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PubMed1982

Standard computer programs in statistical analysis of survival in childhood lymphoblastic leukemia.

A material comprising all children in Sweden with acute lymphoblastic leukemia diagnosed in the years 1973-80 was analysed statistically. The total number of children was 505. Studies were made of 38 different variables, using frequency tables, cross tables, life table studies (1) and linear regression analysis according to Cox's method (2,4). Chi-square tests and log rank tests were included in the methods. The combination of life-table studies and linear regression analysis proved to be of value in assessing the significance of different parameters and treatment programs with regard to prognosis. The aim of this paper is to present a method for analysis of a patient material with use of standard computer programs. The results of the total analysis will be published elsewhere (3).

Child↗
PubMed1991

A computer program for randomizing patients with near-even distribution of important parameters.

In clinical trials, the methods for achieving an event or near-even distribution of important patient parameters have been tedious and often disappointing. In this paper, a computer program for minimizing differences between experimental groups with respect to such important parameters, based on a method described by Traves (Clin. Pharmacol. Ther. London 15, 443, 1974) is presented. The program is available from the author.

Clinical Trials as Topic↗
PubMed1998

Neural network computer program to determine photorefractive keratectomy nomograms.

PURPOSE: To evaluate a commercially available neural network program for calculation of photorefractive keratectomy treatment nomograms. SETTING: University referral refractive surgery clinic. METHODS: PRK/LASIK Brain, a commercial neural network computer program, was trained using the demographics, preoperative clinical data, surgical parameters, and 1 year postoperative clinical data of 44 patients treated with a Summit Technology excimer laser using a 5.0 mm optical zone. The neural-network derived nomogram was compared with the standard treatment nomogram for each patient. The relative contribution of age, sex, keratometry, and intraocular pressure (IOP) to the predicted nomograms was also assessed. RESULTS: Nomograms produced by the neural network were qualitatively similar to the standard nomogram. The sequence of data entry during training affected the network's predictions. Entry ordered by outcome (as opposed to entry by chronological order) yielded a nomogram that was more consistent with the standard nomogram. However, both outcome- and chronologically ordered network-derived nomograms diverged from the standard nomogram in individual patients, including a subset for whom use of the standard nomogram yielded desired refractive results (within 0.25 diopter of emmetropia). Further analysis of the neural-network-derived nomograms revealed marked sensitivity to sex, age, keratometry readings, and IOP. CONCLUSIONS: Neural networks offer a potential means of individualizing treatment nomograms, to account for patient demographics, preoperative examination, surgeon style, and equipment bias. However, a data set of 44 patients was not sufficient to train the PRK/LASIK Brain network to accurately predict treatment parameters in individual cases in the training set. A larger training set or a different learning algorithm may be required to improve the neural network's performance.

Adult↗
PubMed1992

Preoperative assessment of lymph node metastases in patients with gastric cancer: evaluation of the Maruyama computer program.

The probability of survival of patients with gastric cancer depends upon depth of wall penetration by the primary tumour and metastatic lymph node burden. Radical lymphadenectomy may lead to prolonged survival but with increased morbidity. A computer program from Maruyama, National Cancer Centre, Tokyo enables evaluation of individual survival time and infiltration of lymph nodes. This analysis was applied to a German population. Computer-aided predictions were determined retrospectively using the prognostic factors of sex, age, Borrmann classification, histology, depth of wall penetration, location and diameter of the tumour. Data were collected from 222 patients at the Technical University of Munich (median age 66 years, sex ratio (M:F) 2:1), who had been operated on (72 per cent total gastrectomy, 28 per cent subtotal gastrectomy) for gastric cancer. The predicted results were compared with the postoperative pathological findings. The prediction of node metastases was highly accurate (lymph nodes 13-16, 96 per cent; 7-12, 89 per cent; 1-6, 82 per cent). These computer predictions may provide perioperative information of therapeutic value.

Aged↗
PubMed1987

Testing the performance of ECG computer programs: the CSE diagnostic pilot study.

In an international project investigators from 21 institutes are trying to establish a common reference library and evaluation methods for testing the diagnostic performance of various ECG computer programs using ECG independent clinical information. Preliminary results indicate that the classification accuracy of different programs varies widely.

