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PubMedDate not supplied

An interactive computer simulation program for the design of statistical control procedures in clinical chemistry.

A computer simulation program has been developed to aid in the design of statistical quality control procedures in clinical chemistry. This 'QC simulator' permits the user to study the effects of parameters in the analytical procedure (method standard deviation, components of variance, rounding of data) and parameters in the control procedure (choice of statistics, control limits, decision criteria, number of control observations). The performance of the control procedures being studied are characterized by their probability for ejection, estimated at several different levels of random and systematic error, and presented by plots of statistical power vs the size of the analytical errors. The relative performance of different control procedures can be compared based on these performance characteristics. Another important application of the program is in the design of control procedures to assure that a specified level of analytical quality is achieved in routine laboratory analyses. The utility of this interactive simulation tool is illustrated in two typical sample runs.

Chemistry, Clinical↗

PubMed1998

A computer education program to improve physician awareness of rehabilitation hospital charges.

OBJECTIVE: To quantify physician knowledge of hospital charges and determine if computer fiscal feedback would improve physician awareness of hospital charges. DESIGN: Comparison of physicians' knowledge of hospital charges before and 6 months after the instigation of a computer feedback educational program. PARTICIPANTS AND SETTING: All physicians (attendings, residents, and fellows) at a large academic rehabilitation hospital. INTERVENTION: After surveying physicians' knowledge of hospital charges, the billing fees for some items were placed on the computer ordering menu so that these charges were viewed when orders were made by physicians. MAIN OUTCOME MEASURES: Error in physician charge estimates before and after computer education program, and physician confidence in charge estimates. RESULTS: The baseline survey found that physicians had poor awareness of hospital charges, regardless of ordering frequency, relative charge for the item, or physician experience. Physicians expressed little confidence in their knowledge of the charges and were twice as likely to underestimate than to overestimate charges. Six months after the implementation of a computer feedback educational program, improvement was seen in the awareness of hospital charges for all imaging studies and most laboratory tests. Fiscal awareness of items that had not been included in the computer feedback also showed some small improvement. Physicians' confidence in their knowledge of fees improved. Physicians indicated the program was beneficial and should be expanded to include fiscal information on more services. CONCLUSIONS: Immediate computer feedback of hospital charges improves physicians' fiscal awareness and may lead to their practice of more cost-efficient medicine.

Computer-Assisted Instruction↗

PubMed1995

A multimedia-based histology laboratory course: elimination of the traditional microscope laboratory.

UNLABELLED: We have developed a multimedia-based laboratory course which has enabled us to eliminate the microscope and traditional microscope laboratory that have been mainstays of our histology course and histology courses at almost all institutions where histology is taught. The multimedia laboratory uses a library of histology images (approximately 24,000) stored on videodisc ( HISTOLOGY: A Photographic Atlas, by S. Downing) as its microscope slide collection and accesses those images through barcode and computer interfaces. The laboratory workstations consist of a videodisc player, videodisc monitor, computer, and computer monitor. One workstation is available for every 4-students, and our students are encouraged to work together in groups of four or five. In our current set-up, the students are introduced to and instructed in the basic principles of histology using a computer program that interfaces with the videodisc images. The computer program is divided into 19 chapters (the chapters are typical of the chapters found in a normal histology textbook) and has: (1) a laboratory component that covers the material traditionally covered in the microscope laboratory, and (2) a lecture component that enables the students to evaluate their understanding of the lecture material in a non-punishing way. The laboratory section of each chapter is divided into a "MicroLab" section, an "InFo Time" section, and a "Quiz Time" section. Each of these sections interfaces with histological images stored on the videodisc. The students are encouraged to work through the "MicroLab" section of each chapter before moving on to the "InFo Time" and "Quiz Time" sections. The "MicroLab" sections introduce the students to the various tissues and organs of the body and is interfaced with the videodisc player and the histology images stored on the videodisc. These sections describe the basic histological features of the various tissues and organs and give the students access to multiple examples of what they are studying. The "InFo Time" sections bring up specific images and ask the students to think about the images. Information about the images being observed is available if the students want it and the students can flag those images that they found difficult. The Quiz Time section of the program is also interfaced with the videodisc player and provides access to a large number of histology images stored on the videodisc. The "Quiz Time" sections provide non-punishing review questions that the students can study after she has worked her way through the "MicroLab" and "InFo Time" sections. In addition to the use of a computer program to access the histology images stored on videodisc, we use barcodes that address specific images on the histology videodisc in a variety of ways to augment the students' laboratory and lecture experience. The benefits of using multimedia in place of the traditional microscope and microscope slide collection are numerous and include the speed at which specific histological images can be accessed and reviewed (when compared to finding a structure on a glass slide), a significant reduction in the amount of laboratory time needed by the student to learn the same amount of information, the ease of tutoring on a large monitor screen (when compared to trying to discuss a histological structure with a student through the eyepiece of a microscope), the encouragement of group study (which is difficult to do when a student is working 1-on-with a microscope), and the reduction of the number of faculty necessary to cover a typical histology laboratory session. The use of barcodes that address specific videodisc histology images has greatly changed our examination procedures and has significantly expanded the usefulness of the traditional lecture note handouts given to our students.

