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At least 73 records · Page 4Linked to original sources
PubMed1988

[Participation in a simple large-scale randomized trial organized by EORTC through an international computer network].

Case registration and treatment allocation was achieved in a "Simple large-scale trial against colorectal cancer" designed by the European Organization for Research and Treatment of Cancer (EORTC) using an international computer network system VENUS-P. The access to the central computer "EuroCODE" was obtained by simple equipment including ordinary microcomputer, modem and telephone line. Subscription to the KDD data network VENUS-P using a Packet Assembler/Disassembler (PAD) was necessary to connect to the EuroCODE. Intraoperative patient registration and allocation of treatment were possible through this system regardless of the time difference between countries. To organize a large-scale trial as a means to detect moderate but medically worthwhile treatment differences, this method proved to be particularly effective especially for international cooperative studies.

Colonic Neoplasms↗
PubMed1986

Computer-assisted instruction: a library service for the community teaching hospital.

This paper reports on five years of experience with computer-assisted instruction (CAI) at Winthrop-University Hospital, a major affiliate of the SUNY at Stony Brook School of Medicine. It compares CAI programs available from Ohio State University and Massachusetts General Hospital (accessed by telephone and modem), and software packages purchased from the Health Sciences Consortium (MED-CAPS) and Scientific American (DISCOTEST). The comparison documents one library's experience of the cost of these programs and the use made of them by medical students, house staff, and attending physicians. It describes the space allocated for necessary equipment, as well as the marketing of CAI. Finally, in view of the decision of the National Board of Medical Examiners to administer the Part III examination on computer (the so-called CBX) starting in 1988, the paper speculates on the future importance of CAI in the community teaching hospital.

Computer-Assisted Instruction↗
PubMed1986

Bringing the medical literature to physicians. Self-service computerized bibliographic retrieval.

Seven years ago physicians at the Beth Israel Hospital in Boston began doing their own searches of the medical literature. They used PaperChase, a computer program written especially for end users rather than for search librarians. The data base was initially limited to the journals shelved in the library of the Beth Israel Hospital, but it has since been expanded to include the entire MEDLINE collection of the National Library of Medicine-nearly 5 million references published in 3,400 biomedical journals dating back to 1966.PaperChase is now available throughout the United States and Canada to anyone who has a computer terminal or personal computer and a modem. No special training is needed for a successful search and there is no user's manual. Users can search by title word, "medical subject heading," author's name, journal title, year of publication, language of publication or any combination of the above. They can read abstracts on line, and they can request that a photocopy of the full text of any article be mailed to them.

Canada↗
PubMed1985

Outpatient computer-based 32-hour esophageal pH studies teletransmitted to a central esophageal laboratory.

Using a computer-based 32-hour esophageal pH system with a small patient-worn digital recording computer, outpatient studies are performed in the physiologic environment of the patient's workplace and home. Samples are taken at 15-s intervals, and the pH data stored in this computer are then fed into the main computer in the Central Esophageal Laboratory for analysis, scoring, printing out, and storage. Satellite esophageal laboratories located in regional hospitals, clinics, and physicians' offices conduct pH studies by telecommunication, using antimony electrodes, a recording computer, and a modem to transmit data to the main computer for high-quality computer analysis. One main computer and associated personnel serve multiple satellite stations. This maintains patient-physician relationships and is highly cost-effective.

Computers↗
PubMed1984

Transtelephonic electrocardiographic monitoring: reliability in detecting the ischemic ST segment response during exercise.

The ECG detection of ST segment depression during maximal treadmill exercise has diagnostic and prognostic significance in coronary artery disease. This study of 200 consecutive patients undergoing Bruce exercise testing for chest pain documents the ability of a transtelephonic ECG system, capable of storing segments of ECG memory during exercise, to reliably record ST segment depression detected during simultaneous exercise testing (sensitivity 79%; specificity 99.6%). Of the three transtelephonic ECG systems tested, the modified precordial V5 snap-on lead most accurately reflected ST segment amplitude and morphology with no "false positives" (specificity 100%) and few "false negatives" (sensitivity 78%). Therefore, this system is a potentially important clinical tool for accurately and conveniently monitoring coronary patients during exercise outside the hospital (e.g., following myocardial infarction) as well as for providing useful clinical information for ambulatory patients with undiagnosed sporadic chest pain.

Adult↗
PubMed1975

Clinical application of a second generation electrocardiographic computer program.

