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PubMedDate not supplied

Identifying and relating nurses' attitudes toward computer use.

The purpose of this study was to measure nurses' attitudes toward computer use based on an adaptation of Vroom's expectancy theory, and identify variables that may correlate with these attitudes. Content validity and reliability for internal consistency were determined for the developed attitude questionnaire. Nurses' individual characteristics and computer-use satisfaction, beliefs, and motivation were correlated. Data analysis revealed that nurses' attitudes were significantly related (satisfaction to beliefs, r = 0.783, p less than 0.001; satisfaction to motivation, r = 0.598, p less than 0.001; and beliefs to motivation r = 0.651, p less than 0.001), supporting the model based on Vroom's expectancy theory. Computer knowledge significantly related to computer-use beliefs (r = 0.229, p less than 0.05). Length of computer experience (r = -0.265, p less than 0.05) and nursing experience (r = -0.239, p less than 0.05) related negatively to nurses' computer-use satisfaction.

Attitude of Health Personnel↗
PubMedDate not supplied

Nurse educators' acceptance of the computer in baccalaureate nursing programs.

Although several studies have investigated nurse educators' perceived knowledge of and acceptance of computer technology, none have incorporated objective indicators of knowledge or acceptance. This descriptive research study used standardized and investigator-developed tests to examine acceptance of the computer by randomly selected administrators and faculty in private baccalaureate nursing programs. Levels of computer literacy and attitudes were sufficiently positive to promote the awareness, interest, and evaluation stages of Roger's diffusion and adoption model. Responses were not sufficiently positive to promote the trial and adoption of computer technology for instructional and administrative activities. Recommended approaches to meeting this challenge included instruction related to computer software and educational applications and the use of consortial arrangements to share knowledge, computer hardware and software, and application experiences.

Attitude to Computers↗
PubMed1988

Evaluation of computer-assisted instruction versus traditional new-employee training.

Personnel time and costs associated with computer-assisted instruction (CAI) and traditional "one-on-one" instruction in basic computer drug-order entry procedures were compared. Both programs consisted of an introduction to the training session, familiarization of users with the computer hardware and keyboard, and step-by-step instructions in unit dose and intravenous admixture order-entry procedures. The CAI module was developed by a pharmacist with no prior programming experience. It was designed to be used side-by-side with the actual inpatient pharmacy computer system. Fifth-year pharmacy students in their clinical clerkship rotation served as the study population. The personnel (both subject and pharmacy supervisor) time and costs associated with each method were evaluated for significant differences by a two-tailed Student's t test. Of 21 subjects who participated in this study, 11 received CAI and 10 received traditional instruction. CAI was associated with significantly less mean total personnel time (99.64 +/- 18.78 minutes) than one-on-one instruction (133.60 +/- 22.89 minutes). Mean total salary expense was significantly lower for CAI ($13.03 +/- 2.15) than for one-on-one instruction ($28.79 +/- 4.91). Program development time for the CAI module was 18.5 hours longer than that for the one-on-one program. The CAI module cost $1577.77 more to develop than the one-on-one program; however, 24 new employees would be required to offset development costs if the hardware were already available and 100 new employees if hardware had to be purchased. Computer-assisted instruction of new employees in computer order-entry procedures can be a cost-effective alternative to traditional training methods.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer User Training↗
PubMed1987

[Comparison of 3 ECG computer programs with interpretation by physicians].

Three ECG computer programs-Hewlett Packard analog program (HP), Telemed analog program (T) and Marquette 12 SL digital program (MAC)-were evaluated and their accuracy of ECG reading compared with the reading of 4 experienced interpreters on 140 ECGs of patients with various clinical abnormalities. Major disagreement with effect on patient management, and minor disagreement were defined at a joint session with a senior (consensus). The computers identified all normal ECGs correctly (sensitivity 100%). The percentage of major agreements (full agreements and minor disagreements) between consensus and computer was 79% for HP, 90% for T and 93% for MAC. The number of disagreements varied widely between readers and in relation to the different computers. Major problems for the computers were the interpretation of rhythm disturbances and the diagnosis of myocardial infarction, T-wave changes and ventricular hypertrophy: major diagnoses missed by the readers were first degree AV block, QT prolongation, and myocardial infarction. Although there was a considerable difference of accuracy between the 3 computer systems, all of them are sufficiently accurate to be useful to most clinicians. However, every ECG should be over-read by a physician, particularly if a clinical decision is based on the ECG diagnosis.

