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Biomedical subjects

T A Pryor

Publications and source records attributed to T A Pryor.

At least 37 records · Page 2Linked to original sources
PubMed1991

A computer method for visual presentation and programmed evaluation of labor.

Manual graphing of the progress of labor is considered useful but is not often done. The early detection of some deviations requires special graphics aids. Our objective was to develop an easy-to-use computer program for the integrated visual presentation of information characterizing the progress of labor. Through the use of inexpensive personal computers equipped with graphics monitors, the program provides a combined graphics display of timed progressive cervical dilatation, fetal station, and stimulation of uterine activity (oxytocin infusion). For the early detection of abnormalities, phase-specific normal ranges (reference areas) are displayed. In addition, protraction/arrest as well as precipitate labor disorders are highlighted and computer messages are displayed. The program was evaluated through the assessment of 405 labors entered into a local area network of computers. On average, the program identified 1.5 abnormalities per recorded labor (2.0 for labors resulting in vaginal delivery). The graphic presentation of the labor curve, produced within 3 seconds, displayed 27% more information than the tabular format on the same screen area and provided a single-screen display of the labor curve even for patients with excessive data. The computer-generated display of labor curves facilitates visual presentation and interpretation of labor progress and can also help to translate quality assurance criteria into clinical practice.

Computer Graphics↗
PubMed1990

Development of decision support systems.

Use of hospital information systems (HIS) are no longer limited to administrative functions. The addition to these systems of decision support capability is now a necessity. Development of the decision support modules requires a different software architecture than that employed by most HIS systems today. This paper describes the generic uses of decision support throughout the many hospital applications. Several levels of decision support are outlined with examples to illustrate the many areas where decision support is useful. At LDS Hospital in Salt Lake City, Utah we have developed an HIS using a new software architecture which supports the creation of decision support applications. This system uses a frame structure to represent knowledge. Examples of the frames and their syntax is presented. Using the frame tools which are provided, an application developer can easily develop and test decision support modules which interact directly with the clinical user and the patient database.

Decision Making, Computer-Assisted↗
PubMed1989

Computerized nurse charting.

Computerized nurse charting programs have been used at LDS Hospital for over two years. These programs allow the nurse to create nurse care plans for the management of the patient, and chart on the computer actions and information which support the documentation of the management of the patient according to the care plan created for the patient. Computer terminals have been placed at the patient's bedside to facilitate the use of these programs. This paper describes the programs available at LDS Hospital and several evaluation studies which have been performed to measure the efficacy of the programs. The evaluation studies indicated an increase in the level of documentation completeness and accuracy by the nurse but at some minor expense to time available to the nurse for patient care. Evaluation of the need for bedside terminals versus centrally located terminals showed an overwhelming desire by the nurse in favor of the bedside terminal. It was also found that data was entered more timely with less waiting when bedside terminals were available. Physician acceptance of the nurse charting system was found to be favorable.

Humans↗
PubMed1989

Development of a computerized laboratory alerting system.

Using the capabilities of the HELP medical information system at LDS Hospital, a Computerized Laboratory Alerting System (CLAS) was developed. CLAS monitors and alerts for the presence of life-threatening conditions in hospitalized patients which are indicated by laboratory test results. Alerts are posted on computer terminals on the hospital's nursing divisions, where they are reviewed and acknowledged by hospital staff so that appropriate treatment can be rapidly instituted. CLAS was evaluated to determine its effectiveness in relaying alerts to the clinical staff, and improvements were made to develop an effective user interface. Initial average alert response times on nursing divisions ranged from 5.1 to 58.2 hr. The average alert response time dropped to 3.6 hr when alert review was integrated with laboratory result review, and to 0.1 hr after installation of a flashing light to notify hospital staff of the presence of new alerts.

Clinical Laboratory Information Systems↗
PubMed1984

Evaluation of size and dynamics of the inferior vena cava as an index of right-sided cardiac function.

