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PubMedDate not supplied

Optimizing computer-based system use in health professions' education programs.

The use of computer-based systems to support training in health profession education programs has been discussed and analyzed for more than 10 years. The literature is rich with examples of how using these systems can benefit programs by more effectively distributing human resources, by making the delivery of instruction more individual and more flexible, by expanding the professional and technical competence of trainees, and by improving the monitoring of trainee performance. Obstacles to and conventional recommendations for the broadened use of computer-based systems are discussed, and an additional set of system design characteristics are described that health care educators can use in their preview and specifications for procurement of more effective computer-based systems in their training settings.

Attitude to Computers↗
PubMed1994

A computer simulation study of the relation between lipid and probe behaviour in bilayer systems.

Computer simulations are presented of the behaviour of elongated probe molecules anchored to the interface of lipid bilayers above the phase transition of the hydrocarbon chains. The simulations thus mimic the behaviour of the fluorescent probe 1-(4-(trimethylammonio)phenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPH) and Cholestane spin label in lipid systems. In contrast to any experimental technique the simulations follow the behaviour of both the lipid molecules and the probe within the bilayer structure. Thus, the relation between the behaviour of the probe molecules and the order and dynamics of the lipid chains can be studied in detail. We find that the presence of probe molecules, at the low concentrations used experimentally, causes only a marginal perturbation in the intrinsic properties of the lipid chains. The simulations presented support the conventional prescription for describing the orientational behaviour of probe molecules in lipid bilayers in terms of a local effective orienting potential. They indicate, however, that the potential arises from the confinement of the probe molecules between long segments of lipid chains in elongated free-volume cavities within the bilayer structure. In this sense the orienting potential concept needs to be refined in order to take into account the combined effect of the restricted free rattling motions of the probes within the free-volume cavities and the orientations of the cavities themselves relative to the normal to the bilayer plane. The time scale of the motions of the cavities within the bilayer is determined by the rotational motions of long segments of the lipid chains. These observations justify the use of rigid probe molecules such as TMA-DPH and Cholestane spin labels for monitoring the orientational order and dynamics in lipid bilayer systems.

1,2-Dipalmitoylphosphatidylcholine↗
PubMedDate not supplied

A personal computer network system for equitable allocation of cadaver organs.

We developed a personal computer network system for the equitable allocation of cadaveric organs. This network consists of a host computer (IBM PS55 model 5570 T) and various kinds of personal computers manufactured by many different computer makers in Japan. The merits of our personal computer network include lower cost and an easy access to the host computer from all the centres participating in this network while using their own favourite personal computers. Among the programs made for allocating cadaveric organs, we present in this paper the program for livers. This program was developed with a modified version of the logic developed by Starzl et al. The grade modification for the United Network for Organ Sharing (UNOS) in the United States was used as the basis for classification of medical urgency. Our program weighed the factors of medical urgency, compatibility of blood group and waiting time. Distance factors were omitted because of the smaller area of the network compared to that of UNOS. This computer network would be linked to other computer networks in creating a national organ procurement and transplant network in Japan, in order to help them to catch up with other advanced transplant countries. Such an equal and objective computer system should allow organ transplantation to become more widely accepted.

Computer Communication Networks↗
PubMedDate not supplied

Development of a computer-based system for continence health promotion.

Computer-based systems (CBS) can provide information to help individuals analyze their health care needs and make decisions about management of health problems. This article discusses the development of a CBS that delivers an individualized educational intervention for continence health promotion. System development included cycles of prototype design, testing, analysis, and redesign. Knowledge acquisition, representation methods, and design decisions are discussed. Participants completed 4 rounds of usability testing and a pilot test, which resulted in enhancements to both the CBS and the expert system feature that produced individualized feedback. This iterative design process involved users throughout system development. User involvement resulted in a tutorial to explain navigation and other features of the CBS, graphics to enhance the written message, and clarification of continence-related content. The procedures resulted in an informative, usable product; they can be used to develop systems that provide information about symptom self-management for other health conditions.

Aged↗
PubMed1989

Decision analysis: a framework for critical care decision assistance.

The ultimate goal of medical computer systems is to help clinicians make good decisions. Such systems must be based on sound principles. Decision analysis is a 25-year-old discipline that provides the needed rigorous foundation for decision assistance. Decision analysis comprises the philosophy, procedures, and tools that can correct the flaws in existing critical care decision-making practice. Intelligent decision systems--computer-based systems that automate decision analysis--make it practical to apply decision analysis to critical care. Orchestra is a pilot intelligent decision system (now under development) that coordinates the efforts of the critical care specialist, the bedside physician, and the bedside nurse in building decision models that can provide recommendations and insight for ventilator management decisions. Decision analysis delivered by intelligent decision systems has great potential for improving critical care decision-making.

Algorithms↗
PubMedDate not supplied

Microprocessors as intelligent front-end devices for medical-information systems.

