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Evaluation of right ventricular function by NuSMUGA software: gated blood-pool SPECT vs. first-pass radionuclide angiography.

BACKGROUND: In comparison with planar imaging gated blood-pool single photon emission computed tomography (GBPS) has the advantage of separating left and right ventricle. The purpose of this investigation was to evaluate the right ventricular ejection fraction (RVEF) calculations by GBPS software ('NuSMUGA', Northwestern University, Chicago, IL) in comparison to first-pass radionuclide angiography (FPRNA). METHODS: In 22 consecutive patients FPRNA and GBPS acquisition was performed. GBPS RVEF calculations were manually and automatically performed, using all gated short-axis-slices of the right ventricle. RESULTS: Automatic RVEF assessed by GBPS did not correlate with conventional FPRNA (r = 0.40, p = 0.065). Mean FPRNA RVEF was 55 +/- 10% and mean GBPS automatic RVEF was 32 +/- 8%. Also manual GBPS RVEF did not correlate with conventional FPRNA (r = 0.41, p = 0.055). Mean RVEF measurement by manual GBPS was 33 +/- 8%. Manual GBPS RVEF values correlated well with automatically determined GBPS RVEF values (r = 0.96, p < 0.0001). CONCLUSION: Automatic and manual values RVEF values assessed by GBPS did not correlate with conventional FPRNA values. FPRNA and GBPS calculations cannot be considered to be equivalent. Therefore the NuSMUGA program cannot be used to calculate RVEF.

Adult↗

Comparison between segmental wall motion and wall thickening in patients with coronary artery disease using quantitative gated SPECT software.

This study was performed to evaluate regional wall motion (WM) and wall thickening (WT) using gated myocardial perfusion single photon emission computed tomography (SPECT) and to determine their similarity and disparity in patients with coronary artery disease (CAD). A total of 44 patients underwent 1 day stress/rest (MIBI) gated SPECT. Commercially available quantitative analysis of gated SPECT (QGS) software was used to generate 3D surface display and cine-mode SPECT display. Left ventricle was divided into nine segments to score WM and WT from 0 (no abnormality) to 4 (severe abnormality) by six independent observers. Finally a mean score was calculated for each segment from the scores of six observers. There was fairly good correlation between WM and WT of individual segments (r = 0.62, p < 0.0001). Concordance rate (IWM - WTI < 1) was 85%. A large difference between WM and WT (WM - WT > or = 2) was observed in 15 segments, including 12 segments with greater WM abnormalities and 3 segments with greater WT abnormalities (lateral and inferior walls). Greater WM abnormalities were most commonly observed in anteroseptal segments especially in post coronary artery bypass grafting (CABG) patients. In conclusion, WM and WT showed similarity on QGS studies. However, these two parameters may be determined separately in gated SPECT studies for comprehensive and robust evaluation of the functional status of myocardium. Analyses based on WM assessment alone may lead to erroneous results especially in septal regions.

Aged↗

TMA-Combiner, a simple software tool to permit analysis of replicate cores on tissue microarrays.

We have previously published a suite of software tools that facilitates the reformulation of tissue microarray (TMA) data so that it may be analyzed using techniques originally devised for analysis of cDNA microarray data. However, current microarray data often feature multiple scores for a given tissue sample and antibody combination. Furthermore, an efficient and systematic method for combining scores that takes into account the differing staining properties of tissue epitopes has not been described. We thus present the TMA-Combiner, a new Microsoft Excel-based macro that permits analysis of data for which tissues may have two or more scores per antibody, and permits combination of data from multiple different tissue microarrays. It accomplishes this by rendering one score per tissue per antibody from two or more scores, using one of multiple user-selectable combination rules developed to account for the differing staining properties of tissue epitopes. This greatly facilitates analysis of tissue microarrays, particularly for users with large repositories of data, and may facilitate discovery of biological trends and help refine diagnostic accuracy of tissue markers in clinical samples.

Cluster Analysis↗

Automated identification of SUMOylation sites using mass spectrometry and SUMmOn pattern recognition software.

