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A computer-based method of filing photographs and procedures.

Careful preoperative and postoperative photographs are an essential part of facial plastic surgery for medical and legal documentation, publication, patient education, and lectures. Computers play an increasing role in many aspects of the medical practice. A method of filing photographs and procedures and a related data base system allows rapid access by multiple factors, including name, procedure, age, surgeon, assistants, anesthetic, complications, dates of all photographs, multiple procedure subheadings, and so on. Additional variables can be added as a date base for analysis of operation results and postoperative recall of patients. This system is based on a personal computer (IBM-PC Computer) and readily available software. The system allow simple entry and retrieval of photographs on any of the multiple variables. We found it to be a superb adjunct to photography in facial plastic and reconstructive surgery.

Computers↗

Evaluation of clinical data in childhood asthma. Application of a computer file system.

A computer file system was used in our pediatric allergy clinic to assess the value of chest roentgenograms and hemoglobin determinations used in the examination of patients and to correlate exposure to pets and forced hot air with the severity of asthma. Among 889 children with asthma, 20.7% had abnormal chest roentgenographic findings, excluding hyperinflation and peribronchial thickening, and 0.7% had abnormal hemoglobin values. Environmental exposure to pets or forced hot air was not associated with increased severity of asthma, as assessed by five measures of outcome: number of medications administered, requirement for corticosteroids, frequency of clinic visits, frequency of emergency room visits, and frequency of hospitalizations.

Adolescent↗

FILELB: a data file structure for the analysis of physiological systems.

FILELB is a comprehensive library of subroutines for the storage, retrieval, location, inspection and entry of sequences of experimental and analytical data. The general purpose, highly organised data file structure implemented by FILELB is the core of our interactive computer package for the analysis of physiological systems.

Data Display↗

PNSCROLL, a software package for graphical interactive analysis of single channel patch clamp currents and other binary file records: under mouse control.

The PNSCROLL program has been specifically developed for interactively scrolling through binary data files under mouse control, in order to analyse single channel current records and printout, or plot, records and histograms of currents. PNSCROLL requires the use of a Microsoft Mouse and runs on an IBM or IBM-compatible microcomputer operating under MS DOS, ideally with 256K EGA or VGA graphics card and colour display. It will print on Epson dot matrix printers and plot records and histograms on HP plotters and LaserJet laser printers.

Computer Graphics↗

Digital/analog hybrid system for filing of endoscopic images.

A new system was developed for filing all the endoscopic images generated in our hospital. The system is composed of an on-line network for analog images supplied from the endoscopy stations and stored on 300 mm optical disks, on the one hand, and an off-line PACS for digital images recorded on a 130 mm magneto-optical disk (MOD) at each endoscopy station, on the other. For close examination of the images digital images are displayed from the MOD on a high-resolution computer graphic monitor, and for quick review of a large number of images, analog images are retrieved from the 300-mm optical disks. This system has been in clinical use at our university hospital for the past year and has proven useful for education of endoscopy, for the quality control of the endoscopy practice, and for the management of the patients.

Computer Systems↗

Investigation of misfiled cases in the PACS environment and a solution to prevent filing errors for chest radiographs.

RATIONALE AND OBJECTIVE: The aim of the study was to survey misfiled cases in a picture archiving and communication system environment at two hospitals and to demonstrate the potential usefulness of an automated patient recognition method for posteroanterior chest radiographs based on a template-matching technique designed to prevent filing errors. MATERIALS AND METHODS: We surveyed misfiled cases obtained from different modalities in one hospital for 25 months, and misfiled cases of chest radiographs in another hospital for 17 months. For investigating the usefulness of an automated patient recognition and identification method for chest radiographs, a prospective study has been completed in clinical settings at the latter hospital. RESULTS: The total numbers of misfiled cases for different modalities in one hospital and for chest radiographs in another hospital were 327 and 22, respectively. The misfiled cases in the two hospitals were mainly the result of human errors (eg, incorrect manual entries of patient information, incorrect usage of identification cards in which an identification card for the previous patient was used for the next patient's image acquisition). The prospective study indicated the usefulness of the computerized method for discovering misfiled cases with a high performance (ie, an 86.4% correct warning rate for different patients and 1.5% incorrect warning rate for the same patients). CONCLUSION: We confirmed the occurrence of misfiled cases in the two hospitals. The automated patient recognition and identification method for chest radiographs would be useful in preventing wrong images from being stored in the picture archiving and communication system environment.