Adolescent↗
PubMed1986

Bladder cancer diagnosis by computer image analysis of cells in the sediment of voided urine using a video scanning system.

A video-based computerized semiautomated image analysis system was applied to the diagnostic evaluation of 119 sediments of voided urine: 103 from patients with a broad variety of neoplastic and nonneoplastic disorders of the lower urinary tract and 16 normal controls. Each specimen was presented to the machine as a single cytocentrifuge preparation, preserved in 2% Carbowax in 50% ethanol and stained-by the Papanicolaou method. Five hundred sequential "objects" were scanned within an area of 9 sq mm on each slide. "Objects" of no diagnostic value, such as dirt, debris, inflammatory cells, cell clusters, poorly preserved cells, etc., were eliminated from the final diagnostic analysis by a computer-based hierarchic triage system. The final specimen classifier was based on the cell images identified by the computer as well-preserved normal (NEG), atypical (ATY I), suspicious (ATY II) and malignant (POS) cells. For specimen classification by computer, the four categories of "abnormal," "inadequate," "acellular" and "negative" were defined. For high-grade tumors, the performance of the specimen classifier was generally comparable to the visual diagnosis. The specimen classifier unexpectedly identified twice as many low-grade papillary urothelial tumors as abnormal than did the visual analysis. Several false "alarms" were recorded by computer in patients with benign prostatic hypertrophy and prostatic carcinoma, some of whom had atypical urothelium. One of the 16 negative controls was misdiagnosed by the computer as abnormal. The possibility that the video system recognizes nuclear abnormalities not perceived by the human eye is being investigated further. The details of the computer analysis are reported, and the value of the system is discussed. The system appears to be promising as a future laboratory instrument, although it requires further extensive testing.

Adenocarcinoma↗
PubMed1984

[Perspectives in the use of computers in anesthesia].

The remarkable development of computer technology and the early experiments into its clinical use give us cause ot define useful spheres of application and task areas in anaesthesia for this valuable machine. Parallel to this followed the development of computer use in anaesthesia. Here, there are essentially four main areas of application: administration of data, monitoring, teaching, process of decision making. Next to a quite uniform definition of the task areas of a computer, the question of the selection of the suitable computer for the respective requirement cannot be answered in the same uniform way. For the application of computer technology in the practice of anesthesiology it is essential to guarantee not only sufficient safety of data but also a protection from misuse and manipulation. On the whole it is probable that computer technology will take over more and more medical technical tasks especially of the anaesthesia apparatus and evaluate them. An automatic registration of records with combined off-line and on-line recording of measured values represents the logical development of this technology.

Anesthesia↗
PubMed1980

[Veterinarians and computers (author's transl)].

Because of the fact that the use of computers depends both on the user and on the apparatus, some characteristics of veterinarians and computers are discussed. Although veterinarians probably are not pre-eminently computer-minded in view of their choice of profession and training, they will be increasingly confronted with disciplines tending to employ data-processing systems as an item of training and field of interest. The extent to which computers can be used, will depend on their accessibility, reliability in operation, accuracy, flexibility and cost price. A discussion of these features shows that the fear of computers usually is greater than that warranted by the technology currently available. Their use commences at the point at which large numbers of data have to be processed and automation offers advantages from the point of view of economy or organization (systems of administration and payment). Moreover, data which has already been available for a certain period, is rendered accessible for the first time by automatic processing (meat inspection). Finally, a demand will be created by the supply of data. A number of uses in the various veterinary disciplines are discussed. Part of a computer teaching programme of a faculty of veterinary medicine is described as a practical instance.

Computer-Assisted Instruction↗
PubMed1995

[Cranioplasty using computer-designed implants (preliminary report)].

