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[Use of the microcomputer in teaching clinical endocrinology].

The paper is concerned with the results of the use of the Electronika NMS 01900.1 microcomputer manufactured in the USSR for teaching clinical endocrinology. Owing to its small dimensions, simple maintenance and sufficiently vast computing potentialities it can be widely used for teaching. A program with broad functional possibilities was prepared permitting students to objectivize their knowledge in clinical endocrinology. Fast automated test control of knowledge raises the efficacy of teaching many times.

Audiovisual Aids↗

A simple, microcomputer-based transcription system for radiology reports.

A simple, computerized system for radiology transcriptions at a small military medical treatment facility is described. This system can be implemented in any department having access to an MS-DOS-based microcomputer, and can be used by anyone with little or no computer experience or typing skills. Through the use of standard text, this method can expedite considerably the transcription of routine radiographic reports at a nominal cost.

Hospital Departments↗

[Microcomputer-assisted telemetry system for recording ultradian temperature rhythms in large animals].

A radiotelemetry system for measurement of deep body temperature in unrestrained farm animals is presented. Because the main attention is set on the small ultradian temperature rhythms, a system with high sensitivity (0.05 degrees C) and little transmission-interferences (high field intensity of the transmitter) was developed. Circuit diagrams of the implantable thermoprobe and the basic principles of the recording unit are pointed out. Management of measurements as well as recording of data is software-controlled by a microcomputer. Further computerized processing presupposes that there is no incorrect data. Therefore the complete elimination of interferences is carried out automatically by a computer. The algorithm used for this is described in detail.

Algorithms↗

Microcomputer voice-recognition program in a hospital emergency department.

A software program for voice-controlled text creation was used on a microcomputer in the emergency medical department of a large hospital. It was found that automated speech recognition (ASR) permitted doctors to produce their reports faster and more accurately than handwriting or dictation to tape. In addition, ASR reporting is cheaper than dictation to tape. Other advantages include the automatic creation of computer-stored patient files that can be used for statistical purposes. There were a few minor drawbacks, including the need for a procedure for training the system to recognize the user's voice.

Chicago↗

Managing the acquisition, installation and benefit realization of microcomputer based systems in healthcare.

This paper discusses the critical issues which must be addressed when facing the decision to acquire and implement new microcomputer based systems. The first issue is the process for developing a range of alternatives at various levels of sophistication. A second key issue is the development of a full cost analysis which includes such costs as cost of parallel operation, cost of back up systems, training costs and initial system modification costs. The third critical issue is the development of a benefit realization plan which has the support of both top management and line management.

Competitive Bidding↗

Simple analytic procedures for rapid microcomputer-assisted cluster surveys in developing countries.

Surveys are often deemed necessary in developing countries when routine sources of data are not considered adequate to answer important policy-related questions. Although field work often goes smoothly, many surveys become bogged down in the analysis stage. With the availability of microcomputers and contemporary software, investigators in developing countries can use rapid survey methodology (RSM) to process, analyze, and report survey findings more quickly than ever before. Presented in this paper are three simple analytic procedures for planning and doing two-stage, rapid cluster surveys. All were successfully used in three rapid surveys in rural regions of Burma and Thailand. By use of a spreadsheet and graphics software package, the three procedures (a) derive the first-stage selection of 30 cluster sites with probability proportionate to size, (b) calculate variance estimates and confidence limits for the parameters of interest and graphically present the findings as 90, 95, and 99 percent confidence intervals, and (c) estimate the necessary sample size for planning two-stage, rapid cluster surveys. The procedures can be used both in the field and in teaching workshops or courses on survey methods. Examples are given from three rapid surveys conducted in Hlegu Township, Burma, and Sisaket Province, Thailand. In both countries, local health professionals were first taught the methods in a 1-week workshop before they used the procedure for conducting the rapid computer-assisted surveys.

Analysis of Variance↗

Microcomputer analysis of the intraventricular pressure curve of the isolated rat heart.

