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Biomedical subjects

P R Fisher

Publications and source records attributed to P R Fisher.

12 recordsLinked to original sources
PubMed1992

Identifiable semen donors--attitudes of donors and recipient couples.

Fifty-three couples embarking on donor insemination (DI) replied to an anonymous questionnaire asking what they wanted to know about the donor should they become pregnant. Fifty-one percent were definitely and 32% probably going to tell a child of its donor origins. Items most frequently listed for themselves and on behalf of a child were--interests/sports (57%), physical attributes (41%), occupation (37%) and family background (26%). Forty-two percent of the women and 28% of the men thought the child should have access to the identity of the donor eventually. Thirty-eight donors were surveyed by a questionnaire; 68% were agreeable to their identity being available to a donor insemination child when the child reached maturity. When the category of identifiable donor was created, 20 of 36 (56%) new donors and donors still donating chose this option.

Adult↗
PubMed1991

The prospect of expert system-based cognitive support as a by-product of image acquisition and reporting.

In order for computer-based decision-support tools to find routine use in the everyday practice of clinical radiology, further development of user interface and knowledge content are required. In an ideal interface, the interaction between the radiologist and the computer would be minimized and painlessly integrated into existing work patterns. In this article, we explore some of the ways that pre-existing computer interactions in the processes of image acquisition and reporting can be used to feed case information into an expert system and thereby allow users to acquire advice from it in an automatic fashion. We describe interface models that we have developed in the domains of mammography and obstetric ultrasound, and discuss interface and content-related questions that have arisen from informal evaluations of these systems. In particular, the need for clinical outcome-relevant decision support and training level-appropriate decision support are discussed in detail.

Expert Systems↗
PubMed1990

Knowledge-based radiologic image retrieval using axes of clinical relevance.

This paper describes an approach to computer-based intelligent retrieval of feature-coded radiographic images relevant to a specific case being evaluated. The approach involves partitioning the search space along clinically natural groups of attributes which we call "axes of clinical relevance." By embedding knowledge about the domain to help direct the search process, a clinician's needs may be met more comprehensively. Domain knowledge, supplied to the system as "axis heuristics," may make search more robust. These heuristics provide a graded, progressive relaxation of the search constraints. This approach helps show the user groups of images in order of probable relevance to a current case. AXON is a prototype knowledge-based system constructed to illustrate this approach in the domain of chest imaging. This paper describes the AXON system, demonstrates some searches which illustrate the potential utility of this approach, and discusses preliminary tests of the search strategies used by AXON.

Expert Systems↗
PubMed1990

Exploring subjective vs. objective issues in the validation of computer-based critiquing advice.

Evaluation is an important part of the development of computer-based medical expert systems. Such evaluation may be particularly difficult when judging a critiquing system which responds to a proposed management strategy with a discussion of the advisability of that approach. DxCON is an expert system which produces a prose critique discussing the radiologic workup of obstructive jaundice. This paper describes DxCON, and its experimental validation by three independent judges. A central component of the validation involved allowing the judges to react to the system's advice in a quite flexible, unstructured fashion. This project provides a case study of how subjective issues impact both the design and implementation of a validation of a medical expert system whose output is explanatory prose.

Cholestasis↗
PubMed1990

Pseudopodium activation and inhibition signals in chemotaxis by Dictyostelium discoideum amoebae.

The behaviour of Dictyostelium discoideum amoebae has been studied in natural cAMP waves and in controlled spatial and temporal gradients. Chemoattractant gradients induce responses which indicate that amoebae spatially compare concentration increases at different points on the cell surface. This allows them to respond to the relative spatial and temporal gradients in a manner that is little affected by the absolute attractant concentration over several orders of magnitude. The changes in turning behaviour, motility and morphology that are induced by attractant gradients are consistent with transduction of stimuli into two intracellular signals - one activating and the other inhibiting pseudopodium formation. The former measures the present attractant concentration at particular points on the cell surface - the local, current signal. The latter measures the average attractant concentration over the whole cell surface during the recent past - the global, past signal. Both signals may be part of a normal pseudopodium autoactivation and inhibition system responsible for amoeboid morphology and motility. Attractants could modulate this system to generate the complex behavioural responses observed.

Cell Aggregation↗
PubMed1989

Optimizing radiologic workup: an artificial intelligence approach.

The increasing complexity of diagnostic imaging is presenting an ever expanding variety of radiologic test options to clinicians. As a result, it is becoming more difficult for referring physicians to select an appropriate sequence of tests. The current economic pressures on medicine make it particularly important that resources be used judiciously. Radiologic workup often involves a sequence of tests that lead from presenting signs and symptoms to a definitive diagnosis or intervention. This sequence ideally begins with simple, inexpensive, safe, non-invasive tests and progresses to more complex, expensive, and hazardous tests only if the simpler tests are insufficient to establish a diagnosis. DxCON is a developmental artificial intelligence-based computer system that gives advice to physicians about the optimum sequencing of radiologic tests. DxCON evaluates basic clinical information and a physician's proposed workup plan. The system then creates an analysis of the strengths and weaknesses of his plan. The domain chosen to explore computer-based workup advice is the radiologic workup of obstructive jaundice.

Cholestasis↗
PubMed1989

Quantitative analysis of cell motility and chemotaxis in Dictyostelium discoideum by using an image processing system and a novel chemotaxis chamber providing stationary chemical gradients.

An image processing system was programmed to automatically track and digitize the movement of amebae under phase-contrast microscopy. The amebae moved in a novel chemotaxis chamber designed to provide stable linear attractant gradients in a thin agarose gel. The gradients were established by pumping attractant and buffer solutions through semipermeable hollow fibers embedded in the agarose gel. Gradients were established within 30 min and shown to be stable for at least a further 90 min. By using this system it is possible to collect detailed data on the movement of large numbers of individual amebae in defined attractant gradients. We used the system to study motility and chemotaxis by a score of Dictyostelium discoideum wild-type and mutant strains, including "streamer" mutants which are generally regarded as being altered in chemotaxis. None of the mutants were altered in chemotaxis in the optimal cAMP gradient of 25 nM/mm, with a midpoint of 25 nM. The dependence of chemotaxis on cAMP concentration, gradient steepness, and temporal changes in the gradient were investigated. We also analyzed the relationship between turning behavior and the direction of travel during chemotaxis in stable gradients. The results suggest that during chemotaxis D. discoideum amebae spatially integrate information about local increases in cAMP concentration at various points on the cell surface.

Cell Movement↗
PubMed1989

Expert system-controlled image display.

Conventional computer-based medical expert systems deliver advice to physicians as written text. While such advice is useful, it has distinct limitations in a visually oriented discipline such as diagnostic radiology, in which decisions often depend on pattern recognition and appreciation of subtle morphologic features. The authors developed a prototype expert computer system, IMAGE/ICON, which displays groups of images sorted into a series of axes based on different ways in which they may be similar. They may share a common feature, group of features, causes, or clinical setting. IMAGE/ICON may display examples of morphologic variations of a dominant finding or a spectrum of abnormalities seen in an specific disease or group of diseases. The system also assembles a written analysis of key features of a case. Such a tool may be useful as a diagnostic aid or for continuing medical education. It is likely to have particular impact in the form of an intelligent radiologic workstation, as picture archiving and communication systems become available.

Diagnosis, Computer-Assisted↗