The co-operation among plastic surgeons and computer experts is presented demonstrating the reconstruction of a cranial bone defect of a patient. The adequacy of manufactured implant for reconstruction of cranial bone defect on the base of classic methods in only approximate. Computer aided design is needed for creating a more sophisticated implant. Cranial CT is digitised and a 3 dimensional model is created. The precise implant, manufactured by a computer directed milling machine, fits ino the bone defect. During the operation the cranial bone defect is explored, the bone edges are identified. The implant is fixed and the skull skin is closed. The authors demonstrate a successful operation of a cranial bone defect of 9 x 6.7 cm, the complicated shape and bone surface was reconstructed by a computer aided and manufactured implant. The co-operation of plastic surgeon and computer experts are essential during the process of implant design. The computer assisted and manufactured implants are suitable for the most sophisticated functional and aesthetic reconstruction of bone defect with complicated surface and irregular pattern.

Adult↗
PubMed1995

Actual and desired computer literacy among allied health students.

The purpose of this study was to examine the level of computer literacy among allied health students, with specific focus on physical therapy, occupational therapy, and respiratory therapy students, and to investigate the perceived differences between actual computer literacy and desired computer literacy. Two established measurement instruments were used to collect data from a sample of 377 allied health students. T-tests and Pearson product-moment correlations were conducted to analyze the data. Results show that allied health students take very few computer courses, but they are generally aware of the applications of computers in the practice of allied health and they desire a higher level of computer literacy than they currently have.

Adolescent↗
PubMed1976

Computer-aided diagnosis of gastroenterologic diseases in Sherbrooke: preliminary report.

To assess the diagnostic accuracy of a computer-aided-diagnosis system when implemented in different parts of the world, an automated system, which had established its reliability in Leeds, England, was transferred to Sherbrooke, Quebec. In this preliminary study two retrospective series, comprising 104 patients with acute abdominal pain and 101 patients with dyspepsia, were drawn from the files of the Centre Hospitalier Universitaire in Sherbrooke. The history and physical-examination sheet was analyzed, coded and tested against the Leeds data base on a WANG 2200 computer, and the results were compared with the final Sherbrooke pathologic diagnosis. Overall the computer made a correct diagnosis in 78.8% of cases of acute abdominal pain and 70% of cases of dyspepsia. Computer diagnoses of appendicitis were correct in 97% of cases and the system recognized 91% of the actual appendicitis cases. Similar figures for cholecystitis were 91% and for peptic ulcer, 87%. However, the "pick-up" rate by the computer of pancreatitis was only 25%. It is concluded that geographical differences in disease presentation will probably not impair the validity of the computer method used in this study. A comparison of various diagnostic methods and levels of competence will await a prospective trial of this method.

Abdomen↗
PubMed1993

Development of a portable information system: connecting palmtop computers with medical records systems and clinical reference resources.

The portability of palmtop computers makes them an ideal platform to maintain communication between busy physicians and medical information systems. In our academic FHC (Family Health Center) we have developed software that runs on a palmtop computer allowing access to information in the HIS (Hospital Information System) and our FHC's AAMRS (Automated Ambulatory Medical Record System). The resident physicians who staff the hospital and the FHC are frequently at home or otherwise off-site where terminal access is not available. Using a Hewlett-Packard 95LX palmtop computer as the base platform, custom software has been developed to access summary data on in-patients and out-patients. Data is downloaded into a database on a palmtop computer memory card. ASCII data from Medical Information Systems (MIS), is transformed into a database format readable on the palmtop. Our hospital MIS department transmits information daily on our in-patient service (20-30 patients). We also download, weekly, a patient summary on all of our active out-patients in our MUMPS-based AAMRS (2500-3000 patients). Each morning the resident in the Family Practice program updates his palmtop memory card at a central workstation. Palmtop computers with downloaded databases, can be valuable in care of patients when the physical or on-line chart is not easily accessible. They are particularly useful in multi-physician groups when the on-call physician provides care for the patients of other physicians. We have made the palmtop computer even more valuable to physicians by providing an integrated software package.(ABSTRACT TRUNCATED AT 250 WORDS)

Academic Medical Centers↗
PubMed1993

NR-LU-10 monoclonal antibody scanning. A helpful new adjunct to computed tomography in evaluating non-small-cell lung cancer.

