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At least 1,261 records · Page 70Linked to original sources
PubMed2003

Absolute coronary risk analyser--a tool for managing coronary heart disease risk.

OBJECTIVES: The aim of the present study was to develop a coronary risk analyser which can calculate authentically the absolute coronary risk of an individual for coronary risk management. METHODS AND RESULTS: After extensive literature survey was done to derive the most appropriate method to calculate the absolute coronary risk. Joint British recommendations derived from Framingham's heart study were adopted for its supreme sensitivity and specificity. A windows based software is developed using Visual basic programming language. The software is easily installable in any pentium PC with windows operating system and requires entry of a detailed medical profile of an individual for the calculation of absolute coronary risk. CONCLUSION: Coronary risk analyser developed by DEBEL effectively calculates the absolute coronary risk of an individual over 2, 5 or 10 years and stores the patient's data properly. The software is a tool to manage the coronary risk of a patient in the field of preventive cardiology.

Coronary Disease↗
PubMed1997

Approaches for certification of electronic prescription software.

The proper management of drug treatment is essential, since adverse drug reactions are common reasons of hospitalisations. Expenditure on drug therapy has also been growing faster than any other aspect of health care in many countries. Savings and quality improvements in drug treatment could be achieved with computerised prescribing. In this paper, the architecture of an electronic prescription system is described in the light of software certification and registration. An electronic prescription system is an example of a system supporting shared care and therefore it should be person based, integrated, secure and confidential and data should be shared among health care institutions. The system architecture shares the idea of a virtual patient record and a smart card will be used as a key to prescription data located on the network. The certification and registration of medical software is a difficult and costly procedure. Ensuring the quality of software can be based on; certification of development process, voluntary evaluation, and post-market surveillance. Voluntary evaluation practice would be a precious tool for both the customers and software developers, and it would also be an invaluable source of information in terms of developing new software.

Certification↗
PubMed1998

Slope of the peripapillary nerve fiber layer surface in glaucoma.

PURPOSE: To develop structural markers of early glaucomatous optic nerve damage with confocal scanning laser ophthalmoscopy. METHODS: Custom software was developed to analyze the images of 53 patients with open-angle glaucoma and 43 healthy subjects (matched for age, race, and refractive error), with images acquired with a confocal scanning laser ophthalmoscope. Height values were obtained along radial profiles of the peripapillary nerve fiber layer surface at 5-degree intervals around the disc edge. Two new parameters were derived: mean height and mean slope of the peripapillary nerve fiber layer surface. Mean slope was tested for its independence from a retinal reference plane. A logistic regression analysis was used to determine functions of disease probability. Receiver-operating characteristic (ROC) curves were used to evaluate sensitivity and specificity of peripapillary nerve fiber layer slope and height to discriminate normal subjects from glaucoma patients. RESULTS: Mean (+/-SD) visual field mean deviation in the glaucoma group was -4.8 +/- 3.3 dB. Mean slope (+/-SD) of the peripapillary nerve fiber layer was significantly (P < 0.001) steeper (0.30 +/- 0.12) in glaucoma patients than in healthy subjects (0.11 +/- 0.12). Mean slope values were identical with or without the retinal reference plane. Mean height (+/-SD) values with respect to a retinal reference plane were 45.2 +/- 103 microm in healthy subjects and -65.2 +/- 105 microm in glaucoma patients, which were significantly different (P < 0.001). The differences for mean slope and for mean height between the healthy subjects and the glaucoma patients were greatest inferiorly. The diagnostic precision, sensitivity, and specificity of mean slope were 83%, 85%, and 80%, respectively. The diagnostic precision, sensitivity, and specificity of mean height were 75%, 69%, and 83%, respectively. CONCLUSIONS: Mean peripapillary slope of the nerve fiber layer surface can be used to discriminate between healthy subjects and glaucoma patients with clinically useful diagnostic precision. This parameter is independent of a retinal reference plane and may be particularly useful to detect progressive glaucoma damage.