Tandem mass spectrometry (MS/MS) allows for the rapid identification of many types of post-translational modifications (PTMs), especially those that can be detected by a diagnostic mass shift in one or more peptide fragment ions (for example, phosphorylation). But some PTMs (for example, SUMOs and other ubiquitin-like modifiers) themselves produce multiple fragment ions; combined with fragments from the modified target peptide, a complex overlapping fragmentation pattern is thus generated, which is uninterpretable by standard peptide sequencing software. Here we introduce SUMmOn, an automated pattern recognition tool that detects diagnostic PTM fragment ion series within complex MS/MS spectra, to identify modified peptides and modification sites within these peptides. Using SUMmOn, we demonstrate for the first time that human SUMO-1 multimerizes in vitro primarily via three N-terminal lysines, Lys7, Lys16 and Lys17. Notably, our method is theoretically applicable to any type of modification or chemical moiety generating a unique fragment ion pattern.

Algorithms↗

SHEsis, a powerful software platform for analyses of linkage disequilibrium, haplotype construction, and genetic association at polymorphism loci.

In multiloci-based genetic association studies of complex diseases, a powerful and high efficient tool for analyses of linkage disequilibrium (LD) between markers, haplotype distributions and many chi-square/p values with a large number of samples has been sought for long. In order to achieve the goal of obtaining meaningful results directly from raw data, we developed a robust and user-friendly software platform with a series of tools for analysis in association study with high efficiency. The platform has been well evaluated by several sets of real data.

Genetic Predisposition to Disease↗

Automated developmental sentence scoring using computerized profiling software.

This study examined the accuracy of fully automated Developmental Sentence Scoring (DSS; L. L. Lee, 1974) analysis performed by the Computerized Profiling (CP) software (S. H. Long, M. E. Fey, and R. W. Channell, 2000). Samples from 48 school-age children (28 with language impairment) yielded 9,084 utterances that were DSS coded both manually and by CP. The point-by-point agreement of CP with manual coding was 78%, with per-category levels of agreement ranging from 0% to 98%. Agreement levels were about 2% lower on samples from children with language impairment. Though significantly higher, the scores computed by CP were highly correlated (r =.97) with the manually computed scores. Further work on improving the accuracy of automated DSS analysis is warranted.

Child↗

Downloading from MEDLINE: a comparison of personal database software.

The compatibility of downloaded MEDLINE references with software packages designed for maintenance of personal bibliographic databases is considered. The nine packages reviewed enable one to import batches of records downloaded from one or more presentations of the MEDLINE database, online or CD-ROM; and enable the user to re-format records into the various styles required by journal editors. Some basic features of the packages are tabulated, and details of record-importing facilities are described. Details of suppliers and prices are given.

Catalogs, Commercial as Topic↗

Novel software for analysis of root gravitropism: comparative response patterns of Arabidopsis wild-type and axr1 seedlings.

In an earlier study (Evans, Ishikawa & Estelle 1994, Planta 194, 215-222) we used a video digitizer system to compare the kinetics of auxin action on root elongation in wild-type seedlings and seedlings of auxin response mutants of Arabidopsis thaliana (L.) Heynh. We have since modified the system software to allow determination of elongation on opposite sides of vertical or gravistimulated roots and to allow continuous measurement of the angle of orientation of sequential subsections of the root during the response. We used this technology to compare the patterns of differential growth that generate curvature in roots of the Columbia ecotype and in the mutants axr1-3, axr1-12 and axr2, which show reduced gravitropic responsiveness and reduced sensitivity to inhibition by auxin. The pattern of differential growth during gravitropism differed in roots of wild-type and axr1 seedlings. In wild-type roots, initial curvature resulted from differential inhibition of elongation in the distal elongation zone (DEZ). This was followed by an acceleration of elongation along the top side of the DEZ. In roots of axr1-3, curvature resulted from differential stimulation of elongation whereas in roots of axr1-12 the response was variable. Roots of axr2 did not exhibit gravitropic curvature. The observation that the pattern of differential growth causing curvature is dramatically altered by a change in sensitivity to auxin is consistent with the classical Cholodny-Went theory of gravitropism which maintains that differential growth patterns induced by gravistimulation are mediated primarily by gravi-induced shifts in auxin distribution. The new technology introduced with this report allows automated determination of stimulus response patterns in the small but experimentally popular roots of Arabidopsis.

Arabidopsis↗

Neuroretinal rim measurement error using PC-based stereo software.