Electrocardiography↗
PubMed1990

[Development of a computer program for early diagnosis of acute myocardial infarction].

A standardised case history was obtained for 1,163 patients admitted to the Central Hospital of Akershus due to suspected acute myocardial infarction. From this database, a computer program was developed for establishing early diagnosis of acute myocardial infarction. In a given patient the program calculates the probabilities of the different conditions giving rise to the particular chest pain history by applying Baye's conditional probability approach. The program proved valuable as a supportive clinical tool of decision in patients admitted with acute chest pain.

Diagnosis, Computer-Assisted↗
PubMed1998

Teaching the clinical interpretation of peripheral blood smears to a second-year medical school class using the PeripheralBlood-Tutor computer program.

The interpretation of peripheral blood smears has an important role in the diagnosis of hematologic diseases and is, therefore, part of the education of physicians and technologists. We describe a computer program, PeripheralBlood-Tutor (Lippincott-Raven, Philadelphia, Pa), that teaches the morphologic features of normal and abnormal peripheral blood smears; we also describe the evaluation of the effectiveness of the program in 133 second-year medical students who were required to use the program in their hematology course. The version of the PeripheralBlood-Tutor used in the study had 2 distinct but equivalent 20-question examinations; one examination, the pretest, was taken before the students viewed the contents of the program, and the other examination, the posttest, was taken after completing the program. The mean score on the pretest was 61% (SD, 14%), the mean on the posttest was 91% (SD, 10%), and the improvement was significant. In addition, 4 questions about peripheral blood smears, which were based on printed images, were administered at the end of the hematology course. The students scored an average of 2.75 (SD, 0.86), and a positive correlation was found between these scores and the scores on the Tutor posttest. The results of the study suggest that PeripheralBlood-Tutor is feasible to implement, and it helps students learn to interpret peripheral blood smears. The use of PeripheralBlood-Tutor is now a requirement in the medical school curriculum, the medical technology program, and the pathology residency at the University of Washington, Seattle.

Blood Cell Count↗
PubMed2004

A recoding scheme for X-linked and pseudoautosomal loci to be used with computer programs for autosomal LOD-score analysis.

We present a recoding scheme that allows for a parametric multipoint X-chromosomal linkage analysis of dichotomous traits in the context of a computer program for autosomes that can use trait models with imprinting. Furthermore, with this scheme, it is possible to perform a joint multipoint analysis of X-linked and pseudoautosomal loci. It is required that (1) the marker genotypes of all female nonfounders are available and that (2) there are no male nonfounders who have daughters in the pedigree. The second requirement does not apply if the trait locus is pseudoautosomal. The X-linked marker loci are recorded by adding a dummy allele to the males' hemizygous genotypes. For modelling an X-linked trait locus, five different liability classes are defined, in conjunction with a paternal imprinting model for male nonfounders. The formulation aims at the mapping of a diallelic trait locus relative to an arbitrary number of codominant markers with known genetic distances, in cases where a program for a genuine X-chromosomal analysis is not available.

Chromosome Mapping↗
PubMed1997

Nursing process documentation--effects on workload and quality when using a computer program and a key word model for nursing documentation.

In 1993 the federation of County Councils commissioned Spri to carry out a broadly based study aimed at investigating individualised patient care as described in the notes kept at various care units using computers to support documentation of the nursing process. The wards involved in the study represented various disciplines such as surgery, obstetrics, internal medicine, geriatrics and psychiatry. During the study period certain measures designed to improve the documentation were implemented i.e. a special computer program and structured nursing documentation following the VIPS-model. Interviews with staff at the units confirm that the introduction of computers, in combination with the structure of the VIPS-model and training in nursing documentation, has made changes possible to working procedures and brought greater goal orientation to the activity of care. The overall examination of the nursing entries in the patients' notes showed that the language has improved. The entries were to a greater extent expressed clearly and distinctly.

Computer User Training↗
PubMed1987

An evaluation of a computer program to predict the outcome of hyaline membrane disease.