The authors evolved an automatic system for the measurement and analysis of the course of pressure in the left ventricle of the isolated laboratory rat heart perfused in vitro after Langendorff. Attached to it is a microcomputer which automatically samples the course of the left ventricular pressure curve over a segment comprising five cardiac cycles and, within 30 s, evaluates the mean systolic and diastolic pressure, the maximum rate of the increase and decrease in pressure, the contractility index, the mean integral pressure and the heart rate. The apparatus shows a standard error of less than 1% for pressure and of up to 2% for derivation.

Animals↗

EDC: a microcomputer program to record and calculate expected date of confinement.

A microcomputer program was developed to compute the expected date of confinement (EDC) and to record the clinical parameters used in its calculation. In obstetrical care, it is important to establish the EDC. However, the last menstrual period on which the EDC is usually determined may be unknown, inaccurate or disagree with other clinical estimators of the gestational age. Useful predictions of the EDC can be derived from a number of clinical examinations. The program can be used to maintain a register from which the EDC is calculated by averaging the EDCs estimated from up to 19 parameters. The result is also displayed as the gestation age in number of weeks. The register containing information on a large number of pregnancies can be used to calculate the dispersion of estimated EDCs from the various clinical methods.

Female↗

[The Apple II e microcomputer as a databank for registering special donors].

The authors introduced in the Institute of Haematology and Blood Transfusion in Prague records of special donors, voluntary donors of bone marrow and voluntary donors for the separator using the microcomputer Apple II and the system ArchTex. These provisions make it possible to select a suitable donor much more quickly than by the hitherto used system of cards which, however, still are essential for the work of the special donor station.

Bone Marrow Transplantation↗

MEDTUTOR: a microcomputer-based training program for MEDLINE.

MEDTUTOR is an interactive, microcomputer-based training package designed to teach medical and health professionals, as well as librarians and information specialists, how to use MEDLINE effectively. The objective of MEDTUTOR is to provide a comprehensive package for teaching the various commands and search techniques required for utilizing the MEDLINE database through the MEDLARS system. MEDTUTOR's menu-driven design allows novice users to learn about the content and use of MEDLINE, such as author searching, text word searching, MeSH indexing, etc., at their own pace and with considerable program feedback. In addition, MEDTUTOR provides the skilled searcher with a way to reinforce or recall previously-learned search techniques without incurring online charges. MEDTUTOR may be used in place of formal training, as a precursor to or as a refresher following formal training, or for review of a particular concept. It provides inexpensive and easily accessible instruction for searching MEDLINE.

Computer User Training↗

Using microcomputers in rural preceptorships.

Current U.S. health manpower forecasts indicate an oversupply of physicians. In the Intermountain Region this oversupply is concentrated in the medical and surgical subspecialties, not in primary care specialties. Students cite fear of not knowing all that a general field requires as a reason for focusing their studies in a narrow area. Because ambulatory care experiences are not required of medical students at Utah, it is difficult to recruit students into the primary care specialties. One means of exposing students to primary care and rural medicine is through the clinical preceptorship. Beginning in 1985, with a grant from the National Library of Medicine, clinical students who elected the rural family practice preceptorship were given lap-top microcomputers to take with them to their preceptorship sites. Students were taught how to operate the computer and how to perform a MEDLINE search. Student evaluations of the experience were high and students reported feeling less concerned about the knowledge explosion and positive about improving their ability to access current medical literature. It is anticipated that by teaching students how to use this technology to provide better patient care, they will be more likely to consider primary care practices in rural areas.

Family Practice↗

[Description of a system for automatic analysis of ambulatory electrocardiography using a microcomputer].

An automatic ambulatory electrocardiogram analyzer was developed using a self-powered fast reader of FM recorded cassettes and a "general purpose" microcomputer with 640 Kbytes of RAM and 20 Mbytes of mass memory on hard-disk. Original algorithms were developed for analog to digital conversion, data storage on hard-disk, QRS detection and classification and rhythm analysis. Reliability of the system was evaluated, when appropriate, using standard databases. The relevant features of our analyzer include a favourable cost/benefit ratio, powerful interactive facilities and the typical flexibility of the non dedicated hardware.

Algorithms↗

Microcomputer-aided diagnosis in cardiology. An expert system based on clinical and phono-mechanocardiographic data.

