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[Expert systems in oncology: concepts, problems, perspectives].

The architecture and fields of application of the expert systems in oncology are described. These systems allow systematization, developing and realizing the approximate knowledge, heuristics and algorithms of the expert-oncologists by the computer systems for solution of optimization problems of diagnosis and treatment of cancer patients. Principles of the functioning of expert systems are considered through the examples of solutions of concrete problems in oncology. Intellectual possibilities of the man-machine interaction under clinical conditions are discussed. The vistas of technological development of expert systems in oncology are evaluated.

Algorithms↗

[The ideal computer for ECG analysis (author's transl)].

An on-line minicomputer with a suitable structure turns out to be the ideal system for ECG interpretation. The motivations for this conclusion come both from the nature of the ECG analysis process and from the solution that the present state of the process and from the solution that the present state of the computer technology suggests for the controversy on large-scale computers versus minicomputers in the medical environment. In this paper both these aspects of the problem are briefly discussed and an ideal structure is proposed for a system based on a minicomputer. The main goals of this system are flexibility, adequate man-machine interfacing, low cost, high reliability and minimal maintenance, minimum installation space and site preparation.

Analog-Digital Conversion↗

[Development of a monitoring system for radiodiagnostic devices].

The authors review the possibilities of the application of the "man-machine" theory to the radiodiagnostic unit. Show implementation of the theory with special reference to the basic purpose of the unit RENA 50-6 MP equipped with the microprocessor system of monitoring.

Man-Machine Systems↗

[Electronic data processing in medical microbiology--a guide and some critical thoughts].

Applications of electron data processing in all fields of medicine and especially in medical microbiology are increasing rapidly. It seems important to discuss a guide for using such complicated electronical systems, because, on the one hand, computer applications in medicine are desirable for scientific reasons, but on the other hand few very costly and sophisticated projects had to be cancelled, after a shorter or longer time of implementation by reason of lack of co-operation of medical collaborators. This paper puts on discussion such a guide for using electronic data processing in medical microbiology. It is proposed to put through the following tasks before introducing a computer system into a microbiological institution: a system analysis of the status quo, an objective determination of the set state, a system design and a cost-benefit analysis. Those tasks are described in detail and are illustrated to some extent by graphics and tables from own research for preparing a data processing system for medical microbiology. It is emphasized that beside hard- and software criteria of the desired computer system one has to pay attention to the problems of man-machine engineering. The paper finishes with concrete propositions of proceeding when the computer system is implemented and shows possibilities of scientific data evaluation of a microbiological data base.

Costs and Cost Analysis↗

Speech audiometry by a speech synthesizer. I. A preliminary report.

A preliminary report on speech test results with a portable, text-to-speech synthesizer is presented. The differentiation scores achieved at speed 80 words/min vary. So far the best mean differentiation scores in normal material are 75%. The increase of the presentation level improves the differentiation score, as does the decrease of word speed and training. The future and present uses of this system are discussed. These include: devices for the handicapped, e.g. to produce speech for the mute, man-machine communication through speech in industry control, data processing systems and uses in audiological diagnostics. The study is continued.

Adult↗

A minicomputer system for display and rate analysis in vectorcardiography.

A system has been constructed for recording vectorcardiographic signal with a FM taperecorder. Off-line AD-conversion and analysis of rates and magnitudes of partial vectors are made with a minicomputer. The reason for studying particularly initial vectorrates is that according to our hypothesis these contain valuable information for classification of certain cardiac arrythmias according to supraventricular or ventricular impulse focus. Preliminary results confirm the hypothesis. In vectorcardiography one difficulty is to give an easily comprehensible presentation of the vectorloop. In this study a method for '3-dimensional' display has been developed, using a graphic display processor and varying intensities of the beam. The system is to a high degree man-machine interactive.

Arrhythmias, Cardiac↗

Neurophysiological approach to the design of visual prostheses: a theoretical discussion.

This paper deals with the design of systems of sensory substitution of vision in case of blindness. Using the rules of man-machine interactions, one proposes the following optimal design for sensory substitution systems. A model of the visual system might process visual information similarly to its natural counterpart in order to deliver a signal comparable to the one reached in polysensory nervous structures. Then this artificial signal might reach these associative structures through a substitutive sensory system. To achieve this aim, one might model this substitutive system, reverse the information flow, and then trust the natural substitutive system with the stimuli generated by this inverse model. As a result, this artificial system consists of a model of vision connected to an inverse model of the substitutive sensory system. It would first process visual information up to a complex level. Then it would translate this complex signal into coded substitutive stimuli. These stimuli, after processing by the sensory substitutive system, would evoke a vision-like perception.

Blindness↗

A man-machine vision interface for sensing the environment.

This study describes a computer vision approach for sensing the environment with the intent of helping people with a visual impairment. The principal goal in applying computer vision is to exploit, in an optimal fashion, the information acquired by the camera(s) to yield useful descriptions of the viewed environment. The objective is to seek efficient and reliable guidance cues in order to improve the mobility needs of individuals with a visual impairment. In this research direction, the following problems are identified and addressed: 1) the vision system design; 2) establishment of the mapping principles between the two-dimensional (2-D) camera images and the three-dimensional (3-D) real world; 3) development of appropriate imaging techniques for the interpretation of the 2-D images; and, 4) establishment of a communication link between the vision system and the user. The soundness of this research direction is assessed by means of a theoretical framework and experimental evaluations.

