, Japan, and Europe. As the number of installations and level of interest grew, several individuals and corporations active in the automation field recognized that the development of prospective standards might enable customers of such systems or equipment to purchase analyzers, automation systems or devices, and software from different vendors and retain interconnectivity of such equipment. These individuals also believed that the total market for automation systems and equipment would be significantly greater with standards than without standards, especially if customers were not forced to purchase everything from one vendor, and that there might be competitive pricing and new technology fostered via the standards. This early interest in standards development led to the initiation of a program by NCCLS in 1996 to develop prospective standards for laboratory automation. Part of the NCCLS effort has involved interaction and cooperation with other standards organizations in the US and other countries. This report describes the current status of the development of prospective standards for laboratory automation by NCCLS and the relationship of those standards to those of other standards organizations.

Automation↗
PubMed2000

Developing an automation concept that is right for your laboratory.

BACKGROUND: Trends in laboratory automation and critical project principles and design concepts are presented. APPROACH: MDS AutoLab technology development and automation projects were reviewed. Successful methods and approaches were extracted. ISSUES: Continued pressure on the laboratory to reduce costs and increase productivity has catalyzed dramatic development in laboratory automation. Today, laboratories can choose from a wide range of options. The most effective choices are not always the most obvious and will not be the same for all laboratories. Laboratory automation projects are highly complex and must be planned and managed across clinical, technical, operational, financial, and human dimensions. CONCLUSIONS: Success requires excellent communications, an understanding of the risks and barriers, and a dedicated team supported by strong champions throughout the organization. The automation project team will need to use a variety of skills and techniques to evaluate and reengineer processes to identify the highest value targets for automation.

Automation↗
PubMed1998

Teaming humans and automated systems in safely engineered environments.

Human factors research has historically been concerned with interactions among humans, machines, and the environments in which they operate. The introduction of intelligent, automated systems to support human performance and safety in a variety of challenging environments, including undersea systems, high-performance aircraft, and orbiting space stations, has introduced a new dynamic to these relationships. Many missions cannot be accomplished without the active participation of both intelligent human and intelligent machine members. This is particularly true in environments where individuals operate in isolation and without easy access to support crews. However, the teaming of these two systems that function in such different ways can lead to new types of error, with the human frequently unable to determine what the machine is doing and why. The challenge, then is to develop automated systems that support, rather than confound, the human user. Aerospace human factors research has been a leader in attempting to understand human-automation interactions and in establishing guidelines for the design and use of automated systems. This article discusses some of the human-automation interaction problems that have been observed operationally, what the existing research reveals, and several approaches that are being pursued to avoid "disconnects" between humans and automation. Once these disconnects are overcome, intelligent humans and intelligent machines will be able to work together more productively, thus leading to our furthered presence in a variety of challenging environments.

Accidents, Aviation↗
PubMed2002

Automated transport and sorting system in a large reference laboratory: part 1. Evaluation of needs and alternatives and development of a plan.

BACKGROUND: Our laboratory, a large, commercial, esoteric reference laboratory, sought some form of total laboratory automation to keep pace with rapid growth of specimen volumes as well as to meet competitive demands for cost reduction and improved turnaround time. METHODS: We conducted a systematic evaluation of our needs, which led to the development of a plan to implement an automated transport and sorting system. We systematically analyzed and studied our specimen containers, test submission requirements and temperatures, and the workflow and movement of people, specimens, and information throughout the laboratory. We performed an intricate timing study that identified bottlenecks in our manual handling processes. We also evaluated various automation options. RESULTS: The automation alternative viewed to best meet our needs was a transport and sorting system from MDS AutoLab. Our comprehensive plan also included a new standardized transport tube; a centralized automated core laboratory for higher volume tests; a new "automation-friendly" software system for order entry, tracking, and process control; a complete reengineering of our order-entry, handling, and tracking processes; and remodeling of our laboratory facility and specimen processing area. CONCLUSIONS: The scope of this project and its potential impact on overall laboratory operations and performance justified the extensive time we invested (nearly 4 years) in a systematic approach to the evaluation, design, and planning of this project.

Automation↗
PubMed2003

[Time consumption and quality of an automated fusion tool for SPECT and MRI images of the brain].

