Indication-Based Ordering: A New Paradigm for Glycemic Control in Hospitalized Inpatients

PubMed Central

Lee, Joshua; Clay, Brian; Zelazny, Ziband; Maynard, Gregory

2008-01-01

Background Inpatient glycemic control is a constant challenge. Institutional insulin management protocols and structured order sets are commonly advocated but poorly studied. Effective and validated methods to integrate algorithmic protocol guidance into the insulin ordering process are needed. Methods We introduced a basic structured set of computerized insulin orders (Version 1), and later introduced a paper insulin management protocol, to assist users with the order set. Metrics were devised to assess the impact of the protocol on insulin use, glycemic control, and hypoglycemia using pharmacy data and point of care glucose tests. When incremental improvement was seen (as described in the results), Version 2 of the insulin orders was created to further streamline the process. Results The percentage of regimens containing basal insulin improved with Version 1. The percentage of patient days with hypoglycemia improved from 3.68% at baseline to 2.59% with Version 1 plus the paper insulin management protocol, representing a relative risk for hypoglycemic day of 0.70 [confidence interval (CI) 0.62, 0.80]. The relative risk of an uncontrolled (mean glucose over 180 mg/dl) patient stay was reduced to 0.84 (CI 0.77, 0.91) with Version 1 and was reduced further to 0.73 (CI 0.66, 0.81) with the paper protocol. Version 2 used clinician-entered patient parameters to guide protocol-based insulin ordering and simultaneously improved the flexibility and ease of ordering over Version 1. Conclusion Patient parameter and protocol-based clinical decision support, added to computerized provider order entry, has a track record of improving glycemic control indices. This justifies the incorporation of these algorithms into online order management. PMID:19885198

Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury: A Systematic Review.

PubMed

Bogdanova, Yelena; Yee, Megan K; Ho, Vivian T; Cicerone, Keith D

Comprehensive review of the use of computerized treatment as a rehabilitation tool for attention and executive function in adults (aged 18 years or older) who suffered an acquired brain injury. Systematic review of empirical research. Two reviewers independently assessed articles using the methodological quality criteria of Cicerone et al. Data extracted included sample size, diagnosis, intervention information, treatment schedule, assessment methods, and outcome measures. A literature review (PubMed, EMBASE, Ovid, Cochrane, PsychINFO, CINAHL) generated a total of 4931 publications. Twenty-eight studies using computerized cognitive interventions targeting attention and executive functions were included in this review. In 23 studies, significant improvements in attention and executive function subsequent to training were reported; in the remaining 5, promising trends were observed. Preliminary evidence suggests improvements in cognitive function following computerized rehabilitation for acquired brain injury populations including traumatic brain injury and stroke. Further studies are needed to address methodological issues (eg, small sample size, inadequate control groups) and to inform development of guidelines and standardized protocols.

Detection of Acute and Long-Term Effects of Concussion: Dual-Task Gait Balance Control Versus Computerized Neurocognitive Test.

PubMed

Howell, David R; Osternig, Louis R; Chou, Li-Shan

2018-02-16

To examine the acute (within 72h of injury) and long-term (2mo postinjury) independent associations between objective dual-task gait balance and neurocognitive measurements among adolescents and young adults with a concussion and matched controls. Longitudinal case-control. Motion analysis laboratory. A total of 95 participants completed the study: 51 who sustained a concussion (mean age, 17.5±3.3y; 71% men) and 44 controls (mean age, 17.7±2.9y; 72% men). Participants who sustained a concussion underwent a dual-task gait analysis and computerized neurocognitive testing within 72 hours of injury and again 2 months later. Uninjured controls also completed the same test protocol in similar time increments. Not applicable. We compared dual-task gait balance control and computerized neurocognitive test performance between groups using independent samples t tests. Multivariable binary logistic regression models were then constructed for each testing time to determine the association between group membership (concussion vs control), dual-task gait balance control, and neurocognitive function. Medial-lateral center-of-mass displacement during dual-task gait was independently associated with group membership at the initial test (adjusted odds ratio [aOR], 2.432; 95% confidence interval [CI], 1.269-4.661) and 2-month follow-up test (aOR, 1.817; 95% CI, 1.014-3.256) tests. Visual memory composite scores were significantly associated with group membership at the initial hour postinjury time point (aOR, .953; 95% CI, .833-.998). However, the combination of computerized neurocognitive test variables did not predict dual-task gait balance control for participants with concussion, and no single neurocognitive variable was associated with dual-task gait balance control at either testing time. Dual-task assessments concurrently evaluating gait and cognitive performance may allow for the detection of persistent deficits beyond those detected by computerized neurocognitive deficits alone. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Evaluating a Computerized Aid for Conducting a Cognitive Task Analysis

DTIC Science & Technology

2000-01-01

in conducting a cognitive task analysis . The conduct of a cognitive task analysis is costly and labor intensive. As a result, a few computerized aids...evaluation of a computerized aid, specifically CAT-HCI (Cognitive Analysis Tool - Human Computer Interface), for the conduct of a detailed cognitive task analysis . A

Use of Flowchart for Automation of Clinical Protocols in mHealth.

PubMed

Dias, Karine Nóra; Welfer, Daniel; Cordeiro d'Ornellas, Marcos; Pereira Haygert, Carlos Jesus; Dotto, Gustavo Nogara

2017-01-01

For healthcare professionals to use mobile applications we need someone who knows software development, provide them. In healthcare institutions, health professionals use clinical protocols to govern care, and sometimes these documents are computerized through mobile applications to assist them. This work aims to present a proposal of an application of flow as a way of describing clinical protocols for automatic generation of mobile applications to assist health professionals. The purpose of this research is to enable health professionals to develop applications from the description of their own clinical protocols. As a result, we developed a web system that automates clinical protocols for an Android platform, and we validated with two clinical protocols used in a Brazilian hospital. Preliminary results of the developed architecture demonstrate the feasibility of this study.

Validity of multislice computerized tomography for diagnosis of maxillofacial fractures using an independent workstation.

PubMed

Dos Santos, Denise Takehana; Costa e Silva, Adriana Paula Andrade; Vannier, Michael Walter; Cavalcanti, Marcelo Gusmão Paraiso

2004-12-01

The purpose of this study was to demonstrate the sensitivity and specificity of multislice computerized tomography (CT) for diagnosis of maxillofacial fractures following specific protocols using an independent workstation. The study population consisted of 56 patients with maxillofacial fractures who were submitted to a multislice CT. The original data were transferred to an independent workstation using volumetric imaging software to generate axial images and simultaneous multiplanar (MPR) and 3-dimensional (3D-CT) volume rendering reconstructed images. The images were then processed and interpreted by 2 examiners using the following protocols independently of each other: axial, MPR/axial, 3D-CT images, and the association of axial/MPR/3D images. The clinical/surgical findings were considered the gold standard corroborating the diagnosis of the fractures and their anatomic localization. The statistical analysis was carried out using validity and chi-squared tests. The association of axial/MPR/3D images indicated a higher sensitivity (range 95.8%) and specificity (range 99%) than the other methods regarding the analysis of all regions. CT imaging demonstrated high specificity and sensitivity for maxillofacial fractures. The association of axial/MPR/3D-CT images added important information in relationship to other CT protocols.

Patient Safety and Quality Improvement in Otolaryngology Education: A Systematic Review.

PubMed

Gettelfinger, John D; Paulk, P Barrett; Schmalbach, Cecelia E

2017-06-01

Objective The breadth and depth of patient safety/quality improvement (PS/QI) research dedicated to otolaryngology-head and neck surgery (OHNS) education remains unknown. This systematic review aims to define this scope and to identify knowledge gaps as well as potential areas of future study to improved PS/QI education and training in OHNS. Data Sources A computerized Ovid/Medline database search was conducted (January 1, 1965, to May 15, 2015). Similar computerized searches were conducted using Cochrane Database, PubMed, and Google Scholar. Review Methods The study protocol was developed a priori using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were classified by year, subspecialty, Institute of Medicine (IOM) Crossing the Chasm categories, and World Health Organization (WHO) subclass. Results Computerized searches yielded 8743 eligible articles, 267 (3.4%) of which met otolaryngology PS/QI inclusion criteria; 51 (19%) were dedicated to resident/fellow education and training. Simulation studies (39%) and performance/competency evaluation (23.5%) were the most common focus. Most projects involved general otolaryngology (47%), rhinology (18%), and otology (16%). Classification by the IOM included effective care (45%), safety/effective care (41%), and effective and efficient care (7.8%). Most research fell into the WHO category of "identifying solutions" (61%). Conclusion Nineteen percent of OHNS PS/QI articles are dedicated to education, the majority of which are simulation and focus on effective care. Knowledges gaps for future research include facial plastics PS/QI and the WHO category of "studies translating evidence into safer care."

Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines

PubMed Central

2010-01-01

Background Computerized ICUs rely on software services to convey the medical condition of their patients as well as assisting the staff in taking treatment decisions. Such services are useful for following clinical guidelines quickly and accurately. However, the development of services is often time-consuming and error-prone. Consequently, many care-related activities are still conducted based on manually constructed guidelines. These are often ambiguous, which leads to unnecessary variations in treatments and costs. The goal of this paper is to present a semi-automatic verification and translation framework capable of turning manually constructed diagrams into ready-to-use programs. This framework combines the strengths of the manual and service-oriented approaches while decreasing their disadvantages. The aim is to close the gap in communication between the IT and the medical domain. This leads to a less time-consuming and error-prone development phase and a shorter clinical evaluation phase. Methods A framework is proposed that semi-automatically translates a clinical guideline, expressed as an XML-based flow chart, into a Drools Rule Flow by employing semantic technologies such as ontologies and SWRL. An overview of the architecture is given and all the technology choices are thoroughly motivated. Finally, it is shown how this framework can be integrated into a service-oriented architecture (SOA). Results The applicability of the Drools Rule language to express clinical guidelines is evaluated by translating an example guideline, namely the sedation protocol used for the anaesthetization of patients, to a Drools Rule Flow and executing and deploying this Rule-based application as a part of a SOA. The results show that the performance of Drools is comparable to other technologies such as Web Services and increases with the number of decision nodes present in the Rule Flow. Most delays are introduced by loading the Rule Flows. Conclusions The framework is an effective solution for computerizing clinical guidelines as it allows for quick development, evaluation and human-readable visualization of the Rules and has a good performance. By monitoring the parameters of the patient to automatically detect exceptional situations and problems and by notifying the medical staff of tasks that need to be performed, the computerized sedation guideline improves the execution of the guideline. PMID:20082700

Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines.

PubMed

Ongenae, Femke; De Backere, Femke; Steurbaut, Kristof; Colpaert, Kirsten; Kerckhove, Wannes; Decruyenaere, Johan; De Turck, Filip

2010-01-18

Computerized ICUs rely on software services to convey the medical condition of their patients as well as assisting the staff in taking treatment decisions. Such services are useful for following clinical guidelines quickly and accurately. However, the development of services is often time-consuming and error-prone. Consequently, many care-related activities are still conducted based on manually constructed guidelines. These are often ambiguous, which leads to unnecessary variations in treatments and costs.The goal of this paper is to present a semi-automatic verification and translation framework capable of turning manually constructed diagrams into ready-to-use programs. This framework combines the strengths of the manual and service-oriented approaches while decreasing their disadvantages. The aim is to close the gap in communication between the IT and the medical domain. This leads to a less time-consuming and error-prone development phase and a shorter clinical evaluation phase. A framework is proposed that semi-automatically translates a clinical guideline, expressed as an XML-based flow chart, into a Drools Rule Flow by employing semantic technologies such as ontologies and SWRL. An overview of the architecture is given and all the technology choices are thoroughly motivated. Finally, it is shown how this framework can be integrated into a service-oriented architecture (SOA). The applicability of the Drools Rule language to express clinical guidelines is evaluated by translating an example guideline, namely the sedation protocol used for the anaesthetization of patients, to a Drools Rule Flow and executing and deploying this Rule-based application as a part of a SOA. The results show that the performance of Drools is comparable to other technologies such as Web Services and increases with the number of decision nodes present in the Rule Flow. Most delays are introduced by loading the Rule Flows. The framework is an effective solution for computerizing clinical guidelines as it allows for quick development, evaluation and human-readable visualization of the Rules and has a good performance. By monitoring the parameters of the patient to automatically detect exceptional situations and problems and by notifying the medical staff of tasks that need to be performed, the computerized sedation guideline improves the execution of the guideline.

Decision aid on radioactive iodine treatment for early stage papillary thyroid cancer: update to study protocol with follow-up extension.

PubMed

Sawka, Anna M; Straus, Sharon; Rodin, Gary; Thorpe, Kevin E; Ezzat, Shereen; Gafni, Amiram; Goldstein, David P

2015-07-14

Patient decision aids (P-DAs) are used to inform patients about healthcare choices, but there is limited knowledge about their longer term effects, beyond the time period of decision-making. We developed a computerized P-DA that explains the choice of radioactive iodine (RAI) adjuvant treatment or no RAI, for patients with low risk papillary thyroid cancer after total thyroidectomy. The original protocol for a randomized controlled trial, comparing the use of the P-DA (with usual care) to usual care alone, has been published in Trials http://www.trialsjournal.com/content/11/1/81. We found that P-DA (with usual care) significantly improved patients' medical knowledge at the time of decision-making (primary outcome) compared to usual care alone (control). In this update, we present the protocol for an extended follow-up study (15 to 23 months post-randomization), including qualitative and quantitative methods. The patient outcomes evaluated using quantitative questionnaires include: the degree to which patients feel well-informed about their RAI treatment choice, decision satisfaction, decision regret, cancer-related worry, mood, and trust in the treating physician. The qualitative component explores the experiences of RAI treatment decision-making, treatment satisfaction, and trial participation in a representative subgroup of patients. Extended follow-up study results will be described for the entire study population, and data will be compared between the P-DA and control groups. This mixed methods extended follow-up study will provide data on long term outcomes, relating to the use of a computerized P-DA in decision-making about adjuvant RAI treatment in early stage papillary thyroid cancer. Our results are intended to inform future research in this area, particularly relating to long term effects of the use of P-DAs in making healthcare choices. Clinicaltrials.gov identifier NCT01083550, registered 24 February 2010 and last updated 5 January 2015.

PROTOCOL - A COMPUTERIZED SOLID WASTE QUANTITY AND COMPOSITION ESTIMATION SYSTEM: OPERATIONAL MANUAL

EPA Science Inventory

The assumptions of traditional sampling theory often do not fit the circumstances when estimating the quantity and composition of solid waste arriving at a given location, such as a landfill site, or at a specific point in an industrial or commercial process. The investigator oft...

Accurate and reproducible invasive breast cancer detection in whole-slide images: A Deep Learning approach for quantifying tumor extent

NASA Astrophysics Data System (ADS)

Cruz-Roa, Angel; Gilmore, Hannah; Basavanhally, Ajay; Feldman, Michael; Ganesan, Shridar; Shih, Natalie N. C.; Tomaszewski, John; González, Fabio A.; Madabhushi, Anant

2017-04-01

With the increasing ability to routinely and rapidly digitize whole slide images with slide scanners, there has been interest in developing computerized image analysis algorithms for automated detection of disease extent from digital pathology images. The manual identification of presence and extent of breast cancer by a pathologist is critical for patient management for tumor staging and assessing treatment response. However, this process is tedious and subject to inter- and intra-reader variability. For computerized methods to be useful as decision support tools, they need to be resilient to data acquired from different sources, different staining and cutting protocols and different scanners. The objective of this study was to evaluate the accuracy and robustness of a deep learning-based method to automatically identify the extent of invasive tumor on digitized images. Here, we present a new method that employs a convolutional neural network for detecting presence of invasive tumor on whole slide images. Our approach involves training the classifier on nearly 400 exemplars from multiple different sites, and scanners, and then independently validating on almost 200 cases from The Cancer Genome Atlas. Our approach yielded a Dice coefficient of 75.86%, a positive predictive value of 71.62% and a negative predictive value of 96.77% in terms of pixel-by-pixel evaluation compared to manually annotated regions of invasive ductal carcinoma.

Accurate and reproducible invasive breast cancer detection in whole-slide images: A Deep Learning approach for quantifying tumor extent.

PubMed

Cruz-Roa, Angel; Gilmore, Hannah; Basavanhally, Ajay; Feldman, Michael; Ganesan, Shridar; Shih, Natalie N C; Tomaszewski, John; González, Fabio A; Madabhushi, Anant

2017-04-18

With the increasing ability to routinely and rapidly digitize whole slide images with slide scanners, there has been interest in developing computerized image analysis algorithms for automated detection of disease extent from digital pathology images. The manual identification of presence and extent of breast cancer by a pathologist is critical for patient management for tumor staging and assessing treatment response. However, this process is tedious and subject to inter- and intra-reader variability. For computerized methods to be useful as decision support tools, they need to be resilient to data acquired from different sources, different staining and cutting protocols and different scanners. The objective of this study was to evaluate the accuracy and robustness of a deep learning-based method to automatically identify the extent of invasive tumor on digitized images. Here, we present a new method that employs a convolutional neural network for detecting presence of invasive tumor on whole slide images. Our approach involves training the classifier on nearly 400 exemplars from multiple different sites, and scanners, and then independently validating on almost 200 cases from The Cancer Genome Atlas. Our approach yielded a Dice coefficient of 75.86%, a positive predictive value of 71.62% and a negative predictive value of 96.77% in terms of pixel-by-pixel evaluation compared to manually annotated regions of invasive ductal carcinoma.

Accurate and reproducible invasive breast cancer detection in whole-slide images: A Deep Learning approach for quantifying tumor extent

PubMed Central

Cruz-Roa, Angel; Gilmore, Hannah; Basavanhally, Ajay; Feldman, Michael; Ganesan, Shridar; Shih, Natalie N.C.; Tomaszewski, John; González, Fabio A.; Madabhushi, Anant

2017-01-01

With the increasing ability to routinely and rapidly digitize whole slide images with slide scanners, there has been interest in developing computerized image analysis algorithms for automated detection of disease extent from digital pathology images. The manual identification of presence and extent of breast cancer by a pathologist is critical for patient management for tumor staging and assessing treatment response. However, this process is tedious and subject to inter- and intra-reader variability. For computerized methods to be useful as decision support tools, they need to be resilient to data acquired from different sources, different staining and cutting protocols and different scanners. The objective of this study was to evaluate the accuracy and robustness of a deep learning-based method to automatically identify the extent of invasive tumor on digitized images. Here, we present a new method that employs a convolutional neural network for detecting presence of invasive tumor on whole slide images. Our approach involves training the classifier on nearly 400 exemplars from multiple different sites, and scanners, and then independently validating on almost 200 cases from The Cancer Genome Atlas. Our approach yielded a Dice coefficient of 75.86%, a positive predictive value of 71.62% and a negative predictive value of 96.77% in terms of pixel-by-pixel evaluation compared to manually annotated regions of invasive ductal carcinoma. PMID:28418027

The effects of an 8-week computerized cognitive training program in older adults: a study protocol for a randomized controlled trial.

PubMed

Ten Brinke, Lisanne F; Best, John R; Crockett, Rachel A; Liu-Ambrose, Teresa

2018-01-30

Given the world's aging population, it is important to identify strategies that promote healthy cognitive aging and minimize cognitive decline. Currently, no curative pharmaceutical therapy exists for cognitive impairment and dementia. As a result, there is much interest in lifestyle approaches. Specifically, complex mental activity, such as cognitive training, may be a promising method to combat cognitive decline in older adults. As such, the industry of commercial computerized cognitive training (CCT) applications has rapidly grown in the last decade. However, the efficacy of these commercial products is largely not established. Moreover, exercise is a recognized strategy for promoting cognitive outcomes in older adults and may augment the efficacy of computerized cognitive training applications. Therefore, we propose a proof-of-concept randomized controlled trial (RCT) to examine the effect of a commercial CCT program in community-dwelling older adults. An 8-week RCT to examine the effect of a commercial CCT program, alone and preceded by a 15-min brisk walk, on cognitive function and explore the underlying neural mechanisms in adults aged 65-85 years old. Participants will be randomized to one of three intervention groups: 1) Computerized cognitive training (FBT); 2) A 15-min brisk walk followed by computerized cognitive training (Ex-FBT); or 3) A combination of educational classes, sham cognitive training, and balanced and tone exercises (active control, BAT). Participants in all intervention groups will attend three one-hour classes per week over the course of the intervention. Participants will be assessed at baseline, trial completion, and 1-year post study completion (1-year follow-up). If results from this study show benefits for cognition at trial completion, CCT programs, alone or in combination with walking, might be a strategy to promote healthy cognitive aging in older adults. In addition, results from the 1-year follow-up measurement could provide important information regarding the long-term benefits of these CCT programs. ClinicalTrials.gov Protocol Registration System: NCT02564809; registered September 1, 2015.

Evaluation of the Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER) as a Measure of Treatment Effectiveness with Psychiatric Inpatients

ERIC Educational Resources Information Center

Kinnaman, Joanna E. Strong; Farrell, Albert D.; Bisconer, Sarah W.

2006-01-01

Assessment procedures to evaluate inpatient treatment effectiveness can provide information to inform clinical practice. The Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER) represents a standardized approach to assess patients' target problems that combines elements of individualized and nomothetic approaches.…

Computerized tomography versus magnetic resonance imaging: a comparative study in hypothalamic-pituitary and parasellar pathology.

PubMed

Webb, S M; Ruscalleda, J; Schwarzstein, D; Calaf-Alsina, J; Rovira, A; Matos, G; Puig-Domingo, M; de Leiva, A

1992-05-01

We wished to analyse the relative value of computerized tomography and magnetic resonance in patients referred for evaluation of pituitary and parasellar lesions. We performed a separate evaluation by two independent neuroradiologists of computerized tomography and magnetic resonance images ordered numerically and anonymously, with no clinical data available. We studied 40 patients submitted for hypothalamic-pituitary study; 31 were carried out preoperatively, of which histological confirmation later became available in 14. The remaining nine patients were evaluated postoperatively. Over 40 parameters relating to the bony margins, cavernous sinuses, carotid arteries, optic chiasm, suprasellar cisterns, pituitary, pituitary stalk and extension of the lesion were evaluated. These reports were compared with the initial ones offered when the scans were ordered, and with the final diagnosis. Concordance between initial computerized tomography and magnetic resonance was observed in 27 cases (67.5%); among the discordant cases computerized tomography showed the lesion in two, magnetic resonance in 10, while in the remaining case reported to harbour a microadenoma on computerized tomography the differential diagnosis between a true TSH-secreting microadenoma and pituitary resistance to thyroid hormones is still unclear. Both neuroradiologists coincided in their reports in 32 patients (80%); when the initial report was compared with those of the neuroradiologists, concordance was observed with at least one of them in 34 instances (85%). Discordant results were observed principally in microadenomas secreting ACTH or PRL and in delayed puberty. In the eight patients with Cushing's disease (histologically confirmed in six) magnetic resonance was positive in five and computerized tomography in two; the abnormal image correctly identified the side of the lesion at surgery. In patients referred for evaluation of Cushing's syndrome or hyperprolactinaemia (due to microadenomas) or after surgery, magnetic resonance is clearly preferable to computerized tomography. In macroadenomas both scans are equally diagnostic but magnetic resonance offers more information on pituitary morphology and neighbouring structures. Nevertheless, there are cases in which the results of computerized tomography and magnetic resonance will complement each other, since different parameters are analysed with each examination and discordant results are encountered.

Evaluation of computerized health management information system for primary health care in rural India

PubMed Central

2010-01-01

Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

PROTOCOL - A COMPUTERIZED SOLID WASTE QUANTITY AND COMPOSITION ESTIMATION SYSTEM. Project Summary (EPA/600/S2-91/005)

EPA Science Inventory

The assumptions of traditional sampling theory often do not fit the circumstances when estimating the quantity and composition of solid waste arriving at a given location, such as a landfill site, or at a specific point in an industrial or commercial process. The investigator oft...

Evaluation of an ontology-based system for computerized cognitive rehabilitation.

PubMed

Alloni, Anna; Quaglini, Silvana; Panzarasa, Silvia; Sinforiani, Elena; Bernini, Sara

2018-07-01

This paper describes the results of a randomized clinical trial about the effectiveness of a computerized rehabilitation treatment on a sample of 31 patients affected by Parkinson disease. Computerized exercises were administered by the therapists to the intervention group (n = 17) through the CoRe tool, which automatically generates a big variety of exercises leveraging on a stimuli set (words, sounds and images) organized into a dedicated ontology. A battery of standard neuropsychological tests was performed for patients' assessment at baseline, after the treatment (that lasted 1 month), and after 6 months from the treatment stop. The control group underwent a sham intervention. Results show a statistically significant clinical benefit from computerized rehabilitation with respect to sham treatment. For the intervention group, response time and response accuracy were integrated into a weighted score that accounts also for the specific cognitive burden of each exercise. Differently from the control group, the majority of patients in the intervention group showed an improvement in that score, more marked in the first week of treatment, and which lasts for the entire treatment period, which could account both for a quick learning effect and for an improvement of cognitive conditions. Good usability of CoRe, already observed in previous studies, was confirmed by the present trial, where the percentage of protocol completion in the intervention group is very high (all but one patient are above 90%). The CoRe system showed to be effective to improve some cognitive abilities in patients with Parkinson disease. However, after the end of the training, the benefit is hardly maintained over time. These findings support the implementation of CoRe in the clinical routine and the continuation of the treatment after discharge through the use of a homecare version of the system. Copyright © 2018 Elsevier B.V. All rights reserved.

Enhancing GDOT's Computerized Pavement Condition Evaluation System for Pavement Condition Survey

DOT National Transportation Integrated Search

2017-09-01

The Computerized Pavement Condition Evaluation System (COPACES) is a software tool that has been used by the Georgia Department of Transportation (GDOT) for its statewide pavement condition survey since the late 1990s. The previous version was releas...

Development and Evaluation of a Confidence-Weighting Computerized Adaptive Testing

ERIC Educational Resources Information Center

Yen, Yung-Chin; Ho, Rong-Guey; Chen, Li-Ju; Chou, Kun-Yi; Chen, Yan-Lin

2010-01-01

The purpose of this study was to examine whether the efficiency, precision, and validity of computerized adaptive testing (CAT) could be improved by assessing confidence differences in knowledge that examinees possessed. We proposed a novel polytomous CAT model called the confidence-weighting computerized adaptive testing (CWCAT), which combined a…

Multiprofissional electronic protocol in ophtalmology with enfasis in strabismus.

PubMed

Ribeiro, Christie Graf; Moreira, Ana Tereza Ramos; Pinto, José Simão DE Paula; Malafaia, Osvaldo

2016-01-01

to create and validate an electronic database in ophthalmology focused on strabismus, to computerize this database in the form of a systematic data collection software named Electronic Protocol, and to incorporate this protocol into the Integrated System of Electronic Protocols (SINPE(c)). this is a descriptive study, with the methodology divided into three phases: (1) development of a theoretical ophthalmologic database with emphasis on strabismus; (2) computerization of this theoretical ophthalmologic database using SINPE(c) and (3) interpretation of the information with demonstration of results to validate the protocol. We inputed data from the charts of fifty patients with known strabismus through the Electronic Protocol for testing and validation. the new electronic protocol was able to store information regarding patient history, physical examination, laboratory exams, imaging results, diagnosis and treatment of patients with ophthalmologic diseases, with emphasis on strabismus. We included 2,141 items in this master protocol and created 20 new specific electronic protocols for strabismus, each with its own specifics. Validation was achieved through correlation and corroboration of the symptoms and confirmed diagnoses of the fifty included patients with the diagnostic criteria for the twenty new strabismus protocols. a new, validated electronic database focusing on ophthalmology, with emphasis on strabismus, was successfully created through the standardized collection of information, and computerization of the database using proprietary software. This protocol is ready for deployment to facilitate data collection, sorting and application for practitioners and researchers in numerous specialties. criar uma base eletrônica de dados em oftalmologia com ênfase em estrabismo através da coleta padronizada de informações. Informatizar esta base sob a forma de software para a coleta sistemática de dados chamado "Protocolo Eletrônico" e incorporar este "Protocolo Eletrônico" da Oftalmologia ao Sistema Integrado de Protocolos Eletrônicos (SINPE(c)). este é um estudo descritivo e a metodologia aplicada em seu desenvolvimento está didaticamente dividida em três fases: 1) criação da base teórica de dados clínicos de oftalmologia com ênfase em estrabismo; 2) informatização da base teórica dos dados utilizando o SINPE(c); e 3) interpretação das informações com demonstração dos resultados. A informatização da base de dados foi realizada pela utilização da concessão de uso do SINPE(c). Foram incluídos neste protocolo 50 pacientes com estrabismo para validação do protocolo. o protocolo eletrônico desenvolvido permitiu armazenar informações relacionadas à anamnese, exame físico, exames complementares, diagnóstico e tratamento de pacientes com doenças oftalmológicas, com ênfase em estrabismo. Foram incluídos neste trabalho 2141 itens no protocolo mestre e foram criados 20 protocolos específicos de estrabismo, cada um com suas particularidades. Os 50 pacientes que foram incluídos nos protocolos específicos demonstraram a eficácia do método empregado. foi criada uma base eletrônica de dados em oftalmologia com ênfase em estrabismo através da coleta padronizada de informações. Esta base de dados foi informatizada sob a forma de software onde os futuros usuários poderão utilizar o protocolo eletrônico multiprofissional de doenças oftalmológicas com ênfase em estrabismo para a coleta de seus dados.

Computerized Dynamic Adaptive Tests with Immediately Individualized Feedback for Primary School Mathematics Learning

ERIC Educational Resources Information Center

Wu, Huey-Min; Kuo, Bor-Chen; Wang, Su-Chen

2017-01-01

In this study, a computerized dynamic assessment test with both immediately individualized feedback and adaptively property was applied to Mathematics learning in primary school. For evaluating the effectiveness of the computerized dynamic adaptive test, the performances of three types of remedial instructions were compared by a pre-test/post-test…

The Evaluation of SISMAKOM (Computerized SDI Project).

ERIC Educational Resources Information Center

University of Science, Penang (Malaysia).

A survey of 88 users of SISMAKOM, a computerized selective dissemination of information (SDI) and document delivery service provided by the Universiti Sains Malaysia and four other Malaysian universities, was conducted in August 1982 in order to collect data about SISMAKOM and to assess the value of a computerized SDI service in a developing…

Is the cervical spine clear? Undetected cervical fractures diagnosed only at autopsy.

PubMed

Sweeney, J F; Rosemurgy, A S; Gill, S; Albrink, M H

1992-10-01

Undetected cervical-spine injuries are a nemesis to both trauma surgeons and emergency physicians. Radiographic protocols have been developed to avoid missing cervical-spine fractures but are not fail-safe. Three case reports of occult cervical fractures documented at autopsy in the face of normal cervical-spine radiographs and computerized tomography scans are presented.

Computerized PET/CT image analysis in the evaluation of tumour response to therapy

PubMed Central

Wang, J; Zhang, H H

2015-01-01

Current cancer therapy strategy is mostly population based, however, there are large differences in tumour response among patients. It is therefore important for treating physicians to know individual tumour response. In recent years, many studies proposed the use of computerized positron emission tomography/CT image analysis in the evaluation of tumour response. Results showed that computerized analysis overcame some major limitations of current qualitative and semiquantitative analysis and led to improved accuracy. In this review, we summarize these studies in four steps of the analysis: image registration, tumour segmentation, image feature extraction and response evaluation. Future works are proposed and challenges described. PMID:25723599

Rehabilitation of balance disturbances due to chemotherapy-induced peripheral neuropathy: a pilot study.

PubMed

Cammisuli, Sharon; Cavazzi, Enrico; Baldissarro, Eleonora; Leandri, Massimo

2016-08-01

Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have sensory and motor deficits leading to inappropriate proprioceptive feedback, impaired postural control, and fall risk. Balance training with computerized force platforms has been successfully used in rehabilitation of balance disturbances, but programs specifically developed for CIPN patients are lacking. This pilot study evaluated a rehabilitation protocol exclusively based on visual computer-feedback balance training (VCFBT) to improve balance in patients with CIPN. Open-label, non-randomized pilot study, 4-week intervention with pre- vs. post-treatment evaluation. Outpatients of the Rehabilitation Institute of the Salvatore Maugeri Foundation, in Genoa, Italy. Seven out-patients with clinical-instrumental diagnosis of CIPN. At admission, patients were administered the Berg Balance Scale (BBS) and underwent static-dynamic posturography using a computerized force platform to objectively quantify their balance impairment. Their performance was compared to values of a normal age-matched population. Patients then underwent 4 weeks of VCFBT (three 60-minute sessions/week). At discharge, BBS and posturography were repeated and the results compared with those at admission. A significant pre- vs. post-treatment improvement was found in balance as measured by static-dynamic posturography (P=0.004) and BBS (P<0.002). Despite caution needed for the low sample size, this pilot study has shown preliminary evidence that intensive rehabilitation, based on VCFBT can produce a significant improvement in balance outcomes. To our knowledge, this is the first report in CIPN patients of a rehabilitation program based exclusively on VCFBT.

Qualification of computerized monitoring systems in a cell therapy facility compliant with the good manufacturing practices.

PubMed

Del Mazo-Barbara, Anna; Mirabel, Clémentine; Nieto, Valentín; Reyes, Blanca; García-López, Joan; Oliver-Vila, Irene; Vives, Joaquim

2016-09-01

Computerized systems (CS) are essential in the development and manufacture of cell-based medicines and must comply with good manufacturing practice, thus pushing academic developers to implement methods that are typically found within pharmaceutical industry environments. Qualitative and quantitative risk analyses were performed by Ishikawa and Failure Mode and Effects Analysis, respectively. A process for qualification of a CS that keeps track of environmental conditions was designed and executed. The simplicity of the Ishikawa analysis permitted to identify critical parameters that were subsequently quantified by Failure Mode Effects Analysis, resulting in a list of test included in the qualification protocols. The approach presented here contributes to simplify and streamline the qualification of CS in compliance with pharmaceutical quality standards.

Evaluating Content Alignment in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Wise, Steven L.; Kingsbury, G. Gage; Webb, Norman L.

2015-01-01

The alignment between a test and the content domain it measures represents key evidence for the validation of test score inferences. Although procedures have been developed for evaluating the content alignment of linear tests, these procedures are not readily applicable to computerized adaptive tests (CATs), which require large item pools and do…

Pain Perception: Computerized versus Traditional Local Anesthesia in Pediatric Patients.

PubMed

Mittal, M; Kumar, A; Srivastava, D; Sharma, P; Sharma, S

2015-01-01

Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups.

Implementing an evidence-based computerized decision support system linked to electronic health records to improve care for cancer patients: the ONCO-CODES study protocol for a randomized controlled trial.

PubMed

Moja, Lorenzo; Passardi, Alessandro; Capobussi, Matteo; Banzi, Rita; Ruggiero, Francesca; Kwag, Koren; Liberati, Elisa Giulia; Mangia, Massimo; Kunnamo, Ilkka; Cinquini, Michela; Vespignani, Roberto; Colamartini, Americo; Di Iorio, Valentina; Massa, Ilaria; González-Lorenzo, Marien; Bertizzolo, Lorenzo; Nyberg, Peter; Grimshaw, Jeremy; Bonovas, Stefanos; Nanni, Oriana

2016-11-25

Computerized decision support systems (CDSSs) are computer programs that provide doctors with person-specific, actionable recommendations, or management options that are intelligently filtered or presented at appropriate times to enhance health care. CDSSs might be integrated with patient electronic health records (EHRs) and evidence-based knowledge. The Computerized DEcision Support in ONCOlogy (ONCO-CODES) trial is a pragmatic, parallel group, randomized controlled study with 1:1 allocation ratio. The trial is designed to evaluate the effectiveness on clinical practice and quality of care of a multi-specialty collection of patient-specific reminders generated by a CDSS in the IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) hospital. We hypothesize that the intervention can increase clinician adherence to guidelines and, eventually, improve the quality of care offered to cancer patients. The primary outcome is the rate at which the issues reported by the reminders are resolved, aggregating specialty and primary care reminders. We will include all the patients admitted to hospital services. All analyses will follow the intention-to-treat principle. The results of our study will contribute to the current understanding of the effectiveness of CDSSs in cancer hospitals, thereby informing healthcare policy about the potential role of CDSS use. Furthermore, the study will inform whether CDSS may facilitate the integration of primary care in cancer settings, known to be usually limited. The increasing use of and familiarity with advanced technology among new generations of physicians may support integrated approaches to be tested in pragmatic studies determining the optimal interface between primary and oncology care. ClinicalTrials.gov, NCT02645357.

Optimizing radiologist e-prescribing of CT oral contrast agent using a protocoling portal.

PubMed

Wasser, Elliot J; Galante, Nicholas J; Andriole, Katherine P; Farkas, Cameron; Khorasani, Ramin

2013-12-01

The purpose of this study is to quantify the time expenditure associated with radiologist ordering of CT oral contrast media when using an integrated protocoling portal and to determine radiologists' perceptions of the ordering process. This prospective study was performed at a large academic tertiary care facility. Detailed timing information for CT inpatient oral contrast orders placed via the computerized physician order entry (CPOE) system was gathered over a 14-day period. Analyses evaluated the amount of physician time required for each component of the ordering process. Radiologists' perceptions of the ordering process were assessed by survey. Descriptive statistics and chi-square analysis were performed. A total of 96 oral contrast agent orders were placed by 13 radiologists during the study period. The average time necessary to create a protocol for each case was 40.4 seconds (average range by subject, 20.0-130.0 seconds; SD, 37.1 seconds), and the average total time to create and sign each contrast agent order was 27.2 seconds (range, 10.0-50.0 seconds; SD, 22.4 seconds). Overall, 52.5% (21/40) of survey respondents indicated that radiologist entry of oral contrast agent orders improved patient safety. A minority of respondents (15% [6/40]) indicated that contrast agent order entry was either very or extremely disruptive to workflow. Radiologist e-prescribing of CT oral contrast agents using CPOE can be embedded in a protocol workflow. Integration of health IT tools can help to optimize user acceptance and adoption.

Computerized and Paper-and-Pencil Versions of the Rosenberg Self-Esteem Scale: A Comparison of Psychometric Features and Respondent Preferences.

ERIC Educational Resources Information Center

Vispoel, Walter P.; Boo, Jaeyool; Bleiler, Timothy

2001-01-01

Evaluated the characteristics of computerized and paper-and-pencil versions of the Rosenberg Self-Esteem Scale (SES) using scores for 224 college students. Results show that mode of administration has little effect on the psychometric properties of the SES although the computerized version took longer and was preferred by examinees. (SLD)

Automation in an Addiction Treatment Research Clinic: Computerized Contingency Management, Ecological Momentary Assessment, and a Protocol Workflow System

PubMed Central

Vahabzadeh, Massoud; Lin, Jia-Ling; Mezghanni, Mustapha; Epstein, David H.; Preston, Kenzie L.

2009-01-01

Issues A challenge in treatment research is the necessity of adhering to protocol and regulatory strictures while maintaining flexibility to meet patients’ treatment needs and accommodate variations among protocols. Another challenge is the acquisition of large amounts of data in an occasionally hectic environment, along with provision of seamless methods for exporting, mining, and querying the data. Approach We have automated several major functions of our outpatient treatment research clinic for studies in drug abuse and dependence. Here we describe three such specialized applications: the Automated Contingency Management (ACM) system for delivery of behavioral interventions, the Transactional Electronic Diary (TED) system for management of behavioral assessments, and the Protocol Workflow System (PWS) for computerized workflow automation and guidance of each participant’s daily clinic activities. These modules are integrated into our larger information system to enable data sharing in real time among authorized staff. Key Findings ACM and TED have each permitted us to conduct research that was not previously possible. In addition, the time to data analysis at the end of each study is substantially shorter. With the implementation of the PWS, we have been able to manage a research clinic with an 80-patient capacity having an annual average of 18,000 patient-visits and 7,300 urine collections with a research staff of five. Finally, automated data management has considerably enhanced our ability to monitor and summarize participant-safety data for research oversight. Implications and conclusion When developed in consultation with end users, automation in treatment-research clinics can enable more efficient operations, better communication among staff, and expansions in research methods. PMID:19320669

A Computerized Library and Evaluation System for Integral Neutron Experiments.

ERIC Educational Resources Information Center

Hampel, Viktor E.; And Others

A computerized library of references to integral neutron experiments has been developed at the Lawrence Radiation Laboratory at Livermore. This library serves as a data base for the systematic retrieval of documents describing diverse critical and bulk nuclear experiments. The evaluation and reduction of the physical parameters of the experiments…

Development and Evaluation of Computerized Problem-based Learning Cases Emphasizing Basic Sciences Concepts.

ERIC Educational Resources Information Center

Abate, Marie A.; Meyer-Stout, Paula J.; Stamatakis, Mary K.; Gannett, Peter M.; Dunsworth, Teresa S.; Nardi, Anne H.

2000-01-01

Describes development and evaluation of eight computerized problem-based learning (PBL) cases in medicinal chemistry and pharmaceutics concepts. Case versions either incorporated concept maps emphasizing key ideas or did not. Student performance on quizzes did not differ between the different case versions and was similar to that of students who…

Applications of Computer Science to the Management and Evaluation of the Educational Process.

ERIC Educational Resources Information Center

Hebenstreit, Jacques

This synthesis of reports from authors representing seven different countries discusses computerization as it applies to the management and evaluation of the educational process at all levels in developed countries. Focusing on the computerization of educational administration, the first of three sections of the paper suggests that advantages of…

Knowledge Translation of the PERC Rule for Suspected Pulmonary Embolism: A Blueprint for Reducing the Number of CT Pulmonary Angiograms.

PubMed

Drescher, Michael J; Fried, Jeremy; Brass, Ryan; Medoro, Amanda; Murphy, Timothy; Delgado, João

2017-10-01

Computerized decision support decreases the number of computed tomography pulmonary angiograms (CTPA) for pulmonary embolism (PE) ordered in emergency departments, but it is not always well accepted by emergency physicians. We studied a department-endorsed, evidence-based clinical protocol that included the PE rule-out criteria (PERC) rule, multi-modal education using principles of knowledge translation (KT), and clinical decision support embedded in our order entry system, to decrease the number of unnecessary CTPA ordered. We performed a historically controlled observational before-after study for one year pre- and post-implementation of a departmentally-endorsed protocol. We included patients > 18 in whom providers suspected PE and who did not have a contraindication to CTPA. Providers entered clinical information into a diagnostic pathway via computerized order entry. Prior to protocol implementation, we provided education to ordering providers. The primary outcome measure was the number of CTPA ordered per 1,000 visits one year before vs. after implementation. CTPA declined from 1,033 scans for 98,028 annual visits (10.53 per 1,000 patient visits (95% CI [9.9-11.2]) to 892 scans for 101,172 annual visits (8.81 per 1,000 patient visits (95% CI [8.3-9.4]) p<0.001. The absolute reduction in PACT ordered was 1.72 per 1,000 visits (a 16% reduction). Patient characteristics were similar for both periods. Knowledge translation clinical decision support using the PERC rule significantly reduced the number of CTPA ordered.

Histological study on the effects of microablative fractional CO2 laser on atrophic vaginal tissue: an ex vivo study.

PubMed

Salvatore, Stefano; Leone Roberti Maggiore, Umberto; Athanasiou, Stavros; Origoni, Massimo; Candiani, Massimo; Calligaro, Alberto; Zerbinati, Nicola

2015-08-01

Microablative fractional CO2 laser has been proven to determine tissue remodeling with neoformation of collagen and elastic fibers on atrophic skin. The aim of our study is to evaluate the effects of microablative fractional CO2 laser on postmenopausal women with vulvovaginal atrophy using an ex vivo model. This is a prospective ex vivo cohort trial. Consecutive postmenopausal women with vulvovaginal atrophy managed with pelvic organ prolapse surgical operation were enrolled. After fascial plication, the redundant vaginal edge on one side was treated with CO2 laser (SmartXide2; DEKA Laser, Florence, Italy). Five different CO2 laser setup protocols were tested. The contralateral part of the vaginal wall was always used as control. Excessive vagina was trimmed and sent for histological evaluation to compare treated and nontreated tissues. Microscopic and ultrastructural aspects of the collagenic and elastic components of the matrix were studied, and a specific image analysis with computerized morphometry was performed. We also considered the fine cytological aspects of connective tissue proper cells, particularly fibroblasts. During the study period, five women were enrolled, and 10 vaginal specimens were finally retrieved. Four different settings of CO2 laser were compared. Protocols were tested twice each to confirm histological findings. Treatment protocols were compared according to histological findings, particularly in maximal depth and connective changes achieved. All procedures were uneventful for participants. This study shows that microablative fractional CO2 laser can produce a remodeling of vaginal connective tissue without causing damage to surrounding tissue.

Cytological Evaluation of Thyroid Lesions by Nuclear Morphology and Nuclear Morphometry.

PubMed

Yashaswini, R; Suresh, T N; Sagayaraj, A

2017-01-01

Fine needle aspiration (FNA) of the thyroid gland is an effective diagnostic method. The Bethesda system for reporting thyroid cytopathology classifies them into six categories and gives implied risk for malignancy and management protocol in each category. Though the system gives specific criteria, diagnostic dilemma still exists. Using nuclear morphometry, we can quantify the number of parameters, such as those related to nuclear size and shape. The evaluation of nuclear morphometry is not well established in thyroid cytology. To classify thyroid lesions on fine needle aspiration cytology (FNAC) using Bethesda system and to evaluate the significance of nuclear parameters in improving the prediction of thyroid malignancy. In the present study, 120 FNAC cases of thyroid lesions with histological diagnosis were included. Computerized nuclear morphometry was done on 81 cases which had confirmed cytohistological correlation, using Aperio computer software. One hundred nuclei from each case were outlined and eight nuclear parameters were analyzed. In the present study, thyroid lesions were common in female with M: F ratio of 1:5 and most commonly in 40-60 yrs. Under Bethesda system, 73 (60.83%) were category II; 14 (11.6%) were category III, 3 (2.5%) were category IV, 8 (6.6%) were category V, and 22 (18.3%) were category VI, which were malignant on histopathological correlation. Sensitivity, specificity, and diagnostic accuracy of Bethesda reporting system are 62.5, 84.38, and 74.16%, respectively. Minimal nuclear diameter, maximal nuclear diameter, nuclear perimeter, and nuclear area were higher in malignant group compared to nonneoplastic and benign group. The Bethesda system is a useful standardized system of reporting thyroid cytopathology. It gives implied risk of malignancy. Nuclear morphometry by computerized image analysis can be utilized as an additional diagnostic tool.

Computerized Memory Training Leads to Sustained Improvement in Visuospatial Short-Term Memory Skills in Children with Down Syndrome

ERIC Educational Resources Information Center

Bennett, Stephanie J.; Holmes, Joni; Buckley, Sue

2013-01-01

This study evaluated the impact of a computerized visuospatial memory training intervention on the memory and behavioral skills of children with Down syndrome. Teaching assistants were trained to support the delivery of a computerized intervention program to individual children over a 10-16 week period in school. Twenty-one children aged 7-12…

Effectiveness of Computerized Oculomotor Vision Screening in a Military Population: Pilot Study

DTIC Science & Technology

2012-01-01

Medical Center, Bethesda, MD; 3Clinical Services, Illinois College of Optometry, Chicago, IL Abstract—The prevalence of oculomotor dysfunctions associ - ated...vergence and their associated recovery as well as for the monocular accommodative facility measurements. This study demonstrated that non- eye -care...comprehensive eye examination without dilation on all subjects. The optometrists used the identi- cal testing protocol to determine manifest refraction

[The movement computerized analysis as instrumental support for occupational doctors in evaluation of upper limb pathologies in engineering workers].

PubMed

D'Orso, M I; Centemeri, R; Oggionni, P; Latocca, R; Crippa, M; Vercellino, R; Riva, M; Cesana, G

2011-01-01

The movement computerized analysis of upper limb is a valid support in the definition of residual functional capability and of specific work suitability in complex cases. This methodology of evaluation is able to correctly and objectively define the tridimensional ranges of motion of every patient's upper limb. This fact can be particularly useful for workers coming back to work after a work-related or a not work-related accident of for handicapped workers at the beginning of a new work activity. We report a research carried out using computerized analysis of motion of upper limbs in 20 engineering workers.

Evaluation of the Salt Lake City Computerized Rider Information System

DOT National Transportation Integrated Search

1985-11-01

The Utah Transit Authority (UTA) Computerized Rider Information System (CRIS) project involved the installation of an automated telephone service to quickly provide bus stop-specific schedule and service information to residents throughout the Author...

3D conformal radiation therapy for palliative treatment of canine nasal tumors.

PubMed

Buchholz, Julia; Hagen, Regine; Leo, Chiara; Ebling, Alessia; Roos, Malgorzata; Kaser-Hotz, Barbara; Bley, Carla Rohrer

2009-01-01

We evaluated the response of 38 dogs treated with a coarsely fractionated, palliative radiation protocol based on CT-based 3D treatment planning. Dogs with histologically confirmed malignant nasal tumors were studied. Treatment prescriptions consisted of 3-4 x 8 Gy, 4-5 x 6 Gy, or 10 x 3 Gy fractions. Selected patient and tumor factors were evaluated for an effect on outcome. Resolution of clinical signs was reported after irradiation in all dogs. Acute toxicities were mild and short lived. Thirty-seven of 38 dogs died or were euthanized due to tumor-related disease. Overall median progression-free interval (PFI) was 10 months. Tumor stage affected response, with modified stage 1 patients having a median PFI 21.3 months vs. a median PFI of 8.5 months for modified stage 2 patients (P = 0.0006). Modified stage was the only factor significantly related to outcome. Based on these findings, a palliative radiation prescription based on computerized treatment planning may be justified in some canine nasal tumor patients.

A computerized tree growth projection system for forest resource evaluation in the lake states

Treesearch

Allen L. Lundgren; Burton L. Essex

1978-01-01

A computerized tree growth projection system has been developed for the Lake States Region as part of a larger Forest Resources Evaluation Program (FREP). Incorporating data from more than 1500 permanent growth plots throughout the Lake States, this system projects tree growth, mortality, regeneration, and removals in stands with any mixture of tree species and sizes,...

An Evaluation of Computerized Behavioral Skills Training to Teach Safety Skills to Young Children

ERIC Educational Resources Information Center

Vanselow, Nicholas R.; Hanley, Gregory P.

2014-01-01

Previous research has demonstrated the efficacy of behavioral skills training (BST) and in situ training (IST) for teaching children to protect themselves. However, BST may be resource intensive and difficult to implement on a large scale. We evaluated a computerized version of BST (CBST) to teach safety skills and determined the extent to which…

Evaluation of Hospitalized Intractable Epileptic Children with SPECT Scan in Ahvaz, South West of Iran

PubMed Central

Ahmadi, Faramarz; Malekian, Arash; Davoodzadeh, Hannaneh; Kabirinia, Hossein

2016-01-01

Introduction Seizures are the most frequent neurologic disorder seen in childhood. Epilepsy is a group of disorders that includes an abnormally increased susceptibility to seizures. Aim To examine the effectiveness of SPECT (Single Photon Emission Computerized Tomography) in detecting seizure foci in 21 Iranian children who had medically refractory epilepsy. Materials and Methods Children between 2 to 15 years of age with uncontrolled seizures were investigated using SPECT scan as a standardized protocol. Results In 16 cases (76.2%), likely seizure foci were evident, as were seen in the form of decreased regional blood flow, while in 5 cases (23.8%), SPECT scan results were normal. Left temporal lobe was the most common area which had decreased regional blood flow. Conclusion SPECT scan can potentially be used to investigate children with uncontrolled seizures. PMID:27891419

Computerized Adaptive Screening Test (CAST): Development for Use in Military Recruiting Stations

DTIC Science & Technology

1984-01-01

testing ( CAT ) 20. ABSTRACT (Continuo on rover .. efdo II neco .. ., ond Identity bJ’ 11/oclr -llor) The Computerized Adaptive Screening Test (CAST...effort is in progress to develop a computerized adaptive testing ( CAT ) system and to evaluate its potential for use in the military entrance...U.S. Marine Corps) has been designated as lead service for CAT system development; and the Navy Personnel Research and Development Center, as lead

Computerized provider order entry systems.

PubMed

2001-01-01

Computerized provider order entry (CPOE) systems are designed to replace a hospital's paper-based ordering system. They allow users to electronically write the full range of orders, maintain an online medication administration record, and review changes made to an order by successive personnel. They also offer safety alerts that are triggered when an unsafe order (such as for a duplicate drug therapy) is entered, as well as clinical decision support to guide caregivers to less expensive alternatives or to choices that better fit established hospital protocols. CPOE systems can, when correctly configured, markedly increase efficiency and improve patient safety and patient care. However, facilities need to recognize that currently available CPOE systems require a tremendous amount of time and effort to be spent in customization before their safety and clinical support features can be effectively implemented. What's more, even after they've been customized, the systems may still allow certain unsafe orders to be entered. Thus, CPOE systems are not currently a quick or easy remedy for medical errors. ECRI's Evaluation of CPOE systems--conducted in collaboration with the Institute for Safe Medication Practices (ISMP)--discusses these and other related issues. It also examines and compares CPOE systems from three suppliers: Eclipsys Corp., IDX Systems Corp., and Siemens Medical Solutions Health Services Corp. Our testing focuses primarily on the systems' interfacing capabilities, patient safeguards, and ease of use.

Minimization of Hypoglycemia as an Adverse Event During Insulin Infusion: Further Refinement of the Yale Protocol.

PubMed

Marvin, Michael R; Inzucchi, Silvio E; Besterman, Brian J

2016-08-01

The management of hyperglycemia in the intensive care unit has been a controversial topic for more than a decade, with target ranges varying from 80-110 mg/dL to <200 mg/dL. Multiple insulin infusion protocols exist, including several computerized protocols, which have attempted to achieve these targets. Importantly, compliance with these protocols has not been a focus of clinical studies. GlucoCare™, a Food and Drug Administration (FDA)-cleared insulin-dosing calculator, was originally designed based on the Yale Insulin Infusion Protocol to target 100-140 mg/dL and has undergone several modifications to reduce hypoglycemia. The original Yale protocol was modified from 100-140 mg/dL to a range of 120-140 mg/dL (GlucoCare 120-140) and then to 140 mg/dL (GlucoCare 140, not a range but a single blood glucose [BG] level target) in an iterative and evidence-based manner to eliminate hypoglycemia <70 mg/dL. The final modification [GlucoCare 140(B)] includes the addition of bolus insulin "midprotocol" during an insulin infusion to reduce peak insulin rates for insulin-resistant patients. This study examined the results of these protocol modifications and evaluated the role of compliance with the protocol in the incidence of hypoglycemia <70 mg/dL. Protocol modifications resulted in mean BG levels of 133.4, 136.4, 143.8, and 146.4 mg/dL and hypoglycemic BG readings <70 mg/dL of 0.998%, 0.367%, 0.256%, and 0.04% for the 100-140, 120-140, 140, and 140(B) protocols, respectively (P < 0.001). Adherence to the glucose check interval significantly reduced the incidence of hypoglycemia (P < 0.001). Protocol modifications led to a reduction in peak insulin infusion rates (P < 0.001) and the need for dextrose-containing boluses (P < 0.001). This study demonstrates that refinements in protocol design can improve glucose control in critically ill patients and that the use of GlucoCare 140(B) can eliminate all significant hypoglycemia while achieving mean glucose levels between 140 and 150 mg/dL. In addition, attention to the timely performance of glucose levels can also reduce hypoglycemic events.

Treatment algorithms and protocolized care.

PubMed

Morris, Alan H

2003-06-01

Excess information in complex ICU environments exceeds human decision-making limits and likely contributes to unnecessary variation in clinical care, increasing the likelihood of clinical errors. I reviewed recent critical care clinical trials searching for information about the impact of protocol use on clinically pertinent outcomes. Several recently published clinical trials illustrate the importance of distinguishing efficacy and effectiveness trials. One of these trials illustrates the danger of conducting effectiveness trials before the efficacy of an intervention is established. The trials also illustrate the importance of distinguishing guidelines and inadequately explicit protocols from adequately explicit protocols. Only adequately explicit protocols contain enough detail to lead different clinicians to the same decision when faced with the same clinical scenario. Differences between guidelines and protocols are important. Guidelines lack detail and provide general guidance that requires clinicians to fill in many gaps. Computerized or paper-based protocols are detailed and, when used for complex clinical ICU problems, can generate patient-specific, evidence-based therapy instructions that can be carried out by different clinicians with almost no interclinician variability. Individualization of patient therapy can be preserved by these protocols when they are driven by individual patient data. Explicit decision-support tools (eg, guidelines and protocols) have favorable effects on clinician and patient outcomes and can reduce the variation in clinical practice. Guidelines and protocols that aid ICU decision makers should be more widely distributed.

The equivalence of computerized and paper-and-pencil psychological instruments: implications for measures of negative affect.

PubMed

Schulenberg, S E; Yutrzenka, B A

1999-05-01

The use of computerized psychological assessment is a growing practice among contemporary mental health professionals. Many popular and frequently used paper-and-pencil instruments have been adapted into computerized versions. Although equivalence for many instruments has been evaluated and supported, this issue is far from resolved. This literature review deals with recent research findings that suggest that computer aversion negatively impacts computerized assessment, particularly as it relates to measures of negative affect. There is a dearth of equivalence studies that take into account computer aversion's potential impact on the measurement of negative affect. Recommendations are offered for future research in this area.

Computerized symbolic manipulation in structural mechanics Progress and potential

NASA Technical Reports Server (NTRS)

Noor, A. K.; Andersen, C. M.

1978-01-01

Status and recent applications of computerized symbolic manipulation to structural mechanics problems are summarized. The applications discussed include; (1) generation of characteristic arrays of finite elements; (2) evaluation of effective stiffness and mass coefficients of continuum models for repetitive lattice structures; and (3) application of Rayleigh-Ritz technique to free vibration analysis of laminated composite elliptic plates. The major advantages of using computerized symbolic manipulation in each of these applications are outlined. A number of problem areas which limit the realization of the full potential of computerized symbolic manipulation in structural mechanics are examined and some of the means of alleviating them are discussed.

Immediate post-concussion assessment and cognitive testing (ImPACT) practices of sports medicine professionals.

PubMed

Covassin, Tracey; Elbin, Robert J; Stiller-Ostrowski, Jennifer L; Kontos, Anthony P

2009-01-01

Computerized neurocognitive testing is becoming popular among clinicians evaluating sport-related concussions across all levels of sport. Baseline neurocognitive testing has been recommended to provide more accurate representation of the preconcussion cognitive status of individual athletes. However, little is known about the use of baseline neurocognitive testing in concussion assessment and management. To examine implementation and practice trends of sports medicine professionals using baseline neurocognitive testing at the high school and collegiate levels. Quantitative survey research. Online survey. Certified athletic trainers (ATs) from approximately 1209 US institutions listed on the ImPACT Web site were recruited. A total of 399 ATs completed the survey, for a response return rate of 32.7%. Survey questions addressed educational level, years of certification, employment setting, percentage of athletes baseline tested, and accuracy of baseline tests. Other items addressed postconcussive neurocognitive testing protocols and scenarios for return-to-play decisions based on neurocognitive testing. Nearly all ATs (94.7%) administered baseline computerized neurocognitive testing to their athletes. However, only 51.9% examined these baseline tests for validity. The majority of ATs indicated that they administer baseline neurocognitive tests most frequently to football players (88.4%), followed by women's soccer players (78.8%) and men's soccer players (71.2%). Nearly all respondents (95.5%) stated that they would not return a symptomatic athlete to play if the athlete's neurocognitive scores were back to baseline. However, when asked if they would return an athlete who is symptom free but who scores below his or her baseline, 86.5% responded no, 9.8% responded yes, and 3.8% indicated that it depended on the importance of the competition. The use of baseline testing, baseline testing readministration, and postconcussion protocols among ATs is increasing. However, the ATs in this study reported that they relied more on symptoms than on neurocognitive test scores when making return-to-play decisions.

Clinical evaluation of the WOMAC 3.0 OA Index in numeric rating scale format using a computerized touch screen version.

PubMed

Theiler, R; Spielberger, J; Bischoff, H A; Bellamy, N; Huber, J; Kroesen, S

2002-06-01

The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index is a previously described self-administered questionnaire covering three domains: pain, stiffness and function. It has been validated in patients with osteoarthritis (OA) of the hip or knee in a paper-based format. To validate the WOMAC 3.0 using a numerical rating scale in a computerized touch screen format allowing immediate evaluation of the questionnaire. In the computed version cartoons, written and audio instruments were included in order facilitate application. Fifty patients, demographically balanced, with radiographically proven primary hip or knee OA completed the classical paper and the new computerized WOMAC version. Subjects were randomized either to paper format or computerized format first to balance possible order effects. The intra-class correlation coefficients for pain, stiffness and function values were 0.915, 0.745 and 0.940, respectively. The Spearman correlation coefficients for pain, stiffness and function were 0.88, 0.77 and 0.87, respectively. These data indicate that the computerized WOMAC OA index 3.0 is comparable to the paper WOMAC in all three dimensions. The computerized version would allow physicians to get an immediate result and if present a direct comparison with a previous exam. Copyright 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved.

Multitasking capacities in persons diagnosed with schizophrenia: a preliminary examination of their neurocognitive underpinnings and ability to predict real world functioning.

