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PubMedDate not supplied

Medical informatics and the science of cognition.

Recent developments in medical informatics research have afforded possibilities for great advances in health care delivery. These exciting opportunities also present formidable challenges to the implementation and integration of technologies in the workplace. As in most domains, there is a gulf between technologic artifacts and end users. Since medical practice is a human endeavor, there is a need for bridging disciplines to enable clinicians to benefit from rapid technologic advances. This is turn necessitates a broadening of disciplinary boundaries to consider cognitive and social factors pertaining to the design and use of technology. The authors argue for a place of prominence for cognitive science. Cognitive science provides a framework for the analysis and modeling of complex human performance and has considerable applicability to a range of issues in informatics. Its methods have been employed to illuminate different facets of design and implementation. This approach has also yielded insights into the mechanisms and processes involved in collaborative design. Cognitive scientific methods and theories are illustrated in the context of two examples that examine human-computer interaction in medical contexts and computer-mediated collaborative processes. The framework outlined in this paper can be used to refine the process of iterative design, end-user training, and productive practice.

Cognitive Science↗
PubMed2003

Brain-computer interface technology: a review of the Second International Meeting.

This paper summarizes the Brain-Computer Interfaces for Communication and Control, The Second International Meeting, held in Rensselaerville, NY, in June 2002. Sponsored by the National Institutes of Health and organized by the Wadsworth Center of the New York State Department of Health, the meeting addressed current work and future plans in brain-computer interface (BCI) research. Ninety-two researchers representing 38 different research groups from the United States, Canada, Europe, and China participated. The BCIs discussed at the meeting use electroencephalographic activity recorded from the scalp or single-neuron activity recorded within cortex to control cursor movement, select letters or icons, or operate neuroprostheses. The central element in each BCI is a translation algorithm that converts electrophysiological input from the user into output that controls external devices. BCI operation depends on effective interaction between two adaptive controllers, the user who encodes his or her commands in the electrophysiological input provided to the BCI, and the BCI that recognizes the commands contained in the input and expresses them in device control. Current BCIs have maximum information transfer rates of up to 25 b/min. Achievement of greater speed and accuracy requires improvements in signal acquisition and processing, in translation algorithms, and in user training. These improvements depend on interdisciplinary cooperation among neuroscientists, engineers, computer programmers, psychologists, and rehabilitation specialists, and on adoption and widespread application of objective criteria for evaluating alternative methods. The practical use of BCI technology will be determined by the development of appropriate applications and identification of appropriate user groups, and will require careful attention to the needs and desires of individual users.

Algorithms↗
PubMedDate not supplied

Meeting the educational needs of clinical equipment users.

Training equipment users to operate medical equipment effectively and safely is one of the most important and difficult tasks of clinical engineers. As medical equipment proliferates and becomes more complex, the task of education also becomes more difficult. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that all equipment users be trained annually in proper operating procedures for the equipment they use and that the training be documented. Therefore, each hospital must develop educational programs to meet those needs. This paper illustrates the use of an interactive computer-assisted instruction (CAI) program, entitled EquipTeach, to provide an effective, standardized and cost-effective method of training equipment users at the John Dempsey Hospital of The University of Connecticut Health Center in Farmington, Connecticut.

Computer-Assisted Instruction↗
PubMedDate not supplied

Meeting the challenge of continuing education with eLearning.

For many of us, the concept of "e" anything invokes a sense of skepticism and even dread. However, the Web and all it has to offer is certainly an integral part of modern life and, once reconciled, offers great opportunities for commerce and knowledge building. One particular area of promise is that of online learning or "eLearning" as it is referred to in the literature. Particularly for sonographers and technologists, the ability to travel to seminars and conferences on hospital budgets and time is a distant memory. Conversely, the pressure to stay current with CE requirements is greater than ever. With the growing phenomena of accreditation and the use of that as standard for quality care, these staff members are under more pressure than ever to maintain their certification. There is also the issue of accountability. What is being done to track employee training and assist in on-going development? How do we know that the program was appropriate for that particular employee and that an adequate ROI was achieved from a learning perspective? With eLearning, the opportunity to track the employee's progress, scores and areas of interest are possible. This can assist the administrator in "managing" the learning within the group and taking an active role in the development of the staff. The ultimate eLearning experience provides the right content at the right time. It motivates people to learn and apply their knowledge and skills to improve their individual and organizational performance. This is achieved by providing learners with easy and immediate access to the content. The design elements of the site should include a friendly format that facilitates easy navigation through the content. Other helpful features are: book-marking that allows the student to return to the last page studied, interactivity, visualization technologies, and feedback throughout the learning experience. The opportunities for the utilization of eLearning in the global medical community are remarkable. eLearning facilitates learning at anytime and anywhere. It reduces the obstacles of time and distance, providing greater equality of opportunity.