AIM: Although the fusion of images from different modalities may improve diagnostic accuracy, it is rarely used in clinical routine work due to logistic problems. Therefore we evaluated performance and time needed for fusing MRI and SPECT images using a semiautomated dedicated software. PATIENTS, MATERIAL AND METHOD: In 32 patients regional cerebral blood flow was measured using (99m)Tc ethylcystein dimer (ECD) and the three-headed SPECT camera MultiSPECT 3. MRI scans of the brain were performed using either a 0,2 T Open or a 1,5 T Sonata. Twelve of the MRI data sets were acquired using a 3D-T1w MPRAGE sequence, 20 with a 2D acquisition technique and different echo sequences. Image fusion was performed on a Syngo workstation using an entropy minimizing algorithm by an experienced user of the software. The fusion results were classified. We measured the time needed for the automated fusion procedure and in case of need that for manual realignment after automated, but insufficient fusion. RESULTS: The mean time of the automated fusion procedure was 123 s. It was for the 2D significantly shorter than for the 3D MRI datasets. For four of the 2D data sets and two of the 3D data sets an optimal fit was reached using the automated approach. The remaining 26 data sets required manual correction. The sum of the time required for automated fusion and that needed for manual correction averaged 320 s (50-886 s). CONCLUSION: The fusion of 3D MRI data sets lasted significantly longer than that of the 2D MRI data. The automated fusion tool delivered in 20% an optimal fit, in 80% manual correction was necessary. Nevertheless, each of the 32 SPECT data sets could be merged in less than 15 min with the corresponding MRI data, which seems acceptable for clinical routine use.

Automation↗
PubMed2005

Comparison of manual and automated quantification methods of 123I-ADAM.

UNLABELLED: 123I-ADAM is a novel radioligand for imaging of the brain serotonin transporters (SERTs). Traditionally, the analysis of brain receptor studies has been based on observer-dependent manual region of interest definitions and visual interpretation. Our aim was to create a template for automated image registrations and volume of interest (VOI) quantifications and to show that an automated quantification method of 123I-ADAM is more repeatable than the manual method. PATIENTS, METHODS: A template and a predefined VOI map was created from 123I-ADAM scans done for healthy volunteers (n = 15). Scans of another group of healthy persons (HS, n = 12) and patients with bulimia nervosa (BN, n = 10) were automatically fitted to the template and specific binding ratios (SBRs) were calculated by using the VOI map. Manual VOI definitions were done for the HS and BN groups by both one and two observers. The repeatability of the automated method was evaluated by using the BN group. RESULTS: For the manual method, the interobserver coefficient of repeatability was 0.61 for the HS group and 1.00 for the BN group. The introobserver coefficient of repeatability for the BN group was 0.70. For the automated method, the coefficient of repeatability was 0.13 for SBRs in midbrain. CONCLUSION: An automated quantification gives valuable information in addition to visual interpretation decreasing also the total image handling time and giving clear advantages for research work. An automated method for analysing 123I-ADAM binding to the brain SERT gives repeatable results for fitting the studies to the template and for calculating SBRs, and could therefore replace manual methods.

Automation↗
PubMed1988

Automated contrast fluorometry. I. Lymphocytotoxicity testing.

Automated contrast fluorometry has been carried out in lymphocytotoxicity testing using a computer-controlled microscope and direct comparison of the data with controls. The method uses heparinized lymphocytes and permits simultaneous evaluation of both fluorescein and ethidium bromide fluorescence by calculating the quotient between the green/red measurements. After comparison of the quotient with that of control samples, the raw data are automatically transformed into cytotoxicity scores. Fast and reliable measurements with minimum background fluorescence can be obtained for up to 24 hours after performance of the assay by controlling complement reactivity and the exposure time of the cells to the fluorescein. The evaluation of 15,204 cytotoxic reactions showed excellent correlation between the automated and visual results of 125 tissue typings using 120 different antibodies and of 17 HLA antibody titers using case-by-case analysis of variance. The values for the automated cytotoxicity readings were slightly higher and showed more intermediate scores than those of the visual readings suggesting a high sensitivity and objectivity of the automated system. In conclusion, this is a methods paper comparing parallel lymphocytotoxicity testing using automated and manual methods. The automated method was found to be more sensitive and faster than the manual method.

Automation↗
PubMed1996

Automated leucocyte differentials in 292 patients with leucopenia: an evaluation of the Abbott CELL-DYN 3500 (CD3500) haematology analyser.

