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PubMed1993

Physicians' use of computer software in answering clinical questions.

Descriptive data about the use of medical information software were gathered from physicians who were early users of these resources. Eight clinically active internists and medical subspecialists were lent a microcomputer loaded with six commercially available medical information software products. Participants used the software for two weeks to answer questions arising in their practice and completed written questionnaires. They recorded a total of 50 questions (between 3 and 11 per participant per two-week study period). Using the workstation, participants answered 20 questions (40% of the total), partially answered 16 questions (32%), and did not obtain useful information for 14 questions (28%). Participants found answers outside the workstation to 8 of the 14 questions (57%) not answered by using the software. The most common question topic was drug information (16 questions, or 32% of the total). The most common problems encountered using the workstation were retrieval of incomplete information (20 questions, or 40% of the total) and difficulty navigating the software (16 questions, or 32%). Other problems included difficulty translating clinical problems into questions, inappropriate resource selection, inadequate training for using the software, and excessive time required to access information. The study highlights several opportunities for medical librarians and others involved in clinical information management to facilitate the use of computer software for solving clinical problems.

Attitude to Computers↗

PubMed1997

[Job stressors in software developers--a comparison with other occupations].

The aim of this study is to investigate the difference in job stressors among software developers, the sales staff and the clerical staff (n = 2,079) in two companies (A Co. and B Co.) using a self-administered questionnaire that included a job stressor scale and the 30-item General Health Questionnaire (GHQ). We developed the job stressor scale based on the interviews with out-patients who engaged in software development and previous studies about job stressors. Factor analysis with a seven-factor solution showed that seven subscales were abstracted from the job stressor scale, namely, quantitative load of work, dissatisfaction with work, demanding work, uneasiness about work, human relations, ambiguity of work and shortage of private time. Each subscale was significantly (r = .313-.442, p < 0.0001) correlated with the GHQ score and proved to be a reliable instrument, as indicated by a Cronbach's alpha of greater than 0.73. Stepwise multiple regression analysis revealed that quantitative load of work and shortage of private time subscale scores were significantly high in software developers in A Co. Software developers in A Co. tended to score higher (P < .10) than the others in demanding work and ambiguity of work subscale. All subscale scores were significantly low in the clerical staff in B Co. There was no significant difference between the sales staff and software developers in B Co. Results of the interviews with out-patients showed that demanding work, hard deadline, ambiguity of work and precarious work would cause trouble in software developers. The implications of these findings with respect to occupational issues related to software developers are discussed.

Adult↗

PubMed1990

Evaluation of healthcare software from a usability perspective.

This paper provides a framework for evaluating healthcare software from a usability perspective. The framework is based on a review of both the healthcare software literature and the general literature on software usability and evaluation. The need for such a framework arises from the proliferation of software packages in the healthcare field, and from an historical focus on the technical and functional aspects, rather than on the usability, of these packages. Healthcare managers are generally unfamiliar with usability concepts, even though usability differences among software can play a significant role in the acceptance and effectiveness of systems. Six major areas of usability are described, and specific criteria which can be used in the software evaluation process are also presented.

Evaluation Studies as Topic↗

PubMed1988

A microcomputer-based software interface for automatic acquisition of fetal monitoring data.

At University Hospital, interfaces are being designed to link-stand-alone patient care devices to Hospital Information System (HIS). The objective is to have an integrated HIS comprising of data from bedside patient monitors and from stand-alone devices such as infusion pumps, fetal monitors, and pulse oximeters. Interfaces are implemented with standard hardware and software design tools. The feasibility of designing a general purpose interface hardware based on a common microprocessor has been demonstrated for an IMED model 960 infusion pump. The present paper describes the implementation of the software component of the interface using standard microcomputer software packages. The device of choice was the Corometrics model 115 fetal monitor for implementing the software because it is used extensively at University Hospital and has built-in data communication hardware. The Corometrics model 115 fetal monitor was interfaced to an IBM Personal Computer (PC) model XT. Data acquired from the fetal monitor was used to provide data tables and graphs. The feasibility of designing and implementing a software interface capable of acquiring and processing data received from a stand-alone device (fetal monitor) was demonstrated. A description of the important aspects of the interface software design is presented in this paper. This design will eventually be part of the HIS. A brief discussion about the design modifications necessary to acquire data from multiple devices simultaneously is also included.

