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PubMedDate not supplied

A system that facilitates the orientation within procedure nomenclatures through a semantic approach.

The representation of medical concepts should provide the flexibility required to support several purposes. We have implemented a model in which medical terms are represented in a standard format based on a semantic description of the terms. We have focused on the description of procedures. Underlying this project is the assumption that information about medical procedures is crucial in the healthcare system. A prototype has been developed for urology. Because of the large number of terms in the Unified Medical Language System (UMLS) and the abundance of links between them, we have experimented in the use of the UMLS as the foundation for our concept base. We assess the usefulness of this approach and discuss its improvements.

Algorithms↗
PubMedDate not supplied

DIABNET: a qualitative model-based advisory system for therapy planning in gestational diabetes.

An intelligent decision support system for the analysis of home monitoring data and therapy planning in gestational diabetes is presented. The paper describes the integration of qualitative and quantitative reasoning modules within the DIABNET advisory system. The system kernel is a qualitative model of the physiological processes involved in the glucose metabolism of this type of diabetic patient. A causal probabilistic network (CPN) has been used to represent the qualitative model in order to manage uncertain and missing monitoring data. The DIABNET inputs are the patient's available ambulatory monitoring data, and the output is a dietary and insulin therapy adjustment that includes initiation of insulin therapy, quantitative insulin dose changes and qualitative diet and schedule modifications. Over periods of up to seven days, monitoring data are analysed by the CPN to detect any diet or insulin therapy items which may require modification. The qualitative insulin needs are translated into a quantitative proposal in line with the characteristics of the patient and the modification strategies usually used by doctors. The first evaluation of the system has been accomplished, the encouraging results of which are also presented.

Blood Glucose Self-Monitoring↗
PubMed2006

Hidden patterns of play interaction in soccer using SOF-CODER.

Traditional methods for quantifying sport performances are limited in their capacity to describe the complex interactions of events that occur within a performance over time. The following article outlines a new approach to the study of actions between players in team sports--mainly, soccer. Since the observational design is nomothetic, point, and multidimensional, an observational and data-collecting instrument has been developed. The instrument is mixed and combines a field format with a category system for game events, as well as an ad hoc instrument that considers the game actions of one or both teams, each recorded according to the same criteria. The article also outlines a new approach to the analysis of time-based event records--in this case, sports performance--known as T-pattern detection. The relevant elements of the T-pattern detection process are explained, and exemplar data from analyses of soccer matches are presented to highlight the potential of this form of data analysis. The results suggest that it is possible to identify new kinds of profiles for both individuals and teams on the basis of observational criteria and a further analysis of temporal behavioral patterns detected within the performances.

Behavioral Sciences↗
PubMed2006

Developing a coding scheme for detecting usability and fun problems in computer games for young children.

This article describes the development and assessment of a coding scheme for finding both usability and fun problems through observations of young children playing computer games during user tests. The proposed coding scheme is based on an existing list of breakdown indication types of the detailed video analysis method (DEVAN). This method was developed to detect usability problems in task-based products for adults. However, the new coding scheme for children's computer games takes into account that in games, fun, in addition to usability, is an important factor and that children behave differently from adults. Therefore, the proposed coding scheme uses 8 of the 14 original breakdown indications and has 7 new indications. The article first discusses the development of the new coding scheme. Subsequently, the article describes the reliability assessment of the coding scheme. The any-two agreement measure of 38.5% shows that thresholds for when certain user behavior is worth coding will be different for different evaluators. However, the any-two agreement of .92 for a fixed list of observation points shows that the distinction between the available codes is clear to most evaluators. Finally, a pilot study shows that training can increase any-two agreement considerably by decreasing the number of unique observations, in comparison with the number of agreed upon observations.

Child↗
PubMed2002

Toward an Experimental Timing Standards Lab: benchmarking precision in the real world.

