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PubMed1989

Principles of morphometric grading.

Grading of the severity of lesions has increased in importance in histopathology. The simplest grading system has 2 grades. If there is variation in the measuring system, the grading will not be perfect, and there are also misgraded samples. We estimated the fraction of falsely graded cases by applying th NAG (Numerical Algorithm Group) Fortran Library. If all possible measurement values are equally probable the grades based on measurements within +/- 1 SD around the division line are false in 31.6% of cases. The corresponding figures for regions +/- 2 SD, +/- 3 SD, 1 to 2 SD, 1 to 3 SD, and 2 to 3 SD are 19.6, 13.3, 7.5, 4.2, and 0.8%, respectively. Detailed calculations were made which allowed accurate determination of the probability of a grade being false in different positions of the measurement scale. The results suggest that for diagnostic grading a borderline region should be defined (e.g. +/- 2 SD or +/- 3 SD around the division line).

Diagnostic Errors↗

PubMed1995

Verification of the heart rate threshold.

Among the methods for determining anaerobic threshold (AT), the heart rate (HR) method seems to be the simplest. On the other hand, many conflicting results from comparing this method with others have been presented over the last 10 years. Therefore, the aim of this study was to compare the heart rate threshold (HRT) with the lactate turn point (LTP)-"second" break point of dependence of lactate (LA) to power output, ventilatory threshold (VT) and threshold determined by electromyography (EMGAT), all determined by the same exercise test and evaluated by the same computer algorithm. A group of 24 female students [mean age 20.5 (SD 1.6) years, maximal oxygen consumption 48.8 (SD 4.7) ml.kg-1.min-1] performed an incremental exercise test on a cycle ergometer (modified Conconi test) starting with an initial power output (PO) of 40 W with intensity increments of 10 W.min-1 until the subjects were exhausted. The HRT, LTP and EMGAT determination was done by computer-aided break-point regression analysis from dependence of functional measures on PO. The same computer algorithm was used for VT determination from the relationship between ventilation (V) and oxygen uptake (VO2) or carbon dioxide output (VCO2).(ABSTRACT TRUNCATED AT 250 WORDS)

Anaerobic Threshold↗

PubMed2005

Retrieval of aerosol refractive index from extinction spectra with a damped harmonic-oscillator band model.

A new method for the retrieval of the spectral refractive indices of micrometer-sized particles from infrared aerosol extinction spectra has been developed. With this method we use a classical damped harmonic-oscillator model of molecular absorption in conjunction with Mie scattering to model extinction spectra, which we then fit to the measurements using a numerical optimal estimation algorithm. The main advantage of this method over the more traditional Kramers-Kronig approach is that it allows the full complex refractive-index spectra, along with the parameters of the particle size distribution, to be retrieved from a single extinction spectrum. The retrieval scheme has been extensively characterized and has been found to provide refractive indices with a maximum uncertainty of approximately 10% (with a minimum of approximately 0.1%). Comparison of refractive indices calculated from measurements of a ternary solution of HNO3, H2SO4, and H2O with those published in J. Phys. Chem. A 104, 783 (2000) show similar differences as found by other authors.

Journal Article↗

PubMed1999

Automated face analysis by feature point tracking has high concurrent validity with manual FACS coding.

The face is a rich source of information about human behavior. Available methods for coding facial displays, however, are human-observer dependent, labor intensive, and difficult to standardize. To enable rigorous and efficient quantitative measurement of facial displays, we have developed an automated method of facial display analysis. In this report, we compare the results with this automated system with those of manual FACS (Facial Action Coding System, Ekman & Friesen, 1978a) coding. One hundred university students were videotaped while performing a series of facial displays. The image sequences were coded from videotape by certified FACS coders. Fifteen action units and action unit combinations that occurred a minimum of 25 times were selected for automated analysis. Facial features were automatically tracked in digitized image sequences using a hierarchical algorithm for estimating optical flow. The measurements were normalized for variation in position, orientation, and scale. The image sequences were randomly divided into a training set and a cross-validation set, and discriminant function analyses were conducted on the feature point measurements. In the training set, average agreement with manual FACS coding was 92% or higher for action units in the brow, eye, and mouth regions. In the cross-validation set, average agreement was 91%, 88%, and 81% for action units in the brow, eye, and mouth regions, respectively. Automated face analysis by feature point tracking demonstrated high concurrent validity with manual FACS coding.

