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PubMedDate not supplied

Effectiveness of a computer-based system to deliver a continence health promotion intervention.

OBJECTIVE: The objective of this study was to test a computer-based system for continence health promotion that included self-management techniques for women with symptoms of involuntary urine loss, urinary frequency or urgency, or nocturia. DESIGN: A quasi-experimental trial design with repeated measures was used. SETTING AND SUBJECTS: Older women (n = 71) with continence problems were recruited and completed a computer session. INSTRUMENTS: Outcomes were measured with the Urogenital Distress Inventory-Short Form, the Incontinence Impact on Life Questionnaire-Short Form, and a bladder diary. A modified Questionnaire for User Interface Satisfaction was used to measure satisfaction with the system. METHODS: Participants assigned to the intervention group (n = 36) used the computer-based system for continence health promotion, and those in the wait list control group (n = 35) used an alternate system. Data were collected at baseline and 8 weeks after the computer session. RESULTS: Analysis of covariance results on symptom distress and quality of life scores showed no significant treatment effect, although a trend toward improvement was observed. The intervention group improved significantly on urogenital distress (P = .01) and quality of life (P = .003) outcomes, but the control group did not. Women had little difficulty using the system and expressed satisfaction with the individualized information provided. CONCLUSIONS: Although the computer-based system did not result in significantly improved outcomes when comparing women in the 2 groups, the computer-based group improved significantly from baseline to follow-up. Further research on a computer-based system that women could access independently or that nurses could use to supplement traditional care is warranted.

Aged↗
PubMed1982

Microelectronics and computers in medicine.

Microelectronics and computers are in use in virtually every aspect of modern medicine. Computers are used widely in medical research, where an important need is for better microelectronic sensors for data acquisition. In medical practice, data collection from patients as well as subsequent storage, retrieval, and manipulation of data are enhanced by the computer. In medical decision-making computers improve accuracy, increase cost-efficiency, and advance understanding of the structure of medical knowledge and of the decision-making process itself. Powerful new noninvasive diagnostic instruments including x-ray tomographic scanners and ultrasonic imaging systems are based on computers. The efficiency and scope of clinical laboratory procedures and advanced analytical instruments are greatly increased by computerization, and careful application of computers has improved the interpretation of diagnostic tests, such as the electrocardiogram, and monitoring of critically ill patients. The powerful sensory, computational, memory, and display capabilities of microcomputer systems and their compact size offer new opportunities to relieve functional deficiencies associated with loss of limbs, paralysis, speech impediments, deafness, and blindness.

Clinical Laboratory Techniques↗
PubMed2001

A descriptive feast but an evaluative famine: systematic review of published articles on primary care computing during 1980-97.

OBJECTIVES: To appraise findings from studies examining the impact of computers on primary care consultations. DESIGN: Systematic review of world literature from 1980 to 1997. DATA SOURCES: 5475 references were identified from electronic databases (Medline, Science Citation Index, Social Sciences Citation Index, Index of Scientific and Technical Proceedings, Embase, OCLC FirstSearch Proceedings), bibliographies, books, identified articles, and by authors active in the field. 1892 eligible abstracts were independently rated, and 89 studies met the inclusion criteria. MAIN OUTCOME MEASURES: Effect on doctors' performance and patient outcomes; attitudes towards computerisation. RESULTS: 61 studies examined effects of computers on practitioners' performance, 17 evaluated their impact on patient outcome, and 20 studied practitioners' or patients' attitudes. Computer use during consultations lengthened the consultation. Reminder systems for preventive tasks and disease management improved process rates, although some returned to pre-intervention levels when reminders were stopped. Use of computers for issuing prescriptions increased prescribing of generic drugs, and use of computers for test ordering led to cost savings and fewer unnecessary tests. There were no negative effects on those patient outcomes evaluated. Doctors and patients were generally positive about use of computers, but issues of concern included their impact on privacy, the doctor-patient relationship, cost, time, and training needs. CONCLUSIONS: Primary care computing systems can improve practitioner performance, particularly for health promotion interventions. This may be at the expense of patient initiated activities, making many practitioners suspicious of the negative impact on relationships with patients. There remains a dearth of evidence evaluating effects on patient outcomes.

