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At least 1,351 records · Page 75Linked to original sources
PubMed2005

[Computer-based system for monitoring the course of intraocular inflammation].

BACKGROUND: Until now, there has been no consistent rating system for changes of intraocular inflammation. We present such a computer-based system. METHODS: This program is based on a FileMaker database. It is made of anterior and posterior uveitis scores on the basis of published evaluation guidelines of the International Ocular Inflammation Society (IOIS). An anterior uveitis score consisting of anterior chamber cells, flare, and perilimbal injection on the one hand and a posterior uveitis score consisting of vitreous haze, macula, and optic nerve head edema on the other hand are calculated. After adding visual acuity, intraocular pressure, and systemic dose of corticosteroids, all parameters can be visualized by a radar graph. RESULTS: This system of documentation is easy to handle and presents a simplified version of the disease course. The abstract visualization enables the patient to better understand the therapeutic management. CONCLUSIONS: The program presented here offers good opportunities for standardized monitoring of the disease course.

Computer Graphics↗
PubMedDate not supplied

Purchasing a medical office minicomputer system. Guidelines and considerations.

Medical office computer systems can increase practice efficiency, but adequate minicomputer systems are still expensive, and some technical knowledge is needed if potential pitfalls in system acquisition and operation are to be avoided. A general introduction both to the capabilities and costs of currently available medical office computer systems is presented, and considerations which should be examined before acquiring an office computer are discussed.

Computers↗
PubMedDate not supplied

Data-source effects on the sensitivities and specificities of clinical features in the diagnosis of rheumatoid arthritis: the relevance of multiple sources of knowledge for a decision-support system.

An experimental computer system was developed to support diagnosis of rheumatic disorders by computing diagnostic probabilities using modified likelihood ratios. The authors examined whether the performance of the model was affected by the settings in which the data used to derive the likelihood ratios were collected. The sensitivities and specificities of various clinical features for diagnosing rheumatoid arthritis (RA) were obtained from: 1) a study of 1,570 consecutive outpatients at a rheumatology clinic; 2) a review of the literature; 3) estimates by rheumatologists; and 4) a population study. Considerable variations in sensitivity and specificity but satisfactory agreement in likelihood ratios were found across the four data sets. The likelihood ratios were then used to compute the probabilities of RA in a test series of 570 of the rheumatology clinic outpatients. The model's diagnoses with likelihood ratios from the other sources were adequate. When the likelihood ratios from these sources were combined, discrimination came close to what could be achieved by using the likelihood ratios based on the data from the clinic. The method applied in the study, which makes use of variation of input data instead of variation of test series, and the results are relevant to assessing the external validity and transferability of Bayesian decision-support systems.

Adolescent↗
PubMed2000

A string matching computer-assisted system for dolphin photoidentification.

This paper presents a syntactic/semantic string representation scheme as well as a string matching method as part of a computer-assisted system to identify dolphins from photographs of their dorsal fins. A low-level string representation is constructed from the curvature function of a dolphin's fin trailing edge, consisting of positive and negative curvature primitives. A high-level string representation is then built over the low-level string via merging appropriate groupings of primitives in order to have a less sensitive representation to curvature fluctuations or noise. A family of syntactic/semantic distance measures between two strings is introduced. A composite distance measure is then defined and used as a dissimilarity measure for database search, highlighting both the syntax (structure or sequence) and semantic (attribute or feature) differences. The syntax consists of an ordered sequence of significant protrusions and intrusions on the edge, while the semantics consist of seven attributes extracted from the edge and its curvature function. The matching results are reported for a database of 624 images corresponding to 164 individual dolphins. The identification results indicate that the developed string matching method performs better than the previous matching methods including dorsal ratio, curvature, and curve matching. The developed computer-assisted system can help marine mammalogists in their identification of dolphins, since it allows them to examine only a handful of candidate images instead of the currently used manual searching of the entire database.

Animal Identification Systems↗
PubMed1997

Computerized data collection in the operating room during coronary artery bypass surgery: a comparison to the hand-written anesthesia record.

