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PubMed1990

Functionality of the ARPIA ambulatory information system.

Although database-based medical information systems are becoming popular, experiments done by researchers tell us that physicians still do not fully accept them. Key factors for changing physicians' practice habits are the availability of more powerful methods and tools for interactive data acquisition and retrieval. Problems involving human engineering usually require the identification of and experimentation with many novel approaches before the most suitable answer is discovered. ARPIA is an ambulatory information system experimenting on the effectiveness and acceptability (by medical users) of new intelligent and friendly interaction techniques and tools. In particular, it tests a novel flexible dialogue-based man-machine interface offering physical and logical data 'independence' during retrieval operations. Other features of the system are: a fast and robust data acquisition environment; a text- and picture-based data presentation and report generation facility; finally, a set of modules offering the ambulatory staff effective assistance in some extra complex interactive tasks. A user-oriented description of the main functionality of ARPIA is given; users' feedback summarizing almost 2 years of usage of the system is also reported.

Ambulatory Care Information Systems↗

PubMed1988

A week in the life of Mary: the impact of microtechnology on a severely handicapped person.

Microtechnology has an important role to play in maximizing the independence of severely handicapped people, especially those with few reliable voluntary movements. Such movements must be harnessed efficiently to provide control over all aspects of life including communication, mobility and the immediate environment. To highlight the role of microtechnology in the day to day life of a severely handicapped person living at home, a case study is presented. The systems Mary uses for communication and environmental control are described and their limitations discussed. Adaptive man-machine interfaces are proposed and foreseeable developments in the fields of speech technology and robotics are considered. Successful introduction of high technology devices requires a full appreciation of medical and social factors as well as those relating to the technology. This is achieved through close partnership between the clinical engineer and the rehabilitation consultant to the benefit of the severely handicapped person.

Communication Devices for People with Disabilities↗

PubMed1993

[Radiological reports and computer-assisted diagnosis].

Computers, particularly personal computers, have improved the quality and rapidity of radiology reports. Radiology reports are part of the information processing chain and should be found by means of a data base. The computer can help the radiologist to write the report by improving the man-machine interface: graphic interface, pointing tools (mouse, trackball), computer without keyboard, vocal recognition. These computer systems have larger and larger storage capacities (hard disks, optical disks). They can provide a contextual aid during report writing, when the editors use digital supports for their publications.

Diagnosis, Computer-Assisted↗

PubMedDate not supplied

Modelling and simulation of information systems on computer: methodological advantages.

Modelling and simulation of information systems by the means of miniatures on computer aim at two general objectives: (a) as an aid to design and realization of information systems; and (b) a tool to improve the dialogue between the designer and the users. An operational information system has two components bound by a dynamic relationship, an information system and a behavioural system. Thanks to the behaviour system, modelling and simulation allow the designer to integrate into the projects a large proportion of the system's implicit specification. The advantages of modelling to the information system relate to: (a) The conceptual phase: initial objectives are compared with the results of simulation and sometimes modified. (b) The external specifications: simulation is particularly useful for personalising man-machine relationships in each application. (c) The internal specifications: if the miniatures are built on the concept of process, the global design and the software are tested and also the simulation refines the configuration and directs the choice of hardware. (d) The implementation: stimulation reduces costs, time and allows testing. Progress in modelling techniques will undoubtedly lead to better information systems.

Computers↗

PubMed1983

Methods of hazard analysis applied in the light metal industry.

There is a present a wide variety of methods to be used for the identification and evaluation of hazards. The information resulting from a hazard analysis can be used to develop measures for either the elimination or the control of hazards. Hazard analysis has not yet been used very widely in industry. More information is needed, eg, about the applicability of methods to different types of systems. A joint project, where hazard analysis was applied to various fields, was carried out in the Nordic countries. One part of this project concentrated on the light metal industry. A trial was carried out on a production line for which man-machine tasks play an important role. Job analysis was selected as the means of revealing possible accidents. On the production line this procedure turned out to be a good point for systematic investigation. The selection of the methods to be applied within a system should be done carefully. It is important that sufficient knowledge is available both about the characteristics of the system and about the existing methods. The rapid increase of information in this area makes it possible to put hazard analysis to better use in industry.

Accident Prevention↗

PubMed1989

Computer-aided decision support in clinical medicine.