A knowledge-based consultation system capable of making multiple diagnoses in noninvasive cardiology is presented here. The system, expressly designed for a personal computer, is able to provide assistance in the diagnosis of 49 disease-entities. When tested in 52 retrospective cases (33 patients with one disease-entity, 17 with two, 2 with three), it made 39 correct diagnoses (75%). The average score of the actually present disease-entities was 94 +/- 3.2 (mean +/- standard error of the mean), significantly higher than the highest score obtained by the incorrect diagnoses (87.2 +/- 3.1) (p less than 0.001). The system was able to correctly perform 1 triple diagnosis and 9 double diagnoses. The results obtained, comparable with those of well-known expert systems (MYCIN, INTERNIST-1), demonstrate the reliability of a microcomputer-based expert system for medical diagnosis in cardiology.

Diagnosis, Computer-Assisted↗

The advantages of a microcomputer-based procedure log.

Residency training programs in Internal Medicine have come under increasing pressure to document the diagnostic and therapeutic procedures performed by their residents. We initially attempted to do this by asking the residents to fill out log books. We were disappointed in this method because the residents did not keep the log books up-to-date and because the program and division directors did not receive ongoing feedback. We therefore changed to a microcomputer-based procedure log. We have been pleased with this system not only because the information is more complete, but because we are able to use the cumulative data generated in ways we did not originally anticipate. For example, the data can be used to improve quality assurance and to make adjustments in our educational efforts. The method would seem readily applicable to any residency training program and could easily be useful to any non-teaching hospital required to document the performance of procedures for purposes of staff privileges and quality assurance.

Diagnostic Services↗

[A microcomputer system of biotechnical feedback].

A microcomputer system has been constructed and developed for biofeedback research and clinical biofeedback training. Hardware and software enable on-line data acquisition, storage and real-time analysis with visual feedback of chosen parameters, while changes in other physiological variables are recorded and monitored. The software handles control of experimental sessions, data reduction, statistics, data base management and output document forming. Computer analysis of pulse transit time biofeedback training with multiple cardiovascular monitoring in experimental and clinical setting outlined contributions of sympathetic and parasympathetic influences on observed patterns of cardiovascular modifications.

Biofeedback, Psychology↗

Effect of a microcomputer-based registry on adult immunizations.

A survey of patients attending the Cosmopolitan International Diabetes Center showed that one third of those born prior to 1935 did not know their immunization status, and only 56% of this group remembered ever receiving tetanus vaccine. In contrast, of those born after 1935, 98% gave a history of being vaccinated for tetanus, either as a child (76%) or as an adult (22%). Eight of the 35 patients who could not remember or denied receiving pneumococcal vaccine had in fact received it. Most patients could remember whether and when they had received influenza vaccine. A microcomputer-based registry was used to generate summaries of clinical information at each patient visit. These summaries included prevention-related items. There was a three- to five-fold increase in immunization rates when the dates of the most recent vaccinations were prominently displayed on the summary at the time of each visit.

Adult↗

[Microcomputer-assisted system for photographing the movements of biological valve prostheses].

The aim of the study was to develop a clinically usable system of photographic imaging of the movements of biological valve transplants and of evaluating temporal and spatial relationships. The system has been established by means of a microcomputer and associated peripheral electronic equipment so that there is no need to use a high-speed camera. Functioning of the system was verified by testing 37 aortal valve allotransplants and the Björk Shiley mechanical valve prosthesis.

Aortic Valve↗

A microcomputer-based system for mapping microvascular networks.

A new method has been developed for mapping microvascular networks using an IBM-AT microcomputer and a video-microscope. After recording a vascular network on video tape, it can be reconstructed off-line using frame by frame analysis. A software tool, developed for mapping and editing networks, is used to prepare a montage of the network using a video cursor and mouse. Vessel lengths and diameters can also be measured from the video image using the same methodology. When the analysis is completed, the vessel network, together with a tabulation of lengths and diameters of individual vessels, can be displayed on a TV monitor or reduced to hard copy. This system provides a simple method for quantitative studies of arteriolar, venular and capillary networks.

Animals↗