[On the collection and processing of medical data by means of a computer. 1. A data collection and storage program (DASP) for documentation of medical records].
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Computers↗
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Methods of collecting data.
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Data Collection↗
Perils and pitfalls of systems that collect data on homicide.
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Adolescent↗
Improving dental epidemiologic data collection with computers.
A computerized dental data recording system (DDRS) was developed for the New England Elder Dental Study to improve data quality and increase field staff efficiency. The DDRS displays video screens similar to traditional paper forms to record data on coronal and root caries, dentate and denture status, subacute bacterial endocarditis screening, gingival bleeding, calculus, and periodontal attachment level. DDRS provides facilities for date and exam-component time tracking, on-line contextual comments, random record retrieval, editing, data backup, and data output in various data formats. This study compared the DDRS with a paper-form system for data entry accuracy. Dental caries and periodontal disease measurement data from 38 subjects were recorded on paper forms and independently entered using DDRS. The DDRS identified 150 illogical data errors, 39 inconsistent data errors, 7 invalid data and 34 miscellaneous data errors. Four technicians with field experience using both paper forms and DDRS reported time savings using DDRS in the field. DDRS has the potential for additional time savings by minimizing the time for data coding, cleaning, and management. Results demonstrate that DDRS could improve the quality of oral epidemiologic data by mandating strict adherence to protocols, preventing errors, and increasing field efficiency.
Computers↗
A model for multidisciplinary data collection for cervical metastasis.
A system for multidisciplinary data collection for metastatic neck disease is discussed. Information from 87 neck dissections and 3218 lymph nodes is reported to illustrate the strength of the model. Clinical (endoscopic) assessment under general anesthesia, surgical assessment during the neck dissection, and radiographic (computed tomographic scan) assessment were compared with the pathological evaluation. All disciplines stratified the necks by region and node size. This model provides an effective stratagem for multi-institutional studies.
Data Collection↗
How do we collect data for surveillance of wound infection?
The surveillance of surgical wound infection (SWI) may be undertaken for a number of purposes which include evaluating changes in practice, studying the epidemiology of SWI and for assessing the quality of health care. Purchasers require this information from providers as an indicator of the quality of care. Surveillance of SWI can also have a role in audit, by setting standards and comparing observed practice with agreed standards. The level of SWI can be the standard, and the collection, analysis and interpretation of data (undertaken during surveillance) could be the means for measuring the standard. In a surveillance programme, data collection is often the most time consuming and difficult element and requires considerable planning. Initially, the data to be collected should be defined. This will be influenced by the purposes of surveillance, the ways the events (SWI) are defined, the data required to produce meaningful analyses and criteria used for identifying the patient. After the data has been defined, data collection methods should be chosen. The importance of assessing the accuracy and limitations of data collection methods in local settings is stressed. Only then is it possible to be sure that the data is a reliable basis on which to base decisions which promote the quality of health care.
Data Collection↗
Comparison of 180 degrees and 360 degrees data collection in thallium-20 1 imaging using single-photon emission computerized tomography (SPECT): concise communication.
Thallium-201 imaging using SPECT is being done with 180 degrees (RAO to LPO) data collection in some centers with single-gamma camera systems. Using our SPECT system with two gamma cameras, we have compared the effects of 180 degrees data collection without attenuation correction against 360 degrees collection with attenuation correction, using phantoms and patients. With a heart phantom in a chest phantom, TI-201 activities simulating "normal myocardium," "ischemia," "infarction," and "background" were placed in object contrast ratios (with respect to background) of 5.0, 2.0, and -1.0, respectively. The 180 degrees data gave image contrast ratios of 1.6, 0.2, and -0.8, and the 260 degrees data gave ratios of 1.5, 0.8, and -0.3, respectively. Uniform activity throughout the heart gave similar image contrast with both data-collection methods, but there was more variability with the 180 degrees collection than with 360 degrees collection. Since attenuation correction is available with the 260 degrees collection, the effects of attenuation are seen only on the 180 degrees collection images. In eight patients the image contrasts from the 180 degrees and 260 degrees collections are similar. For our two-camera SPECT system, the 360 degrees collection permits attenuation correction, has less variability in counting statistics, and gives contrast ratios like those of 180 degrees collection.
Coronary Circulation↗
["ARCHIDIA": a system for patients' data collection and computerized filing. Part I. Methodology].
