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GOFCOX: a computer program for the goodness-of-fit analysis of the Cox proportional hazards model.

GOFCOX is a user-friendly FORTRAN program for assessing the adequacy of the Cox proportional hazards model. The underlying methodology is based on the comparison of the maximum partial likelihood estimator and a weighted parameter estimator. The latter is the root to an estimation equation that assigns varying weights to the individual contributions to the partial likelihood score function. The weighted and unweighted parameter estimators have the same expectation under the Cox model, but tend to differ when the model is inappropriate. The GOFCOX program computes a rich class of weighted parameter estimators and corresponding goodness-of-fit test statistics. The program runs on both mainframe computers and microcomputers. The running time is minimal even for large data sets. A simple example is provided to illustrate the features of the program.

Computers, Mainframe

Evaluation of mammographic calcifications using a computer program.

A computer pattern recognition program was developed to evaluate calcifications seen on mammograms. When the approximate horizontal length, average internal gray level, and contrast were used as criteria, 84.3% of the lesions studied were correctly identified as malignant or benign. These results show that a computer program can help evaluate calcifications of the breast.

Breast Neoplasms

The diagnostic performance of computer programs for the interpretation of electrocardiograms.

BACKGROUND: Computer programs for the interpretation of electrocardiograms (ECGs) are now widely used. However, a systematic assessment of various computer programs for the interpretation of ECGs has not been performed. METHODS: We undertook a large international study to compare the performance of nine electrocardiographic computer programs with that of eight cardiologists in interpreting ECGs in 1220 clinically validated cases of various cardiac disorders. ECGs from the following groups were included in the sample: control patients (n = 382); patients with left ventricular hypertrophy (n = 183), right ventricular hypertrophy (n = 55), or biventricular hypertrophy (n = 53); patients with anterior myocardial infarction (n = 170), inferior myocardial infarction (n = 273), or combined myocardial infarction (n = 73); and patients with combined infarction and hypertrophy (n = 31). The interpretations of the computer programs and the cardiologists were compared with the clinical diagnoses made independently of the ECGs, and the computer interpretations were compared with those of the cardiologists. RESULTS: The percentage of ECGs correctly classified by the computer programs (median, 91.3 percent) was lower than that of the cardiologists (median, 96.0 percent; P less than 0.01). The median sensitivity of the computer programs was also significantly lower than that of the cardiologists in diagnosing left ventricular hypertrophy (56.6 percent vs. 63.9 percent, P less than 0.02), right ventricular hypertrophy (31.8 percent vs. 46.6 percent, P less than 0.01), anterior myocardial infarction (77.1 percent vs. 84.9 percent, P less than 0.001), and inferior myocardial infarction (58.8 percent vs. 71.7 percent, P less than 0.0001). The median total accuracy level (the percentage of correct classifications) was 6.6 percent lower for the computer programs (69.7 percent) than for the cardiologists (76.3 percent; P less than 0.001). However, the performance of the best programs nearly matched that of the most accurate cardiologists. CONCLUSIONS: Our study shows that some but not all computer programs for the interpretation of ECGs perform almost as well as cardiologists in identifying seven major cardiac disorders.

Cardiology

Statistical comparison of power spectra: a computer program.

A general computer program, of interest to neurobiologists, for comparison of uncorrelated power spectra is presented. The program, ALPHAF, is written in Fortran V language and is easily compiled and executed in any computer with a Fortran software package. The purpose of the program is to read power spectral density (PSD) values into a computer from digital tape and then perform the following functions: (1) compute and report power; (2) compute and report averages of the computed power values over selected frequency bands and (3) compute and report statistical standardised normal distributions for a frequency spectrum of interest. The standardised normal distribution statistic is derived by using equation 7.20, page 250 of Random data: Analysis and measurement procedures (Bendat and Piersol, 1971).

Computers

Clinical application of a second generation electrocardiographic computer program.

An electrocardiographic computer program based on multivariate analysis of orthogonal leads (Frank) was applied to records transmitted daily by telephone from the Veterans Administration Hospital, West Roxbury, Mass., to the Veterans Administration Hospital, Washington, D. C. A Bayesian classification procedure was used to compute probabilities for all diagnostic categories that might be encountered in a given record. Computer results were compared with interpretations of conventional 12 lead tracings. Of 1,663 records transmitted, 1,192 were selected for the study because the clinical diagnosis in these cases could be firmly established on the basis of independent, nonelectrocardiographic information. Twenty-one percent of the records were obtained from patients without evidence of cardiac disease and 79 percent from patients with various cardiovascular illnesses. Diagnostic electrocardiographic classifications were considered correct when in agreement with documented clinical diagnoses. Of the total sample of 1,192 recordings, 86 percent were classified correctly by computer as compared with 68 percent by conventional 12 lead electrocardiographic analysis. Improvement in diagnostic recognition by computer was most striking in patients with hypertensive cardiovascular disease or chronic obstructive lung disease. The multivariate classification scheme functioned most efficiently when a problem-oriented approach to diagnosis was simulated. This was accomplished by a simple method of adjusting prior probabilities according to the diagnostic problem under consideration.

Analysis of Variance

Clinical placements by computer program.

A computer allocation and recording system was developed and implemented to permit an integrated, sequesntial and, to some extent, individually tailored clinical experience for occupational therapy students. Necessary technical information is described for those who may wish to adapt the program to their needs. A difficult administrative task was solved by a machine well known for its speed and accuracy, extensive memory, and copy-typing capabilities.

Clinical Competence

A computer program for long term anticoagulation control.