Bibliometrics↗
PubMed2006

Classification of breast lesions with multimodality computer-aided diagnosis: observer study results on an independent clinical data set.

PURPOSE: To evaluate a computer-aided diagnosis multimodality intelligent workstation as an aid to radiologists in the interpretation of mammograms and breast sonograms. MATERIALS AND METHODS: An institutional review board approved the protocol for an observer study with signed consent, as well as the retrospective use of the mammograms, sonograms, and clinical data with waiver of consent. The HIPAA-compliant observer study was conducted with five breast radiologists and five breast imaging fellows, all of whom gave confidence ratings and patient management decisions, both without and with the computer aid, for 97 lesions that were unknown to both the observers and the computer. The performance of each observer without and with the computer aid was quantified by using four performance measures: area under the receiver operating characteristic curve (A(z)) value, partial A(z) value, sensitivity, and specificity. The statistical significance of the differences in the performance measures without and with the computer aid was determined by using a two-tailed t test for paired data. RESULTS: Use of the computer aid resulted in an improvement of the average performance of the 10 observers, as measured by means of a statistically significant increase in A(z) value (0.87-0.92; P < .001), partial A(z) value (0.47-0.68; P < .001), and sensitivity (0.88-0.93; P = .005). A statistically significant difference was not found in the specificity without and with the computer aid (0.66-0.69; P = .20). CONCLUSION: Use of multimodality intelligent workstations can improve the performance of radiologists in the task of differentiating malignant and benign lesions at mammography and sonography.

Adult↗
PubMed2002

Computer assisted surgery for total knee arthroplasty.

The author has attempted to assess the value of computer-assisted surgery in arthroplasty of the knee. Basic requisites in TKR include adequate alignment and ligament balance. These requisites have become easier to meet as ancillary instrumentations have improved over time. Numerical tools are now available; they are sometimes presented as an essential technical step. The author reviews the various available options, with their advantages and disadvantages. Satisfactory alignment in the three planes classically relies on anatomic landmarks, the reliability of which is limited, and on ligament tension. Targeting systems, intra- or extramedullary, all have a margin of error. Computer-assisted surgery aims at increasing the precision of implant positioning and achieving optimal ligament balance. Among the systems currently available, a distinction must be made between active and passive systems. The former correspond to the "surgical robots", which are capable of performing the various parts of the operation following adequate preparation, at least regarding the bone cuts. Passive systems remain under control from the surgeon and assist him in positioning the cutting jigs. Among localization systems, a distinction must be made between optical and magnetic systems. Certain systems require preoperative imaging--usually CT scan--in order to first reconstruct a 3-D model of the knee. This step is time-consuming, but this will likely improve in the future. Image matching requires the use of a software, with specific landmarks defined preoperatively by the surgeon. Such systems may be used in cases with major deformities; their main drawback is the need for preoperative imaging. Other systems do not require preoperative imaging: a few points are identified by kinematic analysis of the hip, knee and ankle; they are used for 2-D or 3-D reconstruction. Computer-assisted systems may improve the precision in defining anatomic landmarks and achieving accurate location and orientation of the bone cuts, but this must still be validated. Computer-assisted surgery allows for intraoperative control of the orientation of bone cuts, the mechanical axes, the ligament balance and the range of motion. It remains to be demonstrated that using these systems will result into a clinically relevant benefit for the patient, as several of the prostheses widely implanted so far have demonstrated high survivorship rates at 15 or 20 years, so that the demonstration of a possible superiority would need considerable investment. Using these techniques does not solve all problems anyway. The patellar cut remains empirical, and these techniques also do not give any information about femoropatellar joint function. The present systems make use of the classical instrumentation, but it may be anticipated that instrumentations especially intended for computer-assisted surgery will be developed in the future. Regarding imaging, some possibilities have not yet been explored, such as plain radiography or fluoroscopy. Computer-assisted surgery should be of particular interest in revision arthroplasties, but it poses additional problem. The indications are relatively scarce however, and no major advances should be anticipated in the near future. On the whole, this is an emerging technical field. Development is slow, none of the available products is fully mature and caution is warranted in the face of enthusiastic reports and presentations. The value of computer-assisted surgery in TKR has not been demonstrated and its real usefulness still needs to be evaluated. It will, anyway, by no means exempt the surgeon from mastering the classical operative technique.

