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PubMed1991

The use of graphic design in an interactive computer teaching program.

The widespread diffusion of affordable computers into the scientific and educational community has provided the opportunity to design medical and scientific teaching programs illustrated either by hand or by utilizing commercially available software and manipulating existing computer generated images. The medical illustrator can provide the ideal aesthetic link between text format information and the visual representation of such knowledge in a concise presentation format. The availability of interactive multimedia programs has given the medical illustrator an environment to create and enhance Hypermedia designed specifically for the purpose of medical education. This paper will focus on the incorporation of illustration and screen design into "CT The Game," an experimental medical teaching program currently being developed in the Johns Hopkins Body CT Imaging Laboratory. The program is designed to provide an enjoyable approach to learning Computed Tomography (CT), and is directed toward an audience of medical students, residents, and fellows.

Computer Graphics↗
PubMed1987

A computer simulation program to facilitate budgeting and staffing decisions in an intensive care unit.

ICUs have unique problems in choosing their best staffing levels for direct patient care because each unit's total patient needs per shift, quantitated in acuity points, vary widely. We devised a computer program to simulate our 12-bed medical/cardiac ICU workload and staffing system. Nursing staffing policies, costs, and availabilities, and a table of past patient acuities per shift were input; total overstaffing, understaffing, and cost per year for full-time nursing equivalents (FTEs) for direct patient care were output for different staffing levels. Using the model, we considered financial concerns, quality of care issues, and staff working preferences and determined that our best staffing level would be based on 5.5 direct FTEs per shift. The stimulation analysis is straightforward, flexible, adaptable, and easy to update and use.

Budgets↗
PubMedDate not supplied

ESTAGEST: an obstetrical application program in BASIC for the computation of estimated date of confinement.

The establishment of the estimated date of confinement (EDC) is an essential element in the care of pregnant women. Unfortunately, accurate information on the last menstrual period, the usual determinant of EDC, is not always available, or clinical estimations of gestational age may be discrepant. Prior studies have demonstrated that an average of several clinical examinations can provide a useful prediction of EDC. We have developed a simple BASIC computer program which allows the clinician to input up to 20 clinical examinations and determines the average EDC based on the clinical dates. The program displays the EDC for each individual examination, which provides an indication of the dispersion, or discrepancy, among the examinations. Average intervals to delivery date from the occurrence of clinical estimators of gestation are based on observed data at our institution and can be easily modified to fit local norms.

Algorithms↗
PubMedDate not supplied

A theory-based computer training program.

Using Kolb's learning theory resulted in an effective method of implementing a computer training program. The variety of teaching strategies provided an environment for nurses and other health care providers with different learning styles to understand and use the computer system successfully. The comprehensive training program was critical to the successful conversion to a new computer system in this large public teaching hospital. This project reinforces the need for nursing education and research departments to use teaching strategies that accommodate a variety of learning styles in a heterogenous group. The results of this project suggest one approach to stimulate adult learning and facilitate an effective learning environment. Nurses and other computer users have demonstrated effectiveness of this training program through successful activation of the new computer system.

Computer User Training↗
PubMed1978

Clinicians, the Mount Sinai program and the Veterans' Administration program evaluated against clinico-pathological data derived independently of the electrocardiogram.

221 electrocardiograms (ECGs) recorded from adult subjects with cardiac symptomatology were interpreted by clinicians and the Mount Sinai (MS) and Veterans' Administration (VA) computer programs. After the clinicians had eliminated their interobserver variability, their interpretations and those of the computer programs were compared with the corresponding clinico-pathological data that had been derived independently of the ECG. A measure of overall diagnostic accuracy was used which showed that the performance of the 2 computer programs was similar and somewhat worse than that of the clinicians. The clinicians and the computer programs were not as good at diagnosing the ECGs of women as at diagnosing those of men. As the VA program's interpretations may be altered by including information about the patient's provisional diagnosis, 6 different sets of these prior probabilities were used to analyse 141 of the original 221 ECGs. Different fixed sets of prior probabilities made only a small difference to overall diagnostic accuracy but a marked difference to the VA program's ability to differentiate Normal from Abnormal. Optimizing the prior probabilities for the individual subjects increased the VA program's overall diagnostic accuracy up to that of the clinicians. Both computer programs correctly diagnosed sinus rhythm as the dominant rhythm in 165 out of 177 subjects. The MS program diagnosed the dominant rhythm as Atrial Fibrillation in 35 out of 41 subjects and the VA program in 27 (X(2) = 3.24; not significant). ECG interpretation; Mount Sinai program; Veterans' Administration program; independent clinico-pathological data; sex differences in the ECG; prior probabilities.

