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PubMed1987

Computer-aided information system to support direct patient care. The application of a hand-held data collector in a department of medicine.

In the pilot study, described herein, we have tried to develop a computerized system to assist and improve medical and nursing care. Our major goal was to bring the computer to the patient's bedside. This was achieved by a Hand-Held Data Collector, which is easy to carry and operate, and has a big enough memory. In this preliminary study, we have developed appropriate software specifically designed to reflect the daily activities and needs of a department of medicine. Using this software, we have demonstrated that all 'clinical events' and routine tasks of the department can be managed via the Hand-Held Data Collector.

Computer Systems↗

PubMed1991

Construction of new ligand binding sites in proteins of known structure. I. Computer-aided modeling of sites with pre-defined geometry.

We have devised a molecular model building computer program (DEZYMER) which builds new ligand binding sites into a protein of known three-dimensional structure. It alters only the sequence and the side-chain structure of the protein, leaving the protein backbone fold intact by definition. The program searches for a constellation of backbone positions arranged such that if appropriate side-chains were placed there, they would bind the ligand according to a pre-defined geometry of interaction specified by the experimentalist. These binding sites are introduced by the program by taking into account simple rules such as steric hindrance, atomic close-packing and hydrogen bond patterns, which are known to maintain the integrity of a protein structure to a first approximation. A test case is presented in this paper where the copper binding site found in blue-copper proteins such as plastocyanin, azurin and cupredoxin is introduced into Escherichia coli thioredoxin. The model building of one of the solutions found by the program is presented in some detail. The experimental construction and properties of this new protein are described in an accompanying paper. It is hoped that this program provides a general method for the design of ligand binding sites and enzyme active sites, which can then be tested experimentally.

Algorithms↗

PubMed1991

Comparison of computer-aided and human review of general practitioners' management of hypertension.

Computer programs that automatically review decisions can help physicians provide better patient care. In the Netherlands, the ELIAS computer information system has replaced paper medical records in some general practices. We have written a computer program called 'HyperCritic' that audits general practitioners' management of patients with essential hypertension by taking patient-specific data from the ELIAS system. We investigated whether the computer-based medical records contain sufficient information to generate critiques, and compared the limitations of audit by hypercritic with those of review by a panel of eight physicians. Hypercritic and the physicians independently reviewed the medical records of 20 randomly selected patients with hypertension and commented on the decisions made at each of 243 patient visits. Of 468 comments on patient management, 260 were judged correct by six or more of the physicians; hypercritic also made 118 of these 260 comments. The main reasons why the program did not produce the other 142 comments were: insufficient data in the computer-based medical record; absence of sufficient medical consensus; and omissions in the database of hypercritic. Calculation of an "index of merit" ([sensitivity + specificity] - 1) for individual reviewers showed that hypercritic performed better (index of merit 0.62) in its limited domain than did physician reviewers (0.3-0.56). At least in hypertension management, automated review of computer-based medical records compares favourably with review by physicians. Further development of computer-aided clinical audit requires the introduction of computer-based medical records that capture the reasoning of physicians, and of widely accepted practice guidelines.

Adult↗

PubMed1990

Computer-aided analysis of polarized neurite growth. Effects of applied electrical fields on neuronal development.

A computer-based system to record and analyze the polarized growth of neurons growing in culture has been developed. The first application of this system was to study the effects of electrical fields on the growth of isolated Xenopus neurons. Simple coordinate data are collected from photographic negatives of isolated neurons, using a digitizing tablet. Morphometric parameters for individual cells and whole neuronal populations are calculated. A variety of indicators of polarized growth are defined and we compare our methods with those used in previous studies, and the most appropriate methods for describing polarized growth are discussed. Although these methods have been designed specifically to assess the effects of electrical fields on neurite growth, they could be applied to other experiments where biased growth of neurites is expected. They could be used in studies of the tropistic effects of growth factor gradients, or variations in the substrate. Alternatively, they could be useful for the analysis of the many other types of polarized growth found in a wide range of cell types.

Animals↗

PubMedDate not supplied

A six-digit code for computer-aided dental identification.

A six-digit code for dental description is presented. It is intended to simplify the establishment of ante- and postmortem data files in a computer and consists of two digits for designating the individual tooth, two digits for describing the surface or surface combination involved (if any), and two digits for describing treatment type and material. Depending upon the number of teeth present, the dental description of one person may thus comprise from 1 to 32 six-digit numbers, ante- or post-mortem. The comparison by the computer of one antemortem with one postmortem set of numbers is a simple procedure.

Computers↗

PubMed1989

How accurate is computer-aided diagnosis?

A computer program for diagnosis of acute abdominal pain (CAD-A) was compared with an amended program (DIAG) and with clinical performance. The programs were tested at three Scottish hospitals, representing a range of practice, in 6962 cases. Accuracy of CAD-A lay in the range 48-59%, and of DIAG 56-62%. Clinical accuracy was constant at 65%. These figures suggest that computer systems based on Bayes' formula have no useful role in the diagnosis of acute abdominal pain.

