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PubMedDate not supplied

[The diagnosis of epilepsy in the interactive mode using computer technology].

The paper describes an EDITA programming subsystem for computer diagnostic technology for epilepsy. The EDITA is based on a classifier, a system of a patient's individual signs. The classifier has been developed in accordance with the epilepsy classification developed by the International Epilepsy Control League (Kyoto, 1982) and involves many-year experience in diagnosing and treating epilepsy in Udmurtia. The crucial principle for a computer to make a diagnosis is not only medical experience, but a formalized system of weight ratios, which is an integral part of the computer classifier. The validity of weight ratios were assessed in a representative taught sample (260 patients with wellknown types of epilepsy). A statistic method based on the Bayes' approach was applied by employing the same taught sample when the classifier and the reliability of computer-aided diagnosis were checked. Computer-aided diagnosis was made in three steps: registrations or selection of a patient, collection of history data and diagnosis, prescription of antiepileptic drugs. According to these three steps, three sections (or program operating modes) were identified. These included a patient's medical card, a classifier, and drugs.

Anticonvulsants↗
PubMed1986

[Graphic representation on microcomputers. An example of interface construction].

Personal computers are generally used in laboratories as programmable calculators, data base organizers or word processors. With the addition of appropriate interfaces, they can also be used in data acquisition, analysis, and automatic control of experiments. In this paper the basic principles of operation of input and output devices are described, to serve as a guide to the construction of these interfaces. This description is specifically dedicated to the S-100 8-bit computer bus, with detailed explanation of the several signals involved in input-output machine cycles. Complete schematics and software driver for an interface to display analog signals on an oscilloscope or X-Y plotter is included as an example. Applications of this interface to the analysis of currents from membrane ionic channels are also discussed.

Automation↗
PubMed1986

Automation of data acquisition and of experiment control: application to the study of sleep-wake cycles and behavioral paradigms.

The low cost of microcomputers allows them to be dedicated full time to data acquisition and analysis of experimental paradigms. The usual interfaces required for such interaction with the experiment are briefly explained, namely, analog-to-digital converters, input-output control lines and real time clocks. Some basic concepts on the use of microcomputers for the automation of data acquisition and control are summarized, including the characterization of waveshapes, the structure of data storage and on-line data reduction. Off-line, the matrices generated by the data acquisition program become the input for ad-hoc processing programs. Precision, flexibility and fluidity of analysis are outstanding advantages of computer controlled setups. A system for automation of sleep studies and a system for automation of scheduled-controlled behavior are presented as working examples.

Activity Cycles↗
PubMedDate not supplied

Databases for clinical psychiatry.

Clinical information systems support patient care and research while providing data for administrative use. We assessed the informational needs of the psychiatrists at UCLA Neuropsychiatric Hospital and used the resulting criteria in evaluating commercial computer products. The systems that appear to be least expensive, most powerful, and most suitable for widespread use are assembled from various off-the-shelf packages. These newer systems use a structured query language (SQL) database with a graphic user interface. An SQL database can support both large and small clinical operations, and a graphic interface is easy to use. Commercial software systems are too expensive for a small psychiatric hospital or department, but a customized SQL database can be purchased and installed at lower cost.

Computer Graphics↗
PubMed1996

An integrated system for measuring static and dynamic accommodation with a Canon Autoref R-1 refractometer.

An integrated system is described which we have found useful for efficiently collecting and analyzing both static and dynamic accommodation data using the Canon Autoref R-1 refractometer. The system consists of hardware modifications and software designed to both facilitate the measurement of accommodation and to process the resulting data. Several features of the Canon R-1, which may not be evident to some users, are also described. A program written in Microsoft C/C++ running under DOS, and designed for use on a PC, is available from the authors upon request.

Accommodation, Ocular↗
PubMed1996

Using concept maps on the World-Wide Web to access a curriculum database for problem-based learning.

Development of medical school curriculum databases continues to be challenging. Representation of the instructional unit is becoming increasingly difficult due to characteristics of the problem-based learning (PBL) curricula. Curriculum databases may be used to store materials for the PBL curricula, and also to provide a delivery mechanism for those materials. However, in order to take advantage of the curriculum database as a tool for PBL, methods for accessing the curriculum database that are better suited to the information needs of students, faculty, and administrators must be developed. Concept maps are directed graph representations of conceptual relationships, and may be used to represent the content of a curriculum database. In this paper, we describe a Web application that uses Java-based concept maps was the user interface to a curriculum database.

