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Prognostic role of single-photon emission computed tomography (SPECT) imaging in myocardial viability.

PURPOSE OF REVIEW: Cardiac imaging is evolving rapidly. Appropriate use of this technology could reduce morbidity and mortality, but inappropriate use could have a significant financial burden. Single-photon emission computed tomography imaging is widely available. This review summarizes the clinical utility and limitations of the prognostic role of single-photon emission computed tomography imaging for myocardial viability in patients with coronary artery disease and left-ventricular dysfunction. RECENT FINDINGS: 201Tl single-photon emission computed tomography, 99mTc single-photon emission computed tomography with sestamibi or tetrofosmin, and 18F-fluorodeoxyglucose single-photon emission computed tomography are validated tools for assessing myocardial viability. These techniques have a very similar predictive value in determining regional and global response to revascularization. 201Tl single-photon emission computed tomography viability studies are predictive of reverse left-ventricular remodeling, symptom improvement, and patient outcome after revascularization. Combination imaging with dual-isotope simultaneous acquisition single-photon emission computed tomography or positron-emission tomography/single-photon emission computed tomography may improve the positive and negative predictive values of single-photon emission computed tomography-based viability studies. SUMMARY: Single-photon emission computed tomography-based myocardial viability testing is an important diagnostic modality due to widespread availability and reasonably good sensitivity and specificity for detecting viable myocardium and predicting clinical and functional responses to revascularization. In the future single-photon emission computed tomography viability techniques may have a prognostic role in predicting responses to cardiac resynchronization therapy and evaluating myocardial stem-cell transplantation.

Coronary Artery Disease↗

Mediastinal staging of bronchial carcinoma: can computed tomography replace mediastinoscopy?

In bronchial carcinoma the assessment of operability requires an accurate evaluation of the regional and mediastinal lymph nodes. For this, both mediastinoscopy and computed tomography are often used on a routine basis today. The present work considers the relative value of these two methods of investigation. Fifty-seven patients with bronchial carcinoma, in whom both investigations were carried out prior to surgery, were included in this prospective study. In the computed tomogram, lymph nodes with a diameter of more than 1 cm were defined as positive (i.e. suspected malignant infiltration). Sixteen of the 57 patients had histologically confirmed lymph node metastases; in 13 cases the metastases were detected by computed tomography, in 12 cases also by mediastinoscopy and in 3 cases only at thoracotomy. In 41 of the thoracotomized patients, no mediastinal metastases were found. As was to be expected, mediastinoscopy also proved negative in these cases. In 9 of these cases, however, the preoperative computed tomography findings were false-positive. For computed tomography the specificity was 78% and the sensitivity 81%; for mediastinoscopy, on the other hand, the specificity was 100% and the sensitivity 75%. The specificity of computed tomography is too low. Also, lymph nodes which are only inflamed may be considerably enlarged and cannot be differentiated in the computed tomogram from those with malignant infiltration. Mediastinal lymph nodes which appear enlarged in the computed tomogram therefore have to be further investigated by mediastinoscopy. However, in this prospective study, mediastinoscopy provided no additional information in those cases in whom the computed tomography findings were negative (lymph node diameter less than or equal to 1 cm); it did not detect the metastases in the 3 patients with false-negative computed tomography findings. Therefore, in the case of a negative computed tomogram, thoracotomy may be performed immediately, without previous mediastinoscopy.

Adult↗

Estimation of pubertal mammary development in heifers by computed tomography.