Fetal Monitoring↗

PubMed1994

A database schema for public-domain medical software.

The quantity of public-domain medical software available is huge, and a classification schema may be therefore helpful. We developed a schema that includes identification data (name of the software, author, etc.), description (hardware and software requirements), classification (software category, application domain, etc.) and evaluation data (external quality and internal quality factors). The schema was tested on the public-domain software available at the SCAMC meetings (about 36 Mb). We also classified the software by employing students from a master course in computer science and medical informatics. We stored the high quantity of information collected in a database we developed using Paradox.

Databases, Factual↗

PubMedDate not supplied

Analyze: a comprehensive, operator-interactive software package for multidimensional medical image display and analysis.

A comprehensive software package, called ANALYZE, has been developed (1) which permits detailed investigation and evaluation of multidimensional biomedical images. ANALYZE can be used with 3-D imaging modalities based on x-ray computed tomography, radionuclide emission tomography, ultrasound tomography, and magnetic resonance imaging. The software is written entirely in "C" and runs on standard UNIX workstations. The ANALYZE package features integrated, complimentary tools for fully interactive display, manipulation and measurement of multidimensional image data. The software architecture permits systematic enhancements and upgrades which has fostered development of a readily expandable package. It provides an effective shell for custom software prototyping and turnkey applications. This paper provides a general description of this software as well as specific details on the methodology employed to develop it, both conceptual and technical. Applications of the software are illustrated.

Image Processing, Computer-Assisted↗

PubMed2003

Open Source software in medical informatics--why, how and what.

'Open Source' is a 20-40 year old approach to licensing and distributing software that has recently burst into public view. Against conventional wisdom this approach has been wildly successful in the general software market--probably because the openness lets programmers the world over obtain, critique, use, and build upon the source code without licensing fees. Linux, a UNIX-like operating system, is the best known success. But computer scientists at the University of California, Berkeley began the tradition of software sharing in the mid 1970s with BSD UNIX and distributed the major internet network protocols as source code without a fee. Medical informatics has its own history of Open Source distribution: Massachusetts General's COSTAR and the Veterans Administration's VISTA software have been distributed as source code at no cost for decades. Bioinformatics, our sister field, has embraced the Open Source movement and developed rich libraries of open-source software. Open Source has now gained a tiny foothold in health care (OSCAR GEHR, OpenEMed). Medical informatics researchers and funding agencies should support and nurture this movement. In a world where open-source modules were integrated into operational health care systems, informatics researchers would have real world niches into which they could engraft and test their software inventions. This could produce a burst of innovation that would help solve the many problems of the health care system. We at the Regenstrief Institute are doing our part by moving all of our development to the open-source model.

Database Management Systems↗

PubMed2006

Uses and abuses of EIDORS: an extensible software base for EIT.

EIDORS is an open source software suite for image reconstruction in electrical impedance tomography and diffuse optical tomography, designed to facilitate collaboration, testing and new research in these fields. This paper describes recent work to redesign the software structure in order to simplify its use and provide a uniform interface, permitting easier modification and customization. We describe the key features of this software, followed by examples of its use. One general issue with inverse problem software is the difficulty of correctly implementing algorithms and the consequent ease with which subtle numerical bugs can be inadvertently introduced. EIDORS helps with this issue, by allowing sharing and reuse of well-documented and debugged software. On the other hand, since EIDORS is designed to facilitate use by non-specialists, its use may inadvertently result in such numerical errors. In order to address this issue, we develop a list of ways in which such errors with inverse problems (which we refer to as 'cheats') may occur. Our hope is that such an overview may assist authors of software to avoid such implementation issues.

Algorithms↗

PubMed2006

Agile methods in biomedical software development: a multi-site experience report.

