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PubMed2006

A tool for exploring space-time patterns: an animation user research.

BACKGROUND: Ever since Dr. John Snow (1813-1854) used a case map to identify water well as the source of a cholera outbreak in London in the 1800s, the use of spatio-temporal maps have become vital tools in a wide range of disease mapping and control initiatives. The increasing use of spatio-temporal maps in these life-threatening sectors warrants that they are accurate, and easy to interpret to enable prompt decision making by health experts. Similar spatio-temporal maps are observed in urban growth and census mapping--all critical aspects a of a country's socio-economic development. In this paper, a user test research was carried out to determine the effectiveness of spatio-temporal maps (animation) in exploring geospatial structures encompassing disease, urban and census mapping. RESULTS: Three types of animation were used, namely; passive, interactive and inference-based animation, with the key differences between them being on the level of interactivity and complementary domain knowledge that each offers to the user. Passive animation maintains the view only status. The user has no control over its contents and dynamic variables. Interactive animation provides users with the basic media player controls, navigation and orientation tools. Inference-based animation incorporates these interactive capabilities together with a complementary automated intelligent view that alerts users to interesting patterns, trends or anomalies that may be inherent in the data sets. The test focussed on the role of animation passive and interactive capabilities in exploring space-time patterns by engaging test-subjects in thinking aloud evaluation protocol. The test subjects were selected from a geoinformatics (map reading, interpretation and analysis abilities) background. Every test-subject used each of the three types of animation and their performances for each session assessed. The results show that interactivity in animation is a preferred exploratory tool in identifying, interpreting and providing explanations about observed geospatial phenomena. Also, exploring geospatial data structures using animation is best achieved using provocative interactive tools such as was seen with the inference-based animation. The visual methods employed using the three types of animation are all related and together these patterns confirm the exploratory cognitive structure and processes for visualization tools. CONCLUSION: The generic types of animation as defined in this paper play a crucial role in facilitating the visualization of geospatial data. These animations can be created and their contents defined based on the user's presentational and exploratory needs. For highly explorative tasks, maintaining a link between the data sets and the animation is crucial to enabling a rich and effective knowledge discovery environment.

Computer Graphics↗

PubMed2003

Which depression screening tools should be used in palliative care?

Depression is a significant symptom for many palliative care patients, but is difficult to diagnose and therefore treat. In an effort to improve detection, there has been increasing interest in the use of screening tools. Many tools, however, have been developed for physically well patients and it is important that tools are validated for the populations in which they are used. The present study was carried out on behalf of the Association of Palliative Medicine, Science Committee, to assess the available evidence for using screening tools in palliative care. The single question 'Are you depressed?' was the tool with the highest sensitivity and specificity and positive predictive value. Where the Hospital Anxiety and Depression Scale and the Edinburgh Depression Scale are used, the validated cut-off thresholds for palliative care patients should be employed. Patients who report thoughts of self-harm or suicide need prompt assessment and evaluation.

Adult↗

PubMed2004

Using Petri Net tools to study properties and dynamics of biological systems.

Petri Nets (PNs) and their extensions are promising methods for modeling and simulating biological systems. We surveyed PN formalisms and tools and compared them based on their mathematical capabilities as well as by their appropriateness to represent typical biological processes. We measured the ability of these tools to model specific features of biological systems and answer a set of biological questions that we defined. We found that different tools are required to provide all capabilities that we assessed. We created software to translate a generic PN model into most of the formalisms and tools discussed. We have also made available three models and suggest that a library of such models would catalyze progress in qualitative modeling via PNs. Development and wide adoption of common formats would enable researchers to share models and use different tools to analyze them without the need to convert to proprietary formats.

Algorithms↗

PubMed2006

Authorship versus "credit" for participation in research: a case study of potential ethical dilemmas created by technical tools used by researchers and claims for authorship by their creators.

