Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Computer Systems”

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 1,621 records · Page 90Linked to original sources
PubMed1977

Diagnosis of acute abdominal pain in the accident and emergency department.

This paper reports the findings in a study involving 1537 patients with 'acute abdominal pain' presenting over a 13-month period to the Accident and Emergency Department of the General Infirmary at Leeds. Of these, 341 patients who proved to have pain of greater duration than a week, pain incidental to some other identifiable condition or no pain at the time of their attendance were excluded. The remaining 1196 were diagnosed clinically (using a structured case sheet) and subsequently by a Bayesian computer system. Feedback of the results of clinical and computer systems was given to clinicians at regular intervals. Clinical diagnostic accuracy in patients with surgical disorders rose from 40 per cent before the study to 61 per cent. Computer accuracy in these patients was 69-9 per cent. The proportion of patients sent home without ill effects rose from 20 per cent to 39 per cent. In other areas (e.g. gynaecology) the effects were less marked. It is suggested that the introduction of a simple postgraduate educational service, aided by a small computer, might prove of practical benefit in this clinical situation.

Abdomen, Acute↗
PubMed1987

Computer aided diagnosis of jaundice. A comparison of two data bases.

A computer system for probabilistic diagnosis of jaundice was tested on a patient sample from a geographical area different from that for which it was first constructed. 144 consecutive patients with jaundice seen in two Stockholm hospitals were interviewed and examined to record a total of 82 indicants from history, demographic details, physical findings and laboratory tests. Data were compared with those of 319 jaundiced patients previously interviewed and examined at different London hospitals. It was found that disease incidences were different in the two patient samples. There were more patients with acute viral hepatitis, chronic active hepatitis and primary biliary cirrhosis in the London data base whereas the Stockholm data base included significantly more patients with Gilbert's syndrome and alcoholic cirrhosis. Indicant frequencies, standardised for disease incidence, differed with respect to age (Stockholm patients were on average six years older), time from onset of first symptom to hospital admission (Stockholm patients had on average a two-week shorter history of disease) and a number of symptoms such as nausea, vomiting, anorexia, weight loss, itching, pale stools and dark urine which were more frequent among the London patients. Differences in hospital admission policy was regarded as an important reason for the differences in indicant frequency. The results of probabilistic diagnosis were poor. Only 49% of the cases were correctly classified into twelve diagnostic groups. In particular the computer model was poor at separating different causes of malignant bile duct obstruction and at differentiating between malignant and benign bile duct obstruction. However, all cases of acute viral hepatitis were correctly classified and the computer model was 87% accurate in differentiating between medical and surgical jaundice. Reclassification of the 144 patients on their own data showed the computer system to be well calibrated and 97% of the cases were correctly classified according to this procedure. In conclusion, the computer system could not be directly transferred for use in a Swedish hospital but the results of reclassification were sufficiently encouraging to warrant prospective studies.

Adult↗
PubMed1981

Consumer-oriented versus technology-oriented systems: designing services for people.

Current computer systems providing consumer services seem to be designed primarily on 'technology-oriented' thinking, based on the 'efficiency' and the operating methods of the computer. To be of benefit to a wider variety of consumers, the system design may have to reflect a more 'consumer-oriented' approach, based on factors such as the needs, preferences, skills and knowledge of the user. This article demonstrates the differences between user evaluations of two computer systems designed to help in house-hunting, modelled on (a) consumer-oriented, and (b) technology-oriented approaches. Although particularly relevant to consumer systems, the article may have important implications for consumer and public services in general.

Journal Article↗
PubMedDate not supplied

Buying a healthcare information system.

Replacing an antiquated computer system with state of the art equipment and software is a lengthy, at times frustrating, and never an easy decision. At Wesley Woods Center on Aging, Atlanta, an integrated provider of healthcare for the elderly affiliated with Emory University, the process consumed more than two and a half years. This article takes the reader through the entire process, from the initial decision to replace an existing system, through the final purchase and installation. It looks candidly at the problems that were encountered, including turnover among key personnel, difficulties with involving all of the user groups, changes in the technology and coordination with the University. The lessons Wesley Woods learned in its experience can be of benefit to any healthcare facility contemplating an information system change.

Aged↗
PubMed2001

A probabilistic method for identifying start codons in bacterial genomes.