The widespread use of intensive therapies and the need to haematologically monitor patients on a frequent basis means that the proportion of blood samples with moderate to severe leucopenia is significant and increasing. From a laboratory perspective, particularly because of the need to spend significant amounts of time in obtaining manual differentials from stained smears with low leucocyte numbers, these clinical trends have created additional pressures on what is often a limited manpower resource. Moreover in such situations, differentials obtained from examination of only 20 or 50 cells are not uncommon and the statistical consequences of this will be clearly apparent. Currently, there is general user confidence for automated leucocyte differentials for blood samples with normal WBC parameters, but there has been some reluctance to extend this to samples with leucopenia. In order to explore this further, we examined the efficiency of a modern automated five-part differential analyser (Abbott CELL-DYN 3500) in an unselected series of 292 samples with leucopenia (WBC count range range; 0.28-2.48 x 10(9)/l). Of these, 49 were from leucopenic sero-positive HIV patients with the remaining 243 samples originating from haematological oncology clinics, patients receiving radiotherapy for non-haemopoietic malignancies, and from patients with various chronic diseases. Morphologically, 204 of these samples did not show any blast cells or NRBC, 48 had blast cells but no NRBC, 29 had NRBC but no blasts, and the remaining 11 showed both blasts and NRBC. For 277 cases with less than 5% blasts, there was an excellent correlation between the manual and CD3500 automated differential, with no obvious bias between manual and automated subpopulation estimates at any percentage level. Linear regression analyses comparing absolute neutrophil, eosinophil, lymphocyte and monocyte counts for these same samples further revealed impressive correlations (r > 0.92) for all leucocyte populations and the absolute neutrophil count in particular (r = 0.986). Manual and CD3500 leucocyte differential comparisons for 11 cases with > 5% blasts showed good correlations for absolute neutrophil and eosinophil counts although, when the blast cell percentage was high, correlations for lymphocyte and monocyte counts were less consistent (an operator alert in the form of a 'Blast Flag' was, however, given in 10/11 of these particular cases). Four additional cases where manual differentiation between lymphoid cells and monocytes was recorded as difficult also showed consistently good correlations for manual vs automated neutrophil and eosinophil estimates. Not surprisingly, and essentially as a result of the low confidence noted for the manual differential itself, correlations for lymphoid and monocytic cells were relatively poor. In conclusion, this study has demonstrated that the CD3500 provides reliable and accurate absolute neutrophil and eosinophil counts in leucopenic samples irrespective of the presence of blasts or NRBC. These observations are particularly important in terms of monitoring patients who are liable to develop neutropenia as a result of chemotherapy and radiotherapy, and provide evidence that the routine use of automated leucocyte differentials may be confidently extended to the analysis of leucopenic samples.

Automation↗
PubMed1990

Evaluation of an automated bleeding time device in the newborn.

Sick infants frequently developed impaired hemostasis as a secondary event. Abnormal platelet-vessel wall interaction contributes to the hemorrhagic side effects. Currently, the bleeding time is the best measure of in vivo platelet participation in small vessel hemostasis. Bleeding times in the newborn have been previously determined with an automated device designed for the adult or with nonautomated devices. The automated bleeding time device for the adult is not suitable for the infant (length 5 mm, depth 1 mm). We evaluated the performance of an automated bleeding time device designed specifically for the newborn making a cut 2.5 mm in length and 0.5 mm in depth. The results with the automated device showed a strong correlation with the modified template bleeding time device previously used for the newborn. The normal range was shorter and the sensitivity to abnormal vessel wall interaction was greater with the automated device. As well, the ease of determining the bleeding time with the automated device was considerably improved over the template device.

Bleeding Time↗
PubMed2004

Development of an integrated automation system with a magnetic bead-mediated nucleic acid purification device for genetic analysis and gene manipulation.

We have developed an integrated automation system for genetic analysis and gene manipulation. The system, SX-8G Plus, is equipped with an 8-nozzle dispensing unit, a thermal cycler, a cooled reagent reservoir, four tip storage racks, four microplate platforms, buffer reservoirs, an agarose gel electrophoresis unit, a power supply, a pump for exchanging electrophoresis buffer, and a CCD camera. Automation of nucleic acid extraction and purification, the most difficult step in automating genetic analysis and gene manipulation, was realized using magnetic beads with Magtration Technology, which we have previously developed for automating the handling of paramagnetic beads. Using this system, we could perform the automated separation and purification of DNA fragments by agarose gel electrophoresis starting from sample loading. The system would enable the automation of almost all procedures in genetic analysis and gene manipulation.

Computers↗
PubMed1994

Automated peak detection and cell cycle analysis of flow cytometric DNA histograms.

We describe an algorithm for fully automated flow cytometric DNA histogram classification and analysis that provides rapid, reproducible determination of DNA index and S-phase fraction (SPF). Automated classification agreed with subjective assessment of DNA ploidy in 96-98% of DNA histograms. Automated and conventional analyses of DNA index (r = 0.95) and SPF (r = 0.89) were also highly correlated with one another. In a series of 86 node-negative breast carcinomas, SPF calculated with the fully automated method was a significant predictor of 10 year survival (p = 0.009). Automation greatly increased the speed of DNA histogram analysis, allowing evaluation of the same set of histograms with different methods. In a preliminary study exploring the optimization of DNA histogram analysis, the best association between SPF and prognosis of breast cancer patients was achieved using sliced nuclei debris modeling, reporting only the aneuploid SPF (in aneuploid histograms), while excluding small aneuploid clones (< 15% of total cell count) from evaluation. In conclusion, automated DNA histogram analysis does not replace the need for close human supervision but provides a useful guideline for less experienced users, facilitates interlaboratory comparisons, and makes possible extensive reanalyses of large data sets.

