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[Computers in emergency medicine].

Computer's applications in emergency medicine are reviewed. In the Emergency Health Care computer science provides support to the solution of medical problems (with diagnostic and medical decision making softwares) and to the management of emergency departments. Computer interfaced to instrumental equipments allows the monitoring of biomedical signals and their transmission at distance. Finally, the possibilities of computer-aided instruction are presented. Teaching methods such as the tutor-system and the simulation are discussed.

Computer-Assisted Instruction↗
PubMed1990

[Computer and acid-base disorders].

The diagnosis of acid-base disorders has been subject to computerised analysis for many years. Expert systems, an application of artificial intelligence, have been validated. They are of help to clinical decision making, enabling the different diagnostic possibilities of given acid-base and hydro-electrolytic situations to be evaluated and appropriate therapy to be instituted. Computer networks improve the transmission of laboratory results to the intensive care units and the integration of data facilitates the monitoring of biochemical tendencies. Computers can also be used for teaching acid-base physiology and pathology.

Acid-Base Imbalance↗
PubMed1990

Computer applications in orthopaedics.

With the rapid developments in microprocessors, the widespread availability of computers has brought about broad applications in the field of orthopaedics. The present technology enables large quantities of data to be logically processed in a very short span of time. This has led to the development of information management database systems where relevant medical information may be retrieved very quickly and effectively. The analytical power of the computer has also been utilised in expert systems to assist in clinical-decision making process. Computer graphics have revolutionised the visualisation of physical features of internal and external body parts, providing new and improved modalities of diagnosis. In some centres, surgical planning and rehearsals are already being carried out at the computer terminal with the use of animation and computer graphics. Computer technology has also played an active role in the field of prosthetics and rehabilitation. Intelligent robotic systems and microprocessor with functional neuromuscular stimulation have been applied to benefit, and in some cases restore some motor functions to the physically disabled. With more collaboration between engineers, scientists and the medical community, several prototypes of computer-controlled prostheses and prosthesis designed and manufactured by Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) technology are available today to assist the amputees in their daily living and ambulatory activities.

Computer Graphics↗
PubMed1990

[Development and clinical application of an expert system for supporting diagnosis of 201Tl stress myocardial SPECT].

A consultation expert system which supports our computer aided reporting system was developed. The system was used for the evaluation of the two dimensional polar (bull's eye) display of 201Tl myocardial SPECT. The system consists of patients management (PM) and consultation expert systems (ES). The former is connected to image processors coupled with scinticameras. The bull's eye display of myocardial SPECT is transferred from image processor to the data base of PM. When inference request is made, the feature extraction program extracts information on localization, extent and severity of focal defects comparing count-rates pixel by pixel with the reference obtained from seven normal controls. The inference engine is activated to determine presence of focal defects utilizing diagnostic rules in the knowledge base. The results are sent back to PM and reported with the probability of assurance. Fifty eight patients with old myocardial infarction (OMI), angina pectoris (AP) and other diseases as well as normal controls were included in the study. The decision for presence or absence of focal defects by ES agreed with that by nuclear physicians (NP) in 301 segments among 330 (91%) in stress images. The presence of redistribution in delayed images agreed in 43 segments among 67 (64%). Image interpretation by ES agreed well with that of NP in patients with OMI (19/20) and AP (9/11). Seven were interpreted as normal by both ES and NP. The system is useful, as it provides NP with complementary and supportive information applicable to decision making and reporting. Further clinical experiences can improve knowledge base for better ES function.

Computer Systems↗
PubMed1989

Construction of the diagnostic encyclopedia workstation. Computerizing pathology for the pathologist.

The combination of a personal computer and a laser-vision disc player is an adroit tool for storing and retrieving textual information in combination with pictorial information. This paper describes such a system (a "diagnostic encyclopedia workstation"), which provides information to the pathologist engaged in daily diagnostic practice. The system contains a considerable amount of descriptive textual information that might be useful in making diagnoses in histopathology, along with many illustrations; the text is presented in a natural language (English). The descriptive information is divided into 18 categories, including such topics as histology, macroscopy, immunopathology and clinical data; each topic has a separate display in the system. Also present are two types of "decision rules" for making diagnoses (confirmative criteria for a diagnosis under consideration and exclusive criteria for many other diagnoses) and a classifying structure. The present version of this system contains information on about 100 diagnoses in ovarian pathology, illustrated with about 3,000 color slides from about 140 cases. The information and pictures are immediately available. Further characteristics of this system are its flexibility, accessibility and user friendliness; it has been structured so that components of artificial intelligence may be added later.

