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Microcomputer-assisted data management in a case-comparison study.

A system of programs which process data on a microcomputer for a case/comparison study is described. The procedures process the data from the abstracted case source records, to control selection, interview data management, and the selection of data subsets for analysis. The capabilities of various data processing modules are outlined, and cost estimates of an existing implementation are discussed. The microcomputer is presented as an alternative to mainframe data management.

Computers

Microcomputer applications in pathology research.

In a study of over 700 cases of uveal melanoma on file in the Department of Pathology of Wills Eye Hospital, a low-cost microcomputer using commercially available software (without modification) was used to: word process and edit this manuscript, create a patient file storage and retrieval system including the ability to create subfiles, merge files, and interchange file types, plot data points in several different graphic formats, transcribe and store information from microscopic tissue sections containing intraocular melanomas, and solve complex equations including statistical analysis. The results showed that over 150 different ophthalmologists contributed specimens to this data base. The mean age of the patients studied was 57 years and the tumors were evenly distributed according to sex and laterality of the eye. This study illustrates the feasibility of using a low-cost microcomputer and commercially available software in the study of a large patient data base.

Computers

Determining drug-drug interactions and related effects on microcomputers.

Algorithms for determining drug-drug interactions are described. They handle all the generic drugs in the British National Formulary (BNF) (Number 5, British Medical Association and Pharmaceutical Society of Great Britain, 1984) and allow these drugs to be identified by generic or trade name. They also accept and identify interactions for compound drugs prescribed by a single trade name. The algorithms can be implemented on any microcomputer and in a number of languages. The choice of algorithm and number of drugs handled depend on size and disk storage of the microcomputer. It was tested in collaboration with the Department of Geriatric Medicine, Liverpool University, and is used in a prescribing monitoring system operational in some wards of the Royal Liverpool Hospital. The drug data are stored in the form given in the BNF and can be easily updated from this publication. The algorithms can also handle drug allergies and cross-sensitivities.

Algorithms

Laboratory instrument interface system (LIIS): a unit for the acquisition, temporary storage and transfer of data to a microcomputer.

A simple method of interfacing clinical and research laboratory equipment with a microcomputer is described. A four-channel buffer system has been constructed which stores data generated from laboratory instruments and then transmits the data directly to a microcomputer. The system is highly flexible with respect to the type of laboratory equipment and model of computer that can be interfaced, and it allows for virtually automatic data acquisition and analysis.

Computers

External quality assessment data analysis by microcomputer.

Microcomputers are now widely used in clinical laboratories because of their low price and the availability of a wide variety of software that can be adapted to the users' requirements. The continuously increasing numbers of patients, tests and the use of automation are additional factors which emphasize the need for computers. A microcomputer software that meets the exact requirements of the Quality Control Unit was developed to evaluate laboratories participating in the Kuwait National Bacteriological Quality Assessment Scheme.

Computers

A microcomputer program for fitting two-substrate enzyme rate equations.

This paper describes a microcomputer program written in BASIC for fitting different two-substrate enzyme kinetic mechanisms. The present program is a complement of one which was recently published and was developed to fit different models of enzyme inhibition. The complete program resulting from this complementation allows the fitting of the most usual rate equations found in steady-state studies of enzyme kinetics. The program based on a non-linear least-squares regression, can be run on any microcomputer having the CP/M operating system. The initial rate equation for a steady-state random bisubstrate mechanism was chosen to evaluate the performance of the program, with contrived data of known error structure.

Computers

A microcomputer method for designing optimal experiments for estimating enzyme kinetic parameters.

A computer program, written in BASIC, for designing optimal experiments with the aim of evaluating estimates of the parameters for any enzyme kinetic model is given. This computer program can be run on any microcomputer with less than 32 Kbytes of random access memory. The program uses the termed D-optimization design criterion, which minimizes the determinant of the variance-covariance matrix. The user only supplies the rate equation, the maximum and minimum concentrations of substrates and inhibitors, the weighting pattern, and the best possible values of the parameters. The computer supplies the optimal substrate and inhibitor concentrations (one for each parameter), for estimating the parameter values, and the determinant of the variance-covariance matrix. Likewise, the microcomputer supplies the eigenvalues and eigenvectors of information and redundancy matrices, the sensitivity and the global redundancy.

Biometry

A rapid, flexible method for biochemical assays using a microtiter plate reader and a microcomputer. Application for assays of protein, Na,K-ATPase and K-p-nitrophenylphosphatase.

