An Analysis of Minimum System Requirements to Support Computerized Adaptive Testing.

DTIC Science & Technology

1986-09-01

adaptive test ( CAT ); adaptive test ing A;4SRAC:’ (Continue on reverie of necessary and ident4f by block number) % This pape-r discusses the minimum system...requirements needed to develop a computerized adaptive test ( CAT ). It lists some of the benefits of adaptive testing, establishes a set of...discusses the minimum system requirements needed to develop a computerized adaptive test ( CAT ). It lists some of the benefits of adaptive testing

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…

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…

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 Test (CAT) Applications and Item Response Theory Models for Polytomous Items

ERIC Educational Resources Information Center

Aybek, Eren Can; Demirtasli, R. Nukhet

2017-01-01

This article aims to provide a theoretical framework for computerized adaptive tests (CAT) and item response theory models for polytomous items. Besides that, it aims to introduce the simulation and live CAT software to the related researchers. Computerized adaptive test algorithm, assumptions of item response theory models, nominal response…

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 Role of Item Feedback in Self-Adapted Testing.

ERIC Educational Resources Information Center

Roos, Linda L.; And Others

1997-01-01

The importance of item feedback in self-adapted testing was studied by comparing feedback and no feedback conditions for computerized adaptive tests and self-adapted tests taken by 363 college students. Results indicate that item feedback is not necessary to realize score differences between self-adapted and computerized adaptive testing. (SLD)

Development of an Item Bank for the Assessment of Knowledge on Biology in Argentine University Students.

PubMed

Cupani, Marcos; Zamparella, Tatiana Castro; Piumatti, Gisella; Vinculado, Grupo

The calibration of item banks provides the basis for computerized adaptive testing that ensures high diagnostic precision and minimizes participants' test burden. This study aims to develop a bank of items to measure the level of Knowledge on Biology using the Rasch model. The sample consisted of 1219 participants that studied in different faculties of the National University of Cordoba (mean age = 21.85 years, SD = 4.66; 66.9% are women). The items were organized in different forms and into separate subtests, with some common items across subtests. The students were told they had to answer 60 questions of knowledge on biology. Evaluation of Rasch model fit (Zstd >|2.0|), differential item functioning, dimensionality, local independence, item and person separation (>2.0), and reliability (>.80) resulted in a bank of 180 items with good psychometric properties. The bank provides items with a wide range of content coverage and may serve as a sound basis for computerized adaptive testing applications. The contribution of this work is significant in the field of educational assessment in Argentina.

Microcomputer Network for Computerized Adaptive Testing (CAT): Program Listing. Supplement.

DTIC Science & Technology

1984-03-01

UMICROCOMPUTER NETWORK FOR COMPUTERIZED ADAPTIVE TESTING ( CAT ): PROGRAM LISTING in APPROVED FOR PUBLIC RELEASE;IDISTRIBUTION UNLIMITEDPs DTIC ’ Akf 3 0 1-d84...NETWORK FOR COMPUTERIZED ADAPTIVE TESTING ( CAT ).- PROGRAM LISTING , ,j Baldwin Quan Thomas A. Park Gary Sandahl John H. Wolfe Reviewed by James R. McBride A...Center San Diego, California 92152 V.% :-, CONTENTrS Page CATPROJECT.TEXT CAT system driver textfile I 1 ADMINDIR- Subdirectory - Test administration

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

An evaluation of the effectiveness of adaptive histogram equalization for contrast enhancement.

PubMed

Zimmerman, J B; Pizer, S M; Staab, E V; Perry, J R; McCartney, W; Brenton, B C

1988-01-01

Adaptive histogram equalization (AHE) and intensity windowing have been compared using psychophysical observer studies. Experienced radiologists were shown clinical CT (computerized tomographic) images of the chest. Into some of the images, appropriate artificial lesions were introduced; the physicians were then shown the images processed with both AHE and intensity windowing. They were asked to assess the probability that a given image contained the artificial lesion, and their accuracy was measured. The results of these experiments show that for this particular diagnostic task, there was no significant difference in the ability of the two methods to depict luminance contrast; thus, further evaluation of AHE using controlled clinical trials is indicated.

The Effects of Test Difficulty Manipulation in Computerized Adaptive Testing and Self-Adapted Testing.

ERIC Educational Resources Information Center

Ponsoda, Vicente; Olea, Julio; Rodriguez, Maria Soledad; Revuelta, Javier

1999-01-01

Compared easy and difficult versions of self-adapted tests (SAT) and computerized adapted tests. No significant differences were found among the tests for estimated ability or posttest state anxiety in studies with 187 Spanish high school students, although other significant differences were found. Discusses implications for interpreting test…

Technology and Language Testing. A Collection of Papers from the Annual Colloquium on Language Testing Research (7th, Princeton, New Jersey, April 6-9, 1985).

ERIC Educational Resources Information Center

Stansfield, Charles W., Ed.

This collection of essays on measurement theory and language testing includes: "Computerized Adaptive Testing: Implications for Language Test Developers" (Peter Tung); "The Promise and Threat of Computerized Adaptive Assessment of Reading Comprehension" (Michael Canale); "Computerized Rasch Analysis of Item Bias in ESL…

A Fair Comparison of the Performance of Computerized Adaptive Testing and Multistage Adaptive Testing

ERIC Educational Resources Information Center

Wang, Keyin

2017-01-01

The comparison of item-level computerized adaptive testing (CAT) and multistage adaptive testing (MST) has been researched extensively (e.g., Kim & Plake, 1993; Luecht et al., 1996; Patsula, 1999; Jodoin, 2003; Hambleton & Xing, 2006; Keng, 2008; Zheng, 2012). Various CAT and MST designs have been investigated and compared under the same…

Computerized Adaptive Testing for Polytomous Motivation Items: Administration Mode Effects and a Comparison with Short Forms

ERIC Educational Resources Information Center

Hol, A. Michiel; Vorst, Harrie C. M.; Mellenbergh, Gideon J.

2007-01-01

In a randomized experiment (n = 515), a computerized and a computerized adaptive test (CAT) are compared. The item pool consists of 24 polytomous motivation items. Although items are carefully selected, calibration data show that Samejima's graded response model did not fit the data optimally. A simulation study is done to assess possible…

Computerized Adaptive Testing: Overview and Introduction.

ERIC Educational Resources Information Center

Meijer, Rob R.; Nering, Michael L.

1999-01-01

Provides an overview of computerized adaptive testing (CAT) and introduces contributions to this special issue. CAT elements discussed include item selection, estimation of the latent trait, item exposure, measurement precision, and item-bank development. (SLD)

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…

Variable-Length Computerized Adaptive Testing: Adaptation of the A-Stratified Strategy in Item Selection with Content Balancing

ERIC Educational Resources Information Center

Huo, Yan

2009-01-01

Variable-length computerized adaptive testing (CAT) can provide examinees with tailored test lengths. With the fixed standard error of measurement ("SEM") termination rule, variable-length CAT can achieve predetermined measurement precision by using relatively shorter tests compared to fixed-length CAT. To explore the application of…

A "Rearrangement Procedure" for Scoring Adaptive Tests with Review Options.

ERIC Educational Resources Information Center

Papanastasiou, Elena C.

Due to the increased popularity of computerized adaptive testing (CAT), many admissions tests, as well as certification and licensure examinations, have been transformed from their paper-and-pencil versions to computerized adaptive versions. A major difference between paper-and-pencil tests and CAT, from an examinees point of view, is that in many…

A "Rearrangement Procedure" for Scoring Adaptive Tests with Review Options

ERIC Educational Resources Information Center

Papanastasiou, Elena C.; Reckase, Mark D.

2007-01-01

Because of the increased popularity of computerized adaptive testing (CAT), many admissions tests, as well as certification and licensure examinations, have been transformed from their paper-and-pencil versions to computerized adaptive versions. A major difference between paper-and-pencil tests and CAT from an examinee's point of view is that in…

A Mixture Rasch Model-Based Computerized Adaptive Test for Latent Class Identification

ERIC Educational Resources Information Center

Jiao, Hong; Macready, George; Liu, Junhui; Cho, Youngmi

2012-01-01

This study explored a computerized adaptive test delivery algorithm for latent class identification based on the mixture Rasch model. Four item selection methods based on the Kullback-Leibler (KL) information were proposed and compared with the reversed and the adaptive KL information under simulated testing conditions. When item separation was…

Optimal Stratification of Item Pools in a-Stratified Computerized Adaptive Testing.

ERIC Educational Resources Information Center

Chang, Hua-Hua; van der Linden, Wim J.

2003-01-01

Developed a method based on 0-1 linear programming to stratify an item pool optimally for use in alpha-stratified adaptive testing. Applied the method to a previous item pool from the computerized adaptive test of the Graduate Record Examinations. Results show the new method performs well in practical situations. (SLD)

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

Equating Computerized Adaptive Certification Examinations: The Board of Registry Series of Studies.

ERIC Educational Resources Information Center

Lunz, Mary E.; Bergstrom, Betty A.

The Board of Registry (BOR) certifies medical technologists and other laboratory personnel. The BOR has studied adaptive testing for over 6 years and now administers all 17 BOR certification examinations using computerized adaptive testing (CAT). This paper presents an overview of the major research efforts from 1989 to the present related to test…

Validation of a Computerized Adaptive Version of the Schedule for Nonadaptive and Adaptive Personality (SNAP)

ERIC Educational Resources Information Center

Simms, Leonard J.; Clark, Lee Anna

2005-01-01

This is a validation study of a computerized adaptive (CAT) version of the Schedule for Nonadaptive and Adaptive Personality (SNAP) conducted with 413 undergraduates who completed the SNAP twice, 1 week apart. Participants were assigned randomly to 1 of 4 retest groups: (a) paper-and-pencil (P&P) SNAP, (b) CAT, (c) P&P/CAT, and (d) CAT/P&P. With…

Computerized Adaptive Testing: From Inquiry to Operation [Book Review].

ERIC Educational Resources Information Center

Gierl, Mark J.

1998-01-01

This book documents the research, development, and implementation efforts that allowed the U.S. Department of Defense to initiate the Computerized Adaptive Testing Armed Services Vocational Aptitude Battery Program for enlistment testing. Traces the history of this program over 30 years. (SLD)

On the Issue of Item Selection in Computerized Adaptive Testing with Response Times

ERIC Educational Resources Information Center

Veldkamp, Bernard P.

2016-01-01

Many standardized tests are now administered via computer rather than paper-and-pencil format. The computer-based delivery mode brings with it certain advantages. One advantage is the ability to adapt the difficulty level of the test to the ability level of the test taker in what has been termed computerized adaptive testing (CAT). A second…

Precision-Based Item Selection for Exposure Control in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Carroll, Ian A.

2017-01-01

Item exposure control is, relative to adaptive testing, a nascent concept that has emerged only in the last two to three decades on an academic basis as a practical issue in high-stakes computerized adaptive tests. This study aims to implement a new strategy in item exposure control by incorporating the standard error of the ability estimate into…

Preliminary Report on a National Cross-Validation of the Computerized Adaptive Screening Test (CAST).

ERIC Educational Resources Information Center

Knapp, Deirdre J.; Pliske, Rebecca M.

A study was conducted to validate the Army's Computerized Adaptive Screening Test (CAST), using data from 2,240 applicants from 60 army recruiting stations across the nation. CAST is a computer-assisted adaptive test used to predict performance on the Armed Forces Qualification Test (AFQT). AFQT scores are computed by adding four subtest scores of…

Procedures for Selecting Items for Computerized Adaptive Tests.

ERIC Educational Resources Information Center

Kingsbury, G. Gage; Zara, Anthony R.

1989-01-01

Several classical approaches and alternative approaches to item selection for computerized adaptive testing (CAT) are reviewed and compared. The study also describes procedures for constrained CAT that may be added to classical item selection approaches to allow them to be used for applied testing. (TJH)

Termination Criteria for Computerized Classification Testing

ERIC Educational Resources Information Center

Thompson, Nathan A.

2011-01-01

Computerized classification testing (CCT) is an approach to designing tests with intelligent algorithms, similar to adaptive testing, but specifically designed for the purpose of classifying examinees into categories such as "pass" and "fail." Like adaptive testing for point estimation of ability, the key component is the…

Adaptive Computerized Instruction.

ERIC Educational Resources Information Center

Ray, Roger D.; And Others

1995-01-01

Describes an artificially intelligent multimedia computerized instruction system capable of developing a conceptual image of what a student is learning while the student is learning it. It focuses on principles of learning and adaptive behavioral control systems theory upon which the system is designed and demonstrates multiple user modes.…

Balancing Flexible Constraints and Measurement Precision in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Moyer, Eric L.; Galindo, Jennifer L.; Dodd, Barbara G.

2012-01-01

Managing test specifications--both multiple nonstatistical constraints and flexibly defined constraints--has become an important part of designing item selection procedures for computerized adaptive tests (CATs) in achievement testing. This study compared the effectiveness of three procedures: constrained CAT, flexible modified constrained CAT,…

Individual Differences in Computerized Adaptive Testing.

ERIC Educational Resources Information Center

Kim, JinGyu

Research on the major computerized adaptive testing (CAT) strategies is reviewed, and some findings are reported that examine effects of examinee demographic and psychological characteristics on CAT strategies. In fixed branching strategies, all examinees respond to a common routing test, the score of which is used to assign examinees to a…

An Introduction to the Computerized Adaptive Testing

ERIC Educational Resources Information Center

Tian, Jian-quan; Miao, Dan-min; Zhu, Xia; Gong, Jing-jing

2007-01-01

Computerized adaptive testing (CAT) has unsurpassable advantages over traditional testing. It has become the mainstream in large scale examinations in modern society. This paper gives a brief introduction to CAT including differences between traditional testing and CAT, the principles of CAT, psychometric theory and computer algorithms of CAT, the…

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…

Computerized Adaptive Testing: An Overview and an Example.

ERIC Educational Resources Information Center

McBride, James R.

The advantages of computerized adaptive testing are discussed, and an example illustrates its use in sixth grade mathematics. These tests are administered at a computer terminal, and the test items to be administered are selected according to the difficulty level appropriate to the individual's ability. Tailoring increases the psychometric…

A Comparative Study of Online Item Calibration Methods in Multidimensional Computerized Adaptive Testing

ERIC Educational Resources Information Center

Chen, Ping

2017-01-01

Calibration of new items online has been an important topic in item replenishment for multidimensional computerized adaptive testing (MCAT). Several online calibration methods have been proposed for MCAT, such as multidimensional "one expectation-maximization (EM) cycle" (M-OEM) and multidimensional "multiple EM cycles"…

Multidimensional Computerized Adaptive Testing for Indonesia Junior High School Biology

ERIC Educational Resources Information Center

Kuo, Bor-Chen; Daud, Muslem; Yang, Chih-Wei

2015-01-01

This paper describes a curriculum-based multidimensional computerized adaptive test that was developed for Indonesia junior high school Biology. In adherence to the Indonesian curriculum of different Biology dimensions, 300 items was constructed, and then tested to 2238 students. A multidimensional random coefficients multinomial logit model was…

Computerized Adaptive Testing: Some Issues in Development.

ERIC Educational Resources Information Center

Orcutt, Venetia L.

The emergence of enhanced capabilities in computer technology coupled with the growing body of knowledge regarding item response theory has resulted in the expansion of computerized adaptive test (CAT) utilization in a variety of venues. Newcomers to the field need a more thorough understanding of item response theory (IRT) principles, their…

Variable-Length Computerized Adaptive Testing Based on Cognitive Diagnosis Models

ERIC Educational Resources Information Center

Hsu, Chia-Ling; Wang, Wen-Chung; Chen, Shu-Ying

2013-01-01

Interest in developing computerized adaptive testing (CAT) under cognitive diagnosis models (CDMs) has increased recently. CAT algorithms that use a fixed-length termination rule frequently lead to different degrees of measurement precision for different examinees. Fixed precision, in which the examinees receive the same degree of measurement…

Best Design for Multidimensional Computerized Adaptive Testing with the Bifactor Model

ERIC Educational Resources Information Center

Seo, Dong Gi; Weiss, David J.

2015-01-01

Most computerized adaptive tests (CATs) have been studied using the framework of unidimensional item response theory. However, many psychological variables are multidimensional and might benefit from using a multidimensional approach to CATs. This study investigated the accuracy, fidelity, and efficiency of a fully multidimensional CAT algorithm…

Application of the Bifactor Model to Computerized Adaptive Testing

ERIC Educational Resources Information Center

Seo, Dong Gi

2011-01-01

Most computerized adaptive tests (CAT) have been studied under the framework of unidimensional item response theory. However, many psychological variables are multidimensional and might benefit from using a multidimensional approach to CAT. In addition, a number of psychological variables (e.g., quality of life, depression) can be conceptualized…

Computerized Adaptive Testing System Design: Preliminary Design Considerations.

ERIC Educational Resources Information Center

Croll, Paul R.

A functional design model for a computerized adaptive testing (CAT) system was developed and presented through a series of hierarchy plus input-process-output (HIPO) diagrams. System functions were translated into system structure: specifically, into 34 software components. Implementation of the design in a physical system was addressed through…

Anonymity and Electronics: Adapting Preparation for Radiology Resident Examination.

PubMed

Chapman, Teresa; Reid, Janet R; O'Conner, Erin E

2017-06-01

Diagnostic radiology resident assessment has evolved from a traditional oral examination to computerized testing. Teaching faculty struggle to reconcile the differences between traditional teaching methods and residents' new preferences for computerized testing models generated by new examination styles. We aim to summarize the collective experiences of senior residents at three different teaching hospitals who participated in case review sessions using a computer-based, interactive, anonymous teaching tool, rather than the Socratic method. Feedback was collected from radiology residents following participation in a senior resident case review session using Nearpod, which allows residents to anonymously respond to the teaching material. Subjective resident feedback was uniformly enthusiastic. Ninety percent of residents favor a case-based board review incorporating multiple-choice questions, and 94% favor an anonymous response system. Nearpod allows for inclusion of multiple-choice questions while also providing direct feedback to the teaching faculty, helping to direct the instruction and clarify residents' gaps in knowledge before the Core Examination. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Development of a subjective cognitive decline questionnaire using item response theory: a pilot study.

PubMed

Gifford, Katherine A; Liu, Dandan; Romano, Raymond; Jones, Richard N; Jefferson, Angela L

2015-12-01

Subjective cognitive decline (SCD) may indicate unhealthy cognitive changes, but no standardized SCD measurement exists. This pilot study aims to identify reliable SCD questions. 112 cognitively normal (NC, 76±8 years, 63% female), 43 mild cognitive impairment (MCI; 77±7 years, 51% female), and 33 diagnostically ambiguous participants (79±9 years, 58% female) were recruited from a research registry and completed 57 self-report SCD questions. Psychometric methods were used for item-reduction. Factor analytic models assessed unidimensionality of the latent trait (SCD); 19 items were removed with extreme response distribution or trait-fit. Item response theory (IRT) provided information about question utility; 17 items with low information were dropped. Post-hoc simulation using computerized adaptive test (CAT) modeling selected the most commonly used items (n=9 of 21 items) that represented the latent trait well (r=0.94) and differentiated NC from MCI participants (F(1,146)=8.9, p=0.003). Item response theory and computerized adaptive test modeling identified nine reliable SCD items. This pilot study is a first step toward refining SCD assessment in older adults. Replication of these findings and validation with Alzheimer's disease biomarkers will be an important next step for the creation of a SCD screener.

Development of an item bank for the assessment of depression in persons with mental illnesses and physical diseases using Rasch analysis.

PubMed

Forkmann, Thomas; Boecker, Maren; Norra, Christine; Eberle, Nicole; Kircher, Tilo; Schauerte, Patrick; Mischke, Karl; Westhofen, Martin; Gauggel, Siegfried; Wirtz, Markus

2009-05-01

The calibration of item banks provides the basis for computerized adaptive testing that ensures high diagnostic precision and minimizes participants' test burden. The present study aimed at developing a new item bank that allows for assessing depression in persons with mental and persons with somatic diseases. The sample consisted of 161 participants treated for a depressive syndrome, and 206 participants with somatic illnesses (103 cardiologic, 103 otorhinolaryngologic; overall mean age = 44.1 years, SD =14.0; 44.7% women) to allow for validation of the item bank in both groups. Persons answered a pool of 182 depression items on a 5-point Likert scale. Evaluation of Rasch model fit (infit < 1.3), differential item functioning, dimensionality, local independence, item spread, item and person separation (>2.0), and reliability (>.80) resulted in a bank of 79 items with good psychometric properties. The bank provides items with a wide range of content coverage and may serve as a sound basis for computerized adaptive testing applications. It might also be useful for researchers who wish to develop new fixed-length scales for the assessment of depression in specific rehabilitation settings. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

The role of computerized diagnostic proposals in the interpretation of the 12-lead electrocardiogram by cardiology and non-cardiology fellows.

PubMed

Novotny, Tomas; Bond, Raymond; Andrsova, Irena; Koc, Lumir; Sisakova, Martina; Finlay, Dewar; Guldenring, Daniel; Spinar, Jindrich; Malik, Marek

2017-05-01

Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities. A team of 15 junior Cardiology Fellows and 15 Non-Cardiology Fellows interpreted the ECGs in 3 phases: without any diagnostic proposal, with a single diagnostic proposal (half of them intentionally incorrect), and with four diagnostic proposals (only one of them being correct) for each ECG. Self-rated confidence of each interpretation was collected. Availability of diagnostic proposals significantly increased the diagnostic accuracy (p<0.001). Nevertheless, in case of a single proposal (either correct or incorrect) the increase of accuracy was present in interpretations with correct diagnostic proposals, while the accuracy was substantially reduced with incorrect proposals. Confidence levels poorly correlated with interpretation scores (rho≈2, p<0.001). Logistic regression showed that an interpreter is most likely to be correct when the ECG offers a correct diagnostic proposal (OR=10.87) or multiple proposals (OR=4.43). Diagnostic proposals affect the diagnostic accuracy of ECG interpretations. The accuracy is significantly influenced especially when a single diagnostic proposal (either correct or incorrect) is provided. The study suggests that the presentation of multiple computerized diagnoses is likely to improve the diagnostic accuracy of interpreters. Copyright © 2017 Elsevier B.V. All rights reserved.

Microcomputer Network for Computerized Adaptive Testing (CAT). [Final Report, FY81-83].

ERIC Educational Resources Information Center

Quan, Baldwin; And Others

Computerized adaptive testing (CAT) offers the opportunity to replace paper-and-pencil aptitude tests such as the Armed Services Vocational Aptitude Battery with shorter, more accurate, and more secure computer-administered tests. Its potential advantages need to be verified by experimental administration of automated tests to military recruit…

An Efficiency Balanced Information Criterion for Item Selection in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Han, Kyung T.

2012-01-01

Successful administration of computerized adaptive testing (CAT) programs in educational settings requires that test security and item exposure control issues be taken seriously. Developing an item selection algorithm that strikes the right balance between test precision and level of item pool utilization is the key to successful implementation…

A Framework for the Development of Computerized Adaptive Tests

ERIC Educational Resources Information Center

Thompson, Nathan A.; Weiss, David J.

2011-01-01

A substantial amount of research has been conducted over the past 40 years on technical aspects of computerized adaptive testing (CAT), such as item selection algorithms, item exposure controls, and termination criteria. However, there is little literature providing practical guidance on the development of a CAT. This paper seeks to collate some…

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…

Deriving Stopping Rules for Multidimensional Computerized Adaptive Testing

ERIC Educational Resources Information Center

Wang, Chun; Chang, Hua-Hua; Boughton, Keith A.