Adolescent↗

PubMed1995

An inverse approach to determining myocardial material properties.

Passive myocardial material properties have been measured previously by subjecting test samples of myocardium to in vitro load-deformation analysis or, in the intact heart, by pressure-volume relationships. A new method for determining passive material properties, described in this paper, couples a p-version finite element model of the heart, a nonlinear optimization algorithm and a dense set of transmural measured strains that could be obtained in the intact heart by magnetic resonance imaging (MRI) radiofrequency tissue tagging. Unknown material parameters for a nonlinear, nonhomogeneous material law are determined by solving an inverse boundary value problem. An objective function relating the least-squares difference of model-predicted and measured strains is minimized with respect to the unknown material parameters using a novel optimization algorithm that utilizes forward finite element solutions to calculate derivatives of model-predicted strains with respect to the material parameters. Test cases incorporating several salient features of the inverse material identification problem for the heart are formulated to test the performance of the inverse algorithm in typical experimental conditions. Known true material parameters can be determined to within a small tolerance and random noise is shown not to affect the stability of the inverse solution appreciably. On the basis of these validation experiments, we conclude that the inverse material identification problem for the heart can be extended to solve for unknown material parameters that describe in vivo myocardial material behavior.

Algorithms↗

PubMed2003

Identifying physician-recognized depression from administrative data: consequences for quality measurement.

BACKGROUND: Multiple factors limit identification of patients with depression from administrative data. However, administrative data drives many quality measurement systems, including the Health Plan Employer Data and Information Set (HEDIS). METHODS: We investigated two algorithms for identification of physician-recognized depression. The study sample was drawn from primary care physician member panels of a large managed care organization. All members were continuously enrolled between January 1 and December 31, 1997. Algorithm 1 required at least two criteria in any combination: (1) an outpatient diagnosis of depression or (2) a pharmacy claim for an antidepressant Algorithm 2 included the same criteria as algorithm 1, but required a diagnosis of depression for all patients. With algorithm 1, we identified the medical records of a stratified, random subset of patients with and without depression (n = 465). We also identified patients of primary care physicians with a minimum of 10 depressed members by algorithm 1 (n = 32,819) and algorithm 2 (n = 6,837). RESULTS: The sensitivity, specificity, and positive predictive values were: Algorithm 1: 95 percent, 65 percent, 49 percent; Algorithm 2: 52 percent, 88 percent, 60 percent. Compared to algorithm 1, profiles from algorithm 2 revealed higher rates of follow-up visits (43 percent, 55 percent) and appropriate antidepressant dosage acutely (82 percent, 90 percent) and chronically (83 percent, 91 percent) (p < 0.05 for all). CONCLUSIONS: Both algorithms had high false positive rates. Denominator construction (algorithm 1 versus 2) contributed significantly to variability in measured quality. Our findings raise concern about interpreting depression quality reports based upon administrative data.

Algorithms↗

PubMed2001

Efficient noncausal noise reduction for deterministic time series.

We present a simple noncausal noise reduction algorithm for time series that consist of noisy measurements of the state vectors of a deterministic (chaotic) nonlinear system. The underlying dynamical system is assumed to be known and to operate in discrete time. The noise reduction algorithm is an iterative scheme for finding exact deterministic orbits close to the measured noisy orbits. Furthermore, we discuss cases where the solution is not the original orbit but homoclinic to it. (c) 2001 American Institute of Physics.

Journal Article↗

PubMed1998

Registration of MR/MR and MR/SPECT brain images by fast stochastic optimization of robust voxel similarity measures.

This paper describes a robust, fully automated algorithm to register intrasubject 3D single and multimodal images of the human brain. The proposed technique accounts for the major limitations of the existing voxel similarity-based methods: sensitivity of the registration to local minima of the similarity function and inability to cope with gross dissimilarities in the two images to be registered. Local minima are avoided by the implementation of a stochastic iterative optimization technique (fast simulated annealing). In addition, robust estimation is applied to reject outliers in case the images show significant differences (due to lesion evolution, incomplete acquisition, non-Gaussian noise, etc.). In order to evaluate the performance of this technique, 2D and 3D MR and SPECT human brain images were artificially rotated, translated, and corrupted by noise. A test object was acquired under different angles and positions for evaluating the accuracy of the registration. The approach has also been validated on real multiple sclerosis MR images of the same patient taken at different times. Furthermore, robust MR/SPECT image registration has permitted the representation of functional features for patients with partially complex seizures. The fast simulated annealing algorithm combined with robust estimation yields registration errors that are less than 1 degree in rotation and less than 1 voxel in translation (image dimensions of 128(3)). It compares favorably with other standard voxel similarity-based approaches.