Artificial Intelligence↗
PubMed1989

Iliad: moving medical decision-making into new frontiers.

If the essence of clinical practice is a process of sequential problem-solving, whereby a physician works with a patient to formulate a series of decisions about diagnostic treatment, then it would naturally follow that the essence of medical education should evolve around the training of would-be clinicians in the difficult art of diagnostic decision-making. Yet this is not often the case.

Clinical Clerkship↗
PubMed1987

[An aid in decision-making in hematology: characteristics and performances of the program. 200 cases of anemia].

An aid to decision programme has been applied to 200 cases of anaemia. Evaluation by the bayesian method rested on clinical data (age, sex, race) and laboratory data (blood count and differential, erythrocyte morphology). An accurate diagnosis was made initially in 107 cases, and for the first 5 diseases in 173 cases. The programme proved more effective than two clinicians recently trained in haematology. Devised for micro-computers, it can be used in routine practice and for teaching purposes.

Anemia↗
PubMed1985

[Presentation of a system for computer-aided decision in diabetes therapeutics].

This paper presents Sphinx, an expert system for computer-aided diagnosis in diabetes therapeutic. This interactive program makes logic deductions, comprehensible for users and it is not necessary for them to know artificial intelligence methodology. An improvement of the first results is possible and necessary, but the reliability of the advice already expressed by the system makes it useful as a future physician's implement.

Computers↗
PubMed1985

The microcomputer in the dental office: a new diagnostic aid.

The first computer applications in the dental office were based upon standard accountancy procedures. Recently, more and more computer applications have become available to meet the specific requirements of dental practice. This implies not only business procedures, but also facilities to store patient records in the system and retrieve them easily. Another development concerns the automatic calculation of diagnostic data such as those provided in cephalometric analysis. Furthermore, growth and surgical results in the craniofacial area can be predicted by computerized extrapolation. Computers have been useful in obtaining the patient's anamnestic data objectively and for the making of decisions based on such data. Computer-aided instruction systems have been developed for undergraduate students to bridge the gap between textbook and patient interaction without the risks inherent in the latter. Radiology will undergo substantial changes as a result of the application of electronic imaging devices instead of the conventional radiographic films. Computer-assisted electronic imaging will enable image processing, image enhancement, pattern recognition and data transmission for consultation and storage purposes. Image processing techniques will increase image quality whilst still allowing low-dose systems. Standardization of software and system configuration and the development of 'user friendly' programs is the major concern for the near future.

Computer-Assisted Instruction↗
PubMed1984

Computer-aided diagnosis of acute abdominal pain. The British experience.

This presentation reviews the U.K. experience of computer-aided diagnosis of acute abdominal pain--which now relates to over 30,000 cases seen in more than 10 hospitals during a 13 years period. Following a discussion of the philosophy, construction and mode of usage of the systems employed, results of this experience are presented. Computer-aided diagnosis in this area has been shown to be feasible and (if correctly utilised) leads to improvements in patient care, diagnosis, and decision making by the doctors involved. In this context, the computer is simply one element of an integrated package reaffirming the importance of traditional clinical medicine.

Abdomen↗
PubMed1984

[Perspectives in the use of computers in anesthesia].

The remarkable development of computer technology and the early experiments into its clinical use give us cause ot define useful spheres of application and task areas in anaesthesia for this valuable machine. Parallel to this followed the development of computer use in anaesthesia. Here, there are essentially four main areas of application: administration of data, monitoring, teaching, process of decision making. Next to a quite uniform definition of the task areas of a computer, the question of the selection of the suitable computer for the respective requirement cannot be answered in the same uniform way. For the application of computer technology in the practice of anesthesiology it is essential to guarantee not only sufficient safety of data but also a protection from misuse and manipulation. On the whole it is probable that computer technology will take over more and more medical technical tasks especially of the anaesthesia apparatus and evaluate them. An automatic registration of records with combined off-line and on-line recording of measured values represents the logical development of this technology.

Anesthesia↗