Diagnostic Techniques, Ophthalmological↗
PubMed1999

[Digital image archiving--concept of digital image and video documentation in ENT. A contribution to quality assurance].

BACKGROUND: Currently normal or pathologic conditions are documental by color slides, photos or videotape. However, it is more difficult to manage large numbers of images and to recall specific pictures or videos at any time. Digital record archives may be a solution for this problem. MATERIAL AND METHODS: We present a digital video and photographic archive that controls documents with a picture archive software designed for use in ENT examination units. RESULTS: Working on this digital unit we have developed a software program that allows the creation and administration of digital pictures and videos using only one program. To avoid mistakes manual recording of data was reduced to a minimum. Filing is done automatically and similar results can be found via self-explained criteria. Due to the pro-user computer software, less trained persons are not afraid to use the system. Hence, the number of documented diagnoses has increased. Present experience shows that material and videos make it easier to work with patients and clinical confidence is increased. Additionally, the physician is protected indirectly. When many persons work with one system, digital photographic archives increase the clinician's ability to refind documents, even after a period of years. The need for quality assurance in medicine will help find more use for a digital archive in ENT.

Computer Systems↗
PubMedDate not supplied

Using computer systems as microswitches for vocal utterances of persons with multiple disabilities.

We assessed the effects of two computer systems used as microswitches for the vocal utterances of an adolescent and a young adult with multiple disabilities. The systems were to respond to three one-syllable utterances of the first participant and nine word-like utterances of the second participant by presenting favorite stimuli linked to those utterances. The computer system used for the first participant relied on a software program developed specifically for this study. The computer system used for the second participant combined a new software program with a commercially available speech recognition program. Results showed that both participants increased the frequencies of their target utterances and obtained high levels of stimulation. Positive performance was maintained at post-intervention checks. Technical and practical implications of the data are discussed.

Abnormalities, Multiple↗
PubMed2003

Internal dosimetry of uranium isotopes using Bayesian inference methods.

A group of personnel at Los Alamos National Laboratory is routinely monitored for the presence of uranium isotopes by urine bioassay. Samples are analysed by alpha spectroscopy, and the results are examined for evidence of an intake of uranium. Because the measurement uncertainties are often comparable to the quantities of material we wish to detect, statistical considerations are crucial for the proper interpretation of the data. The problem is further complicated by the significant, but highly non-uniform, presence of uranium in local drinking water and, in some cases, food supply. Software originally developed for internal dosimetry of plutonium has been adapted to the problem of uranium dosimetry. The software uses an unfolding algorithm to calculate an approximate Bayesian solution to the problem of characterising any intakes which may have occurred, given the history of urine bioassay results for each individual in the monitored population. The program uses biokinetic models from ICRP Publications 68 and later, and a prior probability distribution derived empirically from the body of uranium bioassay data collected at Los Alamos over the operating history of the laboratory. For each individual, the software creates a posterior probability distribution of intake quantity and solubility type as a function of time. From this distribution, estimates are made of the cumulative committed dose (CEDE) to each individual. Results of the method are compared with those obtained using an earlier classical (non-Bayesian) algorithm for uranium dosimetry. We also discuss the problem of distinguishing occupational intakes from intake of environmental uranium, within a Bayesian framework.

Algorithms↗
PubMed2004

Adaptive software for head-operated computer controls.

Head-operated computer controls provide an alternative means of computer access for people with disabilities who are unable to use a standard mouse. However, a person's disability may limit his or her neck movements as well as upper extremity movements. Software was developed which automatically adjusts the interface sensitivity to the needs of a particular user. This adaptive software was evaluated in two stages. First, 16 novice head-control users with spinal-cord injury or multiple sclerosis used head controls with and without the adaptive software. The adaptive software was associated with increased speed in standardized icon selection exercises (p < 0.05). A small increase in accuracy was also observed. In addition, five current head-control users evaluated the software in a real-world setting. One of these five subjects perceived an improvement in comparison to his current head-control system.