The neuroretinal rims of a set of glaucoma patients were measured using digitized stereo photographs, to determine the reproducibility of computerized stereo measurements of the neuroretinal rim. Each rim was measured five times at 18 locations, with measurement error (ME) defined as the mean of standard deviations of each set of measurements. The following ME were determined: (i) inter-sessional variability (n = 27 right and 24 left eyes, at t1 and t2); (ii) inter-assessor variability (n = 9, 2 assessors); and (iii) variability after colour adjustment algorithms were applied (n = 15). The results were as follows: (i) inter-sessional variability was 3.41+/-1.08 for t1 and 3.22+/-0.84 for t2; (ii) there was a significant difference between the two assessors, although the ME was still low; and (iii) there was no significant differences between the ME of unadjusted and adjusted images. With a measurement error of up to 11% of rim width, these results show that lowcost rim measurements can be made using PC-based software.

Algorithms↗

Software reuse reference model approach in developing an automated medical information system (AMIS) for improving health care practice.

OBJECTIVE: To evaluate patient acceptance of an automated medical information system specific to headache. BACKGROUND: Studies suggest that automated tools may help health care delivery systems to be efficient and effective, but patient satisfaction remains a major concern. METHODS: We adapted our software reuse reference model and Unified Modeling Language to apply the domain model to the headache population. Patients with headache were tested both to validate the system and to evaluate patient satisfaction and headache management with an automated system. RESULTS: The mean age of all study participants was 44 years. Over 95% of the participants were satisfied or strongly satisfied with the Automated Medical Information System. CONCLUSIONS: The results strongly suggest that patients are willing and able to use nontraditional sources, such as the Automated Medical Information System, to learn about their illnesses.

Adult↗

Desktop and mobile software development for surgical practice.

PURPOSE: The aim of this study was to develop a mobile software solution that will merge patient data with a centralized patient database, aid surgical decision making, and document clinical services. METHODS: iIncise is a computerized, menu-driven database that was developed for real-time entry of historical, clinical, and laboratory data. Within the process, examination data, testing rationale, and test results are captured. AAST staging criteria are presented during data entry to describe and classify organ injuries accurately. A legible, time-stamped, conclusive report can be generated for printed or electronic entry into the medical record. The handheld version of the database runs on a Compaq iPAQ Pocket PC in either stand-alone mode or via LAN or WAN through the Internet. Microsoft Information Internet Server 5.0 provides data transaction services to Microsoft SQL Server 2000 to merge multiuser replicate data between the back ends stored on the desktop and handheld devices. RESULTS: The printed report provides superior documentation for comprehensive evaluation and management services, including history and physical examination, documentation of medical decision making, appropriateness of diagnostic/or therapeutic services, and coordination of care in accordance with Health Care Financing Administration (HCFA) regulations. CONCLUSIONS: Rapid data entry, ease of use, and appropriate documentation of detailed and legible patient visits and procedural notes are early benefits. Wireless data transmission between handheld devices and the desktop database provides the required speed, flexibility, and multitasking environment necessary for the mobile surgeon.

Centers for Medicare and Medicaid Services, U.S.↗

Software development, nomenclature schemes, and mapping strategies for an international pediatric cardiac surgery database system.

The field of congenital heart surgery has the opportunity to create the first comprehensive international database for a medical subspecialty. An understanding of the demographics of congenital heart disease and the rapid growth of computer technology leads to the realization that creating a comprehensive international database for pediatric cardiac surgery represents an important and achievable goal. The evolution of computer-based data analysis creates an opportunity to develop software to manage an international congenital heart surgery database and eventually become an electronic medical record. The same database data set for congenital heart surgery is now being used in Europe and North America. Additional work is under way to involve Africa, Asia, Australia, and South America. The almost simultaneous publication of the European Association for Cardio-thoracic Surgery/Society of Thoracic Surgeons coding system and the Association for European Paediatric Cardiology coding system resulted in the potential for multiple coding. Representatives of the Association for European Paediatric Cardiology, Society of Thoracic Surgeons, European Association for Cardio-thoracic Surgery, and European Congenital Heart Surgeons Foundation agree that these hierarchical systems are complementary and not competitive. An international committee will map the two systems. The ideal coding system will permit a diagnosis or procedure to be coded only one time with mapping allowing this code to be used for patient care, billing, practice management, teaching, research, and reporting to governmental agencies. The benefits of international data gathering and sharing are global, with the long-term goal of the continued upgrade in the quality of congenital heart surgery worldwide.

Cardiac Surgical Procedures↗

Precision of EBRA-Digital software for monitoring implant migration after total hip arthroplasty.

