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At least 127 records · Page 7Linked to original sources
PubMed1994

Structuring the patient record: NUCLEUS (customisation environment for multi-media integrated patient records).

The NUCLEUS project (AIM A2025) develops a prototype of a multi-media integrated patient record, based on the concepts of intelligent act management as conceived in RICHE (Esprit 2221). Moreover, NUCLEUS creates facilities for the customisation of such patient record according to the requirements of the health professionals (physicians, nurses, therapists, etc.) who operate and consult the patient record. Health professionals retain full control of the patient record contents:--NUCLEUS offers facilities to structure any significant patient record, subject to the specifications of the health professionals involved. Finally, NUCLEUS implements its results in the practical clinical conditions of the three leading European hospitals.

Europe↗
PubMed1994

ORATEL: telematic system for quality assurance in oral health care (AIM Project A2029).

ORATEL is a 3-year project with the ultimate objective of improving oral health through use of appropriate computerized information systems. These tools will promote quality assurance and development in oral health care by using common quality indicators/standards. The project has completed its first phase, during which two European surveys were made, one on quality assurance clinical practices, and another on existing computerized information systems in oral health care. Pan European consensus was reached on 3 and 4 September 1992 when quality assurance indicators for oral health care services were endorsed. A manual on quality assurance indicators in oral health care has also been issued by the project.

Computer Communication Networks↗
PubMed1994

SETH: an expert system for the management on acute drug poisoning in adults.

The aim of SETH is to give end-users specific advice concerning treatment and monitoring of adult drug poisoning. SETH is developed with an off the shelf expert system shell (KBMS) and runs on a microcomputer. Technical choices were done according to this analysis, financial considerations and portability. Currently, the database contains 1000 French drugs from 75 different toxicological classes. The SETH expert system simulates the expert reasoning, taking into account for each toxicological class delay, signs and dose. Two phases of evaluation were performed. The experimental implementation of Seth began in April 1992 in our Poison Control Centre. Since then, 1100 cases inputted by residents were analysed by SETH. The extension of the knowledge base to child poisoning began in March 1993.

Acute Disease↗
PubMed1994

Development of Design-a-Trial, a knowledge-based critiquing system for authors of clinical trial protocols.

Many published clinical trials are poorly designed, suggesting that the protocol was incomplete, disorganised or contained errors. This fact, doctors' limited statistical skills and the shortage of medical statisticians, prompted us to develop a knowledge-based aid, Design-a-Trial, for authors of clinical trial protocols. This interviews a physician, prompts them with suitable design options, comments on the statistical rigour and feasibility of their proposed design and generates a 6-page draft protocol document. This paper outlines the process used to develop Design-a-Trial, presents preliminary evaluation results, and discusses lessons we learned which may apply to the developed of other medical decision-aids.

Clinical Trials as Topic↗
PubMed1994

Safety-critical software and current standards initiatives.

This paper sets out to examine the role of standards in the development of safety-critical software. It starts with a brief discussion on the nature and role of standards and then moves on to identify some of the standards making bodies. Safety-critical software is next discussed and the problems of software safety are contrasted with those of traditional electromechanical devices. There then follows a review of some of the current initiatives to produce standards addressing the development of safety-critical systems containing software. Two standards are then examined in detail to provide an insight into what requirements are placed on the developers of safety-critical software. Lastly, mention is made of some weaknesses that are inherent in today's standards, and some of the efforts that are being made to address these problems are discussed.

Accidents, Occupational↗
PubMed1994

An overview of software assessment.

Many engineering systems, especially those required to be particularly dependable, traditionally undergo inspections and assessments of safeness and fitness for purpose. Often some form of 'certificate' is provided by the assessment authority. To an increasing degree these systems are beginning to contain software components. The question naturally arises: how can the software component be assessed? This paper explores the feasibility and limitations of software assessment and the link between the process of developing the software and the quality of the resulting software product.

Europe↗
PubMed1994

PACS for radiology conferences--improvement of application software.

The introduction of PACS in a radiology department means that most functions that are available in the film-based system must be included. One important function is the radiology conference. The handling and application programs of digital workstations are normally not developed for demonstrations of many images in a limited time. This paper describes a workstation with specially designed software for radiology conferences. The application is separated in preparation and presentation of the cases to be demonstrated. Very fast image handling is achieved during the conference because the function is based on the principle of prefetching of the selected images. The images are presented on a large screen with high resolution. The experiences of digital radiology conferences are good. However, reference films from previous examinations create extra work because they have to be shown on the conventional lightbox.

Computer Terminals↗
PubMed1994

Microcomputer programs for physiologically-based pharmacokinetic (PB-PK) modeling.

