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At least 1,639 records · Page 91Linked to original sources

3D presentation of the nuclear cell features in quantitative cytometry.

The use of an image cytometer in analysis of smears and needle aspirates provides valuable information to a cytologist. It allows to combine the overall impression, formed by visually inspecting the cells, with measured and numerically expressed nuclear cell features. Both types of information can be used efficiently only if presented to the expert in an appropriate way. Cell images (as they are seen with a microscope) are easily analysed by the experts. However, measured nuclear features can not be presented as a list of numerical values. Instead, an user interface should be developed, providing graphical presentation of the nuclear features. It should show as much information as possible and provide a comprehensive link between nuclear features and cell images. The user interface described in this paper shows nuclear features in three dimensions. It is based on a perspective projection of the three dimensional feature space onto a two dimensional surface. It allows the user to dynamically change the perspective, i.e., to look at the virtual three dimensional structure from different viewpoints. Each nucleus is represented by a single object in the three dimensional space. When an object in the three dimensional feature space is selected, the image (or the visual appearance) of the corresponding cell is shown. When a nucleus image is selected, its position in the feature space is highlighted. This provides an interconnection between nuclear cell features and cell images allowing simultaneous analysis of both types of information.

Cell Nucleus↗

WWW-based interfaces to clinical information systems: the state of the art.

Nine WWW-based interfaces to clinical information systems were reviewed. Five have progressed past the proof of concept phase and into alpha testing in the clinical environment. All key features desirable in an advanced clinical information were present in at least one interface, however many implementations were rudimentary. Much human computer interface research and WWW tool development needs to occur before implementation of a WWW-based interface to a clinical information system should be considered for a mission-critical, production environment.

Computer Communication Networks↗

Evaluation of the Newton Pen-Pad as a tool for collecting clinical research data at the bed-side.

A protocol for the study of practice variation between Quebec Intensive Care Units in the treatment of myocardial infarction by thrombolysis was coded into the Newton Pen-Pad. This tool for the direct recording of clinical data was tested in the working environment by research nurses of 4 different teaching hospitals. Data was sent directly from the pen-pad by telecommunication to the information coordinating center. The results of this evaluation confirm the reliability and robustness of this approach which promises to be an important tool for applied clinical research.

Attitude to Computers↗

Assessment of a cooperative workstation.

Groupware and new Information Technologies have now made it possible for people in different places to work together in synchronous cooperation. Very often, designers of this new type of software are not provided with a model of the common workspace, which is prejudicial to software development and its acceptance by potential users. The authors take the example of a task of medical co-diagnosis, using a multi-media communication workstation. Synchronous cooperative work is made possible by using local ETHERNET or public ISDN Networks. A detailed ergonomic task analysis studies the cognitive functioning of the physicians involved, compares their behaviour in the normal and the mediatized situations, and leads to an interpretation of the likely causes for success or failure of CSCW tools.

Cooperative Behavior↗

Beyond the Web: building information systems with clinical context.

Much of the current research on clinical information systems concentrates on World Wide Web (W3) development. Although the W3 is well suited to many information applications such as nonsensitive data exchange, it has drawbacks that may make it inappropriate for certain clinical environments. We present a solution that addresses many of the W3's limitations by focusing on clinical requirements first and then applying the appropriate technology. We also make a case for clinical information systems researchers to become more involved in the development of Internet standards.

Computer Communication Networks↗

Designing an emergency medicine physician workstation to support risk management in decision making.

The practice of emergency medicine requires rapid decision making. The speed of decision making in the face of limited information contributes to the high risk of medical malpractice suits. We explore design approaches to an emergency physician electronic medical record product, EMstation, that may reduce the risk of adverse medical events by providing cues and tools while the patient may still be in the emergency department. EMstation is an Emergency Medicine Physician Workstation base on a Microsoft Windows 3.1 user interface. Because adaptation and adaptability to physician needs are critical to user acceptance, design to workflow, multisite end user customization, and integrated database support are used to support risk management documentation in EMstation. This article describes techniques that can be incorporated into electronic medical products which may prevent adverse medical events.

Decision Making, Computer-Assisted↗

A decision-supported outpatient practice system.

We describe a Decision-supported Outpatient Practice (DOP) system developed and now in use at the Columbia-Presbyterian Medical Center. DOP is an automated ambulatory medical record system that integrates in-patient and ambulatory care data, and incorporates active and passive decision support mechanisms with a view towards improving the quality of primary care. Active decision support occurs in the form of event-driven reminders created within a remote clinical information system with its central data repository and decision support system (DSS). Novel features of DOP include patient specific health maintenance task lists calculated by the remote DSS. uses of a semantically structured controlled medical vocabulary to support clinical results review and provider data entry, and exploitation of an underlying ambulatory data model that provides for an explicit record of evolution of insight regarding patient management. Benefits, challenges, and plans are discussed.