Computed tomography scanning is introduced as a new technique to quantify parenchymal tissue of heifer mammary glands. Tissue types with different densities attenuate x-rays differently, and computed tomography is based on computer processing of such x-ray attenuation data. Different tissue types can be quantified by summation of defined x-ray attenuation data. Parenchymal tissue was quantified in mammary glands from 25 heifers by computed tomography as well as by dissection and chemical analysis. Parenchymal tissue amounted to 455 g when measured by dissection and 106 cm3 when measured by computed tomography. This difference is related to the ability of computed tomography to exclude extraparenchymal tissue from the estimate. Computed tomography estimates of parenchymal tissue were more closely correlated with amount of fat-free parenchyma than with total parenchyma weight. This suggests that estimates obtained by computed tomography have less variation than estimates obtained by dissection due to the ability of computed tomography to exclude extraparenchymal tissue. Use of computed tomography furthermore eliminates the element of subjectivity present in methods that include dissection. It is concluded that computed tomography can provide reliable estimates of parenchymal tissue of heifer mammary glands.

Animals↗

Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control.

BACKGROUND: The demand for effective behavior therapy for obsessive-compulsive disorder (OCD) by exposure and ritual prevention exceeds its supply by trained therapists. A computer-guided behavior therapy self-help system (BT STEPS) was created that patients access by telephone from home via interactive voice response technology. This study compared the value of computer-guided behavior therapy value with that of clinician-guided behavior therapy and systematic relaxation as a control treatment. METHOD: After screening by a clinician, 218 patients with DSM-IV OCD at 8 North American sites were randomly assigned to 10 weeks of behavior therapy treatment guided by (1) a computer accessed by telephone and a user workbook (N = 74) or (2) a behavior therapist (N = 69) or (3) systematic relaxation guided by an audiotape and manual (N = 75). RESULTS: By week 10, in an intent-to-treat analysis, mean change in score on the Yale-Brown Obsessive Compulsive Scale was significantly greater in clinician-guided behavior therapy (8.0) than in computer-guided (5.6), and changes in scores with both clinician-guided and computer-guided behavior therapy were significantly greater than with relaxation (1.7), which was ineffective. Similarly, the percentage of responders on the Clinical Global Impressions scale was significantly (p < .05) greater with clinician-guided (60%) than computer-guided behavior therapy (38%), and both were significantly greater than with relaxation (14%). Clinician-guided was superior to computer-guided behavior therapy overall, but not when patients completed at least 1 self-exposure session (N = 36 [65%]). At endpoint, patients were more satisfied with either behavior therapy group than with relaxation. Patients assigned to computer-guided behavior therapy improved more the longer they spent telephoning the computer (mostly outside usual office hours) and doing self-exposure. They improved slightly further by week 26 follow-up, unlike the other 2 groups. CONCLUSION: For OCD, computer-guided behavior therapy was effective, although clinician-guided behavior therapy was even more effective. Systematic relaxation was ineffective. Computer-guided behavior therapy can be a helpful first step in treating patients with OCD when clinician-guided behavior therapy is unavailable.

Adolescent↗

How medical students use the computer and Internet at a Turkish military medical school.

The aim of this study was to determine how medical students use the computer and World Wide Web at a Turkish military medical school and to discuss characteristics related to this computer use. The study was conducted in 2003 in the Department of Public Health at the Gulhane Military Medical School in Ankara, Turkey. A survey developed by the authors was distributed to 508 students, after pretest. Responses were analyzed statistically by using a computer. Most of the students (86.4%) could access a computer and the Internet and all of the computers that were used by students had Internet connections, and a small group (8.9%) had owned their own computers. One-half of the students use notes provided by attending stuff and textbooks as assistant resources for their studies. The most common usage of computers was connecting to the Internet (91.9%), and the most common use of the Internet was e-mail communication (81.6%). The most preferred site category for daily visit was newspaper sites (62.8%). Approximately 44.1% of students visited medical sites when they were surfing. Also, there was a negative correlation between school performance and the time spent for computer and Internet use (-0.056 and -0.034, respectively). It was observed that medical students used the computer and Internet essentially for nonmedical purposes. To encourage students to use the computer and Internet for medical purposes, tutors should use the computer and Internet during their teaching activities, and software companies should produce assistant applications for medical students. Also, medical schools should build interactive World Wide Web sites, e-mail groups, discussion boards, and study areas for medical students.