Attitude to Computers↗
PubMed1991

Information workstations in clinical pathology.

Multitasking operating systems and expanding networks now permit smooth access to remote computers, peripherals, data, and information resources. Graphic user interfaces and productivity-enhancing software packages reduce the need for training and memorization of commands. New models of desktop computers based on "data-centered" software architecture can enhance workstation usefulness even more. Pathologists need to consider how these tools might improve access to and management of information and knowledge.

Computer Systems↗
PubMed2000

Brain-computer interface technology: a review of the first international meeting.

Over the past decade, many laboratories have begun to explore brain-computer interface (BCI) technology as a radically new communication option for those with neuromuscular impairments that prevent them from using conventional augmentative communication methods. BCI's provide these users with communication channels that do not depend on peripheral nerves and muscles. This article summarizes the first international meeting devoted to BCI research and development. Current BCI's use electroencephalographic (EEG) activity recorded at the scalp or single-unit activity recorded from within cortex to control cursor movement, select letters or icons, or operate a neuroprosthesis. The central element in each BCI is a translation algorithm that converts electrophysiological input from the user into output that controls external devices. BCI operation depends on effective interaction between two adaptive controllers, the user who encodes his or her commands in the electrophysiological input provided to the BCI, and the BCI which recognizes the commands contained in the input and expresses them in device control. Current BCI's have maximum information transfer rates of 5-25 b/min. Achievement of greater speed and accuracy depends on improvements in signal processing, translation algorithms, and user training. These improvements depend on increased interdisciplinary cooperation between neuroscientists, engineers, computer programmers, psychologists, and rehabilitation specialists, and on adoption and widespread application of objective methods for evaluating alternative methods. The practical use of BCI technology depends on the development of appropriate applications, identification of appropriate user groups, and careful attention to the needs and desires of individual users. BCI research and development will also benefit from greater emphasis on peer-reviewed publications, and from adoption of standard venues for presentations and discussion.

Algorithms↗
PubMed2003

Speeding up backpropagation using multiobjective evolutionary algorithms.

The use of backpropagation for training artificial neural networks (ANNs) is usually associated with a long training process. The user needs to experiment with a number of network architectures; with larger networks, more computational cost in terms of training time is required. The objective of this letter is to present an optimization algorithm, comprising a multiobjective evolutionary algorithm and a gradient-based local search. In the rest of the letter, this is referred to as the memetic Pareto artificial neural network algorithm for training ANNs. The evolutionary approach is used to train the network and simultaneously optimize its architecture. The result is a set of networks, with each network in the set attempting to optimize both the training error and the architecture. We also present a self-adaptive version with lower computational cost. We show empirically that the proposed method is capable of reducing the training time compared to gradient-based techniques.

Algorithms↗
PubMed1996

Users' evaluation of the Navy Computer-Assisted Medical Diagnosis System.

U.S. Navy Independent Duty Corpsmen (IDCs) aboard small ships and submarines are responsible for all clinical and related health care duties while at sea. During deployment, life-threatening illnesses sometimes require evacuation to a shore-based treatment facility. At-sea evacuations are dangerous, expensive, and may compromise the mission of the vessel. Therefore, Group Medical Officers and IDCs were trained to use the Navy Computer-Assisted Medical Diagnosis (NCAMD) system during deployment. They were then surveyed to evaluate the NCAMD system. Their responses show that NCAMD is a cost-efficient, user-friendly package. It is easy to learn, and is especially valuable for training in the diagnosis of chest and abdominal complaints. However, the delivery of patient care at sea would significantly improve if computer hardware were upgraded to current industry standards. Also, adding various computer peripheral devices, structured forms, and reference materials to the at-sea clinician's resources could enhance shipboard patient care.

