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Evaluating the computer systems available to veterinarians involves examining the practice itself and its needs; the veterinarian and staff and their willingness to integrate different system types into the practice; and the systems and the vendors of those systems. This article gives guidelines to follow in all of these areas.
Computer systematized radiotherapy is useful for; The use of diagnostic images for treatment planning; The accuracy of dose distribution; The automatic control of therapy machine; The statistical analysis of patients' documentation. Computer use for radiotherapy has been worked since 1969 in Japan. Radiotherapy documentation should be carried out to be able to judge the effect of the treatment given. A large number of patients are required to obtain a good judgement. Standardization of radiotherapy patient registration and data analysis of the treatment results co-related with radiation injury are described.
We have developed computer software to store data on all surgical and obstetrical anesthetics administered by our department. The computer system provides information for monitoring the residency training program, department and operating room management, professional fee billing, and research. It imposes little additional workload on our clinical personnel, who use simple codes to record the necessary data directly on the anesthetic record. Department secretarial staff transcribe data from the anesthesia and operating room records into the computer file, which is then available for producing scheduled reports and for answering inquiries from a video terminal. The system employs extensive manual and computer verification to minimize errors and omissions in the data. We report design details and more than 3.5 years experience with this system, which is now used at four affiliated teaching hospitals, has over 50,000 cases on file, and adds more than 1800 cases monthly.
An analysis of computer requirements in radiation therapy departments is presented. The performance and structure of an effective computer system designed for large or small radiotherapy departments are described. The system is composed of two or three sets of minicomputer-based subsystems of which can be operated alone or connected to other subsystems. The size of the system can be adjusted to the size of the radiotherapy department. The system covers treatment planning, automatic control, and record processing.
We describe a comprehensive computer system, GENEUS, for extensive DNA, RNA and protein sequence analysis. The analysis system is developed for the DEC VAX/VMS computer and uses the EMBL Nucleic Acid Sequence Data Library. Help information is available on-line on terminal screen. To speed up system handling, a qualifier oriented user communication is employed. All results are stored on files making them accessible to the computer editor. An information retrieval system for the EMBL Nucleotide Sequence Data Library is also described. A defined data-base interface allows connection to other analysis programs.+
This article reviews the issues involved in introducing or upgrading computer automation in the clinical laboratory. The strengths and weaknesses of computers and computer systems are discussed. Information on selecting and educating the laboratory team who will use the computer and analyzing the needs of a particular laboratory is included.
An on-line computer system was developed for issuing histopathology reports as part of an integrated hospital information system. Input is through a Cossor visual display unit with a typewriter keyboard to a Univac 418 III computer. Stored information is available to authorised hospital staff via similar visual display units located in the wards and laboratories. Existing programs and computer staff were used to provide the new service. It has resulted in better method, speedier communication, and saving of laboratory staff time. The system has yet to be fully tested but initial reactions are favourable and indicate that the investment in computer staff time and extra laboratory equipment will be cost effective.
A longitudinal study is being conducted of a clinical laboratory computer information system's impact. This paper reports on effects that laboratory directors anticipated prior to installation, and effects reported by laboratory technologists 7 months postimplementation. Primary changes caused by the computer system were increases in the amount of paper work performed by technologists, and improvements in laboratory results reporting. The system generally was well accepted, but laboratory technologists differed in their responses to it. Technologists in some laboratories focused on work increases, whereas in other laboratories they emphasized improved information flow. The paper considers how changes in processes and outcomes of work might affect responses to a computer system. It also considers the implementation process, and suggests some areas where management could benefit from an improved understanding of responses to a computer information system.
An experimental computer-based bibliographic retrieval system has been implemented to explore how semantic (conceptual) relationships between MeSH terms might assist the retrieval process. To construct the experimental system's database, lists of abstracts were produced using MEDLINE. Each list contained papers discussing a specified pair of terms. Each abstract was then analyzed to determine the specific relationship(s) between the two terms discussed in that paper. The project then explored how these semantic relationships could be incorporated into the computer to enhance bibliographic retrieval.
To improve the off-line data processing a personal-computer-system was set up, including a HP-85A desk-computer with a dual-disc-drive, a plotter, a printer and a digitizer (graphical tablet). The application of the personal-computer-system is focused on the work up of medical reports and records, transformation of physiologic data into graphics (ergometric stress testing, myocardial function curve, lung mechanics) and on speeding up the flow and distribution of information. Further applications include a literature storage and retrieving system, the quantitative analysis of left ventricular wall motion by two dimensional echocardiography and a graphic aided system for medical statistics. Hopefully the data processing at a cardio-pulmonary function laboratory will lead to a better definition of diseased states in quantitative terms and by this support the rational basis for medical intervention. Slow communication of medical information is a critical factor in the practice of high quality medical care (cost/efficiency).
A computer system for handling data collected from antibiotic sensitivity testing of clinical bacterial isolates is described. The system allows a rapid handling of the information collected, supplying the ward and laboratory with cummulative data on each patient. The bacteriologist and the clinician are thus suitably armed when creating a rational antibiotic therapy.
