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PubMed1999

A program to compute McGraw and Wong's common language effect size indicator.

McGraw and Wong (1992) have described a very appealing index of effect size that requires no prior knowledge of statistics to understand, which they termed CL, the common language effect size indicator. CL is the probability that a score randomly sampled from one distribution will be larger than a randomly sampled score from a second distribution. McGraw and Wong describe how to compute CL from the means and standard deviations of two groups, using tables of normal curve probability values. The program described herein computes CL without lookup tables but also permits the user to compute CL from Cohen's d, from a t test for independent groups, or from point-biserial r, the correlation between a dichotomous and a continuous variable. A table giving CL for various values of d is also provided, as are the equations for converting t and r to d.

Models, Statistical↗
PubMed1997

Utility of a software assistant in critical care case review.

A computer program (the Audit Assistant) was developed to help physicians review the care of critically ill emergency department (ED) patients. The program is an example of a new class of decision aids that serves to remind physicians to consider possibilities, not an artificial intelligence program that actually attempts to simulate clinical reasoning. The goal of such programs is to enable physicians to reduce errors--in this case to enable reviewers to notice more of the errors in care in the cases they are reviewing. The objective of this study was to demonstrate on a small set of complex cases that the tested computer program enables the physician to perform a better quality review. The issue of what constitutes improved case review is addressed. In the first part of the study, reviewers reviewed two mock charts without using the Audit Assistant and then immediately reviewed the charts again with the assistance of the program. The reviews were compared. In the second part of the study, a second reviewer also compared the utility of the review of the first reviewer alone and the Audit Assistant output as an aid to review, using an additional mock chart. Six emergency physicians participated; each was a quality assurance director for the ED of one Cleveland area hospital. For the physicians reviewing without the Audit Assistant, 41% of critical actions were listed by three or four reviewers. For those using the Audit Assistant, 83% of critical actions were listed by three or four reviewers. All reviewers preferred the Audit Assistant-suggested list to the critical action list generated by a previous reviewer not using the Audit Assistant (P < .02). Use of the Audit Assistant improved the completeness and the consistency of physician review of mock charts of critically ill ED patients in a small series of cases. The critical actions added for review were important, as demonstrated by the preferential addition of critical actions chosen by other reviewers who were not using the computer program.

Critical Care↗
PubMed1988

Facilitating medication incident analysis through computerization.

A computer program to facilitate medication incident analysis is described. This program was developed to provide the hospital's Medication Quality Assurance Committee with more meaningful data on medication incidents in an easily accessible database as well as enhanced data storage. The menu-driven program was developed on an Olivetti M-24 SP microcomputer using Lotus 1-2-3 and Harvard Business Graphics software. The structured format of the database contains specific information from each individual medication incident report. On a monthly basis, macro commands are used to extract criteria-based data from the database and present this information in a tabular format. In addition, annual data tables are complied to provide year-to-date data summaries. The database and tables are copied and stored on a computer diskette each month. This computer program has provided the Medication Quality Assurance Committee with an improved system for medication incident data analysis. The major benefit of this computer program over the previous manual system is the more timely identification of medication-related practices requiring closer monitoring and/or revision to improve patient care.

Data Interpretation, Statistical↗
PubMed1986

Computerized system for a nutritional support service.

The development of a computerized system for the assistance of a nutritional support service (NSS) is described. A cooperative program exists between the NSS and the Department of Laboratory Medicine, whose computer system is used to support the activities of the NSS. A record is maintained on each patient followed by the NSS (15-20 patients per day). Demographic and anthropometric data, nutritional disorder(s), laboratory data, nutritional support therapy, patient response criteria, and concomitant drug therapy are components of the computer program. Computer reports are provided to the NSS for daily rounds. An automated nutritional assessment program has also been developed. Computer assistance has proven to be a valuable tool to support the patient care, education and research program of the NSS.

Computers↗
PubMed1998

Effect of operationalized computer diagnosis on the therapeutic results of sumatriptan in general practice.

