Clinical problem solving by computer.

B Klemenz; D McSherry; V Grundke

PubMed · 9044195

Clinical problem solving by computer.

Abstract

Computer access to the medical literature has become more convenient than ever with MEDLINE and other bibliographical databases available on CD-ROM. The benefits of literature searching by computer include improvements in the quality of medical decision making and cost effectiveness of patient care. However, the results obtained by physicians with amateur searching skills are often inferior to those obtained through the traditional service mediated by a skilled librarian. To ensure that future physicians develop the skills necessary for effective use of the medical literature, it is essential to provide training in literature searching by computer at medical school.

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CD-ROM Databases, Bibliographic Information Storage and Retrieval MEDLARS Problem Solving Journal Article

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B Klemenz, D McSherry, V Grundke. Clinical problem solving by computer.. https://pubmed.ncbi.nlm.nih.gov/9044195/

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Measurement of facial movement with computer software.

OBJECTIVE: To adapt desktop computer software to objectively grade facial movement. DESIGN: The criteria of the facial nerve grading system by House and Brackmann, the current "gold standard," are prone to ambiguous interpretation. Proposed objective grading systems compare the movement of points on each side of the face or use subtraction and thresholding of digitized images of the face to yield images that represent moving areas of the face. The movement of a point on the face and the area of motion determined by digital subtraction were compared during an increasing smile in healthy subjects. The Nottingham system (calculated using measurement of the movement of 4 points on the face) using desktop computer software (Adobe Photoshop 3.0, Adobe Systems Inc, Mountain View, Calif) to measure movement of the points was compared with the system by House and Brackmann. The computer software was used to subtract digitized images and derive a facial movement score, which was compared with the scores of the systems by Nottingham and House and Brackmann. SETTING: Academic otologic practice. STUDY PARTICIPANTS: Nine patients with varying degrees of facial nerve disability and 7 individuals with normal facial nerve function. RESULTS: The movement of the oral commissure compared with the apparent area of movement of the face determined by digital subtraction had high intersubject variability. In patients with facial weakness, the Nottingham score had a correlation coefficient of -0.97 compared with the House and Brackmann grade, and the digital subtraction score had a correlation coefficient of -0.62 (paired Student t test). CONCLUSIONS: The desktop computer software can be used to calculate the Nottingham score. Digital subtraction as a measure of facial function warrants further study.

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