Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Computers”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,549 records · Page 86Linked to original sources
PubMed1989

Computer use by family physicians in the United States.

In March 1988 the American Academy of Family Physicians (AAFP) sampled approximately 4400 active members to ascertain their interest in office computers. After two mailings an overall response rate of 58.9% was achieved. Approximately 45% of active members currently use a computer in their office practices while 3% use a service bureau. There is a wide variation of use by US census region with approximately one in two family physicians in the West North Central census region using office computers compared to one in three in the Middle Atlantic. Accounts receivable and billing are the principal applications and are used by 86.9% of family physicians with computers in their offices. Very few are using a computer for medical records. Approximately two in five indicated that they have a personal or home computer. It is estimated that approximately 65% of AAFP active members have access to a computer either at home or at their office.

Accounting↗
PubMed1987

Mediastinal lymph node evaluation by computed tomography in lung cancer. An analysis of 345 patients grouped by TNM staging, tumor size, and tumor location.

To more clearly characterize the role of computed tomography in staging the mediastinal lymph nodes of patients with lung cancer, we analyzed computed tomographic and surgical findings in the chest in 345 consecutive patients with lung cancer who underwent operative staging. Patients were grouped according to the TNM staging system of the American Joint Commission, central or peripheral location of the primary tumor, lobar location of the tumor, and maximum tumor diameter as determined by computed tomography or gross pathology. One third of patients with abnormal findings on the computed tomographic scan did not have mediastinal lymph node metastases. Mediastinal metastases occurred frequently in patients with central cancers (38%). The predictive value of a negative scan in all patients was high (greater than or equal to 90%) except for patients with central T3 lesions (72%), left upper lobe lesions (83%), and central adenocarcinomas (75%). However, only the differences between central T3 and central T2 or T1 lesions, and between central adenocarcinomas and central squamous cell carcinomas, were unlikely to be due to chance alone (p less than 0.05). None of the lobar differences were statistically significant. The frequency of mediastinal metastases in patients with peripheral lesions was 15% (28 of 192 patients); computed tomography correctly identified enlarged mediastinal lymph nodes in all but seven patients. However, there were no true-positive computed tomographic scans in 59 patients with peripheral lesions 2 cm in diameter or smaller; accordingly, we suggest that computed tomography is not indicated for the sole purpose of mediastinal staging in this group. Ninety-four percent of patients in this series undergoing thoracotomy with a curative intent had a curative resection. Only 4% had unresectable lesions; palliative resections were done in 2%.

Adult↗
PubMed1985

Voice recognition device as a computer interface for motor and speech impaired people.

A voice recognition device has been identified as an interface for personal computer control by patients presenting with high-level spinal cord injuries and mild dysarthria. The device enables a person to bypass the traditional keyboard and activate a computer through voice control. The user simply creates templates of a spoken vocabulary in computer memory. The computer then matches real-time spoken words to stored templates for activation. The system has been clinically tested with one 10-year-old boy who has C1-C2 quadriplegia and a 19-year-old man who sustained a C6 spinal cord injury and dysarthria secondary to head injury. Each patient created a vocabulary for computer storage to run educational software packages and games. Accuracy rates for computer speech recognition were measured in multiple practice sessions. Intelligibility of single words produced by the dysarthric speaker was measured also. Both patients activated computer programs through voice control. Recognition rates ranged from 45 to 60% for the first patient, and 79 to 96% for the second patient. A mean success rate for voice recognition across trials with both patients was approximately 80%. The device increased the dysarthric speaker's articulatory precision. Results indicate that the system might be appropriate for rehabilitation programs though further technologic refinement of the device would increase its effectiveness.

Adult↗
PubMed1988

Computers in anatomic pathology. A survey of California hospitals.