The distinction between authorship and other forms of credit for contribution to a publication has been a persisting controversy that has resulted in numerous guidelines outlining the expected contributions of those claiming authorship. While there have been flagrant, well-publicized deviations from widely accepted standards, they are largely outnumbered by cases that are not publicity-worthy, and therefore remain known to only those directly involved with the inappropriate conduct. We discuss the definition and ethical requirements of authorship, offer a case example of the authorship debate created by a technical tool at our institution, and review parallels that support and dispute the authorship claims of our software developers. Ultimately, we conclude that development of a technical tool that enables data collection does not adequately substitute for contributions to study design and manuscript preparation for authorship purposes. Unless the designers of such a technical tool prospectively participate as a part of the project, they would not have an adequate understanding of the publication's genesis to defend it publicly and cannot be listed as authors. Therefore, it is incumbent upon project members to invite tool developers to participate at the beginning of such projects, and for tool developers to contribute to study design and manuscript preparation when they desire authorship listings.

Authorship↗

PubMed2003

Informatics tools and medical communication: patient perspectives of "knowledge coupling" in primary care.

The use of various "informatics tools" for routine patient care promises to radically alter the ways whereby medical knowledge and information are processed and applied. In so doing, it can also change the nature of the information exchange and relational communication that occurs between patients and caregivers. This investigation examines how patients view "knowledge coupling" (KC) tools as they are routinely used in a "coupler-centered" family practice (CCP). How do patients view these tools as influencing information exchange and their relationship with caregivers? Based upon close- and open-ended questions of a random sample of patients in the CCP, this study found that most respondents viewed KC informatics tools as elevating the information exchange that occurs between patients and caregivers-increasing the extent to which patients are "heard and understood" by caregivers and come to "know and understand" what is ailing them. Many respondents report being empowered by the use of the tools, and having greater confidence in the care and advice caregivers offer. A few others, however, suggest diminished confidence in care and a more "impersonal" environment, resulting specifically from the use of the computer in the office. The article concludes by suggesting ways whereby such deficiencies might be remedied.

Adult↗

PubMed2005

Use of computer-aided detection (CAD) tools in screening mammography: a multidisciplinary investigation.

We summarise a set of analyses and studies conducted to assess the effects of the use of a computer-aided detection (CAD) tool in breast screening. We have used an interdisciplinary approach that combines: (a) statistical analyses inspired by reliability modelling in engineering; (b) experimental studies of decisions of mammography experts using the tool, interpreted in the light of human factors psychology; and (c) ethnographic observations of the use of the tool both in trial conditions and in everyday screening practice. Our investigations have shown patterns of human behaviour and effects of computer-based advice that would not have been revealed by a standard clinical trial approach. For example, we found that the negligible measured effect of CAD could be explained by a range of effects on experts' decisions, beneficial in some cases and detrimental in others. There is some evidence of the latter effects being due to the experts using the computer tool differently from the intentions of the developers. We integrate insights from the different pieces of evidence and highlight their implications for the design, evaluation and deployment of this sort of computer tool.

Anthropology, Cultural↗

PubMedDate not supplied

A critical evaluation of the use of nutrition screening tools by nurses.

Malnutrition remains a problem in hospital and community patients, the consequences of which have deleterious effects on the sick individual and cost implications for healthcare providers. Provision of nutritional support has been shown to improve patient outcome in those at risk of malnutrition; therefore, the detection and treatment of malnutrition is paramount. Nurses have been identified as being in an ideal position to carry out routine nutritional screening to detect patients at risk of malnutrition and hence refer to the dietitian for detailed nutritional assessment and provision of nutritional support. Therefore, many nutritional screening tools have been developed to guide nurses in basic nutritional screening. However, for a tool to be effective certain criteria must be met including ease of use, cost-effectiveness, the presence of an action plan and prior testing for validity, reliability, sensitivity and specificity. Six such tools are critically evaluated in this article to establish whether they meet these criteria. Surprisingly, none of the screening tools demonstrated a beneficial effect on clinical outcome or met all of the above criteria. It is therefore essential that these tools are refined and retested before becoming part of established nursing practice.