A multicenter test was conducted to investigate the effectiveness of the selective serotonin agonist sumatriptan in patients with the computerized headache diagnosis of migraine. A computer program was used for diagnostic evaluation of patients attending a general practice because of headache. The results of the analysis were taken as a direct decision on therapy. If the patients satisfied the criteria for migraine, they were given subcutaneous sumatriptan for treating three migraine attacks. The patients were able to use the study medication under outpatient conditions. The therapeutic efficacy of the medicine was recorded in a headache diary. A total of 91 patients were included in the study at 22 practices in Germany. An average of four patients per practice were recruited. In the first migraine attack treated, headache improvement was experienced by 77.7% of the patients treated. In the second and third attacks an improvement was experienced by 93.5% and 89.8%, respectively. The results show that by optimizing diagnostic reliability with the aid of the computer program a high response rate can be achieved under practice conditions using the selective serotonin agonist sumatriptan. Since the computer program described permits a specific diagnosis, it improves the prospects of effective headache therapy in the individual patient. Thus treatment based on this approach can reduce inputs of time and money in migraine therapy.

Adolescent↗
PubMed1994

Computer acquisition, analysis and presentation of results from a Cobas Bio analyser.

Two computer programs for Macintosh computers have been developed in the LabVIEW programming language to perform data acquisition, analyses and presentation of results originating from a Cobas Bio analysing machine. One program is very flexible in its human interface, and is intended for research use. The program allows the results to be combined in a variety of ways, and allows the user to generate graphs to highlight the results. The other program is intended for routinely follow-up of analyses of proteases. It only allows the user to follow strict instructions, and only limited flexibility is built-in.

Autoanalysis↗
PubMed1997

Cost-effective management of high-risk patients: a case-map approach.

BACKGROUND: The case-management approach to patient care used by most cardiac surgical practices frequently highlights patients designated as high-risk. Increased risk might be because of advanced age, the need for complex reoperations, high risk of bleeding, and renal failure, all of which may be superimposed on poor ventricular performance. METHODS: A small consensus panel of cardiac surgeons, anesthesiologists, perfusionists, cardiac-care nurse managers, and coagulation experts met to assess the potential for development of case-management pathways targeted towards high-risk coronary artery bypass graft patients. The process comprised review of the literature to identify risk factors and strategies most cost-effective in reducing risk. RESULTS: A series of management strategies driven by data from the literature--or by consensus when such information was not available--were developed to cost-effectively manage the high-risk patient. The process was then converted to a multidimensional computer program. This personal computer-driven program served as a framework upon which any institution could impose its own practice style and modify recommendations. The program was designed to be interactive and to allow easy transition from patient-management strategies to support data. A facilitator generally coordinates the interaction between the local patient-care group and the computer information base to evolve a case-management map. CONCLUSIONS: By using stored information based on current literature and easily updated, the system is both educational and product oriented, and provides a case-map approach to the cost-effective management of patients during the preoperative, intraoperative, and postoperative phases of hospital care.

Case Management↗
PubMed2005

Using a computer to teach patients about fecal occult blood screening. A randomized trial.

OBJECTIVE: To determine whether a multimedia computer program could effectively teach patients about fecal occult blood testing (FOBT) and increase screening rates. DESIGN: Randomized trial. SETTING: University-affiliated, community-based Internal Medicine outpatient practice. PARTICIPANTS: All English-speaking patients aged 50 years and older who were offered FOBT screening by their providers were invited to participate. Two hundred and four patients enrolled in the study. Ten patients were later determined to be ineligible. INTERVENTIONS: Patients were randomized to either the educational multimedia computer program or usual nurse counseling about FOBT screening. Screening instructions were based on the material pre-printed on each test kit. Educational sessions were held in a private setting immediately after each patient's office visit. MEASUREMENTS AND MAIN RESULTS: A knowledge-assessment questionnaire was administered in a blinded fashion by telephone the following day. Successful screening was defined as return of the test kits within 30 d. Completion of the FOBT kits was similar in both groups: 62% (58/93) in the computer group and 63% (64/101) in the nurse group (P=.89). Mean knowledge scores were also similar, but there was a trend toward increased knowledge mastery in the computer group (56% vs 41%, P=.09). CONCLUSIONS: A multimedia educational computer program was as effective as usual nurse counseling in educating patients and achieving adherence to FOBT screening. Future studies are needed to determine whether computer-assisted instruction can improve health outcomes.