PubMed

Laloyaux, Julien; Van der Linden, Martial; Levaux, Marie-Noëlle; Mourad, Haitham; Pirri, Anthony; Bertrand, Hervé; Domken, Marc-André; Adam, Stéphane; Larøi, Frank

2014-07-30

Difficulties in everyday life activities are core features of persons diagnosed with schizophrenia and in particular during multitasking activities. However, at present, patients׳ multitasking capacities have not been adequately examined in the literature due to the absence of suitable assessment strategies. We thus recently developed a computerized real-life activity task designed to take into account the complex and multitasking nature of certain everyday life activities where participants are required to prepare a room for a meeting. Twenty-one individuals diagnosed with schizophrenia and 20 matched healthy controls completed the computerized task. Patients were also evaluated with a cognitive battery, measures of symptomatology and real world functioning. To examine the ecological validity, 14 other patients were recruited and were given the computerized version and a real version of the meeting preparation task. Results showed that performance on the computerized task was significantly correlated with executive functioning, pointing to the major implication of these cognitive processes in multitasking situations. Performance on the computerized task also significantly predicted up to 50% of real world functioning. Moreover, the computerized task demonstrated good ecological validity. These findings suggest the importance of evaluating multitasking capacities in patients diagnosed with schizophrenia in order to predict real world functioning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Evaluation and Certification of Computerized Provider Order Entry Systems

PubMed Central

Classen, David C.; Avery, Anthony J.; Bates, David W.

2007-01-01

Computerized physician order entry (CPOE) is an application that is used to electronically write physician orders either in the hospital or in the outpatient setting. It is used in about 15% of U.S. Hospitals and a smaller percentage of ambulatory clinics. It is linked with clinical decision support, which provides much of the value of implementing it. A number of studies have assessed the impact of CPOE with respect to a variety of parameters, including costs of care, medication safety, use of guidelines or protocols, and other measures of the effectiveness or quality of care. Most of these studies have been undertaken at CPOE exemplar sites with homegrown clinical information systems. With the increasing implementation of commercial CPOE systems in various settings of care has come evidence that some implementation approaches may not achieve previously published results or may actually cause new errors or even harm. This has lead to new initiatives to evaluate CPOE systems, which have been undertaken by both vendors and other groups who evaluate vendors, focused on CPOE vendor capabilities and effective approaches to implementation that can achieve benefits seen in published studies. In addition, an electronic health record (EHR) vendor certification process is ongoing under the province of the Certification Commission for Health Information Technology (CCHIT) (which includes CPOE) that will affect the purchase and use of these applications by hospitals and clinics and their participation in public and private health insurance programs. Large employers have also joined this focus by developing flight simulation tools to evaluate the capabilities of these CPOE systems once implemented, potentially linking the results of such programs to reimbursement through pay for performance programs. The increasing role of CPOE systems in health care has invited much more scrutiny about the effectiveness of these systems in actual practice which has the potential to improve their ultimate performance. PMID:17077453

Evaluation and certification of computerized provider order entry systems.

PubMed

Classen, David C; Avery, Anthony J; Bates, David W

2007-01-01

Computerized physician order entry (CPOE) is an application that is used to electronically write physician orders either in the hospital or in the outpatient setting. It is used in about 15% of U.S. Hospitals and a smaller percentage of ambulatory clinics. It is linked with clinical decision support, which provides much of the value of implementing it. A number of studies have assessed the impact of CPOE with respect to a variety of parameters, including costs of care, medication safety, use of guidelines or protocols, and other measures of the effectiveness or quality of care. Most of these studies have been undertaken at CPOE exemplar sites with homegrown clinical information systems. With the increasing implementation of commercial CPOE systems in various settings of care has come evidence that some implementation approaches may not achieve previously published results or may actually cause new errors or even harm. This has lead to new initiatives to evaluate CPOE systems, which have been undertaken by both vendors and other groups who evaluate vendors, focused on CPOE vendor capabilities and effective approaches to implementation that can achieve benefits seen in published studies. In addition, an electronic health record (EHR) vendor certification process is ongoing under the province of the Certification Commission for Health Information Technology (CCHIT) (which includes CPOE) that will affect the purchase and use of these applications by hospitals and clinics and their participation in public and private health insurance programs. Large employers have also joined this focus by developing flight simulation tools to evaluate the capabilities of these CPOE systems once implemented, potentially linking the results of such programs to reimbursement through pay for performance programs. The increasing role of CPOE systems in health care has invited much more scrutiny about the effectiveness of these systems in actual practice which has the potential to improve their ultimate performance.

Validation of a Self-Administered Computerized System to Detect Cognitive Impairment in Older Adults

PubMed Central

Brinkman, Samuel D.; Reese, Robert J.; Norsworthy, Larry A.; Dellaria, Donna K.; Kinkade, Jacob W.; Benge, Jared; Brown, Kimberly; Ratka, Anna; Simpkins, James W.

2015-01-01

There is increasing interest in the development of economical and accurate approaches to identifying persons in the community who have mild, undetected cognitive impairments. Computerized assessment systems have been suggested as a viable approach to identifying these persons. The validity of a computerized assessment system for identification of memory and executive deficits in older individuals was evaluated in the current study. Volunteers (N = 235) completed a 3-hr battery of neuropsychological tests and a computerized cognitive assessment system. Participants were classified as impaired (n = 78) or unimpaired (n = 157) on the basis of the Mini Mental State Exam, Wechsler Memory Scale-III and the Trail Making Test (TMT), Part B. All six variables (three memory variables and three executive variables) derived from the computerized assessment differed significantly between groups in the expected direction. There was also evidence of temporal stability and concurrent validity. Application of computerized assessment systems for clinical practice and for identification of research participants is discussed in this article. PMID:25332303

COMPUTERIZED SHAWNEE LIME/LIMESTONE SCRUBBING MODEL USERS MANUAL

EPA Science Inventory

The manual gives a general description of a computerized model for estimating design and cost of lime or limestone scrubber systems for flue gas desulfurization (FGD). It supplements PB80-123037 by extending the number of scrubber options which can be evaluated. It includes spray...

Information technology and medication safety: what is the benefit?

PubMed Central

Kaushal, R; Bates, D

2002-01-01



 Medication errors occur frequently and have significant clinical and financial consequences. Several types of information technologies can be used to decrease rates of medication errors. Computerized physician order entry with decision support significantly reduces serious inpatient medication error rates in adults. Other available information technologies that may prove effective for inpatients include computerized medication administration records, robots, automated pharmacy systems, bar coding, "smart" intravenous devices, and computerized discharge prescriptions and instructions. In outpatients, computerization of prescribing and patient oriented approaches such as personalized web pages and delivery of web based information may be important. Public and private mandates for information technology interventions are growing, but further development, application, evaluation, and dissemination are required. PMID:12486992

Cardiopulmonary data-acquisition system

NASA Technical Reports Server (NTRS)

Crosier, W. G.; Reed, R. A.

1981-01-01

Computerized system controls and monitors bicycle and treadmill cardiovascular stress tests. It acquires and reduces stress data and displays heart rate, blood pressure, workload, respiratory rate, exhaled-gas composition, and other variables. Data are printed on hard-copy terminal every 30 seconds for quick operator response to patient. Ergometer workload is controlled in real time according to experimental protocol. Collected data are stored directly on tape in analog form and on floppy disks in digital form for later processing.

[Cause of late death in liver transplant recipients].

PubMed

Coelho, Júlio Cézar Uili; Parolin, Mônica B; Matias, Jorge Eduardo Fouto; Jorge, Fernando Marcus Felipe; Canan Júnior, Lady Wilson

2003-01-01

The objective is to present the causes of late death in patients subjected to liver transplantation. A total of 209 patients were subjected to 223 liver transplantations (14 retransplantations). The computerized study protocol sheets were evaluated to determine the causes of late death (> 6 months after transplantation). Of the 209 patients, 30 had late death. Ductopenic rejection (chronic rejection) was the most common cause and it was observed in 10 patients. Time after transplantation at the moment of death of this group of patients varied from 11 to 57 months, with an average of 29 months. Seven patients died at the hospital admission of hepatic retransplantation. Other causes of late death were sepsis, lymphoproliferative disease, chronic renal insufficiency, and hepatic insufficiency. The most common cause of late death after liver transplantation is ductopenic rejection, followed by complications of retransplantation and sepsis. Death owing to ductopenic rejection may occur even many years after transplantation.

Evaluation of the 10th Grade Computerized Mathematics Curriculum from the Perspective of the Teachers and Educational Supervisors in the Southern Region in Jordan

ERIC Educational Resources Information Center

Al-Tarawneh, Sabri Hassan; Al-Qadi, Haitham Mamdouh

2016-01-01

This study aimed at evaluating the 10th grade computerized mathematics curriculum from the perspective of the teachers and supervisors in the southern region in Jordan. The study population consisted of all the teachers who teach the 10th grade in the southern region, with the total of (309) teachers and (20) supervisors. The sample consisted of…

Studies and research concerning BNFP: computerized nuclear materials control and accounting system development evaluation report, FY 1978

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crawford, J M; Ehinger, M H; Joseph, C

1978-10-01

Development work on a computerized system for nuclear materials control and accounting in a nuclear fuel reprocessing plant is described and evaluated. Hardware and software were installed and tested to demonstrate key measurement, measurement control, and accounting requirements at accountability input/output points using natural uranium. The demonstration included a remote data acquisition system which interfaces process and special instrumentation to a cenral processing unit.

Implementation of an integrated computerized prescriber order-entry system for chemotherapy in a multisite safety-net health system.

PubMed

Chung, Clement; Patel, Shital; Lee, Rosetta; Fu, Lily; Reilly, Sean; Ho, Tuyet; Lionetti, Jason; George, Michael D; Taylor, Pam

2018-03-15

The development of a computerized prescriber order-entry (CPOE) system for chemotherapy in a multisite safety-net health system and the challenges to its successful implementation are described. Before CPOE for chemotherapy was first implemented and embedded in the electronic medical record system of Harris Health System (HHS), pharmacy personnel relied on regimen-specific preprinted order sets. However, due to differences in practice styles and workflow logistics, the paper orders across the 3 facilities were mostly site specific, with varying clinical content. Many of these order sets had not been approved by the oncology subcommittee. In addition, disparities in clinical knowledge and lack of communication contributed to inconsistencies in order set development. Led by medical directors from medical oncology departments at the 3 facilities, pharmacy administrators, and information technology representatives, HHS committed resources to supporting the adoption and use of a CPOE system for chemotherapy. Five practical lessons of broad applicability have been learned: engagement of interprofessional stakeholders, optimization of workflow before CPOE implementation, requirement of verification tool for CPOE, consolidation of protocols, and commitment to ongoing training and support. Evaluation of the CPOE system demonstrated a systemwide reduction in medication errors by 75% ( p < 0.05). Satisfaction with the CPOE system varied among sites and was unchanged institutionwide 6 months after the CPOE implementation. The development and implementation of CPOE for chemotherapy at a multisite safety-net health system created opportunities to optimize patient care and reduce variations through interprofessional collaborations. Initial evaluation suggested that CPOE reduced the medication-order error rate and improved user satisfaction in 1 of 3 facilities. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Towards a Clinical Trial Protocol to Evaluate Health Information Systems: Evaluation of a Computerized System for Monitoring Tuberculosis from a Patient Perspective in Brazil.

PubMed

Crepaldi, Nathalia Yukie; de Lima, Inacia Bezerra; Vicentine, Fernanda Bergamini; Rodrigues, Lídia Maria Lourençon; Sanches, Tiago Lara Michelin; Ruffino-Netto, Antonio; Alves, Domingos; Rijo, Rui Pedro Charters Lopes

2018-05-08

Assessment of health information systems consider different aspects of the system itself. They focus or on the professional who will use the software or on its usability or on the software engineering metrics or on financial and managerial issues. The existent approaches are very resources consuming, disconnected, and not standardized. As the software becomes more critical in the health organizations and in patients, becoming used as a medical device or a medicine, there is an urgency to identify tools and methods that can be applied in the development process. The present work is one of the steps of a broader study to identify standardized protocols to evaluate the health information systems as medicines and medical devices are evaluated by clinical trials. The goal of the present work was to evaluate the effect of the introduction of an information system for monitoring tuberculosis treatment (SISTB) in a Brazilian municipality from the patients' perspective. The Patient Satisfaction Questionnaire and the Hospital Consumer Assessment of Healthcare Providers and Systems were answered by the patients before and after the SISTB introduction, for comparison. Patients from an outpatient clinic, formed the control group, that is, at this site was not implanted the SISTB. Descriptive statistics and mixed effects model were used for data analysis. Eighty-eight interviews were conducted in the study. The questionnaire's results presented better averages after the system introduction but were not considered statistically significant. Therefore, it was not possible to associate system implantation with improved patient satisfaction. The HIS evaluation need be complete, the technical and managerial evaluation, the safety, the impact on the professionals and direct and/or indirect impact on patients are important. Developing the right tools and methods that can evaluate the software in its entirety, from the beginning of the development cycle with a normalized scale, are needed.

Evaluating the Relationship of Computer Literacy Training Competence and Nursing Experience to CPIS Resistance

ERIC Educational Resources Information Center

Reese, Dorothy J.

2012-01-01

The purpose of this quantitative, descriptive/correlational project was to examine the relationship between the level of computer literacy, informatics training, nursing experience, and perceived competence in using computerized patient information systems (CPIS) and nursing resistance to using CPIS. The Nurse Computerized Patient Information…

An Evaluation of an Inquiry-Based Computer-Assisted Learning Environment.

ERIC Educational Resources Information Center

Maor, Dorit; Fraser, Barry

1994-01-01

This study focused on students' development of inquiry skills in a computerized learning environment. Seven Year-11 classes (n=120) interacted with a computerized database, "Birds of Antarctica," and curriculum materials while the teacher used an inquiry approach to learning. Students perceived their classes as more investigative and…

Collaboration Scripts for Enhancing Metacognitive Self-Regulation and Mathematics Literacy

ERIC Educational Resources Information Center

Chen, Cheng-Huan; Chiu, Chiung-Hui

2016-01-01

This study designed a set of computerized collaboration scripts for multi-touch supported collaborative design-based learning and evaluated its effects on multiple aspects of metacognitive self-regulation in terms of planning and controlling and mathematical literacy achievement at higher and lower levels. The computerized scripts provided a…

The Computerized Adaptive Testing System Development Project.

ERIC Educational Resources Information Center

McBride, James R.; Sympson, J. B.

The Computerized Adaptive Testing (CAT) project is a joint Armed Services coordinated effort to develop and evaluate a system for automated, adaptive administration of the Armed Services Vocational Aptitude Battery (ASVAB). The CAT is a system for administering personnel tests that differs from conventional test administration in two major…

Evaluation Plan for the Computerized Adaptive Vocational Aptitude Battery.

ERIC Educational Resources Information Center

Green, Bert F.; And Others

The United States Armed Services are planning to introduce computerized adaptive testing (CAT) into the Armed Services Vocational Aptitude Battery (ASVAB), which is a major part of the present personnel assessment procedures. Adaptive testing will improve efficiency greatly by assessing each candidate's answers as the test progresses and posing…

Methodology for the development of a taxonomy and toolkit to evaluate health-related habits and lifestyle (eVITAL)

PubMed Central

2010-01-01

Background Chronic diseases cause an ever-increasing percentage of morbidity and mortality, but many have modifiable risk factors. Many behaviors that predispose or protect an individual to chronic disease are interrelated, and therefore are best approached using an integrated model of health and the longevity paradigm, using years lived without disability as the endpoint. Findings This study used a 4-phase mixed qualitative design to create a taxonomy and related online toolkit for the evaluation of health-related habits. Core members of a working group conducted a literature review and created a framing document that defined relevant constructs. This document was revised, first by a working group and then by a series of multidisciplinary expert groups. The working group and expert panels also designed a systematic evaluation of health behaviors and risks, which was computerized and evaluated for feasibility. A demonstration study of the toolkit was performed in 11 healthy volunteers. Discussion In this protocol, we used forms of the community intelligence approach, including frame analysis, feasibility, and demonstration, to develop a clinical taxonomy and an online toolkit with standardized procedures for screening and evaluation of multiple domains of health, with a focus on longevity and the goal of integrating the toolkit into routine clinical practice. Trial Registration IMSERSO registry 200700012672 PMID:20334642

Are flexion extension films necessary for cervical spine clearance in patients with neck pain after negative cervical CT scan?

PubMed

Tran, Baotram; Saxe, Jonathan M; Ekeh, Akpofure Peter

2013-09-01

There are variations in cervical spine (CS) clearance protocols in neurologically intact blunt trauma patients with negative radiological imaging but persistent neck pain. Current guidelines from the current Eastern Association for the Surgery of Trauma include options of maintaining the cervical collar or obtaining either magnetic resonance imaging (MRI) or flexion-extension films (FEF). We evaluated the utility of FEF in the current era of routine computerized tomography (CT) for imaging the CS in trauma. All neurologically intact, awake, nonintoxicated patients who underwent FEF for persistent neck pain after negative CT scan of the CS at our level I trauma center over a 13-mo period were identified. Their charts were reviewed and demographic data obtained. There were 354 patients (58.5% male) with negative cervical CS CT scans who had FEF for residual neck pain. Incidental degenerative changes were seen in 37%--which did not affect their acute management. FEF were positive for possible ligamentous injury in 5 patients (1.4%). Two of these patients had negative magnetic resonance images and the other three had collars removed within 3 wk as the findings were ultimately determined to be degenerative. In the current era, where cervical CT has universally supplanted initial plain films, FEF appear to be of little value in the evaluation of persistent neck pain. Their use should be excluded from cervical spine clearance protocols in neurologically intact, awake patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Computerized tomography tailored for the assessment of microscopic hematuria.

PubMed

Lang, Erich K; Macchia, Richard J; Thomas, Raju; Ruiz-Deya, Gilberto; Watson, Richard A; Richter, Frank; Irwin R, Robert; Marberger, Michael; Mydlo, Jack; Lechner, Gerhard; Cho, Kyunghee C; Gayle, Brian

2002-02-01

We report the results of a multicenter study of arterial, corticomedullary, nephrographic and excretory phase helical computerized tomography (CT) for detecting and characterizing abnormalities causing asymptomatic microscopic hematuria. We evaluated 350 consecutive patients, including 216 men and 134 women 23 to 88 years old, with asymptomatic microscopic hematuria of undetermined cause at 4 medical centers. Patients with known urological pathology were excluded from study. We performed 4 helical CT sequences, including pre-enhancement phase imaging from kidney to symphysis pubis, arterial phase imaging of the kidney and lower pelvis, corticomedullary nephrographic phase imaging of the kidney and lower pelvis, and excretory phase imaging from kidney to symphysis pubis with 2 to 5 mm. collimation and 1 to 1.5 pitch. Of 171 proved lesions 158 were correctly diagnosed. There were 10 false-positive and 13 false-negative diagnoses, indicating 0.9239 sensitivity, 0.9441 specificity, 0.9404 positive and 0.9285 negative predictive values, (p <0.001). All cases of congenital renal lesions, calculous disease, ureteral lesion and neoplastic lesion of the bladder were correctly diagnosed, as were 40 of 41 inflammatory renal, 21 of 23 renal masses and 13 of 16 inflammatory bladder lesions. In 27 patients with renal calculi the study was limited to pre-enhancement spiral CT. A positive diagnosis rate of 45.1% (158 of 350 cases) for the causes of heretofore refractory cases of hematuria with high sensitivity and specificity attest to the effectiveness of our hematuria CT protocol and support its use.

SimulCAT: Windows Software for Simulating Computerized Adaptive Test Administration

ERIC Educational Resources Information Center

Han, Kyung T.

2012-01-01

Most, if not all, computerized adaptive testing (CAT) programs use simulation techniques to develop and evaluate CAT program administration and operations, but such simulation tools are rarely available to the public. Up to now, several software tools have been available to conduct CAT simulations for research purposes; however, these existing…

Evaluating the Validity of Computerized Content Analysis Programs for Identification of Emotional Expression in Cancer Narratives

ERIC Educational Resources Information Center

Bantum, Erin O'Carroll; Owen, Jason E.

2009-01-01

Psychological interventions provide linguistic data that are particularly useful for testing mechanisms of action and improving intervention methodologies. For this study, emotional expression in an Internet-based intervention for women with breast cancer (n = 63) was analyzed via rater coding and 2 computerized coding methods (Linguistic Inquiry…

Computerized Writing and Reading Instruction for Students in Grades 4-9 with Specific Learning Disabilities Affecting Written Language

ERIC Educational Resources Information Center

Tanimoto, S.; Thompson, R.; Berninger, V. W.; Nagy, W.; Abbott, R. D.

2015-01-01

Computer scientists and educational researchers evaluated effectiveness of computerized instruction tailored to evidence-based impairments in specific learning disabilities (SLDs) in students in grades 4-9 with persisting SLDs despite prior extra help. Following comprehensive, evidence-based differential diagnosis for dysgraphia (impaired…

Exploiting Semantic Web Technologies to Develop OWL-Based Clinical Practice Guideline Execution Engines.

PubMed

Jafarpour, Borna; Abidi, Samina Raza; Abidi, Syed Sibte Raza

2016-01-01

Computerizing paper-based CPG and then executing them can provide evidence-informed decision support to physicians at the point of care. Semantic web technologies especially web ontology language (OWL) ontologies have been profusely used to represent computerized CPG. Using semantic web reasoning capabilities to execute OWL-based computerized CPG unties them from a specific custom-built CPG execution engine and increases their shareability as any OWL reasoner and triple store can be utilized for CPG execution. However, existing semantic web reasoning-based CPG execution engines suffer from lack of ability to execute CPG with high levels of expressivity, high cognitive load of computerization of paper-based CPG and updating their computerized versions. In order to address these limitations, we have developed three CPG execution engines based on OWL 1 DL, OWL 2 DL and OWL 2 DL + semantic web rule language (SWRL). OWL 1 DL serves as the base execution engine capable of executing a wide range of CPG constructs, however for executing highly complex CPG the OWL 2 DL and OWL 2 DL + SWRL offer additional executional capabilities. We evaluated the technical performance and medical correctness of our execution engines using a range of CPG. Technical evaluations show the efficiency of our CPG execution engines in terms of CPU time and validity of the generated recommendation in comparison to existing CPG execution engines. Medical evaluations by domain experts show the validity of the CPG-mediated therapy plans in terms of relevance, safety, and ordering for a wide range of patient scenarios.

Post-exertion neurocognitive test failure among student-athletes following concussion.

PubMed

McGrath, Neal; Dinn, Wayne M; Collins, Michael W; Lovell, Mark R; Elbin, R J; Kontos, Anthony P

2013-01-01

The purpose of the present study was to examine post-exertion (PE) neurocognitive performance among student-athletes following concussion who were asymptomatic and returned to baseline normal neurocognitive test levels at rest. This study examined the neurocognitive performance of a sub-set of student-athletes who 'failed' to perform at baseline levels of neurocognitive function, i.e. exhibited downward reliable change index (RCI) alterations following a moderate exertional protocol during recovery from concussion. A retrospective records review was carried out of Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) and neuropsychological consultation data among athletes with sports-related concussion from a network of 22 schools and one junior hockey programme. Fifty-four student-athletes met inclusion criteria and participated in the study. A total of 27.7% of concussed student-athletes who were symptom-free and returned to baseline on ImPACT at rest (i.e. no longer demonstrated performance deficits on neurocognitive tests) exhibited cognitive decline following moderate physical exertion. The PE cognitive changes were not simply general performance effects, but significant changes in memory ability in the presence of intact processing speed functions. The PE-Pass and PE-Fail groups did not, however, differ on post-concussive symptoms or concussion history. Clinicians' return-to-play evaluation protocols should include post-exertional computerized neurocognitive testing.

The Aerospace Energy Systems Laboratory: A BITBUS networking application

NASA Technical Reports Server (NTRS)

Glover, Richard D.; Oneill-Rood, Nora

1989-01-01

The NASA Ames-Dryden Flight Research Facility developed a computerized aircraft battery servicing facility called the Aerospace Energy Systems Laboratory (AESL). This system employs distributed processing with communications provided by a 2.4-megabit BITBUS local area network. Customized handlers provide real time status, remote command, and file transfer protocols between a central system running the iRMX-II operating system and ten slave stations running the iRMX-I operating system. The hardware configuration and software components required to implement this BITBUS application are required.

Evaluation of Interactive Computerized Training to Teach Parents to Implement Photographic Activity Schedules with Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Gerencser, Kristina R.; Higbee, Thomas S.; Akers, Jessica S.; Contreras, Bethany P.

2017-01-01

Training parents of children with autism spectrum disorder can be a challenge due to limited resources, time, and money. Interactive computerized training (ICT)--a self-paced program that incorporates instructions, videos, and interactive questions--is one method professionals can use to disseminate trainings to broader populations. This study…

Evaluating the Effectiveness of Nurse-Focused Computerized Clinical Decision Support on Urinary Catheter Practice Guidelines

ERIC Educational Resources Information Center

Lang, Robin Lynn Neal

2012-01-01

A growing national emphasis has been placed on health information technology (HIT) with robust computerized clinical decision support (CCDS) integration into health care delivery. Catheter-associated urinary tract infection is the most frequent health care-associated infection in the United States and is associated with high cost, high volumes and…

Adaptive Decision Aiding in Computer-Assisted Instruction: Adaptive Computerized Training System (ACTS).

ERIC Educational Resources Information Center

Hopf-Weichel, Rosemarie; And Others

This report describes results of the first year of a three-year program to develop and evaluate a new Adaptive Computerized Training System (ACTS) for electronics maintenance training. (ACTS incorporates an adaptive computer program that learns the student's diagnostic and decision value structure, compares it to that of an expert, and adapts the…

Computerized Placement Management Software (CPMS): User Manual, Version 3.0.

ERIC Educational Resources Information Center

College Entrance Examination Board, Princeton, NJ.

This guide is designed to enable the beginner, as well as the advanced user, to understand and use the Computerized Placement Management Software (CPMS). The CPMS is a system for evaluating information about students and recommending their placement into courses best suited for them. It also tracks their progress and maintains their records. The…

The Design and Evaluation of a Computerized Adaptive Test on Mobile Devices

ERIC Educational Resources Information Center

Triantafillou, Evangelos; Georgiadou, Elissavet; Economides, Anastasios A.

2008-01-01

The use of computerized adaptive testing (CAT) has expanded rapidly over recent years mainly due to the advances in communication and information technology. Availability of advanced mobile technologies provides several benefits to e-learning by creating an additional channel of access with mobile devices such as PDAs and mobile phones. This paper…

Technology transfer opportunities: new development: computerized field manual provides valuable resource for hydrologic investigations

USGS Publications Warehouse

Chapel, Paul

1996-01-01

The U.S. Geological Survey (USGS) is known throughout the world for conducting quality scientific investigation is hydrologic environments. Proper and consistent field techniques have been an integral part of this good research. Over the past few decades, the USGS has developed and published detailed, standard protocols for conducting studies in most aspects of the hydrologic environment. These protocols have been published in a number of diverse documents. The wealth of information contained in these diverse documents can benefit other scientists in industry, government, and academia that are involved in conducting hydrologic studies. Scientists at the USGS have brought together many of the most important of the field protocols in a user-friendly, graphical-interfaced field manual that will be useful in both the field and in the office. This electronic field manual can assist hydrologists and other scientists in conducting and documenting their field activities in a manner that is recognized standard throughout the hydrologic community.

Balance Training Programs in Athletes – a Systematic Review

PubMed Central

Brachman, Anna; Kamieniarz, Anna; Michalska, Justyna; Pawłowski, Michał; Słomka, Kajetan J.; Juras, Grzegorz

2017-01-01

Abstract It has become almost routine practice to incorporate balance exercises into training programs for athletes from different sports. However, the type of training that is most efficient remains unclear, as well as the frequency, intensity and duration of the exercise that would be most beneficial have not yet been determined. The following review is based on papers that were found through computerized searches of PubMed and SportDiscus from 2000 to 2016. Articles related to balance training, testing, and injury prevention in young healthy athletes were considered. Based on a Boolean search strategy the independent researchers performed a literature review. A total of 2395 articles were evaluated, yet only 50 studies met the inclusion criteria. In most of the reviewed articles, balance training has proven to be an effective tool for the improvement of postural control. It is difficult to establish one model of training that would be appropriate for each sport discipline, including its characteristics and demands. The main aim of this review was to identify a training protocol based on most commonly used interventions that led to improvements in balance. Our choice was specifically established on the assessment of the effects of balance training on postural control and injury prevention as well as balance training methods. The analyses including papers in which training protocols demonstrated positive effects on balance performance suggest that an efficient training protocol should last for 8 weeks, with a frequency of two training sessions per week, and a single training session of 45 min. This standard was established based on 36 reviewed studies. PMID:28828077

Adolescent substance use screening in primary care: validity of computer self-administered vs. clinician-administered screening

PubMed Central

Harris, Sion Kim; Knight, John R; Van Hook, Shari; Sherritt, Lon; Brooks, Traci; Kulig, John W; Nordt, Christina; Saitz, Richard

2015-01-01

Background Computer self-administration may help busy pediatricians’ offices increase adolescent substance use screening rates efficiently and effectively, if proven to yield valid responses. The CRAFFT screening protocol for adolescents has demonstrated validity as an interview, but a computer self-entry approach needs validity testing. The aim of this study was to evaluate the criterion validity and time efficiency of a computerized adolescent substance use screening protocol implemented by self-administration or clinician-administration. Methods 12- to 17-year-old patients coming for routine care at three primary care clinics completed the computerized screen by both self-administration and clinician-administration during their visit. To account for order effects, we randomly assigned participants to self-administer the screen either before or after seeing their clinician. Both were conducted using a tablet computer and included identical items (any past-12-month use of tobacco, alcohol, drugs; past-3-months frequency of each; and six CRAFFT items). The criterion measure for substance use was the Timeline Follow-Back, and for alcohol/drug use disorder, the Adolescent Diagnostic Interview, both conducted by confidential research assistant-interview after the visit. Tobacco dependence risk was assessed with the self-administered Hooked on Nicotine Checklist (HONC). Analyses accounted for the multi-site cluster sampling design. Results Among 136 participants, mean age was 15.0±1.5 yrs, 54% were girls, 53% were Black or Hispanic, and 67% had ≥3 prior visits with their clinician. Twenty-seven percent reported any substance use (including tobacco) in the past 12 months, 7% met criteria for an alcohol or cannabis use disorder, and 4% were HONC-positive. Sensitivity/specificity of the screener were high for detecting past-12-month use or disorder and did not differ between computer and clinician. Mean completion time was 49 seconds (95%CI 44-54) for computer and 74 seconds (95%CI 68-87) for clinician (paired comparison p<0.001). Conclusions Substance use screening by computer self-entry is a valid and time-efficient alternative to clinician-administered screening. PMID:25774878

Role of tDCS in potentiating poststroke computerized cognitive rehabilitation: Lessons learned from a case study.

PubMed

Leo, Antonino; De Luca, Rosario; Russo, Margherita; Naro, Antonino; Bramanti, Placido; Calabrò, Rocco S

2016-01-01

Cognitive impairment after stroke is quite common and can cause important disability with a relevant impact on quality of life. Cognitive rehabilitation (CR) and related assistive technology may improve functional outcomes. A 30-year-old woman came to our research institute for an intensive CR cycle following a right parieto-temporal stroke. Because the patient was in the chronic phase, we decided to use 3 different rehabilitative protocols: (a) traditional cognitive training (TCT), (b) computerized cognitive training (CCT), and (c) CCT combined with transcranial direct stimulation (CCT plus) with a 2-week interval separating each session. Cognitive and language deficits were investigated using an ad-hoc psychometric battery at baseline (T0), post-TCT (T1), post-CCT (T2), and post-CCT plus (T3). Our patient showed the best neuropsychological improvement, with regard to attention processes and language domain, after T3. Our data showed that CCT plus should be considered a promising tool in the treatment of poststroke neuropsychological deficits.

Installation of Computerized Procedure System and Advanced Alarm System in the Human Systems Simulation Laboratory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Blanc, Katya Lee; Spielman, Zachary Alexander; Rice, Brandon Charles

2016-04-01

This report describes the installation of two advanced control room technologies, an advanced alarm system and a computerized procedure system, into the Human Systems Simulation Laboratory (HSSL). Installation of these technologies enables future phases of this research by providing a platform to systematically evaluate the effect of these technologies on operator and plant performance.

Demonstration and Evaluation of the Effects of Incentives on Resource Sharing Using a Computerized Interlibrary Communications System.

ERIC Educational Resources Information Center

New England Board of Higher Education, Wellesley, MA. New England Library Information Network.

The potential for using a computerized communication system to facilitate resource sharing in New England has been investigated by the staff of the New England Information Network (NELINET). The central purpose of their research was to determine whether a strategy for load leveling of interlibrary loan (ILL) requests could be implemented online as…

Computerized Classification Testing under the One-Parameter Logistic Response Model with Ability-Based Guessing

ERIC Educational Resources Information Center

Wang, Wen-Chung; Huang, Sheng-Yun

2011-01-01

The one-parameter logistic model with ability-based guessing (1PL-AG) has been recently developed to account for effect of ability on guessing behavior in multiple-choice items. In this study, the authors developed algorithms for computerized classification testing under the 1PL-AG and conducted a series of simulations to evaluate their…

SYN-OP-SYS™: A Computerized Management Information System for Quality Assurance and Risk Management

PubMed Central

Thomas, David J.; Weiner, Jayne; Lippincott, Ronald C.

1985-01-01

SYN·OP·SYS™ is a computerized management information system for quality assurance and risk management. Computer software for the efficient collection and analysis of “occurrences” and the clinical data associated with these kinds of patient events is described. The system is evaluated according to certain computer design criteria, and the system's implementation is assessed.

Multidimensional Computerized Adaptive Scholastic Aptitude Test Program Used for Grade 9 Students under Different Reviewing Test Conditions

ERIC Educational Resources Information Center

Khunkrai, Naruemon; Sawangboon, Tatsirin; Ketchatturat, Jatuphum

2015-01-01

The aim of this research is to study the accurate prediction of comparing test information and evaluation result by multidimensional computerized adaptive scholastic aptitude test program used for grade 9 students under different reviewing test conditions. Grade 9 students of the Secondary Educational Service Area Office in the North-east of…

Assessment of butorphanol-azaperone-medetomidine combination as anesthesia for semen collection and evaluation of semen quality in white-tailed deer (Odocoileus virginianus).

PubMed

Kirschner, S M; Rodenkirch, R

2017-09-01

The aim of this current study was to evaluate the level of anesthesia produced by a combination of butorphanol-azaperone-medetomidine (BAM) for semen collection by electroejaculation on captive white-tailed bucks (Odocoileus virginianus). Ten male white-tailed deer, weighing 68.2-115.9kg, ranging in age from one to four years were randomly selected from housing pens and anesthetized with the BAM drug combination at a dose volume of 2.0mL each. Semen was collected from each animal using a standard cervid electroejaculation protocol while under BAM anesthesia. Physiological data was recorded following induction of anesthesia and during semen collection. Collected ejaculates were prepared for analysis using a standard extender protocol for cryopreservation. Eleven sperm viability parameters were quantified for each sample using a Computerized Assisted Sperm Analysis system, including total seminal volume; sperm concentration and total sperm number. kinematic parameters of motile spermatozoa were also assessed. Results demonstrated that BAM provided an effective plane of anesthesia for successful collection of viable sperm. Measured physiological variables of heart rate, respiration and body temperature all remained within safe, normal limits. Data recorded on semen characteristics from all collected ejaculates correlated well with key traits determined to be important for successful fertilization through measurement of total semen volume; sperm concentration; total sperm number; and kinematic parameters of motile spermatozoa. There were no serious adverse events. This field study indicates that BAM anesthesia is suitable for semen collection in white-tailed deer. Copyright © 2017 Elsevier B.V. All rights reserved.

Performances on the CogState and standard neuropsychological batteries among HIV patients without dementia.

PubMed

Overton, Edgar Turner; Kauwe, John S K; Paul, Robert; Tashima, Karen; Tate, David F; Patel, Pragna; Carpenter, Charles C J; Patty, David; Brooks, John T; Clifford, David B

2011-11-01

HIV-associated neurocognitive disorders remain prevalent but challenging to diagnose particularly among non-demented individuals. To determine whether a brief computerized battery correlates with formal neurocognitive testing, we identified 46 HIV-infected persons who had undergone both formal neurocognitive testing and a brief computerized battery. Simple detection tests correlated best with formal neuropsychological testing. By multivariable regression model, 53% of the variance in the composite Global Deficit Score was accounted for by elements from the brief computerized tool (P < 0.01). These data confirm previous correlation data with the computerized battery. Using the five significant parameters from the regression model in a Receiver Operating Characteristic curve, 90% of persons were accurately classified as being cognitively impaired or not. The test battery requires additional evaluation, specifically for identifying persons with mild impairment, a state upon which interventions may be effective.

Computerized Alerts Improve Outpatient Laboratory Monitoring of Transplant Patients

PubMed Central

Staes, Catherine J.; Evans, R. Scott; Rocha, Beatriz H.S.C.; Sorensen, John B.; Huff, Stanley M.; Arata, Joan; Narus, Scott P.

2008-01-01

Authors evaluated the impact of computerized alerts on the quality of outpatient laboratory monitoring for transplant patients. For 356 outpatient liver transplant patients managed at LDS Hospital, Salt Lake City, this observational study compared traditional laboratory result reporting, using faxes and printouts, to computerized alerts implemented in 2004. Study alerts within the electronic health record notified clinicians of new results and overdue new orders for creatinine tests and immunosuppression drug levels. After implementing alerts, completeness of reporting increased from 66 to >99 %, as did positive predictive value that a report included new information (from 46 to >99 %). Timeliness of reporting and clinicians' responses improved after implementing alerts (p <0.001): median times for clinicians to receive and complete actions decreased to 9 hours from 33 hours using the prior traditional reporting system. Computerized alerts led to more efficient, complete, and timely management of laboratory information. PMID:18308982

The poppy seed test for colovesical fistula: big bang, little bucks!

PubMed

Kwon, Eric O; Armenakas, Noel A; Scharf, Stephen C; Panagopoulos, Georgia; Fracchia, John A

2008-04-01

Diagnosis of a colovesical fistula is often challenging, and usually involves numerous invasive and expensive tests and procedures. The poppy seed test stands out as an exception to this rule. We evaluated the accuracy and cost-effectiveness of various established diagnostic tests used to evaluate a suspected colovesical fistula. We identified 20 prospectively entered patients with surgically confirmed colovesical fistulas between 2000 and 2006. Each patient was evaluated preoperatively with a (51)chromium nuclear study, computerized tomography of the abdomen and pelvis with oral and intravenous contrast medium, and the poppy seed test. Costs were calculated using institutional charges, 2006 Medicare limiting approved charges and the market price, respectively. The z test was used to compare the proportion of patients who tested positive for a fistula with each of these modalities. The chromium study was positive in 16 of 20 patients (80%) at a cost of $490.83 per study. Computerized tomography was positive in 14 of 20 patients (70%) at a cost of $652.92 per study. The poppy seed test was positive in 20 of 20 patients (100%) at a cost of $5.37 per study. The difference in the proportion of patients who tested positive for a fistula on computerized tomography and the poppy seed test was statistically significant (p = 0.03). There was no difference between the chromium group and the computerized tomography or poppy seed group (p = 0.72 and 0.12, respectively). The poppy seed test is an accurate, convenient and inexpensive diagnostic test. It is an ideal initial consideration for evaluating a suspected colovesical fistula.

Tackling inpatient penicillin allergies: Assessing tools for antimicrobial stewardship.

PubMed

Blumenthal, Kimberly G; Wickner, Paige G; Hurwitz, Shelley; Pricco, Nicholas; Nee, Alexandra E; Laskowski, Karl; Shenoy, Erica S; Walensky, Rochelle P

2017-07-01

Reported penicillin allergy rarely reflects penicillin intolerance. Failure to address inpatient penicillin allergies results in more broad-spectrum antibiotic use, treatment failures, and adverse drug events. We aimed to determine the optimal approach to penicillin allergies among medical inpatients. We evaluated internal medicine inpatients reporting penicillin allergy in 3 periods: (1) standard of care (SOC), (2) penicillin skin testing (ST), and (3) computerized guideline application with decision support (APP). The primary outcome was use of a penicillin or cephalosporin, comparing interventions to SOC using multivariable logistic regression. There were 625 patients: SOC, 148; ST, 278; and APP, 199. Of 278 ST patients, 179 (64%) were skin test eligible; 43 (24%) received testing and none were allergic. In the APP period, there were 292 unique Web site views; 112 users (38%) completed clinical decision support. Although ST period patients did not have increased odds of penicillin or cephalosporin use overall (adjusted odds ratio [aOR] 1.3; 95% CI, 0.8-2.0), we observed significant increased odds of penicillin or cephalosporin use overall in the APP period (aOR, 1.8; 95% CI, 1.1-2.9) and in a per-protocol analysis of the skin tested subset (aOR, 5.7; 95% CI, 2.6-12.5). Both APP and ST-when completed-increased the use of penicillin and cephalosporin antibiotics among inpatients reporting penicillin allergy. While the skin tested subset showed an almost 6-fold impact, the computerized guideline significantly increased penicillin or cephalosporin use overall nearly 2-fold and was readily implemented. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Biometric correspondence between reface computerized facial approximations and CT-derived ground truth skin surface models objectively examined using an automated facial recognition system.

PubMed

Parks, Connie L; Monson, Keith L

2018-05-01

This study employed an automated facial recognition system as a means of objectively evaluating biometric correspondence between a ReFace facial approximation and the computed tomography (CT) derived ground truth skin surface of the same individual. High rates of biometric correspondence were observed, irrespective of rank class (R k ) or demographic cohort examined. Overall, 48% of the test subjects' ReFace approximation probes (n=96) were matched to his or her corresponding ground truth skin surface image at R 1 , a rank indicating a high degree of biometric correspondence and a potential positive identification. Identification rates improved with each successively broader rank class (R 10 =85%, R 25 =96%, and R 50 =99%), with 100% identification by R 57 . A sharp increase (39% mean increase) in identification rates was observed between R 1 and R 10 across most rank classes and demographic cohorts. In contrast, significantly lower (p<0.01) increases in identification rates were observed between R 10 and R 25 (8% mean increase) and R 25 and R 50 (3% mean increase). No significant (p>0.05) performance differences were observed across demographic cohorts or CT scan protocols. Performance measures observed in this research suggest that ReFace approximations are biometrically similar to the actual faces of the approximated individuals and, therefore, may have potential operational utility in contexts in which computerized approximations are utilized as probes in automated facial recognition systems. Copyright © 2018. Published by Elsevier B.V.

Cognitive Analysis of Decision Support for Antibiotic Prescribing at the Point of Ordering in a Neonatal Intensive Care Unit

PubMed Central

Sheehan, Barbara; Kaufman, David; Stetson, Peter; Currie, Leanne M.

2009-01-01

Computerized decision support systems have been used to help ensure safe medication prescribing. However, the acceptance of these types of decision support has been reported to be low. It has been suggested that decreased acceptance may be due to lack of clinical relevance. Additionally, cognitive fit between the user interface and clinical task may impact the response of clinicians as they interact with the system. In order to better understand clinician responses to such decision support, we used cognitive task analysis methods to evaluate clinical alerts for antibiotic prescribing in a neonatal intensive care unit. Two methods were used: 1) a cognitive walkthrough; and 2) usability testing with a ‘think-aloud’ protocol. Data were analyzed for impact on cognitive effort according to categories of cognitive distance. We found that responses to alerts may be context specific and that lack of screen cues often increases cognitive effort required to use a system. PMID:20351922

The Vaccine Safety Datalink: immunization research in health maintenance organizations in the USA.

PubMed Central

Chen, R. T.; DeStefano, F.; Davis, R. L.; Jackson, L. A.; Thompson, R. S.; Mullooly, J. P.; Black, S. B.; Shinefield, H. R.; Vadheim, C. M.; Ward, J. I.; Marcy, S. M.

2000-01-01

The Vaccine Safety Datalink is a collaborative project involving the National Immunization Program of the Centers for Disease Control and Prevention and several large health maintenance organizations in the USA. The project began in 1990 with the primary purpose of rigorously evaluating concerns about the safety of vaccines. Computerized data on vaccination, medical outcome (e.g. outpatient visits, emergency room visits, hospitalizations, and deaths) and covariates (e.g. birth certificates, census data) are prospectively collected and linked under joint protocol at multiple health maintenance organizations for analysis. Approximately 6 million persons (2% of the population of the USA) are now members of health maintenance organizations participating in the Vaccine Safety Datalink, which has proved to be a valuable resource providing important information on a number of vaccine safety issues. The databases and infrastructure created for the Vaccine Safety Datalink have also provided opportunities to address vaccination coverage, cost-effectiveness and other matters connected with immunization as well as matters outside this field. PMID:10743283

Role stress in nurses: review of related factors and strategies for moving forward.

PubMed

Chang, Esther M; Hancock, Karen M; Johnson, Amanda; Daly, John; Jackson, Debra

2005-03-01

The aim of this paper was to review the literature on factors related to role stress in nurses, and present strategies for addressing this issue based on the findings of this review while considering potential areas for development and research. Computerized databases were searched as well as hand searching of articles in order to conduct this review. This review identified multiple factors related to the experience of role stress in nurses. Role stress, in particular, work overload, has been reported as one of the main reasons for nurses leaving the workforce. This paper concludes that it is a priority to find new and innovative ways of supporting nurses in their experience of role stress. Some examples discussed in this article include use of stress education and management strategies; team-building strategies; balancing priorities; enhancing social and peer support; flexibility in work hours; protocols to deal with violence; and retention and attraction of nursing staff strategies. These strategies need to be empirically evaluated for their efficacy in reducing role stress.

Virginia Transit Performance Evaluation Package (VATPEP).

DOT National Transportation Integrated Search

1987-01-01

The Virginia Transit Performance Evaluation Package (VATPEP), a computer software package, is documented. This is the computerized version of the methodology used by the Virginia Department of Transportation to evaluate the performance of public tran...

CAD/CAM guided surgery in implant dentistry. A review of software packages and step-by-step protocols for planning surgical guides.

PubMed

Scherer, Michael D; Kattadiyil, Mathew T; Parciak, Ewa; Puri, Shweta

2014-01-01

Three-dimensional radiographic imaging for dental implant treatment planning is gaining widespread interest and popularity. However, application of the data from 30 imaging can be a complex and daunting process initially. The purpose of this article is to describe features of three software packages and the respective computerized guided surgical templates (GST) fabricated from them. A step-by-step method of interpreting and ordering a GST to simplify the process of the surgical planning and implant placement is discussed.

[Is the ICU staff satisfied with the computerized physician order entry? A cross-sectional survey study].

PubMed

Fumis, Renata Rego Lins; Costa, Eduardo Leite Vieira; Martins, Paulo Sergio; Pizzo, Vladimir; Souza, Ivens Augusto; Schettino, Guilherme de Paula Pinto

2014-01-01

To evaluate the satisfaction of the intensive care unit staff with a computerized physician order entry and to compare the concept of the computerized physician order entry relevance among intensive care unit healthcare workers. We performed a cross-sectional survey to assess the satisfaction of the intensive care unit staff with the computerized physician order entry in a 30-bed medical/surgical adult intensive care unit using a self-administered questionnaire. The questions used for grading satisfaction levels were answered according to a numerical scale that ranged from 1 point (low satisfaction) to 10 points (high satisfaction). The majority of the respondents (n=250) were female (66%) between the ages of 30 and 35 years of age (69%). The overall satisfaction with the computerized physician order entry scored 5.74±2.14 points. The satisfaction was lower among physicians (n=42) than among nurses, nurse technicians, respiratory therapists, clinical pharmacists and diet specialists (4.62±1.79 versus 5.97±2.14, p<0.001); satisfaction decreased with age (p<0.001). Physicians scored lower concerning the potential of the computerized physician order entry for improving patient safety (5.45±2.20 versus 8.09±2.21, p<0.001) and the ease of using the computerized physician order entry (3.83±1.88 versus 6.44±2.31, p<0.001). The characteristics independently associated with satisfaction were the system's user-friendliness, accuracy, capacity to provide clear information, and fast response time. Six months after its implementation, healthcare workers were satisfied, albeit not entirely, with the computerized physician order entry. The overall users' satisfaction with computerized physician order entry was lower among physicians compared to other healthcare professionals. The factors associated with satisfaction included the belief that digitalization decreased the workload and contributed to the intensive care unit quality with a user-friendly and accurate system and that digitalization provided concise information within a reasonable time frame.

Quality Assessment of Process Measures in Antimicrobial Stewardship: Concordance of Valacyclovir Indication and Automatic Prospective Approval in Computerized Provider Order Entry

PubMed Central

Lee, Tiffany; McCoy, Christopher; Mahoney, Monica V

2017-01-01

Abstract Background The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) recommend computerized decision support at the time of prescribing as an antimicrobial stewardship (AST) tool. Providing antimicrobial indications during prescribing can optimize infection-specific therapy through appropriate antimicrobial selection, dosing, and frequency. The Leapfrog group identifies this as a quality measure for their report card system. At Beth Israel Deaconess Medical Center (BIDMC), indication-based dosing has been incorporated in the computerized provider order entry (CPOE) system since 2006. At BIDMC, valacyclovir is only approved for the treatment of varicella zoster (VZV) infection or prophylaxis of solid organ transplant (SOT) patients at low risk for cytomegalovirus. These indications bypass the need for AST approval. Accuracy validation of the selected indications has not been formally performed. Methods A retrospective chart review was performed in patients prescribed valacyclovir during an 8-month period in 2016. Electronic medical records, laboratory reports, and pharmacy records were reviewed to identify the suspected/confirmed infection. The primary outcome was the concordance rate of selected CPOE valacyclovir indication compared with suspected/confirmed infection at the time of ordering. The secondary outcome was the proportion of valacyclovir use per institutional protocol. Results Overall, 117 patients were included, with a median age of 57.9 years, 51 (43.6%) were male, and 4 (3.4%) were located in an intensive care unit. Fifty-nine orders (50.4%) selected VZV as the indication, followed by 21 orders (17.9%) for SOT prophylaxis. Of orders with any CPOE indication, only 59/101 (58.4%) were concordant with suspected/confirmed infection. Of the valacyclovir orders with a VZV indication, 37 (62.7%) were concordant. Of the orders with SOT prophylaxis indications, 5 (23.8%) were concordant. Furthermore, only 46 orders (39.3%) were per BIDMC-protocol. Conclusion Concordance of CPOE indication selection and suspected/confirmed infection for valacyclovir was low. Using CPOE to grant automatic prospective approval must be monitored and audited for accuracy if employed as an AST tool. Disclosures All authors: No reported disclosures.

An empirical evaluation of graphical interfaces to support flight planning

NASA Technical Reports Server (NTRS)

Smith, Philip J.; Mccoy, Elaine; Layton, Chuck; Bihari, Tom

1995-01-01

Whether optimization techniques or expert systems technologies are used, the underlying inference processes and the model or knowledge base for a computerized problem-solving system are likely to be incomplete for any given complex, real-world task. To deal with the resultant brittleness, it has been suggested that 'cooperative' rather than 'automated' problem-solving systems be designed. Such cooperative systems are proposed to explicitly enhance the collaboration of people and the computer system when working in partnership to solve problems. This study evaluates the impact of alternative design concepts on the performance of airline pilots interacting with such a cooperative system designed to support enroute flight planning. Thirty pilots were studied using three different versions of the system. The results clearly demonstrate that different system design concepts can strongly influence the cognitive processes of users. Indeed, one of the designs studied caused four times as many pilots to accept a poor flight amendment. Based on think-aloud protocols, cognitive models are proposed to account for how features of the computer system interacted with specific types of scenarios to influence exploration and decision-making by the pilots. The results are then used to develop recommendations for guiding the design of cooperative systems.

An Evaluation of Computerized Tests as Predictors of Job Performance: II. Differential Validity for Global and Job Element Criteria. Final Report.

ERIC Educational Resources Information Center

Cory, Charles H.

This report presents data concerning the validity of a set of experimental computerized and paper-and-pencil tests for measures of on-job performance on global and job elements. It reports on the usefulness of 30 experimental and operational variables for predicting marks on 42 job elements and on a global criterion for Electrician's Mate,…

Evaluation of Psychology Clinicians' Attitudes towards Computerized Cognitive Behavior Therapy, for Use in Their Future Clinical Practice, with Regard to Treating Those Suffering from Anxiety and Depression

ERIC Educational Resources Information Center

Dunne, Nivek

2017-01-01

Computerized Cognitive Behavioural Therapy (CCBT) is an empirically supported therapeutic modality used in the treatment of anxiety and depression. It is an important area of research considering there is much research lacking in this area, especially regarding trainee and qualified psychology clinicians' attitudes which are informative in terms…

SU-E-J-275: Review - Computerized PET/CT Image Analysis in the Evaluation of Tumor Response to Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lu, W; Wang, J; Zhang, H

Purpose: To review the literature in using computerized PET/CT image analysis for the evaluation of tumor response to therapy. Methods: We reviewed and summarized more than 100 papers that used computerized image analysis techniques for the evaluation of tumor response with PET/CT. This review mainly covered four aspects: image registration, tumor segmentation, image feature extraction, and response evaluation. Results: Although rigid image registration is straightforward, it has been shown to achieve good alignment between baseline and evaluation scans. Deformable image registration has been shown to improve the alignment when complex deformable distortions occur due to tumor shrinkage, weight loss ormore » gain, and motion. Many semi-automatic tumor segmentation methods have been developed on PET. A comparative study revealed benefits of high levels of user interaction with simultaneous visualization of CT images and PET gradients. On CT, semi-automatic methods have been developed for only tumors that show marked difference in CT attenuation between the tumor and the surrounding normal tissues. Quite a few multi-modality segmentation methods have been shown to improve accuracy compared to single-modality algorithms. Advanced PET image features considering spatial information, such as tumor volume, tumor shape, total glycolytic volume, histogram distance, and texture features have been found more informative than the traditional SUVmax for the prediction of tumor response. Advanced CT features, including volumetric, attenuation, morphologic, structure, and texture descriptors, have also been found advantage over the traditional RECIST and WHO criteria in certain tumor types. Predictive models based on machine learning technique have been constructed for correlating selected image features to response. These models showed improved performance compared to current methods using cutoff value of a single measurement for tumor response. Conclusion: This review showed that computerized PET/CT image analysis holds great potential to improve the accuracy in evaluation of tumor response. This work was supported in part by the National Cancer Institute Grant R01CA172638.« less

Pilot evaluation of a method to assess prescribers' information processing of medication alerts.

PubMed

Russ, Alissa L; Melton, Brittany L; Daggy, Joanne K; Saleem, Jason J

2017-02-01

Prescribers commonly receive alerts during medication ordering. Prescribers work in a complex, time-pressured environment; to enhance the effectiveness of safety alerts, the effort needed to cognitively process these alerts should be minimized. Methods to evaluate the extent to which computerized alerts support prescribers' information processing are lacking. To develop a methodological protocol to assess the extent to which alerts support prescribers' information processing at-a-glance; specifically, the incorporation of information into their working memory. We hypothesized that the method would be feasible and that we would be able to detect a significant difference in prescribers' information processing with a revised alert display that incorporates warning design guidelines compared to the original alert display. A counterbalanced, within-subject study was conducted with 20 prescribers in a human-computer interaction laboratory. We tested a single alert that was displayed in two different ways. Prescribers were informed that an alert would appear for 10s. After the alert was shown, a white screen was displayed, and prescribers were asked to verbally describe what they saw; indicate how many total warnings; and describe anything else they remembered about the alert. We measured information processing via the accuracy of prescribers' free recall and their ability to identify that three warning messages were present. Two analysts independently evaluated participants' responses against a comprehensive catalog of alert elements and then discussed discrepancies until reaching consensus. This feasibility study demonstrated that the method seemed to be effective for evaluating prescribers' information processing of medication alert displays. With this method, we were able to detect significant differences in prescribers' recall of alert information. The proportion of total data elements that prescribers were able to accurately recall was significantly greater for the revised versus original alert display (p=0.006). With the revised display, more prescribers accurately reported that three warnings were shown (p=0.002). The methodological protocol was feasible for evaluating the alert display and yielded important findings on prescribers' information processing. Study methods supplement traditional usability evaluation methods and may be useful for evaluating information processing of other healthcare technologies. Published by Elsevier Inc.

Evaluation of Spontaneous Spinal Cerebrospinal Fluid Leaks Disease by Computerized Image Processing.

PubMed

Yıldırım, Mustafa S; Kara, Sadık; Albayram, Mehmet S; Okkesim, Şükrü

2016-05-17

Spontaneous Spinal Cerebrospinal Fluid Leaks (SSCFL) is a disease based on tears on the dura mater. Due to widespread symptoms and low frequency of the disease, diagnosis is problematic. Diagnostic lumbar puncture is commonly used for diagnosing SSCFL, though it is invasive and may cause pain, inflammation or new leakages. T2-weighted MR imaging is also used for diagnosis; however, the literature on T2-weighted MRI states that findings for diagnosis of SSCFL could be erroneous when differentiating the diseased and control. One another technique for diagnosis is CT-myelography, but this has been suggested to be less successful than T2-weighted MRI and it needs an initial lumbar puncture. This study aimed to develop an objective, computerized numerical analysis method using noninvasive routine Magnetic Resonance Images that can be used in the evaluation and diagnosis of SSCFL disease. Brain boundaries were automatically detected using methods of mathematical morphology, and a distance transform was employed. According to normalized distances, average densities of certain sites were proportioned and a numerical criterion related to cerebrospinal fluid distribution was calculated. The developed method was able to differentiate between 14 patients and 14 control subjects significantly with p = 0.0088 and d = 0.958. Also, the pre and post-treatment MRI of four patients was obtained and analyzed. The results were differentiated statistically (p = 0.0320, d = 0.853). An original, noninvasive and objective diagnostic test based on computerized image processing has been developed for evaluation of SSCFL. To our knowledge, this is the first computerized image processing method for evaluation of the disease. Discrimination between patients and controls shows the validity of the method. Also, post-treatment changes observed in four patients support this verdict.

Anthropometric and computerized tomographic measurements of lower extremity lean body mass.

PubMed

Buckley, D C; Kudsk, K A; Rose, B S; Fatzinger, P; Koetting, C A; Schlatter, M

1987-02-01

The loss of lean muscle mass is one of the hallmarks of protein-calorie malnutrition. Anthropometry is a standardized technique used to assess the response of muscle mass to nutrition therapy by quantifying the muscle and fat compartments. That technique does not accurately reflect actual limb composition, whereas computerized tomography does. Twenty lower extremities on randomly chosen men and women patients were evaluated by anthropometry and computerized tomography. Total area, muscle plus bone area, total volume, and muscle plus bone volume were correlated, using Heymsfield's equation and computerized tomography-generated areas. Anthropometrics overestimated total and muscle plus bone cross-sectional areas at almost every level. Anthropometry overestimated total area and total volume by 5% to 10% but overestimated muscle plus bone area and muscle plus bone volume by as much as 40%. Anthropometry, while easily performed and useful in large population groups for epidemiological studies, offers a poor assessment of lower extremity composition. On the other hand, computerized tomography is also easily performed and, while impractical for large population groups, does offer an accurate assessment of the lower extremity tissue compartments and is an instrument that might be used in research on lean muscle mass.

[Computerized acquisition and elaboration of clinical data in Rheumatology during ten years: state of art and prospectives

PubMed

Troise Rioda, W.; Nervetti, A.

2001-01-01

The well known complexity to collect the clinical data of patients and in particular in the area of rheumatology push us to develop a computerized clinical chart in order to facilitate the classification, evaluation and monitoring of these patients. The proposed computerized clinical chart is easy to use but at the same time is a very potent tool that allow the clinicians to organize the classic rheumatological pathologies as well as the more complexes or even rare. The proposed clinical chart is based on a relational database (FileMaker Pro 5.0v1) available for both the actual operative systems implemented on personal computers (Windows and Macintosh); this allow the full compatibility among the two systems, the possibility of exchanging data without any loss of information. The computerized clinical chart is structured on modules for specific pathologies and for homogeneous groups of illnesses. Basically the modules are defined correlated files of data for a specific pathology but that can be used also as a common pool for different pathologies. Our experience, based on ten years of use, indicates in the computerized rheumatological clinical chart an indispensable tool for rheumatologists with a real friendly use.

