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PubMed2004

Criticism or praise? The impact of verbal versus text-only computer feedback on social presence, intrinsic motivation, and recall.

The Computers Are Social Actors (CASA) paradigm asserts that human computer users interact socially with computers, and has provided extensive evidence that this is the case. In this experiment (n = 134), participants received either praise or criticism from a computer. Independent variables were the direction feedback (praise or criticism), and voice channel (verbal or text-only). Dependent variables measured via a computer-based questionnaire were recall, perceived ability, intrinsic motivation, and perceptions of the computer as a social entity. Results demonstrate that participants had similar reactions to computers as predicted by interpersonal communication research with participants who received text-only criticism reporting higher levels of intrinsic motivation, perceived ability, and recall. Additionally, the computer was seen as more intelligent. Implications for theory and application are discussed.

Adolescent↗
PubMed2005

Personality correlates of employees' personal use of work computers.

The advent of the desktop computer has allowed organizations to help their employees become faster and more productive workers. Some employees, however, use their work computers in unproductive ways as well, such as sending personal email and playing computer games. We call this Personal Use of Work Computers (PUWC). Using a work computer for personal reasons deviates from many organizations' norms. In the current study, we surveyed employees at an educational institution and asked them to report how they use their computers at work. These respondents also answered questions related to their sensation seeking, impulsiveness, conscientiousness, and job satisfaction as well as demographic information. We found that people who use their computers in unproductive ways tend to be men, younger, more impulsive, and less conscientious. We also found that those who use their computers for riskier PUWC behaviors (like viewing sexual content) tended to have sensation seeking personalities.

Adult↗
PubMed1992

General practitioners' attitudes towards future developments in practice computing--a representative survey in the north of Germany.

A postal questionnaire was sent to a random sample of general practitioners in Lower Saxony, Germany to assess how general practitioners regard newly developed but not yet implemented options of practice computers and future applications such as expert systems and information retrieval systems. Replies were received from 276 (response rate 73.6%) general practitioners. Replying doctors were younger (P < 0.05) but they did not differ by sex, practice location, type of vocational training and grade of computerization from non-responding GPs. Twenty-eight per cent of the practices were computerized. Doctors who currently used a computer and those who intended to do so within the next 5 years were significantly younger than those doctors who did not intend to computerize their practice (P < 0.001). Female doctors were less willing to buy a computer than their male colleagues (P < 0.05). A computerized drug database and a medical library ranked best from 8 options given. Overall attitudes to all features were positive, except for an expert system giving criteria for referrals to specialist care. Doctors already working with a computer and those intending to buy one were significantly more positive about future options for computers than those doctors who do not intend to use a computer (P < 0.01). GPs' attitudes about new features of practice computers in general were positive but even more so about those options which are already available. Referral to a specialist seems to be a crucial point for GPs--they apparently do not want to be guided by a computer here.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed2003

Age differences in home computer availability and use.

OBJECTIVES: The purpose of this study was to determine whether age differences in home computer availability and use are due to variations in compositional characteristics (e.g., income or disabilities) of age cohorts. METHODS: Data are drawn from the September 2001 Current Population Survey and its supplement on computer and Internet use (N = 71,182). Patterns of age differences in home computer use are examined using Multiple Classification Analysis with controls for several measures of compositional variability (employment status, marital status, Hispanic origin and race, gender, family income, living arrangements, education, and number of disabilities). RESULTS: Even though home computer availability declines steadily with age, a portion of this zero-order relationship is due to composition effects, with their greatest impact occurring at the oldest ages. Among persons living in households where a computer is available, use also declines with age, but these age differences in computer use are less due to compositional differences. DISCUSSION: The lower rates of home computer availability and use exhibited by older persons may be accounted for to some extent by compositional characteristics negatively associated with availability and, to a lesser extent, use of computers, although unmeasured attitudes, experience, and support undoubtedly play a role.

Adult↗
PubMed1983

Criteria for evaluating a computer aid to clinical reasoning.

