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PubMed1985

Urine saturation with calcium salts in normal subjects and idiopathic calcium stone-formers estimated by an improved computer model system.

The state of saturation of urine with calcium salts has been estimated by means of a computer model system whose accuracy has been improved by the use of stability constants of 31 complexes which were re-determined at 37 degrees C and at the actual ionic strength of urine. The experimental determination of the concentration solubility products of calcium oxalate monohydrate (CaOx) and of calcium hydrogen phosphate dihydrate (bsh) allows an expression of the saturation degree as free concentration product ratio beta CaOx and beta bsh. Morning urine samples from 50 healthy controls and 50 idiopathic calcium stone-formers and 24 h urines from 40 normal subjects and 192 stone-formers, taking normal diet were investigated by this technique. From our results urine supersaturation with calcium oxalate salts seems to play an important role in calcium stone disease. Hypercalciuria and hyperoxaluria seem to be the main pathological features in this regard. The data concerning beta bsh values have not confirmed previous reports in which this parameter was found to be increased in stone-formers.

Calcium↗
PubMed2006

The use of self-organising maps for anomalous behaviour detection in a digital investigation.

The dramatic increase in crime relating to the Internet and computers has caused a growing need for digital forensics. Digital forensic tools have been developed to assist investigators in conducting a proper investigation into digital crimes. In general, the bulk of the digital forensic tools available on the market permit investigators to analyse data that has been gathered from a computer system. However, current state-of-the-art digital forensic tools simply cannot handle large volumes of data in an efficient manner. With the advent of the Internet, many employees have been given access to new and more interesting possibilities via their desktop. Consequently, excessive Internet usage for non-job purposes and even blatant misuse of the Internet have become a problem in many organisations. Since storage media are steadily growing in size, the process of analysing multiple computer systems during a digital investigation can easily consume an enormous amount of time. Identifying a single suspicious computer from a set of candidates can therefore reduce human processing time and monetary costs involved in gathering evidence. The focus of this paper is to demonstrate how, in a digital investigation, digital forensic tools and the self-organising map (SOM)--an unsupervised neural network model--can aid investigators to determine anomalous behaviours (or activities) among employees (or computer systems) in a far more efficient manner. By analysing the different SOMs (one for each computer system), anomalous behaviours are identified and investigators are assisted to conduct the analysis more efficiently. The paper will demonstrate how the easy visualisation of the SOM enhances the ability of the investigators to interpret and explore the data generated by digital forensic tools so as to determine anomalous behaviours.

Behavior↗
PubMed1999

Clinical interpretation of ultrasound biometry for dating and for assessment of fetal growth using a wheel and chart: is it sufficiently accurate?

OBJECTIVES: To investigate how accurately practicing obstetricians (experts) can apply dating rules and compare the interpretation of gestation-sensitive ultrasound data with those of a computer system. SUBJECTS: Seventeen practicing obstetricians. Members of the Royal College of Obstetricians and Gynaecologists, from 14 different units throughout the UK. DESIGN: Six cases with menstrual and ultrasound data together with identical ultrasound charts and obstetric wheels. MAIN OUTCOME MEASURES: Concordance between the calculated estimated date of delivery (EDD) and growth assessment provided by the experts and the computer system. RESULTS: The calculation of the EDD by the experts was imprecise (59% within 3 days overall). Concordance with the computer calculation was poorest when the ultrasound measurements lay close to the upper or lower centile lines (average 7% within 3 days of the computer). Interpretation of growth showed good concordance with the computer when gestation was not critical to the interpretation (94%), but very poor when gestation was critical (7%). CONCLUSIONS: Calculation of EDD by means of an obstetric wheel and charts is not precise. Compared with the computer system, these errors have a significant effect on the subsequent interpretation of growth scans when the data are borderline. A computer system provides the more accurate method for interpreting gestation-sensitive ultrasound biometry.

Anthropometry↗
PubMed1988

[Visualization of the normal bronchial system by computed tomography].