As the pace of genome sequencing has accelerated, the need for highly accurate gene prediction systems has grown. Computational systems for identifying genes in prokaryotic genomes have sensitivities of 98-99% or higher (Delcher et al., Nucleic Acids Res., 27, 4636-4641, 1999). These accuracy figures are calculated by comparing the locations of verified stop codons to the predictions. Determining the accuracy of start codon prediction is more problematic, however, due to the relatively small number of start sites that have been confirmed by independent, non-computational methods. Nonetheless, the accuracy of gene finders at predicting the exact gene boundaries at both the 5' and 3' ends of genes is of critical importance for microbial genome annotation, especially in light of the important signaling information that is sometimes found on the 5' end of a protein coding region. In this paper we propose a probabilistic method to improve the accuracy of gene identification systems at finding precise translation start sites. The new system, RBSfinder, is tested on a validated set of genes from Escherichia coli, for which it improves the accuracy of start site locations predicted by computational gene finding systems from the range 67-77% to 90% correct.

Algorithms↗
PubMedDate not supplied

Collaborative efforts for representing nursing concepts in computer-based systems: international perspectives.

Current nursing terminology efforts have converged toward meeting the demand for a reference terminology for nursing concepts by building on the foundation of existing interface and administrative terminologies and by collaborating with terminology efforts across the spectrum of health care. In this article, the authors illustrate how collaboration is promoting convergence toward a reference terminology for nursing by briefly summarizing a wide range of exemplary activities. These include: 1) the International Classification of Nursing Practice (ICNP) activities of the International Council of Nurses (ICN), 2) work in Brazil and Korea that has contributed to, and been stimulated by, ICNP developments, 3) efforts in the United States to improve understanding of the different types of terminologies needed in nursing and to promote harmonization and linking among them, and 4) current nursing participation in major multi-disciplinary standards initiatives. Although early nursing terminology work occurred primarily in isolation and resulted in some duplicative efforts, the activities summarized in this article demonstrate a tremendous level of collaboration and convergence not only in the discipline of nursing but in multi-disciplinary standards initiatives. These efforts are an important prerequisite for ensuring that nursing concepts are represented in computer-based systems in a manner that facilitates multi-purpose use at local, national, regional, and international levels.

Medical Informatics Applications↗
PubMed1991

[Estimation of sample size in randomized controlled clinical trials--elimination of various systematic biases by the utilization of computer network system].

Although sample size calculation is mandatory in clinical trials, the power of most of the published small size clinical studies, was only about 0.25 instead of 0.80 which is normally required in a standard randomized controlled trial. This phenomenon is probably due to the publication bias. In a cancer clinical study, the ideal sample size needed in a trial exceeds over a thousand, when significance level was fixed under 0.05 and treatment difference is estimated from 10 to 15%. In such cases, evaluation of a new treatment in less common cancers or in a specified strata become unfeasible. Although statistically plausible clinical trial is difficult, small trials of newly advocated treatment is likely to be performed elsewhere, and presentation of these haphazard results might propagate a wrong information about the new treatment. To prevent the dissemination of these biased results, 1) preregistration of all planned clinical trials to an authorized organization before the initiation of the trial, 2) randomization of the patients entered in the trial from the first case, and 3) registration of all available data of the patients and meta-analysis of preregistered multiple trials, should be the most effective counterplans. In order to achieve those functions, installation of a computer assisted coordinating center is considered to be the best solution for the proper evaluation of the clinical trial as well as for the evaluation of a new treatment. With the collaboration of regional affiliating hospitals, a pilot study have started to establish a computer network system.

Database Management Systems↗
PubMed1993

Optimisation of a computer vision system for the interpretation of American Sign Language.

Presented in this paper is a simulation algorithm for the optimisation of camera position with respect to the signer, to have a full and reliable interpretation of the American Sign Language. The simulation includes a three-dimensional world point into two-dimensional image point transformation algorithm, the effect of the depth information loss and a sign projection correction test. It is concluded that the viewing camera should be positioned at any point in a specified area subtended by a solid angle of 30 degrees, where the centre of the area is located at 45 degrees in the azimuth and 45 degrees in elevation relative to the signer. The theory and the technique are tested with regard to the efficiency of interpreting American Sign Language (ASL) by two adult signers. One of the signers had been using ASL on a regular basis since infancy, and the second signer had signed for the past five years. It is demonstrated that positioning the camera anywhere in the specified area provides a 96 per cent correct interpretation of the 36 signs tested. The results also provide a preliminary indication that signer variability may not present a major problem in interpretation, and that a computer vision system which captures the optimum depth information can distinguish between signs which, to the naked eye, appear to have similar characteristics.

Algorithms↗
PubMed1981

Computer-assisted antibiotic use review.

The use of a computer system for an antibiotic review program is described. A commercial system was selected as the software base for the development of the antibiotic use review (AUR) program. The AUR system is composed of three parts: (1) editing and verifying data from the patient's pharmacy profile card, (2) updating the data base, and (3) generation of reports. The system is flexible in its reporting capabilities. Potential functions of the system include identifying patterns of bacterial resistance. The computer system is an efficient tool for the clinical review of antibiotic use in a quality assurance program.