This paper reviews the problems and prospects involved in providing computer-aided decision support in clinical medicine. First, the evaluation of medical innovation is discussed. It is suggested that there are three criteria by which an innovation may be judged, namely (1) a need for the innovation, (2) the ability of the innovation to fulfil that need and (3) the ability to do so without transgressing practical, ethical or legal boundaries. These problems are addressed in turn. The paper suggests, taking one area of clinical medicine as an example (acute abdominal pain) there is a clear need for decision support--since the area is not handled well by doctors in current practice. Evidence is adduced to suggest that the computer can provide decision support and do so without transgressing professional, ethical or legal boundaries. The obstacles to progress, which stand in the way of widespread implementation are briefly discussed. These are lack of medical terminology, poor man-machine interface and above all a lack of co-ordination. Finally, it is suggested that the most valuable facet of current systems is the discipline and precision in data collection they impose upon practicing doctors.

Attitude to Computers↗

PubMed1988

Knowledge-based educational systems.

In knowledge-based educational systems, the key concept is that information and procedures are represented in the same data structure. These structures can search for each other in flexible and, consequently, very robust ways. At the Air Force Human Resources Laboratory (AFHRL), our researchers are building computer environments that know what they know, know how people can best use them, and know how to draw inferences about their state--self-referential electronic tutors. In September 1986, artificial intelligence researchers participated in AFHRL's Research Planning Forum for Intelligent Tutorial Systems (ITS). This essay reviews the state of the philosophy, art, and science of artificial intelligence (AI) approaches to education. Then it summarizes the research issues which were presented, discussed, and better defined in this Forum--namely the nature and representation of 1) expertise modules, 2) student diagnostic modules, 3) adaptive instructional and curriculum modules, 4) instructional environments, and 5) man-machine interfaces. Advances in artificial intelligence, cognitive science, and instructional discourse have provided a means for investigating human learning, for representing an individual's own "knowledge processing." Research and development in knowledge-based educational systems seems promising, not only for helping people learn how to perform complex tasks, but also for explicitly expressing how people learn to learn. Therefore, would it not be wise to establish a scientific legacy for the development of effective knowledge-based tutorial systems which is informed by the best studies of mind and meaning, language and thought, purpose and paradox?

Artificial Intelligence↗

PubMedDate not supplied

AIDA and medical courseware.

For more than a decade the Department of Medical Informatics has offered one-week training courses on the subject of computer applications in medicine and health care. Since 1983 two courses are given at a rate of one course every two weeks. One course is on programming and problem solving and consists of three modules of increasing complexity in techniques and methods in programming and structured system development. This course focusses on only some aspects of medical informatics: the development of a medical information system, and the problems occurring in the process of automation. These aspects, however, are dealt with in detail. To this end the students are trained in using the programming system MUMPS and the fourth-generation software package AIDA. The second, introductory course is an intensive training on several distinct areas of man-machine interactions. It contains lessons in the fields of communication and recording; storage and retrieval and databases; computation and automation; recognition and diagnosis; and therapy and control. This paper describes the use of AIDA in developing and maintaining lessons for the latter course, and the assistance of AIDA for teaching purposes in the former course.

Computer User Training↗

PubMed1985

The computer-based anesthetic monitors: the Duke Automatic Monitoring Equipment (DAME) system and the microDAME.

From 1972 to 1983 the Duke University Department of Anesthesiology designed, built, and maintained most of its own operating room patient monitoring equipment. Construction of a new hospital facility in 1980 provided the opportunity to design and test a new computer-based system, the Duke Automatic Monitoring Equipment (DAME) System. The system consist of microcomputer-based instrumentation on monitoring carts, which communicate with a central minicomputer that allows selection of different software monitoring packages based on the needs of the patient. Multiple problems, including frequent total monitoring failures during surgery, plagued the DAME System in its first year of operation. Despite resolution of many of these problems, user acceptance was poor because of the large size and weight of the monitoring carts, the inadequate quality of displayed physiological waveforms, and inability to overcome the difficulties of the man-machine interface. Because the remaining problems could not be rectified with the existing monitoring carts, a new generation of monitors was designed. The smaller, multiprocessor microDAME was designed to be as automatic and user tolerant as possible. It would omit much of the flexibility that had proved undesirable in the DAME system. When the microDAME was nearly completed, however, departmental research in that area ceased. It remains for others to apply our experiences to further improve operating room patient monitors.

