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PubMedDate not supplied

Software requirements: definition and specification.

The software requirements specification is the single most important document in the software development process. It provides the basis for development as well as for validation. The SRS needs to include adequate definition of all requirements without specifying implementation or project management issues. The SRS should be completed early in the development process. However, it is very likely that changes will occur during the development life cycle. This is not an excuse for approving and releasing the current version of the SRS. When changes occur, the SRS must be revised. In any case, the concept is to deal with the current, approved version of the SRS. Ultimately, the SRS should include all the information needed to proceed into the design phase of software development.

Software↗
PubMed1996

The CARDIO-LOGOS system for ECG training and diagnosis.

A new approach in ECG training is presented. The overall approach is based on a combination of the "page-turning architecture", the "reference model" and AI techniques. A thorough analysis of the training requirements in this field has been carried out; the results determined the educational scenarios and the associated evaluation sessions. The system (CARDIO-LOGOS) is intended to be used mainly by internal medicine physicians and general practitioners, as well as by medical students. The layered structure of the whole CBT application together with the advanced learning strategies and the interactive multimedia technology offer a flexible environment that encourages experimentation and supports individualised training for a wide variety of users.

Computer Simulation↗
PubMed1995

A real time control architecture for continuously managing patients in a care unit.

The monitoring and treatment of patients in a care unit is a complex task in which even the most experienced clinicians can make errors. A hemato-oncology department in which patients undergo chemotherapy asked for a computerized system able to provide intelligent and continuous support in this task. One issue in building such a system is the definition of a control architecture able to manage, in real time, a treatment plan containing prescriptions and protocols in which temporal constraints are expressed in various ways, that is, which supervises the treatment, including controlling the timely execution of prescriptions and suggesting modifications to the plan according to the patient's evolving condition. The system to solve these issues, called SEPIA, has to manage the dynamic, processes involved in patient care. Its role is to generate, in real time, commands for the patient's care (execution of tests, administration of drugs) from a plan, and to monitor the patient's state so that it may propose actions updating the plan. The necessity of an explicit time representation is shown. We propose using a linear time structure towards the past, with precise and absolute dates, open towards the future, and with imprecise and relative dates. Temporal relative scales are introduced to facilitate knowledge representation and access.

Clinical Protocols↗
PubMed1996

Computer-based patient education: observations on effective communication in the clinical setting.

Computer-based patient education materials are becoming more widely used in an attempt to increase the efficacy and efficiency of the delivery of health care. This paper discusses the authors' experiences in designing and implementing interactive multimedia presentations for patient education in an orthopaedic surgery office setting. Content must be chosen carefully to effectively educate without alienating the patient; simple graphics and animation are best for conveying complex medical and surgical concepts. The interface must be simple; both mouse input and touchscreen have proven acceptable and require minimal instruction. Improvements in program design will result in task-oriented evaluation systems that allow the patient to use the information gained to demonstrate understanding.

Communication↗
PubMed1996

Simulators for anesthesia.

Two commercially available complete anesthetic simulators were studied in the United States. Although there are some differences between the two systems, each consists of an adult manikin allowing some direct anesthetic interventions, a system of producing physiologic signals to any commercial monitoring system, and the ability to interface with an anesthetic machine and ventilator. In addition, both simulators model the responses to a variety of drugs used by anesthetists. With their associated computer controls, it is possible to mimic a number of recognized anesthetic critical situations and to record the responses made by the anesthetist and determine the effects on the "patient." In use, one system is devoted principally to teaching crisis resource management to anesthetists. The other system is used more generally to teach anesthetists how to approach a variety of problems. In our opinion, each system could be used in either of these ways. Both systems are capable of development into valuable teaching tools for anesthetists and for others involved in critical care. There is potential for the training of paramedics or nurses involved in anesthetic and recovery room care and intensive care. Other options include the investigation of critical events and the development and subsequent testing of clinical management protocols. Anesthetists are familiar with the use of manikins in the teaching of airway management and basic and advanced life support. Newer manikins can be used to practice skills in intravascular cannulation; some can be used with monitoring equipment and defibrillators to provide more realistic teaching. Computer programs, especially those for personal computers (PCs), can also be used to simulate the pharmacophysiologic behavior of patients in a variety of states. Now available are combined systems using manikins controlled by computer, with interfaces to anesthetic machines, ventilators, and monitoring equipment. Two systems are commercially available in the United States. In this report, we briefly describe their technical specifications and how we saw them being used.

