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PubMed2005

Helical computed tomography alone compared with plain radiographs with adjunct computed tomography to evaluate the cervical spine after high-energy trauma.

BACKGROUND: Current literature supports the use of the three-view plain-radiograph series supplemented, when necessary, with helical computed tomography to evaluate the cervical spine in patients who have sustained trauma injury. The purpose of this study was to determine if helical computed tomography alone can be used to evaluate the cervical spine for acute osseous injury following high-energy trauma, thus eliminating the need to make radiographs. METHODS: Patients were prospectively evaluated with helical computed tomography scanning of the cervical spine and standard three-view plain radiography. At a later date, the plain radiographs and computed tomography scans were independently reviewed by two radiologists who were blinded to both the initial interpretation and the interpretation of the corresponding study. The radiologists documented whether the plain radiographs were adequate and whether they showed an acute process. The findings in the study were compared with the initial findings and, when necessary, with the discharge summaries to determine if an injury had been identified. The accuracy of the plain radiographs, of the plain radiographs that had been deemed adequate, and of helical computed tomography used alone was ascertained. RESULTS: Plain radiographs and helical computed tomography scans were made for 407 patients, and traumatic injuries were identified in fifty-eight of them. Plain radiographs alone were adequate for 194 (48%) of the 407 patients. Plain radiographs had a sensitivity of 45%, a specificity of 97%, a positive predictive value of 74%, and a negative predictive value of 91%. Adequate plain radiographs had a sensitivity of 52%, a specificity of 98%, a positive predictive value of 81%, and a negative predictive value of 93%. Helical computed tomography had a sensitivity and specificity of 98%, a positive predictive value of 89%, and a negative predictive value of >99%. The sensitivity, positive predictive value, and negative predictive value of adequate plain radiographs differed significantly from those of helical computed tomography alone (p < 0.001). Twelve (48%) of twenty-five adequate plain radiographs of patients in whom an injury had been identified on computed tomography missed that injury. Helical computed tomography alone missed one (2%) of the fifty-eight injuries. CONCLUSIONS: Although helical computed tomography has a limited ability to detect pure ligamentous injury, it can be safely used without plain radiographs to evaluate the cervical spine for osseous abnormalities such as fractures and dislocations after high-energy trauma.

Adolescent↗
PubMed2006

A quadratic model for combining quantitative diagnostic assessments from radiologist and computer in computer-aided diagnosis.

RATIONALE AND OBJECTIVES: Some computer-aided diagnosis (CAD) methods produce a quantitative diagnostic assessment (eg, likelihood of malignancy) based on computer image analysis that a radiologist who uses the computer aid must combine with his or her own assessment. Observer studies show that although CAD helps radiologists improve diagnostic performance, ad hoc use of computer aid can produce performance inferior to that of computer alone, indicating that radiologists are unable to incorporate computer assessment optimally into their final assessment. We describe a mathematical model for combining two correlated diagnostic assessments that may provide a basis for merging radiologists' ratings with computer assessments in a way that yields greater diagnostic accuracy than ad hoc merging by radiologists. MATERIALS AND METHODS: We calculate a likelihood ratio from the bivariate binormal model that describes joint probability density functions of latent decision variables of two correlated diagnostic assessments. To the extent that the bivariate binormal model is valid and that the model's parameters can be estimated reliably, results obtained in this way will be optimal because the likelihood ratio is the decision variable used by the ideal observer in any two-group classification task. We evaluated this method on two observer study datasets and in Monte Carlo simulations. RESULTS: This method produced better performance than achieved by radiologists when they incorporated computer assessment in an ad hoc way. Simulations show that with a large number of cases, this method can produce results indistinguishable from the ideal observer performance. CONCLUSIONS: This method can potentially help radiologists use quantitative computed diagnostic assessments optimally, thereby surpassing the computer in accuracy.

Analysis of Variance↗
PubMed1997

Psychology of computer use: XLII. Problem solving and humor as a function of computer anxiety.

From a pool of 115 undergraduate women, 20 were placed in a Computer-anxious group and 20 in a Computer-nonanxious group based on their scores on the Computer Anxiety Scale. Half of the subjects were randomly assigned to a group to which the computer presented the problems first and half to a group to whom the computer presented the jokes first. Electromyograms from subjects' zygomatic muscles were monitored as well as palmar skin conductance. Behavioral measures were collected prior to and following the computer interaction. Although the electromyogram for zygomatic tension (smiles) was higher in the jokes condition, indicating that subjects responded to jokes as humorous, Computer-anxious subjects showed increased scores on anxiety and depression and relatively high skin conductance on the initial joke. Subjects with high computer-anxiety had less experience with computers, had lower scores on the Rosenberg Self-esteem test, and, likely not being familiar with computer humor, reacted anxiously.