OBJECTIVE: To investigate variability between hand-written and computerized anesthesia records and evaluate any associated bias. DESIGN AND MEASUREMENTS: A computer system that was used to collect intraoperative data for a study of hemodynamic management during coronary artery bypass graft surgery is described. The system collected and recorded hemodynamic data automatically downloaded from the anesthesia monitor as well as surgical events and drug administration data entered through menu options. The system then combined, summarized, and graphed the data as well as formatted it for export to a commercially available database program. In a sample of 14 patients, blood pressure data collected by the computer system was compared with the blood pressure data charted in the hand-written anesthesia record. MAIN RESULTS: Although general linear models controlling for within-patient variation and randomization assignment for mean arterial pressure range on cardiopulmonary bypass showed a significant relationship; low R2 values indicated that much of the variability could not be explained and that there was, therefore, poor agreement between the two records. Furthermore, a systematic bias in the hand-written anesthesia record was found when the computer system record was compared with the hand-written record and to the difference of the two records, so that extremes seen in the computer system record tended to be minimized in the hand-written anesthesia record. CONCLUSIONS: Because of the lack of explained variability between the computer system and hand-written anesthesia records and the bias in the hand-written anesthesia record, the hand-written anesthesia record should not be relied on as a source of accurate data for research purposes.

Anesthesia↗
PubMed2002

Development of a handheld computer documentation system to enhance an integrated primary care clerkship.

Documentation systems are used by medical schools and residency programs to record the clinical experiences of their learners. The authors developed a system for their school's (Dartmouth's) multidisciplinary primary care clerkship (family medicine, internal medicine, pediatrics) that documents students' clinical and educational experiences and provides feedback designed to enhance clinical training utilizing a timely data-reporting system. The five critical components of the system are (1) a valid, reliable and feasible data-collection instrument; (2) orientation of and ongoing support for student and faculty users; (3) generation and distribution of timely feedback reports to students, preceptors, and clerkship directors; (4) adequate financial and technical support; and (5) a database design that allows for overall evaluation of educational outcomes. The system, whose development began in 1997, generated and distributed approximately 150 peer-comparison reports of clinical teaching experiences to students, preceptors, and course directors during 2001, in formats that are easy to interpret and use to individualize learning. The authors present report formats and annual cost estimate comparisons of paper- and computer-based system development and maintenance, which range from $35,935 to $53,780 for the paper-based system and from $46,820 to $109,308 for the computer-based system. They mention ongoing challenges in components of the system. They conclude that a comprehensive documentation and feedback system provides an essential infrastructure for the evaluation and enhancement of community-based teaching and learning in primary care ambulatory clerkships, whether separate or integrated.

Clinical Clerkship↗
PubMed1983

What kind of expert should a system be?

Human experts are the source of knowledge required to develop computer systems that perform at an expert level. Human beings are not, however, able to reliably express what they know. As a result, experts often develop non-authentic accounts of their own expertise. These accounts, here termed reconstructed methods of reasoning, lead to computer systems that perform at a high level of proficiency but have the disadvantage that they often do not reflect the heuristics and processing constraints of a system user. Reconstructed methods of reasoning are compared with authentic methods derived from the study of expert human behavior. Tests are proposed to establish the authenticity of reasoning methods and examples from medical diagnosis are used to illustrate how authentic methods of reasoning can be incorporated into an expert computer system.

Clinical Competence↗
PubMed1989

Computer interview system for patients with back pain.

We describe a computer-based interview system for patients with back pain. The system uses a light-pen for the patient--computer interface. The questionnaire consists of over 200 multiple and single choice questions. Graphic presentations are used to identify pain patterns. The procedure has been well accepted by patients and is in routine clinical use in several hospitals.

Adolescent↗
PubMed1991

A computer management system for patient simulations.

A series of interactive videodisc patient simulations is being used to teach clinical problem-solving skills, including diagnosis and management, to dental students. This series is called Oral Disease Simulations for Diagnosis and Management (ODSDM). A computer management system has been developed in response to the following needs. First, the sequence in which students perform simulations is critical. Second, maintaining records of completed simulations and student performance on each simulation is a time-consuming task for faculty. Third, the simulations require ongoing evaluation to ensure high quality instruction. The primary objective of the management system is to ensure that each student masters diagnosis. Mastery must be obtained at a specific level before advancing to the next level. The management system does this by individualizing the sequence of the simulations to adapt to the needs of each student. The management system generates reports which provide information about students or the simulations. Student reports contain demographic and performance information. System reports include information about individual patient simulations and act as a quality control mechanism for the simulations.

