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PubMed1987

Computer technology: state of the art and future trends.

Computer technology and, more broadly, information technology, are bringing about a fundamental transformation in our society from an industrial economy to an information economy. A review of the short history and present state of information technology identifies two major undercurrents: the miniaturization of computer components, which has produced a millionfold increase in the complexity possible in a single chip of silicon, and the integration of four previously separate areas of information technology: computation, communication, databases and the user interface. Microelectronics, computer networks, data storage and user amenities are the basic technologies that support these four areas and stimulate their progress. Future trends in speech recognition, voice synthesis, artificial intelligence, expert systems, computational imaging and scientific workstations are also examined.

Artificial Intelligence↗
PubMedDate not supplied

Computer-aided diagnosis.

The evolution of logic thought in relation to the predominant recent advances in technology is analyzed. In fact, the computer was the prime mover of this major change. At present the use of sophisticated software has allowed to attain increasingly accurate levels of simulation of human reasoning. The computer has determined profound transformations in many sectors of work, study and research. Among these, it is extremely relevant how the computer has completely transformed medicine and the medical role, especially in the field of radiology. Expert systems are the most interesting and futuristic applications of artificial intelligence. These systems are able to reproduce on a computer the behavior of an expert human being. Some of the recent innovations introduced in the field of breast, thoracic and mainly neural pathology are illustrated.

Artificial Intelligence↗
PubMed1993

Hypothalamic-pituitary-adrenal axis function in children with attention-deficit hyperactivity disorder.

Examined hypothalamic-pituitary-adrenal axis (HPA axis) function in 30 children with attention-deficit hyperactivity disorder (ADHD) by measuring the diurnal variation and response to the dexamethasone suppression test (DST) of saliva cortisol. Normal diurnal saliva cortisol rhythm was found in only 43.3% of the ADHD children. DST showed suppression in 46.7% of the ADHD children. An abnormal diurnal rhythm and nonsuppression to the DST were more frequent in the severely hyperactive group than in the mildly were more frequent in the severely hyperactive group than in the mildly hyperactive group of children with ADHD. These results suggest abnormalities in HPA axis function in some children with ADHD, especially those exhibiting severe hyperactivity.

Attention Deficit Disorder with Hyperactivity↗
PubMed2003

Lower cortisol and higher ACTH levels in individuals with autism.

Blood concentrations of pituitary hormones adrenocorticotropin (ACTH), prolactin, growth hormone, and adrenal hormone-cortisol were measured in 36 autistic and 27 control individuals. Individuals with autism had significantly lower serum concentrations of cortisol (p < 10(-6)), and significantly higher concentrations of ACTH (p = 0.002) than control age- and sex-matched subjects. Also, prolactin concentrations in autistic patients with epilepsy were significantly higher when compared with normal subjects. The observed hormonal changes may indicate dysfunction of the hypothalamo-pituitary-adrenal axis in individuals with autism.

Adolescent↗
PubMedDate not supplied

A multi-agent architecture for teaching dermatology.

This work proposes the integration of computer-aided instruction systems in the curricula of medical education, and describes an intelligent tutoring system used for teaching Dermatology. The Dermatology Tutor uses a self-organized society of autonomous software agents which have different capabilities or roles. The society contains tutor, medical and information agents which participate in the tutoring process and collaborate through deliberation in order to achieve a tutoring task. The agents are built according to a BDI architecture, which implements the mental attitudes of beliefs (B), desires (D) and intentions (I). Each medical agent is a specialist in a medical field, while a tutoring agent, which implements a widely accepted dermatology teaching process, coordinates the overall operation of the system. Depending on the subject that is to be taught during any session, the tutoring agent forms teams of medical agents, which in turn use search agents to retrieve information. Although the presented multi-agent architecture is dedicated to teaching dermatology (since the tutor agent is specialized in Dermatology), it can be extended to other domains also with the incorporation of other tutor agents.

Computer Systems↗
PubMed1999

A computer-aided approach to the structural analysis and modification of a large circulatory system model.

The purpose of this study is to show an approach to making an intelligent support system for understanding and modifying a large circulatory system model using techniques of system analysis. Structural analysis makes it possible to visualize hierarchies of Coleman's circulatory model Human. Two techniques are successively applied for structural analysis, model reduction and graph analysis by interpretative structural modeling (ISM). First, the analysis for model reduction removes input-output relations with an input-output gain less than a given threshold, and second, the ISM technique applied to the reduced model of Human provides hierarchical directed graphs. The proposed approach: 1) enables visualization of a hierarchy graph of cause and effect relations of the large circulatory model, 2) suggests control and diagnostic information to the model by tracing back a path in the hierarchy, and 3) allows the user to modify the circulatory model. The efficiency and performance of the proposed approach demonstrates technical indications of success in analyzing and justifying experimental evidences with the online help of the system.

