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A computer system for the identification of the cerebrospinal compensatory model.

A computer system, based on IBM PC, was designed for the cerebrospinal compensatory model identification. The intracranial pressure (ICP) signal, registered during the lumbo-lumbar infusion test is analyzed by means of the spectral analysis algorithm in order to measure precisely the pulse wave amplitude. The amplitude and the mean ICP level, calculated repetetively within the period of about 8 seconds, are stored on the disk and form the basis for further model identification. Three different methods of identification were applied. They enable one to estimate the fundamental model parameters, such as: resistance to the cerebrospinal fluid resorption, pressure-volume index, baseline pressure, rate of formation of the cerebrospinal fluid. Statistical evaluation of the results of the infusion test analysis obtained by means of the system described in two groups of hydrocephalic patients (children and adults) is presented.

Adult

Implementation of a multirule, multistage quality control program in a clinical laboratory computer system.

We developed a computer subsystem that permits users to implement multirule, multistage quality control procedures. The subsystem runs as a task in the RelationaLABCOM information system and permits the collection of data from on-line instruments, as well as through manual (keyboard) entry. The choices of control rules and their combinations are at the discretion of each laboratory section, with the system automatically administering the chosen protocols for all the technologists working with the computer. Retrospective data analysis and statistics are available for review by laboratory personnel. The subsystem provides a significant improvement in the availability of real-time quality control at the bench.

Clinical Laboratory Information Systems

Control of antibiotic therapy in pediatric patients. I. A computer system to collect and analyze antibiotic prescriptions in hospitals.

A computer system to record and analyze antibiotic prescriptions in hospitalized children is described. This system is especially organized in order to obtain simultaneously a quantitative evaluation of antibiotic use and a qualitative analysis of the process by which the physician makes his decision for therapy. The practical employment of this program has been demonstrated by analyzing 765 prescriptions given in nine different pediatric hospital wards. Many errors of prescription have been demonstrated: antibiotic therapy was based on the clinical impression alone in 31.5% of the prescriptions, antibiotic choice was rational in 20.1% and the posology prescribed complied with the usually applied schemes in 22.4%. Finally, the physician's attitude regarding laboratory monitoring of side effects was adequate in 52.8% before treatment and 33.4% during antibiotic treatment.

Aging

A comprehensive laboratory computer system working round the clock.

The special features of a laboratory computer system operated by laboratory staff around the clock are presented. The system provides registration of work, production of worksheets, on-line data acquisition and reporting results. The reasons for the special design features are discussed.

Allied Health Personnel

A comprehensive interactive on-line computer system for research and clinical practice in orthodontics.

An interactive on-line computer system for the measurement of cephalometric radiographs, and facial and plaster cast photographs is described. The details of the hardware (computer and peripherals) and software are provided. Numerical and graphical analysis and presentation of the resultant data are discussed. Many research and clinical applications of the system are outlined.

Cephalometry

AUTOGRP: an interactive computer system for the analysis of health care data.

AUTOGRP is an interactive computer system designed to facilitate rapid analysis of complex medical information. AUTOGRP allows the clinical or administrative expertise of the user to be combined with sophisticated computer techniques to permit rapid information retrieval, hypothesis testing, development of norms, and identification of deviant cases. This interaction yields results of a uniquely high statistical and medical quality. AUTOGRP has been used to aid in understanding the process of patient care management in a variety of settings in order to enhance the effectiveness of decision-making from both a medical and management point of view.

Computers

Medical office computer systems. The selection process.

This article highlights the process that a physician should undertake in selecting and implementing a business computer system for the office. Included are suggested approaches to identifying needs, establishing priorities, and communicating requirements to prospective vendors. Methods for reviewing various systems to evaluate whether they meet the practice's defined requirements are suggested.

Computer Systems

Initial experience with a small dedicated computer system in a diagnostic x-ray department.

The operation of a small computer system involved in day to day management in an X-ray department is described. The system consists of the following equipment: PDP 8/F central processor with 8K core storage, 32K magnetic disc storage, High-speed paper tape reader (300 characters/s) and punch (50 characters/s), 3 Olivetti TE318 terminals with sprocket feed, paper tape reader and punch (10 characters/s). The system stores patient data relating to name, address, age, ward, referring physician, examination(s) requested, date of request, date of examination, date of report. From this data a large volume of relevant statistics is made available to the department and to the health authority. Labels for identifying record card, film envelope and X-ray films are automatically typed. During reporting coded phrases can be used by the radiologist. Interesting films can be recorded and recalled for library or consultation purposes as can research items. At report typing stage, the report heading is automatically recalled from the computer store. Coded phrases are typed automatically as is the radiologist's name and the date of the report. A 'DAYBOOK' IS TYPED AUTOMatically at the end of each working day. Problems encountered in running the system and future developments are described.

Computers

A Macintosh computer system for collecting and analyzing rodent sexual behavior.

We present a Macintosh-based computer system for collection and analysis of rodent sexual behavior. Two computer programs are presented. The first is an entirely generalizable real time data collection program that records any keyboard or keypad inputs (e.g., user defined behavior codes) and their time of occurrence. The second is somewhat generalizable; we use it to analyze frequencies, durations, and latencies relative to a copulatory series (including mounts, intromissions, and ejaculations). To our knowledge, these are the first such programs available on the Macintosh platform.

Animals

Computer system for assisting with clinical interpretation of tumour marker data.