2013-01-01

Multidimensional computerized adaptive testing (MCAT) is able to provide a vector of ability estimates for each examinee, which could be used to provide a more informative profile of an examinee's performance. The current literature on MCAT focuses on the fixed-length tests, which can generate less accurate results for those examinees whose…

Item Pocket Method to Allow Response Review and Change in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Han, Kyung T.

2013-01-01

Most computerized adaptive testing (CAT) programs do not allow test takers to review and change their responses because it could seriously deteriorate the efficiency of measurement and make tests vulnerable to manipulative test-taking strategies. Several modified testing methods have been developed that provide restricted review options while…

Firestar-"D": Computerized Adaptive Testing Simulation Program for Dichotomous Item Response Theory Models

ERIC Educational Resources Information Center

Choi, Seung W.; Podrabsky, Tracy; McKinney, Natalie

2012-01-01

Computerized adaptive testing (CAT) enables efficient and flexible measurement of latent constructs. The majority of educational and cognitive measurement constructs are based on dichotomous item response theory (IRT) models. An integral part of developing various components of a CAT system is conducting simulations using both known and empirical…

A Comparison of Procedures for Content-Sensitive Item Selection in Computerized Adaptive Tests.

ERIC Educational Resources Information Center

Kingsbury, G. Gage; Zara, Anthony R.

1991-01-01

This simulation investigated two procedures that reduce differences between paper-and-pencil testing and computerized adaptive testing (CAT) by making CAT content sensitive. Results indicate that the price in terms of additional test items of using constrained CAT for content balancing is much smaller than that of using testlets. (SLD)

Detection of Person Misfit in Computerized Adaptive Tests with Polytomous Items.

ERIC Educational Resources Information Center

van Krimpen-Stoop, Edith M. L. A.; Meijer, Rob R.

2002-01-01

Compared the nominal and empirical null distributions of the standardized log-likelihood statistic for polytomous items for paper-and-pencil (P&P) and computerized adaptive tests (CATs). Results show that the empirical distribution of the statistic differed from the assumed standard normal distribution for both P&P tests and CATs. Also…

A Feedback Control Strategy for Enhancing Item Selection Efficiency in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Weissman, Alexander

2006-01-01

A computerized adaptive test (CAT) may be modeled as a closed-loop system, where item selection is influenced by trait level ([theta]) estimation and vice versa. When discrepancies exist between an examinee's estimated and true [theta] levels, nonoptimal item selection is a likely result. Nevertheless, examinee response behavior consistent with…

Computerized Adaptive Testing for Effective and Efficient Measurement in Counseling and Education

ERIC Educational Resources Information Center

Weiss, David J.

2004-01-01

Computerized adaptive testing (CAT) is described and compared with conventional tests, and its advantages summarized. Some item response theory concepts used in CAT are summarized and illustrated. The author describes the potential usefulness of CAT in counseling and education and reviews some current issues in the implementation of CAT.

Controlling Item Exposure Conditional on Ability in Computerized Adaptive Testing.

ERIC Educational Resources Information Center

Stocking, Martha L.; Lewis, Charles

1998-01-01

Ensuring item and pool security in a continuous testing environment is explored through a new method of controlling exposure rate of items conditional on ability level in computerized testing. Properties of this conditional control on exposure rate, when used in conjunction with a particular adaptive testing algorithm, are explored using simulated…

Cross-Validation of the Computerized Adaptive Screening Test (CAST).

ERIC Educational Resources Information Center

Pliske, Rebecca M.; And Others

The Computerized Adaptive Screening Test (CAST) was developed to provide an estimate at recruiting stations of prospects' Armed Forces Qualification Test (AFQT) scores. The CAST was designed to replace the paper-and-pencil Enlistment Screening Test (EST). The initial validation study of CAST indicated that CAST predicts AFQT at least as accurately…

Optimal Item Pool Design for a Highly Constrained Computerized Adaptive Test

ERIC Educational Resources Information Center

He, Wei

2010-01-01

Item pool quality has been regarded as one important factor to help realize enhanced measurement quality for the computerized adaptive test (CAT) (e.g., Flaugher, 2000; Jensema, 1977; McBride & Wise, 1976; Reckase, 1976; 2003; van der Linden, Ariel, & Veldkamp, 2006; Veldkamp & van der Linden, 2000; Xing & Hambleton, 2004). However, studies are…

[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.

Multistage Computerized Adaptive Testing with Uniform Item Exposure

ERIC Educational Resources Information Center

Edwards, Michael C.; Flora, David B.; Thissen, David

2012-01-01

This article describes a computerized adaptive test (CAT) based on the uniform item exposure multi-form structure (uMFS). The uMFS is a specialization of the multi-form structure (MFS) idea described by Armstrong, Jones, Berliner, and Pashley (1998). In an MFS CAT, the examinee first responds to a small fixed block of items. The items comprising…

Development and Simulation Testing of a Computerized Adaptive Version of the Philadelphia Naming Test

ERIC Educational Resources Information Center

Hula, William D.; Kellough, Stacey; Fergadiotis, Gerasimos

2015-01-01

Purpose: The purpose of this study was to develop a computerized adaptive test (CAT) version of the Philadelphia Naming Test (PNT; Roach, Schwartz, Martin, Grewal, & Brecher, 1996), to reduce test length while maximizing measurement precision. This article is a direct extension of a companion article (Fergadiotis, Kellough, & Hula, 2015),…

The Influence of Item Calibration Error on Variable-Length Computerized Adaptive Testing

ERIC Educational Resources Information Center

Patton, Jeffrey M.; Cheng, Ying; Yuan, Ke-Hai; Diao, Qi

2013-01-01

Variable-length computerized adaptive testing (VL-CAT) allows both items and test length to be "tailored" to examinees, thereby achieving the measurement goal (e.g., scoring precision or classification) with as few items as possible. Several popular test termination rules depend on the standard error of the ability estimate, which in turn depends…

Hybrid Computerized Adaptive Testing: From Group Sequential Design to Fully Sequential Design

ERIC Educational Resources Information Center

Wang, Shiyu; Lin, Haiyan; Chang, Hua-Hua; Douglas, Jeff

2016-01-01

Computerized adaptive testing (CAT) and multistage testing (MST) have become two of the most popular modes in large-scale computer-based sequential testing. Though most designs of CAT and MST exhibit strength and weakness in recent large-scale implementations, there is no simple answer to the question of which design is better because different…

Assembling a Computerized Adaptive Testing Item Pool as a Set of Linear Tests

ERIC Educational Resources Information Center

van der Linden, Wim J.; Ariel, Adelaide; Veldkamp, Bernard P.

2006-01-01

Test-item writing efforts typically results in item pools with an undesirable correlational structure between the content attributes of the items and their statistical information. If such pools are used in computerized adaptive testing (CAT), the algorithm may be forced to select items with less than optimal information, that violate the content…

Strategies for Controlling Item Exposure in Computerized Adaptive Testing with the Generalized Partial Credit Model

ERIC Educational Resources Information Center

Davis, Laurie Laughlin

2004-01-01

Choosing a strategy for controlling item exposure has become an integral part of test development for computerized adaptive testing (CAT). This study investigated the performance of six procedures for controlling item exposure in a series of simulated CATs under the generalized partial credit model. In addition to a no-exposure control baseline…

Effects of Content Balancing and Item Selection Method on Ability Estimation in Computerized Adaptive Tests

ERIC Educational Resources Information Center

Sahin, Alper; Ozbasi, Durmus

2017-01-01

Purpose: This study aims to reveal effects of content balancing and item selection method on ability estimation in computerized adaptive tests by comparing Fisher's maximum information (FMI) and likelihood weighted information (LWI) methods. Research Methods: Four groups of examinees (250, 500, 750, 1000) and a bank of 500 items with 10 different…

Can Computerized Adaptive Testing Work in Students' Admission to Higher Education Programs in Turkey?

ERIC Educational Resources Information Center

Kalender, Ilker; Berberoglu, Giray

2017-01-01

Admission into university in Turkey is very competitive and features a number of practical problems regarding not only the test administration process itself, but also concerning the psychometric properties of test scores. Computerized adaptive testing (CAT) is seen as a possible alternative approach to solve these problems. In the first phase of…

Computerized Adaptive Testing, Anxiety Levels, and Gender Differences

ERIC Educational Resources Information Center

Fritts, Barbara E.; Marszalek, Jacob M.

2010-01-01

This study compares the amount of test anxiety experienced on a computerized adaptive test (CAT) to a paper-and-pencil test (P&P), as well as the state test anxiety experienced between males and females. Ninety-four middle school CAT examinees were compared to 65 middle school P&P examinees on their responses to the State-Trait Anxiety…

Development and Application of Detection Indices for Measuring Guessing Behaviors and Test-Taking Effort in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Chang, Shu-Ren; Plake, Barbara S.; Kramer, Gene A.; Lien, Shu-Mei

2011-01-01

This study examined the amount of time that different ability-level examinees spend on questions they answer correctly or incorrectly across different pretest item blocks presented on a fixed-length, time-restricted computerized adaptive testing (CAT). Results indicate that different ability-level examinees require different amounts of time to…

Application of Computerized Adaptive Testing to Entrance Examination for Graduate Studies in Turkey

ERIC Educational Resources Information Center

Bulut, Okan; Kan, Adnan

2012-01-01

Problem Statement: Computerized adaptive testing (CAT) is a sophisticated and efficient way of delivering examinations. In CAT, items for each examinee are selected from an item bank based on the examinee's responses to the items. In this way, the difficulty level of the test is adjusted based on the examinee's ability level. Instead of…

Implementation of the Computerized Adaptive Version of the Armed Services Vocational Aptitude Battery.

ERIC Educational Resources Information Center

Curran, Linda T.; Jordan, Linda A.

In the summer of 1996, the U.S. Armed Services will implement the computerized adaptive testing version of the Armed Services Vocational Aptitude Battery (CAT-ASVAB). When conversion is completed at the 65 targeted military entrance processing stations, about half the applicants will take this test version. This paper describes the efforts that…

Multiple Maximum Exposure Rates in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Ramon Barrada, Juan; Veldkamp, Bernard P.; Olea, Julio

2009-01-01

Computerized adaptive testing is subject to security problems, as the item bank content remains operative over long periods and administration time is flexible for examinees. Spreading the content of a part of the item bank could lead to an overestimation of the examinees' trait level. The most common way of reducing this risk is to impose a…

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…

When Cognitive Diagnosis Meets Computerized Adaptive Testing: CD-CAT

ERIC Educational Resources Information Center

Cheng, Ying

2009-01-01

Computerized adaptive testing (CAT) is a mode of testing which enables more efficient and accurate recovery of one or more latent traits. Traditionally, CAT is built upon Item Response Theory (IRT) models that assume unidimensionality. However, the problem of how to build CAT upon latent class models (LCM) has not been investigated until recently,…

Optimizing the Use of Response Times for Item Selection in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Choe, Edison M.; Kern, Justin L.; Chang, Hua-Hua

2018-01-01

Despite common operationalization, measurement efficiency of computerized adaptive testing should not only be assessed in terms of the number of items administered but also the time it takes to complete the test. To this end, a recent study introduced a novel item selection criterion that maximizes Fisher information per unit of expected response…

Item Pool Design for an Operational Variable-Length Computerized Adaptive Test

ERIC Educational Resources Information Center

He, Wei; Reckase, Mark D.

2014-01-01

For computerized adaptive tests (CATs) to work well, they must have an item pool with sufficient numbers of good quality items. Many researchers have pointed out that, in developing item pools for CATs, not only is the item pool size important but also the distribution of item parameters and practical considerations such as content distribution…

A Multiple Objective Test Assembly Approach for Exposure Control Problems in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Veldkamp, Bernard P.; Verschoor, Angela J.; Eggen, Theo J. H. M.

2010-01-01

Overexposure and underexposure of items in the bank are serious problems in operational computerized adaptive testing (CAT) systems. These exposure problems might result in item compromise, or point at a waste of investments. The exposure control problem can be viewed as a test assembly problem with multiple objectives. Information in the test has…

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

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…

Clinical applications of computerized thermography

NASA Technical Reports Server (NTRS)

Anbar, Michael

1988-01-01

Computerized or digital, thermography is a rapidly growing diagnostic imaging modality. It has superseded contact thermography and analog imaging thermography which do not allow effective quantization. Medical applications of digital thermography can be classified in two groups: static and dynamic imaging. They can also be classified into macro thermography (resolution greater than 1 mm) and micro thermography (resolution less than 100 microns). Both modalities allow a thermal resolution of 0.1 C. The diagnostic power of images produced by any of these modalities can be augmented by the use of digital image enhancement and image recognition procedures. Computerized thermography has been applied in neurology, cardiovascular and plastic surgery, rehabilitation and sports medicine, psychiatry, dermatology and ophthalmology. Examples of these applications are shown and their scope and limitations are discussed.

Effects of Calibration Sample Size and Item Bank Size on Ability Estimation in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Sahin, Alper; Weiss, David J.

2015-01-01

This study aimed to investigate the effects of calibration sample size and item bank size on examinee ability estimation in computerized adaptive testing (CAT). For this purpose, a 500-item bank pre-calibrated using the three-parameter logistic model with 10,000 examinees was simulated. Calibration samples of varying sizes (150, 250, 350, 500,…

Construct Validity and Measurement Invariance of Computerized Adaptive Testing: Application to Measures of Academic Progress (MAP) Using Confirmatory Factor Analysis

ERIC Educational Resources Information Center

Wang, Shudong; McCall, Marty; Jiao, Hong; Harris, Gregg

2012-01-01

The purposes of this study are twofold. First, to investigate the construct or factorial structure of a set of Reading and Mathematics computerized adaptive tests (CAT), "Measures of Academic Progress" (MAP), given in different states at different grades and academic terms. The second purpose is to investigate the invariance of test…

An Item Response Theory-Based, Computerized Adaptive Testing Version of the MacArthur-Bates Communicative Development Inventory: Words & Sentences (CDI:WS)

ERIC Educational Resources Information Center

Makransky, Guido; Dale, Philip S.; Havmose, Philip; Bleses, Dorthe

2016-01-01

Purpose: This study investigated the feasibility and potential validity of an item response theory (IRT)-based computerized adaptive testing (CAT) version of the MacArthur-Bates Communicative Development Inventory: Words & Sentences (CDI:WS; Fenson et al., 2007) vocabulary checklist, with the objective of reducing length while maintaining…

Considering the Use of General and Modified Assessment Items in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Wyse, Adam E.; Albano, Anthony D.

2015-01-01

This article used several data sets from a large-scale state testing program to examine the feasibility of combining general and modified assessment items in computerized adaptive testing (CAT) for different groups of students. Results suggested that several of the assumptions made when employing this type of mixed-item CAT may not be met for…

A Method for the Comparison of Item Selection Rules in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Barrada, Juan Ramon; Olea, Julio; Ponsoda, Vicente; Abad, Francisco Jose

2010-01-01

In a typical study comparing the relative efficiency of two item selection rules in computerized adaptive testing, the common result is that they simultaneously differ in accuracy and security, making it difficult to reach a conclusion on which is the more appropriate rule. This study proposes a strategy to conduct a global comparison of two or…

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…

Person Fit Analysis in Computerized Adaptive Testing Using Tests for a Change Point

ERIC Educational Resources Information Center

Sinharay, Sandip

2016-01-01

Meijer and van Krimpen-Stoop noted that the number of person-fit statistics (PFSs) that have been designed for computerized adaptive tests (CATs) is relatively modest. This article partially addresses that concern by suggesting three new PFSs for CATs. The statistics are based on tests for a change point and can be used to detect an abrupt change…

COMP (Computerized Operational Materials Prescription).

ERIC Educational Resources Information Center

Rosenkranz, Catherine I.

Described is Project COMP (Computerized Operational Materials Prescription), an individualized reading instructional program for educable mentally retarded (EMR) children in regular or special classes. The program is designed to correlate with the Wisconsin Design for Reading (WDR) and to utilize a diagnostic teaching specialist who uses specific…

[The clinical economic analysis of the methods of ischemic heart disease diagnostics].

PubMed

Kalashnikov, V Iu; Mitriagina, S N; Syrkin, A L; Poltavskaia, M G; Sorokina, E G

2007-01-01

The clinical economical analysis was applied to assess the application of different techniques of ischemic heart disease diagnostics - the electro-cardiographic monitoring, the treadmill-testing, the stress-echo cardiographic with dobutamine, the single-photon computerized axial tomography with load, the multi-spiral computerized axial tomography with coronary arteries staining in patients with different initial probability of disease occurrence. In all groups, the best value of "cost-effectiveness" had the treadmill-test. The patients with low risk needed 17.4 rubles to precise the probability of ischemic heart disease occurrence at 1%. In the group with medium and high risk this indicator was 9.4 and 24.7 rubles correspondingly. It is concluded that to precise the probability of ischemic heart disease occurrence after tredmil-test in the patients with high probability it is appropriate to use the single-photon computerized axial tomography with load and in the case of patients with low probability the multi-spiral computerized axial tomography with coronary arteries staining.

Cultural adaptation of the Latin American version of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI) (v 3.0) for use in Spain.

PubMed

Navarro-Mateu, Fernando; Morán-Sánchez, Inés; Alonso, Jordi; Tormo, Ma José; Pujalte, Ma Luisa; Garriga, Ascensión; Aguilar-Gaxiola, Sergio; Navarro, Carmen

2013-01-01

To develop a Spanish version of the WHO-Composite International Diagnostic Interview (WHO-CIDI) applicable to Spain, through cultural adaptation of its most recent Latin American (LA v 20.0) version. A 1-week training course on the WHO-CIDI was provided by certified trainers. An expert panel reviewed the LA version, identified words or expressions that needed to be adapted to the cultural or linguistic norms for Spain, and proposed alternative expressions that were agreed on through consensus. The entire process was supervised and approved by a member of the WHO-CIDI Editorial Committee. The changes were incorporated into a Computer Assisted Personal Interview (CAPI) format and the feasibility and administration time were pilot tested in a convenience sample of 32 volunteers. A total of 372 questions were slightly modified (almost 7% of approximately 5000 questions in the survey) and incorporated into the CAPI version of the WHO-CIDI. Most of the changes were minor - but important - linguistic adaptations, and others were related to specific Spanish institutions and currency. In the pilot study, the instrument's mean completion administration time was 2h and 10min, with an interquartile range from 1.5 to nearly 3h. All the changes made were tested and officially approved. The Latin American version of the WHO-CIDI was successfully adapted and pilot-tested in its computerized format and is now ready for use in Spain. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

[Modernized study on eye's signs of blood-stasis syndrome].

PubMed

Wu, Rui; Xie, Jian-xiang; Zhao, Feng-da

2011-03-01

To make out a computerized formula to diagnose eye's signs of blood-stasis syndrome (BSS), and to improve the previous diagnostic methods by naked eyes. The formula was created by detecting and analyzing the changes of eye's signs in 544 patients (261 of non-BSS and 283 of BSS) quantitatively, adopting computer's color scale principle. And the sensitivity, specificity and accuracy of the formula were verified in 382 patients (97 non-BSS and 285 of BSS). The computerized integral was compared with the naked eye integral, and the normal reference value was calculated with percentile. Various observatory indices of eye's sign were positively correlated with BSS. The specificity of the computerized method was 83.5%, and the diagnostic sensitivity was 89.8%, the accuracy 88.2%, and the correct index 0.733. Comparisons between the computerized integral method and the naked eye integral method showed significant difference in patients of non-BSS or of BSS in various degrees (including mild, moderate and severe) (P < 0.01). The reference value of the naked eye method was below 15. The computerized formula of eye's signs has higher specificity and sensitivity in the diagnosis of BSS, while the naked eye integral method is proved to be useful.

A Comparison of Item Selection Procedures Using Different Ability Estimation Methods in Computerized Adaptive Testing Based on the Generalized Partial Credit Model

ERIC Educational Resources Information Center

Ho, Tsung-Han

2010-01-01

Computerized adaptive testing (CAT) provides a highly efficient alternative to the paper-and-pencil test. By selecting items that match examinees' ability levels, CAT not only can shorten test length and administration time but it can also increase measurement precision and reduce measurement error. In CAT, maximum information (MI) is the most…

Development of a Computerized Adaptive Testing for Diagnosing the Cognitive Process of Grade 7 Students in Learning Algebra, Using Multidimensional Item Response Theory

ERIC Educational Resources Information Center

Senarat, Somprasong; Tayraukham, Sombat; Piyapimonsit, Chatsiri; Tongkhambanjong, Sakesan

2013-01-01

The purpose of this research is to develop a multidimensional computerized adaptive test for diagnosing the cognitive process of grade 7 students in learning algebra by applying multidimensional item response theory. The research is divided into 4 steps: 1) the development of item bank of algebra, 2) the development of the multidimensional…

Computer-Based and Paper-Based Measurement of Semantic Knowledge

DTIC Science & Technology

1989-01-01

of Personality Assessment , 34, 353-361. McArthur, D. L., & Choppin, B. H. (1984). Computerized diagnostic testing. Journal 15 of Educational...Computers in Human Behavior, 1, 49-58. Lushene, R. E., O’Neii, H. F., & Dunn, T. (1974). Equivalent validity of a completely computerized MMPI. Journal

Initial clinical experience with computerized tomography of the body.

PubMed

Stephens, D H; Sheedy, P F; Hattery, R R; Hartman, G W

1976-04-01

Computerized tomography of the body, now possible with an instrument that can complete a scan rapidly enough to permit patients to suspend respiration, adds an important new dimension to radiologic diagnosis. Cross-sectional antomy is uniquely reconstructed to provide accurate diagnostic information for various disorders throughout the body.

The Use of Statistical Process Control-Charts for Person-Fit Analysis on Computerized Adaptive Testing. LSAC Research Report Series.

ERIC Educational Resources Information Center

Meijer, Rob R.; van Krimpen-Stoop, Edith M. L. A.

In this study a cumulative-sum (CUSUM) procedure from the theory of Statistical Process Control was modified and applied in the context of person-fit analysis in a computerized adaptive testing (CAT) environment. Six person-fit statistics were proposed using the CUSUM procedure, and three of them could be used to investigate the CAT in online test…

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.

[Complex automatic data processing in multi-profile hospitals].

PubMed

Dovzhenko, Iu M; Panov, G D

1990-01-01

The computerization of data processing in multi-disciplinary hospitals is the key factor in raising the quality of medical care provided to the population, intensifying the work of the personnel, improving the curative and diagnostic process and the use of resources. Even a small experience in complex computerization at the Botkin Hospital indicates that due to the use of the automated system the quality of data processing in being improved, a high level of patients' examination is being provided, a speedy training of young specialists is being achieved, conditions are being created for continuing education of physicians through the analysis of their own activity. At big hospitals a complex solution of administrative and curative diagnostic tasks on the basis of general hospital network of display connection and general hospital data bank is the most prospective form of computerization.

Combining computer adaptive testing technology with cognitively diagnostic assessment.

