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PubMed1995

The medical information superhighway.

Commercial and private use of the Internet has grown exponentially over the last few years. Its estimated size increases by more than 10% per month. Medical information and resources are now available to aid physicians in practice and in research. Users can utilize email to communicate with other medical professionals around the world. The newest and possibly most significant development on the Internet is the World Wide Web. Through it, physicians may access multimedia resources such as databases of medical information, recent news and research, atlases, and electronic journals using an intuitive graphics interface. Medically related software can be obtained from the vast archives on the Internet via the FTP function. As the Internet expands and becomes more ubiquitious, its uses will multiply and become an important mode of medical information dissemination and acquisition.

Computer Communication Networks↗
PubMed1995

A complex cerebrovascular screening system (CERBERUS).

Stroke is unique among neurological diseases since it has a high incidence rate, severe burden of illness, high economic cost, and it may be preventable [1]. Described here is a system for screening the cerebral and vascular status of individuals to detect the initial stages of vascular disorders. The computer based polygraphic system (CERBERUS) questions subjects about risk factors, stresses, neurologic symptoms and monitors impedance pulse waves of the head and extremities, EEG, and ECG. The system has been tested in 691 cases. Doppler control studies were carried out on approximately 300 of these cases. Additional somatic measures and psychological tests related to stroke risk factors were carried out for wide biological basis of possible correlation of CERBERUS data base. The high incidence of cerebrovascular disturbance was established by CERBERUS data, further confirmed by additional data gathered, and moreover was compared by traditional medical records. The polygraphic system is more sensitive at detecting physiological asymmetries of blood flow than even a Doppler measurements. This suggests that it may be a significantly improved means for the differential diagnosis of neurological disease and the screening of subjects for arteriosclerosis, transient ischemic attack and stroke prevention to be offered at the lowest level of medical service.

Adolescent↗
PubMed1995

End-user search behaviors and their relationship to search effectiveness.

One hundred sixty-one MEDLINE searches conducted by third-year medical students were analyzed and evaluated to determine which search moves were used, whether those individual moves were effective, and whether there was a relationship between specific search behaviors and the effectiveness of the search strategy as a whole. The typical search included fourteen search statements, used seven terms or "limit" commands, and resulted in the display of eleven citations. The most common moves were selection of a database, entering single-word terms and free-text term phrases, and combining sets of terms. Syntactic errors were also common. Overall, librarians judged the searches to be adequate, and students were quite satisfied with their own searches. However, librarians also identified many missed opportunities in the search strategies, including underutilization of the controlled vocabulary, subheadings, and synonyms for search concepts. No strong relationships were found between specific search behaviors and search effectiveness (as measured by the librarians' or students' evaluations). Implications of these findings for system design and user education are discussed.

Computer Literacy↗
PubMed1993

Prediction of primate splice junction gene sequences with a cooperative knowledge acquisition system.

We propose a cooperative conceptual modelling environment in which two agents interact: the machine and the human expert. The former is able to extract knowledge from data using a symbolic-numeric machine learning system, and the latter is able to control the learning process by accepting and validating the machine results, or by criticizing those results or the explanation that the system produces on them. The improvement of the conceptual modelling relies on the cooperation between the two agents. Results obtained with our method on prediction of primate splice junctions sites in genetic sequences are far better than those reported in the literature with other symbolic machine learning systems, and are as better as those obtained with some artificial neural networks methods reported at present. But in opposite to neural networks which lack of argumentation, our system provides the user a plausible explanation of its prediction.

Algorithms↗
PubMed1993

Protein structure prediction system based on artificial neural networks.

Methods based on the neural network techniques are among the most accurate in the secondary structure prediction of globular proteins. Here the same principles have been used for the tertiary structure prediction problem. The map of dihedral phi and psi angles is divided into 10 by 10 squares each spanning 36 by 36 degrees. By predicting the classification of each residue in the protein chain in this map a rough tertiary structure can be deduced. A complete prediction system running on a cluster of workstations and a graphical user interface was developed.

Amino Acid Sequence↗
PubMedDate not supplied

Using interactive video to add physical assessment data to computer-based patient simulations in nursing.

The use of computer-based simulations can enhance problem-based learning in nursing education. Adding interactive video allows students to "see" the patient they are interviewing and to "examine" the patient rather than having the examination findings described by the software developer. These features both increase the realism of the simulations and challenge the learner to interpret the physical examination findings. The use of interactive videotape has proved to be a medium that lends itself to in-house production of interactive video.

Computer Simulation↗
PubMed1995

Three-dimensional reconstruction of a bullet path: validation by computed radiography.

Three-dimensional visualization is an important tool in the evaluation and demonstration of injury. Creating convincing graphics, however, requires strict distinction between illustrative and reconstructive visualizations and a method of validation. We present a case in which we used a radiation-planning tool to provide a 3-dimensional illustrative visualization of a contact gunshot wound to the head, and validated the result by comparing computed radiographs with radiographs taken at autopsy. We discuss the use of visualization tools for data exploration in forensic pathology.

Adult↗
PubMed1995

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Blue Cross Blue Shield Insurance Plans↗
PubMed1995

An Internet-based nuclear medicine teaching file.

