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A well-defined method for the design and development of software leads to more reliable software and products that get to market quicker. This article describes how to achieve this and examines good practice, modelling and embedded systems.
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UNLABELLED: The OLINDA/EXM version 1.0 personal computer code was created as a replacement for the widely used MIRDOSE3.1 code. This paper documents the basic function of the code and how it is similar to and different from the MIRDOSE software. METHODS: After creation of the code and alpha- and beta-testing phases, a premarket notification submission (510(k)) was filed with the Food and Drug Administration to permit marketing of the code. Permission was granted in June 2004, and the code is currently being distributed through Vanderbilt University. Not all of the technical details of the dosimetry methods have been shown here, as they have been previously documented. RESULTS: Agreement of doses between the MIRDOSE3.1 and OLINDA/EXM codes was good, within 1%-2% in most cases. CONCLUSION: The extensive testing of the OLINDA/EXM code, based on comparison with literature-established dose calculations and with the widely tested and accepted MIRDOSE3.1 code, should give users confidence in its output. The OLINDA/EXM code should be easy for MIRDOSE users to adopt and for new users to understand. It will be useful in standardizing and automating internal dose calculations, assessing doses in clinical trials with radiopharmaceuticals, making theoretic calculations for existing pharmaceuticals, teaching, and other purposes.
The ability to collect, store, and retrieve community health data is critical to providing health services in a timely and efficient manner. With the widespread availability of computer hardware and software that can assist in this process, the task is becoming easier. One important tool is the database management system (DBMS). A DBMS provides a conceptual framework to assist in organizing data and software that can physically store, maintain and retrieve data. The most popular DBMSs available today support the Relational Data Model, which has a conceptual framework that provides for the organization of data in tables. The authors present a database design, using the Relational Data Model, for a database of community health data.
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Domain-specific modelling is being advocated as the method of choice for increasing productivity and consistency in software development. This article describes how it can be applied.
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The purpose of this paper was to describe the development and testing of a computer simulation program designed to assess the decision-making process in the public health nurses' work in child health care. The work was based primarily on theories of problem-solving and decision making; on knowledge of child development, health care, and education; and on the soft systems methodology. An authoring program and two simulations were designed and produced at the University of Turku by a team of two nurse researchers, a computer specialist, and three public health nurses. The simulations presented two typical situations encountered by the public health nurses' work in child health care. A total of 61 public health nurses from 11 health centers in the southwestern part of Finland completed the simulations. The public health nurses responded positively to the simulations and the program worked very well. The results revealed some inconsistencies in the decision-making process of the public health nurses with respect to the needs of the child and the family. The public health nurses' decisions were more closely related to the developmental stage of the child than to the unique needs of each family. The simulation is acting to test the public health nurses' ability to make decisions "here and now" but not about caring it forward. These shortcomings can be corrected by asking them to explain their decisions and thoughts after each stage and by tape recording their answers. The findings gave many answers to the question of how the computer simulation program can be developed.
AIM: To evaluate the accuracy of the 3-dimensional laser scanner and to propose reproducible soft tissue landmarks in the 3-dimensional facial images. METHODS: A mannequin head was preliminarily scanned 6 times to calculate scanning errors. Mean errors in the linear measurements from the scanned images and the actual mannequin head were assessed and the magnification rate of the scanned images was calculated. The soft tissue landmarks were defined in the mannequin head and the patients with normal, Class II, and Class III malocclusions. The reliability and the reproducibility were investigated by comparing the x-, y-, and z-coordinate of each landmark gained from repeated landmarking procedure. RESULTS: Scanning errors were 0.16 mm in the x axis, 0.15 mm in the y axis, and 0.15 mm in the z axis. The mean error of scanned image was 0.37 mm and the magnification rate was 0.66%. In the four 3-dimensional images, the standard deviations in the localization of all landmarks were less than 1.0 mm in the x, y, and z axes. CONCLUSION: The laser scanner is a useful tool for understanding the 3-dimensional facial structure, and the soft tissue landmarks proposed in this study were considered highly reproducible and reliable.
With the development of 3-dimensional technology it has become increasingly possible to record the facial soft tissue changes that occur with growth and following orthodontic treatment. This article describes the use of the optical surface laser scanner to record and quantify the facial soft tissue changes following orthognathic surgery. Ten skeletal Class III patients were laser scanned, at previously determined time intervals, over a 6-month period following orthognathic surgery. Computer superimposition of the scanned images provided a graphic demonstration of the soft tissue changes as they occurred between the time intervals. Analysis of the results demonstrates a nonuniform, asymmetric resolution of facial swelling and adaptation of the soft tissues to the altered skeletal structure. This occurred principally over the initial 4 months following surgery. However, smaller changes continued to occur throughout the study period. This suggests that the facial soft tissues continue to change over a period of greater than 6 months. This knowledge is important as it is integral for obtaining informed consent from patients.