Database Management Systems↗

Emergency medicine filing system.

The development of an organized filing system for referencing articles pertinent to emergency medicine is presented. This simple and flexible system allows for modification for the individual needs of the emergency physician.

Emergency Medicine↗

Techniques for locating, filing, and retrieving scientific information.

Guidelines for improving the effectiveness and efficiency of conducting a search of scientific literature are presented. Initial leads can be gained by contacting a local expert or consulting a textbook. An impression of advances being made in a particular field can be gained efficiently by scanning weekly issues of Current Contents, containing the tables of contents of most scientific journals. Recent review articles on most topics can usually be found listed in the Index Medicus. With at least one significant reference dealing with a specific topic of interest, the Science Citation Index may be used to identify articles published during a particular indexing period which cited the article as a reference. Practical guidelines are also presented for establishing a simple but comprehensive personal system for filing and retrieving on demand reprints, pamphlets, and notes.

Abstracting and Indexing↗

File management in a radiology department.

OBJECTIVE: The objective of this study was to assess the effectiveness of film management in a large urban teaching hospital. SUBJECTS AND METHODS: For 5 days in March 1998, individuals seeking access to imaging studies performed in the radiology department of a large urban hospital were questioned about their activities and were physically followed in an effort to characterize the efficiency and effectiveness of the department in servicing individuals not employed by the department. Activities in the department were recorded, and the times to visit completion and the failure rates were assessed. RESULTS: Of the 381 visitors to the department who were followed, 321 were hospital employees and 186 were physicians. The average total time spent in the department was 4 min, during which 2 min were spent viewing images or obtaining consultation. Physicians were in the department an average of only 7 min with 3 min for consultation and image viewing. During the 381 visits, we monitored 753 separate transactions, 693 of which were completed successfully. We found no instances in which a physician indicated that a patient's treatment would be delayed or altered because of film mismanagement and only one instance in which it was suggested that a study may have to be repeated. CONCLUSION: This study found a high level of efficiency and effectiveness in file room operations.

Filing↗

An application of an optical disk filing system to the management of medical records.

An optical disk filing system is a promising new method to memorize the contents of medical records. However, due to problems of image quality, input speed and durability with the disk, this has not yet been put to practical use. In the present study the image quality of the laser disk system installed in our hospital were checked, and this system was thought to be useful to store discharge summary. We developed discharge summary management system by inputting into the optical disks the discharge summary written freely by doctors and the discharge abstract automatically formed by computer.

Evaluation Studies as Topic↗

A literature filing system in obstetrics and gynecology.

Standard indexes and classification systems are frequently overly complicated and inappropriate for organizing copies of articles and reprints in a personal literature file. Based on an analysis of the tables of contents from 11 publications in the field of obstetrics and gynecology, a classification system has been developed. The system allows for individual needs in categorizing subspecialty interests and for new developments in the field.

Filing↗

[Filing and processing systems of ultrasonic images in personal computers].

The paper covers the software pattern for the ultrasonic image filing and processing system. The system records images on a computer display in real time or still, processes them by local filtration techniques, makes different measurements and stores the findings in the graphic database. It is stressed that the database should be implemented as a network version.

Computer Communication Networks↗

Personal medical reference files for family physicians.

Family practice has firmly accepted a leadership role in the establishment of practice indexing and control mechanisms for primary care practices and in the continuing education of primary care physicians. These independent programs logically interrelate if the International Classification of Health Problems in Primary Care (ICHPPC) mobidity coding index is adapted to the maintenance of personal reference and bibliographic files. The literature data base so developed then was direct and specific application to patient care situations, and to continuing education oriented around active case material, teaching, and research. Experience demonstrates a high degree of student responsiveness to such a reference resourse. Yet most receive no exposure to this basic tool throughout their entire medical school and specialty training. An inexpensive, simple system is proposed which can be expanded conveniently to any level of detail, cross-reference capability, and content. This has been found useful in teaching and practice and is well accepted by family medicine residents at the Geisinger Medical Center.