Cost-Benefit Analysis↗

PubMed2002

People with an intellectual disability in the criminal justice system: developing an assessment tool for measuring prevalence.

OBJECTIVES: To develop a screening tool to detect those who may have intellectual disabilities or borderline intellectual disabilities in the criminal justice system (CJS). DESIGN: The items for the assessment tool were based on data from an earlier study. The assessment tool was piloted on 80 participants, who also completed a short form of the WAIS-R. METHOD: Items for the screening tool were derived using a discriminant analysis procedure with data from a previous study (measuring IQ and other factors in people on probation). A sample of 40 participants with an intellectual disability and 40 with an IQ in the normal range then completed the screening measure and the WAIS-R. RESULTS: The screening measure showed good concurrent validity, and correctly classified 87% of participants. CONCLUSIONS: The screening measure is a useful tool for people working in the CJS to use in the identification of those who may be in need of further support owing to an intellectual disability or borderline intellectual disability.

Adult↗

PubMed2005

First observation of tool use in wild gorillas.

Descriptions of novel tool use by great apes in response to different circumstances aids us in understanding the factors favoring the evolution of tool use in humans. This paper documents what we believe to be the first two observations of tool use in wild western gorillas (Gorilla gorilla). We first observed an adult female gorilla using a branch as a walking stick to test water deepness and to aid in her attempt to cross a pool of water at Mbeli Bai, a swampy forest clearing in northern Congo. In the second case we saw another adult female using a detached trunk from a small shrub as a stabilizer during food processing. She then used the trunk as a self-made bridge to cross a deep patch of swamp. In contrast to information from other great apes, which mostly show tool use in the context of food extraction, our observations show that in gorillas other factors such as habitat type can stimulate the use of tools.

Animals↗

PubMed2007

Virtual Expert Mass Spectrometrist v3.0: an integrated tool for proteome analysis.

The number of tools described in the literature for analysis of proteome data is growing fast. However, most tools are not able to communicate or exchange data with other tools. In Virtual Expert Mass Spectrometrist (VEMS) v3.0 an effort has been made to interface and export to already existing tools. In this chapter, an outline of how to use the VEMS program to search tandem mass spectrometry data against databases is described. Additionally, examples on how to extend the analysis with other external tools are given.

Calibration↗

PubMedDate not supplied

Handle dynamics predictions for selected power hand tool applications.

This study uses a previously developed single-degree-of-freedom mechanical model to predict the power hand tool operator handle kinematic response to impulsive reaction forces (Lin, 2001). The model considers the human operator as a lumped parameter passive mechanical system, consisting of stiffness, mass moment of inertia, and viscous damping elements. Six power nutrunners were operated by 9 volunteers (3 men, 6 women) in the laboratory, and corresponding handle kinematics were compared against model predictions. A full-factorial experiment considered torque buildup time and work location. Normalized forearm flexor EMG was measured to quantify muscle exertions and used to proportionally adjust the stiffness parameter. The measured handle displacement for actual tool operation strongly correlated to the model predictions (R = .98) for all handle configurations. The overall model prediction error was 3% for predicting tool handle responses to impulsive reaction forces for various tool and workstation parameters. This model should make it possible for designers to identify conditions that minimize the torque reaction experienced by power hand tool operators.

Arm↗

PubMed2000

[Semantic equivalence of the Portuguese version of the Abuse Assessment Screen tool used for the screening of violence against pregnant women].

INTRODUCTION: Research programs and actions regarding family violence have been growing steadily. Therefore, there's a need to develop data collection tools. In Brazil, further problems come up since tools that have been developed elsewhere need to be adapted and translated. This study focuses on the Abuse Assessment Screening (AAS) used to detect violence against pregnant women. The objective is to evaluate the semantic equivalence between the original tool in English and two Portuguese versions, and propose a synthetic version to be used in the field. METHODS: The evaluation of semantic equivalence was carried out in 4 steps: (1) translation, (2) back translation, (3) formal appreciation of equivalence and (4) a final critical assessment by family violence experts. RESULTS: Translation, back translation and the steps 3 and 4 assessment are presented for each item of the tool, along with the original in English. The text covers each discussion that led to the final version. Both versions were quite similar in 14 out of 15 items. Nevertheless, the second version showed to be slightly more adequate although for some items the decision was to combine both versions or, in one case, use an item from version 1. CONCLUSION: The procedure undertaken in this study is discussed in the light of Herdman et al.'s proposal (1998) regarding transcultural equivalence. The study also stresses the importance of using more than one version in the process and the appropriateness of including an additional step about the assessment of the target population's understanding of the tool.

