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PubMed1994

Use of open standards to implement health maintenance guidelines in a clinical workstation.

We are developing a clinical workstation which integrates access to health maintenance guidelines with access to a computer-based medical record. In order to enhance the portability of such a system, we emphasize the use of open standards which can be used in diverse clinical environments. We discuss the use of relational database and expert system technology to provide both patient-specific and patient-independent access to clinical guidelines. We use the Arden Syntax as the format for a textual library which facilitates the storage of structured medical knowledge.

Artificial Intelligence↗

PubMed1994

The use of medical logic modules at LDS hospital.

The development of medical knowledge bases for use in a clinical information system (HELP) has been an ongoing goal at LDS Hospital in Salt Lake City, Utah, for the past 25 years. In building our medical knowledge base we felt the need to implement a decision support syntax which could capture the logic of our experts in a way that was not only executable, but also easily read and shared by others. During these 25 years we defined several simple syntaxes to express this medical logic. Our current approach is to cooperate with international standards groups (ASTM) and use the Arden Syntax for medical logic modules. We are working with the 3M Corporation in the joint development of an Arden Compiler for HELP. We plan to use the Arden Syntax initially to support our alert/reminder system and computerized management protocols.

Artificial Intelligence↗

PubMed1994

Experiences from the use of data-driven decision support in different environments.

The paper reports experiences from the implementation and use of data-driven decision support based on the Arden Syntax in three different environments: in a health-care centre, in a clinical laboratory, and in a research department. Methods and tools used for realization of decision support systems (DSSs) are shortly presented, and integration aspects of the DSS with running clinical applications and existing patient databases are discussed. The application areas are also described, together with validation procedures for the developed knowledge modules.

Artificial Intelligence↗

PubMed1994

The use of the Arden Syntax for MLMs in HIOS+, a decision support system for general practitioners in The Netherlands.

This paper covers query creation and evaluation in HIOS+, a General Practitioner Decision Support System. The International Classification of Primary Care (ICPC), free-text International Classification of Health Problems in Primary Care (ICHPPC)-II-Defined criteria, and the Arden Syntax for medical logic modules (MLMs) are building blocks in query creation with the free-text formalizer (FF) module. The backward-reasoning formal interpreter (FI) module evaluates queries by checking them against medical patient data. It can advise or warn users on the suitability of a registered diagnostic ICPC code in a patient's case. In all, 101 queries were created in MLM form on a wide range of diseases. The MLMs and FI were evaluated in a field and a laboratory test.

Artificial Intelligence↗

PubMed1994

Encoding a post-operative coronary artery bypass surgery care plan in the Arden Syntax.

The Arden Syntax for medical logic modules (Arden) was used to test the feasibility of encoding large, complex care plans. The critical portions of an existing paper-based care plan for the management of patients following coronary artery bypass graft (CABG) surgery were encoded in Arden and an X-windows user-interface was developed. The Arden Syntax proved adequate for encoding all of the necessary functions of the care plan. The limitations of the current Arden Syntax and possible additions to Arden are discussed.

Artificial Intelligence↗

PubMed1994

PCDOSE: an interactive software system to calculate internal radiation dose on a personal computer.

An interactive, menu directed, software system to calculate committed dose equivalents for individuals with different physiques after inhalation, ingestion or injection of radionuclides has been developed. The calculations are based on ICRP 26/30 methods. The programs are written in PASCAL and can be implemented on a personal computer with a MS-DOS operating system and a hard disk with a storage capacity of at least 20 Mb. This paper describes the development and features of the system.

Adult↗

PubMed1995

A PC program for unbiased and predictive linear and quadratic discriminant analysis.

Discriminant analysis plays an important role in biological and medical research. The most popular methods of discrimination in practical applications are parametric methods like linear and quadratic discriminant analysis. However, there exist modifications of these approaches, namely unbiased and predictive discriminant analysis, which lead to reduced error rates in certain situations. In this paper a menu-driven, user-friendly PC program written in Borland Pascal 7.0 is introduced which performs unbiased and predictive linear and quadratic discriminant analysis.

Bias↗

PubMed1986

BACOMP--database of bioactive compounds for structure-activity relationship.