Adult↗
PubMed1996

[Computer-assisted documentation of mandibular fractures].

For the registration, documentation and evaluation of patient data in cranio-maxillo-facial (cmf) trauma surgery a Windows-based application front end for relational data base systems (RDBS) has been developed. A simple-to-learn, easily reconfigurable user interface can be adjusted to the dynamically changing needs of individual departments. A graphical user interface (GUI) eases the entry of complex information like fracture positions, the location of implanted osteosynthesis material, etc. The new program also simplifies the daily routine documentation tasks. Being linked to a Hospital Information System (HIS) it makes use of the patients' individual base data stored there. Statistical data for various studies can be extracted from the database. The program has been successfully tested on a collective of 1.178 cmf trauma patients. Predefined analyses can be generated now by the simple click of a button for various case selections. New users learn to operate the program in a very short time.

Computer Graphics↗
PubMed1996

[The Internet and clinical medicine. An introduction to the biomedical information services available in electronic form on the "net of all nets"].

Clinical users expectations from medical informatics are evolving due to the wide availability of biomedical information services on the Internet. Thanks to hypertexts and advanced browsing tools users with no informatical expertise can travel on the Internet and easily gain access to textual databases. With a multimedia computer other kinds of information can be grabbed: images, sounds and audiovisual documents. Basic Internet services (electronic mail, discussion lists, file transfer protocol, terminal emulation) can be accessed from a wide range of hardware equipment. However, the real power of a world-scale computer network like the Internet will be unleashed only when its global connectivity will be linked to the powerful retrieval ability of existing clinical and related databases. While biomedical journals editors and other medical information providers are in the way to offer electronic versions of their paper-based products, at the leading edge of this world-scale process is the USA National Library of Medicine, with the Internet-compatible version of its Grateful Med software which is expected to be launched during 1996.

Computer Communication Networks↗
PubMed1995

An interactive qualitative model in cardiology.

Qualitative modeling is a generic term that involves explicit and qualitative representations of the physical world. It can extend the realm of pure mathematical modeling in the sense that qualitative descriptions can, on one hand, simulate complex physical systems and processes and, on the other, produce linguistic descriptions and summaries of simulated system behavior. These summaries should be an essential element of the human/machine interface if truly interactive computational environments are to be developed. In the context of cardiac arrhythmias, a thorough understanding of the underlying processes that lead to the different pathological states is a first step toward optimizing diagnosis and therapy. The CARDIOLAB project is dedicated to cardiology and is aimed at providing a theoretical framework composed of computational models of different grain size and based on different formalisms. One of the intended roles of the framework is to assist researchers, clinicians, and pharmacologists in their quest for a better understanding of rhythmic disorders and ischemic events. In this paper, we present the first element of the framework. It is a cardiac simulator conceptualized in terms of a research field known as qualitative physics. As a simulator, the model's role is to produce fairly detailed descriptions, at different levels of abstraction, of cardiac electrical events when initial tissue-state conditions are given. A crude simulated ECG is also produced as a visual aid. At the end of each simulation session, and upon user request, the system can memorize the initial conditions and the descriptions into an arrhythmia knowledge base. As such, the model can be used as an interactive tool, to grossly delineate the regions in parameter space that correspond to causing or predisposing states leading to specific rhythmic disorders. More refined analysis can thereafter be performed using finer-grained models, the initial conditions of which will have been suggested by the qualitative model.

