PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Error minimization”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources

Human error and time of occurrence in hazardous material events in mining and manufacturing.

Human error has played a role in several large-scale hazardous materials events. To assess how human error and time of occurrence may have contributed to acute chemical releases, data from the Hazardous Substances Emergency Events Surveillance (HSEES) system for 1996-2003 were analyzed. Analyses were restricted to events in mining or manufacturing where human error was a contributing factor. The temporal distribution of releases was also evaluated to determine if the night shift impacted releases due to human error. Human error-related events in mining and manufacturing resulted in almost four times as many events with victims and almost three times as many events with evacuations compared with events in these industries where human error was not a contributing factor (10.3% versus 2.7% and 11.8% versus 4.5%, respectively). Time of occurrence of events attributable to human error in mining and manufacturing showed a widespread distribution for number of events, events with victims and evacuations, and hospitalizations and deaths, without apparent increased occurrence during the night shift. Utilizing human factor engineering in both front-end ergonomic design and retrospective incident investigation provides one potential systematic approach that may help minimize human error in workplace-related acute chemical releases and their resulting injuries.

Accidents, Occupational↗

Kinematic analysis of manual tracking in monkeys: characterization of movement intermittencies during a circular tracking task.

Segmentation of the velocity profiles into the submovements has been observed in reaching and tracking limb movements and even in isometric tasks. Submovements have been implicated in both feed-forward and feedback control. In this study, submovements were analyzed during manual tracking in the nonhuman primate with the focus on the amplitude-duration scaling of submovements and the error signals involved in their control. The task consisted of the interception and visually guided pursuit of a target moving in a circle. The submovements were quantified based on their duration and amplitude in the speed profile. Control experiments using passive movements demonstrated that these intermittencies were not instrumentation artifacts. Submovements were prominent in both the interception and tracking phases and their amplitude scaled linearly with duration. The scaling factors increased with tracking speed at the same rate for both interception and pursuit. A cross-correlation analysis between a variety of error signals and the speed profile revealed that direction and speed errors were temporally coupled to the submovements. The cross-correlation profiles suggest that submovements are initiated when speed error reaches a certain limit and when direction error is minimized. The scaling results show that in monkeys submovements characterize both the interception and pursuit portions of the task and that these submovements have similar scaling properties consistent with 1) the concept of stereotypy and 2) adding constant acceleration/force at a specific tracking speed. The correlation results show involvement of speed and direction error signals in controlling the submovements.

Animals↗

Spatiotemporal imaging of human brain activity using functional MRI constrained magnetoencephalography data: Monte Carlo simulations.

The goal of our research is to develop an experimental and analytical framework for spatiotemporal imaging of human brain function. Preliminary studies suggest that noninvasive spatiotemporal maps of cerebral activity can be produced by combining the high spatial resolution (millimeters) of functional MRI (fMRI) with the high temporal resolution (milliseconds) of electroencephalography (EEG) and magnetoencephalography (MEG). Although MEG and EEG are sensitive to millisecond changes in mental activity, the ability to resolve source localization and timing is limited by the ill-posed "inverse" problem. We conducted Monte Carlo simulations to evaluate the use of MRI constraints in a linear estimation inverse procedure, where fMRI weighting, cortical location and orientation, and sensor noise statistics were realistically incorporated. An error metric was computed to quantify the effects of fMRI invisible ("missing") sources, "extra" fMRI sources, and cortical orientation errors. Our simulation results demonstrate that prior anatomical and functional information from MRI can be used to regularize the EEG/MEG inverse problem, giving an improved solution with high spatial and temporal resolution. An fMRI weighting of approximately 90% was determined to provide the best compromise between separation of activity from correctly localized sources and minimization of error caused by missing sources. The accuracy of the estimate was relatively independent of the number and extent of the sources, allowing for incorporation of physiologically realistic multiple distributed sources. This linear estimation method provides an operator-independent approach for combining information from fMRI, MEG, and EEG and represents a significant advance over traditional dipole modeling.

Brain↗

Development of low entropy coding in a recurrent network.

In this paper we present an unsupervised neural network which exhibits competition between units via inhibitory feedback. The operation is such as to minimize reconstruction error, both for individual patterns, and over the entire training set. A key difference from networks which perform principal components analysis, or one of its variants, is the ability to converge to non-orthogonal weight values. We discuss the network's operation in relation to the twin goals of maximizing information transfer and minimizing code entropy, and show how the assignment of prior probabilities to network outputs can help to reduce entropy. We present results from two binary coding problems, and from experiments with image coding.