Abdomen, Acute↗

PubMed1992

Computer-aided optimization of choice and positioning of bone plates and screws used for internal fixation of mandibular fractures.

The present study describes a biomechanical integrated model of the mandibular system in which the maxilla and mandible, the masticatory muscles, and the temporomandibular joints are regarded as one system. In this model, strains in plate-osteosynthesis devices for internal fixation of mandibular fractures can be minimized by optimizing their positions. The model evaluates maximal bite force strategies on all possible dental elements; it uses a linear programming technique and a muscle architecture model, resulting in muscle recruitment patterns. The shape of a "standard" lower jaw is digitized by means of a three-dimensional (3-D) coordinate retrieval device and drawn on a computer screen after its dimensions have been changed according to the clinical case at hand. The 3-D location of the fracture as well as the anatomic restrictions for screw placement can be indicated on the screen. Osteosynthesis devices can be indicated in terms of dimensions, number, and material properties.

Biomechanical Phenomena↗

PubMedDate not supplied

The uses of computer-aided signal peptide selection and polymerase chain reaction in gene construction and expression of secreted proteins.

The computer program, SIGSEQ2, was used to select heterologous signal peptides from a catalog of published sequences to express the echistatin gene in insect (Sf9) cells. S-values for each amino acid were determined to select empirically the site of cleavage between the signal peptide and mature echistatin. Five gene fragments encoding the signal peptides for human immunoglobulin kappa (Ig kappa), Drosophila 68C glue, antistasin, bovine growth hormone (bGH), and human apolipoprotein E (Apo E) were constructed by the use of long synthetic oligonucleotides or polymerase chain reaction (PCR). Echistatin expression vectors then were constructed using the baculovirus polyhedrin promoter. Following transient transfection, the media were assayed for echistatin activity. The results indicate that the computer program greatly facilitated the selection and design of five different signal peptides and accurately predicted their relative functionality in the expression and secretion of echistatin in insect cell cultures.

Animals↗

PubMed1987

Two different approaches to computer-aided teaching of microbial genetics.

Two computer packages have been developed to teach bacterial genetics on an introductory genetics course for undergraduate students in biology. The first package, 'CONJUGACION', is designed to teach bacterial conjugation and its genetic outcomes. It includes four main parts. Firstly, a tutorial part presents a theoretical framework using screens of text and animated graphics. Secondly, an interactive concept application section requires students to carry out experiments for the determination of the correct sex and genotype of 10 bacterial strains. The third part uses the previously obtained data for simulating interrupted mating experiments and mapping the bacterial genome. Finally, an evaluation section allows the students to test their understanding through a series of multiple choice questions. The second package, 'LURIDEL', is intended for teaching the preadaptative character of mutation in bacterial populations on the basis of the fluctuation test of Luria and Delbrück. It simulates, graphically, the appearance of mutations in microbial cultures and gives results of simulated fluctuation experiments. Programs were written under the PCOS operating system in MBASIC extended to graphics for running on Olivetti M20 microcomputers.

Computer-Assisted Instruction↗

PubMed1991

The use of modified constellation graph method for computer-aided classification of congenital heart diseases.

This paper describes a new method of data reduction and classification in a multidimensional symptom space for diagnostic aid of congenital heart diseases. The algorithm developed here is to reduce interactively a multidimensional symptom space to sectorial regions representing each disease in a semicircle using the modified constellation graph method. This method enables us to classify patients using the angle in the semicircle as a single classifying parameter with an accuracy of about 90%, that is, with little overlapping between disease sectors. Comparing this method with conventional factor analysis, we have found the former far more effective than the latter for disease region separation.

Algorithms↗

PubMed1984

Computer-aided tinnitus characterization.

A purpose-built tinnitus synthesizer interfaced to a computer has been designed which can be used to characterize most types of subjective tinnitus. A patient is able to match his own tinnitus by making responses to simple questions using push buttons on a hand-held box. The system can be used to determine the characteristics of tinnitus consisting of tones, random noise or combinations of these sounds; any sound can also be pulsed synchronously with a patient's pulse beat in order to match pulsatile tinnitus. It is then possible to use the frequency and loudness characteristics of tinnitus in order to determine the suitability of masking therapy for a patient.

Audiometry↗

PubMed1987

Computer-aided volume measurement of choroidal melanomas.

Using a combination of conventional B-scan ultrasonography, standard video techniques, computer image digitization and area analysis, it is possible to measure the volume of choroidal melanomas by area calculation of successive ultrasound image slices, allowing the monitoring of such tumors. The design of a combined water-bath and linear tracking B-scan transducer is presented, together with a description of the instrumentation and computer software required. The results of volume measurements performed upon eye models demonstrated that melanomas of volume greater than 100 mm3 could be measured with an average error of 6%. The problems associated with linear calibration of the system from scan-head to analysed image, resolution of the digitised image, reproducibility of the measurements, sources of error and assumptions made in formulating the measurement procedure are discussed.