Diagnostic Yield of Transbronchial Biopsy in Comparison to High Resolution Computerized Tomography in Sarcoidosis Cases

PubMed

Akten, H Serpil; Kilic, Hatice; Celik, Bulent; Erbas, Gonca; Isikdogan, Zeynep; Turktas, Haluk; Kokturk, Nurdan

2018-04-25

This study aimed to evaluate the diagnostic yield of fiberoptic bronchoscopic (FOB) transbronchial biopsy and its relation with quantitative findings of high resolution computerized tomography (HRCT). A total of 83 patients, 19 males and 64 females with a mean age of 45.1 years diagnosed with sarcoidosis with complete records of high resolution computerized tomography were retrospectively recruited during the time period from Feb 2005 to Jan 2015. High resolution computerized tomography scans were retrospectively assessed in random order by an experienced observer without knowledge of the bronchoscopic results or lung function tests. According to the radiological staging with HRCT, 2.4% of the patients (n=2) were stage 0, 19.3% (n=16) were stage 1, 72.3% (n=60) were stage 2 and 6.0% (n=5) were stage 3. This study showed that transbronchial lung biopsy showed positive results in 39.7% of the stage I or II sarcoidosis patients who were diagnosed by bronchoscopy. Different high resolution computerized tomography patterns and different scores of involvement did make a difference in the diagnostic accuracy of transbronchial biopsy (p=0.007). Creative Commons Attribution License

Linked Orders Improve Safety in Scheduling and Administration of Chemotherapeutic Agents

PubMed Central

Whipple, Nancy; Boulware, Joy; Danca, Kala; Boyarin, Kirill; Ginsberg, Eliot; Poon, Eric; Sweet, Micheal; Schade, Sue; Rogala, Jennifer

2010-01-01

The pharmacologic treatment for cancer must adhere to complex, finely orchestrated treatment plans, including not only chemotherapy medications, but pre/post-hydration, anti-emetics, anti-anxiety, and other medications that are given before, during and after chemotherapy doses. The treatment plans specify the medications and dictate precise dosing, frequency, and timing. This is a challenge to most Computerized Physician Order Entry (CPOE), Pharmacy and Electronic Medication Administration record (eMAR) Systems. Medications are scheduled on specific dates, referred to as chemo days, from the onset of the treatment, and precisely timed on the designated chemo day. For patients enrolled in research protocols, the adherence to the defined schedule takes on additional import, since variation is a violation of the protocol. If the oncologist determines that medications must be administered outside the defined constraints, the patient must be un-enrolled from the protocol and the course of therapy is re-written. Pharmacy and eMAR systems utilized in processing chemotherapy medications must be able to support the intricate relationships between each drug defined in the treatment plans. PMID:21347104

Features of computerized clinical decision support systems supportive of nursing practice: a literature review.

PubMed

Lee, Seonah

2013-10-01

This study aimed to organize the system features of decision support technologies targeted at nursing practice into assessment, problem identification, care plans, implementation, and outcome evaluation. It also aimed to identify the range of the five stage-related sequential decision supports that computerized clinical decision support systems provided. MEDLINE, CINAHL, and EMBASE were searched. A total of 27 studies were reviewed. The system features collected represented the characteristics of each category from patient assessment to outcome evaluation. Several features were common across the reviewed systems. For the sequential decision support, all of the reviewed systems provided decision support in sequence for patient assessment and care plans. Fewer than half of the systems included problem identification. There were only three systems operating in an implementation stage and four systems in outcome evaluation. Consequently, the key steps for sequential decision support functions were initial patient assessment, problem identification, care plan, and outcome evaluation. Providing decision support in such a full scope will effectively help nurses' clinical decision making. By organizing the system features, a comprehensive picture of nursing practice-oriented computerized decision support systems was obtained; however, the development of a guideline for better systems should go beyond the scope of a literature review.

Recovery of postural equilibrium control following space flight

NASA Technical Reports Server (NTRS)

Paloski, William H.; Reschke, Millard F.; Black, F. Owen; Dow, R. S.

1999-01-01

DSO 605 represents the first large study of balance control following spaceflight. Data collected during DSO 605 confirm the theory that postural ataxia following short duration spaceflight is of vestibular origin. We used the computerized dynamic posturography technique developed by Nashner et al. to study the role of the vestibular system in balance control in astronauts during quiet stance before and after spaceflight. Our results demonstrate unequivocally that balance control is disrupted in all astronauts immediately after return from space. The most severely affected returning crew members performed in the same way as vestibular deficient patients exposed to this test battery. We conclude that otolith mediated spatial reference provided by the terrestrial gravitational force vector is not used by the astronauts balance control systems immediately after spaceflight. Because the postflight ataxia appears to be mediated primarily by CNS adaptation to the altered vestibular inputs caused by loss of gravitational stimulation, we believe that intermittent periods of exposure to artificial gravity may provide an effective in-flight countermeasure. Specifically, we propose that in-flight centrifugation will allow crew members to retain their terrestrial sensory-motor adapted states while simultaneously developing microgravity adapted states. The dual-adapted astronaut should be able to make the transition from microgravity to unit gravity with minimal sensory-motor effects. We have begun a ground based program aimed at developing short arm centrifuge prescriptions designed to optimize adaptation to altered gravitational environments. Results from these experiments are expected to lead directly to in-flight evaluation of the proposed centrifuge countermeasure. Because our computerized dynamic posturography system was able to (1) quantify the postflight postural ataxia reported by crew members and observed by flight surgeons and scientists, (2) track the recovery of normal (preflight) balance control, (3) differentiate between rookie and veteran subjects, and (4) provide normative and clinical databases for comparison, and because our study successfully characterized postflight balance control recovery in a large cross-section of Shuttle crew members, we recommend that this system and protocol be adopted as a standard dependent measure for evaluating the efficacy of countermeasures and/or evaluating the postflight effects of changing mission durations or activities.

Computerized cognitive training in children and adolescents with attention deficit/hyperactivity disorder as add-on treatment to stimulants: feasibility study and protocol description.

PubMed

Rosa, Virginia de Oliveira; Schmitz, Marcelo; Moreira-Maia, Carlos Roberto; Wagner, Flavia; Londero, Igor; Bassotto, Caroline de Fraga; Moritz, Guilherme; de Souza, Caroline Dos Santos; Rohde, Luis Augusto Paim

2017-01-01

Cognitive training has received increasing attention as a non-pharmacological approach for the treatment of attention deficit/hyperactivity disorder (ADHD) in children and adolescents. Few studies have assessed cognitive training as add-on treatment to medication in randomized placebo controlled trials. The purpose of this preliminary study was to explore the feasibility of implementing a computerized cognitive training program for ADHD in our environment, describe its main characteristics and potential efficacy in a small pilot study. Six ADHD patients aged 10-12-years old receiving stimulants and presenting residual symptoms were enrolled in a randomized clinical trial to either a standard cognitive training program or a controlled placebo condition for 12 weeks. The primary outcome was core ADHD symptoms measured using the Swanson, Nolan and Pelham Questionnaire (SNAP-IV scale). We faced higher resistance than expected to patient enrollment due to logistic issues to attend face-to-face sessions in the hospital and to fill the requirement of medication status and absence of some comorbidities. Both groups showed decrease in parent reported ADHD symptoms without statistical difference between them. In addition, improvements on neuropsychological tests were observed in both groups - mainly on trained tasks. This protocol revealed the need for new strategies to better assess the effectiveness of cognitive training such as the need to implement the intervention in a school environment to have an assessment with more external validity. Given the small sample size of this pilot study, definitive conclusions on the effects of cognitive training as add-on treatment to stimulants would be premature.

The effects of mild and severe traumatic brain injury on speed of information processing as measured by the computerized tests of information processing (CTIP).

PubMed

Tombaugh, Tom N; Rees, Laura; Stormer, Peter; Harrison, Allyson G; Smith, Andra

2007-01-01

In spite of the fact that reaction time (RT) measures are sensitive to the effects of traumatic brain injury (TBI), few RT procedures have been developed for use in standard clinical evaluations. The computerized test of information processing (CTIP) [Tombaugh, T. N., & Rees, L. (2000). Manual for the computerized tests of information processing (CTIP). Ottawa, Ont.: Carleton University] was designed to measure the degree to which TBI decreases the speed at which information is processed. The CTIP consists of three computerized programs that progressively increase the amount of information that is processed. Results of the current study demonstrated that RT increased as the difficulty of the CTIP tests increased (known as the complexity effect), and as severity of injury increased (from mild to severe TBI). The current study also demonstrated the importance of selecting a non-biased measure of variability. Overall, findings suggest that the CTIP is an easy to administer and sensitive measure of information processing speed.

Learning effect of computerized cognitive tests in older adults

PubMed Central

de Oliveira, Rafaela Sanches; Trezza, Beatriz Maria; Busse, Alexandre Leopold; Jacob-Filho, Wilson

2014-01-01

ABSTRACT Objective: To evaluate the learning effect of computerized cognitive testing in the elderly. Methods: Cross-sectional study with 20 elderly, 10 women and 10 men, with average age of 77.5 (±4.28) years. The volunteers performed two series of computerized cognitive tests in sequence and their results were compared. The applied tests were: Trail Making A and B, Spatial Recognition, Go/No Go, Memory Span, Pattern Recognition Memory and Reverse Span. Results: Based on the comparison of the results, learning effects were observed only in the Trail Making A test (p=0.019). Other tests performed presented no significant performance improvements. There was no correlation between learning effect and age (p=0.337) and education (p=0.362), as well as differences between genders (p=0.465). Conclusion: The computerized cognitive tests repeated immediately afterwards, for elderly, revealed no change in their performance, with the exception of the Trail Making test, demonstrating high clinical applicability, even in short intervals. PMID:25003917

Sensitive Quantitative Assessment of Balance Disorders

NASA Technical Reports Server (NTRS)

Paloski, Willilam H.

2007-01-01

Computerized dynamic posturography (CDP) has become a standard technique for objectively quantifying balance control performance, diagnosing the nature of functional impairments underlying balance disorders, and monitoring clinical treatment outcomes. We have long used CDP protocols to assess recovery of sensory-motor function in astronauts following space flight. The most reliable indicators of post-flight crew performance are the sensory organization tests (SOTs), particularly SOTs 5 and 6, which are sensitive to changes in availability and/or utilization of vestibular cues. We have noted, however, that some astronauts exhibiting obvious signs of balance impairment after flight are able to score within clinical norms on these tests, perhaps as a result of adopting competitive strategies or by their natural skills at substituting alternate sensory information sources. This insensitivity of the CDP protocol could underestimate of the degree of impairment and, perhaps, lead to premature release of those crewmembers to normal duties. To improve the sensitivity of the CDP protocol we have introduced static and dynamic head tilt SOT trials into our protocol. The pattern of postflight recovery quantified by the enhanced CDP protocol appears to more aptly track the re-integration of sensory-motor function, with recovery time increasing as the complexity of sensory-motor/biomechanical task increases. The new CDP protocol therefore seems more suitable for monitoring post-flight sensory-motor recovery and for indicating to crewmembers and flight surgeons fitness for return to duty and/or activities of daily living. There may be classes of patients (e.g., athletes, pilots) having motivation and/or performance characteristics similar to astronauts whose sensory-motor treatment outcomes would also be more accurately monitored using the enhanced CDP protocol. Furthermore, the enhanced protocol may be useful in early detection of age-related balance disorders.

Computerized quantitative evaluation of mammographic accreditation phantom images

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Yongbum; Tsai, Du-Yih; Shinohara, Norimitsu

2010-12-15

Purpose: The objective was to develop and investigate an automated scoring scheme of the American College of Radiology (ACR) mammographic accreditation phantom (RMI 156, Middleton, WI) images. Methods: The developed method consisted of background subtraction, determination of region of interest, classification of fiber and mass objects by Mahalanobis distance, detection of specks by template matching, and rule-based scoring. Fifty-one phantom images were collected from 51 facilities for this study (one facility provided one image). A medical physicist and two radiologic technologists also scored the images. The human and computerized scores were compared. Results: In terms of meeting the ACR's criteria,more » the accuracies of the developed method for computerized evaluation of fiber, mass, and speck were 90%, 80%, and 98%, respectively. Contingency table analysis revealed significant association between observer and computer scores for microcalcifications (p<5%) but not for masses and fibers. Conclusions: The developed method may achieve a stable assessment of visibility for test objects in mammographic accreditation phantom image in whether the phantom image meets the ACR's criteria in the evaluation test, although there is room left for improvement in the approach for fiber and mass objects.« less

Implementation of real-time digital endoscopic image processing system

NASA Astrophysics Data System (ADS)

Song, Chul Gyu; Lee, Young Mook; Lee, Sang Min; Kim, Won Ky; Lee, Jae Ho; Lee, Myoung Ho

1997-10-01

Endoscopy has become a crucial diagnostic and therapeutic procedure in clinical areas. Over the past four years, we have developed a computerized system to record and store clinical data pertaining to endoscopic surgery of laparascopic cholecystectomy, pelviscopic endometriosis, and surgical arthroscopy. In this study, we developed a computer system, which is composed of a frame grabber, a sound board, a VCR control board, a LAN card and EDMS. Also, computer system controls peripheral instruments such as a color video printer, a video cassette recorder, and endoscopic input/output signals. Digital endoscopic data management system is based on open architecture and a set of widely available industry standards; namely Microsoft Windows as an operating system, TCP/IP as a network protocol and a time sequential database that handles both images and speech. For the purpose of data storage, we used MOD and CD- R. Digital endoscopic system was designed to be able to store, recreate, change, and compress signals and medical images. Computerized endoscopy enables us to generate and manipulate the original visual document, making it accessible to a virtually unlimited number of physicians.

[Impact of quality-indicator-based measures to improve the treatment of acute poisoning in pediatric emergency patients].

PubMed

Martínez Sánchez, Lidia; Trenchs Sainz de la Maza, Victoria; Azkunaga Santibáñez, Beatriz; Nogué-Xarau, Santiago; Ferrer Bosch, Nuria; García González, Elsa; Luaces I Cubells, Carles

2016-02-01

To analyze the impact of quality-indicator-based measures for improving quality of care for acute poisoning in pediatric emergency departments. Recent assessments of quality indicators were compared with benchmark targets and with results from previous studies. The first study evaluated 6 basic indicators in the pediatric emergency departments of members of to the working group on poisoning of the Spanish Society of Pediatric Emergency Medicine (GTI-SEUP). The second study evaluated 20 indicators in a single emergency department of GTI-SEUP members. Based on the results of those studies, the departments implemented the following corrective measures: creation of a team for gastric lavage follow-up, preparation of a new GTI-SEUP manual on poisoning, implementation of a protocol for poisoning incidents, and creation of specific poisoning-related fields for computerized patient records. The benchmark targets were reached on 4 quality indicators in the first study. Improvements were seen in the availability of protocols, as indicators exceeded the target in all the pediatric emergency departments (vs 29.2% of the departments in an earlier study, P < .001). No other significant improvements were observed. In the second study the benchmarks were reached on 13 indicators. Improvements were seen in compliance with incident reporting to the police (recently, 44.4% vs 19.2% previously, P = .036), case registration in the minimum basic data set (51.0% vs 1.9%, P < .001), and a trend toward increased administration of activated carbon within 2 hours (93.1% vs 83.5%, P = .099). No other significant improvements were seen. The corrective measures led to improvements in some quality indicators. There is still room for improvement in these emergency departamens' care of pediatric poisoning.

A pilot study on the benefit of cognitive rehabilitation in Parkinson’s disease

PubMed Central

Adamski, Natalia; Adler, Matthias; Opwis, Klaus; Penner, Iris-Katharina

2016-01-01

Purpose: Patients with Parkinson’s disease (PD) show inefficiencies in cognitive performance including working memory functions. Since these problems impact on quality of life and overall well-being, the current study was aimed at improving patients’ situations by evaluating the computerized cognitive training tool, BrainStim. Method: A total of 19 healthy controls (HCs) and six patients with PD were included in the study. While all PD patients received cognitive training, the HC sample was subdivided into 12 subjects with training (HC-T) and 10 subjects without (HC-NT). Participants underwent a double baseline assessment, a post-training assessment, and a 3-month follow up on neuropsychological tests and self-report measures on fatigue and depression. Training was administered between the second baseline and postassessment. It comprised 16 supervised sessions according to a standardized training protocol over 4 weeks. Results: Significant improvements in verbal and visuospatial short-term and long-term memory were found in both training groups. In addition, the HC-T improved on mental speed, and verbal and visuospatial working memory. Both training groups showed stable results for all short-term visuospatial measures after 3 months. Further, the HC-T showed stable results for working memory, verbal, and visuospatial short-term and long-term memory. Conclusions: The efficacy of the applied computerized cognitive training tool BrainStim could be verified in patients with PD and healthy age-matched controls. The preliminary findings highlighted the suitability of a specific cognitive intervention to improve cognitive inefficiencies in patients with PD as well as in healthy older people. Further research on cognitive training in combination with PD drug therapy is needed to better understand the mutual interaction and to offer optimal therapeutic approaches to patients. PMID:27134671

Randomized double-blind comparison of cognitive and EEG effects of lacosamide and carbamazepine.

PubMed

Meador, Kimford J; Loring, David W; Boyd, Alan; Echauz, Javier; LaRoche, Suzette; Velez-Ruiz, Naymee; Korb, Pearce; Byrnes, William; Dilley, Deanne; Borghs, Simon; De Backer, Marc; Story, Tyler; Dedeken, Peter; Webster, Elizabeth

2016-09-01

Differential effectiveness of antiepileptic drugs (AEDs) is more commonly determined by tolerability than efficacy. Cognitive effects of AEDs can adversely affect tolerability and quality of life. This study evaluated cognitive and EEG effects of lacosamide (LCM) compared with carbamazepine immediate-release (CBZ-IR). A randomized, double-blind, double-dummy, two-period crossover, fixed-dose study in healthy subjects compared neuropsychological and EEG effects of LCM (150mg, b.i.d.) and CBZ-IR (200mg, t.i.d.). Testing was conducted at screening, predrug baseline, the end of each treatment period (3-week titration; 3-week maintenance), and the end of each washout period (4weeks after treatment). A composite Z-score was derived for the primary outcome variable (computerized cognitive tests and traditional neuropsychological measures) and separately for the EEG measures. Other variables included individual computer, neuropsychological, and EEG scores and adverse events (AEs). Subjects included 60 healthy adults (57% female; mean age: 34.4years [SD: 10.5]); 44 completed both treatments; 41 were per protocol subjects. Carbamazepine immediate-release had worse scores compared with LCM for the primary composite neuropsychological outcome (mean difference=0.33 [SD: 1.36], p=0.011) and for the composite EEG score (mean difference=0.92 [SD: 1.77], p=0.003). Secondary analyses across the individual variables revealed that CBZ-IR was statistically worse than LCM on 36% (4/11) of the neuropsychological tests (computerized and noncomputerized) and 0% of the four EEG measures; none favored CBZ-IR. Drug-related AEs occurred more with CBZ-IR (49%) than LCM (22%). Lacosamide had fewer untoward neuropsychological and EEG effects and fewer AEs and AE-related discontinuations than CBZ-IR in healthy subjects. Lacosamide exhibits a favorable cognitive profile. Copyright © 2016 Elsevier Inc. All rights reserved.

Computerized Adaptive Testing Project: Objectives and Requirements.

DTIC Science & Technology

1982-07-01

developing a cqmputerlzed adaptive lwfb system ( CAT ). SiN 0102- LP. Old. "O AM"- S/M "of F.g~ smuuim ftmAYUSN 0 IM ~ A joint-service coordinated effort is In...progress to develop a computerized adaptive testing ( CAT ) system and to evaluate its potential for use in the Military Enlistment Processing Stations...lead laboratory for this effort. This report is intended to serve as a working paper documenting CAT system functional requirements and schedules. It

COMPLY

EPA Pesticide Factsheets

A computerized screening tool for evaluating radiation exposure from atmospheric releases of radionuclides. May be used for demonstrating compliance with some EPA and Nuclear Regulatory Commission regulations

Pearls and pitfalls in neural CGRP immunohistochemistry.

PubMed

Warfvinge, Karin; Edvinsson, Lars

2013-06-01

This review outlines the pearls and pitfalls of calcitonin-gene related protein (CGRP) immunohistochemistry of the brain. In 1985, CGRP was first described in cerebral arteries using immunohistochemistry. Since then, cerebral CGRP (and, using novel antibodies, its receptor components) has been widely scrutinized. Here, we describe the distribution of cerebral CGRP and pay special attention to the surprising reliability of results over time. Pitfalls might include a fixation procedure, antibody clone and dilution, and interpretation of results. Standardization of staining protocols and true quantitative methods are lacking. The use of computerized image analysis has led us to believe that our examination is objective. However, in the steps of performing such an analysis, we make subjective choices. By pointing out these pitfalls, we aim to further improve immunohistochemical quality. Having a clear picture of the tissue/cell morphology is a necessity. A primary morphological evaluation with, for example, hematoxylin-eosin, helps to ensure that small changes are not missed and that background and artifactual changes, which may include vacuoles, pigments, and dark neurons, are not over-interpreted as compound-related changes. The antigen-antibody reaction appears simple and clear in theory, but many steps might go wrong. Remember that methods including the antigen-antibody complex rely on handling/fixation of tissues or cells, antibody shipping/storing issues, antibody titration, temperature/duration of antibody incubation, visualization of the antibody and interpretation of the results. Optimize staining protocols to the material you are using.

Context and clinical reasoning : Understanding the medical student perspective.

PubMed

McBee, Elexis; Ratcliffe, Temple; Schuwirth, Lambert; O'Neill, Daniel; Meyer, Holly; Madden, Shelby J; Durning, Steven J

2018-04-27

Studies have shown that a physician's clinical reasoning performance can be influenced by contextual factors. We explored how the clinical reasoning performance of medical students was impacted by contextual factors in order to expand upon previous findings in resident and board certified physicians. Using situated cognition as the theoretical framework, our aim was to evaluate the verbalized clinical reasoning processes of medical students in order to describe what impact the presence of contextual factors has on their reasoning performance. Seventeen medical student participants viewed three video recordings of clinical encounters portraying straightforward diagnostic cases in internal medicine with explicit contextual factors inserted. Participants completed a computerized post-encounter form as well as a think-aloud protocol. Three authors analyzed verbatim transcripts from the think-aloud protocols using a constant comparative approach. After iterative coding, utterances were analyzed and grouped into categories and themes. Six categories and ten associated themes emerged, which demonstrated overlap with findings from previous studies in resident and attending physicians. Four overlapping categories included emotional disturbances, behavioural inferences about the patient, doctor-patient relationship, and difficulty with closure. Two new categories emerged to include anchoring and misinterpretation of data. The presence of contextual factors appeared to impact clinical reasoning performance in medical students. The data suggest that a contextual factor can be innate to the clinical scenario, consistent with situated cognition theory. These findings build upon our understanding of clinical reasoning performance from both a theoretical and practical perspective.

Virtual Reality Therapy for the Treatment of Alcohol Dependence: A Preliminary Investigation With Positron Emission Tomography/Computerized Tomography.

PubMed

Son, Ji Hyun; Lee, Sang Hoon; Seok, Ju Won; Kee, Baik Seok; Lee, Hyun Woong; Kim, Hyung Joon; Lee, Tae Kyung; Han, Doug Hyun

2015-07-01

Virtual reality therapy (VRT) uses multimodal stimulation that includes visual, auditory, olfactory, and gustatory stimuli. The aim of this study was to assess the effectiveness of VRT in treating subjects with alcohol dependence (AD) by evaluating changes in brain metabolism. The VRT protocol consisted of three steps: relaxation, presentation of a high-risk situation, and presentation of an aversive situation. Twelve alcohol-dependent subjects underwent 10 sessions of VRT. The alcohol-dependent subjects were assessed with 18F-fluorodeoxyglucose positron emission tomography images before and after VRT, whereas the control group underwent imaging according to the same protocol only at baseline. Compared with the healthy control group, AD subjects showed higher metabolism in the right lentiform nucleus and right temporal lobe (BA20) at baseline (P(FDR < .05) = .026). In addition, the metabolism in the left anterior cingulate was lower in subjects with AD (P(uncorr) = .001). After VRT, alcohol-dependent subjects showed decreased brain metabolism in the right lentiform nucleus (P(FDR < .05) = .026) and right temporal lobe (BA38, P(FDR < .05) = .032) relative to that at baseline. Our results suggest a neurobiological imbalance, notably, a high sensitivity to stimuli, in the limbic system in subjects with AD. Furthermore, we determined that metabolism decreased in the basal ganglia after VRT, which may explain the limbic-regulated responses of reward and regulation. Therefore, we tentatively recommend VRT to treat AD through its regulating effect on limbic circuits.

A computerized stroop test for the evaluation of psychotropic drugs in healthy participants.

PubMed

Pilli, Raveendranadh; Naidu, Mur; Pingali, Usha Rani; Shobha, J C; Reddy, A Praveen

2013-04-01

The Stroop paradigm evaluates susceptibility to interference and is sensitive to dysfunction in frontal lobes and drug effects. The aim of the present study was to establish a simple and reliable computerized version of Stroop color-word test, which can be used for screening of various psychotropic drugs. The standardized method was followed in all cases, by recording the reaction time (RT) in msec in 24 healthy participants using computerized version of Stroop color-word test. Reproducibility of the test procedure was evaluated by recording the RTs by a single experimenter on two sessions (interday reproducibility). Validity of the model was further tested by evaluating the psychotropic effect of Zolpidem 5 mg, Caffeine 500 mg, or Placebo on 24 healthy subjects in a randomized, double blind three-way crossover design. The method was found to produce low variability with coefficient of variation less than 10%. Interday reproducibility was very good as shown by Bland-Altman plot with most of the values within ±2SD. There was a significant increase in RTs in Stroop performance with Zolpidem at 1 hr and 2 hrs; in contrast, caffeine significantly decreased RTs in Stroop performance at 1 hr only compared to placebo. The Stroop color-word recording and analysis system is simple, sensitive to centrally acting drug effects, and has potential for future experimental psychomotor assessment studies.

Computerization of a preanesthetic evaluation and user satisfaction evaluation.

PubMed

Arias, Antonio; Benítez, Sonia; Canosa, Daniela; Borbolla, Damián; Staccia, Gustavo; Plazzotta, Fernando; Casais, Marcela; Michelangelo, Hernán; Luna, Daniel; Bernaldo de Quirós, Fernán Gonzalez

2010-01-01

Preanesthetic evaluation purpose is to reduce morbidity and mortality through the review of the patient's medical history, clinical examination, and targeted clinical studies, providing referrals for medical consultations when appropriated. Changes in patient care, standards of health information management and patterns of perioperative care, have resulted in a re-conceptualization of this process where the documentation of patient medical information, the efforts in training and maintaining the integrity of the medical-legal evaluation are areas of concern. The aim of this paper is to describe the design, development, training, and implementation of a computerized preanesthetic evaluation form associated to the evaluation of the user satisfaction with the system. Since the system went live in September 2008 there were 15121 closed structured forms, 60% for ambulatory procedures and 40 % for procedures that required hospital admission. 82% of total closed structured forms had recorded a risk of the procedures of 1-2, according to the American Society of Anesthesiologists classification. The survey indicates a positive general satisfaction of the users with the system.

Investigation of the reproducibility and reliability of sagittal vertebral inclination measurements from MR images of the spine.

PubMed

Vrtovec, Tomaž; Pernuš, Franjo; Likar, Boštjan

2014-10-01

In this study, sagittal vertebral inclination (SVI) was systematically evaluated for 28 vertebrae (segments between T4 and L5) in magnetic resonance (MR) images of one normal and one scoliotic subject to compare the performance of manual and computerized measurements, and identify the most reproducible and reliable measurements. Manual measurements were performed by three observers, who identified on two occasions the distinctive anatomical landmarks required to evaluate SVI by six measurement methods, i.e. the superior tangents, inferior tangents, anterior tangents, posterior tangents, mid-endplate lines and mid-wall lines. Computerized measurements were performed by automatically evaluating SVI from the symmetry of vertebral anatomical structures in two-dimensional (2D) sagittal cross-sections and in three-dimensional (3D) volumetric images. The mid-wall lines and posterior tangents proved to be the manual measurements with the lowest intra-observer (standard deviation, SD, of 1.4° and 1.7°, respectively) and inter-observer variability (SD of 1.9° and 2.4°, respectively). The strongest inter-method agreement was found between the mid-wall lines and posterior tangents (SD of 2.0°). Computerized measurements in 2D and in 3D resulted in intra-observer (SD of 2.8° and 3.1°, respectively) and inter-observer variability (SD of 3.8° and 5.2°, respectively) that were comparable to those of the superior tangents (SD of 2.6° and 3.7°) and inferior tangents (SD of 3.2° and 4.5°), which represent standard Cobb angle measurements. It can be concluded that computerized measurements of SVI should be based on the inclination of vertebral body walls. Copyright © 2014 Elsevier Ltd. All rights reserved.

Feasibility and Efficacy of Nurse-Driven Acute Stroke Care.

PubMed

Mainali, Shraddha; Stutzman, Sonja; Sengupta, Samarpita; Dirickson, Amanda; Riise, Laura; Jones, Donald; Yang, Julian; Olson, DaiWai M

2017-05-01

Acute stroke care requires rapid assessment and intervention. Replacing traditional sequential algorithms in stroke care with parallel processing using telestroke consultation could be useful in the management of acute stroke patients. The purpose of this study was to assess the feasibility of a nurse-driven acute stroke protocol using a parallel processing model. This is a prospective, nonrandomized, feasibility study of a quality improvement initiative. Stroke team members had a 1-month training phase, and then the protocol was implemented for 6 months and data were collected on a "run-sheet." The primary outcome of this study was to determine if a nurse-driven acute stroke protocol is feasible and assists in decreasing door to needle (intravenous tissue plasminogen activator [IV-tPA]) times. Of the 153 stroke patients seen during the protocol implementation phase, 57 were designated as "level 1" (symptom onset <4.5 hours) strokes requiring acute stroke management. Among these strokes, 78% were nurse-driven, and 75% of the telestroke encounters were also nurse-driven. The average door to computerized tomography time was significantly reduced in nurse-driven codes (38.9 minutes versus 24.4 minutes; P < .04). The use of a nurse-driven protocol is feasible and effective. When used in conjunction with a telestroke specialist, it may be of value in improving patient outcomes by decreasing the time for door to decision for IV-tPA. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

The role of preoperative CT scan in patients with tracheoesophageal fistula: a review.

PubMed

Garge, Saurabh; Rao, K L N; Bawa, Monika

2013-09-01

The morbidity and mortality associated with esophageal atresia with or without a fistula make it a challenging congenital abnormality for the pediatric surgeon. Anatomic factors like inter-pouch gap and origin of fistula are not taken into consideration in various prognostic classifications. The preoperative evaluation of these cases with computerized tomography (CT) has been used by various investigators to delineate these factors. We reviewed these studies to evaluate the usefulness of this investigation in the intra operative and post operative period. A literature search was done on all peer-reviewed articles published on preoperative computed tomography (CT) in cases of tracheoesophageal fistula using the PUBMED and MEDLINE search engines. Key words included tracheoesophageal fistula, computerized tomography, virtual bronchoscopy, and 3D computerized tomography reconstruction. Further, additional articles were selected from the list of references obtained from the retrieved publications. A total of 8 articles were selected for analysis. In most of the studies, comprising 96 patients, observations noted in preoperative CT were confirmed during surgery. In a study by Mahalik et al [Mahalik SK, Sodhi KS, Narasimhan KL, Rao KL. Role of preoperative 3D CT reconstruction for evaluation of patients with esophageal atresia and tracheoesophageal fistula. Pediatr Surg Int. 2012 Jun 22. [Epub ahead of print

[The importance of neurological examinations in the age of the technological revolution].

PubMed

Berbel-García, A; González-Spínola, J; Martínez-Salio, A; Porta-Etessam, J; Pérez-Martínez, D A; de Toledo, M; Sáiz-Díaz, R A

Neurologic practice and care have been modified in many important ways during the past ten years, to adapt to the explosion of new information and new technology. Students, residents and practicing physicians have been continuing programs to a model that focuses almost exclusively on the applications to neurologic disorders of the new knowledge obtained from biomedical research. On the other hand high demand for outpatient neurologic care prevents adequate patient's evaluation. Case 1: 65 years old female. Occipital headache diagnosed of tensional origin (normal computerized tomography). Two months later is re-evaluated due to intractable pain and hypoglossal lesion. An amplified computerized tomography revealed a occipital condyle metastasis. Case 2: 21 years old female. Clinical suspicion of demyelinating disease due to repeated facial paresis and sensitive disorder. General exploration and computerized tomography revealed temporo-mandibular joint. Case 3: 60 years old female. Valuation of anticoagulant therapy due to repeated transient ischemic attacks. She suffered from peripheral facial palsy related to auditory cholesteatoma. Neurologic education is nowadays orientated to new technologies. On the other hand, excessive demand prevents adequate valuation and a minute exploration is substituted by complementary evaluations. These situations generate diagnostic mistakes or iatrogenic. It would be important a consideration of the neurologic education profiles and fulfillment of consultations time recommendations for outpatients care.

Impact of implementing electronic clinical practice guidelines for the diagnosis, control and treatment of cardiovascular risk factors: A pre-post controlled study.

PubMed

Comin, Eva; Catalan-Ramos, Arantxa; Iglesias-Rodal, Manuel; Grau, Maria; Del Val, Jose Luis; Consola, Alicia; Amado, Ester; Pons, Angels; Mata-Cases, Manel; Franzi, Alicia; Ciurana, Ramon; Frigola, Eva; Cos, Xavier; Davins, Josep; Verdu-Rotellar, Jose M

To evaluate the impact of computerized clinical practice guidelines on the management, diagnosis, treatment, control, and follow-up of the main cardiovascular risk factors: hypertension, hypercholesterolaemia, and type 2 diabetes mellitus. Pre-post controlled study. Catalonia, autonomous community located in north-eastern Spain. Individuals aged 35-74 years assigned to general practitioners of the Catalan Health Institute. The intervention group consisted of individuals whose general practitioners had accessed the computerized clinical practice guidelines at least twice a day, while the control group consisted of individuals whose general practitioner had never accessed the computerized clinical practice guidelines platform. The Chi-squared test was used to detect significant differences in the follow-up, control, and treatment variables for all three disorders (hypertension, hypercholesterolaemia, and type 2 diabetes mellitus) between individuals assigned to users and non-users of the computerized clinical practice guidelines, respectively. A total of 189,067 patients were included in this study, with a mean age of 56 years (standard deviation 12), and 55.5% of whom were women. Significant differences were observed in hypertension management, treatment and control; type 2 diabetes mellitus management, treatment and diagnoses, and the management and control of hypercholesterolaemia in both sexes. Computerized clinical practice guidelines are an effective tool for the control and follow-up of patients diagnosed with hypertension, type 2 diabetes mellitus, and hypercholesterolaemia. The usefulness of computerized clinical practice guidelines to diagnose and adequately treat individuals with these disorders remains unclear. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Brief cognitive and behavioral screening in children with new-onset epilepsy: a pilot feasibility trial.

PubMed

Triplett, Regina L; Asato, Miya R

2015-01-01

Minimal work has used psychometrically robust measures in a systematic fashion to identify and monitor children at risk for cognitive and behavioral comorbidities in current epilepsy care. We piloted a computerized cognitive battery and behavioral questionnaire for children with newly diagnosed epilepsy to determine clinical feasibility and acceptability to parents and patients. We recruited medication-naïve children (ages 8-17 years) with recent-onset seizures and typical developmental history from an outpatient child neurology clinic. Children completed the CNS Vital Signs computerized battery, whereas parents completed the Strengths and Difficulties Questionnaire. Post-test interviews with parents and patients were completed regarding the acceptability of the assessment procedures. Forty-four families were eligible, and 39 agreed to participate (89%). All assessments were completed in less than 45 minutes. Parents rated testing in clinic as convenient and important, expressing strong interest in the cognitive and behavioral impact of epilepsy and medication. Children also rated the testing procedure as acceptable and agreed that they would recommend it to peers. Our brief battery was tolerated and well received by children and their parents. Computerized testing of children along with a parent questionnaire is a psychometrically viable approach that is acceptable to families. Our protocol is time efficient for clinical use with the potential to detect early cognitive and behavioral difficulties related to epilepsy. Ongoing longitudinal study will provide further information regarding the success of our screening methods in monitoring for disease- or treatment-related changes. Copyright © 2015 Elsevier Inc. All rights reserved.

Microcomputers: Software Evaluation. Evaluation Guides. Guide Number 17.

ERIC Educational Resources Information Center

Gray, Peter J.

This guide discusses three critical steps in selecting microcomputer software and hardware: setting the context, software evaluation, and managing microcomputer use. Specific topics addressed include: (1) conducting an informal task analysis to determine how the potential user's time is spent; (2) identifying tasks amenable to computerization and…

Why Data Linkage? The Importance of CODES (Crash Outcome Data Evaluation System)

DOT National Transportation Integrated Search

1996-06-01

This report briefly explains the computerized linked data system, Crash Outcome : Data Evaluation System (CODES) that provides greater depth accident data : analysis. The linking of data helps researchers to understand the nature of : traffic acciden...

[Evaluation of the capacity of work using upper limbs after radical latero-cervical surgery].

PubMed

Capodaglio, P; Strada, M R; Grilli, C; Lodola, E; Panigazzi, M; Bernardo, G; Bazzini, G

1998-01-01

Evaluation of arm work capacity after radical neck surgery. The aim of this paper is to describe an approach for the assessment of work capacity in patients who underwent radical neck surgery, including those treated with radiation therapy. Nine male patients, who underwent radical neck surgery 2 months before being referred to our Unit, participated in the study. In addition to manual muscle strength test, we performed the following functional evaluations: 0-100 Constant scale for shoulder function; maximal shoulder strength in adduction/abduction and intrarotation/extrarotation; instrumental. We measured maximal isokinetic strength (10 repetitions) with a computerized dynamometer (Lido WorkSET) set at 100 degrees/sec. During the rehabilitation phase, the patients' mechanical parameters, the perception of effort, pain or discomfort, and the range of movement were monitored while performing daily/occupational task individually chosen on the simulator (Lido WorkSET) under isotonic conditions. On this basis, patients were encouraged to return to levels of daily physical activities compatible with the individual tolerable work load. The second evaluation at 2 month confirmed that the integrated rehabilitation protocol successfully increased patients' capacities and "trust" in their physical capacity. According to the literature, the use of isokinetic and isotonic exercise programs appears to decrease shoulder rehabilitation time. In our experience an excellent compliance has been noted. One of the advantages of the method proposed is to provide quantitative reports of the functional capacity and therefore to facilitate return-to-work of patients who underwent radical neck surgery.

Knowledge translation and implementation in spinal cord injury: a systematic review.

PubMed

Noonan, V K; Wolfe, D L; Thorogood, N P; Park, S E; Hsieh, J T; Eng, J J

2014-08-01

To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions.

Development of a method for measuring femoral torsion using real-time ultrasound.

PubMed

Hafiz, Eliza; Hiller, Claire E; Nicholson, Leslie L; Nightingale, E Jean; Clarke, Jillian L; Grimaldi, Alison; Eisenhuth, John P; Refshauge, Kathryn M

2014-07-01

Excessive femoral torsion has been associated with various musculoskeletal and neurological problems. To explore this relationship, it is essential to be able to measure femoral torsion in the clinic accurately. Computerized tomography (CT) and magnetic resonance imaging (MRI) are thought to provide the most accurate measurements but CT involves significant radiation exposure and MRI is expensive. The aim of this study was to design a method for measuring femoral torsion in the clinic, and to determine the reliability of this method. Details of design process, including construction of a jig, the protocol developed and the reliability of the method are presented. The protocol developed used ultrasound to image a ridge on the greater trochanter, and a customized jig placed on the femoral condyles as reference points. An inclinometer attached to the customized jig allowed quantification of the degree of femoral torsion. Measurements taken with this protocol had excellent intra- and inter-rater reliability (ICC2,1 = 0.98 and 0.97, respectively). This method of measuring femoral torsion also permitted measurement of femoral torsion with a high degree of accuracy. This method is applicable to the research setting and, with minor adjustments, will be applicable to the clinical setting.

Magnetic resonance imaging and computerized tomography in malignant external otitis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gherini, S.G.; Brackmann, D.E.; Bradley, W.G.

1986-05-01

In malignant external otitis (MEO), determining the anatomic extent of disease and evaluating the physiologic response to therapy remain a problem. Magnetic resonance imaging (MRI) has recently become available in limited clinical settings. Four patients with MEO were evaluated using MRI, computerized tomography (CT), technetium-99 (Tc-99) bone scanning, and gallium-67 citrate (Ga-67 citrate) scanning. MRI is superior to CT, Tc-99 bone scanning, and Ga-67 citrate scanning in evaluating the anatomic extent of soft tissue changes in MEO. MRI alone cannot be relied upon to determine the physiologic response to therapy. MRI can, however, serve as a valuable guide to themore » interpretation of Tc-99 bone and Ga-67 citrate scans, and in this respect, MRI is extremely useful in the treatment of MEO.« less

Evaluation and Information in the Field of Technical Aids for Disabled Persons: An European Perspective. Monograph Number Thirty-Five.

ERIC Educational Resources Information Center

Pedotti, Antonio, Ed.; Andrich, Renzo, Ed.

The monograph provides information on evaluation of technical aids, wheelchairs, and computerized information systems for disabled persons. The first chapter provides a general overview of actions of the European Community concerning technical aids evaluation, information on the "Concerted Action" program called "Evaluation of…

A computerized faculty time-management system in an academic family medicine department.

PubMed

Daugird, Allen J; Arndt, Jane E; Olson, P Richard

2003-02-01

The authors describe the development, implementation, and evaluation of a computerized faculty time-management system (FTMS) in the Department of Family Medicine at the University of North Carolina-Chapel Hill. The FTMS is presented as an integrated set of computerized spreadsheets used annually to allocate faculty time across all mission activities of the department. It was first implemented in 1996 and has been continuously developed since then. An iterative approach has been used to gain consensus among faculty about time resources needed for various tasks of all missions of the department. These time-resource assumptions are used in the computerized system. Faculty time is allocated annually by the department vice chair in negotiation with individual faculty, making sure that the activities planned do not exceed the work time each faculty member has available for the year. During this process, faculty preferences are balanced against department aggregate needs to meet mission commitments and obligations. The authors describe how the computerized FTMS is used for faculty time management and career development, department planning, budget planning, clinical scheduling, and mission cost accounting. They also describe barriers and potential abuses and the challenge of building an organizational culture willing to discuss faculty time openly and committed to developing a system perceived as fair and accurate. The spreadsheet file is available free from the authors for use in other departments.

Evaluation of data requirements for computerized constructability analysis of pavement rehabilitation projects.

DOT National Transportation Integrated Search

2013-08-01

This research aimed to evaluate the data requirements for computer assisted construction planning : and staging methods that can be implemented in pavement rehabilitation projects in the state of : Georgia. Results showed that two main issues for the...

Head Tilt Posturography to Enhance Balance Control Assessment for Astronauts: A Case Study

NASA Technical Reports Server (NTRS)

Hwang, E. Y.; Paloski, W. H.

2006-01-01

For many years, we have used a standard clinical computerized dynamic posturography (CDP) protocol to assess recovery of integrated sensory-motor function in astronauts returning from space flight. The most reliable indications of postflight crew performance capabilities have been obtained from the sensory organization tests (SOTs) within the CDP protocol, particularly SOTs 5 (eyes closed, surface support sway referenced) and 6 (eyes open, surface support and visual surround sway referenced), which are sensitive to changes in availability and/or utilization of vestibular cues. We have observed, however, that some astronauts exhibiting visible signs of incomplete sensory-motor recovery are able to score within clinical norms on standard SOTs 5 and 6 trials, perhaps as a result of cognitive strategies driven by their naturally competitive natures. To improve the sensitivity of the CDP protocol for assessing recovery of integrated sensory-motor function and fitness to return to duties and/or activities of daily living, we have introduced pitch plane head tilt SOT trials to our protocol. In a preliminary study of 5 short duration (11day missions) astronauts, we showed that they were unable to maintain balance on landing day when performing dynamic head tilt trials, despite scoring within the clinically normal range on the standard SOT trials. The present case report illustrates the advantages of including head tilt trials for assessing sensory-motor recovery in long duration crewmembers.

A Head and Neck Simulator for Radiology and Radiotherapy

NASA Astrophysics Data System (ADS)

Thompson, Larissa; Campos, Tarcísio P. R.

2013-06-01

Phantoms are suitable tools to simulate body tissues and organs in radiology and radiation therapy. This study presents the development of a physical head and neck phantom and its radiological response for simulating brain pathology. The following features on the phantom are addressed and compared to human data: mass density, chemical composition, anatomical shape, computerized tomography images and Hounsfield Units. Mass attenuation and kerma coefficients of the synthetic phantom and normal tissues, as well as their deviations, were also investigated. Radiological experiments were performed, including brain tumors and subarachnoid hemorrhage simulations. Computerized tomography images of such pathologies in phantom and human were obtained. The anthropometric dimensions of the phantom present anatomical conformation similar to a human head and neck. Elemental weight percentages of the equivalent tissues match the human ones. Hounsfield Unit values of the main developed structures are presented, approaching human data. Kerma and mass attenuation coefficients spectra from human and phantom are presented, demonstrating smaller deviations in the radiological X-ray spectral domain. In conclusion, the phantom presented suitable normal and pathological radiological responses relative to those observed in humans. It may improve radiological protocols and education in medical imaging.

Clinical results of computerized tomography-based simulation with laser patient marking.

PubMed

Ragan, D P; Forman, J D; He, T; Mesina, C F

1996-02-01

Accuracy of a patient treatment portal marking device and computerized tomography (CT) simulation have been clinically tested. A CT-based simulator has been assembled based on a commercial CT scanner. This includes visualization software and a computer-controlled laser drawing device. This laser drawing device is used to transfer the setup, central axis, and/or radiation portals from the CT simulator to the patient for appropriate patient skin marking. A protocol for clinical testing is reported. Twenty-five prospectively, sequentially accessioned patients have been analyzed. The simulation process can be completed in an average time of 62 min. Under many cases, the treatment portals can be designed and the patient marked in one session. Mechanical accuracy of the system was found to be within +/- 1mm. The portal projection accuracy in clinical cases is observed to be better than +/- 1.2 mm. Operating costs are equivalent to the conventional simulation process it replaces. Computed tomography simulation is a clinical accurate substitute for conventional simulation when used with an appropriate patient marking system and digitally reconstructed radiographs. Personnel time spent in CT simulation is equivalent to time in conventional simulation.

A study of commuter airplane design optimization

NASA Technical Reports Server (NTRS)

Keppel, B. V.; Eysink, H.; Hammer, J.; Hawley, K.; Meredith, P.; Roskam, J.

1978-01-01

The usability of the general aviation synthesis program (GASP) was enhanced by the development of separate computer subroutines which can be added as a package to this assembly of computerized design methods or used as a separate subroutine program to compute the dynamic longitudinal, lateral-directional stability characteristics for a given airplane. Currently available analysis methods were evaluated to ascertain those most appropriate for the design functions which the GASP computerized design program performs. Methods for providing proper constraint and/or analysis functions for GASP were developed as well as the appropriate subroutines.

Computerized measurement and analysis of scoliosis: a more accurate representation of the shape of the curve.

PubMed

Jeffries, B F; Tarlton, M; De Smet, A A; Dwyer, S J; Brower, A C

1980-02-01

A computer program was created to identify and accept spatial data regarding the location of the thoracic and lumbar vertebral bodies on scoliosis films. With this information, the spine can be mathematically reconstructed and a scoliotic angle calculated. There was a 0.968 positive correlation between the computer and manual methods of measuring scoliosis. The computer method was more reproducible with a standard deviation of only 1.3 degrees. Computerized measurement of scoliosis also provides better evaluation of the true shape of the curve.

Heuristic Evaluation and Usability Testing of a Computerized Patient-Reported Outcomes Survey for Headache Sufferers

PubMed Central

Saris-Baglama, Renee N.; Smith, Kevin J.; DeRosa, Michael A.; Paulsen, Christine A.; Hogue, Sarah J.

2011-01-01

Abstract Objective The aim of this study was to evaluate usability of a prototype tablet PC-administered computerized adaptive test (CAT) of headache impact and patient feedback report, referred to as HEADACHE-CAT. Materials and Methods Heuristic evaluation specialists (n = 2) formed a consensus opinion on the application's strengths and areas for improvement based on general usability principles and human factors research. Usability testing involved structured interviews with headache sufferers (n = 9) to assess how they interacted with and navigated through the application, and to gather input on the survey and report interface, content, visual design, navigation, instructions, and user preferences. Results Specialists identified the need for improved instructions and text formatting, increased font size, page setup that avoids scrolling, and simplified presentation of feedback reports. Participants found the tool useful, and indicated a willingness to complete it again and recommend it to their healthcare provider. However, some had difficulty using the onscreen keyboard and autoadvance option; understanding the difference between generic and headache-specific questions; and interpreting score reports. Conclusions Heuristic evaluation and user testing can help identify usability problems in the early stages of application development, and improve the construct validity of electronic assessments such as the HEADACHE-CAT. An improved computerized HEADACHE-CAT measure can offer headache sufferers an efficient tool to increase patient self-awareness, monitor headaches over time, aid patient–provider communications, and improve quality of life. PMID:21214341

Evaluation of a Computerized Clinical Information System (Micromedex).

PubMed Central

Lundsgaarde, H. P.; Moreshead, G. E.

1991-01-01

This paper summarizes data collected as part of a project designed to identify and assess the technical and organizational problems associated with the implementation and evaluation of a Computerized Clinical Information System (CCIS), Micromedex, in three U.S. Department of Veterans Affairs Medical Centers (VAMCs). The study began in 1987 as a national effort to implement decision support technologies in the Veterans Administration Decentralized Hospital Computer Program (DHCP). The specific objectives of this project were to (1) examine one particular decision support technology, (2) identify the technical and organizational barriers to the implementation of a CCIS in the VA host environment, (3) assess the possible benefits of this system to VA clinicians in terms of therapeutic decision making, and (4) develop new methods for identifying the clinical utility of a computer program designed to provide clinicians with a new information tool. The project was conducted intermittently over a three-year period at three VA medical centers chosen as implementation and evaluation test sites for Micromedex. Findings from the Kansas City Medical Center in Missouri are presented to illustrate some of the technical problems associated with the implementation of a commercial database program in the DHCP host environment, the organizational factors influencing clinical use of the system, and the methods used to evaluate its use. Data from 4581 provider encounters with the CCIS are summarized. Usage statistics are presented to illustrate the methodological possibilities for assessing the "benefits and burdens" of a computerized information system by using an automated collection of user demographics and program audit trails that allow evaluators to monitor user interactions with different segments of the database. PMID:1807583

Evaluation of a Computerized Clinical Information System (Micromedex).

PubMed

Lundsgaarde, H P; Moreshead, G E

1991-01-01

This paper summarizes data collected as part of a project designed to identify and assess the technical and organizational problems associated with the implementation and evaluation of a Computerized Clinical Information System (CCIS), Micromedex, in three U.S. Department of Veterans Affairs Medical Centers (VAMCs). The study began in 1987 as a national effort to implement decision support technologies in the Veterans Administration Decentralized Hospital Computer Program (DHCP). The specific objectives of this project were to (1) examine one particular decision support technology, (2) identify the technical and organizational barriers to the implementation of a CCIS in the VA host environment, (3) assess the possible benefits of this system to VA clinicians in terms of therapeutic decision making, and (4) develop new methods for identifying the clinical utility of a computer program designed to provide clinicians with a new information tool. The project was conducted intermittently over a three-year period at three VA medical centers chosen as implementation and evaluation test sites for Micromedex. Findings from the Kansas City Medical Center in Missouri are presented to illustrate some of the technical problems associated with the implementation of a commercial database program in the DHCP host environment, the organizational factors influencing clinical use of the system, and the methods used to evaluate its use. Data from 4581 provider encounters with the CCIS are summarized. Usage statistics are presented to illustrate the methodological possibilities for assessing the "benefits and burdens" of a computerized information system by using an automated collection of user demographics and program audit trails that allow evaluators to monitor user interactions with different segments of the database.

Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review.

PubMed

Patel, Minal R; Vichich, Jennifer; Lang, Ian; Lin, Jessica; Zheng, Kai

2017-04-01

The introduction of health information technology systems, electronic health records in particular, is changing the nature of how clinicians interact with patients. Lack of knowledge remains on how best to integrate such systems in the exam room. The purpose of this systematic review was to (1) distill "best" behavioral and communication practices recommended in the literature for clinicians when interacting with patients in the presence of computerized systems during a clinical encounter, (2) weigh the evidence of each recommendation, and (3) rank evidence-based recommendations for electronic health record communication training initiatives for clinicians. We conducted a literature search of 6 databases, resulting in 52 articles included in the analysis. We extracted information such as study setting, research design, sample, findings, and implications. Recommendations were distilled based on consistent support for behavioral and communication practices across studies. Eight behavioral and communication practices received strong support of evidence in the literature and included specific aspects of using computerized systems to facilitate conversation and transparency in the exam room, such as spatial (re)organization of the exam room, maintaining nonverbal communication, and specific techniques that integrate the computerized system into the visit and engage the patient. Four practices, although patient-centered, have received insufficient evidence to date. We developed an evidence base of best practices for clinicians to maintain patient-centered communications in the presence of computerized systems in the exam room. Further work includes development and empirical evaluation of evidence-based guidelines to better integrate computerized systems into clinical care. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

The effectiveness of computerized drug-lab alerts: a systematic review and meta-analysis.

PubMed

Bayoumi, Imaan; Al Balas, Mosab; Handler, Steven M; Dolovich, Lisa; Hutchison, Brian; Holbrook, Anne

2014-06-01

Inadequate lab monitoring of drugs is a potential cause of ADEs (adverse drug events) which is remediable. To determine the effectiveness of computerized drug-lab alerts to improve medication-related outcomes. Citations from the Computerized Clinical Decision Support System Systematic Review (CCDSSR) and MMIT (Medications Management through Health Information Technology) databases, which had searched MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts from 1974 to March 27, 2013. Randomized controlled trials (RCTs) of clinician-targeted computerized drug lab alerts conducted in any healthcare setting. Two reviewers performed full text review to determine study eligibility. A single reviewer abstracted data and evaluated validity of included studies using Cochrane handbook domains. Thirty-six studies met the inclusion criteria (25 single drug studies with 22,504 participants, 14 targeting anticoagulation; 11 multi-drug studies with 56,769 participants). ADEs were reported as an outcome in only four trials, all targeting anticoagulants. Computerized drug-lab alerts did not reduce ADEs (OR 0.89, 95% CI 0.79-1.00, p=0.05), length of hospital stay (SMD 0.00, 95%CI -0.93 to 0.93, p=0.055, 1 study), likelihood of hypoglycemia (OR 1.29, 95% CI 0.31-5.37) or likelihood of bleeding, but were associated with increased likelihood of prescribing changes (OR 1.73, 95% CI 1.21-2.47) or lab monitoring (OR 1.47, 95% confidence interval 1.12-1.94) in accordance with the alert. There is no evidence that computerized drug-lab alerts are associated with important clinical benefits, but there is evidence of improvement in selected clinical surrogate outcomes (time in therapeutic range for vitamin K antagonists), and changes in process outcomes (lab monitoring and prescribing decisions). Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Computerized symptom and quality-of-life assessment for patients with cancer part II: acceptability and usability.

PubMed

Mullen, Kristin H; Berry, Donna L; Zierler, Brenda K

2004-09-01

To determine the acceptability and usability of a computerized quality-of-life (QOL) and symptom assessment tool and the graphically displayed QOL and symptom output in an ambulatory radiation oncology clinic. Descriptive, cross-sectional. Radiation oncology clinic located in an urban university medical center. 45 patients with cancer being evaluated for radiation therapy and 10 clinicians, who submitted 12 surveys. Acceptability of the computerized assessment was measured with an online, 16-item, Likert-style survey delivered as 45 patients undergoing radiation therapy completed a 25-item QOL and symptom assessment. Usability of the graphic output was assessed with clinician completion of a four-item paper survey. Acceptability and usability of computerized patient assessment. The patient acceptability survey indicated that 70% (n = 28) liked computers and 10% (n = 4) did not. The program was easy to use for 79% (n = 26), easy to understand for 91% (n = 30), and enjoyable for 71% (n = 24). Seventy-six percent (n = 25) believed that the amount of time needed to complete the computerized survey was acceptable. Sixty-six percent (n = 21) responded that they were satisfied with the program, and none of the participants chose the very dissatisfied response. Eighty-three percent (n = 10) of the clinicians found the graphic output helpful in promoting communication with patients, 75% (n = 9) found the output report helpful in identifying appropriate areas of QOL deficits or concerns, and 83% (n = 10) indicated that the output helped guide clinical interactions with patients. The computer-based QOL and symptom assessment tool is acceptable to patients, and the graphically displayed QOL and symptom output is useful to radiation oncology nurses and physicians. Wider application of computerized patient-generated data can continue in various cancer settings and be tested for clinical and organizational outcomes.

Sources of Information for Evaluating Rural Development: An Overview.

ERIC Educational Resources Information Center

Grayburn, Laura; And Others

Designed to help rural development evaluators and other social scientists use their bibliographic search time more efficiently, this information guide presents the following: (1) detailed information on computerized information retrieval systems, including name, location, subject matter, turnaround time, cost, availability, and utility…

Computerized stroop test to assess selective attention in children with attention deficit hyperactivity disorder.

PubMed

Assef, Ellen Carolina dos Santos; Capovilla, Alessandra Gotuzo Seabra; Capovilla, Fernando Cesar

2007-05-01

Research shows abnormal function of the pre-frontal cortex in Attention Deficit Hyperactivity Disorder (ADHD). This cortex is involved in the control of executive functions related to planning and execution of goal-oriented strategies, working memory, inhibitions, cognitive flexibility, and selective attention. Selective attention involves focus on the target stimulus, ignoring competing distractions. The Stroop Test (Stroop, 1935) is usually used to evaluate selective attention. This study investigated whether children with ADHD could exhibit modified performance in the Stroop Test. Using a computerized version of this test (Capovilla, Montiel, Macedo, & Charin, 2005), the study compared the reaction times (RTs) of 62 Brazilian children, between 8 and 12 years of age, 31 of whom were diagnosed with ADHD and sent to psychiatric clinics, and 31 without ADHD studying in regular schools. All children with ADHD satisfied the criteria of the DSM-IV-TR and were evaluated with the Conners Abbreviated Questionnaire (Goyette, Conners, & Ulrich, 1978), completed by parents and teachers. The results revealed that children with ADHD exhibit greater interference in RT than children without ADHD. This corroborated the hypothesis that children with ADHD exhibit a deficit in selective attention, consisting in augmented RTs, as measured by the Computerized Stroop Test.

Analysis of internal and external validity criteria for a computerized visual search task: A pilot study.

PubMed

Richard's, María M; Introzzi, Isabel; Zamora, Eliana; Vernucci, Santiago

2017-01-01

Inhibition is one of the main executive functions, because of its fundamental role in cognitive and social development. Given the importance of reliable and computerized measurements to assessment inhibitory performance, this research intends to analyze the internal and external criteria of validity of a computerized conjunction search task, to evaluate the role of perceptual inhibition. A sample of 41 children (21 females and 20 males), aged between 6 and 11 years old (M = 8.49, SD = 1.47), intentionally selected from a private management school of Mar del Plata (Argentina), middle socio-economic level were assessed. The Conjunction Search Task from the TAC Battery, Coding and Symbol Search tasks from Wechsler Intelligence Scale for Children were used. Overall, results allow us to confirm that the perceptual inhibition task form TAC presents solid rates of internal and external validity that make a valid measurement instrument of this process.

Computerized bioterrorism education and training for nurses on bioterrorism attack agents.

PubMed

Nyamathi, Adeline M; Casillas, Adrian; King, Major L; Gresham, Louise; Pierce, Elaine; Farb, Daniel; Wiechmann, Carrie; Weichmann, Carrie

2010-08-01

Biological agents have the ability to cause large-scale mass casualties. For this reason, their likely use in future terrorist attacks is a concern for national security. Recent studies show that nurses are ill prepared to deal with agents used in biological warfare. Achieving a goal for bioterrorism preparedness is directly linked to comprehensive education and training that enables first-line responders such as nurses to diagnose infectious agents rapidly. The study evaluated participants' responses to biological agents using a computerized bioterrorism education and training program versus a standard bioterrorism education and training program. Both programs improved participants' ability to complete and solve case studies involving the identification of specific biological agents. Participants in the computerized bioterrorism education and training program were more likely to solve the cases critically without reliance on expert consultants. However, participants in the standard bioterrorism education and training program reduced the use of unnecessary diagnostic tests.

Preliminary evaluation of a micro-based repeated measures testing system

NASA Technical Reports Server (NTRS)

Kennedy, Robert S.; Wilkes, Robert L.; Lane, Norman E.

1985-01-01

A need exists for an automated performance test system to study the effects of various treatments which are of interest to the aerospace medical community, i.e., the effects of drugs and environmental stress. The ethics and pragmatics of such assessment demand that repeated measures in small groups of subjects be the customary research paradigm. Test stability, reliability-efficiency and factor structure take on extreme significance; in a program of study by the U.S. Navy, 80 percent of 150 tests failed to meet minimum metric requirements. The best is being programmed on a portable microprocessor and administered along with tests in their original formats in order to examine their metric properties in the computerized mode. Twenty subjects have been tested over four replications on a 6.0 minute computerized battery (six tests) and which compared with five paper and pencil marker tests. All tests achieved stability within the four test sessions, reliability-efficiencies were high (r greater than .707 for three minutes testing), and the computerized tests were largely comparable to the paper and pencil version from which they were derived. This computerized performance test system is portable, inexpensive and rugged.

Contributions to Objective Measurement and Evaluation of Trainee Competency.

ERIC Educational Resources Information Center

Moonan, William J.