PubMed

McGlohen, Meghan; Chang, Hua-Hua

2008-08-01

A major advantage of computerized adaptive testing (CAT) is that it allows the test to home in on an examinee's ability level in an interactive manner. The aim of the new area of cognitive diagnosis is to provide information about specific content areas in which an examinee needs help. The goal of this study was to combine the benefit of specific feedback from cognitively diagnostic assessment with the advantages of CAT. In this study, three approaches to combining these were investigated: (1) item selection based on the traditional ability level estimate (theta), (2) item selection based on the attribute mastery feedback provided by cognitively diagnostic assessment (alpha), and (3) item selection based on both the traditional ability level estimate (theta) and the attribute mastery feedback provided by cognitively diagnostic assessment (alpha). The results from these three approaches were compared for theta estimation accuracy, attribute mastery estimation accuracy, and item exposure control. The theta- and alpha-based condition outperformed the alpha-based condition regarding theta estimation, attribute mastery pattern estimation, and item exposure control. Both the theta-based condition and the theta- and alpha-based condition performed similarly with regard to theta estimation, attribute mastery estimation, and item exposure control, but the theta- and alpha-based condition has an additional advantage in that it uses the shadow test method, which allows the administrator to incorporate additional constraints in the item selection process, such as content balancing, item type constraints, and so forth, and also to select items on the basis of both the current theta and alpha estimates, which can be built on top of existing 3PL testing programs.

Developing a modular architecture for creation of rule-based clinical diagnostic criteria.

PubMed

Hong, Na; Pathak, Jyotishman; Chute, Christopher G; Jiang, Guoqian

2016-01-01

With recent advances in computerized patient records system, there is an urgent need for producing computable and standards-based clinical diagnostic criteria. Notably, constructing rule-based clinical diagnosis criteria has become one of the goals in the International Classification of Diseases (ICD)-11 revision. However, few studies have been done in building a unified architecture to support the need for diagnostic criteria computerization. In this study, we present a modular architecture for enabling the creation of rule-based clinical diagnostic criteria leveraging Semantic Web technologies. The architecture consists of two modules: an authoring module that utilizes a standards-based information model and a translation module that leverages Semantic Web Rule Language (SWRL). In a prototype implementation, we created a diagnostic criteria upper ontology (DCUO) that integrates ICD-11 content model with the Quality Data Model (QDM). Using the DCUO, we developed a transformation tool that converts QDM-based diagnostic criteria into Semantic Web Rule Language (SWRL) representation. We evaluated the domain coverage of the upper ontology model using randomly selected diagnostic criteria from broad domains (n = 20). We also tested the transformation algorithms using 6 QDM templates for ontology population and 15 QDM-based criteria data for rule generation. As the results, the first draft of DCUO contains 14 root classes, 21 subclasses, 6 object properties and 1 data property. Investigation Findings, and Signs and Symptoms are the two most commonly used element types. All 6 HQMF templates are successfully parsed and populated into their corresponding domain specific ontologies and 14 rules (93.3 %) passed the rule validation. Our efforts in developing and prototyping a modular architecture provide useful insight into how to build a scalable solution to support diagnostic criteria representation and computerization.

How to Use the DX SYSTEM of Diagnostic Testing. Methodology Project.

ERIC Educational Resources Information Center

McArthur, David; Cabello, Beverly

The DX SYSTEM of Diagnostic Testing is an easy-to-use computerized system for developing and administering diagnostic tests. A diagnostic test measures a student's mastery of a specific domain (skill or content area). It examines the necessary subskills hierarchically from the most to the least complex. The DX SYSTEM features tailored testing with…

Combined single photon emission computerized tomography and conventional computerized tomography: Clinical value for the shoulder surgeons?

PubMed Central

Hirschmann, Michael T.; Schmid, Rahel; Dhawan, Ranju; Skarvan, Jiri; Rasch, Helmut; Friederich, Niklaus F.; Emery, Roger

2011-01-01

With the cases described, we strive to introduce single photon emission computerized tomography in combination with conventional computer tomography (SPECT/CT) to shoulder surgeons, illustrate the possible clinical value it may offer as new diagnostic radiologic modality, and discuss its limitations. SPECT/CT may facilitate the establishment of diagnosis, process of decision making, and further treatment for complex shoulder pathologies. Some of these advantages were highlighted in cases that are frequently seen in most shoulder clinics. PMID:22058640

Computerized Adaptive Testing System Design: Preliminary Design Considerations.

DTIC Science & Technology

1982-07-01

the administrative or operational requirements of CAT and presented - # k*----.,ku nh-n.-utu (IPOI efi~g.2me (PMU tQ7q. vim NPRDC TR 82-52 July 1982...design model for a computerized adaptive testing ( CAT ) system was developed and presented through a series of hierarchy plus input-process-output (HIPO...physical system was addressed through brief discussions of hardware, software, interfaces, and personnel requirements. Further steps in CAT system

[The role of multidetector computer tomography in diagnosis of acute pancreatitis].

PubMed

Lohanikhina, K Iu; Hordiienko, K P; Kozarenko, T M

2014-10-01

With the objective to improve the diagnostic semiotics of an acute pancreatitis (AP) 35 patients were examined, using 64-cut computeric tomograph Lightspeed VCT (GE, USA) with intravenous augmentation in arterial and portal phases. Basing on analysis of the investigations conducted, using multidetector computeric tomography (MDCT), the AP semiotics was systematized, which is characteristic for oedematous and destructive forms, diagnosed in 19 (44.2%) and 16 (45.8%) patients, accordingly. The procedure for estimation of preservation of the organ functional capacity in pancreonecrosis pres- ence was elaborated, promoting rising of the method diagnostic efficacy by 5.3 - 9.4%.

Rapid and Accurate Behavioral Health Diagnostic Screening: Initial Validation Study of a Web-Based, Self-Report Tool (the SAGE-SR)

PubMed Central

Purcell, Susan E; Rhea, Karen; Maier, Philip; First, Michael; Zweede, Lisa; Sinisterra, Manuela; Nunn, M Brad; Austin, Marie-Paule; Brodey, Inger S

2018-01-01

Background The Structured Clinical Interview for DSM (SCID) is considered the gold standard assessment for accurate, reliable psychiatric diagnoses; however, because of its length, complexity, and training required, the SCID is rarely used outside of research. Objective This paper aims to describe the development and initial validation of a Web-based, self-report screening instrument (the Screening Assessment for Guiding Evaluation-Self-Report, SAGE-SR) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the SCID-5-Clinician Version (CV) intended to make accurate, broad-based behavioral health diagnostic screening more accessible within clinical care. Methods First, study staff drafted approximately 1200 self-report items representing individual granular symptoms in the diagnostic criteria for the 8 primary SCID-CV modules. An expert panel iteratively reviewed, critiqued, and revised items. The resulting items were iteratively administered and revised through 3 rounds of cognitive interviewing with community mental health center participants. In the first 2 rounds, the SCID was also administered to participants to directly compare their Likert self-report and SCID responses. A second expert panel evaluated the final pool of items from cognitive interviewing and criteria in the DSM-5 to construct the SAGE-SR, a computerized adaptive instrument that uses branching logic from a screener section to administer appropriate follow-up questions to refine the differential diagnoses. The SAGE-SR was administered to healthy controls and outpatient mental health clinic clients to assess test duration and test-retest reliability. Cutoff scores for screening into follow-up diagnostic sections and criteria for inclusion of diagnoses in the differential diagnosis were evaluated. Results The expert panel reduced the initial 1200 test items to 664 items that panel members agreed collectively represented the SCID items from the 8 targeted modules and DSM criteria for the covered diagnoses. These 664 items were iteratively submitted to 3 rounds of cognitive interviewing with 50 community mental health center participants; the expert panel reviewed session summaries and agreed on a final set of 661 clear and concise self-report items representing the desired criteria in the DSM-5. The SAGE-SR constructed from this item pool took an average of 14 min to complete in a nonclinical sample versus 24 min in a clinical sample. Responses to individual items can be combined to generate DSM criteria endorsements and differential diagnoses, as well as provide indices of individual symptom severity. Preliminary measures of test-retest reliability in a small, nonclinical sample were promising, with good to excellent reliability for screener items in 11 of 13 diagnostic screening modules (intraclass correlation coefficient [ICC] or kappa coefficients ranging from .60 to .90), with mania achieving fair test-retest reliability (ICC=.50) and other substance use endorsed too infrequently for analysis. Conclusions The SAGE-SR is a computerized adaptive self-report instrument designed to provide rigorous differential diagnostic information to clinicians. PMID:29572204

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).

Equivalent-Groups versus Single-Group Equating Designs for the Accelerated CAT-ASVAB (Computerized Adaptive Test-Armed Services Vocational Aptitude Battery) Project.

DTIC Science & Technology

1987-01-01

DESIGNS FOR THE ACCELERATED CAT -ASVAB * PROJECT Peter H. Stoloff DTIC’- , " SELECTE -NOV 2 3 987 A Division of Hudson Institute CENTER FOR NAVAL ANALYSES...65153M C0031 SI TITLE (Include Security Classification) Equivalent-Groups Versus Single-Group Equating Designs For The Accelerated CAT -ASVAB Project...GROUP ACAP (Accelerated CAT -ASVAB Program), Aptitude tests, ASVAB (Armed 05 10 Services Vocational Aptitude Battery), CAT (Computerized Adaptive Test

Methodology for vocational psychodiagnostics of senior schoolchildren using information technologies

NASA Astrophysics Data System (ADS)

Bogdanovskaya, I. M.; Kosheleva, A. N.; Kiselev, P. B.; Davydova, Yu. A.

2017-01-01

The article identifies the role and main problems of vocational psychodiagnostics in modern socio-cultural conditions. It analyzes the potentials of information technologies in vocational psychodiagnostics of senior schoolchildren. The article describes the theoretical and methodological grounds, content and diagnostic potentials of the computerized method in vocational psychodiagnostics. The computerized method includes three blocks of sub-tests to identify intellectual potential, personal qualities, professional interests and values, career orientations, as well as subtests to analyze the specific life experience of senior schoolchildren. The results of diagnostics allow developing an integrated psychodiagnostic conclusion with recommendations. The article contains options of software architecture for the given method.

Clinical Use of the Pediatric Attention Disorders Diagnostic Screener for Children at Risk for Attention Deficit Hyperactivity Disorder: Case Illustrations

ERIC Educational Resources Information Center

Keiser, Ashley; Reddy, Linda

2013-01-01

The Pediatric Attention Disorders Diagnostic Screener is a multidimensional, computerized screening tool designed to assess attention and global aspects of executive functioning in children at risk for attention disorders. The screener consists of a semi-structured diagnostic interview, brief parent and teacher rating scales, 3 computer-based…

A cognitive task analysis of information management strategies in a computerized provider order entry environment.

PubMed

Weir, Charlene R; Nebeker, Jonathan J R; Hicken, Bret L; Campo, Rebecca; Drews, Frank; Lebar, Beth

2007-01-01

Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system.

Potential of Audiographic Computerized Telelearning for Distance Extension Education.

ERIC Educational Resources Information Center

Verma, Satish; And Others

In the last 10 years, an approach to electronic distance education called audiographic computerized telelearning using standard telephone lines has come to the fore. Telelearning is a cost-effective system which optimizes existing computer facilities and creates a teaching-learning environment that is interactive, efficient, and adaptable to a…

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.

Validation of diabetes mellitus and hypertension diagnosis in computerized medical records in primary health care

PubMed Central

2011-01-01

Background Computerized Clinical Records, which are incorporated in primary health care practice, have great potential for research. In order to use this information, data quality and reliability must be assessed to prevent compromising the validity of the results. The aim of this study is to validate the diagnosis of hypertension and diabetes mellitus in the computerized clinical records of primary health care, taking the diagnosis criteria established in the most prominently used clinical guidelines as the gold standard against which what measure the sensitivity, specificity, and determine the predictive values. The gold standard for diabetes mellitus was the diagnostic criteria established in 2003 American Diabetes Association Consensus Statement for diabetic subjects. The gold standard for hypertension was the diagnostic criteria established in the Joint National Committee published in 2003. Methods A cross-sectional multicentre validation study of diabetes mellitus and hypertension diagnoses in computerized clinical records of primary health care was carried out. Diagnostic criteria from the most prominently clinical practice guidelines were considered for standard reference. Sensitivity, specificity, positive and negative predictive values, and global agreement (with kappa index), were calculated. Results were shown overall and stratified by sex and age groups. Results The agreement for diabetes mellitus with the reference standard as determined by the guideline was almost perfect (κ = 0.990), with a sensitivity of 99.53%, a specificity of 99.49%, a positive predictive value of 91.23% and a negative predictive value of 99.98%. Hypertension diagnosis showed substantial agreement with the reference standard as determined by the guideline (κ = 0.778), the sensitivity was 85.22%, the specificity 96.95%, the positive predictive value 85.24%, and the negative predictive value was 96.95%. Sensitivity results were worse in patients who also had diabetes and in those aged 70 years or over. Conclusions Our results substantiate the validity of using diagnoses of diabetes and hypertension found within the computerized clinical records for epidemiologic studies. PMID:22035202

Rapid and Accurate Behavioral Health Diagnostic Screening: Initial Validation Study of a Web-Based, Self-Report Tool (the SAGE-SR).

PubMed

Brodey, Benjamin; Purcell, Susan E; Rhea, Karen; Maier, Philip; First, Michael; Zweede, Lisa; Sinisterra, Manuela; Nunn, M Brad; Austin, Marie-Paule; Brodey, Inger S

2018-03-23

The Structured Clinical Interview for DSM (SCID) is considered the gold standard assessment for accurate, reliable psychiatric diagnoses; however, because of its length, complexity, and training required, the SCID is rarely used outside of research. This paper aims to describe the development and initial validation of a Web-based, self-report screening instrument (the Screening Assessment for Guiding Evaluation-Self-Report, SAGE-SR) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the SCID-5-Clinician Version (CV) intended to make accurate, broad-based behavioral health diagnostic screening more accessible within clinical care. First, study staff drafted approximately 1200 self-report items representing individual granular symptoms in the diagnostic criteria for the 8 primary SCID-CV modules. An expert panel iteratively reviewed, critiqued, and revised items. The resulting items were iteratively administered and revised through 3 rounds of cognitive interviewing with community mental health center participants. In the first 2 rounds, the SCID was also administered to participants to directly compare their Likert self-report and SCID responses. A second expert panel evaluated the final pool of items from cognitive interviewing and criteria in the DSM-5 to construct the SAGE-SR, a computerized adaptive instrument that uses branching logic from a screener section to administer appropriate follow-up questions to refine the differential diagnoses. The SAGE-SR was administered to healthy controls and outpatient mental health clinic clients to assess test duration and test-retest reliability. Cutoff scores for screening into follow-up diagnostic sections and criteria for inclusion of diagnoses in the differential diagnosis were evaluated. The expert panel reduced the initial 1200 test items to 664 items that panel members agreed collectively represented the SCID items from the 8 targeted modules and DSM criteria for the covered diagnoses. These 664 items were iteratively submitted to 3 rounds of cognitive interviewing with 50 community mental health center participants; the expert panel reviewed session summaries and agreed on a final set of 661 clear and concise self-report items representing the desired criteria in the DSM-5. The SAGE-SR constructed from this item pool took an average of 14 min to complete in a nonclinical sample versus 24 min in a clinical sample. Responses to individual items can be combined to generate DSM criteria endorsements and differential diagnoses, as well as provide indices of individual symptom severity. Preliminary measures of test-retest reliability in a small, nonclinical sample were promising, with good to excellent reliability for screener items in 11 of 13 diagnostic screening modules (intraclass correlation coefficient [ICC] or kappa coefficients ranging from .60 to .90), with mania achieving fair test-retest reliability (ICC=.50) and other substance use endorsed too infrequently for analysis. The SAGE-SR is a computerized adaptive self-report instrument designed to provide rigorous differential diagnostic information to clinicians. ©Benjamin Brodey, Susan E Purcell, Karen Rhea, Philip Maier, Michael First, Lisa Zweede, Manuela Sinisterra, M Brad Nunn, Marie-Paule Austin, Inger S Brodey. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.03.2018.

Controlled Trial Using Computerized Feedback to Improve Physicians' Diagnostic Judgments.

ERIC Educational Resources Information Center

Poses, Roy M.; And Others

1992-01-01

A study involving 14 experienced physicians investigated the effectiveness of a computer program (providing statistical feedback to teach a clinical diagnostic rule that predicts the probability of streptococcal pharyngitis), in conjunction with traditional lecture and periodic disease-prevalence reports. Results suggest the integrated method is a…

Developing Computerized Tests for Classroom Teachers: A Pilot Study.

ERIC Educational Resources Information Center

Glowacki, Margaret L.; And Others

Two types of computerized testing have been defined: (1) computer-based testing, using a computer to administer conventional tests in which all examinees take the same set of items; and (2) adaptive tests, in which items are selected for administration by the computer, based on examinee's previous responses. This paper discusses an option for…

Computerized tomography as a diagnostic aid in acute hemorrhagic leukoencephalitis.

PubMed

Rothstein, T L; Shaw, C M

1983-03-01

Computerized tomography (CT) in a pathologically proven case of acute hemorrhagic leukoencephalitis (AHL) showed a mass effect and increased absorption coefficient in the right hemisphere within 18 hours of the onset of neurological symptoms. The changes corresponded to the site of white matter edema, necrosis, and petechial hemorrhages demonstrated postmortem. The early changes of CT reflect the hyperacute nature of AHL and differ from those of herpes simplex encephalitis.

A Cognitive Task Analysis of Information Management Strategies in a Computerized Provider Order Entry Environment

PubMed Central

Weir, Charlene R.; Nebeker, Jonathan J.R.; Hicken, Bret L.; Campo, Rebecca; Drews, Frank; LeBar, Beth

2007-01-01

Objective Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Design Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Measurements Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Results Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Conclusion Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system. PMID:17068345

Computerized adaptive measurement of depression: A simulation study

PubMed Central

Gardner, William; Shear, Katherine; Kelleher, Kelly J; Pajer, Kathleen A; Mammen, Oommen; Buysse, Daniel; Frank, Ellen

2004-01-01

Background Efficient, accurate instruments for measuring depression are increasingly important in clinical practice. We developed a computerized adaptive version of the Beck Depression Inventory (BDI). We examined its efficiency and its usefulness in identifying Major Depressive Episodes (MDE) and in measuring depression severity. Methods Subjects were 744 participants in research studies in which each subject completed both the BDI and the SCID. In addition, 285 patients completed the Hamilton Depression Rating Scale. Results The adaptive BDI had an AUC as an indicator of a SCID diagnosis of MDE of 88%, equivalent to the full BDI. The adaptive BDI asked fewer questions than the full BDI (5.6 versus 21 items). The adaptive latent depression score correlated r = .92 with the BDI total score and the latent depression score correlated more highly with the Hamilton (r = .74) than the BDI total score did (r = .70). Conclusions Adaptive testing for depression may provide greatly increased efficiency without loss of accuracy in identifying MDE or in measuring depression severity. PMID:15132755

An automated computerized auscultation and diagnostic system for pulmonary diseases.

PubMed

Abbas, Ali; Fahim, Atef

2010-12-01

Respiratory sounds are of significance as they provide valuable information on the health of the respiratory system. Sounds emanating from the respiratory system are uneven, and vary significantly from one individual to another and for the same individual over time. In and of themselves they are not a direct proof of an ailment, but rather an inference that one exists. Auscultation diagnosis is an art/skill that is acquired and honed by practice; hence it is common to seek confirmation using invasive and potentially harmful imaging diagnosis techniques like X-rays. This research focuses on developing an automated auscultation diagnostic system that overcomes the limitations inherent in traditional auscultation techniques. The system uses a front end sound signal filtering module that uses adaptive Neural Networks (NN) noise cancellation to eliminate spurious sound signals like those from the heart, intestine, and ambient noise. To date, the core diagnosis module is capable of identifying lung sounds from non-lung sounds, normal lung sounds from abnormal ones, and identifying wheezes from crackles as indicators of different ailments.

A qualitative study of the cultural appropriateness of the Diagnostic Interview Schedule for Children (DISC-IV) in South Africa

PubMed Central

Skinner, Donald; Serekoane, Motsaathebe; Ross, Michael W.

2012-01-01

Background The Diagnostic Interview Schedule for Children (DISC-IV) has been designed for use by trained laypersons. It therefore shows great promise for use in developing countries such as South Africa, where there is a lack of clinically trained and skilled professionals at the primary care level. Against this background, the aim of the current study was to investigate the sociocultural appropriateness of the DISC-IV for use with Sesotho families in South Africa. Methods Qualitative methodology of expert review and contextualized content analyses were used. Ten Sesotho-speaking clinicians were recruited through a snowball sampling technique to the review the DISC through expert review reports. Results Several themes emerged, including the structure of the DISC-IV, its computerized nature, Americanisms, problems in interpretation due to the adversity children live under, language problems, the effect of rural settings and education level, and cultural norms regarding psychiatric symptoms, gender, the experience of time, the expression of emotion, and family structure. Conclusion Recommendations for the sociocultural adaptation and translation of the DISC into Sesotho are made. PMID:20526764

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.

Severity of Organized Item Theft in Computerized Adaptive Testing: An Empirical Study. Research Report. ETS RR-06-22

ERIC Educational Resources Information Center

Yi, Qing; Zhang, Jinming; Chang, Hua-Hua

2006-01-01

Chang and Zhang (2002, 2003) proposed several baseline criteria for assessing the severity of possible test security violations for computerized tests with high-stakes outcomes. However, these criteria were obtained from theoretical derivations that assumed uniformly randomized item selection. The current study investigated potential damage caused…

Skilled but Unaware of It: CAT Undermines a Test Taker's Metacognitive Competence

ERIC Educational Resources Information Center

Ortner, Tuulia M.; Weisskopf, Eva; Gerstenberg, Friederike X. R.

2013-01-01

We investigated students' metacognitive experiences with regard to feelings of difficulty (FD), feelings of satisfaction (FS), and estimate of effort (EE), employing either computerized adaptive testing (CAT) or computerized fixed item testing (FIT). In an experimental approach, 174 students in grades 10 to 13 were tested either with a CAT or a…

Modernizing quality of life assessment: development of a multidimensional computerized adaptive questionnaire for patients with schizophrenia.

PubMed

Michel, Pierre; Baumstarck, Karine; Lancon, Christophe; Ghattas, Badih; Loundou, Anderson; Auquier, Pascal; Boyer, Laurent

2018-04-01

Quality of life (QoL) is still assessed using paper-based and fixed-length questionnaires, which is one reason why QoL measurements have not been routinely implemented in clinical practice. Providing new QoL measures that combine computer technology with modern measurement theory may enhance their clinical use. The aim of this study was to develop a QoL multidimensional computerized adaptive test (MCAT), the SQoL-MCAT, from the fixed-length SQoL questionnaire for patients with schizophrenia. In this multicentre cross-sectional study, we collected sociodemographic information, clinical characteristics (i.e., duration of illness, the PANSS, and the Calgary Depression Scale), and quality of life (i.e., SQoL). The development of the SQoL-CAT was divided into three stages: (1) multidimensional item response theory (MIRT) analysis, (2) multidimensional computerized adaptive test (MCAT) simulations with analyses of accuracy and precision, and (3) external validity. Five hundred and seventeen patients participated in this study. The MIRT analysis found that all items displayed good fit with the multidimensional graded response model, with satisfactory reliability for each dimension. The SQoL-MCAT was 39% shorter than the fixed-length SQoL questionnaire and had satisfactory accuracy (levels of correlation >0.9) and precision (standard error of measurement <0.55 and root mean square error <0.3). External validity was confirmed via correlations between the SQoL-MCAT dimension scores and symptomatology scores. The SQoL-MCAT is the first computerized adaptive QoL questionnaire for patients with schizophrenia. Tailored for patient characteristics and significantly shorter than the paper-based version, the SQoL-MCAT may improve the feasibility of assessing QoL in clinical practice.

Age, sex, and symptom intensity influence test taking parameters on functional patient-reported outcomes.

