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At least 1,297 records · Page 72Linked to original sources
PubMed1994

The role of technology in diabetes therapy.

This decade will bring major changes to the therapy of diabetes. New drugs are likely to include monomeric insulins, fatty-acid-oxidation inhibitors, insulin-secretion inducers, and nutrition modifiers. Likely new devices include improved insulin pens, less invasive methods of insulin administration, and noninvasive blood glucose monitoring. The use of computers will integrate this care, and artificial intelligence will provide new approaches to all of health care. An integrated system for using these new technologies, such as staged diabetes management, will ensure an orderly, cost-effective transition in therapy by the entire health-care community.

Blood Glucose↗
PubMed1993

Automated DNA sequencing: an image processing approach.

An automatic DNA sequencing analysis system has been developed by Scanalytics/CSPI. The strategies used to solve some of the common problems in the automation of DNA sequencing systems will be discussed. Algorithms developed include fast image background correction, automatic base detection, resolution enhancement by deconvolution, desmiling and artificial intelligence algorithms for sequence interpretation.

Algorithms↗
PubMed1993

Can medical decisions be standardized? Should they be?

After a variety of regulatory and payment schemes have failed to stem the rising tide of health care cost, the Omnibus Budget Reconciliation Act of 1989 mandates the creation of a system of decision rules called practice parameters for appropriate medical action in many circumstances. A large body of practice guidelines already exists, but lacks the internal coherence required of a policy tool. Professional organizations therefore have developed attributes to achieve uniform style. However, little has been said or published about the constraints that might be imposed on the structure and content of an efficient and coherent system. The arguments presented here lead to the following conclusions: (a) process control is an inefficient tool to manage outcome--standards should reflect product control; (b) guidelines that proscribe are more likely to be supported by scientific data and consensus than those that prescribe; (c) the decision thresholds contained in such directives are policy choices rather than scientific imperatives; (d) neither decision analysis nor artificial intelligence is likely to readily influence medical decisions; and (e) as suggested by operations research, the development of practice parameters should concentrate on issues of therapeutic management in preference to issues of diagnostic activity.

Chemistry, Clinical↗
PubMed1993

Trends in computer hardware and software.

Previously identified and current trends in the development of computer systems and in the use of computers for health care applications are reviewed. Trends identified in a 1982 article were increasing miniaturization and archival ability, increasing software costs, increasing software independence, user empowerment through new software technologies, shorter computer-system life cycles, and more rapid development and support of pharmaceutical services. Most of these trends continue today. Current trends in hardware and software include the increasing use of reduced instruction-set computing, migration to the UNIX operating system, the development of large software libraries, microprocessor-based smart terminals that allow remote validation of data, speech synthesis and recognition, application generators, fourth-generation languages, computer-aided software engineering, object-oriented technologies, and artificial intelligence. Current trends specific to pharmacy and hospitals are the withdrawal of vendors of hospital information systems from the pharmacy market, improved linkage of information systems within hospitals, and increased regulation by government. The computer industry and its products continue to undergo dynamic change. Software development continues to lag behind hardware, and its high cost is offsetting the savings provided by hardware.

Clinical Pharmacy Information Systems↗
PubMed1995

Computer methods of assessment of patients state for practical use in clinical laboratory.

Results in the development of computer methods of assessment of patient state are presented as tasks of; diagnostics, gravity of disease assessment, selection of treatment based upon analysis of alternatives, forecast of the patient's state. Practice-oriented PC-based inquiry-consulting system is given as a result of this study. The system combines clinical data base and analysis functions, including the elements of artificial intelligence techniques in a user-friendly interface.

Algorithms↗
PubMed1995

Curriculum of medical informatics and medical technology in the medical faculty.

1. CURRICULUM DESCRIPTION. Twenty years ago, our faculty organized several lessons in a physiology course to inform students about computers. Recently, new courses in informatics were established. In their first year, students take a compulsory course (15 hours=h) of basic computer science (computers databases, networking, and basic non-medical computer software). A special elective course in medical informatics (30h) can be taken in the 4th year (about 20% of students pass tis course). This course includes the following lessons: computers in medicine (2h), scientific information (4h), classification in medicine (2h- including ICD, SNOMED etc.), computer support of clinical decision (2h-calculation principles with demonstration), artificial intelligence (2h), statistical software (2h), hospital information systems (2h), software for practitioners (2h), biosignal and image analysis (4th), computers in pharmacology (2h), computer simulation (2h), support of metabolic care (2h-consultations, risk calculations), and laboratory information systems (2h). The same course, though slightly differences, is used for paramedical students (occupational therapy, health education, and nursing). Medical technology was established in a three year curriculum courses in the 1st year include common courses in electronic devices (60 h), computers and programming (120 h), biophysics (90 h), biomechanics (30 h), and different medical courses (500 h). For the 2nd and 3rd year, 75% of the courses (700 h per year) are technical e.g., medical devices, information systems, signal and picture analysis, laboratory technique, and data protection. 2. CONCLUSION AND PERSPECTIVES. Students of medicine, and some paramedical studies, are able to use computer in their profession after having taken these courses. Bachelors of medical technology find application in biomedical research, hospitals, and medical technology firms.