The anatomic pathology services of 434 health care institutions in California were surveyed about their use of computers. Of 200 (46%) respondents, 106 (53%) did not use computers at all. Of 94 (47%) respondents who used computers, 77 (82%) used them for administrative purposes; 74 (79%), for any routine processing of surgical specimens; 43 (45%), for processing surgical specimens other than word processing (eg, database); 52 (55%), for processing cytology specimens; and 60 (63%), for processing autopsy specimens (including word processing). Computer use was slightly greater with higher work loads. Among nonusers, on a scale of 1 to 5 the average interest in using computers was 3.5 for surgical pathology data, 3.4 for cytology data, and 2.8 for autopsy data. The interest rate also increased with work load, and was nearly 4 for laboratories with greater than 4000 surgical or cytology cases per year. The average interest in controlling and/or making decisions about computer hardware and software was 3.9 for hardware and 4 for software. Reasons for low computer use in anatomic pathology despite interest in utilization are discussed, including the limited selection of affordable commercial software for anatomic pathology and difficulties of in-house software development.

Autopsy↗
PubMed1977

Use of computers in clinical electrocardiography: an evaluation.

The use of computers in clinical electrocardiography is increasing rapidly; however, the role of computers with respect to the electrocardiographer has not been established. At present all electrocardiograms (ECGs) processed by computer are also interpreted by electrocardiographers; hense effort is duplicated. In an investigation of whether conditions can be defined under which the electrocardiographer can use the computer more profitably by eliminating some of the duplication, ECGs recorded in a university teaching hospital were processed by a computer program and subsequently reviewed by 1 of 10 electrocardiographers. For ECGs interpreted as showing normal sinus rhythm the rate of agreement between computer and human reviewer was 99%. For those showing a normal ECG pattern (contour) the rate of direct agreement was only 88%. However, the rate of occurrence of clinically significant differences was only 1.64%; hence the rate of essential agreement for this classification was 98.36%. Other classifications with good agreement were myocardial infarction, sinus bradycardia and sinus tachycardia. Therefore, in circumstances comparable to those of this investigation it is feasible for electrocardiographers to use computers to reduce greatly their workload without compromising the quality of the service provided.

Bradycardia↗
PubMed1988

The role of computed tomography scanning in the initial assessment and the follow-up of malignant pleural mesothelioma.

Between October 1983 and April 1987, 20 patients with malignant mesothelioma underwent computed tomography scans of the chest and upper abdomen to evaluate the extent of disease before treatment. Twelve of these 20 patients deemed to have some potential for long-term survival had scans performed every 3 months after operation to help detect recurrent disease. Anatomic correlation of computed tomography scan findings was available in all 20 patients. The limitations of computed tomography in initial evaluation were its difficulties in assessing (1) chest wall involvement (nine patients), (2) mediastinal lymph nodes (four patients), (3) transdiaphragmatic extension of tumor (four patients), and (4) peritoneal studding and solid organ metastases less than 2 mm in size (one patient). Computed tomography was helpful in detecting recurrent disease in the 12 patients having long-term follow-up. In six of eight cases with histologically proved recurrence, computed tomography detected tumors from 1 to 8 months before the onset of signs or symptoms. Although computed tomography is known to provide far more information about the extent of disease than plain radiographs, it remains an imperfect tool for the staging of disease in patients with malignant mesothelioma. Despite its limitations, computed tomography is probably the most accurate way to provide follow-up for patients during treatment.

Follow-Up Studies↗
PubMed1986

Determination of cardiac output by ultrafast computed tomography.

Three methods of determining cardiac output were compared in six anesthetized dogs (23-28 kg) for the purpose of evaluating the ability of ultrafast computed tomography to measure cardiac output at three points of the circulation: pulmonary artery, left ventricle, and descending aorta. Computed tomography cardiac output is calculated by indicator dilution analysis of an iodinated contrast bolus time-density curve. Computed tomography cardiac output was compared to thermodilution and radioactive microsphere cardiac output methods. The results show very good agreement between thermodilution and computed tomography methods (r = .90) and good agreement between microsphere and computed tomography (r = .88). Comparison of computed tomography cardiac output measurements from the left ventricle and pulmonary artery was excellent (r = .99), as were measurements from the left ventricle and descending aorta (r = .97). This study also showed minimal interlevel scan-density response variability (3%) and minimal variability between experiments (7%). Therefore, it is concluded that cardiac output can be accurately measured at many points in the blood pool by ultrafast computed tomography.

