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Evaluation of a phenytoin dosage regimen design and adjustment computer program.

A computer program for phenytoin (PHT) dosing was developed containing seven different menus: two for drug-naive patients, one using an empirical equation, the other using means for Vmax and Km; two for patients in whom either one or two dose rates and steady-state concentrations are available; two for patients with hypoalbuminemia, and uremia, respectively; and one menu that optimizes Vmax and Km from available steady-state concentrations. The program accepts or converts PHT and sodium PHT, and makes blood level correction for the concomitant administration of 25 different drugs. The evaluation of the program was done by retrospective analysis using data from three study pools: group I involved 47 patients from the University Hospital, group II relied upon 29 patient data supplied from a collaborative Veterans Administration study, and group III involved 26 patients from the Children's Hospital. Predictions were made and compared with found data to be within a range of +/- 15, 20, or 25%. For study group III, many individual blood samples were less than 8 micrograms ml-1; hence, saturation kinetics may not have been involved. It is suspected that saturation kinetics in infants may begin at higher levels. Compliance seems to still be a major problem in PHT monitoring and dosage regimen adjustment. Accepting the data as they are, using one or two dose rates with the corresponding blood concentrations resulted overall in 73-86% achieving blood levels within +/- 25% of the predicted value.

Adolescent↗

Evaluation of mammographic calcifications using a computer program.

A computer pattern recognition program was developed to evaluate calcifications seen on mammograms. When the approximate horizontal length, average internal gray level, and contrast were used as criteria, 84.3% of the lesions studied were correctly identified as malignant or benign. These results show that a computer program can help evaluate calcifications of the breast.

Breast Neoplasms↗

Pediatric parenteral nutrition management using a comprehensive user-friendly computer program designed for personal computers.

The use of parenteral nutrition is becoming more widespread. The need for individualized parenteral nutrition solutions in pediatric patients makes the ordering and preparation of these solutions more complex and error-prone. A computer program is described which performs comprehensive management of parenteral nutrition by assisting in accurately ordering and preparing parenteral nutrition solutions. It also performs extensive error-checking and provides additional nutritional information. Data base management is also a feature which permits future large scale analysis of parenteral nutrition data for research purposes. This program, designed to run on a personal computer, is very comprehensive, yet flexible and user-friendly.

Adolescent↗

Red blood cell antibody identification and confirmation using commercial panels. A computer program for the IBM personal computer.

A menu-driven computer program that utilizes a data base of commercial panels was developed to assist in the identification and confirmation of red blood cell antibodies. A selected panel, along with the corresponding serum reactions, is displayed on the monitor and possible antibody patterns including dosage-dependent patterns are highlighted. A panel interpretation is then printed that includes a list of the possible (nonexcluded) antibodies, a probability level of identification for each possible antibody, and a table of antibody characteristics to aid in the differentiation among the possible antibodies. The panel data base can also be searched for additional red blood cells of specified phenotypes to confirm each suspected antibody. These additional red blood cells may be combined into a temporary panel for computer analysis. The program can also enter, print, edit, and delete any commercial panel from the data base. This computer program has proved to be faster and more accurate than the standard manual method for panel analysis, especially when multiple antibodies are present.

Antibodies↗

Signatures of small-world and scale-free properties in large computer programs.

A large computer program is typically divided into many hundreds or even thousands of smaller units, whose logical connections define a network in a natural way. This network reflects the internal structure of the program, and defines the "information flow" within the program. We show that (1) due to its growth in time this network displays a scale-free feature in that the probability of the number of links at a node obeys a power-law distribution, and (2) as a result of performance optimization of the program the network has a small-world structure. We believe that these features are generic for large computer programs. Our work extends the previous studies on growing networks, which have mostly been for physical networks, to the domain of computer software.

Journal Article↗

Differential diagnosis of ophthalmic syndromes using a computer program.

A Fortran computer program has been written for the differential diagnosis of ophthalmic syndromes. Input for the program are the observed symptoms and the result is a list of syndromes relevant to one or more of the symptoms. The program was written for the Control Data Cyber 840 at the Computer Center of the University of Innsbruck, which is connected permanently by terminals to institutes. A second version of the program has been adapted for IBM-compatible personal computers. At present, the program includes 219 syndromes with their individual symptoms. However, it is possible to supplement or alter the list of syndromes and symptoms. The use of this computer program is expected to make the differential diagnosis easier and to simplify and improve the scientific clarification of syndromes.

Diagnosis, Computer-Assisted↗

Determining survivals of platelets and fibrinogen using HAP an interactive hemostasis analysis computer program.

An interactive computer program is described which permits computation of platelet survivals based on the gamma function model of Murphy. An additional feature permits the treatment of other labelled proteins, e. g. fibrinogen, disappearing via an exponential process. The program requires no prior computer background [corrected] and typical determinations of survivals can be effected in about five min, representing a substantial enhancement to the gamma function program as currently provided by the International Committee for the Standardization of Hematology. Provision has also been made for modification to meet individual needs. The program is described in sufficient detail, including sample calculations, to permit evaluation for possible complications.

Blood Platelets↗

The diagnostic performance of computer programs for the interpretation of electrocardiograms.