We assessed the precision of the EBRA-Digital software (EBRA, University of Innsbruck, Innsbruck, Austria) for measuring implant migration after total hip arthroplasty. Study subjects (n = 29) underwent consecutive, standardized, plain radiographic examinations of the hip on the same day after repositioning. The resulting radiograph pairs were digitized and analyzed using EBRA. The precision (95% confidence interval) of the method for measuring migration and wear was <+/-0.9 mm for both implant components. The 95% confidence intervals for measurement of cup inclination and anteversion and femoral stem/shaft angle were <+/-1.7 degrees. Measurement precision was not strongly related to patient gender, digitization method, or observer. The EBRA-Digital method has sufficient precision to detect clinically relevant migration to allow individual patient monitoring after total hip arthroplasty. The method requires careful patient positioning and radiographic technique to produce consistently images suitable for analysis.

Arthroplasty, Replacement, Hip↗

A software-based pacemaker pulse detection and paced rhythm classification algorithm.

A new pacemaker pulse detection and paced electrocardiogram (ECG) rhythm classification algorithm with high sensitivity and positive predictive value has been implemented as part of the Philips Medical Systems' (Andover, MA) ECG analysis program. The detection algorithm was developed on 1,108 paced ECGs with 16,029 individual pulse locations. It operates on 12-lead, 500 sample per second, 150 Hz low-pass filtered ECG signals. Even after low-pass filtering, this algorithm distinguishes between pacemaker pulses and narrow QRS complexes from newborns. An individual pulse detection sensitivity of 99.7% and positive predictive value of 99.5% was obtained by the multi-lead detector. A 10-second, 12-lead ECG database (n = 13,155) of paced (n = 2,190), non-paced adult (n = 8,070), non-paced pediatric (n = 1,209) and "noisy" ECGs with spike noise and muscle artifact (n = 1,686) was assembled and annotated by two readers. The overall performance in identification of an ECG as paced with any pacing present versus non-paced is 97.2% in sensitivity and 99.9% in specificity. The paced ECGs were classified by the mode in which the beats were paced, such as, atrial, ventricular, A-V dual, or dual/inhibited chamber (ie, combinations of atrial, ventricular and dual) pacing. An algorithm was developed for paced rhythm classification. The algorithm performance results show that accurate and robust pacemaker pulse detection and classification can be done in software on diagnostic bandwidth ECG signals.

Adult↗

[Tuebingen Education System (TES)--An interactive case demonstration software].

BACKGROUND: Presentations based on slides, videos and/or computer presentations are usually sequentially structured, resulting in an inflexible order of the demonstrated information and examination results. However, in (medical) education such a system only inadequately reflects the real physician-patient situation. MATERIALS AND METHODS: The software solution presented here is based on the widespread computer programme Microsoft PowerPoint(R) (PPT) which offers an opportunity to present information via text boxes, figures, illustrations, video sequences and/or audio files in an user-friendly way. However, PPT's capabilities of simulating realistic decision processes (e. g. by "interactive keys" and "hyperlinks") are still restricted as far as adapting the order of the information/slides to the individual demand is concerned. The Tuebingen Education System (TES) uses an additional user interface based on Visual Basic. By means of this, every examination result or information can be chosen via five additional pull-up menus in an arbitrary order. Furthermore, the pathway - i. e. the examinations used to arrive at a diagnosis - as well as the costs incurred are documented in parallel and are finally compared to the costs incurred using an optimum pathway. RESULTS: TES has been used routinely in the education of the students and residents of the University Eye Hospital Tuebingen for three (half-)terms. Meanwhile, an adapted version of TES is used to educate students in the department of paediatric surgery. TES was judged in extensive evaluations of both subjects very positively. CONCLUSIONS: TES is an easy to use tool suitable for lecturers and students, a further step towards realistic, practice-oriented and interactive education.

Computer-Assisted Instruction↗

The electronic assessment of the longitudinal course of bipolar disorder: the ChronoRecord software.

Longitudinal studies are the optimal approach when investigating the highly variable course of bipolar disorder, but such studies are expensive, prone to reporting errors and to missing data. Automation of data collection may reduce such errors and improve data quality. The ChronoRecord, validated software that patients can install on a home computer to report mood, medications, sleep, life events, weight and menstrual data, has been designed to achieve such automation. In the trial of the ChronoRecord reported here, 80 of 96 (83 %) patients with bipolar disorder showed high acceptance of this computer-based system for self-report, entering daily recordings for a period of 3-months. This new technology, in addition to providing an accurate longitudinal record for research purposes, also facilitates on-going patient feedback and accurate study monitoring.