Animals↗
PubMedDate not supplied

[Value of computer tomography during investigation of sub-diaphragmatic adenopathies occurring during the course of lymphomas and pelvic cancers (author's transl)].

A series of 60 patients were examined by abdominopelvic computer tomography 48 hours after foot lymphography. The diagnosis was Hodgkins's disease in 10 patients, lymphomas other than Hodgkin's in 20 cases, and 30 patients with pelvic carcinomas. The value of lymphography in lymphomas other than Hodgkin's is re-emphasized, and a good correlation exists between the results obtained and those observed with computer tomography, which is particularly useful for studying the upper lumbo-aortic regions. The group of Hodgkin's disease patients particularly demonstrates the limits of pelvic lymph node investigations with computer tomography, but supplies confirmation of the quality of examination of the lumbo-aortic chains. The group of patients with pelvic carcinomas is more heterogenous, and computer tomography is if greater value, mainly in cases with blocked lymphatics. Computer tomography examinations do not replace lymphography in the study of sub-diaphragmatic lymph node chains but are a useful complement as they demonstrate excluded or poorly opacified adenopathies. When lymphography is contra-indicated, computer tomography can supply valuable information, but the differential diagnosis of inguino-iliac chain lesions is difficult. Computer tomography is a logical procedure during pretreatment investigations whenever there is a doubt concerning possible lesions in the lumbo-aortic chains. It is the most valid guide for establishing details of a course of radiotherapy.

Adult↗
PubMed1979

[Use of cerebral computer tomography for the diagnosis of multiple sclerosis].

The authors describe computer tomography findings in multiple sclerosis (MS)), and attempt an evaluation of the value of cerebral computer tomography for the diagnosis of this disease, especially those forms in which the clinical diagnosis is uncertain. A total of 33 patients, 15 men and 18 women, were studied. According to McAlpine's criteria, 21 patients had established MS, 2 were probably MS cases, and the other 10 were possible cases of the disease. The scanner used was an EMI 1010 apparatus giving 13 mm thick sections, with a matrix of 160 X 160. A contrast medium was injected systematically. Abnormal computer tomography results were noted in 28 of the 33 patients, including one or more low density areas in the white substance in 26 patients, taking up of the contrast medium after injection in 10 patients, and cerebral atrophy in 24 patients. Cases where only one of these anomalies was present are rare, and the various anomalies noted on computer tomography are usually associated in varying proportions. In most cases, the computer tomography findings were not related to any specific clinical picture. In cases of established MS, computer tomography can provide information on the extension and progression of the lesions at the time of examination. Out of the 12 cases in which clinical diagnosis was uncertain, 9 presented abnormal findings (low densities and/or taking up of contrast medium); the level of CSF gamma-globulins was normal in 4 of these 9 patients; visual evoked potentials were not altered in the 5 out of these 9 patients studied. In 3 patients with medullary signs, several low cerebral trunk and white substance of the cerebral hemispheres. When diagnosis is uncertain, cerebral computer tomography is the method of choice for demonstrating latent MS lesions of a certain type: it complements neurophysiological studies (visual, auditory, and somesthesic evoked potentials), used at the present time for the diagnosis of MS by exploration of the optic tracts and cerebral trunk.

Adult↗
PubMed1984

Computed tomography. An effective technique for mediastinal staging in lung cancer.