A computerized model was developed to predict the severity of hyaline membrane disease. This study compared the program's predictive ability with that of three neonatologists. Blood gas and respiratory support data of 33 infants were entered into the computer which then predicted the severity of disease. The computer predicted 18 outcomes correctly. The neonatologists, provided with the same data, predicted 24 outcomes correctly. Both sets of predictions--computer and physician--found that patients predicted to have mild outcomes had the shortest oxygen requirements, duration of mechanical ventilation, and length of hospitalization, and infants predicted to have severe outcomes had the greatest oxygen requirements, duration of mechanical ventilation, and length of hospitalization. While actual severity was linked to birth weight, the model did not utilize birth weight in its predictive algorithm. Consequently, although the computer program predicted the outcomes with moderate success, it was less accurate than the neonatologists.

Blood Gas Analysis↗
PubMed1989

Estimation of quantal dose response of drugs by the Spearman-Karber method: a computer program written in BASIC.

Quantal-dose response is an important concept in pharmacology and toxicology. The best known variables are the median effective dose and the median lethal dose. These are measured according to the frequency of dichotomous response of the subjects being studied. The Spearman-Karber method is a simple and convenient algorithm to evaluate these indices. A highly portable computer program in BASIC language is also included for the convenience of computation.

Algorithms↗
PubMed1992

Assessment of a computer program to detect epileptiform spikes.

This study compares an automated spike detection program to a group of 6 electroencephalographers. Since group members varied in experience, an expertise factor was devised to weight their scoring. EEGers underscored epileptiform events on 6 records in a manner analogous to the computer's storage of EEG segments. A summation of expertise factors was determined for every event. This sum was normalized and interpreted as a probability the event would be called a spike by a given EEGer. The performance of each scorer and of the computer at different amplitude thresholds was analyzed based on this probability. Higher rated scorers identified more subtle events. Lowering the threshold of the computer program produced a comparable increase in sensitivity. The increase in total events detected by the computer was linear over the range studied. While the proportion of false positive detections increased with lowering threshold, our readers have not found a moderate number of these distracting. We conclude that the computer system, while not as specific as an EEGer, can be as sensitive and can be a reliable screening editor for large amounts of monitoring data. On balance it is more effective than an EEGer for this limited purpose.

Electroencephalography↗
PubMed1994

apoB-100 has a pentapartite structure composed of three amphipathic alpha-helical domains alternating with two amphipathic beta-strand domains. Detection by the computer program LOCATE.

Due to the great length of apolipoprotein (apo) B-100, the localization of lipid-associating domains in this protein has been difficult. To address this question, we developed a computer program called Locate that searches amino acid sequences to identify potential amphipathic alpha-helixes and beta-strands by using sets of rules for helix and strand termination. A series of model chimeric protein test datasets were created by tandem linking of amino acid sequences of multiple proteins containing four different secondary structural motifs: motif A (exchangeable plasma apolipoproteins); motif G (globular alpha-helical proteins); motif C (coiled-coil alpha-helical proteins); and motif B (beta pleated-sheet proteins). These four test datasets, as well as randomly scrambled sequences of each dataset, were analyzed by Locate using increasingly stringent parameters. Using intermediately stringent parameters under which significant numbers of amphipathic helixes were found only in the unscrambled motif A, two dense clusters of putative lipid-associating amphipathic helixes were located precisely in the middle and at the C-terminal end of apoB-100 (a sparse cluster of class G* helixes is located at the N-terminus). The dense clusters are located between residues 2103 through 2560 and 4061 through 4338 and have densities of 2.4 and 2.2 amphipathic helixes per 100 residues, respectively; under these conditions, motif A has a density of 1.4 amphipathic helixes per 100 residues. These two domains correspond closely to the two major apoB-100 lipid-associated domains at residues 2100 through 2700 and 4100 through 4500 using the principle of releasability of tryptic peptides from trypsin-treated intact low-density lipoprotein. The classes of amphipathic helixes identified within these two putative lipid-associating domains are considerably more diverse than those found in the exchangeable plasma apolipoproteins. Interestingly, apoB-48 terminates at the N-terminal edge of the middle cluster. By using a similar strategy for analysis of amphipathic beta-strands, we discovered that the two gap regions between the three amphipathic helix clusters are highly enriched in putative amphipathic beta-strands, while the three amphipathic helical domains are essentially devoid of this putative lipid-associating motif. We propose, therefore, that apoB-100 has a pentapartite structure, NH2-alpha 1-beta 1-alpha 2-beta 2-alpha 3-COOH, with alpha 1 representing a globular domain.