Physiologically-based pharmacokinetic (PB-PK) models are each defined as a set of mathematical equations offering a fairly comprehensive time course of a chemical's disposition in several pre-selected anatomical compartments. Each of these compartments has its characteristic blood flow, volume, tissue-blood partition coefficient, and metabolic or clearance rate constants that together are deemed responsible for a chemical's disposition in that region. Numerous investigators have used these models to predict tissue dose in the animal or human body in recent years. This simulation technique, if proven effective, will eventually reduce the large number of animals that are required in the costly classic, in vivo studies to be conducted for chemical disposition or metabolism. This communication offers 2 affordable micro-computer programs which can be used as a practical simulation tool in further exploring the application of PB-PK modeling in chemical risk assessment. These 2 programs are written especially for investigators who prefer to have some appreciation of the required computer simulation first before committing themselves to using more advanced, expensive simulation software packages that are commercially available.

Administration, Cutaneous↗
PubMed1995

Supercomputer algorithms for efficient linear octree encoding of three-dimensional brain images.

We designed and implemented algorithms for three-dimensional (3-D) reconstruction of brain images from serial sections using two important supercomputer architectures, vector and parallel. These architectures were represented by the Cray YMP and Connection Machine CM-2, respectively. The programs operated on linear octree representations of the brain data sets, and achieved 500-800 times acceleration when compared with a conventional laboratory workstation. As the need for higher resolution data sets increases, supercomputer algorithms may offer a means of performing 3-D reconstruction well above current experimental limits.

Algorithms↗
PubMed1990

Testing a 3-D radiation therapy planning program.

This report describes a systematic effort to test all functions of a large 3-D radiation therapy planning program, including graphics and user interaction. Previous studies in quality assurance for radiation therapy programs do not adequately address the problem of programming errors. They compare dose estimates calculated by planning programs to actual doses measured in phantoms, so they cannot distinguish programming errors from measurement errors or physical unsoundness of the beam model. Moreover, they fail to exercise graphics and user interaction functions. This report describes a different methodology: test cases are derived from the program specification, results are calculated by an independent technique, and compared to program output. Derivation of test cases is described in detail. Effectiveness of testing is assessed by reporting the number of errors revealed by testing and comparing to the number of errors discovered during routine use in five successive program versions. The size of the test set is related to the total program size, and the effort devoted to deriving and performing tests is compared to the total program development effort. We conclude that systematic testing can reveal errors that are not found by informal testing, routine program use, or comparison with measurements. However, additional errors remain that are only discovered during use. This study suggests that a typical large planning system may include more than 100 errors when it is released for clinical use. Methods for increasing testing effectiveness are recommended.

Radiotherapy, Computer-Assisted↗
PubMed1990

Portal dose images. I: Quantitative treatment plan verification.

The comparison of a predicted portal dose image, calculated during treatment planning, with the measured image obtained during treatment is proposed as an approach to verify the correct implementation of a patient treatment plan. The comparison inherently verifies both the geometric alignment and the dose delivered. Feasibility studies were conducted with 60Co irradiation of a modular plastic phantom, an anthropomorphic phantom and a patient with lung cancer. Calculations were made with the 3-dimensional scatter ray-trace Delta Volume method. Calculated distributions and/or selected points of transmitted dose correction factors were compared with measurements made with TLD, scanning ionization chamber and film. For the two phantom studies, excellent agreement, usually to within 3%, was achieved when positioning of the phantoms were accurate. The patient study showed that selected point comparisons were inadequate in identifying the cause of errors when disagreement occurred. Simple subtraction of the calculated and measured images showed a 4 mm translational misalignment. The results are encouraging and demonstrate that portal dose images can be used to detect large geometric and dosimetric discrepancies between treatment plan calculations and measurements. The results also show that perfect verification is virtually impossible in the clinical situation. More work is required to use the verification information for improving the estimation of dose to the patient.

Cobalt Radioisotopes↗
PubMed1990

Portal dose images. II: Patient dose estimation.

Due to the many sources of uncertainties in radiotherapy, conventional treatment planning can only provide a nominal presentation of the dose delivered to the patient. Provided that large setup errors can be detected and corrected, we propose that measured and calculated portal dose images can be used to improve estimation of patient dose. The iterative approach described in this paper requires an accurate method of dose calculations, 3-dimensional CT data that closely represents the patient and the measured portal dose image. From the CT data, a portal dose image is calculated for comparison with the measured one. The differences are then used to modify the original CT data so that a new image can be calculated. The process is repeated until the calculated and measured images agree to satisfaction. At that point, the internal dose is calculated using the modified CT data. If the method is successful, daily portal dose images could be used to cumulatively estimate patient dose throughout the course of treatment. This manuscript describes 60Co simulation results to demonstrate the feasibility of the approach.