PubMed

Cheville, Andrea L; Wang, Chun; Ni, Pengsheng; Jette, Alan M; Basford, Jeffrey R

2014-11-01

Item response theory-based patient-reported outcomes such as the Activity Measure for Post Acute Care Computerized Adaptive Test are gaining use because of their flexibility and ease of administration. Their psychometric properties are being explored, but little is known about how respondent characteristics may impact precision. The goal of this study was, therefore, to assess the effects of age, sex, and symptom intensity on respondents' test taking behaviors and scores. Three hundred eleven adults with late-stage lung cancer were consecutively enrolled between April 2008 and April 2009. Demographics and comorbidities were abstracted from their electronic medical records. The participants were followed on a 3- to 4-wk basis by telephonic interviews that involved administration of the Activity Measure for Post Acute Care Computerized Adaptive Test, followed by numerical rating scales scoring of their pain, fatigue, and dyspnea. In more than 2538 computerized adaptive test (CAT) sessions, three findings were prominent. First, the women and the older patients took longer to complete CAT sessions, were more likely to skip items, and produced scores with larger standard errors. Second, the respondents with higher levels of dyspnea and fatigue, but not pain, completed their CAT sessions more rapidly and were less likely to skip items. Third, fatigue and dyspnea interact with age but not sex to influence CAT duration and skip count. The findings of this study suggest that certain common clinical populations, for example, women, geriatric patients, and patients with intense symptoms, differ systematically in the time they are willing to devote to testing and the precision of their responses. The latter finding, unstable precision, is unlikely to be CAT specific and has implications for the interpretation of the scores of the Activity Measure for Post Acute Care Computerized Adaptive Test and other patient-reported outcomes.

NASA: Biomedical applications team

NASA Technical Reports Server (NTRS)

1981-01-01

The status of projects involving the adaptation of NASA technologies for medical purposes is reviewed. Devices for the measurement of joint deformation of arthritic hands, the development of an artificial pancreas, provision of an auditory signal to avert epileptic seizures, are described along with the control of medication levels, a compressed air tank to supply power for field dentistry, and an electroencephalogram monitor. The use of the Lixiscope as a portable fluoroscope, thermal laminates for hand and foot warmers for patients with Raynaud's syndrome, and the use of absorptive coatings for instruments for controlling medication levels are described. The applicability of occupation health and safety practices to industry, computerized patient scheduling, impregnation of the common facial tissue with an agent for killing respiratory viruses, commercial applications of anthropometric data, and multispectral image analysis of the skin as a diagnostic tool are reviewed.

Otolaryngology and ophthalmology

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

Hanafee, W.N.

A literature review with 227 references of the diagnostic use of computerized tomography for head and neck problems is presented. The anatomy, congenital malformations, infectious diseases, and nioplasms of the auditory organs, paranasal sinuses, pharynx, larynx and salivary glands are examined in detail. A major impetus to the use of computerized tomography has been the realization by the health care industry that CT scanning offers details of tumors in the head and neck area that are not available by other modalities. (KRM)

Development and Validation of a Computerized-Adaptive Test for PTSD (P-CAT).

PubMed

Eisen, Susan V; Schultz, Mark R; Ni, Pengsheng; Haley, Stephen M; Smith, Eric G; Spiro, Avron; Osei-Bonsu, Princess E; Nordberg, Sam; Jette, Alan M

2016-10-01

The primary purpose was to develop, field test, and validate a computerized-adaptive test (CAT) for posttraumatic stress disorder (PTSD) to enhance PTSD assessment and decrease the burden of symptom monitoring. Data sources included self-report and interviewer-administered diagnostic interviews. The sample included 1,288 veterans. In phase 1, 89 items from a previously developed PTSD item pool were administered to a national sample of 1,085 veterans. A multidimensional graded-response item response theory model was used to calibrate items for incorporation into a CAT for PTSD (P-CAT). In phase 2, in a separate sample of 203 veterans, the P-CAT was validated against three other self-report measures (PTSD Checklist, Civilian Version; Mississippi Scale for Combat-Related PTSD; and Primary Care PTSD Screen) and the PTSD module of the Structured Clinical Interview for DSM-IV. A bifactor model with one general PTSD factor and four subfactors consistent with DSM-5 (reexperiencing, avoidance, negative mood-cognitions, and arousal), yielded good fit. The P-CAT discriminated veterans with PTSD from those with other mental health conditions and those with no mental health conditions (Cohen's d effect sizes >.90). The P-CAT also discriminated those with and without a PTSD diagnosis and those who screened positive versus negative for PTSD. Concurrent validity was supported by high correlations (r=.85-.89) with the validation measures. The P-CAT appears to be a promising tool for efficient and accurate assessment of PTSD symptomatology. Further testing is needed to evaluate its responsiveness to change. With increasing availability of computers and other technologies, CAT may be a viable and efficient assessment method.

Bayesian Item Selection in Constrained Adaptive Testing Using Shadow Tests

ERIC Educational Resources Information Center

Veldkamp, Bernard P.

2010-01-01

Application of Bayesian item selection criteria in computerized adaptive testing might result in improvement of bias and MSE of the ability estimates. The question remains how to apply Bayesian item selection criteria in the context of constrained adaptive testing, where large numbers of specifications have to be taken into account in the item…

Robustness of Ability Estimation to Multidimensionality in CAST with Implications to Test Assembly

ERIC Educational Resources Information Center

Zhang, Yanwei; Nandakumar, Ratna

2006-01-01

Computer Adaptive Sequential Testing (CAST) is a test delivery model that combines features of the traditional conventional paper-and-pencil testing and item-based computerized adaptive testing (CAT). The basic structure of CAST is a panel composed of multiple testlets adaptively administered to examinees at different stages. Current applications…

Practical Considerations about Expected A Posteriori Estimation in Adaptive Testing: Adaptive A Priori, Adaptive Correction for Bias, and Adaptive Integration Interval.

ERIC Educational Resources Information Center

Raiche, Gilles; Blais, Jean-Guy

In a computerized adaptive test (CAT), it would be desirable to obtain an acceptable precision of the proficiency level estimate using an optimal number of items. Decreasing the number of items is accompanied, however, by a certain degree of bias when the true proficiency level differs significantly from the a priori estimate. G. Raiche (2000) has…

Impact of centralized diagnostic review on quality of initial staging in Hodgkin lymphoma: experience of the German Hodgkin Study Group.

PubMed

Bröckelmann, Paul J; Goergen, Helen; Fuchs, Michael; Kriz, Jan; Semrau, Robert; Baues, Christian; Kobe, Carsten; Behringer, Karolin; Eichenauer, Dennis A; von Tresckow, Bastian; Klimm, Beate; Halbsguth, Teresa; Wongso, Diana; Plütschow, Annette; Haverkamp, Heinz; Dietlein, Markus; Eich, Hans T; Stein, Harald; Diehl, Volker; Borchmann, Peter; Engert, Andreas

2015-11-01

Accurate clinical staging is crucial for adequate risk-adapted treatment in Hodgkin lymphoma (HL) to prevent patients from under- or over-treatment. Within the latest German Hodgkin Study Group trial generation, diagnostic findings such as histopathology, computerized tomography imaging and clinical risk factors were re-evaluated by expert panels. Here, we retrospectively analysed 5965 patients and identified 399 in who major discordant findings changed their first-line treatment allocation. Histopathology review did not confirm the initial diagnosis of HL in 87 patients. Treatment allocation was revised in 312 of the remaining 5878 patients: 176 were assigned to a higher and 128 to a lower risk group, respectively; the correct treatment group remained unclear in 8 patients. Cases of revised treatment allocation accounted for 9·8%, 6·0%, 0·8%, and 14·8% of patients initially assigned to the HD13, HD14, HD15 trials and stage IA lymphocyte-predominant HL project, respectively. Most revisions were due to wrong application of clinical stage (20·5% of 312 patients with revised treatment group), histological subtype (9·0%) or the risk factors ≥3 involved areas (46·8%) or large mediastinal mass (9·3%). In conclusion, centralized review by experienced experts changed risk-adapted first-line treatment in a relevant proportion of HL patients. Quality control measures clearly improve the accuracy of treatment and should be implemented in clinical practice. © 2015 John Wiley & Sons Ltd.

Psychometrics behind Computerized Adaptive Testing.

PubMed

Chang, Hua-Hua

2015-03-01

The paper provides a survey of 18 years' progress that my colleagues, students (both former and current) and I made in a prominent research area in Psychometrics-Computerized Adaptive Testing (CAT). We start with a historical review of the establishment of a large sample foundation for CAT. It is worth noting that the asymptotic results were derived under the framework of Martingale Theory, a very theoretical perspective of Probability Theory, which may seem unrelated to educational and psychological testing. In addition, we address a number of issues that emerged from large scale implementation and show that how theoretical works can be helpful to solve the problems. Finally, we propose that CAT technology can be very useful to support individualized instruction on a mass scale. We show that even paper and pencil based tests can be made adaptive to support classroom teaching.

Construction of a Computerized Adaptive Testing Version of the Quebec Adaptive Behavior Scale.

ERIC Educational Resources Information Center

Tasse, Marc J.; And Others

Multilog (Thissen, 1991) was used to estimate parameters of 225 items from the Quebec Adaptive Behavior Scale (QABS). A database containing actual data from 2,439 subjects was used for the parameterization procedures. The two-parameter-logistic model was used in estimating item parameters and in the testing strategy. MicroCAT (Assessment Systems…

An Investigation on Computer-Adaptive Multistage Testing Panels for Multidimensional Assessment

ERIC Educational Resources Information Center

Wang, Xinrui

2013-01-01

The computer-adaptive multistage testing (ca-MST) has been developed as an alternative to computerized adaptive testing (CAT), and been increasingly adopted in large-scale assessments. Current research and practice only focus on ca-MST panels for credentialing purposes. The ca-MST test mode, therefore, is designed to gauge a single scale. The…

The Impact of Receiving the Same Items on Consecutive Computer Adaptive Test Administrations.

ERIC Educational Resources Information Center

O'Neill, Thomas; Lunz, Mary E.; Thiede, Keith

2000-01-01

Studied item exposure in a computerized adaptive test when the item selection algorithm presents examinees with questions they were asked in a previous test administration. Results with 178 repeat examinees on a medical technologists' test indicate that the combined use of an adaptive algorithm to select items and latent trait theory to estimate…

Computerized Adaptive Performance Evaluation.

DTIC Science & Technology

1980-02-01

based on classical psychological test theory, with the result that the obtained measurements ani statements of achievement or performance have... psychological aspects of the achievement testing environment. Results , C Applications of Item Characteristic Curve Models and Adaptive Testing Strategies ICC...of immediate knowledge of results and adaptive testing on ability test performance (Research Report 76-4). Minneapolis: Department of Psychology

Integration of healthcare information: from enterprise PACS to patient centered multimedia health record.

PubMed

Soriano, Enrique; Plazzotta, Fernando; Campos, Fernando; Kaminker, Diego; Cancio, Alfredo; Aguilera Díaz, Jerónimo; Luna, Daniel; Seehaus, Alberto; Carcía Mónaco, Ricardo; de Quirós, Fernán González Bernaldo

2010-01-01

Every single piece of healthcare information should be fully integrated and transparent within the electronic health record. The Italian Hospital of Buenos Aires initiated the project Multimedia Health Record with the goal to achieve this integration while maintaining a holistic view of current structure of the systems of the Hospital, where the axis remains are the patient and longitudinal history, commencing with section Computed Tomography. Was implemented DICOM standard for communication and image storage and bought a PACS. It was necessary adapt our generic reporting system for live up to the commercial RIS. The Computerized Tomography (CT) Scanners of our hospital were easily integrated into the DICOM network and all the CT Scans generated by our radiology service were stored in the PACS, reported using the Structured Reporting System (we installed diagnostic terminals equipped with 3 monitors) and displayed in the EHR at any point of HIBA's healthcare network.

Simplified diagnostic coding sheet for computerized data storage and analysis in ophthalmology.

PubMed

Tauber, J; Lahav, M

1987-11-01

A review of currently-available diagnostic coding systems revealed that most are either too abbreviated or too detailed. We have compiled a simplified diagnostic coding sheet based on the International Coding and Diagnosis (ICD-9), which is both complete and easy to use in a general practice. The information is transferred to a computer, which uses the relevant (ICD-9) diagnoses as database and can be retrieved later for display of patients' problems or analysis of clinical data.

A Bayesian Method for the Detection of Item Preknowledge in CAT. Law School Admission Council Computerized Testing Report. LSAC Research Report Series.

ERIC Educational Resources Information Center

McLeod, Lori D.; Lewis, Charles; Thissen, David.

With the increased use of computerized adaptive testing, which allows for continuous testing, new concerns about test security have evolved, one being the assurance that items in an item pool are safeguarded from theft. In this paper, the risk of score inflation and procedures to detect test takers using item preknowledge are explored. When test…

Procedures to develop a computerized adaptive test to assess patient-reported physical functioning.

PubMed

McCabe, Erin; Gross, Douglas P; Bulut, Okan

2018-06-07

The purpose of this paper is to demonstrate the procedures to develop and implement a computerized adaptive patient-reported outcome (PRO) measure using secondary analysis of a dataset and items from fixed-format legacy measures. We conducted secondary analysis of a dataset of responses from 1429 persons with work-related lower extremity impairment. We calibrated three measures of physical functioning on the same metric, based on item response theory (IRT). We evaluated efficiency and measurement precision of various computerized adaptive test (CAT) designs using computer simulations. IRT and confirmatory factor analyses support combining the items from the three scales for a CAT item bank of 31 items. The item parameters for IRT were calculated using the generalized partial credit model. CAT simulations show that reducing the test length from the full 31 items to a maximum test length of 8 items, or 20 items is possible without a significant loss of information (95, 99% correlation with legacy measure scores). We demonstrated feasibility and efficiency of using CAT for PRO measurement of physical functioning. The procedures we outlined are straightforward, and can be applied to other PRO measures. Additionally, we have included all the information necessary to implement the CAT of physical functioning in the electronic supplementary material of this paper.

Mini-Stroke vs. Regular Stroke: What's the Difference?

MedlinePlus

... may need various diagnostic tests, such as a magnetic resonance imaging (MRI) scan or a computerized tomography ( ... org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation ...

Computer-Adaptive Testing in Second Language Contexts.

ERIC Educational Resources Information Center

Chalhoub-Deville, Micheline; Deville, Craig

1999-01-01

Provides a broad overview of computerized testing issues with an emphasis on computer-adaptive testing (CAT). A survey of the potential benefits and drawbacks of CAT are given, the process of CAT development is described; and some L2 instruments developed to assess various language skills are summarized. (Author/VWL)

The Effect of Test and Examinee Characteristics on the Occurrence of Aberrant Response Patterns in a Computerized Adaptive Test

ERIC Educational Resources Information Center

Rizavi, Saba; Hariharan, Swaminathan

2001-01-01

The advantages that computer adaptive testing offers over linear tests have been well documented. The Computer Adaptive Test (CAT) design is more efficient than the Linear test design as fewer items are needed to estimate an examinee's proficiency to a desired level of precision. In the ideal situation, a CAT will result in examinees answering…

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.

Hydrologic data-verification management program plan

USGS Publications Warehouse

Alexander, C.W.

1982-01-01

Data verification refers to the performance of quality control on hydrologic data that have been retrieved from the field and are being prepared for dissemination to water-data users. Water-data users now have access to computerized data files containing unpublished, unverified hydrologic data. Therefore, it is necessary to develop techniques and systems whereby the computer can perform some data-verification functions before the data are stored in user-accessible files. Computerized data-verification routines can be developed for this purpose. A single, unified concept describing master data-verification program using multiple special-purpose subroutines, and a screen file containing verification criteria, can probably be adapted to any type and size of computer-processing system. Some traditional manual-verification procedures can be adapted for computerized verification, but new procedures can also be developed that would take advantage of the powerful statistical tools and data-handling procedures available to the computer. Prototype data-verification systems should be developed for all three data-processing environments as soon as possible. The WATSTORE system probably affords the greatest opportunity for long-range research and testing of new verification subroutines. (USGS)

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.

Statistical Indexes for Monitoring Item Behavior under Computer Adaptive Testing Environment.

ERIC Educational Resources Information Center

Zhu, Renbang; Yu, Feng; Liu, Su

A computerized adaptive test (CAT) administration usually requires a large supply of items with accurately estimated psychometric properties, such as item response theory (IRT) parameter estimates, to ensure the precision of examinee ability estimation. However, an estimated IRT model of a given item in any given pool does not always correctly…

A Monte Carlo Approach for Adaptive Testing with Content Constraints

ERIC Educational Resources Information Center

Belov, Dmitry I.; Armstrong, Ronald D.; Weissman, Alexander

2008-01-01

This article presents a new algorithm for computerized adaptive testing (CAT) when content constraints are present. The algorithm is based on shadow CAT methodology to meet content constraints but applies Monte Carlo methods and provides the following advantages over shadow CAT: (a) lower maximum item exposure rates, (b) higher utilization of the…

Fairness in Computerized Testing: Detecting Item Bias Using CATSIB with Impact Present

ERIC Educational Resources Information Center

Chu, Man-Wai; Lai, Hollis

2013-01-01

In educational assessment, there is an increasing demand for tailoring assessments to individual examinees through computer adaptive tests (CAT). As such, it is particularly important to investigate the fairness of these adaptive testing processes, which require the investigation of differential item function (DIF) to yield information about item…

A Guide to Computer Adaptive Testing Systems

ERIC Educational Resources Information Center

Davey, Tim

2011-01-01

Some brand names are used generically to describe an entire class of products that perform the same function. "Kleenex," "Xerox," "Thermos," and "Band-Aid" are good examples. The term "computerized adaptive testing" (CAT) is similar in that it is often applied uniformly across a diverse family of testing methods. Although the various members of…

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"…

34 CFR 462.11 - What must an application contain?

Code of Federal Regulations, 2013 CFR

2013-07-01

... (ii) Examinees, for adaptive tests in which items are selected in real time. (d) Maintenance..., including the number of times the test has been administered; and (5) For a computerized adaptive test, the... termination conditions; (iii) Score the test; and (iv) Control for item exposure. (e) Match of content to the...

34 CFR 462.11 - What must an application contain?

Code of Federal Regulations, 2014 CFR

2014-07-01

... (ii) Examinees, for adaptive tests in which items are selected in real time. (d) Maintenance..., including the number of times the test has been administered; and (5) For a computerized adaptive test, the... termination conditions; (iii) Score the test; and (iv) Control for item exposure. (e) Match of content to the...

34 CFR 462.11 - What must an application contain?

Code of Federal Regulations, 2012 CFR

2012-07-01

... (ii) Examinees, for adaptive tests in which items are selected in real time. (d) Maintenance..., including the number of times the test has been administered; and (5) For a computerized adaptive test, the... termination conditions; (iii) Score the test; and (iv) Control for item exposure. (e) Match of content to the...

Regulatory issues for computerized electrocardiographic devices.

PubMed

Muni, Neal I; Ho, Charles; Mallis, Elias

2004-01-01

Computerized electrocardiogram (ECG) devices are regulated in the U.S. by the FDA Center for Devices and Radiological Health (CDRH). This article aims to highlight the salient points of the FDA regulatory review process, including the important distinction between a "tool" claim and a "clinical" claim in the intended use of a computerized ECG device. Specifically, a tool claim relates to the ability of the device to accurately measure a certain ECG parameter, such as T-wave alternans (TWA), while a clinical claim imputes a particular health hazard associated with the identified parameter, such as increased risk of ventricular tachyarrhythmia or sudden death. Given that both types of claims are equally important and receive the same regulatory scrutiny, the manufacturer of a new ECG diagnostic device should consider the distinction and regulatory pathways for approval between the two types of claims discussed in this paper.

Applications of Computerized Adaptive Testing. Proceedings of a Symposium presented at the Annual Convention of the Military Testing Association (18th, October 1976). Research Report 77-1.

ERIC Educational Resources Information Center

Weiss, David J., Ed.

This symposium consists of five papers and presents some recent developments in adaptive testing which have applications to several military testing problems. The overview, by James R. McBride, defines adaptive testing and discusses some of its item selection and scoring strategies. Item response theory, or item characteristic curve theory, is…

Comprehensive Digital Imaging Network Project At Georgetown University Hospital

NASA Astrophysics Data System (ADS)

Mun, Seong K.; Stauffer, Douglas; Zeman, Robert; Benson, Harold; Wang, Paul; Allman, Robert

1987-10-01

The radiology practice is going through rapid changes due to the introduction of state-of-the-art computed based technologies. For the last twenty years we have witnessed the introduction of many new medical diagnostic imaging systems such as x-ray computed tomo-graphy, digital subtraction angiography (DSA), computerized nuclear medicine, single pho-ton emission computed tomography (SPECT), positron emission tomography (PET) and more re-cently, computerized digital radiography and nuclear magnetic resonance imaging (MRI). Other than the imaging systems, there has been a steady introduction of computed based information systems for radiology departments and hospitals.

Atlas of computerized blood flow analysis in bone disease.

PubMed

Gandsman, E J; Deutsch, S D; Tyson, I B

1983-11-01

The role of computerized blood flow analysis in routine bone scanning is reviewed. Cases illustrating the technique include proven diagnoses of toxic synovitis, Legg-Perthes disease, arthritis, avascular necrosis of the hip, fractures, benign and malignant tumors, Paget's disease, cellulitis, osteomyelitis, and shin splints. Several examples also show the use of the technique in monitoring treatment. The use of quantitative data from the blood flow, bone uptake phase, and static images suggests specific diagnostic patterns for each of the diseases presented in this atlas. Thus, this technique enables increased accuracy in the interpretation of the radionuclide bone scan.

Thermal comfort: research and practice.

PubMed

van Hoof, Joost; Mazej, Mitja; Hensen, Jan L M

2010-01-01

Thermal comfort--the state of mind, which expresses satisfaction with the thermal environment--is an important aspect of the building design process as modern man spends most of the day indoors. This paper reviews the developments in indoor thermal comfort research and practice since the second half of the 1990s, and groups these developments around two main themes; (i) thermal comfort models and standards, and (ii) advances in computerization. Within the first theme, the PMV-model (Predicted Mean Vote), created by Fanger in the late 1960s is discussed in the light of the emergence of models of adaptive thermal comfort. The adaptive models are based on adaptive opportunities of occupants and are related to options of personal control of the indoor climate and psychology and performance. Both models have been considered in the latest round of thermal comfort standard revisions. The second theme focuses on the ever increasing role played by computerization in thermal comfort research and practice, including sophisticated multi-segmental modeling and building performance simulation, transient thermal conditions and interactions, thermal manikins.

Recommendations for the standardization and interpretation of the electrocardiogram: part II: Electrocardiography diagnostic statement list: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology.

PubMed

Mason, Jay W; Hancock, E William; Gettes, Leonard S; Bailey, James J; Childers, Rory; Deal, Barbara J; Josephson, Mark; Kligfield, Paul; Kors, Jan A; Macfarlane, Peter; Pahlm, Olle; Mirvis, David M; Okin, Peter; Rautaharju, Pentti; Surawicz, Borys; van Herpen, Gerard; Wagner, Galen S; Wellens, Hein

2007-03-13

This statement provides a concise list of diagnostic terms for ECG interpretation that can be shared by students, teachers, and readers of electrocardiography. This effort was motivated by the existence of multiple automated diagnostic code sets containing imprecise and overlapping terms. An intended outcome of this statement list is greater uniformity of ECG diagnosis and a resultant improvement in patient care. The lexicon includes primary diagnostic statements, secondary diagnostic statements, modifiers, and statements for the comparison of ECGs. This diagnostic lexicon should be reviewed and updated periodically.

Recommendations for the standardization and interpretation of the electrocardiogram: part II: electrocardiography diagnostic statement list a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society Endorsed by the International Society for Computerized Electrocardiology.

