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At least 1,243 records · Page 69Linked to original sources
PubMed2003

An inductive method for automatic generation of referring physician prefetch rules for PACS.

To prefetch images in a hospital-wide picture archiving and communication system (PACS), a rule must be devised to permit accurate selection of examinations in which a patient's images are stored. We developed an inductive method to compose prefetch rules from practical data which were obtained in a hospital using a decision tree algorithm. Our methods were evaluated on data acquired in Osaka University Hospital for one month. The data collected consisted of 58,617 cases of consultation reservations, 643,797 examination histories of patients, and 323,993 records of image requests in PACS. Four parameters indicating whether the images of the patient were requested or not for each consultation reservation were derived from the database. As a result, the successful selection sensitivity for consultations in which images were requested was approximately 0.8, and the specificity for excluding consultations accurately where images were not requested was approximately 0.7.

Algorithms↗
PubMed1992

PACS experiences in Trieste.

The installation of a commercial PACS in the Hospitals of Trieste has been the start-point for a project of technology assessment, aimed at the evaluation of technical, clinical and economic aspects related to the introduction of this new and expensive technology in the health care system. During more than two years of use of this system in the clinical environment, several research activities have been carried out concerning the analysis of the organization of radiology departments in Italy, the analysis of work and data volumes, the evaluation of technical and clinical performances of PACS versus conventional film-based radiology, the integration between PACS and RIS, the experimentation of teleradiology applications. An overview of the most important activities and related results is given in this paper as well as some indications about future developments of the Trieste Project.

Computer Communication Networks↗
PubMed1994

Health care data standards are required for medically effective use of workstations.

Uniform, accurate, and longitudinal patient care data is needed for greater quality and efficiency in institutional and ambulatory care. Further, the knowledge to be gained from medical effectiveness research methods, applied to large quantities of such clinical data about the practice of medicine in the community, is immense. National standards for the coding, content, and electronic transfer of patient care data are needed to achieve uniformity and accuracy. These standards are slow in developing because no single private organization can capture sufficient benefit. Yet, the general public can benefit substantially. Consequently, there may be a role for the Federal Government to work with the private sector to accelerate needed health care data standards. This paper suggests activities that help to define this role.

Computer Communication Networks↗
PubMed2005

What we know about offenders who drive under the influence: analysis of court case file reviews.

This paper presents findings from a quantitative study about alcohol-impaired drivers in Utah. The University of Utah's Social Research Institute conducted a retrospective case file evaluation about the adjudication and sanctioning phases associated with driving under the influence (DUI) to determine Utah's response to DUI crime from arrest forward. Although Utah driver's license and court systems are on the cutting edge of dealing with DUI offenders, we found a variety of limitations for analysis due to data collection and entry. Therefore, it is difficult to develop a thorough understanding about the process of dealing with DUI offenders and the effectiveness of court actions and treatments. The purpose of this paper is to provide recommendations about how to ensure more accurate data collection about impaired drivers.

Accidents, Traffic↗
PubMed2005

Spectrum file size optimization for EPR tooth dosimetry.

Spectral acquisition time is one of the limiting factors in electron paramagnetic resonance (EPR) retrospective biodosimetry in teeth. Acquisition times for one sample can be from 2 to 4h. This problem is even more acute for in vivo EPR measurements in L-band. Patients cannot be expected to remain stationary for these lengths of time. In order to overcome this limitation, we investigated the dependence of EPR dose measurements on the number of data points in an EPR spectrum. We have shown that this number could be reduced from 1024 to 256 (factor of 4 reduction in spectral acquisition time) at 5 mT magnetic field sweep without a loss of precision in the dose measurements.

Algorithms↗
PubMed2006

The value of an evidence database for occupational therapists: an international online survey.

