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Medical reference filing systems.

Low priced shareware packages may be adequate for those whose main need is to index a collection of articles read in journals. Those who search the literature electronically will need a package able to import mass data. Pro-Cite is set up for bibliographic functions only, but Reference File and Notebook II can be used to index any kind of collection, with Reference File having the advantage of being memory-resident. Other reference filing databases being considered for purchase could be measured against those reviewed here.

Abstracting and Indexing

An innovation in flow cytometry data collection and analysis producing a correlated multiple sample analysis in a single file.

The problems associated with rapid analysis and interpretation of data from multicolor immunofluorescence panels have been a formidable barrier to their routine use. Using present flow cytometry concepts, a panel of 11 tubes each containing multiple phenotypic markers or controls requires postdata acquisition manipulation of many multiparameter histogram and listmode files. We have developed a method that compresses all of the information from such a panel into a single listmode data file during run time. A single data file is used to record the entire phenotypic analysis for a particular patient or series within an experiment. This is accomplished by the incorporation of a tube identifier parameter (TIP) as well as the fluorescence and light scatter parameters normally collected. The TIP can then be used for gating discrimination of any tube or set of tubes within a panel. When the TIP is correlated with the PRISM parameter the entire patient phenotypic image can be represented within a single two-parameter histogram we have called a phenogram. This phenogram can be generated in real time, providing on-line preprocessing of a complex multicolor experiment. By examining the image created by the phenogram it is possible to rapidly flag abnormalities such as incorrect gating. This procedure was carried out on an EPICS Elite flow cytometer in its standard configuration with the addition of hardware to provide an input for the TIP.

Data Collection

Patch-clamp studies on the anomalous mole fraction effect of the K+ channel in cytoplasmic droplets of Nitella: an attempt to distinguish between a multi-ion single-file pore and an enzyme kinetic model with lazy state.

Patch-clamp studies have been employed in order to check whether the assumption of a multi-ion single-file pore is necessary for the explanation of the anomalous mole fraction effect or whether this effect can also be explained by a single-barrier enzyme kinetic model. Experiments in the cell-attached configuration were done on the tonoplast membrane of cytoplasmic droplets of Nitella in solutions containing 150 mol m-3 of K+ plus Tl+ with seven different K+/Tl+ ratios. At first sight, the results seem to support the multi-ion single-file pore, because apparent open channel conductivity displays the anomalous mole fraction effect, whereas open-probability has not been found to be dependent on the K+/Tl+ ratio. Changes in open probability would be expected for a single-barrier enzyme kinetic model with a lazy state. On the other hand, the lazy-state model is more successful in explaining the measured I-V curves. The entire slope of the apparent open channel current-voltage curves rotates with changing K+/Tl+ ratios in the whole voltage range between -100 and +80 mV. Numerical calculations on the basis of multi-ion single-file pores could create the anomalous mole fraction effect only in a limited voltage range with intersecting I-V curves. The apparent absence of an effect on open probability which is postulated by the lazy-state model can be explained if switching into and out of the lazy state is faster than can be resolved by the temporal resolution of 1 msec.

Biological Transport

Radiographic interpretation of endodontic file length.

The purpose of this study was to evaluate the accuracy of examiners when asked to make file length adjustments with only a radiograph. The examiners viewed several radiographs under proper viewing conditions but without the aid of measuring devices. Two files of varying lengths (sizes 10 and 15) were placed in maxillary and mandibular premolars and molars from cadavers. The nine examiners were 67.91% in agreement of actual file length adjustment needed when adjustments of up to 0.5 mm were needed, 17.76% when adjustments of from 0.5 up to 1.0 mm were needed, and 14.33% when adjustments of greater than 1.0 mm were needed.

Dental Pulp Cavity

User discipline in a personal computer-based filing of ultrasound records.

The discipline of entering ultrasound examination data in a personal computer file was studied over two periods. During the first period (19 weeks), the use of the computer was limited to one laboratory. During the second period (14 weeks), the computer was shared by three laboratories operating in nearby premises. During the study, 2857 (89%) of a total of 3209 ultrasound examinations performed were duly recorded in the data file. The frequency of failure to enter data was markedly higher during the second period (7-45%) than during the first period (5%) of the study. Overall, there was a highly significant (p less than 0.001) tendency to enter pathological findings at the expense of normal and non-diagnostic findings. The ease of access to the computer and the number of examinations recorded appear to determine user conscientiousness in filing data. Selection and omission of data impair the usefulness of the data log in research.

Humans

Computer printing and filing of microbiology reports. 1. Description of the system.

From March 1974 all reports from this microbiology department have been computer printed and filed. The system was designed to include every medically important microorganism and test. Technicians at the laboratory bench made their results computer-readable using Port-a-punch cards, and specimen details were recorded on paper-tape, allowing the full description of each specimen to appear on the report. A summary form of each microbiology phrase enabled copies of reports to be printed on wide paper with 12 to 18 reports per sheet; such copies, in alphabetical order for one day, and cumulatively for one week were used by staff answering enquiries to the office. This format could also be used for printing allthe reports for one patient. Retrieval of results from the files was easily performed and was useful to medical and laboratory staff and for control-of-infection purposes. The system was written in COBOL and was designed to be as cost-effective as possible without sacrificing accuracy; the cost of a report and its filing was 17-97 pence.

Computers

[Image filing system for radiotherapy using a video tape recorder].

The compact media of video tape is applied to store medical images with spoken reporting. Video tape recorder (VTR), personal computer, and video/computer interface constitute our image filing system. VTR is controlled automatically by personal computer. Our system enable to file images including moving images, and color images easily, and established cheap and useful image filing system.