Computed tomographic scans of the chest were utilized to stage mediastinal disease in 148 instances of bronchogenic carcinoma considered for resection in 146 patients. Nodes greater than or equal to 1.5 cm in diameter were interpreted as abnormal. All nodes positive by computed tomography were evaluated by mediastinoscopy, anterior mediastinotomy, or thoracotomy. All patients with negative computed tomographic findings underwent thoracotomy without prior surgical staging. Patients undergoing thoracotomy were divided into two groups. In Group I (first 51 instances) routine mediastinal exploration was not carried out; in Group II (last 97 instances) the mediastinum was explored in every patient and nodes were submitted for histopathological study. The computed tomographic and pathological findings on the mediastinal lymph nodes were compared. The sensitivity, specificity, and accuracy of computed tomography in Group I were 88%, 94%, and 92%, respectively, in Group II 75%, 89%, and 86%, and in the combined group, 80%, 91%, and 88%. The positive predictive index in Group I, Group II, and in the combined group was 88%, 69%, and 77%, respectively. It was lower for central than peripheral lesions (74% versus 88%) and was lowest for lesions in the right upper and left lower lobes. The negative predictive index was greater than 90% for all groups and all tumor sites except the left upper lobe, where it was 89%. Ten patients had false-positive scans, three with old mediastinitis and seven with postobstructive pneumonia; nine of the 10 had central lesions, and seven of these lesions were located in the right upper lobe. Eight patients had false-negative scans; six had para-aortic, subaortic, or postsubcarinal nodes. These nodes would not have been accessible to mediastinoscopy. In only one patient with false-negative nodes would routine mediastinoscopy have prevented thoracotomy and resection. Computed tomographic staging of mediastinal disease is indicated for all patients with lung cancer in whom operation is contemplated. Computed tomography directs the most appropriate staging procedure for patients with positive findings and obviates invasive staging for patients with negative findings.

Adult↗
PubMed1983

[Results of a computer-based analysis of peripheral pulse waves in arterial occlusive diseases of the lower extremity].

A system of data acquisition and computer analysis for pulse wave measurements, realized by means of electronic oscillography (Boucke-Brecht system) or impedance rheography, is described. The system includes: 1. Computer-compatible data acquisition and registration 2. Conversion of data into digital form 3. Data processing and evaluation of parameters 4. Classification. Records are taken from equivalent points of left and right lower extremities. Computer analysis is performed off-line using a small computer (TPA-i). The computer program evaluates the following parameters: 1. Time intervals and amplitudes of pulse propagation time, inclinations, crest time, peak width, maximum and minimum of dicrotic wave 2. Areas between pulse curve and baseline 3. Extremes of 1st and 2nd derivates for the dynamic characterization of signal 4. Fourier coefficients All parameters are computed for 12 single pulse cycles and finally averaged, printed out, and stored in a data bank. The diagnostic significance of all these parameters was examined and evaluated for separation of normal and pathological curves. With linear discriminance analysis a correct classification of about 90% was obtained. Advantages of computer analysis are: 1. Time-consuming visual evaluation is avoided. 2. Accuracy and reliability of diagnosis are improved. 3. Additional parameters offer more diagnostic information. Further investigations are directed toward reducing the number of parameters and developing an efficient screening method for early diagnosis of peripheral arterial obstructions.

Arterial Occlusive Diseases↗
PubMedDate not supplied

Computed tomography in degenerative spinal stenosis.

To assess the value of computed tomography in degenerative lumbar spinal stenosis, postoperative computed tomography was compared to preoperative studies and other radiographic modalities in 20 patients, ten with an excellent surgical result and ten with a poor result. A close correlation was found between moderate to severe residual stenosis on postoperative CT and surgical failure. The most common cause of failure was inadequate unroofing of the lateral gutters. Computed tomography with multiplanar reconstructions detected stenosis not only in the central canal and lateral recesses, but in the neuroforaminal as well. Central canal stenosis corresponded to a marked deformity of complete block on myelography. Lateral recess stenosis was shown more often by computed tomography than by blunting of the nerve root sheaths on the myelograms. Neuroforaminal encroachment seen on computed tomography sagittal reconstructions was not demonstrable by myelography. Degenerative spondylolisthesis, a special stenotic condition, produced a characteristic "double margin" sign on computed tomography and the critical stenosis of the lateral recesses was demonstrated. This study suggests that the superior definition of the sites of degenerative spinal stenosis provided by computed tomography should lead to higher surgical success rates.

Aged↗
PubMedDate not supplied

[Dynamic high-contrast computed tomography in the diagnosis of pancreatic necrosis].