Algorithms↗

PubMed2004

Assessment of the relative therapeutic effects of vaccines on virus load and immune responses in small groups at several time points: efficacy of mucosal and subcutaneous polypeptide vaccines in rhesus macaques exposed to SHIV.

BACKGROUND: Due to the high cost, subject availability and ethical constraints, it is often critically important in pre-clinical and clinical studies to carry out an adequate statistical analysis of longitudinal multivariate data over several time points in trials in several small groups. OBJECTIVES: We aim to accurately assess and develop an appropriate distribution-free longitudinal model for an estimate of the comparative treatment effects of several biological factors in several small groups even if data sets should contain outlier measurements and censored values. This approach is used to evaluate the relative efficacy of mucosal and subcutaneous polypeptide vaccines in rhesus macaques exposed to SHIV. STUDY DESIGN: The algorithms of the non-parametric repeated measures ANOVA models [Mack GA. A quick and easy distribution-free test for main effects in a two-factor ANOVA. Communic Stat Part B: Simp Comp 1981;10:571-91; Akritas MG, Brunner, E. A unified approach to rank tests for mixed models. J Stat Plan Inference 1997;61:249-77; Brunner E, Puri ML. Nonparametric methods in factorial designs. Stat Pap 2001;42:1-52.] are described, programmed and assessed. The viral loads, CD4(+) and CD8(+) cell counts were analyzed at several time points in peripheral blood of the 11 MamuA(*)01 positive macaques intrarectally challenged with pathogenic SHIV-Ku2 and immunized intrarectally with synthetic HIV/SIV peptide vaccine. RESULTS: Using nonparametric ANOVA tests, we demonstrated with statistical significance that after intrarectal challenge with pathogenic SHIV-Ku2, intrarectally immunized monkeys expressed viral titers that fell below the level of detection in blood and intestine (which is a major reservoir of viral replication), whereas the subcutaneously immunized or control macaques had residual viraemia. Moreover, the proliferative response of T cells and both CD4(+) and CD8(+) cells were better preserved in intrarectally immunized animals. Robustness of the comparisons was confirmed by gradual removal of up to 50% of data points. CONCLUSION: Despite limited data, our analysis shows better preservation of both CD4(+) and CD8(+) cells in intrarectally immunized animals. The result is consistent with our hypothesis that mucosal immunization is more effective than systemic immunization and that an induction of specific CTLs in the intestinal mucosa, a key site of virus replication, with a mucosal AIDS vaccine ameliorates SHIV infection in non-human primates. Our analytical methodology can be applicable in comparative estimates of the different treatment-associated effects and their synergy for a variety of longitudinal data sets in small treatment groups.

Animals↗

PubMed2001

Effective normalization of complexity measurements for epoch length and sampling frequency.

The algorithmic complexity of a symbol sequence is sensitive to the length of the message. Additionally, in those cases where the sequence is constructed by the symbolic reduction of an experimentally observed wave form, the corresponding value of algorithmic complexity is also sensitive to the sampling frequency. In this contribution, we present definitions of algorithmic redundancy that are sequence-sensitive generalizations of Shannon's original definition of information redundancy. In contrast with algorithmic complexity, we demonstrate that algorithmic redundancy is not sensitive to message length or to observation scale (sampling frequency) when stationary systems are examined.

Journal Article↗

PubMed2001

Implementation and refinement of the emergency severity index.