Computer Communication Networks↗
PubMed1996

The patient advocate: a cooperative agent to support patient-centered needs and demands.

Knowledge-based monitoring and therapy planning systems were mainly built for the convenience of health care providers. They neglected the consumers of health care, namely, the patients. Our approach is concentrated on the individual patients' demands and needs. We are designing, building, and demonstrating a cooperative agent to support patients' management of their own health-related behavior on a day-to-day basis at home. Clinical treatment protocols are represented in an intention-based time-oriented representation language to overcome the drawbacks of vague or ill-structured problem definitions (e.g., missing functional dependencies). These representations are used to guide the patients, to provide necessary explanations, and to observe and critique whether the patients obey the instructions of the health-care providers. We will present a prototype which supports women with gestational diabetes mellitus.

Ambulatory Care↗
PubMed1996

Informatics and computational neuroanatomy.

Rapid and convenient access to digital image archives, as well as archive-based computational tools, are fundamental to many hypothesis-driven investigations of brain anatomy and function in health and disease. The complexity and density of brain image data requires the design of intelligent tools which allow scientific and clinical data, collected at numerous research centers, to be compared, integrated, and disseminated. We describe our results in the development of image data navigational tools, a World Wide Web repository of image analysis software, and strategies to represent populations of brain image data involving atlas descriptions of its variance.

Algorithms↗
PubMed1996

A Web-based repository manager for brain mapping data.

The Web provides a rapid prototyping environment for building platform-independent graphical user interfaces. A Web-based console can be implemented as a suite of CGI scripts that generate HTML code, manipulate files, execute system commands, and invoke external tools. Often these tools share data by reading and writing flat files, which must be explicitly maintained by the CGI programmer. In a repository system, meta-data about each file object are maintained in a database, and access to all data is regulated by a layer of control services. This paper describes the design and implementation of a Web-based Repository Manager (WRM), which provides an application programmer's interface for controlling applications, generating HTML documents, handling Web forms, and managing multi-media data. The WRM is being used to develop a console for the Brain Mapping Framework, a system for visualizing cortical stimulation data obtained during neurosurgery.

Brain Mapping↗
PubMed1996

Knowledge representation for platform-independent structured reporting.

Structured reporting systems allow health care providers to record observations using predetermined data elements and formats. We present a generalized language, based on the Standard Generalized Markup Language (SGML), for platform-independent structured reporting. DRML (Data-entry and Report Markup Language) specifies hierarchically organized concepts to be included in data-entry forms and reports. DRML documents serve as the knowledge base for SPIDER, a reporting system that uses the World Wide Web as its data-entry medium. SPIDER generates platform-independent documents that incorporate familiar data-entry objects such as text windows, checkboxes, and radio buttons. From the data entered on these forms, SPIDER uses its knowledge base to generate outline-format textual reports, and creates datasets for analysis of aggregate results. DRML allows knowledge engineers to design a wide variety of clinical reports and survey instruments.

Computer Communication Networks↗
PubMed1996

Experiences with a distributed virtual patient record system.

TeleMed is a distributed diagnosis and analysis system, which permits physicians who are not collocated to consult on the status of a patient. The patient's record is dynamically constructed from data that may reside at several sites but which can be quickly assembled for viewing by pointing to the patient's name. Then, a graphical patient record appears, through which consulting physicians can retrieve textual and radiographic data with a single mouse click. TeleMed uses modern distributed object technology and emerging telecollaboration tools.

Computer Communication Networks↗
PubMed1996

An information system to improve the safety and efficiency of chemotherapy ordering.

We developed a computer application to support the ordering of chemotherapy. Key goals were to guard against errors in chemotherapy ordering and dosing, to, coordinate the outpatient and inpatient chemotherapy services, and to support the overall process flow of a chemotherapy cycle. In a six-month period, 512 daily-dose and 386 weekly-dose warnings were generated; 167 (19%) resulted in a cancellation or re-evaluation of the dose. The system has been well accepted, and has helped to coordinate the efforts of the many members of the oncology care team.

