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Biomedical subjects

Arie Hasman

Publications and source records attributed to Arie Hasman.

9 recordsLinked to original sources
PubMed2003

Automated quantitative evaluation of diseased and nondiseased renal transplants with MR renography.

PURPOSE: To present a method of automated parametric quantification of dynamic MR enhancement curves of renal transplants and evaluate the disease-discriminating properties of the resulting MR renography (MRR) data. MATERIALS AND METHODS: This study included 27 patients with nondiseased renal transplants and eight patients with diseased renal transplants. The examination was repeated in 10 patients and the reproducibility of the enhancement parameters was estimated by analysis of variance (ANOVA). The disease-discriminating properties of the transplant volumes and enhancement parameters were tested with t-tests and logistic regression analysis. RESULTS: The enhancement parameters were reproducible. The mean medullary nephronal washout rate (lambda1) and cortical arterial blood volume (mu0) were lower in diseased renal transplants. The combination of these parameters was a strong predictor of renal transplant disease (area under ROC curve 0.98; 95% confidence interval 0.96-1.0). CONCLUSION: Automated parametric quantification of cortical and medullary enhancement is feasible and allows the accurate detection of nonsurgical disease in renal transplants by MRR.

Analysis of Variance↗
PubMed2003

PropeR: a multi disciplinary EPR system.

This article describes the architecture of an EPR system developed for the PropeR project. This EPR system not only aims at supporting home care of stroke patients, but is also designed in such a way that it can be ported to other medical services without much effort. We will briefly describe the Stroke Service and the related PropeR project. Starting from a list of requirements to construct a generic EPR system we will outline the architecture and describe the standards and methods used. Subsequently we describe the implementation and the problems encountered. In the discussion, we will go into the advantages and disadvantages of the tools and techniques we have used.

Computer Systems↗
PubMed2003

Towards a PropeR combination of patient records and protocols.

PROBLEM: The combination of a computer-based patient record and a decision-support system (DSS) may give physicians the decisive push they need to accept such systems. In the PropeR-project we determine the requirements for a generic interface between both these systems and evaluate its potential impact on patient care. This article reports results from the first year in one of the domains under study. It also provides background information about the project, including design considerations and experimental approach of forthcoming years. PURPOSE: The objectives of the first year were to determine bottlenecks of the current situation and to determine expected improvements and conditions for implementation of a future situation with computer support. METHODS: These topics were investigated in general by literature review and in the local situation by a requirements analysis. For the analysis we used a combination of observation, interviews, and patient record study. For the literature survey we searched for reviews, meta-analyses and original studies concerning experiences with computer-based patient records and DSSs in conventional settings and in integrated care. RESULTS: Main bottleneck was the poor use of shared patient record and paper guidelines. Expected improvements were better protocol adherence and communication. Conditions for implementation of computer support were a proper system interface and adoption by the user. CONCLUSION: Our main conclusion was that the aspect of cooperation needs more decision support than the clinical work itself.

Clinical Protocols↗
PubMed2003

Validity and reliability of the Nursing Minimum Data Set for the Netherlands (NMDSN).

UNLABELLED: The Nursing Minimum Data Set for the Netherlands (NMDSN) describes nursing care based on nursing phenomena, interventions and outcomes. The validity and reliability of its data collection has not been tested yet. PURPOSE: To report about the discriminative validity and the interrater reliability of the NMDSN. DESIGN: Data were collected in an intensive care ward, in a nursing home and in a residential home. The unit of measurement and analysis is the 'patient day'. The analysis for validity consisted of ridits calculations, and their graphical representations. Interrater reliability was measured by percentage agreement and Cohen's kappa. RESULTS: Graphs illustrate the differences on most nursing phenomena and interventions as expected beforehand. The percentage agreements for the residential home vary from 60.4 to 100%, and the kappa statistics from -0.09 to 0.85, indicating a poor to almost perfect interrater reliability. CONCLUSION: Intensive care patients and patients in the nursing home have more problems and need more nursing interventions compared with general hospital patients, while the patients in the residential home have lesser of both. This illustrates the discriminative validity of the NMDSN. The kappa values for various NMDSN variables are sufficient. A similar test in the general hospital is recommended.

Adult↗
PubMed2002

Application of computer simulation analysis to assess the effects of relocating a hospital phlebotomy department.

BACKGROUND: This study describes a systematic approach to assess the effects of relocating a hospital department. METHODS: Using the phlebotomy service as an example, computer simulation was applied to predict changes in performance indicators, such as patient turn-around time (TAT), when planning a procedural and/or architectural redesign. RESULTS: Average patient TAT fell from 12 to 8 min, enabling the department to cope with any increase in numbers of patients. CONCLUSION: This type of study can provide useful information in assessing the consequences of future changes in the location of a hospital department.

Appointments and Schedules↗
PubMed2002

Turn-around time for chemical and endocrinology analyzers studied using simulation.

Simulation can be a means for the laboratory management to investigate the effects of proposed changes in the laboratory. Also, when specifications of analyzers are available one can investigate which analyzer should be purchased to fulfill existing needs. The potential of simulation is shown here by simulating the turn-around time of batched samples under several conditions. Three routine analyzers (DAX, AXON and Immuno-1) were modeled. The temporal pattern of the arrival of the samples at the different analyzers was determined. The impact of these patterns and the two batching methods on the turn-around time was investigated. Simulation proved to be a useful method to study the effects of batching and arrival patterns on the turn-around time.

Blood Chemical Analysis↗
PubMed1998

Assessing the importance of features for multi-layer perceptrons.

In this paper we establish a mathematical framework in which we develop measures for determining the contribution of individual features to the performance of a classifier. Corresponding to these measures, we design metrics that allow estimation of the importance of features for a specific multi-layer perceptron neural network. It is shown that all measures constitute lower bounds for the correctness that can be obtained when the feature under study is excluded and the classifier rebuilt. We also present a method for pruning input nodes from the network such that most of the knowledge encoded in its weights is retained. The proposed metrics and the pruning method are validated with a number of experiments with artificial classification tasks. The experiments indicate that the metric called replaceability results in the tightest error bounds. Both this metric and the metric called expected influence result in good rankings of the features.

Journal Article↗
PubMedDate not supplied

The reliability of assessing the appropriateness of requested diagnostic tests.

Despite a poor reliability, peer assessment is the traditional method to assess the appropriateness of health care activities. This article describes the reliability of the human assessment of the appropriateness of diagnostic tests requests. The authors used a random selection of 1217 tests from 253 request forms submitted by general practitioners in the Maastricht region of The Netherlands. Three reviewers independently assessed the appropriateness of each requested test. Interrater kappa values ranged from 0.33 to 0.42, and kappa values of intrarater agreement ranged from 0.48 to 0.68. The joint reliability coefficient of the 3 reviewers was 0.66. This reliability is sufficient to review test ordering over a series of cases but is not sufficient to make case-by-case assessments. Sixteen reviewers are needed to obtain a joint reliability of 0.95. The authors conclude that there is substantial variation in assessment concerning what is an appropriately requested diagnostic test and that this feedback method is not reliable enough to make a case-by-case assessment. Computer support maybe beneficial to support and make the process of peer review more uniform.

Decision Support Systems, Clinical↗