Description of an original miniature computer system capable of recording biomechanical parameters during locomotion, providing auditory signals which can be used in biofeedback locomotor learning, and triggering functional electrical stimulation of nerves and muscles at preselected moments in the locomotor cycle. The system, which is worn on the patient's back, is connected to appropriate gauges with which it is possible to measure knee angle and to record the time of heel contact with the ground. The relevant data are stored in the system memory and can be transferred to a microcassette and later displayed as a function of time on a video screen or printed on paper. The same data can be used on-line to provide a patient with a sound signal as a basis for biofeedback training. This kind of training has been successfully used to correct knee hyperextension during locomotion in hemiplegic patients. The system can also be used to trigger a stimulator and thus constitutes a valuable tool for investigations and treatments involving functional electrical stimulation. Many other applications may be developed, both in basic research and in various fields where motor training is required.
Using the commercially available shell programs NeuroShell and EXSYS, example-based and rule-based expert computer systems were developed to explore how such systems could be applied in an optometric environment. To demonstrate such an application, the example-based NeuroShell system was taught to prescribe sphere and cylinder powers for low refractive error myopes. When the system learned with only the chief complaint, habitual prescription and acuity through the habitual, and best refraction with resulting acuity, it predicted the sphere and cylinder powers prescribed by human optometrists within 0.25 diopter 97 and 98 percent of the time, respectively, for 60 test eyes. With a set of only three rules, the rule-based EXSYS system predicted sphere powers within 0.25 diopter of the prescribed powers for 100 percent of the 60 test eyes. Results with these very simple refractive problems suggest that teaching expert computer systems to prescribe ophthalmic lens corrections is possible, and further suggest that the concept could be extended to more complex and challenging patient populations.
The Clinical Laboratory Computer System currently in use at the Medical University of South Carolina is described. Not only is the existing hardware listed and shown in some detail, but also the workload, laboratory data center personnel, typical procedures, and examples of selected input and output documents are included. Particular emphasis is placed on the dynamic nature of the system, which allows the user to proceed easily in developing new programs as the requirements of the laboratory continue to change and grow. To illustrate this point, programs written by the user are described in general terms.
We present a computer system for obstetrical and perinatological data collection. All deliveries of the years 1984, 1985, and 1986 have been collected with this data collection program, so that there is how a data base containing 7,975 data records. A relational data base was chosen for data collection and storage. Either off-line or on-line data collection is possible by medical users via menu monitoring. Various possibilities of use are described.
The possibilities of application of the "Hepar" computer system in medical didactics are discussed. The usefulness of hepatological diagnosis assistance with information++ systems is described and the multistage schema of diagnostic management is presented. In the conclusions the advantages of this system in medicine teaching is stressed and its usefulness in clinical practice is outlined.
A pharmacy-based computer system for monitoring and reporting drug interactions is described, and physicians' responses to patient management suggestions generated by the system are reported. Using information from a commercially available drug-interaction database, a pharmacist chose 41 potentially interacting drug combinations to include in the pharmacy's automated system. A warning notice appears on the computer screen if one of these drug combinations is prescribed. Pharmacists who encounter these notices while entering medication orders telephone the prescribing physician if the combination represents a Class I interaction (immediate onset, major severity, established documentation); for Class II interactions, which have a delayed onset, a copy of the warning notice and suggestions for patient management are placed in the prescribing physician's mailbox. The system was evaluated during a three-month period in 1985 to determine physicians' responses to the patient management suggestions. A total of 927 patients had 1004 potentially interacting drug combinations prescribed for them. Changes in drug dosage were made in 44% of these instances, and in 75%, patients were monitored for the development of adverse clinical effects. A computerized drug-interaction monitoring system can help increase physicians' awareness of possibly interacting drug combinations and provide them with useful information about the clinical management of patients for whom such drug combinations have been prescribed.
A personal computer system for electrocardiogram (ECG) ST-segment recognition is developed based on neural networks. The system consists of a preprocessor, neural networks and a recogniser. The adaptive resonance theory (ART) is employed to implement the neural networks in the system, which self-organise in response to the input ECG. Competitive and co-operative interaction among neurons in the neural networks makes the system robust to noise. The preprocessor detects the R points and divides the ECG into cardiac cycles. Each cardiac cycle is fed into the neural networks. The neural networks then address the approximate locations of the J point and the onset of the T-wave (T(on)). The recogniser determines the respective ranges in which the J and T(on) points lie, based on the locations addressed. Within those ranges, the recogniser finds the exact locations of the J and T(on) points either by a change in the sign of the slope of the ECG, a zero slope or a significant change in the slope. The ST-segment is thus recognised as the portion of the ECG between the J and T(on) points. Finally, the appropriateness of the length of the ST-segment is evaluated by an evaluation rule. As the process goes on, the neural networks self-organise and learn the characteristics of the ECG patterns which vary with each patient.(ABSTRACT TRUNCATED AT 250 WORDS)