The purpose of this paper is to lay a basis for and discuss the components of a system, called COMET, designed to objectively measure and evaluate the competency of trainees in military training enterprises. COMET is an acronym for "Computerized Objective Measurement and Evaluation of Trainees." These goals will be accomplished by: (a)…

Towards a Better Understanding of the Legibility Bias in Performance Assessments: The Case of Gender-Based Inferences

ERIC Educational Resources Information Center

Greifeneder, Rainer; Zelt, Sarah; Seele, Tim; Bottenberg, Konstantin; Alt, Alexander

2012-01-01

Background: Handwriting legibility systematically biases evaluations in that highly legible handwriting results in more positive evaluations than less legible handwriting. Because performance assessments in educational contexts are not only based on computerized or multiple choice tests but often include the evaluation of handwritten work samples,…

Identification of Target Complaints by Computer Interview: Evaluation of the Computerized Assessment System for Psychotherapy Evaluation and Research.

ERIC Educational Resources Information Center

Farrell, Albert D.; And Others

1987-01-01

Evaluated computer interview to standardize collection of target complaints. Adult outpatients (N=103) completed computer interview, unstructured intake interview, Symptoms Checklist-90, and Minnesota Multiphasic Personality Inventory. Results provided support for the computer interview in regard to reliability and validity though there was low…

Evaluating and selecting an information system, Part 1.

PubMed

Neal, T

1993-01-01

Initial steps in the process of evaluating and selecting a computerized information system for the pharmacy department are described. The first step in the selection process is to establish a steering committee and a project committee. The steering committee oversees the project, providing policy guidance, making major decisions, and allocating budgeted expenditures. The project committee conducts the departmental needs assessment, identifies system requirements, performs day-to-day functions, evaluates vendor proposals, trains personnel, and implements the system chosen. The second step is the assessment of needs in terms of personnel, workload, physical layout, and operating requirements. The needs assessment should be based on the department's mission statement and strategic plan. The third step is the development of a request for information (RFI) and a request for proposal (RFP). The RFI is a document designed for gathering preliminary information from a wide range of vendors; this general information is used in deciding whether to send the RFP to a given vendor. The RFP requests more detailed information and gives the purchaser's exact specifications for a system; the RFP also includes contractual information. To help ensure project success, many institutions turn to computer consultants for guidance. The initial steps in selecting a computerized pharmacy information system are establishing computerization committees, conducting a needs assessment, and writing an RFI and an RFP. A crucial early decision is whether to seek a consultant's expertise.

Computer-Based Oral Hygiene Instruction versus Verbal Method in Fixed Orthodontic Patients

PubMed Central

Moshkelgosha, V.; Mehrvarz, Sh.; Saki, M.; Golkari, A.

2017-01-01

Statement of Problem: Fixed orthodontic appliances in the oral cavity make tooth cleaning procedures more complicated. Objectives: This study aimed to compare the efficacy of computerized oral hygiene instruction with verbal technique among fixed orthodontic patients referred to the evening clinic of Orthodontics of Shiraz Dental School. Materials and Methods: A single-blind study was performed in Orthodontic Department of Shiraz, Islamic Republic of Iran, from January to May 2015 following the demonstrated exclusion and inclusion criteria. The sample size was considered 60 patients with 30 subjects in each group. Bleeding on probing and plaque indices and dental knowledge were assessed in the subjects to determine pre-intervention status. A questionnaire was designed for dental knowledge evaluation. The patients were randomly assigned into the computerized and verbal groups. Three weeks after the oral hygiene instruction, indices of bleeding on probing and plaque index and the dental knowledge were evaluated to investigate post-intervention outcome. The two groups were compared by chi-square and student t tests. The pre- and post-intervention scores in each group were compared using paired t-test. Results: In the computerized group, the mean score for plaque index and bleeding on probing index was significantly decreased while dental health knowledge was significantly increased after oral hygiene instruction, in contrast to the verbal group. Conclusions: Within the limitations of the current study, computerized oral hygiene instruction is proposed to be more effective in providing optimal oral health status compared to the conventional method in fixed orthodontic patients. PMID:28959765

Using Computerized Cytomorphometry to Distinguish between Benign and Malignant Cases in Thyroid Fine-Needle Aspiration Cytology.

PubMed

Celik, Zeliha Esin; Altinay, Serdar; Kilinc, Fahriye; Arslan, Nur; Yilmaz, Burcu Sanal; Karabagli, Pınar; Ugurluoglu, Ceyhan

2016-11-01

Only a small number of studies on computerized cytomorphometry have been performed for thyroid FNAC. The present study aimed to determine the usefulness of computerized cytomorphometry methods to further classify thyroid lesions as benign or malignant and to compare the practicability and value of using Papanicolaou (Pap) and Giemsa stains in thyroid FNAC by evaluating their association to various cytologic nuclear parameters. Fifty-eight thyroid lesions diagnosed by FNAC and categorized according to the Bethesda system for reporting thyroid cytopathology were evaluated in terms of various cytologic nuclear parameters, including nuclear area (NA), nuclear perimeter (NP), nuclear density (ND), long nuclear diameter (LND), and short nuclear diameter (SND). The Pap- and Giemsa-stained slides were examined separately. In the malignant cases, NA, NP, LND, and SND were higher than in the benign cases for both the Pap and Giemsa stains. NA, NP, LND, and SND were higher in Giemsa than Pap for both the benign and malignant groups. Statistically significant differences were detected between the benign and malignant cases in the AUS category. Computerized cytomorphometry is useful in distinguishing between benign and malignant lesions in thyroid FNAC. The measurement of cytologic nuclear parameters in cases suggestive of AUS may be useful for the probable classification of cases as benign or malignant. Although further studies are needed, in nuclear morphometric assessment of thyroid FNAC, Giemsa staining may be more useful and valuable than the Pap stain because of its association with various cytologic nuclear parameters. Diagn. Cytopathol. 2016;44:902-911. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Computerized cognitive behavioural therapy at work: a randomized controlled trial in employees with recent stress-related absenteeism.

PubMed

Grime, Paul R

2004-08-01

Emotional distress has major implications for employees and employers. Cognitive behavioural therapy (CBT) is a recommended treatment, but demand outstrips supply. CBT is well suited to computerization. Most employee assistance programmes have not been systematically evaluated and computerized CBT has not previously been studied in the workplace. To evaluate the effect of an 8 week computerized cognitive behavioural therapy programme, 'Beating The Blues', on emotional distress in employees with recent stress-related absenteeism, and to explore the reasons for non-participation. An open, randomized trial in a London NHS occupational health department. Forty-eight public sector employees, with 10 or more cumulative days stress-related absenteeism in the last 6 months, randomized equally to 'Beating The Blues' plus conventional care, or conventional care alone. Main outcome measures were Hospital Anxiety and Depression Scale and Attributional Style Questionnaire scores at end of treatment and 1, 3 and 6 months later; and reasons for non-participation. At end of treatment and 1 month later, adjusted mean depression scores and adjusted mean negative attributional style scores were significantly lower in the intervention group. One month post-treatment, adjusted mean anxiety scores were also significantly lower in the intervention group. The differences were not statistically significant at 3 and 6 months post-treatment. Non-participation was common and related to access problems, preference for other treatments, time commitment, scepticism about the intervention and the employer connection. 'Beating The Blues' may accelerate psychological recovery in employees with recent stress-related absenteeism. Greater flexibility and accessibility might improve uptake.

The Development of MUMPS-Based Rehabilitation Psychology Computer Applications.

ERIC Educational Resources Information Center

Dutro, Kenneth R.

The use of computer assisted programs in career exploration and occupational information is well documented. Various phases of the vocational counseling process, i.e., diagnostic evaluation, program planning, career exploration, case management, and program evaluation, offer similarly promising opportunities for computerization. Using the…

COMPUTERIZED NEEDS-ORIENTED QUALITY MEASUREMENT EVALUATION SYSTEM (CONQUEST)

EPA Science Inventory

CONQUEST is an easy-to-use quality improvement software tool that uses a common structure and language to help users identity, understand, compare, evaluate, and select among 1,200 clinical performance measures that can be used to assess and improve quality of care. CONQUEST's in...

Enhancement of multimodality texture-based prediction models via optimization of PET and MR image acquisition protocols: a proof of concept

NASA Astrophysics Data System (ADS)

Vallières, Martin; Laberge, Sébastien; Diamant, André; El Naqa, Issam

2017-11-01

Texture-based radiomic models constructed from medical images have the potential to support cancer treatment management via personalized assessment of tumour aggressiveness. While the identification of stable texture features under varying imaging settings is crucial for the translation of radiomics analysis into routine clinical practice, we hypothesize in this work that a complementary optimization of image acquisition parameters prior to texture feature extraction could enhance the predictive performance of texture-based radiomic models. As a proof of concept, we evaluated the possibility of enhancing a model constructed for the early prediction of lung metastases in soft-tissue sarcomas by optimizing PET and MR image acquisition protocols via computerized simulations of image acquisitions with varying parameters. Simulated PET images from 30 STS patients were acquired by varying the extent of axial data combined per slice (‘span’). Simulated T 1-weighted and T 2-weighted MR images were acquired by varying the repetition time and echo time in a spin-echo pulse sequence, respectively. We analyzed the impact of the variations of PET and MR image acquisition parameters on individual textures, and we investigated how these variations could enhance the global response and the predictive properties of a texture-based model. Our results suggest that it is feasible to identify an optimal set of image acquisition parameters to improve prediction performance. The model constructed with textures extracted from simulated images acquired with a standard clinical set of acquisition parameters reached an average AUC of 0.84 +/- 0.01 in bootstrap testing experiments. In comparison, the model performance significantly increased using an optimal set of image acquisition parameters (p = 0.04 ), with an average AUC of 0.89 +/- 0.01 . Ultimately, specific acquisition protocols optimized to generate superior radiomics measurements for a given clinical problem could be developed and standardized via dedicated computer simulations and thereafter validated using clinical scanners.

Reflecting on the ethical administration of computerized medical records

NASA Astrophysics Data System (ADS)

Collmann, Jeff R.

1995-05-01

This presentation examines the ethical issues raised by computerized image management and communication systems (IMAC), the ethical principals that should guide development of policies, procedures and practices for IMACS systems, and who should be involved in developing a hospital's approach to these issues. The ready access of computerized records creates special hazards of which hospitals must beware. Hospitals must maintain confidentiality of patient's records while making records available to authorized users as efficiently as possible. The general conditions of contemporary health care undermine protecting the confidentiality of patient record. Patients may not provide health care institutions with information about themselves under conditions of informed consent. The field of information science must design sophisticated systems of computer security that stratify access, create audit trails on data changes and system use, safeguard patient data from corruption, and protect the databases from outside invasion. Radiology professionals must both work with information science experts in their own hospitals to create institutional safeguards and include the adequacy of security measures as a criterion for evaluating PACS systems. New policies and procedures on maintaining computerized patient records must be developed that obligate all members of the health care staff, not just care givers. Patients must be informed about the existence of computerized medical records, the rules and practices that govern their dissemination and given the opportunity to give or withhold consent for their use. Departmental and hospital policies on confidentiality should be reviewed to determine if revisions are necessary to manage computer-based records. Well developed discussions of the ethical principles and administrative policies on confidentiality and informed consent and of the risks posed by computer-based patient records systems should be included in initial and continuing staff system training. Administration should develop ways to monitor staff compliance with confidentiality policies and should assess diligence in maintaining patient record confidentiality as part of staff annual performance evaluations. Ethical management of IMAC systems is the business of all members of the health care team. Computerized patient records management (including IMAC) should be scrutinized as any other clinical medial ethical issue. If hospitals include these processes in their planning for RIS, IMACS, and HIS systems, they should have time to develop institutional expertise on these questions before and as systems are installed rather than only as ethical dilemmas develop during their use.

Assessing Flight Potential of the Invasive Asian Longhorned Beetle (Coleoptera: Cerambycidae) With Computerized Flight Mills.

PubMed

Lopez, Vanessa M; Hoddle, Mark S; Francese, Joseph A; Lance, David R; Ray, Ann M

2017-06-01

The Asian longhorned beetle, Anoplophora glabripennis (Motschulsky) (Coleoptera: Cerambycidae: Lamiinae), is an invasive woodborer that poses a serious threat to urban and natural landscapes. In North America, this beetle is a quarantine pest, and populations are subject to eradication efforts that consist of the identification, removal, and destruction of infested host material, and removal or prophylactic treatment of high-risk host plant species. To enhance Asian longhorned beetle eradication protocols in landscapes with extensive host availability, we assessed the dispersal potential of male and female adults of varying age, mating, and nutritional status using computerized flight mills. In total, 162 individuals were tethered to computerized flight mills for a 24-h trial period to collect information on total distance flown, flight times and velocities, and number and duration of flight bouts. Adult Asian longhorned beetles (in all treatments) flew an average of 2,272 m within a 24-h period, but are capable of flying up to 13,667 m (8.5 miles). Nutrition and age had the greatest impacts on flight, with Asian longhorned beetle adults >5 d of age that had fed having greater overall flight performance than any other group. However, mating status, sex, and body size (pre-flight weight and elytron length) had a minimal effect on flight performance. This information will be useful for refining quarantine zones surrounding areas of infestation, and for providing greater specificity as to the risk the Asian longhorned beetle poses within invaded regions. Published by Oxford University Press on behalf of Entomological Society of America 2017. This work is written by US Government employees and is in the public domain in the US.

D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.

PubMed

Abidi, Samina; Vallis, Michael; Raza Abidi, Syed Sibte; Piccinini-Vallis, Helena; Imran, Syed Ali

2014-06-01

To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians. We have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated. D-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Agreement between Computerized and Human Assessment of Performance on the Ruff Figural Fluency Test

PubMed Central

Elderson, Martin F.; Pham, Sander; van Eersel, Marlise E. A.; Wolffenbuttel, Bruce H. R.; Kok, Johan; Gansevoort, Ron T.; Tucha, Oliver; van der Klauw, Melanie M.; Slaets, Joris P. J.

2016-01-01

The Ruff Figural Fluency Test (RFFT) is a sensitive test for nonverbal fluency suitable for all age groups. However, assessment of performance on the RFFT is time-consuming and may be affected by interrater differences. Therefore, we developed computer software specifically designed to analyze performance on the RFFT by automated pattern recognition. The aim of this study was to compare assessment by the new software with conventional assessment by human raters. The software was developed using data from the Lifelines Cohort Study and validated in an independent cohort of the Prevention of Renal and Vascular End Stage Disease (PREVEND) study. The total study population included 1,761 persons: 54% men; mean age (SD), 58 (10) years. All RFFT protocols were assessed by the new software and two independent human raters (criterion standard). The mean number of unique designs (SD) was 81 (29) and the median number of perseverative errors (interquartile range) was 9 (4 to 16). The intraclass correlation coefficient (ICC) between the computerized and human assessment was 0.994 (95%CI, 0.988 to 0.996; p<0.001) and 0.991 (95%CI, 0.990 to 0.991; p<0.001) for the number of unique designs and perseverative errors, respectively. The mean difference (SD) between the computerized and human assessment was -1.42 (2.78) and +0.02 (1.94) points for the number of unique designs and perseverative errors, respectively. This was comparable to the agreement between two independent human assessments: ICC, 0.995 (0.994 to 0.995; p<0.001) and 0.985 (0.982 to 0.988; p<0.001), and mean difference (SD), -0.44 (2.98) and +0.56 (2.36) points for the number of unique designs and perseverative errors, respectively. We conclude that the agreement between the computerized and human assessment was very high and comparable to the agreement between two independent human assessments. Therefore, the software is an accurate tool for the assessment of performance on the RFFT. PMID:27661083

Integrated Psychosocial and Opioid-Antagonist Treatment for Alcohol Dependence: A Systematic Review of Controlled Evaluations

ERIC Educational Resources Information Center

Vaughn, Michael G.; Howard, Matthew O.

2004-01-01

Methodological characteristics and outcomes of 14 controlled clinical investigations of integrated psychosocial and opioid-antagonist alcohol dependence treatment were evaluated. The 14 studies were identified through computerized bibliographic and manual literature searches. Clients receiving integrated psychosocial and opioid-antagonist…

Automated classification of brain tumor type in whole-slide digital pathology images using local representative tiles.

PubMed

Barker, Jocelyn; Hoogi, Assaf; Depeursinge, Adrien; Rubin, Daniel L

2016-05-01

Computerized analysis of digital pathology images offers the potential of improving clinical care (e.g. automated diagnosis) and catalyzing research (e.g. discovering disease subtypes). There are two key challenges thwarting computerized analysis of digital pathology images: first, whole slide pathology images are massive, making computerized analysis inefficient, and second, diverse tissue regions in whole slide images that are not directly relevant to the disease may mislead computerized diagnosis algorithms. We propose a method to overcome both of these challenges that utilizes a coarse-to-fine analysis of the localized characteristics in pathology images. An initial surveying stage analyzes the diversity of coarse regions in the whole slide image. This includes extraction of spatially localized features of shape, color and texture from tiled regions covering the slide. Dimensionality reduction of the features assesses the image diversity in the tiled regions and clustering creates representative groups. A second stage provides a detailed analysis of a single representative tile from each group. An Elastic Net classifier produces a diagnostic decision value for each representative tile. A weighted voting scheme aggregates the decision values from these tiles to obtain a diagnosis at the whole slide level. We evaluated our method by automatically classifying 302 brain cancer cases into two possible diagnoses (glioblastoma multiforme (N = 182) versus lower grade glioma (N = 120)) with an accuracy of 93.1% (p < 0.001). We also evaluated our method in the dataset provided for the 2014 MICCAI Pathology Classification Challenge, in which our method, trained and tested using 5-fold cross validation, produced a classification accuracy of 100% (p < 0.001). Our method showed high stability and robustness to parameter variation, with accuracy varying between 95.5% and 100% when evaluated for a wide range of parameters. Our approach may be useful to automatically differentiate between the two cancer subtypes. Copyright © 2015 Elsevier B.V. All rights reserved.

An Integrated On-Line Transfer Credit Evaluation System-Admissions through Graduation Audit.

ERIC Educational Resources Information Center

Schuman, Chester D.

This document discusses a computerized transfer evaluation system designed by Pennsylvania College of Technology, a comprehensive two-year institution with an enrollment of over 4,800 students. It is noted that the Admissions Office processes approximately 500 transfer applications for a fall semester, as well as a large number of evaluations for…

Identification of drug interactions in hospitals--computerized screening vs. bedside recording.

PubMed

Blix, H S; Viktil, K K; Moger, T A; Reikvam, A

2008-04-01

Managing drug interactions in hospitalized patients is important and challenging. The objective of the study was to compare two methods for identification of drug interactions (DDIs)--computerized screening and prospective bedside recording--with regard to capability of identifying DDIs. Patient characteristics were recorded for patients admitted to five hospitals. By bedside evaluation drug-related problems, including DDIs, were prospectively recorded by pharmacists and discussed in multidisciplinary teams. A computer screening programme was used to identify DDIs retrospectively--dividing DDIs into four classes: A, avoid; B, avoid/take precautions; C, take precautions; D, no action needed. Among 827 patients, computer screening identified DDIs in 544 patients (66%); 351 had DDIs introduced in hospital. The 1513 computer-identified DDIs had the following distribution: type A 78; type B 915; type C 38; type D 482. By bedside evaluation, 99 DDIs were identified in 73 patients (9%). The proportions of computer recorded DDIs which were also identified at the bedside were: 5%, 8%, 8%, 2% DDIs of types A, B, C and D respectively. In 10 patients, DDIs not registered by computer screening were identified by bedside evaluation. The drugs most frequently involved in DDIs, identified by computerized screening were acetylsalicylic acid, warfarin, furosemide and digitoxin compared with warfarin, simvastatin, theophylline and carbamazepine, by bedside evaluation. Despite an active prospective bedside search for DDIs, this approach identified less than one in 10 of the DDIs recorded by computer screening, including those regarded as hazardous. However, computer screening overestimates considerably when the objective is to identify clinically relevant DDIs.

Efficacy of computerized discrimination between structure-related and non-structure-related echoes in ultrasonographic images for the quantitative evaluation of the structural integrity of superficial digital flexor tendons in horses.

PubMed

van Schie, H T; Bakker, E M; Jonker, A M; van Weeren, P R

2001-07-01

To evaluate effectiveness of computerized discrimination between structure-related and non-structure-related echoes in ultrasonographic images for quantitative evaluation of tendon structural integrity in horses. 4 superficial digital flexor tendons (2 damaged tendons, 2 normal tendons). Transverse ultrasonographic images that precisely matched histologic sections were obtained in fixed steps along the long axis of each tendon. Distribution, intensity, and delineation of structure-related echoes, quantitatively expressed as the correlation ratio and steadiness ratio , were compared with histologic findings in tissue that was normal or had necrosis, early granulation, late granulation, early fibrosis, or inferior repair. In normal tendon, the even distribution of structure-related echoes with high intensity and sharp delineation yielded high correlation ratio and steadiness ratio. In areas of necrosis, collapsed endotendon septa yielded solid but blurred structure-related echoes (high correlation ration and low steadiness ratio). In early granulation tissue, complete lack of organization caused zero values for both ratios. In late granulation tissue, reorganization and swollen endotendon septa yielded poorly delineated structure-related echoes (high correlation ratio, low steadiness ratio). In early fibrosis, rearrangement of bundles resulted in normal correlation ration and slightly low steadiness ratio. In inferior repair, the almost complete lack of structural reorganization resulted in heterogeneous poorly delineated low-intensity echoes (low correlation ratio and steadiness ratio). The combination of correlation ratio and steadiness ratio accurately reflects histopathologic findings, making computerized correlation of ultrasonographic images an efficient tool for quantitative evaluation of tendon structural integrity.

Knowledge translation and implementation in spinal cord injury: a systematic review

PubMed Central

Noonan, VK; Wolfe, DL; Thorogood, NP; Park, SE; Hsieh, JT; Eng, JJ

2015-01-01

Objective To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes. Methods MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation. Results A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively. Conclusion The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions. PMID:24796445

Review of a fluid resuscitation protocol: "fluid creep" is not due to nursing error.

PubMed

Faraklas, Iris; Cochran, Amalia; Saffle, Jeffrey

2012-01-01

Recent reviews of burn resuscitation have included the suggestion that "fluid creep" may be influenced by practitioner error. Our center uses a nursing-driven resuscitation protocol that permits titration of fluid based on hourly urine output, including the addition of colloid when patients fail to respond appropriately. The purpose of this study was to examine protocol compliance. We reviewed 140 patients (26 children) with burns of ≥20% TBSA who received protocol-directed resuscitation from 2005 to 2010. We compared each patient's actual hourly fluid infusion with that predicted by the protocol. Sixty-seven patients (48%) completed resuscitation using crystalloid alone, whereas 73 patients required colloid supplementation. Groups did not differ in age, gender, weight, or time from injury to admission. Patients requiring colloid had larger median total burns (33.0 vs 23.5% TBSA) and full-thickness burns (15.5 vs 4.5% TBSA) and more inhalation injuries (60.3 vs 28.4%; P < .001) than those who resuscitated with crystalloid alone. Because we included basic maintenance fluids in their regimen, patients had median predicted requirements of 5.4 ml/kg/%TBSA. Crystalloid-only patients required fluid volumes close to Parkland predictions (4.7 ml/kg/%TBSA), whereas patients who received colloid required more fluid than the predicted volume (7.5 ml/kg/%TBSA). However, the hourly difference between the predicted and received fluids was a median of only 1.0% (interquartile range: -6.1 to 11.1%) and did not differ between groups. Pediatric patients had greater calculated differences than adults. Crystalloid patients exhibited higher urine outputs than colloid patients until colloid was started, suggesting that early over-resuscitation did not contribute to fluid creep. Adherence to our protocol for burn shock resuscitation was excellent overall. Fluid creep exhibited by more seriously injured patients was not due to nurses' failure to follow the protocol. This review has illuminated some opportunities for practice improvement, possibly using a computerized decision support system.

Management System for EMR Work Study Program.

ERIC Educational Resources Information Center

Columbia County Board of Public Instruction, Lake City, FL. Exceptional Child Education Dept.

A computerized information management system involving the specification of objectives, the coding of teacher evaluations of students, and a variety of possible outputs has been used in a work study program for educable mentally retarded adolescents. Instructional objectives are specified and coded by number and category. Evaluation is by means of…

VAMP: A computer program for calculating volume, area, and mass properties of aerospace vehicles

NASA Technical Reports Server (NTRS)

Norton, P. J.; Glatt, C. R.

1974-01-01

A computerized procedure developed for analyzing aerospace vehicles evaluates the properties of elemental surface areas with specified thickness by accumulating and combining them with arbitrarily specified mass elements to form a complete evaluation. Picture-like images of the geometric description are capable of being generated.

Using Bayesian Networks to Improve Knowledge Assessment

ERIC Educational Resources Information Center

Millan, Eva; Descalco, Luis; Castillo, Gladys; Oliveira, Paula; Diogo, Sandra

2013-01-01

In this paper, we describe the integration and evaluation of an existing generic Bayesian student model (GBSM) into an existing computerized testing system within the Mathematics Education Project (PmatE--Projecto Matematica Ensino) of the University of Aveiro. This generic Bayesian student model had been previously evaluated with simulated…

Evaluation of retroreflectometers.

DOT National Transportation Integrated Search

2002-08-01

This project performed field-testing and analysis of two pavement marking retroreflectometers: the Laserlux and the : LTL2000. The Laserlux is a vehiclemounted device that takes readings at driving speed and produces : computerized output. The LTL...

3D multimodal cardiac data reconstruction using angiography and computerized tomographic angiography registration.

PubMed

Moosavi Tayebi, Rohollah; Wirza, Rahmita; Sulaiman, Puteri S B; Dimon, Mohd Zamrin; Khalid, Fatimah; Al-Surmi, Aqeel; Mazaheri, Samaneh

2015-04-22

Computerized tomographic angiography (3D data representing the coronary arteries) and X-ray angiography (2D X-ray image sequences providing information about coronary arteries and their stenosis) are standard and popular assessment tools utilized for medical diagnosis of coronary artery diseases. At present, the results of both modalities are individually analyzed by specialists and it is difficult for them to mentally connect the details of these two techniques. The aim of this work is to assist medical diagnosis by providing specialists with the relationship between computerized tomographic angiography and X-ray angiography. In this study, coronary arteries from two modalities are registered in order to create a 3D reconstruction of the stenosis position. The proposed method starts with coronary artery segmentation and labeling for both modalities. Then, stenosis and relevant labeled artery in X-ray angiography image are marked by a specialist. Proper control points for the marked artery in both modalities are automatically detected and normalized. Then, a geometrical transformation function is computed using these control points. Finally, this function is utilized to register the marked artery from the X-ray angiography image on the computerized tomographic angiography and get the 3D position of the stenosis lesion. The result is a 3D informative model consisting of stenosis and coronary arteries' information from the X-ray angiography and computerized tomographic angiography modalities. The results of the proposed method for coronary artery segmentation, labeling and 3D reconstruction are evaluated and validated on the dataset containing both modalities. The advantage of this method is to aid specialists to determine a visual relationship between the correspondent coronary arteries from two modalities and also set up a connection between stenosis points from an X-ray angiography along with their 3D positions on the coronary arteries from computerized tomographic angiography. Moreover, another benefit of this work is that the medical acquisition standards remain unchanged, which means that no calibration in the acquisition devices is required. It can be applied on most computerized tomographic angiography and angiography devices.

A quantitative model for designing keyboard layout.

PubMed

Shieh, K K; Lin, C C

1999-02-01

This study analyzed the quantitative relationship between keytapping times and ergonomic principles in typewriting skills. Keytapping times and key-operating characteristics of a female subject typing on the Qwerty and Dvorak keyboards for six weeks each were collected and analyzed. The results showed that characteristics of the typed material and the movements of hands and fingers were significantly related to keytapping times. The most significant factors affecting keytapping times were association frequency between letters, consecutive use of the same hand or finger, and the finger used. A regression equation for relating keytapping times to ergonomic principles was fitted to the data. Finally, a protocol for design of computerized keyboard layout based on the regression equation was proposed.

Management software for a universal device communication controller: application to monitoring and computerized infusions.

PubMed

Coussaert, E J; Cantraine, F R

1996-11-01

We designed a virtual device for a local area network observing, operating and connecting devices to a personal computer. To keep the widest field of application, we proceeded by using abstraction and specification rules of software engineering in the design and implementation of the hardware and software for the Infusion Monitor. We specially built a box of hardware to interface multiple medical instruments with different communication protocols to a PC via a single serial port. We called that box the Universal Device Communication Controller (UDCC). The use of the virtual device driver is illustrated by the Infusion Monitor implemented for the anaesthesia and intensive care workstation.

Focus of attention in systems for visual monitoring of experiments

NASA Technical Reports Server (NTRS)

Blank, G. E.; Martin, W. N.

1987-01-01

The problem of designing a computerized experiment monitoring system for use in a space station or elsewhere is examined. It is shown that the essential challenge of such a system - attaining a reasonable expected running time - can be attacked using the concept of focus of attention and by exploiting parallelism. The use of the Contract Net Protocol for the latter purpose is discussed. The use of ideas from information science to help focus a programs's efforts on those computations likely to bring results is addressed, and the incorporation of those ideas into a design in order to aid the system in deciding upon the best course of action is considered.

Tailored care for somatoform vertigo/dizziness: study protocol for a randomised controlled trial evaluating integrative group psychotherapy.

PubMed

Lahmann, Claas; Henningsen, P; Dieterich, M; Radziej, K; Schmid, G

2015-08-01

Vertigo/dizziness (VD) ranks high in lifetime prevalence and clinical relevance. Nearly half of the complex VD disorders presenting at specialised units for vertigo or otoneurological disorders are not fully explained by an identifiable medical illness, but instead are related to anxiety, depressive, or somatoform disorders. Although there is some evidence that psychotherapy may be effective for these patients, therapeutic options remain unsatisfactory. This report describes the objectives, design and methods of a randomised, controlled clinical trial, evaluating the efficacy of manualised, multimodal group psychotherapy, based on integrative psychotherapy (IPT) and tailored to subgroups of mental disorders in medically unexplained VD. This psychotherapeutic approach will be compared to self-help groups (n = 172; n = 86 per study arm). Improvements with regard to handicap due to VD at 12 months follow-up will serve as primary outcome. Additionally, measures of generic quality of life, severity of vertigo, depression, anxiety, somatisation as well as Head Impulse Test and Computerized Static Posturography will be applied. We will also analyse the cost-effectiveness of this trial. The study aims to improve treatment of this therapeutically underserved population who are often severely impaired in their working and daily lives. ClinicalTrials.gov Identifier: NCT02320851. This is an on-going study; recruitment for the study is about to start.

Measurement of General and Specific Approaches to Physical Activity Parenting: A Systematic Review

PubMed Central

McDonald, Samantha; Cohen, Alysia

2013-01-01

Abstract Background Parents play a significant role in shaping youth physical activity (PA). However, interventions targeting PA parenting have been ineffective. Methodological inconsistencies related to the measurement of parental influences may be a contributing factor. The purpose of this article is to review the extant peer-reviewed literature related to the measurement of general and specific parental influences on youth PA. Methods A systematic review of studies measuring constructs of PA parenting was conducted. Computerized searches were completed using PubMed, MEDLINE, Academic Search Premier, SPORTDiscus, and PsycINFO. Reference lists of the identified articles were manually reviewed as well as the authors' personal collections. Articles were selected on the basis of strict inclusion criteria and details regarding the measurement protocols were extracted. A total of 117 articles met the inclusionary criteria. Methodological articles that evaluated the validity and reliability of PA parenting measures (n=10) were reviewed separately from parental influence articles (n=107). Results A significant percentage of studies used measures with indeterminate validity and reliability. A significant percentage of articles did not provide sample items, describe the response format, or report the possible range of scores. No studies were located that evaluated sensitivity to change. Conclusion The reporting of measurement properties and the use of valid and reliable measurement scales need to be improved considerably. PMID:23944923

Neurosurgical applications of ion beams

NASA Astrophysics Data System (ADS)

Fabrikant, Jacob I.; Levy, Richard P.; Phillips, Mark H.; Frankel, Kenneth A.; Lyman, John T.

1989-04-01

The program at Donner Pavilion has applied nuclear medicine research to the diagnosis and radiosurgical treatment of life-threatening intracranial vascular disorders that affect more than half a million Americans. Stereotactic heavy-charged-particle Bragg peak radiosurgery, using narrow beams of heavy ions, demonstrates superior biological and physical characteristics in brain over X-and γ-rays, viz., improved dose distribution in the Bragg peak and sharp lateral and distal borders and less scattering of the beam. Examination of CNS tissue response and alteration of cerebral blood-flow dynamics related to heavy-ion Bragg peak radiosurgery is carried out using three-dimensional treatment planning and quantitative imaging utilizing cerebral angiography, computerized tomography (CT), magnetic resonance imaging (MRI), cine-CT, xenon X-ray CT and positron emission tomography (PET). Also under examination are the physical properties of narrow heavy-ion beams for improving methods of dose delivery and dose distribution and for establishing clinical RBE/LET and dose-response relationships for human CNS tissues. Based on the evaluation and treatment with stereotactically directed narrow beams of heavy charged particles of over 300 patients, with cerebral angiography, CT scanning and MRI and PET scanning of selected patients, plus extensive clinical and neuroradiological followup, it appears that Stereotactic charged-particle Bragg peak radiosurgery obliterates intracranial arteriovenous malformations or protects against rebleeding with reduced morbidity and no mortality. Discussion will include the method of evaluation, the clinical research protocol, the Stereotactic neuroradiological preparation, treatment planning, the radiosurgery procedure and the protocol for followup. Emphasis will be placed on the neurological results, including the neuroradiological and clinical response and early and late delayed injury in brain leading to complications (including vasogenic edema, arterial occlusion, venous thrombosis and radiation necrosis). Clinical results in both children and adults will be illustrated and health outcome will be related to the advantages of charged-particle treatment planning, the radiosurgical procedure, dose distribution and dose localization.

PP167. A process evaluation of an innovative implementation strategy of the Dutch guidelines on hypertensive disorders in pregnancy using a computerized decision support system.

PubMed

Luitjes, S; Mesri, K; Wouters, M; van Tulder, M; Hermens, R

2012-07-01

Hypertensive disorders in pregnancy remain the leading cause of maternal mortality in the Netherlands. The Dutch Society of Obstetrics and Gynecology (NVOG) has developed evidence-based guidelines on the management of hypertension in pregnancy. Previous studies showed a low adherence rate to other NVOG guidelines and a large variation in usual care in different hospitals. In the BIG CHANGE trial an innovative implementation strategy of the NVOG guidelines on hypertension using a web-based application (BOS, by Giant Soft, Leeuwarden, The Netherlands) was compared to a common strategy of professional audit and feedback. In this study a process evaluation of BOS has been done, analyzing its efficiency, barriers and formulate improvement points. Gynecologists, residents and clinical midwives from seven hospitals using BOS were asked to fill in the questionnaire. A questionnaire was developed on the following items: efficiency, barriers and improvement. Thirty four completed questionnaires useful for analysis. 63.6% of the respondent also consulted the NVOG guideline or local protocol, mainly for confirmation of information, background information, medication. Technical problems were found in 44.1%. Positive opinions on user friendliness varied from 73.5% to 100%. No significant difference was found between the user frequency of BOS compared to the NVOG guidelines or local protocol, or between the time needed to consult them. Improvements mentioned by the respondents were mainly regarding the lay-out. Most respondents (85.3%) found it useful to make a computer based support system for other guidelines and 79.4% would also use this. BOS is regarded suitable as an instrument for implementing guidelines and respondents find it useful to develop it for other guidelines as well. Technical problems and poor implementation are important areas of improvement. Copyright © 2012. Published by Elsevier B.V.

How to Train an Injured Brain? A Pilot Feasibility Study of Home-Based Computerized Cognitive Training.

PubMed

Verhelst, Helena; Vander Linden, Catharine; Vingerhoets, Guy; Caeyenberghs, Karen

2017-02-01

Computerized cognitive training programs have previously shown to be effective in improving cognitive abilities in patients suffering from traumatic brain injury (TBI). These studies often focused on a single cognitive function or required expensive hardware, making it difficult to be used in a home-based environment. This pilot feasibility study aimed to evaluate the feasibility of a newly developed, home-based, computerized cognitive training program for adolescents who suffered from TBI. Additionally, feasibility of study design, procedures, and measurements were examined. Case series, longitudinal, pilot, feasibility intervention study with one baseline and two follow-up assessments. Nine feasibility outcome measures and criteria for success were defined, including accessibility, training motivation/user experience, technical smoothness, training compliance, participation willingness, participation rates, loss to follow-up, assessment timescale, and assessment procedures. Five adolescent patients (four boys, mean age = 16 years 7 months, standard deviation = 9 months) with moderate to severe TBI in the chronic stage were recruited and received 8 weeks of cognitive training with BrainGames. Effect sizes (Cohen's d) were calculated to determine possible training-related effects. The new cognitive training intervention, BrainGames, and study design and procedures proved to be feasible; all nine feasibility outcome criteria were met during this pilot feasibility study. Estimates of effect sizes showed small to very large effects on cognitive measures and questionnaires, which were retained after 6 months. Our pilot study shows that a longitudinal intervention study comprising our novel, computerized cognitive training program and two follow-up assessments is feasible in adolescents suffering from TBI in the chronic stage. Future studies with larger sample sizes will evaluate training-related effects on cognitive functions and underlying brain structures.

COMPUTERIZED EXPERT SYSTEM FOR EVALUATION OF AUTOMATED VISUAL FIELDS FROM THE ISCHEMIC OPTIC NEUROPATHY DECOMPRESSION TRIAL: METHODS, BASELINE FIELDS, AND SIX-MONTH LONGITUDINAL FOLLOW-UP

PubMed Central

Feldon, Steven E

2004-01-01

ABSTRACT Purpose To validate a computerized expert system evaluating visual fields in a prospective clinical trial, the Ischemic Optic Neuropathy Decompression Trial (IONDT). To identify the pattern and within-pattern severity of field defects for study eyes at baseline and 6-month follow-up. Design Humphrey visual field (HVF) change was used as the outcome measure for a prospective, randomized, multi-center trial to test the null hypothesis that optic nerve sheath decompression was ineffective in treating nonarteritic anterior ischemic optic neuropathy and to ascertain the natural history of the disease. Methods An expert panel established criteria for the type and severity of visual field defects. Using these criteria, a rule-based computerized expert system interpreted HVF from baseline and 6-month visits for patients randomized to surgery or careful follow-up and for patients who were not randomized. Results A computerized expert system was devised and validated. The system was then used to analyze HVFs. The pattern of defects found at baseline for patients randomized to surgery did not differ from that of patients randomized to careful follow-up. The most common pattern of defect was a superior and inferior arcuate with central scotoma for randomized eyes (19.2%) and a superior and inferior arcuate for nonrandomized eyes (30.6%). Field patterns at 6 months and baseline were not different. For randomized study eyes, the superior altitudinal defects improved (P = .03), as did the inferior altitudinal defects (P = .01). For nonrandomized study eyes, only the inferior altitudinal defects improved (P = .02). No treatment effect was noted. Conclusions A novel rule-based expert system successfully interpreted visual field defects at baseline of eyes enrolled in the IONDT. PMID:15747764

Computerized Agility Training Improves Change-of-Direction and Balance Performance Independently of Footwear in Young Adults.

PubMed

Paquette, Max R; Schilling, Brian K; Bravo, Joshua D; Peel, Shelby A; Li, Yuhua; Townsend, Robert J

2017-03-01

Understanding the effects of training in different footwear on sporting performance would be useful to coaches and athletes. This study compared the effects of computerized agility training using 3 types of footwear on change-of-direction and balance performance in young adults. Thirty recreationally active young adults (M age  = 22.8 ± 3.1 years; M height  = 1.71 ± 0.7 m; M bodymass  = 73.4 ± 10.3 kg) were randomly assigned to a 6-week computerized agility training intervention in 1 of 3 footwear groups (n = 10/group): barefoot, minimal footwear, or traditional shoes. Participants had no previous barefoot or minimal-footwear training experience. Dependent variables included change-of-direction test time to completion, Star Excursion Balance Test, and single-leg stability evaluation. Testing was performed at the start of the training program, after 2 weeks, after 4 weeks, and at the end of the training program. No group or time interactions were found for any of the dependent variables. Time main effects were observed for the performance measures of change of direction, Star Excursion, and single-leg-with-eyes-open stability evaluation. Participants improved in all 3 tests as early as 2 weeks into the intervention, with improvements continuing through the entire 6-week intervention. The lack of interaction and footwear effects suggests that agility and balance improvements during foot agility training are independent of footwear in a recreationally active young-adult population. Computerized agility training improves change-of-direction and balance performance within 2 weeks of training implementation. Future studies should consider footwear training effects in different populations, including frail older adults and athletes.

Computerized Writing and Reading Instruction for Students in Grades 4 to 9 With Specific Learning Disabilities Affecting Written Language

PubMed Central

Tanimoto, Steven; Thompson, Rob; Berninger, Virginia W.; Nagy, William; Abbott, Robert D.

2015-01-01

Computer scientists and educational researchers evaluated effectiveness of computerized instruction tailored to evidence-based impairments in specific learning disabilities (SLDs) in students in grades 4 to 9 with persisting SLDs despite prior extra help. Following comprehensive, evidence-based differential diagnosis for dysgraphia (impaired handwriting), dyslexia (impaired word reading and spelling), and oral and written language learning disability (OWL LD), students completed 18 sessions of computerized instruction over about 3 months. The 11 students taught letter formation with sequential, numbered, colored arrow cues with full contours who wrote letters on lines added to iPAD screen showed more and stronger treatment effects than the 21 students taught using only visual motion cues for letter formation who wrote on an unlined computer monitor. Teaching to all levels of language in multiple functional language systems (by ear, eye, mouth, and hand) close in time resulted in significant gains in reading and writing skills for the group and in diagnosed SLD hallmark impairments for individuals; also, performance on computerized learning activities correlated with treatment gains. Results are discussed in reference to need for both accommodations and explicit instruction for persisting SLDs and the potential for computers to teach handwriting, morphophonemic orthographies, comprehension, and composition. PMID:26858470

Computerized Doppler Tomography and Spectrum Analysis of Carotid Artery Flow

PubMed Central

Morton, Paul; Goldman, Dave; Nichols, W. Kirt

1981-01-01

Contrast angiography remains the definitive study in the evaluation of atherosclerotic occlusive vascular disease. However, a safer technique for serial screening of symptomatic patients and for routine follow up is necessary. Computerized pulsed Doppler ultrasonic arteriography is a noninvasive technique developed by Miles6 for imaging lateral, antero-posterior and transverse sections of the carotid artery. We [ill] this system with new software and hardware to analyze the three-dimensional blood flow data. The system now provides information about the location of the occlusive process in the artery and a semi-quantitative evaluation of the degree of obstruction. In addition, we interfaced a digital signal analyzer to the system which permits spectrum analysis of the pulsed Doppler signal. This addition has allowed us to identify lesions which are not yet hemodynamically significant. ImagesFig. 2bFig. 2c

Uroradiographic manifestations of Burkitt's lymphoma in children

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fernbach, S.K.; Glass, R.B.

1986-05-01

The radiological studies of 18 children with biopsy proved Burkitt's lymphoma were analyzed retrospectively. Before therapy the genitourinary tract was evaluated in 15 children by excretory urography, sonography, computerized tomography and/or gallium citrate scintigraphy. Genitourinary abnormalities were detected in 9 children. Changes due to tumor included renal or ureteral displacement in 4 children, hydronephrosis in 3 and intraparenchymal masses in 4. Extrinsic compression of the bladder causing no compromise of function was seen in only 2 children. Gonadal involvement occurred in 2 boys and 1 girl. The modality of choice for evaluating the genitourinary tract in patients with Burkitt's lymphomamore » has been excretory urography. Since ultrasound and computerized tomography provide more direct information about tumor deposits within the kidney and retroperitoneum, either should be performed in this population before initiation of chemotherapy.« less

Low intensity vs. self-guided Internet-delivered psychotherapy for major depression: a multicenter, controlled, randomized study

PubMed Central

2013-01-01

Background Major depression will become the second most important cause of disability in 2020. Computerized cognitive-behaviour therapy could be an efficacious and cost-effective option for its treatment. No studies on cost-effectiveness of low intensity vs self-guided psychotherapy has been carried out. The aim of this study is to assess the efficacy of low intensity vs self-guided psychotherapy for major depression in the Spanish health system. Methods The study is made up of 3 phases: 1.- Development of a computerized cognitive-behaviour therapy for depression tailored to Spanish health system. 2.- Multicenter controlled, randomized study: A sample (N=450 patients) with mild/moderate depression recruited in primary care. They should have internet availability at home, not receive any previous psychological treatment, and not suffer from any other severe somatic or psychological disorder. They will be allocated to one of 3 treatments: a) Low intensity Internet-delivered psychotherapy + improved treatment as usual (ITAU) by GP, b) Self-guided Internet-delivered psychotherapy + ITAU or c) ITAU. Patients will be diagnosed with MINI psychiatric interview. Main outcome variable will be Beck Depression Inventory. It will be also administered EuroQol 5D (quality of life) and Client Service Receipt Inventory (consume of health and social services). Patients will be assessed at baseline, 3 and 12 months. An intention to treat and a per protocol analysis will be performed. Discussion The comparisons between low intensity and self-guided are infrequent, and also a comparative economic evaluation between them and compared with usual treatment in primary. The strength of the study is that it is a multicenter, randomized, controlled trial of low intensity and self-guided Internet-delivered psychotherapy for depression in primary care, being the treatment completely integrated in primary care setting. Trial registration Clinical Trials NCT01611818 PMID:23312003

Analysis of heart rate deflection points to predict the anaerobic threshold by a computerized method.

PubMed

Marques-Neto, Silvio R; Maior, Alex S; Maranhão Neto, Geraldo A; Santos, Edil L

2012-07-01

Many studies have used the heart rate deflection points (HRDPs) during incremental exercise tests, because of their strong correlation with the anaerobic threshold. The aim of this study was to evaluate the profile of the HRDPs identified by a computerized method and compare them with ventilatory and lactate thresholds. Twenty-four professional soccer players (age, 22 ± 5 years; body mass, 74 ± 7 kg; height 177 ± 7 cm) volunteered for the study. The subjects completed a Bruce-protocol incremental treadmill exercise test to volitional fatigue. Heart rate (HR) and alveolar gas exchange were recorded continuously at ≥1 Hz during exercise testing. Subsequently, the time course of the HR was fit by a computer algorithm, and a set of lines yielding the lowest pooled residual sum of squares was chosen as the best fit. This procedure defined 2 HRDPs (HRDP1 and HRDP2). The HR break points averaged 43.9 ± 5.9 and 89.7 ± 7.5% of the VO2peak. The HRDP1 showed a poor correlation with ventilatory threshold (VT; r = 0.50), but HRDP2 was highly correlated to the respiratory compensation (RC) point (r = 0.98). Neither HRDP1 nor HRDP2 was correlated with LT1 (at VO2 = 2.26 ± 0.72 L·min(-1); r = 0.26) or LT2 (2.79 ± 0.59 L·min(-1); r = 0.49), respectively. LT1 and LT2 also were not well correlated with VT (2.93 ± 0.68 L·min(-1); r = 0.20) or RC (3.82 ± 0.60 L·min(-1); r = 0.58), respectively. Although the HR deflection points were not correlated to LT, HRDP2 could be identified in all the subjects and was strongly correlated with RC, consistent with a relationship to cardiorespiratory fatigue and endurance performance.

Implementing an evidence-based computerized decision support system to improve patient care in a general hospital: the CODES study protocol for a randomized controlled trial.

PubMed

Moja, Lorenzo; Polo Friz, Hernan; Capobussi, Matteo; Kwag, Koren; Banzi, Rita; Ruggiero, Francesca; González-Lorenzo, Marien; Liberati, Elisa Giulia; Mangia, Massimo; Nyberg, Peter; Kunnamo, Ilkka; Cimminiello, Claudio; Vighi, Giuseppe; Grimshaw, Jeremy; Bonovas, Stefanos

2016-07-07

Computerized decision support systems (CDSSs) are information technology-based software that provide health professionals with actionable, patient-specific recommendations or guidelines for disease diagnosis, treatment, and management at the point-of-care. These messages are intelligently filtered to enhance the health and clinical care of patients. CDSSs may be integrated with patient electronic health records (EHRs) and evidence-based knowledge. We designed a pragmatic randomized controlled trial to evaluate the effectiveness of patient-specific, evidence-based reminders generated at the point-of-care by a multi-specialty decision support system on clinical practice and the quality of care. We will include all the patients admitted to the internal medicine department of one large general hospital. The primary outcome is the rate at which medical problems, which are detected by the decision support software and reported through the reminders, are resolved (i.e., resolution rates). Secondary outcomes are resolution rates for reminders specific to venous thromboembolism (VTE) prevention, in-hospital all causes and VTE-related mortality, and the length of hospital stay during the study period. The adoption of CDSSs is likely to increase across healthcare systems due to growing concerns about the quality of medical care and discrepancy between real and ideal practice, continuous demands for a meaningful use of health information technology, and the increasing use of and familiarity with advanced technology among new generations of physicians. The results of our study will contribute to the current understanding of the effectiveness of CDSSs in primary care and hospital settings, thereby informing future research and healthcare policy questions related to the feasibility and value of CDSS use in healthcare systems. This trial is seconded by a specialty trial randomizing patients in an oncology setting (ONCO-CODES). ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT02577198?term=NCT02577198&rank=1.

Objective and automated protocols for the evaluation of biomedical search engines using No Title Evaluation protocols.

PubMed

Campagne, Fabien

2008-02-29

The evaluation of information retrieval techniques has traditionally relied on human judges to determine which documents are relevant to a query and which are not. This protocol is used in the Text Retrieval Evaluation Conference (TREC), organized annually for the past 15 years, to support the unbiased evaluation of novel information retrieval approaches. The TREC Genomics Track has recently been introduced to measure the performance of information retrieval for biomedical applications. We describe two protocols for evaluating biomedical information retrieval techniques without human relevance judgments. We call these protocols No Title Evaluation (NT Evaluation). The first protocol measures performance for focused searches, where only one relevant document exists for each query. The second protocol measures performance for queries expected to have potentially many relevant documents per query (high-recall searches). Both protocols take advantage of the clear separation of titles and abstracts found in Medline. We compare the performance obtained with these evaluation protocols to results obtained by reusing the relevance judgments produced in the 2004 and 2005 TREC Genomics Track and observe significant correlations between performance rankings generated by our approach and TREC. Spearman's correlation coefficients in the range of 0.79-0.92 are observed comparing bpref measured with NT Evaluation or with TREC evaluations. For comparison, coefficients in the range 0.86-0.94 can be observed when evaluating the same set of methods with data from two independent TREC Genomics Track evaluations. We discuss the advantages of NT Evaluation over the TRels and the data fusion evaluation protocols introduced recently. Our results suggest that the NT Evaluation protocols described here could be used to optimize some search engine parameters before human evaluation. Further research is needed to determine if NT Evaluation or variants of these protocols can fully substitute for human evaluations.

Assessment of text documentation accompanying uncoded diagnoses in computerized health insurance claims in Japan.

PubMed

Tanihara, Shinichi

2015-01-01

Uncoded diagnoses in health insurance claims (HICs) may introduce bias into Japanese health statistics dependent on computerized HICs. This study's aim was to identify the causes and characteristics of uncoded diagnoses. Uncoded diagnoses from computerized HICs (outpatient, inpatient, and the diagnosis procedure-combination per-diem payment system [DPC/PDPS]) submitted to the National Health Insurance Organization of Kumamoto Prefecture in May 2010 were analyzed. The text documentation accompanying the uncoded diagnoses was used to classify diagnoses in accordance with the International Classification of Diseases-10 (ICD-10). The text documentation was also classified into four categories using the standard descriptions of diagnoses defined in the master files of the computerized HIC system: 1) standard descriptions of diagnoses, 2) standard descriptions with a modifier, 3) non-standard descriptions of diagnoses, and 4) unclassifiable text documentation. Using these classifications, the proportions of uncoded diagnoses by ICD-10 disease category were calculated. Of the uncoded diagnoses analyzed (n = 363 753), non-standard descriptions of diagnoses for outpatient, inpatient, and DPC/PDPS HICs comprised 12.1%, 14.6%, and 1.0% of uncoded diagnoses, respectively. The proportion of uncoded diagnoses with standard descriptions with a modifier for Diseases of the eye and adnexa was significantly higher than the overall proportion of uncoded diagnoses among every HIC type. The pattern of uncoded diagnoses differed by HIC type and disease category. Evaluating the proportion of uncoded diagnoses in all medical facilities and developing effective coding methods for diagnoses with modifiers, prefixes, and suffixes should reduce number of uncoded diagnoses in computerized HICs and improve the quality of HIC databases.

Evaluation of Hand Written and Computerized Out-Patient Prescriptions in Urban Part of Central Gujarat.

PubMed

Joshi, Anuradha; Buch, Jatin; Kothari, Nitin; Shah, Nishal

2016-06-01

Prescription order is an important therapeutic transaction between physician and patient. A good quality prescription is an extremely important factor for minimizing errors in dispensing medication and it should be adherent to guidelines for prescription writing for benefit of the patient. To evaluate frequency and type of prescription errors in outpatient prescriptions and find whether prescription writing abides with WHO standards of prescription writing. A cross-sectional observational study was conducted at Anand city. Allopathic private practitioners practising at Anand city of different specialities were included in study. Collection of prescriptions was started a month after the consent to minimize bias in prescription writing. The prescriptions were collected from local pharmacy stores of Anand city over a period of six months. Prescriptions were analysed for errors in standard information, according to WHO guide to good prescribing. Descriptive analysis was performed to estimate frequency of errors, data were expressed as numbers and percentage. Total 749 (549 handwritten and 200 computerised) prescriptions were collected. Abundant omission errors were identified in handwritten prescriptions e.g., OPD number was mentioned in 6.19%, patient's age was mentioned in 25.50%, gender in 17.30%, address in 9.29% and weight of patient mentioned in 11.29%, while in drug items only 2.97% drugs were prescribed by generic name. Route and Dosage form was mentioned in 77.35%-78.15%, dose mentioned in 47.25%, unit in 13.91%, regimens were mentioned in 72.93% while signa (direction for drug use) in 62.35%. Total 4384 errors out of 549 handwritten prescriptions and 501 errors out of 200 computerized prescriptions were found in clinicians and patient details. While in drug item details, total number of errors identified were 5015 and 621 in handwritten and computerized prescriptions respectively. As compared to handwritten prescriptions, computerized prescriptions appeared to be associated with relatively lower rates of error. Since out-patient prescription errors are abundant and often occur in handwritten prescriptions, prescribers need to adapt themselves to computerized prescription order entry in their daily practice.

Radionuclide and Fluorescence Imaging of Clear Cell Renal Cell Carcinoma Using Dual Labeled Anti-Carbonic Anhydrase IX Antibody G250.

PubMed

Muselaers, Constantijn H J; Rijpkema, Mark; Bos, Desirée L; Langenhuijsen, Johan F; Oyen, Wim J G; Mulders, Peter F A; Oosterwijk, Egbert; Boerman, Otto C

2015-08-01

Tumor targeted optical imaging using antibodies labeled with near infrared fluorophores is a sensitive imaging modality that might be used during surgery to assure complete removal of malignant tissue. We evaluated the feasibility of dual modality imaging and image guided surgery with the dual labeled anti-carbonic anhydrase IX antibody preparation (111)In-DTPA-G250-IRDye800CW in mice with intraperitoneal clear cell renal cell carcinoma. BALB/c nu/nu mice with intraperitoneal SK-RC-52 lesions received 10 μg DTPA-G250-IRDye800CW labeled with 15 MBq (111)In or 10 μg of the dual labeled irrelevant control antibody NUH-82 (20 mice each). To evaluate when tumors could be detected, 4 mice per group were imaged weekly during 5 weeks with single photon emission computerized tomography/computerized tomography and the fluorescence imaging followed by ex vivo biodistribution studies. As early as 1 week after tumor cell inoculation single photon emission computerized tomography and fluorescence images showed clear delineation of intraperitoneal clear cell renal cell carcinoma with good concordance between single photon emission computerized tomography/computerized tomography and fluorescence images. The high and specific accumulation of the dual labeled antibody conjugate in tumors was confirmed in the biodistribution studies. Maximum tumor uptake was observed 1 week after inoculation (mean ± SD 58.5% ± 18.7% vs 5.6% ± 2.3% injected dose per gm for DTPA-G250-IRDye800CW vs NUH-82, respectively). High tumor uptake was also observed at other time points. This study demonstrates the feasibility of dual modality imaging with dual labeled antibody (111)In-DTPA-G250-IRDye800CW in a clear cell renal cell carcinoma model. Results indicate that preoperative and intraoperative detection of carbonic anhydrase IX expressing tumors, positive resection margins and metastasis might be feasible with this approach. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Evaluation of Hand Written and Computerized Out-Patient Prescriptions in Urban Part of Central Gujarat

PubMed Central

Buch, Jatin; Kothari, Nitin; Shah, Nishal

2016-01-01

Introduction Prescription order is an important therapeutic transaction between physician and patient. A good quality prescription is an extremely important factor for minimizing errors in dispensing medication and it should be adherent to guidelines for prescription writing for benefit of the patient. Aim To evaluate frequency and type of prescription errors in outpatient prescriptions and find whether prescription writing abides with WHO standards of prescription writing. Materials and Methods A cross-sectional observational study was conducted at Anand city. Allopathic private practitioners practising at Anand city of different specialities were included in study. Collection of prescriptions was started a month after the consent to minimize bias in prescription writing. The prescriptions were collected from local pharmacy stores of Anand city over a period of six months. Prescriptions were analysed for errors in standard information, according to WHO guide to good prescribing. Statistical Analysis Descriptive analysis was performed to estimate frequency of errors, data were expressed as numbers and percentage. Results Total 749 (549 handwritten and 200 computerised) prescriptions were collected. Abundant omission errors were identified in handwritten prescriptions e.g., OPD number was mentioned in 6.19%, patient’s age was mentioned in 25.50%, gender in 17.30%, address in 9.29% and weight of patient mentioned in 11.29%, while in drug items only 2.97% drugs were prescribed by generic name. Route and Dosage form was mentioned in 77.35%-78.15%, dose mentioned in 47.25%, unit in 13.91%, regimens were mentioned in 72.93% while signa (direction for drug use) in 62.35%. Total 4384 errors out of 549 handwritten prescriptions and 501 errors out of 200 computerized prescriptions were found in clinicians and patient details. While in drug item details, total number of errors identified were 5015 and 621 in handwritten and computerized prescriptions respectively. Conclusion As compared to handwritten prescriptions, computerized prescriptions appeared to be associated with relatively lower rates of error. Since out-patient prescription errors are abundant and often occur in handwritten prescriptions, prescribers need to adapt themselves to computerized prescription order entry in their daily practice. PMID:27504305

Computerizing medical records in Japan.

PubMed

Yasunaga, Hideo; Imamura, Tomoaki; Yamaki, Shintaro; Endo, Hiroyoshi

2008-10-01

The present study reports the current status of computerizing medical records in Japan. In 2001, the Ministry of Health, Labour and Welfare formulated the Grand Design for the Development of Information Systems in the Healthcare and Medical Fields. The Grand Design stated a numerical target for "spreading the use of electronic medical records (EMR) in at least 60% of Japan's hospitals with 400 or more beds by 2006." The objective of this study was to examine the extent to which EMR and order entry systems (OES) have been adopted as of February 2007 and to evaluate the Japanese government's policy regarding the computerization of medical records. We conducted a postal survey targeting medical institutions throughout Japan. In February 2007, we mailed self-administered questionnaires to all 1574 hospitals with 300 or more beds, and to a random selection of 1000 hospitals with less than 300 beds in addition to 4000 clinics. Responses were received from 812 (51.6%), 504 (50.5%), and 1769 (44.8%), respectively. We asked questions concerning: (i) the extent to which EMR and OES had been introduced; (ii) the reasons why certain institutions had not introduced EMR and (iii) the subjective evaluation of the efficacy and cost-effectiveness of EMR. The percentage of institutions that had introduced EMR as of February 2007 was 10.0% for hospitals and 10.1% for clinics. Even the percentage for hospitals with 400 or more beds was just 31.2%, illustrating that the government's target had not been reached. The most common reason given for not introducing EMR was: "The cost is high" which was observed in 82.0% of hospitals. It was considered that the introduction of EMR could improve 'inter-hospital networks', and 'time efficiency for physicians' by around 45% and 25% of hospitals, respectively. Healthcare information computerization in Japan is behind schedule because the introductory costs are high. For the computerization of healthcare information to be further promoted, prices of EMR systems should be lowered to a level which individual hospitals can afford. Furthermore, the communication between EMR systems should be further standardized to secure functional and semantic interoperability in Japan.

Computerized Virtual Reality Simulation in Preclinical Dentistry: Can a Computerized Simulator Replace the Conventional Phantom Heads and Human Instruction?

