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Initial evaluation of a continuous speech recognition program for radiology.

The aims of this work were to measure the accuracy of one continuous speech recognition product and dependence on the speaker's gender and status as a native or nonnative English speaker, and evaluate the product's potential for routine use in transcribing radiology reports. IBM MedSpeak/Radiology software, version 1.1 was evaluated by 6 speakers. Two were nonnative English speakers, and 3 were men. Each speaker dictated a set of 12 reports. The reports included neurologic and body imaging examinations performed with 6 different modalities. The dictated and original report texts were compared, and error rates for overall, significant, and subtle significant errors were computed. Error rate dependence on modality, native English speaker status, and gender were evaluated by performing ttests. The overall error rate was 10.3 +/- 3.3%. No difference in accuracy between men and women was found; however, significant differences were seen for overall and significant errors when comparing native and nonnative English speakers (P = .009 and P = .008, respectively). The speech recognition software is approximately 90% accurate, and while practical implementation issues (rather than accuracy) currently limit routine use of this product throughout a radiology practice, application in niche areas such as the emergency room currently is being pursued. This methodology provides a convenient way to compare the initial accuracy of different speech recognition products, and changes in accuracy over time, in a detailed and sensitive manner.

Female↗

Open source software for experiment design and control.

The purpose of this paper is to describe a software package that can be used for performing such routine tasks as controlling listening experiments (e.g., simple labeling, discrimination, sentence intelligibility, and magnitude estimation), recording responses and response latencies, analyzing and plotting the results of those experiments, displaying instructions, and making scripted audio-recordings. The software runs under Windows and is controlled by creating text files that allow the experimenter to specify key features of the experiment such as the stimuli that are to be presented, the randomization scheme, interstimulus and intertrial intervals, the format of the output file, and the layout of response alternatives on the screen. Although the software was developed primarily with speech-perception and psychoacoustics research in mind, it has uses in other areas as well, such as written or auditory word recognition, written or auditory sentence processing, and visual perception.

Humans↗

Adaptive communication systems for patients with mobility disorders.

An adaptive communication system has been developed for individuals with mobility disorders. It uses specialized computer software and hardware that compensate for this disability. For an individual with a motor-control impairment who is not able to use a keyboard effectively, a computer voice-recognition technology now removes this communication barrier. Speech-recognition systems consist of three basic components: speech processing, speech recognition, and speech understanding. The new Dragon Dictate (Dragon Systems, Inc., Newton, Mass.) is the first large-vocabulary speech recognition system in the personal computer industry that interactively learns a user's vocabulary and mode of speaking and responds to natural language rather than to limited sets of words. This speech-recognition system requires a microprocessor, a display monitor, a printer, and specific software packages, including word-processing and enhanced memory-management software. Important considerations in the use of this speech-recognition system include microphone positioning and training of the system. With the advent of this new voice-recognition computer system, another communication barrier between the disabled and society has been overcome.

Communication Devices for People with Disabilities↗

A system for three-dimensional visualization of human jaw motion in speech.

With the development of precise three-dimensional motion measurement systems and powerful computers for three-dimensional graphical visualization, it is possible to record and fully reconstruct human jaw motion. In this paper, we describe a visualization system for displaying three-dimensional jaw movements in speech. The system is designed to take as input jaw motion data obtained from one or multi-dimensional recording systems. In the present application, kinematic records of jaw motion were recorded using an optoelectronic measurement system (Optotrak). The corresponding speech signal was recorded using an analog input channel. The three orientation angles and three positions that describe the motion of the jaw as a rigid skeletal structure were derived from the empirical measurements. These six kinematic variables, which in mechanical terms account fully for jaw motion kinematics, act as inputs that drive a real-time three-dimensional animation of a skeletal jaw and upper skull. The visualization software enables the user to view jaw motion from any orientation and to change the viewpoint during the course of an utterance. Selected portions of an utterance may be replayed and the speed of the visual display may be varied. The user may also display, along with the audio track, individual kinematic degrees of freedom or several degrees of freedom in combination. The system is presently being used as an educational tool and for research into audio-visual speech recognition. Interested researchers may obtain the software and source code free of charge from the authors.

Computer Graphics↗

Capabilities of computerized clinical decision support systems: the implications for the practicing dental professional.