Battered Women↗

PubMed2005

Conditional phosphorus index as an educational tool for risk assessment and phosphorus management.

Phosphorus index (PI) is a risk-assessment tool that combines phosphorus (P) source factors and transport factors to rank the vulnerability of fields to P losses. Here we present the structure and concepts of conditional PI, developed as an educational and P-management tool adjusted for Swedish conditions. Because the significance of certain factors for P losses depends on their interplay with other factors, conditional rules are needed for a more accurate process description and quantification. Accounting for P losses through the soil profile, separate calculations for reactive and unreactive P and a changed approach to P loss assessment from erosion losses are some of the new features included in the tool presented here. The performance of the tool was tested by comparing the calculated PI values with measured annual P transport from seven observation fields included in a Swedish water quality monitoring program. This first test indicated that the tool could be used successfully for P loss risk assessment.

Environmental Monitoring↗

PubMed2026

Digital Structured Education With Behavioral Nudge Tools for Adults With Type 2 Diabetes: Multicenter Randomized Controlled Trial.

BACKGROUND: Digital interventions offer scalable alternatives to traditional face-to-face diabetes education, but often face challenges related to inconsistent clinical effectiveness, and declining user engagement. However, whether a digital structured education program integrated with behavioral nudge tools can improve metabolic, behavioral, and psychological outcomes in adults with type 2 diabetes remains unclear. OBJECTIVE: This study aimed to evaluate the effectiveness of a digital structured education program integrated with behavioral nudge tools in improving metabolic, behavioral, and psychological outcomes among adults with type 2 diabetes. METHODS: This multicenter randomized controlled trial was conducted in the endocrinology departments of 4 hospitals in China. Adults with type 2 diabetes were randomly assigned to an intervention group receiving a digital structured education program integrated with behavioral nudge tools (n=146) or a control group receiving standard digital diabetes education (n=147). Assessments were conducted at baseline and 12-week follow-up. The primary outcome was hemoglobin A1c (HbA1c) at 12 weeks, adjusted for baseline HbA1c, and study center. Secondary outcomes included fasting blood glucose (FBG), weight, BMI, waist circumference, blood pressure, lipid profiles, self-management behaviors, self-efficacy, and habit strength. RESULTS: Among 293 participants (mean age 49.19, SD 10.02 y), 287 (97.9%) completed follow-up. At 12 weeks, the intervention group demonstrated significantly greater improvements than the control group in HbA1c (adjusted mean difference -0.38%, 95% CI -0.68% to -0.09%; P=.01), FBG (adjusted mean difference -0.75, 95% CI -1.27 to -0.44 mmol/L; P<.001), weight (adjusted mean difference -0.84, 95% CI -1.61 to -0.07 kg; P=.03), BMI (adjusted mean difference -0.38, 95% CI -0.65 to -0.11 kg/m²; P=.01), systolic blood pressure (adjusted mean difference -2.71, 95% CI -4.62 to -0.79 mm Hg; P=.01), diastolic blood pressure (adjusted mean difference -2.92, 95% CI -4.47 to -1.37 mm Hg; P<.001), and total cholesterol (adjusted mean difference -0.27, 95% CI -0.48 to -0.05 mmol/L; P=.02). The intervention was also associated with significantly greater improvements in self-management behaviors, self-efficacy, and habit strength (all P<.05). CONCLUSIONS: Digital structured education integrated with behavioral nudge tools improved metabolic outcomes and strengthened psychological and behavioral determinants of self-management among adults with type 2 diabetes over a 12-week period. These findings suggest that a digital structured education program integrated with behavioral nudge tools may enhance diabetes self-management beyond standard digital diabetes education. Further studies with longer follow-up and real-world implementation are warranted to evaluate the sustainability, generalizability, and long-term clinical impact of this integrated intervention.