PubMed

Plessas, Anastasios

2017-10-01

In preclinical dental education, the acquisition of clinical, technical skills, and the transfer of these skills to the clinic are paramount. Phantom heads provide an efficient way to teach preclinical students dental procedures safely while increasing their dexterity skills considerably. Modern computerized phantom head training units incorporate features of virtual reality technology and the ability to offer concurrent augmented feedback. The aims of this review were to examine and evaluate the dental literature for evidence supporting their use and to discuss the role of augmented feedback versus the facilitator's instruction. Adjunctive training in these units seems to enhance student's learning and skill acquisition and reduce the required faculty supervision time. However, the virtual augmented feedback cannot be used as the sole method of feedback, and the facilitator's input is still critical. Well-powered longitudinal randomized trials exploring the impact of these units on student's clinical performance and issues of cost-effectiveness are warranted.

Accounting Information Systems in Healthcare: A Review of the Literature.

PubMed

Hammour, Hadal; Househ, Mowafa; Razzak, Hira Abdul

2017-01-01

As information technology progresses in Saudi Arabia, the manual accounting systems have become graduallyinadequate for decision needs. Subsequently, private and public healthcare divisions in Saudi Arabia perceive Computerized accounting information system (CAIS) as a vehicle to safeguard efficient and effective flow of information during the analysis, processes, and recording of financial data. Efficient and effective flow of information improvesthe decision making of staff, thereby improving the capability of health care sectors to reduce cost of the medical services.In this paper, we define computerized accounting systems from the point of view of health informatics. Also, the challenges and benefits of supporting CAIS applications in hospitals of Saudi Arabia. With these elements, we conclude that CAIS in Saudi Arabia can serve as a valuable tool for evaluating and controlling the cost of medical services in healthcare sectors. Supplementary education on the significance of having systems of computerized accounting within hospitals for nurses, doctors, and accountants with other health care staff is warranted in future.

Improving investigational drug service operations through development of an innovative computer system.

PubMed

Sweet, Burgunda V; Tamer, Helen R; Siden, Rivka; McCreadie, Scott R; McGregory, Michael E; Benner, Todd; Tankanow, Roberta M

2008-05-15

The development of a computerized system for protocol management, dispensing, inventory accountability, and billing by the investigational drug service (IDS) of a university health system is described. After an unsuccessful search for a commercial system that would accommodate the variation among investigational protocols and meet regulatory requirements, the IDS worked with the health-system pharmacy's information technology staff and informatics pharmacists to develop its own system. The informatics pharmacists observed work-flow and information capture in the IDS and identified opportunities for improved efficiency with an automated system. An iterative build-test-design process was used to provide the flexibility needed for individual protocols. The intent was to design a system that would support most IDS processes, using components that would allow automated backup and redundancies. A browser-based system was chosen to allow remote access. Servers, bar-code scanners, and printers were integrated into the final system design. Initial implementation involved 10 investigational protocols chosen on the basis of dispensing volume and complexity of study design. Other protocols were added over a two-year period; all studies whose drugs were dispensed from the IDS were added, followed by those for which the drugs were dispensed from decentralized pharmacy areas. The IDS briefly used temporary staff to free pharmacist and technician time for system implementation. Decentralized pharmacy areas that rarely dispense investigational drugs continue to use manual processes, with subsequent data transcription into the system. Through the university's technology transfer division, the system was licensed by an external company for sale to other IDSs. The WebIDS system has improved daily operations, enhanced safety and efficiency, and helped meet regulatory requirements for investigational drugs.

Measuring neural and behavioral activity during ongoing computerized social interactions: an examination of event-related brain potentials.

PubMed

Themanson, Jason R

2014-11-15

Social exclusion is a complex social phenomenon with powerful negative consequences. Given the impact of social exclusion on mental and emotional health, an understanding of how perceptions of social exclusion develop over the course of a social interaction is important for advancing treatments aimed at lessening the harmful costs of being excluded. To date, most scientific examinations of social exclusion have looked at exclusion after a social interaction has been completed. While this has been very helpful in developing an understanding of what happens to a person following exclusion, it has not helped to clarify the moment-to-moment dynamics of the process of social exclusion. Accordingly, the current protocol was developed to obtain an improved understanding of social exclusion by examining the patterns of event-related brain activation that are present during social interactions. This protocol allows greater precision and sensitivity in detailing the social processes that lead people to feel as though they have been excluded from a social interaction. Importantly, the current protocol can be adapted to include research projects that vary the nature of exclusionary social interactions by altering how frequently participants are included, how long the periods of exclusion will last in each interaction, and when exclusion will take place during the social interactions. Further, the current protocol can be used to examine variables and constructs beyond those related to social exclusion. This capability to address a variety of applications across psychology by obtaining both neural and behavioral data during ongoing social interactions suggests the present protocol could be at the core of a developing area of scientific inquiry related to social interactions.

Microleakage of 4 post-luting cements evaluated by the computerized fluid filtration method.

PubMed

Ceyhanli, Kadir T; Orucoglu, Hasan; Erdilek, Necdet; Turkun, Murat; Akdağ, Mustafa S

2015-12-01

The aim of this study was to evaluate the microleakage of 4 fiber post-luting systems using the computerized fluid filtration method. 60 extracted human mandibular permanent premolar teeth were used for the study. The teeth were instrumented with Hedstroem files up to size 60, post spaces were prepared and then Unicore fiber posts were cemented using 4 luting systems. Group1: Duolink, Group 2: Resinomer, Group 3: Fuji Plus, Group 4: Multilink Sprint, Group 5: Positive Control, and Group 6: Negative Control. The samples were stored in distilled water for 2 weeks and then microleakage was evaluated. Data were analyzed with 1 way-ANOVA and Dunett T3 tests (P<.05). Groups 2 and 3 significantly exhibited higher microleakage values than groups 1 and 4 (P<.05). Resin cements used with total etch-bonding systems demonstrated lower microleakage values than the other cements. Reduction of steps in dentin conditioning of resin luting cements may have a promoting effect on microleakage.

A description of STEMS-- the stand and tree evaluation and modeling system.

Treesearch

David M. Belcher; Margaret R. Holdaway; Gary J. Brand

1982-01-01

This paper describes STEMS (Stand and Tree Evaluation and Modeling System), the current computerized Lake State tree growth projection system. It presents the program structure, discusses the growth and mortality components, the management subsystem, and the regeneration subsystem. Some preliminary results of model testing are presented and an application is...

Guide for the Establishment and Evaluation of Services for Selective Dissemination of Information.

ERIC Educational Resources Information Center

Poncelet, J.

This guide describes the components of a selective dissemination of information (SDI) service which is designed to give developing countries access to international sources of bibliographic information and provides guidelines for the establishment and evaluation of this type of service. It defines the main features of a computerized documentation…

Data entry errors and design for model-based tight glycemic control in critical care.

PubMed

Ward, Logan; Steel, James; Le Compte, Aaron; Evans, Alicia; Tan, Chia-Siong; Penning, Sophie; Shaw, Geoffrey M; Desaive, Thomas; Chase, J Geoffrey

2012-01-01

Tight glycemic control (TGC) has shown benefits but has been difficult to achieve consistently. Model-based methods and computerized protocols offer the opportunity to improve TGC quality but require human data entry, particularly of blood glucose (BG) values, which can be significantly prone to error. This study presents the design and optimization of data entry methods to minimize error for a computerized and model-based TGC method prior to pilot clinical trials. To minimize data entry error, two tests were carried out to optimize a method with errors less than the 5%-plus reported in other studies. Four initial methods were tested on 40 subjects in random order, and the best two were tested more rigorously on 34 subjects. The tests measured entry speed and accuracy. Errors were reported as corrected and uncorrected errors, with the sum comprising a total error rate. The first set of tests used randomly selected values, while the second set used the same values for all subjects to allow comparisons across users and direct assessment of the magnitude of errors. These research tests were approved by the University of Canterbury Ethics Committee. The final data entry method tested reduced errors to less than 1-2%, a 60-80% reduction from reported values. The magnitude of errors was clinically significant and was typically by 10.0 mmol/liter or an order of magnitude but only for extreme values of BG < 2.0 mmol/liter or BG > 15.0-20.0 mmol/liter, both of which could be easily corrected with automated checking of extreme values for safety. The data entry method selected significantly reduced data entry errors in the limited design tests presented, and is in use on a clinical pilot TGC study. The overall approach and testing methods are easily performed and generalizable to other applications and protocols. © 2012 Diabetes Technology Society.

Learning from a cluster randomized controlled trial to improve healthcare workers' access to prevention and care for tuberculosis and HIV in Free State, South Africa: the pivotal role of information systems.

PubMed

Yassi, Annalee; Adu, Prince A; Nophale, Letshego; Zungu, Muzimkhulu

2016-01-01

Occupational tuberculosis (TB) continues to plague the healthcare workforce in South Africa. A 2-year cluster randomized controlled trial was therefore launched in 27 public hospitals in Free State province, to better understand how a combined workforce and workplace program can improve health of the healthcare workforce. This mid-term evaluation aimed to analyze how well the intervention was being implemented, seek evidence of impact or harm, and draw lessons. Both intervention and comparison sites had been instructed to conduct bi-annual and issue-based infection control assessments (when healthcare workers [HCW] are diagnosed with TB) and offer HCWs confidential TB and HIV counseling and testing, TB treatment and prophylaxis for HIV-positive HCWs. Intervention sites were additionally instructed to conduct quarterly workplace assessments, and also offer HCWs HIV treatment at their occupational health units (OHUs). Trends in HCW mortality, sick-time, and turnover rates (2005-2014) were analyzed from the personnel salary database ('PERSAL'). Data submitted by the OHUs were also analyzed. Open-ended questionnaires were then distributed to OHU HCWs and in-depth interviews conducted at 17 of the sites to investigate challenges encountered. OHUs reported identifying and treating 23 new HCW cases of TB amongst the 1,372 workers who used the OHU for HIV and/or TB services; 39 new cases of HIV were also identified and 108 known-HIV-positive HCWs serviced. Although intervention-site workforces used these services significantly more than comparison-site healthcare staff (p<0.001), the data recorded were incomplete for both the intervention and comparison OHUs. An overall significant decline in mortality and turnover rates was documented over this period, but no significant differences between intervention and comparison sites; sick-time data proved unreliable. Severe OHU workload as well as residual confidentiality concerns prevented the proper implementation of protocols, especially workplace assessments and data recording. Particularly, the failure to implement computerized data collection required OHU staff to duplicate their operational data collection duties by also entering research paper forms. The study was therefore halted pending the implementation of a computerized system. The significant differences in OHU use documented cannot be attributable to the intervention due to incomplete data reporting; unreliable sick-time data further precluded ascertaining the benefit potentially attributable to the intervention. Computerized data collection is essential to facilitate operational monitoring while conducting real-world intervention research. The digital divide still requires the attention of researchers along with overall infrastructural constraints.

Text-interpreter language for flexible generation of patient notes and instructions.

PubMed

Forker, T S

1992-01-01

An interpreted computer language has been developed along with a windowed user interface and multi-printer-support formatter to allow preparation of documentation of patient visits, including progress notes, prescriptions, excuses for work/school, outpatient laboratory requisitions, and patient instructions. Input is by trackball or mouse with little or no keyboard skill required. For clinical problems with specific protocols, the clinician can be prompted with problem-specific items of history, exam, and lab data to be gathered and documented. The language implements a number of text-related commands as well as branching logic and arithmetic commands. In addition to generating text, it is simple to implement arithmetic calculations such as weight-specific drug dosages; multiple branching decision-support protocols for paramedical personnel (or physicians); and calculation of clinical scores (e.g., coma or trauma scores) while simultaneously documenting the status of each component of the score. ASCII text files produced by the interpreter are available for computerized quality audit. Interpreter instructions are contained in text files users can customize with any text editor.

Regularly scheduled, day-time, slow-onset 60 Hz electric and magnetic field exposure does not depress serum melatonin concentration in nonhuman primates

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rogers, W.R.; Smith, H.D.; Orr, J.L.

Experiments conducted with laboratory rodents indicate that exposure to 60 Hz electric fields or magnetic fields can suppress nocturnal melatonin concentrations in pineal gland and blood. In three experiments employing three field-exposed and three sham-exposed nonhuman primates, each implanted with an indwelling venous cannula to allow repeated blood sampling, the authors studied the effects of either 6 kV/m and 50 {micro}T (0.5 G) or 30 kV/m and 100 {micro}T (1.0 G) on serum melatonin patterns. The fields were ramped on and off slowly, so that no transients occurred. Extensive quality control for the melatonin assay, computerized control and monitoring ofmore » field intensities, and consistent exposure protocols were used. No changes in nocturnal serum melatonin concentration resulted from 6 weeks of day-time exposure with slow field onset/offset and a highly regular exposure protocol. These results indicate that, under the conditions tested, day-time exposure to 60 Hz electric and magnetic fields in combination does not result in melatonin suppression in primates.« less

Clinical guideline representation in a CDS: a human information processing method.

PubMed

Kilsdonk, Ellen; Riezebos, Rinke; Kremer, Leontien; Peute, Linda; Jaspers, Monique

2012-01-01

The Dutch Childhood Oncology Group (DCOG) has developed evidence-based guidelines for screening childhood cancer survivors for possible late complications of treatment. These paper-based guidelines appeared to not suit clinicians' information retrieval strategies; it was thus decided to communicate the guidelines through a Computerized Decision Support (CDS) tool. To ensure high usability of this tool, an analysis of clinicians' cognitive strategies in retrieving information from the paper-based guidelines was used as requirements elicitation method. An information processing model was developed through an analysis of think aloud protocols and used as input for the design of the CDS user interface. Usability analysis of the user interface showed that the navigational structure of the CDS tool fitted well with the clinicians' mental strategies employed in deciding on survivors screening protocols. Clinicians were more efficient and more complete in deciding on patient-tailored screening procedures when supported by the CDS tool than by the paper-based guideline booklet. The think-aloud method provided detailed insight into users' clinical work patterns that supported the design of a highly usable CDS system.

MDCT for Computerized Volumetry of Pneumothoraces in Pediatric Patients

PubMed Central

Cai, Wenli; Lee, Edward Y.; Vij, Abhinav; Mahmood, Soran A.; Yoshida, Hiroyuki

2010-01-01

OBJECTIVE Our purpose in this study was to develop an automated computer-aided volumetry (CAV) scheme for quantifying pneumothorax in MDCT images for pediatric patients and to investigate the imaging parameters that may affect its accuracy. MATERIALS AND METHODS Fifty-eight consecutive pediatric patients (mean age 12±6 years) with pneumothorax who underwent MDCT for evaluation were collected retrospectively for this study. All cases were imaged by a 16- or 64-MDCT scanner with weight-based kilovoltage, low-dose tube current, 1.0 ~ 1.5 pitch, 0.6 ~ 5.0 mm slice thickness, and a B70f (sharp) or B31f (soft) reconstruction kernel. Sixty-three pneumothoraces ≥1 cc were visually identified in the left (n = 30) or/and right (n = 33) lungs. Each identified pneumothorax was contoured manually on an Amira workstation V4.1.1 (Mercury Computer Systems, Chelmsford, Massachusetts) by two radiologists in consensus. The computerized volumes of the pneumothoraces were determined by application of our CAV scheme. The accuracy of our automated CAV scheme was evaluated by comparison between computerized volumetry and manual volumetry, for the total volume of pneumothoraces in the left and right lungs. RESULTS The mean difference between the computerized volumetry and the manual volumetry for all 63 pneumothoraces ≥1 cc was 8.2%. For pneumothoraces ≥10 cc, ≥50 cc, and ≥200 cc, the mean differences were 7.7% (n=57), 7.3% (n=33), and 6.4% (n=13), respectively. The correlation coefficient was 0.99 between the computerized volume and the manual volume of pneumothoraces. Bland-Altman analysis showed that computerized volumetry has a mean difference of −5.1% compared to manual volumetry. For all pneumothoraces ≥10 cc, the mean differences for slice thickness ≤1.25 mm, =1.5 mm, and =5.0 mm were 6.1% (n=28), 3.5% (n=10), and 12.2% (n=19), respectively. For the two reconstruction kernels, B70f and B31f, the mean differences were 6.3% (n=42, B70f) and 11.7% (n=15, B31f), respectively. CONCLUSION Our automated CAV scheme provides an accurate measurement of pneumothorax volume in MDCT images of pediatric patients. For accurate volumetric quantification of pneumothorax in children in MDCT images by use of the automated CAV scheme, we recommended reconstruction parameters based on a slice thickness ≤1.5 mm and the reconstruction kernel B70f. PMID:21216160

MDCT for computerized volumetry of pneumothoraces in pediatric patients.

PubMed

Cai, Wenli; Lee, Edward Y; Vij, Abhinav; Mahmood, Soran A; Yoshida, Hiroyuki

2011-03-01

Our purpose in this study was to develop an automated computer-aided volumetry (CAV) scheme for quantifying pneumothorax in multidetector computed tomography (MDCT) images for pediatric patients and to investigate the imaging parameters that may affect its accuracy. Fifty-eight consecutive pediatric patients (mean age 12 ± 6 years) with pneumothorax who underwent MDCT for evaluation were collected retrospectively for this study. All cases were imaged by a 16- or 64-MDCT scanner with weight-based kilovoltage, low-dose tube current, 1.0-1.5 pitch, 0.6-5.0 mm slice thickness, and a B70f (sharp) or B31f (soft) reconstruction kernel. Sixty-three pneumothoraces ≥1 mL were visually identified in the left (n = 30) and right (n = 33) lungs. Each identified pneumothorax was contoured manually on an Amira workstation V4.1.1 (Mercury Computer Systems, Chelmsford, MA) by two radiologists in consensus. The computerized volumes of the pneumothoraces were determined by application of our CAV scheme. The accuracy of our automated CAV scheme was evaluated by comparison between computerized volumetry and manual volumetry, for the total volume of pneumothoraces in the left and right lungs. The mean difference between the computerized volumetry and the manual volumetry for all 63 pneumothoraces ≥1 mL was 8.2%. For pneumothoraces ≥10 mL, ≥50 mL, and ≥200 mL, the mean differences were 7.7% (n = 57), 7.3% (n = 33), and 6.4% (n = 13), respectively. The correlation coefficient was 0.99 between the computerized volume and the manual volume of pneumothoraces. Bland-Altman analysis showed that computerized volumetry has a mean difference of -5.1% compared to manual volumetry. For all pneumothoraces ≥10 mL, the mean differences for slice thickness ≤1.25 mm, = 1.5 mm, and = 5.0 mm were 6.1% (n = 28), 3.5% (n = 10), and 12.2% (n = 19), respectively. For the two reconstruction kernels, B70f and B31f, the mean differences were 6.3% (n = 42, B70f) and 11.7% (n = 15, B31f), respectively. Our automated CAV scheme provides an accurate measurement of pneumothorax volume in MDCT images of pediatric patients. For accurate volumetric quantification of pneumothorax in children in MDCT images by use of the automated CAV scheme, we recommended reconstruction parameters based on a slice thickness ≤1.5 mm and the reconstruction kernel B70f. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Results of the National CT Colonography Trial: Questions and Answers

Cancer.gov

Learn the results of the National Computerized Tomographic Colonography (CTC) clinical trial, which evaluated how well CTC identifies participants with at least one significantly large polyp using colonoscopy as the gold (or reference) standard.

Evaluation of roadway sites for queue management.

DOT National Transportation Integrated Search

1991-01-01

This study addresses the problem of queueing on highway facilities, wherein a large number of computerized methods for the analysis of different queueing situations are available. A three-tier classification system of the methodologies was used with ...

HRIS Vendor Selection.

ERIC Educational Resources Information Center

Moore, James C.

1985-01-01

Questions administrators need to answer when selecting or evaluating a computerized personnel and/or payroll information system cover the type of system, resources for purchasing and/or developing it, activities needed and used for, its use, and issues of responsibility. (MSE)

Weigh-in-Motion systems evaluation : final report.

DOT National Transportation Integrated Search

1976-04-01

This relatively short-term project was initiated in order to perfect installation, operation, and maintenance practices necessary for continued accurate and reliable operation of a computerized Weigh-in-Motion system which will be used to gather truc...

Computerized symptom and quality-of-life assessment for patients with cancer part I: development and pilot testing.

PubMed

Berry, Donna L; Trigg, Lisa J; Lober, William B; Karras, Bryant T; Galligan, Mary L; Austin-Seymour, Mary; Martin, Stephanie

2004-09-01

To develop and test an innovative computerized symptom and quality-of-life (QOL) assessment for patients with cancer who are evaluated for and treated with radiation therapy. Descriptive, longitudinal prototype development and cross-sectional clinical data. Department of radiation oncology in an urban, academic medical center. 101 outpatients who were evaluated for radiation therapy, able to communicate in English (or through one of many interpreters available at the University of Washington), and competent to understand the study information and give informed consent. Six clinicians caring for the patients in the sample were enrolled. Iterative prototype development was conducted using a standing focus group of clinicians. The software was developed based on survey markup language and implemented in a wireless, Web-based format. Patient participants completed the computerized assessment prior to consultation with the radiation physician. Graphical output pages with flagged areas of symptom distress or troublesome QOL issues were made available to consulting physicians and nurses. Pain intensity, symptoms, QOL, and demographics. Computerized versions of a 0 to 10 Pain Intensity Numerical Scale (PINS), Symptom Distress Scale, and Short Form-8. Focus group recommendations included clinician priorities of brevity, flexibility, and simplicity for both input interface and output and that the assessment output contain color graphic display. Patient participants included 45 women and 56 men with a mean age of 52.7 years (SD = 13.8). Fewer than half of the participants (40%) reported using a computer on a regular basis (weekly or daily). Completion time averaged 7.8 minutes (SD = 3.7). Moderate to high levels of distress were reported more often for fatigue, pain, and emotional issues than for other symptoms or concerns. Computerized assessment of cancer symptoms and QOL is technically possible and feasible in an ambulatory cancer clinic. A wireless, Web-based system facilitates access to results and data entry and retrieval. The symptom and QOL profiles of these patients new to radiation therapy were comparable to other samples of outpatients with cancer. The ability to capture an easily interpreted illustration of a patients symptom and QOL experience in less than 10 minutes is a potentially useful adjunct to traditional face-to-face interviewing. Ultimately, electronic patient-generated data could produce automated red flags directed to the most appropriate clinicians (e.g., nurse, pain specialist, social worker, nutritionist) for further evaluation. Such system enhancement could greatly facilitate oncology nurses coordination role in caring for complex patients with cancer.

Computerized Tests of Team Performance and Crew Coordination Suitable for Military/Aviation Settings.

PubMed

Lawson, Ben D; Britt, Thomas W; Kelley, Amanda M; Athy, Jeremy R; Legan, Shauna M

2017-08-01

The coordination of team effort on shared tasks is an area of inquiry. A number of tests of team performance in challenging environments have been developed without comparison or standardization. This article provides a systematic review of the most accessible and usable low-to-medium fidelity computerized tests of team performance and determines which are most applicable to military- and aviation-relevant research, such as studies of group command, control, communication, and crew coordination. A search was conducted to identify computerized measures of team performance. In addition to extensive literature searches (DTIC, Psychinfo, PubMed), the authors reached out to team performance researchers at conferences and through electronic communication. Identified were 57 potential tests according to 6 specific selection criteria (e.g., the requirement for automated collection of team performance and coordination processes, the use of military-relevant scenarios). The following seven tests (listed alphabetically) were considered most suitable for military needs: Agent Enabled Decision Group Environment (AEDGE), C3Conflict, the C3 (Command, Control, & Communications) Interactive Task for Identifying Emerging Situations (NeoCITIES), Distributed Dynamic Decision Making (DDD), Duo Wondrous Original Method Basic Awareness/Airmanship Test (DuoWOMBAT), the Leader Development Simulator (LDS), and the Planning Task for Teams (PLATT). Strengths and weaknesses of these tests are described and recommendations offered to help researchers identify the test most suitable for their particular needs. Adoption of a few standard computerized test batteries to study team performance would facilitate the evaluation of interventions intended to enhance group performance in multiple challenging military and aerospace operational environments.Lawson BD, Britt TW, Kelley AM, Athy JR, Legan SM. Computerized tests of team performance and crew coordination suitable for military/aviation settings. Aerosp Med Hum Perform. 2017; 88(8):722-729.

Impact of computerized pre-authorization of broad spectrum antibiotics in Pseudomonas aeruginosa at a children's hospital in Japan.

PubMed

Horikoshi, Yuho; Higuchi, Hiroshi; Suwa, Junichi; Isogai, Mihoko; Shoji, Takayo; Ito, Kenta

2016-08-01

The spread of antimicrobial-resistant organisms is a global concern. To stem this tide, an antimicrobial stewardship program at hospitals is essential to optimize the prescription of broad spectrum antibiotics. In this study we examined the impact of computerized pre-authorization for broad spectrum antibiotics for Pseudomonas aeruginosa at a children's hospital. An antimicrobial stewardship program at Tokyo Metropolitan Children's Medical Center was assessed between March 2010 and March 2015. A paper-based post-prescription audit was switched to computerized pre-authorization for broad antipseudomonal agents in October 2011. The prescriber was required to obtain approval from physicians in the pediatric infectious diseases division before prescribing restricted antimicrobial agents. Approved prescriptions were processed and logged electronically. We evaluated days of therapy per 1000 patient-days, the cost of antibiotics, and the susceptibility of P. aeruginosa to piperacillin, ceftazidime, cefepime, piperacillin/tazobactam, carbapenems, and ciprofloxacin. Also, the average length of admission and infection-related mortality at 30 days were compared pre- and post-intervention. Administration of carbapenems, piperacillin/tazobactam, and ceftazidime decreased significantly after the introduction of computerized pre-authorization. Antibiotic costs were reduced by JPY2.86 million (USD 26,000) annually. None of the antipseudomonal agents showed decreased sensitivity. The average length of admission was shorter in post-intervention. Infection-related mortality at 30 days showed no difference between the pre- and post-intervention periods. An antimicrobial stewardship program using computerized pre-authorization decreased the use and cost of broad spectrum antibiotics without significant difference in infection-related mortality at 30 days, although our study did not improve susceptibilities of P. aeruginosa. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Canadian adaptation of the Newest Vital Sign©, a health literacy assessment tool.

PubMed

Mansfield, Elizabeth D; Wahba, Rana; Gillis, Doris E; Weiss, Barry D; L'Abbé, Mary

2018-04-25

The Newest Vital Sign© (NVS) was developed in the USA to measure patient health literacy in clinical settings. We adapted the NVS for use in Canada, in English and French, and created a computerized version. Our objective was to evaluate the reliability of the Canadian NVS as a self-administered computerized tool. We used a randomized crossover design with a washout period of 3-4 weeks to compare health literacy scores obtained using the computerized version with scores obtained using the standard interviewer-administered NVS. ANOVA models and McNemar's tests assessed differences in outcomes assessed with each version of the NVS and order effects of the testing. Participants were recruited from multicultural catchment areas in Ontario and Nova Scotia. English- and French-speaking adults aged 18 years or older. A total of 180 (81 %) of the 222 adults (112 English/110 French) initially recruited completed both the interviewer-NVS and computer-NVS. Scores for those who completed both assessments ranged from 0 to 6 with a mean of 3·63 (sd 2·11) for the computerized NVS and 3·41 (sd 2·21) for the interview-administered NVS. Few (n 18; seven English, eleven French) participants' health literacy assessments differed between the two versions. Overall, the computerized Canadian NVS performed as well as the interviewer-administered version for assessing health literacy levels of English- and French-speaking participants. This Canadian adaptation of the NVS provides Canadian researchers and public health practitioners with an easily administered health literacy assessment tool that can be used to address the needs of Canadians across health literacy levels and ultimately improve health outcomes.

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... magnetic media, such as magnetic tapes or magnetic diskettes, containing the computerized information at.... The computerized magnetic media shall be prepared and delivered at the committee's expense and shall... Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal...

An in vitro study of the accuracy of a new protocol for planning distraction osteogenesis of the mandible.

PubMed

Gateno, J; Allen, M E; Teichgraeber, J F; Messersmith, M L

2000-09-01

The purpose of this study was to determine the in vitro accuracy of a new protocol for distraction osteogenesis of the mandible that involves a planning process and a surgical technique. An experimental design was developed to simulate distraction osteogenesis on stereolithographic models of patients with craniofacial deformities. All patients had previously undergone 3-dimensional computerized scans of the craniofacial skeleton. The data from these scans were used to generate stereolithographic models. Before the fabrication of the models, the computed tomography (CT) data were manipulated to add a series of rulers and markers to the models. The 3-dimensional computerized scans were also used as the basis of the planning process. They were imported into an animation software (3D-Studio Max; Discreet, Montreal, Canada), and a virtual distractor was built and installed on the model, and the osteotomies and distraction processes were simulated. Finally, a recipe for sequencing the linear and angular changes of the distractor were calculated. A surgical technique was developed to facilitate the precise installation of the distractor as indicated in the presurgical plan. The transfer of information regarding pin position and orientation from the computer model to the patient was accomplished by creating a surgical template. This template was designed in the computer and fabricated by use of stereolithography. Mock surgery was performed on the stereolithographic models, and the results were compared with those predicted by the computer. The difference between the actual position and the predicted position was recorded. On the X-axis, the difference between the predicted position for the condylar marker and the actual position of the marker on the stereolithographic models was 0.6 +/- 1.1 mm. On the Y-axis, the difference between the predicted position for the condylar marker and the actual position of the marker on the stereolithographic models was -0.9 +/- 2.6. On the Z-axis, the difference between the predicted position for the condylar marker and the actual position of the marker on the stereolithographic models was 0.04 +/- 0.8 mm. There was excellent correlation between the predicted and the actual measurements for the X, Y, and Z axes: 0.98, 0.93, and 0.98, respectively. The results indicate that the combination of this planning process and surgical technique was very accurate. This in vitro study is the first step in determining the clinical usefulness of this protocol. If the results of this study are validated in clinical practice, this protocol will allow clinicians to improve the clinical outcomes of patients treated with distraction osteogenesis.

Metacognitive Prediction and Evaluation Skills and Mathematical Learning in Third-Grade Students

ERIC Educational Resources Information Center

Desoete, Annemie

2009-01-01

In a 2-year longitudinal study, 66 children were assessed in Grades 3 and 4 with a within-method-and-time design on metacognition (including the computerized Evaluation and Prediction Assessment [EPA2000]) and mathematics. Moreover, half of the children were trained in Grade 3 in the metacognitive skill of predicting their abilities in solving…

Service Evaluation in a Special Library: Supporting Development Research at the Institute of Social Sciences Library, New Delhi.

ERIC Educational Resources Information Center

Ghosh, Sharmila

2003-01-01

Discusses the development of special libraries to meet demands of interdisciplinary information and describes the library at The Institute of Social Sciences, New Delhi (India) which establishes a synergy between research and information derived from research through a computerized information management system. Considers evaluation of special…

An Evaluation of Results and Effectiveness of Job Banks: Volume I, Parts I and II.

ERIC Educational Resources Information Center

Ultrasystems, Inc., Irvine, CA.

In order to assist the Manpower Administration of the U. S. Department of Labor in the planning, development, and expansion of over a hundred computerized "job banks," located in nearly every State, field interviews were conducted with job applicants, employers, Employment Service staff, and community agencies to evaluate the current…

Mood Assessment via Animated Characters: A Novel Instrument to Evaluate Feelings in Young Children with Anxiety Disorders

ERIC Educational Resources Information Center

Manassis, Katharina; Mendlowitz, Sandra; Kreindler, David; Lumsden, Charles; Sharpe, Jason; Simon, Mark D.; Woolridge, Nicholas; Monga, Suneeta; Adler-Nevo, Gili

2009-01-01

We evaluated a novel, computerized feelings assessment instrument (MAAC) in 54 children with anxiety disorders and 35 nonanxious children ages 5 to 11. They rated their feelings relative to 16 feeling animations. Ratings of feelings, order of feeling selection, and correlations with standardized anxiety measures were examined. Positive emotions…

[Computerized ranking test in three French universities: Staff experience and students' feedback].

PubMed

Roux, D; Meyer, G; Cymbalista, F; Bouaziz, J-D; Falgarone, G; Tesniere, A; Gervais, J; Cariou, A; Peffault de Latour, R; Marat, M; Moenaert, E; Guebli, T; Rodriguez, O; Lefort, A; Dreyfuss, D; Hajage, D; Ricard, J-D

2016-03-01

The year 2016 will be pivotal for the evaluation of French medical students with the introduction of the first computerized National Ranking Test (ECNi). The SIDES, online electronic system for medical student evaluation, was created for this purpose. All the universities have already organized faculty exams but few a joint computerized ranking test at several universities simultaneously. We report our experience on the organization of a mock ECNi by universities Paris Descartes, Paris Diderot and Paris 13. Docimological, administrative and technical working groups were created to organize this ECNi. Students in their fifth year of medical studies, who will be the first students to sit for the official ECNi in 2016, were invited to attend this mock exam that represented more than 50% of what will be proposed in 2016. A final electronic questionnaire allowed a docimological and organizational evaluation by students. An analysis of ratings and rankings and their distribution on a 1000-point scale were performed. Sixty-four percent of enrolled students (i.e., 654) attended the three half-day exams. No difference in total score and ranking between the three universities was observed. Students' feedback was extremely positive. Normalized over 1000 points, 99% of students were scored on 300 points only. Progressive clinical cases were the most discriminating test. The organization of a mock ECNi involving multiple universities was a docimological and technical success but required an important administrative, technical and teaching investment. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Surgical treatment of diaphyseal stress fractures of the fifth metatarsal in competitive athletes: long-term follow-up and computerized pedobarographic analysis.

PubMed

Pecina, Marko; Bojanic, Ivan; Smoljanovic, Tomislav; Ivkovic, Alan; Mirkovic, Maja; Jelic, Miroslav

2011-01-01

Proximal diaphyseal stress fractures of the fifth metatarsal are common in athletes. Conservative treatment has been shown to result in high rates of delayed union, nonunion, and refracture, so internal fixation has become the treatment of choice in competitive athletes. Twenty top-level athletes with diaphyseal stress fractures fixed with intramedullary malleolar screws were evaluated. Functional outcome was assessed by American Orthopaedic Foot and Ankle Society midfoot score. Static and dynamic maximum vertical force and peak plantar pressures were evaluated with a computerized pedobarograph. Mean follow-up from surgery to interview was 10.3 years (range, 3.5-19.0 years). Clinical healing was 95%, and there has been one refracture (5%). The mean time from surgery to return to sport was 9 weeks (range, 5-14 weeks). Twelve athletes (60%) returned to a higher level of training, 7 (35%) to the same level, and 1 (5%) to a lower level compared with the level of training before injury. Average American Orthopaedic Foot and Ankle Society midfoot score was 93.8 (range, 85-100). During the computerized pedobarographic evaluations, 18 patients (90%) presented with varus of the metatarsus and the midfoot and 2 (10%) presented with a normal plantigrade foot. Intramedullary malleolar screws can yield reliable and effective healing of fifth metatarsal stress fractures in athletes. Varus of the metatarsus and the midfoot were predisposing factors for stress fractures in this population of competitive athletes, and all were recommended to wear orthoses until their competitive careers were completed.

Prospective radiographic followup after en bloc ligation of the renal hilum.

PubMed

White, Wesley M; Klein, Frederick A; Gash, Judson; Waters, W Bedford

2007-11-01

We determined the risk of arteriovenous fistula after en bloc ligation of the renal hilum. A prospective evaluation of all patients who underwent en bloc ligation of the renal hilum during nephrectomy for malignant disease was performed. Pertinent operative data were recorded and patients were followed for clinical evidence of arteriovenous fistula formation, including hypertension, abdominal bruit and new onset congestive heart failure. Patients with at least 12 months of followup underwent computerized tomographic arteriography to assess arteriovenous fistula formation. A total of 94 patients underwent en bloc renal hilar ligation during open (43) and laparoscopic (51) nephrectomy using a 45 mm titanium endovascular stapler. Of this cohort 11 patients were lost to followup and 3 died of disease. The remaining 80 patients were followed an average of 35.2 months with no clinical evidence of arteriovenous fistula formation. Specifically there was no statistically significant difference in preoperative and postoperative blood pressure (p = 0.18 and 0.62, respectively), no evidence of abdominal bruit on examination and no new onset congestive heart failure. A total of 32 had increased serum creatinine and, therefore, they were excluded from followup computerized tomographic arteriography. Eight patients had a followup of less than 1 year and they were not yet eligible for evaluation. In the 40 patients who underwent computerized tomographic arteriography no fistulas were noted. Based on clinical followup and prospective radiographic evaluation there appears to be a low risk of arteriovenous fistula formation after en bloc ligation of the renal hilum using a titanium endovascular stapler.

Uptake of a web-based oncology protocol system: how do cancer clinicians use eviQ cancer treatments online?

PubMed Central

2013-01-01

Background The use of computerized systems to support evidence-based practice is commonplace in contemporary medicine. Despite the prolific use of electronic support systems there has been relatively little research on the uptake of web-based systems in the oncology setting. Our objective was to examine the uptake of a web-based oncology protocol system (http://www.eviq.org.au) by Australian cancer clinicians. Methods We used web-logfiles and Google Analytics to examine the characteristics of eviQ registrants from October 2009-December 2011 and patterns of use by cancer clinicians during a typical month. Results As of December 2011, there were 16,037 registrants; 85% of whom were Australian health care professionals. During a typical month 87% of webhits occurred in standard clinical hours (08:00 to 18:00 weekdays). Raw webhits were proportional to the size of clinician groups: nurses (47% of Australian registrants), followed by doctors (20%), and pharmacists (14%). However, pharmacists had up to three times the webhit rate of other clinical groups. Clinicians spent five times longer viewing chemotherapy protocol pages than other content and the protocols viewed reflect the most common cancers: lung, breast and colorectal. Conclusions Our results demonstrate eviQ is used by a range of health professionals involved in cancer treatment at the point-of-care. Continued monitoring of electronic decision support systems is vital to understanding how they are used in clinical practice and their impact on processes of care and patient outcomes. PMID:23497080

Investigations of a simulated geomagnetic field experienced by the International Space Station on attentional performance

NASA Astrophysics Data System (ADS)

Del Seppia, C.; Mezzasalma, L.; Messerotti, M.; Cordelli, A.; Ghione, S.

2009-01-01

We have previously reported that the exposure to an abnormal magnetic field simulating the one encountered by the International Space Station (ISS) orbiting around the Earth may enhance autonomic response to emotional stimuli. Here we report the results of the second part of that study which tested whether this field also affects cognitive functions. Twenty-four volunteers participated in the study, 12 exposed to the natural geomagnetic field and 12 to the magnetic field encountered by ISS. The test protocol consisted of a set of eight tests chosen from a computerized test battery for the assessment of attentional performance. The duration of exposure was 90 min. No effect of exposure to ISS magnetic field was observed on attentional performance.

NASA Operational Environment Team (NOET): NASA's key to environmental technology

NASA Technical Reports Server (NTRS)

Cook, Beth

1993-01-01

NASA has stepped forward to face the environmental challenge to eliminate the use of Ozone-Layer Depleting Substances (OLDS) and to reduce our Hazardous Air Pollutants (HAP) by 50 percent in 1995. These requirements have been issued by the Clean Air Act, the Montreal Protocol, and various other legislative acts. A proactive group, the NASA Operational Environment Team or NOET, received its charter in April 1992 and was tasked with providing a network through which replacement activities and development experiences can be shared. This is a NASA-wide team which supports the research and development community by sharing information both in person and via a computerized network, assisting in specification and standard revisions, developing cleaner propulsion systems, and exploring environmentally-compliant alternatives to current processes.

AphasiaBank as BigData

PubMed Central

MacWhinney, Brian; Fromm, Davida

2017-01-01

AphasiaBank has used a standardized protocol to collect narrative, procedural, personal, and descriptive discourse from 290 persons with aphasia, as well as 190 control participants. These data have been transcribed in the Codes for the Human Analysis of Transcripts (CHAT) format for analysis by the Computerized Language Analysis (CLAN) programs. Here, we review results from 45 studies based on these data that investigate aphasic productions in terms of these eight areas: discourse, grammar, lexicon, gesture, fluency, syndrome classification, social factors, and treatment effects. For each area, we also indicate how use of the CLAN programs has facilitated the analysis. We conclude with an examination of ways in which the size of the database could be increased through on-site recordings and data from teletherapy. PMID:26882361

Simplified follow-up after medical abortion using a low-sensitivity urinary pregnancy test and a pictorial instruction sheet in Rajasthan, India--study protocol and intervention adaptation of a randomised control trial.

PubMed

Paul, Mandira; Iyengar, Kirti; Iyengar, Sharad; Gemzell-Danielsson, Kristina; Essén, Birgitta; Klingberg-Allvin, Marie

2014-08-15

The World Health Organisation suggests that simplification of the medical abortion regime will contribute to an increased acceptability of medical abortion, among women as well as providers. It is expected that a home-based follow-up after a medical abortion will increase the willingness to opt for medical abortion as well as decrease the workload and service costs in the clinic. This study protocol describes a study that is a randomised, controlled, non-superiority trial. Women screened to participate in the study are those with unwanted pregnancies and gestational ages equal to or less than nine weeks. The randomisation list will be generated using a computerized random number generator and opaque sealed envelopes with group allocation will be prepared. Randomization of the study participants will occur after the first clinical encounter with the doctor. Eligible women randomised to the home-based assessment group will use a low-sensitivity pregnancy test and a pictorial instruction sheet at home, while the women in the clinic follow-up group will return to the clinic for routine follow-up carried out by a doctor. The primary objective of the study this study protocol describes is to evaluate the efficacy of home-based assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet 10-14 days after an early medical abortion. Providers or research assistants will not be blinded during outcome assessment. To ensure feasibility of the self-assessment intervention an adaption phase took place at the selected study sites before study initiation. This resulted in an optimized, tailor-made intervention and in the development of the pictorial instruction sheet with a guide on how to use the low-sensitivity pregnancy test and the danger signs after a medical abortion. In this paper, we will describe the study protocol for a randomised control trial investigating the efficacy of simplified follow-up in terms of home-based assessment, 10-14 days after a medical abortion. Moreover, a description of the adaptation phase is included for a better understanding of the implementation of the intervention in a setting where literacy is low and the road-connections are poor. Clinicaltrials.gov NCT01827995. Registered 04 May 2013.

Intrapartum amnioinfusion for meconium-stained fluid: meta-analysis of prospective clinical trials.

PubMed

Pierce, J; Gaudier, F L; Sanchez-Ramos, L

2000-06-01

To evaluate the effectiveness of intrapartum prophylactic amnioinfusion in pregnancies complicated by meconium-stained amniotic fluid. We identified prospective clinical trials of amnioinfusion in pregnancies complicated by meconium-stained amniotic fluid (AF) published in English by using computerized databases, references in published studies, and index reviews. We analyzed prospective studies of intrapartum amnioinfusion for meconium-stained AF. In every case, group allocation was based exclusively on meconium in AF. Only published studies with clearly documented outcome data were included. The trials were evaluated for meconium below the vocal cords, meconium aspiration syndrome, fetal acidemia, cesarean delivery, and postpartum endometritis. Each trial was evaluated for the quality of its methodology, inclusion and exclusion criteria, adequacy of randomization, amnioinfusion protocols, definition of outcomes, and statistical analyses. Thirteen studies met inclusion criteria for our systematic review. Odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated for each outcome. Estimates of ORs and risk differences for dichotomous outcomes were calculated using random and fixed-effects models. We tested for homogeneity across the studies. We found that intrapartum amnioinfusion significantly reduced the frequency of meconium aspiration syndrome (OR 0.30; 95% CI 0.19, 0. 46), of meconium below the vocal cords, and neonatal acidemia. Subjects allocated to receive amnioinfusion also had a significantly lower overall cesarean rate (OR 0.74, 95% CI 0.59, 0.93) without increased postpartum endometritis. Amnioinfusion in cases of meconium-stained fluid significantly improves neonatal outcome, lowers the cesarean delivery rate, and does not increase the postpartum endometritis rate.

Can sensory attention focused exercise facilitate the utilization of proprioception for improved balance control in PD?

PubMed

Lefaivre, Shannon C; Almeida, Quincy J

2015-02-01

Impaired sensory processing in Parkinson's disease (PD) has been argued to contribute to balance deficits. Exercises aimed at improving sensory feedback and body awareness have the potential to ameliorate balance deficits in PD. Recently, PD SAFEx™, a sensory and attention focused rehabilitation program, has been shown to improve motor deficits in PD, although balance control has never been evaluated. The objective of this study was to measure the effects of PD SAFEx™ on balance control in PD. Twenty-one participants with mild to moderate idiopathic PD completed 12 weeks of PD SAFEx™ training (three times/week) in a group setting. Prior to training, participants completed a pre-assessment evaluating balance in accordance with an objective, computerized test of balance (modified clinical test of sensory integration and balance (m-CTSIB) and postural stability testing (PST)) protocols. The m-CTSIB was our primary outcome measure, which allowed assessment of balance in both eyes open and closed conditions, thus enabling evaluation of specific sensory contributions to balance improvement. At post-test, a significant interaction between time of assessment and vision condition (p=.014) demonstrated that all participants significantly improved balance control, specifically when eyes were closed. Balance control did not change from pre to post with eyes open. These results provide evidence that PD SAFEx™ is effective at improving the ability to utilize proprioceptive information, resulting in improved balance control in the absence of vision. Enhancing the ability to utilize proprioception for individuals with PD is an important intermediary to improving balance deficits. Copyright © 2015. Published by Elsevier B.V.

Using a virtual reality temporal bone simulator to assess otolaryngology trainees.

PubMed

Zirkle, Molly; Roberson, David W; Leuwer, Rudolf; Dubrowski, Adam

2007-02-01

The objective of this study is to determine the feasibility of computerized evaluation of resident performance using hand motion analysis on a virtual reality temporal bone (VR TB) simulator. We hypothesized that both computerized analysis and expert ratings would discriminate the performance of novices from experienced trainees. We also hypothesized that performance on the virtual reality temporal bone simulator (VR TB) would differentiate based on previous drilling experience. The authors conducted a randomized, blind assessment study. Nineteen volunteers from the Otolaryngology-Head and Neck Surgery training program at the University of Toronto drilled both a cadaveric TB and a simulated VR TB. Expert reviewers were asked to assess operative readiness of the trainee based on a blind video review of their performance. Computerized hand motion analysis of each participant's performance was conducted. Expert raters were able to discriminate novices from experienced trainees (P < .05) on cadaveric temporal bones, and there was a trend toward discrimination on VR TB performance. Hand motion analysis showed that experienced trainees had better movement economy than novices (P < .05) on the VR TB. Performance, as measured by hand motion analysis on the VR TB simulator, reflects trainees' previous drilling experience. This study suggests that otolaryngology trainees could accomplish initial temporal bone training on a VR TB simulator, which can provide feedback to the trainee, and may reduce the need for constant faculty supervision and evaluation.

Computerized tomography-guided sphenopalatine ganglion pulsed radiofrequency treatment in 16 patients with refractory cluster headaches: Twelve- to 30-month follow-up evaluations.

PubMed

Fang, Luo; Jingjing, Lu; Ying, Shen; Lan, Meng; Tao, Wang; Nan, Ji

2016-02-01

Sphenopalatine ganglion percutaneous radiofrequency thermocoagulation treatment can improve the symptoms of cluster headaches to some extent. However, as an ablation treatment, radiofrequency thermocoagulation treatment also has side effects. To preliminarily evaluate the efficacy and safety of a non-ablative computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion in patients with refractory cluster headaches. We included and analysed 16 consecutive cluster headache patients who failed to respond to conservative therapy from the Pain Management Center at the Beijing Tiantan Hospital between April 2012 and September 2013 treated with pulsed radiofrequency treatment of sphenopalatine ganglion. Eleven of 13 episodic cluster headaches patients and one of three chronic cluster headaches patient were completely relieved of the headache within an average of 6.3 ± 6.0 days following the treatment. Two episodic cluster headache patients and two chronic cluster headache patients showed no pain relief following the treatment. The mean follow-up time was 17.0 ± 5.5 months. All patients enrolled in this study showed no treatment-related side effects or complications. Our data show that patients with refractory episodic cluster headaches were quickly, effectively and safely relieved from the cluster period after computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion, suggesting that it may be a therapeutic option if conservative treatments fail. © International Headache Society 2015.

A detailed description of the implementation of inpatient insulin orders with a commercial electronic health record system.

PubMed

Neinstein, Aaron; MacMaster, Heidemarie Windham; Sullivan, Mary M; Rushakoff, Robert

2014-07-01

In the setting of Meaningful Use laws and professional society guidelines, hospitals are rapidly implementing electronic glycemic management order sets. There are a number of best practices established in the literature for glycemic management protocols and programs. We believe that this is the first published account of the detailed steps to be taken to design, implement, and optimize glycemic management protocols in a commercial computerized provider order entry (CPOE) system. Prior to CPOE implementation, our hospital already had a mature glycemic management program. To transition to CPOE, we underwent the following 4 steps: (1) preparation and requirements gathering, (2) design and build, (3) implementation and dissemination, and (4) optimization. These steps required more than 2 years of coordinated work between physicians, nurses, pharmacists, and programmers. With the move to CPOE, our complex glycemic management order sets were successfully implemented without any significant interruptions in care. With feedback from users, we have continued to refine the order sets, and this remains an ongoing process. Successful implementation of glycemic management protocols in CPOE is dependent on broad stakeholder input and buy-in. When using a commercial CPOE system, there may be limitations of the system, necessitating workarounds. There should be an upfront plan to apply resources for continuous process improvement and optimization after implementation. © 2014 Diabetes Technology Society.

Integrating Prevention into Obstetrics/Gynecology.

ERIC Educational Resources Information Center

Carey, J. Christopher

2000-01-01

Discusses formats to teach preventive medicine in obstetrics and gynecology (including learning objectives, lectures/seminars, and rounds/office practice) and evaluation methods (oral examinations, computerized question banks, objective structured clinical examinations). Offers examples from specific programs at American medical schools, including…

Critical factors influencing physicians' intention to use computerized clinical practice guidelines: an integrative model of activity theory and the technology acceptance model.

PubMed

Hsiao, Ju-Ling; Chen, Rai-Fu

2016-01-16

With the widespread use of information communication technologies, computerized clinical practice guidelines are developed and considered as effective decision supporting tools in assisting the processes of clinical activities. However, the development of computerized clinical practice guidelines in Taiwan is still at the early stage and acceptance level among major users (physicians) of computerized clinical practice guidelines is not satisfactory. This study aims to investigate critical factors influencing physicians' intention to computerized clinical practice guideline use through an integrative model of activity theory and the technology acceptance model. The survey methodology was employed to collect data from physicians of the investigated hospitals that have implemented computerized clinical practice guidelines. A total of 505 questionnaires were sent out, with 238 completed copies returned, indicating a valid response rate of 47.1 %. The collected data was then analyzed by structural equation modeling technique. The results showed that attitudes toward using computerized clinical practice guidelines (γ = 0.451, p < 0.001), organizational support (γ = 0.285, p < 0.001), perceived usefulness of computerized clinical practice guidelines (γ = 0.219, p < 0.05), and social influence (γ = 0.213, p < 0.05) were critical factors influencing physicians' intention to use computerized clinical practice guidelines, and these factors can explain 68.6 % of the variance in intention to use computerized clinical practice guidelines. This study confirmed that some subject (human) factors, environment (organization) factors, tool (technology) factors mentioned in the activity theory should be carefully considered when introducing computerized clinical practice guidelines. Managers should pay much attention on those identified factors and provide adequate resources and incentives to help the promotion and use of computerized clinical practice guidelines. Through the appropriate use of computerized clinical practice guidelines, the clinical benefits, particularly in improving quality of care and facilitating the clinical processes, will be realized.

39 CFR 501.15 - Computerized Meter Resetting System.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AND DISTRIBUTE POSTAGE EVIDENCING SYSTEMS § 501.15 Computerized Meter Resetting System. (a) Description. The Computerized Meter Resetting System (CMRS) permits customers to reset their postage meters at... 39 Postal Service 1 2010-07-01 2010-07-01 false Computerized Meter Resetting System. 501.15...

Identifying MRI markers to evaluate early treatment-related changes post-laser ablation for cancer pain management

NASA Astrophysics Data System (ADS)

Tiwari, Pallavi; Danish, Shabbar; Madabhushi, Anant

2014-03-01

Laser interstitial thermal therapy (LITT) has recently emerged as a new treatment modality for cancer pain management that targets the cingulum (pain center in the brain), and has shown promise over radio-frequency (RF) based ablation which is reported to provide temporary relief. One of the major advantages enjoyed by LITT is its compatibility with magnetic resonance imaging (MRI), allowing for high resolution in vivo imaging to be used in LITT procedures. Since laser ablation for pain management is currently exploratory and is only performed at a few centers worldwide, its short-, and long-term effects on the cingulum are currently unknown. Traditionally treatment effects are evaluated by monitoring changes in volume of the ablation zone post-treatment. However, this is sub-optimal since it involves evaluating a single global parameter (volume) to detect changes pre-, and post-MRI. Additionally, the qualitative observations of LITT-related changes on multi-parametric MRI (MPMRI) do not specifically address differentiation between the appearance of treatment related changes (edema, necrosis) from recurrence of the disease (pain recurrence). In this work, we explore the utility of computer extracted texture descriptors on MP-MRI to capture early treatment related changes on a per-voxel basis by extracting quantitative relationships that may allow for an in-depth understanding of tissue response to LITT on MRI, subtle changes that may not be appreciable on original MR intensities. The second objective of this work is to investigate the efficacy of different MRI protocols in accurately capturing treatment related changes within and outside the ablation zone post-LITT. A retrospective cohort of studies comprising pre- and 24-hour post-LITT 3 Tesla T1-weighted (T1w), T2w, T2-GRE, and T2-FLAIR acquisitions was considered. Our scheme involved (1) inter-protocol as well as inter-acquisition affine registration of pre- and post-LITT MRI, (2) quantitation of MRI parameters by correcting for intensity drift in order to examine tissue-specific response, and (3) quantification of MRI maps via texture and intensity features to evaluate changes in MR markers pre- and post-LITT. A total of 78 texture features comprising of non-steerable and steerable gradient and second order statistical features were extracted from pre- and post-LITT MP-MRI on a per-voxel basis. Quantitative, voxel-wise comparison of the changes in MRI texture features between pre-, and post-LITT MRI indicate that (a) steerable and non-steerable gradient texture features were highly sensitive as well as specific in predicting subtle micro-architectural changes within and around the ablation zone pre- and post-LITT, (b) FLAIR was identified as the most sensitive MRI protocol in identifying early treatment changes yielding a normalized percentage change of 360% within the ablation zone relative to its pre-LITT value, and (c) GRE was identified as the most sensitive MRI protocol in quantifying changes outside the ablation zone post-LITT. Our preliminary results thus indicate great potential for non-invasive computerized MRI features in determining localized micro-architectural focal treatment related changes post-LITT.

Outcome in early-onset fetal growth restriction is best combining computerized fetal heart rate analysis with ductus venosus Doppler: insights from the Trial of Umbilical and Fetal Flow in Europe.

PubMed

Frusca, Tiziana; Todros, Tullia; Lees, Christoph; Bilardo, Caterina M

2018-02-01

Early-onset fetal growth restriction represents a particular dilemma in clinical management balancing the risk of iatrogenic prematurity with waiting for the fetus to gain more maturity, while being exposed to the risk of intrauterine death or the sequelae of acidosis. The Trial of Umbilical and Fetal Flow in Europe was a European, multicenter, randomized trial aimed to determine according to which criteria delivery should be triggered in early fetal growth restriction. We present the key findings of the primary and secondary analyses. Women with fetal abdominal circumference <10th percentile and umbilical pulsatility index >95th percentile between 26-32 weeks were randomized to 1 of 3 monitoring and delivery protocols. These were: fetal heart rate variability based on computerized cardiotocography; and early or late ductus venosus Doppler changes. A safety net based on fetal heart rate abnormalities or umbilical Doppler changes mandated delivery irrespective of randomized group. The primary outcome was normal neurodevelopmental outcome at 2 years. Among 511 women randomized, 362/503 (72%) had associated hypertensive conditions. In all, 463/503 (92%) of fetuses survived and cerebral palsy occurred in 6/443 (1%) with known outcome. Among all women there was no difference in outcome based on randomized group; however, of survivors, significantly more fetuses randomized to the late ductus venosus group had a normal outcome (133/144; 95%) than those randomized to computerized cardiotocography alone (111/131; 85%). In 118/310 (38%) of babies delivered <32 weeks, the indication was safety-net criteria: 55/106 (52%) in late ductus venosus, 37/99 (37%) in early ductus venosus, and 26/105 (25%) in computerized cardiotocography groups. Higher middle cerebral artery impedance adjusted for gestation was associated with neonatal survival without severe morbidity (odds ratio, 1.24; 95% confidence interval, 1.02-1.52) and infant survival without neurodevelopmental impairment at 2 years (odds ratio, 1.33; 95% confidence interval, 1.03-1.72) although birthweight and gestational age were more important determinants. Perinatal and 2-year outcome was better than expected in all randomized groups. Among survivors, 2-year neurodevelopmental outcome was best in those randomized to delivery based on late ductus venosus changes. Given a high rate of delivery based on the safety-net criteria, deciding delivery based on late ductus venosus changes and abnormal computerized fetal heart rate variability seems prudent. There is no rationale for delivery based on cerebral Doppler changes alone. Of note, most women with early-onset fetal growth restriction develop hypertension. Copyright © 2018 Elsevier Inc. All rights reserved.

21 CFR 884.2800 - Computerized Labor Monitoring System.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Computerized Labor Monitoring System. 884.2800... Devices § 884.2800 Computerized Labor Monitoring System. (a) Identification. A computerized labor monitoring system is a system intended to continuously measure cervical dilation and fetal head descent and...

Evaluating the Predictive Validity of the Computerized Comprehension Task: Comprehension Predicts Production

PubMed Central

Friend, Margaret; Schmitt, Sara A.; Simpson, Adrianne M.

2017-01-01

Until recently, the challenges inherent in measuring comprehension have impeded our ability to predict the course of language acquisition. The present research reports on a longitudinal assessment of the convergent and predictive validity of the CDI: Words and Gestures and the Computerized Comprehension Task (CCT). The CDI: WG and the CCT evinced good convergent validity however the CCT better predicted subsequent parent reports of language production. Language sample data in the third year confirm this finding: the CCT accounted for 24% of the variance in unique word use. These studies provide evidence for the utility of a behavior-based approach to predicting the course of language acquisition into production. PMID:21928878

[Application of regular expression in extracting key information from Chinese medicine literatures about re-evaluation of post-marketing surveillance].

PubMed

Wang, Zhifei; Xie, Yanming; Wang, Yongyan

2011-10-01

Computerizing extracting information from Chinese medicine literature seems more convenient than hand searching, which could simplify searching process and improve the accuracy. However, many computerized auto-extracting methods are increasingly used, regular expression is so special that could be efficient for extracting useful information in research. This article focused on regular expression applying in extracting information from Chinese medicine literature. Two practical examples were reported in this article about regular expression to extract "case number (non-terminology)" and "efficacy rate (subgroups for related information identification)", which explored how to extract information in Chinese medicine literature by means of some special research method.

Computerized estimation of compatibility of stressors at work and worker's health characteristics.

PubMed

Susnik, J; Bizjak, B; Cestnik, B

1996-09-01

A system of computerized estimation of compatibility of stressors at work and worker's health characteristics is presented. Each characteristic is defined and scored on a specific scale. Incompatible workplace characteristics as related to worker's characteristics are singled out and offered to the user for an ergonomic solution. Work on the system started in 1987. This paper deals with the system's further development, which involves a larger number of topics, changes of the algorithm and presentation of an applicative case. Comparison of the system's results with those of medical experts shows that the use of the system tends to improve the thoroughness and consistency of incompatibility evaluations and consequently to make working ability assessment more objective.

45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... computerized support enforcement systems. 307.15 Section 307.15 Public Welfare Regulations Relating to Public... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS § 307.15 Approval of advance planning documents for computerized support enforcement systems. (a...

Arkansas' Curriculum Guide. Competency Based Computerized Accounting.

ERIC Educational Resources Information Center

Arkansas State Dept. of Education, Little Rock. Div. of Vocational, Technical and Adult Education.

This guide contains the essential parts of a total curriculum for a one-year secondary-level course in computerized accounting. Addressed in the individual sections of the guide are the following topics: the complete accounting cycle, computer operations for accounting, computerized accounting and general ledgers, computerized accounts payable,…

Prevention of prescription errors by computerized, on-line, individual patient related surveillance of drug order entry.

PubMed

Oliven, A; Zalman, D; Shilankov, Y; Yeshurun, D; Odeh, M

2002-01-01

Computerized prescription of drugs is expected to reduce the number of many preventable drug ordering errors. In the present study we evaluated the usefullness of a computerized drug order entry (CDOE) system in reducing prescription errors. A department of internal medicine using a comprehensive CDOE, which included also patient-related drug-laboratory, drug-disease and drug-allergy on-line surveillance was compared to a similar department in which drug orders were handwritten. CDOE reduced prescription errors to 25-35%. The causes of errors remained similar, and most errors, on both departments, were associated with abnormal renal function and electrolyte balance. Residual errors remaining on the CDOE-using department were due to handwriting on the typed order, failure to feed patients' diseases, and system failures. The use of CDOE was associated with a significant reduction in mean hospital stay and in the number of changes performed in the prescription. The findings of this study both quantity the impact of comprehensive CDOE on prescription errors and delineate the causes for remaining errors.