Journal Article↗

Magnetoencephalographic comparison of cortical sensorimotor extrema evoked by flexion of index finger and thumb.

A seven sensor array (6 sensors equally spaced on a 4 cm dia. with 1 sensor at the center) was used to differentiate two close sensorimotor sources (voluntary movements of right index finger and right thumb). Magnetic field amplitude data was analyzed from a single-session recording (single sensor-array location). The sensor array was positioned to record the peak magnetic field amplitude (an extremum) of one or both digits (analyzed at 145 ms after the electromyogram). An extremum was obtained by plotting a topographic field map and also by mathematical interpolation (both) from the seven-sensor amplitudes while at a fixed location. This method of analysis graphically showed digit extrema separation in all subjects over the negative extrema and thus separation of the neural generator populations at this specific time. Statistical significance of the seven sensor amplitudes was examined by null hypotheses testing. The digit extrema separation (over the negative extrema) was influenced by errors primarily due to noise, signal-to-noise ratio = 6 +/- 2.4, and the subjects' variability in digit flexion. This analysis eliminated sensor array position error and minimized the analysis time to a single session. From the plotted distribution of extrema pertaining to a particular flexion (same subject), obtained from repeated sessions, a mean extrema location for each digit was determined. In this manner, a separation between the digit extrema was demonstrated. The mapped distribution also provided a clear display of the error in plotting extrema locations. For both digits the error in mapping extrema locations (negative only) was 0.9 cm.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Mapping↗

Comparison of CT- and radiograph-based post-implant dosimetry for transperineal 125I prostate brachytherapy using single seeds and a commercial treatment-planning software.

BACKGROUND AND PURPOSE: The objective of this investigation was a direct comparison of the dosimetry of CT-based and radiograph- based postplanning procedures for seed implants. PATIENTS AND METHODS: CT- and radiograph-based postplans were carried out for eight iodine-125 ((125)I) seed implant patients with a commercial treatment-planning system (TPS). To assess a direct comparison of the dosimetric indices (D90, V100, V400), the radiograph-based seed coordinates were transformed to the coordinate system of the CT postplan. Afterwards, the CT-based seed positions were replaced by the radiograph-based coordinates in the TPS and the dose distribution was recalculated. RESULTS: The computations demonstrated that the radiograph-based dosimetric values for the prostate (D(p)90, V(p)100, and V(p)400) were on average lower than the values of the CT postplan. Normalized to the CT postplan the following mean values were found: D(p)90: 90.6% (standard deviation [SD]: 9.0%), V(p)100: 86.1% (SD: 14.7%), and V(p)400: 79.4% (SD: 14.4%). For three out of the eight patients the D(p)90 decreased to 90% of the initial CT postplan values. The reason for this dosimetric difference is supposed to be evoked by an error of the reconstruction software used. It was detected that the TPS algorithm assigned some sources to wrong coordinates, partly out of the prostate gland. CONCLUSION: The radiograph-based postplanning technique of the investigated TPS should only be used in combination with CT postplanning. Furthermore, complex testing procedures of reconstruction algorithms are recommended to minimize calculation errors.

Algorithms↗

Fiducial point placement and the accuracy of point-based, rigid body registration.

OBJECTIVE: To demonstrate that the shape of the configuration of fiducial points is an important factor governing target registration error (TRE) in point-based, rigid registration. METHODS: We consider two clinical situations: cranial neurosurgery and pedicle screw placement. For cranial neurosurgery, we apply theoretical results concerning TRE prediction, which we have previously derived and validated, to three hypothetical fiducial marker configurations. We illustrate the profile of expected TRE for each configuration. For pedicle screw placement, we apply the same theory to a common anatomic landmark configuration (tips of spinous and transverse processes) used for pedicle screw placement, and we estimate the error rate expected in placement of the screw. RESULTS: In the cranial neurosurgery example, we demonstrate that relatively small values of TRE may be achieved by using widely spread fiducial markers and/or placing the centroid of the markers near the target. We also demonstrate that near-collinear marker configurations far from the target may result in large TRE values. In the pedicle screw placement example, we demonstrate that the screw must be approximately 4 mm narrower than the pedicle in which it is implanted to minimize the chance of pedicle violation during placement. CONCLUSION: The placement of fiducial points is an important factor in minimizing the error rate for point-based, rigid registration. By using as many points as possible, avoiding near-collinear configurations, and ensuring that the centroid of the fiducial points is as near as possible to the target, TREs can be minimized.

Brain Diseases↗

[Simulator training in medicine and health care. A new pedagogic model for good patient safety].