BACKGROUND: Online evidence databases can provide access to high quality evidence at the point of care, making evidence-based practice more achievable. A discipline-specific online bibliographic database called OTseeker (www.otseeker.com) was designed for use by occupational therapists. The database is free, and contains citations and abstracts of systematic reviews, and critically appraised randomized controlled trials relevant to occupational therapy. OBJECTIVES: The aim of this study was to investigate search practices of database users, their views on its functionality, and the reported impact, if any, on their practice from using OTseeker. DESIGN: An online survey, placed on the database website for 30 days. SAMPLE: Potential participants were users of OTseeker during a 30-day period. A total of 498 people who had used the database more than once from over 40 countries completed the survey. RESULTS: Three hundred and nine (62%) participants believed that OTseeker had improved their ability to locate research about the effectiveness of occupational therapy interventions, and 92 (19%) agreed that the information in the database had contributed to a change in practice. Those reporting no practice changes agreed that use of OTseeker had improved their knowledge generally (n=189; 38%), confirmed their practice (n=75; 15%), or revealed that there was insufficient research relevant to their search topic (n=92; 19%). Features of the database which helped respondents locate research evidence included: having discipline-specific content, providing critical appraisal ratings for randomized controlled trials, and presenting search results ranked for methodological quality. CONCLUSION: This study confirms the value of a discipline-specific, online database for helping occupational therapists locate high quality research evidence. Information located on databases such as OTseeker can help change or confirm practice, and improve knowledge.

Australia↗
PubMed2006

Evidence-based medicine: what it is and what it is not.

The evidence-based medicine (EBM) related concepts of hierarchy of evidence, meta-analyses, confidence intervals, study design, etc. are nowadays so widespread, that clinicians willing to use today's medical literature with understanding have no choice but to become familiar with EBM principles and methodologies. Although surgeons may perceive that evidence-based medicine mandates a strict adherence to randomised trials, it more accurately involves informed and effective use of all types of evidence (from meta-analysis of randomised trials to individual case series and case reports. With the ever-increasing amount of available information, surgeons must consider a shift in paradigm from traditional practice to one that involves question formulation, validity assessment of available studies and appropriate application of research evidence to individual patients.

Data Collection↗
PubMedDate not supplied

Neuroradiology workstation reading in an inter-hospital environment: a nineteen month study.

Two workstations (WS) each with two, 2500 line display monitors were installed in the in-patient and the out-patient neuroradiology reading areas for inter-hospital workstation readings. These WSs are part of the display component of a hospital-integrated picture archiving and communication system (PACS). Direct digital neuro images from 10 CT and MR scanners located at various buildings from two medical centers are first transmitted to the PACS database and then distributed to these two WSs automatically. This paper attempts to answer two questions. First, do the WSs facilitate neuroradiology operation? Second, does it cost less for preparing WS reading than that for the traditional film reading? Two parameters, the "time required before images become available for reading after the examination" and a "workstation utilization index" were derived as a means for answering these two questions. Nineteen months of clinical data were collected and analyzed. The results demonstrate that the workstation utilization index goes up from 40% in September 1994 when the WS was first introduced to over 80% in March 1996. This upward trend substantiates the hypothesis that these WSs do facilitate the neuroradiology operation. The derived results also exhibit that it costs much less to prepare images for WS reading than for film reading. Other indirect results derived from this study including the WS utilization hours, WS functions used, and the time duration of each WS session are also presented.

Ambulatory Care↗
PubMed2003

A practical method of linking data from Medicare claims and a comprehensive electronic medical records system.

BACKGROUND: Linking administrative and clinical databases provides opportunities for richer studies to improve healthcare, but linkage may require sophisticated algorithms. Linking US Medicare data with large databases used for everyday clinical practice is seldom described in detail in medical literature. OBJECTIVES: Test a deterministic method of linking data from a local electronic medical records system to Medicare data, and report specific details of the algorithm used as well as lessons learned from the linkage process. SUBJECTS: Medicare beneficiaries with medical encounters in selected Indiana counties in the 5-year period ending in 1999. RESULTS: For 6,388 beneficiaries with Medicare data indicating inpatient encounters in the system, 98% had links to the clinical database. Of 7,231 patients hospitalized and registered in the local clinical system, 86% contained a link to Medicare data, and 69% contained a link even without using Social security number (SSN) as an identifier. Medicare data that conflicted with local hospital records by indicating no local hospitalization occurred in 1.8%. More than 2,000 claims contained hospital identifiers that did not exist in the hospital codebook. CONCLUSIONS: Details of a practical, deterministic method of linking Medicare claims to a large electronic records system have been applied and described. Most records were linked without SSN. A variety of inconsistencies were found and these, along with missing or incomplete data, can influence linking. Integrity of specific variables must be assessed carefully.

