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At least 109 records · Page 6Linked to original sources

Data acquisition and analysis of pulsatile signals using a personal computer: an application in cardiovascular physiology.

Software is described which collects and analyzes pulsatile analog signals using an APPLE PC and a modestly priced analog-digital interface. The program will input and output data, store and retrieve data to disk and display data on the monitor. Four types of data analysis determine mean, maximum and minimum values and frequency in various combinations. For example, the present program analyzes cardiovascular signals for heart rate, stroke volume, cardiac output, systolic, diastolic and mean pressures over a representative 10 s period. Simple modifications to the program are described which extend its range of application.

Computers

Topography of brain electrical activity: a bioengineering approach.

The aim of this work is to describe a system for the mono- and bi-dimensional analysis of brain electrical activity. The analysis was carried on either by visual inspection of mono- and bi-dimensional data, or by automatic feature extraction from the bidimensional data. Because of the importance of visual inspection for the analysis of experimental data, particular care was devoted to optimize the displayed data perceptually. For automatic screening of large amounts of data (and to allow long term studies of clinical records), statistical facilities were also provided. One purpose of the system was to develop image processing algorithms oriented toward biomedical images, that could be easily implemented on special purpose, low cost hardware, like VLSI or microcomputer arrays. This was possible because of the modularity of the larger part of bidimensional processing, such as interpolation and statistical analysis. Results of an experiment on Visual Evoked Response are presented, showing that through abidimensional analysis of the recorded data the resolution achievable in the localization of brain electrical activity can be increased to less than 1 cm.

Brain

Advanced alerting features: displaying new relevant data and retracting alerts.

We added two advanced features to our automated alerting system. The first feature identifies and displays, at the time an alert is reviewed, relevant data filed between the login time of a specimen leading to an alerting result and the time the alert is reviewed. Relevant data is defined as data of the same kind as generated the alert. The other feature retracts alerts when the alerting value is edited and no longer satisfies the alerting criteria. We evaluated the two features for a 14-week period (new relevant data) and a 6-week period (retraction). Of a total of 1104 alerts in the 14-week evaluation, 286 (25.9%) had new relevant data displayed at alert review time. Of the 286, 75.2% were due to additions of comments to the original piece of alerting data; 24.1% were due to new or pending laboratory results of the same type that generated the alert. Two alerts (out of 490) were retracted in a 6 week period. We conclude that in our system, new clinically relevant data is often added between the time of specimen login and the time that an alerting result from that specimen is reviewed. Retractions occur rarely but are important to detect and communicate.

Data Display

Real-time display of flow-pressure-volume loops.

Graphic display of respiratory waveforms can be valuable for monitoring the progress of ventilated patients. A system has been developed that can display flow-pressure-volume loops as derived from a patient's respiratory circuit in real time. It can also display, store, print, and retrieve ventilatory waveforms. Five loops can be displayed at once: current, previous, reference, "ideal," and previously saved. Two components, the data-display device (DDD) and the data-collection device (DCD), comprise the system. An IBM 286/386 computer with a graphics card (VGA) and bidirectional parallel port is used for the DDD; an eight-bit microprocessor card and an A/D convertor card make up the DCD. A real-time multitasking operating system was written to control the DDD, while the DCD operates from in-line assembly code. The DCD samples the pressure and flow sensors at 100 Hz and looks for a complete flow waveform pattern based on flow slope. These waveforms are then passed to the DDD via the mutual parallel port. Within the DDD a process integrates the flow to create a volume signal and performs a multilinear regression on the pressure, flow, and volume data to calculate the elastance, resistance, pressure offset, and coefficient of determination. Elastance, resistance, and offset are used to calculate Pr and Pc where: Pr[k] = P[k]-offset-(elastance.V[k]) and Pc[k] = P[k]-offset-(resistance.F[k]). Volume vs. Pc and flow vs. Pr can be displayed in real time. Patient data from previous clinical tests were loaded into the device to verify the software calculations. An analog waveform generator was used to simulate flow and pressure waveforms that validated the system.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Graphics

Resident tracking health information system. Inpatient setting.

The tracking of residents' patient care activities in the hospital setting is valuable to the residency program directors for consideration of curricular changes and to the resident for documentation of experience. Furthermore, the cost-effective method of using patient data generated by hospital billing systems eliminates the need for double entry and assures a high degree of accuracy. This article discusses the use of a computerized tracking system, providing examples of data displays and interpretations.