Algorithms↗
PubMed1993

A computer program for the estimation of time of death.

In the 1960s Marshall and Hoare presented a "Standard Cooling Curve" based on their mathematical analyses on the postmortem cooling of bodies. Although fairly accurate under standard conditions, the "curve" or formula is based on the assumption that the ambience temperature is constant and that the temperature at death is known. Also, Marshall and Hoare's formula expresses the temperature as a function of time, and not vice versa, the latter being the problem most often encountered by forensic scientists. A simple BASIC program that enables solving of Marshall and Hoare's equation for the postmortem cooling of bodies is presented. It is proposed that by having a computer program that solves the equation, giving the length of the cooling period in response to a certain rectal temperature, and which allows easy comparison of multiple solutions, the uncertainties related to ambience temperature and temperature at death can be quantified, substantiating estimations of time of death.

Body Temperature↗
PubMed1998

Variations in the diagnostic process among urologists in one region recorded using an interactive computer program.

To analyse how male cases suffering from lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are handled within a well-defined health-care region in Scandinavia, an interactive computer program containing 20 cases suffering from LUTS due to BPH was used for recording the diagnostic process and the treatment decisions; 37 out of a total of 50 urologists practicing within a small health region participated. The diagnostic process varied considerably due to a varying choice of diagnostic tests and the large differences in interpreting the qualities described by the tests. The probability that a patient would be offered a treatment within the region was analysed. For many patients the probability that a treatment was chosen was in the vicinity of 50%. No treatment probability was correlated to the symptom score of the patients. While the probability that a transurethral prostatic resection would be offered to the patients within the region was correlated significantly to urodynamic variables, residual urine and to cystoscopy findings, the probability that transurethral microwave or finasteride therapy would be offered was not correlated to any of the described qualities. The costs of the diagnostic process in all the patients incurred by each of the urologists varied by up to 500%. It was estimated that approximately 40% of the costs involved diagnostic tests that did not influence the decision to offer or not to offer treatment. In conclusion, the enormous variations in the handling of the cases recorded in the study stress the need that a management formula should be used in the handling of patients with LUTS.

Decision Making, Computer-Assisted↗
PubMed1998

Correlation between aerobic and anaerobic resistance to metronidazole in trichomonads: application of a new computer program for permutation tests.

An indispensable step of any comparative study is testing the concordance between the distribution of phenetic traits and the evolutionary history of the taxa under study. Here we present a computer program TREEPT which can perform these tasks on the basis of a permutation test. The use of the program was demonstrated on trichomonad drug sensitivity data. The program can also perform permutation tests analogous to the t-test, analysis of variance (ANOVA) and correlation analysis and is available at http://www.natur.cuni.cz/flegr/PROGRAMS/+ ++TREEPT.ZIP and http://www.karlin. mff.cuni.cz/-zaboj/treept.

Aerobiosis↗
PubMed1981

A computer program for calculating respiratory anatomic dead space.

The Fowler technique for estimating anatomic dead space (VD -- the volume of the airway conducting system) on the basis of CO2 changes in the expired air of a single breath was adapted to computer analysis. The areas above and below the sigmoid CO2 curve in the region of transition from inspired to alveolar concentration were simultaneously integrated (forward and backward) on a time base until the sum of the two integrated values equalled the total area representing the transition. The point on the CO2 curve was defined as the CO2 midpoint. Expiratory flow was then integrated with time from its beginning to the CO2 midpoint, and the resultant volume represented VD for that breath. The computer program was able to compensate for differences in response time between the gas monitor and the flow measuring device and was able to integrate the areas rapidly. The program provided a rapid calculation of VD, which compared well with values calculated by tedious, manual methods.

Carbon Dioxide↗