The acceptance or rejection of computer aids to clinical reasoning is determined not only by the preferences and prejudices of potential users, but also by whether the output generated by the computer aid represents sound clinical judgment. This paper deals with the issue of the appropriate criteria for evaluating the clinical 'reasoning' of computer aids. Evaluation of a computer aid should include an assessment of the accuracy or appropriateness of its conclusions and an assessment of the scope of its considerations. In order to use a conclusion generated by a computer aid as a basis for clinical action, information must be available on the alternative conclusions that might have been drawn, the degree of confidence in each conclusion, and the consequences that may result from acting upon the wrong conclusion. If this information is not generated as part of the output of a computer aid, it may be obtained through the use of its explanation and display capabilities, if the aid has such capabilities. Explanation and display capabilities permit the examination of the operations of the computer aid. Examination of a computer's operations is also the most feasible means to evaluate the soundness of its 'reasoning'.

Diagnosis, Computer-Assisted↗
PubMed1997

Pilot studies of in-course assessment for a revised medical curriculum: II. Computer-based, individual.

PURPOSE: To test a computer-based method of in-course assessment for a modular, systems-oriented medical curriculum at the University of Otago Medical School. METHOD: For the in-course assessment in anatomic pathology, 193 students completed five biweekly (i.e., every two weeks), criterion-referenced, computer-based quizzes incorporating many digitized photographs and a variety of question formats. The students signed up to take quizzes at any of ten available times during each quiz week. A score of 70% was required for passing each quiz, but the students could retake quizzes up to two more times in alternative versions. The students' opinions about biweekly testing and computer-based testing were sought. RESULTS: All 193 students satisfactorily completed the assessment program, with no significant problems with hardware, software, or administration during the more than 1,000 computer-based quizzes. The students valued the bi-weekly quizzes as a stimulus for study and for feedback. They strongly supported computer-based quizzes, identifying a variety of benefits in their responses to the questionnaire. The staff found that development of visually rich quizzes was greatly facilitated by the use of computers. CONCLUSION: The study confirmed the feasibility of using regular, computer-based quizzes for in-course assessment of a large medical school class and demonstrated assessments of a kind that would be difficult to achieve by means other than with computers.

Computer-Assisted Instruction↗
PubMed2002

Interactive computer simulations of knee-replacement surgery.

OBJECTIVE: Current surgical training programs in the United States are based on an apprenticeship model. This model is outdated because it does not provide conceptual scaffolding, promote collaborative learning, or offer constructive reinforcement. Our objective was to create a more useful approach by preparing students and residents for operative cases using interactive computer simulations of surgery. Total-knee-replacement surgery (TKR) is an ideal procedure to model on the computer because there is a systematic protocol for the procedure. Also, this protocol is difficult to learn by the apprenticeship model because of the multiple instruments that must be used in a specific order. We designed an interactive computer tutorial to teach medical students and residents how to perform knee-replacement surgery. We also aimed to reinforce the specific protocol of the operative procedure. Our final goal was to provide immediate, constructive feedback. DESCRIPTION: We created a computer tutorial by generating three-dimensional wire-frame models of the surgical instruments. Next, we applied a surface to the wire-frame models using three-dimensional modeling. Finally, the three-dimensional models were animated to simulate the motions of an actual TKR. The tutorial is a step-by-step tutorial that teaches and tests the correct sequence of steps in a TKR. The student or resident must select the correct instruments in the correct order. The learner is encouraged to learn the stepwise surgical protocol through repetitive use of the computer simulation. Constructive feedback is acquired through a grading system, which rates the student's or resident's ability to perform the task in the correct order. The grading system also accounts for the time required to perform the simulated procedure. We evaluated the efficacy of this teaching technique by testing medical students who learned by the computer simulation and those who learned by reading the surgical protocol manual. Both groups then performed TKR on manufactured bone models using real instruments. Their technique was graded with the standard protocol. The students who learned on the computer simulation performed the task in a shorter time and with fewer errors than the control group. They were also more engaged in the learning process. DISCUSSION: Surgical training programs generally lack a consistent approach to preoperative education related to surgical procedures. This interactive computer tutorial has allowed us to make a quantum leap in medical student and resident teaching in our orthopedic department because the students actually participate in the entire process. Our technique provides a linear, sequential method of skill acquisition and direct feedback, which is ideally suited for learning stepwise surgical protocols. Since our initial evaluation has shown the efficacy of this program, we have implemented this teaching tool into our orthopedic curriculum. Our plans for future work with this simulator include modeling procedures involving other anatomic areas of interest, such as the hip and shoulder.

Arthroplasty, Replacement, Knee↗
PubMed2001

Computed tomography findings in patients with sacroiliac pain.