Abstracting and Indexing↗

[Record and preservation of ultrasound images and computer-assistant analysis--estimation of digital filing system and texture analysis].

Digital filing systems have advanced with computer technology and are among the most interesting modalities for recording and preserving ultrasound images. The benefits are reduced expense, superior imaging, and ease in searching previous records compared with those factors in conventional constant film, videotape, and other storage systems. Computer-assisted analysis of digital images for automatic differentiation of diseases has recently been studied. Conventional quantitative estimation methods of tissue characterization or histogram are not easy to apply to clinical studies because these methods are time-consuming, and require a specialized machine for this propose. We propose a new method of texture analysis of echo images. This new method depends on the echo-texture of the organ, and can clearly differentiate liver cirrhosis from normal liver. These new digital techniques for clinical studies may facilitate examination.

Diagnosis, Computer-Assisted↗

[Digital filing system for medical image data].

To establish practical, effective medical digital image filing systems, various problems remain to be solved. The authors focused on 2 such problems of great importance: image data compression and standard specifications for digital data storage. From a variety of image compression algorithms now available, 2D-Color Doppler image compression was clinically investigated using the Joint Photographic Expert Group (JPEG) method. In low grade compression, the images decompressed showed no significant alterations in image quality, however, in higher grades of compression attained through irreversible coding in the JPEG method, the images showed subtle but significant alterations: emergence of 2 kinds of artifact, i.e., borderline-artifact produced in the DCT procedures and pseudo color spots. The reproducibility of colors was found to be altered by changing the quantization table in the JPEG procedure. It was thought necessary to choose a proper quantization table and examine the DC coefficients (number of pixels) in the DCT procedure to attain practical 2D-Color Doppler image compression by the JPEG method. Although attempts in Japan are being made to establish common standards for electronic data storage, based on MEDIS, in an effort to promote standardization there are many problems to be solved before practical use is possible. To ensure common availability as required by the technical standards, it is necessary to organize minimum-required specifications into common standards and make them open to the public.

Algorithms↗

A teaching file, using 10 X 10 cm format copies.

A teaching file is of paramount importance for a teaching department. It should be easily accessible and readily available. Considerations of costs and available space influence the choice of film size for the copies. We have chosen for 10 X 10 cm copies, because the majority can be viewed by individuals on normal lightboxes, while for larger audiences various ways of projection are feasible. The possibility, offered by the Delcomat copying apparatus, of making copies of interesting parts of the original film in varying degrees of reduction in size, enhances the practicability of the method.

Filing↗

Quantitative regional contraction analysis of cineventriculography: reporting, filing, and retrieval functions using a personal computer.

A new method for the semiobjective evaluation of left ventricular wall contraction is proposed that uses a percent reduction of areas. The calculation model uses orthogonal coordinates, an internal reference system, and the concept of nonuniform reduction of the cavity, with its obliteration at the apex. From a normal patient population (ten males, four females; aged 45 +/- 13 years), a "normal reference curve" of contraction was obtained. A second patient group (56 males, two females, aged 56 +/- 7 years) with definite contraction abnormalities was then analyzed. A third group (eight males, one female, aged 56 +/- 10 years) was studied before and after nifedipine administration (1 mg over 2 min IV). Specific algorithms compare individual patient contraction curves with the normal reference curve and compute the score point system of contraction analysis. Data are automatically codified and filed during introduction. This saves time and allows a rapid retrieval of data grouped under different coded features. These features include the location and type of wall contraction abnormalities. This method of reading ventriculograms has been shown to be in accordance with the diagnosis of experienced observers and can detect small contraction changes that are induced pharmacologically. The method is proposed as a valuable tool for semiobjective evaluation of left ventricle wall contraction and to facilitate data collection in multicenter collaborative studies.

Algorithms↗