Aged↗
PubMed1997

An ab Initio Study of the NH2+ Absorption Spectrum

In a previous publication (1997. P. Jensen, J. Mol. Spectrosc. 181, 207-214), rotation-vibration energy levels for the electronic ground state X3B1 of the amidogen ion, NH2+, were predicted using the MORBID Hamiltonian and computer program with an ab initio potential energy surface. In the present paper we calculate a new ab initio potential energy surface for the X3B1 state, and we calculate ab initio the potential energy surfaces of the a1A1 and b1B1 excited singlet electronic states (which become degenerate as a 1Delta state at linearity). We use the multireference configuration interaction (MR-CI) level of theory with molecular orbital bases that are optimized separately for each state by complete-active-space SCF (CASSCF) calculations. For the X state we use the MORBID Hamiltonian and computer program to obtain the rotation-vibration energies. For the a and b excited singlet electronic states we calculate the rovibronic energy levels using the RENNER Hamiltonian and computer program. We also calculate ab initio the dipole moment surfaces for the X, a, and b electronic states, and the out-of-plane transition moment surface for the b <-- a electronic transition. We use this information to simulate absorption spectra within X3B1 and a1A1 state and of the b1B1 <-- a1A1 transition in order to aid in the search for them. Copyright 1997 Academic Press. Copyright 1997Academic Press

Journal Article↗
PubMed1984

Personal computer based programs for the handicapped.

This is an experience report concerning the utilization of personal (micro) computers for in and outpatients of The Burke Rehabilitation Center. Three Apple II Plus desk computers and peripherals are in use with the following objectives:-- To provide access via a variety of interface switches. To motivate and train child and juvenile amputees undergoing upper limb amputation rehabilitation. To provide a different approach to neuropsychological testing and behavioural assessment. To provide cognitive rehabilitation programs for patients with head trauma and stroke. To add another option for pre-vocational evaluation. The report discusses computer access technology along with a description of program applications. Conclusions based on the preliminary results of observing 101 patients are given.

Computers↗
PubMedDate not supplied

An educational intervention for advance directives.

In spite of the passage of the Patient Self-Determination Act in 1991, research indicates that providing information alone has not brought about a significant increase in the completion rates of advance directive (AD) documents. The purpose of this pilot study was to design, implement, and evaluate an interactive multimedia CD-ROM educational program on AD. Study subjects consisted of 31 volunteer elderly men and women in a senior citizens center. An interactive multimedia CD-ROM program was developed in phase I of the study. Subjects were administered on-line pretests and posttests. The effectiveness of the CD-ROM intervention was measured by AD attitude and knowledge changes. A program satisfaction scale was used, and an observer rated the subjects' use of the computer program. Subjects had a statistically significant change in posttest knowledge scores and a high degree of satisfaction and ease in using the computer program. The use of an interactive multimedia CD-ROM program with a touch-sensitive monitor to operate a computer-based AD program for senior citizens shows future promise.

Advance Directives↗
PubMed2000

Computer support for interpreting family histories of breast and ovarian cancer in primary care: comparative study with simulated cases.

OBJECTIVES: To evaluate the potential effect of computer support on general practitioners' management of familial breast and ovarian cancer, and to compare the effectiveness of two different types of computer program. DESIGN: Crossover experiment with balanced block design. PARTICIPANTS: Of a random sample of 100 general practitioners from Buckinghamshire who were invited, 41 agreed to participate. From these, 36 were selected for a fully balanced study. INTERVENTIONS: Doctors managed 18 simulated cases: 6 with computerised decision support system Risk Assessment in Genetics (RAGs), 6 with Cyrillic (an established pedigree drawing program designed for clinical geneticists), and 6 with pen and paper. MAIN OUTCOME MEASURES: Number of appropriate management decisions made (maximum 6), mean time taken to reach a decision, number of pedigrees accurately drawn (maximum 6). Secondary measures were method of support preferred for particular aspects of managing family histories of cancer; importance of specific information on cancer genetics that might be provided by an "ideal computer program." RESULTS: RAGs resulted in significantly more appropriate management decisions (median 6) than either Cyrillic (median 3) or pen and paper (median 3); median difference between RAGs and Cyrillic 2.5 (95% confidence interval 2.0 to 3.0; P<0.0001). RAGs also resulted in significantly more accurate pedigrees (median 5) than both Cyrillic (median 3.5) and pen and paper (median 2); median difference between RAGs and Cyrillic 1.5 (1.0 to 2.0; P<0.0001). The time taken to use RAGs (median 178 seconds) was 51 seconds longer per case (95% confidence interval 36 to 65; P<0.0001) than pen and paper (median 124 seconds) but was less than Cyrillic (median 203 seconds; difference 23. (5 to 43; P=0.02)). 33 doctors (92% (78% to 98%)) preferred using RAGs overall. The most important elements of an "ideal computer program" for genetic advice in primary care were referral advice, the capacity to create pedigrees, and provision of evidence and explanations to support advice. CONCLUSIONS: RAGs could enable general practitioners to be more effective gatekeepers to genetics services, empowering them to reassure the majority of patients with a family history of breast and ovarian cancer who are not at increased genetic risk.