PubMed

Mason, Jay W; Hancock, E William; Gettes, Leonard S; Bailey, James J; Childers, Rory; Deal, Barbara J; Josephson, Mark; Kligfield, Paul; Kors, Jan A; Macfarlane, Peter; Pahlm, Olle; Mirvis, David M; Okin, Peter; Rautaharju, Pentti; Surawicz, Borys; van Herpen, Gerard; Wagner, Galen S; Wellens, Hein

2007-03-13

This statement provides a concise list of diagnostic terms for ECG interpretation that can be shared by students, teachers, and readers of electrocardiography. This effort was motivated by the existence of multiple automated diagnostic code sets containing imprecise and overlapping terms. An intended outcome of this statement list is greater uniformity of ECG diagnosis and a resultant improvement in patient care. The lexicon includes primary diagnostic statements, secondary diagnostic statements, modifiers, and statements for the comparison of ECGs. This diagnostic lexicon should be reviewed and updated periodically.

Implementing Sympson-Hetter Item-Exposure Control in a Shadow-Test Approach to Constrained Adaptive Testing

ERIC Educational Resources Information Center

Veldkamp, Bernard P.; van der Linden, Wim J.

2008-01-01

In most operational computerized adaptive testing (CAT) programs, the Sympson-Hetter (SH) method is used to control the exposure of the items. Several modifications and improvements of the original method have been proposed. The Stocking and Lewis (1998) version of the method uses a multinomial experiment to select items. For severely constrained…

Impact of Violation of the Missing-at-Random Assumption on Full-Information Maximum Likelihood Method in Multidimensional Adaptive Testing

ERIC Educational Resources Information Center

Han, Kyung T.; Guo, Fanmin

2014-01-01

The full-information maximum likelihood (FIML) method makes it possible to estimate and analyze structural equation models (SEM) even when data are partially missing, enabling incomplete data to contribute to model estimation. The cornerstone of FIML is the missing-at-random (MAR) assumption. In (unidimensional) computerized adaptive testing…

A Conditional Exposure Control Method for Multidimensional Adaptive Testing

ERIC Educational Resources Information Center

Finkelman, Matthew; Nering, Michael L.; Roussos, Louis A.

2009-01-01

In computerized adaptive testing (CAT), ensuring the security of test items is a crucial practical consideration. A common approach to reducing item theft is to define maximum item exposure rates, i.e., to limit the proportion of examinees to whom a given item can be administered. Numerous methods for controlling exposure rates have been proposed…

Lost in Search: (Mal-)Adaptation to Probabilistic Decision Environments in Children and Adults

ERIC Educational Resources Information Center

Betsch, Tilmann; Lehmann, Anne; Lindow, Stefanie; Lang, Anna; Schoemann, Martin

2016-01-01

Adaptive decision making in probabilistic environments requires individuals to use probabilities as weights in predecisional information searches and/or when making subsequent choices. Within a child-friendly computerized environment (Mousekids), we tracked 205 children's (105 children 5-6 years of age and 100 children 9-10 years of age) and 103…

EXSPRT: An Expert Systems Approach to Computer-Based Adaptive Testing.

ERIC Educational Resources Information Center

Frick, Theodore W.; And Others

Expert systems can be used to aid decision making. A computerized adaptive test (CAT) is one kind of expert system, although it is not commonly recognized as such. A new approach, termed EXSPRT, was devised that combines expert systems reasoning and sequential probability ratio test stopping rules. EXSPRT-R uses random selection of test items,…

A Comparison of Four Item-Selection Methods for Severely Constrained CATs

ERIC Educational Resources Information Center

He, Wei; Diao, Qi; Hauser, Carl

2014-01-01

This study compared four item-selection procedures developed for use with severely constrained computerized adaptive tests (CATs). Severely constrained CATs refer to those adaptive tests that seek to meet a complex set of constraints that are often not conclusive to each other (i.e., an item may contribute to the satisfaction of several…

A Computer-Based Diagnostic/Information Patient Management System for Isolated Environments. MEDIC Ten Years Later

DTIC Science & Technology

1987-02-04

corpsmen for application to computerized medical diagnosis. Proceedings of the 6th Congress of the International Ergonomics Associationf 1976, p...Internal medicine; Cardiovascular diseases; Pulmonary diseases; Abdomen; Pain; Mental disorders; Psychiatry; Oral diseases; Dentistry ; Medical

Adapting Scheduling Programs for Educational Specifications.

ERIC Educational Resources Information Center

Glass, Thomas E.

1984-01-01

Planners of a new Arizona school used the district's existing computerized master scheduling program to identify instructional spaces needed. Total classroom needs by subject were translated into total square footage requirements. (MLF)

Decision support in psychiatry – a comparison between the diagnostic outcomes using a computerized decision support system versus manual diagnosis

PubMed Central

Bergman, Lars G; Fors, Uno GH

2008-01-01

Background Correct diagnosis in psychiatry may be improved by novel diagnostic procedures. Computerized Decision Support Systems (CDSS) are suggested to be able to improve diagnostic procedures, but some studies indicate possible problems. Therefore, it could be important to investigate CDSS systems with regard to their feasibility to improve diagnostic procedures as well as to save time. Methods This study was undertaken to compare the traditional 'paper and pencil' diagnostic method SCID1 with the computer-aided diagnostic system CB-SCID1 to ascertain processing time and accuracy of diagnoses suggested. 63 clinicians volunteered to participate in the study and to solve two paper-based cases using either a CDSS or manually. Results No major difference between paper and pencil and computer-supported diagnosis was found. Where a difference was found it was in favour of paper and pencil. For example, a significantly shorter time was found for paper and pencil for the difficult case, as compared to computer support. A significantly higher number of correct diagnoses were found in the diffilt case for the diagnosis 'Depression' using the paper and pencil method. Although a majority of the clinicians found the computer method supportive and easy to use, it took a longer time and yielded fewer correct diagnoses than with paper and pencil. Conclusion This study could not detect any major difference in diagnostic outcome between traditional paper and pencil methods and computer support for psychiatric diagnosis. Where there were significant differences, traditional paper and pencil methods were better than the tested CDSS and thus we conclude that CDSS for diagnostic procedures may interfere with diagnosis accuracy. A limitation was that most clinicians had not previously used the CDSS system under study. The results of this study, however, confirm that CDSS development for diagnostic purposes in psychiatry has much to deal with before it can be used for routine clinical purposes. PMID:18261222

TFTR diagnostic control and data acquisition system

NASA Astrophysics Data System (ADS)

Sauthoff, N. R.; Daniels, R. E.

1985-05-01

General computerized control and data-handling support for TFTR diagnostics is presented within the context of the Central Instrumentation, Control and Data Acquisition (CICADA) System. Procedures, hardware, the interactive man-machine interface, event-driven task scheduling, system-wide arming and data acquisition, and a hierarchical data base of raw data and results are described. Similarities in data structures involved in control, monitoring, and data acquisition afford a simplification of the system functions, based on ``groups'' of devices. Emphases and optimizations appropriate for fusion diagnostic system designs are provided. An off-line data reduction computer system is under development.

TFTR diagnostic control and data acquisition system

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

Sauthoff, N.R.; Daniels, R.E.; PPL Computer Division

1985-05-01

General computerized control and data-handling support for TFTR diagnostics is presented within the context of the Central Instrumentation, Control and Data Acquisition (CICADA) System. Procedures, hardware, the interactive man--machine interface, event-driven task scheduling, system-wide arming and data acquisition, and a hierarchical data base of raw data and results are described. Similarities in data structures involved in control, monitoring, and data acquisition afford a simplification of the system functions, based on ''groups'' of devices. Emphases and optimizations appropriate for fusion diagnostic system designs are provided. An off-line data reduction computer system is under development.

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.

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.

Separating Business Logic from Medical Knowledge in Digital Clinical Workflows Using Business Process Model and Notation and Arden Syntax.

PubMed

de Bruin, Jeroen S; Adlassnig, Klaus-Peter; Leitich, Harald; Rappelsberger, Andrea

2018-01-01

Evidence-based clinical guidelines have a major positive effect on the physician's decision-making process. Computer-executable clinical guidelines allow for automated guideline marshalling during a clinical diagnostic process, thus improving the decision-making process. Implementation of a digital clinical guideline for the prevention of mother-to-child transmission of hepatitis B as a computerized workflow, thereby separating business logic from medical knowledge and decision-making. We used the Business Process Model and Notation language system Activiti for business logic and workflow modeling. Medical decision-making was performed by an Arden-Syntax-based medical rule engine, which is part of the ARDENSUITE software. We succeeded in creating an electronic clinical workflow for the prevention of mother-to-child transmission of hepatitis B, where institution-specific medical decision-making processes could be adapted without modifying the workflow business logic. Separation of business logic and medical decision-making results in more easily reusable electronic clinical workflows.

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…

An Analysis of Community Health Nurses Documentation: The Best Approach to Computerization

PubMed Central

Chalmers, M.

1988-01-01

The study explored and analyzed the actual patient-related documentation performed by a sample of community health nurses working in voluntary home health agencies. The outcome of the study was a system flow chart of that documentation and included: common components of the documentation, where in the existing systems they are recorded, when they are recorded by the nurse and why they are used by the nurses and administrative personnel in the agencies. The flow chart is suitable for use as a prototype for the development of a computer software package for the computerization of the patient-related documentation by community health nurses. General System and communication theories were used as a framework for this study. A thorough analysis of the documenation resulted in a complete and exhaustive explication of the documentation by community health nurses, as well as the identification of what parts of that documentation lend themselves most readily to computerization and what areas, if any, may not readily adapt to computerization.

Computerized tomography calibrator

NASA Technical Reports Server (NTRS)

Engel, Herbert P. (Inventor)

1991-01-01

A set of interchangeable pieces comprising a computerized tomography calibrator, and a method of use thereof, permits focusing of a computerized tomographic (CT) system. The interchangeable pieces include a plurality of nestable, generally planar mother rings, adapted for the receipt of planar inserts of predetermined sizes, and of predetermined material densities. The inserts further define openings therein for receipt of plural sub-inserts. All pieces are of known sizes and densities, permitting the assembling of different configurations of materials of known sizes and combinations of densities, for calibration (i.e., focusing) of a computerized tomographic system through variation of operating variables thereof. Rather than serving as a phanton, which is intended to be representative of a particular workpiece to be tested, the set of interchangeable pieces permits simple and easy standardized calibration of a CT system. The calibrator and its related method of use further includes use of air or of particular fluids for filling various openings, as part of a selected configuration of the set of pieces.

Person Fit Based on Statistical Process Control in an Adaptive Testing Environment. Research Report 98-13.

ERIC Educational Resources Information Center

van Krimpen-Stoop, Edith M. L. A.; Meijer, Rob R.

Person-fit research in the context of paper-and-pencil tests is reviewed, and some specific problems regarding person fit in the context of computerized adaptive testing (CAT) are discussed. Some new methods are proposed to investigate person fit in a CAT environment. These statistics are based on Statistical Process Control (SPC) theory. A…

To Weight or Not to Weight? Balancing Influence of Initial Items in Adaptive Testing

ERIC Educational Resources Information Center

Chang, Hua-Hua; Ying, Zhiliang

2008-01-01

It has been widely reported that in computerized adaptive testing some examinees may get much lower scores than they would normally if an alternative paper-and-pencil version were given. The main purpose of this investigation is to quantitatively reveal the cause for the underestimation phenomenon. The logistic models, including the 1PL, 2PL, and…

Increasing Testing Efficiency through the Development of an IT-Based Adaptive Testing Tool for Competency Measurement

ERIC Educational Resources Information Center

Kleinhans, Janne; Schumann, Matthias

2015-01-01

Purpose: This paper investigates the potential of computerized adaptive testing for CMs to reduce test time. In the context of education and training, competency measurement (CM) is a central challenge in competency management. For complex CMs, a compromise must be addressed between the time available and the quality of the measurements.…

Effects of Adaptive Training on Working Memory and Academic Achievement of Children with Learning Disabilities: A School-Based Study

ERIC Educational Resources Information Center

Cunningham, Rhonda Phillips

2013-01-01

Research has suggested many children with learning disabilities (LD) have deficits in working memory (WM) that hinder their academic achievement. Cogmed RM, a computerized intervention, uses adaptive training over 25 sessions and has shown efficacy in improving WM in children with attention deficit hyperactivity disorder (ADHD) and a variety of…

Considerations about expected a posteriori estimation in adaptive testing: adaptive a priori, adaptive correction for bias, and adaptive integration interval.

PubMed

Raiche, Gilles; Blais, Jean-Guy

2009-01-01

In a computerized adaptive test, we would like to obtain an acceptable precision of the proficiency level estimate using an optimal number of items. Unfortunately, decreasing the number of items is accompanied by a certain degree of bias when the true proficiency level differs significantly from the a priori estimate. The authors suggest that it is possible to reduced the bias, and even the standard error of the estimate, by applying to each provisional estimation one or a combination of the following strategies: adaptive correction for bias proposed by Bock and Mislevy (1982), adaptive a priori estimate, and adaptive integration interval.

Emission computerized axial tomography from multiple gamma-camera views using frequency filtering.

PubMed

Pelletier, J L; Milan, C; Touzery, C; Coitoux, P; Gailliard, P; Budinger, T F

1980-01-01

Emission computerized axial tomography is achievable in any nuclear medicine department from multiple gamma camera views. Data are collected by rotating the patient in front of the camera. A simple fast algorithm is implemented, known as the convolution technique: first the projection data are Fourier transformed and then an original filter designed for optimizing resolution and noise suppression is applied; finally the inverse transform of the latter operation is back-projected. This program, which can also take into account the attenuation for single photon events, was executed with good results on phantoms and patients. We think that it can be easily implemented for specific diagnostic problems.

Exploring the Impact of Technology on Communication in Medicine and Health.

ERIC Educational Resources Information Center

Auyash, Stewart

1984-01-01

Summarizes some events in the use of medical technology in relation to the spoken word and doctor-patient communication. Reports on a new computerized diagnostic system (PROMIS-the Problem Oriented Medical Record System) and discusses its impact on health communication and medical education. (PD)

Computerized Instructional Adaptive Testing Model: Formulation and Validation.

DTIC Science & Technology

1980-02-01

AD-AO1 855 CONTROL DATA EDUCATION CO MINNEAPOLIS MN F/6 5/9MPUTERIZED INSTRUCTIONAL ADAPTIVE TESTING MODELS FORMULATION --EC(U) FEB 80 S J KALISCH...final report wus submitted by Control Data Education Company, 8100 34th Avenue, South, Minneapolis, Minnesota 55440, under contract F33615-17-C.0071... DATA EDUCATION CO MINNEAPOLIS MN p/e 5/9 I COMPULTERIZED :LSTUCTIONAL ADAPTIVE TESTING MODELS FORMULATION --EIC(U) FEB 80 S J KALISCH F33615-77-C-0O71

The Development of STAR Early Literacy. Report.

ERIC Educational Resources Information Center

School Renaissance Inst., Inc., Madison, WI.

This report describes the development and testing of a computerized early literacy diagnostic assessment for students in prekindergarten to grade 3 that can measure skills across a variety of preliteracy and reading domains. The STAR Early Literacy assessment was developed by a team of more than 50 people, including literacy experts,…

An Antibiotic Resource Program for Students of the Health Professions.

ERIC Educational Resources Information Center

Tritz, Gerald J.

1986-01-01

Provides a description of a computer program developed to supplement instruction in testing of antibiotics on clinical isolates of microorganisms. The program is a simulation and database for interpretation of experimental data designed to enhance laboratory learning and prepare future physicians to use computerized diagnostic instrumentation and…

Using three-dimensional-computerized tomography as a diagnostic tool for temporo-mandibular joint ankylosis: a case report.

PubMed

Kao, S Y; Chou, J; Lo, J; Yang, J; Chou, A P; Joe, C J; Chang, R C

1999-04-01

Roentgenographic examination has long been a useful diagnostic tool for temporo-mandibular joint (TMJ) disease. The methods include TMJ tomography, panoramic radiography and computerized tomography (CT) scan with or without injection of contrast media. Recently, three-dimensional CT (3D-CT), reconstructed from the two-dimensional image of a CT scan to simulate the soft tissue or bony structure of the real target, was proposed. In this report, a case of TMJ ankylosis due to traumatic injury is presented. 3D-CT was employed as one of the presurgical roentgenographic diagnostic tools. The conventional radiographic examination including panoramic radiography and tomography showed lesions in both sides of the mandible. CT scanning further suggested that the right-sided lesion was more severe than that on the left. With 3D-CT image reconstruction the size and extent of the lesions were clearly observable. The decision was made to proceed with an initial surgical approach on the right side. With condylectomy and condylar replacement using an autogenous costochondral graft on the right side, the range of mouth opening improved significantly. In this case report, 3D-CT demonstrates its advantages as a tool for the correct and precise diagnosis of TMJ ankylosis.

Conceptualising computerized adaptive testing for measurement of latent variables associated with physical objects

NASA Astrophysics Data System (ADS)

Camargo, F. R.; Henson, B.

2015-02-01

The notion of that more or less of a physical feature affects in different degrees the users' impression with regard to an underlying attribute of a product has frequently been applied in affective engineering. However, those attributes exist only as a premise that cannot directly be measured and, therefore, inferences based on their assessment are error-prone. To establish and improve measurement of latent attributes it is presented in this paper the concept of a stochastic framework using the Rasch model for a wide range of independent variables referred to as an item bank. Based on an item bank, computerized adaptive testing (CAT) can be developed. A CAT system can converge into a sequence of items bracketing to convey information at a user's particular endorsement level. It is through item banking and CAT that the financial benefits of using the Rasch model in affective engineering can be realised.

Strategies for controlling item exposure in computerized adaptive testing with the partial credit model.

PubMed

Davis, Laurie Laughlin; Dodd, Barbara G

2008-01-01

Exposure control research with polytomous item pools has determined that randomization procedures can be very effective for controlling test security in computerized adaptive testing (CAT). The current study investigated the performance of four procedures for controlling item exposure in a CAT under the partial credit model. In addition to a no exposure control baseline condition, the Kingsbury-Zara, modified-within-.10-logits, Sympson-Hetter, and conditional Sympson-Hetter procedures were implemented to control exposure rates. The Kingsbury-Zara and the modified-within-.10-logits procedures were implemented with 3 and 6 item candidate conditions. The results show that the Kingsbury-Zara and modified-within-.10-logits procedures with 6 item candidates performed as well as the conditional Sympson-Hetter in terms of exposure rates, overlap rates, and pool utilization. These two procedures are strongly recommended for use with partial credit CATs due to their simplicity and strength of their results.

Outcome assessment via handheld computer in community mental health: consumer satisfaction and reliability.

PubMed

Goldstein, Lizabeth A; Connolly Gibbons, Mary Beth; Thompson, Sarah M; Scott, Kelli; Heintz, Laura; Green, Patricia; Thompson, Donald; Crits-Christoph, Paul

2011-07-01

Computerized administration of mental health-related questionnaires has become relatively common, but little research has explored this mode of assessment in "real-world" settings. In the current study, 200 consumers at a community mental health center completed the BASIS-24 via handheld computer as well as paper and pen. Scores on the computerized BASIS-24 were compared with scores on the paper BASIS-24. Consumers also completed a questionnaire which assessed their level of satisfaction with the computerized BASIS-24. Results indicated that the BASIS-24 administered via handheld computer was highly correlated with pen and paper administration of the measure and was generally acceptable to consumers. Administration of the BASIS-24 via handheld computer may allow for efficient and sustainable outcomes assessment, adaptable research infrastructure, and maximization of clinical impact in community mental health agencies.

Virtual-reality-based attention assessment of ADHD: ClinicaVR: Classroom-CPT versus a traditional continuous performance test.

PubMed

Neguț, Alexandra; Jurma, Anda Maria; David, Daniel

2017-08-01

Virtual-reality-based assessment may be a good alternative to classical or computerized neuropsychological assessment due to increased ecological validity. ClinicaVR: Classroom-CPT (VC) is a neuropsychological test embedded in virtual reality that is designed to assess attention deficits in children with attention deficit hyperactivity disorder (ADHD) or other conditions associated with impaired attention. The present study aimed to (1) investigate the diagnostic validity of VC in comparison to a traditional continuous performance test (CPT), (2) explore the task difficulty of VC, (3) address the effect of distractors on the performance of ADHD participants and typically-developing (TD) controls, and (4) compare the two measures on cognitive absorption. A total of 33 children diagnosed with ADHD and 42 TD children, aged between 7 and 13 years, participated in the study and were tested with a traditional CPT or with VC, along with several cognitive measures and an adapted version of the Cognitive Absorption Scale. A mixed multivariate analysis of covariance (MANCOVA) revealed that the children with ADHD performed worse on correct responses had more commissions and omissions errors than the TD children, as well as slower target reaction times . The results showed significant differences between performance in the virtual environment and the traditional computerized one, with longer reaction times in virtual reality. The data analysis highlighted the negative influence of auditory distractors on attention performance in the case of the children with ADHD, but not for the TD children. Finally, the two measures did not differ on the cognitive absorption perceived by the children.

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.

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.

Information Technology and Literacy Assessment.

ERIC Educational Resources Information Center

Balajthy, Ernest

2002-01-01

Compares technology predictions from around 1989 with the technology of 2002. Discusses the place of computer-based assessment today, computer-scored testing, computer-administered formal assessment, Internet-based formal assessment, computerized adaptive tests, placement tests, informal assessment, electronic portfolios, information management,…

How Spreadsheets Boost Productivity.

ERIC Educational Resources Information Center

Ross, James

1988-01-01

Explains the use of computerized bookkeeping systems called spreadsheets to perform mathematical and accounting functions such as totaling expenditures, averaging test grades, and transferring funds. Advises about adapting spreadsheet programs and discusses several essential features, including linkage, macro functions, and sharing capabilities.…

Effective Heart Disease Detection Based on Quantitative Computerized Traditional Chinese Medicine Using Representation Based Classifiers.

PubMed

Shu, Ting; Zhang, Bob; Tang, Yuan Yan

2017-01-01

At present, heart disease is the number one cause of death worldwide. Traditionally, heart disease is commonly detected using blood tests, electrocardiogram, cardiac computerized tomography scan, cardiac magnetic resonance imaging, and so on. However, these traditional diagnostic methods are time consuming and/or invasive. In this paper, we propose an effective noninvasive computerized method based on facial images to quantitatively detect heart disease. Specifically, facial key block color features are extracted from facial images and analyzed using the Probabilistic Collaborative Representation Based Classifier. The idea of facial key block color analysis is founded in Traditional Chinese Medicine. A new dataset consisting of 581 heart disease and 581 healthy samples was experimented by the proposed method. In order to optimize the Probabilistic Collaborative Representation Based Classifier, an analysis of its parameters was performed. According to the experimental results, the proposed method obtains the highest accuracy compared with other classifiers and is proven to be effective at heart disease detection.

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.

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…

Identification of Alcohol Disorders at a University Mental Health Centre, Using the CAGE.

ERIC Educational Resources Information Center

Ross, Helen E.; Tisdall, Gordon W.

1994-01-01

Examined usefulness of CAGE in screening for alcohol use disorders in university students (n=110) attending campus psychiatric health service. Fourteen students were identified as having current alcohol use disorder by means of Computerized Diagnostic Interview Schedule. Results suggest that CAGE is able in this population to detect usually mild…

The Design of an ITS-Based Business Simulation: A New Epistemology for Learning.

ERIC Educational Resources Information Center

Gold, Steven C.