Computer technology has produced increasingly powerful systems whose miniaturization has spawned the term microprocessor. The role of microcomputers is optimal if they are linked to larger systems in a distributed, hierarchical network with each element performing those functions for which it is best suited. Obstacles to the development of such a network include incompatibilities in operating systems, application languages, file structures, and communication protocols. Some attempts to address these problems are briefly reviewed. Given the availability on an effective distributed hierarchy of computers, the microprocessor can be useful in a number of functions requiring rapid response and limited access to large, central data files. Examples of such activities in the medical-information environment included program development and testing, forms entry, and text-management systems. With adequate attention to the systems support as well as the development of effective application techniques, the role of microprocessor-based intelligent terminals will inevitably expand rapidly in coming years.

Computers↗
PubMed1992

A statistical test to assess changes in spontaneous behavior of rats observed with a computer pattern recognition system.

A computer pattern recognition system, RAPID, has been used to study the spontaneous motor activity of Sprague-Dawley rats. This system produces a large number of measures of the activity of control and experimental groups in any given study. The large number of measures involved presents a problem when one attempts to decide whether the behavioral activity of the exposed group differs from that of the control group. Extensive Monte Carlo studies have been performed in an attempt to develop and validate a simple statistic to be used in such decisions.

Animals↗
PubMed1987

Knowledge-based systems in laboratory medicine and pathology. A review and survey of the field.

Knowledge-based systems are computer systems designed to handle knowledge-intensive tasks, usually involving reasoning and inference. They are increasingly being applied to problems in laboratory medicine and pathology. In this article we provide a brief introduction to the basic concepts of knowledge-based systems, review some of their published applications, and report on an informal survey of specialists in laboratory medicine and pathology. The survey, sent to 102 individuals, indicated that 24% were involved in developing knowledge-based systems, with most systems at an early stage of development. Recent advances in knowledge-based systems research as well as survey responses suggest that this technology will have increasing value in laboratory medicine and pathology.

Artificial Intelligence↗
PubMed1975

Experience in implementing the Mark III Rad 8 system for radiotherapy dose computations.

Rad 8 is a small, in-house computer system for calculating radiotherapy dose distributions, both for multiple field and rotational external beam techniques and for interstitial and intracavitary redium treatments. Implementing the system has its difficulties, particularly in obtaining the necessary beam profile information. Several approaches have been tried and finally a separate profile generator program was written. Other difficulties encountered with beam data storage were overcome by making minor changes to the system programs. The various calculation techniques have been evaluated, and in general found to be satisfactory, and suitable factors to be used in the inhomogeneity correction for 4 MV X rays have been calculated based on previously published measured data. An option to change beam weightings exists and this can be used to renormalize dose distributions to give percentage isodose curves relative to the prescribed tumour dose. If this procedure is followed dose homogeneity over the target volume can readily be assessed, and the exposure times may easily be calculated from the new weightings. Certain shortcomings in the rotating beam program and the radium program may easily lead to error if extreme care is not exercised.

Computers↗
PubMed1989

Modeling emergency department operations using advanced computer simulation systems.

We developed a computer simulation model of emergency department operations using simulation software. This model uses multiple levels of preemptive patient priority; assigns each patient to an individual nurse and physician; incorporates all standard tests, procedures, and consultations; and allows patient service processes to proceed simultaneously, sequentially, repetitively, or a combination of these. Selected input data, including the number of physicians, nurses, and treatment beds, and the blood test turnaround time, then were varied systematically to determine their simulated effect on patient throughput time, selected queue sizes, and rates of resource utilization. Patient throughput time varied directly with laboratory service times and inversely with the number of physician or nurse servers. Resource utilization rates varied inversely with resource availability, and patient waiting time and patient throughput time varied indirectly with the level of patient acuity. The simulation can be animated on a computer monitor, showing simulated patients, specimens, and staff members moving throughout the ED. Computer simulation is a potentially useful tool that can help predict the results of changes in the ED system without actually altering it and may have implications for planning, optimizing resources, and improving the efficiency and quality of care.

Appointments and Schedules↗
PubMed1992

Analysis of physician questions in an ambulatory care setting.

We collected 69 questions generated by physicians based on their active patient medical records. Each question was associated with a single term in a specific record (Key Term). These questions were analyzed with respect to word content and concept content. Concepts were matched to the National Library of Medicine's Metathesaurus (Meta-1). Sixty-eight Key Terms were completely matched by Meta-1 terms. Each question matched to an average of 3.7 Meta-1 terms for a total of 255 concepts. Based on word count, these 255 concepts accounted for 43%, stop words accounted for 36%, and numbers and drug trade names accounted for 3% of the words. The remaining 18% of the words could be matched to 143 concepts not in Meta-1. Review of all concepts showed that they could be divided into medical terms (Noun Concepts), modifiers (Modifier Concepts), and concepts that provided context for the questions (Relation Concepts). The majority of Relation Concepts did not match concepts in Meta-1. A vocabulary of Relation Concepts would provide a useful starting point for a computer system designed to aid physicians in answering these questions.