Adult↗

[Assessment of global and regional left ventricular function with a 16-slice spiral-CT using two different software tools for quantitative functional analysis and qualitative evaluation of wall motion changes in comparison with magnetic resonance imaging].

PURPOSE: To determine global and regional left ventricular (LV) function from retrospectively gated multidetector row computed tomography (CT) by using two different semiautomated analysis tools and to correlate the results with those of magnetic resonance imaging (MRI). MATERIALS AND METHODS: Nineteen patients (5 females, 14 males, mean age 69 years) underwent 16-slice spiral-CT (MS-CT) with standard technique without administration of beta-blockers for a decrease in the cardiac rate. Ten series of images were reconstructed at every 10 % of the RR-interval. With commercially available software capable of semiautomated contour detection, end-diastolic and end-systolic LV volumes (EDV and ESV) were determined from short-axis multiplanar CT reformations (MPR). Axial images of the end-systolic and end-diastolic cardiac phase were transformed to 3D volumes (3D) to determine EDV and ESV by using a threshold-supported reconstruction algorithm dependent on the contrast enhancement of the left ventricle. Steady-state free-precession cine MR images were acquired in short-axis orientation on the same day in all but one patient. Regional wall motion was assessed qualitatively in 17 left ventricular segments and classified as normo-, hypo-, a- or dyskinetic. Bland-Altman analysis was performed to calculate limits of agreement and systematic errors between CT and MRI. RESULTS: For MPR/3D, mean end-diastolic (144.4/142.8 mL +/- 67.5/67.1) and end-systolic (66.4/68.7 mL +/- 52.1/49.9) LV volumes as determined with MS-CT correlated well with MRI measurements (147.6 mL +/- 67.6 [ r = 0.98/0.96] and 73.3 mL +/- 55.5 [ r = 0.98/0.98], respectively [ p <.001]). LV stroke volume (77.6/74.1 +/- 19.2/23.4 mL for CT vs. 74.4 mL +/- 18.4 for MRI, r = 0.92/0.74) and LV ejection fraction (58.6/55.9 % +/- 13.5/13.7 for CT vs. 55.6 % +/- 13.5 for MRI, r = 0.95/0.91) also showed good correlation (p <.001). Regional wall motion analysis revealed agreement between CT and MRI in 316/323 (97.8 %) myocardial segments. CONCLUSION: Semiautomated analysis of 16-detector row CT data sets enables global and regional volumetric and functional analysis. The CT results correlate well with MRI findings for short axis MPR and for 3D volume reconstructions, with a higher statistical spread for the 3D method. The underestimation of end-systolic and end-diastolic volumes with CT may be caused by partial volume averaging due to the lower temporal resolution as compared with MRI.

Aged↗

[Analysis of Foetal Heart Rate Data using Complex Software: Comparison of Recurrence Plot of Foetal Heart Rate with the Course of Pregnancy -].

BACKGROUND: Is it useful to further analyse foetal heart rate to improve the prediction of pregnancy complications? The analysis of the foetal heart rate is usually based on the variability of the heart rate, i. e. the more variable the heart rate presents - except a decrease - the better the condition of the foetus is. The same concept is applied in our own analysis which differs only in the presentation of the data. MATERIAL AND METHODS: We analysed 25 non-stress-tests from unselected third trimester pregnancies using sophisticated software. The recurrence plot (RP) is able to rearrange data from foetal heart rate monitoring in order to make the heart rate variability visible. We developed criteria for a normal and an abnormal test result describing the structure of the diagram to predict an uneventful and a high-risk pregnancy, respectively. RESULTS: 11 out of 11 patients with uneventful course and outcome of pregnancy showed a coarse and blurred RP pattern. 12 out of 14 (86 %) patients developing either intrauterine growth retardation or preeclampsia and requiring caesarean section because of foetal heart rate abnormalities showed a fine and clear RP pattern. CONCLUSIONS: Our preliminary results show that it makes sense to further evaluate foetal heart rate variability in order to predict pregnancy complications. Computer programs including the algorithms needed (calculation of the recurrence plot) are not expensive and easy to handle. A widespread use of these programs represents the basis requirement for large controlled clinical trials.

Analysis of Variance↗