This article presents the use of captured data within the range of patient care activities of the dental practitioner with an emphasis on prosthodontic activities. It describes the use of computer technology in dentistry during a typical patient encounter in a dental care facility. The oral health record, the need for speech recognition technology, and existing documentation software are discussed. Ongoing development of the capabilities of Clinical Decision Support (CDS) systems is becoming an important part of the oral health setting; including systems applicable to prosthodontics. These systems all rely on a common standardized structure for the electronic (oral) health record (EHR/EOHR). Current developments in radiological technology and digital imaging are explained as well as fundamentals of decision support systems clarified. Recent developments in the representation of domain knowledge as well as the implementation of a dental nomenclature and metathesaurus are also presented. A quality matrix identifies target values for dental informatics while demonstrating an "importance-weighting" of dental characteristics.

Bayes Theorem↗

[Automatic voice recognition for radiologic reports. Experiment with a prototype in an operational environment].

Large vocabulary speech recognition, its techniques and its software and hardware technology, are being developed, aimed at providing the office user with a tool that could significantly improve both quantity and quality of his work: the dictation machine, which allows memos and documents to be input using voice and a microphone instead of fingers and a keyboard. The IBM Rome Science Center, together with the IBM Research Division, has built a prototype recognizer that accepts sentences in natural language from a 20,000-word Italian vocabulary. The unit runs on a personal computer equipped with a special hardware capable of giving all the necessary computing power. The first laboratory experiments yielded very interesting results and pointed out such system characteristics to make its use possible in operational environments. To this purpose, the dictation of medical reports was considered as a suitable application. In cooperation with the 2nd Radiology Department of S. Maria della Misericordia Hospital (Udine, Italy), a system was experimented by radiology department doctors during their everyday work. The doctors were able to directly dictate their reports to the unit. The text appeared immediately on the screen, and eventual errors could be corrected either by voice or by using the keyboard. At the end of report dictation, the doctors could both print and archive the text. The report could also be forwarded to hospital information system, when the latter was available. Our results have been very encouraging: the system proved to be robust, simple to use, and accurate (over 95% average recognition rate). The experiment was precious for suggestions and comments, and its results are useful for system evolution towards improved system management and efficiency.

Medical Records Systems, Computerized↗

Voice recognition.

Voice recognition represents one of the new technologies that are changing the practice of radiology. Thirty percent of radiology practices are either currently or plan to have voice recognition (VR) systems. VR software encompasses 4 core processes: spoken recognition of human speech, synthesis of human readable characters into speech, speaker identification and verification, and comprehension. Many software packages are available offering VR. All these packages should contain an interface with the radiology information system. The benefits include decreased turnaround time and cost savings. Its advantages include the transfer of secretarial duties to the radiologist with a result in decreased productivity.

Humans↗

Narrative speech in aging: quantity, information content, and cohesion.

This study examined age-related changes in narrative speech of 79 adults aged 40-91 who told stories from their pictorial representations. Quantity, information content and cohesion of narratives were analysed using a detailed transcription and codification system. We carried out a LISREL analysis to study relationships between narrative performance and age, level of education and verbal capacity. Our results showed that aging increases quantity, reduces density of informational content and cohesive reference of narratives and increases the units of irrelevant content. Verbal capacity measured by a vocabulary test improves content and cohesion. The implications of the findings for the cognitive deficit and pragmatic change explanations of narrative speech are discussed.

Adult↗

Evaluating a computer system used as a microswitch for word utterances of persons with multiple disabilities.

PURPOSE: To assess the effectiveness of a computer system used as a microswitch for word utterances of two adults with multiple disabilities. The system combined a new control software programme with a commercially available speech recognition programme. METHOD: Nine word utterances were targeted for each participant. The participant's emission of those utterances triggered the occurrence of related (favourite) stimuli during the intervention and the post-intervention check. RESULTS: Intervention data showed that (1) the participants increased the frequencies of the target utterances and (2) the computer system recognized about 80% of those utterances correctly, providing the participants with high levels of favourite stimulation. The post-intervention check showed comparable data with both participants. CONCLUSIONS: The computer system proved an adequate microswitch for word utterances. Based on this evidence, microswitch programmes could be extended beyond the use of conventional motor responses.

Abnormalities, Multiple↗

Processing of visual syntax in a globally aphasic patient.

A globally aphasic patient was trained on a computerized visual communication system. His ability to comprehend reversible locative prepositional phrases after training was studied and compared with the performance of Broca's aphasics on a similar task. This patient's ability to generalize symbols for actions was also investigated. The results demonstrate our patient's capacity to master a formal visual syntax in the absence of natural language and illustrate how this capacity may be used successfully in a visual communication system. A problem in generalizing symbols for actions is demonstrated, suggesting that certain heuristic and cueing capabilities in the approach may be helpful.

Aphasia↗

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↗

Comparison of voice-automated transcription and human transcription in generating pathology reports.