This report describes a computer based program of patient clinical data collection: the ARCHIDIA system. The project relies on descriptive analysis of clinical events according to well defined methodological criteria. This allows the formulation of a concise diagnosis which is, at the same time, exhaustive of all essential information. Two are the basis principles of this methodology: To define, as accurately as possible, the logical steps necessary to elaborate the diagnosis, that is construed by a sequence of codes. To define all the conditions that must be followed so to use any code in a controlled and independent way. These criteria were derived from literature. The major claim of the system is likely to be the introduction of a "common language" between different ICUs. Uniformed diagnostic and clinical criteria are the main source of large data collection for descriptive, analytic and prospective studies. After a one year pilot study performed by 4 ICUs, ARCHIDIA was used, in 1991, by 20 centers from the area of Milan, Pavia, Como, Varese (70% of total) and 4148 patient data were collected. A descriptive analysis will be reported in the following paper.
Electronic Data Processing↗
["ARCHIDIA": a system for patients' data collection and computerized filing. Part II. General description of a caseload].
OBJECTIVE: To describe a population of patients admitted in ICU in an homogeneous urban area by means of a computed system. EXPERIMENTAL DESIGN: Observational study. SETTING: 20 general intensive care units of general and university hospitals. PATIENTS: Patients admitted in ICU from 1-1-1991 to 31-12-1991. 3 centers collected patients only for 6 months, starting on 1-6-1991. MEASUREMENTS: For each patient demographic data, hospitalization data, outcome, diagnosis and diagnostic procedures used during hospitalization according to defined criteria previously described, were collected. Data have been collected on PC using dedicated software. RESULTS: All centers concluded data collection, none abandoned the study. General characteristics of 4148 valuable patients were reported. Age was 52.9 years, SAPS 12.4 and mortality 21.7%. The patients spent 8.7 days in ICU and, when transferred to a general ward, the following hospitalization was 21.5 days. CONCLUSIONS: Data collection demonstrated the project feasibility. It realizes a continue up to date system inside each unit and allows the use of a "common language" and homogeneous methodology between centers.
Adolescent↗
A pen-based system to support pre-operative data collection within an anaesthesia department.
This paper describes the design and implementation of a pen-based computer system for remote preoperative data collection. The system is envisaged to be used by anaesthesia staff at different hospital scenarios where pre-operative data are generated. Pen-based technology offers important advantages in terms of portability and human-computer interaction, as direct manipulation interfaces by direct pointing, and "notebook user interfaces metaphors". Being the human factors analysis and user interface design a vital stage to achieve the appropriate user acceptability, a methodology that integrates the "usability" evaluation from the earlier development stages was used. Additionally, the selection of a pen-based computer system as a portable device to be used by health care personnel allows to evaluate the appropriateness of this new technology for remote data collection within the hospital environment. The work presented is currently being realised under the Research Project "TANIT: Telematics in Anaesthesia and Intensive Care", within the "A.I.M.--Telematics in Health CARE" European Research Program.
Anesthesia Department, Hospital↗
The Sheffield data collection system.
Because of the intrinsically low sensitivity of any surface potential measurement to resistivity changes within a volume conductor, any data collection system for impedance imaging must be sensitive to changes in the peripheral potential profile of the order of 0.1%. For example, whilst the resistivity changes associated with lung ventilation and the movement of blood during the cardiac cycle range from 3 to 100% the changes recorded at the surface are very much less than this. The Sheffield data collection system uses 16 electrodes which are addressed through 4 multiplexers. Overall system accuracy is largely determined by the front-end equivalent circuit which is considered in some detail. This equivalent circuit must take into account wiring and multiplexer capacitances. A current drive of 5 mA p-p at 5 kHz is multiplexed to adjacent pairs of electrodes and peripheral potential profiles are recorded by serially stepping around adjacent electrode pairs. The existing Sheffield system collects the 208 data points for one image in 79 ms and offers 10 image data sets per second to the microprocessor. For a homogeneous circular conductor the ratio of the maximum to minimum signals within each peripheral potential profile is 45:1. The temptation to increase the number of electrodes in order to improve resolution is great and an achievable performance for 128 electrodes is given. However, any improvement in spatial resolution can only be made at the expense of speed and sensitivity which may well be the more important factors in determining the clinical utility of APT.
Amplifiers, Electronic↗
Assessment of an on-line computerized perinatal data collection and information system.