UNLABELLED: Computed tomographic scanning has improved the noninvasive staging of lung cancer but has the deficiency of not distinguishing benign from malignant lesions. This prospective trial evaluated the usefulness of a new radiolabeled monoclonal antibody, NR-LU-10, as an adjunct to computed tomography by assessing its clinical applicability and accuracy in detecting malignancy in primary lung tumors and mediastinal nodes. NR-LU-10 is a technetium 99m-labeled Fab fragment of a murine immunoglobulin G2b monoclonal antibody that recognizes a 40 kD glycoprotein expressed in lung and other epithelial cancers. METHODS: (1) Patients with potentially resectable non-small-cell lung cancer were eligible; (2) all patients had computed tomographic scans of the chest; (3) whole body and single photon emission computed tomographic imaging were performed 14 to 17 hours after intravenous infusion of 20 to 30 mCi of NR-LU-10; (4) subsequent mediastinoscopy or thoracotomy with complete mediastinal nodal mapping provided pathologic correlation. RESULTS: Twenty-four patients were entered, 14 men and 10 women. No allergic reactions or other adverse effects were seen. Interference from a prior ventilation-perfusion scan precluded adequate imaging in 1 patient, but high-quality images were obtained in the other 23 patients. The 22 primary malignant tumors all had uptake and there was no uptake in 1 lung nodule found to be benign. In 21 patients who had surgical correlation of mediastinal nodal involvement, NR-LU-10 was false-positive in 5 and false-negative in 1; results of computed tomography were false-positive in 6 and false-negative in 1. In this preliminary study, NR-LU-10 antibody scanning was safe and easily performed, it produced high-quality images of the lung and mediastinum, and it was accurate in detecting primary non-small-cell lung cancers. Further evaluation of its value in staging the mediastinum is needed, in particular, its role as an adjunct to computed tomography to help distinguish benign from malignant lesions.

Antibodies, Monoclonal↗
PubMed1993

Prenatal behavioral risk screening by computer among Native Americans.

BACKGROUND AND OBJECTIVES: Computer interviews have potential value in screening pregnant patients for substance abuse and other behavioral risk factors linked to adverse pregnancy outcomes. The focus of this study was to determine whether a patient-interactive computerized assessment and education program was an acceptable and valid means of obtaining behavioral risk data. METHODS: Study participants completed a computer interview, and computer-generated reports of substance use and physical abuse within the past year were compared with information in the participants' prenatal records. The accuracy of computer interview reports of substance use was evaluated by performing urine drug screens. RESULTS: More than 95% of the 265 women who completed the computer interview rated it favorably. Drug use and physical abuse were reported significantly more often during the computer interview, compared with information obtained from the patients' medical records. Results of urine drug screens demonstrated a high concurrence rate between self-reports of drug use and the results of urine analyses. CONCLUSIONS: Results indicated that the computerized assessment was well received by patients and yielded valid information regarding risk factors for adverse pregnancy outcomes.

Adult↗
PubMed1993

Basics of computer hardware and software.

The basics of computer hardware and software are presented. A computer is a general-purpose electronic counting device used in data processing because of its accuracy and high speed. The physical components of a computer system are called the hardware, which includes the central processing unit and peripheral equipment for data input, output, and storage. Computer capacity is measured by the amount of data that can be stored in main memory and by the computer word size. Performance is indicated by the speed with which instructions are executed. Input devices (e.g., keyboard-type terminals) are the components that accept raw data and convert it into electronic form, and output devices (e.g., video display terminals) present the results of data processing in human-readable form. System software is the set of instructions that facilitate hardware use and allow the application software, which solves specific user problems, to run efficiently. System and application software is written by using various machine and symbolic languages. Milestones in software-development techniques include program subroutine use, modular programming, functional decomposition, structured programming, and structured analysis. Objectives in improving software quality are reducing development costs, making maintenance easier, and making development results more predictable. Because software development has lagged behind revolutionary advances in hardware, the full potential of computers has yet to be realized.