Much discussion has taken place over the relative merits of various platforms and operating systems for real-time data collection. Most would agree that, provided great care is taken, many are capable of millisecond timing precision. However, to date, much of this work has focused on the theoretical aspects of raw performance. It is our belief that researchers would be better informed if they could place confidence limits on their own specific paradigms in situ and without modification. To this end, we have developed a millisecond precision test rig that can control and time experiments on a second presentation machine. In this paper, we report on the specialist hardware and software used. We elucidate the importance of the approach in relation to real-world experimentation.

Computers↗
PubMed2003

Using the observer to analyze learning in virtual worlds.

In this study, we describe and analyze the ways in which high school students explored a virtual solar system (VSS). VSS is a nonimmersive virtual environment that affords visual manipulations of space by altering its frame of reference. The Observer software was used to code and analyze the participants' real-time free-exploration task. Two basic behaviors were identified across participants: establishing several home bases, and shifting between a still mode and a dynamic mode. Moreover, three overall exploration patterns emerged: the butterfly pattern represents a superficial mode of learning; the bee pattern represents an in-depth mode of studying the various celestial objects; and the eagle pattern represents a global approach of studying the complex system. This virtual reality environment promises to provide a setting in which to further study consistent patterns and individual differences in exploration strategies.

Adolescent↗
PubMed2003

Computerizing reading training: evaluation of a latent semantic analysis space for science text.

The effectiveness of a domain-specific latent semantic analysis (LSA) in assessing reading strategies was examined. Students were given self-explanation reading training (SERT) and asked to think aloud after each sentence in a science text. Novice and expert human raters and two LSA spaces (general reading, science) rated the similarity of each think-aloud protocol to benchmarks representing three different reading strategies (minimal, local, and global). The science LSA space correlated highly with human judgments, and more highly than did the general reading space. Also, cosines from the science LSA spaces can distinguish between different levels of semantic similarity, but may have trouble in distinguishing local processing protocols. Thus, a domain-specific LSA space is advantageous regardless of the size of the space. The results are discussed in the context of applying the science LSA to a computer-based version of SERT that gives online feedback based on LSA cosines.

Artificial Intelligence↗
PubMedDate not supplied

Laser in situ keratomileusis results of DOS and windows software versions for the Nidek EC-5000 excimer laser using the same nomogram.

PURPOSE: To compare the results of laser in situ keratomileusis (LASIK) correction for myopia and myopic astigmatism between the previous DOS software version and the Windows software version for the Nidek EC-5000 excimer laser, using the same nomogram. METHODS: This retrospective review included 2021 eyes (980 patients) after LASIK using the Nidek EC-5000 excimer laser. Of these, 1,632 eyes were corrected with the DOS software version and the other 389 eyes were corrected with the Windows software version of the laser. Both groups were treated with the same surgical nomogram. Minimum follow-up time was 6 months. Patients were classified into range of myopia: low, moderate, and high. RESULTS: Postoperative uncorrected visual acuity was not statistically significantly different between the two groups in any range of refractive error. There was no loss of best spectacle-corrected visual acuity for any patient. Uncorrected visual acuity equal to or better than 20/40 was achieved in 96.3% of eyes in the Windows version group and 94.9% in the DOS version. CONCLUSION: Results for the correction of myopia or myopic astigmatism were similar using the Nidek EC-5000 excimer laser with either the DOS software version or Windows software version, with the same surgical nomogram.

Adolescent↗
PubMed1992

The use of computers in occupational therapy for visual-scanning training.