Anesthesiology↗

PubMed1989

Digital image display station performance requirements based on physician experience with a prototype system.

The authors report on observations of and interviews with physicians using a prototype digital image display and reporting station. While the users generally agree that image quality is clinically satisfactory, they are unanimous in their opinion that improvements in the man-machine interface are required before case review by this mechanism is clinically acceptable in a production environment. A model image and information user interface is presented. It was developed in answer to the needs of radiologists and referring physicians operating in the imaging department of a community acute-care facility. In such an environment images and related information must be communicated quickly and often simultaneously to different parts of the department and hospital. The user interface with the management system and the management system itself must address the varied functions and the needs of both the medical and clerical staff. Image enhancement processes, for example, must be restricted to those that quickly provide significantly more perceivable diagnostic information. Little-used processes that may occupy significant portions of the display and the console's computing power must be trimmed or eliminated.

Computer Systems↗

PubMed1990

The artificial substitution of missing hands with myoelectrical prostheses.

The fitting of upper-extremity amputees requires special efforts, and its significance has been increased by the development of myoelectrically controlled prosthetic arm. Although an artificial hand only represents a relatively modest substitute for the missing hand of human beings, the efforts of designers and the achievements of manufacturers should not go unnoticed. Because of the development of myoelectrically controlled prosthetic arm, the amputee's standard of function can be improved and a cosmetic and functional solution provided. For control of the electromechanical hand, muscular potentials are received from the residual limb surface, amplified in the electrodes, and transmitted as control signals to the distal area. An important factor in providing a successful fitting is a reliable man-machine connection. This article summarizes the historic development and state of the art of the myoelectrically controlled arm prosthesis. The components and technical evaluations of the Myobock system as well as the procedures for fitting and fabricating a below-elbow prosthesis have been improved recently. A critical analysis of adaptive hands suggests that the prospects for the future are good.

Adult↗

PubMed1995

X-HUSAR, an X-based graphical interface for the analysis of genomic sequences.

Management and analysis of nucleotide and protein sequence and structure data constitute a traditional area of bioinformatics. Since the analytical programs are frequently developed by researchers, rather than software engineers, they tend to suffer from idiosyncratic and non-ergonomic man-machine interfaces. We report on HUSAR, our 140+ collection of third-party, as well as in-house developed or adapted, sequence manipulation and analysis tools, well integrated into the UNIX operating system environment and accessible via consistent menu-aware interface. Most of the HUSAR programs can be completely specified by UNIX command-line options; they can thus be run in batches or combined into pipes. Adding such a program into the HUSAR environment is almost a 'plug-and-play' exercise. HUSAR has been recently complemented with a graphical client interface, X-HUSAR, to support users on UNIX platforms with X11 windowing systems. The whole X-HUSAR interface is based on a single generic program, COMLIGEN, and a number of specific configuration files. COMLIGEN interprets those files and renders appropriate windows, menus, and other interactive elements, which help the end user in selecting application programs and specifying their options. Efforts of extending both HUSAR and X-HUSAR are roughly linear to the size of the collection.

Animals↗

PubMed1983

Automated analysis of abnormal electroencephalograms.

This paper presents a critical review of various attempts at computerized analysis of abnormal electroencephalograms (EEGs). A description of normal and abnormal EEGs from the viewpoint of the clinician is presented at first, along with guidelines used in the visual detection and quantification of EEG abnormalities, followed by a brief review of some important computerized methodologies for clinical EEG analysis. Automated detection and quantification of epileptogenic EEG transients and seizures are reviewed next, and digital computer (software) as well as hardwired systems are presented. Computerized techniques for the quantification of abnormal EEGs in cerebrovascular disorders and coma, metabolic disorders, and for the localization of brain lesions and tumors are presented as well. Future directions and the general problem of man-machine agreement are elaborated upon.

Brain Diseases↗

PubMed1992

XELE--a polypeptide model-building program for a graphics workstation.

A model-building program, XELE, for use in protein crystallography has been written in C under UNIX on a graphics workstation. This program makes full use of the X Window system to display the electron density distribution and to manipulate the polypeptide model, and therefore is named XELE. It utilizes a fast three-dimensional rendering package, Dorè, and is portable to other types of graphics workstations. A part of the program for the man-machine interface uses the library of X Window and X Toolkit, and therefore is highly interactive. The structure analysis program package, PROTEIN, is also implemented in an interactive mode using X Window, and has been interfaced with XELE.