Aged↗
PubMed2003

European data format 'plus' (EDF+), an EDF alike standard format for the exchange of physiological data.

The European data format (EDF) is a widely accepted standard for exchange of electroencephalogram and polysomnogram data between different equipment and labs. But it hardly accommodates other investigations. EDF+ is a more flexible but still simple format which is compatible to EDF except that an EDF+ file may contain interrupted recordings. Also, EDF+ supports time-stamped annotations for the storage of events such as text annotations, stimuli, averaged signals, electrocardiogram parameters, apnoeas and so on. When compared to EDF, EDF+ can not only store annotations but also electromyography, evoked potentials, electroneurography, electrocardiography and many more types of investigations. Further improvements over EDF include the use of standard electrode names. EDF+ is so much like EDF that existing EDF viewers still display the signals in EDF+ files. Software development is limited mainly to implementing the annotations. EDF+ offers a format for a wide range of neurophysiological investigations which can become a standard within a few years.

Data Interpretation, Statistical↗
PubMed1997

Information access in a dual-task context: testing a model of optimal strategy selection.

Pilots were required to access information from a hierarchical aviation database by navigating under single-task conditions (Experiment 1) and when this task was time-shared with an altitude-monitoring task of varying bandwidth and priority (Experiment 2). In dual-task conditions, pilots had 2 viewports available, 1 always used for the information task and the other to be allocated to either task. Dual-task strategy, inferred from the decision of which task to allocate to the 2nd viewport, revealed that allocation was generally biased in favor of the monitoring task and was only partly sensitive to the difficulty of the 2 tasks and their relative priorities. Some dominant sources of navigational difficulties failed to adaptively influence selection strategy. The implications of the results are to provide tools for jumping to the top of the database, to provide 2 viewports into the common database, and to provide training as to the optimum viewport management strategy in a multitask environment.

Aerospace Medicine↗
PubMed2004

Large-scale database searching using tandem mass spectra: looking up the answer in the back of the book.

Database searching is an essential element of large-scale proteomics. Because these methods are widely used, it is important to understand the rationale of the algorithms. Most algorithms are based on concepts first developed in SEQUEST and PeptideSearch. Four basic approaches are used to determine a match between a spectrum and sequence: descriptive, interpretative, stochastic and probability-based matching. We review the basic concepts used by most search algorithms, the computational modeling of peptide identification and current challenges and limitations of this approach for protein identification.

Algorithms↗
PubMed1997

Optimizing the malaria data recording system through a study of case detection and treatment in Sri Lanka.

The potential of using malaria incidence data routinely collected from endemic regions for disease control and research has increased with the availability of advanced computer-based technologies, but will depend on the quality of the data itself. We report here an investigation into the relevance of malaria statistics provided by the routine data collection system in Moneragala, a rural malaria-endemic region in Sri Lanka. All patients (n = 321) treated for malaria in 2 clusters of health care centres (HCCs) of both the private and the public sector in the administrative regions of Moneragala and Buttala Divisional Secretariat (D.S.). Divisions were studied in December 1995/ January 1996. The catchment area of these HCCs included a population resident in 53 Grama Niladhari (GN) areas, the smallest administrative units of the country. Almost equal numbers of malaria patients were detected and treated at Government and private health care institutions, and in 70% of them treatment was based on a diagnosis confirmed by microscopy. The routine data recording system, however, included only statistics from the Government sector, and only of patients whose diagnosis was microscopically confirmed. In compiling data, the origin of a case of malaria is attributed to the D.S. Division in which the institution (at which the patient was treated) was located, rather than the area in which the patient was resident, which was inaccurate because 90% of malaria patients sought health care at institutions located closest to their residence, thus crossing administrative boundaries. It also led to a loss of resolution of spatial data because patients' addresses recorded at the Government HCCs to the village-level are replaced in the statistics by the D.S. Division, which is a coarse spatial unit. Modifications to the system for malaria case recording needed to correct these anomalies are defined here. If implemented, these could result in major improvements to the quality of data, a valuable resource for the future of malaria control. The paper reiterates the call for the use of a standard spatial unit within a country to facilitate exchange of data among health and other sectors for the control of tropical diseases.