Imaging of the normal bronchial system by CT was examined in 75 patients while employing different imaging parameters. The main and lobar bronchi could be demonstrated almost without exception in the standard examination of the thorax. Segmental bronchi were delineated in an average of 81% of the cases (512 image matrix) or 74% (256 image matrix), respectively. The lowest identification rate was seen in the segmental bronchi of the middle lobe and lingula being 38% (512 image matrix) and 18% (256 image matrix), respectively. Increase of the magnification factor did not result in any significant improvement of imaging. An increase in the identification rate of the segmental bronchi of the middle lobe and lingula was achieved only after reducing the slice thickness from 8 mm to 4 mm, the yield being now 87% (512 image matrix) and 82% (256 image matrix), respectively, whereas the remaining segmental bronchi could be made to show up almost without exception. The standard parameters are sufficient for routine examination of the bronchial system. If imaging is diagnostically not satisfactory, reducing the slice thickness yields improved imaging, especially of small bronchi.

Adult↗
PubMedDate not supplied

A computer-aided system for the diagnosis of hepato-biliary diseases. A comparison with the performance of physicians.

A computer-aided system has been developed for the diagnosis of disease of the liver and biliary system. The program is based on the use of 30 indicants, all of which are available within six hours after patient's admission: 18 of them are clinical signs, 12 are laboratory parameters including routine liver-function tests. To date, the program concerns 52 hepato-biliary diseases. From the analysis of the 30 items collected in any patient, the diagnoses are computed according to Bayes' theorem and printed by decreasing order of probability. The performance of the program was tested using records of patients with fully proven diagnosis. The first diagnosis given by the computer was correct in 57 per cent of the cases. In 80 per cent, the right diagnosis was among the first four proposed. When the performance of the model was compared to that of physicians, the number of correct answers was roughly the same for the computer and for the specialists in hepatology; in contrast, the computer's responses were far better than those of general practitioners. These results demonstrate the efficiency of the program for the diagnosis of hepato-bilitary diseases and its potential interest for helping clinicians in decision-making.

Adult↗
PubMed1978

A nationwide system for computer recording of neuroradiologic examinations.

For 2 years the system of recording radiologic examinations connected with the computer called SYBAR has been in operation. The examination methods are coded using the Index of Roentgen Examinations of the Swedish National Medical Board (1970), while the diagnoses are coded according to [4]. The positive experience accumulated so far prompted the authors to project and put in operation the system NEURO-SYBAR in order to organize a bank of data of neuroradiologic examinations. This system required the widening of two anatomic fields, 'skull and contents' and 'spine and contents,' according to the 'Index for Roentgen Diagnoses' of the American College of Radiology [1]. The NEURO-SYBAR system was adopted by ten radiologic departments in the country. The complete neuroradiologic data from these departments were collected in one computer center in Lodz.

Computers↗
PubMed1987

A computer-controlled system to perturb the ankle joint of freely standing cats trained to maintain a given force.

A computer-based system was developed to (1) train freely standing cats to match various target forces with the left hindlimb, (2) perturb the left ankle joint when the cat was maintaining a desired force and (3) compare reflex responses before and after decerebration. Cats quickly learned to stand unaided on 4 pedestals. During a training session, a range of target force windows was presented to the cat. A successful trial consisted of maintaining the force applied on the left rear pedestal within the target window for a preset time period. To assist the cat, a light was turned on whenever the force was within the target window. A food pellet reward was delivered by the computer after each successful trial. To test reflex responses, the position of the left hindlimb could be briefly perturbed by activating a servo-controlled printed motor configured to rotate the pedestal about the axis of the ankle joint. Perturbations that either flexed or extended the ankle joint were presented pseudo-randomly by the computer. This approach has been used to quantify the magnitude of muscle afferent volleys and the reflex EMG in ankle extensor muscles of normal and decerebrated cats, in response to similar mechanical perturbations. It has also been used to study dynamic features in the electroneurogram recorded from a cutaneous nerve by implanted nerve cuff electrodes, and the correlations among the electroneurogram, the vertical contact force applied on the pedestal and the force recorded from muscle tendons by implanted transducers. This approach may have general applications in the study of postural control, including the study of the discharge patterns of individual motor, sensory or spinal cord neurons in freely standing cats.

Animals↗
PubMed2000

Clinical governance in primary care groups: the feasibility of deriving evidence-based performance indicators.