To define normal criteria of size and dynamics of the inferior vena cava (IVC) and its clinical value in assessing right-sided cardiac function, 2-dimensional (2-D) and M-mode echocardiography (echo) were performed in 175 subjects, who were classified into 3 groups: group 1-80 normal subjects; group IIA--65 patients with documented right-sided cardiac disease, and group IIB--30 patients with cardiac disease but no right-sided abnormality. The IVC was adequately imaged in 175 of 185 subjects (95%). There was good correlation between M-mode and 2-D echo (r = 0.84) and long- and short-axis (r = 0.88) measurements. The IVC diameter during expiration was: group 1-9 to 28 mm (mean 18.2 +/- 4.6); group IIA--15 to 40 mm (mean 23.1 +/- 4.8) and group IIB-8-24 mm (mean 15.6 +/- 3.7). Collapsibility index (inspiratory decrease in diameter) was: group I-37 to 100% (mean 55.8 +/- 15.9); group IIA--0 to 39% (mean 13.5 +/- 10.5); and group IIB--44 to 100% (mean 60.4 +/- 13.1). A and V waves could be measured in 120 of 151 cases (79%). Both A and V waves were less than 125% of its diameter in group I. The A wave was absent in 34 patients; 30 (88%) were in atrial fibrillation. Among 8 patients with tricuspid regurgitation, 5 (63%) had V waves greater than 125%. There was no correlation between diameter or collapsibility index and age, sex, rhythm or body surface area.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Application of a computerized medical decision-making process to the problem of digoxin intoxication.

A computerized medical decision-making system was used to monitor signs and predisposing factors of digoxin intoxication in patients receiving digoxin. This process automatically reviewed the patient's data base nightly for drug interactions, laboratory data and electrocardiographic findings with known association with digoxin intoxication. These decisions were formated into a "digoxin alert report" and sent to line printers in the nursing division to be placed on the individual patients' charts. To assess the effect of these reports on patient management, a randomized double-blind study was undertaken. Patients were assigned to an alert or nonalert group. Alert reports were withheld from charts of patients in the nonalert group. A medical record review was subsequently carried out, wherein the physician's orders were searched to identify actions taken with possible relation to the digoxin alerts. The computer monitored 396 patients over a 3 month period. Of these, 211 (53%) were randomized to the alert group and 185 (47%) to the nonalert group. Seventy-two percent of patients received at least one alert. The most frequently occurring alerts included: hypoxemia, hypokalemia, concurrent use of a beta-adrenergic blocking agent, renal insufficiency and ventricular arrhythmia. Results from the record review demonstrated a 22% increase in physician actions for the alert group. Specifically, patients in the alert group were 2.7 times more likely to have a serum digoxin determination ordered and 2.8 times more likely to have digoxin withheld on the day of a digoxin alert than were patients in the nonalert group.

Aged↗
PubMed1983

The HELP system.

Explore the source record for details and available documents.

Computers↗
PubMed1981

Noninvasive evaluation of exercise training in college-age men.

The purpose of this study was to assess noninvasively the effects of intense aerobic training on cardiac structure and function in a group of healthy, college-age men (25 experimental and 11 control, mean age 22 years). Echocardiographic, electrocardiographic (ECG), and fitness measurements were obtained before and after a 3-month endurance training program and compared with similar measurements obtained in nonexercising subjects. The supervised training program consisted of 50-minute jogging sessions 5 days a week at 85% of maximal heart rate. Compared with the control group, echocardiography after training showed an increase in left ventricular (LV) end-diastolic dimension (p less than 0.05). LV posterobasal wall thickness, septal wall thickness and ejection fraction did not change significantly. ECG measurements revealed a decrease in resting heart rate (p less than 0.05) and an increase in R-wave voltage in leads V5 and V6 (p less than 0.01). The measured maximal oxygen consumption increased by 16% (p less than 0.001). These data indicate that intense aerobic training in college-age men results in a significant increase in resting LV end-diastolic dimension and volume. The increase in maximal stroke volume associated with exercise training may be partially explained by these changes in cardiac dimensions.

Adipose Tissue↗
PubMed1977

Evaluation of a computerized arrhythmia alarm system.

A prospective study of a computerized arrhythmia alarm system was carried out in the coronary care unit during 200 patient hours of monitoring. The computer system was designed to activate an alarm on the development of rhythm and conduction disorders including asystole, ventricular tachycardia, atrial tachycardia, sinus tachtcardia, bradycardia, frequent premature ventricular beats, atrial fibrillation and bundle branch block. Study patients were simultaneously monitored by the computer system and a conventional analog heart rate alarm system. All alarms generated by the two systems were evaluated. Of 79 computer alarms, 42 (53 percent) were true positive alarms; during the same period there were 167 analog alarms of which only 13 (8 percent) were true positive alarms. In both systems, false positive alarms were primarily due to patient movement, but they occurred only 25 percent as often with the computer system as with the analog system. These results indicate that computerized arrhythmia monitoring systems offer significant advantages over conventional monitoring techniques.

Arrhythmias, Cardiac↗