This study examined the effect of computer-assisted remediation, with the use of specific visual-scanning software, in the retraining of a functional scanning deficit. Three subjects who displayed significant deficits in visual scanning were selected. A single-subject study was conducted, involving an ABA multiple baseline across-subjects design. Introduction of computer-based intervention with visual-scanning software occurred after 2 to 3 weeks of the gathering of baseline data. Removal of this intervention followed six to nine sessions of 15 to 30 min each over 3 weeks, and data were collected over a 2-week return-to-baseline phase. The dependent variables--speed, accuracy, and the number of re-referencing glances--were measured on functional performance of a grocery-shelf scanning task. Analysis with the two standard deviation band method did not reveal a significant change in performance on the functional task between the three phases. Visual and graphic analyses confirmed that computer intervention did not significantly affect performance on the functional task. The clinical significance of the results suggest that software-assisted remediation may not be an appropriate modality for achievement of a functional occupational therapy outcome.

Craniocerebral Trauma↗
PubMed2004

[Development of automatic verification system for portal image in radiotherapy].

The current method of verification for external beam radiation therapy visually compares a simulation image with a portal image. However, because this method depends largely upon the observer's experience, it sometimes results in inter-observer differences. In this study, we developed software to measure atomatically the quantitative difference between the simulation image and portal image using an image-analysis method. The feasibility of this software was evaluated on a rectangular field in the pelvic region. We took 12 simulation images of a pelvic phantom, setting 4 different field shapes on each of 3 isocenters. We then obtained 84 portal images setting 7 known distances from each of the 12 simulation images. Using this software, the direction of shift was detected correctly, and the distance of shift was detected correctly to within less than 3 mm. We consider that this software could be a useful method of verification.

Computer Simulation↗
PubMed2002

[Development and evaluation of QA software for the monitor chamber of an accelerator].

The monitor chamber of a radiotherapy system needs to be calibrated once a week. Because the calibration procedure requires a large variety of complicated calculations, we have developed software that facilitates calculation and enables comparison and storage of data. According to the standard measurement of absorbed dose, we used Visual Basic 6.0 (Microsoft Corp.) to establish the calibration method. This new technique has simplified the conventional intricate calculation required for calibration of the monitor chamber and enabled automatic processing of calculated results. We have confirmed the usefulness of this software in calibrating the monitor chamber. In the routine inspection, we can compare the current data with former results. Because of this advantage, it is possible to eliminate serious accidents such as overdosing and underdosing.

Calibration↗
PubMed2005

Development of a semi-automated superimposing image verification system using a template matching algorithm in radiotherapy.

To analyze shifts in the isocenter of images, we developed a semi-automated superimposing image-verification system that is capable of automatically quantifying shifts in the isocenter through image analysis with a personal computer (PC). The accuracy and usefulness of this software were examined through a comparison of nine portal images with a simulation image and by comparing nine portal images with a DRR image, using a human pelvic phantom. The difference between the known magnitude of shift and the magnitude of shift detected with this method was analyzed as detection error. When the portal images were compared with the simulation image, the 95% confidence interval (95% CI) of detection errors (mean+/-SD) was 0.57+/-0.36 mm (95% CI: 0.49-0.65 mm). When the portal images were compared with the DRR image, the respective figures were 0.68+/-0.38 mm (95% CI: 0.59-0.77 mm). No significant difference was noted between these two categories of comparison (N.S). The absolute detection error (mean+/-SD) in all directions was 0.34+/-0.34 mm for the comparison of portal images with the simulation image and 0.41+/-0.36 mm for the comparison of portal images with the DRR image. This system seems to be appropriate for verification of the treatment field by improving the accuracy of radiotherapy as a method of computer-assisted landmark recognition during image comparison.

Algorithms↗
PubMed1997

Summary recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, The Computer-based Patient Record Institute, The Medical Library Association, The Association of Academic Health Science Libraries, The American Health Information Management Association, and The American Nurses Association.