Anxiety↗
PubMed1998

Computer anxiety: a comparison of pen-based personal digital assistants, conventional computer and paper assessment of mood and performance.

The recent growth of pen-based devices, such as the Personal Digital Assistant (PDA), offer mobility and a more natural interface than that of a conventional computer. The feasibility and application of the PDA for mood and cognitive assessment were investigated by examining possible interactions of individual characteristics and administration medium. Previous studies have provided evidence that individual characteristics of 'computer anxiety' and 'private self-consciousness' divergently covaried with mood scores measured by computer and paper methods. To investigate the relationship between individual characteristics and medium effects, 136 paid participants were allocated to and completed mood assessment tasks and a short battery of cognitive tasks by either the computer, PDA or the paper method. Self-ratings of mood measured by these three modalities covaried divergently with measures of computer anxiety and private self-consciousness. In addition, computer anxiety covaried with reaction time on the visual search task obtained on computers, but there was no such relationship when measured by a PDA. These results show that computer anxiety can affect the results of assessments of cognitive function as well as of mood ratings, and suggest that pen-based systems may have advantages over conventional computers in this respect.

Adolescent↗
PubMed1996

Computer use, computer training, and employment. Outcomes among people with spinal cord injuries.

Computer use and training may be of special benefit to people with spinal cord injuries (SCIs) because computer technology may help lessen the impact of mobility limitations that are inherent with this disability. This article summarizes several findings from a 1994 survey conducted of New Jersey residents who suffered SCIs within the previous 10 years. The results indicate that, among people with SCIs, 46% currently use a computer in some capacity and 22% received computer training since the date of their injury. Perhaps surprisingly, both corresponding percentages are higher in the general population. People with SCIs appear to have less access to computers because most people learn how to use computers at work, and only a minority of people with SCIs work. The lower rate of use of computers among people with SCIs is unfortunate because the steep employment and earnings declines often experienced after an SCI are partially mitigated for those who have computer skills. The results suggest the importance of policies and programs aimed at increasing access to computers and computer training for people with severe disabilities.

Adult↗
PubMed2005

Examining the architecture of cellular computing through a comparative study with a computer.

The computer and the cell both use information embedded in simple coding, the binary software code and the quadruple genomic code, respectively, to support system operations. A comparative examination of their system architecture as well as their information storage and utilization schemes is performed. On top of the code, both systems display a modular, multi-layered architecture, which, in the case of a computer, arises from human engineering efforts through a combination of hardware implementation and software abstraction. Using the computer as a reference system, a simplistic mapping of the architectural components between the two is easily detected. This comparison also reveals that a cell abolishes the software-hardware barrier through genomic encoding for the constituents of the biochemical network, a cell's "hardware" equivalent to the computer central processing unit (CPU). The information loading (gene expression) process acts as a major determinant of the encoded constituent's abundance, which, in turn, often determines the "bandwidth" of a biochemical pathway. Cellular processes are implemented in biochemical pathways in parallel manners. In a computer, on the other hand, the software provides only instructions and data for the CPU. A process represents just sequentially ordered actions by the CPU and only virtual parallelism can be implemented through CPU time-sharing. Whereas process management in a computer may simply mean job scheduling, coordinating pathway bandwidth through the gene expression machinery represents a major process management scheme in a cell. In summary, a cell can be viewed as a super-parallel computer, which computes through controlled hardware composition. While we have, at best, a very fragmented understanding of cellular operation, we have a thorough understanding of the computer throughout the engineering process. The potential utilization of this knowledge to the benefit of systems biology is discussed.

Cell Physiological Phenomena↗
PubMed1993

Work stress in Japanese computer engineers: effects of computer work or bioeducational factors.

To examine whether computer work and bioeducational factors (age and school career) have significant effects on work stress in computer engineers in Japan, we administered a stress questionnaire to 764 male computer engineers and 211 male office workers in a computer-manufacturing factory in Tokyo. Four scales of perceived psychological stress at work examined were work overload, poor human relationships at work, unsuitable job, and competition-dismissal anxiety. The results of the three-way analysis of variance, in which age (20-29, 30-39, and 40-49 years), school career (high school and university graduates), and computer work (computer engineers and office workers) were three variation factors, indicated that: (1) there were no significant differences in all scores of work stress between computer engineers and office workers (P > 0.05); (2) scores for unsuitable job and poor human relationships at work were significantly higher in high school graduates than in university graduates (P < 0.05); and (3) there were significant age differences in scores for three scales of work stress (unsuitable job, competition-dismissal anxiety, and work overload: P < 0.001, P < 0.01, and P < 0.05, respectively). These findings suggest that computer work has no significant effect on perceived work stress in computer engineers; on the other hand, age and school career do have effects.