1998-01-01

Discusses the design and use of intelligent tutoring systems (ITS) for computerized business simulations. Reviews the use of ITS as an instructional technology; presents a model for ITS-based business simulations; examines the user interface and link between the ITS and simulation; and recommends expert-consultant diagnostic testing, and…

Interpretation Training in Individuals with Generalized Social Anxiety Disorder: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Amir, Nader; Taylor, Charles T.

2012-01-01

Objective: To examine the efficacy of a multisession computerized interpretation modification program (IMP) in the treatment of generalized social anxiety disorder (GSAD). Method: The sample comprised 49 individuals meeting diagnostic criteria for GSAD who were enrolled in a randomized, double-blind placebo-controlled trial comparing IMP (n = 23)…

A Pilot Study of a Computerized Decision Support System to Detect Invasive Fungal Infection in Pediatric Hematology/Oncology Patients.

PubMed

Bartlett, Adam; Goeman, Emma; Vedi, Aditi; Mostaghim, Mona; Trahair, Toby; O'Brien, Tracey A; Palasanthiran, Pamela; McMullan, Brendan

2015-11-01

Computerized decision support systems (CDSSs) can provide indication-specific antimicrobial recommendations and approvals as part of hospital antimicrobial stewardship (AMS) programs. The aim of this study was to assess the performance of a CDSS for surveillance of invasive fungal infections (IFIs) in an inpatient hematology/oncology cohort. Between November 1, 2012, and October 31, 2013, pediatric hematology/oncology inpatients diagnosed with an IFI were identified through an audit of the CDSS and confirmed by medical record review. The results were compared to hospital diagnostic-related group (DRG) coding for IFI throughout the same period. A total of 83 patients were prescribed systemic antifungals according to the CDSS for the 12-month period. The CDSS correctly identified 19 patients with IFI on medical record review, compared with 10 patients identified by DRG coding, of whom 9 were confirmed to have IFI on medical record review. CDSS was superior to diagnostic coding in detecting IFI in an inpatient pediatric hematology/oncology cohort. The functionality of CDSS lends itself to inpatient infectious diseases surveillance but depends on prescriber adherence.

Relationships Between Vestibular Measures as Potential Predictors for Spaceflight Sensorimotor Adaptation

NASA Technical Reports Server (NTRS)

Clark, T. K.; Peters, B.; Gadd, N. E.; De Dios, Y. E.; Wood, S.; Bloomberg, J. J.; Mulavara, A. P.

2016-01-01

Introduction: During space exploration missions astronauts are exposed to a series of novel sensorimotor environments, requiring sensorimotor adaptation. Until adaptation is complete, sensorimotor decrements occur, affecting critical tasks such as piloted landing or docking. Of particularly interest are locomotion tasks such as emergency vehicle egress or extra-vehicular activity. While nearly all astronauts eventually adapt sufficiently, it appears there are substantial individual differences in how quickly and effectively this adaptation occurs. These individual differences in capacity for sensorimotor adaptation are poorly understood. Broadly, we aim to identify measures that may serve as pre-flight predictors of and individual's adaptation capacity to spaceflight-induced sensorimotor changes. As a first step, since spaceflight is thought to involve a reinterpretation of graviceptor cues (e.g. otolith cues from the vestibular system) we investigate the relationships between various measures of vestibular function in humans. Methods: In a set of 15 ground-based control subjects, we quantified individual differences in vestibular function using three measures: 1) ocular vestibular evoked myogenic potential (oVEMP), 2) computerized dynamic posturography and 3) vestibular perceptual thresholds. oVEMP responses are elicited using a mechanical stimuli approach. Computerized dynamic posturography was used to quantify Sensory Organization Tests (SOTs), including SOT5M which involved performing pitching head movements while balancing on a sway-reference support surface with eyes closed. We implemented a vestibular perceptual threshold task using the tilt capabilities of the Tilt-Translation Sled (TTS) at JSC. On each trial, the subject was passively roll-tilted left ear down or right ear down in the dark and verbally provided a forced-choice response regarding which direction they felt tilted. The motion profile was a single-cycle sinusoid of angular acceleration with a duration of 5 seconds (frequency of 0.2 Hz), which was selected as it requires sensory integration of otolith and semicircular canal cues. Stimuli direction was randomized and magnitude was determined using an adaptive sampling procedure. One hundred trials were provided and each subject's responses were fit with a psychometric curve to estimate the subject's threshold. Results: Roll tilt perceptual thresholds at 0.2 Hz ranged from 0.5 degrees to 1.82 degrees across the 15 subjects (geometric mean of 1.04 degrees), consistent with previous studies. The inter-individual variability in thresholds may be able to help explain individual differences observed in sensorimotor adaptation to spaceflight. Analysis is ongoing for the oVEMPS and computerized dynamic posturography to identify relationships between the various vestibular measures. Discussion: Predicting individual differences in sensorimotor adaptation is critical both for the development of personalized countermeasures and mission planning. Here we aim to develop a basis of vestibular tests and parameters which may serve as predictors of individual differences in sensorimotor adaptability through studying the relationship between these measures.

E-waste Management and Refurbishment Prediction (EMARP) Model for Refurbishment Industries.

PubMed

Resmi, N G; Fasila, K A

2017-10-01

This paper proposes a novel algorithm for establishing a standard methodology to manage and refurbish e-waste called E-waste Management And Refurbishment Prediction (EMARP), which can be adapted by refurbishing industries in order to improve their performance. Waste management, particularly, e-waste management is a serious issue nowadays. Computerization has been into waste management in different ways. Much of the computerization has happened in planning the waste collection, recycling and disposal process and also managing documents and reports related to waste management. This paper proposes a computerized model to make predictions for e-waste refurbishment. All possibilities for reusing the common components among the collected e-waste samples are predicted, thus minimizing the wastage. Simulation of the model has been done to analyse the accuracy in the predictions made by the system. The model can be scaled to accommodate the real-world scenario. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using Response-Time Constraints in Item Selection To Control for Differential Speededness in Computerized Adaptive Testing. LSAC Research Report Series.

ERIC Educational Resources Information Center

van der Linden, Wim J.; Scrams, David J.; Schnipke, Deborah L.

This paper proposes an item selection algorithm that can be used to neutralize the effect of time limits in computer adaptive testing. The method is based on a statistical model for the response-time distributions of the test takers on the items in the pool that is updated each time a new item has been administered. Predictions from the model are…

LUNGx Challenge for computerized lung nodule classification

DOE PAGES

Armato, Samuel G.; Drukker, Karen; Li, Feng; ...

2016-12-19

The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants’ computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. We present ten groups that applied their own methods to 73 lung nodules (37 benign and 36 malignant) thatmore » were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists’ AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. Lastly, the continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community.« less

LUNGx Challenge for computerized lung nodule classification

PubMed Central

Armato, Samuel G.; Drukker, Karen; Li, Feng; Hadjiiski, Lubomir; Tourassi, Georgia D.; Engelmann, Roger M.; Giger, Maryellen L.; Redmond, George; Farahani, Keyvan; Kirby, Justin S.; Clarke, Laurence P.

2016-01-01

Abstract. The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants’ computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. Ten groups applied their own methods to 73 lung nodules (37 benign and 36 malignant) that were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists’ AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. The continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community. PMID:28018939

LUNGx Challenge for computerized lung nodule classification

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

Armato, Samuel G.; Drukker, Karen; Li, Feng

The purpose of this work is to describe the LUNGx Challenge for the computerized classification of lung nodules on diagnostic computed tomography (CT) scans as benign or malignant and report the performance of participants’ computerized methods along with that of six radiologists who participated in an observer study performing the same Challenge task on the same dataset. The Challenge provided sets of calibration and testing scans, established a performance assessment process, and created an infrastructure for case dissemination and result submission. We present ten groups that applied their own methods to 73 lung nodules (37 benign and 36 malignant) thatmore » were selected to achieve approximate size matching between the two cohorts. Area under the receiver operating characteristic curve (AUC) values for these methods ranged from 0.50 to 0.68; only three methods performed statistically better than random guessing. The radiologists’ AUC values ranged from 0.70 to 0.85; three radiologists performed statistically better than the best-performing computer method. The LUNGx Challenge compared the performance of computerized methods in the task of differentiating benign from malignant lung nodules on CT scans, placed in the context of the performance of radiologists on the same task. Lastly, the continued public availability of the Challenge cases will provide a valuable resource for the medical imaging research community.« less

Accuracy of dementia diagnosis: a direct comparison between radiologists and a computerized method.

PubMed

Klöppel, Stefan; Stonnington, Cynthia M; Barnes, Josephine; Chen, Frederick; Chu, Carlton; Good, Catriona D; Mader, Irina; Mitchell, L Anne; Patel, Ameet C; Roberts, Catherine C; Fox, Nick C; Jack, Clifford R; Ashburner, John; Frackowiak, Richard S J

2008-11-01

There has been recent interest in the application of machine learning techniques to neuroimaging-based diagnosis. These methods promise fully automated, standard PC-based clinical decisions, unbiased by variable radiological expertise. We recently used support vector machines (SVMs) to separate sporadic Alzheimer's disease from normal ageing and from fronto-temporal lobar degeneration (FTLD). In this study, we compare the results to those obtained by radiologists. A binary diagnostic classification was made by six radiologists with different levels of experience on the same scans and information that had been previously analysed with SVM. SVMs correctly classified 95% (sensitivity/specificity: 95/95) of sporadic Alzheimer's disease and controls into their respective groups. Radiologists correctly classified 65-95% (median 89%; sensitivity/specificity: 88/90) of scans. SVM correctly classified another set of sporadic Alzheimer's disease in 93% (sensitivity/specificity: 100/86) of cases, whereas radiologists ranged between 80% and 90% (median 83%; sensitivity/specificity: 80/85). SVMs were better at separating patients with sporadic Alzheimer's disease from those with FTLD (SVM 89%; sensitivity/specificity: 83/95; compared to radiological range from 63% to 83%; median 71%; sensitivity/specificity: 64/76). Radiologists were always accurate when they reported a high degree of diagnostic confidence. The results show that well-trained neuroradiologists classify typical Alzheimer's disease-associated scans comparable to SVMs. However, SVMs require no expert knowledge and trained SVMs can readily be exchanged between centres for use in diagnostic classification. These results are encouraging and indicate a role for computerized diagnostic methods in clinical practice.

Accuracy of dementia diagnosis—a direct comparison between radiologists and a computerized method

PubMed Central

Stonnington, Cynthia M.; Barnes, Josephine; Chen, Frederick; Chu, Carlton; Good, Catriona D.; Mader, Irina; Mitchell, L. Anne; Patel, Ameet C.; Roberts, Catherine C.; Fox, Nick C.; Jack, Clifford R.; Ashburner, John; Frackowiak, Richard S. J.

2008-01-01

There has been recent interest in the application of machine learning techniques to neuroimaging-based diagnosis. These methods promise fully automated, standard PC-based clinical decisions, unbiased by variable radiological expertise. We recently used support vector machines (SVMs) to separate sporadic Alzheimer's disease from normal ageing and from fronto-temporal lobar degeneration (FTLD). In this study, we compare the results to those obtained by radiologists. A binary diagnostic classification was made by six radiologists with different levels of experience on the same scans and information that had been previously analysed with SVM. SVMs correctly classified 95% (sensitivity/specificity: 95/95) of sporadic Alzheimer's disease and controls into their respective groups. Radiologists correctly classified 65–95% (median 89%; sensitivity/specificity: 88/90) of scans. SVM correctly classified another set of sporadic Alzheimer's disease in 93% (sensitivity/specificity: 100/86) of cases, whereas radiologists ranged between 80% and 90% (median 83%; sensitivity/specificity: 80/85). SVMs were better at separating patients with sporadic Alzheimer's disease from those with FTLD (SVM 89%; sensitivity/specificity: 83/95; compared to radiological range from 63% to 83%; median 71%; sensitivity/specificity: 64/76). Radiologists were always accurate when they reported a high degree of diagnostic confidence. The results show that well-trained neuroradiologists classify typical Alzheimer's disease-associated scans comparable to SVMs. However, SVMs require no expert knowledge and trained SVMs can readily be exchanged between centres for use in diagnostic classification. These results are encouraging and indicate a role for computerized diagnostic methods in clinical practice. PMID:18835868

Motion Estimation and Compensation Strategies in Dynamic Computerized Tomography

NASA Astrophysics Data System (ADS)

Hahn, Bernadette N.

2017-12-01

A main challenge in computerized tomography consists in imaging moving objects. Temporal changes during the measuring process lead to inconsistent data sets, and applying standard reconstruction techniques causes motion artefacts which can severely impose a reliable diagnostics. Therefore, novel reconstruction techniques are required which compensate for the dynamic behavior. This article builds on recent results from a microlocal analysis of the dynamic setting, which enable us to formulate efficient analytic motion compensation algorithms for contour extraction. Since these methods require information about the dynamic behavior, we further introduce a motion estimation approach which determines parameters of affine and certain non-affine deformations directly from measured motion-corrupted Radon-data. Our methods are illustrated with numerical examples for both types of motion.

Validation of a systems-actuarial computer process for multidimensional classification of child psychopathology.

PubMed

McDermott, P A; Hale, R L

1982-07-01

Tested diagnostic classifications of child psychopathology produced by a computerized technique known as multidimensional actuarial classification (MAC) against the criterion of expert psychological opinion. The MAC program applies series of statistical decision rules to assess the importance of and relationships among several dimensions of classification, i.e., intellectual functioning, academic achievement, adaptive behavior, and social and behavioral adjustment, to perform differential diagnosis of children's mental retardation, specific learning disabilities, behavioral and emotional disturbance, possible communication or perceptual-motor impairment, and academic under- and overachievement in reading and mathematics. Classifications rendered by MAC are compared to those offered by two expert child psychologists for cases of 73 children referred for psychological services. Experts' agreement with MAC was significant for all classification areas, as was MAC's agreement with the experts held as a conjoint reference standard. Whereas the experts' agreement with MAC averaged 86.0% above chance, their agreement with one another averaged 76.5% above chance. Implications of the findings are explored and potential advantages of the systems-actuarial approach are discussed.

[Multi-centre clinical assessment of the Russian language version of the Diagnostic Interview for Psychoses].

PubMed

Smirnova, D A; Petrova, N N; Pavlichenko, A V; Martynikhin, I A; Dorofeikova, M V; Eremkin, V I; Izmailova, O V; Osadshiy, Yu Yu; Romanov, D V; Ubeikon, D A; Fedotov, I A; Sheifer, M S; Shustov, A D; Yashikhina, A A; Clark, M; Badcock, J; Watterreus, A; Morgan, V; Jablensky, A

2018-01-01

The Diagnostic Interview for Psychoses (DIP) was developed to enhance the quality of diagnostic assessment of psychotic disorders. The aim of the study was the adaptation of the Russian language version and evaluation of its validity and reliability. Ninety-eight patients with psychotic disorders (89 video recordings) were assessed by 12 interviewers using the Russian version of DIP at 7 clinical sites (in 6 cities of the Russian Federation). DIP ratings on 32 cases of a randomized case sample were made by 9 interviewers and the inter-rater reliability was compared with the researchers' DIP ratings. Overall pairwise agreement and Cohen's kappa were calculated. Diagnostic validity was evaluated on the basis of comparing the researchers' ratings using the Russian version of DIP with the 'gold standard' ratings of the same 62 clinical cases from the Western Australia Family Study Schizophrenia (WAFSS). The mean duration of the interview was 47±21 minutes. The Kappa statistic demonstrated a significant or almost perfect level of agreement on the majority of DIP items (84.54%) and a significant agreement for the ICD-10 diagnoses generated by the DIP computer diagnostic algorithm (κ=0.68; 95% CI 0.53,0.93). The level of agreement on the researchers' diagnoses was considerably lower (κ=0.31; 95% CI 0.06,0.56). The agreement on affective and positive psychotic symptoms was significantly higher than agreement on negative symptoms (F(2,44)=20.72, p<0.001, η2=0.485). The diagnostic validity of the Russian language version of DIP was confirmed by 73% (45/62) of the Russian DIP diagnoses matching the original WAFSS diagnoses. Among the mismatched diagnoses were 80 cases with a diagnosis of F20 Schizophrenia in the medical documentation compared to the researchers' F20 diagnoses in only 68 patients and in 62 of the DIP computerized diagnostic outputs. The reported level of subjective difficulties experienced when using the DIP was low to moderate. The results of the study confirm the validity and reliability of the Russian version of the DIP for evaluating psychotic disorders. DIP can be recommended for use in education and training, clinical practice and research as an important diagnostic resource.

Asymptomatic Emphysematous Pyelonephritis - Positron Emission Tomography Computerized Tomography Aided Diagnostic and Therapeutic Elucidation

PubMed Central

Pathapati, Deepti; Shinkar, Pawan Gulabrao; kumar, Satya Awadhesh; Jha; Dattatreya, Palanki Satya; Chigurupati, Namrata; Chigurupati, Mohana Vamsy; Rao, Vatturi Venkata Satya Prabhakar

2017-01-01

The authors report an interesting coincidental unearthing by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of a potentially serious medical condition of emphysematous pyelonephritis in a case of nasopharyngeal carcinoma. The management by conservative ureteric stenting and antibiotics was done with gratifying clinical outcome. PMID:28242985

An evaluation of computerized adaptive testing for general psychological distress: combining GHQ-12 and Affectometer-2 in an item bank for public mental health research.

PubMed

Stochl, Jan; Böhnke, Jan R; Pickett, Kate E; Croudace, Tim J

2016-05-20

Recent developments in psychometric modeling and technology allow pooling well-validated items from existing instruments into larger item banks and their deployment through methods of computerized adaptive testing (CAT). Use of item response theory-based bifactor methods and integrative data analysis overcomes barriers in cross-instrument comparison. This paper presents the joint calibration of an item bank for researchers keen to investigate population variations in general psychological distress (GPD). Multidimensional item response theory was used on existing health survey data from the Scottish Health Education Population Survey (n = 766) to calibrate an item bank consisting of pooled items from the short common mental disorder screen (GHQ-12) and the Affectometer-2 (a measure of "general happiness"). Computer simulation was used to evaluate usefulness and efficacy of its adaptive administration. A bifactor model capturing variation across a continuum of population distress (while controlling for artefacts due to item wording) was supported. The numbers of items for different required reliabilities in adaptive administration demonstrated promising efficacy of the proposed item bank. Psychometric modeling of the common dimension captured by more than one instrument offers the potential of adaptive testing for GPD using individually sequenced combinations of existing survey items. The potential for linking other item sets with alternative candidate measures of positive mental health is discussed since an optimal item bank may require even more items than these.

Computer simulation of a pilot in V/STOL aircraft control loops

NASA Technical Reports Server (NTRS)

Vogt, William G.; Mickle, Marlin H.; Zipf, Mark E.; Kucuk, Senol

1989-01-01

The objective was to develop a computerized adaptive pilot model for the computer model of the research aircraft, the Harrier II AV-8B V/STOL with special emphasis on propulsion control. In fact, two versions of the adaptive pilot are given. The first, simply called the Adaptive Control Model (ACM) of a pilot includes a parameter estimation algorithm for the parameters of the aircraft and an adaption scheme based on the root locus of the poles of the pilot controlled aircraft. The second, called the Optimal Control Model of the pilot (OCM), includes an adaption algorithm and an optimal control algorithm. These computer simulations were developed as a part of the ongoing research program in pilot model simulation supported by NASA Lewis from April 1, 1985 to August 30, 1986 under NASA Grant NAG 3-606 and from September 1, 1986 through November 30, 1988 under NASA Grant NAG 3-729. Once installed, these pilot models permitted the computer simulation of the pilot model to close all of the control loops normally closed by a pilot actually manipulating the control variables. The current version of this has permitted a baseline comparison of various qualitative and quantitative performance indices for propulsion control, the control loops and the work load on the pilot. Actual data for an aircraft flown by a human pilot furnished by NASA was compared to the outputs furnished by the computerized pilot and found to be favorable.

The Computerized Laboratory Notebook concept for genetic toxicology experimentation and testing.

PubMed

Strauss, G H; Stanford, W L; Berkowitz, S J

1989-03-01

We describe a microcomputer system utilizing the Computerized Laboratory Notebook (CLN) concept developed in our laboratory for the purpose of automating the Battery of Leukocyte Tests (BLT). The BLT was designed to evaluate blood specimens for toxic, immunotoxic, and genotoxic effects after in vivo exposure to putative mutagens. A system was developed with the advantages of low cost, limited spatial requirements, ease of use for personnel inexperienced with computers, and applicability to specific testing yet flexibility for experimentation. This system eliminates cumbersome record keeping and repetitive analysis inherent in genetic toxicology bioassays. Statistical analysis of the vast quantity of data produced by the BLT would not be feasible without a central database. Our central database is maintained by an integrated package which we have adapted to develop the CLN. The clonal assay of lymphocyte mutagenesis (CALM) section of the CLN is demonstrated. PC-Slaves expand the microcomputer to multiple workstations so that our computerized notebook can be used next to a hood while other work is done in an office and instrument room simultaneously. Communication with peripheral instruments is an indispensable part of many laboratory operations, and we present a representative program, written to acquire and analyze CALM data, for communicating with both a liquid scintillation counter and an ELISA plate reader. In conclusion we discuss how our computer system could easily be adapted to the needs of other laboratories.

The Norwegian Computerized Adaptive Test of Personality Disorder-Static Form (CAT-PD-SF): Reliability, Factor Structure, and Relationships With Personality Functioning.

PubMed

Thimm, Jens C

2017-12-01

The Computerized Adaptive Test of Personality Disorder-Static Form (CAT-PD-SF) is a self-report inventory developed to assess pathological personality traits. The current study explored the reliability and higher order factor structure of the Norwegian version of the CAT-PD-SF and the relationships between the CAT-PD traits and domains of personality functioning in an undergraduate student sample ( N = 375). In addition to the CAT-PD-SF, the short form of the Severity Indices of Personality Problems and the Brief Symptom Inventory were administered. The results showed that the Norwegian CAT-PD-SF has good score reliability. Factor analysis of the CAT-PD-SF scales indicated five superordinate factors that correspond to the trait domains of the alternative DSM-5 model for personality disorders. The CAT-PD traits were highly predictive of impaired personality functioning after controlling for psychological distress. It is concluded that the CAT-PD-SF is a promising tool for the assessment of personality disorder traits.

Development of a Computerized Adaptive Test for Anxiety Based on the Dutch-Flemish Version of the PROMIS Item Bank.

PubMed

Flens, Gerard; Smits, Niels; Terwee, Caroline B; Dekker, Joost; Huijbrechts, Irma; Spinhoven, Philip; de Beurs, Edwin

2017-12-01

We used the Dutch-Flemish version of the USA PROMIS adult V1.0 item bank for Anxiety as input for developing a computerized adaptive test (CAT) to measure the entire latent anxiety continuum. First, psychometric analysis of a combined clinical and general population sample ( N = 2,010) showed that the 29-item bank has psychometric properties that are required for a CAT administration. Second, a post hoc CAT simulation showed efficient and highly precise measurement, with an average number of 8.64 items for the clinical sample, and 9.48 items for the general population sample. Furthermore, the accuracy of our CAT version was highly similar to that of the full item bank administration, both in final score estimates and in distinguishing clinical subjects from persons without a mental health disorder. We discuss the future directions and limitations of CAT development with the Dutch-Flemish version of the PROMIS Anxiety item bank.