BACOMP database is presented for structure-activity relationship (SAR) investigations; it was realized on a BK-1300 general purpose microcomputer using the MICRO-SETOR network database management system. Some general considerations of database design are given and the models and facilities for a development of a microcomputer-based SAR oriented database are described. The database contains the following information for the bioactive compounds: chemical structures, biological activities, trade names, reference numbers and information sources. For computer representation of chemical structures SAR oriented language is used. The database software includes: system software, data capture and data editing software, information retrieval and data processing applications. The software development is done in FORTRAN IV and MACRO assembly language. The programs are written in a completely interactive mode. The information retrieval software includes 12 functions giving an information for the database as a whole and for a single compound as well. The data processing software includes 8 functions for finding common structural fragments among compounds with similar biological activity and for estimating a structural similarity between different compounds. The functions are selected from corresponding screen MENUs. The function realization results are framed as appropriate screen formats and the receipt of hardcopies is available. The database can be used to develop predictive methods in respect of the investigated biological activity.

Drug Information Services↗

PubMed1989

MacSECPROT: two programs in BASIC to evaluate protein secondary structure.

Two interactive programs in BASIC are described, which provide useful tools to evaluate protein secondary structure. Output is given in two formats: (1) graphics are displayed on screen, which can be printed immediately, and (2) textfiles are saved to disk as permanent records and can be printed with a word-processing program. The programs are fast and easy to use and could be a valuable teaching aid in biochemical and molecular biology courses. Program lists are written in Microsoft BASIC for the Apple Macintosh, but can be adapted to other machines accepting graphic commands.

Microcomputers↗

PubMed1990

GLUCOPAGE: a computer program for managing diabetic pregnancy.

The microcomputer is an invaluable aid in the management of diabetes mellitus because of its ability to manipulate, summarise, and produce graphical displays from blood glucose data in such a way that new trends, or the effects of changes in therapy, are more readily apparent to the clinician. Currently available software however, while adequate for most purposes, has not been written to cope with the unique problems presented by diabetic pregnancy in which large amounts of data are generated over short periods of time, insulin requirements may change rapidly, and blood glucose control must be extremely tight. We have produced a new program, GLUCOPAGE, specifically for use in the management of diabetic pregnancy. GLUCOPAGE operates in conjunction with the Ames Memory Glucometer, from which it can download data either directly or telemetrically via a modern into the host IBM PC or compatible microcomputer. Large amounts of data can be summarised in various tabular and graphical formats on screen or in printed form. A single A4-size printout, the Glucopage, provides tabular and graphical summaries of a full week's blood glucose data. Copies of the Glucopage may conveniently be filed in the case notes, given to the patient or distributed to other medical staff.

Blood Glucose Self-Monitoring↗

PubMed1990

POLAR: a menu driven computerized analysis of fluorescence polarization data.

While fluorescence polarization is a powerful tool for the measurement of ligand-receptor (e.g. antigen-antibody) interactions, its application in routine clinical chemistry and immunochemistry has been limited because collection of data was error prone, and because analysis of data previously required tedious and imprecise manual graphical methods. We present the series of linear and curvilinear regressions required to calculate parameters (p', Q', pf, Qf, Pb, Qb, Fb max, a and Ko) and their corresponding standard errors. The values of a and Ko are comparable to those obtained by the method of finding the minimal the sum of squares. A menu operated computer program that uses these regressions, simplifies the collection, analysis and presentation of fluorescence polarization data. A simple spread sheet system permits the insertion, deletion or modification of data. The results are presented in graphical and tabular form, either on a monitor, a printer or an X-Y plotter. The system has its own graphical routines.

Algorithms↗

PubMed1990

Computer aided interpretation of acid-base disorders.

This paper describes an expert system for the interpretation of acid-base disorders. The target users are residents in training in internal medicine, anaesthesia and intensive care medicine. The program is written in PROLOG and runs on a SUN 3/160 minicomputer. Evaluation of a learning set (N = 202) and a test set (N = 194) has proved that the system's accuracy is acceptable. As a result, the program has recently been put in routine clinical practice.

Acid-Base Imbalance↗

PubMed1990

The recent development and evaluation of a medical expert system (ABVAB).

A medical expert system for the diagnosis of abnormal vaginal bleeding named as ABVAB had been reported. This paper will describe the recent development of ABVAB and its clinical evaluation. The overall testing results are quite satisfactory in spite of the limitations of time and small domain. This expert system, by using the fuzzy and certainty factor concepts, is able to handle imprecise and incomplete medical knowledge which has become informative. The paper also analyses the relative degrees of importance of the history and physical examination data in making a medical diagnosis.