This retrospective study evaluated the diagnostic value of computed tomography in patients with sacroiliac pain. Computed tomography scans of the sacroiliac joints of 62 patients with sacroiliac joint pain were reviewed. The criteria to include the patient in the current study were pain relief after a local injection in the sacroiliac joint under computed tomography guidance, a physical examination consistent with a sacroiliac origin of the pain, and negative magnetic resonance imaging of the lumbar spine. A control group consisted of 50 patients of matched age who had computed tomography scans of the pelvis for a reason other than pelvic or back pain. Computed tomography scans showed one or more findings in 57.5% and 31% of the sacroiliac joints in the symptomatic and the control groups, respectively. The computed tomography scans were negative in 37 (42.5%) symptomatic sacroiliac joints with a positive sacroiliac joint injection test. The sensitivity of computed tomography was 57.5 % and its specificity was 69%. The finding of the current study suggests limited diagnostic value of computed tomography in sacroiliac joint disease because of its low sensitivity and specificity. With clinical suspicion of a sacroiliac origin of pain, intraarticular injection is currently the only means to confirm that diagnosis.

Adolescent↗
PubMed1996

Application of pharmacokinetics to computed tomography: injection rates and schemes: mono-, bi-, or multiphasic?

OBJECTIVE: The objective of the current study was to test whether optimization of dose regimens for detecting focal liver lesions by computed tomography is possible by using the available time-density data of former studies published in the literature and a computer program so that the number of further clinical tests with the exclusive objective of optimizing injection schemes could be reduced. METHODS: Computed tomography enhancement data of the aorta and/or the liver obtained after injecting a conventional ionic and a nonionic contrast agent were used to calculate pharmacokinetic parameters and to simulate the time course of enhancement for a variety of different infusion regimens modifying contrast medium strength, dose, and injection rate. The study consisted of two parts. In the first part, mean relative enhancement curves of the aorta and of liver parenchyma (0 to 300 sec) using meglumine diatrizoate (306 mg iodine per mL, 300 mg iodine per kg) were taken from the literature and their values were approximated using the computer program TOPFIT. In the second part, equivalent data for iohexol including a total of three strengths (240, 300, and 350 mg iodine per kg) and doses from 30 to 45 grams of iodine were used. "Validation" of the simulation method was obtained, first by comparing measured and calculated maximum intensities and times to reach maximum and, second, by using one injection scheme for the simulation of a second and comparing the results with actually measured data. RESULTS: The computer program TOPFIT allowed for excellent curve fitting of the measured density values. The data obtained in the first part of the study showed that after a dose of 300 mg I/kg and a rate of 2 mL/sec maximal enhancement is achieved in the aorta after 30 seconds (approximately 100 HU) and in the liver after 50 seconds (approximately 30 HU). The higher the dose and the rate of infusion were, the higher was the enhancement. The difference in density between aorta and liver was proportional to the infusion rate approaching asymptotically approximately 90 HU at 8 mL/sec for a dose of 300 mg I/kg. Bi- or triphasic infusion schemes did not improve differences in enhancement. The curve fitting obtained in the second part of the study also confirmed the results reported in the literature. A "crossover" prediction of data was possible within the range of interindividual variations of pharmacokinetic parameters and thus validated the chosen approach of computer simulation. Furthermore, data sets selected randomly out of the simulation results could be used--within the limits of interindividual variability--to predict data determined in other clinical trials. CONCLUSION: The computer program TOPFIT appears useful for the optimization of time--density profiles in computed tomography. The number of further clinical studies with the objective of optimization could therefore possibly be reduced.

Aortography↗
PubMed1997

Legal issues of computer imaging in plastic surgery: a primer.

Although plastic surgeons are increasingly incorporating computer imaging techniques into their practices, many fear the possibility of legally binding themselves to achieve surgical results identical to those reflected in computer images. Computer imaging allows surgeons to manipulate digital photographs of patients to project possible surgical outcomes. Some of the many benefits imaging techniques pose include improving doctor-patient communication, facilitating the education and training of residents, and reducing administrative and storage costs. Despite the many advantages computer imaging systems offer, however, surgeons understandably worry that imaging systems expose them to immense legal liability. The possible exploitation of computer imaging by novice surgeons as a marketing tool, coupled with the lack of consensus regarding the treatment of computer images, adds to the concern of surgeons. A careful analysis of the law, however, reveals that surgeons who use computer imaging carefully and conservatively, and adopt a few simple precautions, substantially reduce their vulnerability to legal claims. In particular, surgeons face possible claims of implied contract, failure to instruct, and malpractice from their use or failure to use computer imaging. Nevertheless, legal and practical obstacles frustrate each of those causes of actions. Moreover, surgeons who incorporate a few simple safeguards into their practice may further reduce their legal susceptibility.