Ambulatory Care Facilities↗

Voice recognition: an enabling technology for modern health care?

Recent performance breakthroughs in affordable, large vocabulary, speaker independent voice recognition systems have rekindled widespread interest in using voice recognition technology to enhance the palatability and effectiveness of clinician-mediated computing. However, even if industry fully addresses the formidable hardware requirements, less than perfect recognition accuracies, discrete voice recognition requirements, and throughput limitations, there are significant cognitive and implementation issues that must be adequately resolved before voice can become a ubiquitous input modality. Cognitive issues include making allowances for individual differences in verbal communication style and skill levels, the relative cognitive load of using a voice enabled interface compared to alternative modalities, and the user's cognitive style. Implementation issues include a significant training requirement, limited portability, lengthy user switching time, questionable privacy, satisfying hardware requirements and the suitability of voice recognition in specific work environments. The inevitable resolution of these issues coupled with continuously improving voice recognition performance, promises a new era for voice recognition in medicine.

Information Storage and Retrieval↗

Optimizing physician access to surgical intensive care unit laboratory information through mobile computing.

Approximately 30 minutes of computer access time are required by surgical residents at Stanford University Medical Center (SUMC) to examine the lab values of all patients on a surgical intensive care unit (ICU) service, a task that must be performed several times a day. To reduce the time accessing this information and simultaneously increase the readability and currency of the data, we have created a mobile, pen-based user interface and software system that delivers lab results to surgeons in the ICU. The ScroungeMaster system, loaded on a portable tablet computer, retrieves lab results for a subset of patients from the central laboratory computer and stores them in a local database cache. The cache can be updated on command; this update takes approximately 2.7 minutes for all ICU patients being followed by the surgeon, and can be performed as a background task while the user continues to access selected lab results. The user interface presents lab results according to physiologic system. Which labs are displayed first is governed by a layout selection algorithm based on previous accesses to the patient's lab information, physician preferences, and the nature of the patient's medical condition. Initial evaluation of the system has shown that physicians prefer the ScroungeMaster interface to that of existing systems at SUMC and are satisfied with the system's performance. We discuss the evolution of ScroungeMaster and make observations on changes to physician work flow with the presence of mobile, pen-based computing in the ICU.

Algorithms↗

Virtual reality: an assistive technology in neurological rehabilitation.

The need for improved neurological rehabilitation strategies is self-evident. Recent developments in the computer technology of virtual reality hold the promise of exciting progress in this area. In this paper four areas of potential application of virtual reality to neurological rehabilitation are reviewed.

Activities of Daily Living↗

An object-oriented class library for medical software development.

The objective of this research is the development of a Medical Object Library (MOL) consisting of reusable, inheritable, portable, extendable C++ classes that facilitate rapid development of medical software at reduced cost and increased functionality. The result of this research is a library of class objects that range in function from string and hierarchical file handling entities to high level, procedural agents that perform increasingly complex, integrated tasks. A system built upon these classes is compatible with any other system similarly constructed with respect to data definitions, semantics, data organization and storage. As new objects are built, they can be added to the class library for subsequent use. The MOL is a toolkit of software objects intended to support a common file access methodology, a unified medical record structure, consistent message processing, standard graphical display facilities and uniform data collection procedures. This work emphasizes the relationship that potentially exists between the structure of a hierarchical medical record and procedural language components by means of a hierarchical class library and tree structured file access facility. In doing so, it attempts to establish interest in and demonstrate the practicality of the hierarchical medical record model in the modern context of object oriented programming.

Humans↗

[The individual typological characteristics of operator activity during long-term monotonous work on the computer].

Individual neurophysiological and psychophysiological characteristics were analyzed in two groups of subjects with different extraversion and genetically determined levels of cortical activity during learning the novel for them monotonous computer operation. Most of the subjects improved their performance to the end of four-hour work. The degree of visual fatigue correlated with changes in P70 component of the evoked potentials. The intergroup difference was revealed in overcoming the visual discomfort during attention concentration. The visual cortex was facilitated in the introverts with high-voltage cortical activity (1st group) and disfacilitated in the extraverts with the low-voltage cortical activity (2nd group). Increase of the simple motor reaction time in the extraverts is considered as a result of temporary impairment of the visual function during the monotonous operator's work, and the worsening of the emotional condition as a consequence of the visual discomfort. The problems are discussed concerning different adaptation mechanisms in realization of the activity under study depending on the genetically determined features of the CNS.

Adaptation, Physiological↗

Patient information systems: unbiased information is key.

Successful patient information systems must have user-friendly services to transfer vast amounts of information. Whether it is preprinted discharge instructions for standard wound care, an algorithm-based triage discussion of one's chest pain, or simply a database to search out the current recommendations for flu shots or pediatric immunizations, the challenge for patient education in the communications revolution is high stakes indeed.

Humans↗