Computer-Assisted Instruction↗

PubMed1995

A computer simulation program for MR imaging: application to RF and static magnetic field imperfections.

A computer simulation program capable of demonstrating various artifacts, such as image distortion caused by metallic implants in MR imaging, is presented. The structure of the program allows for the implementation of various imaging situations as long as spins only experience weak interaction, i.e., the Bloch equations are obeyed. The raw data are obtained by repeatedly applying the Bloch equations to the magnetization vector of each point of the simulated object, throughout the pulse sequence. With only a limited number of spins in each voxel, the effects of intravoxel dephasing and rephasing require special attention, and algorithms for this have been implemented.

Algorithms↗

PubMed2001

The coming of age of computerized ECG processing: can it replace the cardiologist in epidemiological studies and clinical trials?

In spite of decades of research and widespread use of computer programs for the analysis of electrocardiograms (ECGs), the accuracy and usefulness of computerized ECG processing has been questioned. To determine whether ECG computer programs can replace cardiologists in epidemiological studies and clinical trials, we reviewed the literature for evidence, concentrating on one influential ECG measurement, viz. QT interval duration, and one classification method, the Minnesota Code, which is the de facto standard for ECG coding. We compared interobserver variabilities of cardiologists with differences between computer programs and cardiologists, in order not to prejudice against the computer. Studies that contain this type of information indicate that interobserver variabilities are at least as large as differences between computer and cardiologist. This suggests that ECG computer programs perform at least equally well as human observers in ECG measurement and coding, and can replace the cardiologist in epidemiological studies and clinical trials.

Cardiology↗

PubMed2002

Prediction of arch perimeter changes due to orthodontic treatment.

A borderline orthodontic case with mild to moderate space deficiency can be treated without extractions. Expansion can be used to relieve space deficiency. The prediction of arch perimeter change for a given amount of expansion is helpful in planning the treatment of a patient who needs expansion, and it can facilitate nonextraction orthodontic treatment. To date, different amounts of arch perimeter change have been proposed for the same amount of expansion. A computer program is explained in this study, and examples of its uses are given. By entering 4 parameters of a dental arch into the computer program before and after an orthodontic procedure, one can simply calculate the total and the anterior arch perimeters and see the differences between them numerically and graphically. The program can save, print, change, and delete the calculated data for each patient. For clinicians who do not choose to use the computer program, 2 regression formulas are also presented to calculate the anterior and the total dental arch perimeters. The perimeters of 23 pairs of well-aligned dental arches were measured to check the accuracy of the computer program and the formulas. Paired t tests did not show statistically significant differences between the actual, the computer-derived, and the formula-derived perimeters of the dental arches at 95% confidence level.

Computer Graphics↗

PubMed2004

The child maltreatment log: a computer-based program for describing research samples.