Breast Neoplasms↗
PubMed1997

An automated registration algorithm for measuring MRI subcortical brain structures.

An automated registration algorithm was used to elastically match an anatomical magnetic resonance (MR) atlas onto individual brain MR images. Our goal was to evaluate the accuracy of this procedure for measuring the volume of MRI brain structures. We applied two successive algorithms to a series of 28 MR brain images, from 14 schizophrenia patients and 14 normal controls. First, we used an automated segmentation program to differentiate between white matter, cortical and subcortical gray matter, and cerebrospinal fluid. Next, we elastically deformed the atlas segmentation to fit the subject's brain, by matching the white matter and subcortical gray matter surfaces. To assess the accuracy of these measurements, we compared, on all 28 images, 11 brain structures, measured with elastic matching, with the same structures traced manually on MRI scans. The similarity between the measurements (the relative difference between the manual and the automated volume) was 97% for whole white matter, 92% for whole gray matter, and on average 89% for subcortical structures. The relative spatial overlap between the manual and the automated volumes was 97% for whole white matter, 92% for whole gray matter, and on average 75% for subcortical structures. For all pairs of structures rendered with the automated and the manual method, Pearson correlations were between r = 0.78 and r = 0.98 (P < 0.01, N = 28), except for globus pallidus, where r = 0.55 (left) and r = 0. 44 (right) (P < 0.01, N = 28). In the schizophrenia group, compared to the controls, we found a 16.7% increase in MRI volume for the basal ganglia (i.e., caudate nucleus, putamen, and globus pallidus), but no difference in total gray/white matter volume or in thalamic MR volume. This finding reproduces previously reported results, obtained in the same patient population with manually drawn structures, and suggests the utility/efficacy of our automated registration algorithm over more labor-intensive manual tracings.

Adolescent↗
PubMed1992

Multicenter trial of automated nitroprusside infusion for postoperative hypertension. Titrator Multicenter Study Group.

Hypertension is common after a cardiac operation and may result in postoperative hemorrhagic and other complications. Most often this problem has been treated using manually controlled doses of intravenous sodium nitroprusside. To evaluate the clinical impact of an automated closed-loop administration system on patients after cardiotomy, a prospective trial was conducted at nine clinical centers. Patients with hypertension were managed by either manual nitroprusside titration (n = 532) or a closed-loop automated titration system (n = 557). Patient groups were not significantly different in age, weight, or height. Moreover, the types of surgical procedures were comparable: primary coronary artery bypass grafting, 59.2% and 58.9%, manual group versus automated group; repeat coronary artery bypass grafting, 10.5% and 8.6%, respectively; valve procedures, 11.3% and 15.1%, respectively; and other cardiac procedures, 19.0% and 17.4%, respectively (all p = not significant). The automated group showed a significant reduction in the number of hypertensive episodes per patient (1.8 +/- 0.2 versus 0.6 +/- 0.07; p = 0.0001. At the same time, the number of hypotensive episodes per patient was reduced with automated closed-loop titration (0.40 +/- 0.05 versus 0.30 +/- 0.03; p = 0.02). Chest tube drainage (866 +/- 37 mL versus 693 +/- 23 mL [mean +/- standard error of the mean]; p = 0.0001), percentage of patients receiving transfusion (40.0% versus 33.0%; p = 0.02), and total amount transfused (2.4 +/- 0.12 units versus 2.0 +/- 0.10 units; p = 0.0003) were all reduced significantly by the use of an automated titration system.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Transfusion↗
PubMed1992

Evaluation of an automated method of percent reactive antibody determination.

A fluorescence-based automated method of percent reactive antibody (PRA) analysis is described. This method utilizes the conventional antibody-mediated, C'-dependent lymphocyte microcytotoxicity assay to detect alloantibodies, but replaces the eosin-based method for detection of cell death with a fluorescence-based method. To identify viable cells, lymphocytes were pretreated with carboxy fluorescein diacetate (CFDA), which fluoresces green, to identify viable cells. To identify dead cells after the reaction with antibody and C', they were treated with propidium iodide (PI), which fluoresces red. Pretreatment of lymphocytes with CFDA did not affect their ability or interact with alloantibodies in the microcytotoxicity assays. When visually analyzed, detection of cell death by fluorescence was as sensitive as detection by eosin exclusion. However electronic detection of fluorescence was slightly more sensitive than visual detection. Automation of the fluorescent method required a calculation that converts electronic data to an ASHI score for cell death. One such method is described and evaluated. Both the automated and the conventional methods of analysis were used to obtain PRA values for various sera. There was good correlation between the PRA values obtained with the automated method versus the conventional method. Further, there was good correlation for PRA-derived alloantibody specificities obtained with the automated method versus the conventional method. These data demonstrate that automated fluorescence-based PRA analysis is an effective and practical alternative to conventional PRA analysis.

Antibodies↗