[Pseudomonas aeruginosa and Escherichia coli: reliability of antibiotic resistance results obtained by manual tests and automated and semi-automated equipment].
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PURPOSE: To determine the prevalence and incidence of short wavelength automated perimetry deficits in comparison to standard automated perimetry deficits in patients with ocular hypertension. METHODS: Five hundred eyes of 250 patients with ocular hypertension were recruited into a prospective, longitudinal study and tested with standard automated perimetry and short wavelength automated perimetry annually for 5 years. Both eyes of 60 normal subjects, 21 to 85 years of age, were used to establish normative data for short wavelength automated perimetry and standard automated perimetry. This allowed independent evaluation of left and right eyes of patients. All normal data were corrected for age, and short wavelength automated perimetry results were corrected for lens transmission. The lowest fifth and first percentiles for the normal observers were derived for the 10 glaucoma hemifield test zones for short wavelength automated perimetry and standard automated perimetry. Visual fields were considered outside normal limits if two glaucoma hemifield test zones were below the normal fifth percentile or one glaucoma hemifield test zone was below the normal first percentile. RESULTS: Baseline prevalence of short wavelength automated perimetry and standard automated perimetry deficits were 9.4% and 1.4%, respectively. During the study, incident rates of field loss were 6.2% (1.23% per year) for short wavelength automated perimetry and 5.9% (1.18% per year) for standard automated perimetry. Once abnormal, 80% of short wavelength automated perimetry fields remained abnormal on the next examination, whereas only 45% of abnormal standard automated perimetry fields remained abnormal. New short wavelength automated perimetry deficits in ocular hypertensives were more prominent and more persistent than new standard automated perimetry deficits. CONCLUSIONS: Our findings are consistent with the interpretation that short wavelength automated perimetry deficits occur before standard automated perimetry deficits in glaucoma. The similar incidence rates suggest that both standard automated perimetry and short wavelength automated perimetry are monitoring the same underlying glaucomatous disease process.
In May 1982, a questionnaire was sent to all of the 170 French Blood Transfusion Services (BTS), on behalf of the French Society of Blood Transfusion. The purpose was to determine the types of automated equipment used for immunohematological controls, the way in which they are used and the result of automation and computerization in daily laboratory operations. We received 135 replies (80%). A generalized conclusion can be drawn from the collected information. 50% of the respondents are neither automated nor computerized. 30% are both automated and computerized. 10% are automated but not computerized and 8% are not automated but are computerized. In the field of automated serology there is an increased tendency to complete the ABO/Rh testing by Cc D Ee and Kell phenotyping. The use of computers allows the current test determination to be compared with previous donation data. However, no fully automated equipment, which can conduct antibody screening, exists, cost effectively, in small or average BTS. In France, there has been a significant increase in automation between 1970 and 1980 but only the most important BTS have carried out automation at the same time as computerization. The smaller BTS have usually become automated without becoming computerized. In 1978, Codabar was first used. This has been one of the principal advances of the last 10 years, allowing all the users of automation to start moving towards complete computerization. This advance was assisted by the use of prepackaged software. This questionnaire also determined that the current emphasis is now to computerize administrative and management activities before laboratory activities. This survey has been conducted during a turning point of the automation of French BTS. It shows that they are, on the whole, satisfied with their automation. As far as the safety and the efficiency of the service are concerned, it is only fair to consider that the main purposes of the automation have been achieved. But in terms of cost, and serological accuracy for antibody screening, a new generation of automated equipment should appear to satisfy the users in the nineties.
Laboratory automation is in its infancy, following a path parallel to the development of laboratory information systems in the late 1970s and early 1980s. Changes on the horizon in healthcare and clinical laboratory service that affect the delivery of laboratory results include the increasing age of the population in North America, the implementation of the Balanced Budget Act (1997), and the creation of disease management companies. Major technology drivers include outcomes optimization and phenotypically targeted drugs. Constant cost pressures in the clinical laboratory have forced diagnostic manufacturers into less than optimal profitability states. Laboratory automation can be a tool for the improvement of laboratory services and may decrease costs. The key to improvement of laboratory services is implementation of the correct automation technology. The design of this technology should be driven by required functionality. Automation design issues should be centered on the understanding of the laboratory and its relationship to healthcare delivery and the business and operational processes in the clinical laboratory. Automation design philosophy has evolved from a hardware-based approach to a software-based approach. Process control software to support repeat testing, reflex testing, and transportation management, and overall computer-integrated manufacturing approaches to laboratory automation implementation are rapidly expanding areas. It is clear that hardware and software are functionally interdependent and that the interface between the laboratory automation system and the laboratory information system is a key component. The cost-effectiveness of automation solutions suggested by vendors, however, has been difficult to evaluate because the number of automation installations are few and the precision with which operational data have been collected to determine payback is suboptimal. The trend in automation has moved from total laboratory automation to a modular approach, from a hardware-driven system to process control, from a one-of-a-kind novelty toward a standardized product, and from an in vitro diagnostics novelty to a marketing tool. Multiple vendors are present in the marketplace, many of whom are in vitro diagnostics manufacturers providing an automation solution coupled with their instruments, whereas others are focused automation companies. Automation technology continues to advance, acceptance continues to climb, and payback and cost justification methods are developing.
