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PubMed2002

Public use of automated external defibrillators.

BACKGROUND: Automated external defibrillators save lives when they are used by designated personnel in certain public settings. We performed a two-year prospective study at three Chicago airports to assess whether random bystanders witnessing out-of-hospital cardiac arrests would retrieve and successfully use automated external defibrillators. METHODS: Defibrillators were installed a brisk 60-to-90-second walk apart throughout passenger terminals at O'Hare, Midway, and Meigs Field airports, which together serve more than 100 million passengers per year. The use of defibrillators was promoted by public-service videos in waiting areas, pamphlets, and reports in the media. We assessed the time from notification of the dispatchers to defibrillation, survival rate at 72 hours and at one year among persons with cardiac arrest, their neurologic status, and the characteristics of rescuers. RESULTS: Over a two-year period, 21 persons had nontraumatic cardiac arrest, 18 of whom had ventricular fibrillation. With two exceptions, defibrillator operators were good Samaritans, acting voluntarily. In the case of four patients with ventricular fibrillation, defibrillators were neither nearby nor used within five minutes, and none of these patients survived. Three others remained in fibrillation and eventually died, despite the rapid use of a defibrillator (within five minutes). Eleven patients with ventricular fibrillation were successfully resuscitated, including eight who regained consciousness before hospital admission. No shock was delivered in four cases of suspected cardiac arrest, and the device correctly indicated that the problem was not due to ventricular fibrillation. The rescuers of 6 of the 11 successfully resuscitated patients had no training or experience in the use of automated defibrillators, although 3 had medical degrees. Ten of the 18 patients with ventricular fibrillation were alive and neurologically intact at one year. CONCLUSIONS: Automated external defibrillators deployed in readily accessible, well-marked public areas in Chicago airports were used effectively to assist patients with cardiac arrest. In the cases of survivors, most of the users had no duty to act and no prior training in the use of these devices.

Aged↗

PubMedDate not supplied

Accuracy of the automated assessment of left ventricular function with gated perfusion SPECT in the presence of perfusion defects and left ventricular dysfunction: correlation with equilibrium radionuclide ventriculography and echocardiography.

BACKGROUND: Gated single photon emission computed tomography (SPECT) with automated methods allows the quantitative assessment of left ventricular function and perfusion; however, its accuracy must be defined for patients with large earlier infarctions and severe rest perfusion defects, in whom the estimation of endocardial and epicardial borders might be more difficult, even with automated edge-detection techniques. METHODS AND RESULTS: We prospectively compared the automated measurements of left ventricular ejection fraction (LVEF) and volumes from rest-injected gated Technetium 99m (Tc99m) perfusion SPECT with equilibrium radionuclide angiocardiography (ERNA) in 62 patients and the assessment of regional function with echocardiography in 22 patients. Forty-six patients had an earlier myocardial infarction (mean defect size, 34% of left ventricle; SD, 12.7%; range, 8% to 56%); 27 patients had large defects (> or = 20% of left ventricle; LVEF range, 8% to 75%). LVEF, as determined with Cedars-Sinai software (quantitative gated SPECT), correlated well with ERNA (r = 0.941; y = 1.003x + 1.15; P<.0001; SE of the estimate = 6.3%; mean difference -1.3% for LVEF) in the entire study population and in the subgroups of patients with an earlier infarction, severe defects, and large infarctions (> or = 20% of the left ventricle). A correlation existed between gated SPECT and ERNA volumes (r = 0.882, y = 1.040x - 14.7, P<.0001 for end-diastolic volume; r = 0.954, y = 1.147x - 13.9, P<.0001 for end-systolic volumes with the count-ratio technique), but with wider limits of agreement. The exact segmental score agreement between gated SPECT and echocardiography for regional function was 79.8% (281 of 352, kappa = 0.682). CONCLUSIONS: Automated gated SPECT provides an accurate assessment of ejection fraction and regional function, even in the presence of an earlier myocardial infarction with large perfusion defects and significant left ventricular dysfunction.

Echocardiography↗

PubMed2003

Evaluation of aortoiliac aneurysm before endovascular repair: comparison of contrast-enhanced magnetic resonance angiography with multidetector row computed tomographic angiography with an automated analysis software tool.