Adult↗

PubMed1990

Development of computer-aided motion analyzing (CAMA) system for radiopaque implanted tilting disk heart valves.

The newly developed semiautomatic data acquisition and processing system allows progress in quantitative evaluation of functions of implanted tilting disk valves. In the new system, data acquisition could be carried out semiautomatically by utilizing image processing methods, and the data analysis time was shortened. The system consists of a computer-controlled cinefilm loading device, a CCD camera, a frame memory, a superimposer, and CRT displays. Since series of the open- and shut-mode frames are commonly observed by turns in normal subjects, data acquisition was carried out manually at the first frame of each mode and semiautomatically from the second frame to the last. By processing the image data with the binarization method, the valve contours were detected, and an open angle and other motion properties can be obtained. Analyzing 90 frames of the cinefilm, this system analyzes data in a time period 20 min shorter than the manual procedure. With the implanted Medtronic Hall valve, a 60 to 65 degrees open angle was calculated.

Cineradiography↗

PubMedDate not supplied

Bayesian statistics: a guided tour.

An overview of Bayesian statistical decision theory is presented in the tutorial spirit. A section on fundamental principles is followed by selected applications of the Bayesian approach to parameter estimation, pattern recognition, image processing, computer-aided medical diagnosis, optimal diagnostic test selection, and radiotherapy treatment planning.

Decision Making↗

PubMed1992

Patch test results of the Dermatology Clinic Zurich in 1989: personal computer-aided statistical evaluation.

The patch test results of 921 consecutively tested patients were registered on an IBM personal computer. A computer program based on the dBase III plus database software, especially designed for this purpose, was used. The statistical evaluation was performed with dBase III plus. 59% of the probands were females and 41% males. The average age was 42.8 years. 26% of the probands were inpatients and 74% outpatients. A majority of the patients presented with eczema of the hands, face or the lower legs. The largest occupational groups were houseworkers and cleaning personnel, office workers and pensioners. To 450 of the 921 patients, at least 4 test series were applied simultaneously. These included European standard, vehicles and emulgators, topical medications, and preservatives and biocides. The other 20 test series available were employed only by 2-81 patients each. The highest sensitization rates were found with: nickel, 18.7%; cobalt, 10.2%; balsam of Peru, 8.8%; framycetin, 8.0%; neomycin, 6.8%; potassium dichromate, 6.1%; p-phenylene diamine, 5.4%; paramix, 4.9%; formaldehyde, 4.8%, and (chlor)methylisothiazolinone, 4.7%. The critical evaluation of the data showed two kinds of problems: first, test-specific aspects led to optimization of the patch test procedures; second, the crucial importance of an adequate statistical analysis for epidemiological investigation was revealed.

Adolescent↗

PubMed1992

A comparison of conventional intra-oral radiography and computer imaging techniques for the detection of proximal surface dental caries.

The detection of proximal surface caries by the visual interpretation of bitewing radiographs is known to be relatively inaccurate. The present study was designed to examine whether computer image processing could improve the diagnostic accuracy. A computer-aided, software-driven, TV-based system was used to digitize conventional radiographs and digitally process the images using histogram equalization and grey-scale inversion to enhance the images. The computer-enhanced images were compared with conventional intra-oral radiographs for the detection of proximal surface caries using receiver operating characteristic analysis. The results indicate that the digital image processing techniques used did not improve the diagnostic accuracy of dental radiographs. No significant difference in diagnostic accuracy could be detected between the non-enhanced digital images and conventional film-based images for the detection of proximal surface caries.

Dental Caries↗

PubMedDate not supplied

A system for computer-aided diagnosis.

MEDICIS is an integrated environment for computer-aided diagnosis. It consists of two subsystems: a module used by the expert to build knowledge bases and a consultation module to exploit those bases. MEDICIS uses a framed representation of knowledge. The inference engine performs logical reasoning without recourse to certainty factors. This phase is followed by a multicriteria analysis.

Diagnosis, Computer-Assisted↗

PubMed1992

[Computer-aided prediction of optimal composition of multicomponent mobile phase in high performance liquid chromatography].

This paper proposed a systematic optimizing method for the composition of multicomponent mobile phase in high performance liquid chromatography. A new chromatographic response function (CRF) has been constructed according to the fundamental retention equation and rule of peak width at half-height, and the optimal composition of multicomponent mobile phase can be automatically predicted by a computer with CRF. This paper improved the known complex method, therefore, the optimal mobile phase composition in the global area may be found by means of this modified complex method. The optimal separation conditions of four vitamins and three nitrophenols were determined by use of the optimizing method reported in this paper. The results predicted by the computer were verified by the experimental data obtained in HPLC using ternary mobile phase.

Chromatography, High Pressure Liquid↗