Computer Literacy↗
PubMed1997

Simulation of cardiac conduction system in distributed computer environment.

A high resolution, three dimensional, computer model of the cardiac conduction system has been developed. Cardiac geometry was constructed from sectional images of VHP project of the National Library of Medicine. The heart was modeled as a matrix of cells that fill its anatomical structure. The intracellular distance was 1 mm and the total number of cells were 457,482. Electrophysiological parameters like action potential, absolute refractory period and conduction velocity were assigned to each of the cells. The pattern of the excitation sequence propagation as well as potentials on the body surface points were computed on a single processor. The working memory and the time for computation of the algorithms were minimized using efficient data structures. The time to compute an excitation sequence over one cardiac cycle was 4 hours. The algorithms were also implemented on a distributed network of personal computers running on a QNX operating system. The speed of computation of the excitation sequence algorithm was improved by a factor of 2.52 when the algorithm was implemented on a network of three Intel-66 MHz machines.

Body Surface Potential Mapping↗
PubMed1998

[Computer-assisted diagnosis in mammography: the R2 ImageChecker System in detection of spiculated lesions].

Because of the rapid development of computer systems for digitalization and image analysis, they play an increasing important role in computer-assisted diagnosis (CAD). Especially in the field of mammography, the early signs of malignancy are relatively uniform and therefore more easily detected by a computer algorithm. In this study, we tested one of the few commercially available systems for the detection of both microcalcifications and suspicious, spiculated solid lesions on 40 cases of proven breast carcinomas. These mammograms were analyzed by three independent observers with and without knowledge of the computer results, respectively. Depending on the time of their radiologic experience, the sensitivity of the observers alone was 92.4%, 86.1% and 82%. With knowledge of the computer interpretation, sensitivity of all three observers rose significantly to 100%, 92.7%, and 95%, respectively. However, due to a high number of false positive results of the computer algorithm (0.4 markers per image), the positive predictive value of the interpretations worsened from 100%, 92.7%, and 95.5% to 86.4%, 97.3%, and 91.1%, respectively. It can be expected that future developments will soon overcome this problem and CAD will become an effective tool in screening mammography.

Adult↗
PubMed1995

Medical image processing utilizing neural networks trained on a massively parallel computer.

While finding many applications in science, engineering, and medicine, artificial neural networks (ANNs) have typically been limited to small architectures. In this paper, we demonstrate how very large architecture neural networks can be trained for medical image processing utilizing a massively parallel, single-instruction multiple data (SIMD) computer. The two- to three-orders of magnitude improvement in processing time attainable using a parallel computer makes it practical to train very large architecture ANNs. As an example we have trained several ANNs to demonstrate the tomographic reconstruction of 64 x 64 single photon emission computed tomography (SPECT) images from 64 planar views of the images. The potential for these large architecture ANNs lies in the fact that once the neural network is properly trained on the parallel computer the corresponding interconnection weight file can be loaded on a serial computer. Subsequently, relatively fast processing of all novel images can be performed on a PC or workstation.

Computer Systems↗
PubMed2005

Patients' perception of preoperative information by interactive computer program-exemplified by cholecystectomy.

Patients' perception of preoperative information by interactive computer program informing about cholecystectomy was assessed. Patients were asked to qualify the computer program after hospital discharge by an anonymous questionnaire. Two hundred and fifty-seven of 278 consecutive patients completed the questionnaire resulting in a response rate of 92%. Sixty-three percent were very satisfied and 37% were satisfied, whereas none were dissatisfied or undecided. Patients' satisfaction was not associated with sex, age, surgeon or prior knowledge of computers. Most of the patients considered the clarity of text and illustrations and the volume of information as good or excellent and found the information well adapted to their prior knowledge. Ninety-eight percent stated that they would like to be informed again by an interactive computer program in case of another surgical intervention. Thus, interactive computer programs seem to be a valuable adjunct to written and oral information in the preoperative informed consent procedure.

Adult↗