The Child Maltreatment Log (CML) is a computer-based program designed to record information about children's maltreatment experiences and associated life events. Addressing concerns posed by scientific panels and grant review panels, the CML was designed to improve upon existing instruments to facilitate collaboration among researchers interested in maltreatment. The CML encourages researchers to collect information from multiple sources and informants concerning children's maltreatment experiences. Rather than classifying types of maltreatment a priori, the CML allows researchers to describe children's experiences using objective descriptors pertaining to potential acts of abuse, potential perpetrators, frequency, onset, consequential injuries, and treatment. The CML can be downloaded by interested agencies and groups without charge.

Child↗

PubMed1994

A computer-directed program for smoking cessation treatment.

This report describes a computer-directed cigarette smoking cessation program that individualizes nicotine fading schedules for smokers based upon their daily smoking behavior. Previous outcome data from minimal intervention and intensive stop-smoking treatment studies are presented. Preliminary urinary cotinine data also are presented to validate the program's underlying assumption that computer-directed nicotine fading results in across-treatment reductions in biological levels of nicotine.

Cotinine↗

PubMed1988

A computer-based program for the follow-up of prostatic cancer patients.

A computer-based record program for the follow-up of prostatic cancer patients is described and its practical applications discussed. The system enables the user to record personal data, medical history follow-up (including laboratory and imaging tests), treatment and the response to it. The program can generate reports as a summary letter to the referring physician, follow-up notes on a specific date, laboratory test results on a chronological base, etc. It has the capability to analyse statistically the medical database accumulated with the aid of SPSS (Statistical Package for Social Sciences). The program, which is designed for a micro-computer, is conducted on the IBM Personal Computer. By providing instant access to all comprehensive information, the system is a valuable tool for the correct staging of disease and for systematic follow-up; most of all, it is a "real-time instrument" for the analysis of medical results.

Follow-Up Studies↗

PubMedDate not supplied

Using a computer simulation program to assess the decision-making process in child health care.

The purpose of this paper was to describe the development and testing of a computer simulation program designed to assess the decision-making process in the public health nurses' work in child health care. The work was based primarily on theories of problem-solving and decision making; on knowledge of child development, health care, and education; and on the soft systems methodology. An authoring program and two simulations were designed and produced at the University of Turku by a team of two nurse researchers, a computer specialist, and three public health nurses. The simulations presented two typical situations encountered by the public health nurses' work in child health care. A total of 61 public health nurses from 11 health centers in the southwestern part of Finland completed the simulations. The public health nurses responded positively to the simulations and the program worked very well. The results revealed some inconsistencies in the decision-making process of the public health nurses with respect to the needs of the child and the family. The public health nurses' decisions were more closely related to the developmental stage of the child than to the unique needs of each family. The simulation is acting to test the public health nurses' ability to make decisions "here and now" but not about caring it forward. These shortcomings can be corrected by asking them to explain their decisions and thoughts after each stage and by tape recording their answers. The findings gave many answers to the question of how the computer simulation program can be developed.

Computer Simulation↗

PubMed1996

Application of pharmacokinetics to computed tomography: injection rates and schemes: mono-, bi-, or multiphasic?