Adult↗
PubMed1993

Educational Technology Network: a computer conferencing system dedicated to applications of computers in radiology practice, research, and education.

Educational Technology Network (ET Net) is a free, easy to use, on-line computer conferencing system organized and funded by the National Library of Medicine that is accessible via the SprintNet (SprintNet, Reston, VA) and Internet (Merit, Ann Arbor, MI) computer networks. It is dedicated to helping bring together, in a single continuously running electronic forum, developers and users of computer applications in the health sciences, including radiology. ET Net uses the Caucus computer conferencing software (Camber-Roth, Troy, NY) running on a microcomputer. This microcomputer is located in the National Library of Medicine's Lister Hill National Center for Biomedical Communications and is directly connected to the SprintNet and the Internet networks. The advanced computer conferencing software of ET Net allows individuals who are separated in space and time to unite electronically to participate, at any time, in interactive discussions on applications of computers in radiology. A computer conferencing system such as ET Net allows radiologists to maintain contact with colleagues on a regular basis when they are not physically together. Topics of discussion on ET Net encompass all applications of computers in radiological practice, research, and education. ET Net has been in successful operation for 3 years and has a promising future aiding radiologists in the exchange of information pertaining to applications of computers in radiology.

Computer Communication Networks↗
PubMed2003

Differences between general computer attitudes and perceived computer attributes: development and validation of a scale.

The aim of this study was to develop a tool for measuring individuals' dispositions toward the use of computers in their work environment. The study reports the construction and validation of a general computer attitude and perceived computer attribute scale. Exploratory factor analytical evidence with a sample of 381 employees indicated a structure underpinned by two constructs, an attitudinal factor and a perceived computer attribute factor. The internal consistency estimates of reliability of scores were .81 for the attitudinal factor and .89 for the perceived computer attribute factor. Compared to the computer attitude subscale, scores on the perceived computer attribute subscale correlated higher with computer experience and professional computer use within the sample.

Adult↗
PubMed2001

State-of-the-art ultrasonography is as accurate as helical computed tomography and computed tomographic angiography for detecting unresectable periampullary cancer.

OBJECTIVE: To compare the ability of state-of-the-art ultrasonography with that of helical computed tomography and computed tomographic angiography in detecting unresectable periampullary cancer. In most patients periampullary cancer is unresectable because of either distant metastasis or local vascular involvement. The advent of gray scale and color Doppler ultrasonography has improved the ability of ultrasonography to detect vascular involvement. METHODS: Twenty-three consecutive patients with periampullary cancer were enrolled for prospective staging of their disease by comparing helical computed tomography and computed tomographic angiography with gray scale and color Doppler ultrasonography of the abdomen. Portal vein, superior mesenteric vein, splenic vein, and superior mesenteric artery involvement was graded 0 to 4, grade 0 being no vascular involvement and grade 4 being total occlusion of the vessel. Agreement between ultrasonography and computed tomographic angiography for determining vascular involvement was measured by chi2 analysis. RESULTS: Two patients (9%) were excluded because excessive overlying bowel gas hampered the ability of ultrasonography to visualize the pancreas. For the remaining 21 patients, there was significant agreement between ultrasonography and computed tomographic angiography for detecting vascular involvement in all vessels (P < .001; portal vein, kappa = 0.67; superior mesenteric vein, kappa = 0.67; splenic vein, kappa = 0.85; and superior mesenteric artery, kappa = 0.59). Ultrasonography was in agreement with computed tomographic angiography in all cases of unresectability. Both modalities were equally poor in preoperatively showing lymphadenopathy and metastases. CONCLUSIONS: Provided that there is adequate visualization on ultrasonography of the head of the pancreas in the periampullary region, then state-of-the-art gray scale and color Doppler ultrasonography are as accurate as helical computed tomography and computed tomographic angiography for detecting the unresectability of periampullary cancer. If performed as the initial investigation and the region of the pancreatic head is clearly shown, and if vascular encasement or occlusion or distant metastasis is identified, further investigations are unnecessary.

Adult↗
PubMed1991

Understanding computers or some of the things you always wanted to know about computers ... but were afraid to ask.