Allied Health Personnel↗
PubMed1993

Planning and implementing a microcomputer local-area network.

Factors to be considered in planning and implementing a microcomputer local-area network (LAN) in a pharmacy department are discussed. Reasons for implementing a LAN include the ability to share data, programs, and peripheral devices among multiple users. The network operating system may be full featured or a peer-to-peer system. Full-featured networks require a dedicated file server but are more powerful and versatile. The file server, if used, is the most important piece of equipment. Factors that affect the choice of a file server are the processor, the bus, memory and speed, the supplier, and the power supply. It is necessary to select network adapters and wiring and to decide whether any of the department's current computer equipment will be used in the network. Decisions must also be made about software. The equipment should be set up by the computer services department or a vendor. Two or more pharmacists must be appointed and trained as supervisors to manage the network, diagnose and correct problems, perform network backup, and guard against computer viruses. Security is a major concern because of the need for confidentiality, the licensure of software for only a limited number of users, and the risk of inadvertent alteration or erasure of data. Network users must be trained to use the system properly. Department managers should consider the need to access the LAN from computers outside the department and the possible incorporation of the LAN into a wide-area network. A microcomputer LAN can provide valuable information services, but careful planning is necessary to avoid pitfalls and to ensure that the network meets current and future needs.

Clinical Pharmacy Information Systems↗
PubMed2004

SpliceMachine: predicting splice sites from high-dimensional local context representations.

MOTIVATION: In this age of complete genome sequencing, finding the location and structure of genes is crucial for further molecular research. The accurate prediction of intron boundaries largely facilitates the correct prediction of gene structure in nuclear genomes. Many tools for localizing these boundaries on DNA sequences have been developed and are available to researchers through the internet. Nevertheless, these tools still make many false positive predictions. RESULTS: This manuscript presents a novel publicly available splice site prediction tool named SpliceMachine that (i) shows state-of-the-art prediction performance on Arabidopsis thaliana and human sequences, (ii) performs a computationally fast annotation and (iii) can be trained by the user on its own data. AVAILABILITY: Results, figures and software are available at http://www.bioinformatics.psb.ugent.be/supplementary_data/ CONTACT: sven.degroeve@psb.ugent.be; yves.vandepeer@psb.ugent.be.

Algorithms↗
PubMed1986

Data base management systems extend computer use.

A data base management system (DBMS) is a tool that can help the healthcare industry manage more information efficiently. This tool has the capability to store and retrieve data without the need for several programs or files. The DBMS is a sophisticated yet "user friendly" program that does not require any extensive computer training. In the age of microcomputers, the DBMS provides more power, eliminates seemingly unnecessary and repetitive work with data input, and falls within the budget range of most healthcare institutions.

Computers↗
PubMed2004

Detection of temporal delays in visual-haptic interfaces.

This paper addresses the question of how large the temporal delay between a visual and a haptic stimulus may be such that the stimuli are still perceived as being synchronous. Participants had to judge whether the moment at which a graphical object collided with a virtual wall occurred simultaneously with the moment at which a force was felt through a force feedback joystick. Participants either moved the joystick to drive the object (active touch) or held the joystick in a steady position while the object moved by itself (passive touch). Participants were found to be very sensitive to visual-haptic time delays. Sensitivity was higher for passive touch than for active touch. The minimum delay at which participants judged the stimuli as asynchronous was on average 45 ms. The delay at which the proportion of synchronous judgments reached a maximum was on average close to zero. The results indicate that the temporal accuracy of visual-haptic interfaces has to meet stringent requirements in order to optimize the overall realism that users experience. Actual or potential applications of this research include teleoperation, medical training, computer-aided-design, and scientific visualization.

Data Interpretation, Statistical↗
PubMed1997

Transitioning to the Internet: results of a National Library of Medicine user survey.