OBJECTIVES: To implement a new five-level emergency department (ED) triage algorithm, the Emergency Severity Index (ESI), into nursing practice, and validate the instrument with a population-based cohort using hospitalization and ED length of stay as outcome measures. METHODS: The five-level ESI algorithm was introduced to triage nurses at two university hospital EDs, and implemented into practice with reinforcement and change management strategies. Interrater reliability was assessed by a posttest and by a series of independent paired patient triage assignments, and a staff survey was performed. A cohort validation study of all adult patients registered during a one-month period immediately following implementation was performed. RESULTS: Eight thousand two hundred fifty-one ED patients were studied. Weighted kappa for reproducibility of triage assignments was 0.80 for the posttest (n = 62 nurses), and 0.73 for patient triages (n = 219). Hospitalization was 28% overall and was strongly associated with triage level, decreasing from 58/63 (92%) of patients in triage category 1, to 12/739 (2%) in triage category 5. Median lengths of stay were two hours shorter at either triage extreme (high and low acuity) than in intermediate categories. Outcomes followed a-priori predictions. Staff nurses rated the new program easier to use, and more useful as a triage instrument than previous three-level triage. They provided feedback, which resulted in significant revisions to the algorithm and educational materials. CONCLUSIONS: Triage nurses at these two hospitals successfully implemented the ESI algorithm and provided useful feedback for further refinement of the instrument. Emergency Severity Index triage reproducibly stratifies patients into five groups with distinct clinical outcomes.

Adolescent↗

PubMedDate not supplied

Performance evaluation of implantable artificial organs by sound spectrum analysis.

In this paper, a sound spectrum analyzing method was proposed to pre detect malfunctions of implantable artificial organs, such as an electromechanical total artificial heart (TAH) or prosthetic valves, without any percutaneous invasion. For this purpose, a sound detecting device was developed using a high sensitivity condenser microphone with a frequency range of more than 13 kHz. Output signals of this device are sampled at 100 kHz maximally, and sampled data are stored in an IBM PC (SamBo, Korea). To remove environmental noises in the measured sound, an adaptive least-mean square algorithm was employed. Using the squared value of the sound signal, the best position where only sounds from mechanical components can be measured was found. The sound spectrum was obtained by the periodogram spectral estimating method. Experiments were performed with this system, and the results indicated that: 1) by using an adaptive noise cancelling algorithm, a more noise-free signal can be obtained; 2) the harmonics from the mechanical components of a pendulum type electromechanical TAH were approximately 1.3 KHz; 3) a spectral change was observed when we compared the power spectral densities of a normal and failed TAH; 4) the spectral shift to higher harmonics occurred with an increase in heart rate; and 5) the sound propagation properties of tissue were investigated with animal experiments. The method proposed was found to be applicable in the detection of implantable artificial organ mechanical failure by sound spectrum analysis without the need for percutaneous invasion.

Acoustics↗

PubMed1988

Jitter correction: a computer algorithm for reduction of the velocity recovery function artifact.

The measurement of neuromuscular jitter in single fiber electromyography may be artifactually raised by a component of interdischarge interval (IDI)-dependent jitter caused by the velocity recovery function (VRF) in muscle fibers. We have developed a computer algorithm for on-line mathematical correction for this artifact, thus improving the reliability of neuromuscular jitter estimates. The method, based on a modeling technique, was validated using intramuscular stimulation in order to either exclude an IDI-dependent component (using regular stimulation) or to include an IDI-dependent component (using pseudorandom stimulation). In 10 normal subjects the distribution of 106 corrected jitter values obtained using voluntary activity showed no difference from the measured values. This finding implies that previously published values for normal jitter are not likely to have been influenced by the VRF effect.

Action Potentials↗

PubMed2005

Comparison of predictive accuracy for pathologically organ confined clinical stage T1c prostate cancer using human glandular kallikrein 2 and prostate specific antigen combined with clinical stage and Gleason grade.