Area Health Education Centers

Comparison of nurse and computer charting of physiological variables in an intensive care unit.

OBJECTIVES: To compare charting of physiological parameters manually by nurses and automatically by computer and so decide whether this task could accurately be performed by computer. SUBJECTS/SETTING: 101 consecutive patients admitted for tertiary neonatal intensive care. DESIGN: Direct comparison of 48 hours of data collected by both methods. Computer data stored each second and the hourly median compared with the single hourly value noted by the nurse. METHODS: All patients were monitored by standard patient monitor and a computer. Four physiological parameters were compared between nurse and computer (both derived information from the standard patient monitor): heart rate, transcutaneous oxygen, mean blood pressure, central temperature. A random 51% of patients had the computer data displayed as trends at the cotside. Comparison of the hourly nurse observation and a computer hourly median value. Computer data was compared before and after the removal of artifact. In addition, the effects on nursing observations of either display or non display of the computer trend data was assessed. RESULTS: Nurse and computer observations were statistically significantly different (p < 0.001), though these were not clinically important. Nurses tended to note a higher figure than the computer median. The cotside display of computer data improved consistency between the nurse and computer observations. Artifact present in the data had little influence on the accuracy of the computer median value. CONCLUSIONS: Computer systems can accurately chart physiological data, providing a more flexible record with a minimal risk to data reliability from artifact.

Bias

Controlled vocabulary and design of laboratory results displays.

Traditional data-review displays are driven by the ancillary systems that produced the data. A different paradigm is being used at Columbia-Presbyterian Medical Center (CPMC) where a controlled medical vocabulary-the Medical Entities Dictionary (MED) is the driving force behind laboratory data-review displays. Using hierarchical and semantic networks the authors have constructed a Web-based tool that considerably simplifies the MED-editing task required to create new displays. The tool uses knowledge in the MED to extract contextually relevant hierarchic and semantic sub-nets from the MED. The tool has a sensitivity of 92.2% and a relevance of 94.7% for retrieval of terms from the MED. Based on these results and given sufficient domains' structure within controlled vocabularies, we conclude that similar algorithms will enable applications to design and generate customized displays on-the-fly.

Algorithms

A measure of intraoperative attention to monitor displays.

Vigilance is an important but difficult to measure attribute in anesthesia practitioners. We present a modified standard method to assess intraoperative vigilance toward electronic data displays. The response time to detect a simulated abnormal value on the physiologic monitor was measured. Eight anesthesia residents were studied during 60 surgical procedures. Responses to 439 abnormal values were analyzed. The average response time was 61 +/- 61 s (mean +/- SD), and 56% of the detections were made within 60 s. However, 16% of the abnormal values were undetected during the 5 min that they were displayed. Response times and the rate of missed events were greater during induction of anesthesia (a time of high workload) than during the maintenance or emergence phases of anesthesia. Response times were shorter during procedures on ASA 1 patients than on ASA 3 patients. The results suggest that anesthesiologists usually quickly detect abnormal values on physiologic monitors and that less attention is devoted to monitors during periods of high workload.

Anesthesiology

FP/MIS: a management information system for a community family planning clinic.

The management information system (FP/MIS) used by the Howard University Center for Family Planning Services, which operates community family planning clinics in Washington, D.C. is described. The system was developed to satisfy program objectives in patient management, program planning and evaluation, resource management, federal reporting systems and clinical, epidemiological and health services research. The data collection forms used in the system and the output from the four data display groups--patient profile, resource management, quality of care and epidemiology-are described along with examples of their use.

Computers

A generic approach to the management of time-related signals and images in medicine.

A framework concept for design and implementation of medical workstations is described by (a) its underlying principles, (b) the handlers provided by the concept, (c) the available data structures and (d) the graphical user interface (GUI). The design principle takes care of a modular approach both for the framework and for the applications. The GUI provides a coherent look and feel for applications based on toolkits for displaying data objects and application control. The data handler allows management of n-dimensional data matrices in a multi-vendor environment, whereas the parameter handler takes care of the data object description. An implementation of a medical workstation exploiting the framework concept is presented.

Computer Graphics

EPIX: an interactive computer application program for cross-sectional epidemiological, periodontal investigations from X-ray films.