Computers↗

The gap between exposure and implementation of computer workstation ergonomics in the workplace.

The population of people using computers is increasing in home, school and work environments [20,21]. Research suggests that more computer usage may lead to increased incidence of upper extremity cumulative trauma disorder (UECTD) and other work related musculoskeletal injuries [8]. Yet, proper computer workstation ergonomics training is not readily available. This pilot study attempts to better understand the gap between ergonomic interventions and the initiation of work-practice change. The pilot study used self-report through an anonymous Internet survey to explore university faculty and staff training in computer workstation ergonomics, assess UECTD and other computer-use related symptoms, and learn about the respondents' success implementing their knowledge of computer workstation ergonomics. The 55 respondents ranged in age from 21 to 65, and spent an average of 5.3 hours at the computer during a typical workday. Over 70% of respondents experienced symptoms associated with excessive computer use. Although 60% of respondents had exposure to computer workstation ergonomics information, less than 10% reported implementing their knowledge of computer workstation ergonomics in their tasks. This paper looks at organizational and individual issues preventing the implementation of computer workstation ergonomics in the workplace. The Transtheoretical Model for Health Behavior Change [25,27] is used to further evaluate effectiveness of ergonomic interventions. Recommendations for interventions and future evaluations are presented.

Adult↗

Computer-based interview for screening blood donors for risk of HIV transmission.

OBJECTIVE: To test the ability of a computer-based interview to detect factors related to the risk of the human immunodeficiency virus (HIV) among potential blood donors and to determine donor reactions to the use of the interview. DESIGN: A comparison of the rate of detection of HIV-related factors elicited by a computer interview with that obtained by standard American Red Cross procedures for assessment of donor suitability, including a randomized crossover trial in which the order of the two methods was reversed. Information obtained by the computer was not available to influence the use of blood components for transfusion. SETTING: The computer interview was administered to donors at an American Red Cross blood donor center and at a mobile blood drive at a hospital. SUBJECTS: Consecutive sample of 294 male and female blood donors 18 to 75 years of age. MAIN OUTCOME MEASURES: Subjects' responses to the computer-based interview as well as responses to the standard Red Cross written questionnaires and face-to-face interviews were used for donor assessment. RESULTS: The interview took an average of 8 minutes to complete. From among 272 donors who provided complete data, the computer identified 12 donors who reported either behaviors associated with a risk of HIV acquisition or symptoms compatible with the acquired immunodeficiency syndrome; none of these donors had been so identified either by routine written questionnaires or by face-to-face interviews used to screen potential blood donors. Only one of the 12 identified donors used the confidential unit exclusion procedure to prevent use of his donated unit. The rate of elicitation of HIV-related factors by the computer interview was 12 (4.4%) of 272 (95% confidence interval [CI], 2.3% to 7.6%), compared with two (0.13%) of 1536 (95% confidence upper bound, 0.28%) using the standard Red Cross procedure (P less than .0001). Tests for antibodies to HIV were negative in blood samples from all of the 272 subjects studied. The subjects enjoyed the computer interview and judged it to be more private than the standard donor assessment method. They also predicted that donors would be more honest with the computer interview than with a human interviewer. CONCLUSIONS: Computer-based screening elicits more HIV-related factors in the health histories of blood donors than do the standard questionnaire and interviewing methods currently in use. Computer-based screening is also acceptable to blood donors.

Adolescent↗

Diagnostic efficacy of hepatic computed tomography in the detection of body iron overload.