PURPOSE: The purpose of this study was to assess accuracy and reliability of a volumetric analysis of abdominal aneurysms on the basis of multidetector row computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) with a commercially available automated vessel analysis software program. MATERIALS AND METHODS: Twenty patients with abdominal aortic aneurysms underwent preoperative CTA and MRA before endovascular repair. Postdeployment CTA was performed in 15 of these 20 patients (75%). All preoperative CTA and MRA and postdeployment CTA data sets were analyzed with an automated software tool. The length of the stent grafts on postdeployment CTA was measured and compared with the true length of the primary component. Two readers independently evaluated 13 vessel parameters on preoperative CTA and MRA, which are considered to be important in planning stent graft deployment. RESULTS: With the automated analysis software tool, all measurements could be performed on either CTA or MRA data sets. There was no statistically significant difference between postdeployment measurements of stent graft length on CTA and the true dimensions of the implanted stent grafts. Interobserver agreement for all of the measurements with either CTA or MRA was good to excellent (interclass coefficient, 0.71 to 0.99) with only minimal mean differences of measured dimensions between both readers (range, -2.0 to +2.3 mm, Bland-Altman). Intermodality agreement between CTA and MRA was good to excellent (interclass coefficient, 0.62 to 0.98) with small mean differences of measured dimensions between both methods (range, -4.1 to +2.1 mm, Bland-Altman). CONCLUSION: Volumetric measurement with an automated analysis software tool allows a fast, precise, and reliable noninvasive preoperative determination of all aortic dimensions on the basis of either CTA or MRA data sets.

Aged↗

PubMed2006

Automated cell lineage tracing in Caenorhabditis elegans.

The invariant cell lineage and cell fate of Caenorhabditis elegans provide a unique opportunity to decode the molecular mechanisms of animal development. To exploit this opportunity, we have developed a system for automated cell lineage tracing during C. elegans embryogenesis, based on 3D, time-lapse imaging and automated image analysis. Using ubiquitously expressed histone-GFP fusion protein to label cells/nuclei and a confocal microscope, the imaging protocol captures embryogenesis at high spatial (31 planes at 1 microm apart) and temporal (every minute) resolution without apparent effects on development. A set of image analysis algorithms then automatically recognizes cells at each time point, tracks cell movements, divisions and deaths over time and assigns cell identities based on the canonical naming scheme. Starting from the four-cell stage (or earlier), our software, named starrynite, can trace the lineage up to the 350-cell stage in 25 min on a desktop computer. The few errors of automated lineaging can then be corrected in a few hours with a graphic interface that allows easy navigation of the images and the reported lineage tree. The system can be used to characterize lineage phenotypes of genes and/or extended to determine gene expression patterns in a living embryo at the single-cell level. We envision that this automation will make it practical to systematically decipher the developmental genes and pathways encoded in the genome of C. elegans.

Animals↗

PubMed1978

An automated method for determination of serum and urine alpha-amylase.

An automated method for the determination of alpha-amylase activities of serum and urine using the Phadebas Amylase Test is described. The procedure has been adapted for the System Olli 3000 analyser using amylase tablets whose weight is half of that of normal tablets. The results are calculated by the computer with the aid of a standard curve calculated theoretically. This automated procedure is fast, as many as 120 analyses per hour can be carried out. Intra-assay precision of 2.0 and 2.2% (CV) is obtained from serum samples containing 301 and 181 u/l of alpha-amylase, respectively (n = 20), and inter-assay precision is 4.4 and 3.3% with mean values of 337 and 196 u/l, respectively (n = 20). When the automated procedure is compared with the manual procedure on 85 sera with alpha-amylase activities below 1000 u/l, a good correlation r = 0.992, and a regression equation y = 1.01x-6 are found. In the case of serum and urine samples, which contain high enzyme activities, the automated method gives slightly higher results than the manual method.

Amylases↗

PubMed2006

The development of an automated method for analyzing communication rate in augmentative and alternative communication.