BACKGROUND: Agile is an iterative approach to software development that relies on strong collaboration and automation to keep pace with dynamic environments. We have successfully used agile development approaches to create and maintain biomedical software, including software for bioinformatics. This paper reports on a qualitative study of our experiences using these methods. RESULTS: We have found that agile methods are well suited to the exploratory and iterative nature of scientific inquiry. They provide a robust framework for reproducing scientific results and for developing clinical support systems. The agile development approach also provides a model for collaboration between software engineers and researchers. We present our experience using agile methodologies in projects at six different biomedical software development organizations. The organizations include academic, commercial and government development teams, and included both bioinformatics and clinical support applications. We found that agile practices were a match for the needs of our biomedical projects and contributed to the success of our organizations. CONCLUSION: We found that the agile development approach was a good fit for our organizations, and that these practices should be applicable and valuable to other biomedical software development efforts. Although we found differences in how agile methods were used, we were also able to identify a set of core practices that were common to all of the groups, and that could be a focus for others seeking to adopt these methods.

Algorithms↗

PubMed2004

The RUMBA software: tools for neuroimaging data analysis.

The enormous scale and complexity of data sets in functional neuroimaging makes it crucial to have well-designed and flexible software for image processing, modeling, and statistical analysis. At present, researchers must choose between general purpose scientific computing environments (e.g., Splus and Matlab), and specialized human brain mapping packages that implement particular analysis strategies (e.g., AFNI, SPM, VoxBo, FSL or FIASCO). For the vast majority of users in Human Brain Mapping and Cognitive Neuroscience, general purpose computing environments provide an insufficient framework for a complex data-analysis regime. On the other hand, the operational particulars of more specialized neuroimaging analysis packages are difficult or impossible to modify and provide little transparency or flexibility to the user for approaches other than massively multiple comparisons based on inferential statistics derived from linear models. In order to address these problems, we have developed open-source software that allows a wide array of data analysis procedures. The RUMBA software includes programming tools that simplify the development of novel methods, and accommodates data in several standard image formats. A scripting interface, along with programming libraries, defines a number of useful analytic procedures, and provides an interface to data analysis procedures. The software also supports a graphical functional programming environment for implementing data analysis streams based on modular functional components. With these features, the RUMBA software provides researchers programmability, reusability, modular analysis tools, novel data analysis streams, and an analysis environment in which multiple approaches can be contrasted and compared. The RUMBA software retains the flexibility of general scientific computing environments while adding a framework in which both experts and novices can develop and adapt neuroimaging-specific analyses.

Algorithms↗

PubMed2003

SoFAR: software for fully automatic evaluation of real-time PCR data.

Quantitative real-time PCR has proven to be an extremely useful technique in life sciences for many applications. Although a lot of attention has been paid to the optimization of the assay conditions, the analysis of the data acquired is often done with software tools that do not make optimum use of the information provided by the data. Particularly, this is the case for high-throughput analysis, which requires a careful characterization and interpretation of the complete data by suitable software. Here we present a software solution for the robust, reliable, accurate, and fast evaluation of real-time PCR data, called SoFAR. The software automatically evaluates the data acquired with the LightCycler system. It applies new algorithms for an adaptive background correction of signal trends, the calculation of the effective signal noise, the automated identification of the exponential phases, the adaptive smoothing of the raw data, and the correction of melting curve data. Finally, it provides information regarding the validity of the results obtained. The SoFAR software minimizes the time required for evaluation and increases the accuracy and reliability of the results. The software is available upon request.

Algorithms↗

PubMed1988

Software quality assurance in the healthcare environment.

Healthcare managers are demanding ever more flexible and sophisticated capabilities from their management information systems, without sacrificing software reliability. This is paradoxical, since, all things being equal, the number of bugs residing in a program is a function of how complex it is. One method of addressing the problem of software reliability is to focus on software testing tools and techniques within the framework of an effective Quality Assurance methodology. The purpose of this article is to discuss the integral role Quality Assurance plays in the software life cycle that forges the development of new and enhanced software. An in-depth discussion of the software life cycle is beyond the scope of this article; it will be discussed only in its relation to the role of Quality Assurance.

Health Facilities↗

PubMedDate not supplied

Development of a computer software for easy storage and analysis of fibreoptic bronchoscopy data.