Nike Facility Diagnostics and Data Acquisition System

NASA Astrophysics Data System (ADS)

Chan, Yung; Aglitskiy, Yefim; Karasik, Max; Kehne, David; Obenschain, Steve; Oh, Jaechul; Serlin, Victor; Weaver, Jim

2013-10-01

The Nike laser-target facility is a 56-beam krypton fluoride system that can deliver 2 to 3 kJ of laser energy at 248 nm onto targets inside a two meter diameter vacuum chamber. Nike is used to study physics and technology issues related to laser direct-drive ICF fusion, including hydrodynamic and laser-plasma instabilities, material behavior at extreme pressures, and optical and x-ray diagnostics for laser-heated targets. A suite of laser and target diagnostics are fielded on the Nike facility, including high-speed, high-resolution x-ray and visible imaging cameras, spectrometers and photo-detectors. A centrally-controlled, distributed computerized data acquisition system provides robust data management and near real-time analysis feedback capability during target shots. Work supported by DOE/NNSA.

Responsiveness of a Neuromuscular Recovery Scale for Spinal Cord Injury: Inpatient and Outpatient Rehabilitation

DTIC Science & Technology

2013-10-01

Velozo’s research focus is on the development of functional outcome measures using Rasch measurement theory. Dr. Velozo’s research team has...functional outcome measures using Rasch measurement theory. Dr. Velozo’s research team has developed computerized adaptive measurement of physical

Automated Simultaneous Assembly for Multistage Testing

ERIC Educational Resources Information Center

Breithaupt, Krista; Ariel, Adelaide; Veldkamp, Bernard P.

2005-01-01

This article offers some solutions used in the assembly of the computerized Uniform Certified Public Accountancy (CPA) licensing examination as practical alternatives for operational programs producing large numbers of forms. The Uniform CPA examination was offered as an adaptive multistage test (MST) beginning in April of 2004. Examples of…

An expert system for headache diagnosis: the Computerized Headache Assessment tool (CHAT).

PubMed

Maizels, Morris; Wolfe, William J

2008-01-01

Migraine is a highly prevalent chronic disorder associated with significant morbidity. Chronic daily headache syndromes, while less common, are less likely to be recognized, and impair quality of life to an even greater extent than episodic migraine. A variety of screening and diagnostic tools for migraine have been proposed and studied. Few investigators have developed and evaluated computerized programs to diagnose headache. To develop and determine the accuracy and utility of a computerized headache assessment tool (CHAT). CHAT was designed to identify all of the major primary headache disorders, distinguish daily from episodic types, and recognize medication overuse. CHAT was developed using an expert systems approach to headache diagnosis, with initial branch points determined by headache frequency and duration. Appropriate clinical criteria are presented relevant to brief and longer-lasting headaches. CHAT was posted on a web site using Microsoft active server pages and a SQL-server database server. A convenience sample of patients who presented to the adult urgent care department with headache, and patients in a family practice waiting room, were solicited to participate. Those who completed the on-line questionnaire were contacted for a diagnostic interview. One hundred thirty-five patients completed CHAT and 117 completed a diagnostic interview. CHAT correctly identified 35/35 (100%) patients with episodic migraine and 42/49 (85.7%) of patients with transformed migraine. CHAT also correctly identified 11/11 patients with chronic tension-type headache, 2/2 with episodic tension-type headache, and 1/1 with episodic cluster headache. Medication overuse was correctly recognized in 43/52 (82.7%). The most common misdiagnoses by CHAT were seen in patients with transformed migraine or new daily persistent headache. Fifty patients were referred to their primary care physician and 62 to the headache clinic. Of 29 patients referred to the PCP with a confirmed diagnosis of migraine, 25 made a follow-up appointment, the PCP diagnosed migraine in 19, and initiated migraine-specific therapy or prophylaxis in 17. The described expert system displays high diagnostic accuracy for migraine and other primary headache disorders, including daily headache syndromes and medication overuse. As part of a disease management program, CHAT led to patients receiving appropriate diagnoses and therapy. Limitations of the system include patient willingness to utilize the program, introducing such a process into the culture of medical care, and the difficult distinction of transformed migraine.

Design of a solar array simulator for the NASA EOS testbed

NASA Technical Reports Server (NTRS)

Butler, Steve J.; Sable, Dan M.; Lee, Fred C.; Cho, Bo H.

1992-01-01

The present spacecraft solar array simulator addresses both dc and ac characteristics as well as changes in illumination and temperature and performance degradation over the course of array service life. The computerized control system used allows simulation of a complete orbit cycle, in addition to automated diagnostics. The simulator is currently interfaced with the NASA EOS testbed.

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.

Interactive computerized learning program exposes veterinary students to challenging international animal-health problems.

PubMed

Conrad, Patricia A; Hird, Dave; Arzt, Jonathan; Hayes, Rick H; Magliano, Dave; Kasper, Janine; Morfin, Saul; Pinney, Stephen

2007-01-01

This article describes a computerized case-based CD-ROM (CD) on international animal health that was developed to give veterinary students an opportunity to "virtually" work alongside veterinarians and other veterinary students as they try to solve challenging disease problems relating to tuberculosis in South African wildlife, bovine abortion in Mexico, and neurologic disease in horses in Rapa Nui, Chile. Each of the three case modules presents, in a highly interactive format, a problem or mystery that must be solved by the learner. As well as acquiring information via video clips and text about the specific health problem, learners obtain information about the different countries, animal-management practices, diagnostic methods, related disease-control issues, economic factors, and the opinions of local experts. After assimilating this information, the learner must define the problem and formulate an action plan or make a recommendation or diagnosis. The computerized program invokes three principles of adult education: active learning, learner-centered education, and experiential learning. A medium that invokes these principles is a potentially efficient learning tool and template for developing other case-based problem-solving computerized programs. The program is accessible on the World Wide Web at . A broadband Internet connection is recommended, since the modules make extensive use of embedded video and audio clips. Information on how to obtain the CD is also provided.

Language Testing Research. Selected Papers from the Colloquium (Monterey, California, February 27-28, 1986).

ERIC Educational Resources Information Center

Bailey, Kathleen M., Ed.; And Others

This collection of 10 selected conference papers report the results of language testing research. Titles and authors are: "Computerized Adaptive Language Testing: A Spanish Placement Exam" (Jerry W. Larson); "Utilizing Rasch Analysis to Detect Cheating on Language Examinations" (Harold S. Madsen); "Scalar Analysis of…

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…

Image Processing: A State-of-the-Art Way to Learn Science.

ERIC Educational Resources Information Center

Raphael, Jacqueline; Greenberg, Richard

1995-01-01

Teachers participating in the Image Processing for Teaching Process, begun at the University of Arizona's Lunar and Planetary Laboratory in 1989, find this technology ideal for encouraging student discovery, promoting constructivist science or math experiences, and adapting in classrooms. Because image processing is not a computerized text, it…

Community Level Impact Assessment--Extension Applications.

ERIC Educational Resources Information Center

Woods, Mike D.; Doeksen, Gerald A.

Using the Oklahoma State University (OSU) computerized community simulation model, extension professionals can provide local decision makers with information derived from an impact model that is dynamic, community specific, and easy to adapt to different communities. The four main sections of the OSU model are an economic account, a capital…

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…

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…

Cell Phone-Based Expert Systems for Smoking Cessation

DTIC Science & Technology

2011-09-01

computerized tailored intervention (CTI) with feedback messages delivered via cell phone . CTIs have shown increasing promise as useful behavior change programs...behaviors. This will be the first study to adapt a smoking cessation Internet-based CTI to provide personalized feedback on a cell phone to reduce smoking behaviors in military veterans.

A Comparison of Item Selection Techniques for Testlets

ERIC Educational Resources Information Center

Murphy, Daniel L.; Dodd, Barbara G.; Vaughn, Brandon K.

2010-01-01

This study examined the performance of the maximum Fisher's information, the maximum posterior weighted information, and the minimum expected posterior variance methods for selecting items in a computerized adaptive testing system when the items were grouped in testlets. A simulation study compared the efficiency of ability estimation among the…

Computerized Adaptive Test vs. decision trees: Development of a support decision system to identify suicidal behavior.

PubMed

Delgado-Gomez, D; Baca-Garcia, E; Aguado, D; Courtet, P; Lopez-Castroman, J

2016-12-01

Several Computerized Adaptive Tests (CATs) have been proposed to facilitate assessments in mental health. These tests are built in a standard way, disregarding useful and usually available information not included in the assessment scales that could increase the precision and utility of CATs, such as the history of suicide attempts. Using the items of a previously developed scale for suicidal risk, we compared the performance of a standard CAT and a decision tree in a support decision system to identify suicidal behavior. We included the history of past suicide attempts as a class for the separation of patients in the decision tree. The decision tree needed an average of four items to achieve a similar accuracy than a standard CAT with nine items. The accuracy of the decision tree, obtained after 25 cross-validations, was 81.4%. A shortened test adapted for the separation of suicidal and non-suicidal patients was developed. CATs can be very useful tools for the assessment of suicidal risk. However, standard CATs do not use all the information that is available. A decision tree can improve the precision of the assessment since they are constructed using a priori information. Copyright © 2016 Elsevier B.V. All rights reserved.

Sensitivity of a computer adaptive assessment for measuring functional mobility changes in children enrolled in a community fitness programme.

PubMed

Haley, Stephen M; Fragala-Pinkham, Maria; Ni, Pengsheng

2006-07-01

To examine the relative sensitivity to detect functional mobility changes with a full-length parent questionnaire compared with a computerized adaptive testing version of the questionnaire after a 16-week group fitness programme. Prospective, pre- and posttest study with a 16-week group fitness intervention. Three community-based fitness centres. Convenience sample of children (n = 28) with physical or developmental disabilities. A 16-week group exercise programme held twice a week in a community setting. A full-length (161 items) paper version of a mobility parent questionnaire based on the Pediatric Evaluation of Disability Inventory, but expanded to include expected skills of children up to 15 years old was compared with a 15-item computer adaptive testing version. Both measures were administered at pre- and posttest intervals. Both the full-length Pediatric Evaluation of Disability Inventory and the 15-item computer adaptive testing version detected significant changes between pre- and posttest scores, had large effect sizes, and standardized response means, with a modest decrease in the computer adaptive test as compared with the 161-item paper version. Correlations between the computer adaptive and paper formats across pre- and posttest scores ranged from r = 0.76 to 0.86. Both functional mobility test versions were able to detect positive functional changes at the end of the intervention period. Greater variability in score estimates was generated by the computerized adaptive testing version, which led to a relative reduction in sensitivity as defined by the standardized response mean. Extreme scores were generally more difficult for the computer adaptive format to estimate with as much accuracy as scores in the mid-range of the scale. However, the reduction in accuracy and sensitivity, which did not influence the group effect results in this study, is counterbalanced by the large reduction in testing burden.

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…

Influence of Context on Item Parameters in Forced-Choice Personality Assessments

ERIC Educational Resources Information Center

Lin, Yin; Brown, Anna

2017-01-01

A fundamental assumption in computerized adaptive testing is that item parameters are invariant with respect to context--items surrounding the administered item. This assumption, however, may not hold in forced-choice (FC) assessments, where explicit comparisons are made between items included in the same block. We empirically examined the…

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…

A CEFR-Based Computerized Adaptive Testing System for Chinese Proficiency

ERIC Educational Resources Information Center

Wang, Hsuan-Po; Kuo, Bor-Chen; Tsai, Ya-Hsun; Liao, Chen-Huei

2012-01-01

In the era of globalization, the trend towards learning Chinese as a foreign language (CFL) has become increasingly popular worldwide. The increasing demand in learning CFL has raised the profile of the Chinese proficiency test (CPT). This study will analyze in depth the inadequacy of current CPT's utilizing the common European framework of…

Variable-Length Computerized Adaptive Testing Using the Higher Order DINA Model

ERIC Educational Resources Information Center

Hsu, Chia-Ling; Wang, Wen-Chung

2015-01-01

Cognitive diagnosis models provide profile information about a set of latent binary attributes, whereas item response models yield a summary report on a latent continuous trait. To utilize the advantages of both models, higher order cognitive diagnosis models were developed in which information about both latent binary attributes and latent…

Designing P-Optimal Item Pools in Computerized Adaptive Tests with Polytomous Items

ERIC Educational Resources Information Center

Zhou, Xuechun

2012-01-01

Current CAT applications consist of predominantly dichotomous items, and CATs with polytomously scored items are limited. To ascertain the best approach to polytomous CAT, a significant amount of research has been conducted on item selection, ability estimation, and impact of termination rules based on polytomous IRT models. Few studies…

Comparing the Performance of Five Multidimensional CAT Selection Procedures with Different Stopping Rules

ERIC Educational Resources Information Center

Yao, Lihua

2013-01-01

Through simulated data, five multidimensional computerized adaptive testing (MCAT) selection procedures with varying test lengths are examined and compared using different stopping rules. Fixed item exposure rates are used for all the items, and the Priority Index (PI) method is used for the content constraints. Two stopping rules, standard error…

A Top-Down Approach to Designing the Computerized Adaptive Multistage Test

ERIC Educational Resources Information Center

Luo, Xiao; Kim, Doyoung

2018-01-01

The top-down approach to designing a multistage test is relatively understudied in the literature and underused in research and practice. This study introduced a route-based top-down design approach that directly sets design parameters at the test level and utilizes the advanced automated test assembly algorithm seeking global optimality. The…

Two-Phase Item Selection Procedure for Flexible Content Balancing in CAT

ERIC Educational Resources Information Center

Cheng, Ying; Chang, Hua-Hua; Yi, Qing

2007-01-01

Content balancing is an important issue in the design and implementation of computerized adaptive testing (CAT). Content-balancing techniques that have been applied in fixed content balancing, where the number of items from each content area is fixed, include constrained CAT (CCAT), the modified multinomial model (MMM), modified constrained CAT…

A Comparison of Linking and Concurrent Calibration under the Graded Response Model.

ERIC Educational Resources Information Center

Kim, Seock-Ho; Cohen, Allan S.

Applications of item response theory to practical testing problems including equating, differential item functioning, and computerized adaptive testing, require that item parameter estimates be placed onto a common metric. In this study, two methods for developing a common metric for the graded response model under item response theory were…

A Bayesian Tutoring System for Newtonian Mechanics: Can It Adapt to Different Learners?

ERIC Educational Resources Information Center

Pek, Peng-Kiat; Poh, Kim-Leng

2004-01-01

Newtonian mechanics is a core module in technology courses, but is difficult for many students to learn. Computerized tutoring can assist the teachers to provide individualized instruction. This article presents the application of decision theory to develop a tutoring system, "iTutor", to select optimal tutoring actions under uncertainty of…

Outlier Detection in High-Stakes Certification Testing. Research Report.

ERIC Educational Resources Information Center

Meijer, Rob R.

Recent developments of person-fit analysis in computerized adaptive testing (CAT) are discussed. Methods from statistical process control are presented that have been proposed to classify an item score pattern as fitting or misfitting the underlying item response theory (IRT) model in a CAT. Most person-fit research in CAT is restricted to…

Outlier Detection in High-Stakes Certification Testing.

ERIC Educational Resources Information Center

Meijer, Rob R.

2002-01-01

Used empirical data from a certification test to study methods from statistical process control that have been proposed to classify an item score pattern as fitting or misfitting the underlying item response theory model in computerized adaptive testing. Results for 1,392 examinees show that different types of misfit can be distinguished. (SLD)

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…

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…

Varying the valuating function and the presentable bank in computerized adaptive testing.

PubMed

Barrada, Juan Ramón; Abad, Francisco José; Olea, Julio

2011-05-01

In computerized adaptive testing, the most commonly used valuating function is the Fisher information function. When the goal is to keep item bank security at a maximum, the valuating function that seems most convenient is the matching criterion, valuating the distance between the estimated trait level and the point where the maximum of the information function is located. Recently, it has been proposed not to keep the same valuating function constant for all the items in the test. In this study we expand the idea of combining the matching criterion with the Fisher information function. We also manipulate the number of strata into which the bank is divided. We find that the manipulation of the number of items administered with each function makes it possible to move from the pole of high accuracy and low security to the opposite pole. It is possible to greatly improve item bank security with much fewer losses in accuracy by selecting several items with the matching criterion. In general, it seems more appropriate not to stratify the bank.

Computerized provider order entry in the clinical laboratory

PubMed Central

Baron, Jason M.; Dighe, Anand S.

2011-01-01

Clinicians have traditionally ordered laboratory tests using paper-based orders and requisitions. However, paper orders are becoming increasingly incompatible with the complexities, challenges, and resource constraints of our modern healthcare systems and are being replaced by electronic order entry systems. Electronic systems that allow direct provider input of diagnostic testing or medication orders into a computer system are known as Computerized Provider Order Entry (CPOE) systems. Adoption of laboratory CPOE systems may offer institutions many benefits, including reduced test turnaround time, improved test utilization, and better adherence to practice guidelines. In this review, we outline the functionality of various CPOE implementations, review the reported benefits, and discuss strategies for using CPOE to improve the test ordering process. Further, we discuss barriers to the implementation of CPOE systems that have prevented their more widespread adoption. PMID:21886891

[Assessment of gestures and their psychiatric relevance].

PubMed

Bulucz, Judit; Simon, Lajos

2008-01-01

Analyzing and investigating non-verbal behavior and gestures has been receiving much attention since the last century. Thanks to the pioneer work of Ekman and Friesen we have a number of descriptive-analytic, categorizing and semantic content related scales and scoring systems. Generation of gestures, the integrative system with speech and the inter-cultural differences are in the focus of interest. Furthermore, analysis of the gestural changes caused by lesions of distinct neurological areas point toward to formation of new diagnostic approaches. The more widespread application of computerized methods resulted in an increasing number of experiments which study gesture generation, reproduction in mechanical and virtual reality. Increasing efforts are directed towards the understanding of human and computerized recognition of human gestures. In this review we describe the results emphasizing the relations of those results with psychiatric and neuropsychiatric disorders, specifically schizophrenia and affective spectrum.

[Use of the prenosology approach for attaining the objectives of pilot medical expertise].

PubMed

Ushakov, I B; Simakova, T G; Zipa, O M; Chernikova, A G; Baevskij, R M

2014-01-01

Early diagnostics of senior pilots for diseases and conditions undesirable in terms of flight safety is tightly linked with evaluation of risks of their development. Prenosology diagnostics is focused on borderline states that may pass from health to disease (prenosology and premorbidity) and, vice versa, from disease to recovery (postnosology). Regarding health as a vital adaptation reserve, prenosology diagnostics is concerned with the ability of organism to adapt to an environment rather than probability of disease. Constant drain of adaptation reserves may become a reason for increased risks of disease. Heart rate variability analysis is one of the instruments of prenosology diagnostics. Authors of the paper discuss applicability of the space medicine oriented probabilistic approach to evaluation of adaptation risks by medical expertise boards certifying civil pilots. Results of 2 series of investigations showed increased adaptation risks and reduced functional reserves in pilots found unfit to continue career.

Construct Validation of a Multidimensional Computerized Adaptive Test for Fatigue in Rheumatoid Arthritis

PubMed Central

Nikolaus, Stephanie; Bode, Christina; Taal, Erik; Vonkeman, Harald E.; Glas, Cees A. W.; van de Laar, Mart A. F. J.

2015-01-01

Objective Multidimensional computerized adaptive testing enables precise measurements of patient-reported outcomes at an individual level across different dimensions. This study examined the construct validity of a multidimensional computerized adaptive test (CAT) for fatigue in rheumatoid arthritis (RA). Methods The ‘CAT Fatigue RA’ was constructed based on a previously calibrated item bank. It contains 196 items and three dimensions: ‘severity’, ‘impact’ and ‘variability’ of fatigue. The CAT was administered to 166 patients with RA. They also completed a traditional, multidimensional fatigue questionnaire (BRAF-MDQ) and the SF-36 in order to examine the CAT’s construct validity. A priori criterion for construct validity was that 75% of the correlations between the CAT dimensions and the subscales of the other questionnaires were as expected. Furthermore, comprehensive use of the item bank, measurement precision and score distribution were investigated. Results The a priori criterion for construct validity was supported for two of the three CAT dimensions (severity and impact but not for variability). For severity and impact, 87% of the correlations with the subscales of the well-established questionnaires were as expected but for variability, 53% of the hypothesised relations were found. Eighty-nine percent of the items were selected between one and 137 times for CAT administrations. Measurement precision was excellent for the severity and impact dimensions, with more than 90% of the CAT administrations reaching a standard error below 0.32. The variability dimension showed good measurement precision with 90% of the CAT administrations reaching a standard error below 0.44. No floor- or ceiling-effects were found for the three dimensions. Conclusion The CAT Fatigue RA showed good construct validity and excellent measurement precision on the dimensions severity and impact. The dimension variability had less ideal measurement characteristics, pointing to the need to recalibrate the CAT item bank with a two-dimensional model, solely consisting of severity and impact. PMID:26710104

Development and validation of a survey instrument for assessing prescribers' perception of computerized drug-drug interaction alerts.

PubMed

Zheng, Kai; Fear, Kathleen; Chaffee, Bruce W; Zimmerman, Christopher R; Karls, Edward M; Gatwood, Justin D; Stevenson, James G; Pearlman, Mark D

2011-12-01

To develop a theoretically informed and empirically validated survey instrument for assessing prescribers' perception of computerized drug-drug interaction (DDI) alerts. The survey is grounded in the unified theory of acceptance and use of technology and an adapted accident causation model. Development of the instrument was also informed by a review of the extant literature on prescribers' attitude toward computerized medication safety alerts and common prescriber-provided reasons for overriding. To refine and validate the survey, we conducted a two-stage empirical validation study consisting of a pretest with a panel of domain experts followed by a field test among all eligible prescribers at our institution. The resulting survey instrument contains 28 questionnaire items assessing six theoretical dimensions: performance expectancy, effort expectancy, social influence, facilitating conditions, perceived fatigue, and perceived use behavior. Satisfactory results were obtained from the field validation; however, a few potential issues were also identified. We analyzed these issues accordingly and the results led to the final survey instrument as well as usage recommendations. High override rates of computerized medication safety alerts have been a prevalent problem. They are usually caused by, or manifested in, issues of poor end user acceptance. However, standardized research tools for assessing and understanding end users' perception are currently lacking, which inhibits knowledge accumulation and consequently forgoes improvement opportunities. The survey instrument presented in this paper may help fill this methodological gap. We developed and empirically validated a survey instrument that may be useful for future research on DDI alerts and other types of computerized medication safety alerts more generally.

Efficiently measuring dimensions of the externalizing spectrum model: Development of the Externalizing Spectrum Inventory-Computerized Adaptive Test (ESI-CAT).

PubMed

Sunderland, Matthew; Slade, Tim; Krueger, Robert F; Markon, Kristian E; Patrick, Christopher J; Kramer, Mark D

2017-07-01

The development of the Externalizing Spectrum Inventory (ESI) was motivated by the need to comprehensively assess the interrelated nature of externalizing psychopathology and personality using an empirically driven framework. The ESI measures 23 theoretically distinct yet related unidimensional facets of externalizing, which are structured under 3 superordinate factors representing general externalizing, callous aggression, and substance abuse. One limitation of the ESI is its length at 415 items. To facilitate the use of the ESI in busy clinical and research settings, the current study sought to examine the efficiency and accuracy of a computerized adaptive version of the ESI. Data were collected over 3 waves and totaled 1,787 participants recruited from undergraduate psychology courses as well as male and female state prisons. A series of 6 algorithms with different termination rules were simulated to determine the efficiency and accuracy of each test under 3 different assumed distributions. Scores generated using an optimal adaptive algorithm evidenced high correlations (r > .9) with scores generated using the full ESI, brief ESI item-based factor scales, and the 23 facet scales. The adaptive algorithms for each facet administered a combined average of 115 items, a 72% decrease in comparison to the full ESI. Similarly, scores on the item-based factor scales of the ESI-brief form (57 items) were generated using on average of 17 items, a 70% decrease. The current study successfully demonstrates that an adaptive algorithm can generate similar scores for the ESI and the 3 item-based factor scales using a fraction of the total item pool. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Computerized study with 201T1 of the cold thyroid node.