Criteria for computer systems evaluation are changing. No longer can we rely on an evaluation based solely on what the combination of hardware and software does for the user (functional criteria). Significant improvements in software productivity have occurred in recent years as a result of the availability of tools such as relational database management systems and fourth-generation languages. Meanwhile new technologies such as image processing and graphical user interfaces, e.g. MS-Windows and X Window, are coming onstream. Most of these technologies and capabilities require substantially more computing resources than traditional character-based systems. Fortunately, the open systems revolution is creating a more competitive marketplace and computer price/performance ratios are soaring, making the additional computing resources readily available at reasonable prices. But the opportunities of the future will not be for everyone. They will exist only for those medical record practitioners who recognize that a shift away from purely functional evaluation is necessary. Those that make the shift successfully will not become computer technicians, but they will understand the few technical criteria that are truly essential in systems evaluation. They will, in short, apply the 80/20 principle successfully to make future system selections. Medical record professionals must take steps to upgrade their computer system knowledge in order to accommodate the needs of technical criteria evaluation. For the active practitioner this means taking the time to learn from the many sources available in print, educational programs, and knowledgeable persons. Students should seek out courses that will give them a balanced view of the computer sciences, without being overloaded with specifics. AMRA should look for ways to augment the computer sciences requirements in the student's curriculum. Development of study tracks that concentrate on combining standard curricula with computer science would both create a new breed of practitioner and expand the horizons of the profession. The medical record profession must actively work to keep pace with the ever-changing information management environment in order to maintain its position of healthcare information management leadership.

Computer User Training↗
PubMed1985

Computer charting: an evaluation of a respiratory care computer system.

A respiratory care computer-charting system was developed and implemented as an addition to our hospital's computerized information system. Medical personnel charted and reviewed respiratory care procedures at nursing station computer terminals instead of using the patient's traditional paper chart. The computer automatically performed billing and provided management as well as clinical information. In an attempt to isolate specific benefits or shortcomings, we evaluated charting systems both before and after computer implementation. Four assessments were made: (1) a survey of therapists' attitudes, (2) an observation of work patterns, (3) an audit of the content of charting, and (4) an analysis of productivity statistics. Computer charting was well accepted by therapists. Charge capture was reduced from a four-step manual process to a single-step computer documentation of the procedure. Computer charting was more complete and informative. Productivity increased 18%, although it remains unclear to what degree the computer was responsible. Computer charting streamlined the process of documentation and allowed more beneficial use of clinical information.

Computers↗
PubMedDate not supplied

[The world of computer games II: a demographic study on prevalence of computer players in secondary school students].

The article presents the results of the first stage of our own research on the popularization of computer games among adolescents. A questionnaire was filled by 2678 class one pupils of secondary schools (born in 1979). The investigations were aimed at selecting a group of secondary school pupils particularly interested in computers and computer games. The investigations proved that the problem of computer games playing regards more than a half of the school pupils population we examined. There are twice as many boys as girls among the computer games players. Also, boys have better knowledge of computer games, they start to play at a younger age, devote more time to playing these games. The most popular hardware are Amiga or IBM compatible PCs. As many as 3/4 of computer games players have their own computers. The most significant information was the data concerning the time devoted to playing, both daily and weekly. The investigations show that boys spend much more time playing computer games than girls do. The selected group of pupils will undergo detailed clinical as well as psychological examination.

Adolescent↗
PubMed1982

Computational and noncomputational clinical information processing by computer.

Computers have been used in their computational as well as noncomputational modes for the scientific study of the clinical decision making. As computational tools, computers serve as storage devices for hospital file data so that these data can be analyzed statistically for a large variety of epidemiological and diagnostic purposes. As noncomputational devices, computers are functioning as knowledgable medical teachers that interface with students who can query the system. In this mode, computers are sometimes used as consultants to clinicians who need information on technical topics. Noncomputational computers are also used to simulate the inferences of clinicians. Byproducts of these simulations are computer programs that become formal statements or theories of the decision processes under investigation.

Computer-Assisted Instruction↗
PubMed1995

Medical education and computer literacy: learning about, through, and with computers.

The call for medical students to become literate in the uses of information technology has become a familiar refrain. Over ten years ago, the Association of American Medical College's GPEP Report recommended that medical schools incorporate into their curricula training in the use of such technology; however, in the intervening decade, discouragingly little progress has been made toward meeting this goal, even though the need for such changes has grown more compelling. The author contends that teaching medical students to be computer-literate will not only enable them to use information technology competently, but will foster their capacity for "termless learning," which involves the ability to assess the adequacy of one's knowledge, to efficiently redress identified deficiencies, and to direct one's ongoing learning well in a rapidly changing world. He contends that by exposing medical students early in their training to the vast profusion of electronic information resources, medical educators can help produce a generation of practitioners who have a different orientation toward knowledge and learning. The author then assesses three different approaches to computer-literacy training: learning about computers, learning through computers (i.e., using computers as tools for instructional delivery), and learning with computers (i.e., requiring students to use computers in their work on a day-to-day basis). He concludes that none of the approaches is sufficient unto itself, but learning with computers offers the most powerful means of fostering the forms of termless learning that students will need to practice medicine in the future.

Computer Literacy↗