Humans↗

PubMed2026

Performance of AI-Based Screening Tools for Obstructive Sleep Apnea Across Apnea-Hypopnea Index Thresholds: Systematic Review and Meta-Analysis.

BACKGROUND: Obstructive sleep apnea (OSA) is highly prevalent but remains substantially underdiagnosed. Polysomnography (PSG) is the reference standard, but its cost and limited availability constrain large-scale case identification. AI-based screening tools may support risk stratification and referral prioritization, but their diagnostic accuracy across apnea-hypopnea index (AHI) thresholds remains uncertain. OBJECTIVE: This review aimed to systematically evaluate the diagnostic accuracy of AI-based OSA screening tools at AHI thresholds of ≥5, ≥15, and ≥30 events/hour, with emphasis on models using non-PSG-derived inputs. METHODS: PubMed, Embase, Scopus, and Web of Science were searched for studies published from January 1, 2016, to May 3, 2026. Eligible studies included adults evaluated for suspected OSA or recruited from population-based cohorts, assessed AI-based models intended or interpretable for OSA screening, risk prediction, or screening-oriented severity classification, used PSG as the reference standard, and reported sufficient data to construct or reconstruct 2×2 contingency tables. Diagnostic accuracy was synthesized separately by AHI threshold and input source using bivariate random-effects models, with 95% CIs and prediction intervals (PIs). Risk of bias and certainty of evidence were assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) and GRADE (Grading of Recommendations Assessment, Development, and Evaluation), respectively. RESULTS: A total of 60 studies were included, of which 47 contributed data to the meta-analysis. At AHI thresholds of ≥5, ≥15, and ≥30 events/hour, pooled sensitivities were 0.94 (95% CI 0.92-0.96; 95% PI 0.71-0.99), 0.87 (95% CI 0.84-0.89; 95% PI 0.66-0.96), and 0.83 (95% CI 0.79-0.87; 95% PI 0.61-0.94), respectively; the corresponding specificities were 0.77 (95% CI 0.69-0.84; 95% PI 0.30-0.96), 0.81 (95% CI 0.75-0.85; 95% PI 0.39-0.96), and 0.91 (95% CI 0.87-0.94; 95% PI 0.55-0.99), respectively. The corresponding areas under the summary receiver operating characteristic curves were 0.943, 0.907, and 0.920. For non-PSG-derived tools, sensitivities were 0.92, 0.85, and 0.81, and specificities were 0.70, 0.74, and 0.85 at the 3 thresholds, respectively. For PSG-derived models, sensitivities were 0.96, 0.90, and 0.85, and specificities were 0.82, 0.88, and 0.96, respectively. Exploratory subgroup analyses suggested performance variation across selected study and model characteristics, including region, algorithmic framework, data source, and validation method. CONCLUSIONS: AI-based tools showed generally favorable screening performance for OSA across clinically relevant AHI thresholds, although wide PIs suggest variable performance across future comparable populations and settings. By synthesizing diagnostic accuracy across 3 AHI thresholds and distinguishing non-PSG-derived from PSG-derived models, this review extends previous broad or modality-specific reviews and offers a clinically interpretable, pathway-specific basis for linking model performance to intended use. The findings may clarify potential roles for non-PSG-derived tools in front-end screening and referral prioritization and for PSG-derived models in reduced-channel assessment and sleep-laboratory workflow support. Given substantial heterogeneity, limited external validation, and low or very low certainty of evidence, prospective validation is needed before routine implementation.

Humans↗

PubMed2005

Pilot study of an Internet patient-physician communication tool for heart failure disease management.