PURPOSE: Previously human glandular kallikrein 2 (hK2) has been implicated to predict pathologically organ confined prostate cancer (PCa) in patients with stage T2 disease. Now we evaluated the usefulness of hK2, as measured by 2 entirely different immunoassay designs, to enhance the discrimination of pathologically organ from nonorgan confined clinical stage T1c PCa. MATERIALS AND METHODS: A consecutive series of pretreatment serum from 148 men with clinical stage T1c PCa was used in 2 equally sensitive and specific methods to measure total hK2 with independent reagents and entirely different assay designs. Total prostate specific antigen (tPSA) and free PSA (fPSA) were measured and percent fPSA was calculated. We determined the algorithm, hK2*tPSA/fPSA, from data generated by each hK2 assay, calculated means, medians and ranges for each analyte and algorithm, and calculated the significance of differences on univariate analysis. Using pretreatment PSA, clinical stage and biopsy Gleason grade we then developed a multivariate logistic regression base model to predict organ confined cancer and we compared predictions of the base model supplemented by the different hK2 measurements. RESULTS: hK2 and hK2 based algorithms obtained by each hK2 assay were significantly different for pT2a/b vs pT3a or greater PCa (p = 0.034 to 0.0001) compared to tPSA (p = 0.06), fPSA (p = 0.90) or percent fPSA (p = 0.059). However, AUC (0.67 to 0.70) calculated by ROC analysis of the 4 models containing hK2 derived information was not significantly larger than that of the base model (AUC = 0.64, p = 0.52). CONCLUSIONS: The current data confirm that hK2 alone or hK2*tPSA/fPSA measured by 2 immunoassays is significantly lower in men with pT2a/b vs pT3a or greater PCa compared to tPSA, fPSA or percent fPSA on univariate analysis of a validation set of clinical stage T1c prostate cancer treated at an American center of excellence for prostate cancer surgery. However, the incorporation of preoperative hK2 into multiparameter predictive models for pT2 cancers did not increase predictive accuracy in this cohort of men.

Adult↗

PubMed1992

A new algorithm for the identification of multiple input Wiener systems.

Multiple-input Wiener systems consist of two or more linear dynamic elements, whose outputs are transformed by a multiple-input static non-linearity. Korenberg (1985) demonstrated that the linear elements of these systems can be estimated using either a first order input-output cross-covariance or a slice of the second, or higher, order input-output cross-covariance function. Korenberg's work used a multiple input LNL structure, in which the output of the static nonlinearity was then filtered by a linear dynamic system. In this paper we show that by restricting our study to the slightly simpler Wiener structure, it is possible to improve the linear subsystem estimates obtained from the measured cross-covariance functions. Three algorithms, which taken together can identify any multiple-input Wiener system, have been developed. We present the theory underlying these algorithms and detail their implementation. Simulation results are then presented which demonstrate that the algorithms are robust in the presence of output noise, and provide good estimates of the system dynamics under a wide set of conditions.

Algorithms↗

PubMed1994

EIT image reconstruction using sensitivity weighted filtered backprojection.

A set of specifications thought useful to advance the utility of electrical impedance tomography as a clinical imaging modality is proposed, together with an approach to image reconstruction designed to fulfil these specifications. Computer simulations are used to investigate the performance of this reconstruction approach on simple, known, impedance distributions and to develop the method to the stage of a complete reconstruction algorithm. The algorithm is then tested on data sets produced by measurements on a physical phantom, and on a set of measurements made on a volunteer human subject.

Algorithms↗

PubMed1990

Real-time tracking of parameters of lung mechanics: emphasis on algorithm tuning.

We consider the problem of tracking rapid changes in the viscous and elastic properties of the respiratory system by using mouth flow and transpulmonary pressure data measured during mechanical ventilation. A recursive least-squares algorithm with adjustable compensator is used for online estimation of an R-C model of the breathing mechanics. Specific simulation experiments are presented to provide guidelines to select suitable values for the key variable, which controls the compromise between tracking ability and noise sensitivity. The results obtained confirm the critical role of the optimum tuning in relation to the noise level. Experimental results obtained from data measured on mechanically-ventilated dogs, in which respiratory distress syndrome was intravenously induced by oleic acid, demonstrate that the tuned algorithm is able to track appropriately both the viscous and elastic properties of lung mechanics. Parameter estimates are consistent with those obtained by standard and robust offline algorithms and their time course is in qualitative agreement with known physiopathological behaviour.

Airway Resistance↗

PubMed1993

A fast spot segmentation algorithm for two-dimensional gel electrophoresis analysis.

An important issue in the automation of two-dimensional gel electrophoresis image analysis is the detection and quantification of protein spots. A spot segmentation algorithm must detect, define the extent of, and measure the integrated density of spots under a wide variety of actual gel image conditions. Besides these functions, the algorithm must be memory efficient to be able to process very large gel images and do this in a reasonable amount of computation time on low-cost computers, such as workstations and personal computers. We have developed a fast spot segmentation algorithm, extending the GELLAB-II segmenter, which extracts spots in a single raster scanning pass through the gel image. The performance analysis of the algorithm will be given in the paper as well as a discussion of the algorithm.

Algorithms↗