Communication↗
PubMed2000

Comparative results between conventional and computer-assisted pedicle screw installation in the thoracic, lumbar, and sacral spine.

STUDY DESIGN: A comparative study on the position of pedicle screws in patients treated surgically with and without computer assistance. OBJECTIVES: To evaluate the accuracy of computer-assisted pedicle screw installation, and to evaluate its clinical benefit as compared with conventional pedicle screw installation techniques. SUMMARY OF BACKGROUND DATA: In vitro and clinical studies have documented a significant rate of misplaced screws in the thoracolumbar area. Neurologic complications are recognized problems caused by screw misplacement. METHODS: Patients treated surgically with computer assistance were compared with a historical control group of patients treated surgically with conventional techniques in the same hospital and by the same surgical team. All screw positions were measured with a postoperative magnetic resonance tomography, and cortical effractions were categorized in 2-mm increments. Patients' charts also were reviewed to assess individual neurologic outcomes. RESULTS: The control cohort was composed of 100 patients, with 544 screws from T5 to S1. The computer-assisted cohort was composed of 50 patients, with 294 screws from T2 to S1. In the control cohort, 461 of 544 screws (85%) were found completely within their pedicles as compared with 278 of 294 screws (95%) correctly placed in the computer-assisted group (P < 0.0001). All 16 screws incorrectly placed with computer assistance were found 0.1 mm to 2 mm from the pedicle cortex. In the control cohort, 68 screws were found 0.1 mm to 2 mm, 10 screws 2.1 mm to 4 mm, and 5 screws more than 4 mm from the pedicle cortex. Seven patients in the control cohort were surgically retreated because of postoperative neurologic deficits, whereas no patients in the computer-assisted group were surgically retreated. CONCLUSIONS: Computer assistance can decrease the incidence of incorrectly positioned pedicle screws.

Bone Screws↗
PubMed2002

Atlantoaxial rotatory fixation-subluxation revisited: a computed tomographic analysis of acute torticollis in pediatric patients.

STUDY DESIGN: Cross-sectional clinical and radiologic study with a normal control group. OBJECTIVES: To compare the range of motion of the atlantoaxial joint in patients with acute torticollis with those of normals as measured from computed tomography scans, to look for the existence of atlantoaxial rotatory fixation in any position (subluxation or normal range of motion) in this group of patients, and to clarify the definition of atlantoaxial rotatory subluxation by measuring the atlantodental interval and analyzing the location of the center of rotation in patients as well as normal controls. SUMMARY OF BACKGROUND DATA: Although acute acquired torticollis is usually termed atlantoaxial rotatory subluxation or atlantoaxial rotatory fixation, the radiologic definition of these conditions is not clear. PATIENTS AND METHODS: Thirty-three consecutive pediatric patients (average age 8.5 years, range 2-18 years) with acute acquired torticollis were analyzed. All were neurologically intact. Anteroposterior and lateral radiographs were obtained in all atlantoaxial computed tomography scans in 31 patients (dynamic in 23 and static in 8). Twelve age-matched patients with normal cervical spines were also analyzed with dynamic computed tomography as normal controls. Atlantoaxial rotatory subluxation, atlantoaxial angle, center of rotation, and presence of atlantoaxial rotatory fixation were analyzed in each computed tomography. All patients were treated conservatively. Eight had control dynamic computed tomography scans at the end of the treatment. RESULTS: All patients had atlantoaxial rotatory subluxation <or=3 mm. On dynamic computed tomography, the range of atlantoaxial rotation was 30.4 degrees (range 11-54 degrees) toward deformity and 28.3 degrees (range 18-54 degrees) away from deformity (P = 0.333). Atlantoaxial rotatory fixation was not noted in any of the patients. The same measurement for the normal control group was 28 degrees (range 5-41 degrees) (P = 0.770). Of the eight patients with repeat control computed tomography, the atlantoaxial rotatory subluxation was 26 degrees before and 29 degrees after treatment (P = 0.691 to right and P= 0.199 to left). The center of rotation was within dens in 15 of 19 patients, outside dens in 2 of 19, and undetectable in 2 of 19. In the control group, it was within dens in 8 of 11, outside dens in 2 of 11, and undetectable in 1 of 11. All patients were symptom free at the end of the conservative treatment. CONCLUSION: We could not demonstrate the presence of atlantoaxial rotatory subluxation or atlantoaxial rotatory fixation in our series of 33 consecutive pediatric patients with acute torticollis. Our findings suggest that the existence of these phenomena are doubtful, although not associated with acute acquired torticollis. Acute acquired torticollis is not necessarily the sign of a pathologic condition of the atlantoaxial joint. Finally, it is probably not necessary to obtain computed tomography scans (static or dynamic) in this group of patients at the time of presentation.