PURPOSE: To evaluate the influence of a blue light spectrum filter (BLSF), similar in light spectrum transmittance to the intraocular lens Acrysof Natural, on standard automated perimetry (SAP) and short-wavelength automated perimetry (SWAP). METHODS: Twenty young individuals (< 30 y.o.), without any systemic or ocular alterations (twenty eyes) underwent a random sequence of four Humphrey visual field tests: standard automated perimetry (SAP) and short-wavelength automated perimetry (SWAP) with and without a blue light spectrum filter. All patients had intraocular pressure lower than 21 mmHg, normal fundus biomicroscopy, and no crystalline lens opacity. Foveal threshold (FT), mean deviation (MD), and pattern standard deviation (PSD) indexes obtained from the visual field tests and the difference caused by eccentricity in short-wavelength automated perimetry examinations were analyzed using paired t test. Interindividual variability (standard deviation) was calculated using Pitman's test for correlated samples. RESULTS: Statistically significant reductions in the mean deviation (p < 0.001) and in the foveal threshold (p < 0.001) measured by short-wavelength automated perimetry with the use of the blue light spectrum filter in comparison to short-wavelength automated perimetry without the use of the blue light spectrum filter were observed, but not in standard automated perimetry exams. No other parameters showed statistically significant differences in the short-wavelength automated perimetry and standard automated perimetry tests. Interindividual standard deviation of the test points in the short-wavelength automated perimetry exams increased with eccentricity both with and without the use of the blue light spectrum filter, as sensitivity for inferior and superior hemifields (inferior hemifield minus superior hemifield), but no statistically significant difference in the variability when comparing the use or not of the blue light spectrum filter was noted. When comparing only the four most inferior points and the four most superior points, the inferior-superior difference increases in both situations - without and with the use of the blue light spectrum filter. The difference between without and with the use of the blue light spectrum filter was not statistically significant. CONCLUSION: Statistically significant reductions in mean deviation and foveal threshold in the short-wavelength automated perimetry with the use of the blue light spectrum filter were observed, but not in standard automated perimetry examinations. Additional studies are necessary to determine the influence of intraocular lenses with short-wavelength light filter after cataract extraction on short-wavelength automated perimetry.
Operators can be poor monitors of automation if they are engaged concurrently in other tasks. However, in previous studies of this phenomenon the automated task was always presented in the periphery, away from the primary manual tasks that were centrally displayed. In this study we examined whether centrally locating an automated task would boost monitoring performance during a flight-simulation task consisting of system monitoring, tracking and fuel resource management sub-tasks. Twelve nonpilot subjects were required to perform the tracking and fuel management tasks manually while watching the automated system monitoring task for occasional failures. The automation reliability was constant at 87.5% for six subjects and variable (alternating between 87.5% and 56.25%) for the other six subjects. Each subject completed four 30 min sessions over a period of 2 days. In each automation reliability condition the automation routine was disabled for the last 20 min of the fourth session in order to simulate catastrophic automation failure (0 % reliability). Monitoring for automation failure was inefficient when automation reliability was constant but not when it varied over time, replicating previous results. Furthermore, there was no evidence of resource or speed accuracy trade-off between tasks. Thus, automation-induced failures of monitoring cannot be prevented by centrally locating the automated task.
Technical developments in computer hardware and software now make it possible to introduce automation into virtually all aspects of human-machine systems. Given these technical capabilities, which system functions should be automated and to what extent? We outline a model for types and levels of automation that provides a framework and an objective basis for making such choices. Appropriate selection is important because automation does not merely supplant but changes human activity and can impose new coordination demands on the human operator. We propose that automation can be applied to four broad classes of functions: 1) information acquisition; 2) information analysis; 3) decision and action selection; and 4) action implementation. Within each of these types, automation can be applied across a continuum of levels from low to high, i.e., from fully manual to fully automatic. A particular system can involve automation of all four types at different levels. The human performance consequences of particular types and levels of automation constitute primary evaluative criteria for automation design using our model. Secondary evaluative criteria include automation reliability and the costs of decision/action consequences, among others. Examples of recommended types and levels of automation are provided to illustrate the application of the model to automation design.