A significant barrier to evidence-based practice in Augmentative and Alternative Communication (AAC) is the lack of validated performance measures that can be used by speech-language pathologists and rehabilitation engineers to evaluate the communication and device use of AAC consumers. Recently an effort has been made to develop automated data-logging techniques to facilitate the transcription and analysis of the AAC speaker's device use. A major source of error for the automated measurement of communication rate is the presence of excessive Inter-Selection Intervals (ISIs) (i.e., pause times), for which no communicative activity is occurring. The goal of this study was to develop an automated technique to filter out extreme ISIs, while preserving true communication rate performance. AAC data log files were obtained from seven individuals participating in a 1-month field trial of an AAC technology. Two temporal filtering techniques (arbitrary and individual) were compared for their ability to eliminate excessive ISIs. Results indicated that use of an individualized temporal filter was more sensitive to performance variability than use of an arbitrary temporal filter. Further, the individualized temporal filter elevated the participants' communication rate (measured by words per minute) by a factor of 1.8 to 34.5 greater than that of the unfiltered communication rate estimate. In addition, the first AAC communication rate performance estimates taken from the field are presented. Implications for further research and the valid use of automated data logging and analysis are discussed.

Activities of Daily Living↗

PubMed2002

Capturing tobacco status using an automated billing system: steps toward a tobacco registry.

In 1999, Group Health Cooperative (GHC), a health system with 575,000 enrollees, launched a quality improvement initiative to systematically record patient tobacco-use status and provider intervention using an automated billing system. Performance feedback and senior-level incentives were added to foster compliance with the automated recording. Prior to this period, tobacco-use status was recorded primarily via a paper-based chart system, with billing-system recording averaging only 7.5% of primary care visits. In 2000, tobacco-use status was recorded using the billing system in an average of 82% of visits (p<0.001). Significant increases (p<0.0001) were also observed for the absolute number of visits in which automated entry of tobacco-use status was documented using the billing system, as well as for visits where intervention was documented. In 1998, tobacco use was documented in 22,086 visits, with intervention documentation in 13,235 of these visits. By 2000, tobacco-use documentation increased to 76,180, with intervention documentation in 45,527. This work demonstrates the feasibility of using automated performance feedback and senior-level incentives to increase provider compliance with a new system of tobacco status identification and intervention. Other potential uses of this system, and potential limitations, are discussed.

Adult↗

PubMed2004

Evaluation of a new method for automated detection of left ventricular boundaries in time series of magnetic resonance images using an Active Appearance Motion Model.

The purpose of this study was the evaluation of a computer algorithm for the automated detection of endocardial and epicardial boundaries of the left ventricle in time series of short-axis magnetic resonance images based on an Active Appearance Motion Model (AAMM). In 20 short-axis MR examinations, manual contours were defined in multiple temporal frames (from end-diastole to end-systole) in multiple slices from base to apex. Using a leave-one-out procedure, the image data and contours were used to build 20 different AAMMs giving a statistical description of the ventricular shape, gray value appearance, and cardiac motion patterns in the training set. Automated contour detection was performed by iteratively deforming the AAMM within statistically allowed limits until an optimal match was found between the deformed AAMM and the underlying image data of the left-out subject. Global ventricular function results derived from automatically detected contours were compared with results obtained from manually traced boundaries. The AAMM contour detection method was successful in 17 of 20 studies. The three failures were excluded from further statistical analysis. Automated contour detection resulted in small, but statistically nonsignificant, underestimations of ventricular volumes and mass: differences for end-diastolic volume were 0.3%+/-12.0%, for end-systolic volume 2.0%+/-23.4% and for left ventricular myocardial mass 0.73%+/-14.9% (mean+/-SD). An excellent agreement was observed in the ejection fraction: difference of 0.1%+/-6.7%. In conclusion, the presented fully automated contour detection method provides assessment of quantitative global function that is comparable to manual analysis.

Adolescent↗

PubMed2004

A prospective study of the impact of automated dipstick urinalysis on the diagnosis of preeclampsia.