A computerized system which greatly accelerates and eases the collection, storage, and analysis of data has been applied to several standard biochemical assays. The system uses a commercially available microtiter plate reader connected to an Apple IIe microcomputer via a standard serial port. Data are transmitted automatically from the reader to the microcomputer, where they can be viewed, printed, further analyzed immediately, or stored on a diskette for later retrieval and processing. Some or all of the data may be entered manually. The program calculates a linear least squares best fit to a standard curve after correcting all data for blanks, then determines the quantities of substrate or product contained in each well of a microtiter plate. Data from two plates may be combined, enabling calculation of enzyme specific activities. This system can be adapted to any assay whose final step can be performed by a microtiter plate reader. Its use is described for determination of protein concentration, Na,K-ATPase activity, and K-stimulated p-nitrophenylphosphatase activity.

4-Nitrophenylphosphatase

Microcomputer-based local area network system for controlling information on perinatal medicine.

We present an outline of our microcomputer-based Local Area Network (LAN) system designed to process information related to perinatal events. This system enables any of the medical personnel to use a microcomputer terminal installed at the bedside and also to process, in a real-time manner, new input-information together with past information, thereby correlating the processing of medical information to actual clinical care. In addition, using the utility subsystem, a more desired form of data-output can be substituted for conventional hand-prepared clinical charts. Over a 3-month test period for clinical use, it became evident that this could serve as a suitable prototype system capable of covering the entire scope of information required by perinatologists. This system also enables any form of statistical assessment to be made of events, such as calculating the perinatal mortality rate and the incidence of preeclampsia. Problems arising from the clinical application of this system are given immediate attention and appropriate steps taken.

Computer Systems

Microcomputer application of Bayesean probability testing for the identification of bacteria.

A computer program (BACTID) is described which facilitates the identification of bacteria based on a priori data and Bayesean probability testing. The program is not limited to a specific format, has a short execution time, can be easily applied to a variety of situations, and can be run on almost any microcomputer system operating under either 8-bit CP/M or 16-bit MS-DOS/PC-DOS. Additionally, BACTID (1) is not limited to one type of computer (hardware independent), (2) is not limited by size of the computer's random access (RAM independent), (3) can recognize various data bases matrices (format independent), (4) is able to compensate for missing data and (5) allows for various methods of data entry. The efficacy of the program was checked against a commercially available test system and a 99.34% agreement was obtained. Also, the execution time for a 46 x 21 element data matrix was as little as 3.5 s. These results show that microcomputer identification programs are not only viable alternatives to code book registers, but also offer flexibility which is not found in commercial systems.

Bacteria

Application of a microcomputer-based system in the analysis of infection data at the emergency units of a large hospital.

After three years of retrospective study in four emergency units from a large hospital (2000 beds) and analysis of 6283 positive cultures, a microcomputer database system was built to store information concerning nosocomial infections in order to help the clinical staff from those units to study the incidence of 20 bacterial species and their sensitivity pattern evolutions for 27 antibiotics (from samples in 15 different collecting sites). This system was developed as an alternative to the hospital mainframe computer microbiological reports. It put emphasis on graphical outputs instead of the coded tables generated by the bigger system. This orientation and the possibility of sectorial infection data analysis were responsible for the general acceptance of the microcomputer-based system by the clinical staff. As the first practical results, the system was able to detect a particular increase in the incidence of Staphylococcus aureus in surgical emergency units (up to 21.6% in 1982) as well as the dissemination of the antimicrobial resistance patterns of S. aureus and Klebsiella pneumoniae from the surgical units to the clinical ones. The time evolution behaviour of Pseudomonas aeruginosa, Escherichia coli and other nonfermentative Gram negative bacilli was also studied to complete the analysis of the most pathogenic bacterial species found in our emergency units.

Brazil

A microcomputer controlled snow ski binding system--I. Instrumentation and field evaluation.

This paper presents the design and field evaluation of the first microcomputer controlled ski binding system. This system incorporates an Intel 8086 microcomputer controller and an integral binding/dynamometer. This instrumentation system not only undertakes real time control, but also it records dynamometer data via a miniature digital cassette tape recorder. The integral binding/dynamometer offers the same operational and mounting convenience of commercially available mechanical bindings. The binding may be released either manually or electrically via the controller. Comprised of four octagonal half strain rings, the strain gage dynamometer measures the three moment load components at the boot. To enable the user to conveniently operate the computer, extensive operating software was developed. The operating software is discussed in relation to both the acquisition and storage of data from the dynamometer and the control of the electro-mechanical snow ski binding. The binding system has been used successfully to both record boot moment components and control ski binding release during actual skiing maneuvers. Moment histories typical of three common recreational skiing maneuvers are presented.

Athletic Injuries

An interactive 24-channel event-logging system based on the AIM 65 single-board microcomputer.