OBJECTIVE: To design and evaluate a computer advisory system for the treatment of gestational trophoblastic tumour. DESIGN: A comparison of clinicians' treatment decisions with those of the computer system. Two datasets were used: one to calibrate the system and one to independently evaluate it. SETTING: Department of medical oncology. PATIENTS: Computerised records of 290 patients with low risk gestational trophoblastic tumour for whom the advisory system could predict the adequacy of treatment. The calibration set comprised patients admitted during 1979-86(227) and the test set patients during 1986-89(63). MAIN OUTCOME MEASURES: The system's accuracy in predicting need to change treatment compared with clinicians' actions. The mean time faster that the system was in predicting the need to change treatment. RESULTS: On the calibration dataset the system was 94% (164/174) accurate in predicting patients whose treatment was adequate, recommending change when none occurred in only 10 (6%) patients. In patients whose treatment was changed the system recommended change earlier than clinicians in 39/53 cases (74%), with a mean time advantage of 14.9 (SE 2.02) days. On the test dataset the system had an accuracy of 91% (31/34) in predicting treatment adequacy and a false positive rate of 9% (3/34). The system recommended change earlier than clinicians in 22/29 cases (76%), with a mean time advantage of 12.5 (2.22) days. CONCLUSIONS: The computer advisory system could improve patient management by reducing the time spent receiving ineffective treatment. This has implications for both patient time and clinical costs.

Biomarkers, Tumor

A computer system for processing data from routine pulmonary function tests.

In larger pulmonary function laboratories there is a need for computerised techniques of data processing. A flexible computer system, which is used routinely, is described. The system processes data from a relatively large range of tests. Two types of output are produced--one for laboratory purposes, and one for return to the referring physician. The system adds an automatic interpretative report for each set of results. In developing the interpretative system it has been necessary to utilise a number of arbitrary definitions. The present terminology for reporting pulmonary function tests has limitations. The computer interpretation system affords the opportunity to take account of known interaction between measurements of function and different pathological states.

Computers

Applications of expert computer systems.

An expert system is a computer program which uses artificial intelligence to make logical decisions on the basis of input data. The rules the system uses to make its decisions are called heuristics which can be provided in the form of IF . . . THEN statements, or they can be learned by the system from examples. The term "expert" is used because the rules or examples come from human experts and the program is considered to have captured their expertise. Currently there are many expert systems in business and medical use but few, if any, are used in optometry. The rule-oriented nature of many ophthalmic procedures suggests a future role for these systems, but their cost-effectiveness may not yet be favorable enough to justify development of expert systems for optometric practice.

Diagnosis, Computer-Assisted

A personal computer system for testing gas exchange, heart, lungs, ventilatory pump.

This paper reports the development of a computer system for testing gas exchange and lung function in the ICU. The essence of the system is a software package that uses an IBM personal computer for data processing and analysis. Front end hardware is modular, as is software, so that portions or all of the system can be used. The system provides measurements of lung mechanics work, functional residual volume, spirometry, oxygen uptake, carbon dioxide output, lung water, blood gas interpretation, hemodynamics. Reports are provided by standard data base manager and so are easily customized.

Computers

[Quality control of a computer system for repeat prescriptions].

The results of a quality control of a computer system of repeated prescription (RPS) and its basic features are reported. The selected quality criteria were the following: reduction of the bureaucratic index in the visit, correct fulfillment of the treatment order, health attention circuits of the RPS, and compliance of the patient with the treatment. The record of activities and a random sample of treatment orders (TO) were used as sources of data. Quality indexes near the optimal standard (OS) were achieved: bureaucratic index 12.8% (OS = 15%), fulfillment of the TO 94% (OS = 100%), specified dosages 86% (OS = 100%), prescriptions in out-of-date orders 7% (OS = 0%), use higher than calculated 1% (OS = 0%), and use lower than calculated 36% (OS = 25%). Finally, the corrective measures for the detected quality problems are proposed, and the advantages of the computer RPS are discussed.

Algorithms

The EPICS C analyzer. An ergometrically designed flow cytometer computer system.

A description is presented of a new flow-cytometer (FCM) computer system, the EPICS C analyzer, which was developed to be used by a moderately trained technician as opposed to an FCM expert. The system was made robust and user-friendly by the use of menu-based rather than command-driven software. The user primarily interacts with the self-explanatory menus by depressing one of the eight membrane selector switches located on each side of the screen. The minimizing of typing and restriction of the user's responses greatly simplify the use and design of the software. The EPICS C operates in two modes: as a reliable clinical instrument and as a research tool. The instrument settings are stored on disk files rather than manually logged into a book. The settings for the predefined tests are read from the disk.

Cell Separation

An interactive computer system for the analysis of cell lineages.

We have developed an interactive computer system for analysing cell lineage data. It can be utilized in studies of cell motility, cell division, cell differentiation, and cell aging. It has enabled us to document the heterogeneity of human foreskin fibroblasts in culture and to propose that loss of proliferative potential may mean that cells enter a state of differentiation which makes them unable to respond to mitotic stimulation. Our method, which enables us to apply immunological and cytochemical probes after recording the history of a cell lineage, should allow us to define precisely features which uniquely distinguish cycling from noncycling cells on an individual cell basis.

Cell Cycle

[Computer systems for general practitioners. Status and development].

Patient-administrative systems are becoming increasingly accepted in general practice. The market is now more mature than before. Many physicians are now purchasing computer systems for general practice the second time. Due to national characteristics of the health services the market for these systems is not truly international. In Norway this market is dominated by two makes: Infodoc and Profdoc. In future more physicians will use systems for general practice, and more functions will be added, although the usefulness of these may be a matter for discussion. Furthermore, the importance of telecommunications is expected to increase, and similarly, integration with other services. This development would be furthered by central government action for the purpose of harmonizing and standardizing data, systems and possibly user-interface.

Computer Systems