OBJECTIVES: To test the feasibility of deriving comparative indicators in all the practices within a primary care group. DESIGN: A retrospective audit using practice computer systems and random note review. SETTING: A primary care group in southern England. SUBJECTS: All 18 general practices in a primary care group. MAIN OUTCOME MEASURES: Twenty six evidence-based process indicators including aspirin therapy in high risk patients, detection and control of hypertension, smoking cessation advice, treatment of heart failure, raised cholesterol levels in those with established cardiovascular disease, and the treatment of atrial fibrillation. Feasibility was tested by examining whether it was possible to derive these indicators in all the practices; the problems and constraints incurred when collecting data; the variations in indicator values between practices in both their identification of diseases and in the uptake of various interventions; the possible reasons for these variations; and the cost of generating such indicators. RESULTS: It was possible to derive eight indicators in all practices and in three practices all 26 indicators. The median number of indicators derived was 12 with two practices able to generate eight. There was considerable variation in the use of computers between practices and in the ability and ease of various practice computer systems to generate indicators. Practices varied greatly in the identification of diseases and in the uptake of effective interventions. Variation in identification of ischaemic heart disease could not be explained by a higher prevalence in practices with a more deprived population. The cost of generating these indicators was 5300 Pounds. CONCLUSION: Comparative evidence-based indicators, used as part of clinical governance in primary care groups, could have the potential to turn evidence into everyday practice, to improve the quality of patient care, and to have an impact on the population's health. However, to derive such indicators and to be able to make meaningful comparisons primary care groups need greater conformity and compatibility of computer systems, improved computer skills for practice staff, and appropriate funding.

Benchmarking↗
PubMed2004

An evaluation of one-on-one advanced proficiency training in clinicians' use of computer information systems.

OBJECTIVE: We examined the effectiveness of a one-on-one training strategy for advanced proficiency in computer information systems (CIS) by clinicians in a large Health Maintenance Organization (HMO). Specifically, this study assessed the level of self-reported improvement in CIS efficiency following one-on-one training, and assessed the perceived value of one-on-one training compared to other teaching methods. DESIGN: We performed a cross-sectional study using a paper-based survey of 129 clinicians practicing in the HMO. MEASUREMENTS: We used a multi-item satisfaction index to measure clinician satisfaction with the one-on-one training. We measured whether clinicians thought they were more efficient using the system after training. RESULTS: The one-on-one method was significantly preferred over other teaching methods. Compared to other CIS components, use of the electronic medical record (EMR) improved most following one-on-one training. Sixty-one percent of the clinicians reported major improvements (i.e., >3 on a 5-point Likert scale; five being the highest score) in using the EMR. CONCLUSION: Perceived effectiveness of one-on-one training and overall satisfaction were ranked high by clinicians. The findings support the assumption that clinicians value one-on-one training and value this training method above other methods.

Adult↗
PubMed1988

A personal computer database system for head and neck cancer records.

The computerized database system described was initially developed in 1986 to facilitate analysis of retrospective head and neck cancer data from the Royal Adelaide Hospital Department of Otolaryngology. This has now been expanded to become an on-going patient information management system. It is based on the dBase-III-Plus database package and is implemented on an IBM XT compatible computer. The system was designed to be used by staff without specialist computer skills and is therefore largely "menu-driven." The main functions include patient record creation, update, and retrieval, and the production of reports including graphical presentations. There is also a powerful but easy to use query facility. The system has already provided much useful epidemiological material but is now beginning to fulfill an even more important role in patient follow-up and in assisting evaluation of alternative treatment protocols.

Computers↗
PubMed1982

Radiation dosimetry survey of computed tomography systems from ten manufacturers.

Profiles of the absorbed dose delivered throughout cylindrical and anthropomorphic phantoms during single scans by computed tomography systems from ten manufacturers were measured using LiF thermoluminescent dosemeters (TLD) and X-ray therapy verification film. The dose profiles demonstrate that a significant portion of the dose is delivered outside the imaged volume of a single scan. The doses measured in cylindrical Plexiglas phantoms were similar to those measured in anthropomorphic cross sections of tissue substitute materials except near the centre of the thorax section. The film results, obtained using a single calibration curve, agreed with the TLD results to within 25% for most systems.