Acute Disease↗
PubMed2002

Computational physics: a perspective.

Computing comprises three distinct strands: hardware, software and the ways they are used in real or imagined worlds. Its use in research is more than writing or running code. Having something significant to compute and deploying judgement in what is attempted and achieved are especially challenging. In science or engineering, one must define a central problem in computable form, run such software as is appropriate and, last but by no means least, convince others that the results are both valid and useful. These several strands are highly interdependent. A major scientific development can transform disparate aspects of information and computer technologies. Computers affect the way we do science, as well as changing our personal worlds. Access to information is being transformed, with consequences beyond research or even science. Creativity in research is usually considered uniquely human, with inspiration a central factor. Scientific and technological needs are major forces in innovation, and these include hardware and software opportunities. One can try to define the scientific needs for established technologies (atomic energy, the early semiconductor industry), for rapidly developing technologies (advanced materials, microelectronics) and for emerging technologies (nanotechnology, novel information technologies). Did these needs define new computing, or was science diverted into applications of then-available codes? Regarding credibility, why is it that engineers accept computer realizations when designing engineered structures, whereas predictive modelling of materials has yet to achieve industrial confidence outside very special cases? The tensions between computing and traditional science are complex, unpredictable and potentially powerful.

Computer Simulation↗
PubMed2004

Comparing hand-held computers and paper diaries for haemophilia home therapy: a randomized trial.

Treatment of severe haemophilia with factor concentrates is by self-infusion in the home. Adherence to record keeping on paper diaries is poor. A randomized-controlled trial compared adherence with record keeping of paper diaries with hand-held computers. Forty-one individuals with severe haemophilia, were randomized to hand-held computers (n = 22) or paper diaries (n = 19) and followed for 6 months. About 86.2% (679 of 788) of infusions by patients in the computer group were in compliance with the data submission schedule compared with only 48.3% (358 of 741) of infusions by patients using paper diaries (P < 0.0001). The time intervals between infusions and the receipt of data were shorter in the computer group (median 0.25 vs. 25 days respectively, P < 0.0001). Reminder phone calls by the clinic were made less frequently to users of hand-held computers than to users of paper diaries (median one vs. five times, P < 0.0001). Accuracy of data was similar for both methods. Compliance with hand-held computers was superior to paper diaries. The clinic received data from hand-held computers mostly on the same day, and nurses could thereby provide clinical advice more effectively. Although hand-held computers did not result in increased accuracy, errors could be detected and corrected more rapidly. Electronic data can more easily be verified, analysed and summarized than that from paper diaries.

Adolescent↗
PubMed1998

A new computer program for mass screening of visual defects in preschool children.

AIMS: To test the effectiveness of a PC computer program for detecting vision disorders which could be used by non-trained personnel, and to determine the prevalence of visual impairment in a sample population of preschool children in the city of Beer-Sheba, Israel. METHODS: 292 preschool children, aged 4-6 years, were examined in the kindergarten setting, using the computer system and "gold standard" tests. Visual acuity and stereopsis were tested and compared using Snellen type symbol charts and random dot stereograms respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and kappa test were evaluated. A computer pseudo Worth four dot test was also performed but could not be compared with the standard Worth four dot test owing to the inability of many children to count. RESULTS: Agreement between computer and gold standard tests was 83% and 97.3% for visual acuity and stereopsis respectively. The sensitivity of the computer stereogram was only 50%, but it had a specificity of 98.9%, whereas the sensitivity and specificity of the visual acuity test were 81.5% and 83% respectively. The positive predictive value of both tests was about 63%. 27.7% of children tested had a visual acuity of 6/12 or less and stereopsis was absent in 28% using standard tests. Impairment of fusion was found in 5% of children using the computer pseudo Worth four dot test. CONCLUSIONS: The computer program was found to be stimulating, rapid, and easy to perform. The wide availability of computers in schools and at home allow it to be used as an additional screening tool by non-trained personnel, such as teachers and parents, but it is not a replacement for standard testing.