Adult↗
PubMed2003

Computer-automated quantification of plus disease in retinopathy of prematurity.

BACKGROUND: In some cases of retinopathy of prematurity (ROP), it difficult to determine with certainty whether plus disease is present or absent. We have developed a computer program that captures digital images from a video-indirect ophthalmoscope, identifies and traces the major posterior pole blood vessels, measures the dilation and tortuosity of each vessel, and calculates whether or not an eye has plus disease. Our purpose was to determine the accuracy of the computer program in comparison with two masked examiners. METHODS: A representative sample of posterior pole images from 20 premature infants, 10 normal and 10 representing various degrees of dilation and tortuosity, was extracted from our video database and analyzed by the computer program as well as by two masked examiners experienced in the diagnosis of ROP. The standard photograph from the Cryotherapy for ROP study, representing the minimum degree of dilation and tortuosity required for plus disease, was also digitized, analyzed, and used as a numeric comparison for the automated determination of plus disease. RESULTS: Of the five images determined to have plus disease by both examiners, four were calculated to have plus disease by the computer program (80% sensitivity). Of the 11 images without plus disease, 10 were calculated not to have plus disease by the computer program (91% specificity). CONCLUSIONS: Our computer program has very good sensitivity and specificity compared with masked examiners' determination of the presence or absence of plus disease. Automated analysis of dilation and tortuosity of posterior pole blood vessels has the potential to remove subjectivity from the determination of plus disease.

Diagnosis, Computer-Assisted↗
PubMed2000

[Computer simulation programs as an alternative for classical nerve, muscle and heart experiments using frog tissues].

Courses in Physiology include different methodical approaches such as exercises with living animals, experiments using organs or tissues from killed or slaughtered animals, application of diagnostic techniques in humans and theoretical seminars. In addition to these classical approaches computer programs for multimedia simulation of nerve, muscle and heart physiology are now a regular component of courses in Physiology at the School of Veterinary Medicine in Hannover. It is the aim of the present paper to give the first experiences about these new components.

Animal Testing Alternatives↗
PubMed1988

Laboratory use of the personal computer: a program in MS-DOS BASIC, for generating specimen labels and data sheets for electron microscopy.

Conventionally, all specimen vial and block labels are handwritten or typed, a labor-intensive process open to human error, particularly in a lab that processes large numbers of samples. The computer program described in this report was developed to reduce or eliminate this problem. The program is menu-driven, asking specific information from the user, and runs on an IBM PC (or compatible). It is designed to accurately produce specimen collection vial labels, resin block labels, and data sheets for inclusion in a research notebook. A task that in the past may have required much time at the typewriter can now be accomplished without error in a few minutes. Although designed to fit the needs of a pathology laboratory, the program (written in BASIC) can be easily modified to fit other applications.

Microcomputers↗
PubMed1986

Efficacy of computer-assisted management of respiratory failure in neonates.

We modified an algorithm for mechanical ventilation of infants with respiratory distress syndrome to create an interactive user-friendly computer program. To determine the effectiveness of this computer program, we evaluated the correction of deranged arterial blood gases in three groups of neonates: group I, treated before the introduction of the computer into the nursery; group II, managed by pediatric residents with the guidance of the computer program; group III, treated after the introduction of the computer into the nursery but managed without consideration of the computer output. Arterial blood gas values improved more frequently in the neonates managed with computer consultation (group II, 65/75, 87%) than in both control groups (group I, 37/57, 65%, P less than .005; and group III, 46/63, 73%, P less than .05). Furthermore, increases in ventilatory support in the presence of normal arterial blood gas values occurred only in patients managed without computer guidance. In a teaching institution, more effective care of neonates with respiratory failure may be facilitated by computer-assisted management of mechanical ventilators.

Blood Gas Analysis↗
PubMed2000

Granularity of the carotid artery intima-medial layer: reproducibility of quantification by a computer-based program.