To determine whether or not hepatic computed tomography density is an alternative to liver biopsy for the diagnosis of body iron overload, hepatic computed tomography density was determined in healthy controls, patients with idiopathic hemochromatosis, and patients with liver disease. Hepatic computed tomography density was obtained from a single computed tomography slice taken through the liver on a General Electric CT/T 8800 scanner. In 69 controls, hepatic computed tomography density ranged from 11 to 36 units (mean = 30). Given an upper limit of normal of 36 computed tomography units, 4 of 6 untreated patients with idiopathic hemochromatosis had elevated hepatic computed tomography density compared with 0 of 8 patients after venesection (X2 = 7.5, p = 0.01). Hepatic computed tomography density correlated directly with serum ferritin (r = 0.72, p = 0.01). In 58 consecutive patients with clinical or biochemical evidence, or both, of liver disease who underwent liver biopsy for diagnostic purposes, 0 of 52 patients with normal hepatic iron had an elevated hepatic computed tomography density as compared with 4 of 6 patients with excess iron (X2 = 35, p less than 0.001). An elevated hepatic computed tomography density associated with an elevated serum ferritin indicates iron overload; however, a normal hepatic computed tomography density does not exclude iron overload. When computerized tomography is applied to patients with an unexplained elevation of the serum ferritin, it provides a noninvasive alternative to liver biopsy for the detection of excess hepatocellular iron.

Adult↗

The impact of computers on electrocardiography.

The development of the electrocardiograph was the culmination of a scientific effort aimed at perfection of a device conceived for the elucidation of a physiologic phenomenon. The development of the digital computer was the culmination of a scientific effort aimed at perfection of warfare. Both of these fairly recent innovations of modern technology have been moderately successful in their initial objectives. Electrocardiography has had a profound influence on the practice of medicine. On the global scene, computers have so far had an insignificant influence on the practice of electrocardiography. In North America, however, computer interpretation of ECGs has already made a modest impact, perhaps more in terms of commercial gains rather than producing a substantial benefits to health care. The introduction of computers into clinical electrocardiography has not resulted in any widespread application of improved diagnostic criteria. The automation of ECG interpretation has not resulted in reduction of the cost of health care, on the contrary, in general it has increased the cost. Perhaps the most dismal failure has been the negligible use of computers in epidemiologic studies and heart disease prevention efforts. Palmistry, astrology, the art of palpation of the pulse, auscultation and acupuncture have had a more profound influence on the practice of medicine than computer analysis of the electrocardiogram. On the positive side, one of the beneficial effects of the use of computers has been the increasing awareness of the limited diagnostic accuracy of currently used ECG criteria, and the recognition of the fact that a substantial improvement is warranted; if such improvement can not be achieved in the foreseeable future, electrocardiography will lose much of its current clinical utility. Computers have had a profound influence on research in electrocardiology, and although a very few tangible concrete results have thus far diffused into clinical electrocardiography, their impact can be expected during the last two decades of this century. Computers will produce at least containment of costs if not actual net cost reduction in clinical electrocardiography. Computer analysis will rapidly antiquate the present primitive visual ECG classification in epidemiologic studies and clinical heart disease intervention trials. Computer analysis will enhance the diagnostic accuracy of the electrocardiogram. However, a radical departure from the current ECG display and interpretation practice will be mandatory before any substantial breakthrough can be materialized. All these anticipated evolutionary and perhaps even revolutionary changes will require a continuing intensive research effort, a change in the professional attitude of practicing electrocardiographers and a considerable effort in professional education. Finally, the elucidation and exploration of the full diagnostic and predictive value of the ECG remains the challenge of first magnitude in electrocardiography...

Adult↗

Towards computing with proteins.

Can proteins be used as computational devices to address difficult computational problems? In recent years there has been much interest in biological computing, that is, building a general purpose computer from biological molecules. Most of the current efforts are based on DNA because of its ability to self-hybridize. The exquisite selectivity and specificity of complex protein-based networks motivated us to suggest that similar principles can be used to devise biological systems that will be able to directly implement any logical circuit as a parallel asynchronous computation. Such devices, powered by ATP molecules, would be able to perform, for medical applications, digital computation with natural interface to biological input conditions. We discuss how to design protein molecules that would serve as the basic computational element by functioning as a NAND logical gate, utilizing DNA tags for recognition, and phosphorylation and exonuclease reactions for information processing. A solution of these elements could carry out effective computation. Finally, the model and its robustness to errors were tested in a computer simulation.

