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Microfiling and automatic filing of radiographs.

When advantage is taken of the newest qualities of microfilms and copy films and when using their special developers and developing machines, it seems today that the microfilming of radiographs on 35 mm film is successful. Equipment in the price range of 67 000 DM is available. It includes automated filming and developing, but slipping microfilms onto the punch card jackets is semi-automatic. The advantage of the equipment is its low price, its small size compared to the Delcomat system, and thus its smaller filing space need. Also, the automation of filing is possible with this system. The system seems to be quite suitable for at least creating and maintenance of teaching files.

Finland

A filing system for transparencies.

A system has been developed to facilitate filing of 2 inches X 2 inches Kodachrome slides. This is coordinated with a diagnostic and therapeutic index that allows for easy retrieval. Compact metal filing cabinets are used, eliminating the need for subsequent rearrangement of slides. The system also provides a method for recall of patients. Preoperative photographs are maintained in plastic folders and checked periodically until the postoperative photographs have been taken.

Filing

The ophthalmologist's office: planning and practice. Patient records and filing systems.

Suggestions and examples of the components of patient charts have been offered for the most efficient office system and for the greatest protection of the ophthalmologist against malpractice charges. Emphasis has been placed on the alphabetical system of filing, the need for well-designed filing cabinets, and measures to reduce the incidence of misplacing and losing patient charts.

Filing

A patient and family number assignment and chart filing system for family physicians.

The Department of Family Medicine and Practice at the University of Wisconsin-Madison has devised and implemented an alpha-numeric system of identifying patient records together with a system of chart filing based on a variation of terminal digit filing. The system provides each patient with a unique identification number. This permanently assigned number is used as part of the medical record (chart) information, as the basis for assigning an account number, as the basis for determining the storage location of the chart in the record room, and as the basis for a family identification number. The number defines the patient's sex and position within the family, and its permanency ensures a capability for conducting both short- and long-term ambulatory care research in the family context.

Color

Students evaluate MEDFILE, a preprinted medical literature filing system.

Medical professionals are highly dependent on personal libraries and reprint files as their sources for current information. A large population of practising doctors have poorly organized medical literature data bases in their professional environment. To expedite the development of a personal library data base by medical students, we created MEDFILE, a preprinted, cross-indexed file folder system for organizing the medical literature. This paper reports the results of two surveys performed in connection with the distribution of the MEDFILE system. One hundred per cent of the students who used MEDFILE found the system to be beneficial. Ninety-seven per cent felt their ability to find their personal literature improved by using MEDFILE, and 65% felt MEDFILE improved their clinical preparation. Of all surveyed recipients of the system, 96.8% felt MEDFILE would be useful in their future studies.

Attitude of Health Personnel

Indexing and filing of pathological illustrations.

An inexpensive feature card retrieval system has been combined with the Systematised Nomenclature of Pathology (SNOP) to provide simple but efficient means of indexing and filing 2 in. x 2 in. transparencies within a department of pathology. Using this system 2400 transparencies and the associated index cards can be conveniently stored in one drawer of a standard filing cabinet.

Abstracting and Indexing

Local image filing system in neurosurgery: validity of selective storage of radiographic images.

In an effort to achieve efficient image management in the practice of neurosurgery, a clinical data base system was designed and developed to process, store and retrieve neuroradiologic image information on hospitalized patients with the use of a local image filing system (EFPACS-500, Fuji Electric Co., Ltd). Storage and retrieval of radiographic images were studied to quantify existing procedures and to evaluate the validity of new technology. One of our hospitals (Southern Tohoku Research Institute for Neuroscience) has annually produced approximately 100,000 sheets of film radiographs, resulting in a great deal of serious problems, particularly lack of space for storage. In addition, the overall averaged ratio of selected key films to total files of radiographs was estimated to be 16.3% for hospitalized patients during the past 5 years. It is assumed that, by means of digital storage on this selective basis, radiographic storage problems can be solved with the use of the current data base system which efficiently handles image information involving patient care. In the practical view another substantial improvement in this work is the high functionality of the system, with which radiographic images coupled with a variety of clinical data on patients can be stored in a descriptive fashion.

Database Management Systems

Personal computers, medical slide files, and retrieval. An organized approach.

This discussion provides an organized, rational approach to filing, storage, and retrieval of a large medical photographic slide collection. Advantages of this approach include: minimal slide storage space, simple filing, rapid retrieval based on descriptive "key words" utilizing database software, inexpensive and readily available technology for users of personal computers, and reliable tracking of slides.

Audiovisual Aids

[Software for record reporting and filing with the personal computer].

During the past four years the authors have been gaining experience in reporting radiological examinations by personal computer. Today they describe the project of a new software which allows the reporting and filing of roentgenograms. This program was realized by a radiologist, using a well known data base management system: dBASE III. The program was shaped to fit the radiologist's needs: it helps to report, and allows to file, radiological data, with the diagnostic codes used by the American College of Radiology. In this paper the authors describe the data base structure and indicate the software functions which make its use possible. Thus, this paper is not aimed at advertising a new reporting program, but at demonstrating how the radiologist can himself manage some aspects of his work with the help of a personal computer.

Database Management Systems

[Use of files for forms no. 063y in planning preventive immunization].