Arthroplasty, Replacement, Knee↗
PubMedDate not supplied

A randomized trial comparing human e-mail counseling, computer-automated tailored counseling, and no counseling in an Internet weight loss program.

BACKGROUND: Several studies have shown that e-mail counseling improves weight loss achieved in self-directed Internet programs. Computer-tailored feedback offers a population-based alternative to human e-mail counseling. METHODS: One hundred ninety-two adults, aged 49.2 +/- 9.8 years, having a body mass index (calculated as weight in kilograms divided by height in meters squared) of 32.7 +/- 3.5, were randomized to 1 of 3 Internet treatment groups: No counseling, computer-automated feedback, or human e-mail counseling. All participants received 1 weight loss group session, coupons for meal replacements, and access to an interactive Web site. The human e-mail counseling and computer-automated feedback groups also had access to an electronic diary and message board. The human e-mail counseling group received weekly e-mail feedback from a counselor, and the computer-automated feedback group received automated, tailored messages. RESULTS: Retention was 82% at 3 months and 80% at 6 months for all 3 groups. At 3 months, completers in both the computer-automated feedback (-5.3 +/- 4.2 kg) and human e-mail counseling (-6.1 +/- 3.9 kg) groups had significantly greater weight losses compared with the no counseling group (-2.8 +/- 3.5 kg) and these groups did not differ from each other. At 6 months, weight losses were significantly greater in the human e-mail counseling group (-7.3 +/- 6.2 kg) than in the computer-automated feedback (-4.9 +/- 5.9 kg) or no counseling (-2.6 +/- 5.7 kg) groups. Intent-to-treat analyses using single or multiple imputation techniques showed the same pattern of significance. CONCLUSIONS: Providing automated computer-tailored feedback in an Internet weight loss program was as effective as human e-mail counseling at 3 months. Further research is needed to improve the efficacy of automated computer-tailored feedback as a population-based weight loss approach.

Adult↗
PubMed2001

Computational issues in mapping variation affecting susceptibility to complex disorders: the chicken and the egg.

Linkage mapping strategies for complex disorders have evolved under a variety of constraints. Some of these constraints reflect the nature of complex disorders and are manifest in limitations on the kinds of data that can be collected, while others were (at least historically) strictly computational. This paper focuses on how computational issues have impacted the design of studies on complex disorders and, conversely, how our study designs have influenced the computational issues that have been addressed. We now have unprecedented computational resources, but also face unprecedented computational and methodological challenges as we move from the linkage mapping of genes influencing susceptibility to complex disorders toward the identification of the actual variation affecting susceptibility to these disorders. The near-term computational and methodological issues we must address will be profoundly influenced by the study designs of the recent past. But future study designs, as well as our investments in computational and methodological research, ought to be developed considering the computational and informatics resources we now have at hand.

Algorithms↗
PubMed1993

MEPSIM: a computational package for analysis and comparison of molecular electrostatic potentials.

MEPSIM is a computational system which allows an integrated computation, analysis, and comparison of molecular electrostatic potential (MEP) distributions. It includes several modules. Module MEPPLA supplies MEP values for the points of a grid defined on a plane which is specified by a set of three points. The results of this program can easily be converted into MEP maps using third-parties graphical software. Module MEPMIN allows to find automatically the MEP minima of a molecular system. It supplies the cartesian coordinates of these minima, their values, and all the geometrical relationships between them (distances, angles, and dihedral angles). Module MEPCOMP computes a similarity coefficient between the MEP distributions of two molecules and finds their relative position that maximizes the similarity. Module MEPCONF performs the same process as MEPCOMP, considering not only the relative position of both molecules but also a conformational degree of freedom of one of them. The most recently developed module, MEPPAR, is another modification of MEPCOMP in order to compute the MEP similarity between two molecules, but only taking into account a particular plane. The latter module is particularly useful to compare MEP distributions generated by pi systems of aromatic rings. MEPSIM can use several wavefunction computation approaches to obtain MEP distributions. MEPSIM has a menu type interface to simplify the following tasks: creation of input files from output files of external programs (GAUSSIAN and AMPAC/MOPAC), setting the parameters for the current computation, and submitting jobs to the batch queues of the computer. MEPSIM has been coded in FORTRAN and its current version runs on VMS/VAX computers.