Adenosine Triphosphate↗

Role of virtual computed tomographic colonography in patients with colorectal cancers and obstructing colorectal lesions.

PURPOSE: The aim of this study was to assess the ability of computed tomographic colonography to diagnose colorectal masses, stage colorectal cancers, image the proximal colon in obstructing colorectal lesions, and evaluate the anastomoses in patients with previous colorectal surgery. METHODS: We prospectively performed computed tomographic colonography examinations in 34 patients (20 males; mean age, 64.2; range, 19-91 years): 20 patients had colorectal masses (defined at endoscopy as intraluminal masses 2 cm or larger), 7 patients had benign obstructing colorectal strictures, and 7 patients had a prior colorectal resection. Final tumor staging was available in all 16 patients who had colorectal cancers and 15 patients were referred after incomplete colonoscopy. The ability of computed tomographic colonography to stage colorectal cancers, identify synchronous lesions in patients with colorectal masses, and image the proximal colon in patients with obstructing colorectal lesions was assessed. RESULTS: Computed tomographic colonography identified all colorectal masses, but overcalled two masses in patients who were either poorly distended or poorly prepared. Computed tomographic colonography correctly staged 13 of 16 colorectal cancers (81 percent) and detected 16 of 17 (93 percent) synchronous polyps. Computed tomographic colonography over-staged two Dukes Stage A cancers and understaged one Dukes Stage C cancer. A total of 97 percent (87/90) of all colonic segments were adequately visualized at computed tomographic colonography in patients with obstructing colorectal lesions compared with 60 percent (26/42) of segments at barium enema (P < 0.01). Colonic anastomoses were visualized in all nine patients, but in one patient, computed tomographic colonography could not distinguish between local tumor recurrence and surgical changes. CONCLUSION: Computed tomographic colonography can accurately identify all colorectal masses but may overcall stool as masses in poorly distended or poorly prepared colons. Computed tomographic colonography has an overall staging accuracy of 81 percent for colorectal cancer and is superior to barium enema in visualizing colonic segments proximal to obstructing colorectal lesions.

Adult↗

[Computer-assisted surgery: automated screw placement in the vertebral pedicle].

AIM OF THE STUDY: Previous studies of conventional surgical procedures have shown a significant rate of incorrect pedicle screw placement ranging from 10 to 40%. Transpedicle screw insertion may cause three types of complications: neurologic, vascular and mechanical. The aim of this prospective study is to improve the reliability of pedicle screwing with computer assistance. MATERIAL AND METHODS: A new and original technique that combines preoperative computed tomography imaging with intraoperative passive navigation has been used to perform 48 pedicle screwings in the thoracolumbar region. In the same time, 48 pedicle screwings were performed manually in the same region and on the same vertebral levels. With postoperative X-rays and computed tomography examination, screw position related to pedicle position could be assessed and comparison could be made between the two groups (with and without computer assistance). RESULTS: Two screws in 48 vertebra (4%) had incorrect placement with computer assisted technique whereas 18 screws in 48 vertebra (37%) had incorrect placement with manual insertion. The intraoperative accuracy provided by the computer after registration was better than 1 mm. The difference between the two groups was statistically highly significant (P < 0.0001). The cortex penetration observed with the computer assisted technique was not imputed to computer failures. Errors in acquiring data by the surgeon in the pre and peroperative steps may explain the two incorrect placements of the screws. CONCLUSION: This clinical experience confirms that the accuracy and reliability of this computer assisted technique are very good.

Bone Screws↗

A grid-enabled lightweight computational steering client: a .NET PDA implementation.