Curriculum↗
PubMed1995

Evaluation of partial classification algorithms using ROC curves.

When using computer programs for decision support in clinical routine, an assessment or a comparison of the underlying classification algorithms is essential. In classical (forced) classification, the classification rule always selects exactly one alternative. A number of proven discriminant measures are available here, e.g.sensitivity and error rate. For probabilistic classification, a series of additional measures has been developed [1]. However, for many clinical applications, there are models where an observation is classified into several classes (partial classification), e.g., models from artificial intelligence, decision analysis, or fuzzy set theory. In partial classification, the discriminatory ability (Murphy) can be adjusted a priori to any level, in most practical cases. Here the usual measures do not apply. We investigate the preconditions for assessment and comparison based on medical decision theory. We focus on problems in the medical domain and establish a methodological framework. When using partial classification procedures, a ROC analysis in the classical sense is no longer appropriate. In forced classification for two classes, the problem is to find a cutoff point on the ROC curve; while in partial classification, you have to find two of them. They characterize the elements being classified as coming from both classes. This extends to several classes. We propose measures corresponding to the usual discriminant measures for forced classification (e.g., sensitivity and error rate) and demonstrate the effects using the ROC approach. For this purpose, we extend the existing method for forced classification in a mathematically sound manner. Algorithms for the construction of thresholds can easily be adapted. Two specific measurement models, based on parametric and non-parametric approaches, will be introduced. The basic methodology is suitable for all partial classification problems, whereas the extended ROC analysis assumes a rank order of the selected alternatives. The method is based on the black box principle and makes use only of the results of the compared algorithms and some general intuitive principles. Therefore, algorithms arising from different "philosophical" approaches may also be compared according to their results. For demonstration purposes, a clinical example from cranial computed tomography is presented. Linear discriminant analysis as a reference is compared to a Bayesian and a fuzzy procedure.

Algorithms↗
PubMed1995

A computer-assisted case report and diagnosis system: sharing the knowledge database ADM and using hypermedia techniques.

The practice of medicine is characterized by its great variability and by many rare diseases. When the medical students work in hospital units, they must learn the general medical practice in the care of the patient. The purpose of this work was to present a French multifunction decision aid system using artificial intelligence techniques and Hypercard tools for different modules. Through an ergonomic interface, the system assists the user in the construction of medical observations, suggests diagnostic hypothesis, provides documentation and helps the user perform retrieval tasks. The knowledge comes from senior experts and from the pre-existent and large knowledge database, ADM.

Computer Peripherals↗
PubMed1996

Decision aids in radiology.

Computer systems can help radiologists decide which tests to perform and which diagnoses to consider. Repositories of clinical data and general medical knowledge can provide information on demand for decision-making tasks; many of these information resources are available remotely via the Internet. Decision support systems can incorporate the techniques of artificial intelligence to apply their general knowledge to the features of a particular patient. Successful use of these technologies requires careful attention to design, implementation, and rigorous evaluation. Computer-based decision aids can improve the cost effectiveness and diagnostic accuracy of radiologic practice and are poised to play an important role in the future of radiology.

Decision Support Techniques↗
PubMed1994

[Informatics education in undergraduate study at the 1st Medical School of Charles University].

History of medical informatics at the 1st Medical Faculty goes to 25 years back. Currently curriculum is divided in two parts. In the first year of studies and obligatory course of computer technique is organized including: computer functions, communications with computers, database systems and text editors. In the 4th year of studies a course in clinical informatics is realized including: principles of computer science, statistical software, artificial intelligence, computer in pedagogy, scientific information, classification in medicine, biological signal and picture analysis, hospital information systems, computer in outpatient ward, clinical decision support, computer simulation in clinical medicine, computers in pharmacology, computer in metabolic care, computers in medical devices. In this way medical students are prepared to be able to use technical means in scientific information management.

Czech Republic↗
PubMed1995

[Glossary of terms used by radiologists in image processing].