The use of color-coded files, form No. 063y (prophylatic immunization records), with special cards, having a double row of perforations at the top, and with colored riders for the indication of months in planning and coverage with immunization considerably facilitates work in planning prophylactic immunization. The files can be rather easily analyzed for the coverage of the population groups with immunization without reading each card. As the plan of immunization for the current year is realized, the riders are used for planning the immunizations for the following years. Thus, at the end of the current year the plan for the next year, indicating the monthly schedule, and the kinds of immunization, is ready.

Child

Starting a reprint filing system.

A reprint collection represents an investment of time, money, and resources. As with any data base you gather, however, the problem is storing the information for retrieval. This article describes how to design and implement a filing system to make retrieval of reprints both quick and easy. Although reprints are the data base described in this article, the applicability of this filing system to other information can be seen readily.

Abstracting and Indexing

An image filing system for the implementation of image processing algorithms in a research environment.

An image filing system (IFS) has been written to facilitate the implementation and testing of image processing algorithms in a research environment. A programming substrate has been developed to provide applications with routines for acquiring, displaying, and manipulating images without regard for the underlying information format. Images of diverse modalities are cataloged and tracked through a series of image operations with descriptive pointers to all antecedents. This paper presents the design and implementation of the image filing system and describes one of the major image processing applications developed in the IFS environment.

Algorithms

Clinical application of a magneto-optical disk image filing system/image save and carry (ISAC) system.

We propose the utilization of portable magneto optical disks for image filing. The main problems in PACS are the need for a high-speed local area network (LAN) and a large mass storage device. An image filing system--image save and carry (ISAC)--is one solution for these problems in present PACS and requires minimal additional hardware and cost for the installation. Whenever a patient is examined, the clerk carries the medical record and the ISAC magneto-optical disk for recording image data, and after inspection records the image data into the magneto-optical disk. We investigated the number of image retrievals done for inpatients and outpatients in 1988 at our radiation therapy department. The data storage requirements were on the average 18.5 MB for outpatients and 173.9 MB for inpatients. An ISAC display console needs also an easy-to-use man/machine interface for specifying images and image display characteristics in order to realize the ISAC system.

Computer Systems

Oral diagnostic reporting and synchronized image filing using magneto-optical disks.

An experimental radiologic reporting system has been developed and tested. The rewritable and compact magneto-optical disk (MOD) is applied to storing medical images with oral diagnostic reports of these radiologic images. The disk is 5.25 inches in diameter, has 600 MB memory capacity, is erasable, light and compact. Advantages are simultaneous recording of radiologic images and their oral reports by radiologists, and application to circulation of media inside the hospital as well as to filing of medical images. The MOD has a multimedia function of communication and filing. When medical images are taken and stored, oral interpretation by radiologists can be simultaneously added. Physicians can get information of the images and their reports by oral speech at the same time in front of computer workstation. Furthermore, integration of a voice recognition capability is now being undertaken.

Image Processing, Computer-Assisted

Identification of fractures from computerized Medicare files.

Study of non-hip fractures, which are a serious public health problem for persons greater than or equal to 65 years of age, has been hindered by the absence of an economical method for case identification. We assessed the utility of computerized Medicare inpatient, emergency room, hospital outpatient department and physician claims for identifying fractures in an elderly Tennessee Medicaid population. We used these files for 1987 to identify 3086 possible fractures and reviewed medical records for a sample of 1440. Using this sample, we developed a definition of probable fractures that excluded claims unlikely to represent newly diagnosed fractures. For all fractures, this definition had a positive predictive value of 94%, which for individual fracture sites, ranged from 79% (tibia/fibula) to 98% (hip). Of fractures in the reviewed sample, 91% were identified as probable fractures; this upper bound for sensitivity varied between 75% (femoral shaft) and 100% (patella). These data suggest that computerized Medicare files can be used for rapid and economical fracture ascertainment among persons greater than or equal to 65 years of age. However, further work is needed to obtain better estimates of sensitivity.

Aged

A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques.

Sixty extracted human teeth were divided into three groups of 20 each. Apically extruded debris and irrigant were collected, dried, and weighed by the following three instrumentation techniques: (a) group 1, filing 1 mm short of the foramen; (b) group 2, Canal Master instrumentation to the foramen; and (c) group 3, filing to the foramen (for a relative comparison). The results indicated that all three groups were significantly different from one another. Group 1 had the least amount of debris extruded. Of the two groups instrumented to the foramen, group 3 had twice as much debris extruded as group 2. An apical dentinal plug was frequently found in group 1 and was probably a major reason why this group had the least amount of extruded debris. The significance of this dentinal plug and possible indications for instrumentation to the foramen are discussed.

Analysis of Variance

Comparison of the Canal Master endodontic instrument and K-type files for enlargement of curved root canals.

Twenty mandibular molars with 40 mesial curved root canals were instrumented with a circumferential technique using K files and the Canal Master instrumentation technique by junior dental students whose only endodontic experience had been completion of a preclinical endodontic course. Preoperative and postoperative radiographs were taken facially and mesially with instruments in place. The canals were evaluated radiographically for transportation 1 mm and 4 mm from the apex. The mesial roots were cross-sectioned at the same level. The sections were evaluated for roundness of the canal preparation. It was concluded that the Canal Master instrumentation technique transported the root canal less and produced rounder preparations than the K file circumferential technique. There appears to be a greater tendency for breakage with the Canal Master.

Dental Pulp Cavity