Computerized Measurement of Negative Symptoms in Schizophrenia

PubMed Central

Cohen, Alex S.; Alpert, Murray; Nienow, Tasha M.; Dinzeo, Thomas J.; Docherty, Nancy M.

2008-01-01

Accurate measurement of negative symptoms is crucial for understanding and treating schizophrenia. However, current measurement strategies are reliant on subjective symptom rating scales which often have psychometric and practical limitations. Computerized analysis of patients’ speech offers a sophisticated and objective means of evaluating negative symptoms. The present study examined the feasibility and validity of using widely-available acoustic and lexical-analytic software to measure flat affect, alogia and anhedonia (via positive emotion). These measures were examined in their relationships to clinically-rated negative symptoms and social functioning. Natural speech samples were collected and analyzed for 14 patients with clinically-rated flat affect, 46 patients without flat affect and 19 healthy controls. The computer-based inflection and speech rate measures significantly discriminated patients with flat affect from controls, and the computer-based measure of alogia and negative emotion significantly discriminated the flat and non-flat patients. Both the computer and clinical measures of positive emotion/anhedonia corresponded to functioning impairments. The computerized method of assessing negative symptoms offered a number of advantages over the symptom scale-based approach. PMID:17920078

COMPUTERIZED ASSESSMENT OF HUMAN NEUROTOXICITY: SENSITIVITY TO NITROUS OXIDE EXPOSURE

EPA Science Inventory

The authors recently developed a flexible, portable, computer based neurobehavioral evaluation system (NES) to standardize data collection in epidemiologic field studies of individuals at risk for neurobehavioral toxicity. The current study was performed to examine the system's s...

Development of an HPV Educational Protocol for Adolescents

PubMed Central

Wetzel, Caitlin; Tissot, Abbigail; Kollar, Linda M.; Hillard, Paula A.; Stone, Rachel; Kahn, Jessica A.

2007-01-01

Study Objectives To develop an educational protocol about HPV and Pap tests for adolescents, to evaluate the protocol for understandability and clarity, and to evaluate the protocol for its effectiveness in increasing knowledge about HPV. Design In phase 1, investigators and adolescents developed the protocol. In phase 2, adolescents evaluated the protocol qualitatively, investigators evaluated its effectiveness in increasing HPV knowledge in a sample of adolescents, and the protocol was revised. In phase 3, investigators evaluated the effectiveness of the revised protocol in an additional adolescent sample. Setting Urban, hospital-based teen health center. Participants A total of 252 adolescent girls and boys in the three study phases. Main Outcome Measures Pre- and post-protocol knowledge about HPV, measured using a 10- or 11-item scale. Results Scores on the HPV knowledge scale increased significantly (p<.0001) among adolescents who participated in phases 2 and 3 after they received the protocol. Initial differences in scores based on race, insurance type and condom use were not noted post-protocol. Conclusion The protocol significantly increased knowledge scores about HPV in this population, regardless of sociodemographic characteristics and risk behaviors. Effective, developmentally appropriate educational protocols about HPV and Pap tests are particularly important in clinical settings as cervical cancer screening guidelines evolve, HPV DNA testing is integrated into screening protocols, and HPV vaccines become available. In-depth, one-on-one education about HPV may also prevent adverse psychosocial responses and promote healthy sexual and Pap screening behaviors in adolescents with abnormal HPV or Pap test results. Synopsis The investigators developed an educational protocol about HPV and Pap tests and evaluated its effectiveness in increasing knowledge about HPV among adolescents. PMID:17868894

Prototype of a computerized scale for the active search for potential organ donors.

PubMed

Ludwig, Érika Fernanda Dos Santos Bezerra; Pereira, Marta Cristiane Alves; Martinez, Yolanda Dora Évora; Mendes, Karina Dal Sasso; Rossaneis, Mariana Angela

2017-09-12

to develop a prototype of a computerized scale for the active search for potential organ and tissue donors. methodological study, with the analysis of 377 electronic medical records of patients who died due to encephalic death or cardiorespiratory arrest in the intensive care units of a tertiary hospital. Among the deaths due to cardiorespiratory arrest, the study aimed to identify factors indicating underreported encephalic death cases. The Acute Physiology and Chronic Health Evaluation II and Sepsis Related Organ Failure Assessment severity indexes were applied in the protocols. Based on this, a scale was built and sent to five experts for assessment of the scale content, and subsequently, it was computerized by using a prototyping model. 34 underreported encephalic death cases were identified in the medical records of patients with cardiorespiratory arrest. Statistically significant differences were found in the Wilcoxon test between the scores of hospital admissions in the intensive care unit and the opening of the encephalic death protocol for both severity indexes. the prototype was effective for identifying potential organ donors, as well as for the identification of the degree of organ dysfunction in patients with encephalic death. desenvolver protótipo de escala informatizada para busca ativa de potenciais doadores de órgãos e tecidos. pesquisa metodológica, com análise de 377 prontuários eletrônicos de pacientes que evoluíram a óbito, por morte encefálica, ou parada cardiorrespiratória, nas unidades de terapia intensiva de hospital terciário. Nos óbitos por parada cardiorrespiratória, buscou-se identificar fatores que indicassem subnotificação de morte encefálica. Nos protocolos, foram aplicados os índices de gravidade Acute Physiology and Chronic Health Evaluation II e Sepsis Related Organ Failure Assessment. A partir disso, construiu-se a escala que foi encaminhada a cinco especialistas, para avaliação de conteúdo, e, posteriormente, foi informatizada por modelo de prototipação. foram identificadas 34 subnotificações de morte encefálica nos prontuários dos casos de parada cardiorrespiratória. O teste de Wilcoxon demonstrou diferença estatisticamente significativa entre os escores de admissão em unidade de terapia intensiva e abertura do protocolo de morte encefálica, para ambos os índices de gravidade. o protótipo foi efetivo para identificação de potenciais doadores, bem como o grau de disfunção orgânica de pacientes em morte encefálica. desarrollar un prototipo de escala informatizada para la búsqueda activa de potenciales donantes de órganos y tejidos. investigación metodológica, con el análisis de 377 registros médicos electrónicos de pacientes, que fallecieron por muerte encefálica o paro cardiorrespiratorio, en las unidades de cuidados intensivos de un hospital terciario. Entre las muertes por paro cardiorrespiratorio, se buscó identificar los factores que indicasen subnotificación de muerte encefálica. Las puntuaciones de los índices de gravedad Acute Physiology and Chronic Health Evaluation II y Sepsis Related Organ Failure Assessment se aplicaron en los protocolos. A partir de eso, la escala fue construida y enviada a cinco expertos para la evaluación del contenido, y posteriormente, fue informatizada mediante un modelo de prototipación. se identificaron 34 casos de subnotificación de muerte encefálica en los registros médicos de los casos de paro cardiorrespiratorio. Se encontraron diferencias estadísticamente significativas en la prueba de Wilcoxon, entre las puntuaciones de los ingresos hospitalarios en unidad de cuidados intensivos y apertura del protocolo de muerte encefálica para ambos índices de gravedad. el prototipo fue eficaz para la identificación de potenciales donantes, así como para la identificación del grado de disfunción orgánica en pacientes con muerte encefálica.

Retrospective Evaluation of a Teleretinal Screening Program in Detecting Multiple Nondiabetic Eye Diseases.

PubMed

Maa, April Y; Patel, Shivangi; Chasan, Joel E; Delaune, William; Lynch, Mary G

2017-01-01

Diabetic teleretinal screening programs have been utilized successfully across the world to detect diabetic retinopathy (DR) and are well validated. Less information, however, exists on the ability of teleretinal imaging to detect nondiabetic ocular pathology. This study performed a retrospective evaluation to assess the ability of a community-based diabetic teleretinal screening program to detect common ocular disease other than DR. A retrospective chart review of 1,774 patients who underwent diabetic teleretinal screening was performed. Eye clinic notes from the Veterans Health Administration's electronic medical record, Computerized Patient Record System, were searched for each of the patients screened through teleretinal imaging. When a face-to-face examination note was present, the physical findings were compared to those obtained through teleretinal imaging. Sensitivity, specificity, and positive and negative predictive values were calculated for suspicious nerve, cataract, and age-related macular degeneration. A total of 903 patients underwent a clinical examination. The positive predictive value was highest for cataract (100%), suspicious nerve (93%), and macular degeneration (90%). The negative predictive value and the percent agreement between teleretinal imaging and a clinical examination were over 90% for each disease category. A teleretinal imaging protocol may be used to screen for other common ocular diseases. It may be feasible to use diabetic teleretinal photographs to screen patients for other potential eye diseases. Additional elements of the eye workup may be added to enhance accuracy of disease detection. Further study is necessary to confirm this initial retrospective review.

Effect of a physiotherapy program in women with primary dysmenorrhea.

PubMed

Ortiz, Mario I; Cortés-Márquez, Sandra Kristal; Romero-Quezada, Luis C; Murguía-Cánovas, Gabriela; Jaramillo-Díaz, Alfonso P

2015-11-01

To evaluate the efficacy of a physiotherapy program for relieving symptoms of primary dysmenorrhea among Mexican women. This was a single-center, prospective, experimental, parallel group, randomized controlled trial. This cross-sectional study was performed at the Universidad Politécnica de Pachuca, Hidalgo, Mexico. Female patients with primary dysmenorrhea, age of 18-22 years; pain intensity from 4 to 10cm on a Visual Analogue Scale (VAS); and sedentary lifestyle were included. The patients were then randomized to receive a physiotherapy program for three months or to no intervention program. The physiotherapy program consisted of overall stretching, specific stretches, Kegel exercises, jogging, and relaxation exercises. Patient evaluations of symptomatology and pain intensity were recorded basally and throughout for three menstrual periods. The data were entered into a computerized database for descriptive and inferential statistical analyses. A per-protocol population of eighty three women with a mean age of 20.2±1.8 years underwent the physiotherapy program, and seventy seven participants with a mean age of 20.4±1.2 years received no treatment. The participant assessments of pain on the VAS during the second and the third menstrual cycles demonstrated a significant reduction in the treatment group (p<0.05) compared with the control group. The results showed that strengthening, stretching and muscle relaxation techniques, in addition to jogging, are effective for reducing dysmenorrheic symptoms when they are regularly performed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of causes and frequency of medication errors during information technology downtime.

PubMed

Hanuscak, Tara L; Szeinbach, Sheryl L; Seoane-Vazquez, Enrique; Reichert, Brendan J; McCluskey, Charles F

2009-06-15

The causes and frequency of medication errors occurring during information technology downtime were evaluated. Individuals from a convenience sample of 78 hospitals who were directly responsible for supporting and maintaining clinical information systems (CISs) and automated dispensing systems (ADSs) were surveyed using an online tool between February 2007 and May 2007 to determine if medication errors were reported during periods of system downtime. The errors were classified using the National Coordinating Council for Medication Error Reporting and Prevention severity scoring index. The percentage of respondents reporting downtime was estimated. Of the 78 eligible hospitals, 32 respondents with CIS and ADS responsibilities completed the online survey for a response rate of 41%. For computerized prescriber order entry, patch installations and system upgrades caused an average downtime of 57% over a 12-month period. Lost interface and interface malfunction were reported for centralized and decentralized ADSs, with an average downtime response of 34% and 29%, respectively. The average downtime response was 31% for software malfunctions linked to clinical decision-support systems. Although patient harm did not result from 30 (54%) medication errors, the potential for harm was present for 9 (16%) of these errors. Medication errors occurred during CIS and ADS downtime despite the availability of backup systems and standard protocols to handle periods of system downtime. Efforts should be directed to reduce the frequency and length of down-time in order to minimize medication errors during such downtime.

PubMed Central

FOUNTOULAKIS, E.N.; PAPADAKI, E.; PANAGIOTAKI, I.; GIANNIKAKI, E.; LAGOUDIANAKIS, G.; BIZAKIS, J.

2011-01-01

SUMMARY Haemangiopericytoma is a rare soft tissue tumour, with great histological variability and unpredictable clinical and biological behaviour. The precise cell type origin is uncertain. One third of haemangiopericytomas occur in the head and neck area, but only a few cases have been reported regarding localization at the parapharyngeal space. Herewith, case is presented of a 54-year-old female, referred to our Department due to a parapharyngeal space tumour with non-specific imaging characteristics. The patient underwent radical excision of the tumour with a trans-cervical sub-mandibular approach. The histolopathologic examination revealed a neoplasm with the characteristic features of haemangiopericytoma. One year later, during the scheduled follow-up, the computerized tomography scan showed no evidence of recurrence or residual disease. The pre-operative evaluation of a haemangiopericytoma must include a thorough imaging evaluation with computerized tomography and magnetic resonance imaging, even if results may not be specific for haemangiopericytoma. Angiography and pre-operative embolization may be performed in cases of large tumours with significant vascularity. The treatment of choice is radical excision. The follow-up includes clinical evaluation every 6 months and annual magnetic resonance imaging for at least 3 years. PMID:22058597

A computerized system to evaluate volumetric infusion pumps.

PubMed

Kobayashi, S; Ogata, T

1992-01-01

A computerized system was developed to examine the performance characteristics of infusion pumps. This system collects solution delivered by an infusion pump through an intravenous needle into a collection vessel. Using an inductor-type weight sensor and a semiconductor type of strain-gauge pressure sensor, the weight of the collection vessel and the pressure at the needle were monitored over a specific period (the sampling time), and changes in pressure, flow rate, and volume of fluid were calculated. This system was applied to five volumetric infusion pumps with different pumping mechanisms. Test conditions involved two different solutions, two sizes of needle gauge, and seven flow rates, for a total of 28 measurements per pump. Results showed considerable variation in the infusion pumps' performances based on differences in these indices. Use of an inductance weight sensor as a means to evaluate gravimetric performance appears to be an improvement over conventional methods, which use analytical balances for data generation. The results indicate that this system will be useful in evaluating the performances of commercially available infusion pumps as well as those in development.

Reliability and validity of the Arabic version of the computerized Battery for Neuropsychological Evaluation of Children (BENCI).

PubMed

Fasfous, Ahmed F; Peralta-Ramirez, Maria Isabel; Pérez-Marfil, María Nieves; Cruz-Quintana, Francisco; Catena-Martinez, Andrés; Pérez-García, Miguel

2015-01-01

Batería de Evaluación Neuropsicológica Infantil (BENCI) is a computerized battery for the neuropsychological evaluation of children. This battery has been used in different studies to evaluate neuropsychological functions and neurodevelopment in children. The objective of this study is to test the validity and reliability of the first Arabic version of the BENCI on an Arabic population where neuropsychological tests are very scarce. We administrate the BENCI to 198 school-age children (98 boys and 100 girls) from Morocco. To examine the test retest reliability of the BENCI battery, we administered the battery 2 times to 43 children (23 boys and 20 girls) with 15 days in between the pre- and posttest. The results revealed good validity and reliability of the battery in Arabic children. Also, the BENCI battery has demonstrated the capacity to differentiate between children by their age group. This battery can be of great use to both the research and clinical areas of Arabic countries and/or in assistance to Arabic immigrants that live outside of their native country.

Formative evaluation of a multimedia self-administered computerized hearing loss prevention program.

PubMed

Saunders, Gabrielle H; Vachhani, Jay J; Galvez, Gino; Griest, Susan E

2015-04-01

To determine which features make a computer-based hearing health education intervention effective, easy to use, and enjoyable. The study examined which features of a multimedia self-administered computerized hearing loss prevention program, developed by the National Center for Rehabilitative Auditory Research (referred to as the NCRAR-HLPP), users liked and disliked, and the reasons why. A formative evaluation was conducted in which participants completed a questionnaire to assess knowledge and attitudes towards hearing and hearing loss prevention, used the NCRAR-HLPP, completed the questionnaire for a second time, and were interviewed to learn their opinions about the NCRAR-HLPP. Twenty-five male and four female Veterans recruited from the Portland VA Medical Center who were aged between 25 and 65 years. Participants reported that using the NCRAR-HLPP was a positive experience. Ease of use, multimedia content, personal relevance, and use of emotion were positive features of the program. The questionnaire showed increased knowledge and improved attitude scores following use of the program. This formative evaluation showed changes designed to target user preferences and improve user instructions will be made in future versions of the program.

SITEQUAL--A User's Guide: Computerized Site Evaluation for 14 Southern Hardwood Species

Treesearch

Constance A. Harrington; Bettina M. Casson

1986-01-01

An interactive computer program, SITEQUAL, has been developed from the widely-used Baker and Broadfoot field guides, which evaluate site quality for 14 southern hardwood tree species. The SITEQUAL program calculates site index for all species simultaneously and provides a breakdown of site index into the component contributions by each of the four major soil factors...

Evaluation of the VA's Pilot Program in Institutional Reorganization toward Primary and Ambulatory Care: Part I, Changes in the Process and Outcomes of Care.

ERIC Educational Resources Information Center

Rubenstein, Lisa V.; And Others

1996-01-01

A study evaluated the impact of the reorganization of the academic Sepulveda (California) Veterans' Administration medical center toward primary and ambulatory care. Surveys of several thousand patients were linked to computerized utilization and mortality data and related to the center's strategic plan and goals. Substantial improvement in…

Richardson Instructional Management System (RIMS). How to Blend a Computerized Objectives-Referenced Testing System, Distributive Data Processing, and Systemwide Evaluation.

ERIC Educational Resources Information Center

Riegel, N. Blyth

Recent changes in the structure of curriculum and the instructional system in Texas have required a major reorganization of teaching, evaluating, budgeting, and planning activities in the local education agencies, which has created the need for a database. The history of Richardson Instructional Management System (RIMS), its data processing…

Evaluation of Automated Natural Language Processing in the Further Development of Science Information Retrieval. String Program Reports No. 10.

ERIC Educational Resources Information Center

Sager, Naomi

This investigation matches the emerging techniques in computerized natural language processing against emerging needs for such techniques in the information field to evaluate and extend such techniques for future applications and to establish a basis and direction for further research toward these goals. An overview describes developments in the…

Assessment, evaluation, and testing of technologies for environmental restoration, decontamination, and decommissioning and high level waste management. Progress report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Uzochukwu, G.A.

1997-12-31

Nuclear and commercial non-nuclear technologies that have the potential of meeting the environmental restoration, decontamination and decommissioning, and high-level waste management objectives are being assessed and evaluated. A detailed comparison of innovative technologies available will be performed to determine the safest and most economical technology for meeting these objectives. Information derived from this effort will be matched with the multi-objectives of the environmental restoration, decontamination and decommissioning, and high-level waste management effort to ensure that the best, most economical, and the safest technologies are used in decision making at USDOE-SRS. Technology-related variables will be developed and the resulting data formattedmore » and computerized for multimedia systems. The multimedia system will be made available to technology developers and evaluators to ensure that the best, most economical, and the safest technologies are used in decision making at USDOE-SRS. Technology-related variables will be developed and the resulting data formatted and computerized for multimedia systems. The multimedia system will be made available to technology developers and evaluators to ensure that the safest and most economical technologies are developed for use at SRS and other DOE sites.« less

Randomized controlled trial of a 12-month computerized mindfulness-based intervention for obese patients with binge eating disorder: The MindOb study protocol.

PubMed

Ruffault, Alexis; Carette, Claire; Lurbe I Puerto, Kàtia; Juge, Nicolas; Beauchet, Alain; Benoliel, Jean-Jacques; Lacorte, Jean-Marc; Fournier, Jean F; Czernichow, Sébastien; Flahault, Cécile

2016-07-01

Mindfulness-based interventions for healthy behaviors such as exercise and dietary modifications have aroused growing interest. This study aims to test the effectiveness of a mindfulness-based intervention for the reduction of impulsive eating and the improvement of motivation to exercise among obese individuals. One-hundred and twenty obese outpatients, aged 18 to 65years, diagnosed with a binge eating disorder, will be randomly assigned to one of the three following groups: mindfulness practice, sham meditation, or treatment as usual control. The tested intervention consists of a 1-year computerized mindfulness-based program. Mindfulness sessions are audio recordings that the patients are asked to listen to, 10min every day. Self-reported questionnaires measuring impulsive eating, motivation to exercise, physical activity level, mood, and mindfulness skills are filled in at baseline, 1, 6, and 12months. Physical activity, calories consumption, and biomarkers are measured with more objective measurement tools at baseline, 6months and 12months. Mindfulness, as both a de-automation element and as a moderator of motivation to exercise, can lead to the reduction of impulsive eating and also to an increase in levels of physical activity. These effects could cause weight loss in obese patients suffering from binge eating disorder. clinicaltrials.gov: NCT02571387. Copyright © 2016 Elsevier Inc. All rights reserved.

Demonstration and Certification of Amphibian Ecological Risk Assessment Protocol. Cost and Performance Report (Version 2)

DTIC Science & Technology

2009-07-01

sediment protocol, respectively). The soil protocol evaluates impacts to adult salamanders and the sediment protocol evaluates impacts to larval tadpoles ...the sediment protocol evaluates impacts to larval tadpoles . When selecting appropriate receptors to derive ERA-based remedial goals, amphibians...Sediment tests are conducted with recently hatched tadpoles (i.e., Rana pipiens; Gosner Stages 17-20). Young tadpoles are placed in beakers

Computerized Adaptive Personality Testing: A Review and Illustration With the MMPI-2 Computerized Adaptive Version.

ERIC Educational Resources Information Center

Forbey, Johnathan D.; Ben-Porath, Yossef S.

2007-01-01

Computerized adaptive testing in personality assessment can improve efficiency by significantly reducing the number of items administered to answer an assessment question. Two approaches have been explored for adaptive testing in computerized personality assessment: item response theory and the countdown method. In this article, the authors…

A Randomized Controlled Trial of the "Cool Teens" CD-ROM Computerized Program for Adolescent Anxiety

ERIC Educational Resources Information Center

Wuthrich, Viviana M.; Rapee, Ronald M.; Cunningham, Michael J.; Lyneham, Heidi J.; Hudson, Jennifer L.; Schniering, Carolyn A.

2012-01-01

Objective: Computerized cognitive behavioral interventions for anxiety disorders in adults have been shown to be efficacious, but limited data are available on the use of computerized interventions with young persons. Adolescents in particular are difficult to engage in treatment and may be especially suited to computerized technologies. This…

Chapter 2: Commercial and Industrial Lighting Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurnik, Charles W; Gowans, Dakers; Telarico, Chad

The Commercial and Industrial Lighting Evaluation Protocol (the protocol) describes methods to account for gross energy savings resulting from the programmatic installation of efficient lighting equipment in large populations of commercial, industrial, and other nonresidential facilities. This protocol does not address savings resulting from changes in codes and standards, or from education and training activities. A separate Uniform Methods Project (UMP) protocol, Chapter 3: Commercial and Industrial Lighting Controls Evaluation Protocol, addresses methods for evaluating savings resulting from lighting control measures such as adding time clocks, tuning energy management system commands, and adding occupancy sensors.

Combining computerized social cognitive training with neuroplasticity-based auditory training in schizophrenia.

PubMed

Sacks, Stephanie; Fisher, Melissa; Garrett, Coleman; Alexander, Phillip; Holland, Christine; Rose, Demian; Hooker, Christine; Vinogradov, Sophia

2013-01-01

Social cognitive deficits are an important treatment target in schizophrenia, but it is unclear to what degree they require specialized interventions and which specific components of behavioral interventions are effective. In this pilot study, we explored the effects of a novel computerized neuroplasticity-based auditory training delivered in conjunction with computerized social cognition training (SCT) in patients with schizophrenia. Nineteen clinically stable schizophrenia subjects performed 50 hours of computerized exercises that place implicit, increasing demands on auditory perception, plus 12 hours of computerized training in emotion identification, social perception, and theory of mind tasks. All subjects were assessed with MATRICS-recommended measures of neurocognition and social cognition, plus a measure of self-referential source memory before and after the computerized training. Subjects showed significant improvements on multiple measures of neurocognition. Additionally, subjects showed significant gains on measures of social cognition, including the MSCEIT Perceiving Emotions, MSCEIT Managing Emotions, and self-referential source memory, plus a significant decrease in positive symptoms. Computerized training of auditory processing/verbal learning in schizophrenia results in significant basic neurocognitive gains. Further, addition of computerized social cognition training results in significant gains in several social cognitive outcome measures. Computerized cognitive training that directly targets social cognitive processes can drive improvements in these crucial functions.

Computerized tests to evaluate recovery of cognitive function after deep sedation with propofol and remifentanil for colonoscopy.

PubMed

Borrat, Xavier; Ubre, Marta; Risco, Raquel; Gambús, Pedro L; Pedroso, Angela; Iglesias, Aina; Fernandez-Esparrach, Gloria; Ginés, Àngels; Balust, Jaume; Martínez-Palli, Graciela

2018-03-27

The use of sedation for diagnostic procedures including gastrointestinal endoscopy is rapidly growing. Recovery of cognitive function after sedation is important because it would be important for most patients to resume safe, normal life soon after the procedure. Computerized tests have shown being accurate descriptors of cognitive function. The purpose of the present study was to evaluate the time course of cognitive function recovery after sedation with propofol and remifentanil. A prospective observational double blind clinical study conducted in 34 young healthy adults undergoing elective outpatient colonoscopy under sedation with the combination of propofol and remifentanil using a target controlled infusion system. Cognitive function was measured using a validated battery of computerized cognitive tests (Cogstate™, Melbourne, Australia) at different predefined times: prior to starting sedation (Tbaseline), and then 10 min (T10), 40 min (T40) and 120 min (T120) after the end of colonoscopy. Tests included the assessment of psychomotor function, attention, visual memory and working memory. All colonoscopies were completed (median time: 26 min) without significant adverse events. Patients received a median total dose of propofol and remifentanil of 149 mg and 98 µg, respectively. Psychomotor function and attention declined at T10 but were back to baseline values at T40 for all patients. The magnitude of psychomotor task reduction was large (d = 0.81) however 100% of patients were recovered at T40. Memory related tasks were not affected 10 min after ending sedation. Cognitive impairment in attention and psychomotor function after propofol and remifentanil sedation was significant and large and could be easily detected by computerized cognitive tests. Even though, patients were fully recovered 40 min after ending the procedure. From a cognitive recovery point of view, larger studies should be undertaken to propose adequate criteria for discharge after sedation.

Comparison between Long-Menu and Open-Ended Questions in computerized medical assessments. A randomized controlled trial

PubMed Central

Rotthoff, Thomas; Baehring, Thomas; Dicken, Hans-Dieter; Fahron, Urte; Richter, Bernd; Fischer, Martin R; Scherbaum, Werner A

2006-01-01

Background Long-menu questions (LMQs) are viewed as an alternative method for answering open-ended questions (OEQs) in computerized assessment. So far this question type and its influence on examination scores have not been studied sufficiently. However, the increasing use of computerized assessments will also lead to an increasing use of this question type. Using a summative online key feature (KF) examination we evaluated whether LMQs can be compared with OEQs in regard to the level of difficulty, performance and response times. We also evaluated the content for its suitability for LMQs. Methods We randomized 146 fourth year medical students into two groups. For the purpose of this study we created 7 peer-reviewed KF-cases with a total of 25 questions. All questions had the same content in both groups, but nine questions had a different answer type. Group A answered 9 questions with an LM type, group B with an OE type. In addition to the LM answer, group A could give an OE answer if the appropriate answer was not included in the list. Results The average number of correct answers for LMQs and OEQs showed no significant difference (p = 0.93). Among all 630 LM answers only one correct term (0.32%) was not included in the list of answers. The response time for LMQs did not significantly differ from that of OEQs (p = 0.65). Conclusion LMQs and OEQs do not differ significantly. Compared to standard multiple-choice questions (MCQs), the response time for LMQs and OEQs is longer. This is probably due to the fact that they require active problem solving skills and more practice. LMQs correspond more suitable to Short answer questions (SAQ) then to OEQ and should only be used when the answers can be clearly phrased, using only a few, precise synonyms. LMQs can decrease cueing effects and significantly simplify the scoring in computerized assessment. PMID:17032439

Improving the utility of the fine motor skills subscale of the comprehensive developmental inventory for infants and toddlers: a computerized adaptive test.

PubMed

Huang, Chien-Yu; Tung, Li-Chen; Chou, Yeh-Tai; Chou, Willy; Chen, Kuan-Lin; Hsieh, Ching-Lin

2017-07-27

This study aimed at improving the utility of the fine motor subscale of the comprehensive developmental inventory for infants and toddlers (CDIIT) by developing a computerized adaptive test of fine motor skills. We built an item bank for the computerized adaptive test of fine motor skills using the fine motor subscale of the CDIIT items fitting the Rasch model. We also examined the psychometric properties and efficiency of the computerized adaptive test of fine motor skills with simulated computerized adaptive tests. Data from 1742 children with suspected developmental delays were retrieved. The mean scores of the fine motor subscale of the CDIIT increased along with age groups (mean scores = 1.36-36.97). The computerized adaptive test of fine motor skills contains 31 items meeting the Rasch model's assumptions (infit mean square = 0.57-1.21, outfit mean square = 0.11-1.17). For children of 6-71 months, the computerized adaptive test of fine motor skills had high Rasch person reliability (average reliability >0.90), high concurrent validity (rs = 0.67-0.99), adequate to excellent diagnostic accuracy (area under receiver operating characteristic = 0.71-1.00), and large responsiveness (effect size = 1.05-3.93). The computerized adaptive test of fine motor skills used 48-84% fewer items than the fine motor subscale of the CDIIT. The computerized adaptive test of fine motor skills used fewer items for assessment but was as reliable and valid as the fine motor subscale of the CDIIT. Implications for Rehabilitation We developed a computerized adaptive test based on the comprehensive developmental inventory for infants and toddlers (CDIIT) for assessing fine motor skills. The computerized adaptive test has been shown to be efficient because it uses fewer items than the original measure and automatically presents the results right after the test is completed. The computerized adaptive test is as reliable and valid as the CDIIT.

High-Tech Roof Management.

ERIC Educational Resources Information Center

Benzie, Tim

1997-01-01

Describes the use of a computerized roof management system (CRMS) for school districts to foster multiple roof maintenance efficiency and cost effectiveness. Highlights CRMS software manufacturer choices, as well as the types of nondestructive testing equipment tools that can be used to evaluate roof conditions. (GR)

45 CFR 310.40 - What requirements apply for accessing systems and records for monitoring Computerized Tribal IV-D...

Code of Federal Regulations, 2010 CFR

2010-10-01

... records for monitoring Computerized Tribal IV-D Systems and Office Automation? 310.40 Section 310.40... COMPUTERIZED TRIBAL IV-D SYSTEMS AND OFFICE AUTOMATION Accountability and Monitoring Procedures for... monitoring Computerized Tribal IV-D Systems and Office Automation? In accordance with Part 95 of this title...

Accuracy of a computerized clinical decision-support system for asthma assessment and management.

PubMed

Hoeksema, Laura J; Bazzy-Asaad, Alia; Lomotan, Edwin A; Edmonds, Diana E; Ramírez-Garnica, Gabriela; Shiffman, Richard N; Horwitz, Leora I

2011-05-01

To evaluate the accuracy of a computerized clinical decision-support system (CDSS) designed to support assessment and management of pediatric asthma in a subspecialty clinic. Cohort study of all asthma visits to pediatric pulmonology from January to December, 2009. CDSS and physician assessments of asthma severity, control, and treatment step. Both the clinician and the computerized CDSS generated assessments of asthma control in 767/1032 (74.3%) return patients, assessments of asthma severity in 100/167 (59.9%) new patients, and recommendations for treatment step in 66/167 (39.5%) new patients. Clinicians agreed with the CDSS in 543/767 (70.8%) of control assessments, 37/100 (37%) of severity assessments, and 19/66 (29%) of step recommendations. External review classified 72% of control disagreements (21% of all control assessments), 56% of severity disagreements (37% of all severity assessments), and 76% of step disagreements (54% of all step recommendations) as CDSS errors. The remaining disagreements resulted from pulmonologist error or ambiguous guidelines. Many CDSS flaws, such as attributing all 'cough' to asthma, were easily remediable. Pediatric pulmonologists failed to follow guidelines in 8% of return visits and 18% of new visits. The authors relied on chart notes to determine clinical reasoning. Physicians may have changed their assessments after seeing CDSS recommendations. A computerized CDSS performed relatively accurately compared to clinicians for assessment of asthma control but was inaccurate for treatment. Pediatric pulmonologists failed to follow guideline-based care in a small proportion of patients.

Computerized counseling reduces HIV-1 viral load and sexual transmission risk: findings from a randomized controlled trial.

PubMed

Kurth, Ann E; Spielberg, Freya; Cleland, Charles M; Lambdin, Barrot; Bangsberg, David R; Frick, Pamela A; Severynen, Anneleen O; Clausen, Marc; Norman, Robert G; Lockhart, David; Simoni, Jane M; Holmes, King K

2014-04-15

Evaluate a computerized intervention supporting antiretroviral therapy (ART) adherence and HIV transmission prevention. Longitudinal randomized controlled trial. An academic HIV clinic and a community-based organization in Seattle. In a total of 240 HIV-positive adults on ART, 209 completed 9-month follow-up (87% retention). Randomization to computerized counseling or assessment only, 4 sessions over 9 months. HIV-1 viral suppression, and self-reported ART adherence and transmission risks, compared using generalized estimating equations. Overall, intervention participants had reduced viral load: mean 0.17 log10 decline, versus 0.13 increase in controls, P = 0.053, and significant difference in ART adherence baseline to 9 months (P = 0.046). Their sexual transmission risk behaviors decreased (odds ratio = 0.55, P = 0.020), a reduction not seen among controls (odds ratio = 1.1, P = 0.664), and a significant difference in change (P = 0.040). Intervention effect was driven by those most in need; among those with detectable virus at baseline (>30 copies/mL, n = 89), intervention effect was mean 0.60 log10 viral load decline versus 0.15 increase in controls, P = 0.034. ART adherence at the final follow-up was 13 points higher among intervention participants versus controls, P = 0.038. Computerized counseling is promising for integrated ART adherence and safer sex, especially for individuals with problems in these areas. This is the first intervention to report improved ART adherence, viral suppression, and reduced secondary sexual transmission risk behavior.

Computerized cytometry and wavelet analysis of follicular lesions for detecting malignancy: A pilot study in thyroid cytology.

PubMed

Gilshtein, Hayim; Mekel, Michal; Malkin, Leonid; Ben-Izhak, Ofer; Sabo, Edmond

2017-01-01

The cytologic diagnosis of indeterminate lesions of the thyroid involves much uncertainty, and the final diagnosis often requires operative resection. Computerized cytomorphometry and wavelets analysis were examined to evaluate their ability to better discriminate between benign and malignant lesions based on cytology slides. Cytologic reports from patients who underwent thyroid operation in a single, tertiary referral center were retrieved. Patients with Bethesda III and IV lesions were divided according to their final histopathology. Cytomorphometry and wavelet analysis were performed on the digitized images of the cytology slides. Cytology slides of 40 patients were analyzed. Seven patients had a histologic diagnosis of follicular malignancy, 13 had follicular adenomas, and 20 had a benign goiter. Computerized cytomorphometry with a combination of descriptors of nuclear size, shape, and texture was able to predict quantitatively adenoma versus malignancy within the indeterminate group with 95% accuracy. An automated wavelets analysis with a neural network algorithm reached an accuracy of 96% in identifying correctly malignant vs. benign lesions based on cytology. Computerized analysis of cytology slides seems to be more accurate in defining indeterminate thyroid lesions compared with conventional cytologic analysis, which is based on visual characteristics on cytology as well as the expertise of the cytologist. This pilot study needs to be validated with a greater number of samples. Providing a successful validation, we believe that such methods carry promise for better patient treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Normal computerized Q wave measurements in healthy young athletes.

PubMed

Saini, Divakar; Grober, Aaron F; Hadley, David; Froelicher, Victor

Recent Expert consensus statements have sought to decrease false positive rates of electrocardiographic abnormalities requiring further evaluation when screening young athletes. These statements are largely based on traditional ECG patterns and have not considered computerized measurements. To define the normal limits for Q wave measurements from the digitally recorded ECGs of healthy young athletes. All athletes were categorized by sex and level of participation (high school, college, and professional), and underwent screening ECGs with routine pre-participation physicals, which were electronically captured and analyzed. Q wave amplitude, area and duration were recorded for athletes with Q wave amplitudes greater than 0.5mm at standard paper amplitude display (1mV/10mm). ANOVA analyses were performed to determine differences these parameters among all groups. A positive ECG was defined by our Stanford Computerized Criteria as exceeding the 99th percentile for Q wave area in 2 or more leads. Proportions testing was used to compare the Seattle Conference Q wave criteria with our data-driven criteria. 2073 athletes in total were screened. Significant differences in Q wave amplitude, duration and area were identified both by sex and level of participation. When applying our Stanford Computerized Criteria and the Seattle criteria to our cohort, two largely different groups of athletes are identified as having abnormal Q waves. Computer analysis of athletes' ECGs should be included in future studies that have greater numbers, more diversity and adequate end points. Copyright © 2017 Elsevier Inc. All rights reserved.

Towards a Framework for Developing Semantic Relatedness Reference Standards

PubMed Central

Pakhomov, Serguei V.S.; Pedersen, Ted; McInnes, Bridget; Melton, Genevieve B.; Ruggieri, Alexander; Chute, Christopher G.

2010-01-01

Our objective is to develop a framework for creating reference standards for functional testing of computerized measures of semantic relatedness. Currently, research on computerized approaches to semantic relatedness between biomedical concepts relies on reference standards created for specific purposes using a variety of methods for their analysis. In most cases, these reference standards are not publicly available and the published information provided in manuscripts that evaluate computerized semantic relatedness measurement approaches is not sufficient to reproduce the results. Our proposed framework is based on the experiences of medical informatics and computational linguistics communities and addresses practical and theoretical issues with creating reference standards for semantic relatedness. We demonstrate the use of the framework on a pilot set of 101 medical term pairs rated for semantic relatedness by 13 medical coding experts. While the reliability of this particular reference standard is in the “moderate” range; we show that using clustering and factor analyses offers a data-driven approach to finding systematic differences among raters and identifying groups of potential outliers. We test two ontology-based measures of relatedness and provide both the reference standard containing individual ratings and the R program used to analyze the ratings as open-source. Currently, these resources are intended to be used to reproduce and compare results of studies involving computerized measures of semantic relatedness. Our framework may be extended to the development of reference standards in other research areas in medical informatics including automatic classification, information retrieval from medical records and vocabulary/ontology development. PMID:21044697

Effectiveness of computerized clinical decision support systems for asthma and chronic obstructive pulmonary disease in primary care: a systematic review.

PubMed

Fathima, Mariam; Peiris, David; Naik-Panvelkar, Pradnya; Saini, Bandana; Armour, Carol Lyn

2014-12-02

The use of computerized clinical decision support systems may improve the diagnosis and ongoing management of chronic diseases, which requires recurrent visits to multiple health professionals, disease and medication monitoring and modification of patient behavior. The aim of this review was to systematically review randomized controlled trials evaluating the effectiveness of computerized clinical decision systems (CCDSS) in the care of people with asthma and COPD. Randomized controlled trials published between 2003 and 2013 were searched using multiple electronic databases Medline, EMBASE, CINAHL, IPA, Informit, PsychINFO, Compendex, and Cochrane Clinical Controlled Trials Register databases. To be included, RCTs had to evaluate the role of the CCDSSs for asthma and/or COPD in primary care. Nineteen studies representing 16 RCTs met our inclusion criteria. The majority of the trials were conducted in patients with asthma. Study quality was generally high. Meta-analysis was not conducted because of methodological and clinical heterogeneity. The use of CCDSS improved asthma and COPD care in 14 of the 19 studies reviewed (74%). Nine of the nineteen studies showed statistically significant (p < 0.05) improvement in the primary outcomes measured. The majority of the studies evaluated health care process measures as their primary outcomes (10/19). Evidence supports the effectiveness of CCDSS in the care of people with asthma. However there is very little information of its use in COPD care. Although there is considerable improvement in the health care process measures and clinical outcomes through the use of CCDSSs, its effects on user workload and efficiency, safety, costs of care, provider and patient satisfaction remain understudied.

Effects of computerized decision support systems on blood glucose regulation in critically ill surgical patients.

PubMed

Fogel, Sandy L; Baker, Christopher C

2013-04-01

The use of computerized decision support systems (CDSS) in glucose control for critically ill surgical patients has been reported in both diabetic and nondiabetic patients. Prospective studies evaluating its effect on glucose control are, however, lacking. The objective of this study was to evaluate patient-specific computerized IV insulin dosing on blood glucose levels (BGLs) by comparing patients treated pre-CDSS with those treated post-CDSS. A prospective study was performed in 4 surgical ICUs and 1 progressive care unit comparing patient data pre- and post-implementation of CDSS. The primary outcomes measures were the impact of the CDSS on glycemic control in this population and on reducing the incidence of severe hypoglycemia. Data on 1,682 patient admissions were evaluated, which corresponded to 73,290 BGLs post-CDSS compared with 44,972 BGLs pre-CDSS. The percentage of hyperglycemic events improved, with BGLs of >150 mg/dL decreasing by 50% compared with 6-month historical controls during the 18-month study period from July 2010 through December 2011. This was true for all 5 units individually (p < 0.0001, by one sample sign test). In addition, severe hypoglycemia (defined as BGL <40 mg/dL) decreased from 1% to 0.05% after implementing CDSS (p < 0.0001 by 2-sided binomial test). Patients whose BGLs were managed using CDSS were statistically significantly more likely to have a glucose reading under control (<150 mg/dL) than in the 6-month historical controls and to avoid serious hypoglycemia (p < 0.0001). Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A Performance Evaluation of NACK-Oriented Protocols as the Foundation of Reliable Delay- Tolerant Networking Convergence Layers

NASA Technical Reports Server (NTRS)

Iannicca, Dennis; Hylton, Alan; Ishac, Joseph

2012-01-01

Delay-Tolerant Networking (DTN) is an active area of research in the space communications community. DTN uses a standard layered approach with the Bundle Protocol operating on top of transport layer protocols known as convergence layers that actually transmit the data between nodes. Several different common transport layer protocols have been implemented as convergence layers in DTN implementations including User Datagram Protocol (UDP), Transmission Control Protocol (TCP), and Licklider Transmission Protocol (LTP). The purpose of this paper is to evaluate several stand-alone implementations of negative-acknowledgment based transport layer protocols to determine how they perform in a variety of different link conditions. The transport protocols chosen for this evaluation include Consultative Committee for Space Data Systems (CCSDS) File Delivery Protocol (CFDP), Licklider Transmission Protocol (LTP), NACK-Oriented Reliable Multicast (NORM), and Saratoga. The test parameters that the protocols were subjected to are characteristic of common communications links ranging from terrestrial to cis-lunar and apply different levels of delay, line rate, and error.

Economic Evaluation of Computerized Structural Analysis

NASA Technical Reports Server (NTRS)

Fortin, P. E.

1985-01-01

This completed effort involved a technical and economic study of the capabilities of computer programs in the area of structural analysis. The applicability of the programs to NASA projects and to other users was studied. The applications in other industries was explored including both research and development and applied areas. The costs of several alternative analysis programs were compared. A literature search covered applicable technical literature including journals, trade publications and books. In addition to the literature search, several commercial companies that have developed computerized structural analysis programs were contacted and their technical brochures reviewed. These programs include SDRC I-DEAS, MSC/NASTRAN, SCADA, SUPERSAP, NISA/DISPLAY, STAAD-III, MICAS, GTSTRUDL, and STARS. These programs were briefly reviewed as applicable to NASA projects.

Remote sensing inputs to National Model Implementation Program for water resources quality improvement

NASA Technical Reports Server (NTRS)

Eidenshink, J. C.; Schmer, F. A.

1979-01-01

The Lake Herman watershed in southeastern South Dakota has been selected as one of seven water resources systems in the United States for involvement in the National Model Implementation Program (MIP). MIP is a pilot program initiated to illustrate the effectiveness of existing water resources quality improvement programs. The Remote Sensing Institute (RSI) at South Dakota State University has produced a computerized geographic information system for the Lake Herman watershed. All components necessary for the monitoring and evaluation process were included in the data base. The computerized data were used to produce thematic maps and tabular data for the land cover and soil classes within the watershed. These data are being utilized operationally by SCS resource personnel for planning and management purposes.

Computer-based, personalized cognitive training versus classical computer games: a randomized double-blind prospective trial of cognitive stimulation.

PubMed

Peretz, Chava; Korczyn, Amos D; Shatil, Evelyn; Aharonson, Vered; Birnboim, Smadar; Giladi, Nir

2011-01-01

Many studies have suggested that cognitive training can result in cognitive gains in healthy older adults. We investigated whether personalized computerized cognitive training provides greater benefits than those obtained by playing conventional computer games. This was a randomized double-blind interventional study. Self-referred healthy older adults (n = 155, 68 ± 7 years old) were assigned to either a personalized, computerized cognitive training or to a computer games group. Cognitive performance was assessed at baseline and after 3 months by a neuropsychological assessment battery. Differences in cognitive performance scores between and within groups were evaluated using mixed effects models in 2 approaches: adherence only (AO; n = 121) and intention to treat (ITT; n = 155). Both groups improved in cognitive performance. The improvement in the personalized cognitive training group was significant (p < 0.03, AO and ITT approaches) in all 8 cognitive domains. However, in the computer games group it was significant (p < 0.05) in only 4 (AO) or 6 domains (ITT). In the AO analysis, personalized cognitive training was significantly more effective than playing games in improving visuospatial working memory (p = 0.0001), visuospatial learning (p = 0.0012) and focused attention (p = 0.0019). Personalized, computerized cognitive training appears to be more effective than computer games in improving cognitive performance in healthy older adults. Further studies are needed to evaluate the ecological validity of these findings. Copyright © 2011 S. Karger AG, Basel.

Melanoma Is Skin Deep: A 3D Reconstruction Technique for Computerized Dermoscopic Skin Lesion Classification

PubMed Central

Satheesha, T. Y.; Prasad, M. N. Giri; Dhruve, Kashyap D.

2017-01-01

Melanoma mortality rates are the highest amongst skin cancer patients. Melanoma is life threating when it grows beyond the dermis of the skin. Hence, depth is an important factor to diagnose melanoma. This paper introduces a non-invasive computerized dermoscopy system that considers the estimated depth of skin lesions for diagnosis. A 3-D skin lesion reconstruction technique using the estimated depth obtained from regular dermoscopic images is presented. On basis of the 3-D reconstruction, depth and 3-D shape features are extracted. In addition to 3-D features, regular color, texture, and 2-D shape features are also extracted. Feature extraction is critical to achieve accurate results. Apart from melanoma, in-situ melanoma the proposed system is designed to diagnose basal cell carcinoma, blue nevus, dermatofibroma, haemangioma, seborrhoeic keratosis, and normal mole lesions. For experimental evaluations, the PH2, ISIC: Melanoma Project, and ATLAS dermoscopy data sets is considered. Different feature set combinations is considered and performance is evaluated. Significant performance improvement is reported the post inclusion of estimated depth and 3-D features. The good classification scores of sensitivity = 96%, specificity = 97% on PH2 data set and sensitivity = 98%, specificity = 99% on the ATLAS data set is achieved. Experiments conducted to estimate tumor depth from 3-D lesion reconstruction is presented. Experimental results achieved prove that the proposed computerized dermoscopy system is efficient and can be used to diagnose varied skin lesion dermoscopy images. PMID:28512610

Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia

PubMed Central

El.Mahalli, Azza; El-Khafif, Sahar H.; Yamani, Wid

2016-01-01

The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended. PMID:26903780

Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia.

PubMed

El Mahalli, Azza; El-Khafif, Sahar H; Yamani, Wid

2016-01-01

The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended.

Computerized wheeze detection in young infants: comparison of signals from tracheal and chest wall sensors.

PubMed

Puder, Lia C; Wilitzki, Silke; Bührer, Christoph; Fischer, Hendrik S; Schmalisch, Gerd

2016-12-01

Computerized wheeze detection is an established method for objective assessment of respiratory sounds. In infants, this method has been used to detect subclinical airway obstruction and to monitor treatment effects. The optimal location for the acoustic sensors, however, is unknown. The aim of this study was to evaluate the quality of respiratory sound recordings in young infants, and to determine whether the position of the sensor affected computerized wheeze detection. Respiratory sounds were recorded over the left lateral chest wall and the trachea in 112 sleeping infants (median postmenstrual age: 49 weeks) on 129 test occasions using an automatic wheeze detection device (PulmoTrack ® ). Each recording lasted 10 min and the recordings were stored. A trained clinician retrospectively evaluated the recordings to determine sound quality and disturbances. The wheeze rates of all undisturbed tracheal and chest wall signals were compared using Bland-Altman plots. Comparison of wheeze rates measured over the trachea and the chest wall indicated strong correlation (r  ⩾  0.93, p  <  0.001), with a bias of 1% or less and limits of agreement of within 3% for the inspiratory wheeze rate and within 6% for the expiratory wheeze rate. However, sounds from the chest wall were more often affected by disturbances than sounds from the trachea (23% versus 6%, p  <  0.001). The study suggests that in young infants, a better quality of lung sound recordings can be obtained with the tracheal sensor.

Evaluation and implementation of chemotherapy regimen validation in an electronic health record.

PubMed

Diaz, Amber H; Bubalo, Joseph S

2014-12-01

Computerized provider order entry of chemotherapy regimens is quickly becoming the standard for prescribing chemotherapy in both inpatient and ambulatory settings. One of the difficulties with implementation of chemotherapy regimen computerized provider order entry lies in verifying the accuracy and completeness of all regimens built in the system library. Our goal was to develop, implement, and evaluate a process for validating chemotherapy regimens in an electronic health record. We describe our experience developing and implementing a process for validating chemotherapy regimens in the setting of a standard, commercially available computerized provider order entry system. The pilot project focused on validating chemotherapy regimens in the adult inpatient oncology setting and adult ambulatory hematologic malignancy setting. A chemotherapy regimen validation process was defined as a result of the pilot project. Over a 27-week pilot period, 32 chemotherapy regimens were validated using the process we developed. Results of the study suggest that by validating chemotherapy regimens, the amount of time spent by pharmacists in daily chemotherapy review was decreased. In addition, the number of pharmacist modifications required to make regimens complete and accurate were decreased. Both physician and pharmacy disciplines showed improved satisfaction and confidence levels with chemotherapy regimens after implementation of the validation system. Chemotherapy regimen validation required a considerable amount of planning and time but resulted in increased pharmacist efficiency and improved provider confidence and satisfaction. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Stem cells in bone diseases: current clinical practice.

PubMed

Beyth, Shaul; Schroeder, Josh; Liebergall, Meir

2011-01-01

Bone is an obvious candidate tissue for stem cell therapy. This review provides an update of existing stem cell-based clinical treatments for bone pathologies. A systematic computerized literature search was conducted. The following databases were accessed on 10 February 2011: NIH clinical trials database, PubMed, Ovid and Cochrane Reviews. Stem cell therapy offers new options for bone conditions, both acquired and inherited. There is still no agreement on the exact definition of 'mesenchymal stem cells'. Consequently, it is difficult to appreciate the effect of culture expansion and the feasibility of allogeneic transplantation. Based on the sound foundations of pre-clinical research, stem cell-based treatments and protocols have recently emerged. Well-designed prospective clinical trials are needed in order to establish and develop stem cell therapy for bone diseases.

AphasiaBank as BigData.

PubMed

MacWhinney, Brian; Fromm, Davida

2016-02-01

AphasiaBank has used a standardized protocol to collect narrative, procedural, personal, and descriptive discourse from 290 persons with aphasia, as well as 190 control participants. These data have been transcribed in the Codes for the Human Analysis of Transcripts (CHAT) format for analysis by the Computerized Language Analysis (CLAN) programs. Here, we review results from 45 studies based on these data that investigate aphasic productions in terms of these eight areas: discourse, grammar, lexicon, gesture, fluency, syndrome classification, social factors, and treatment effects. For each area, we also indicate how use of the CLAN programs has facilitated the analysis. We conclude with an examination of ways in which the size of the database could be increased through on-site recordings and data from teletherapy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Investigations of a simulated geomagnetic field experienced by the International Space Station on attentional performance.

PubMed

Del Seppia, Cristina; Mezzasalma, Lorena; Messerotti, Mauro; Cordelli, Alessandro; Ghione, Sergio

2009-01-01

We have previously reported that the exposure to an abnormal magnetic field simulating the one encountered by the International Space Station (ISS) orbiting around the Earth may enhance autonomic response to emotional stimuli. Here we report the results of the second part of that study which tested whether this field also affects cognitive functions. Twenty-four volunteers participated in the study, 12 exposed to the natural geomagnetic field and 12 to the magnetic field encountered by ISS. The test protocol consisted of a set of eight tests chosen from a computerized test battery for the assessment of attentional performance. The duration of exposure was 90 min. No effect of exposure to ISS magnetic field was observed on attentional performance. (c) 2008 Wiley-Liss, Inc.

Student Monitoring in Distance Education.

ERIC Educational Resources Information Center

Holt, Peter; And Others

1987-01-01

Reviews a computerized monitoring system for distance education students at Athabasca University designed to solve the problems of tracking student performance. A pilot project for tutors is described which includes an electronic conferencing system and electronic mail, and an evaluation currently in progress is briefly discussed. (LRW)

Advanced prediction technique for the low speed aerodynamics of V/STOL aircraft. Volume 1: Technical discussion

NASA Technical Reports Server (NTRS)

Beatty, T. D.; Worthey, M. K.

1984-01-01

The V/STOL Aircraft Propulsive Effects (VAPE) computerized prediction method is evaluated. The program analyzes viscous effects, various jet, inlet, and Short TakeOff and Landing (STOL) models, and examines the aerodynamic configurations of V/STOL aircraft.

Usability Evaluation at the Point-of-Care: A Method to Identify User Information Needs in CPOE Applications

PubMed Central

Washburn, Jeff; Fiol, Guilherme Del; Rocha, Roberto A.

2006-01-01

Point of care usability evaluation may help identify information needs that occur during the process of providing care. We describe the process of using usability-specific recording software to record Computerized Physician Order Entry (CPOE) ordering sessions on admitted adult and pediatric patients at two urban tertiary hospitals in the Intermountain Healthcare system of hospitals. PMID:17238756

Evaluating the Comparability of Paper-and-Pencil and Computerized Versions of a Large-Scale Certification Test. Research Report. ETS RR-05-21

ERIC Educational Resources Information Center

Puhan, Gautam; Boughton, Keith A.; Kim, Sooyeon

2005-01-01

The study evaluated the comparability of two versions of a teacher certification test: a paper-and-pencil test (PPT) and computer-based test (CBT). Standardized mean difference (SMD) and differential item functioning (DIF) analyses were used as measures of comparability at the test and item levels, respectively. Results indicated that effect sizes…

Effects of Methylphenidate and Bupropion on DHEA-S and Cortisol Plasma Levels in Attention-Deficit Hyperactivity Disorder

ERIC Educational Resources Information Center

Lee, Moon-Soo; Yang, Jae-Won; Ko, Young-Hoon; Han, Changsu; Kim, Seung-Hyun; Lee, Min-Soo; Joe, Sook-Haeng; Jung, In-Kwa

2008-01-01

We evaluated plasma levels of DHEA-S and cortisol before and after treating ADHD patients with one of two medications: methylphenidate (n = 12) or bupropion (n = 10). Boys with ADHD (combined type) were evaluated with the Korean ADHD rating scale (K-ARS) and the computerized ADHD diagnostic system (ADS). All assessments were measured at baseline…

Redesign of a computerized clinical reminder for colorectal cancer screening: a human-computer interaction evaluation

PubMed Central

2011-01-01

Background Based on barriers to the use of computerized clinical decision support (CDS) learned in an earlier field study, we prototyped design enhancements to the Veterans Health Administration's (VHA's) colorectal cancer (CRC) screening clinical reminder to compare against the VHA's current CRC reminder. Methods In a controlled simulation experiment, 12 primary care providers (PCPs) used prototypes of the current and redesigned CRC screening reminder in a within-subject comparison. Quantitative measurements were based on a usability survey, workload assessment instrument, and workflow integration survey. We also collected qualitative data on both designs. Results Design enhancements to the VHA's existing CRC screening clinical reminder positively impacted aspects of usability and workflow integration but not workload. The qualitative analysis revealed broad support across participants for the design enhancements with specific suggestions for improving the reminder further. Conclusions This study demonstrates the value of a human-computer interaction evaluation in informing the redesign of information tools to foster uptake, integration into workflow, and use in clinical practice. PMID:22126324

Evaluation of a computerized aid for creating human behavioral representations of human-computer interaction.

PubMed

Williams, Kent E; Voigt, Jeffrey R

2004-01-01

The research reported herein presents the results of an empirical evaluation that focused on the accuracy and reliability of cognitive models created using a computerized tool: the cognitive analysis tool for human-computer interaction (CAT-HCI). A sample of participants, expert in interacting with a newly developed tactical display for the U.S. Army's Bradley Fighting Vehicle, individually modeled their knowledge of 4 specific tasks employing the CAT-HCI tool. Measures of the accuracy and consistency of task models created by these task domain experts using the tool were compared with task models created by a double expert. The findings indicated a high degree of consistency and accuracy between the different "single experts" in the task domain in terms of the resultant models generated using the tool. Actual or potential applications of this research include assessing human-computer interaction complexity, determining the productivity of human-computer interfaces, and analyzing an interface design to determine whether methods can be automated.

A Computerized Asthma Outcomes Measure Is Feasible for Disease Management.

PubMed

Turner-Bowker, Diane M; Saris-Baglama, Renee N; Anatchkova, Milena; Mosen, David M

2010-04-01

OBJECTIVE: To develop and test an online assessment referred to as the ASTHMA-CAT (computerized adaptive testing), a patient-based asthma impact, control, and generic health-related quality of life (HRQOL) measure. STUDY DESIGN: Cross-sectional pilot study of the ASTHMA-CAT's administrative feasibility in a disease management population. METHODS: The ASTHMA-CAT included a dynamic or static Asthma Impact Survey (AIS), Asthma Control Test, and SF-8 Health Survey. A sample of clinician-diagnosed adult asthmatic patients (N = 114) completed the ASTHMA-CAT. Results were used to evaluate administrative feasibility of the instrument and psychometric performance of the dynamic AIS relative to the static AIS. A prototype aggregate (group-level) report was developed and reviewed by care providers. RESULTS: Online administration of the ASTHMA-CAT was feasible for patients in disease management. The dynamic AIS functioned well compared with the static AIS in preliminary studies evaluating response burden, precision, and validity. Providers found reports to be relevant, useful, and applicable for care management. CONCLUSION: The ASTHMA-CAT may facilitate asthma care management.

Developing a customized multiple interview for dental school admissions.

PubMed

Gardner, Karen M

2014-04-01

From the early 1980s until recently, the University of British Columbia Faculty of Dentistry had employed the Canadian Dental Association (CDA) Structured Interview in its Phase 2 admissions process (with those applicants invited for interviews). While this structured interview had demonstrated reliability and validity, the Faculty of Dentistry came to believe that a multiple interview process using scenarios would help it better identify applicants who would match its mission. After a literature review that investigated such interview protocols as unstructured, semi-structured, computerized, and telephone formats, a multiple interview format was chosen. This format was seen as an emerging trend, with evidence that it has been deemed fairer by applicants, more reliable by interviewers, more difficult for applicants to provide set answers for the scenarios, and not to require as many interviewers as other formats. This article describes the process undertaken to implement a customized multiple interview format for admissions and reports these outcomes of the process: a smoothly running multiple interview; effective training protocols for staff, interviewers, and applicants; and reports from successful applicants and interviewers that they felt the multiple interview was a more reliable and fairer recruiting tool than other models.

Controlled ovarian hyperstimulation with sequential letrozole co-treatment in normo/high responders.

PubMed

Ecemis, Tolga; Tasci, Yasemin; Caglar, Gamze Sinem

2016-01-01

To investigate the effect of co-administration of letrozole in an ovarian stimulation protocol using recombinant FSH and GnRH antagonists for ICSI in normo/high responders. Computerized data of 320 antagonist ICSI/ET cycles with or without letrozole were retrospectively analyzed. In 105 cases, letrozole (5 mg/day) was started at the second day of the cycle continued for 5 days. At the second day of letrozole, gonadotropins were added. The remaining 215 cases were stimulated with recombinant FSH only. In all cases on day 6, GnRH antagonist was started. Ovarian stimulation protocols with or without letrozole were compared for cycle outcome parameters. In cycles with letrozole, significantly lower gonadotropin consumption and lower peak estradiol levels were found. In cycles with letrozole, mean number of metaphase II and fertilized oocytes retrieved were significantly higher compared to cycles without letrozole. The pregnancy and clinical pregnancy rates were similar. Should the number of oocytes retrieved being higher in letrozole group might indicate that letrozole might contribute to successful ovarian stimulation with a lower dosage of gonadotropins. Despite the lower peak estradiol levels, pregnancy rates being similar to other group also support the idea that letrozole can contribute to normal potential of implantation.

Computerized adaptive control weld skate with CCTV weld guidance project

NASA Technical Reports Server (NTRS)

Wall, W. A.