Drug Design↗
PubMed2002

Vibrotactile sense and mechanical functional state of the arm and hand among computer users compared with a control group.

OBJECTIVES: To measure sensory perception and mechanical muscle function of the arm among experienced female computer users with (+sPC) and without (-sPC) symptoms compared with a control group (ctrl). METHODS: Group +sPC had severe symptoms in the hand/wrist and/or the forearm/elbow region. They worked with the computer 75% and used a computer mouse 50% of the working day. Group -sPC had no or minimal symptoms. They used the computer 80% and a computer mouse 58% of the working day. The control group had no symptoms and worked with the computer for 2 h or fewer per day. Sensory perception threshold was measured using vibrotactilometry at five sites on the right hand representing nn. medianus, ulnaris and radialis. Mechanical muscle function was assessed by measuring muscle strength, wrist extension endurance, hand-eye co-ordination, and range of motion. Furthermore, performance was measured during standardized computer work. RESULTS: The perception thresholds for +sPC were greater in the areas innervated by n. medianus and n. ulnaris than for non-symptomatic groups, indicating that nerve compression is involved. For n. radialis, no differences were found between groups. No difference in isometric muscle strength was found for hand-grip, wrist extension, vertical pinch-grip and knee extension. However, for horizontal pinch-grip (pronated forearm) lower values were obtained for the +sPC group than for non-symptomatic groups. At the end of the endurance task, the perceived exertion was highest for +sPC. Furthermore, slower recovery was found for +sPC. No differences in range of motion, hand-eye co-ordination, and error rate during computer work were found between groups. CONCLUSIONS: Increased perception threshold values indicating entrapment of n. medianus and n. ulnaris were found for +sPC. Only few differences in mechanical muscle performance were found among the groups. The +sPC group had lower pinch-grip strength when measured in the pronated hand position, and the results indicated shorter muscle endurance for +sPC than for -sPC and ctrl.

Adult↗
PubMed2006

Intra and inter-observer reliability of determining degree of pelvic incidence in high-grade spondylolisthesis using a computer assisted method.

Pelvic incidence was described as a fundamental parameter to describe spino-pelvic balance. In high-grade spondylolisthesis, severe dystrophic changes of the upper sacral endplate may be responsible for technical difficulties in pelvic incidence measurement. We propose to evaluate the reliability of PI measurement in high-grade spondylolisthesis patients and to compare the manual method with a computer-assisted method. In 30 high-grade spondylolisthesis patients, pelvic incidence was measured by manual and computer-assisted technique by the Spineview software package. We statistically assessed agreement between the manual and the computer-assisted technique, the intra-observer and the inter-observer reliability of the computer-assisted technique. Significant correlation was found (Spearman's rank R = 0.921 with P<0.001) between manual and computer-assisted results. The paired t test (t = 0.979 with P<0.001) and the intraclass correlation coefficient (ICC) were also significant. Intra- and inter-observer reliability of the computer-assisted technique were excellent with Spearman's rank correlation from 0.964 to 0.985 with P<0.001, a paired t test from 0.978 to 0.983 with P<0.001) and an ICC from 0.986 to 0.992. Intra- and inter-observer repeatability were better with the computer-assisted method than with the manual technique. We proved the reliability and repetability of a computer-assisted angular measurement method in high-grade spondylolisthesis patients. This validated measurement technique could be now used to measure the main parameters of the sagittal balance of the spine in further studies on spondylolisthesis patients.

Humans↗
PubMed1998

Computed radiography versus screen-film mammography in detection of simulated microcalcifications: a receiver operating characteristic study based on phantom images.