Advanced simulation within medicine and health care is a rapidly growing field. Simulator based training can be applied in minimal invasive surgery, in endoscopic procedures as well as in anaesthesia and critical care management. At Huddinge University Hospital a center for advanced simulation of both endoscopic surgery and anaesthesia/critical care management is currently being set up. The objective is to focus on improved medical and health care training and thus improving patient safety by reducing medical errors.

Anesthesiology↗

Hepatic and extrahepatic insulin action in humans: measurement in the absence of non-steady-state error.

The isotope dilution technique has been extensively used to assess insulin action in humans. To determine if nonsteady state (NSS) has led to erroneous estimates of hepatic and extrahepatic insulin sensitivity, we measured glucose turnover in healthy subjects during infusion of insulin at rates of 0.25, 0.6, and 2.0 mU.kg-1.min-1. Turnover was calculated using Steele's traditional NSS equations [fixed-effective volume (pV) method] as well as with methods [radioactive infused glucose (hot-GINF) or variable pV] designed to minimize NSS error. In contrast to the fixed-pV method, both the hot-GINF and variable-pV methods indicated that several hours were required for suppression of hepatic glucose release at all insulin concentrations and that small increases in plasma insulin (approximately 100 pmol/l) had comparable effects on glucose disappearance and hepatic glucose release. Nevertheless, despite these differences, when turnover during the final hour of the insulin infusions was plotted vs. the prevailing insulin concentration, all three methods yielded similar insulin dose-response curves for suppression of hepatic glucose release. Thus despite previous errors in measurement of glucose turnover, the widely accepted belief that the human liver is exquisitely sensitive to small changes in insulin is correct.

Adult↗

Optimization of T assay: a model study.

Factors involved in the optimization of competitive binding radioassays have been analyzed using a thyroxine (T4) radioassay as a model system. The effects of kinetic errors are minimized by the use of the lowest possible incubation temperature for the separation step and by the use of labeled T4 of high purity (which is not consistently available from commerical sources). The use of labeled T4 containing significant quantities of labeled triiodothyronine (T3) can lead to a marked increase in bias and a decrease in precision with relatively small errors in the separation step due to the relatively short half-life of the T3-binder complex. The determination of the dissociation rate constant (not to be confused with the affinity constant) allows one to make useful estimates of the tolerances that can be allowed in the separation step in order to achieve a desired level of accuracy and precison.

Evaluation Studies as Topic↗

Sensitivity testing of ciprofloxacin for Pseudomonas aeruginosa.

UK clinical laboratories overestimate ciprofloxacin resistance amongst Pseudomonas aeruginosa isolates, relative to the MIC breakpoint of 1 mg/L. Most tests leading to this overestimation use 1 microg discs and are by Stokes' method with the breakpoint taken as the zone radius for P. aeruginosa NCTC 10662 minus 3 mm. Aiming to reduce this error rate, we examined alternative disc breakpoints. Tests were performed for 100 P. aeruginosa isolates on three media, with breakpoints selected (i) as the zone for P. aeruginosa NCTC 10662 minus 7 mm, as recommended for ciprofloxacin by the BSAC; (ii) with reference to MIC/zone correlation lines; (iii) from natural divisions in zone distribution histograms; and (iv) so as to minimize categorization errors. Breakpoints from regression lines, and those optimized to the susceptibility distribution, reduced the proportion of susceptible organisms misreported as resistant, but the improvement was not significant (P > 0.05, chi2 test). The breakpoint of the zone radius for P. aeruginosa NCTC 10662 minus 7 mm significantly reduced (P < 0.05) the number of susceptible organisms reported as resistant, but led to 50-75% of those with low level resistance (MIC 2-4 mg/L) and 4-10% of those with high-level resistance (MIC > 4 mg/L) being classed as susceptible. Irrespective of the medium and the basis of choosing breakpoints, 5 microg ciprofloxacin discs gave a lower rate of susceptible organisms being reported as resistant than did 1 microg discs; however, the improvement was not significant (P > 0.05, chi2 test) and the 5 microg discs had the disadvantages of forming very large zones for susceptible isolates and giving some--albeit small--zones for highly resistant organisms. In conclusion, the over-reporting of resistance could be reduced by use of zone breakpoints optimized to the MIC distribution and by the use of 5 microg discs, but the case for these changes is not overwhelming; taking the breakpoint as the zone for NCTC 10662 minus 7 mm led to unacceptable numbers of resistant organisms being reported as susceptible. More fundamentally, ciprofloxacin zones and MICs are continuously distributed for P. aeruginosa isolates, so susceptibility tests cannot divide the species into discrete populations. In these circumstances, it is optimistic to expect disc and MIC categorizations to agree perfectly.

