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["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

Data collection using a palm-top computer.

Palm-top computers can be ideal for collecting nursing research data in the ward or community. The hand-held computer has several programs and special features that could be useful to the nurse researcher. The palm-top's limitations, as well as its advantages, must be considered in the light of the particular research project planned.

Data Collection

Use of a cassette recorder for data collection in prehospital cardiac arrest research.

The methods of obtaining data and assessing protocol compliance in prehospital research can present difficulties. The Norwalk Hospital Mobile Emergency Medical Service paramedics use a minicassette recorder carried in the monitor-defibrillator pack during their participation in a cardiac arrest study. The device is simple, inexpensive, and well accepted by the paramedics. With this recorder, the investigator is able to accurately identify when interventions occurred and the patients' response to therapy. The use of a minicassette recorder can facilitate data collection for prehospital research with minimal disruption for the paramedic providing care.

Allied Health Personnel

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

Prediction of future serum concentrations with Bayesian fitted pharmacokinetic models: results with data collected by nurses versus trained pharmacy residents.

Recording the times of dosage administration and serum sampling by trained personnel resulted in significantly greater adherence to the protocol of therapeutic drug monitoring and in significantly greater precision in the achievement of desired serum concentration goals of aminoglycoside therapy than when relatively untrained personnel recorded it as a comparatively unemphasized part of their job. This was true even when only data of peak and trough serum concentrations were used. This study demonstrates that thoughtful data collection by appropriately trained nursing, pharmacy, or other clinical personnel is an essential part of therapeutic drug monitoring and plays a significant role in the optimal individualization of drug dosage regimens for patient care.

Aged

Computer-assisted drug data collection.

Computerized systems for recording information about medication prescribing and use are important for studies in health services and pharmacoepidemiology. Such systems, if properly designed, can facilitate analysis as well as data collection. Although drug information systems exist for pharmacy service delivery applications, there are currently no descriptions of systems developed primarily for research applications in this area. This paper describes a computerized data collection system, developed for researchers, usable on portable equipment, and containing error checking features; the system has been extensively tested in over 850 study subjects taking part in a study of medication use in nursing homes that examines the impact of educational interventions for doctors and nurses on prescribing practices.

Clinical Pharmacy Information Systems

Data collection and changing health care systems. 2. New Zealand.

Radical changes planned in the New Zealand health system aim to improve its cost effectiveness, quality and consumer responsiveness. These changes will take place despite a paucity of data on the use of resources and outcomes. Data collection systems are to be introduced into hospitals and primary care with the use of the Read clinical codes (RCC) in addition to ICD-9-CM (International classification of disease--clinical modification) and ICPC (International classification of primary care). This paper discusses the proposed changes to the New Zealand health care system and describes their effect on the present and future data collection methods in general practice.

Abstracting and Indexing

Rapid prototyping of database systems in human genetics data collection.

This work examines some of the problems encountered in developing small and large database application systems involving human genetics data collection efforts that include data on individuals as well as family pedigree data. Rapid prototyping of a database application requires software tools to produce the application with little or no programming. Features of MEGADATS-4 that provide for rapid prototyping and for producing stand-alone applications are examined.

Data Collection

Automated data collection and processing for a cycle ergometer.

A system is described for collection and processing of data from a cycle ergometer. Cycle pedals, specially made to withstand the extremely high forces exerted during maximal power cycling, contain transducers to measure pedal angle relative to the crank and foot forces both perpendicular and parallel to the pedal surface. An additional transducer monitors crank position. Output signals are conditioned, amplified, digitized by a 12-bit analog-to-digital converter, fed into a computer at 100 Hz/channel, and mathematically smoothed to attenuate noise. For each sample interval, foot force components perpendicular and parallel to the crank arm are calculated. Power generated on each crank revolution is determined from transducer information. Computer graphics display pedaling parameters vs. crank angle in both rectangular and circular format. Data files containing variables descriptive of pedaling force curves are produced to enable computerized statistical analysis of cycling performance.

Computer Graphics

Data collection in the Adult Day Health Care Evaluation Study.

This report presents data collection measures and methods for the evaluation of Adult Day Health Care (ADHC) in the Department of Veterans Affairs (VA). Measures of patient health were survival, the Sickness Impact Profile, self-rated health, the Mini-Mental State Exam, Psychological Distress Scale, Social Support Scale, and Problem Behaviors Scale. Measures of health for the care giver were: Activities of Daily Living, Instrumental Activities of Daily Living, health perceptions, Psychological Distress Scale, life satisfaction, Social Support Scale, and Caregiver Burden Scale. We also assessed patient and care giver satisfaction with the care received by the patient. Measures of health status and outcomes were assessed primarily through patient and care giver interview at study enrollment, 6 months, and 12 months. Utilization and cost both within and outside VA were assessed for hospital, ambulatory care, nursing home, ADHC, home care, pharmacy, laboratory, and other forms of health care. Sources of utilization data included VA's computerized patient database, VA medical records, patient questionnaires, care giver questionnaires, and health care providers outside VA. Costs were obtained from VA's cost accounting system, VA Central Office, VA's contracts with outside providers, and directly from outside providers. Utilization and cost were assessed for each patient for a period of 1 year after entry into the study.

Activities of Daily Living