Data Collection↗
PubMed2003

Digital imaging.

Explore the source record for details and available documents.

Artificial Intelligence↗
PubMed2005

Common strategies in clinical data collection displayed by experienced clinician-teachers in internal medicine.

The role model displayed by clinician-teachers influences learning experiences but learners may face various reasoning styles. Our goal was to describe common strategies in clinical data collection displayed by experienced clinician-teachers in internal medicine. We studied six internists heavily involved in teaching while they were working up the same seven cases portrayed by a standardized patient. Each encounter was audio-recorded and replayed to allow the subjects commenting on the purpose and diagnostic hypotheses considered for each piece of information collected. Information and hypotheses elicited by all physicians were considered key items. Although the subjects reached the same final diagnoses, they differed on several characteristics of their data collection process. They also displayed common behaviours, such as: early acquisition of key data (half of them acquired within the first 19 questions asked) through clarification of the patients' complaints and focused data collection; early generation of the final diagnosis (within the first 10 questions asked) and use of diagnostic hypotheses to frame data collection; and summarization of the information at hand during the encounter (at least twice). Whether making teachers explicitly conscious about their own reasoning processes may help them better model and explain their diagnostic approach to specific cases should be assessed in follow-up studies.

Adolescent↗
PubMed2003

Sources of information about how to obtain assistive technology: findings from a national survey of persons with disabilities.

A modified discriminant function analysis was performed to determine the interaction between the source of information for assistive technology used by persons with disabilities. In the sample of 1,412 such persons, 901 were found to use some form of assistive technology in their daily lives. Ten distinct sources of information were specified. Respondents were able to mention up to three sources of information for each example of assistive technology used. A total of 930 sources were mentioned. Overall, the most mentioned information source was a physician or other health care professional, accounting for 53% of all sources mentioned. The only other frequently mentioned sources were family and friends (15%) and vocational rehabilitation counselors (13%). We found that physicians and health care professionals provide information to all groups without significant variance--this source of information is clearly nondiscriminant. Respondents who use family and friends as a source of information tend to be older, poorer, unemployed, more severely impaired, non-White, and, most significantly, render a more negative opinion of the amount and utility of information they have received about assistive technology, as well as the helpfulness of assistive technology in general. Persons obtaining information from vocational rehabilitation counselors tend to be better educated, non-White, unemployed, and have a more positive opinion about assistive technology. The limited size of the national population-based sample (n = 1,412) and very low number of responses indicating a state-based agency as the source of information about assistive technology did not allow state-by-state comparisons; alternative approaches, however, suggest a slight decline in the usage of the primary source (physician or other health care professional) with decreasing population, and a larger increase in the usage of family and friends as a source of information.

Data Collection↗
PubMed2002

The POPPs: clustering and searching using peptide probability profiles.

The POPPs is a suite of inter-related software tools which allow the user to discover what is statistically 'unusual' in the composition of an unknown protein, or to automatically cluster proteins into families based on peptide composition. Finally, the user can search for related proteins based on peptide composition. Statistically based peptide composition provides a view of proteins that is, to some extent, orthogonal to that provided by sequence. In a test study, the POPP suite is able to regroup into their families sets of approximately 100 randomised Pfam protein domains. The POPPs suite is used to explore the diverse set of late embryogenesis abundant (LEA) proteins.

Algorithms↗