Breast Neoplasms↗
PubMed1987

A program which determines mutagenic concentrations of chemical carcinogens via a diffusion bioassay.

A computer program implementing a mathematical model for determining mutagenic concentrations of chemical carcinogens was developed. The mathematical model describes the experiment in which a droplet of a suspected carcinogen is put at the center of a petri dish containing a bacterial lawn in an agar gel. After a period of incubation during which the chemical diffuses outward, one observes a concentric ring of mutants around the center. The largest radius at which mutation occurs, r mut, corresponds to the lowest (threshold) concentration of the chemical sufficient to produce bacterial mutation. Given a series of initial concentrations of a chemical and the resulting r mut's, the program computes and reports the threshold concentration and the decay time of the chemical. The program is also used as a method to determine the lowest mutagenic concentration for a particular time of exposure.

Diffusion↗
PubMed1995

Computer-assisted multidimensional atlas for functional stereotaxy.

Functional stereotactic operations are currently performed primarily for medically uncontrollable Parkinson's disease and pain. In contrast to the targets in neuro-oncology, those in functional stereotaxy cannot be represented directly by modern imaging methods. The target co-ordinates must therefore be calculated with the aid of special stereotactic atlases. These are publications in which a model brain has been constructed from autopsy examinations on a number of brains, or the data obtained have been compiled in the form of tables and histograms on which the calculation is then based. The target can then be determined based on the classic stereotactic landmarks and reference lines, such as the anterior commissure (AC), the foramen of Monro (FM), the posterior commissure (PC) or the base line FM-PC or AC-PC and the height of thalamus, taking into account the interindividually different anatomical proportions. Since the computational procedures involve repetitious algorithms, it was obvious that such procedures should be run by a computer program. For the most common stereotactic targets, we have developed a computer program for data storage on the one hand and computation and graphic output on the other. The output can be displayed on the monitor and can also be plotted out on paper or overhead transparency. Calibrating between the program and printer renders a 1:1 reproduction, i.e. the graph can be superimposed directly onto original x-rays or images from computed tomography or nuclear magnetic imaging. The graph can be plotted in the three dimensions of the Cartesian co-ordinate system. An additional dimension can be attained by simultaneously including and plotting the data from different atlases and thus from different authors, including one's own data. In addition to the information capacity which this system offers, it also makes possible a considerable reduction in the time for computing the target while at the same time increasing the reliability.

Algorithms↗
PubMed2004

A new method for semiautomatic analysis of surface EMG in patients with oral parafunctions.

Sleep-related phenomena or disorders, including snoring and tooth grinding, can be investigated using polysomnography. This method, however, generates large amounts of synchronically recorded data that are often analyzed visually with subjective interpretation. The purpose of this study was to minimize the need for subjective evaluation by developing a computer program for analysis of EMG data linked with polysomnographic recordings in a standardized and semi-automatic way. The selected algorithm differs from the Root Mean Square (RMS) method by being based on the theory of "differentiated EMG" (DIFEMG), which relies on two principles. The first says that the activation of a larger number of motor units results in a greater force production. The second principle says that the force production will continue for some time after the muscle is no longer stimulated. After a visual check for artifacts in the basic EMG recordings, the computer program is used to analyze the corrected basic EMG signal. The results were that both methods yield identical results as far as the detected number of events is concerned. There is, however, a significant difference when the duration of the events is considered, because the start and end of an event can be more accurately determined with the new method presented here. The computer program described will make comparison of data from different studies easier.