Antineoplastic Agents↗
PubMed1996

Impact of a computerized patient tracking system in a pediatric clinic.

A computerized patient tracking system with an intuitive graphical interface was deployed in a large multidisciplinary pediatric outpatient clinic and has been enthusiastically embraced by both physicians and non-physician staff. Usage of the computerized patient tracking system has been associated with a significant decrease in the total time patients spend in the clinic. The total duration of an average patient visit has declined from 99.25 +/- 57.44 minutes to 66.94 +/- 30.47 minutes (p = 0.03). Most of this decrease has been due to a decrease in total waiting time from 54.17 +/- 37.61 minutes to 27.29 +/- 14.05 minutes (p = 0.006). Usage of the patient tracking system has also been associated with a significant increase in examination room utilization during peak business hours from 58.47 +/- 21.18% to 64.49 +/- 13.38% (p = 0.0329).

Ambulatory Care Facilities↗
PubMed1996

GTDS--a tool for tumor registries to support shared patient care.

German hospital tumor registries play an active role in the treatment of cancer patients. Besides the documentation of the course of a disease, they directly support medical treatment and follow-up care over a long period. As the treatment of oncologic patients is a shared multidisciplinary task, the availability of information is one of the most valuable outputs. Therefore, the documentation has to be integrated into the medical treatment, which only can be achieved when useful services are based on it. Since 1983 the basis of the documentation has been a uniform basic data set which was revised in 1990 and, according to be requirements mentioned above, allows detailed documentation, especially of therapy. During the last four years a new documentation system for tumor diseases has been developed and was implemented in 30 hospital tumor registries by the "Arbeitsgruppe zur Koordination Klinischer Krebsregister". The so-called "Giessener Tumordokumentationssystem" (GTDS) is the basis of the work in those registries. In this paper the functions and services which were implemented in order to support the individual treatment of oncologic patients and the methods of collecting and delivering that information to the physician are presented.

Documentation↗
PubMed1996

Assessment of a knowledge-acquisition tool for writing Medical Logic Modules in the Arden Syntax.

We have created a tool that allows users unfamiliar with the Arden Syntax and our underlying database to create Medical Logic Modules (MLMs). In a study of this tool (N 16), subjects found it easy to use (mean score - 4.69 on a scale of 1-5, 5 being best). Each subject created 3 MLMs of varying complexity following a protocol. On average, subjects required 312, 308 and 318 seconds, respectively, to complete each MLM. Comparison of clinicians to non-clinicians and those with to those without knowledge of Arden showed no significant difference. Of the 48 MLMs, 47 compiled and executed with appropriate output. Independent manual review of the MLM correlated well and found few errors. We conclude that our tool is easily used by inexperienced persons to write MLMs in the Arden Syntax.

Artificial Intelligence↗
PubMed1996

Clinical decision support for physician order-entry: design challenges.

We report on a joint development effort between ALLTEL Information Services Health Care Division and IBM Worldwide Healthcare Industry to demonstrate concurrent clinical decision support using Arden Syntax at order-entry time. The goal of the partnership is to build a high performance CDS toolkit that may be easily customized for multiple health care enterprises. Our work uses and promotes open technologies and health care standards while building a generalizable interface to a legacy patient-care system and clinical database. This paper identifies four areas of design challenges and solutions unique to a concurrent order-entry environment: the clinical information model, the currency of the patient virtual chart, the granularity of event triggers and rule evaluation context, and performance.

Artificial Intelligence↗
PubMed1996

Evolution of a legacy system to a Web patient record server: leveraging investment while opening the system.

A layered system is under development to enhance our legacy system as a backend in a WEB-enabled system. Each layer of the system has defined functionality, leverages the investment in the layer below, and follows the strategy of reducing support requirements for workstations. The mainframe system provides administrative integration of sub-systems, security, and the central data repository for most information. The second layer is a graphical user interface (GUI) to the system for Windows platforms. Support needs are limited by relying chiefly on X-terminals and application servers. The "Intranet" layer is a WEB Server building upon the second layer gateways to provide platform-independent access to selected information and images. The fourth layer, under evaluation, will extend access to the central data repository for Internet users of web browsers that support private-key/public-key encryption.

Computer Communication Networks↗