In late 1995, several months prior to the introduction of Internet Grateful Med, the National Library of Medicine (NLM) conducted a customer survey as part of its efforts to make a transition from Grateful Med to new forms of electronic information access and retrieval. A questionnaire survey was mailed to a sample of 2,500 online users randomly selected from domestic users (excluding fixed-fee users) who searched NLM databases during the second quarter of 1995. The final response rate was nearly 83% of eligible respondents. About 70% of NLM customers responding already had access to the Internet, and of those, more than 90% had access to the World Wide Web. However, only 26% of customers with Internet access were using the Internet to access NLM databases. Health care providers account for about 46% of NLM customers but, as a group, search NLM databases relatively infrequently even though they have higher-end equipment. Librarians and information professionals represent about one-fifth of NLM customers and are by far the most intensive users, but tend to have lower-end equipment. Overall, the survey results provide a strong basis for the transition to Internet-based delivery of NLM online database services, including Internet Grateful Med and the NLM family of World Wide Web sites. However, Internet access is uneven, especially in rural areas and at hospitals. This reinforces the need for continuing special outreach efforts directed at improving access for rural and hospital-based users and rural libraries, upgrading computer equipment for medical librarians, and training health care providers in more effective use of Internet-based biomedical information resources.

Chi-Square Distribution↗
PubMed2005

Use of point-of-care online clinical evidence by junior and senior doctors in New South Wales public hospitals.

BACKGROUND: The Clinical Information Access Program (CIAP), an online evidence retrieval system, provides NSW health professionals in public hospitals with 24 h access to information supporting evidence-based practice. AIM: To assess the frequency and type of CIAP usage by senior and junior medical staff and doctors' attitudes to CIAP. METHODS: A convenience sample of 25% of doctors from 65 randomly selected public hospitals completed a survey. Junior (n = 392) and senior (n = 684) doctors' responses were compared using chi2 analyses and t-tests. RESULTS: Most doctors had heard of CIAP (71.8%) and 60.6% had used it. More junior (72.4%) than senior (53.8%) doctors had used CIAP and junior doctors found it easier to use. Of the users 93.5% believed CIAP had the potential to improve patient care; 55.2% had directly experienced this. Most usage (61.5%) occurred at point-of-care; 74% of users found all/most of the information they sought and 71.6% found the search time to be 'good/excellent'. Users had increased their usage in the past year and predicted increased future usage. The most popular databases were Medline and MIMS. Age, access to other evidence, and lack of training, time and computer skills were associated with non-usage. Junior and senior users differed in 4 of 15 reasons for using CIAP. CONCLUSIONS: CIAP is used and valued by the majority of doctors. Patterns of usage, online experiences and the attitudes toward CIAP of senior doctors who use CIAP are relatively similar to those of junior doctors.

Adult↗
PubMed1993

A national survey to assess current use of computerised information systems in obstetrics.

OBJECTIVE: To ascertain the number and type of obstetric computer systems (OCS) in Great Britain, and to ascertain user satisfaction with these systems. DESIGN: A postal questionnaire was circulated to every consultant obstetrician in Great Britain at the beginning of 1992. MAIN OUTCOME MEASURES: Information was sought on the hardware, software and uses of obstetric computer systems. Satisfaction with, benefits and problems of the system were also assessed. RESULTS: There was an 87.5% response rate. Of the 264 units questioned, 100 units reported that they had a computer system. Sixty-five units used terminals connected to a mainframe or minicomputer and 17 used stand-alone personal computers (PCs). Local area networks (LANs) were used in 19 units and wide area network (WANs) in 22 units. Software varied from commercial turnkey systems to in-house systems. The quoted annual running cost ranged from 50 pounds to 48,000 pounds. Most units were satisfied with their system. Problems included slow operating times, unreliability, user unfriendliness, deficiencies in training and inadequate customer support services. CONCLUSIONS: Obstetric computer systems are now coming into widespread use. Despite problems, the use of such systems is likely to increase. This survey establishes a database for those units who are considering acquiring or changing their computer system for the purpose of audit or research.

Attitude to Computers↗