Activities of Daily Living↗
PubMed1984

Computer software design for pediatric practice. A modular approach.

Practical applications for using computers in everyday medical practice have not kept pace with the technical developments that now make this tool available to the pediatric practitioner. A modular approach to user-developed applications software is presented as a model for computerizing the pediatric office. Benefits have included lower cost, greater data reliability and validity, standardization of office and medical procedures, and automation of jobs formerly requiring much personnel time. Some patient services have improved, and other new services have become possible, through the application of computer software designed in accordance with our practice philosophy.

Computers↗
PubMed2000

[Development of DICOM image viewing software for efficient image reading and evaluation of distributed server system for diagnostic environment].

To construct an efficient diagnostic environment using computer displays, the author investigated the time of network transmission using clinical images. In our hospital, we introduced optical-fiber 100Base-Fx Ethernet connections between 22 HIS-segments and one RIS-segment. Although Ethernet architecture is inexpensive, the speed of image transmission becomes 2371 KB/sec. (4.6 CT-slice/sec.) in the RIS-segment and 996 KB/sec. (1.9 CT-slice/sec.) from the RIS-segment to HIS-segments. Because one examination is transmitted in one minute, it does not disturb image reading. Otherwise, a distributed server system using inexpensive personal computers helps in constructing an efficient system. This investigation showed that commercially based Digital Imaging and Communications in Medicine(DICOM) servers and RSNA Central Test Node servers are not so different in transmission speed. The author programmed and developed DICOM transmission and viewing software for Macintosh computers. This viewer includes two inventions, dynamic tiling window system (DTWS) and window binding mode(WBM). On DTWS, windows, tiles, and images are independent objects, which are movable and resizable. The tile-matrix is changeable by mouse dragging, which realizes suitable tile rectangles for wide-low or narrow-high images. The arranging window tool prevents windows from scattering. Using WBM, any operation affects each window similarly. This means that the relationship of compared images is always equivalent. DTWS and WBM contribute greatly to a filmless diagnostic environment.

Computer Communication Networks↗
PubMed2004

Development of the IM147: an alternative inspection/maintenance mass-emission transient test to address vehicle preconditioning concerns.

A series of studies was performed to develop an alternative to the U.S. Environmental Protection Agency's gold standard IM240 mass-based emission test. The new IM147 test was based on the second phase of the IM240 that consists of 147 sec of transient vehicle operation. Paired IM240/IM147 tests were conducted on vehicles ranging from 1981 to 1996 to determine IM147 cutpoints and excess emissions were identified. Additionally, an optimized test procedure was developed that combined possible triplicate IM147s with improved drive trace quality control, fast-pass, and retest methods. The optimized procedure was found to provide improved vehicle preconditioning with a relatively minor decrease in excess emissions identification. Resulting identification rates ranged from 96 to 100% for hydrocarbons (HC), 93-100% for CO, and 93-100% for NOx, depending on cutpoint selection, while false failures caused by lack of vehicle preconditioning were reduced to essentially zero. Significant vehicle throughput improvements were achieved through the development of software algorithms involving modal fast-pass and retest procedures. Modal drive trace variation limits also were developed to improve test accuracy. The combination of the algorithms reduced average IM147 test times by nearly 60%.

Air Pollutants↗
PubMed1991

Automated pupil perimetry. Pupil field mapping in patients and normal subjects.