The grid has been developed to support large-scale computer simulations in a diverse range of scientific and engineering fields. Consequently, the increasing availability of powerful distributed computing resources is changing how scientists undertake large-scale modelling/simulation. Instead of being limited to local computing resources, scientists are now able to make use of supercomputing facilities around the world. These grid resources comprise specialized distributed three-dimensional visualization environments through to massive computational systems. The scientist usually accesses these resources from reasonably high-end desktop computers. Even though most modern desktop computers are provided with reasonably powerful three-dimensional graphical hardware, not all scientific applications require high-end three-dimensional visualization because the data of interest is essentially numerical or two-dimensional graphical data. For these applications, a much simpler two-dimensional graphical displays can be used. Since large jobs can take many hours to complete the scientist needs access to a technology that will allow them to still monitor and control their job while away from their desks. This paper describes an effective method of monitoring and controlling a set of chained computer simulations by means of a lightweight steering client based on a small personal digital assistant (PDA). The concept of using a PDA to steer a series of computational jobs across a supercomputing resource may seem strange at first but when scientists realize they can use these devices to connect to their computation wherever there is a wireless network (or cellular phone network) the concept becomes very compelling. Apart from providing a much needed easy-to-use interface, the PDA-based steering client has the benefit of freeing the scientist from the desktop. It is during this monitoring stage that the hand-held PDA client is of particular value as it gives the application scientist greater freedom to leave his or her desk but still communicate with their simulation, with the proviso that they remain within the range of a wireless network.

Computer Graphics↗

Requiring students to have computers: questions for consideration.

For the past several years a dialogue has been taking place in the offices, lounges, and meeting rooms of medical schools about whether medical students should be required to bring or purchase computers when they enter school. Microcomputers offer educators a unique opportunity to provide students with access to computer-assisted instruction, asynchronous communication, and extensive knowledge bases. However, there is still no evidence attesting to the effectiveness of computers as teaching or learning tools in medical education. The author raises questions that schools need to consider before requiring students to own computers: What kind of computer best suits their needs? What might impede using computers to teach? And who is currently requiring computers? In addressing the last question, the author presents information about 15 North American schools that currently require their students to have computers, reporting each school's software and hardware requirements; how each expects students to use the computers; and who covers the cost of the computers (the students or the school). Finally, he argues that major institutional commitment is needed for computers to be successfully integrated into any medical school curriculum.

Canada↗

Accuracy of diagnosis of psychosis on general practice computer system.

OBJECTIVES: To determine the accuracy of diagnoses of schizophrenia and non-affective psychosis entered by general practitioners on a computer system. To compare recording of clinical events on computer with written records. DESIGN: Examination of case notes of all patients with a computer diagnosis of psychosis. Search of 8000 randomly selected patient records to identify patients with psychosis not recorded on computer and comparison of 141 computer and written entries for prescribing and consultation in each practice. SETTING: 13 London practices on the VAMP research bank. MAIN OUTCOME MEASURES: Accuracy of record of psychosis compared with ICD 9, American Psychiatric Association diagnostic manual, and syndrome checklist criteria. RESULTS: Computer search revealed 102 patients with schizophrenia, 78 with other psychoses, and 71 with non-affective psychosis who had adequate case notes. The sensitivity and positive predictive value of the computer diagnosis of schizophrenia were 88% (95% confidence interval 62% to 98%) and 71% (48% to 88%). For all non-organic psychoses sensitivity was 91% (74% to 97%) and positive predictive value was 91% (74% to 98%). On average 95% of all known prescriptions and 74% of all consultations were recorded on computer compared with 42% and 75% in written records. CONCLUSIONS: Recording of psychotic illness on the VAMP computer is accurate and complete. Prescribing was more fully recorded on the computer than on the written records. Computer databases of well motivated general practitioners could be used for research.

Ambulatory Care Information Systems↗

Computational maps in the brain.

