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At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Evaluating the appropriateness of a nurse expert system's patient assessment.

The Urological Nursing Information System (UNIS) is an expert-system prototype designed to help nurses perform patient assessments on elderly nursing home residents known to be incontinent of urine. A study was conducted to evaluate the appropriateness of the patient-assessment parameters stored in the knowledge base of UNIS. These parameters were stored as objects--a kind of template for holding related clusters of data, facts, rules, hypotheses, or any knowledge in a single conceptual unit. Each object was rated for its appropriateness by 14 nurse experts. Resulting scores ranged from +14 to -14. The effect of the nurse experts' educational backgrounds and work settings on their ratings were also analyzed. The results indicated that 95.6% of the objects received favorable ratings from the nurse experts. Educational background was not a significant factor chi 2 = 5.2, but work settings did have a significant affect chi 2 = 21.07, p = 0.01.

Aged↗
PubMed1992

An optimal controller for an electric ventricular-assist device: theory, implementation, and testing.

This paper addresses the development and testing of an optimal position feedback controller for the Penn State electric ventricular-assist device (EVAD). The control law is designed to minimize the expected value of the EVAD's power consumption for a targeted patient population. The closed-loop control law is implemented on an Intel 8096 microprocessor and in vitro test runs show that this controller improves the EVAD's efficiency by 15-21%, when compared with the performance of the currently used feedforward control scheme.

Computers↗
PubMed1990

Clinical evaluation of an automatic sensitivity adjustment feature in a dual chamber pacemaker.

The clinical evaluation of a new automatic sensitivity adjustment feature in the Cosmos II, Model #284-05 is described. This feature, designed to maintain a 2:1 safety margin for sensing intrinsic signals, was activated by way of special programmer software in ten patients at two centers. While the feature worked satisfactorily in some cases, it did not perform as expected, and undersensing in both chambers was observed. This may have been due to biasing the adjustment toward maximum rather than minimum electrograms. This study suggested that electrograms may vary by more than 100% which underscores the importance of this feature, and reinforces the need for continued development.

Algorithms↗
PubMed1990

Activation times for "emergency back-up" programs.

A bench study was performed on 34 different pulse generators to evaluate the time necessary to actuate an "emergency back-up" (EBU) program. Pacemakers were programmed to loss of capture before the EBU was activated. Two pauses were measured that included the total pause from captured beat to captured beat and the time from the first pacing artifact showing loss of capture to the first captured beat resulting from EBU activation. Special features for threshold testing such as temporary pacing, auto threshold, Vario, and an alternating pulse ventricular threshold test were also evaluated. Activation times of the EBU ranged from 1.8 to 11.1 seconds with total pauses of 2.7 to 13.2 seconds, respectively. There were considerable variations in EBU times even within a single manufacturers' pulse generators. The special features for threshold testing resulted in pauses measuring 0.6 to 3.0 seconds with total pauses of 1.2 to 4.0 seconds, respectively, and in all cases were faster than using the EBU. Utilization of the EBU to regain capture during threshold testing in pacemaker dependent patients may result in prolonged pauses and syncope or near syncopal episodes.

Electrocardiography↗
PubMedDate not supplied

Educational software evaluation process.

The Active Digital Library at the Vanderbilt University Medical Center has created and implemented an educational software evaluation process to facilitate the timely recommendation for product acquisition. Using this process, breadth and depth of subject coverage, clarity of presentation, quality of construction, and ease of use are being assessed by content and technical experts. The process uses a team approach, employing a bi-level evaluation instrument based on existing software evaluation forms and system bug reports.

Computer-Assisted Instruction↗
PubMed1991

A computer program designed for the analysis of data from rat caries studies.

The Keyes method for scoring dental caries in the rat animal model has been used as the basis for a computer-assisted scoring system on the Apple Macintosh personal computer that is described here. The program provides the ability to draw on diagrams of the rat molar dentition and to enter enamel lesion scores (L, E) and dentinal lesion scores (Ds, Dm, and Dx) for all aspects of the molars. The scores and drawings may be changed at any time. Total carious teeth and totals of L, E, Ds, Dm, and Dx are automatically calculated and presented upon user command. Error trapping for typographical errors is provided. In addition, the program provides automatic storage of the collected information, searching and sorting on any of the experimental parameters and on-disk help files that can be accessed from any place within the program. The capacity to obtain printed copy of any or all of the stored information is provided in the program. The program also enables the creation of external data files containing totals for carious teeth, in addition to L, E, Ds, Dm, and Dx totals for each animal of each group represented in the data base. These files are suitable for the transfer of data to commercially available programs for graphical and statistical analyses. The programming technique we describe could be extended to other model systems with standardized scoring for oral disease.