BACKGROUND: Computer programs for the interpretation of electrocardiograms (ECGs) are now widely used. However, a systematic assessment of various computer programs for the interpretation of ECGs has not been performed. METHODS: We undertook a large international study to compare the performance of nine electrocardiographic computer programs with that of eight cardiologists in interpreting ECGs in 1220 clinically validated cases of various cardiac disorders. ECGs from the following groups were included in the sample: control patients (n = 382); patients with left ventricular hypertrophy (n = 183), right ventricular hypertrophy (n = 55), or biventricular hypertrophy (n = 53); patients with anterior myocardial infarction (n = 170), inferior myocardial infarction (n = 273), or combined myocardial infarction (n = 73); and patients with combined infarction and hypertrophy (n = 31). The interpretations of the computer programs and the cardiologists were compared with the clinical diagnoses made independently of the ECGs, and the computer interpretations were compared with those of the cardiologists. RESULTS: The percentage of ECGs correctly classified by the computer programs (median, 91.3 percent) was lower than that of the cardiologists (median, 96.0 percent; P less than 0.01). The median sensitivity of the computer programs was also significantly lower than that of the cardiologists in diagnosing left ventricular hypertrophy (56.6 percent vs. 63.9 percent, P less than 0.02), right ventricular hypertrophy (31.8 percent vs. 46.6 percent, P less than 0.01), anterior myocardial infarction (77.1 percent vs. 84.9 percent, P less than 0.001), and inferior myocardial infarction (58.8 percent vs. 71.7 percent, P less than 0.0001). The median total accuracy level (the percentage of correct classifications) was 6.6 percent lower for the computer programs (69.7 percent) than for the cardiologists (76.3 percent; P less than 0.001). However, the performance of the best programs nearly matched that of the most accurate cardiologists. CONCLUSIONS: Our study shows that some but not all computer programs for the interpretation of ECGs perform almost as well as cardiologists in identifying seven major cardiac disorders.

Cardiology↗

Statistical comparison of power spectra: a computer program.

A general computer program, of interest to neurobiologists, for comparison of uncorrelated power spectra is presented. The program, ALPHAF, is written in Fortran V language and is easily compiled and executed in any computer with a Fortran software package. The purpose of the program is to read power spectral density (PSD) values into a computer from digital tape and then perform the following functions: (1) compute and report power; (2) compute and report averages of the computed power values over selected frequency bands and (3) compute and report statistical standardised normal distributions for a frequency spectrum of interest. The standardised normal distribution statistic is derived by using equation 7.20, page 250 of Random data: Analysis and measurement procedures (Bendat and Piersol, 1971).

Computers↗

Computer programs and clinical contexts: two computer based exercises for cognitive rehabilitation.

Two examples taken from computer programs for cognitive rehabilitation of patients with schizophrenia show how different groups of clinicians attribute different meanings to the same exercise. This illustrates that the meaning of an artifact or a technology is socially constructed and thereby intimately bound to the context of use. This perspective has implications on issues such as the design process, the assessment of technology and the issue of standardization.

Cognition Disorders↗

Turbidimetric microbiological assay results calculated by a BASIC computer program.

A BASIC computer program was used to calculate the results of microbiological vitamin assays. The program, which incorporates the official AOAC guidelines for microbiological methods, reduces the uncertainty inherent in manual curve plotting and interpolation and minimizes the human error of repetitive calculations. Because the BASIC programming language is well suited for use on self-contained personal computers, it can be easily adapted by small laboratories.

Food Microbiology↗

Software for experimental design: the computer program EXCAD.

A computer program (EXCAD) dedicated to the optimization of experimental designs to estimate parameters of a mathematical model, is presented. EXCAD computes D-optimal designs and sequentially augmented designs. D-optimal designs minimize the determinant of the variance-covariance matrix and parameters, thus obtaining the average most accurate estimate of parameters. D-optimal designs have generally as many support points as the number of parameters in the mathematical model, so sample scheduling is minimal, not extensive. Augmented designs add to an original design the point that maximizes the decrement of the determinant of the variance-covariance matrix. The general model, linearly or not linearly parametrized Y = F(X,P), that relates two independent variables and P parameters to different responses may be written in the program, while a set of prewritten models is provided.

Algorithms↗

Ethical and legal issues related to the use of computer programs in clinical medicine.

As computer programs are used with increasing frequency in the clinical setting, ethicists, lawyers, computer scientists, clinicians, and patients must confront a group of problems: In what situations is it appropriate to use a medical computer program? Who should use these programs and how should they be used? What is the legal status of a computer program that provides medical advice? Can a proper balance be achieved between confidentiality of patient information and shared access to records by health care personnel? How can regulatory agencies, physicians, and patients determine if a program is safe for human use? Will programs be able to communicate with users well enough to prevent clinically harmful misunderstandings? Because few if any definitive answers are yet available, these questions remain the subject of much discussion.

Computers↗

[Hemodialysis and urea kinetics. An elementary computational program].

An elementary computational program to optimize dialysis in children with chronic renal failure was developed. The program is based on the urea kinetics model. Parameters involved in the efficiency of hemodialysis such as time and clearance, hemofilter performance and body surface area, as well as nutritional needs of the child are considered in the program.

Child↗

A computer program in compiled BASIC for the IBM personal computer to calculate the mean platelet survival time with the multiple-hit and weighted mean methods.

We developed an easy-to-operate computer program for the IBM personal computer to calculate, display and store in a database platelet kinetic data determined by analysis of the rate of clearance of radiolabeled blood platelets from the circulation. This was done by curve fitting using the weighted mean method and multiple-hit model. These models are complementary and calculating the mean platelet survival time with both is recommended. Improvement of the weighted mean method was investigated. The optimized weighting and fitting the exponential function with the Marquardt non-linear least squares method improved the weighted mean method. The weighted mean and multiple-hit models fit the survival curve data equally well. The calculation of the mean platelet survival time with the weighted mean method was very fast. The duration of calculation with the multiple-hit model could take up to 2 minutes. Calculation of the mean platelet survival time using both models has the advantage that conditions when calculation of the mean platelet survival time would be invalid, can be detected. The computer program will promote the valid comparison of results obtained at different institutions.

Blood Platelets↗