OBJECTIVE: To develop a simple software for management of fibreoptic bronchoscopy records. METHODS: After identification of the specific needs at our hospital, a software was developed. A graphical interface with structured data entry related to patient information and diagnosis, bronchoscopic findings and specimens obtained, and their reports were envisaged. After initial construction, the software was tested over a four-week period. The software was put to routine use after necessary corrections, and validated over the next few months through actual data entry. RESULTS: The software has various modules for input and modification of data, as well as for generation of reports, and can work both on stand-alone personal computers and on networks. With little practice, residents soon became adept at entering details correctly and quickly. The slightly increased time of data entry into the computer was more than made up by uniform and complete report generation. The database component was evaluated by analyzing 1000 consecutive records entered over a 14-month period, and no discrepancies were observed. CONCLUSION: A user-friendly software providing uniform and complete data entry regarding fibreoptic bronchoscopic procedures was developed.

Bronchoscopy↗

PubMed2005

Software-induced variance in two-dimensional gel electrophoresis image analysis.

Experimental variability in 2-DE is well documented, but little attention has been paid to variability arising from postexperimental quantitative analyses using various 2-DE software packages. The performance of two 2-DE analysis software programs, Phoretix 2D Expression v2004 (Expression) and PDQuest 7.2 (PDQuest), was evaluated in this study. All available background subtraction and smoothing algorithms were tested using both data generated from one single 2-DE gel image, thus excluding experimental variance, and with authentic sets of replicate gels (n = 5). A slight shift of the image boundaries (the "cropping area") caused both programs to induce variance in protein spot quantification of otherwise identical gel images. The resulting variance for PDQuest (CV(mean) = 8%) was approximately twice that for Expression (CV(mean) = 4%). In authentic sets of replicate 2-DE gels (n = 5), the experimental variance confounded the software-induced variance to some extent. However, Expression still outperformed PDQuest, which exhibited software-induced variance as high as 25% of the total observed variance. Surprisingly, the complete omission of background subtraction algorithms resulted in the least amount of software-based variance. These data indicate that 2-DE gel analysis software constitutes a significant source of the variance observed in quantitative proteomics, and that the use of background subtraction algorithms can further increase the variance.

Algorithms↗

PubMed1995

The effects of analytic software and scan analysis technique on the comparison of dual X-ray absorptiometry with dual photon absorptiometry of the hip in the elderly.

As part of a longitudinal comparison of bone mineral density (BMD) results originally obtained using a Lunar dual photon absorptiometry (DPA) scanner and later, using a Lunar dual X-ray absorptiometry (DXA) scanner, we compared femur results between DPA and DXA according to DXA analytic software (versions 1.3y and 1.4), and according to the method of placement of the femoral neck box (software algorithm or operator placement according to the appearance of the pair of images) in 58 elderly men and women. The mean BMD at each of three femoral sites was higher using DXA version 1.3y than DPA, but the use of software version 1.4 brought the BMD value closer to that of DPA at all sites. Of 58 scans, 12 (21%) were changed by the operator, resulting in an overall reduction in mean percent BMD difference between scan pairs of 79% (from 1.24% to 0.29%). Although the differences between the DPA/DXA software-driven analysis and the DPA/DXA operator-driven analysis appeared small (high r2 values and intra-class correlation coefficients), the increase in sample size that would be required for the same power to detect 2-year changes in BMD if the software-driven analysis was used instead of taking the time to perform the operator-driven analysis was 18%. The findings of this study highlight the need to account for upgrades in analytic software. Furthermore, we present a rational approach for the analysis of serial scans that has face validity and that results in smaller differences between pairs of scans performed on the same individual. The decision to adapt these methods must be based on the relative costs of reducing unwanted scan variability.

Absorptiometry, Photon↗

PubMed2002

Detection and false-positive rates of maternal serum markers for Down syndrome screening according to maternal age in women over 35 years of age. A study of the agreement of eight dedicated software packages.