The nervous system performs computations to process information that is biologically important. Some of these computations occur in maps--arrays of neurons in which the tuning of neighboring neurons for a particular parameter value varies systematically. Computational maps transform the representation of information into a place-coded probability distribution that represents the computed values of parameters by sites of maximum relative activity. Numerous computational maps have been discovered, including visual maps of line orientation and direction of motion, auditory maps of amplitude spectrum and time interval, and motor maps of orienting movements. The construction of the auditory map of space is the most thoroughly understood: information about interaural delays and interaural intensity differences is processed in parallel by separate computational maps, and the outputs of these maps feed into a higher order processor that integrates sets of cues corresponding to sound source locations and creates a map of auditory space. Computational maps represent ranges of parameter values that are relevant to the animal, and may differentially magnify the representation of values that are of particular importance. The tuning of individual neurons for values of a mapped parameter is broad relative to the range of the map. Consequently, neurons throughout a large portion of a computational map are activated by any given stimulus, and precise information about the mapped parameter is coded by the locations of peak activity. There are a number of advantages of performing computations in maps. First, information is processed rapidly because the computations are preset and are executed in parallel. Second, maps simplify the schemes of connectivity required for processing and utilizing the information. Third, a common, mapped representation of the results of different kinds of computations allows the nervous system to employ a single strategy for reading the information. Finally, maps enable several classes of neuronal mechanisms to sharpen tuning in a manner not possible for information that is represented in a non-topographic code.

Animals↗

Use of computer-based instruction in athletic training education.

Computer-based instruction is being widely used in the education programs of many allied health professions. However, there has been little, if any, documentation of computer-based instruction use in athletic training education. The primary purpose of this study was to determine what percentage of undergraduate and graduate NATA-approved athletic training education programs are using some form of computer-based instruction (ie, computer-assisted instruction or interactive video). We also addressed the following research questions: 1) What athletic training educational software is currently being used by athletic training students and educators? 2) What factors currently impede the use of computer-based instruction in athletic training education? 3) What instructional methods are commonly used to incorporate computer-based instruction into the athletic training curricula? and 4) What are the attitudes of athletic training program directors toward the use of computer-based instruction in athletic training education? Surveys were mailed to the program directors (n = 97) of all graduate and undergraduate NATA-approved athletic training education programs. Eighty-six (87.7%) usable surveys were returned. Forty-eight (55.8%) of the respondents reported using some form of computer-based instruction in their athletic training education program; 47 (54.7%) used computer-assisted instruction and 9 (10.6%) used interactive video. Respondents also identified the educational software they use and their method for implementing this software. Software was used most often to supplement traditional instructional methods. A lack of funds was reported to be the primary impeding factor for those programs not using computer-based instruction. Respondents reported an overall positive attitude toward computer-based instruction use in athletic training education and indicated the need for increased development of athletic training/sports medicine software.

Journal Article↗

Computers and quality control in nuclear medicine.

The general topic of computers and nuclear medicine quality control may be approached from two main areas; controlling the quality of computerized studies, and computer applications in general nuclear medicine quality control. Overlap occurs when quality control of computer studies is performed by the computer itself. The uses of computers in record-keeping and in quality control of imaging instrumentation and in vitro studies, including radioimmunoassay, are discussed in this review. Aspects of quality control for computerized clinical cardiovascular, cerebral, and renal studies and emission computed tomography are reviewed, including consideration of difficulties and inaccuracies involved in the studies. Any automatic computer analysis program should incorporate adequate checks and error detection protocols and should illustrate results for verification. Current routine quality control procedures using the computer unfortunately are few. Quality control criteria are needed for camera/computer systems in high count rate clinical applications, and increasing emphasis should be aimed at quality control of those computerized dynamic and function studies in current clinical use. The computer has a valuable potential for nuclear medicine quality control. In vitro and computerized in vivo studies can be analyzed by readily available statistical programs, and variances can be monitored continuously. Computers can calibrate and monitor instrument performance regularly, and can handle managerial and clerical duties such as bookkeeping.

Cardiovascular Diseases↗