This article introduces the interactive computer application program EPIX and the associated personal computer/digitizer system. The system is used to measure marginal alveolar bone height and to record angular alveolar bone defects, defective margins of dental restorations and dental calculus from 5 X-magnified periapical radiographs in cross-sectional epidemiological investigations. The 134-kBytes compiled BASIC program provides 17 menu options. A complete recording of interproximal tooth surfaces takes on average 20 minutes per subject. Data from 200 subjects can be stored on one 5.25" floppy disk. EPIX transforms data files into text files to enable transfer to main-frame computer for statistical analyses. Data displays on VDU or paper are available. Routines for data location and processing, file processing and visual display of an operator's manual provide additional facilities. EPIX has been used to process an epidemiological material of 912 subjects and has proved to be useful.

Cross-Sectional Studies

A new DSP-based multichannel EMG acquisition and analysis system.

This paper describes the design of a digital signal processor based system for a personal computer for EMG data acquisition to monitor muscle activity during gait and to estimate the power spectrum of the acquired data under normal and pathological conditions. It also gives the hardware details of the velocity meter which is used to monitor the muscle activity with speed of walking. Software has been developed for system initialization, data acquisition, processing of acquired data, and data display for five channels. The developed equipment will be useful to clinicians for enhancing the understanding of a patient's dynamic performance.

Analog-Digital Conversion

Feto-maternal surveillance in labour: a new approach with an on-line microcomputer.

A new method of real-time computer surveillance during labour is described with a commercially available "low-cost' microcomputer and integral video display unit (VDU). The fetal monitoring program gives accurate and reliable information on eight parameters of fetal and maternal wellbeing, four of which may be displayed simultaneously, with the facility of instant data recall. Emphasis is on simplicity of operation, and clarity of data display in the form of horizontal bar graphs updated at 5-min intervals, with most recent information in numerical form. Flexibility of the system enables program modification with relative ease, and adaptation to two unmodified commercial electronic fetal monitors.

Cervix Uteri

A comparison of fifteen pulse oximeters. Part I: A clinical comparison; Part II: A test of performance under conditions of poor perfusion.

Fifteen pulse oximeters were compared. Their physical characteristics, price, warranty, information handling and displays were catalogued. Times for changes in data display and susceptibility to interference were assessed. A model for comparison of oximeters under conditions of poor perfusion was developed using a tourniquet to progressively diminish limb perfusion pressure (systolic minus tourniquet pressure). The oximeters evidenced a wide variety of features and performance in poor perfusion states. Instruments lacking a beep varying in pitch with saturation or a waveform/pulse bar display of plethysmograph signal were considered less satisfactory. The majority of instruments, with some notable exceptions, performed remarkably well in a state of diminished perfusion. The study demonstrates that purchasers of pulse oximeters need to exercise care in assessing the suitability of particular instruments to their specific requirements.

Adult

Use of the virtual instrumentation laboratory for the assessment of human factors in surgery and anesthesia.

There is a growing consensus that human factors issues for anesthesiologists, surgeons, and other operating room personnel require serious attention. We have established a program of collaboration between the University of California Davis Medical Center Departments of Anesthesiology and Surgery and the California State University Sacramento Biomedical Engineering Program to address ergonomic problems in anesthesiology and surgery using a Virtual Instrumentation Laboratory. A 17-workstation Virtual Instrument Laboratory using LabVIEW software on Power Macintosh platforms permits rapid prototyping of medical monitor displays as well as rapid development of data acquisition and processing circuits for physiologic data collection. The Virtual Instrument Lab has been used for three Master's thesis projects and a BME course titled Human Factors in the Design of Medical and Assistive Technology. Course projects have included: 1) The design of novel physiologic data displays for potential use in anesthesia workstations, and 2) The measurement of surface electromyographic signals and heart rate variability to investigate the physical and mental workload of performing laparoscopic surgery. The Virtual Instrument Lab allows BME students to investigate relatively complex human factors issues in anesthesiology and surgery in a short time span.

Anesthesiology

Readers' forum: experiences with a system. The implementation of a completely operational computer system in a cardio-thoracic department.

Wythenshawe Hospital is a large general district hospital with more than 1000 beds, situated approximately 9 miles south of Manchester. The Cardio-Thoracic department, housed in the new section of the hospital which was completed in 1973, is the major centre for cardiothoracic surgery in the greater Manchester area. It also receives any major accident cases which require treatment within the Intensive Therapy Unit. This paper describes a Patient Data Display System and the methods used to introduce the concept of such a system, to doctors, nurses, laboratory and paramedical staff, and the manner in which these staff were trained in the use of computer terminals. Principles underlying the need for and requirements of such a system are also discussed. Six months after hardware commissioning the system was fully operational throughout the whole department.

Computers