Algorithms↗

[Clincio-electroencephalographic syndromes in several diseases of the nervous system].

An analysis of the indices of bioelectrical brain activity and clinical symptoms was accomplished by a computer according to the principle "man-machine". The authors examined 2 groups of patients with some hereditary forms of diseases of the nervous system (62 cases) and with disorders of cerebral circulation (106 cases). It was demonstrated that there is a possibility of clarifying the typical localization of lesion and of differentiating the different clinico EEG syndromes.

Central Nervous System Diseases↗

Querying medical databases in an environment offering logical data independence.

Medical information systems are becoming popular. Furthermore, their use is expected to be expanded in future. In order to easily extract information from the underlying databases, easy to use man-machine interfaces are required. This paper concerns the doctor interface of the ARPIA medical information system based on a relational database management system. The whole system is currently used inside the Outpatient Pediatric Clinic of the Catholic University of Rome, Italy. The interface provides logical data independence towards the underlying relational database. The paper contains some background about this kind of interfaces, and also, it sketches the software architecture of the implemented prototype.

Database Management Systems↗

Functionality of the ARPIA ambulatory information system.

Although database-based medical information systems are becoming popular, experiments done by researchers tell us that physicians still do not fully accept them. Key factors for changing physicians' practice habits are the availability of more powerful methods and tools for interactive data acquisition and retrieval. Problems involving human engineering usually require the identification of and experimentation with many novel approaches before the most suitable answer is discovered. ARPIA is an ambulatory information system experimenting on the effectiveness and acceptability (by medical users) of new intelligent and friendly interaction techniques and tools. In particular, it tests a novel flexible dialogue-based man-machine interface offering physical and logical data 'independence' during retrieval operations. Other features of the system are: a fast and robust data acquisition environment; a text- and picture-based data presentation and report generation facility; finally, a set of modules offering the ambulatory staff effective assistance in some extra complex interactive tasks. A user-oriented description of the main functionality of ARPIA is given; users' feedback summarizing almost 2 years of usage of the system is also reported.

Ambulatory Care Information Systems↗

Computer-aided decision support in clinical medicine.

This paper reviews the problems and prospects involved in providing computer-aided decision support in clinical medicine. First, the evaluation of medical innovation is discussed. It is suggested that there are three criteria by which an innovation may be judged, namely (1) a need for the innovation, (2) the ability of the innovation to fulfil that need and (3) the ability to do so without transgressing practical, ethical or legal boundaries. These problems are addressed in turn. The paper suggests, taking one area of clinical medicine as an example (acute abdominal pain) there is a clear need for decision support--since the area is not handled well by doctors in current practice. Evidence is adduced to suggest that the computer can provide decision support and do so without transgressing professional, ethical or legal boundaries. The obstacles to progress, which stand in the way of widespread implementation are briefly discussed. These are lack of medical terminology, poor man-machine interface and above all a lack of co-ordination. Finally, it is suggested that the most valuable facet of current systems is the discipline and precision in data collection they impose upon practicing doctors.

Attitude to Computers↗

Digital image display station performance requirements based on physician experience with a prototype system.

The authors report on observations of and interviews with physicians using a prototype digital image display and reporting station. While the users generally agree that image quality is clinically satisfactory, they are unanimous in their opinion that improvements in the man-machine interface are required before case review by this mechanism is clinically acceptable in a production environment. A model image and information user interface is presented. It was developed in answer to the needs of radiologists and referring physicians operating in the imaging department of a community acute-care facility. In such an environment images and related information must be communicated quickly and often simultaneously to different parts of the department and hospital. The user interface with the management system and the management system itself must address the varied functions and the needs of both the medical and clerical staff. Image enhancement processes, for example, must be restricted to those that quickly provide significantly more perceivable diagnostic information. Little-used processes that may occupy significant portions of the display and the console's computing power must be trimmed or eliminated.

Computer Systems↗

The artificial substitution of missing hands with myoelectrical prostheses.

The fitting of upper-extremity amputees requires special efforts, and its significance has been increased by the development of myoelectrically controlled prosthetic arm. Although an artificial hand only represents a relatively modest substitute for the missing hand of human beings, the efforts of designers and the achievements of manufacturers should not go unnoticed. Because of the development of myoelectrically controlled prosthetic arm, the amputee's standard of function can be improved and a cosmetic and functional solution provided. For control of the electromechanical hand, muscular potentials are received from the residual limb surface, amplified in the electrodes, and transmitted as control signals to the distal area. An important factor in providing a successful fitting is a reliable man-machine connection. This article summarizes the historic development and state of the art of the myoelectrically controlled arm prosthesis. The components and technical evaluations of the Myobock system as well as the procedures for fitting and fabricating a below-elbow prosthesis have been improved recently. A critical analysis of adaptive hands suggests that the prospects for the future are good.

Adult↗