UNLABELLED: Teaching file cases play an important role in the training of nuclear medicine residents; however, film-based teaching files have limitations, such as difficulty in accessing cases in a department with several remote clinical sites. The goal of this project was to develop a digital teaching file with the capability for local and remote (Internet) network access, with the additional requirements that viewing existing cases and addition of new cases be easy and simple. METHODS: The teaching file software (TF-Web) utilizes applications developed for the World-Wide-Web in combination with locally developed programs for importing images, entering case information, indexing, searching, case selection and case editing. The time required to add cases to the TF-Web and to access existing cases from local and remote network sites as well as computer storage requirements were assessed. RESULTS: Cases entered in TF-Web may be viewed either with or without diagnoses and may be accessed with acceptable speed (2-14 sec) from both local and remote network sites. A relatively complex case required 1.2 megabytes of storage, with lesser storage requirements for simpler cases. CONCLUSION: A digital teaching file has been developed that allows easy access from computers located both locally and elsewhere on the Internet. Digital storage requirements are reasonable, and, because of the unique nature of TF-Web, case storage may be distributed among multiple institutions.

Computer Communication Networks↗
PubMed1995

User interface reengineering. Innovative applications of bar coding in a clinical microbiology laboratory.

Some clinical laboratory departments (such as microbiology) provide extensive reporting of text and other data not generated by instruments that can be interfaced to a laboratory information system. These data are usually entered into the laboratory information system manually by keyboard data entry, which can be cumbersome and time consuming. Bar codes, which are already used in laboratories to facilitate rapid entry of sample-identifying information, have the potential to be used much more broadly as a generalizable data entry technique. We developed a comprehensive system that takes advantage of several applications of bar coding to facilitate the work of our Clinical Microbiology Laboratory. Central to our system is the use of bar code "scripts" to meet many of our complex data entry requirements. Use of these scripts is transparent to the laboratory information system (ie, no special "drivers" are needed) because data are received as if they had been generated by typing the characters on the keyboard. The scripts consist of bar codes that encode the series of keystrokes needed to give the appropriate response at the series of prompts offered by the laboratory information system. Both alphanumeric and other keys, including carriage returns and special characters, can be converted into bar codes and incorporated into scripts. By creating and printing these scripts in the laboratory using standard wordprocessing software and bar code fonts for personal computers, laboratorians without specialized computer training have the tools to substantially improve the data entry efficiency of existing data entry terminals for a variety of laboratory information systems.

Clinical Laboratory Information Systems↗
PubMed1994

[Ergonomics of computer programs].

There are many different factors to be taken into account while planning, designing and implementing user interface to a new programme. The most important factors are price, quality, documentation, installation and ergonomic properties of software. Ergonomic aspects are classified into two groups. One group deals with problems of direct human-computer interaction e.g. sort of dialogues, screen layout, response time. The other deals with problems of flexibility, consistency, structuring. Out of a number of ergonomic factors, some of the most important are listed in this paper.

Ergonomics↗
PubMed1995

The evolution of the implanted pacemaker's window to the world.

An implanted pacemaker can only communicate with the outside world through its window, i.e., the clinical programmer. Since its inception, the pacemaker has evolved from a non-programmable device to a complex device. Therefore, programming a modern implantable pacemaker could be very challenging for non-experienced or infrequent users. Various programmer-based automatic functions have been developed to reduce programming time and complexity and to obtain accurate measurements. With increasing interests in the telecommunications and information exchange, these programmer-based automatic functions are pushing forward a future vision that automatic pacemaker follow-up procedures via telecommunications are possible for patients located in any corner of the globe.

Biomedical Engineering↗
PubMed1995

Integrating legacy laboratory information systems into a client-server world: the University of Minnesota Clinical Workstation (CWS) project.

The development of an innovative clinical decision-support project such as the University of Minnesota's Clinical Workstation initiative mandates the use of modern client-server network architectures. Preexisting conventional laboratory information systems (LIS) cannot be quickly replaced with client-server equivalents because of the cost and relative unavailability of such systems. Thus, embedding strategies that effectively integrate legacy information systems are needed. Our strategy led to the adoption of a multi-layered connection architecture that provides a data feed from our existing LIS to a new network-based relational database management system. By careful design, we maximize the use of open standards in our layered connection structure to provide data, requisition, or event messaging in several formats. Each layer is optimized to provide needed services to existing hospital clients and is well positioned to support future hospital network clients.

Artificial Intelligence↗
PubMed1995

Multi-dimensional visualisation of laboratory findings and functional test results for analysing the clinical course of disease in medicine.

The illustration of a patient's history by a graphical primitive is discussed. Illustration technology is presented which simultaneously represents quantitative examination findings (e.g., laboratory values) and qualitative findings (e.g., from function diagnostics) by a single geometrical figure. Depending on the medical results, this figure takes on characteristic forms which can be identified as patterns typical for a specific disease. The procedure developed is integrated in a user interface which is implemented in the form of a computerized medical record for use on a pentop computer. This portable computer assists the physician during ward rounds, supplies additional, intelligence-based information, serves quality control, and streamlines working procedures making them more efficient.

Clinical Laboratory Information Systems↗
PubMedDate not supplied

Exploring the Internet.

The Internet is a vast network connecting smaller networks of computers in the United States and overseas. The chief existing structure that will support the proposed information superhighway, the Internet has grown exponentially in recent years. It is now a major tool for sharing computer resources, research issues, and communication with groups or individuals. This review will describe the history of the Internet, the various ways of connecting to it, and some of the tools that are particularly useful for medical researchers and clinicians.

Computer Communication Networks↗