Anti-Bacterial Agents↗
PubMed1995

Tracing the planned probe trajectory on axial computed tomography slices: a computation-based support for stereotactic procedures. A computational tool for tracing of probe trajectories on CT slices.

Stereotactic frames are designed to hit point-like intracranial targets. Their routine performance does not include a display of the intended transcerebral probe path. Since the latter can render stereotactic procedures safer, more accurate and versatile, it has increasingly been implemented by potent computer systems. A low-cost alternative is presented in the form of a small extension of the computation program which is usually employed for the conversion of imaging coordinates to frame adjustments. It allows any desired point on the planned probe trajectory, in terms of its distance to the target, to be defined in Cartesian coordinates and thus to be traced on computed tomography. Thus, in biopsy procedures, for instance, instead of sampling tissue at the target only or in a 'blind' serial way, samples can be collected in a previewed and therefore safer and more purposeful way, thereby improving the yield of pathological tissue. The method seems particularly interesting for institutions that have a low to moderate number of stereotactic procedures and for which the investment of sophisticated computer systems for this purpose alone would not be economically feasible.

Biopsy↗
PubMed2003

Accuracy evaluation of a shape-based registration method for a computer navigation system for total knee arthroplasty.

This study evaluated the effect of computed tomography (CT) slice thickness, reconstruction pitch, intraoperative data sampling area, and data sampling volume on the accuracy of registration and determined a clinically acceptable trade-off between accuracy and surgical invasiveness. One cadaveric femur and one cadaveric tibia were used. Computed tomography of the femur and tibia were obtained using a helical scanner. Three sets of slice thickness and slice pitch were chosen for data acquisition, and two additional sets of reconstructed data were made. Bone contours were extracted by removing surrounding substrate. Surface models of bones were made from the resulting data. Registration of surface models to real objects was performed by measuring the position of various surface points on various areas of each object using an OPTOTRAK pen-probe (Northern Digital Inc, Ontario, Canada). The following trade-off is proposed as clinically optimal: perform CT with 3-mm slice thickness and 1-mm reconstruction pitch, and sample a periarticular area of 30 sampling points. The accuracy of registration in terms of position and angle was 0.8 mm and 0.6 degrees of bias with 0.2 mm and 0.3 degrees of root-mean-square in the femur, and 0.5 mm and 0.4 degrees of bias with 0.2 mm and 0.3 degrees of root-mean-square in the tibia.

Arthroplasty, Replacement, Knee↗
PubMed1997

KAMEDIN: a telemedicine system for computer supported cooperative work and remote image analysis in radiology.

The software system KAMEDIN (Kooperatives Arbeiten und MEdizinische Diagnostik auf Innovativen Netzen) is a multimedia telemedicine system for exchange, cooperative diagnostics, and remote analysis of digital medical image data. It provides components for visualisation, processing, and synchronised audio-visual discussion of medical images. Techniques of computer supported cooperative work (CSCW) synchronise user interactions during a teleconference. Visibility of both local and remote cursor on the conference workstations facilitates telepointing and reinforces the conference partner's telepresence. Audio communication during teleconferences is supported by an integrated audio component. Furthermore, brain tissue segmentation with artificial neural networks can be performed on an external supercomputer as a remote image analysis procedure. KAMEDIN is designed as a low cost CSCW tool for ISDN based telecommunication. However it can be used on any TCP/IP supporting network. In a field test, KAMEDIN was installed in 15 clinics and medical departments to validate the systems' usability. The telemedicine system KAMEDIN has been developed, tested, and evaluated within a research project sponsored by German Telekom.

Humans↗
PubMed2006

Evaluation of the diagnostic value of a computed radiography system by comparison of digital hard copy images with screen-film mammography: results of a prospective clinical trial.

The purpose of the study was to determine prospectively the diagnostic value of a computed radiography (CR) system by comparing mammographic hard copy images with screen-film mammography (SFM). A series of 100 patients, who came for diagnostic investigation, underwent two-view SFM (Lorad M-IV Platinum) and digital mammography with a CR system (AGFA CR system). The images were obtained by double exposure, i.e. same view without removing compression of the corresponding breast. The CR images were processed with dedicated processing for mammography. Six radiologists read sets of SFM and CR images. The primary efficacy parameter was the overall diagnostic value. The secondary efficacy parameters were lesion conspicuity and lesion details (for masses and micro-calcifications), tissue visibility at chest wall and at skin line, axillary details, overall density and sharpness impression and the overall noise impression. These parameters were scored by a 7-point scoring system. "CR non-inferior to SFM" was concluded if the lower confidence interval bound exceeded 80%. The confidence interval for the overall diagnostic value was between 96.4% and 100%. Pooled analysis of the ten features for image quality comparison demonstrated for all but one feature (lesion details of the calcifications) CR non-inferiority to SFM.