UNLABELLED: This work intended to find out whether dynamic high-contrast computed axial tomography (CAT scan) in effective and more useful than conventional computed tomography for the diagnosis of pancreatic necrosis in patients with severe acute pancreatitis. BACKGROUND: Although many methods have been used to predict the severity and extent of pancreatic necrosis, few studies have assessed computed tomography. METHODS: Longitudinal, prospective and comparative study was performed on consecutive patients with severe acute pancreatitis in which dynamic high-contrast computed tomography and conventional computed tomography were carried out. RESULTS: In pancreatic necrosis, pancreatic densities were lower. Necrosis by itself was also associated with higher severity scores, but not with a higher mortality rate. However, mortality rates were influenced by the extent of pancreatic necrosis. Sensitivity of 100%, specificity of 68%, positive predictive and negative predictive values of 100 and 42% were achieved. STATISTICS: Densities of TCNL and TCAC were analyzed using student's t test of independent samples. The correlation of the aorta/pancreas index and the presence of necrosis was analyzed using a linear correlation test. CONCLUSIONS: The authors conclude that dynamic high-contrast computed tomography is more effective than conventional computed tomography in diagnosing pancreatic necrosis. Moreover, the diagnosis of pancreatic necrosis and its extent makes it possible to formulate a prognosis as to severity of the disease.

Acute Disease↗
PubMed1978

Computer assisted monitoring in intensive medicine.

Intensive Medicine is always associated with the problem of handling the mass and assuring the quality of information on vital signs, fluid and blood balance, laboratory data, physiological calculations, etc., required in patient care. A computer based monitoring system for intensive care was introduced in 1973 at the Academic Hospital in Leuven. The basic software was developed at the Peter Bent Brigham Hospital of the Harvard Medical School and the medical division of the Hewlett Packard Company; the computer used was a H.P. 2100 central processor with 32K of core memory. Initially, the program allowed mainly acquisition, storage and retrieval of bedside monitored and manual data of cardiac and circulatory function. Very soon however, the software was extended and modified by the division of "Medical Informatics" in order to meet new or different requirements. In the present situation our vision on the use of computer-assisted monitoring has changed and our present program has been extended as follows : 1. On-line collection and retrieval of bedside monitored data including heart rate, arterial blood pressure (systolic-diastolic-mean) left atrial pressure, central venous pressure, pulmonary artery pressure, intracranial pressure. Trend analysis of those data, with calculation of mean values, standard variation and corresponding t-tests. 2. Computer assistance in performing time consuming calculations on off-line data such as : -- clearance-values (renal function), -- temperature-correction of blood-gasvalues, -- hour-to-hour fluid balance, including calculation of in-sensible losses, -- blood-balance. 3. Data transmission of laboratory results as soon as available in the central laboratory through a direct link between laboratory and I.T.U. 4. Computer assisted E.C.G. analysis. The three first objectives are realised, on-line E.C.G.-analysis is being developed. The same computer serves the remotely located medical and coronary care units and one bed in the emergency department. An assessment of computer assistance in intensive therapy, on nursing labor and on quality of patient care is made.

Clinical Laboratory Techniques↗
PubMed1996

Intraobserver, interobserver variation of sperm critical morphology: comparison of examiner and computer-assisted analysis.

OBJECTIVE: To examine intraobservational and interobservational variation in sperm critical morphology analysis between trained andrologists and a computer over the range of 0% to 15% normal forms. DESIGN: Retrospective. SETTING: Fertility center. PATIENTS: Twenty-four semen specimen slides were read five times in a randomized, blinded fashion by two andrologists and a computerized semen analyzer. Twenty-five samples were analyzed using a different stain and a centrifugation step. MAIN OUTCOME MEASURE: Sperm strict morphology. RESULTS: Mean average intraobserver deviation of normal forms was small (1.3% to 2.7%). Intraobserver deviation did not differ between andrologists, but both differed from the computer. Interobserver deviation for percent normal forms was similar for andrologists and computer. Mean average deviations were small over the variation was independent of the initial percent normal forms. The computer frequently evaluated significantly fewer cells than the andrologists. Updated software increased the number of cells read by the computer requiring more time than the andrologist. CONCLUSIONS: Trained andrologists and a computer determine sperm critical morphology similarly over the range of 0% to 15% normal forms. A single evaluation is highly predictive of multiple evaluations. Improvements in the speed of computer assessment are still necessary.

Diagnosis, Computer-Assisted↗
PubMed1996

Constructing retinal fundus photomontages. A new computer-based method.