Humans

The Social Security Administration's 10-percent sample file of OASDI beneficiaries.

This is another in a series of technical articles describing Social Security Administration sample files and statistical systems. The focus of this article is the 10-percent sample file that provides program and demographic information on Social Security beneficiaries under the Old-Age, Survivors, and Disability Insurance program. The article explains the contents and availability of the 10-percent sample and presents several statistical tabulations as examples of the wide variety of data that can be developed from the file.

Female

Medical malpractice claims filed by Medicaid and non-Medicaid recipients in Maryland.

Several databases available in Maryland are used to investigate whether Medicaid recipients are more likely than other persons to engage in medical malpractice litigation. All malpractice claims filed during 1985 and 1986 (N = 1037) were updated for outcomes through 1989 and described with regard to the payer status of claimants. The proportion of claims filed by persons enrolled in Medicaid before and/or during the alleged malpractice incident was lower than the proportion of state residents enrolled in Medicaid. In addition, the proportion of obstetric claims filed by Medicaid recipients was identical to their proportion of hospital discharges for obstetric services during the period in which the incidents occurred.

Attitude to Health

Microfiling and automatic filing of radiographs.

When advantage is taken of the newest qualities of microfilms and copy films and when using their special developers and developing machines, it seems today that the microfilming of radiographs on 35 mm film is successful. Equipment in the price range of 67 000 DM is available. It includes automated filming and developing, but slipping microfilms onto the punch card jackets is semi-automatic. The advantage of the equipment is its low price, its small size compared to the Delcomat system, and thus its smaller filing space need. Also, the automation of filing is possible with this system. The system seems to be quite suitable for at least creating and maintenance of teaching files.

Finland

A filing system for transparencies.

A system has been developed to facilitate filing of 2 inches X 2 inches Kodachrome slides. This is coordinated with a diagnostic and therapeutic index that allows for easy retrieval. Compact metal filing cabinets are used, eliminating the need for subsequent rearrangement of slides. The system also provides a method for recall of patients. Preoperative photographs are maintained in plastic folders and checked periodically until the postoperative photographs have been taken.

Filing

The ophthalmologist's office: planning and practice. Patient records and filing systems.

Suggestions and examples of the components of patient charts have been offered for the most efficient office system and for the greatest protection of the ophthalmologist against malpractice charges. Emphasis has been placed on the alphabetical system of filing, the need for well-designed filing cabinets, and measures to reduce the incidence of misplacing and losing patient charts.

Filing

A patient and family number assignment and chart filing system for family physicians.

The Department of Family Medicine and Practice at the University of Wisconsin-Madison has devised and implemented an alpha-numeric system of identifying patient records together with a system of chart filing based on a variation of terminal digit filing. The system provides each patient with a unique identification number. This permanently assigned number is used as part of the medical record (chart) information, as the basis for assigning an account number, as the basis for determining the storage location of the chart in the record room, and as the basis for a family identification number. The number defines the patient's sex and position within the family, and its permanency ensures a capability for conducting both short- and long-term ambulatory care research in the family context.

Color

Indexing and filing of pathological illustrations.

An inexpensive feature card retrieval system has been combined with the Systematised Nomenclature of Pathology (SNOP) to provide simple but efficient means of indexing and filing 2 in. x 2 in. transparencies within a department of pathology. Using this system 2400 transparencies and the associated index cards can be conveniently stored in one drawer of a standard filing cabinet.

Abstracting and Indexing

Local image filing system in neurosurgery: validity of selective storage of radiographic images.

In an effort to achieve efficient image management in the practice of neurosurgery, a clinical data base system was designed and developed to process, store and retrieve neuroradiologic image information on hospitalized patients with the use of a local image filing system (EFPACS-500, Fuji Electric Co., Ltd). Storage and retrieval of radiographic images were studied to quantify existing procedures and to evaluate the validity of new technology. One of our hospitals (Southern Tohoku Research Institute for Neuroscience) has annually produced approximately 100,000 sheets of film radiographs, resulting in a great deal of serious problems, particularly lack of space for storage. In addition, the overall averaged ratio of selected key films to total files of radiographs was estimated to be 16.3% for hospitalized patients during the past 5 years. It is assumed that, by means of digital storage on this selective basis, radiographic storage problems can be solved with the use of the current data base system which efficiently handles image information involving patient care. In the practical view another substantial improvement in this work is the high functionality of the system, with which radiographic images coupled with a variety of clinical data on patients can be stored in a descriptive fashion.

Database Management Systems

Personal computers, medical slide files, and retrieval. An organized approach.

This discussion provides an organized, rational approach to filing, storage, and retrieval of a large medical photographic slide collection. Advantages of this approach include: minimal slide storage space, simple filing, rapid retrieval based on descriptive "key words" utilizing database software, inexpensive and readily available technology for users of personal computers, and reliable tracking of slides.

Audiovisual Aids

Clinical application of a magneto-optical disk image filing system/image save and carry (ISAC) system.

We propose the utilization of portable magneto optical disks for image filing. The main problems in PACS are the need for a high-speed local area network (LAN) and a large mass storage device. An image filing system--image save and carry (ISAC)--is one solution for these problems in present PACS and requires minimal additional hardware and cost for the installation. Whenever a patient is examined, the clerk carries the medical record and the ISAC magneto-optical disk for recording image data, and after inspection records the image data into the magneto-optical disk. We investigated the number of image retrievals done for inpatients and outpatients in 1988 at our radiation therapy department. The data storage requirements were on the average 18.5 MB for outpatients and 173.9 MB for inpatients. An ISAC display console needs also an easy-to-use man/machine interface for specifying images and image display characteristics in order to realize the ISAC system.

Computer Systems