Cobalt Radioisotopes↗
PubMed1990

On-line radiotherapy imaging with an array of fiber-optic image reducers.

In the optical approach for on-line radiotherapy imaging, a large metal sheet-fluorescent screen combination is used to convert the radiation intensity distribution into a visible light image. Data are then captured via a mirror with a camera located out of the beam. Although usable portal images can be acquired, presence of the large mirror renders the system impractical in many treatment geometries. We have overcome this limitation by replacing the mirror with an array of 16 by 16 bundles of plastic fiber-optic image reducers. Each bundle, in turn, is made up of 16 by 16 individual optical fibers. The total of 256 by 256 fibers spans an input area of 40 cm by 40 cm with each individual fiber viewing an area of 1.6 mm by 1.6 mm. Within a height of 12 cm, each fiber is reduced to an area of 0.1 mm by 0.1 mm. The reduced portal image is then turned and "piped" to a final 3.0 cm by 3.0 cm output area. For data acquisition and digitization, the fiber output is directly coupled to the sensor of a TV camera interfaced to a small computer via a 512 by 512 frame grabber. In this initial evaluation, the imaging system has been characterized in terms of its line spread function, noise and resistance to radiation damage. Adequate phantom and patient images are presented.

Fiber Optic Technology↗
PubMed1990

Full integration of the beam's eye view concept into computerized treatment planning.

A complete set of beam's eye view (BEV) and beam portal design features have been integrated into a computerized 3-dimensional radiotherapy treatment planning system. Among the features implemented is the ability to mix BEV graphics with gray-scale images such as simulator and verification radiographs, and digital reconstructed radiographs. Image processing techniques have been developed to both enhance verification images and to detect radiation field boundaries. These portal simulation and presentation techniques are being used clinically to design and verify radiation fields with manual or automatically-designed field shaping blocks. The ability to perform computer dose calculations for planes which are parallel or perpendicular to a specified beam's central axis is available and this feature has also proven useful for treatment plan evaluation and optimization. Finally, direct comparison of computer-generated portal images with actual simulation and verification radiographs is also possible. These techniques allow the direct integration of "CT-directed treatment planning" with block design, simulator films and port films, and other Beam's Eye View-type displays.

Computer Simulation↗
PubMedDate not supplied

A gray-level thinning method for delineation and representation of arteries.

The quantification of three dimensional (3D) properties of coronary arteries is of significant importance. The performance of the 3D analysis is critically based on low-level representation of the arterial tree for different projections. A skeletal representation of arteries can provide appropriate data structure for registration of multiple angiographic projections and it can be further utilized for 3D reconstruction of the arterial tree. This paper presents an automated method for extracting the skeletal points of an arterial tree directly from the gray-level information without determining the edges a priori. It offers the advantage of improved reliability compared to methods based on detecting dual edges of the arteries. Novel application of filtering techniques provide accurate estimates of the statistics of the background. A recursive search scheme is used to aggregate the skeletal representation at multiple resolutions. Results on a set of Digitally Subtracted Angiograms (DSA) have been presented.

Algorithms↗
PubMed1994

[Continuous administration of drugs by infusion pumps. Presentation of an infusion rate mathematical computing software].

Intensive therapy includes continuous delivery of drugs with infusion pump. This article describes an infusion rate computing programme using a Macintosh micro-computer and the HyperCard 2 software. The latter permits the classification of data onto cards collected in stacks. The card that is displayed when the programme is launched shows fifteen buttons assigned to various drugs. Click upon a button opens the corresponding card which displays the presentation of the drug and suggests a dilution. The next step associates input of patient's weight into the appropriate field and a click on the main button. A display then indicates for various standard dosages, the corresponding rate of infusion in mL.h-1 and the daily consumption of the drug. In order to avoid casual or voluntary changes of the setting, soft securities have been inserted in the programme.

Humans↗
PubMed1993

An adaptive, object oriented strategy for base calling in DNA sequence analysis.

An algorithm has been developed for the determination of nucleotide sequence from data produced in fluorescence-based automated DNA sequencing instruments employing the four-color strategy. This algorithm takes advantage of object oriented programming techniques for modularity and extensibility. The algorithm is adaptive in that data sets from a wide variety of instruments and sequencing conditions can be used with good results. Confidence values are provided on the base calls as an estimate of accuracy. The algorithm iteratively employs confidence determinations from several different modules, each of which examines a different feature of the data for accurate peak identification. Modules within this system can be added or removed for increased performance or for application to a different task. In comparisons with commercial software, the algorithm performed well.

Algorithms↗