CONTEXT: Software that can convert spoken words into written text has been available since the early 1980s. Early continuous speech systems were developed in 1994, with the latest commercially available editions having a claimed accuracy of up to 98% of speech recognition at natural speech rates. OBJECTIVES: To evaluate the efficacy of one commercially available voice-recognition software system with pathology vocabulary in generating pathology reports and to compare this with human transcription. To draw cost analysis conclusions regarding human versus computer-based transcription. DESIGN: Two hundred six routine pathology reports from the surgical pathology material handled at St Joseph's Healthcare, Hamilton, Ontario, were generated simultaneously using computer-based transcription and human transcription. The following hardware and software were used: a desktop 450-MHz Intel Pentium III processor with 192 MB of RAM, a speech-quality sound card (Sound Blaster), noise-canceling headset microphone, and IBM ViaVoice Pro version 8 with pathology vocabulary support (Voice Automated, Huntington Beach, Calif). The cost of the hardware and software used was approximately Can 2250 dollars. RESULTS: A total of 23 458 words were transcribed using both methods with a mean of 114 words per report. The mean accuracy rate was 93.6% (range, 87.4%-96%) using the computer software, compared to a mean accuracy of 99.6% (range, 99.4%-99.8%) for human transcription (P <.001). Time needed to edit documents by the primary evaluator (M.A.) using the computer was on average twice that needed for editing the documents produced by human transcriptionists (range, 1.4-3.5 times). The extra time needed to edit documents was 67 minutes per week (13 minutes per day). CONCLUSIONS: Computer-based continuous speech-recognition systems in pathology can be successfully used in pathology practice even during the handling of gross pathology specimens. The relatively low accuracy rate of this voice-recognition software with resultant increased editing burden on pathologists may not encourage its application on a wide scale in pathology departments with sufficient human transcription services, despite significant potential financial savings. However, computer-based transcription represents an attractive and relatively inexpensive alternative to human transcription in departments where there is a shortage of transcription services, and will no doubt become more commonly used in pathology departments in the future.

Feasibility Studies↗

Adaptive computer use for a person with visual impairment.

A single-subject research design that used multiple baselines across behaviors compared traditional adaptations (e.g., the use of readers) to adapted computer technologies for typical reading activities performed by an adult with severe visual impairment. A Macintosh IIci equipped with software that translated information displayed on the monitor into synthesized speech was paired with a page scanner and optical character recognition software to convert scanned images of printed text into computer documents. These computer technologies were applied to three reading behaviors: proofreading of word-processed documents, reading of printed research articles, and reading of common printed materials such as letters and instruction sheets. The findings demonstrated that the use of adapted computer technology, rather than traditional methods, increased the subject's reading efficiency and frequency. The increased functional independence that occurred as a result of the computer technology improved the subject's patterns of adaptation in reading-related tasks and improved the quality of her life.

Activities of Daily Living↗

Trends in computer hardware and software.

Previously identified and current trends in the development of computer systems and in the use of computers for health care applications are reviewed. Trends identified in a 1982 article were increasing miniaturization and archival ability, increasing software costs, increasing software independence, user empowerment through new software technologies, shorter computer-system life cycles, and more rapid development and support of pharmaceutical services. Most of these trends continue today. Current trends in hardware and software include the increasing use of reduced instruction-set computing, migration to the UNIX operating system, the development of large software libraries, microprocessor-based smart terminals that allow remote validation of data, speech synthesis and recognition, application generators, fourth-generation languages, computer-aided software engineering, object-oriented technologies, and artificial intelligence. Current trends specific to pharmacy and hospitals are the withdrawal of vendors of hospital information systems from the pharmacy market, improved linkage of information systems within hospitals, and increased regulation by government. The computer industry and its products continue to undergo dynamic change. Software development continues to lag behind hardware, and its high cost is offsetting the savings provided by hardware.

Clinical Pharmacy Information Systems↗

Computer-based speech recognition as a replacement for medical transcription.

OBJECTIVE: We have implemented computerized speech recognition in a high-volume clinical setting using a newly developed commercial software system. This paper compares the performance of the computerized system with conventional transcription during a trial week followed by 3 months of routine clinical use. CONCLUSION: The speech recognition system was used for 97% of the cases during the trial week and 87% of cases during the months of continuous use. For a similar mixture of cases, no change occurred in the length of reports after introduction of the computerized system. Speech recognition decreased the time until the report became available by 99% and resulted in a substantial savings in transcription costs. We conclude that speech recognition by computer is practical in a high-volume clinical implementation.

Cost-Benefit Analysis↗