OBJECTIVE: The objective of the current study was to test whether optimization of dose regimens for detecting focal liver lesions by computed tomography is possible by using the available time-density data of former studies published in the literature and a computer program so that the number of further clinical tests with the exclusive objective of optimizing injection schemes could be reduced. METHODS: Computed tomography enhancement data of the aorta and/or the liver obtained after injecting a conventional ionic and a nonionic contrast agent were used to calculate pharmacokinetic parameters and to simulate the time course of enhancement for a variety of different infusion regimens modifying contrast medium strength, dose, and injection rate. The study consisted of two parts. In the first part, mean relative enhancement curves of the aorta and of liver parenchyma (0 to 300 sec) using meglumine diatrizoate (306 mg iodine per mL, 300 mg iodine per kg) were taken from the literature and their values were approximated using the computer program TOPFIT. In the second part, equivalent data for iohexol including a total of three strengths (240, 300, and 350 mg iodine per kg) and doses from 30 to 45 grams of iodine were used. "Validation" of the simulation method was obtained, first by comparing measured and calculated maximum intensities and times to reach maximum and, second, by using one injection scheme for the simulation of a second and comparing the results with actually measured data. RESULTS: The computer program TOPFIT allowed for excellent curve fitting of the measured density values. The data obtained in the first part of the study showed that after a dose of 300 mg I/kg and a rate of 2 mL/sec maximal enhancement is achieved in the aorta after 30 seconds (approximately 100 HU) and in the liver after 50 seconds (approximately 30 HU). The higher the dose and the rate of infusion were, the higher was the enhancement. The difference in density between aorta and liver was proportional to the infusion rate approaching asymptotically approximately 90 HU at 8 mL/sec for a dose of 300 mg I/kg. Bi- or triphasic infusion schemes did not improve differences in enhancement. The curve fitting obtained in the second part of the study also confirmed the results reported in the literature. A "crossover" prediction of data was possible within the range of interindividual variations of pharmacokinetic parameters and thus validated the chosen approach of computer simulation. Furthermore, data sets selected randomly out of the simulation results could be used--within the limits of interindividual variability--to predict data determined in other clinical trials. CONCLUSION: The computer program TOPFIT appears useful for the optimization of time--density profiles in computed tomography. The number of further clinical studies with the objective of optimization could therefore possibly be reduced.

Aortography↗

PubMed2004

Biological applications of support vector machines.

One of the major tasks in bioinformatics is the classification and prediction of biological data. With the rapid increase in size of the biological databanks, it is essential to use computer programs to automate the classification process. At present, the computer programs that give the best prediction performance are support vector machines (SVMs). This is because SVMs are designed to maximise the margin to separate two classes so that the trained model generalises well on unseen data. Most other computer programs implement a classifier through the minimisation of error occurred in training, which leads to poorer generalisation. Because of this, SVMs have been widely applied to many areas of bioinformatics including protein function prediction, protease functional site recognition, transcription initiation site prediction and gene expression data classification. This paper will discuss the principles of SVMs and the applications of SVMs to the analysis of biological data, mainly protein and DNA sequences.

Algorithms↗

PubMed1990

Evaluation of ECG interpretation results obtained by computer and cardiologists.

In an international project investigators from 25 institutes are trying to establish a common reference library and evaluation methods for testing the diagnostic performance of various ECG computer programs and of cardiologists, based on ECG-independent clinical information. A first set of 500 validated ECGs was collected and analyzed by fifteen different computer programs and nine cardiologists, seven of who analysed the ECG and five the VCG. A coding scheme was used to map individual diagnostic statements onto a common set. Combined program and referee results were obtained by weighted averaging. Preliminary results indicate that the classification accuracy of several programs can still be improved. However, it was also apparent that the results of the best 12-lead ECG computer programs proved to be almost as accurate as the best of seven cardiologists in classifying seven main disease categories, i.e., normal, left, right and biventricular hypertrophy, anterior, inferior and combined myocardial infarction. Evaluation of rhythm statements and conduction disturbances was not included in the study. The data collection is still being pursued in order to reach over 1,000 cases. In this way a common diagnostic database is being established for comparative testing of diagnostic computer programs. This should lead to consumer protection and improve the accuracy and reliability of computerized electrocardiography.

Cardiovascular Diseases↗

PubMedDate not supplied

Ventilator risk management using a programmed monitor.

A computer program was written to improve quality control and risk management of patients on ventilators. The software was designed to run on the new-generation Spacelabs PC Monitor interfaced to the Puritan-Bennett 7200a ventilator. Before the program allows connection of the ventilator to a patient, the ventilator is polled for initial hardware status, alarm statuses and alarm limit settings. If there are no hardware failures, alarm violations, or improperly set alarm limits, the program prompts the clinician to connect the ventilator to the patient. Polling is done periodically after patient ventilation begins, and patient data, alarm conditions, or changes to the ventilator settings are automatically written to disk. In addition, real-time data can be displayed at any time during the ventilation session by using a set of touch-screen options. After the ventilation session is complete, the clinician can print the final report in hard copy or to disk.