OBJECTIVE: To determine prospectively in hypertensive pregnant women 1) the accuracy of dipstick testing for proteinuria using automated urinalysis, 2) factors that might affect such accuracy, and 3) the potential impact of automated dipstick testing on the accuracy of diagnosis of preeclampsia according to acceptance of proteinuria at either 1 + or 2 + level. DESIGN: Prospective study. SETTING: Antenatal day assessment unit and antenatal ward of St George Hospital, a teaching hospital in Sydney, Australia. POPULATION: 170 hypertensive pregnant women attending as outpatients or inpatients. METHODS: 503 midstream urine samples were collected prospectively on separate occasions from 170 women. Full urinalysis was recorded using the Bayer Clinitek 50 automated urinalysis device and Multistix 10SG urinalysis strips (Bayer Diagnostics, Victoria, Australia). Each MSU was analysed for spot protein/creatinine ratio and also for culture and sensitivity if symptoms of a urinary tract infection were present or dipstick included positive nitrites. Urinalysis protein results were compared with spot urinary protein/creatinine ratio (previously shown to correlate with 24-hr urine protein excretion) to determine the accuracy of urinalysis. True proteinuria was defined as a ratio >/= 30 mg protein/mmol creatinine. RESULTS: False positive dipstick tests ranged from 7% at 3 + level to 71% at 1 + proteinuria level while false negative rates were 7% for "nil" and 14% for "trace" proteinuria, 9% overall. Accepting the dipstick proteinuria result at face value led to an incorrect diagnosis of preeclampsia or gestational hypertension in 85 (50%) women. Dipstick proteinuria was significantly more likely to be correct (true positive/true negative) if diastolic blood pressure was elevated > 90 mmHg (p = 0.032) and in the absence of ketonuria (p = 0.001). Accepting a diagnosis of preeclampsia on the basis of de novo hypertension and dipstick testing alone was accurate less often (70%) when > 1 + was used as a discriminant value than at the 82% of presentations when > 2 + was used (p = 0.001). CONCLUSION: Accepting "nil" or "trace" proteinuria as a true negative dipstick results fails to identify approximately 1 in 11 hypertensive pregnant women with true proteinuria, a false negative rate that may be acceptable provided these women are subject to ongoing vigilant clinical review. Even with automated urinalysis the false positive rate for dipstick levels >/= 1 + is very high, particularly in the presence of ketonuria and relying on this alone to diagnose preeclampsia leads to significant errors in diagnosis. Accepting >/= 2 + dipstick proteinuria improves overall diagnostic accuracy for preeclampsia at the expense of a higher false negative rate. This study emphasizes the need to confirm dipstick proteinuria with a further test such as a spot urine protein/creatinine ratio in all hypertensive pregnant women, particularly in research studies.

Australia↗

PubMed2005

Local back massage with an automated massage chair: general muscle and psychophysiologic relaxing properties.

OBJECTIVES: The objective of the present study was to test massage applied with an automated massage chair on the back muscles with regard to the effects on the tension of other muscles or on the neurovegetative tone, and to compare three different automated massage techniques. METHODS: Ten healthy volunteers participated in the study. The experiment consisted of an initial 5-minute period of relaxation without massage, and 5-minute periods of three different massage programs (roll-stretch massage, shiatsu massage, and beat massage). Subjects were randomized as to the presentation order. The following physiologic data were collected: frontalis and gastrocnemius electromyogram (EMG) activity, skin conductance, and peripheral skin temperature. Judgments of valence and arousal were registered using the pencil and- paper version of the five-point Self-Assessment Manikin. RESULTS: Roll-stretch and shiatsu massage were rated by participants as more pleasant than the relaxation period without massage or the beat massage. Whereas the four conditions were similar with regard to the mean frontal EMG values (reflecting primarily affective states), they differed regarding the gastrocnemius EMG (relating more to a general level of tension), roll-stretch massage, and shiatsu massage, resulting in less muscle tension than the control condition. Shiatsu massage was associated with significantly lower skin conductance than the control condition, whereas beat massage increased it significantly. A significant increase of skin temperature was found during the roll-stretch massage compared to the no-massage condition. CONCLUSIONS: Automated roll-stretch massage and shiatsu massage applied on the back can rapidly induce measurable relaxation in distant muscles not directly massaged, and is accompanied by signs of neurovegetative calming. Back massage applied by an automated massage chair may be an efficient and inexpensive general relaxation approach, and is especially interesting for patients who dislike to be touched.

Adult↗

PubMed2004

Automated higher-throughput compound screening on ion channel targets based on the Xenopus laevis oocyte expression system.