Computer Simulation↗
PubMed1976

A method of estimating intracranial decompensation in man.

A new method of estimating intracranial decompensation in man is described. An on-line computer system is connected to an intracranial pressure (ICP) monitoring system to compute regression plots of mean ICP vs standard deviation; standard deviation is used as a measure of ICP instability. Two zones with distinctly different slopes are a characteristic feature of these plots. It is thought that the changes of slope signify intracranial decompensation.

Humans↗
PubMed2006

cisRED: a database system for genome-scale computational discovery of regulatory elements.

We describe cisRED, a database for conserved regulatory elements that are identified and ranked by a genome-scale computational system (www.cisred.org). The database and high-throughput predictive pipeline are designed to address diverse target genomes in the context of rapidly evolving data resources and tools. Motifs are predicted in promoter regions using multiple discovery methods applied to sequence sets that include corresponding sequence regions from vertebrates. We estimate motif significance by applying discovery and post-processing methods to randomized sequence sets that are adaptively derived from target sequence sets, retain motifs with p-values below a threshold and identify groups of similar motifs and co-occurring motif patterns. The database offers information on atomic motifs, motif groups and patterns. It is web-accessible, and can be queried directly, downloaded or installed locally.

Animals↗
PubMed1987

Validation of a computer based system for assessing dietary intake.

Dietary intake was assessed in 50 patients in hospital by using a dietary history method and computer based system for data collection and standard food tables to calculate the composition of nutrients. The results were compared with those from a weighed assessment that was calculated by using both food tables and manufacturers' food analyses. The use of the food tables overestimated mean (SEM) individual nutrient intakes by between 2.5% (1.5%) and 15.5% (3.0%). The mean errors associated with the dietary history assessment varied from -23% (7.8%) for fat intake to +21.4% (8.5%) for carbohydrate intake. Overall, 30% of the assessments of total nutrient intakes that were calculated using this method were within -20% to +20% of actual values; 18% were within -10% to +10%. The mean errors associated with the computer based assessment varied from -1.0% (4.3%) for carbohydrate intake to +8.5% (3.4%) for protein intake. Overall, 56% of the assessments of total nutrient intakes were within -20% to +20% of actual intakes; 31% were within -10% to +10%. The computer based system provides an accurate, reproducible, convenient, and inexpensive method for assessing dietary intake.

Data Collection↗
PubMed1996

Computer-assisted systems for forensic pathology and forensic toxicology.

A computer software, RättsBASE (RB), was developed for all forensic pathology units in Sweden and introduced in 1992. Simultaneously, a corresponding software, ToxBASE (TB), was developed for the Department of Forensic Toxicology, where all forensic toxicology in Sweden is managed. Both of the databases were created using dBASE IV, and the programming was carried out according to specifications from the staff at the forensic toxicology and forensic pathology units. since the development or RB and TB was coordinated, the systems can run together smoothly. The purpose of both systems was to automate the offices and to enable compilation of detailed statistics. Installation of Novell Netware and ISDN-connections (Integrated Service Digital Network) has enabled rapid communication between the units and easy compilation of nationwide statistics of forensic pathology and forensic toxicology. the systems offer a wide spectrum of reports and include a simple module for evaluation of the importance of the forensic efforts for th whole death investigation. The configuration of the softwares has also enabled processing of a large amount of related toxicological and autopsy data that in turn has yielded a base for compilation of toxicology interpretation lists. This article includes a summary of the features of the software and a discussion of its benefits and limitations.

Autopsy↗
PubMed2006

Needs assessment for health care management education in Russia.

INTRODUCTION: For more than 70 years, health care management in the Soviet Union reflected a centralized directive style familiar to the Soviet political system. Market-oriented reform in post-Soviet Russia is pushing practicing physicians and physician-executives to acquire new information and skills regarding health care management. To assist with health care management in Russia, we analyzed health care providers' educational needs, as they perceive them. METHODS: A total of 4, 367 questionnaires were sent to practicing physicians and physician-executives in 3 regions of the Russian Federation. The questionnaires included 14 items designed to determine respondents' current levels of satisfaction and preferences for health care management education in Russia. RESULTS: There were 847 questionnaires returned, for a total response rate of 19.4%. Physicians were dissatisfied with the current status of health care management education, but they were interested in learning the skills of health care management. The health care legal system and computer systems and data analysis were the most popular courses requested; health care management and marketing were the least popular. Learning interests of executives differed from those of practicing physicians, and regions differed in their combined interests for courses. Medical school and continuing education departments were seen as the best choices for delivering health care management education. DISCUSSION: As health care policy shifts in new directions, physicians in leadership positions expect Russian medical schools and continuing education departments to provide courses that enable improvements in health care.