RATIONALE AND OBJECTIVES: The authors compare a 43-micron computed radiographic system with a mammographic screen-film system for detection of simulated microcalcifications in an observer-performance study. MATERIALS AND METHODS: The task of detecting microcalcifications was simulated by imaging aluminum wire segments (200-500 microns in length; 100, 125, or 150 microns in diameter) that overlapped with tissue background structures produced by beef brisket. A total of 288 such simulations were generated and examined with both computed radiography and conventional screen-film mammography techniques. Computed radiography was performed with high-resolution plates, a 43-micron image reader, and a 43-micron laser film printer. Computed radiographic images were printed with simple contrast enhancement and compared with screen-film images in a receiver operating characteristic study in which experienced readers detected and scored the simulated microcalcifications. Observer performance was quantitated and compared by computing the area under the receiver operating characteristic curve. RESULTS: Although the resolution of the computed radiography system was better than that of commercial systems, it fell short of that of screen-film systems. For the 100-micron microcalcifications, the difference in the average area under the curve was not statistically significant, but it was significant for the larger simulated microcalcifications: the average area under the curve was 0.58 for computed radiography versus 0.76 for screen-film imaging for the 125-micron microcalcifications and 0.83 versus 1.00, respectively, for the 150-micron microcalcifications. CONCLUSION: Observer performance in the detection of small simulated microcalcifications (100-150 microns in diameter) is better with screen-film images than with high-resolution computed radiographic images.

Breast Diseases↗
PubMed2007

Structures of the hexafluorocyclopropane, octafluorocyclobutane, and decafluorocyclopentane radical anions probed by experimental and computational studies of anisotropic electron spin resonance (ESR) spectra.

Anisotropic electron spin resonance (ESR) spectra are reported for the radical anions of hexafluorocyclopropane (c-C(3)F(6)(-)), octafluorocyclobutane (c-C(4)F(8)(-)), and decafluorocyclopentane (c-C(5)F(10)(-)) generated via gamma-irradiation in plastically crystalline tetramethylsilane (TMS) and rigid 2-methyltetrahydrofuran (MTHF) matrices. By combining the analysis of these experimental ESR spectra involving anisotropic hyperfine (hf) couplings with a series of quantum chemical computations, the geometrical and electronic structure of these unusual perfluorocycloalkane radical anions have been characterized more fully than in previous studies that considered only the isotropic couplings. Unrestricted Hartree-Fock (UHF) computations with the 6-311+G(d,p) basis set predict planar ring structures for all three radical anions, the ground electronic states being (2)A(2)(") for c-C(3)F(6)(-) (D(3h) symmetry), (2)A(2u) for c-C(4)F(8)(-) (D(4h)), and (2)A(2)(") for c-C(5)F(10)(-) (D(5h)), in which the respective six, eight, and ten 19F-atoms are equivalent by symmetry. A successful test of the theoretical computation is indicated by the fact that the isotropic 19F hf couplings computed by the B3LYP method with the 6-311+G(2df,p) basis set for the optimized geometries are in almost perfect agreement with the experimental values: viz., 19.8 mT (exp) vs 19.78 mT (calc) for c-C(3)F(6)(-); 14.85 mT (exp) vs 14.84 mT (calc) for c-C(4)F(8)(-); 11.6 mT (exp) vs 11.65 mT (calc) for c-C(5)F(10)(-). Consequently, the same computation method has been applied to calculate the almost axially symmetric anisotropic 19F hf couplings for the magnetically equivalent 19F atoms: (-4.90 mT, -4.84 mT, 9.75 mT) for c-C(3)F(6), (-3.54 mT, -3.48 mT, 7.02 mT) for c-C(4)F(8)(-), and (-2.62 mT, -2.56 mT, 5.18 mT) for c-C(5)F(10)(-). ESR spectral simulations performed using the computed principal values of the hf couplings and the spatial orientations of the 19F nuclei as input parameters reveal an excellent fit to the experimental anisotropic ESR spectra of c-C(3)F(6)(-), c-C(4)F(8)(-), and c-C(5)F(10)(-), thereby providing a convincing proof of the highly symmetric D(nh) structures that are predicted for these negative ions. Furthermore, using the computed 19F principal values and their orientations, the effective 19F anisotropic hf couplings along the molecular symmetry axes were evaluated for c-C(3)F(6)(-) and c-C(4)F(8)(-) and successfully correlated with the positions of the characteristic outermost features in both the experimental and calculated anisotropic spectra. In addition, the electronic excitation energies and oscillator strengths for the c-C(3)F(6)(-) , c-C(4)F(8)(-), and c-C(5)F(10)(-) radical anions were computed for the first time using time-dependent density functional theory (TD-DFT) methods.