Algorithms↗
PubMed1989

Logistic regression model for the assessment of microalbuminuria and microproteinuria in insulin-dependent diabetic patients at risk.

Diabetic microalbuminuria, which predisposes to the irreversible macroproteinuria and terminal renal failure, has been shown to be reversible by stringent metabolic control. In this study, using logistic regression, 23 patients with insulin-dependent diabetes mellitus were evaluated. Basing on the reported biochemical changes in patients with diabetes mellitus, the relationship between microalbuminuria and serum biochemistries was assessed. Four biochemical parameters were shown to be significantly related to the amount of microalbuminuria and microproteinuria. The microalbuminuria as assayed by rocket immunoelectrophoresis is closely correlated with the microproteinuria as measured by the Coomassie dye binding method and both have a significant relationship with plasma creatinine, bicarbonate, albumin and globulin as assessed by the Minitab computer program and the Biomedical Data Package--Logistic Regression computer program. The relationship with bicarbonate and creatinine can be due to a decrease in glomerular filtration rate associated with more advanced microproteinuria. The relationship with albumin and globulin is the result of impaired albumin synthesis by the liver in diabetes mellitus. From these data, two simple equations which can provide a relative risk factor with rough quantitative assessment for microproteinuria and microalbuminuria are derived. Thus, from these four parameters available from relatively simple blood biochemistries, assessment can be made of the severity of coexisting diabetic proteinuria. The measurement of the latter is not readily available and is more costly and tedious. This assessment together with the finding of a decrease in albumin, slight increase in creatinine and decrease in bicarbonate associated with the more severe microalbuminuria can be used to alert the diabetologist in implementing tighter metabolic control and other interventional methods before irreversible macroproteinuria develops.

Adult↗
PubMed2003

High-throughput fingerprinting of bacterial artificial chromosomes using the snapshot labeling kit and sizing of restriction fragments by capillary electrophoresis.

We have developed an automated, high-throughput fingerprinting technique for large genomic DNA fragments suitable for the construction of physical maps of large genomes. In the technique described here, BAC DNA is isolated in a 96-well plate format and simultaneously digested with four 6-bp-recognizing restriction endonucleases that generate 3' recessed ends and one 4-bp-recognizing restriction endonuclease that generates a blunt end. Each of the four recessed 3' ends is labeled with a different fluorescent dye, and restriction fragments are sized on a capillary DNA analyzer. The resulting fingerprints are edited with a fingerprint-editing computer program and contigs are assembled with the FPC computer program. The technique was evaluated by repeated fingerprinting of several BACs included as controls in plates during routine fingerprinting of a BAC library and by reconstruction of contigs of rice BAC clones with known positions on rice chromosome 10.

Chromosome Mapping↗
PubMed2003

Instrument for extraction socket measurement in immediate implant installation.

The aim of the present study was to create an instrument and a computer program for measurement of extraction sockets and for planning of the immediate replacement of teeth using screw-shaped dental implants. Ten titanium screw-shaped Osteofix Dental Implant System implants (Osteofix, Oulu, Finland) were immediately installed after extraction in nine patients, four women and five men (age 17-62 years). The measurements of fresh extraction sockets were taken at six points (mesio-buccal, buccal, disto-buccal, disto-lingual, lingual and mesio-lingual) using an instrument created by the author. The area of no contact between bone and dental implant was 11-40% (mean 31%, SD 9%), calculated by computer program. If less than 30% of the implant surface area would be in contact with the bone, immediate replacement was abandoned because sufficient primary stability could not be achieved. Guided bone regeneration was promoted by covering the implant and bone defect with deproteinized bovine bone mineral (Bio-Oss, Geistlich AG, Wolhusen, Switzerland) and bioresorbable collagen membrane (Bio-Gide, Geistlich AG), fixed in place with resorbable pins (Resor Pin, Geistlich AG). After 6 months a considerable, statistically significant (P < 0.05) defect reduction of 90% (SD 7%) was noted. It was concluded that an instrument and a computer program created for extraction socket measurement are useful in some borderline cases when there is lack of bone and the success of one-stage implantation is doubtful.

Absorbable Implants↗