1976-01-01

This report summarizes progress of the automatic computerized weld skate development portion of the Computerized Weld Skate with Closed Circuit Television (CCTV) Arc Guidance Project. The main goal of the project is to develop an automatic welding skate demonstration model equipped with CCTV weld guidance. The three main goals of the overall project are to: (1) develop a demonstration model computerized weld skate system, (2) develop a demonstration model automatic CCTV guidance system, and (3) integrate the two systems into a demonstration model of computerized weld skate with CCTV weld guidance for welding contoured parts.

An Application of Computerized Axial Tomography (CAT) Technology to Mass Raid Tracking

DTIC Science & Technology

1989-08-01

ESD-TR-89-305 MTR-10542 An Application of Computerized Axial Tomography ( CAT ) Technology to Mass Raid Tracking By John K. Barr August 1989...NO 11. TITLE (Include Security Classification) An Application of Computerized Axial Tomography ( CAT ) Technology to Mass Raid Tracking 12...by block number) Computerized Axial Tomography ( CAT ) Scanner Electronic Support Measures (ESM) Fusion (continued) 19. ABSTRACT (Continue on

Increasing profitability through computerization.

PubMed

Sokol, D J

1988-01-01

The author explores the pragmatic or financial justification for computerizing a dental practice and discusses a computerized approach to precollection and collection for the dental office. The article also deals with the use of computerized correspondence to augment the recall policy of the office and to help generate new patient referrals and discusses the pros and cons of utilizing a dental computer service bureau in implementing these policies.

[Evaluation of the risk of mediastinal or retroperitoneal injuries caused by dorso-lumbar pedicle screws].

PubMed

Hernigou, P; Germany, W

1998-09-01

Within an anatomical and a clinical study, the authors employed computerized tomographic scans to evaluate the risks of anterior surrounding tissues injuries during screw insertion. CT scans of 20 patients suffering from cardiac disease were reviewed retrospectively. Scans through the thoracic and lumbar spine were obtained using 6 mm slice thickness. These examinations were performed with intravenous contrast medium. Measurements of vessel diameters and distance of the soft tissues situated directly anterior to the spine were done. A retrospective study of 61 pedicle screws implanted for spine fractures evaluated the penetration of the anterior vertebral cordex with X rays and CT scans. Computerized tomographic scans of the thoracic and lumbar spine of the 20 patients in the control group confirmed proximity of the posterior mediastinal structures to the anterior vertebral cortex. Many structures of the posterior mediastinum were within five millimeters of the anterior vertebral cortex and thus were at risk: aorta, azygos vein, vena cava, parietal pleura and lungs. The theoretical risk of unrecognized screw penetrations evaluated on geometric shape of the anterior vertebral body is as high as 21 per cent when screw position is only seen with an antero posterior and a lateral X Ray. In the other group, computerized tomographic scans showed that 30 per cent of the implanted screws were outside the boundaries of the anterior thoracic spine. Two orthogonal incidences do not enable determination of whether the extremity of the screw is slightly outside the anterior cortex of the vertebral body. However the geometric shape of the anterior vertebral body enables peroperative definition of a safety zone on two orthogonal incidences. Even if a breach of a few millimeters of the anterior cortical boundaries of the vertebral body may not initially damage the adjacent soft-tissue structures, chronic irritation may result in late damages of these structures. The use of metallic markers and the respect of a safe vertebral zone on X Rays could guide the choice of the appropriate screw length.

Measuring value for money: a scoping review on economic evaluation of health information systems.

PubMed

Bassi, Jesdeep; Lau, Francis

2013-01-01

To explore how key components of economic evaluations have been included in evaluations of health information systems (HIS), to determine the state of knowledge on value for money for HIS, and provide guidance for future evaluations. We searched databases, previously collected papers, and references for relevant papers published from January 2000 to June 2012. For selection, papers had to: be a primary study; involve a computerized system for health information processing, decision support, or management reporting; and include an economic evaluation. Data on study design and economic evaluation methods were extracted and analyzed. Forty-two papers were selected and 33 were deemed high quality (scores ≥ 8/10) for further analysis. These included 12 economic analyses, five input cost analyses, and 16 cost-related outcome analyses. For HIS types, there were seven primary care electronic medical records, six computerized provider order entry systems, five medication management systems, five immunization information systems, four institutional information systems, three disease management systems, two clinical documentation systems, and one health information exchange network. In terms of value for money, 23 papers reported positive findings, eight were inconclusive, and two were negative. We found a wide range of economic evaluation papers that were based on different assumptions, methods, and metrics. There is some evidence of value for money in selected healthcare organizations and HIS types. However, caution is needed when generalizing these findings. Better reporting of economic evaluation studies is needed to compare findings and build on the existing evidence base we identified.

A CAD system and quality assurance protocol for bone age assessment utilizing digital hand atlas

NASA Astrophysics Data System (ADS)

Gertych, Arakadiusz; Zhang, Aifeng; Ferrara, Benjamin; Liu, Brent J.

2007-03-01

Determination of bone age assessment (BAA) in pediatric radiology is a task based on detailed analysis of patient's left hand X-ray. The current standard utilized in clinical practice relies on a subjective comparison of the hand with patterns in the book atlas. The computerized approach to BAA (CBAA) utilizes automatic analysis of the regions of interest in the hand image. This procedure is followed by extraction of quantitative features sensitive to skeletal development that are further converted to a bone age value utilizing knowledge from the digital hand atlas (DHA). This also allows providing BAA results resembling current clinical approach. All developed methodologies have been combined into one CAD module with a graphical user interface (GUI). CBAA can also improve the statistical and analytical accuracy based on a clinical work-flow analysis. For this purpose a quality assurance protocol (QAP) has been developed. Implementation of the QAP helped to make the CAD more robust and find images that cannot meet conditions required by DHA standards. Moreover, the entire CAD-DHA system may gain further benefits if clinical acquisition protocol is modified. The goal of this study is to present the performance improvement of the overall CAD-DHA system with QAP and the comparison of the CAD results with chronological age of 1390 normal subjects from the DHA. The CAD workstation can process images from local image database or from a PACS server.

Identifying design considerations for a shared decision aid for use at the point of outpatient clinical care: An ethnographic study at an inner city clinic.

PubMed

Hajizadeh, Negin; Perez Figueroa, Rafael E; Uhler, Lauren M; Chiou, Erin; Perchonok, Jennifer E; Montague, Enid

2013-03-06

Computerized decision aids could facilitate shared decision-making at the point of outpatient clinical care. The objective of this study was to investigate whether a computerized shared decision aid would be feasible to implement in an inner-city clinic by evaluating the current practices in shared decision-making, clinicians' use of computers, patient and clinicians' attitudes and beliefs toward computerized decision aids, and the influence of time on shared decision-making. Qualitative data analysis of observations and semi-structured interviews with patients and clinicians at an inner-city outpatient clinic. The findings provided an exploratory look at the prevalence of shared decision-making and attitudes about health information technology and decision aids. A prominent barrier to clinicians engaging in shared decision-making was a lack of perceived patient understanding of medical information. Some patients preferred their clinicians make recommendations for them rather than engage in formal shared decision-making. Health information technology was an integral part of the clinic visit and welcomed by most clinicians and patients. Some patients expressed the desire to engage with health information technology such as viewing their medical information on the computer screen with their clinicians. All participants were receptive to the idea of a decision aid integrated within the clinic visit although some clinicians were concerned about the accuracy of prognostic estimates for complex medical problems. We identified several important considerations for the design and implementation of a computerized decision aid including opportunities to: bridge clinician-patient communication about medical information while taking into account individual patients' decision-making preferences, complement expert clinician judgment with prognostic estimates, take advantage of patient waiting times, and make tasks involved during the clinic visit more efficient. These findings should be incorporated into the design and implementation of a computerized shared decision aid at an inner-city hospital.

Use of the Dynamic Visual Acuity Test as a screener for community-dwelling older adults who fall.

PubMed

Honaker, Julie A; Shepard, Neil T

2011-01-01

Adequate function of the peripheral vestibular system, specifically the vestibulo-ocular reflex (VOR; a network of neural connections between the peripheral vestibular system and the extraocular muscles) is essential for maintaining stable vision during head movements. Decreased visual acuity resulting from an impaired peripheral vestibular system may impede balance and postural control and place an individual at risk of falling. Therefore, sensitive measures of the vestibular system are warranted to screen for the tendency to fall, alerting clinicians to recommend further risk of falling assessment and referral to a falling risk reduction program. Dynamic Visual Acuity (DVA) testing is a computerized VOR assessment method to evaluate the peripheral vestibular system during head movements; reduced visual acuity as documented with DVA testing may be sensitive to screen for falling risk. This study examined the sensitivity and specificity of the computerized DVA test with yaw plane head movements for identifying community-dwelling adults (58-78 years) who are prone to falling. A total of 16 older adults with a history of two or more unexplained falls in the previous twelve months and 16 age and gender matched controls without a history of falls in the previous twelve months participated. Computerized DVA with horizontal head movements at a fixed velocity of 120 deg/sec was measured and compared with the Dynamic Gait Index (DGI) a gold standard gait assessment measurement for identifying falling risk. Receiver operating characteristics (ROC) curve analysis and area under the ROC curve (AUC) were used to assess the sensitivity and specificity of the computerized DVA as a screening measure for falling risk as determined by the DGI. Results suggested a link between computerized DVA and the propensity to fall; DVA in the yaw plane was found to be a sensitive (92%) and accurate screening measure when using a cutoff logMAR value of >0.25.

Influence of computerized sounding out on spelling performance for children who do and do not rely on AAC.

PubMed

McCarthy, Jillian H; Hogan, Tiffany P; Beukelman, David R; Schwarz, Ilsa E

2015-05-01

Spelling is an important skill for individuals who rely on augmentative and alternative communication (AAC). The purpose of this study was to investigate how computerized sounding out influenced spelling accuracy of pseudo-words. Computerized sounding out was defined as a word elongated, thus providing an opportunity for a child to hear all the sounds in the word at a slower rate. Seven children with cerebral palsy, four who use AAC and three who do not, participated in a single subject AB design. The results of the study indicated that the use of computerized sounding out increased the phonologic accuracy of the pseudo-words produced by participants. The study provides preliminary evidence for the use of computerized sounding out during spelling tasks for children with cerebral palsy who do and do not use AAC. Future directions and clinical implications are discussed. We investigated how computerized sounding out influenced spelling accuracy of pseudowords for children with complex communication needs who did and did not use augmentative and alternative communication (AAC). Results indicated that the use of computerized sounding out increased the phonologic accuracy of the pseudo-words by participants, suggesting that computerized sounding out might assist in more accurate spelling for children who use AAC. Future research is needed to determine how language and reading abilities influence the use of computerized sounding out with children who have a range of speech intelligibility abilities and do and do not use AAC.

Design and pilot results of a single blind randomized controlled trial of systematic demand-led home visits by nurses to frail elderly persons in primary care [ISRCTN05358495].

PubMed

van Hout, Hein P J; Nijpels, Giel; van Marwijk, Harm W J; Jansen, Aaltje P D; Van't Veer, Petronella J; Tybout, Willemijn; Stalman, Wim A B

2005-09-08

The objective of this article is to describe the design of an evaluation of the cost-effectiveness of systematic home visits by nurses to frail elderly primary care patients. Pilot objectives were: 1. To determine the feasibility of postal multidimensional frailty screening instruments; 2. to identify the need for home visits to elderly. Main study: The main study concerns a randomized controlled in primary care practices (PCP) with 18 months follow-up and blinded PCPs. Frail persons aged 75 years or older and living at home but neither terminally ill nor demented from 33 PCPs were eligible. Trained community nurses (1) visit patients at home and assess the care needs with the Resident Assessment Instrument-Home Care, a multidimensional computerized geriatric assessment instrument, enabling direct identification of problem areas; (2) determine the care priorities together with the patient; (3) design and execute interventions according to protocols; (4) and visit patients at least five times during a year in order to execute and monitor the care-plan. Controls receive usual care. Outcome measures are Quality of life, and Quality Adjusted Life Years; time to nursing home admission; mortality; hospital admissions; health care utilization. Pilot 1: Three brief postal multidimensional screening measures to identify frail health among elderly persons were tested on percentage complete item response (selected after a literature search): 1) Vulnerable Elders Screen, 2) Strawbridge's frailty screen, and 3) COOP-WONCA charts. Pilot 2: Three nurses visited elderly frail patients as identified by PCPs in a health center of 5400 patients and used an assessment protocol to identify psychosocial and medical problems. The needs and experiences of all participants were gathered by semi-structured interviews. The design holds several unique elements such as early identification of frail persons combined with case-management by nurses. From two pilots we learned that of three potential postal frailty measures, the COOP-WONCA charts were completed best by elderly and that preventive home visits by nurses were positively evaluated to have potential for quality of care improvement.

Internet-Delivered Dialectical Behavioral Therapy Skills Training for Suicidal and Heavy Episodic Drinkers: Protocol and Preliminary Results of a Randomized Controlled Trial.

PubMed

Wilks, Chelsey; Yin, Qingqing; Ang, Sin Yee; Matsumiya, Brandon; Lungu, Anita; Linehan, Marsha

2017-10-25

The need to develop effective and accessible interventions for suicidal individuals engaging in heavy episodic drinking (HED) cannot be understated. While the link between alcohol use and suicidality is a complex one that remains to be elucidated, emotion dysregulation may play a key role in alcohol-related suicide risk in these individuals. In the current study, an 8-week Internet-delivered dialectical behavior therapy (DBT) skills training intervention was developed and preliminarily evaluated for suicidal individuals who engage in HED to regulate emotions. The aim of the study is to evaluate the feasibility and effectiveness of the therapist-assisted and Internet-delivered intervention, and to inform the design of a subsequent full-scale study. The study was a pilot randomized controlled trial comparing participants receiving immediate-treatment (n=30) to waitlist controls (n=29) over a period of 16 weeks. Intervention effects will be assessed longitudinally using hierarchical linear modeling and generalized estimating equations, along with analyses of effect sizes and clinically significant change. The primary outcomes are suicidal ideation, alcohol problems, and emotion dysregulation. Secondary outcomes include alcohol-related consequences, reasons for living, skills use, and depression. The trial is ongoing. A total of 60 individuals returned their informed consent and were randomized, of whom 59 individuals were intended to treat. A total of 50 participants in the study were retained through the 16-week enrollment. There is a dearth of evidence-based treatment for individuals presenting with high risk and complex behaviors. Furthermore, computerized interventions may provide a beneficial alternative to traditional therapies. The particular clinical features and treatment needs of suicidal individuals who also engage in HED constitute key domains for further investigation that are needed to consolidate the design of appropriate interventions for this high-risk population. Clinicaltrials.gov NCT02932241; https://clinicaltrials.gov/ct2/show/NCT02932241 (Archived by WebCite at http://www.webcitation.org/6uJHdQsC2). ©Chelsey Wilks, Qingqing Yin, Sin Yee Ang, Brandon Matsumiya, Anita Lungu, Marsha Linehan. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 25.10.2017.

Learning from a cluster randomized controlled trial to improve healthcare workers’ access to prevention and care for tuberculosis and HIV in Free State, South Africa: the pivotal role of information systems

PubMed Central

Yassi, Annalee; Adu, Prince A.; Nophale, Letshego; Zungu, Muzimkhulu

2016-01-01

Background Occupational tuberculosis (TB) continues to plague the healthcare workforce in South Africa. A 2-year cluster randomized controlled trial was therefore launched in 27 public hospitals in Free State province, to better understand how a combined workforce and workplace program can improve health of the healthcare workforce. Objective This mid-term evaluation aimed to analyze how well the intervention was being implemented, seek evidence of impact or harm, and draw lessons. Methods Both intervention and comparison sites had been instructed to conduct bi-annual and issue-based infection control assessments (when healthcare workers [HCW] are diagnosed with TB) and offer HCWs confidential TB and HIV counseling and testing, TB treatment and prophylaxis for HIV-positive HCWs. Intervention sites were additionally instructed to conduct quarterly workplace assessments, and also offer HCWs HIV treatment at their occupational health units (OHUs). Trends in HCW mortality, sick-time, and turnover rates (2005–2014) were analyzed from the personnel salary database (‘PERSAL’). Data submitted by the OHUs were also analyzed. Open-ended questionnaires were then distributed to OHU HCWs and in-depth interviews conducted at 17 of the sites to investigate challenges encountered. Results OHUs reported identifying and treating 23 new HCW cases of TB amongst the 1,372 workers who used the OHU for HIV and/or TB services; 39 new cases of HIV were also identified and 108 known-HIV-positive HCWs serviced. Although intervention-site workforces used these services significantly more than comparison-site healthcare staff (p<0.001), the data recorded were incomplete for both the intervention and comparison OHUs. An overall significant decline in mortality and turnover rates was documented over this period, but no significant differences between intervention and comparison sites; sick-time data proved unreliable. Severe OHU workload as well as residual confidentiality concerns prevented the proper implementation of protocols, especially workplace assessments and data recording. Particularly, the failure to implement computerized data collection required OHU staff to duplicate their operational data collection duties by also entering research paper forms. The study was therefore halted pending the implementation of a computerized system. Conclusions The significant differences in OHU use documented cannot be attributable to the intervention due to incomplete data reporting; unreliable sick-time data further precluded ascertaining the benefit potentially attributable to the intervention. Computerized data collection is essential to facilitate operational monitoring while conducting real-world intervention research. The digital divide still requires the attention of researchers along with overall infrastructural constraints. PMID:27341793

Postural Control in Children with Autism.

ERIC Educational Resources Information Center

Kohen-Raz, Reuven; And Others

1992-01-01

Postural control was evaluated in 91 autistic, 166 normal, and 18 mentally retarded children using a computerized posturographic procedure. In comparison to normal children, the autistic subjects were less likely to exhibit age-related changes in postural performance, and postures were more variable and less stable. (Author/JDD)

Computerized Online Bibliographic Searching. SPEC Kit #154.

ERIC Educational Resources Information Center

Hocker, Susan

For this kit, 106 Association of Research Libraries (ARL) academic libraries were surveyed concerning: (1) current administration/organization; (2) evaluation; (3) patron relations; (4) services; and (5) the impact of online searching on collections. Responses were received from 83 libraries, many of which contributed sample materials. Analyses of…

I.T.S. camera deployment and systems integration P.I.N. 4ITV.09.121 : evaluation

DOT National Transportation Integrated Search

2006-08-01

The Monroe County Department of Transportation (MCDOT) has built upon the success of its first computerized traffic signal system. The system has been operational since 1985. In the late 1990s the Department initiated a project to integrate Intell...

The Impact of Goal Setting on Team Simulation Experience.

ERIC Educational Resources Information Center

Fandt, Patricia M.; And Others

1990-01-01

Describes a study that examined the effects of goal setting on undergraduate students competing in a computerized business simulation. Group cohesiveness is discussed, treatments for the experimental and control groups are described, perceived team success is measured, and team simulation performance is evaluated. (30 references) (LRW)

Contemporary computerized methods for logging planning

Treesearch

Chris B. LeDoux

1988-01-01

Contemporary harvest planning graphic software is highlighted with practical applications. Planning results from a production study of the Clearwater Cable Yarder are summarized. Application of the planning methods to evaluation of proposed silvicultural treatments is included. Results show that 3-dimensional graphic analysis of proposed harvesting or silvicultural...

Use of Microcomputer to Manage Assessment Data.

ERIC Educational Resources Information Center

Vance, Booney; Hayden, David

1982-01-01

Examples are provided of a computerized special education management system used to manage assessment data for exceptional students. The system is designed to provide a simple yet efficient method of tracking data from educational and psychological evaluations (specifically the Wechsler Intelligence Scale for Children--Revised scores). (CL)

Item Analysis in Introductory Economics Testing.

ERIC Educational Resources Information Center

Tinari, Frank D.

1979-01-01

Computerized analysis of multiple choice test items is explained. Examples of item analysis applications in the introductory economics course are discussed with respect to three objectives: to evaluate learning; to improve test items; and to help improve classroom instruction. Problems, costs and benefits of the procedures are identified. (JMD)

Computerized Manufacturing Automation: Employment, Education, and the Workplace.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Office of Technology Assessment.

This report describes the technologies of programmable automation (PA) in manufacturing, their uses, and future capabilities. Following the summary and introduction, the prospects for PA are examined from several perspectives. Chapter 3 defines PA technologies, describes their developmental trends, and evaluates the potential for the integration…

Extra-Vehicular Activity (EVA) glove evaluation test protocol

NASA Technical Reports Server (NTRS)

Hinman-Sweeney, E. M.

1994-01-01

One of the most critical components of a space suit is the gloves, yet gloves have traditionally presented significant design challenges. With continued efforts at glove development, a method for evaluating glove performance is needed. This paper presents a pressure-glove evaluation protocol. A description of this evaluation protocol, and its development is provided. The protocol allows comparison of one glove design to another, or any one design to bare-handed performance. Gloves for higher pressure suits may be evaluated at current and future design pressures to drive out differences in performance due to pressure effects. Using this protocol, gloves may be evaluated during design to drive out design problems and determine areas for improvement, or fully mature designs may be evaluated with respect to mission requirements. Several different test configurations are presented to handle these cases. This protocol was run on a prototype glove. The prototype was evaluated at two operating pressures and in the unpressurized state, with results compared to bare-handed performance. Results and analysis from this test series are provided, as is a description of the configuration used for this test.

The Memory Aid study: protocol for a randomized controlled clinical trial evaluating the effect of computer-based working memory training in elderly patients with mild cognitive impairment (MCI)

PubMed Central

2014-01-01

Background Mild cognitive impairment (MCI) is a condition characterized by memory problems that are more severe than the normal cognitive changes due to aging, but less severe than dementia. Reduced working memory (WM) is regarded as one of the core symptoms of an MCI condition. Recent studies have indicated that WM can be improved through computer-based training. The objective of this study is to evaluate if WM training is effective in improving cognitive function in elderly patients with MCI, and if cognitive training induces structural changes in the white and gray matter of the brain, as assessed by structural MRI. Methods/Designs The proposed study is a blinded, randomized, controlled trail that will include 90 elderly patients diagnosed with MCI at a hospital-based memory clinic. The participants will be randomized to either a training program or a placebo version of the program. The intervention is computerized WM training performed for 45 minutes of 25 sessions over 5 weeks. The placebo version is identical in duration but is non-adaptive in the difficulty level of the tasks. Neuropsychological assessment and structural MRI will be performed before and 1 month after training, and at a 5-month folllow-up. Discussion If computer-based training results in positive changes to memory functions in patients with MCI this may represent a new, cost-effective treatment for MCI. Secondly, evaluation of any training-induced structural changes to gray or white matter will improve the current understanding of the mechanisms behind effective cognitive interventions in patients with MCI. Trial registration ClinicalTrials.gov NCT01991405. November 18, 2013. PMID:24886034

The Memory Aid study: protocol for a randomized controlled clinical trial evaluating the effect of computer-based working memory training in elderly patients with mild cognitive impairment (MCI).

PubMed

Flak, Marianne M; Hernes, Susanne S; Chang, Linda; Ernst, Thomas; Douet, Vanessa; Skranes, Jon; Løhaugen, Gro C C

2014-05-03

Mild cognitive impairment (MCI) is a condition characterized by memory problems that are more severe than the normal cognitive changes due to aging, but less severe than dementia. Reduced working memory (WM) is regarded as one of the core symptoms of an MCI condition. Recent studies have indicated that WM can be improved through computer-based training. The objective of this study is to evaluate if WM training is effective in improving cognitive function in elderly patients with MCI, and if cognitive training induces structural changes in the white and gray matter of the brain, as assessed by structural MRI. The proposed study is a blinded, randomized, controlled trail that will include 90 elderly patients diagnosed with MCI at a hospital-based memory clinic. The participants will be randomized to either a training program or a placebo version of the program. The intervention is computerized WM training performed for 45 minutes of 25 sessions over 5 weeks. The placebo version is identical in duration but is non-adaptive in the difficulty level of the tasks. Neuropsychological assessment and structural MRI will be performed before and 1 month after training, and at a 5-month folllow-up. If computer-based training results in positive changes to memory functions in patients with MCI this may represent a new, cost-effective treatment for MCI. Secondly, evaluation of any training-induced structural changes to gray or white matter will improve the current understanding of the mechanisms behind effective cognitive interventions in patients with MCI. ClinicalTrials.gov NCT01991405. November 18, 2013.

Donor recruitment and selection for adult-to-adult living donor liver transplantation in urgent and elective circumstances.

PubMed

Ben-Haim, Menahem; Carmiel, Michal; Lubezky, Nir; Keidar, Rivka; Katz, Paulina; Blachar, Arye; Nimrod, Adi; Sorkine, Patrick; Oren, Ran; Klausner, Joseph M; Nakache, Richard

2005-03-01

Adult-to-adult living donor liver transplantation is becoming an alternative to cadaveric transplantation in urgent and elective settings. Donor selection crucially affects donor safety and recipient outcome. To present our algorithm of urgent and elective donor selection. Urgent selection is expeditious and protocol-based. Elective selection permits a comprehensive process. Both include medical, psychosocial and surgical-anatomic evaluations. Liver volumes and vascular anatomy are evaluated with computerized tomographic angiography. Informed consent is obtained after painstaking explanations. Independent institutional committees review and approve all cases. Between July 2003 and June 2004 we evaluated 43 potential live donors for 12 potential recipients (fulminant hepatic failure, n = 5; chronic end-stage liver disease, n = 6; primary graft non-function, n = 1). Thirty-three candidates (76%) were excluded due to blood type incompatibility (n = 14, 42%), incompatible anatomy (n = 8, 24%)--including problematic volume distribution (n = 2) or vascular anatomy (n = 6)--psychosocial issues (n = 4, 12%), or medical co-morbidity (n = 7, 22%). Five recipients (FHF, n = 4; chronic ESLD, n = 1) were successfully transplanted from living donors. In the acute setting, two patients (FHF, PGNF) died in the absence of an appropriate donor (cadaveric or living donor). In the elective group, one patient died of unexpected variceal bleeding and one received a cadaveric graft just before the planned living donor transplantation was performed. One candidate was transplanted overseas and two cases are scheduled. The ratio of compatibility for donation was 34% (10/29) for blood type-compatible candidates. Donor selection for living donor liver transplantation is a complex, labor-intensive multidisciplinary process. Most exclusions are due to blood type incompatibility or anatomic details. Psychosocial aspects of these donations warrant special attention.

The Impact of Order Source Misattribution on Computerized Provider Order Entry (CPOE) Performance Metrics

PubMed Central

Gellert, George A.; Catzoela, Linda; Patel, Lajja; Bruner, Kylynn; Friedman, Felix; Ramirez, Ricardo; Saucedo, Lilliana; Webster, S. Luke; Gillean, John A.

2017-01-01

Background One strategy to foster adoption of computerized provider order entry (CPOE) by physicians is the monthly distribution of a list identifying the number and use rate percentage of orders entered electronically versus on paper by each physician in the facility. Physicians care about CPOE use rate reports because they support the patient safety and quality improvement objectives of CPOE implementation. Certain physician groups are also motivated because they participate in contracted financial and performance arrangements that include incentive payments or financial penalties for meeting (or failing to meet) a specified CPOE use rate target. Misattribution of order sources can hinder accurate measurement of individual physician CPOE use and can thereby undermine providers’ confidence in their reported performance, as well as their motivation to utilize CPOE. Misattribution of order sources also has significant patient safety, quality, and medicolegal implications. Objective This analysis sought to evaluate the magnitude and sources of misattribution among hospitalists with high CPOE use and, if misattribution was found, to formulate strategies to prevent and reduce its recurrence, thereby ensuring the integrity and credibility of individual and facility CPOE use rate reporting. Methods A detailed manual order source review and validation of all orders issued by one hospitalist group at a midsize community hospital was conducted for a one-month study period. Results We found that a small but not dismissible percentage of orders issued by hospitalists—up to 4.18 percent (95 percent confidence interval, 3.84–4.56 percent) per month—were attributed inaccurately. Sources of misattribution by department or function were as follows: nursing, 42 percent; pharmacy, 38 percent; laboratory, 15 percent; unit clerk, 3 percent; and radiology, 2 percent. Order management and protocol were the most common correct order sources that were incorrectly attributed. Conclusion Order source misattribution can negatively affect reported provider CPOE use rates and should be investigated if providers perceive discrepancies between reported rates and their actual performance. Preventive education and communication efforts across departments can help prevent and reduce misattribution. PMID:28566988

Automated Computerized Analysis of Speechin Psychiatric Disorders

PubMed Central

Cohen, Alex S.; Elvevåg, Brita

2014-01-01

Purpose of Review Disturbances in communication are a hallmark of severe mental illnesses. Recent technological advances have paved the way for objectifying communication using automated computerized linguistic and acoustic analysis. We review recent studies applying various computer-based assessments to the natural language produced by adult patients with severe mental illness. Recent Findings Automated computerized methods afford tools with which it is possible to objectively evaluate patients in a reliable, valid and efficient manner that complements human ratings. Crucially, these measures correlate with important clinical measures. The clinical relevance of these novel metrics has been demonstrated by showing their relationship to functional outcome measures, their in vivo link to classic ‘language’ regions in the brain, and, in the case of linguistic analysis, their relationship to candidate genes for severe mental illness. Summary Computer based assessments of natural language afford a framework with which to measure communication disturbances in adults with SMI. Emerging evidence suggests that they can be reliable and valid, and overcome many practical limitations of more traditional assessment methods. The advancement of these technologies offers unprecedented potential for measuring and understanding some of the most crippling symptoms of some of the most debilitating illnesses known to humankind. PMID:24613984

Evaluating anesthetic protocols for functional blood flow imaging in the rat eye

NASA Astrophysics Data System (ADS)

Moult, Eric M.; Choi, WooJhon; Boas, David A.; Baumann, Bernhard; Clermont, Allen C.; Feener, Edward P.; Fujimoto, James G.

2017-01-01

The purpose of this study is to evaluate the suitability of five different anesthetic protocols (isoflurane, isoflurane-xylazine, pentobarbital, ketamine-xylazine, and ketamine-xylazine-vecuronium) for functional blood flow imaging in the rat eye. Total retinal blood flow was measured at a series of time points using an ultrahigh-speed Doppler OCT system. Additionally, each anesthetic protocol was qualitatively evaluated according to the following criteria: (1) time-stability of blood flow, (2) overall rate of blood flow, (3) ocular immobilization, and (4) simplicity. We observed that different anesthetic protocols produced markedly different blood flows. Different anesthetic protocols also varied with respect to the four evaluated criteria. These findings suggest that the choice of anesthetic protocol should be carefully considered when designing and interpreting functional blood flow studies in the rat eye.

The use of high-fidelity human patient simulation as an evaluative tool in the development of clinical research protocols and procedures.

PubMed

Wright, Melanie C; Taekman, Jeffrey M; Barber, Linda; Hobbs, Gene; Newman, Mark F; Stafford-Smith, Mark

2005-12-01

Errors in clinical research can be costly, in terms of patient safety, data integrity, and data collection. Data inaccuracy in early subjects of a clinical study may be associated with problems in the design of the protocol, procedures, and data collection tools. High-fidelity patient simulation centers provide an ideal environment to apply human-centered design to clinical trial development. A draft of a complex clinical protocol was designed, evaluated and modified using a high-fidelity human patient simulator in the Duke University Human Simulation and Patient Safety Center. The process included walk-throughs, detailed modifications of the protocol and development of procedural aids. Training of monitors and coordinators provided an opportunity for observation of performance that was used to identify further improvements to the protocol. Evaluative steps were used to design the research protocol and procedures. Iterative modifications were made to the protocol and data collection tools. The success in use of human simulation in the preparation of a complex clinical drug trial suggests the benefits of human patient simulation extend beyond training and medical equipment evaluation. Human patient simulation can provide a context for informal expert evaluation of clinical protocol design and for formal "rehearsal" to evaluate the efficacy of procedures and support tools.

Selecting and Evaluating Software for Use in a Preschool Classroom: From the Young Child's and Researcher's Perspective.

ERIC Educational Resources Information Center

Vartuli, Sue; And Others

A 16-item evaluation form is presented to aid in selection of appropriate computerized game materials for preschool children. The form was derived from a 32-week-long study involving 66 children 3, 4, and 5 years of age who were allowed to play computer games during free play or work time while attending a modified Montessori preschool program. In…

Computerized planimetry evaluation of hyperbaric oxygen therapy in the treatment of diabetic foot.

PubMed

Kawecki, Marek; Pasek, Jarosław; Cieślar, Grzegorz; Sieroń, Aleksander; Knefel, Grzegorz; Nowak, Mariusz; Glik, Justyna

2018-01-01

Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. The aim of the study was to conduct a planimetry evaluation of the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of patients with vascular disorders caused by diabetic foot. The study included 94 patients, 30 females (32%) and 64 males (68%), aged 33-76 years, with diabetes lasting 1.5-32 years, who underwent HBOT due to diabetic foot. All patients from that group underwent vascular procedures prior to HBOT. In qualifying patients for hyperbaric oxygen therapy, transcutaneous oximetry method was applied (30-60 exposures in hyperbaric oxygen at pressure of 2.5 ATA). Progress in wound healing was evaluated by computerized planimetry system IRIS 4. In 26 patients the wounds were completely closed and in 37 patients the topical state was significantly improved - the wound surface decreased by 34% in average. During the treatment, in 11 patients amputation of fingers and metatarsal necrotic bones was performed, while in 9 patients amputation was prevented. A planimetry evaluation showed that the application of HBOT in the treatment of diabetic foot enhances foot ulcer healing, reduces tissue damage, contributes to the reduction of complications related to soft tissue and bone infections.

A new computerized diagnostic algorithm for quantitative evaluation of binocular misalignment in patients with strabismus

NASA Astrophysics Data System (ADS)

Nam, Kyoung Won; Kim, In Young; Kang, Ho Chul; Yang, Hee Kyung; Yoon, Chang Ki; Hwang, Jeong Min; Kim, Young Jae; Kim, Tae Yun; Kim, Kwang Gi

2012-10-01

Accurate measurement of binocular misalignment between both eyes is important for proper preoperative management, surgical planning, and postoperative evaluation of patients with strabismus. In this study, we proposed a new computerized diagnostic algorithm that can calculate the angle of binocular eye misalignment photographically by using a dedicated three-dimensional eye model mimicking the structure of the natural human eye. To evaluate the performance of the proposed algorithm, eight healthy volunteers and eight individuals with strabismus were recruited in this study, the horizontal deviation angle, vertical deviation angle, and angle of eye misalignment were calculated and the angular differences between the healthy and the strabismus groups were evaluated using the nonparametric Mann-Whitney test and the Pearson correlation test. The experimental results demonstrated a statistically significant difference between the healthy and strabismus groups (p = 0.015 < 0.05), but no statistically significant difference between the proposed method and the Krimsky test (p = 0.912 > 0.05). The measurements of the two methods were highly correlated (r = 0.969, p < 0.05). From the experimental results, we believe that the proposed diagnostic method has the potential to be a diagnostic tool that measures the physical disorder of the human eye to diagnose non-invasively the severity of strabismus.

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... conform to the technical specifications, including file requirements, described in the Federal Election Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal... outstanding campaign obligations. (b) Organization of computerized information and technical specifications...

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... conform to the technical specifications, including file requirements, described in the Federal Election Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal... outstanding campaign obligations. (b) Organization of computerized information and technical specifications...

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... conform to the technical specifications, including file requirements, described in the Federal Election Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal... outstanding campaign obligations. (b) Organization of computerized information and technical specifications...

Microcomputer Network for Computerized Adaptive Testing (CAT)

DTIC Science & Technology

1984-03-01

PRDC TR 84-33 \\Q.�d-33- \\ MICROCOMPUTER NETWOJlt FOR COMPUTERIZED ADAPTIVE TESTING ( CAT ) Baldwin Quan Thomas A . Park Gary Sandahl John H...ACCEIIION NO NPRDC TR 84-33 4. TITLE (-d Sul>tlllo) MICROCOMP UTER NETWORK FOR COMPUTERIZED ADA PTIVE TESTING ( CAT ) 1. Q B. uan T. A . Park...adaptive testing ( CAT ) Bayesian sequential testing 20. ABSTitACT (Continuo on ro•••• aide II noco .. _, _., ld-tlly ,.,. t.loclt _._.) DO Computerized

Computerized Adaptive Testing (CAT): A User Manual

DTIC Science & Technology

1984-03-12

NPRDC TR 84-32 COMPUTERIZED ADAPTIVE TESTING ( CAT ): A USER MANUAL Susan Hardwick Lawrence Eastman Ross Cooper Rehab Group, Incorporated San...a ~EI’IOD COVIRED COMPUTERIZED ADAPTIVE TESTING ( CAT ) Final Report Aug 1981-June 1982 A USER MANUAL 1. ~l:l’t,ORMINCI ORCI. RE~ORT NUM.I:R 62-83...II nee• .. _, entl ldentll)’ ,,. llloclr _,.,) A joint-service effort is underway to develop a computerized adaptive testing ( CAT ) system and to

Evaluation of computed tomography numbers for treatment planning of lung cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mira, J.G.; Fullerton, G.D.; Ezekiel, J.

1982-09-01

Computerized tomography numbers (CTN) were evaluated in 32 computerized tomography scans performed on patients with carcinoma of the lung, with the aim of evaluating CTN in normal (lung, blood, muscle, etc) and pathologic tissues (tumor, atelectasis, effusion, post-radiation fibrosis). Our main findings are: 1. Large individual CTN variations are encountered in both normal and pathologic tissues, above and below mean values. Hence, absolute numbers are meaningless. Measurements of any abnormal intrathoracic structure should be compared in relation to normal tissue CTN values in the same scan. 2. Tumor and complete atelectasis have CTN basically similar to soft tissue. Hence, thesemore » numbers are not useful for differential diagnosis. 3. Effusions usually have lower CTN and can be distinguished from previous situations. 4. Dosimetry based on uniform lung density assumptions (i.e., 300 mg/cm/sup 3/) might produce substantial dose errors as lung CTN exhibit variations indicating densities well above and below this value. 5. Preliminary information indicates that partial atelectasis and incipient post-radiation fibrosis can have very low CTN. Hence, they can be differentiated from solid tumors in certain cases, and help in differential diagnosis of post radiation recurrence within the radiotherapy field versus fibrosis.« less

The Naval Enlisted Professional Development Information System (NEPDIS): Front End Analysis (FEA) Process. Technical Report 159.

ERIC Educational Resources Information Center

Aagard, James A.; Ansbro, Thomas M.

The Naval Enlisted Professional Development Information System (NEPDIS) was designed to function as a fully computerized information assembly and analysis system to support labor force, personnel, and training management. The NEPDIS comprises separate training development, instructional, training record and evaluation, career development, and…

Computerized Testing in a Hospital Setting: Psychometric and Psychological Effects.

ERIC Educational Resources Information Center

Peterson, Leif; And Others

1996-01-01

This Swedish study sought to evaluate a touch-screen computer-based (CB) test administration system in a hospital setting in comparison with paper-and-pencil administrative routine. Patients were given psychometric tests (involving depression, mood, and intelligence measurement) in both formats. Patient pleasantness, activation, and calmness were…

Ability Level Estimation of Students on Probability Unit via Computerized Adaptive Testing

ERIC Educational Resources Information Center

Özyurt, Hacer; Özyurt, Özcan

2015-01-01

Problem Statement: Learning-teaching activities bring along the need to determine whether they achieve their goals. Thus, multiple choice tests addressing the same set of questions to all are frequently used. However, this traditional assessment and evaluation form contrasts with modern education, where individual learning characteristics are…

JPRS Report, Science & Technology, Europe, EC Commissioners Evaluate Electronics, Computer Industries

DTIC Science & Technology

1991-06-14

American firms of foreign origin as regards R&TD is being practised by the Department of Defense, and Sematech is one example here. As negotiations... taxation measures. Training schemes for staff in the banking sector encom- passing both the financial side and computerized sys- tems applications

Computerization of School Administration: Impact on the Principal's Role--A Case Study.

ERIC Educational Resources Information Center

Telem, Moshe

2001-01-01

Describes a study at an Israeli high school that investigated changes in the principal's role as the result of the introduction of a school management information system (SMIS). Discusses information handling and flow, interrelations with teachers, accountability, instruction evaluation, supervision, feedback, frequency of meetings, and shared…

Evaluation of the CATSIB DIF Procedure in a Pretest Setting

ERIC Educational Resources Information Center

Nandakumar, Ratna; Roussos, Louis

2004-01-01

A new procedure, CATSIB, for assessing differential item functioning (DIF) on computerized adaptive tests (CATs) is proposed. CATSIB, a modified SIBTEST procedure, matches test takers on estimated ability and controls for impact-induced Type 1 error inflation by employing a CAT version of the IBTEST "regression correction." The…

Development and Evaluation of a Computerized Engagement Intervention for IPS Supported Employment

ERIC Educational Resources Information Center

Haslett, William R.

2013-01-01

Background: Current information technology offers the promise of innovative approaches to engagement for mental health. Specific psychosocial services may also benefit from technology-based engagement interventions. Individual Placement and Support (IPS) is an evidence-based service that helps people who have a severe mental illness to gain…

A Comparison Study of Item Exposure Control Strategies in MCAT

ERIC Educational Resources Information Center

Mao, Xiuzhen; Ozdemir, Burhanettin; Wang, Yating; Xiu, Tao

2016-01-01

Four item selection indexes with and without exposure control are evaluated and compared in multidimensional computerized adaptive testing (CAT). The four item selection indices are D-optimality, Posterior expectation Kullback-Leibler information (KLP), the minimized error variance of the linear combination score with equal weight (V1), and the…

Guide to the Use of Information. Question Negotiation, Search Delivery, Search Evaluation.

ERIC Educational Resources Information Center

Kansas State Dept. of Education, Topeka.

This guide to the use of information reviews the development of Kansas Project Communicate from 1972-1976, and the Kansas State Department of Education (KSDE) computerized information service (KEDDS), which serves as the resource component of the information dissemination system. KEDDS (Kansas Educational Dissemination Diffusion system) is…

Topographic Brain Mapping: A Window on Brain Function?

ERIC Educational Resources Information Center

Karniski, Walt M.

1989-01-01

The article reviews the method of topographic mapping of the brain's electrical activity. Multiple electroencephalogram (EEG) electrodes and computerized analysis of the EEG signal are used to generate maps of frequency and voltage (evoked potential). This relatively new technique holds promise in the evaluation of children with behavioral and…

A Comparative Evaluation of Computer Based and Non-Computer Based Instructional Strategies.

ERIC Educational Resources Information Center

Emerson, Ian

1988-01-01

Compares the computer assisted instruction (CAI) tutorial with its non-computerized pedagogical roots: the Socratic Dialog with Skinner's Programmed Instruction. Tests the effectiveness of a CAI tutorial on diffusion and osmosis against four other interactive and non-interactive instructional strategies. Notes computer based strategies were…

Optical analysis of crystal growth

NASA Technical Reports Server (NTRS)

Workman, Gary L.; Passeur, Andrea; Harper, Sabrina

1994-01-01

Processing and data reduction of holographic images from Spacelab presents some interesting challenges in determining the effects of microgravity on crystal growth processes. Evaluation of several processing techniques, including the Computerized Holographic Image Processing System and the image processing software ITEX150, will provide fundamental information for holographic analysis of the space flight data.

Cambridge Crystallographic Data Centre. II. Structural Data File

ERIC Educational Resources Information Center

Allen, F. H.; And Others

1973-01-01

The Cambridge Crystallographic Data Centre is concerned with the retrieval, evaluation, synthesis, and dissemination of structural data obtained by diffraction methods. This article (Part I is EJ053033) describes the work of the center and deals with the organization and maintenance of a computerized file of numeric crystallographic structural…

Self-Report Measures of Juvenile Psychopathic Personality Traits: A Comparative Review

ERIC Educational Resources Information Center

Vaughn, Michael G.; Howard, Matthew O.

2005-01-01

The authors evaluated self-report instruments currently being used to assess children and adolescents with psychopathic personality traits with respect to their reliability, validity, and research utility. Comprehensive searches across multiple computerized bibliographic databases were conducted and supplemented with manual searches. A total of 30…

Towards a framework for developing semantic relatedness reference standards.

PubMed

Pakhomov, Serguei V S; Pedersen, Ted; McInnes, Bridget; Melton, Genevieve B; Ruggieri, Alexander; Chute, Christopher G

2011-04-01

Our objective is to develop a framework for creating reference standards for functional testing of computerized measures of semantic relatedness. Currently, research on computerized approaches to semantic relatedness between biomedical concepts relies on reference standards created for specific purposes using a variety of methods for their analysis. In most cases, these reference standards are not publicly available and the published information provided in manuscripts that evaluate computerized semantic relatedness measurement approaches is not sufficient to reproduce the results. Our proposed framework is based on the experiences of medical informatics and computational linguistics communities and addresses practical and theoretical issues with creating reference standards for semantic relatedness. We demonstrate the use of the framework on a pilot set of 101 medical term pairs rated for semantic relatedness by 13 medical coding experts. While the reliability of this particular reference standard is in the "moderate" range; we show that using clustering and factor analyses offers a data-driven approach to finding systematic differences among raters and identifying groups of potential outliers. We test two ontology-based measures of relatedness and provide both the reference standard containing individual ratings and the R program used to analyze the ratings as open-source. Currently, these resources are intended to be used to reproduce and compare results of studies involving computerized measures of semantic relatedness. Our framework may be extended to the development of reference standards in other research areas in medical informatics including automatic classification, information retrieval from medical records and vocabulary/ontology development. Copyright © 2010 Elsevier Inc. All rights reserved.

“Computerized Counseling Reduces HIV-1 Viral Load and Sexual Transmission Risk: Findings from a Randomized Controlled Trial”

PubMed Central

KURTH, Ann E.; SPIELBERG, Freya; CLELAND, Charles M.; LAMBDIN, Barrot; BANGSBERG, David R.; FRICK, Pamela A.; SEVERYNEN, Anneleen O.; CLAUSEN, Marc; NORMAN, Robert G.; LOCKHART, David; SIMONI, Jane M.; HOLMES, King K.

2014-01-01

Objective Evaluate a computerized intervention supporting antiretroviral therapy (ART) adherence and HIV transmission prevention. Design Longitudinal RCT. Settings An academic HIV clinic and a community-based organization in Seattle. Subjects 240 HIV-positive adults on ART; 209 completed nine-month follow-up (87% retention). Intervention Randomization to computerized counseling or assessment-only, 4 sessions over 9 months. Main Outcome Measures HIV-1 viral suppression, and self-reported ART adherence, and transmission risks, compared using generalized estimating equations. Results Overall, intervention participants had reduced viral load (VL): mean 0.17 log10 decline, versus 0.13 increase in controls, p = 0.053, and significant difference in ART adherence baseline to 9 months (p = 0.046). Their sexual transmission risk behaviors decreased (OR = 0.55, p = 0.020), a reduction not seen among controls (OR = 1.1, p = 0.664), and a significant difference in change (p = 0.040). Intervention effect was driven by those most in need: among those with detectable virus at baseline (>30 copies/milliliter, n=89), intervention effect was mean 0.60 log10 VL decline versus 0.15 increase in controls, p=0.034. ART adherence at the final follow-up was 13 points higher among intervention participants versus controls, p = 0.038. Conclusions Computerized counseling is promising for integrated ART adherence and safer sex, especially for individuals with problems in these areas. This is the first intervention to report improved ART adherence, viral suppression, and reduced secondary sexual transmission risk behavior. PMID:24384803

Neurosurgery simulation in residency training: feasibility, cost, and educational benefit.

PubMed

Gasco, Jaime; Holbrook, Thomas J; Patel, Achal; Smith, Adrian; Paulson, David; Muns, Alan; Desai, Sohum; Moisi, Marc; Kuo, Yong-Fan; Macdonald, Bart; Ortega-Barnett, Juan; Patterson, Joel T

2013-10-01

The effort required to introduce simulation in neurosurgery academic programs and the benefits perceived by residents have not been systematically assessed. To create a neurosurgery simulation curriculum encompassing basic and advanced skills, cadaveric dissection, cranial and spine surgery simulation, and endovascular and computerized haptic training. A curriculum with 68 core exercises per academic year was distributed in individualized sets of 30 simulations to 6 neurosurgery residents. The total number of procedures completed during the academic year was set to 180. The curriculum includes 79 simulations with physical models, 57 cadaver dissections, and 44 haptic/computerized sessions. Likert-type evaluations regarding self-perceived performance were completed after each exercise. Subject identification was blinded to junior (postgraduate years 1-3) or senior resident (postgraduate years 4-6). Wilcoxon rank testing was used to detect differences within and between groups. One hundred eighty procedures and surveys were analyzed. Junior residents reported proficiency improvements in 82% of simulations performed (P < .001). Senior residents reported improvement in 42.5% of simulations (P < .001). Cadaver simulations accrued the highest reported benefit (71.5%; P < .001), followed by physical simulators (63.8%; P < .001) and haptic/computerized (59.1; P < .001). Initial cost is $341,978.00, with $27,876.36 for annual operational expenses. The systematic implementation of a simulation curriculum in a neurosurgery training program is feasible, is favorably regarded, and has a positive impact on trainees of all levels, particularly in junior years. All simulation forms, cadaver, physical, and haptic/computerized, have a role in different stages of learning and should be considered in the development of an educational simulation program.

Evaluation of interactive computerized training to teach parents to implement photographic activity schedules with children with autism spectrum disorder.

PubMed

Gerencser, Kristina R; Higbee, Thomas S; Akers, Jessica S; Contreras, Bethany P

2017-07-01

Training parents of children with autism spectrum disorder can be a challenge due to limited resources, time, and money. Interactive computerized training (ICT)-a self-paced program that incorporates instructions, videos, and interactive questions-is one method professionals can use to disseminate trainings to broader populations. This study extends previous research on ICT by assessing the effect of ICT to teach three parents how to implement a photographic activity schedule using a systematic prompting procedure with their child. Following ICT, all parents increased their fidelity to implementation of an activity schedule during role-play sessions with an adult. Fidelity remained high during implementation with their child and maintained during a 2-week follow-up. © 2017 Society for the Experimental Analysis of Behavior.

Computerized content analysis of some adolescent writings of Napoleon Bonaparte: a test of the validity of the method.

PubMed

Gottschalk, Louis A; DeFrancisco, Don; Bechtel, Robert J

2002-08-01

The aim of this study was to test the validity of a computer software program previously demonstrated to be capable of making DSM-IV neuropsychiatric diagnoses from the content analysis of speech or verbal texts. In this report, the computer program was applied to three personal writings of Napoleon Bonaparte when he was 12 to 16 years of age. The accuracy of the neuropsychiatric evaluations derived from the computerized content analysis of these writings of Napoleon was independently corroborated by two biographers who have described pertinent details concerning his life situations, moods, and other emotional reactions during this adolescent period of his life. The relevance of this type of computer technology to psychohistorical research and clinical psychiatry is suggested.

Visualization techniques for tongue analysis in traditional Chinese medicine

NASA Astrophysics Data System (ADS)

Pham, Binh L.; Cai, Yang

2004-05-01

Visual inspection of the tongue has been an important diagnostic method of Traditional Chinese Medicine (TCM). Clinic data have shown significant connections between various viscera cancers and abnormalities in the tongue and the tongue coating. Visual inspection of the tongue is simple and inexpensive, but the current practice in TCM is mainly experience-based and the quality of the visual inspection varies between individuals. The computerized inspection method provides quantitative models to evaluate color, texture and surface features on the tongue. In this paper, we investigate visualization techniques and processes to allow interactive data analysis with the aim to merge computerized measurements with human expert's diagnostic variables based on five-scale diagnostic conditions: Healthy (H), History Cancers (HC), History of Polyps (HP), Polyps (P) and Colon Cancer (C).

Preliminary performance estimates of a highly maneuverable remotely piloted vehicle. [computerized synthesis program to assess effects of vehicle and mission parameters

NASA Technical Reports Server (NTRS)

Nelms, W. P., Jr.; Axelson, J. A.

1974-01-01

A computerized synthesis program has been used to assess the effects of various vehicle and mission parameters on the performance of a highly maneuverable remotely piloted vehicle (RPV) for the air-to-air combat role. The configuration used in the study is a trapezoidal-wing and body concept, with forward-mounted stabilizing and control surfaces. The study mission consists of an outbound cruise, an acceleration phase, a series of subsonic and supersonic turns, and a return cruise. Performance is evaluated in terms of both the required vehicle weight to accomplish this mission and combat effectiveness as measured by turning and acceleration capability. The report describes the synthesis program, the mission, the vehicle, and the results of sensitivity and trade studies.

Quantification of osteolytic bone lesions in a preclinical rat trial

NASA Astrophysics Data System (ADS)

Fränzle, Andrea; Bretschi, Maren; Bäuerle, Tobias; Giske, Kristina; Hillengass, Jens; Bendl, Rolf

2013-10-01

In breast cancer, most of the patients who died, have developed bone metastasis as disease progression. Bone metastases in case of breast cancer are mainly bone destructive (osteolytic). To understand pathogenesis and to analyse response to different treatments, animal models, in our case rats, are examined. For assessment of treatment response to bone remodelling therapies exact segmentations of osteolytic lesions are needed. Manual segmentations are not only time-consuming but lack in reproducibility. Computerized segmentation tools are essential. In this paper we present an approach for the computerized quantification of osteolytic lesion volumes using a comparison to a healthy reference model. The presented qualitative and quantitative evaluation of the reconstructed bone volumes show, that the automatically segmented lesion volumes complete missing bone in a reasonable way.

Resources for Improving Computerized Learning Environments.

ERIC Educational Resources Information Center

Yeaman, Andrew R. J.

1989-01-01

Presents an annotated review of human factors literature that discusses computerized environments. Topics discussed include the application of office automation practices to educational environments; video display terminal (VDT) workstations; health and safety hazards; planning educational facilities; ergonomics in computerized offices; and…

An overview of selected information storage and retrieval issues in computerized document processing

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Ihebuzor, Valentine U.

1984-01-01

The rapid development of computerized information storage and retrieval techniques has introduced the possibility of extending the word processing concept to document processing. A major advantage of computerized document processing is the relief of the tedious task of manual editing and composition usually encountered by traditional publishers through the immense speed and storage capacity of computers. Furthermore, computerized document processing provides an author with centralized control, the lack of which is a handicap of the traditional publishing operation. A survey of some computerized document processing techniques is presented with emphasis on related information storage and retrieval issues. String matching algorithms are considered central to document information storage and retrieval and are also discussed.

Development and validation of a remote home safety protocol.

PubMed

Romero, Sergio; Lee, Mi Jung; Simic, Ivana; Levy, Charles; Sanford, Jon

2018-02-01

Environmental assessments and subsequent modifications conducted by healthcare professionals can enhance home safety and promote independent living. However, travel time, expense and the availability of qualified professionals can limit the broad application of this intervention. Remote technology has the potential to increase access to home safety evaluations. This study describes the development and validation of a remote home safety protocol that can be used by a caregiver of an elderly person to video-record their home environment for later viewing and evaluation by a trained professional. The protocol was developed based on literature reviews and evaluations from clinical and content experts. Cognitive interviews were conducted with a group of six caregivers to validate the protocol. The final protocol included step-by-step directions to record indoor and outdoor areas of the home. The validation process resulted in modifications related to safety, clarity of the protocol, readability, visual appearance, technical descriptions and usability. Our final protocol includes detailed instructions that a caregiver should be able to follow to record a home environment for subsequent evaluation by a home safety professional. Implications for Rehabilitation The results of this study have several implications for rehabilitation practice The remote home safety evaluation protocol can potentially improve access to rehabilitation services for clients in remote areas and prevent unnecessary delays for needed care. Using our protocol, a patient's caregiver can partner with therapists to quickly and efficiently evaluate a patient's home before they are released from the hospital. Caregiver narration, which reflects a caregiver's own perspective, is critical to evaluating home safety. In-home safety evaluations, currently not available to all who need them due to access barriers, can enhance a patient's independence and provide a safer home environment.

Computerized Sociometric Assessment for Preschool Children

ERIC Educational Resources Information Center

Endedijk, Hinke M.; Cillessen, Antonius H. N.

2015-01-01

In preschool classes, sociometric peer ratings are used to measure children's peer relationships. The current study examined a computerized version of preschool sociometric ratings. The psychometric properties were compared of computerized sociometric ratings and traditional peer ratings for preschoolers. The distributions, inter-item…

Evaluation of the validity of the Psychology Experiment Building Language tests of vigilance, auditory memory, and decision making.

PubMed

Piper, Brian; Mueller, Shane T; Talebzadeh, Sara; Ki, Min Jung

2016-01-01

Background. The Psychology Experimental Building Language (PEBL) test battery (http://pebl.sourceforge.net/) is a popular application for neurobehavioral investigations. This study evaluated the correspondence between the PEBL and the non-PEBL versions of four executive function tests. Methods. In one cohort, young-adults (N = 44) completed both the Conner's Continuous Performance Test (CCPT) and the PEBL CPT (PCPT) with the order counter-balanced. In a second cohort, participants (N = 47) completed a non-computerized (Wechsler) and a computerized (PEBL) Digit Span (WDS or PDS) both Forward and Backward. Participants also completed the Psychological Assessment Resources or the PEBL versions of the Iowa Gambling Task (PARIGT or PEBLIGT). Results. The between-test correlations were moderately high (reaction time r = 0.78, omission errors r = 0.65, commission errors r = 0.66) on the CPT. DS Forward was significantly greater than DS Backward on the WDS (p < .0005) and the PDS (p < .0005). The total WDS score was moderately correlated with the PDS (r = 0.56). The PARIGT and the PEBLIGTs showed a very similar pattern for response times across blocks, development of preference for Advantageous over Disadvantageous Decks, and Deck selections. However, the amount of money earned (score-loan) was significantly higher in the PEBLIGT during the last Block. Conclusions. These findings are broadly supportive of the criterion validity of the PEBL measures of sustained attention, short-term memory, and decision making. Select differences between workalike versions of the same test highlight how detailed aspects of implementation may have more important consequences for computerized testing than has been previously acknowledged.

Implementation of a Computerized Order Entry Tool to Reduce the Inappropriate and Unnecessary Use of Cardiac Stress Tests With Imaging in Hospitalized Patients.

PubMed

Gertz, Zachary M; O'Donnell, William; Raina, Amresh; Balderston, Jessica R; Litwack, Andrew J; Goldberg, Lee R

2016-10-15

The rising use of imaging cardiac stress tests has led to potentially unnecessary testing. Interventions designed to reduce inappropriate stress testing have focused on the ambulatory setting. We developed a computerized order entry tool intended to reduce the use of imaging cardiac stress tests and improve appropriate use in hospitalized patients. The tool was evaluated using preimplementation and postimplementation cohorts at a single urban academic teaching hospital. All hospitalized patients referred for testing were included. The co-primary outcomes were the use of imaging stress tests as a percentage of all stress tests and the percentage of inappropriate tests, compared between the 2 cohorts. There were 478 patients in the precohort and 463 in the postcohort. The indication was chest pain in 66% and preoperative in 18% and was not significantly different between groups. The use of nonimaging stress tests increased from 4% in the pregroup to 15% in the postgroup (p <0.001). Among very low-risk chest pain patients, the use of nonimaging stress tests increased from 7% to 25% (p <0.001). Inappropriate testing did not change significantly between groups (12% vs 11%). Inappropriate tests were most often preoperative evaluations (83%). In conclusion, our computerized ordering tool significantly increased the use of nonimaging cardiac stress tests and reduced the use of imaging tests yet was not able to reduce inappropriate use. Our study highlights the differences in cardiac stress testing between hospitalized and ambulatory patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Visual Function Metrics in Early and Intermediate Dry Age-related Macular Degeneration for Use as Clinical Trial Endpoints.

PubMed

Cocce, Kimberly J; Stinnett, Sandra S; Luhmann, Ulrich F O; Vajzovic, Lejla; Horne, Anupama; Schuman, Stefanie G; Toth, Cynthia A; Cousins, Scott W; Lad, Eleonora M

2018-05-01

To evaluate and quantify visual function metrics to be used as endpoints of age-related macular degeneration (AMD) stages and visual acuity (VA) loss in patients with early and intermediate AMD. Cross-sectional analysis of baseline data from a prospective study. One hundred and one patients were enrolled at Duke Eye Center: 80 patients with early AMD (Age-Related Eye Disease Study [AREDS] stage 2 [n = 33] and intermediate stage 3 [n = 47]) and 21 age-matched, normal controls. A dilated retinal examination, macular pigment optical density measurements, and several functional assessments (best-corrected visual acuity, macular integrity assessment mesopic microperimety, dark adaptometry, low-luminance visual acuity [LLVA] [standard using a log 2.0 neutral density filter and computerized method], and cone contrast test [CCT]) were performed. Low-luminance deficit (LLD) was defined as the difference in numbers of letters read at standard vs low luminance. Group comparisons were performed to evaluate differences between the control and the early and intermediate AMD groups using 2-sided significance tests. Functional measures that significantly distinguished between normal and intermediate AMD were standard and computerized (0.5 cd/m 2 ) LLVA, percent reduced threshold and average threshold on microperimetry, CCTs, and rod intercept on dark adaptation (P < .05). The intermediate group demonstrated deficits in microperimetry reduced threshhold, computerized LLD2, and dark adaptation (P < .05) relative to early AMD. Our study suggests that LLVA, microperimetry, CCT, and dark adaptation may serve as functional measures differentiating early-to-intermediate stages of dry AMD. Copyright © 2018 Elsevier Inc. All rights reserved.