Journal Article↗
PubMed2006

Counterfactual quantum computation through quantum interrogation.

The logic underlying the coherent nature of quantum information processing often deviates from intuitive reasoning, leading to surprising effects. Counterfactual computation constitutes a striking example: the potential outcome of a quantum computation can be inferred, even if the computer is not run. Relying on similar arguments to interaction-free measurements (or quantum interrogation), counterfactual computation is accomplished by putting the computer in a superposition of 'running' and 'not running' states, and then interfering the two histories. Conditional on the as-yet-unknown outcome of the computation, it is sometimes possible to counterfactually infer information about the solution. Here we demonstrate counterfactual computation, implementing Grover's search algorithm with an all-optical approach. It was believed that the overall probability of such counterfactual inference is intrinsically limited, so that it could not perform better on average than random guesses. However, using a novel 'chained' version of the quantum Zeno effect, we show how to boost the counterfactual inference probability to unity, thereby beating the random guessing limit. Our methods are general and apply to any physical system, as illustrated by a discussion of trapped-ion systems. Finally, we briefly show that, in certain circumstances, counterfactual computation can eliminate errors induced by decoherence.

Journal Article↗
PubMed2007

High-speed linear optics quantum computing using active feed-forward.

As information carriers in quantum computing, photonic qubits have the advantage of undergoing negligible decoherence. However, the absence of any significant photon-photon interaction is problematic for the realization of non-trivial two-qubit gates. One solution is to introduce an effective nonlinearity by measurements resulting in probabilistic gate operations. In one-way quantum computation, the random quantum measurement error can be overcome by applying a feed-forward technique, such that the future measurement basis depends on earlier measurement results. This technique is crucial for achieving deterministic quantum computation once a cluster state (the highly entangled multiparticle state on which one-way quantum computation is based) is prepared. Here we realize a concatenated scheme of measurement and active feed-forward in a one-way quantum computing experiment. We demonstrate that, for a perfect cluster state and no photon loss, our quantum computation scheme would operate with good fidelity and that our feed-forward components function with very high speed and low error for detected photons. With present technology, the individual computational step (in our case the individual feed-forward cycle) can be operated in less than 150 ns using electro-optical modulators. This is an important result for the future development of one-way quantum computers, whose large-scale implementation will depend on advances in the production and detection of the required highly entangled cluster states.

Journal Article↗
PubMed2000

Emergence of quantum chaos in the quantum computer core and how to manage it

We study the standard generic quantum computer model, which describes a realistic isolated quantum computer with fluctuations in individual qubit energies and residual short-range interqubit couplings. It is shown that in the limit where the fluctuations and couplings are small compared to the one-qubit energy spacing, the spectrum has a band structure, and a renormalized Hamiltonian is obtained which describes the eigenstate properties inside one band. Studies are concentrated on the central band of the computer ("core") with the highest density of states. We show that above a critical interqubit coupling strength, quantum chaos sets in, leading to a quantum ergodicity of the computer eigenstates. In this regime the ideal qubit structure disappears, the eigenstates become complex, and the operability of the computer is quickly destroyed. We confirm that the quantum chaos border decreases only linearly with the number of qubits n, although the spacing between multiqubit states drops exponentially with n. The investigation of time evolution in the quantum computer shows that in the quantum chaos regime, an ideal (noninteracting) state quickly disappears, and exponentially many states become mixed after a short chaotic time scale for which the dependence on system parameters is determined. Below the quantum chaos border an ideal state can survive for long times, and an be used for computation. The results show that a broad parameter region does exist where the efficient operation of a quantum computer is possible.

Journal Article↗
PubMed1999

Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior.