Data Interpretation, Statistical↗

PubMed1990

Criteria for the design of fetal heart rate analysis systems.

Criteria are described for the automated analysis of fetal pulse intervals, fetal movements and of uterine contractions measured externally, antenatally and interactively on-line, for implementation on a personal computer interfaced to an appropriate fetal monitor, and tested on 10,000 records. Measurements of short and longer term fetal heart rate variation are compared; both are required to identify sinister records. Recall and display of records acquired on the same patient over several weeks has proved a useful diagnostic aid.

Computer Graphics↗

PubMed1990

A consultation system constructor for medical data analysis.

MAD is a system that helps an expert data analyst in a specific application domain (like epidemiology or image analysis) to build reasoning models aimed at fulfilling specific tasks. These models may be subsequently used to guide doctors in the analysis of a set of data referring to a specific ground domain. Expert knowledge is represented at various levels: a general description of an application domain and various models that formalize the reasoning followed to perform specific tasks within a defined application domain. Reasoning models are represented as rules of propositional calculus, and a meta-knowledge permits to support knowledge acquisition. During the consultation, different external programs may be run when needed, without the doctor having to learn how to use them. MAD is written in Golden Common LISP and may be linked to any external software for data analysis, provided it runs under MS-DOS and does not require more than 192 Kb. Examples of application of the system to epidemiology and image analysis are given.

Computer Simulation↗

PubMedDate not supplied

The PRIST-2 development environment: architecture and implementation.

The PRIST-2 system has been designed as an interactive and high-productivity tool for the rapid prototyping and development of medical applications. Three major issues were addressed in this research project which derived from the evolution of a previous 4th generation software package, called PRIST (patient record information system tool): a high transportability on different hardware and operating systems, a conversational and interactive user-interface and user-independence Relational Data Base Management System (RDBMS). Although we developed PRIST-2 on the top of the ORACLE RDBMS, it does not depend on SQL commercial products because the ORACLE features have been directly used only for SQL relational data base management. The application design methodology implemented in the system architecture allows an interactive and formal description of the application constraints in terms of the semantic data model rather than in terms of the data structure. The translation of the conceptual constraints into SQL tables is performed by several pre-defined routines. In the PC based release (MS/DOS, OS/2, Xenix operating systems), the Graphic-User Interface (GUI) has been developed using Microsoft Windows Software Development Kit. The UNIX release will use a GUI developed on top of the X-Windows environment.

Computer Graphics↗

PubMedDate not supplied

Formula predicting survival in patients with invasive cutaneous malignant melanoma.

Popescu et al. (Mayo Clin Proc., 65 (1990) 1293-1302) reported survival data in 107 patients who were diagnosed as having malignant melanoma during the years 1950-1985. Survival was evaluated by using the Kaplan-Meier method. A microcomputer program in BASIC for predicting the survival probability after diagnosis in patients with invasive cutaneous malignant melanoma is designed. A formula used in this program is derived from the survival data reported by Popescu et al. A mathematical model of generalized lognormal distribution and a computer program previously published by the author are employed in this study. Analysis of the computer-assisted predicted values and the data reported by Popescu et al. indicates that the program is accurate and reliable with a close agreement in expressing survival probability as a function of time after diagnosis. The computer-assisted predictive formula can determine the relationship between the time and the survival probability, and may be of value for prognostic evaluation of patients. The mathematical model representing the generalized lognormal distribution may be used as a method of parametric analysis of survival data of estimates determined by the nonparametric product-limit method of Kaplan-Meier in certain biological phenomena.

Female↗

PubMedDate not supplied

REPLI: a program in BASIC for determination of approximate sample size.

REPLI, a program written in elementary BASIC, calculates the approximate sample size, which is required to detect a desired difference between any two group means in an experiment with n groups for a given probability and at three significance levels of the means difference. A prior knowledge of the variability of data in the groups is expected in order to base the estimate on a rational footing. If this knowledge does not exist, an educated guess and/or several trials with different assumptions on the most likely variability can be used. The a priori estimate prevents that sample sizes are completely out of a reasonable range. Since the program is applicable for experimental settings where several groups need be investigated, it is particularly interesting to users of ANOVA and/or comparable non-parametric tests.

Analysis of Variance↗