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At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Obligations of the expert system builder: meeting the needs of the user.

Builders of expert systems have generally accepted the principle that computer software should not be subject to government regulation if health care practitioners can be expected to interpret and apply the systems intelligently. The purpose of this paper is to identify the information that builders must make available to permit health care practitioners to exercise their clinical judgment in interpreting and applying the output of computing systems.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

Development of a totally implantable total artificial heart controller.

Using a one chip microcontroller, 87C196 (One chip EPROM), and an erasable and programmable logic device (EPLD), an implantable control system to drive a pendulum type electromechanical total artificial heart was developed. This control system consists of four parts: a main management system, a motor driver with power regulator, a state monitoring system, and a communication portion. The main system has a speed detector, proportional and integral (PI) control, pulse width modulation (PWM) generation, serial communication, and an analog data processor. Two kinds of power system are used, separated by eight photocoupler arrays to improve system stability. When the performance of each compartment was compared with that of the previously used Z80 microprocessor based control system, good correspondence was shown. Logic power consumption was reduced to one third that of the previous controller. Using mock circulation tests, the overall performance of the control system was evaluated.

Blood Flow Velocity↗
PubMed1991

Validation, clinical trial, and evaluation of a radiology expert system.

The PHOENIX Radiology Consultant is a rule-based expert system which assists physicians in planning radiological work-up strategies. This article describes the methods used to create and validate the system's knowledge base. The feasibility and acceptability of PHOENIX were tested for two years in a clinical trial. During this period, the system was used 1,421 times, an average of 13.7 times per week, primarily by medical students and nonradiologist physicians. Much of the system's use occurred at night and on weekends, when the radiology department was not fully staffed. Several physicians were enlisted to further evaluate the utility of the system. The results of their evaluation indicate that an expert system that helps physicians select diagnostic-imaging studies can serve as a useful and informative component of a radiology information system, and is particularly useful for medical students and physicians in training.

Algorithms↗
PubMedDate not supplied

Exploitation of statistical tables: conceptual interaction with epidemiologic data.

Health-care applications need flexible data and interaction models capable of dealing with data of different natures coming from different sources. These applications are usually devoted to diverse user groups, often casual or novice. The user interface must help the user to understand the database information content in his or her querying process. The authors synthetically describe FLN, a system featuring an integrated interaction with epidemiologic data. In an integrated model the statistical aspects of data (macro data) are represented, together with the intensional and extensional views of the variables involved in statistical tables.

Database Management Systems↗
PubMedDate not supplied

A database perspective of the transition from single-use (ancillary-based) systems to integrated models supporting clinical care and research in a MUMPS-based system.

The Composite Health Care System (CHCS), a MUMPS-based hospital information system (HIS), has evolved from the Decentralized Hospital Computer Program (DHCP) installed within VA Hospitals. The authors explore the evolution of an ancillary-based system toward an integrated model with a look at its current state and possible future. The history and relationships between orders of different types tie specific patient-related data into a logical and temporal model. Diagrams demonstrate how the database structure has evolved to support clinical needs for integration. It is suggested that a fully integrated model is capable of meeting traditional HIS needs.

Database Management Systems↗
PubMed1991

[A proposal of an original system of "voice-mediated input" in radiological reporting].

The recent introduction of vocal input systems in diagnostic radiology will produce many changes in reporting. Statistical analyses of the texts put in (the so-called "mediated vocal input") are an interesting possibility which allows the radiologist to evaluate both readability and efficacy of his reports. The structure of a vocal input system is also suitable to define standardized vocabularies of commonly used radiological terms. This paper describes the structure of an original system, built by assembling low-cost components, with a self-made software. The aim is the reduction of noise in the communication between the radiologist and the physician, by means of new solutions which will make the radiological report one of the key points of the diagnostic procedure.

Communication↗
PubMed1991

[Changes in the rate and accuracy of information processing in the computer training of middle-grade pupils].

The computer enters more and more quickly the new school. Therefore an important problem is the influence of computer training on the velocity and accuracy of information processing. For this purpose were examined 28 school-children from VI-VII class, participating in computer training, computer plays and traditional lesion. This activity was carried out in the computer study of the Pioneer Palace, Sofia. An electronic determinator with test programme, containing preliminary arranged succession of 50 visual stimulants on red, blue, green, yellow and white colours, at vas used at 1,2 s. speed. The changes in the correct, delayed and wrong reactions were traced. The results as a whole point out, that the computer training, on the one hand, has no unfavourable effect on the velocity and accuracy of information processing, and on the other hand--forms positive psychoemotional adjustment to work.

Bulgaria↗
PubMed1991

[Changes in the rate and accuracy of information processing in the computer training of upper-grade pupils].

The basic activity of the student during the "computer training process" is the introduction and processing of information. In the dialogue regime of work, between student and computer, the velocity and accuracy of the information processing take important place. In this aspect, special attention is given to the changes in the indicated indices during the computer lesson, computer plays and the traditional training. Studies are carried out on 30 students from classes X and XI, educated in vocational school "V. Levski", the town of Pravets. For the purpose is used electron determinator with test programme, containing consecutively exposure to 50 visual stimulators in red, blue, green, yellow and white colours at 1,2 s/speed. The results as a whole show that the most favourable results concerning the computer plays, very likely could be explained with the diversion effect and the positive motivation adjustment to the activity performed. By means of dispersion analysis is established, that only the type of activity has an essential effect on the velocity and accuracy of the information processing.

Bulgaria↗
PubMed1991

A specialized framework for Medical Diagnostic Knowledge Based Systems.