BACKGROUND: Internet disease management has the promise of improving care in patients with heart failure but evidence supporting its use is limited. We have designed a Heart Failure Internet Communication Tool (HFICT), allowing patients to enter messages for clinicians, as well as their daily symptoms, weight, blood pressure and heart rate. Clinicians review the information on the same day and provide feedback. OBJECTIVE: This pilot study evaluated the feasibility and patients' acceptability of using the Internet to communicate with patients with symptomatic heart failure. METHODS: Patients with symptomatic heart failure were instructed how to use the Internet communication tool. The primary outcome measure was the proportion of patients who used the system regularly by entering information on average at least once per week for at least 3 months. Secondary outcomes measures included safety and maintainability of the tool. We also conducted a content analysis of a subset of the patient and clinician messages entered into the comments field. RESULTS: Between May 3, 1999 and November 1, 2002, 62 patients (mean age 48.7 years) were enrolled.. At 3 months 58 patients were alive and without a heart transplant. Of those, 26 patients (45%; 95% Confidence Interval, 0.33-0.58) continued using the system at 3 months. In 97% of all entries by participants weight was included; 68% of entries included blood pressure; and 71% of entries included heart rate. In 3386 entries out of all 5098 patient entries (66%), comments were entered. Functions that were not used included the tracking of diuretics, medications and treatment goals. The tool appeared to be safe and maintainable. Workload estimates for clinicians for entering a response to each patient's entry ranged from less than a minute to 5 minutes or longer for a detailed response. Patients sent 3386 comments to the Heart Function Clinic. Based on the content analysis of 100 patient entries, the following major categories of communication were identified: patient information; patient symptoms; patient questions regarding their condition; patient coordinating own care; social responses. The number of comments decreased over time for both patients and clinicians. CONCLUSION: While the majority of patients discontinued use, 45% of the patients used the system and continued to use it on average for 1.5 years. An Internet tool is a feasible method of communication in a substantial proportion of patients with heart failure. Further study is required to determine whether clinical outcomes, such as quality of life or frequency of hospitalization, are improved.

Adult↗

PubMed2005

Developing a cultural competence assessment tool for people in recovery from racial, ethnic and cultural backgrounds: the journey, challenges and lessons learned.

In 1997, Maryland implemented a new managed care mental health system. Consumer satisfaction, evaluation and cultural competency were considered high priorities for the new system. While standardized tools for measuring consumer satisfaction were readily available, no validated, reliable and standardized tool existed to measure the perception of people from minority groups receiving mental health services. The MHA*/MHP* Cultural Competency Advisory Group (CCAG) accepted the challenge of developing a consumer assessment tool for cultural competency. The CCAG, composed of people in recovery, clinicians and administrators used their collective knowledge and experiences to develop a 52-item tool that met standards for validity and reliability. Consultation from a researcher helped to further develop the tool into one possessing tremendous potential for statewide implementation within Maryland's Public Mental Health System. Recognizing the limitations of the study and the need for further research, this instrument is a work in progress. Strategies to improve the instrument are currently underway with the Mental Hygiene Administration's Systems Evaluation Center of the University of Maryland and several national researchers.

Adult↗

PubMedDate not supplied

Reliability and validity of preverbal pain assessment tools.

Pain assessments using three different observational pain assessment tools--the Post Operative Pain Score (POPS), the Nursing Assessment of Pain Intensity (NAPI), and the Pain Rating Scale (PRS)--were made on 98 preverbal children following surgery in an attempt to establish the reliability and validity of the three tools. Two observers (raters) scored pain intensity using each of the three instruments before and after administration of an analgesic. Interrater agreements were satisfactory on all three tools, with Interclass Correlations (ICC) ranging from .71 to .85. T tests supported the discriminant validity of all three tools at the p < .0001 level. The POPS and NAPI had internal consistency reliability alphas ranging from .79 to .88 for the POPS and .59 to .77 for the NAPI. Item analyses suggested specific revisions of the tools that might increase their reliability.

Age Factors↗