Ciprofloxacin↗

The ideal fetal head circumference calculation.

Various formulas have been employed to compute the circumference of an ellipse. These formulas can be separated into three groups: formulas for a circle, formulas for an incorrect ellipse, and a very complicated formula for a correct ellipse. The errors caused by the first two groups are termed systematic because they occur every time that one of these formulas is used. When measuring fetal head circumference, the errors increase as the fetal head is more ellipsoid, becoming more than 1% when the ratio of the biparietal to fronto-occipital diameter decreases to less than .70. Near term, when the fetal head is large, this could create an error in predicting gestational age of almost .8 weeks. The third group is associated with mathematical random errors because of the difficulty in using a cumbersome equation. All of these formulas and their shortcomings are analyzed. A calculation for the correct circumference of an ellipse is proposed using the simple formula for a circle times a correction factor. The correction factor depends solely on the ratio of the biparietal to fronto-occipital diameter. This formula should minimize random errors and eliminate systematic errors in the calculation of fetal head circumference and will permit a more accurate analysis of fetal age.

Cephalometry↗

Laboratory issues: use of nutritional biomarkers.

Biomarkers of nutritional status provide alternative measures of dietary intake. Like the error and variation associated with dietary intake measures, the magnitude and impact of both biological (preanalytical) and laboratory (analytical) variability need to be considered when one is using biomarkers. When choosing a biomarker, it is important to understand how it relates to nutritional intake and the specific time frame of exposure it reflects as well as how it is affected by sampling and laboratory procedures. Biological sources of variation that arise from genetic and disease states of an individual affect biomarkers, but they are also affected by nonbiological sources of variation arising from specimen collection and storage, seasonality, time of day, contamination, stability and laboratory quality assurance. When choosing a laboratory for biomarker assessment, researchers should try to make sure random and systematic error is minimized by inclusion of certain techniques such as blinding of laboratory staff to disease status and including external pooled standards to which laboratory staff are blinded. In addition analytic quality control should be ensured by use of internal standards or certified materials over the entire range of possible values to control method accuracy. One must consider the effect of random laboratory error on measurement precision and also understand the method's limit of detection and the laboratory cutpoints. Choosing appropriate cutpoints and reducing error is extremely important in nutritional epidemiology where weak associations are frequent. As part of this review, serum lipids are included as an example of a biomarker whereby collaborative efforts have been put forth to both understand biological sources of variation and standardize laboratory results.

Behavior↗

The precision of a special purpose analog computer in clinical cardiac output determination.

Three hundred dye-dilution curves taken during our first year of clinical experience with the Waters CO-4 cardiac output computer were analyzed to estimate the errors involved in its use. Provided that calibration is accurate and 5.0 mg of dye are injected for each curve, then the percentage standard deviation of measurement using this computer is about 8.7%. Included in this are the errors inherent in the computer, errors due to baseline drift, errors in the injection of dye and acutal variation of cardiac output over a series of successive determinations. The size of this error is comparable to that involved in manual calculation. The mean value of five successive curves will be within 10% of the real value in 99 cases out of 100. Advances in methodology and equipment are discussed which make calibration simpler and more accurate, and which should also improve the quality of computer determination. A list of suggestions is given to minimize the errors involved in the clinical use of this equipment.

Cardiac Output↗

Non-steady state: error analysis of Steele's model and developments for glucose kinetics.

The model proposed by Steele (Ann. NY Acad. Sci. 82: 420-430, 1959) to compute rates of appearance and disappearance in non-steady state is subjected to theoretical analysis. It is shown that this model introduces an error with two components, one dependent on the volume of the compartment, the other related to the complex configuration of the system. The errors depend on the time course of specific activity, change differently with time, and may take the opposite sign but they do not, in general, cancel each other. Corollaries of this analysis are the following: there is no single pool-fraction value satisfactory under all non-steady-state situations; keeping tracer specific activity as constant as possible during the experiment minimizes both errors; and non-steady-state analysis demands proper modeling of the system. Tracer experiments were carried out in five normal volunteers. Plasma [3-3H]glucose concentration was first brought to equilibrium by means of a primed constant 2-h infusion, and then the steady state was perturbed by a 2-h euglycemic insulin (1 mU X min-1 X kg-1) clamp, realizing a transition between a basal and a euglycemic hyperinsulinemic steady state. These data were analyzed with Steele's equation, the two compartment models of Radziuk et al. [Am. J. Physiol. 234 (Endocrinol. Metab. Gastrointest. Physiol. 3): E84-E93, 1978], and a new model based on a study on glucose kinetics carried out in the two steady states separately. Steele's equation yielded negative values for hepatic glucose production already 40 min into the clamp and throughout the study. The average value of glucose production during the 2nd h was -0.88 mg X min-1 X kg-1; the suppression of basal release over the 2-h period was 115%. In contrast, the new model calculated a mean glucose production of 0.37 mg X min-1 X kg-1 during the 2nd h and an overall suppression of 62%; no negative values were obtained.