Adult↗
PubMed1997

The effect of flash duration and flash shape on entrainment in Pteroptyx malaccae, a synchronic Southeast Asian firefly.

Southeast Asian synchronic fireflies respond to stimulus flashes by phase-shifting their endogenous oscillator. This is called 'flash entrainment'. The releasers for entrainment were studied by changing stimulus flash shape and duration in Pteroptyx malaccae. Stimulus flash shapes and durations were synthesized digitally and delivered by a field-portable computer system. The computer also recorded male firefly flashes that were detected with a photometer. We found that the type of entrainment and its magnitude was influenced by the duration of the entrainment flash and by its shape.

Journal Article↗
PubMed1996

Detection of simulated lung nodules with computed radiography: effects of nodule size, local optical density, global object thickness, and exposure.

RATIONALE AND OBJECTIVES: We quantified differences in the detection of simulated lung nodules on computed radiographs on the basis of variations in nodule size, local contrast, body habitus (global contrast), and exposure. METHODS: A step-wedge phantom was developed to simulate the attenuation ranges of the lung, retrocardiac, and subdiaphragmatic regions of the adult human chest. Additional Lucite wedges were used to simulate two different body thicknesses and to provide variable structural noise. Soft-tissue-equivalent nodules of 3-mm and 5-mm diameter that resulted in 10% differences in attenuation from lung equivalence were embedded in lung-equivalent material. By superimposing the sheets in various positions, 84 unique nodule configurations containing eight nodules per image were exposed on a computed radiography system. Computed radiographs were acquired at two different exposures approximating standard exposure and underexposure. For each resulting phantom image, seven observers scored the presence or absence of a nodule within individual cells of a 5 x 5 grid matrix. RESULTS: True-positive fractions for 3-mm-diameter nodules were very low across all conditions. True-positive fractions for 5-mm-diameter nodules varied from 0.23 to 0.98. Significant differences in the conspicuity of 5-mm nodules depended on differences in phantom thickness and differences in the locations of nodules within lung-, retrocardiac-, or subdiaphragmatic-equivalent regions. Accuracy in detecting nodules was significantly lower at lower exposures when nodules were located in the subdiaphragmatic-equivalent region. CONCLUSION: On computed radiographs, small nodules (5-mm diameter) can be reliably detected when they are located in areas of high or moderate surrounding local contrast, such as the lung or mediastinal regions. Detection of nodules decreases in regions of lower optical density corresponding to the subdiaphragmatic regions of the chest. The decrease in nodule detectability is greatest under conditions that simulate large body thickness and underexposure.

Adult↗
PubMed2005

Towards quantitative biology: integration of biological information to elucidate disease pathways and to guide drug discovery.

Developing a new drug is a tedious and expensive undertaking. The recently developed high-throughput experimental technologies, summarised by the terms genomics, transcriptomics, proteomics and metabolomics provide for the first time ever the means to comprehensively monitor the molecular level of disease processes. The "-omics" technologies facilitate the systematic characterisation of a drug target's physiology, thereby helping to reduce the typically high attrition rates in discovery projects, and improving the overall efficiency of pharmaceutical research processes. Currently, the bottleneck for taking full advantage of the new experimental technologies are the rapidly growing volumes of automatically produced biological data. A lack of scalable database systems and computational tools for target discovery has been recognised as a major hurdle. In this review, an overview will be given on recent progress in computational biology that has an impact on drug discovery applications. The focus will be on novel in silico methods to reconstruct regulatory networks, signalling cascades, and metabolic pathways, with an emphasis on comparative genomics and microarray-based approaches. Promising methods, such as the mathematical simulation of pathway dynamics are discussed in the context of applications in discovery projects. The review concludes by exemplifying concrete data-driven studies in pharmaceutical research that demonstrate the value of integrated computational systems for drug target identification and validation, screening assay development, as well as drug candidate efficacy and toxicity evaluations.

Animals↗