The authors developed an automated method of pupil perimetry by linking an infrared video pupillometer to a Humphrey Field Analyzer. Software was developed to automatically analyze the pupil responses to focal light stimuli and display the results graphically. All 76 locations of Humphrey program 30-2 could be tested twice within 5.5 minutes and the relative sensitivity of the field was determined by comparing the amplitude of pupil constriction or latency time at each stimulus location. The mean pupil responses within annular areas at 3 degrees, 9 degrees, 15 degrees, 21 degrees, and 27 degrees were shown to be linearly related to log stimulus intensity over a 15 dB range under low level mesopic conditions (3.15 asb bowl background). In normal subjects, the superior temporal quadrant usually had the greatest mean pupillomotor response and the inferior nasal quadrant had the least. Pupil responses in the temporal field were larger than corresponding locations in the nasal field. Patients with visual field defects who underwent testing by pupil perimetry showed pupillary deficits in the same location within the field, providing evidence that pupil perimetry may be a useful, objective means of assessing visual field function.

Adolescent↗
PubMed1999

The analysis of heart rate variability in unrestrained rats. Validation of method and results.

An experimental setting and software were developed to evaluate cardiac autonomic function in unrestrained rats. Subcutaneously implanted ECG electrodes and an indwelling venous catheter were tunneled to a tail cuff in five rats. The ECG was A/D converted at 1000 Hz. After peak detection, a time series of RR intervals was obtained. Programs for the analysis of heart rate variability (HRV) were implemented in LabVIEW. Statistical properties were determined in the time domain. After cubic spline function curve fitting, resampling at 0.1 s and test for stationarity, power spectral analysis was performed on sampled records of 30 min duration after applying a sliding Hanning window (Welch method: 256 points (duration 25.6 s), 50% overlap and 0.039 Hz resolution). Algorithms were tested with simulated signals consisting of isolated frequency components, which were retrieved at their exact locations. Physiological validation of the system was performed by, beta-adrenergic and cholinergic blockade and by forced breathing at a fixed rate. Measurements were performed on five unrestrained rats under basal conditions. Mean RR was 174.2 +/- 3.6 ms; S.D., 13.3 +/- 4.6 ms; rMSSD, 5.2 + /- 1.2 ms; pNN10, 3.5 +/- 1.9% and pNN5, 18.7 +/- 6.4%. Low (0.19-0.74 Hz) and high frequency (0.78-2.5 Hz) power were determined (and also percent of low to total and high to total): 18.42 +/- 10.74 ms2 (22.9 +/- 6.5%) and 15.66 +/- 5.56 ms2 (19.9 +/- 2.7%), and the ratio low/high: 1.16 +/- 0.39. In conclusion, HRV analysis programs were developed and thoroughly tested through simulations and in vivo, under basal conditions and after pharmacological blockades. Using this software, HRV data from unrestrained rats were obtained.

Animals↗
PubMed1992

[Registration and analysis of airway pressure and gas flow in ventilated patients. The "Hyper-DAQ Respiration Mechanics Recorder"].

Respiratory data monitored in ventilated patients commonly consists of monitoring some inspiratory and expiratory pressures and volumes. For a more sophisticated analysis of respiratory mechanics in ventilated patients, a combined hardware and software system is presented that allows for continuous monitoring of airway pressure and gas flow. Gas flow is measured using a pneumotach. The "Hyper-DAQ" is an 8-channel 12-bit analog to a digital converter that can be connected to IBM PCs as well as to Macintosh computers using a standard RS 232 link. A special module consisting of three pressure transducers (airway pressure, differential pressure for a Fleisch head and ambient pressure) and five additional analog inputs is used for recording respiratory data. Once set up, the Hyper-DAQ records all the data in real time, independently of the host system that can query the data via the RS 232 link. The software runs on IBM and compatible PCs, as well as on Macintosh computers. The software simulates a strip-chart recorder and can be controlled by the keyboard and the mouse. We developed special software for the calibration of pressure and flow. Using models of the gas distribution in the lung compliance, resistance and lung time constants can be calculated from the raw data. For special purposes the data can be transferred to spread-sheet software. A mainstream CO2-detector connected to one of the additional analog inputs allows for additional data: alveolar ventilation, series deadspace, etc. The system presented can be recommended in routine work as well as for scientific studies in ventilated patients.