Maternal serum markers for trisomy 21 screening (MSS) can be assayed in women > or =35 years in an attempt to reduce the need for invasive procedures and thereby avoid their side effects. Our objective was to compare, in women > or =35, eight different software packages dedicated to second trimester MSS, thus providing reliable data for patient counselling. A simulation study was carried out on 189 sera from women with Down syndrome fetuses and 11 962 sera from mothers of unaffected babies. The first step was to estimate the joint distribution of alpha-fetoprotein (AFP) and free beta-human chorionic gonadotrophin (beta-hCG). The second step was to calculate trisomy 21 detection and false-positive rates for each software according to maternal age (35-45 years), using the usual 1:250 risk threshold. Agreement between software packages was measured using 2 x 2 kappa coefficients. Detection rates and false-positive rates increased with maternal age. Depending on the software, 57-71% detection rates were achieved at 35 years with 12-18% false-positive rates. At 45 years, 61-100% detection rates were achieved with 66-95% false-positive rates. Up to 39 years, all softwares were concordant (kappa coefficients >0.75). In the range 35-45 years, false-positive and detection rates increased substantially with maternal age and differences between software packages are observed.

Adult↗

PubMed1994

Population approaches in drug development. Report on an expert meeting to discuss population pharmacokinetic/pharmacodynamic software.

An expert meeting to discuss population pharmacokinetic/pharmacodynamic software was held in Brussels in November 1993 under the auspices of the European Co-operation in Science and Technology (COST), Medicine (B1) programme. Recently developed statistical methods offer the possibility of gaining integrated information on pharmacokinetics and response from relatively sparse observational data obtained directly in patients who are being treated with the drug under development. These methods can minimize the need to exclude patient groups and also allow analysis of a variety of unbalanced designs that frequently arise in the evaluation of the relationships between dose or concentration on the one hand and efficacy or safety on the other relationships that do not readily lend themselves to other forms of statistical analysis. The purpose of the Brussels meeting was to evaluate the state of both existing software and software under development, and to specify the needs and wishes of potential users of such software. It was apparent from the meeting that software development for population data analysis is currently a very active area of investigation and that several very good packages are already available, with more in development. The general consensus of the meeting was that well validated, easy to use software was essential to the implementation of the population approach to drug development.

Humans↗

PubMed2001

Integrating digital teaching-file systems with off-the-shelf presentation software to facilitate speaker-led conferences.

OBJECTIVE: Develop methods for automated transfer of images and associated text from a teaching-file repository into presentation material for speaker-led conferences. MATERIALS/METHODS: Our institution uses a Microsoft Windows (Microsoft Corp, Redmond, WA) software application to maintain a digital teaching-file database that can store and retrieve content in a case-centric fashion. Virtually any number of images can be stored with any given case. Cases and their associated images can be retrieved via a module that supports searches by American College of Radiology (ACR) code and by free-text Boolean queries on the history, findings, diagnosis, and discussion components of a case. In addition to the software system serving directly as an interactive teaching tool, the digital teaching file itself serves as an image repository and resource for attending radiologists who create their own presentations and lectures. To better support this use, software modules were developed for interprocess communication and automated creation of Powerpoint slides. These modules are fully integrated with the teaching-file software application. A single image or a set of selected images can be automatically made into individual slides with two mouse clicks. Images are automatically centered and optimally sized. A slide title is automatically rendered from the user's preference of the case history or diagnosis (stored with the case), or via the entry of freeform text. We describe the programming techniques that are used, as well as how several features of the operating system and Powerpoint itself can be integrated with a customized software application to facilitate this objective. RESULTS: The creation of presentation-ready Powerpoint slides is fully automated from within our teaching-file application, and the time required to create a presentation compared to the conventional method of manually seeking and inserting files from within Powerpoint itself, on a per-slide basis, is drastically reduced. The benefits are magnified by having all imagery stored within an organized and searchable database system so that desired images can be easily located. CONCLUSION: A digital teaching-file system can serve as a useful image repository for purposes ancillary to direct computerized instruction. Software that supports these uses, such as the automated creation of presentation material for speaker-led conferences, facilitates the radiologist's role as an educator.

Computer-Assisted Instruction↗