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The accuracy of skin lesion description by 24 general practitioners was assessed as they used a computer diagnosis assistance system (DERMIS). Descriptive accuracy determines the quality of advice. Only four doctors showed a trend to accurate description over 25 hospital referrals.
A new generation of computer programs for dental patient management eliminates total dependence on the vendor for programming support. The software design enables information collected with the dental system to be transferred to popular off-the-shelf programs designed for business. A simplified example is used to illustrate for practitioners the advantages of this type of data structure management. Programs designed on this basis offer optimum performance and expandibility for both present and future needs.
A new generation of computer programs for dental patient management eliminates total dependence on the vendor for programming support. The software design enables information collected with the dental system to be transferred to popular off-the-shelf programs designed for business. A simplified example is used to illustrate the practitioners the advantages of this type of data structure management. Programs designed on this basis offer optimum performance and expandability for both present and future needs.
A new program, BlockSearch, is described that allows biologists to search protein sequences against the BLOCKS database of aligned protein blocks by converting these blocks to site-specific scoring matrices. It thus complements existing tools for standard similarity searches and pattern searches which aid in elucidating the function of newly determined protein-coding sequences. The speed of the program and the existence of a command-line interface render BlockSearch particularly interesting for the batch analysis of many new sequences, such as collections of expressed sequence tags. Although written primarily for Digital's Alpha and VAX systems, the code is easily portable to other platforms.
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OBJECTIVE: Treatment of patients with diabetes often falls short of recommended process and outcome guidelines. To improve the quality of the provided diabetes care, a program (the Comprehensive Diabetes Care Service [CDCS]) using a computerizing tracking and recall system in conjunction with nurses following protocols was implemented in a managed care setting. The impact of this program was studied and compared to the care provided to patients in another managed care setting. RESEARCH DESIGN AND METHODS: Patients followed in the CDCS who completed a diabetes education course were compared with patients followed in a group model health maintenance organization (GMH) who also completed a diabetes education course. CDCS patients received routine care in the program. GMH patients came to the CDCS yearly to have a diabetes evaluation. A chart review was also performed on their GMH outpatient records. RESULTS: Initial HbA1c levels were higher in the CDCS group than in the GMH group (median of 11.9 vs. 10.0%). In the CDCS patients, HbA1c levels not only fell significantly but were also significantly lower (P < 0.05) than in the GMH patients during the 2nd and 3rd year of follow-up care. There were no significant changes in HbA1c levels in the GMH patients. When CDCS patients were divided into compliant and noncompliant patients, the median HbA1c levels in compliant patients was 8.2%, compared with 11.5% in the noncompliant group. The CDCS patients who needed treatment for hypercholesterolemia were more likely to have a lowering of their cholesterol levels than the GMH patients. All process measures, such as yearly measurement of HbA1c levels, lipid levels, and foot and retinal exams, occurred much more frequently in the CDCS patients. CONCLUSIONS: The system developed and implemented for managing diabetes improved both outcome and process measures. The comparison group, followed at another managed care setting, received the care consistent with the average (suboptimal) quality of care provided to patients with diabetes in the U.S. Therefore, by using innovative systems of management, the treatment of patients with diabetes can be greatly improved.
This paper presents a system for reconstructing a four-dimensional (4D) heart-beating image from transesophageal echocardiographic (TEE) data acquired with a rotational approach. The system consists of the necessary processing modules for two-dimensional (2D) echocardiogram reformation and 3D/4D-image reconstruction. These include the modules of image decoding, image re-coordinating, and three-dimensional (3D) volume rendering. The system is implemented under PC platform with Windows 95 operating system (with Intel Pentium-166 CPU, 64 MB RAM on board, and 2.0 GB hard disk capacity). It takes 6 min to reconstruct a 4D echocardiographic data set. The resultant 2D/3D/4D echocardiographic image provide the tools for investigating the phenomenon of heart beating, exploring the heart structure, and reformatting the 2D echocardiograms in an arbitrary plane. The functions provided by the system can be applied for further studies, such as 3D cardiac shape analysis, cardiac function measurement, and so forth.
Rapid review, digital recording, on-line quantification, and three-dimensional reconstruction are all essential in the evaluation of intracoronary ultrasound images during coronary interventions. We describe a low-cost method that offers all these necessary features. The proposed method uses the QuickTime compatible video digitizers of standard multimedia Apple Macintosh or PowerPC desktop computers and the freeware software Object Image 1.60.
A technique is described which utilises the full analysis and display capabilities of a commercial MRI system to produce digital maps of multi-parameter functions produced by MR contrast theory. The technique is utilised to determine the effects of nominating specific overall scan times on the optimum solutions as produced by the theory and it is shown that different solutions are obtained when the theory is applied using typical clinical constraints. The digital mapping approach is potentially of great value in prospectively determining pulse timing parameters to produce optimum contrast images, in producing contrast maps to aid retrospective image interpretation, and as a training aid for clinicians inexperienced in the interpretation MR images.
The potential of a commercially-available nuclear medicine computer, with a digital video interface, supplied by its manufacturers, for digital fluoroscopy is described. In the absence of universally accepted standards against which the performance of digital fluoroscopy systems may be judged, the parameters included in the description of this system included linearity, uniformity, signal-to-noise ratio, matrix size at given frame rates and study sizes. In addition some examples of clinical studies involving subtraction are presented.
With the advent of extremely rapid, powerful, compact, and inexpensive microcomputers, a revolution in data manipulation is ongoing. We have customized and used for over two years prepackaged software to track residents' operative experiences in the Department of Otolaryngology at Jefferson Medical College of Thomas Jefferson University, Philadelphia. An attempt is presently being made to develop a similar system that might be utilized by all otolaryngology teaching programs and thus enable the collection and review of residents' operative experiences nationally. A basic, relational database system is proposed for entering resident caseload data and generating reports for periodic review.
Little research has been conducted on the nature and impact of system downtime. Downtime may have a major impact both on patient care and on operating costs. We examined different system components that contributed to downtime of an emergency department information system and characterized the frequency and length of these downtimes during a period of four months.
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Under a subcontract with UCLA the Planning Research Corporation has changed the MEDLARS system to make it possible to use the IBM 7094/7040 direct-couple computer instead of the Honeywell 800 for demand searches. The major tasks were the rewriting of the programs in COBOL and copying of the stored information on the narrower tapes that IBM computers require. (In the future NLM will copy the tapes for IBM computer users.) The differences in the software required by the two computers are noted. Major and costly revisions would be needed to adapt the large MEDLARS system to the smaller IBM 1401 and 1410 computers. In general, MEDLARS is transferrable to other computers of the IBM 7000 class, the new IBM 360, and those of like size, such as the CDC 1604 or UNIVAC 1108, although additional changes are necessary. Potential future improvements are suggested.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.