We give the definition of 166 words used in image processing. Adaptivity, aliazing, analog-digital converter, analysis, approximation, arc, artifact, artificial intelligence, attribute, autocorrelation, bandwidth, boundary, brightness, calibration, class, classification, classify, centre, cluster, coding, color, compression, contrast, connectivity, convolution, correlation, data base, decision, decomposition, deconvolution, deduction, descriptor, detection, digitization, dilation, discontinuity, discretization, discrimination, disparity, display, distance, distorsion, distribution dynamic, edge, energy, enhancement, entropy, erosion, estimation, event, extrapolation, feature, file, filter, filter floaters, fitting, Fourier transform, frequency, fusion, fuzzy, Gaussian, gradient, graph, gray level, group, growing, histogram, Hough transform, Houndsfield, image, impulse response, inertia, intensity, interpolation, interpretation, invariance, isotropy, iterative, JPEG, knowledge base, label, laplacian, learning, least squares, likelihood, matching, Markov field, mask, matching, mathematical morphology, merge (to), MIP, median, minimization, model, moiré, moment, MPEG, neural network, neuron, node, noise, norm, normal, operator, optical system, optimization, orthogonal, parametric, pattern recognition, periodicity, photometry, pixel, polygon, polynomial, prediction, pulsation, pyramidal, quantization, raster, reconstruction, recursive, region, rendering, representation space, resolution, restoration, robustness, ROC, thinning, transform, sampling, saturation, scene analysis, segmentation, separable function, sequential, smoothing, spline, split (to), shape, threshold, tree, signal, speckle, spectrum, spline, stationarity, statistical, stochastic, structuring element, support, syntaxic, synthesis, texture, truncation, variance, vision, voxel, windowing.

Diagnostic Imaging↗
PubMedDate not supplied

The role of nuclear medicine in pulmonary embolism.

Nuclear medicine procedures and mainly perfusion lung scanning (often associated with ventilation lung scanning), after thirty years still play a major role in the diagnosis of pulmonary embolism. International study groups with accurate statistical methods have shown their efficacy in the diagnosis and follow-up, in reducing the clinical uncertainty, in directing the therapy and in lowering health care costs. The major limitation of nuclear medicine procedures lies in the high percentage of patients for whom intermediate or indeterminate probability is reported. However this percentage is steadily decreasing based on: patient clinical preselection; improved procedures and especially an extensive use of D-SPET with a three-head gamma camera; the combination with other advanced diagnostic imaging procedures (HRCT, fast-CT, MRI); suitable diagnostic algorithms for nuclear medicine procedures which should consider laboratory data (D-dimer, TAT) and the study of deep vein thrombosis; the use of artificial intelligence; the introduction of radiopharmaceuticals which enable direct scanning of the intravasal embolus (as P180 polypeptide) in combination with perfusion scanning which shows the hemodynamic alterations.

Humans↗
PubMed1995

Proper staging techniques in testicular cancer patients.

Testicular cancer has become a highly curable neoplasm, and research efforts in the 1990s are focusing on ways to improve staging and treatment so as to limit cost and morbidity. Our group has performed a number of recent studies that help to answer a number of important clinical questions. First, do we need to order computed tomography of the chest (CCT) to stage all newly diagnosed patients? Second, how accurate is contemporary era abdominal CT to stage the retroperitoneum in low-stage nonseminoma patients, and are there techniques that may improve accuracy? Third, can histological primary tumor factors be useful to predict stage in low-stage nonseminoma patients? In a study of 201 testicular cancer patients [117 (58%) NSGCT, 84 (42%) seminoma] who had both CCT and chest X-ray (CXR) in initial staging, CXR alone was found to be sufficient initial chest staging in all seminoma patients and in NSGCT patients who had a negative abdominal (CTA). For low-stage patients without retroperitoneal adenopathy, CCT had unacceptable false-positive rates, which precipitated additional invasive maneuvers. For higher stage NSGCT patients with retroperitoneal disease on initial CTA, CXR alone missed a significant number of occult thoracic metastases and CCT remains indicated. In a study of 57 clinical stage 1 NSGCT all having negative staging CTA followed by surgical staging, third and fourth generation CT had a 67% accuracy in predicting retroperitoneal metastases. This contemporary experience shows a 33% false-negative abdominal CT staging rate. Consideration of any nodes, regardless of size, in the primary echelon retroperitoneal areas as indicative of retroperitoneal metastases may hold promise for improving accuracy of CTA in low-stage NSGCT testis cancer. In a study of 92 clinical stage 1 NSGCT patients, determination of primary tumor vascular invasion (VI) and percentage of tumor composed of embryonal carcinoma component (%EMB) was found to be a useful staging tool. A multivariate model using VI and %EMB was able to predict correct stage in 86% of the study cohort, and a probability table with these two variables was created. Using these histological variables in a neural network artificial intelligence program, an expert correctly predicted stage in 92% of patients. In the 1990s chest staging should be tailored to tumor cell type and retroperitoneal disease status. Staging of the retroperitoneum utilizing abdominal CT remains problematic due to the inability to detect microscopic metastases. Primary tumor histological factors, particularly vascular invasion and quantitation of embryonal carcinoma, are clinically useful staging tools.

