CORTEX: A COMPUTER-BASED SYSTEM FOR AIDING DECISION MAKING. ESD-TDR-64-677.
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Computer Systems↗
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The NCI Drug Information System. 1. System overview.
An interactive computer system has been designed to handle all the data associated with the National Cancer Institute's (NCI) drug screening program. The system resides on the NIH DEC System 10 computers and allows interactive access to the entire NCI screening data system. This contains over 20 separate databases, including a chemistry file of about 400,000 structures and a biology file of approximately 1.5 million test records. New compounds and test data are added daily to the files, and the system also controls and records all the daily operations of the screening program, such as acquisition, shipping, and biological testing of chemicals.
Antineoplastic Agents↗
Computer-based system for maintaining and printing a hospital formulary.
Use of a pharmacy department personal computer (PC) with database management and word processing (WP) systems to maintain a hospital formulary is described. Data input and formatting were accomplished with IBM-PC/XT-compatible equipment, the Nutshell (Leading Edge) database management system, and the Wordperfect (WordPerfect Corporation) WP system. Computer-generated pages were photocopied and placed in loose-leaf binders; reduced copies were made for pocket-size binders. The cost of an outside printing service was eliminated, and the loose-leaf format made it possible to replace only the pages with revisions. The large binders were prominently placed and clearly marked to encourage use by physicians; the number of copies needed was reduced because individual copies were no longer provided to each physician. Excluding first-year one-time costs, the annual formulary maintenance cost (for 250 copies) was projected to be approximately one sixth the cost incurred previously, when 1300 bound formularies were printed annually. Maintaining and printing the hospital formulary on a PC facilitated the updating of the formulary and reduced printing costs.
Computer Systems↗
Three-dimensional computer modelling system for the study of biological structures.
A three-dimensional computer modelling system has been developed for use in biology, and is currently running on a Sun3 computer. The data originate as a series of two-dimensional micrographs which are digitised via a TV camera. The two-dimensional images are used to select features of interest and to construct a three-dimensional model. This model can be viewed in vector or solid format, it can be rotated about three orthogonal axes and can be viewed in three dimensions as a stereo pair or an anaglyph. The system has been used in a large number of projects over the past 10-15 years, for example, to examine physiological and nerve structures. The time-consuming part of the process is the selection of features, which involves a high level of biological expertise. Present developments are concerned with reduction of the time spent in feature recognition and involve the introduction of expert systems together with human-computer interaction to deal with problems of identification.
Computer Simulation↗
Fast personal computer based retrieval system for a high-volume database of a radiology information system.
A personal computer system has been used to facilitate search and analysis of a radiology information system database (RADOS) for research purposes. The system enables flexible retrieval of examination data and radiographic findings with subsequent graphical manipulations. With modifications it could be implemented on other radiology information systems.
Medical Records Systems, Computerized↗
Cost comparison of searching the Iowa Drug Information Service index manually and by computer.
A cost comparison of searching the Iowa Drug Information Service index manually and by computer is presented. Identical searches were performed on a computer system and by hand. The searches were timed and the results compared. Costs of start-up, maintenance, and operation were calculated for the manual and computer systems. Both systems yielded a similar number of relevant references. Start-up and maintenance costs were found more expensive for the computer system, but operational costs were less expensive (p less than 0.05). Operational costs varied according to the number of uses per year. Operational costs were found to increase faster for the manual system than the computer system. At 980 uses per year, the overall cost of the computer system was less than the manual system. A dedicated microcomputer system to search the Iowa Drug Information Service index was found less costly than, and as effective as, the common manual system.
Computers↗
[Robot-assisted knee endoprosthesis].
With the development of powerful computer systems, computer-assisted medical diagnosis and therapy have become common over the last 10 years. Even in the surgical field, computer- and robotic-assisted techniques are becoming practical but are not yet used on a daily basis. In the orthopaedic field, computer and robotic assistance is used in planning and performing demanding three-dimensional osteotomies, setting pedicle screws in the spine and milling the femoral medullary canal in total hip replacement. This article introduces a computer- and robotic-assisted system for performing arthroplasty in total knee replacement procedures.
Computer Simulation↗
Value of a long-term clinical database.
To study the value of historical clinical information, which we defined as data more than one year old, we measured the frequency and patterns of use of historical laboratory data among 87 providers in a multispecialty group practice delivering ambulatory care. During a one-month observation period, 38% of the providers requested historical data for use in clinical decision making. The requests were made for 19% of the patients, and represent 4% of the provider-initiated transactions on the computing system (328 per month). A survey also indicated that historical data are beneficial in clinical decision making.
Attitude of Health Personnel↗
Computer expert systems for African-American smokers in physicians offices: a feasibility study.