BACKGROUND: We sought to examine the demographic and clinical features and psychiatric comorbidity in persons reporting compulsive computer use. METHOD: Sixteen men and 5 women were recruited by advertisement and word-of-mouth. All reported excessive computer use that interfered with social or occupational functioning or caused personal distress. The subjects completed structured and semistructured assessments, including a computer version of the Diagnostic Interview Schedule (DIS), the Minnesota Impulsive Disorders Interview, the Personality Diagnostic Questionnaire-Revised (PDQ-R), and a brief version of the Medical Outcome Study Short Form-36 (SF-36). RESULTS: The typical subject was a 32-year-old single white man with a mean yearly income of $27,000; problem computer use began at age 29 and consumed 27 hours each week. Eleven subjects (52%) reported school or academic problems resulting from their computer use, and 12 (57%) reported that family members had confronted them about it. Thirteen subjects (62%) had tried to cut back on their computer usage. Nine subjects (43%) reported missing work or school owing to their computer use. According to DIS results, 7 subjects (33%) had a lifetime mood disorder, 8 subjects (38%) had a substance use disorder, and 4 subjects (19%) had a lifetime anxiety disorder. According to the PDQ-R results, 11 subjects (52%) met criteria for at least one personality disorder, the most frequent being the borderline, antisocial, and narcissistic types. Impulse-control disorders were also common, particularly compulsive buying. On the SF-36, subjects showed impaired mental health functioning compared with a normative sample. CONCLUSION: The results show that persons reporting compulsive computer use suffer substantial psychiatric comorbidity and show evidence of emotional distress. While the disorder appears to be increasing in prevalence, more work is needed to determine its relationship with other disorders and to determine its risk factors, family history, psychosocial complications, and natural history.

Adult↗
PubMedDate not supplied

A computational approach to medical imaging.

Notwithstanding the progress in medical imaging by means of computer-based techniques, several problems still remain unsolved in this field. In particular, a unified approach for the treatment of biological complexity and variability is lacking. Moreover, perceptive and cognitive aspects of medical vision play an important role in a computational approach to medical imaging and must be carefully considered. The recent developments of Computer Vision and Artificial Intelligence suggest that such a computational approach is feasible. As a consequence, symbolic representations of the clinical information contained in the images as well as adequate processing techniques are necessary. In this way the treatment of uncertainty and the qualitative analysis are made possible. Moreover, due to the intrinsic homogeneity of symbolic representations, the comparison of different image sources, signals and clinical data is attainable. In the paper, the basic principles of Computer Vision are summarized and the need of a specific computational theory for medical vision is emphasized. Afterwards, the main characteristics of integrated systems for computational imaging in medicine, are described. Some examples relative to the imaging of the cardiovascular system are also given. Although the development of artificial vision systems in biomedicine is still an area of research, very promising perspectives are opened by a computational approach.

Artificial Intelligence↗
PubMed1996

Completeness and accuracy of morbidity and repeat prescribing records held on general practice computers in Scotland.

BACKGROUND: A high proportion of Scottish general practices use a standard computer software package (GPASS, general practice administration system for Scotland), and thus, Scotland is uniquely placed to amalgamate primary care data on a national scale. Practices, however, vary widely in the nature and extent of data entered on computer and a major limitation on the use of the collected data is the absence of information on the completeness and accuracy of the computer database. AIM: This study set out to assess the quality of morbidity and repeat prescribing records held on computer by general practices in Scotland. METHOD: Forty-one practices, with above average levels of morbidity data recorded on computer, were selected on a geographic basis in relation to the national population distribution. Within each practice, 250 patients aged 45-64 years were selected at random. Data relating to 19 diagnoses, six surgical procedures and 40 repeat prescription drugs were extracted from the computer records of these patients and compared with information held on patients' paper records and supplied by patients in response to a postal questionnaire. The completeness and accuracy of computer entries were assessed in terms of sensitivity and positive predictive value, respectively. RESULTS: For the 5567 patients for whom all three sources of data (validated computer records, paper records and questionnaire responses) were available, sensitivity (completeness) of morbidity recording had median values of 0.67 for diagnoses, 0.93 for surgical procedures and 0.75 over all conditions examined. Practices varied both in the completeness of recording of each condition and in their overall performance. The predictive value (accuracy) of morbidity data was uniformly high for all conditions examined (median 1.00). For repeat prescription drugs, recording on GPASS was both complete and accurate. CONCLUSION: The recording of morbidity data on GPASS for 45-64-year-old patients in a selected group of 41 highly-computerized practices is about 75% complete and highly accurate. For national morbidity studies, it seems likely that amalgamated data from the best GPASS practices will be as complete and accurate as the morbidity statistics currently derived from hospital-based activities in Scotland.

Drug Prescriptions↗