Assessing older drivers: a primary care protocol to evaluate driving safety risk.

PubMed

Murden, Robert A; Unroe, Kathleen

2005-08-01

Most articles on elder drivers offer either general advice, or review testing protocols that divide drivers into two distinct groups: safe or unsafe. We believe it is unreasonable to expect any testing to fully separate drivers into just these two mutually exclusive groups, so we offer a protocol for a more practical approach. This protocol can be applied by primary care physicians. We review the justification for the many steps of this protocol, which have branches that lead to identifying drivers as low risk, high risk (for accidents) or needing further evaluation. Options for further evaluation are provided.

Hypoxia-induced changes in standing balance.

PubMed

Wagner, Linsey S; Oakley, Sarah R; Vang, Pao; Noble, Brie N; Cevette, Michael J; Stepanek, Jan P

2011-05-01

A few studies in the literature have reported postural changes with hypoxia, but none have quantified the magnitude of change. Further understanding of this condition could have implications for patients at risk for falls, individuals undergoing acute altitude exposure, and pilots and commercial passengers. The objective of this study was to evaluate the effect of different levels of hypoxia (oxygen nitrogen mixtures) on postural standing balance using the computerized dynamic posturography (CDP) system. This improves upon previous protocols by manipulating vision and standing balance with a sway-referenced visual field and/or platform. Additionally, normative data were available for comparison with the cumulative test scores and scores for each condition. Altitude hypoxia was simulated by use of admixing nitrogen to the breathing gas to achieve equivalent altitudes of 1524 m, 2438 m, and 3048 m. Subjects were evaluated using the CDP system. Subjects showed an overall trend toward decreased performance at higher simulated altitudes consistent with the initial hypothesis. Composite standing balance sway scores for the sensory organization subtest of CDP were decreased compared to baseline for simulated altitudes as low as 2438 m (mean sway scores: 81.92 at baseline; 81.85 at 1524 m; 79.15 at 2438 m; 79.15 at 3048 m). Reaction times to unexpected movements in the support surface for the motor control subtest (MCT) increased compared to baseline (mean composite scores: 133.3 at baseline; 135.9 ms at 1524 m; 138.0 ms at 2438 m; 140.9 ms at 3048 m). The CDP testing provided a reliable objective measurement of degradation of balance under hypoxic conditions.

Who needs inpatient detox? Development and implementation of a hospitalist protocol for the evaluation of patients for alcohol detoxification.

PubMed

Stephens, John R; Liles, E Allen; Dancel, Ria; Gilchrist, Michael; Kirsch, Jonathan; DeWalt, Darren A

2014-04-01

Clinicians caring for patients seeking alcohol detoxification face many challenges, including lack of evidence-based guidelines for treatment and high recidivism rates. To develop a standardized protocol for determining which alcohol dependent patients seeking detoxification need inpatient versus outpatient treatment, and to study the protocol's implementation. Review of best evidence by ad hoc task force and subsequent creation of standardized protocol. Prospective observational evaluation of initial protocol implementation. Patients presenting for alcohol detoxification. Development and implementation of a protocol for evaluation and treatment of patients requesting alcohol detoxification. Number of admissions per month with primary alcohol related diagnosis (DRG), 30-day readmission rate, and length of stay, all measured before and after protocol implementation. We identified one randomized clinical trial and three cohort studies to inform the choice of inpatient versus outpatient detoxification, along with one prior protocol in this population, and combined that data with clinical experience to create an institutional protocol. After implementation, the average number of alcohol related admissions was 15.9 per month, compared with 18.9 per month before implementation (p = 0.037). There was no difference in readmission rate or length of stay. Creation and utilization of a protocol led to standardization of care for patients requesting detoxification from alcohol. Initial evaluation of protocol implementation showed a decrease in number of admissions.

A protocol for evaluating video trackers under real-world conditions.

PubMed

Nawaz, Tahir; Cavallaro, Andrea

2013-04-01

The absence of a commonly adopted performance evaluation framework is hampering advances in the design of effective video trackers. In this paper, we present a single-score evaluation measure and a protocol to objectively compare trackers. The proposed measure evaluates tracking accuracy and failure, and combines them for both summative and formative performance assessment. The proposed protocol is composed of a set of trials that evaluate the robustness of trackers on a range of test scenarios representing several real-world conditions. The protocol is validated on a set of sequences with a diversity of targets (head, vehicle and person) and challenges (occlusions, background clutter, pose changes and scale changes) using six state-of-the-art trackers, highlighting their strengths and weaknesses on more than 187000 frames. The software implementing the protocol and the evaluation results are made available online and new results can be included, thus facilitating the comparison of trackers.

Chapter 15: Commercial New Construction Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurnik, Charles W.; Keates, Steven

This protocol is intended to describe the recommended method when evaluating the whole-building performance of new construction projects in the commercial sector. The protocol focuses on energy conservation measures (ECMs) or packages of measures where evaluators can analyze impacts using building simulation. These ECMs typically require the use of calibrated building simulations under Option D of the International Performance Measurement and Verification Protocol (IPMVP).

78 FR 17940 - Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

..., Software, Implants, and Components Thereof; Notice of Receipt of Complaint; Solicitation of Comments... Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof, DN 2945; the... importation of certain computerized orthopedic surgical devices, software, implants, and components thereof...

Designing a Computerized Presentation Center.

ERIC Educational Resources Information Center

Christopher, Doris A.

1995-01-01

The Office Systems and Business Education Department at California State University (Los Angeles) developed a computerized presentation center, with multimedia classrooms and a multipurpose room, where students learn computerized presentation design skills, faculty can develop materials for class, and local business can do videoconferencing and…

Fiber Optic Communication System For Medical Images

NASA Astrophysics Data System (ADS)

Arenson, Ronald L.; Morton, Dan E.; London, Jack W.

1982-01-01

This paper discusses a fiber optic communication system linking ultrasound devices, Computerized tomography scanners, Nuclear Medicine computer system, and a digital fluoro-graphic system to a central radiology research computer. These centrally archived images are available for near instantaneous recall at various display consoles. When a suitable laser optical disk is available for mass storage, more extensive image archiving will be added to the network including digitized images of standard radiographs for comparison purposes and for remote display in such areas as the intensive care units, the operating room, and selected outpatient departments. This fiber optic system allows for a transfer of high resolution images in less than a second over distances exceeding 2,000 feet. The advantages of using fiber optic cables instead of typical parallel or serial communication techniques will be described. The switching methodology and communication protocols will also be discussed.

Incentives and Barriers That Influence Clinical Computerization in Hong Kong: A Population-based Physician Survey

PubMed Central

Leung, Gabriel M.; Yu, Philip L. H.; Wong, Irene O. L.; Johnston, Janice M.; Tin, Keith Y. K.

2003-01-01

Objective: Given the slow adoption of medical informatics in Hong Kong and Asia, we sought to understand the contributory barriers and potential incentives associated with information technology implementation. Design and Measurements: A representative sample of 949 doctors (response rate = 77.0%) was asked through a postal survey to rank a list of nine barriers associated with clinical computerization according to self-perceived importance. They ranked seven incentives or catalysts that may influence computerization. We generated mean rank scores and used multidimensional preference analysis to explore key explanatory dimensions of these variables. A hierarchical cluster analysis was performed to identify homogenous subgroups of respondents. We further determined the relationships between the sets of barriers and incentives/catalysts collectively using canonical correlation. Results: Time costs, lack of technical support and large capital investments were the biggest barriers to computerization, whereas improved office efficiency and better-quality care were ranked highest as potential incentives to computerize. Cost vs. noncost, physician-related vs. patient-related, and monetary vs. nonmonetary factors were the key dimensions explaining the barrier variables. Similarly, within-practice vs external and “push” vs “pull” factors accounted for the incentive variables. Four clusters were identified for barriers and three for incentives/catalysts. Canonical correlation revealed that respondents who were concerned with the costs of computerization also perceived financial incentives and government regulation to be important incentives/catalysts toward computerization. Those who found the potential interference with communication important also believed that the promise of improved care from computerization to be a significant incentive. Conclusion: This study provided evidence regarding common barriers associated with clinical computerization. Our findings also identified possible incentive strategies that may be employed to accelerate uptake of computer systems. PMID:12595409

Can computerized tomography accurately stage childhood renal tumors?

PubMed

Abdelhalim, Ahmed; Helmy, Tamer E; Harraz, Ahmed M; Abou-El-Ghar, Mohamed E; Dawaba, Mohamed E; Hafez, Ashraf T

2014-07-01

Staging of childhood renal tumors is crucial for treatment planning and outcome prediction. We sought to identify whether computerized tomography could accurately predict the local stage of childhood renal tumors. We retrospectively reviewed our database for patients diagnosed with childhood renal tumors and treated surgically between 1990 and 2013. Inability to retrieve preoperative computerized tomography, intraoperative tumor spillage and nonWilms childhood renal tumors were exclusion criteria. Local computerized tomography stage was assigned by a single experienced pediatric radiologist blinded to the pathological stage, using a consensus similar to the Children's Oncology Group Wilms tumor staging system. Tumors were stratified into up-front surgery and preoperative chemotherapy groups. The radiological stage of each tumor was compared to the pathological stage. A total of 189 tumors in 179 patients met inclusion criteria. Computerized tomography staging matched pathological staging in 68% of up-front surgery (70 of 103), 31.8% of pre-chemotherapy (21 of 66) and 48.8% of post-chemotherapy scans (42 of 86). Computerized tomography over staged 21.4%, 65.2% and 46.5% of tumors in the up-front surgery, pre-chemotherapy and post-chemotherapy scans, respectively, and under staged 10.7%, 3% and 4.7%. Computerized tomography staging was more accurate in tumors managed by up-front surgery (p <0.001) and those without extracapsular extension (p <0.001). The validity of computerized tomography staging of childhood renal tumors remains doubtful. This staging is more accurate for tumors treated with up-front surgery and those without extracapsular extension. Preoperative computerized tomography can help to exclude capsular breach. Treatment strategy should be based on surgical and pathological staging to avoid the hazards of inaccurate staging. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: methods of a decision-maker-researcher partnership systematic review.

PubMed

Haynes, R Brian; Wilczynski, Nancy L

2010-02-05

Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Data will be summarized using descriptive summary measures, including proportions for categorical variables and means for continuous variables. Univariable and multivariable logistic regression models will be used to investigate associations between outcomes of interest and study specific covariates. When reporting results from individual studies, we will cite the measures of association and p-values reported in the studies. If appropriate for groups of studies with similar features, we will conduct meta-analyses. A decision-maker-researcher partnership provides a model for systematic reviews that may foster knowledge translation and uptake.

A multicentre evaluation of two intensive care unit triage protocols for use in an influenza pandemic.

PubMed

Cheung, Winston K; Myburgh, John; Seppelt, Ian M; Parr, Michael J; Blackwell, Nikki; Demonte, Shannon; Gandhi, Kalpesh; Hoyling, Larissa; Nair, Priya; Passer, Melissa; Reynolds, Claire; Saunders, Nicholas M; Saxena, Manoj K; Thanakrishnan, Govindasamy

2012-08-06

To determine the increase in intensive care unit (ICU) bed availability that would result from the use of the New South Wales and Ontario Health Plan for an Influenza Pandemic (OHPIP) triage protocols. Prospective evaluation study conducted in eight Australian, adult, general ICUs, between September 2009 and May 2010. All patients who were admitted to the ICU, excluding those who had elective surgery, were prospectively evaluated using the two triage protocols, simulating a pandemic situation. Both protocols were originally developed to determine which patients should be excluded from accessing ICU resources during an influenza pandemic. Increase in ICU bed availability. At admission, the increases in ICU bed availability using Tiers 1, 2 and 3 of the NSW triage protocol were 3.5%, 14.7% and 22.7%, respectively, and 52.8% using the OHPIP triage protocol (P < 0.001). Re-evaluation of patients at 12 hours after admission using Tiers 1, 2 and 3 of the NSW triage protocol incrementally increased ICU bed availability by 19.2%, 16.1% and 14.1%, respectively (P < 0.001). The maximal cumulative increases in ICU bed availability using Tiers 1, 2 and 3 of the NSW triage protocol were 23.7%, 31.6% and 37.5%, respectively, at 72 hours (P < 0.001), and 65.0% using the OHPIP triage protocol, at 120 hours (P < 0.001). Both triage protocols resulted in increases in ICU bed availability, but the OHPIP protocol provided the greatest increase overall. With the NSW triage protocol, ICU bed availability increased as the protocol was escalated.

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

Innovations in Computerized Assessment.

ERIC Educational Resources Information Center

Drasgow, Fritz, Ed.; Olson-Buchanan, Julie B., Ed.

Chapters in this book present the challenges and dilemmas faced by researchers as they created new computerized assessments, focusing on issues addressed in developing, scoring, and administering the assessments. Chapters are: (1) "Beyond Bells and Whistles; An Introduction to Computerized Assessment" (Julie B. Olson-Buchanan and Fritz Drasgow);…

Advanced Composition and the Computerized Library.

ERIC Educational Resources Information Center

Hult, Christine

1989-01-01

Discusses four kinds of computerized access tools: online catalogs; computerized reference; online database searching; and compact disks and read only memory (CD-ROM). Examines how these technologies are changing research. Suggests how research instruction in advanced writing courses can be refocused to include the new technologies. (RS)

Computerized neurocognitive testing in the management of sport-related concussion: an update.

PubMed

Resch, Jacob E; McCrea, Michael A; Cullum, C Munro

2013-12-01

Since the late nineties, computerized neurocognitive testing has become a central component of sport-related concussion (SRC) management at all levels of sport. In 2005, a review of the available evidence on the psychometric properties of four computerized neuropsychological test batteries concluded that the tests did not possess the necessary criteria to warrant clinical application. Since the publication of that review, several more computerized neurocognitive tests have entered the market place. The purpose of this review is to summarize the body of published studies on psychometric properties and clinical utility of computerized neurocognitive tests available for use in the assessment of SRC. A review of the literature from 2005 to 2013 was conducted to gather evidence of test-retest reliability and clinical validity of these instruments. Reviewed articles included both prospective and retrospective studies of primarily sport-based adult and pediatric samples. Summaries are provided regarding the available evidence of reliability and validity for the most commonly used computerized neurocognitive tests in sports settings.

Measuring value for money: a scoping review on economic evaluation of health information systems

PubMed Central

Bassi, Jesdeep; Lau, Francis

2013-01-01

Objective To explore how key components of economic evaluations have been included in evaluations of health information systems (HIS), to determine the state of knowledge on value for money for HIS, and provide guidance for future evaluations. Materials and methods We searched databases, previously collected papers, and references for relevant papers published from January 2000 to June 2012. For selection, papers had to: be a primary study; involve a computerized system for health information processing, decision support, or management reporting; and include an economic evaluation. Data on study design and economic evaluation methods were extracted and analyzed. Results Forty-two papers were selected and 33 were deemed high quality (scores ≥8/10) for further analysis. These included 12 economic analyses, five input cost analyses, and 16 cost-related outcome analyses. For HIS types, there were seven primary care electronic medical records, six computerized provider order entry systems, five medication management systems, five immunization information systems, four institutional information systems, three disease management systems, two clinical documentation systems, and one health information exchange network. In terms of value for money, 23 papers reported positive findings, eight were inconclusive, and two were negative. Conclusions We found a wide range of economic evaluation papers that were based on different assumptions, methods, and metrics. There is some evidence of value for money in selected healthcare organizations and HIS types. However, caution is needed when generalizing these findings. Better reporting of economic evaluation studies is needed to compare findings and build on the existing evidence base we identified. PMID:23416247

A comparative study of routing protocols of heterogeneous wireless sensor networks.

PubMed

Han, Guangjie; Jiang, Xu; Qian, Aihua; Rodrigues, Joel J P C; Cheng, Long

2014-01-01

Recently, heterogeneous wireless sensor network (HWSN) routing protocols have drawn more and more attention. Various HWSN routing protocols have been proposed to improve the performance of HWSNs. Among these protocols, hierarchical HWSN routing protocols can improve the performance of the network significantly. In this paper, we will evaluate three hierarchical HWSN protocols proposed recently--EDFCM, MCR, and EEPCA--together with two previous classical routing protocols--LEACH and SEP. We mainly focus on the round of the first node dies (also called the stable period) and the number of packets sent to sink, which is an important aspect to evaluate the monitoring ability of a protocol. We conduct a lot of experiments and simulations on Matlab to analyze the performance of the five routing protocols.

Evaluation of the University of Florida lomustine, vincristine, procarbazine, and prednisone chemotherapy protocol for the treatment of relapsed lymphoma in dogs: 33 cases (2003-2009).

PubMed

Fahey, Christine E; Milner, Rowan J; Barabas, Karri; Lurie, David; Kow, Kelvin; Parfitt, Shannon; Lyles, Sarah; Clemente, Monica

2011-07-15

To evaluate the toxicity and efficacy of a modification of a previously evaluated combination of lomustine, vincristine, procarbazine, and prednisone (LOPP) as a rescue protocol for refractory lymphoma in dogs. Retrospective case series. Animals-33 dogs with a cytologic or histologic diagnosis of lymphoma that developed resistance to their induction chemotherapy protocol. Lomustine was administered on day 0 of the protocol. Vincristine was administered on day 0 and again 1 time on day 14. Procarbazine and prednisone were administered on days 0 through 13 of the protocol. This cycle was repeated every 28 days. Median time from initiation to discontinuation of the University of Florida LOPP protocol was 84 days (range, 10 to 308 days). Overall median survival time was 290 days (range, 51 to 762 days). Overall response rate with this protocol was 61% (20/33), with 36% (12) having a complete response and 24% (8) having a partial response. Toxicosis rates were lower than for the previously published LOPP protocol. The University of Florida LOPP protocol may be an acceptable alternative to the mechlorethamine, vincristine, procarbazine, and prednisone protocol as a rescue protocol for dogs with lymphoma.

Sensitivity comparison of sequential monadic and side-by-side presentation protocols in affective consumer testing.

PubMed

Colyar, Jessica M; Eggett, Dennis L; Steele, Frost M; Dunn, Michael L; Ogden, Lynn V

2009-09-01

The relative sensitivity of side-by-side and sequential monadic consumer liking protocols was compared. In the side-by-side evaluation, all samples were presented at once and evaluated together 1 characteristic at a time. In the sequential monadic evaluation, 1 sample was presented and evaluated on all characteristics, then returned before panelists received and evaluated another sample. Evaluations were conducted on orange juice, frankfurters, canned chili, potato chips, and applesauce. Five commercial brands, having a broad quality range, were selected as samples for each product category to assure a wide array of consumer liking scores. Without their knowledge, panelists rated the same 5 retail brands by 1 protocol and then 3 wk later by the other protocol. For 3 of the products, both protocols yielded the same order of overall liking. Slight differences in order of overall liking for the other 2 products were not significant. Of the 50 pairwise overall liking comparisons, 44 were in agreement. The different results obtained by the 2 protocols in order of liking and significance of paired comparisons were due to the experimental variation and differences in sensitivity. Hedonic liking scores were subjected to statistical power analyses and used to calculate minimum number of panelists required to achieve varying degrees of sensitivity when using side-by-side and sequential monadic protocols. In most cases, the side-by-side protocol was more sensitive, thus providing the same information with fewer panelists. Side-by-side protocol was less sensitive in cases where sensory fatigue was a factor.

Computerized Numerical Control Curriculum Guide.

ERIC Educational Resources Information Center

Reneau, Fred; And Others

This guide is intended for use in a course in programming and operating a computerized numerical control system. Addressed in the course are various aspects of programming and planning, setting up, and operating machines with computerized numerical control, including selecting manual or computer-assigned programs and matching them with…

Comparing Dual-Language Versions of an International Computerized-Adaptive Certification Exam.

ERIC Educational Resources Information Center

Sireci, Stephen G.; Foster, David F.; Robin, Frederic; Olsen, James

Evaluating the comparability of a test administered in different languages is a difficult, if not impossible, task. Comparisons are problematic because observed differences in test performance between groups who take different language versions of a test could be due to a difference in difficulty between the tests, to cultural differences in test…

University Faculty Use of Computerized Databases: An Assessment of Needs and Resources.

ERIC Educational Resources Information Center

Borgman, Christine L.; And Others

1985-01-01

Results of survey indicate that: academic faculty are unaware of range of databases available; few recognize need for databases in research; most delegate searching to librarian or assistant, rather than perform searching themselves; and 39 database guides identified tended to be descriptive rather than evaluative. A comparison of the guides is…

The economic potential of CT scanners for hardwood sawmills

Treesearch

Donald G. Hodges; Walter C. Anderson; Charles W. McMillin

1990-01-01

Research has demonstrated that a knowledge of internal log defects prior to sawing could improve lumber value yields significantly. This study evaluated the potential economic returns from investments in computerized tomographic (CT) scanners to detect internal defects in hardwood logs at southern sawmills. The results indicate that such investments would be profitable...

Teenage Pregnancy Prevention and Adolescents' Sexual Outcomes: An Experiential Approach

ERIC Educational Resources Information Center

Somers, Cheryl L.

2006-01-01

This study evaluates the effectiveness of an experiential approach to teen pregnancy (TP) prevention called "Baby Think It Over," a computerized infant simulator, on adolescents' attitudes and behaviors regarding teen pregnancy and sexuality. Recently, a more realistic model called "Real Care Baby" was developed. The small amount of research on…

Establishing Ongoing, Early Identification Programs for Mental Health Problems in Our Schools: A Feasibility Study

ERIC Educational Resources Information Center

Nemeroff, Robin; Levitt, Jessica Mass; Faul, Lisa; Wonpat-Borja, Ahtoy; Bufferd, Sara; Setterberg, Stephen; Jensen, Peter S.

2008-01-01

The study evaluates the feasibility and effectiveness of several mental health screening and assessment tools in schools. A computerized version of the Diagnostic Interview Schedule for Children-IV proved to be feasible bridging the gap between mental health providers and unmet need of children accompanying risks.

Pallet part grading trainer

Treesearch

Deborah F. Cook; Philip A. Araman; Matthew F. Winn

2000-01-01

A computerized pallet grading training system was developed to facilitate the production of higher quality pallets. Higher quality pallets would be more durable and could be re-used many times, resulting in long-term savings. Schmoldt et al. (1993) evaluated the economic impact of grading and sorting pallet parts. They determined that higher quality pallets produced by...

Project BABS: Bilingual Academic and Business Skills 1983-1984. OEA Evaluation Report.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn. Office of Educational Assessment.

Project BABS, in its final year of funding, provided career exploration and advisement, after-school summer job internships with business enterprises, and a computerized reading program to approximately 690 students of limited English proficiency of Asian, Greek, Russian, and Hispanic descent in four New York City high schools. Project staff,…

Learners' Reflections in Technological Learning Environments: Why To Promote and How To Evaluate.

ERIC Educational Resources Information Center

Rimor, Rikki; Kozminsky, Ely

In this study, 24 9th-grade students investigated several issues related to modern Israeli society. In their investigation, students were engaged in activities such as data search, data sorting, making inquiries, project writing, and construction of a new computerized database related to the subjects of their investigations. Students were…

The library as a reference tool: online catalogs

USGS Publications Warehouse

Stark, M.

1991-01-01

Online catalogs are computerized listings of materials in a particular library or group of libraries. General characteristics of online catalogs include ability for searching interactively and for locating descriptions of books, maps, and reports on regional or topical geology. Suggestions for searching, evaluating results, modifying searches, and limitations of searching are presented. -Author

Puerto Rico's PLATO Learning Program: An Independent Evaluation of the PLATO Learning Model

ERIC Educational Resources Information Center

Shillady, Lucinda; Miller, Libbie

2004-01-01

The Comprehensive School Reform (CSR) program has become a valuable resource in the implementation of the Puerto Rico Department of Education's educational reform process. To support the process, the Commonwealth of Puerto Rico granted computerized equipment, reading and mathematics software and training designed for schools. This included reading…

School Management and Evaluation System. Project Termination Report (PTR).

ERIC Educational Resources Information Center

Cincinnati Public Schools, OH.

Financed with ESEA Title III funds since 1970, the School Information System (SIS) was designed essentially to furnish school administrators with data and information with which to make better decisions. The basic means were to (1) build and improve a data bank, (2) prepare and disseminate computerized reports to the decisionmakers--especially…

Enhanced Case Management versus Substance Abuse Treatment Alone among Substance Abusers with Depression

ERIC Educational Resources Information Center

Striley, Catherine W.; Nattala, Prasanthi; Ben Abdallah, Arbi; Dennis, Michael L.; Cottler, Linda B.

2013-01-01

This pilot study evaluated the effectiveness of enhanced case management for substance abusers with comorbid major depression, which was an integrated approach to care. One hundred and 20 participants admitted to drug treatment who also met Computerized Diagnostic Interview Schedule criteria for major depression at baseline were randomized to…

Using a Computerized Classroom Simulation to Prepare Pre-Service Teachers

ERIC Educational Resources Information Center

McPherson, Rebekah; Tyler-Wood, Tandra; McEnturff Ellison, Amber; Peak, Pamela

2011-01-01

This study at a large midwestern university evaluated the use of a web-based simulated classroom, simSchool, with pre-service and in-service special education students, to determine if use of the simulated classroom influences students' perceptions of inclusion and teacher preparation. The project used a nonequivalent comparison group,…

Energy conversion research and development with diminiodes

NASA Technical Reports Server (NTRS)

Morris, J. F.

1974-01-01

Diminiodes are variable-gap cesium diodes with plane miniature guarded electrodes. These converters allow thermionic evaluations of tiny pieces of rare solids. In addition to smallness, diminiode advantages comprise simplicity, precision, fabrication ease, parts interchangeability, cleanliness, full instrumentation, direct calibration, ruggedness, and economy. Diminiodes with computerized thermionic performance mapping make electrode screening programs practical.

Examining an Executive Function Battery for Use with Preschool Children with Disabilities

ERIC Educational Resources Information Center

Kuhn, Laura J.; Willoughby, Michael T.; Blair, Clancy B.; McKinnon, Rachel

2017-01-01

Performance-based assessments of EF for use with young children who have or are at risk for disabilities are lacking. The current study investigates the use of a computerized battery for children with subclinical behaviors (N = 846) across a variety of developmental disabilities and evaluates practical information about feasibility of task…

Device-Task Fidelity and Transfer of Training: Aircraft Cockpit Procedures Training.

ERIC Educational Resources Information Center

Prophet, Wallace W.; Boyd, H. Alton

An evaluation was made of the training effectiveness of two cockpit procedures training devices, differing greatly in physical fidelity and cost, for use on the ground for a twin-engine, turboprop, fixed-wing aircraft. One group of students received training in cockpit procedures in a relatively expensive, sophisticated, computerized trainer,…

The Effects of Teacher Directed Writing Instruction Combined with SOLO Literacy Suite

ERIC Educational Resources Information Center

Park, Y.; Ambrose, G.; Coleman, M. B.; Moore, T. C.

2017-01-01

The purpose of this study was to examine the effectiveness of an intervention in which teacher-led instruction was combined with computerized writing software to improve paragraph writing for three middle school students with intellectual disability. A multiple probe across participants design was used to evaluate the effectiveness of the…

A Randomized Trial of Two Promising Computer-Based Interventions for Students with Attention Difficulties

ERIC Educational Resources Information Center

Rabiner, David L.; Murray, Desiree W.; Skinner, Ann T; Malone, Patrick S.

2010-01-01

Few studies have examined whether attention can be improved with training, even though attention difficulties adversely affect academic achievement. The present study was a randomized-controlled trial evaluating the impact of Computerized Attention Training (CAT) and Computer Assisted Instruction (CAI) on attention and academic performance in 77…

Positron emission tomography/computerized tomography in lung cancer

PubMed Central

Vural, Gulin Ucmak

2014-01-01

Positron emission tomography (PET) using 2-(18F)-flouro-2-deoxy-D-glucose (FDG) has emerged as a useful tool in the clinical work-up of lung cancer. This review article provides an overview of applications of PET in diagnosis, staging, treatment response evaluation, radiotherapy planning, recurrence assessment and prognostication of lung cancer. PMID:24914421

Computer versus In-Person Intervention for Students Violating Campus Alcohol Policy

ERIC Educational Resources Information Center

Carey, Kate B.; Henson, James M.; Carey, Michael P.; Maisto, Stephen A.

2009-01-01

In this study, the authors evaluated the efficacy of a brief motivational intervention (BMI) and a computerized program for reducing drinking and related problems among college students sanctioned for alcohol violations. Referred students (N = 198, 46% women), stratified by gender, were randomly assigned to a BMI or to the Alcohol 101 Plus…

Computerized Simulation in the Social Sciences: A Survey and Evaluation

ERIC Educational Resources Information Center

Garson, G. David

2009-01-01

After years at the periphery of the social sciences, simulation is now emerging as an important and widely used tool for understanding social phenomena. Through simulation, researchers can identify causal effects, specify critical parameter estimates, and clarify the state of the art with respect to what is understood about how processes evolve…

Adaptation of Different Computerized Methods of Distance Learning to an External PharmD Degree Program.

ERIC Educational Resources Information Center

Kaplan, Irene Petzinger; And Others

1996-01-01

A distance education course in drug information, scholarly literature evaluation, and biostatistics, offered as part of a doctoral pharmacy program, incorporates teleconferencing and online critiquing of pharmacy journal literature. Structure of the class, software and hardware, student performance, and student response to the teaching methods are…

The Development of the New York State Bank of Reading Objectives.

ERIC Educational Resources Information Center

O'Reilly, Robert P.

This report presents the rationale, structure, content and procedures for the computerized bank of reading objectives being developed for New York State schools. The project was initiated to provide a technical resource which would contribute to planning, design, and evaluation of reading programs. The report defines the organizing concepts for…

Evaluating the Content Validity of Multistage-Adaptive Tests

ERIC Educational Resources Information Center

Crotts, Katrina; Sireci, Stephen G.; Zenisky, April

2012-01-01

Validity evidence based on test content is important for educational tests to demonstrate the degree to which they fulfill their purposes. Most content validity studies involve subject matter experts (SMEs) who rate items that comprise a test form. In computerized-adaptive testing, examinees take different sets of items and test "forms"…

Maryland Department of Natural Resources Camp Initiatives Program

Treesearch

Kelly R. Schaeffer

1992-01-01

The Camp Initiatives Program was developed to increase revenue and visitation through a series of policy changes. During the summer of 1990, the program was evaluated at six Maryland State Parks and found to increase revenue and visitation by 3% and 16%, respectively. More intensive marketing efforts, implementation of a computerized reservation system, increased...

Evaluating Bilingual and Monolingual Dictionaries for L2 Learners.

ERIC Educational Resources Information Center

Hunt, Alan

1997-01-01

A discussion of dictionaries and their use for second language (L2) learning suggests that lack of computerized modern language corpora can adversely affect bilingual dictionaries, commonly used by L2 learners, and shows how use of such corpora has benefitted two contemporary monolingual L2 learner dictionaries (1995 editions of the Longman…

The Development and Evaluation of Listening and Speaking Diagnosis and Remedial Teaching System

ERIC Educational Resources Information Center

Hsiao, Hsien-Sheng; Chang, Cheng-Sian; Lin, Chiou-Yan; Chen, Berlin; Wu, Chia-Hou; Lin, Chien-Yu

2016-01-01

In this study, a system was developed to offer adaptive remedial instruction materials to learners of Chinese as a foreign language (CFL). The Chinese Listening and Speaking Diagnosis and Remedial Instruction (CLSDRI) system integrated computerized diagnostic tests and remedial instruction materials to diagnose errors made in listening…

A Comparison of Exposure Control Procedures in CATs Using the 3PL Model

ERIC Educational Resources Information Center

Leroux, Audrey J.; Lopez, Myriam; Hembry, Ian; Dodd, Barbara G.

2013-01-01

This study compares the progressive-restricted standard error (PR-SE) exposure control procedure to three commonly used procedures in computerized adaptive testing, the randomesque, Sympson-Hetter (SH), and no exposure control methods. The performance of these four procedures is evaluated using the three-parameter logistic model under the…

A Computerized Asthma Outcomes Measure Is Feasible for Disease Management

PubMed Central

Turner-Bowker, Diane M.; Saris-Baglama, Renee N.; Anatchkova, Milena; Mosen, David M.

2010-01-01

Objective To develop and test an online assessment referred to as the ASTHMA-CAT (computerized adaptive testing), a patient-based asthma impact, control, and generic health-related quality of life (HRQOL) measure. Study Design Cross-sectional pilot study of the ASTHMA-CAT’s administrative feasibility in a disease management population. Methods The ASTHMA-CAT included a dynamic or static Asthma Impact Survey (AIS), Asthma Control Test, and SF-8 Health Survey. A sample of clinician-diagnosed adult asthmatic patients (N = 114) completed the ASTHMA-CAT. Results were used to evaluate administrative feasibility of the instrument and psychometric performance of the dynamic AIS relative to the static AIS. A prototype aggregate (group-level) report was developed and reviewed by care providers. Results Online administration of the ASTHMA-CAT was feasible for patients in disease management. The dynamic AIS functioned well compared with the static AIS in preliminary studies evaluating response burden, precision, and validity. Providers found reports to be relevant, useful, and applicable for care management. Conclusion The ASTHMA-CAT may facilitate asthma care management. PMID:20852675

Multidetector computerized tomographic fistulography in the evaluation of congenital branchial cleft fistulae and sinuses.

PubMed

Sun, Zhipeng; Fu, Kaiyuan; Zhang, Zuyan; Zhao, Yanping; Ma, Xuchen

2012-05-01

The aim of this study was to primarily investigate the usefulness of computerized tomographic (CT) fistulography in the diagnosis and management of branchial cleft fistulae and sinuses. Fifteen patients with confirmed branchial fistulae or sinuses who had undergone CT fistulography were included. The diagnoses were confirmed by clinical, radiologic, or histopathologic examinations. The internal openings, distribution, and neighboring relationship of the lesions presented by CT fistulography were analyzed to evaluate the usefulness in comparison with x-ray fistulography. Nine patients were diagnosed with first branchial fistulae or sinuses, 2 with second branchial fistulae, and 4 with third or fourth branchial fistulae. The presence and location of the lesions could be seen on x-ray fistulography. The distribution of the lesions, internal openings, and neighboring relationship with parotid gland, carotid sheath, and submandibular gland could be clearly demonstrated on CT cross-sectional or volume-rendering images. CT fistulography could provide valuable information and benefit surgical planning by demonstrating the courses of branchial anomalies in detail. Copyright © 2012 Elsevier Inc. All rights reserved.

Chapter 6: Residential Lighting Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurnik, Charles W; Dimetrosky, Scott; Parkinson, Katie

Given new regulations, increased complexity in the market, and the general shift from CFLs to LEDs, this evaluation protocol was updated in 2017 to shift the focus of the protocols toward LEDs and away from CFLs and to resolve evaluation uncertainties affecting residential lighting incentive programs.

EVALUATION OF THE PROTOCOL FOR THE NATURAL ATTENUATION OF CHLORINATED SOLVENTS: CASE STUDY AT THE TWIN CITIES ARMY AMMUNITION PLANT

EPA Science Inventory

At the request of staff in the EPA Regions, EPA?s Office of Research and Development carried out an independent evaluation of the Technical Protocol for Evaluating Natural Attenuation of Chlorinated Solvents in Ground Water (EPA/600/R-98/128). The Protocol was developed around c...

Field validation of protocols developed to evaluate in-line mastitis detection systems.

PubMed

Kamphuis, C; Dela Rue, B T; Eastwood, C R

2016-02-01

This paper reports on a field validation of previously developed protocols for evaluating the performance of in-line mastitis-detection systems. The protocols outlined 2 requirements of these systems: (1) to detect cows with clinical mastitis (CM) promptly and accurately to enable timely and appropriate treatment and (2) to identify cows with high somatic cell count (SCC) to manage bulk milk SCC levels. Gold standard measures, evaluation tests, performance measures, and performance targets were proposed. The current study validated the protocols on commercial dairy farms with automated in-line mastitis-detection systems using both electrical conductivity (EC) and SCC sensor systems that both monitor at whole-udder level. The protocol for requirement 1 was applied on 3 commercial farms. For requirement 2, the protocol was applied on 6 farms; 3 of them had low bulk milk SCC (128×10(3) cells/mL) and were the same farms as used for field evaluation of requirement 1. Three farms with high bulk milk SCC (270×10(3) cells/mL) were additionally enrolled. The field evaluation methodology and results were presented at a workshop including representation from 7 international suppliers of in-line mastitis-detection systems. Feedback was sought on the acceptance of standardized performance evaluation protocols and recommended refinements to the protocols. Although the methodology for requirement 1 was relatively labor intensive and required organizational skills over an extended period, no major issues were encountered during the field validation of both protocols. The validation, thus, proved the protocols to be practical. Also, no changes to the data collection process were recommended by the technology supplier representatives. However, 4 recommendations were made to refine the protocols: inclusion of an additional analysis that ignores small (low-density) clot observations in the definition of CM, extension of the time window from 4 to 5 milkings for timely alerts for CM, setting a maximum number of 10 milkings for the time window to detect a CM episode, and presentation of sensitivity for a larger range of false alerts per 1,000 milkings replacing minimum performance targets. The recommended refinements are discussed with suggested changes to the original protocols. The information presented is intended to inform further debate toward achieving international agreement on standard protocols to evaluate performance of in-line mastitis-detection systems. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Applicability of the Compensatory Encoding Model in Foreign Language Reading: An Investigation with Chinese College English Language Learners

PubMed Central

Han, Feifei

2017-01-01

While some first language (L1) reading models suggest that inefficient word recognition and small working memory tend to inhibit higher-level comprehension processes; the Compensatory Encoding Model maintains that slow word recognition and small working memory do not normally hinder reading comprehension, as readers are able to operate metacognitive strategies to compensate for inefficient word recognition and working memory limitation as long as readers process a reading task without time constraint. Although empirical evidence is accumulated for support of the Compensatory Encoding Model in L1 reading, there is lack of research for testing of the Compensatory Encoding Model in foreign language (FL) reading. This research empirically tested the Compensatory Encoding Model in English reading among Chinese college English language learners (ELLs). Two studies were conducted. Study one focused on testing whether reading condition varying time affects the relationship between word recognition, working memory, and reading comprehension. Students were tested on a computerized English word recognition test, a computerized Operation Span task, and reading comprehension in time constraint and non-time constraint reading. The correlation and regression analyses showed that the strength of association was much stronger between word recognition, working memory, and reading comprehension in time constraint than that in non-time constraint reading condition. Study two examined whether FL readers were able to operate metacognitive reading strategies as a compensatory way of reading comprehension for inefficient word recognition and working memory limitation in non-time constraint reading. The participants were tested on the same computerized English word recognition test and Operation Span test. They were required to think aloud while reading and to complete the comprehension questions. The think-aloud protocols were coded for concurrent use of reading strategies, classified into language-oriented strategies, content-oriented strategies, re-reading, pausing, and meta-comment. The correlation analyses showed that while word recognition and working memory were only significantly related to frequency of language-oriented strategies, re-reading, and pausing, but not with reading comprehension. Jointly viewed, the results of the two studies, complimenting each other, supported the applicability of the Compensatory Encoding Model in FL reading with Chinese college ELLs. PMID:28522984

Applicability of the Compensatory Encoding Model in Foreign Language Reading: An Investigation with Chinese College English Language Learners.

PubMed

Han, Feifei

2017-01-01

While some first language (L1) reading models suggest that inefficient word recognition and small working memory tend to inhibit higher-level comprehension processes; the Compensatory Encoding Model maintains that slow word recognition and small working memory do not normally hinder reading comprehension, as readers are able to operate metacognitive strategies to compensate for inefficient word recognition and working memory limitation as long as readers process a reading task without time constraint. Although empirical evidence is accumulated for support of the Compensatory Encoding Model in L1 reading, there is lack of research for testing of the Compensatory Encoding Model in foreign language (FL) reading. This research empirically tested the Compensatory Encoding Model in English reading among Chinese college English language learners (ELLs). Two studies were conducted. Study one focused on testing whether reading condition varying time affects the relationship between word recognition, working memory, and reading comprehension. Students were tested on a computerized English word recognition test, a computerized Operation Span task, and reading comprehension in time constraint and non-time constraint reading. The correlation and regression analyses showed that the strength of association was much stronger between word recognition, working memory, and reading comprehension in time constraint than that in non-time constraint reading condition. Study two examined whether FL readers were able to operate metacognitive reading strategies as a compensatory way of reading comprehension for inefficient word recognition and working memory limitation in non-time constraint reading. The participants were tested on the same computerized English word recognition test and Operation Span test. They were required to think aloud while reading and to complete the comprehension questions. The think-aloud protocols were coded for concurrent use of reading strategies, classified into language-oriented strategies, content-oriented strategies, re-reading, pausing, and meta-comment. The correlation analyses showed that while word recognition and working memory were only significantly related to frequency of language-oriented strategies, re-reading, and pausing, but not with reading comprehension. Jointly viewed, the results of the two studies, complimenting each other, supported the applicability of the Compensatory Encoding Model in FL reading with Chinese college ELLs.

The development and role of megavoltage cone beam computerized tomography in radiation oncology

NASA Astrophysics Data System (ADS)

Morin, Olivier

External beam radiation therapy has now the ability to deliver doses that conform tightly to a tumor volume. The steep dose gradients planned in these treatments make it increasingly important to reproduce the patient position and anatomy at each treatment fraction. For this reason, considerable research now focuses on in-room three-dimensional imaging. This thesis describes the first clinical megavoltage cone beam computed tomography (MVCBCT) system, which utilizes a conventional linear accelerator equipped with an amorphous silicon flat panel detector. The document covers the system development and investigation of its clinical applications over the last 4-5 years. The physical performance of the system was evaluated and optimized for soft-tissue contrast resolution leading to recommendations of imaging protocols to use for specific clinical applications and body sites. MVCBCT images can resolve differences of 5% in electron density for a mean dose of 9 cGy. Hence, the image quality of this system is sufficient to differentiate some soft-tissue structures. The absolute positioning accuracy with MVCBCT is better than 1 mm. The accuracy of isodose lines calculated using MVCBCT images of head and neck patients is within 3% and 3 mm. The system shows excellent stability in image quality, CT# calibration, radiation exposure and absolute positioning over a period of 8 months. A procedure for MVCBCT quality assurance was developed. In our clinic, MVCBCT has been used to detect non rigid spinal cord distortions, to position a patient with a paraspinous tumor close to metallic hardware, to position prostate cancer patients using gold markers or soft-tissue landmarks, to monitor head and neck anatomical changes and their dosimetric consequences, and to complement the convention CT for treatment planning in presence of metallic implants. MVCBCT imaging is changing the clinical practice of our department by increasingly revealing patient-specific errors. New verification protocols are being developed to minimize those errors thus moving the practice of radiation therapy one step closer to personalized medicine.

Zoom Reconstruction Tool: Evaluation of Image Quality and Influence on the Diagnosis of Root Fracture.

PubMed

Queiroz, Polyane Mazucatto; Santaella, Gustavo Machado; Capelozza, Ana Lúcia Alvares; Rosalen, Pedro Luiz; Freitas, Deborah Queiroz; Haiter-Neto, Francisco

2018-04-01

This study evaluated the image quality and the diagnosis of root fractures when using the Zoom Reconstruction tool (J Morita, Kyoto, Japan). A utility wax phantom with a metal sample inside was used for objective evaluation, and a mandible with 27 single-rooted teeth (with and without obturation and with and without vertical or horizontal fractures) was used for diagnostic evaluation. The images were acquired in 3 protocols: protocol 1, field of view (FOV) of 4 × 4 cm and a voxel size of 0.08 mm; protocol 2, FOV of 10 × 10 cm and a voxel size of 0.2 mm; and protocol 3, Zoom Reconstruction of images from protocol 2 (FOV of 4 × 4 cm and a voxel size of 0.08 mm). The objective evaluation was achieved by measuring the image noise, and the diagnosis of fractures was performed by 3 evaluators. The area under the receiver operating characteristic curve was used to calculate accuracy, and analysis of variance compared the accuracy and image quality of the protocols. Regarding quality, protocol 1 was superior to protocol 2 (P < .0001) and Zoom Reconstruction (P < .0001). Additionally, images of protocol 2 presented less noise than the Zoom Reconstruction image (P < .0001); however, for diagnosis, Zoom Reconstruction was superior in relation to protocol 2 (P = .011) and did not differ from protocol 1 (P = .228) for the diagnosis of a vertical root fracture in filled teeth. The Zoom Reconstruction tool allows better accuracy for vertical root fracture detection in filled teeth, making it possible to obtain a higher-resolution image from a lower-resolution examination without having to expose the patient to more radiation. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

An Application of the Rasch Model to Computerized Adaptive Testing.

ERIC Educational Resources Information Center

Wisniewski, Dennis R.

Three questions concerning the Binary Search Method (BSM) of computerized adaptive testing were studied: (1) whether it provided a reliable and valid estimation of examinee ability; (2) its effect on examinee attitudes toward computerized adaptive testing and conventional paper-and-pencil testing; and (3) the relationship between item response…

The Reality, Direction, and Future of Computerized Publications

ERIC Educational Resources Information Center

Levenstein, Nicholas

2012-01-01

Sharing information in digital form by using a computer is a growing phenomenon. Many universities are making their applications available on computer. More than one hundred and thirty-six universities have developed computerized applications on their own or through a commercial vendor. Universities developed computerized applications in order to…

Computerized Classification Testing with the Rasch Model

ERIC Educational Resources Information Center

Eggen, Theo J. H. M.

2011-01-01

If classification in a limited number of categories is the purpose of testing, computerized adaptive tests (CATs) with algorithms based on sequential statistical testing perform better than estimation-based CATs (e.g., Eggen & Straetmans, 2000). In these computerized classification tests (CCTs), the Sequential Probability Ratio Test (SPRT) (Wald,…

Severity of Organized Item Theft in Computerized Adaptive Testing: A Simulation Study

ERIC Educational Resources Information Center

Yi, Qing; Zhang, Jinming; Chang, Hua-Hua

2008-01-01

Criteria had been proposed for assessing the severity of possible test security violations for computerized tests with high-stakes outcomes. However, these criteria resulted from theoretical derivations that assumed uniformly randomized item selection. This study investigated potential damage caused by organized item theft in computerized adaptive…

Computerized Adaptive Assessment of Cognitive Abilities among Disabled Adults.

ERIC Educational Resources Information Center

Engdahl, Brian

This study examined computerized adaptive testing and cognitive ability testing of adults with cognitive disabilities. Adult subjects (N=250) were given computerized tests on language usage and space relations in one of three administration conditions: paper and pencil, fixed length computer adaptive, and variable length computer adaptive.…

Year 2000 Computerized Farm Project. Final Report.

ERIC Educational Resources Information Center

McGrann, James M.; Lippke, Lawrence A.

An ongoing project was funded to develop and demonstrate a computerized approach to operation and management of a commercial-sized farm. Other project objectives were to facilitate the demonstration of the computerized farm to the public and to develop individual software packages and make them available to the public. Project accomplishments…

10 CFR 719.44 - What categories of costs require advance approval?

Code of Federal Regulations, 2014 CFR

2014-01-01

... application software, or non-routine computerized databases, if they are specifically created for a particular matter. For costs associated with the creation and use of computerized databases, contractors and retained legal counsel must ensure that the creation and use of computerized databases is necessary and...

Computerized Diagnostic Testing: Problems and Possibilities.

ERIC Educational Resources Information Center

McArthur, David L.

The use of computers to build diagnostic inferences is explored in two contexts. In computerized monitoring of liquid oxygen systems for the space shuttle, diagnoses are exact because they can be derived within a world which is closed. In computerized classroom testing of reading comprehension, programs deliver a constrained form of adaptive…

45 CFR 307.13 - Security and confidentiality for computerized support enforcement systems in operation after...

Code of Federal Regulations, 2010 CFR

2010-10-01

... ENFORCEMENT SYSTEMS § 307.13 Security and confidentiality for computerized support enforcement systems in... systems in operation after October 1, 1997. (a) Information integrity and security. Have safeguards... 45 Public Welfare 2 2010-10-01 2010-10-01 false Security and confidentiality for computerized...

A First Life with Computerized Business Simulations

ERIC Educational Resources Information Center

Thavikulwat, Precha

2011-01-01

The author discusses the theoretical lens, origins, and environment of his work on computerized business simulations. Key ideas that inform his work include the two dimensions (control and interaction) of computerized simulation, the two ways of representing a natural process (phenotypical and genotypical) in a simulation, which he defines as a…

45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS..., organization, services and constraints related to the computerized support enforcement system; (4) The APD must... design, development, installation or enhancement; (5) The APD must contain a description of each...

45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS..., organization, services and constraints related to the computerized support enforcement system; (4) The APD must... design, development, installation or enhancement; (5) The APD must contain a description of each...

45 CFR 307.15 - Approval of advance planning documents for computerized support enforcement systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS..., organization, services and constraints related to the computerized support enforcement system; (4) The APD must... design, development, installation or enhancement; (5) The APD must contain a description of each...

Protecting Privacy in Computerized Medical Information.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Office of Technology Assessment.

This report analyzes the implications of computerized medical information and the challenges it brings to individual privacy. The report examines the nature of the privacy interest in health care information and the current state of the law protecting that information; the nature of proposals to computerize health care information and the…

45 CFR 310.25 - What conditions apply to acquisitions of Computerized Tribal IV-D Systems?

Code of Federal Regulations, 2010 CFR

2010-10-01

... FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED TRIBAL IV-D SYSTEMS AND OFFICE AUTOMATION... Acquisition Threshold; (c) Software and ownership rights. (1) All procurement and contract instruments must... Computerized Tribal IV-D System software or enhancements thereof and all associated documentation designed...

Computerization of the Newspaper in the 1980s.

ERIC Educational Resources Information Center

Garrison, Bruce

A review of the literature on the computerization of newspaper newsrooms shows that since 1960, computers have assumed an increasingly important role in information collection, news writing and editing, pagination, and news transmission. When newspaper libraries are computerized, reporters are able to find information more quickly and to use…

[Computerized medical record: deontology and legislation].

PubMed

Allaert, F A; Dusserre, L

1996-02-01

Computerization of medical records is making headway for patients' follow-up, scientific research, and health expenses control, but it must not alter the guarantees provided to the patients by the medical code of ethics and the law of January 6, 1978. This law, modified on July 1, 1994, requires to register all computerized records of personal data and establishes rights to protect privacy against computer misdemeanor. All medical practitioners using computerized medical records must be aware that the infringement of this law may provoke suing in professional, civil or criminal court.

Automated tumor volumetry using computer-aided image segmentation.

PubMed

Gaonkar, Bilwaj; Macyszyn, Luke; Bilello, Michel; Sadaghiani, Mohammed Salehi; Akbari, Hamed; Atthiah, Mark A; Ali, Zarina S; Da, Xiao; Zhan, Yiqang; O'Rourke, Donald; Grady, Sean M; Davatzikos, Christos

2015-05-01

Accurate segmentation of brain tumors, and quantification of tumor volume, is important for diagnosis, monitoring, and planning therapeutic intervention. Manual segmentation is not widely used because of time constraints. Previous efforts have mainly produced methods that are tailored to a particular type of tumor or acquisition protocol and have mostly failed to produce a method that functions on different tumor types and is robust to changes in scanning parameters, resolution, and image quality, thereby limiting their clinical value. Herein, we present a semiautomatic method for tumor segmentation that is fast, accurate, and robust to a wide variation in image quality and resolution. A semiautomatic segmentation method based on the geodesic distance transform was developed and validated by using it to segment 54 brain tumors. Glioblastomas, meningiomas, and brain metastases were segmented. Qualitative validation was based on physician ratings provided by three clinical experts. Quantitative validation was based on comparing semiautomatic and manual segmentations. Tumor segmentations obtained using manual and automatic methods were compared quantitatively using the Dice measure of overlap. Subjective evaluation was performed by having human experts rate the computerized segmentations on a 0-5 rating scale where 5 indicated perfect segmentation. The proposed method addresses a significant, unmet need in the field of neuro-oncology. Specifically, this method enables clinicians to obtain accurate and reproducible tumor volumes without the need for manual segmentation. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Automated Tumor Volumetry Using Computer-Aided Image Segmentation

PubMed Central

Bilello, Michel; Sadaghiani, Mohammed Salehi; Akbari, Hamed; Atthiah, Mark A.; Ali, Zarina S.; Da, Xiao; Zhan, Yiqang; O'Rourke, Donald; Grady, Sean M.; Davatzikos, Christos

2015-01-01

Rationale and Objectives Accurate segmentation of brain tumors, and quantification of tumor volume, is important for diagnosis, monitoring, and planning therapeutic intervention. Manual segmentation is not widely used because of time constraints. Previous efforts have mainly produced methods that are tailored to a particular type of tumor or acquisition protocol and have mostly failed to produce a method that functions on different tumor types and is robust to changes in scanning parameters, resolution, and image quality, thereby limiting their clinical value. Herein, we present a semiautomatic method for tumor segmentation that is fast, accurate, and robust to a wide variation in image quality and resolution. Materials and Methods A semiautomatic segmentation method based on the geodesic distance transform was developed and validated by using it to segment 54 brain tumors. Glioblastomas, meningiomas, and brain metastases were segmented. Qualitative validation was based on physician ratings provided by three clinical experts. Quantitative validation was based on comparing semiautomatic and manual segmentations. Results Tumor segmentations obtained using manual and automatic methods were compared quantitatively using the Dice measure of overlap. Subjective evaluation was performed by having human experts rate the computerized segmentations on a 0–5 rating scale where 5 indicated perfect segmentation. Conclusions The proposed method addresses a significant, unmet need in the field of neuro-oncology. Specifically, this method enables clinicians to obtain accurate and reproducible tumor volumes without the need for manual segmentation. PMID:25770633

A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study

PubMed Central

Ortiz-Gutiérrez, Rosa; Cano-de-la-Cuerda, Roberto; Galán-del-Río, Fernando; Alguacil-Diego, Isabel María; Palacios-Ceña, Domingo; Miangolarra-Page, Juan Carlos

2013-01-01

Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session).The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test) was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available. PMID:24185843

An Accelerated Multi-Modality Rehabilitation Protocol Combined with Botulinum Toxin-A Injection in Adult Idiopathic Toe Walking: Case Report

PubMed Central

Yavuz, Ferdi; Balaban, Birol

2016-01-01

Diagnosis of Adult Idiopathic Toe Walking (AITW) is very rare in clinical practice. High quality studies regarding AITW and its treatment options have not been conducted previously. A 28-year-old male patient complaining of lower leg pain was referred to outpatient rehabilitation clinic. Physical examination revealed a gait abnormality of insufficient heel strike at initial contact. The aetiology was investigated and the patient’s walking parameters were assessed using a computerized gait analysis system. The AITW was diagnosed. Botulinum toxin-A (Dysport®) was injected to the bilateral gastrocnemius muscles. A combined 10-days rehabilitation program was designed, including a daily one-hour physiotherapist supervised exercise program, ankle dorsiflexion exercises using an EMG-biofeedback unit assisted virtual rehabilitation system (Biometrics) and virtual gait training (Rehawalk) every other day. After treatment, the patient was able to heel strike at the initiation of the stance phase of the gait. Ankle dorsiflexion range of motions increased. The most prominent improvement was seen in maximum pressure and heel force. In addition center of pressure evaluations were also improved. To the best of our knowledge this is the first case, of AITW treated with combined botulinum toxin, exercise and virtual rehabilitation systems. This short report demonstrates the rapid effect of this 10-days combined therapy. PMID:27504395

Is there a link between the hospital-acquired injurious fall rates in US acute care hospitals and these institutions' implementation levels of computerized systems?

PubMed

Tzeng, Huey-Ming; Hu, Hsou Mei; Yin, Chang-Yi

2011-12-01

Medicare no longer reimburses acute care hospitals for the costs of additional care required due to hospital-acquired injuries. Consequently, this study explored the effective computerized systems to inform practice for better interventions to reduce fall risk. It provided a correlation between type of computerized system and hospital-acquired injurious fall rates at acute care hospitals in California, Florida, and New York. It used multiple publicly available data sets, with the hospital as the unit of analysis. Descriptive and Pearson correlation analyses were used. The analysis included 462 hospitals. Significant correlations could be categorized into two groups: (1) meaningful computerized systems that were associated with lower injurious fall rates: the decision support systems for drug allergy alerts, drug-drug interaction alerts, and drug-laboratory interaction alerts; and (2) computerized systems that were associated with higher injurious fall rates: the decision support system for drug-drug interaction alerts and the computerized provider order entry system for radiology tests. Future research may include additional states, multiple years of data, and patient-level data to validate this study's findings. This effort may further inform policy makers and the public about effective clinical computerized systems provided to clinicians to improve their practice decisions and care outcomes.

Symposium on Aviation Psychology, 1st, Ohio State University, Columbus, OH, April 21, 22, 1981, Proceedings

NASA Technical Reports Server (NTRS)

1981-01-01

The impact of modern technology on the role, responsibility, authority, and performance of human operators in modern aircraft and ATC systems was examined in terms of principles defined by Paul Fitts. Research into human factors in aircraft operations and the use of human factors engineering for aircraft safety improvements were discussed, and features of the man-machine interface in computerized cockpit warning systems are examined. The design and operational features of computerized avionics displays and HUDs are described, along with results of investigations into pilot decision-making behavior, aircrew procedural compliance, and aircrew judgment training programs. Experiments in vision and visual perception are detailed, as are behavioral studies of crew workload, coordination, and complement. The effectiveness of pilot selection, screening, and training techniques are assessed, as are methods for evaluating pilot performance.

Internet Telehealth for Pediatric Asthma Case Management: Integrating Computerized and Case Manager Features for Tailoring a Web-Based Asthma Education Program

PubMed Central

Wise, Meg; Gustafson, David H.; Sorkness, Christine A.; Molfenter, Todd; Staresinic, Anthony; Meis, Tracy; Hawkins, Robert P.; Shanovich, Kathleen Kelly; Walker, Nola P.

2008-01-01

This article reports on the development of a personalized, Web-based asthma-education program for parents whose 4- to 12-year-old children have moderate to severe asthma. Personalization includes computer-based tailored messages and a human coach to build asthma self-management skills. Computerized features include the Asthma Manager, My Calendar/Reminder, My Goals, and a tailored home page. These are integrated with monthly asthma-education phone calls from an asthmanurse case manager. The authors discuss the development process and issues and describe the current randomized evaluation study to test whether the yearlong integrated intervention can improve adherence to a daily asthma controller medication, asthma control, and parent quality of life to reduce asthma-related healthcare utilization. Implications for health education for chronic disease management are raised. PMID:16928987

A case study on the impacts of computerized provider order entry (CPOE) system on hospital clinical workflow.

PubMed

Mominah, Maher; Yunus, Faisel; Househ, Mowafa S

2013-01-01

Computerized provider order entry (CPOE) is a health informatics system that helps health care providers create and manage orders for medications and other health care services. Through the automation of the ordering process, CPOE has improved the overall efficiency of hospital processes and workflow. In Saudi Arabia, CPOE has been used for years, with only a few studies evaluating the impacts of CPOE on clinical workflow. In this paper, we discuss the experience of a local hospital with the use of CPOE and its impacts on clinical workflow. Results show that there are many issues related to the implementation and use of CPOE within Saudi Arabia that must be addressed, including design, training, medication errors, alert fatigue, and system dep Recommendations for improving CPOE use within Saudi Arabia are also discussed.

Computerized Cognitive Training in Children With Autism and Intellectual Disabilities: Feasibility and Satisfaction Study

PubMed Central

Benyakorn, Songpoom; Calub, Catrina A; Riley, Steven J; Schneider, Andrea; Iosif, Ana-Maria; Solomon, Marjorie; Hessl, David

2018-01-01

Background Researchers are increasingly interested in testing and developing computerized cognitive training interventions for individuals with autism spectrum disorder due to the limited accessibility of treatments for this disorder. Understanding the feasibility of testing cognitive interventions for this population is critical, especially for individuals with ASD who have low to moderate intellectual ability. Objective The aim of the study was to evaluate the feasibility of computerized cognitive training as measured by attrition rate and a parent satisfaction survey. Methods A total of 26 participants aged 8-17 years with an autism spectrum disorder diagnosis and significant intellectual impairment were enrolled (mean age 11.1 years). They were instructed to complete 25 sessions of Cogmed Working Memory Training in 5 to 6 weeks with coach assistance. Attrition rate and parent satisfaction surveys were measured after the completion of training. Results Most participants (96%, 25/26) completed the training and indicated high satisfaction (>88%). However, among the participants who completed the training, 5 participants (19%) were unable to finish in 6 weeks, the recommended training period by Cogmed. Parents noted various positive (eg, voice-overs) and negative (eg, particular graphic and sounds associated with a stimulus) features of the game that they thought affected their child’s response. Conclusions Children with autism spectrum disorder and intellectual impairments can successfully participate in computerized cognitive training interventions but may require additional weeks to complete the training beyond the time needed for children without intellectual impairments. The overall completion rate, with extended time to complete the training, was high. Developers of cognitive training programs for this population should take into account potential issues regarding the noise level of stimuli and characteristics of the visual graphics. PMID:29802090