Anesthesiology↗
PubMed2005

Clinical decision support software for management of chronic heart failure: development and evaluation.

OBJECTIVE: To develop and evaluate clinical decision support software (CDSS) to aid physicians treat patients with chronic heart failure (CHF). METHODS: The CDSS was developed after discussions with a multidisciplinary panel. Evaluation was performed in three stages over a 6 month period including an editorial check, one-to-one interviews with potential users and educational meetings with general practitioners (GPs), junior doctors and medical students during which the CDSS was assessed in a cross-over design against paper guidelines. Opinions of the CDSS and the computer literacy of the participants were assessed by questionnaire. RESULTS: There were several changes to the CDSS at various stages of development and evaluation. One-to-one interviews generated extensive qualitative feedback. GPs had lower computer literacy scores than junior doctors and students (both p<0.01). There were small trends when comparing the CDSS with paper guidelines. GPs scored less well (CDSS 75% vs. 80%, p=0.41), while junior doctors and medical students appeared to improve their scores (72%-84%, p=0.32 and 66%-77%, p=0.19, respectively). Most (70%) found the CDSS more useful than the written guidelines. CONCLUSION: Development of CDSS using guidelines and expert opinion requires a multidisciplinary iterative process of feedback and software adaptation. Barriers to implementation identified include lower computer literacy among GPs, a lack of complexity within CDSS in addressing non-medical needs of patients and a reluctance among medical staff to consult guidelines during patient consultations. Improving computer skills, integrating CDSS into referral pathways and requests for investigations may be ways of enhancing use of this emerging technology.

Cardiology↗
PubMed2005

Objective computerized determination of the minimum cross-sectional area of the nasal passage on computed tomography.

OBJECTIVES/HYPOTHESIS: Current methods that measure cross-sectional areas of the nasal passage on computed tomography (CT) do not determine the minimum cross-sectional area that may be an important factor in nasal airway resistance. Objective measurement of the dimensions of the nasal passage may help in the diagnosis, as well as the choice and evaluation of surgical treatment for upper airway insufficiencies. STUDY DESIGN: Retrospective and clinical study. METHODS: Software was developed that automatically calculates the minimum cross-sectional area of the nasal passage on CT. RESULTS: Evaluation shows that the minimization algorithm in the software reliably calculates the position and orientation of the oblique plane on which the minimum cross-section lies. CONCLUSION: The developed method may be used for objective and observer-independent evaluation of surgical treatment options.

Algorithms↗
PubMed2004

Online annotation tool for digital mammography.

RATIONALE AND OBJECTIVES: To develop a software tool for radiologists to annotate mammograms online. MATERIALS AND METHODS: The tool is web-based with a Java development environment and composed of a Digital Image and Communication in Medicine (DICOM) image viewer, a clinical information collector, and a database. The use of the tool with a sample case is demonstrated in this article. RESULTS: An online tool for the annotation of digital mammograms for teaching and research purposes has been developed. CONCLUSION: This annotation tool can be used to provide an annotated-case library on mammography education for residents and fellows.

Education, Medical, Continuing↗
PubMed1999

Web-based training: a new paradigm in computer-assisted instruction in medicine.

Computer-assisted instruction (CAI) programs based on internet technologies, especially on the world wide web (WWW), provide new opportunities in medical education. The aim of this paper is to examine different aspects of such programs, which we call 'web-based training (WBT) programs', and to differentiate them from conventional CAI programs. First, we will distinguish five different interaction types: presentation; browsing; tutorial dialogue; drill and practice; and simulation. In contrast to conventional CAI, there are four architectural types of WBT programs: client-based; remote data and knowledge; distributed teaching; and server-based. We will discuss the implications of the different architectures for developing WBT software. WBT programs have to meet other requirements than conventional CAI programs. The most important tools and programming languages for developing WBT programs will be listed and assigned to the architecture types. For the future, we expect a trend from conventional CAI towards WBT programs.

Artificial Intelligence↗