BACKGROUND: Stage-based computer expert systems (CES), delivered in physician offices, may offer unique opportunities to combine high participation and high efficacy, resulting in a high public health impact. Applying this technology in settings serving low-income African-American smokers, with the addition of practical tools for stress reduction, may help to reduce disparities in morbidity and mortality from smoking-related diseases. METHODS: Ninety-eight African-American smokers were recruited from a publicly funded, continuity care clinic waiting room to a study of computer interactive feedback and stress reduction audiotapes. The study was designed to assess: participation and retention rates; acceptability of both the computer expert system and the audiotapes; the fit of the transtheoretical model for the target population; and the 6-month shift in stages of change. RESULTS: Overall, 55.6% of invited smokers participated, 75.5% were seen at all three observation points. The CES and the audiotape were rated as highly interesting, relevant, and new, and most participants tried them. The predictable relationship between stage and decisional balance was reproduced in this low income African-American population. Significant stage progression occurred from baseline to 3 months (P = 0.011), from 3 to 6 months (P = 0.0001), and from baseline to 6 months (P = 0.0001). CONCLUSIONS: These data support the feasibility, acceptability and potential efficacy of stage-tailored computer interactive feedback plus stress reduction intervention delivered at the point of service to low-income African-Americans.
Black or African American↗
[Design principles, structure, and specific features of kardiovid computer diagnostic system].
The design principles and hardware implementation of Kardiovid computer diagnostic system are considered. The system is intended for diagnosis of the state of cardiovascular system on the basis of the results of electrocardiographic and fluorographic examinations. It provides simulation and visualization of the state of cardiovascular system.
Cardiovascular Diseases↗
[Evaluation of the GNF computer-coding system for the identification of non-fermentative Gram-negative bacilli].
In order to evaluate the effectiveness of the GNF computer-coding system for the identification of glucose non-fermenting gram-negative bacilli, we employed 406 strains of bacteria including 367 clinical isolates and 39 standard strains for testing. These strains were inoculated into the following eleven conventional biochemical test media: Triple Sugar Iron Agar, Simmon's Citrate Agar, Christensen's Urea Agar, Sulfide-Indole-Motility Medium, Semisolid Voges-Proskauer Test Medium, Moeller's Ornithine Decarboxylase Test Medium, Pyocyanin Test Medium, Oxidation/Fermentation (O/F) Glucose, O/F Fructose, Nitrate Broth, Moeller's Arginine Dihydrolase Test Medium. The results of these tests plus those from the hanging drop motility test and the oxidase test were converted into bacterial code number and then checked with the GNF computer-coding system. It was found that the first preference of agreement was 75.6%, second 15.3%, third 5.9%, and fourth or more 3.2%. In regard to the speed of bacterial identification by using the GNF system and information from hemolysis pattern and flagella stain, it was indicated that 84.7% would be correctly identified within 36-48 hours after isolation. If more confirmational tests were employed, the accurate identification rate would reach to 98.7% after 4 days of isolation. In addition, the use of the GNF computer-coding system can standardize identification procedures, shorten the identification period, and save cost in terms of materials supply, inoculation time, media preparation and media-storing space. Therefore, we conclude that the GNF computer-coding system is an effective tool in the identification of the glucose non-fermenting gram-negative bacilli.
Computers↗
[Computer expert system for diagnosis of joint pain. Differential diagnosis per computer anamnesis].
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Arthritis↗
Technology assessment. A framework for generating questions useful in evaluating nursing information systems.
Nursing information systems are computer systems that enable nurses to collect, manipulate, store, retrieve, display, and communicate data to administer nursing services and resources, manage nursing practice to improve patient care, and advance nursing knowledge. Selection and implementation of a nursing information system require a clear vision of the need for the system, careful planning, and astute forward thinking. Technology assessment provides a framework for generating pragmatic questions that can be used in systematically evaluating nursing information systems. This article provides a brief overview of nursing information systems, explains the technology assessment framework, and gives examples of questions useful in evaluating a nursing information system.
Computer Security↗
Methodology to evaluate a computer-based system for surveillance of hospital-acquired infections.
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Computer Systems↗
Development of a portable information system: connecting palmtop computers with medical records systems and clinical reference resources.