To have a knowledge based system (KBS) exhibiting an intelligent behavior, it must be endowed even with knowledge able to represent the expert's strategies, other than with domain knowledge. The elicitation task is inherently difficult for strategic knowledge, because strategy is often tacit, and, even when it has been made explicit, it is not an easy task to describe it in a form that may be directly translated and implemented into a program. This paper describes a Specialized Framework for Medical Diagnostic Knowledge Based Systems able to help an expert in the process of building KBSs in a medical domain. The framework is based on an epistemological model of diagnostic reasoning which has proved to be helpful in describing the diagnostic process in terms of the tasks by which it is composed of.

Artificial Intelligence↗
PubMed1991

Outpatient medical records for a teaching hospital: beginning the physician-computer dialogue.

We have developed an outpatient medical record (OMR) system designed to facilitate direct physician interaction with the computer-based medical record. During the first two years the system was in use, staff physicians, residents, and nurse practitioners entered 15,121 active and 1996 inactive problems for 3524 patients, and 12,651 active medications and 1894 discontinued medications for 3430 patients. These clinicians entered 20,321 items on health promotion and disease prevention screening sheets and with the help of automatic updating by the computer an additional 21,897 entries on screening sheets were made for 8686 patients. On the computer, clinicians wrote more than twice as much--10.9 words per problem, in contrast to 4.3 words per problem in the paper record (p less than 0.0001, Student's t). We conclude that clinicians perceived the computer-based problem list to be more valuable than its paper counterpart.

Ambulatory Care Information Systems↗
PubMed1991

FORMREVU: an online formulary adjunct to the HELP System in a community hospital.

The hospital formulary is an important information source on drug availability for staff physicians, nurses and therapists. To facilitate rapid access to formulary data and reduce printing costs, an online formulary review program, FORMREVU, was developed as an adjunct to the HELP System at Rex Hospital. FORMREVU, written in the PTXT Application Language (PAL), is menu-driven, and qualified users can select drug entries from lists matching a specific drug category or subcategory (e.g. cardiovascular drugs, cephalosporins) or keyword (e.g. lasix). Individual drug entries consist of trade and generic names, category and subcategory, comments, and available doses and corresponding manufacturers. A detailed description of the formulary review program, along with a review of implementation objectives and qualitative and quantitative benefits, will be presented.

Clinical Pharmacy Information Systems↗
PubMed1991

Knowledge gains from a computer-based health risk appraisal.

During 1990, 83 patients seen for a general physical examination at a family practice clinic completed a computer-based health risk appraisal in one of two formats, batch or interactive. They also completed a written questionnaire on their health risks and knowledge before taking the appraisal, and 65 of them completed another health risk appraisal and questionnaire three months later. No difference in user evaluation of the appraisal regarding its helpfulness, their intent to change behavior based on the appraisal, or amount learned from the appraisal was found between batch and interactive formats. About half (48%) of the individuals correctly estimated their overall health risks before taking the health risk appraisal. Among those who initially misjudged their health risks, few women adjusted their health risk rating at followup. Men showed a tendency to adjust their rating to more closely agree with the health risk appraisal estimates although the differences are not statistically significant. Eighty percent of the men and 55% of the women accurately rated their overall risk at followup. Knowledge of specific causes of death did not improve at followup.

Adult↗
PubMed1991

End-user participation in the needs assessment for a clinical information system.

The successful introduction of a new information system requires technological and behavioral changes. Intended users of the new system should participate in defining goals for the system, examining alternatives for achieving these goals, and selecting from these alternatives. Broad-based end-user involvement is especially useful during the needs assessment (goal definition) phase, both to identify the diverse expectations of the end-user community and to develop a sense of system ownership by these users. System planners can stimulate active end-user involvement by inviting each constituent user group (for example, each hospital department) to assume responsibility for specifying its objectives for the new system. The collection of all groups' objectives defines the organization's expectations of a new system, provides a means for comparing systems, and aids in predicting the overall acceptance of any proposed system. Each constituent group's list of objectives likewise provides a measure of anticipated acceptance for that group.

Computer User Training↗
PubMed1991

Assessing the effectiveness of a computerized blood order "consultation" system.

To optimize blood ordering and accurately assess transfusion practice, in 1987, an "on line" computerized, knowledge-based, blood order critiquing system was integrated into the HELP Hospital Information System (HIS) at LDS Hospital. Evaluations of the computerized ordering system demonstrated its benefits and limitations on transfusion practice. Based on this experience, a second generation blood ordering system using a consultation mode was developed. A pilot test of this blood order consultant system, using historical data in the HELP system's database, was performed. This pilot test demonstrated that the consultation system provided accurate recommendations for red blood cell (RBC) and platelet orders. Comparing the appropriateness of blood orders with the recommendations made by the director of the blood bank, the orders recommended by the computer "consultant" agreed 95.5% of the time. The computer consultation system also recommended fewer RBC units for transfusion. Preliminary results obtained using the consultant approach suggest that we may be able to simplify blood ordering practice and also reduce the number of units of blood products ordered. Based on these findings we are now preparing to compare the "critiquing" and "consultation" approaches using a clinical trial.

Artificial Intelligence↗
PubMed1991

Intelligent management of epidemiologic data.

In the lifecycle of epidemiologic data three steps can be identified: production, interpretation and exploitation for decision. Computerized support can be precious, if not indispensable, at any of the three levels, therefore several epidemiologic data management systems were developed. In this paper we focus on intelligent management of epidemiologic data, where intelligence is needed in order to analyze trends or to compare observed with reference value and possibly detect abnormalities. After having outlined the problems involved in such a task, we show the features of ADAMS, a system realized to manage aggregated data and implemented in a personal computer environment.

Artificial Intelligence↗