PubMed · 9233500
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C W Hart. 1997. Does computerized dynamic posturography help us care for our patients?. https://pubmed.ncbi.nlm.nih.gov/9233500/
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A new element in the Papanicolaou smear liability crisis is the recent US Food and Drug Administration approval of 2 automated rescreening devices. Their manufacturers have undertaken aggressive advertising in medical journals and in women's magazines, generating controversy about whether this positions such devices as the new standard of care and whether failure to offer such rescreening might lead to liability alleging to tort of negligent nondisclosure, with contributing opinions from pathologists' and manufacturers' counsels. Cases are cited in prenatal diagnostics and blood banking that established liability for failing to disclose diagnostic modalities used by at most only a minority of practitioners and, therefore, have not yet achieved standard-of-care status. It is concluded that informed consent for cervicovaginal smears should include disclosure of the availability of automated rescreening to reduce negligence liability.
The PAPNET-system is a current example of automated technological progress in the pathological laboratory field. As the first Department of Pathology in Denmark, we have tested the applicability of this semi-automatical screening system in screening against cervical cancer. 3000 prospectively selected cervical smears were entered into the project. 1500 of these were first prescreened by the use of PAPNET and the negative slides were then manually rescreened. The remaining 1500 slides consisted of manually screened smears diagnosed as negative or inadequate. They were subsequently rescreened by the use of PAPNET. We only found one false negative smear in each group. Compared with histological follow-up the diagnoses CIN 1-3 were histologically confirmed in both groups. The PAPNET-assisted screening of cervical smears is faster, more valid and less fatiguing than the conventional screening method. Nevertheless, our results show no diagnostic quality improvement by the use of PAPNET. This is probably due to a strict screening procedure and a limited work load of a maximum of about 40-50 slides per cytotechnologist a day in our laboratory.
Discrete, Hidden Markov model based speech recognition and phoneme based speech synthesis techniques were applied for gastroscopy reporting and machine control. The authors developed a special program for grammatical analysis of the sentences. Altogether 100 patient findings were grammatically analysed. The sentences were grouped according to the topographical order of the investigation: oesophagus, cardia, fundus, corpus, antrum, pylorus, bulbus, postbulbar section, and the pathological findings: erosion, ulceration, malignancy. Speech samples from 3 deep voiced male investigators were collected. The recognition rate was above 95%. A simulation program was also developed for dictation and controlling of the different equipment (monitor, printer, video, endoscope) in the gastroscopy laboratory by speech recognition. Speech synthesis was applied for the evaluation of understanding. This module artificially synthesizes the answer of the system giving backup for the understood information. With additional developments the discrete word speech 'recognition' achieved the level of routine application in medical reporting. However, ready-to-use developments need the joint activity of speech technology and endoscopy industry with end-user teams.