Ultrasound of the carotid artery identifies the hypoechoic intima-medial layer (IML). Increased granularity of the IML has been associated with early atherosclerosis. The aim of the study was to assess the reproducibility and observer agreement of a computer-based program measure of IML granularity. Ten healthy adult volunteers (median age 32 years, range 18-34 years) were examined twice, 2 weeks apart, with a 7 MHz linear transducer using standardized imaging settings, by two observers. Images of both common carotid arteries were digitized and analysed on a customized computer program. The ratio (averaged over a 1 cm length of arterial wall) of the lowest pixel brightness in the IML to the maximum pixel brightness in the intima-medial interface was determined. Overall mean intima-medial reflectivity (IMR) indices for the two observers were 0.761 +/- 0.101 and 0.707 +/- 0.103, with single determination standard deviation values of 0.090 and 0.073, respectively. For interobserver calculations, the overall mean IMR index for both sessions was 0.734 +/- 0.107, with a single determination standard deviation of 0.067. Comparison with the intima-medial thickness (IMT) showed an inverse correlation (r = -0.72). This method of quantifying the reflectivity of the IML demonstrates good reproducibility in subjects with normal IMT measurements. The technique may be of value in identifying subjects at high risk of atherosclerosis but with IMT still within the normal range.

Adolescent↗
PubMed1988

A computer graphics program system for protein structure representation.

We have developed a computer graphics program system for the schematic representation of several protein secondary structure analysis algorithms. The programs calculate the probability of occurrence of alpha-helix, beta-sheet and beta-turns by the method of Chou and Fasman and assign unique predicted structure to each residue using a novel conflict resolution algorithm based on maximum likelihood. A detailed structure map containing secondary structure, hydrophobicity, sequence identity, sequence numbering and the location of putative N-linked glycosylation sites is then produced. In addition, helical wheel diagrams and hydrophobic moment calculations can be performed to further analyze the properties of selected regions of the sequence. As they require only structure specification as input, the graphics programs can easily be adapted for use with other secondary structure prediction schemes. The use of these programs to analyze protein structure-function relationships is described and evaluated.

Algorithms↗
PubMed1997

Using an interactive computer game to increase skill and self-efficacy regarding safer sex negotiation: field test results.

This article describes the development, field testing, and evaluation of an interactive computer program, "Life Challenge," developed by the New York State Department of Health as a tool for enhancing adolescents' sense of self-efficacy in HIV/AIDS prevention programs. The computer kiosks were field tested in 13 sites serving high-risk adolescents. The program uses a time travel adventure game format to provide information and nonthreatening skill practice. Users record and play back their responses as they "negotiate" with their chosen partners. A proof of concept evaluation with analysis of 211 audio responses found that users took negotiating tasks seriously; statistically significant learning gains were achieved on knowledge items and in self-efficacy scores (greatest improvement for those with low baseline self-efficacy levels). Challenges and problems encountered in implementing the project are described, and the potential of using computers for skill practice and educational interventions in health education is explored.

Adolescent↗
PubMed1983

Interactive electronic computing of the mortality odds ratio.

An interactive computer program which computes the standardized mortality odds ratio and the standardized proportional mortality ratio has been developed for use in the analysis of occupational mortality studies. The program provides flexibility in the selection of the comparison (unexposed) population, permitting both internal and external comparison, including comparison with the United States general population. Considerable control for potential confounding factors and for differences in information collection procedures can be exercised through careful choice of the comparison population. The user must select the reference cause(s) of death among 55 categories (59 for women). The condition for equivalence of the standardized mortality odds ratio and the standardized mortality ratio will be met when the selected reference cause(s) is unrelated to the exposure. The program reduces the loss of information due to sparse data during stratification by allowing the user to define the length of the age and time intervals. The program is written in Fortran IV and is designed to produce rapid, cost-efficient interactive results on any mainframe computer system.

Adult↗
PubMed1988

ERCP diagnosis of tumors in the region of the head of the pancreas. Analysis of criteria and computer-aided diagnosis.

During the period 1974-1983, 320 patients with pancreas carcinoma, papilla of Vater carcinoma, bile duct bifurcation carcinoma, or duodenal carcinoma were examined by ERCP. Using 30 ERCP criteria, a radiological diagnosis was made. A valid pathological diagnosis was available in 200 patients (62.5%). In 183 of the 200 patients (91.5%), the ERCP diagnosis and the pathological diagnosis were identical. We then performed an analysis using 52 ERCP criteria. In 192 of the 200 patients (96.0%), the ERCP diagnosis based on this reanalysis and the pathological diagnosis were identical. By discriminant analysis, 13 ERCP criteria with a maximal discriminatory value were selected in patients in whom all diagnostic structures (bile ducts, pancreatic duct, and duodenum) were visible. Using these 13 criteria selected by discriminant analysis, the diagnostic score was 98.9%. A computer program based on these 13 ERCP criteria was designed for use in practice. The diagnostic accuracy of this computer program was 98.4%. Finally we tested this computer program on 171 new patients who were seen in the period 1983-1986. In 143 of the 171 patients, a valid pathological diagnosis was available (83.6%). Comparing the ERCP diagnosis in all patients (even if not all structures were visible) with a valid pathological diagnosis, the prospective score of the computer program was 91.6%. Using this program it was possible to evaluate examinations in which not all structures were visible. When the ERCP diagnosis was uncertain, the doubt could be quantified.

