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A computer system for the storage and retrieval of clinical pharmacokinetic data.

A computer system is described which stores patients data relating to clinical pharmacokinetic assessments made by clinical pharmacists, who are participating in a clinical pharmacokinetics service. The system was developed to assist in the documentation of service activities and storage of patients' pharmacokinetic data. An additional component of the system is the ability for retrospective review of the stored data. Application of this system to the derivation of new information on drug pharmacokinetics and drug efficacy/toxicity in various patient groups is discussed. The implications for phase IV drug studies and toxicity screening studies is also described.

Computers

Computerized radiation therapy data.

A computer data system by which data from radiation therapy records are stored, corrected, and up-dated continuously as information becomes available is described. Two main programs are involved. A data storage and retrieval system called TAXIR uses a high-level language similar to English and allows display of information in alphabetic or numerical fashion. The other program, MIDAS, is a statistical package designed to perform multiple statistical analyses on the data accumulated on the former program. Both of these programs utilize a logical syntax permitting easy identification and partition of a data set. In addition, several smaller program have been developed to advance survival information in a rapid and reliable way and to obtain information directly from computerized data available at the University of Michigan Cancer Follow-Up Unit. Programs to obtain life tables or graphs on survival or reactivation of neoplasms have been developed. Stress is placed on the development of a strategy to obtain the maximum accurate information with a minimum input. The development of suitable coding sheets including appropriate diagnoses and tumor classifications is discussed. The importance of keeping a continuous up-to-date flow of information is stressed.

Computers

[Electronic data processing system for clinical microbiology].

A computerized clinical microbiology data storage and retrieval system, which was introduced at the Institute of Medical Microbiology 14 month ago, is described. This institute has to perform routine diagnostic microbiology for hospitals in the Kanton of Zuerich including the university hospital. In addition, it serves as a public health laboratory for Zuerich and adjacent districts. Patient and physician data are entered into a data station IBM 3741 and stored on discettes. Each afternoon, these data are printed on special report forms, which then are transferred to the diagnostic laboratories. After completion of the investigation, a copy of this form containing the results is sent to the physician. Every two weeks, the information stored on the discettes are converted onto the magnetic tape "discette". In addition, the original report form, containing the codified results and the fees, are read by an optic reader, which transfers the information onto the tape "report". Both tapes then serve the computer to print the accounts as well as to summarize the results monthly in form of the medical statistics. These provide valuable information to enhance patient care. All data are stored in a cumalative microbiology data bank for later retrieval.

Accounting

The retrieval, storage, numerical and graphical trending of data from an Ohmeda 3700e pulse oximeter by personal computer.

A suite of computer programs are described to facilitate the transfer, disc storage, graphical trending and statistical analysis of data from an Ohmeda 3700e pulse oximeter. The programs are written in GWBASIC and designed to operate on a low cost IBM PC or compatible personal computer. The programs have been proved to be clinically useful in determining response to therapy as discerned from the long-term monitoring of arterial oxygen saturation. The computerised system is superior to analogue display system, such as a chart recorder, since it provides a logical method of presentation and analysis of data from long term monitoring.

Computer Graphics

Dealing with large data sets.

Collection, storage and retrieval of large amounts of data from multiple experiments for subsequent reduction, graphing and statistical analysis need not be a burdensome task. Although turnkey systems may offer significant economies for single well-defined and repetitive tasks, they may not permit sufficient flexibility to achieve the diverse aims required by many research programs. Using popular microcomputers to run one or a few experimental subjects may confront the investigator not only with significant bookkeeping problems, but also with an allocation of labor resources to computer maintenance and support that might be better invested in research effort. By using networked minicomputers, economies of scale emerge both in data collection, transfer, reduction, and analysis, as well as in maintenance, support, and scientific effort.

Data Collection

Storage and retrieval of coded patient diagnoses and data on a clinical laboratory computer system.

A system has been developed which allows for easy storage and retrieval of patient diagnoses using ICD-9-CM codes. Entered codes are automatically interpreted by the computer and then both the code and the interpretation are stored as in integral part of the patient record. Teaching clinicians may use an automated, keyword-search algorithm to display the code for a diagnosis of interest and then use that code to find any hospitalized patient with such a primary or secondary diagnosis. Entered diagnoses automatically appear on worksheets in the clinical laboratory. Retrospective studies also may be performed whenever a pathologist wants to compare diagnoses with laboratory results.

Clinical Laboratory Techniques

The outcome index and system outcome score: a method of quality assurance through outcome analysis in the special care area.

A scoring system intended to assess mortality risk and permit surveillance, evaluation and comparison of medical care was developed in our Surgical Intensive Care Unit. Five simple clinical components were identified and assigned scores according to their statistically validated relationship to mortality and the summation of the component scores resulted in a daily System Outcome Score (SOS). Cluster analysis was used to divide the creation data set of 2,777 patients into suitable groupings of scores to predict mortality and the clustering was confirmed for reproducibility with a validation set of an additional 2,860 patients. Two patient care surveillance techniques were then developed. The first involved the definition of three unfavourable SOS patterns evolving during the course of a patient's admission and detection of one or more of these patterns permits identification of specific patients for whom review of care delivered may be appropriate. The second involves a global assessment of care utilizing the Outcome Index (OI) which relates overall mortality risk in the unit to the actual mortality rate over a given time period. The effectiveness of care can then be compared between different time periods within the one unit or between different units with similar patient mix. A simple menu driven program has been developed for the IBM personal computer and clones that facilitates data storage and retrieval, production of outcome reports and customization of the scoring ranges to meet local standards of performance.