Clinical software systems are becoming ubiquitous. A growing literature documents how these systems can improve health care delivery, but concerns about patient safety must now be formally addressed. In 1996, the U.S. Food and Drug Administration (FDA) called for discussions on regulation of software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. These recommendations were revised and approved by the American Medical informatics Association Public Policy Committee and Board. Other organizations reviewed, modified, and approved the recommendations, and the Boards of Directors of most of the organizations in the consortium endorsed the guidelines. The consortium proposes four categories of clinical system risk and four classes of monitoring and regulatory action that can be applied on the basis of the risk level. The consortium recommends that most clinical software systems be supervised locally and that developers of health care information systems adopt a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively; therefore, the FDA should exempt most clinical software systems and focus on systems that pose high clinical risk and provide limited opportunity for competent human intervention.

Clinical Medicine↗
PubMedDate not supplied

The laboratory information system as a medical device: inspection and accreditation issues.

Laboratory information systems (LISs) allow laboratories to produce more reliable results than can be provided with manual systems--as long as attention has been given to system testing, monitoring, maintenance, and repair of the LIS. Regulatory and voluntary accrediting agencies have recently begun reminding us of what we should have been doing all along--ensuring that our computerized systems are operating properly. Initial regulatory efforts caused some misunderstandings and confusion, but a more balanced approach is now being taken. The safety and reliability of software can be improved, at reasonable cost, by paying attention to standards for requirements definition, initial testing, monitoring, change control, and overall documentation. We must continue using and improving our automated systems, rather than abandoning automation in favor of error-prone manual systems.

Accreditation↗
PubMed1994

Innovations in intra-aortic balloon pump management: computer modem technology.

The computer modem technology being developed by Datascope Corporation for the purpose of off-site intra-aortic balloon pump (IABP) monitoring was clinically evaluated in 30 patients requiring IABP support. The Datascope System 95 model IABP with built-in modem was used on all patients. Remote communications via a personal computer with modem were conducted under both routine and emergency settings. The Datascope PC IABP software was evaluated for its user compatibility, efficiency, diagnostic capability and overall usefulness as a clinical tool. During the eight month evaluation period, 87 remote communications were conducted for both routine and emergency IABP evaluation checks. Adjustments were recommended on 22 occasions relevant to balloon timing, trigger mode selection and augmentation volume settings. Eight communications were initiated in emergency settings due to a variety of patient conditions. Emergency intervention was successful in diagnosing and resolving critical situations including atrial arrhythmias, pacemaker timing, low cardiac output syndrome, loss of trigger source, catheter malpositioning and poor augmentation. The diagnostic capabilities and efficient means of data collection by the computer software provide the clinician with a valuable tool for routine IABP clinical monitoring, as well as emergency problem resolution.

Adult↗
PubMedDate not supplied

Computer programs that teach the interpretation of image-based laboratory tests.

OBJECTIVE: To review the effort of the University of Washington (UW) Department of Laboratory Medicine to develop and use personal computer programs to teach the interpretation of image-based clinical laboratory tests to medical technologists and other health care workers. DATA SOURCES: Professional journals and books; Software owned by and licensed by the University of Washington. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: We have been developing interactive personal computer (PC) programs for teaching image-based laboratory tests to medical technologists and other health care workers. The programs, called "Laboratory Tutors," are useful for teaching microscope-based tests and tests based on electrophoresis. Our programs include ANA-Tutor, which teaches the immunofluorescence assay for anti-nuclear antibodies; Gram Stain-Tutor, which teaches the direct Gram stain; Electrophoresis-Tutor, which teaches the interpretation of agarose gel protein electrophoretic patterns; Urinalysis-Tutor, which teaches the microscopic examination of urine sediment; in addition to other programs. The tutorials are all based on high-quality digital images that were acquired and processed using digital imaging systems. They require minimal computer literacy and have a number of advantages over standard approaches to teaching image-based laboratory tests. The computer tutorials are used in UW's medical technology and medical school curriculum, where they are used as supplements to traditional instruction. CONCLUSION: Laboratory tutors are computer programs that use high resolution digital images to teach the interpretation of image-based laboratory tests. We plan to continue to develop these programs, study their educational effectiveness, and update them periodically.

Clinical Laboratory Information Systems↗