Ambulatory Care Information Systems↗
PubMedDate not supplied

Medical computing standards ASTM (American Society for Testing and Materials) Committee E-31. A review of published standards and current projects February, 1992.

This document describes the activities of ASTM Committee E-31 in the area of standards for computer systems in medical applications. Some of these efforts have already culminated in published standards, some are well along in the development process, and some are just getting started.

Clinical Laboratory Information Systems↗
PubMed2000

[Information processing in the gynecological endocrinological laboratory. Current concepts and integration strategies].

While computer applications are widely accepted in clinical chemical departments, small numbers of computer systems are used in gynecological endocrinological laboratories. Modern applications should be integrated in local area networks and clinical information systems that improve communication and data exchange within hospitals and the outer resources. Better communication may improve medical quality and will lead to a better therapy for gynecological endocrinological patients.

Clinical Laboratory Information Systems↗
PubMed1990

An improved video-based computer tracking system for soft biomaterials testing.

We present an improved video-based computer system for on-line tracking of small markers moving in a plane. The system consists of a CCD camera, a video monitor, a dedicated 80386/20 microcomputer, a video frame grabber, and custom software. Up to four markers can be tracked at the 30-Hz video frame rate using a two-step, correlation-based search procedure. We discuss the requisite hardware and software requirements and illustrate how this tracking system can be used to collect strain data during biaxial stretching tests on planar soft tissues. Operating at 30 Hz, this system is an improvement over those previously reported, which are either slower or yield less information.

Algorithms↗
PubMed1987

Stereotactic computer graphic system with brain maps.

We have developed a stereotactic computer graphic system with brain maps that runs on a personal computer. This system consists of three parts: 1. firmware for dizitizing radiological films with a TV camera or scanner (when digital image is not directly obtained from floppy disks); 2. software for introducing or processing brain maps by matching them with CT or NMR images; 3. hardware. Our system is designed to: 1. recognize the relevant frame points and calculate targets, their volume and surgical instrument trajectory; 2. match between brain maps of an ideal brain and patient's CT or NMR images with visible and invisible pathology; 3. monitor during surgery the position of the surgical instrument or target modification. The whole procedure and processed images are stored in a data-base for further study.

Brain Mapping↗
PubMed1987

Serum phenobarbital concentration predictions by a personal computer software system.

The ability of a personal computer software system to predict actual serum phenobarbital concentrations (SPC) in outpatients taking phenobarbital chronically was assessed by comparing actual with predicted SPC for accuracy, bias, and precision. Data for a four-year period were collected on patients at an outpatient clinic's pharmacokinetic consultation service. The study group included 50 adults and children with at least one SPC taken at a known time after dose administration. Input variables were weight, sex, height, age, concomitant drugs and diseases, phenobarbital dosage regimen, and the time and reported value of all SPC. Initially, SIMKIN (SIMulated KINetics) simulated dosing regimens on the basis of literature estimates of pharmacokinetic parameters; SPC were then estimated for these regimens and compared with actual values. One or two additional SPC were added to the input data and analyzed, and the predicted SPC compared with actual values. Although SIMKIN's accuracy and bias as measured by regression analysis and mean prediction error, respectively, were within clinically acceptable limits, the precision was not. However, these results are limited by the population studied. Patient compliance, concomitant phenytoin therapy, changes in phenobarbital pharmacokinetic parameters with chronic dosing, and disease interactions may significantly affect predictive ability. The clinical effects of these factors need to be evaluated to further improve predictions.

Adolescent↗
PubMed1995

Digital data capture for electronic patient record systems.

The importance of digital data capture in optimizing the benefit and cost savings provided by an EPRS has been shown. Data will come from several sources including ADT systems, laboratory computer systems, and transcription computers, and the data will need to be stored in the electronic patient record. The HL7 standard provides a common language for new systems to exchange data. For older systems, an interface engine or toolkit may be necessary to transfer the data from another hospital system to the EPRS. In any case, capturing and storing digital data will greatly enhance the usability of an EPRS.

Computer Communication Networks↗
PubMed1978

RAPID ANALYSIS OF ECHOCARDIOGRAPHIC DATA AND TWO-DIMENSIONAL IMAGES WITH A MINI-COMPUTER BASED SYSTEM.

This study evaluates a mini-computer based system (ECHO-COMP(*)) for analyzing echocardiographic and cineangiographic data. The system consists of a programmed 16-bit mini-computer, a digitizer and a printer. Any M-mode echocardiographic recording or two-dimensional image can be analyzed with a minimal number of operator controls, and large quantities of data can be processed with statistical accuracy.

Journal Article↗