An electrocardiographic computer program based on multivariate analysis of orthogonal leads (Frank) was applied to records transmitted daily by telephone from the Veterans Administration Hospital, West Roxbury, Mass., to the Veterans Administration Hospital, Washington, D. C. A Bayesian classification procedure was used to compute probabilities for all diagnostic categories that might be encountered in a given record. Computer results were compared with interpretations of conventional 12 lead tracings. Of 1,663 records transmitted, 1,192 were selected for the study because the clinical diagnosis in these cases could be firmly established on the basis of independent, nonelectrocardiographic information. Twenty-one percent of the records were obtained from patients without evidence of cardiac disease and 79 percent from patients with various cardiovascular illnesses. Diagnostic electrocardiographic classifications were considered correct when in agreement with documented clinical diagnoses. Of the total sample of 1,192 recordings, 86 percent were classified correctly by computer as compared with 68 percent by conventional 12 lead electrocardiographic analysis. Improvement in diagnostic recognition by computer was most striking in patients with hypertensive cardiovascular disease or chronic obstructive lung disease. The multivariate classification scheme functioned most efficiently when a problem-oriented approach to diagnosis was simulated. This was accomplished by a simple method of adjusting prior probabilities according to the diagnostic problem under consideration.

Analysis of Variance↗
PubMed1976

Simple method for computer-aided analysis of echocardiograms.

The use of echocardiography in the diagnosis and assessment of heart disease is increasing as greater familiarity is obtained with this noninvasive procedure. Quantitative evaluation of echocardiographic studies has heretofore required time-consuming manipulation of mathematical formulas. A simple method utilizing a sonic digitizing tablet has been developed for computer-aided analysis of M-mode echocardiograms. This device can convert a point located manually with a digitizing pen into X and Y coordinates and with use of the standard telephone network can communicate on a time-shared basis with a DECSYSTEM-10 computer. A program has been written to compute and type the results of standard calculations involving mitral valve motion and left ventricular function. The information can also be stored on disk by the computer for future use. This simple, relatively inexpensive system is valuable because of the ease with which it permits usually laboriously obtained information to be extracted from the standard echocardiogram.

Diagnosis, Computer-Assisted↗
PubMed1990

Impact of field-transmitted electrocardiography on time to in-hospital thrombolytic therapy in acute myocardial infarction.

To assess the impact of a field-transmitted electrocardiogram (ECG) on patients with possible acute myocardial infarction, randomized and open trials were performed with a portable electrocardiographic system coupled with a cellular phone programmed to automatically transmit ECGs to the base hospital. Consecutive patients served by the 6 units of the Salt Lake City Emergency Rescue System were studied; 71 patients were randomized to in-field ECG (n = 34) versus no ECG (n = 37). Time on scene was 16.4 +/- 9.7 minutes for the ECG group versus 16.1 +/- 7.0 minutes for the non ECG group (difference not significant). Time of transport averaged 18.2 +/- 9.9 and 17.6 +/- 13.1 minutes, respectively (difference not significant). Six of 34 patients with in-field ECG showed acute myocardial infarction, qualified for and received thrombolytic therapy at 48 +/- 12 minutes after hospital arrival (range 30 to 60) compared with 103 +/- 44 minutes (p less than 0.01) for 51 historical control patients and 68 +/- 29 minutes for 6 concurrent control patients without in-field ECG. Thus, in-field ECG causes negligible delays in paramedic time, leads to significant decreases in time to in-hospital thrombolysis and may make in-field therapy feasible. In-field ECG may be an important addition to reperfusion strategies.

Allied Health Personnel↗
PubMed1986

Detection of preterm labor by ambulatory monitoring of uterine activity for the management of oral tocolysis.

A study to evaluate whether ambulatory tocodynamometry at home could enhance the management of oral tocolysis was performed. On discharge from the hospital, after completing parenteral tocolysis, 60 patients received a lightweight tocodynamometer, designed for storage and transmission of uterine activity data. Sixty additional contemporary patients, who were matched for maternal age, parity, and risk factors, served as a control group. In addition to instructions regarding self-detection of recurrent preterm labor, monitored patients recorded uterine activity for greater than or equal to 200 min/day and then transmitted the data to the study center. Tocolytic dosage was adjusted to maintain mean uterine contraction frequency of less than 4/hr. Persistent uterine contractions of greater than or equal to 4/hr lead to in-hospital evaluation for recurrent preterm labor. The results indicate that the monitored group had a lower incidence of preterm births mostly because of a decrease in the proportion of patients with failed tocolysis. It is suggested that surveillance of uterine activity at home during oral treatment for preterm labor may be instrumental in improving perinatal outcome in high-risk patients.

Adult↗
PubMed1976

Systems analysis of computerized EKG processing center.

A functional description of a computerized system for analysis of electrocardiograms (EKGs) is presented. Although it is recognized that the diagnostic accuracy of the program is the critical parameter in determining system acceptance, other system features such as quality control, turn around time and cost are shown to be of high importance. A digital simulation of alternative configurations for on-line data acquisition is presented. The simulation predicts the system throughout and wait times in different phases of a telephone EKG transmission for combinations of interfaces, telephone lines and acquisition procedures. These results should be helpful in selecting the appropriate configuration for each special situation.

Computers↗