Arrhythmias, Cardiac↗
PubMedDate not supplied

EEG-based brain computer interface (BCI). Search for optimal electrode positions and frequency components.

Several laboratories around the world have recently started to investigate EEG-based brain computer interface (BCI) systems in order to create a new communication channel for subjects with severe motor impairments. The present paper describes an initial evaluation of 64-channel EEG data recorded while subjects used one EEG channel over the left sensorimotor area to control on-line vertical cursor movement. Targets were given at the top or bottom of a computer screen. Data from 3 subjects in the early stages of training were analyzed by calculating band power time courses and maps for top and bottom targets separately. In addition, the Distinction Sensitive Learning Vector Quantizer (DSLVQ) was applied to single-trial EEG data. It was found that for each subject there exist optimal electrode positions and frequency components for on-line EEG-based cursor control.

Adult↗
PubMedDate not supplied

Assessment of a computerized patient record system: a cognitive approach to evaluating medical technology.

Numerous research and development projects have been aimed at implementing computerized patient record (CPR) systems. Yet little emphasis has been placed on physicians' ability to learn and use these systems or on their effects on physicians' reasoning. This article describes an innovative approach to assessing these aspects of a CPR system. The method involves observing physicians' use of a CPR under various clinical conditions and analyzing the CPR system with a technique called the cognitive walkthrough. We will show how learning to use a CPR system can change a physician's performance, with accompanying effects on information gathering and reasoning.

Cognitive Science↗
PubMed1996

Effectiveness of computer-assisted interactive videodisc instruction in teaching rheumatology to physical and occupational therapy students.

A computer-assisted interactive videodisc instructional program, HP-RHEUM was designed to teach clinical findings in arthritis to occupational and physical therapy students. Using the Rheumatology Image Library videodisc produced by the National Library of Medicine, HP-RHEUM consists of instructional modules which employ advance organizers, examples/nonexamples, summaries, and immediate feedback. To see if HP-RHEUM would be as effective as traditional classroom instruction, control data were collected in 1991 from 52 OT and PT students. Treatment data were collected from 61 students in 1992 when HP-RHEUM entirely replaced lectures. Identical pre- and post-tests consisted of 70 multiple choice questions, with 24 matched to slides. On the slide questions the HP-RHEUM group had significantly higher scores. Otherwise, there was no significant difference in performance between groups. HP-RHEUM provided an independent learning method and enhanced visual comprehension of rheumatologic disease concepts.

Analysis of Variance↗
PubMed1995

OREST II--ergonomic workplace and systems platform for endoscopic technologies.

Endoscopic interventions require a multitude of technical devices, like gas-insufflators, cameras, light sources, high-frequency scalpels and others. The devices available today represent stand-alone "function-insulas" from the view-point of systems technique. They have to be placed in the operating theatre and set-up right before each specific intervention. From each of these single devices supplies, cables and hoses lead to the body of the patient and have to be connected on both sides within the sterile and the non-sterile field. This not only requires a long setup time in the OR but also restricts the mobility of the operative personnel. Besides the ergonomic and the hygienic weakness of the contemporary solution, significant functional problems limit the efficiency of the OR environment. One of the major drawbacks lies in the lack of direct control of the devices by the surgeon and the confusing display of parameters and technical status. Against this background the systematic revision of the current endo-surgical workplace appears to be a major requirement for further technical and surgical progress. As a result of close cooperation between surgeons and engineers a systems workplace for minimally invasive surgery, OREST, has been developed and clinically tested. It integrates all devices into a mobile cabinet. The single devices are connected to a central computer and can be remote controlled directly by the surgeon from the table. A special display continuously informs about the system status. The lines and cables are guided into the sterile field by means of a swivel arm from one side of the patient. Multi-plugs are used to connect all lines at a central terminal within the sterile area. Clinical application of the first prototype OREST I started in 1993. OREST II is now available as a series product. Further development is focused on the integration of advanced sub-systems like tactile devices and advanced vision system.

Computer Systems↗