Measures of the spontaneous behaviour of animals commonly involve the repetitive counting of behavioural events over successive periods of time following some experimental treatment. An automated event-logging system has been designed for such applications. The system is based on an AIM 65 microcomputer with 4 Kbytes of random-access memory and facilities for manual event-logging through the keyboard, or automatic logging via a signal-conditioning buffer, connected to the backplane connector of the computer. The control program is written in 6500 machine code and stored in an onboard, read-only, memory chip. The software generates a simple interactive dialogue for the selection of operating options which include manual or automatic modes, configuration of active channels, duration and number of logging cycles, and the choice of printed or transmitted output. The microcomputer can also be instructed to pause and then to restart, to print out its current status, or to abort. The system has been used over a period of 18 months in numerous experiments in this laboratory, and has proved to be reliable, accurate and entirely suited to its application.

Animals

A microcomputer technique for the detailed behavioural, and automatic statistical, analysis of animal behaviour.

In view of the intense concentration and time investment required for the detailed assessment of animal behaviour, various strategies have been employed to facilitate the quantitative description of movements and postures of animals. In a recent communication, we outlined a microcomputer technique which enabled individual operators to record frequency and duration of a large number of behavioural elements. However, this method required the manual collation and transcription of summary data in order to effect statistical analysis, an operation which involved avoidable and time-consuming repeated data handling. The present communication details a microcomputer technique which aids the recording of frequency, real-time duration and real-time latency measures. Further, this program automatically collates, transcribes and executes statistical analysis (Kruskal-Wallis, Mann-Whitney) without involving manual data manipulation, other than at the initial behavioural analysis level and thus, represents an aid to reducing the total time investment required to effect complete behavioural analysis.

Animals

Microcomputer-driven digital data processing of mouse actograph activity.

The system is designed to measure the ambulatory activity of each of a set of eight mice, using a group of actographs driven by an inexpensive microcomputer, thus avoiding unnecessary usage of a costly instrument over an extended period. A toric actograph was chosen since it is sensitive to ambulatory activity even at low amplitudes. In this computerized system, actograph data are recorded on audio cassettes during the experiment, and later reread by an Apple II microcomputer for storage on floppy disks. This makes it possible to perform all types of mathematical treatment at a later date. Since the experiments last for several days and the environment is kept constant, activity rhythms can be studied. The data processing takes place off-line and employs digital filtering, which is shown to be preferable for the presentation of temporal data to a simple smoothing, by a moving average. Spectral analysis is obtained through a discrete Fourier transform. Two methods of reconstitution of temporal curves from the frequency analyses are presented: an inverse Fourier transform, or summation of the Fourier series.

Animals

A distributed computer network using microcomputers for on-line data processing in clinical monitoring and medical research.

Microelectronic technology has made possible a rapid expansion in the exploitation of the digital computer in medicine, but software development remains an increasingly significant problem. This paper describes a distributed computer network which combines the low cost computing power of the microcomputer with the highly developed features of a minicomputer. Powerful data processing facilities are provided through centralization of major resources on the minicomputer. Parallel real-time computing is assigned to microcomputers which have access to the minicomputer filestore, and to its comprehensive software development aids.

Animals

A microcomputer system for the measurement of finger forces.

In the analysis of hand functions, the production and control of forces exerted during voluntary contraction of the finger muscles plays an important role; unfortunately such an analysis is rarely seen in routine clinical examinations of neurological patients. A microcomputer controlled system for the measurement and analysis of finger forces is described. The system consists of a modified Z80 based microcomputer, a commercially available high precision force transducer, a specially designed force signal amplifier and a suite of menu-driven user interactive programs. A variety of tasks is implemented by means of the computer programs. In addition to the measurement of maximum hand grip force, the system is able to record forces continuously as a function of time. Task characteristics and the type of feedback presented to the subject are under user control; they can be varied to meet clinical or experimental requirements. Examples of programs and clinical applications are presented and discussed.

Biomechanical Phenomena

Microcomputer system for the analysis of muscle function.

Though skeletal muscle function has recently been increasingly studied, a system for routine clinical examination in patients is not widely available. A microcomputer based system has been developed for the measurement and analysis of force-frequency characteristics, relaxation rate, fatiguability and endurance in the adductor pollicis muscle. The mobile system consists of a modified displacement transducer fitted with a linear-output Hall-effect sensor, a specially designed signal processing unit and a microcomputer for control of both the electrical stimulus and a suite of menu-driven, user-interactive programs. One hundred normal volunteers have been studied to produce a normal database for comparison with malnourished surgical patients. The system compares favourably with other systems in use for objective measurement of skeletal muscle function and introduces a refined technique for evaluating endurance.

Biomedical Engineering