Animals↗
PubMed1989

Analysis of urinary stones by computerized infrared spectroscopy.

The computerized assessment of infrared spectra of urinary stones with existing programmes such as SEARCH (Lehmann, C. A. et al. (1988) Clin. Chim. Acta 173, 107-116), TWIN or CIRCOM (Hesse, A. et al. (1988) Fresenius Z. Anal. Chem. 330, 372-373) has proved to be unreliable when used for routine urinary stone analysis. A more refined method has to be used in place of simple comparison algorithms. STONES is a new programme for computerized analysis of urinary stones developed with the intention of simulating the former non-computerized analysis procedure. STONES is a rule-based system, which interprets the infrared spectra qualitatively by its rules. A quantitative result is obtained by means of library search. Combining these two methods 93% of the tests were correct with regard to clinical relevance.

Evaluation Studies as Topic↗
PubMedDate not supplied

Information systems for the community health services.

This paper is concerned with the design and implementation of an information system which fulfils some of the local needs of fourteen nursing and para-medical professions working in the community in a district health authority, whilst satisfying the statutory requirements of the NHS Körner steering group for those professions. The implementation of the computer information system was achieved through the participation of those professionals who would eventually use the system. A prototype system, which has now been extended, has been operational for some time covering the chiropody and school nursing staff groups. An evaluation of this system has shown that a significant number of the problems and objectives of those groups have been successfully addressed, the value of community health information has been increased, and information has been fed back to staff and better utilized.

Ambulatory Care Information Systems↗
PubMedDate not supplied

Evaluating medical expert systems: what to test and how?

Many believe that medical expert systems have great potential to improve health care, but few of these systems have been rigorously evaluated, and even fewer are in routine use. We propose the evaluation of medical expert systems in two stages: laboratory and field testing. In the former, the perspectives of both prospective users and experts responsible for implementation are valuable. In the latter, the study must be designed to test, in an unbiased manner, whether the system is used in clinical practice, and if it is used, how it affects the structure, process and outcome of health care encounters. We conclude with proposals for encouraging the objective evaluation of these systems.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

The evaluation of decision aids: the role of the decision owner.

This paper is a discussion of the role patient preferences should play in the evaluation of medical decision aids. The use of 'practitioner acceptability' as an unproblematic criterion in the evaluation of such aids is questioned, along with the wider imbalance in resource allocation between research relevant to the 'technical' and 'value' aspects of medical decision-making.

Decision Making, Computer-Assisted↗
PubMedDate not supplied

Evaluating black-boxes as medical decision aids: issues arising from a study of neural networks.

The rigorous evaluation of medical decision aids will be critical to promoting their development, establishing their clinical value and legalizing their use. Many decision aids are transparent in the sense that their internal structure and function can be examined and verified. Some decision aids, however, use complex models of associations in training data to construct 'black-box' systems whose workings are largely impenetrable and inexplicable. The issues surrounding the evaluation of such systems, as exemplified by connectionist (neural network) models, are discussed. For such systems the two major aspects that can be evaluated are the training data from which the system is derived, and its performance on test data. A number of questions about the use of black-box systems as medical decision aids are posed which require consideration by the medical informatics community.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

Human-computer interface evaluation: not user-friendliness but design for operation.

This paper considers human-computer interface evaluation in the context of design and development. It is argued that it is not helpful to view evaluation as a method for achieving user-friendliness, rather it should be seen as a participating activity within design and development. The centre of concern is the operation of the system when employed in practice. Such evaluation is not necessarily to be conducted by independent observation and experiment, but may be closely integrated with other design activities. In fact the very theory underlying the evaluation finds its embodiment in the artifact of the user interface. Taking this view has technical, as well as human factors, implications.

Decision Making, Computer-Assisted↗
PubMedDate not supplied

Field trials of Baby Check: a scoring system to quantify illness in babies under 6 months.

Baby Check, a scoring system for quantifying illness in young babies, was developed from a study of 1007 well and ill babies in Cambridge and Melbourne. This paper describes the setting up of field trials to test the performance of the scoring system when used by mothers, GPs and hospital doctors. Preliminary results suggest that the scoring system is attractive, easy to use, useful and of high specificity. Its sensitivity to serious illness is also thought to be high but this will become clearer when the main hospital field trial has been completed.

Diagnosis, Computer-Assisted↗
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↗
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↗