Algorithms↗
PubMedDate not supplied

Expert systems in medicine: academic exercise or practical tool?

From the earliest stages of computer development, scientists have aspired to the creation of advanced systems which could simulate human thought and reasoning. Of all the modern technological quests, this research to create artificially intelligent computer systems has been one of the most ambitious and fascinating. Although attempts have been made for the last 30 years to develop and apply such systems to the medical sciences, only limited progress has been made. This paper reviews and discusses the important role of expert systems in medicine and outlines future trends in this area.

Artificial Intelligence↗
PubMed1996

Strange hemodynamic attractor parameter with 1/R total artificial heart automatic control algorithm.

To evaluate the automatic control algorithm of the total artificial heart (TAH) as an entity, and not just as parts, a non-linear mathematical analyzing technique including chaos theory was utilized. Chronic experiments on the biventricular bypass type artificial heart implantation were performed in healthy adult goats after the natural ventricles were removed. Hemodynamic time series data were recorded under the awake standing condition with TAH 1/R and fixed driving. Time series data were recorded on a magnetic tape and analyzed on a personal computer system with an A-D converter. Using the nonlinear mathematical technique, the time series data were embedded into the phase space and the Lyapunov numerical method was carried out for the quantitative evaluation of the sensitive dependence on the initial condition of the reconstructed attractor. Calculation of the largest Lyapunov exponents suggested that the reconstructed attractor of the left pump output during TAH 1/R control was a larger dimensional strange attractor, a characteristic pattern of deterministic chaos. A total system indicating chaotic dynamics was thought to be a flexible and intelligent control system. Thus, our results suggest that 1/R TAH control may be suitable for the biventricular assist type total artificial heart.

Algorithms↗
PubMed1988

A prototype system for perinatal knowledge engineering using an artificial intelligence tool.

Though several perinatal expert systems are extant, the use of artificial intelligence has, as yet, had minimal impact in medical computing. In this evaluation of the potential of AI techniques in the development of a computer based "Perinatal Consultant," a "top down" approach to the development of a perinatal knowledge base was taken, using as a source for such a knowledge base a 30-page manuscript of a chapter concerning high risk pregnancy. The UNIX utility "style" was used to parse sentences and obtain key words and phrases, both as part of a natural language interface and to identify key perinatal concepts. Compared with the "gold standard" of sentences containing key facts as chosen by the experts, a semiautomated method using a nonmedical speller to identify key words and phrases in context functioned with a sensitivity of 79%, i.e., approximately 8 in 10 key sentences were detected as the basis for PROLOG, rules and facts for the knowledge base. These encouraging results suggest that functional perinatal expert systems may well be expedited by using programming utilities in conjunction with AI tools and published literature.

Expert Systems↗
PubMed2006

[Clinical laboratory system in a complete electronic hospital].

The use of a Laboratory Information System (LIS) and Laboratory Automation System (LAS) are clearly superior to manual results in terms of completeness and legibility. As the current clinical information system (CIS) in Gifu University Hospital consists of a complete electronic medical record system, the clinical laboratory was re-engineered to simplify workflow, pay attention to quality assurance, and decrease various costs by an intelligent laboratory management system. We named the new system Gifu Premiotic Intelligent Laboratory System (GPILS). Further advances will concentrate on the cost-effective use of LIS, and the potential use of GPILS in our laboratories will be discussed. In addition, because one of our clinical laboratories currently provides various useful clinical laboratory-oriented information to physicians and patients, we have developed new tools named the "Reference Data Base (RefDB)". In the near future, several different types of computer technology for various clinical laboratory information will lead to the development of highly specific platforms for LIS corresponding to a complete electronic medical record system.

Clinical Laboratory Information Systems↗
PubMed1991

RedSoar--a system for red blood cell antibody identification.

The primary goal of our research is to build an intelligent tutoring system for red blood cell antibody identification. In this paper, we describe the basis for a tutoring system--an expert system called RedSoar. RedSoar is built from two task-specific architectures that were designed for building flexible systems (i.e. systems that can use a variety of problem-solving strategies, and to which knowledge can easily-be added). RedSoar solves the antibody identification task correctly 81% of the time and new knowledge can be added in a straightforward manner. The system is capable of exhibiting human-like behavior which we believe is a necessary condition for building a successful tutoring system.

Blood Grouping and Crossmatching↗
PubMedDate not supplied

Expert systems for medical applications.

Expert systems, also known as intelligent knowledge based systems (IKBS), are computer programs which act as decision-support systems. They are currently being applied to a number of medical domains, most notably diagnosis and treatment planning. Their function is to assist the medical practitioner by giving ready access to the levels of skill shown by experts in a particular field. Much research effort has been expended but few systems have reached routine medical use. This paper presents a tutorial introduction to expert systems in medicine, explaining the basis of the technology, its current limitations and its prospective uses.