PURPOSE: To develop computer algorithms for reconstructing 24-bit color, wide-angle composite retinal fundus images from a set of adjacent 45 degrees fundus slides. The authors present the description, technical details, and results of the image reconstruction technique. METHODS: Patients with retinal degeneration underwent fundus photography with a 45 degrees field-of-view fundus camera. Individual photographic slides were digitized for creating fundus montages. Background variations in individual 45 degrees images were modeled to first- or second-order two-dimensional polynomial functions to generate a background image. The background image was subtracted from the original image to obtain background corrected image. Background corrected images were registered and spatially transformed using a first- or second-order two-dimensional polynomial warp model to reconstruct a composite retinal fundus montage. RESULTS: The authors successfully reconstructed 24-bit color, 100 degrees field-of-view, composite retinal fundus images. The computer-reconstructed montages are an improvement over manually generated montages because computer analysis can be performed on the computer-based montages. In addition, background variations and discontinuities between individual photographs observed in manually generated montages are reduced greatly in computer-generated montages. Most important, the computer-generated montages are better aligned than the manually generated photomontages. CONCLUSIONS: This method of reconstructing a wide-angle composite retinal fundus image from a set of adjacent small- and wide-angle fundus slides is a new tool for creating montages as large as 100 degrees field of view. The computer-generated montages may be used for documenting and quantifying retinal findings. This can greatly assist studies of retinal manifestations of diseases, such as gyrate atrophy, retinitis pigmentosa, sickle cell disease, and acquired immune deficiency syndrome.

Algorithms↗
PubMed1997

Computer-assisted psychotherapy.

The rationale for using computers in psychotherapy includes the possibility that therapeutic software could improve the efficiency of treatment and provide access for greater numbers of patients. Computers have not been able to reliably duplicate the type of dialogue typically used in clinician-administered therapy. However, computers have significant strengths that can be used to advantage in designing treatment programs. Software developed for computer-assisted therapy generally has been well accepted by patients. Outcome studies have usually demonstrated treatment effectiveness for this form of therapy. Future development of computer tools may be influenced by changes in health care financing and rapid growth of new technologies. An integrated care delivery model incorporating the unique attributes of both clinicians and computers should be adopted for computer-assisted therapy.

Forecasting↗
PubMed1997

A computer-administered telephone interview to identify mental disorders.

CONTEXT: Common mental disorders are often not identified in primary care settings. OBJECTIVE: To evaluate the validity and clinical utility of a telephone-assisted computer-administered version of Primary Care Evaluation of Mental Disorders (PRIME-MD), a brief questionnaire and interview instrument designed to identify psychiatric disorders in primary care patients. DESIGN: Comparison of diagnoses obtained by computer over the telephone using interactive voice response (IVR) technology vs those obtained by a trained clinician over the telephone using the Structured Clinical Interview for DSM-IV [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition] Diagnosis (SCID). A subsample also received the clinician-administered version of PRIME-MD. PATIENTS: Outpatients (N=200) from 4 primary care clinics, an eating disorders clinic, an alcohol treatment facility, psychiatric outpatients, and community controls. SETTING: Interviews conducted by telephone, except for face-to-face administration of PRIME-MD, which was conducted at either the primary care clinic or a research clinic. MEASUREMENTS AND MAIN RESULTS: Prevalence rates for any psychiatric disorder were similar between diagnoses made by the computer and those made by a mental health professional using the SCID (60.0% vs 58.5%). Prevalence rates for individual diagnoses were generally similar across versions. However, primary care patients reported twice as much alcohol abuse on the computer (15.0%) as on either the SCID (7.5%) or the clinician-administered PRIME-MD (7.5%). Using the SCID as the criterion, both the computer- and clinician-administered versions of PRIME-MD demonstrated high and roughly equivalent levels of sensitivity and specificity. Overall agreement (K) for any diagnosis was 0.67 for the computer-administered PRIME-MD and 0.70 for the clinician-administered PRIME-MD. CONCLUSIONS: The computer-administered PRIME-MD appears to be a valid instrument for assessing psychopathology in primary care patients. Interactive voice response technology allows for increased availability, and provides primary care physicians with information that will increase the quality of patient care without additional physician time and at minimal expense.

Adult↗