The portability of palmtop computers makes them an ideal platform to maintain communication between busy physicians and medical information systems. In our academic FHC (Family Health Center) we have developed software that runs on a palmtop computer allowing access to information in the HIS (Hospital Information System) and our FHC's AAMRS (Automated Ambulatory Medical Record System). The resident physicians who staff the hospital and the FHC are frequently at home or otherwise off-site where terminal access is not available. Using a Hewlett-Packard 95LX palmtop computer as the base platform, custom software has been developed to access summary data on in-patients and out-patients. Data is downloaded into a database on a palmtop computer memory card. ASCII data from Medical Information Systems (MIS), is transformed into a database format readable on the palmtop. Our hospital MIS department transmits information daily on our in-patient service (20-30 patients). We also download, weekly, a patient summary on all of our active out-patients in our MUMPS-based AAMRS (2500-3000 patients). Each morning the resident in the Family Practice program updates his palmtop memory card at a central workstation. Palmtop computers with downloaded databases, can be valuable in care of patients when the physical or on-line chart is not easily accessible. They are particularly useful in multi-physician groups when the on-call physician provides care for the patients of other physicians. We have made the palmtop computer even more valuable to physicians by providing an integrated software package.(ABSTRACT TRUNCATED AT 250 WORDS)
Academic Medical Centers↗
[Electronic data processing in medical microbiology--a guide and some critical thoughts].
Applications of electron data processing in all fields of medicine and especially in medical microbiology are increasing rapidly. It seems important to discuss a guide for using such complicated electronical systems, because, on the one hand, computer applications in medicine are desirable for scientific reasons, but on the other hand few very costly and sophisticated projects had to be cancelled, after a shorter or longer time of implementation by reason of lack of co-operation of medical collaborators. This paper puts on discussion such a guide for using electronic data processing in medical microbiology. It is proposed to put through the following tasks before introducing a computer system into a microbiological institution: a system analysis of the status quo, an objective determination of the set state, a system design and a cost-benefit analysis. Those tasks are described in detail and are illustrated to some extent by graphics and tables from own research for preparing a data processing system for medical microbiology. It is emphasized that beside hard- and software criteria of the desired computer system one has to pay attention to the problems of man-machine engineering. The paper finishes with concrete propositions of proceeding when the computer system is implemented and shows possibilities of scientific data evaluation of a microbiological data base.
Costs and Cost Analysis↗
Objective evaluation of human and computational stereoscopic visual systems.
Several computational models have been proposed to account for the abilities of human observers in solving the stereo correspondence problem. Such models are often evaluated by counting the number of correct matches that the model makes when presented with a test stimulus, but this measure is difficult to compare with conventional psychophysical measures of human stereo performance. This paper develops an absolute comparison of human and model stereo correspondence by using the concept of statistical efficiency, through which the performance of both humans and models is compared against that of an ideal observer. Some important assumptions need to be examined before the efficiencies of human and model can be compared because these assumptions affect the statistical performance of models. One assumption involves the use of an epipolar constraint to help constrain the matching problem but it is unclear what the resolution (or "height") of an epipolar line should be. Experimental estimates were obtained of the vertical region over which dot position may be varied without disruption of human stereoacuity. These estimates constrained the effective "height" of the zone above and below an epipolar line. Two models of stereopsis were then compared against human performance: the first (due to Pollard, Mayhew & Frisby, Perception, 14, 449-470, 1985) uses local constraints to solve the correspondence problem; the second is a simple area-based correlation model. For nearly all the stimuli tested, both models show strong similarities with human observers. For one particular stimulus, the efficiency of the correlation model is different from that of humans and of the PMF algorithm. This implies that a more complex process than simple correlation may be required to account for human stereo processing and indicates other limitations of correlation models.
Algorithms↗
Automated water analyser computer supported system (AWACSS) Part I: Project objectives, basic technology, immunoassay development, software design and networking.
A novel analytical system AWACSS (automated water analyser computer-supported system) based on immunochemical technology has been developed that can measure several organic pollutants at low nanogram per litre level in a single few-minutes analysis without any prior sample pre-concentration nor pre-treatment steps. Having in mind actual needs of water-sector managers related to the implementation of the Drinking Water Directive (DWD) (98/83/EC, 1998) and Water Framework Directive WFD (2000/60/EC, 2000), drinking, ground, surface, and waste waters were major media used for the evaluation of the system performance. The instrument was equipped with remote control and surveillance facilities. The system's software allows for the internet-based networking between the measurement and control stations, global management, trend analysis, and early-warning applications. The experience of water laboratories has been utilised at the design of the instrument's hardware and software in order to make the system rugged and user-friendly. Several market surveys were conducted during the project to assess the applicability of the final system. A web-based AWACSS database was created for automated evaluation and storage of the obtained data in a format compatible with major databases of environmental organic pollutants in Europe. This first part article gives the reader an overview of the aims and scope of the AWACSS project as well as details about basic technology, immunoassays, software, and networking developed and utilised within the research project. The second part article reports on the system performance, first real sample measurements, and an international collaborative trial (inter-laboratory tests) to compare the biosensor with conventional anayltical methods.
Algorithms↗