[The physician and the computer. 23. Graphics methods. II].
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The PC is and will remain a basic instrument in the laboratory arsenal in the next few years. The key role of the IBM PC and its clones prompted us to develop a universal multifunctional I/O board (UNIMUL) for this computer. The board will make it possible to use the IBM PC for a wide range of tasks from a simple interface for laboratory processing of data to complex IBM PC-based instruments, e.g. a stimulator, signal analyzer, chart recorder. The present article summarizes the experience gathered during the design and application of the described I/O board in more than 10 different IBM PC-based laboratory and clinical systems listed in the Appendix. An example of the application of the I/O board is presented in the conclusion of this report together with the discussion of the future role of new Application-Specific Integration Circuits (ASICs) and single chip processors in this domain.
Even though the problem of collecting and processing information is of paramount importance in any radiology department, the choice of the best information system--as for organization and effectiveness--largely depends on specific and different local situations and is therefore still largely debated. In the ULSS 18 in Veneto (Dolo, Venezia), all patients are referred to the only existing hospital radiology. Therefore, a central computer system has been be realized and used also by the radiology department, for completely computed procedures, since January 1, 1988. We describe the computer configuration of both the ULSS and the radiology department and report on our 5-year experience with full computerization within a central information system. As for department organization, any information system--with appropriate hardware and software--can be equivalent to others, since it largely contributes to both management (programming, booking, filing, accounting) and reporting (automatic reporting with memorized texts and/or voice recognition; reprinting; immediate correction at the video-terminal). Thanks to more rational exploitation of human and technological resources, any information system makes a radiology department more functional and efficient. However, some peculiarities of the central computer system must be stressed, as they allow: 1) to use pre-existing and updated patients files (unequivocal identification in the whole ULSS); 2) to gain access to the databanks of different specialties and to patients' clinical histories (complete data collected from many sources); 3) to intervene in booking and ticket collection centers with none of the relative loads; 4) to have no limits of memory, storage or speed for complex programs (automatic reporting also with the recognition of the dictating voice, accounting and statistical analyses, ecc.); 5) to profit by continually updated and fitted hardware and software, with the relative expenses and benefits shared by the whole ULSS. Within the possibilities given by a double role-ruled password, all different menus and programs are accessible from any video-terminal, even while other programs are running, thus allowing cost-effective hardware to be available in the radiology department.
Computers, these days, are almost smaller than a bread box. They sit unobtrusively atop a desk, silently awaiting the next command. And yet, for such a small package, these microelectronic-based, information-processing devices have profoundly affected mankind in the second half of the 20th century. Computer technology has radically altered how -- and how fast -- the world changes.
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The unified Medical Language System (UMLS) project provides resources on an experimental basis to the research community. In 1995 the four UMLS Knowledge Sources have been provided in an additional data format, Abstract Syntax Notation One (ASN.1). The benefits of ASN.1 are that it provides a standard, formal grammar for complex data and allows exchange of that data in a way which is independent of the particular software and hardware environment in which the data are created and stored. The paper begins with an introduction to the ASN.1 standard itself. It continues with a discussion of the ASN.1 implementation of the UMLS Knowledge Sources and some of the consequences for the newly released UMLS Knowledge Source Server. It concludes with a discussion of some of the benefits of using ASN.1 encoded data.
By building a medical conceptual model inside the galen project, a methodology has been defined to deal with both operative goals and deep and unsolved problems about knowledge. This knowledge sharing oriented approach exploits existing medical coding systems such as knowledge sources and enables us to represent their concepts in a wider cognitive context referring to ontological theories. The tasks of cognitive ergonomy, quasi-naturalness of language, versatility, and flexibility seem to be supported through some functions, such as viewpoint, context, and sign, which act as spin-off points to knowledge or information which is not modeled.
A universal soft-art complex tentatively named Arm-Stomatolog, covering all sections of dentistry, has been developed. It is based on individual programs in dentistry, making use of high-level algorithmic languages fitted to modern operation systems and permitting block-to-block fitting of individual programs to unite them in a complex.
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With such a wide array of computational tools to solve inference problems, andrologists and their mathematical or statistical collaborators face perhaps bewildering choices. It is tempting to criticize a method with which one is unfamiliar for its apparent complexity. Yet, many methods are quite elegant; neural computation uses nature's own best biological classifier, for example, and genetic algorithms apply rules of natural selection. Computer scientists will likely find no one single best inference engine to solve all classification problems. Rather, the modeler should choose the most appropriate computational tool based on the specific nature of a problem. If the problem can be separated into obvious components, a Markov chain may be useful. If the andrologist would like to encode a well-known clinical algorithm into the computer, the programmer may use an expert system. Once a modeler builds an inference engine, that engine is not truly useful until other andrologists use it to make inferences with their own data. Because a wide variety of computer hardware and software exists, it is a significant endeavor to translate, or "port," software designed and built on one machine to many other different computers. Fortunately, the World Wide Web offers a means by which computational tools may be made directly available to multiple users on many different systems, or "platforms." The World Wide Web refers to a standardization of information traffic on the global computer network, the Internet. The Internet is simply the linkage of many computers worldwide by computer operators who have chosen to allow other users access to their systems. Because many different types of computers exist, until recently only communication in very rudimentary form, such as text, or between select compatible machines, was available. Within the last half-decade, computer scientists and operators began to use standard means of communication between computers. Interpreters of these standard languages, such as Mosaic and Netscape, are now widely available, and they allow the casual user to access the most sophisticated multimedia aspects of computer information on a variety of different systems. Andrologists may thus use the World Wide Web to make inference engines that they have programmed available to other clinicians and researchers. For example, we programmed a World Wide Web interface to the neural networks that we trained in order to solve a number of andrology classification problems. Interested users connect to our address (at this writing http:@godot.urol.uic.edu), and they may fill out electronic forms with their own patient data, press a "predict" button, and nearly immediately view the results of our neural networks' prediction on their own computers. With the explosion in computer hardware technology, mathematics and computer science that once seemed esoteric can now be investigated on computers available to nearly all andrologists. Rapid advances in computer network technology now render a tool developed by one andrologist immediately available to many. Clearly, andrologists may expect that computational investigations in their field will be a productive ground in the near and far future.
Over the past 20 years, computer simulation has become an invaluable third leg of research in the physical sciences, adding to the traditional tools of theoretical studies and experimental observation. Simulation can give far more accurate pictures than can be provided by theoretical analysis, and show processes that are difficult to observe in detail. Recently, this invaluable tool has been successfully applied to medicine, where the systems tend to be more complex, requiring more computer power. The results are likely to be as far reaching as they have been in physics and chemistry.