Equipment Failure↗

PubMed2003

Validation and reproducibility of computerised cell-viability analysis of tissue slices.

BACKGROUND: The identification of live cells using membrane integrity dyes has become a frequently used technique, especially with articular cartilage and chondrocytes in situ where tissue slices are used to assess cell recovery as a function of location. The development of a reproducible computerised method of cell evaluation would eliminate many variables associated with manual counting and significantly reduce the amount of time required to evaluate experimental results. METHODS: To validate a custom computerised counting program, intra-person and inter-person cell counts of nine human evaluators (three groups - unskilled, novice, and experienced) were compared with repeated pixel counts of the custom program on 15 digitised images (in triplicate) of chondrocytes in situ stained with fluorescent dyes. RESULTS: Results indicated increased reproducibility with increased experience within evaluators [Intraclass Correlation Coefficient (ICC) range = 0.67 (unskilled) to 0.99 (experienced)] and between evaluators [ICC = 0.47 (unskilled), 0.85 (novice), 0.93 (experienced)]. The computer program had perfect reproducibility (ICC = 1.0). There was a significant relationship between the average of the experienced evaluators results and the custom program results (ICC = 0.77). CONCLUSIONS: This study demonstrated that increased experience in cell counting resulted in increased reproducibility both within and between human evaluators but confirmed that the computer program was the most reproducible. There was a good correlation between the intact cell recovery determined by the computer program and the experienced human evaluators. The results of this study showed that the computer counting program was a reproducible tool to evaluate intact cell recovery after use of membrane integrity dyes on chondrocytes in situ. This and the significant decrease in the time used to count the cells by the computer program advocate its use in future studies because it has significant advantages.

Animals↗

PubMedDate not supplied

A patient's perspective of medical informatics.

From my viewpoint as a patient, 1. Medical knowledge has expanded to the point that individuals cannot adequately improve quality without the assistance of computer programs. 2. The medical profession must concentrate on why and how computer program projects must be used, not on why they cannot be used. 3. The successful application of computer programs to clinical medicine is dependent mainly on the efforts of individual institutions and people at the local level.

Diagnosis, Computer-Assisted↗

PubMed2003

How to improve microscopic images obtained with consumer-type digital cameras.

AIM: Digital imaging is useful in conventional photography because it immediately provides images, and the image quality can be improved afterwards by the use of computer programs. The major disadvantages of consumer-type digital cameras mounted on microscopes are (i) unequal illumination through the image, and (ii) a coloured background. A computer program was specifically adapted and refined to improve images obtained with consumer-type digital cameras mounted on microscopes. METHODS AND RESULTS: An approach using a division operation between the specimen image and a background image leads to homogeneous illumination throughout the image, with automatically corrected brightness and white background. The correct colour spectrum is preserved by correction of the histogram. This approach was obtained from the freeware computer program 'Image Arithmetic'. In a test, three different consumer-type digital cameras (Sony, Nikon, Olympus) on different microscopes were used to obtain images of different types of histological specimens (cervical smear, bone marrow biopsy, and colonic biopsy). The computer program dramatically improved the quality of images obtained with all tested cameras. CONCLUSION: Using this approach, even low-cost digital cameras mounted on microscopes produce brilliant images with homogeneous illumination and a white background, the image quality being comparable with expensive cameras especially designed for microscopes.

Humans↗

PubMedDate not supplied

A program to compute the generalized Mantel-Haenszel chi-square for multiple 2 x J tables.

A FORTRAN program for computing the generalized Mantel-Haenszel chi 2-test statistic for multiple 2 X J tables is presented. The output contains the additional information of expected cell values and the individual odds ratios for each stratum. For the case of 2 X 2 tables, an internal check of the expectation is made to assure that the asymptotic assumptions are met. Optionally, the Yate's correction for continuity can be employed for 2 X 2 tables. The program can handle frequency count data as found in contingency tables or fractional values as in life table procedures.

Computers↗