As numerous diseases have been shown to be related to dysfunction of ion channels and neurotransmitter receptors and to affect regulatory pathways, ion channels have attracted increasing attention as a target class for drug discovery. The concomitant demand of the pharmaceutical industry for adequate electrophysiological methods to investigate drug effects on specific ion channels in secondary and safety screening has resulted in the development of electrophysiological instrumentation that allows automated monitoring of ion channel function with a higher throughput. Here we tested a fully automated screening system based on the Xenopus laevis oocyte expression system. We addressed the questions of data quality and reproducibility obtained by automated oocyte injection and two-electrode voltage-clamp (TEVC) recording using the Roboocyte (Multi Channel Systems GmbH, Reutlingen, Germany) technology compared to conventional oocyte recording. A gamma-aminobutyric acid (GABA)A-receptor subtype (alpha(1)beta(2)) was chosen as an example for a ligand-gated ion channel, and the slowly activating potassium current I(Ks) as a voltage-activated ion channel. Oocytes were injected with cDNA or cRNA via the Roboocyte injection stage. Ion channel currents were successfully recorded after 2-7 days in about 40% of the oocytes injected with GABA(A) receptor cDNA, and after 2-4 days in about 60% of the oocytes injected with KCNE1 cRNA. EC(50) values for the GABA(A) receptor and IC(50) values for blockers of I(Ks) were comparable to values obtained with conventional TEVC recording techniques. In conclusion, our results show that the Roboocyte is a valuable automated tool for oocyte injection and TEVC recording that can be used in drug screening and target validation to enhance the number of compounds and oocytes tested per day.

Animals↗

PubMed1994

Performance analysis of manual and automated systemized nomenclature of medicine (SNOMED) coding.

Many pathology departments rely on the accuracy of computer-generated diagnostic coding for surgical specimens. At present, there are no published guidelines to assure the quality of coding devices. To assess the performance of systemized nomenclature of medicine (SNOMED) coding software, manual coding was compared with automated coding in 9353 consecutive surgical pathology reports at the Baltimore Veterans Affairs Medical Center. Manual SNOMED coding produced 13,454 morphologic codes comprising 519 distinct codes; 209 were unique codes (assigned to only one report apiece). Automated coding obtained 23,744 morphologic codes comprising 498 distinct codes, of which 129 were unique codes. Only 44 (.5%) instances were found in which automated coding missed key diagnoses on surgical case reports. Thus, automated coding compared favorably with manual coding. To achieve the maximum performance, departments should monitor the output from automatic coders. Modifications in reporting style, code dictionaries, and coding algorithms can lead to improved coding performance.

Classification↗

PubMed1996

Estimation of the lower limits of manual and automated platelet counting.

Most evaluators of automated or manual methods for platelet counting focus on characteristics such as imprecision, linearity, and carry over. The limits of the analytical procedure are usually not assessed. The limits of the different techniques are neither discussed in the literature nor do manufacturers of analytical systems supply these data. A new procedure is presented to assess the performance of the manual as well as the automated platelet count. This procedure allows, with defined statistical confidence (eg, 95%), the determination of (1) the limit of platelet detection (LD) at which signals of platelets can be discriminated from the system noise; (2) the lower limit of quantification (LLQ), at which a certain imprecision is not surpassed; and (3) the power of definition (PD) that defines the number of values that can be discriminated in a certain interval. For each value, the PD allows calculation of the two adjacent (lower and higher) values that are significantly (P > or = 0.95) different. For the manual count, LD was found to be 1.6 x 10(9) plt/L and the LLQ 6.9 x 10(9) plt/L. For the automated count with the Technicon H1, LD was 4.3 x 10(9) plt/L and LLQ 13.8 x 10(9) plt/L (CVmax = 15%). The PD in the range 20 to 100 x 10(9) plt/L is 8 for the automated and 7 for the manual count.

Analysis of Variance↗

PubMed1993

Determination of low-molecular-weight heparin by Heptest on the automated coagulation laboratory system.

The manual Heptest for measuring low-molecular-weight heparin fractions was applied to a fully automated, coagulation-dedicated analyzer, the Automated Coagulation Laboratory 300 Plus. The clot-based assay mode of the instrument was used, which operates on the principle of light scattering. Undiluted plasmas and the original reagents of the Heptest kit were used. Also, the 2-minute incubation time of the manual procedure was maintained. Automation reduced plasma and reagent volumes by about one half. As a result of the high precision of the automated procedure, single determinations suffice, and 18 plasma samples can be analyzed in about 8 minutes. Coefficients of variation were 1.0% to 3.2% for within-run and 1.9% to 6.0% for inter-run analyses. Analytical recovery was 98% to 104%. Comparisons of 132 samples between the two procedures yielded an R value of 0.974 for activity expression in seconds and 0.945 for U/mL. Several low-molecular-weight heparin fractions were tested.