Female↗

The benefits of stereoscopic vision in robotic-assisted performance on bench models.

BACKGROUND: Previous studies have failed to establish clear advantages for the use of stereoscopic visualization systems in minimal-access surgery. The aim of this study was to objectively assess whether stereoscopic visualization improves performance on bench models using the da Vinci robotic system. METHODS: Eleven surgeons carried out a series of four tasks. Positional data streamed from the da Vinci system was analyzed by means of a previously validated custom-designed software-package. An independent blinded observer scored errors. Statistical analysis included the Wilcoxon signed rank test. A p < 0.05 was deemed significant. RESULTS: We found significant improvements in all tasks and for all parameters (p < 0.05). In addition, a significantly lower number of errors was scored using the stereoscopic mode as compared to the standard two-dimensional image (p < 0.001). CONCLUSION: Robotic-assisted performance on bench models is more efficient and accurate using stereoscopic visualization.

Data Display↗

Relative contribution of gravity to pulmonary perfusion heterogeneity.

We designed a series of experiments and analyses to quantify the contribution of gravity to pulmonary perfusion heterogeneity. Regional pulmonary perfusion was measured in five anesthetized and ventilated dogs in both supine and prone positions by use of radiolabeled microspheres injected during apnea at functional residual capacity. Measurements of flow were repeated in each position, and the sequence of positions was prospectively designed to nullify any effect of order. The lungs of each animal were excised, perfused with saline until clear, dried at an inflation pressure of 25 cmH2O, and cut into 1.9-cm3 pieces. Each piece was weighed and the radioactivity determined in a scintillation counter. Measurement errors were minimized by excluding lung pieces that had greater than 25% airway and weighed less than 10 mg or greater than 60 mg. Weight-normalized flows in each position and repetition were determined for each lung piece. An analysis of variance model was used to identify the percentage of variation in regional flow that was due to position (supine vs. prone), to random error and time (measurement and repetition), and to structure, where structure was defined as the component of flow that remained constant across position and replication. The contributions of position, error/time, and structure to the total variability of flow across the five dogs were 7.8 +/- 0.6, 8.4 +/- 8.3, and 83.8 +/- 8.4%, (SD), respectively. Because the contribution of position represents the additive effect of gravity between two opposite positions, the contribution of gravity to perfusion heterogeneity in one position may be as little as 4%.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Programming errors contribute to death from patient-controlled analgesia: case report and estimate of probability.

PURPOSE: To identify the factors that threaten patient safety when using patient-controlled analgesia (PCA) and to obtain an evidence-based estimate of the probability of death from user programming errors associated with PCA. CLINICAL FEATURES: A 19-yr-old woman underwent Cesarean section and delivered a healthy infant. Postoperatively, morphine sulfate (2 mg bolus, lockout interval of six minutes, four-hour limit of 30 mg) was ordered, to be delivered by an Abbott Lifecare 4100 Plus II Infusion Pump. A drug cassette containing 1 mg.mL(-1) solution of morphine was unavailable, so the nurse used a cassette that contained a more concentrated solution (5 mg.mL(-1)). 7.5 hr after the PCA was started, the patient was pronounced dead. Blood samples were obtained and autopsy showed a toxic concentration of morphine. The available evidence is consistent with a concentration programming error where morphine 1 mg.mL(-1) was entered instead of 5 mg.mL(-1). Based on a search of such incidents in the Food and Drug Administration MDR database and other sources and on a denominator of 22,000,000 provided by the device manufacturer, mortality from user programming errors with this device was estimated to be a low likelihood event (ranging from 1 in 33,000 to 1 in 338,800), but relatively numerous in absolute terms (ranging from 65-667 deaths). CONCLUSION: Anesthesiologists, nurses, human factors engineers, and device manufacturers can work together to enhance the safety of PCA pumps by redesigning user interfaces, drug cassettes, and hospital operating procedures to minimize programming errors and to enhance their detection before patients are harmed.

Adult↗