Adolescent

Ambulatory electrocardiography and computer technology--practical advantages.

Ambulatory electrocardiography has employed computer technology for more than two decades. This review pertains to current state-of-the-art interaction between ambulatory electrocardiography and computer technology with regard to data analysis, quantitation and standardization, data formatting, data storage and retrieval, and comparative interpretation of ambulatory ECGs. This report also addresses evolving techniques expected in the near future.

Computers

A program for handling data obtained by 'blind' histopathological evaluations.

An interactive data input, storage, retrieval and treatment system (LAMES) is described for use in histopathological studies where pathologists evaluate tissues without any identification (termed evaluations which are 'blind'). The system produces the mean values of individual groups within an experiment, and results of statistical comparisons between the groups. The system was implemented on a Hewlett-Packard (HP) 1000-F minicomputer operating under RTE-6/VM, and was written using FORTRAN IV.

Computers

Computer-assisted mapping with the light microscope.

With the system described specific features in a histological section such as neuronal degeneration, specific cell types, or the silver grains of autoradiography can be accurately localized. It is simple to operate, and allows for data storage and retrieval. The system consists of a Zeiss Universal microscope equipped with stepping motor drives on the X and Y axes and interfaced to a PDP-12 computer equipped with a printer/plotter. The user controls the system through a joystick control box and teletype. In spite of magnification changes all points in the field remain constant relative to a point of origin selected at the beginning of the mapping sequence. Therefore, the outline and major features of a section are entered at low magnification while the detail of neuronal degeneration, for example, is added in its precise location at a higher magnification. The plotting of points can be done in either random fashion or in a systemized series of horizontal or vertical scans. A graphic display is available throughout the procedure and all maps are both printed on a Versatec printer/plotter and stored on a disk for future recall and analysis. Use of the system in plotting neuronal degeneration is described.

Animals

Temporal reasoning and temporal data maintenance in medicine: issues and challenges.

We present a brief, nonexhaustive overview of research efforts in designing and developing time-oriented systems in medicine. The growing volume of research on time-oriented systems in medicine can be viewed from either an application point of view, focusing on different generic tasks (e.g. diagnosis) and clinical areas (e.g. cardiology), or from a methodological point of view, distinguishing between different theoretical approaches. In this overview, we focus on highlighting methodological and theoretical choices, and conclude with suggestions for new research directions. Two main research directions can be noted: temporal reasoning, which supports various temporal inference tasks (e.g. temporal abstraction, time-oriented decision support, forecasting, data validation), and temporal data maintenance, which deals with storage and retrieval of data that have heterogeneous temporal dimensions. Efforts common to both research areas include the modeling of time, of temporal entities, and of temporal queries. We suggest that tasks such as abstraction of time-oriented data and the handling of different temporal-granularity levels should provide common ground for collaboration between the two research directions and fruitful areas for future research.

Artificial Intelligence

A computer assisted follow up system for spinal cord injury patients.

The comprehensive care of patients with traumatic spinal cord injuries (SCI) necessitates, among other things, a structured, life-long follow up. The high consumption of medical care in chronic SCI patients, often a result of diseases affecting many different organ systems, soon causes the cumulated medical documentation to be extensive and therefore hard to survey. The possibilities for rational patient management, adequate quality assurance, and clinical research may improve considerably by computerisation of medical records. A computerised medical records system for SCI has recently been developed, using a semistructured medical record format for data input and a medical entity dictionary for facilitated data storage and retrieval. The principles for developing this computer-assisted follow up system are described.

Humans

Sulfur dioxide and tracheobronchial clearance in man.

Tracheobronchial clearance was measured in nine healthy, nonsmoking adults. Technetium Tc 99m albumin aerosol (mass median diameter, 3 mu; geometric standard deviation, 1.6) was inhaled as a bolus under controlled conditions to achieve reproducible deposition in large airways. Each subject was studied in three seperate three-hour experiments: twice under control conditions and once exposed to 5 ppm sulfur dioxide (pollutant exposure after aerosol inhalation). Lung retention of activity was measured using a gamma camera interfaced to a data storage and retrieval system. The study showed that (1) Both deposition and clearance were highly reproducible in individuals in repeat control studies. (2) Acute exposure to 5 ppm sulfur dioxide had no significant effect (P greater than .05) on mucocillary clearance in resting healthy subjects, except perhaps for a small transient change (P=.05) after one hour. (3) Pulmonary function tests showed a decrease in maximal midexpiratory flow (P less than .01) but no other significant changes.

Adult

Development of a computer workstation for famine early warning and food security.

Beginning in 1990, the University of Arizona, Arizona Remote Sensing Center (ARSC) has been involved in a collaborative effort with the Global Information and Early Warning System (GIEWS) and the Remote Sensing Center of the Food and Agriculture Organization (FAO) of the United Nations in designing and developing an integrated computer workstation for famine early warning. The goal of the project is to provide food security analysts with a set of computer tools to manage a very large and diverse set of data for predicting the onset of food security emergencies for every country on Earth. The initial stage of the project involved the conceptual definition of system elements and the development of overall system architecture. We are now developing an open, flexible, and portable system designed to significantly assist the work of the analysts. System architecture provides a task-specific and user-friendly graphic user interface (GUI) within a Windows environment that will link image processing, geographic information system (GIS), spreadsheet, text, and graphics software packages into a single operational environment. A relational database management system (RDBMS) is serving as the back-end of the workstation to facilitate data storage and retrieval and as a means to preserve analysis methodologies.

Computer Systems