Child↗
PubMed1994

Indication for computed tomography of the brain in patients with first uncomplicated generalised seizure.

OBJECTIVES: To assess the yield of emergency computed tomography of the brain in patients with a first generalised epileptic seizure and to evaluate a four item screening questionnaire on alcohol misuse (CAGE questionnaire) as a triage tool to avoid unnecessary scans in cases of seizures related to withdrawal from alcohol. DESIGN: Prospective, observational. SETTING: Medical casualty unit in a university hospital. PATIENTS: 119 adult patients presenting to casualty within one hour of a generalised seizure. MEASUREMENTS: A clinical examination focusing on focal neurological symptoms, the CAGE questionnaire, and computed tomography of the brain with contrast enhancement. RESULTS: Computed tomography showed a focal, structural lesion of the brain in 40 patients (34% (95% confidence interval 25% to 42%)). In 20 patients (17% (10% to 24%)) an important therapeutic intervention resulted. The presence of a focal neurological deficit had a sensitivity of 50% and a specificity of 89% in predicting focal lesions on computed tomography. Answering "yes" to fewer than two CAGE questions had a sensitivity of 90% and specificity of 44% in identifying patients with focal computed tomography lesions. Focal lesions were not detected on computed tomography in any of the 35 patients (0% (0% to 10%)) who showed no focal neurological symptoms and answered "yes" to two or more CAGE questions. CONCLUSIONS: The diagnostic yield of computed tomography of the brain in adults after a first generalised seizure is high. Combined with the clinical examination, the CAGE questionnaire can reliably identify patients with uncomplicated seizures related to withdrawal from alcohol, in whom computed tomography may not be absolutely necessary.

Adolescent↗
PubMed1998

A systematic review of the use of computers in the management of hypertension.

STUDY OBJECTIVE: To assess the effect of computers and computer-based clinical decision support systems on the management of hypertension. DESIGN: Systematic review of randomised controlled trials. SETTING: Ambulatory hypertension clinics, community-based health centres, and general practices. PARTICIPANTS: 11,962 patients enrolled in seven trials retrieved from a systematic search (electronic databases, contact with authors, reference lists; no restriction on language). MAIN RESULTS: Individual trials report on a diverse population of patients (newly diagnosed or established hypertensive patients), interventions (computers used for case finding, recall and registration, feedback on quality of blood pressure control and prescribing information), and outcomes (administration, physician performance and blood pressure control). Four of five trials reported an improvement in patient administration using a computer. Two of three trials reported an improvement in physician performance using a computer. Two of six trials. reported an improvement in blood pressure control in patients using a computer. However, positive findings in two trials should be regarded cautiously because of the potential effects of cluster randomisation. CONCLUSIONS: It seems that computers have a favourable effect on the uptake and follow up of patients in hypertension management. The effect of computers on physician knowledge, recording of information, and blood pressure control in patients is less conclusive and further studies are required.

Decision Making, Computer-Assisted↗
PubMed1990

Comparison of thin section computed tomography with bronchography for identifying bronchiectatic segments in patients with chronic sputum production.

Computed tomography is widely used in the investigation of patients in whom bronchiectasis is suspected, despite considerable variation in its reported sensitivity and specificity. The findings with 3 mm high resolution computed tomography were compared at segmental level with bronchography by two radiologists independently in 27 patients (aged 20-67 years) undergoing investigation of chronic sputum production. Fifteen patients were found to have bronchiectasis by both investigations. Five were identified by computed tomography alone, including two in whom disease was revealed in segments underfilled at bronchography. The sensitivity of computed tomography compared with bronchography in the diagnosis of bronchiectasis at segmental level was 84% and the specificity 82%. The predictive value of computed tomography in the diagnosis of bronchiectasis was 38% overall, but increased to 75% when only those segmental bronchi moderately or severely dilated on the computed tomography scan were considered. There was no relation between the degree of bronchial wall thickening on the computed tomogram and the diagnosis of bronchiectasis by bronchography. Bronchography may be avoided in patients being considered for surgical resection of their bronchiectasis in whom computed tomography shows diffuse disease.

Adult↗