Blood Coagulation Tests↗

PubMed2001

Use of an automated database to evaluate markers for early detection of pregnancy.

The objective of this study was to develop and validate algorithms to detect pregnancies from the time of first clinical recognition by using Kaiser Permanente automated databases from Portland, Oregon. In 1993--1994, the authors evaluated these databases retrospectively to identify markers indicative of initial clinical detection of pregnancy and pregnancy outcomes. Pregnancy markers were found for 99% of the women for whom pregnancy outcomes were included in the automated databases, and pregnancy outcomes were identified for 77% of the women for whom there were pregnancy markers. The earliest marker most predictive of a pregnancy outcome was a positive human chorionic gonadotropin test; least predictive was an obstetric outpatient visit. Medical record review indicated that in a sample of women with pregnancy markers in the database, an estimated 6% of pregnancy outcomes (primarily early fetal deaths and elective terminations) were lost. Pregnancies were first captured in automated databases 6--8 weeks after the last menstrual period, and a combination of a positive human chorionic gonadotropin test and an outpatient obstetric visit was the most sensitive and specific early marker of pregnancy. When combined with automated pharmacy records, these databases may be valuable tools for evaluating prescription drug effects on all major outcomes of clinically recognized pregnancies.

Abortion, Legal↗

PubMed2005

Automated genome annotation and pathway identification using the KEGG Orthology (KO) as a controlled vocabulary.

MOTIVATION: High-throughput technologies such as DNA sequencing and microarrays have created the need for automated annotation of large sets of genes, including whole genomes, and automated identification of pathways. Ontologies, such as the popular Gene Ontology (GO), provide a common controlled vocabulary for these types of automated analysis. Yet, while GO offers tremendous value, it also has certain limitations such as the lack of direct association with pathways. RESULTS: We demonstrated the use of the KEGG Orthology (KO), part of the KEGG suite of resources, as an alternative controlled vocabulary for automated annotation and pathway identification. We developed a KO-Based Annotation System (KOBAS) that can automatically annotate a set of sequences with KO terms and identify both the most frequent and the statistically significantly enriched pathways. Results from both whole genome and microarray gene cluster annotations with KOBAS are comparable and complementary to known annotations. KOBAS is a freely available stand-alone Python program that can contribute significantly to genome annotation and microarray analysis.

Artificial Intelligence↗

PubMed1999

An automated telephone system for monitoring the functional status of community-residing elders.

We tested the reliability and validity of an automated telephone monitoring system for assessing changes in the functional status of disabled elders living in the community. The sample consisted of 20 adults older than 60 years of age enrolled in a home care program due to functional disabilities. Within a 72-hour period, each participant received, in random order, two automated and one personal telephone functional assessment as well as a home visit assessment by a case manager. The results indicated similarities between the personal and automated telephone assessments, but neither telephone method captured as many impairments as the case manager's home assessment. These findings suggest that the automated system cannot substitute for a case manager's in-home assessment, but it does offer a means to target individuals for additional professional assessment.

Activities of Daily Living↗

PubMed2003

Automated semen analysis: 'zona pellucida preferred' sperm morphometry and straight-line velocity are related to pregnancy rate in subfertile couples.

BACKGROUND: Standard semen analysis has low objectivity and reproducibility and is not closely related to fertility. We assess the prognostic value of automated measurements of sperm motility and morphology. METHODS: During 1997-1999, 1191 infertile couples with no known absolute barrier to conception were assessed by conventional semen analysis, and automated measurements of average straight-line velocity (VSL) and the percentage of sperm with characteristics that conform to those of sperm which bind to the zona pellucida of the human oocyte (%Z). During follow-up to 2001, there were 336 natural pregnancies. RESULTS: Only %Z, VSL and female age were independently significantly related to pregnancy rate by Cox regression analysis. Pregnancy rate was higher with above average %Z and VSL, indicating a continuous rather than a threshold relationship. The likelihood of pregnancy within 12 cycles can be evaluated for specific values of %Z, VSL and female age using the Cox regression model. CONCLUSIONS: The automated semen measures of sperm morphometry (%Z) and velocity (VSL) are related to pregnancy rates in subfertile couples and should assist clinicians in counselling subfertile patients about their prognosis for a natural pregnancy. Objective automated methods should replace the traditional manual assessments of semen quality.

Adult↗