An on-line maternity data collection system has been designed to provide the information required for perinatal audit and to allow many of the letters and forms required for effective communication in pregnancy to be produced automatically. The system meets the requirements of the Korner Committee on Health Services Information and has been approved by the Computer Policy Committee. Pregnancy is followed prospectively from the first antenatal clinic visit until the file is closed 28 days after delivery. Data are entered by midwives and secretaries onto a network of microcomputers placed at convenient points in the maternity unit. The system has been fully operational with no significant problems since the beginning of 1984 and has led to improved communication between hospital and the community. Analysis of 253 consecutive case notes showed a high level of accuracy of the data recorded on computer. Reports and clinical audit are readily available both from the system locally, from standard programmes on the regional mainframe computer and via a mainframe computer at London University.
Computer Systems↗
Comparison between 180 degrees and 360 degrees data collection in technetium-99m MIBI SPECT of the myocardium.
In a series of 12 patients presenting with a single-vessel coronary artery disease and who were injected with 370 MBq of 99mTc-2-methoxyisobutylisonitrile at peak exercise, two consecutive single photon emission computed tomography (SPECT) data collections, i.e., 32 views of 30 sec during a 180 degrees rotation and 64 views of 15 sec during a 360 degrees rotation, were performed 1 hr later. In both cases, transverse sections were reconstructed using (a) a backprojection method with a ramp filter, (b) a correction for downscatter, (c) a correction for depth attenuation by the Chang method, or (d) both corrections. Each reconstructed myocardium was then divided into four short-axis sections which were radially divided into nine sectors. Sectors with an activity below 80% of the maximum were considered as abnormal. Sensitivity and specificity were calculated relative to a sector-by-sector theoretical anatomic distribution of the perfusion abnormalities. Results demonstrate that, of all situations, the best balance between sensitivity and specificity was achieved with the 180 degrees data collection and no correction at reconstruction. Using the 360 degrees data sampling technique mainly lowered the sensitivity in the patients with a circumflex or right coronary artery disease. It is concluded that there does not seem to be any definite advantage in performing a 360 degrees rather than a 180 degrees data collection in 99mTc myocardial SPECT.
Adult↗
A 32-electrode data collection system for electrical impedance tomography.
A 32-electrode data collection system for Electrical Impedance Tomography (EIT) will be presented. In this system, the demodulator is a multiplexed sample and hold (S&H) circuit followed by a voltage difference stage. This configuration provides high CMRR due to the low (almost DC) operating frequency of the signals the difference stage is required to process.
Amplifiers, Electronic↗
[Proposal for a data collection system for colposcopy services].
A computerized system for colpocytologic data collection and filing, is presented. A descriptive and easy to elaborate recording of anamnestical data and examination findings is achieved using two correlated files. Step by step filing is obtained by multichoice scheme which progressively appears on the screen.
Colposcopy↗
Data collection on spinal cord injuries: urological outcome.
Analysis of 628 consecutive admissions to the Spinal Injuries Unit, Austin Hospital, between July 1978 and December, 1985 illustrates the value of a comprehensive data collection system which has been developed at the hospital since 1978. Some brief epidemiological data is presented, together with a detailed analysis of the urological outcome of patients with traumatic lesions whose discharge has been completed. A high rate of catheter-free status and urine sterility at discharge is reported, and factors affecting these results are analysed. The authors hope that an international system of data collection can be developed in the future to allow meaningful comparison of results between units.
Data Collection↗
Monitoring disease in England and Wales: methods applicable to routine data-collecting systems.
This paper reviews routine data-collecting systems and methods for disease surveillance in England and Wales. It discusses population-based correlation studies, which seek to explain disease trends by relating routine health statistics to possible causative agents on a secular, geographical, or occupational basis. It describes recent developments in linking information collected by routine general purpose systems as a means of identifying and following individuals exposed to potential hazards.
Death Certificates↗
The impact of changing methods of data collection on the reliability of self-reported drug use of adolescents.
The purpose of this study is to determine the impact of different modes of data collection on the reliability of self-reported drug use of adolescents in a panel study. Adolescents were assigned to four groups based upon the ways they chose to respond to the survey instruments: 1) mailed questionnaires in both years, 2) survey interview in one year and mailed questionnaire in the next year, 3) mailed questionnaire in one year and survey interview in the following year, and 4) survey interview in both years. The quality of the self-reported data was examined in terms of return rates, missing data, internal consistency, and consistency of reported information over time. No significant differences were found between groups, suggesting that the mode of data collection does not affect the reliability of adolescents' self-reports of substance use.
Adolescent↗