A computer program is described which calculates suggested daily anticoagulant dose schedules for long term patients. This program is a part of the real-time Information System for Thrombosis Centres. The program requires only the most recent information on the patient from the Information System's data base. This information consists of the latest two measured coagulation times, the previous dose schedule, the target and limiting values set by the physician to the coagulation time, and a very limited number of parameters accounting for the patient's anticoagulation history. A simple dose-response model is used to simulate and predict a coagulation time. By comparing this prediction with the measured coagulation time the program computes the necessary adjustment in the average dose and the appointment period. It gives remarks, if necessary. The Information System is used successfully for the majority of patients of Leiden Thrombosis Centre, where it operates as a part of a real-time Hospital Information System.

Anticoagulants

A computer program for calculation and interpretation of pulmonary function studies.

A computer program to calculate and interpret the standard pulmonary function tests has been developed on a programmable calculator system. The program computes both predicted and measured values for static and dynamic lung volumes, airways resistance and diffusing capacity. It then checks for differences between predicted and obtained values and interprets them according to a specific, clinically useful set of diagnostic criteria. By acquisition of a reliable and easy-to-use data processing system, a pulmonary function laboratory can significantly increase the efficiency and accuracy of its day-to-day work.

Computers

Computer-assisted differential diagnosis of laboratory abnormalities and follow-up testing. Evaluation of the accuracy of a computer program.

An evaluation is made of a computer program which generates a differential diagnostic list given a set of input data obtained from an admission chemistry screening profile. The program is tested by supplying input data on patients for whom diseases are known. The laboratory data from 367 patients are examined. Accurate computer diagnosis is obtained in many disease categories. The original computer program is modified to suggest the follow-up tests indicated based on the diagnoses it makes. By using this program and some additional clinical input from the physician, the clinical pathologist can select the most appropriate computer diagnosis and begin the follow-up testing. Accelerated diagnosis and patient care should result.

Aged

A strategy of DNA sequencing employing computer programs.

With modern fast sequencing techniques and suitable computer programs it is now possible to sequence whole genomes without the need of restriction maps. This paper describes computer programs that can be used to order both sequence gel readings and clones. A method of coding for uncertainties in gel readings is described. These programs are available on request.

Base Sequence

MODFIT: a pharmacokinetics computer program.

This paper presents a computer program, MODFIT, written in FORTRAN, primarily for use on the Digital Equipment Company VAX series computers for the mathematical analysis of concentration-time data. Drug data generated from biological fluids and tissues may be fitted by a variety of different models. For many models, parameter starting estimates are program generated prior to automatic nonlinear regression analysis using a modified Davidon-Fletcher-Powell algorithm. The output of results is extensive and plotting facilities are available. Explicit and differential equation models may be fitted to single dose data and simulations using all models (single or repeat dose) may be employed to generate drug concentration-time data with plotting output. The package has been tested on numerous data with no problems regarding local function minima. Some comparisons with existing programs have been made and MODFIT compares well with respect to robustness, efficiency, and ease of use.

Algorithms

Radioimmunoassay data handling and calculations with a graphics-statistics computer program.

This paper discusses the application of the data handling-graphics-statistics program Stata (Computing Resources Center, Santa Monica, CA) to radioimmunoassay. We have found that this program is more powerful and easier to use than a spreadsheet for analyzing various kinds of laboratory data generated from chromatography, radiolabeling experiments, enzyme-linked immunosorbent assays, and radioimmunoassays, to name several examples. Data from a radioimmunoassay procedure, originally analyzed using a spreadsheet, Lotus 1-2-3, have been processed with Stata. Simple programs (batch files) have been devised for computations and graphics. The original data and a comparison of results are presented.

Radioimmunoassay

A comparative study to evaluate three separate computer programs for electrocardiographic interpretation.

To compare the efficiency and accuracy of three separate computer programs for interpreting electrocardiograms, 50 EKGs run on patients hospitalized in our institution were transmitted to each of the three participating computer programs. The EKGs were then inspected individually by three cardiologists who later correlated and compared their results with the interpretations provided by the computer. The computer program used by Telemed Corporation provided the greatest frequency of totally correct and clinically acceptable interpretations as well as the least number of unacceptable or incorrect interpretations. The Bonner program was an acceptable second. The Mayo-Smith program had a much larger number of disagreements with the clinical cardiologists, and was far less acceptable for clinical use in their opinion.

Diagnosis, Computer-Assisted

Developing a computer program to assist the nursing process: phase I-from systems analysis to an expandable program.

In a three-stage project, a computer program was devised to assist in the nursing process. As Stage I, a definition of nursing was developed upon which a systems model of the nursing process was constructed. In Stage II, the computer program was written to collect patient data and formulate nursing diagnoses related to functions of the skin, mucous membranes, nails, and hair. The program was designed to serve as a model for the development of a more comprehensive program that would include other functional areas, suggest patient objectives and nurse interventions, and help to evaluate nursing care. In Stage III, initial trials were conducted to obtain feedback from nurses. Nurses found the program took too long but agreed that with modification it could help them give better care.

Computers

Repeated plasma volume determination with the Evans Blue dye dilution technique: the method and a computer program.

This paper describes a reliable multiple sample Evans Blue dye dilution technique and a Pascal program which computes plasma and blood volume on the basis of this technique. The program performs needed corrections and dye disappearance curve fitting. It provides menu-driven facilities for data correction, graphic display of the dye disappearance curve, and print-out of all the involved data. Means +/- S.E.M. for three plasma volume determinations in each of six resting subjects were: 3239 +/- 96 ml, 3189 +/- 81 ml, and 3187 +/- 102 ml. The differences were not statistically significant.

Blood Volume