Expert Systems↗
PubMed2003

Homecare: a telemedical application.

The advent of telecommunication and information technologies and the miniaturisation of technologies have enabled the evolution of telemonitoring systems. Early systems for hospitals and clinics, which usually required the patients to be wired to desktop devices, have evolved into homecare that requires devices to be lighter and simpler to use. In addition to miniaturisation and extended autonomy, further requirements for the telemonitoring system include local intelligence (that is, the system can take decisions without referring to external advice) and no moving parts to allow the patient to move freely during measurement periods. Body and local communication networks can prolong the connection of the homecare patient with a monitoring centre through the public networks. Additional medical functions and processing have been added to homecare equipment for telemedicine and patient discomfort is decreasing because of miniaturisation, autonomy and increased versatility of new systems. The applications have evolved rapidly from manually triggered alarms and single physiological parameter monitors to autonomous telemedical monitoring tailored to complete needs. This will eventually make telemedicine beneficial to patients, doctors and society.

Home Care Services↗
PubMed2001

Intellectual classification of Black and White children in special education programs using the WISC-III and the Cognitive Assessment System.

The Wechsler Intelligence Scale for Children--Third Edition and the Cognitive Assessment System were compared for a sample of 78 White and Black students in special education programs for children with mental retardation. Results showed that the WISC-III identified more children as having mental retardation than did the Cognitive Assessment System. More important, however, the WISC-III classified disproportionately more Blacks than Whites as having mental retardation as compared to the Cognitive Assessment System. Results imply that the problem of disproportionate representation of Black children in special education classes for children with mental retardation may be addressed if the Cognitive Assessment System were used instead of the WISC-III.

Adolescent↗
PubMed1988

The effects of different frequency responses on sound quality judgments and speech intelligibility.

Four speech programs and two music programs were reproduced using five different frequency responses: one flat and the others combinations of reductions at lower frequencies and/or increases at higher frequencies. Twelve hearing impaired (HI) and 8 normal hearing (NH) subjects listened monaurally to the reproductions at comfortable listening level and judged the sound quality on seven perceptual scales and a scale for total impression. Speech intelligibility was measured for phonetically balanced (PB) word lists and for sentences in noise. Significant differences among the reproductions appeared in practically all scales. The most preferred system was characterized by a flat response at lower frequencies and a 6 dB/octave increase thereafter. There were certain differences between the NH and HI listeners in the judgments of the other systems. The intelligibility of PB word lists did not differ among the systems, and the S/N threshold for the sentences in noise only distinguished the flat response as worse than all others for the HI listeners. There was little correspondence between intelligibility measures and sound quality measures. The latter provided more information and distinctions among systems.

Adult↗
PubMed2000

Computers in imaging and health care: now and in the future.

Early picture archiving and communication systems (PACS) were characterized by the use of very expensive hardware devices, cumbersome display stations, duplication of database content, lack of interfaces to other clinical information systems, and immaturity in their understanding of the folder manager concepts and workflow reengineering. They were implemented historically at large academic medical centers by biomedical engineers and imaging informaticists. PACS were nonstandard, home-grown projects with mixed clinical acceptance. However, they clearly showed the great potential for PACS and filmless medical imaging. Filmless radiology is a reality today. The advent of efficient softcopy display of images provides a means for dealing with the ever-increasing number of studies and number of images per study. Computer power has increased, and archival storage cost has decreased to the extent that the economics of PACS is justifiable with respect to film. Network bandwidths have increased to allow large studies of many megabytes to arrive at display stations within seconds of examination completion. PACS vendors have recognized the need for efficient workflow and have built systems with intelligence in the management of patient data. Close integration with the hospital information system (HIS)-radiology information system (RIS) is critical for system functionality. Successful implementation of PACS requires integration or interoperation with hospital and radiology information systems. Besides the economic advantages, secure rapid access to all clinical information on patients, including imaging studies, anytime and anywhere, enhances the quality of patient care, although it is difficult to quantify. Medical image management systems are maturing, providing access outside of the radiology department to images and clinical information throughout the hospital or the enterprise via the Internet. Small and medium-sized community hospitals, private practices, and outpatient centers in rural areas will begin realizing the benefits of PACS already realized by the large tertiary care academic medical centers and research institutions. Hand-held devices and the Worldwide Web are going to change the way people communicate and do business. The impact on health care will be huge, including radiology. Computer-aided diagnosis, decision support tools, virtual imaging, and guidance systems will transform our practice as value-added applications utilizing the technologies pushed by PACS development efforts. Outcomes data and the electronic medical record (EMR) will drive our interactions with referring physicians and we expect the radiologist to become the informaticist, a new version of the medical management consultant.

Computers↗
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↗