Adult↗
PubMed2003

Identification of stroke in the community: a comparison of three methods.

BACKGROUND: Evidence concerning secondary prevention of cerebrovascular disease is not optimally used in clinical practice. A necessary first step is to identify those eligible for treatment. In primary care, this equates to setting up a register of prevalent stroke. AIM: To compare three different methods for identifying prevalent cases of cerebrovascular disease in the community: general practice-based computer systems; population surveys; and hospital-based routine information systems. DESIGN OF STUDY: Comparison of results of each method applied to a defined population and then assessed against reference criteria for cerebrovascular disease. SETTING: A total of 5801 people aged 65 years or over, resident in seven practices situated within the South Birmingham Primary Care Trust area. METHOD: The sensitivity, specificity, and predictive value of each method of identification were calculated against reference criteria applied by two investigators independently of each other. RESULTS: The prevalence of reference criteria-validated cerebrovascular disease in patients aged 65 years or over was 8.2%. Overall, general practice-based computer systems had a sensitivity of 81.0%, a specificity of 97.2% and a positive predictive value (PPV) of 71.8%, but there was a wide range of sensitivity (33% to 90%) and PPV (42% to 92%) between practices. Patient survey and hospital information systems were less sensitive (75.7% and 28.4%, respectively) but had higher PPVs (77.5% and 89.2%, respectively). Thirty-nine per cent of patients with a history of cerebrovascular disease had not been admitted to hospital. CONCLUSION: General practice-based computer systems can produce reasonably accurate prevalent stroke registers. In areas where these are poorly developed, patient survey is an alternative.

Aged↗
PubMed2003

Model building and model checking for biochemical processes.

A central claim of computational systems biology is that, by drawing on mathematical approaches developed in the context of dynamic systems, kinetic analysis, computational theory and logic, it is possible to create powerful simulation, analysis, and reasoning tools for working biologists to decipher existing data, devise new experiments, and ultimately to understand functional properties of genomes, proteomes, cells, organs, and organisms. In this article, a novel computational tool is described that achieves many of the goals of this new discipline. The novelty of this system involves an automaton-based semantics of the temporal evolution of complex biochemical reactions starting from the representation given as a set of differential equations. The related tools also provide ability to qualitatively reason about the systems using a propositional temporal logic that can express an ordered sequence of events succinctly and unambiguously. The implementation of mathematical and computational models in the Simpathica and XSSYS systems is described briefly. Several example applications of these systems to cellular and biochemical processes are presented: the two most prominent are Leibler et al.'s repressilator (an artificial synthesized oscillatory network), and Curto- Voit-Sorribas-Cascante's purine metabolism reaction model.

Biochemical Phenomena↗
PubMed2002

3D-DIASemb: a computer-assisted system for reconstructing and motion analyzing in 4D every cell and nucleus in a developing embryo.

A computer-assisted three-dimensional (3D) system, 3D-DIASemb, has been developed that allows reconstruction and motion analysis of cells and nuclei in a developing embryo. In the system, 75 optical sections through a live embryo are collected in the z axis by using differential interference contrast microscopy. Optical sections for one reconstruction are collected in a 2.5-s period, and this process is repeated every 5 s. The outer perimeter and nuclear perimeter of each cell in the embryo are outlined in each optical section, converted into beta-spline models, and then used to construct 3D faceted images of the surface and nucleus of every cell in the developing embryo. Because all individual components of the embryo (i.e., each cell surface and each nuclear surface) are individually reconstructed, 3D-DIASemb allows isolation and analysis of (1) all or select nuclei in the absence of cell surfaces, (2) any single cell lineage, and (3) any single nuclear lineage through embryogenesis. Because all reconstructions represent mathematical models, 3D-DIASemb computes over 100 motility and dynamic morphology parameters for every cell, nucleus, or group of cells in the developing embryo at time intervals as short as 5 s. Finally, 3D-DIASemb reconstructs and motion analyzes cytoplasmic flow through the generation and analysis of "vector flow plots." To demonstrate the unique capabilities of this new technology, a Caenorhabditis elegans embryo is reconstructed and motion analyzed through the 28-cell stage. Although 3D-DIASemb was developed by using the C. elegans embryo as the experimental model, it can be applied to other embryonic systems. 3D-DIASemb therefore provides a new method for reconstructing and motion analyzing in 4D every cell and nucleus in a live, developing embryo, and should provide a powerful tool for assessing the effects of drugs, environmental perturbations, and mutations on the cellular and nuclear dynamics accompanying embryogenesis.

Animals↗