Computer Graphics↗

PubMed1987

[Statistical indices of 201Tl distribution in the myocardium].

A study was made of the diagnostic potentialities of a histogram analysis of scintigraphic count distribution on myocardium scans using 201Tl in 9 patients with dilated cardiomyopathy, 12 patients with coronary heart disease and 6 patients with primary pulmonary hypertension. Scans were recorded 10 min., 4 and 24 h after a single administration of 201Tl at rest in the front-forward, 45 degrees left forward oblique and left lateral projections. The heart area on a scan was marked by hand. Count distribution was represented by an intensity histogram. An array of 243 scans was processed independently by 2 operators of different professional skill. A man-machine classification procedure with algorithm teaching was implemented. The author showed a possibility of group distinction by scintillation count distribution in the heart area on myocardium scans using 201Tl, the distinguishing information being within the interval of 41-80% of maximum intensity in this area. Automatic marking of the heart area on a scan was found necessary to have an entirely automated system for distinguishing groups of examinees.

Adolescent↗

PubMed1990

Integrated Broadband Communication (IBC) requirements of people with special needs.

In order to make the benefits of the Integrated Broadband Communication (IBC) services available to the largest possible part of the population, special attention should be given to user groups with special needs, such as elderly and handicapped people. For some of these groups the IBC services will facilitate their members socio-economic integration and offer them the opportunity to satisfy some of their everyday needs (e.g. video-telephony for the inter-personal communication of hearing impaired people). For some other categories (e.g. people with motor or sensory impairment), special design considerations are needed at a very early stage of technical development, in order to ensure that they are not prevented from using future sophisticated telecommunication services (e.g. by incorporating appropriate man-machine interaction techniques in general purpose terminals, adapting the user interface of terminals, etc.). This paper gives an overview of the work that is currently taking place within the framework of the Research and development on Advanced Communication in Europe (RACE) programme.

Communication Devices for People with Disabilities↗

PubMed1978

MEDLINE searching and retrieval.

The development of MEDLINE searching philosophy and methodology is described. Searcher requirements and capabilities in moving from a batch-mode linear operation to the iterative searching and retrieval provided by the random access mode of MEDLARS II are discussed. A detailed tutorial on searching methodology for individual queries is covered. Elements of search formulation include requestor interview, query analysis, presearching, technics of selecting terminology, formulation logic, adapting indexing protocol in the search, on-line man-machine interface, and retrieval analysis. Similar searching technics are utilized in producing the two basic types of MEDLINE publications, recurring bibliographies (RBs) and literature searches (LSs). RBs are co-operative ventures between the NLM and professional organizations or other government agencies. LSs are NLM sponsored non-recurring bibliographies on a topic of current but also general interest to the medical community. All publications are produced through the retrieval and publication systems of MEDLARS II and graphic arts composing equipment. At the beginning of the 1978 publication year there were 27 RBs in routine production including Index Medicus. Through 1977, over 375 LSs had been produced.

MEDLARS↗

PubMed1987

Resistance to computerization. An examination of the relationship between resistance and the cognitive style of the clinician.

The introduction of computer technology into the health care environment has been fraught with difficulty. The literature has identified that while there are many applications that have been successfully implemented, there are many others that have met significant resistance. As such, the diffusion of computer technology has been scattered and uneven in the health care arena. Some scholars attribute the problems of resistance to structural variables such as value conflicts, power conflicts, and ones that involve the man-machine interface. Other view the resistance as process-oriented, citing such key factors as inadequate training, lack of user involvement, and discomfort due to organizational change. It is held here that the essence of resistance to computerization in clinical settings is based upon the difference between the cognitive style of the user and that required by the computer. It appears that since the decision-making methods of the user tend to favor intuitive processes, he or she becomes more resistant to using a system that forces qualitative information into quantitative niches. This study examines the cognitive style of two groups of health care providers within a hospital, and attempts to provide insight into how personal decision-making processes are related to resistance to computerization. It is suggested that a more thorough understanding of this relationship will enhance the ability of health care facilities to implement new systems in the future.

Adult↗