Absorption↗
PubMed1992

Pharmacist work activity before and after pharmacy department computerization.

The effects of a dedicated computer system on pharmacists' daily activities at a 363-bed hospital were studied. A one-group pretest-posttest design was used. Twenty-four pharmacists recorded activity frequency and time for seven consecutive days several months before and after a pharmacy computer system was implemented. The computer system could be used for printing unit dose fill lists and i.v. labels, entering data, and printing patient profiles. An admissions, discharge, and transfer interface between the hospital system and the pharmacy system was also operational. The data were organized into 28 activities for analysis. For seven activities that were considered directly affected by computerization, a net 0.1-minute increase in the average time was found. Four of those seven showed an increase in average time (a total of 1.86 minutes): (1) calculating the composition of total parenteral nutrient or i.v. solution, (2) compounding large-volume i.v. solution, (3) profiling orders, and (4) checking the work of pharmacy technicians. The other three showed a decrease in average time (a total of 1.76 minutes): (1) preparing syringe or small-volume i.v. solution, (2) monitoring drug profiles, and (3) dispensing unit dose medications. However, with all 28 activities considered, a 1.03-minute decrease occurred in the average time per activity. Installation of a dedicated pharmacy computer decreased the amount of time pharmacists spent performing 28 activities by an average of 1.03 minutes per activity but increased the amount of time spent on activities directly affected by the computer by an average of 0.1 minute per activity.

Computers↗
PubMed1981

[Documentation of central venous catheterization using a computer laboratory system (author's transl)].

Full documentation of every case of central venous catheterization is a prerequisite for reducing the incidence of failures and complications. A laboratory computer program already in use was modified for this purpose: the start of the operation is put in in "real time", abandoned or failed procedures or incomplete data are detected, and can be queried on the day of patient is discharged from hospital. Adverse effects are shown up at an early stage by the quarterly print-out. The program involves less work than a conventional system without computer. The experiences gained with this modified system in the course of one year (including the run-in period) are reviewed.

Catheterization↗
PubMedDate not supplied

Departmental and laboratory computing in two hospitals.

This report describes the departmental and laboratory use of integrated, hospital-wide computing systems at Beth Israel and Brigham and Women's hospitals in Boston. The systems have an important role in the admitting, outpatient, and medical records departments; in the clinical departments (blood bank, cardiology, neurophysiology, pathology, radiology, and pharmacy); in the clinical laboratories; and at Brigham and Women's Hospital, in the financial departments. Information that is collected in the computers from these departments and laboratories is available for viewing by clinicians at terminals located throughout each hospital and is used in compiling charges for each patient's account. The programs are heavily used. During a one-week study period, 742 departmental and laboratory workers at Beth Israel Hospital filed or edited information in patients' computerized records 137,526 times. During the same week, 984 departmental and laboratory workers at Brigham and Women's Hospital filed or edited information 293,367 times. After the computing systems were introduced, the time required to collect unpaid bills decreased substantially at both hospitals.

Boston↗
PubMed1987

[Clinical staging of malignant tumors of the digestive system by the TNM system].

Computed tomography has decisively improved the determination of the clinical stage of tumors of the esophagus- and rectum. This method enables tumors to be diagnosed and localized as well as the extend of tumor spread to adjacent organs and metastatic lymph node involvement to be evaluated in most cases without additional invasive imaging procedures. CT is rarely used for tumors of the stomach, small bowel and colon.

Digestive System Neoplasms↗
PubMed1988

The AI/RHEUM knowledge-based computer consultant system in rheumatology. Performance in the diagnosis of 59 connective tissue disease patients from Japan.

AI/RHEUM is a knowledge-based computer consultant system for the diagnosis of rheumatic diseases. Its diagnostic accuracy was evaluated using information that was supplied by Japanese rheumatologists on 59 patients with connective tissue diseases. The diagnoses of the AI/RHEUM model were in full or partial agreement with those of the Japanese rheumatologists in 54 of 59 cases (92%). Preliminary evaluation of the criteria tissue disease showed a sensitivity of 90% and a specificity of 96%.

Artificial Intelligence↗