Carcinoma, Embryonal↗
PubMed1997

CARTHAGENE: constructing and joining maximum likelihood genetic maps.

Genetic mapping is an important step in the study of any organism. An accurate genetic map is extremely valuable for locating genes or more generally either qualitative or quantitative trait loci (QTL). This paper presents a new approach to two important problems in genetic mapping: automatically ordering markers to obtain a multipoint maximum likelihood map and building a multipoint maximum likelihood map using pooled data from several crosses. The approach is embodied in an hybrid algorithm that mixes the statistical optimization algorithm EM with local search techniques which have been developed in the artificial intelligence and operations research communities. An efficient implementation of the EM algorithm provides maximum likelihood recombination fractions, while the local search techniques look for orders that maximize this maximum likelihood. The specificity of the approach lies in the neighborhood structure used in the local search algorithms which has been inspired by an analogy between the marker ordering problem and the famous traveling salesman problem. The approach has been used to build joined maps for the wasp Trichogramma brassicae and on random pooled data sets. In both cases, it compares quite favorably with existing softwares as far as maximum likelihood is considered as a significant criteria.

Algorithms↗
PubMedDate not supplied

The Internet and medicine: past, present, and future.

The enormous growth of the Internet and the World Wide Web has made these two technologies an important potential adjunct to cost-effective health care research and delivery. This article surveys some recent developments in telecommunications, networking and artificial intelligence that are likely to have a significant impact on improving the efficiency and quality of future health care. Issues discussed include: clinical record keeping on the Internet, Internet-assisted medical diagnosis, privacy and security matters, financial transactions, digital money, bandwidth concerns, multimedia (music, audio and video) information delivery via the Internet, intellectual property, and the concept of Information Philanthropy.

Clinical Medicine↗
PubMed1997

[Current responsibilities of information processing in gynecology].

The importance of information management systems for obstetrics and gynecology has largely increased during the last years. The reasons are increasing demands for valuable medical data for economical and medical purposes and the growing complexity of sufficient applications. Actual working fields are quality assurance in perinatology and gynecological surgery, networking, image processing and applications for artificial intelligence.

Electronic Data Processing↗
PubMed1996

[The application of the expert system in prosthedontics].

In this study, we developed an expert system for designing of frame work of Removable Partial Denture by the method of Artificial Intelligence. Both of Quick Basic and Tuber C language are used in this program. This system consider more other relative factors in removable partial denture designing except the amount and position of missing teeth. Base the idea of multy-layer knowledge we divide the process RPD designing into different layers according to their logical relationships. So, this system could imitate better the expert of prosthedontics to do the clinical examination, diagnosis, treatment plan and denture designing. There are 11 modules in this system totally. They are used to accomplish the case register, first visit examination, treatment plan, abutment examination, denture designing, biomechanic analysis of abutment, reference, explanation and etc. We used this system for 20 partial edentulous patients and compared the results with the designing plans of expert of prosthedontics, the rate of conformity is 83.6%.

Denture, Partial, Removable↗
PubMed1998

[Incidence and elimination of false-negative results of ferritin determination].

Introduction of turbidimetric homogeneous immunoassays made the determination of plasma ferritin concentration wide-ranging available. However, high-dose hook effect or prozone effect occurring at samples with high ferritin concentration can lead to false-negative results. According to the authors, this phenomenon has considerable clinical significance, in patients with iron-overload disorders false-negative laboratory values may result in inaccurate diagnosis. The prozone effect can be eliminated by reaction kinetic analysis of measurements. The authors developed a neural network classification procedure based on artificial intelligence technology for the recognition of the reactions with differing kinetic flow, and made a computer software for helping the application of the classification system. False-negative results can be filtered using this new technology following the laboratory determination, thus sensitivity of plasma ferritin determination may become safe enough even in case of high concentration samples.

False Negative Reactions↗