Ampulla of Vater↗
PubMed2004

Predictability of soft tissue profile changes following bimaxillary surgery in skeletal class III Chinese patients.

PURPOSE: The aim of this study was to evaluate the accuracy of soft tissue profile predictions generated by a recently developed computer program (Computer-Assisted Simulation System for Orthognathic Surgery [CASSOS] 2001, SoftEnable Technology, Ltd, Hong Kong) in Chinese skeletal Class III patients treated with bimaxillary surgery. MATERIALS AND METHODS: Presurgical and posttreatment lateral cephalograms of 35 Chinese patients who had combined 1-piece Le Fort I and bilateral sagittal split osteotomies were digitized using the CASSOS 2001 program, and a cranial base superimposition was performed. The hard tissue movements were simulated on the presurgical cephalogram until good superimposition of the hard tissues on the presurgical and posttreatment cephalograms was achieved. A customized cephalometric analysis consisting of 32 linear measurements was used to analyze the differences in the soft tissue profile between the actual posttreatment results and the computer-generated predictions. RESULTS: Comparison of the predicted and actual changes found that 16 of the 32 soft tissue measurements were significantly different ( P <.05). Most of the significant prediction errors were observed in the upper and lower lip region. The software tended to underestimate the vertical position of both the upper and lower lip and overestimate the horizontal position of the lower lip. However, the mean differences were relatively small, with the greatest mean difference being 2 mm in the vertical position of stomium inferius. The CASSOS 2001 program produced a clinically useful prediction of soft tissue profile changes following bimaxillary surgery in skeletal Class III Chinese patients.

Adolescent↗
PubMed1995

A portable software tool for computing digitally reconstructed radiographs.

PURPOSE: To develop a portable software tool for fast computation of digitally reconstructed radiographs (DRR) with a friendly user interface and versatile image format and display options. To provide a means for interfacing with commercial and custom three-dimensional (3D) treatment planning systems. To make the tool freely available to the Radiation Oncology community. METHODS AND MATERIALS: A computer program for computing DRRs was enhanced with new features and rewritten to increase computational efficiency. A graphical user interface was added to improve ease of data input and DRR display. Installer, programmer, and user manuals were written, and installation test data sets were developed. The code conforms to the specifications of the Cooperative Working Group (CWG) of the National Cancer Institute (NCI) Contract on Radiotherapy Treatment Planning Tools. RESULTS: The interface allows the user to select DRR input data and image formats primarily by point-and-click mouse operations. Digitally reconstructed radiograph formats are predefined by configuration files that specify 19 calculation parameters. Enhancements include improved contrast resolution for visualizing surgical clips, an extended source model to stimulate the penumbra region in a computed port film, and the ability to easily modify the CT numbers of objects contoured on the planning computed tomography (CT) scans. CONCLUSIONS: The DRR tool can be used with 3D planning systems that lack this functionality, or perhaps improve the quality and functionality of existing DRR software. The tool can be interfaced to 3D planning systems that run on most modern graphics workstations, and can also function as a stand-alone program.

Radiographic Image Enhancement↗
PubMed1985

Computer analysis of toxicological data bases: mutagenicity of aromatic amines in Salmonella tester strains.

There is an increasing problem in the world of toxicological evaluation in that, while test results of new compounds are appearing regularly, traditional methods of analysis of such data are cumbersome and slow. The new computer program CASE (computer automated structure evaluator) was designed to handle just such problems. It analyzes molecules and their associated biological activity on the basis of structural fragments found and identified by the program as being important for the activity based on statistical tests of significance. The program was used to examine mutagenicity in Salmonella typhimurium strains TA98 and TA100 (with S9 activation) of approximately 80-100 aromatic amines. The resulting structural features were then used in a predictive fashion to test the expected mutagenic properties of a smaller set of about 20 compounds.

Amines↗