OBJECTIVES: Medical telecare services' designing and redesigning still remains a challenging issue since it often depends on how a number of socio-technological issues are framed. This work has two key objectives; the former is to theoretically analyze the nature of a telecare environment by developing a model that reveals potential areas of analysis and the latter is to support designing and redesigning medical telecare services by formulating a strategy as well as a number of 'state of the art' guidelines. METHODS: We have extended Leavitt's diamond to develop a model capable of accurately reflecting the telecare environment building dimensions as well as their interactions. This model depends on the i) technology, ii) collaborators, iii) tasks, iv) structure, v) social forces, and the vi) procedure dimensions. Taking this model as a core element we have proposed a service designing and redesigning strategy formulating, in parallel, six scalable dimension-oriented guidelines. RESULT: During the two-year period (2003-2005) an enormous amount of data was collected (by active participating in two EU projects, by conducting semistructured interviews, by performing onsite observations as well as by reviewing 78 previous projects) and classified, structuring six guidelines. These guidelines can be considered as the 'state of the art' to support future services' design and redesign. CONCLUSIONS: This work considering the telecare environment as a multi-dimensional, operational organization has put the focus on accurate telecare services' design and redesign. The parameters are not limited, by any means, and are drawn from experience of designing services in a variety of telecare domains. The optimal parameter combination must be chosen according to the aim of each telecare procedure. Further research is needed to determine the minimum parameters to support telecare service design.
This study deals with a set of coding directives that were conceived for trained coding clerks and rely upon knowledge of their cultural background. These directives were formalized and adapted for computer use and in this form must rely upon a background of explicit medical knowledge. Medical data on death certificates are an invaluable source of information regarding prevention of major causes of death. These causes are coded and tabulated worldwide by means of the International Classification of Diseases (ICD). The ICD manual issues directives to achieve uniformity of coding throughout the world. The coder is required to trace back the flow of events which caused death and to single out the most significant concept from the statistical point of view. After emphasizing the problems encountered in the formalization, the methodological contribution of this work to the identification of a modular architecture for a system which represents and "reshapes" knowledge from medical documents is presented. Therefore we focus on the features of the two kinds of knowledge that must be supplied to a knowledge-based system, in order to enable it to perform semantic conversions on given medical data, namely: i) generic guidelines; ii) detailed medical knowledge.
The authors have developed a one step quantitative method for radioimmunoassay optimization. The method is rapid and necessitates only to perform a series of saturation curves with different titres of the antiserum. After calculating the saturation point at several antiserum titres using the Scatchard plot, the authors have produced a table that predicts the main characteristics of the standard curve (Bo/T, Bo and T) that will prevail for any combination of antiserum titre and percentage of sites saturation. The authors have developed a microcomputer program able to interpolate all the data needed to produce such a table from the results of the saturation curves. This computer program permits also to predict the sensitivity of the assay at any experimental conditions if the antibody does not discriminate between the labeled and the non labeled antigen. The authors have tested the accuracy of this optimization table with two in house RIA systems: 17-beta-estradiol, and hLH. The results obtained experimentally, including sensitivity determinations, were concordant with those predicted from the optimization table. This method accelerates and improves greatly the process of optimization of radioimmunoassays.
Continuing from the previous paper (Byass 1989), practical considerations in setting up a computer system to assist in the collection of data from an epidemiological project are discussed. Organizing field work so as to facilitate computer processing is considered, together with establishing data entry and checking procedures. The use of the hypothetical example in the first paper is continued here.
External stereotactic radiotherapy allows to irradiate a small and carefully delimited intracranial volume according to the spatial definition of the target. To determine the distribution of the dose in the volume irradiated, we developed a dosimetric programme adapted to our particular treatment conditions (arc therapy in the frontal and oblique planes converging onto the centre of the target volume with circular beams 8 to 20 mm in diameter using 18 MV X photons). The principle of the programme is a 3D reconstruction based on ten transverse CT slices. This reconstruction, related to the stereotactic coordinates defined during stereotactic localization, visualises the outline of each oblique frontal treatment plane and the outline of the three perpendicular reference planes passing through the centre of the target volume (i.e. transverse, sagittal, coronal). The isodose distribution is then calculated in the planes defined by these reconstructions. Under treatment conditions, we use the parameters measured for each beam with their additional collimation. We present an evaluation of this software performed on a phantom consisting of a skull containing a defined target.
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In an international project investigators from 21 institutes are trying to establish a common reference library and evaluation methods for testing the diagnostic performance of various ECG computer programs using ECG independent clinical information. Preliminary results indicate that the classification accuracy of different programs varies widely.