PubMed

Palermo, F; Saitta, B; Coghetto, F; Tiberio, M; Caldato, L

1982-02-01

Because of its physical and potassium-metabolic characteristics 201T1 is more suitable than 131Cs for radioisotopic studies of the cold thyroid nodule, with the further diagnostic possibility of quantitatively assessing intranodular behavior for a specific differentiation among different kinds of neoformations. Using a gamma-camera on line with a computer data processing device, sequential scintiscans were recorded for the first 20-30 min after i.v. administration of 15-20 microCi/kg of radiothallium; delayed sequences were taken at 40-60 min if intranodular uptake appeared. A quantitative appraisal was made of the differential 201T1 uptake-ratio between nodule and healthy thyroid tissue (density-index) and the multiparameter analysis of thyroid time/activity curves generated on the relative regions of interest (ROIs). This computerized study, in 120 out of 293 patients submitted to this radiothallium test, has shown a) diagnostic agreement between clinical-histological and radioisotopic findings in 76 out of 79 colloid-cystic or degenerative neoformations, in all 16 malignant and in 23 out of 25 hyperplastic benign nodules; b) significant statistical difference of the density-index in solid versus cystic but not between benign and malignant nodules; c) different 201T1 kinetics behaviour in different kinds of solid thyroid lesions with a satisfactory statistical difference of the radiothallium nodular disappearance-index.

Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis.

PubMed

Ahmad, Mansur; Hollender, Lars; Anderson, Quentin; Kartha, Krishnan; Ohrbach, Richard; Truelove, Edmond L; John, Mike T; Schiffman, Eric L

2009-06-01

As part of the Multisite Research Diagnostic Criteria For Temporomandibular Disorders (RDC/TMD) Validation Project, comprehensive temporomandibular joint diagnostic criteria were developed for image analysis using panoramic radiography, magnetic resonance imaging (MRI), and computerized tomography (CT). Interexaminer reliability was estimated using the kappa (kappa) statistic, and agreement between rater pairs was characterized by overall, positive, and negative percent agreement. Computerized tomography was the reference standard for assessing validity of other imaging modalities for detecting osteoarthritis (OA). For the radiologic diagnosis of OA, reliability of the 3 examiners was poor for panoramic radiography (kappa = 0.16), fair for MRI (kappa = 0.46), and close to the threshold for excellent for CT (kappa = 0.71). Using MRI, reliability was excellent for diagnosing disc displacements (DD) with reduction (kappa = 0.78) and for DD without reduction (kappa = 0.94) and good for effusion (kappa = 0.64). Overall percent agreement for pairwise ratings was >or=82% for all conditions. Positive percent agreement for diagnosing OA was 19% for panoramic radiography, 59% for MRI, and 84% for CT. Using MRI, positive percent agreement for diagnoses of any DD was 95% and of effusion was 81%. Negative percent agreement was >or=88% for all conditions. Compared with CT, panoramic radiography and MRI had poor and marginal sensitivity, respectively, but excellent specificity in detecting OA. Comprehensive image analysis criteria for the RDC/TMD Validation Project were developed, which can reliably be used for assessing OA using CT and for disc position and effusion using MRI.

Development and Standardization of the Diagnostic Adaptive Behavior Scale: Application of Item Response Theory to the Assessment of Adaptive Behavior

ERIC Educational Resources Information Center

Tassé, Marc J.; Schalock, Robert L.; Thissen, David; Balboni, Giulia; Bersani, Henry, Jr.; Borthwick-Duffy, Sharon A.; Spreat, Scott; Widaman, Keith F.; Zhang, Dalun; Navas, Patricia

2016-01-01

The Diagnostic Adaptive Behavior Scale (DABS) was developed using item response theory (IRT) methods and was constructed to provide the most precise and valid adaptive behavior information at or near the cutoff point of making a decision regarding a diagnosis of intellectual disability. The DABS initial item pool consisted of 260 items. Using IRT…

Simulating Nonmodel-Fitting Responses in a CAT Environment. ACT Research Report Series 98-10.

ERIC Educational Resources Information Center

Yi, Qing; Nering, Michael L.

This study developed a model to simulate nonmodel-fitting responses in a computerized adaptive testing (CAT) environment, and to examine the effectiveness of the model. The underlying idea was to simulate examinees' test behaviors realistically. This study simulated a situation in which examinees are exposed to or are coached on test items before…

Computerized Adaptive Testing with Item Clones. Research Report.

ERIC Educational Resources Information Center

Glas, Cees A. W.; van der Linden, Wim J.

To reduce the cost of item writing and to enhance the flexibility of item presentation, items can be generated by item-cloning techniques. An important consequence of cloning is that it may cause variability on the item parameters. Therefore, a multilevel item response model is presented in which it is assumed that the item parameters of a…

Comparison of Exposure Controls, Item Pool Characteristics, and Population Distributions for CAT Using the Partial Credit Model

ERIC Educational Resources Information Center

Lee, HwaYoung; Dodd, Barbara G.

2012-01-01

This study investigated item exposure control procedures under various combinations of item pool characteristics and ability distributions in computerized adaptive testing based on the partial credit model. Three variables were manipulated: item pool characteristics (120 items for each of easy, medium, and hard item pools), two ability…

The Applicability of Multidimensional Computerized Adaptive Testing for Cognitive Ability Measurement in Organizational Assessment

ERIC Educational Resources Information Center

Makransky, Guido; Glas, Cees A. W.

2013-01-01

Cognitive ability tests are widely used in organizations around the world because they have high predictive validity in selection contexts. Although these tests typically measure several subdomains, testing is usually carried out for a single subdomain at a time. This can be ineffective when the subdomains assessed are highly correlated. This…

Development and Evaluation of an Adaptive Computerized Training System (ACTS). R&D Report 78-1.

ERIC Educational Resources Information Center

Knerr, Bruce W.; Nawrocki, Leon H.

This report describes the development of a computer based system designed to train electronic troubleshooting procedures. The ACTS uses artificial intelligence techniques to develop models of student and expert troubleshooting behavior as they solve a series of troubleshooting problems on the system. Comparisons of the student and expert models…

The MMPI-2 Computerized Adaptive Version (MMPI-2-CA) in a Veterans Administration Medical Outpatient Facility

ERIC Educational Resources Information Center

Forbey, Johnathan D.; Ben-Porath, Yossef S.; Arbisi, Paul A.

2012-01-01

The ability to screen quickly and thoroughly for psychological difficulties in existing and returning combat veterans who are seeking treatment for physical ailments would be of significant benefit. In the current study, item and time savings, as well as extratest correlations, associated with an audio-augmented version of the computerized…

Reducing the Impact of Inappropriate Items on Reviewable Computerized Adaptive Testing

ERIC Educational Resources Information Center

Yen, Yung-Chin; Ho, Rong-Guey; Liao, Wen-Wei; Chen, Li-Ju

2012-01-01

In a test, the testing score would be closer to examinee's actual ability when careless mistakes were corrected. In CAT, however, changing the answer of one item in CAT might cause the following items no longer appropriate for estimating the examinee's ability. These inappropriate items in a reviewable CAT might in turn introduce bias in ability…

Using Automatic Item Generation to Meet the Increasing Item Demands of High-Stakes Educational and Occupational Assessment

ERIC Educational Resources Information Center

Arendasy, Martin E.; Sommer, Markus

2012-01-01

The use of new test administration technologies such as computerized adaptive testing in high-stakes educational and occupational assessments demands large item pools. Classic item construction processes and previous approaches to automatic item generation faced the problems of a considerable loss of items after the item calibration phase. In this…

Validity Study in Multidimensional Latent Space and Efficient Computerized Adaptive Testing. Final Report.

ERIC Educational Resources Information Center

Samejima, Fumiko

This paper is the final report of a multi-year project sponsored by the Office of Naval Research (ONR) in 1987 through 1990. The main objectives of the research summarized were to: investigate the non-parametric approach to the estimation of the operating characteristics of discrete item responses; revise and strengthen the package computer…

Investigating Item Exposure Control Methods in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Ozturk, Nagihan Boztunc; Dogan, Nuri

2015-01-01

This study aims to investigate the effects of item exposure control methods on measurement precision and on test security under various item selection methods and item pool characteristics. In this study, the Randomesque (with item group sizes of 5 and 10), Sympson-Hetter, and Fade-Away methods were used as item exposure control methods. Moreover,…

"MSTGen": Simulated Data Generator for Multistage Testing

ERIC Educational Resources Information Center

Han, Kyung T.

2013-01-01

Multistage testing, or MST, was developed as an alternative to computerized adaptive testing (CAT) for applications in which it is preferable to administer a test at the level of item sets (i.e., modules). As with CAT, the simulation technique in MST plays a critical role in the development and maintenance of tests. "MSTGen," a new MST…

Using Out-of-Level Items in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Wei, Hua; Lin, Jie

2015-01-01

Out-of-level testing refers to the practice of assessing a student with a test that is intended for students at a higher or lower grade level. Although the appropriateness of out-of-level testing for accountability purposes has been questioned by educators and policymakers, incorporating out-of-level items in formative assessments for accurate…

Performance Factors Analysis -- A New Alternative to Knowledge Tracing

ERIC Educational Resources Information Center

Pavlik, Philip I., Jr.; Cen, Hao; Koedinger, Kenneth R.

2009-01-01

Knowledge tracing (KT)[1] has been used in various forms for adaptive computerized instruction for more than 40 years. However, despite its long history of application, it is difficult to use in domain model search procedures, has not been used to capture learning where multiple skills are needed to perform a single action, and has not been used…

CFES--California Fire Economics Simulator: A Computerized System for Wildland Fire Protection Planning

Treesearch

Jeremy S. Fried; J. Keith Gilless; Robert E. Martin

1987-01-01

The University of California's Department of Forestry and Resource Management, under contract with the California Department of Forestry and Fire Protection, has developed and released the first version of the California Fire Economics Simulator (CFES). The current release is adapted from the Initial Action Assessment component of the USFS's National Fire...

Utilizing Response Time Distributions for Item Selection in CAT

ERIC Educational Resources Information Center

Fan, Zhewen; Wang, Chun; Chang, Hua-Hua; Douglas, Jeffrey

2012-01-01

Traditional methods for item selection in computerized adaptive testing only focus on item information without taking into consideration the time required to answer an item. As a result, some examinees may receive a set of items that take a very long time to finish, and information is not accrued as efficiently as possible. The authors propose two…

The Random-Threshold Generalized Unfolding Model and Its Application of Computerized Adaptive Testing

ERIC Educational Resources Information Center

Wang, Wen-Chung; Liu, Chen-Wei; Wu, Shiu-Lien

2013-01-01

The random-threshold generalized unfolding model (RTGUM) was developed by treating the thresholds in the generalized unfolding model as random effects rather than fixed effects to account for the subjective nature of the selection of categories in Likert items. The parameters of the new model can be estimated with the JAGS (Just Another Gibbs…

A Multidimensional Computerized Adaptive Short-Form Quality of Life Questionnaire Developed and Validated for Multiple Sclerosis: The MusiQoL-MCAT.

PubMed

Michel, Pierre; Baumstarck, Karine; Ghattas, Badih; Pelletier, Jean; Loundou, Anderson; Boucekine, Mohamed; Auquier, Pascal; Boyer, Laurent

2016-04-01

The aim was to develop a multidimensional computerized adaptive short-form questionnaire, the MusiQoL-MCAT, from a fixed-length QoL questionnaire for multiple sclerosis.A total of 1992 patients were enrolled in this international cross-sectional study. The development of the MusiQoL-MCAT was based on the assessment of between-items MIRT model fit followed by real-data simulations. The MCAT algorithm was based on Bayesian maximum a posteriori estimation of latent traits and Kullback-Leibler information item selection. We examined several simulations based on a fixed number of items. Accuracy was assessed using correlations (r) between initial IRT scores and MCAT scores. Precision was assessed using the standard error measurement (SEM) and the root mean square error (RMSE).The multidimensional graded response model was used to estimate item parameters and IRT scores. Among the MCAT simulations, the 16-item version of the MusiQoL-MCAT was selected because the accuracy and precision became stable with 16 items with satisfactory levels (r ≥ 0.9, SEM ≤ 0.55, and RMSE ≤ 0.3). External validity of the MusiQoL-MCAT was satisfactory.The MusiQoL-MCAT presents satisfactory properties and can individually tailor QoL assessment to each patient, making it less burdensome to patients and better adapted for use in clinical practice.

A Multidimensional Computerized Adaptive Short-Form Quality of Life Questionnaire Developed and Validated for Multiple Sclerosis

PubMed Central

Michel, Pierre; Baumstarck, Karine; Ghattas, Badih; Pelletier, Jean; Loundou, Anderson; Boucekine, Mohamed; Auquier, Pascal; Boyer, Laurent

2016-01-01

Abstract The aim was to develop a multidimensional computerized adaptive short-form questionnaire, the MusiQoL-MCAT, from a fixed-length QoL questionnaire for multiple sclerosis. A total of 1992 patients were enrolled in this international cross-sectional study. The development of the MusiQoL-MCAT was based on the assessment of between-items MIRT model fit followed by real-data simulations. The MCAT algorithm was based on Bayesian maximum a posteriori estimation of latent traits and Kullback–Leibler information item selection. We examined several simulations based on a fixed number of items. Accuracy was assessed using correlations (r) between initial IRT scores and MCAT scores. Precision was assessed using the standard error measurement (SEM) and the root mean square error (RMSE). The multidimensional graded response model was used to estimate item parameters and IRT scores. Among the MCAT simulations, the 16-item version of the MusiQoL-MCAT was selected because the accuracy and precision became stable with 16 items with satisfactory levels (r ≥ 0.9, SEM ≤ 0.55, and RMSE ≤ 0.3). External validity of the MusiQoL-MCAT was satisfactory. The MusiQoL-MCAT presents satisfactory properties and can individually tailor QoL assessment to each patient, making it less burdensome to patients and better adapted for use in clinical practice. PMID:27057832

Enhancing and Customizing Laboratory Information Systems to Improve/Enhance Pathologist Workflow.

PubMed

Hartman, Douglas J

2015-06-01

Optimizing pathologist workflow can be difficult because it is affected by many variables. Surgical pathologists must complete many tasks that culminate in a final pathology report. Several software systems can be used to enhance/improve pathologist workflow. These include voice recognition software, pre-sign-out quality assurance, image utilization, and computerized provider order entry. Recent changes in the diagnostic coding and the more prominent role of centralized electronic health records represent potential areas for increased ways to enhance/improve the workflow for surgical pathologists. Additional unforeseen changes to the pathologist workflow may accompany the introduction of whole-slide imaging technology to the routine diagnostic work. Copyright © 2015 Elsevier Inc. All rights reserved.

Enhancing and Customizing Laboratory Information Systems to Improve/Enhance Pathologist Workflow.

PubMed

Hartman, Douglas J

2016-03-01

Optimizing pathologist workflow can be difficult because it is affected by many variables. Surgical pathologists must complete many tasks that culminate in a final pathology report. Several software systems can be used to enhance/improve pathologist workflow. These include voice recognition software, pre-sign-out quality assurance, image utilization, and computerized provider order entry. Recent changes in the diagnostic coding and the more prominent role of centralized electronic health records represent potential areas for increased ways to enhance/improve the workflow for surgical pathologists. Additional unforeseen changes to the pathologist workflow may accompany the introduction of whole-slide imaging technology to the routine diagnostic work. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinically expedient reporting of rapid diagnostic test information.

PubMed

Doern, G V

1986-03-01

With the development of rapid diagnostic tests in the clinical microbiology laboratory has come an awareness of the importance of rapid results reporting. Clearly, the potential clinical impact of rapid diagnostic tests is dependent on expeditious reporting. Traditional manual reporting systems are encumbered by the necessity of transcription of test information onto hard copy reports and then the subsequent distribution of such reports into the hands of the user. Laboratory computers when linked directly to CRTs located in nursing stations, ambulatory clinics, or physician's offices, both inside and outside of the hospital, permit essentially instantaneous transfer of test results from the laboratory to the clinician. Computer-assisted results reporting, while representing a significant advance over manual reporting systems is not, however, without problems. Concerns include validation of test information, authorization of users with access to test information, mechanical integrity, and cost. These issues notwithstanding, computerized results reporting will undoubtedly play a central role in optimizing the clinical impact of rapid diagnostic tests.

Working memory training in survivors of pediatric cancer: a randomized pilot study.

PubMed

Hardy, Kristina K; Willard, Victoria W; Allen, Taryn M; Bonner, Melanie J

2013-08-01

Survivors of pediatric brain tumors and acute lymphoblastic leukemia (ALL) are at increased risk for neurocognitive deficits, but few empirically supported treatment options exist. We examined the feasibility and preliminary efficacy of a home-based, computerized working memory training program, CogmedRM, with survivors of childhood cancer. Survivors of brain tumors or ALL (n = 20) with identified deficits in attention and/or working memory were randomized to either the success-adapted computer intervention or a non-adaptive, active control condition. Specifically, children in the adaptive condition completed exercises that became more challenging with each correct trial, whereas those in the non-adaptive version trained with exercises that never increased in difficulty. All participants were asked to complete 25 training sessions at home, with weekly, phone-based coaching support. Brief assessments were completed pre-intervention and post-intervention; outcome measures included both performance-based and parent-report measures of working memory and attention. Eighty-five percent of survivors were compliant with the intervention, with no adverse events reported. After controlling for baseline intellectual functioning, survivors who completed the intervention program evidenced significant post-training improvements in their visual working memory and in parent-rated learning problems compared with those in the active control group. No differences in verbal working memory functioning were evident between groups, however. Home-based, computerized cognitive training demonstrates good feasibility and acceptability in our sample. Children with higher intellectual functioning at baseline appeared to benefit more from the training, although further study is needed to clarify the strength, scope, and particularly the generalizability of potential treatment effects. Copyright © 2012 John Wiley & Sons, Ltd.

Management of convulsive status epilepticus in children: an adapted clinical practice guideline for pediatricians in Saudi Arabia

PubMed Central

Bashiri, Fahad A.; Hamad, Muddathir H.; Amer, Yasser S.; Abouelkheir, Manal M.; Mohamed, Sarar; Kentab, Amal Y.; Salih, Mustafa A.; Nasser, Mohammad N. Al; Al-Eyadhy, Ayman A.; Othman, Mohammed A. Al; Al-Ahmadi, Tahani; Iqbal, Shaikh M.; Somily, Ali M.; Wahabi, Hayfaa A.; Hundallah, Khalid J.; Alwadei, Ali H.; Albaradie, Raidah S.; Al-Twaijri, Waleed A.; Jan, Mohammed M.; Al-Otaibi, Faisal; Alnemri, Abdulrahman M.; Al-Ansary, Lubna A.

2017-01-01

Objective: To increase the use of evidence-based approaches in the diagnosis, investigations and treatment of Convulsive Status Epilepticus (CSE) in children in relevant care settings. Method: A Clinical Practice Guideline (CPG) adaptation group was formulated at a university hospital in Riyadh. The group utilized 2 CPG validated tools including the ADAPTE method and the AGREE II instrument. Results: The group adapted 3 main categories of recommendations from one Source CPG. The recommendations cover; (i)first-line treatment of CSE in the community; (ii)treatment of CSE in the hospital; and (iii)refractory CSE. Implementation tools were built to enhance knowledge translation of these recommendations including a clinical algorithm, audit criteria, and a computerized provider order entry. Conclusion: A clinical practice guideline for the Saudi healthcare context was formulated using a guideline adaptation process to support relevant clinicians managing CSE in children. PMID:28416791

Early Diagnosis of Breast Cancer.

PubMed

Wang, Lulu

2017-07-05

Early-stage cancer detection could reduce breast cancer death rates significantly in the long-term. The most critical point for best prognosis is to identify early-stage cancer cells. Investigators have studied many breast diagnostic approaches, including mammography, magnetic resonance imaging, ultrasound, computerized tomography, positron emission tomography and biopsy. However, these techniques have some limitations such as being expensive, time consuming and not suitable for young women. Developing a high-sensitive and rapid early-stage breast cancer diagnostic method is urgent. In recent years, investigators have paid their attention in the development of biosensors to detect breast cancer using different biomarkers. Apart from biosensors and biomarkers, microwave imaging techniques have also been intensely studied as a promising diagnostic tool for rapid and cost-effective early-stage breast cancer detection. This paper aims to provide an overview on recent important achievements in breast screening methods (particularly on microwave imaging) and breast biomarkers along with biosensors for rapidly diagnosing breast cancer.

[Possibilities of the TruScreen for screening of precancer and cancer of the uterine cervix].

PubMed

Zlatkov, V

2009-01-01

The classic approach of detection of pre-cancer and cancer of uterine cervix includes cytological examination, followed by colposcopy assessment of the detected cytological abnormalities. Real-time devices use in-vivo techniques for the measurement, computerized analysis and classifying of different types of cervical tissues. The aim of the present review is to present the technical characteristics and to discus the diagnostic possibilities of TruScreen-automated optical-electron system for cervical screening. The analysis of the presented in the literature diagnostic value of the method at different grades intraepithelial lesions shows that it has higher sensitivity (67-70%) and lower specificity (81%) in comparison to the Pap test with the following results (45-69% sensitivity and 95% specificity). This makes the method suitable for independent primary screening, as well as for adding the diagnostic assurance of the cytological method.

Testing HyDE on ADAPT

NASA Technical Reports Server (NTRS)

Sweet, Adam

2008-01-01

The IVHM Project in the Aviation Safety Program has funded research in electrical power system (EPS) health management. This problem domain contains both discrete and continuous behavior, and thus is directly relevant for the hybrid diagnostic tool HyDE. In FY2007 work was performed to expand the HyDE diagnosis model of the ADAPT system. The work completed resulted in a HyDE model with the capability to diagnose five times the number of ADAPT components previously tested. The expanded diagnosis model passed a corresponding set of new ADAPT fault injection scenario tests with no incorrect faults reported. The time required for the HyDE diagnostic system to isolate the fault varied widely between tests; this variance was reduced by tuning HyDE input parameters. These results and other diagnostic design trade-offs are discussed. Finally, possible future improvements for both the HyDE diagnostic model and HyDE itself are presented.

ISHM-oriented adaptive fault diagnostics for avionics based on a distributed intelligent agent system

NASA Astrophysics Data System (ADS)

Xu, Jiuping; Zhong, Zhengqiang; Xu, Lei

2015-10-01

In this paper, an integrated system health management-oriented adaptive fault diagnostics and model for avionics is proposed. With avionics becoming increasingly complicated, precise and comprehensive avionics fault diagnostics has become an extremely complicated task. For the proposed fault diagnostic system, specific approaches, such as the artificial immune system, the intelligent agents system and the Dempster-Shafer evidence theory, are used to conduct deep fault avionics diagnostics. Through this proposed fault diagnostic system, efficient and accurate diagnostics can be achieved. A numerical example is conducted to apply the proposed hybrid diagnostics to a set of radar transmitters on an avionics system and to illustrate that the proposed system and model have the ability to achieve efficient and accurate fault diagnostics. By analyzing the diagnostic system's feasibility and pragmatics, the advantages of this system are demonstrated.

Location Indices for Ordinal Polytomous Items Based on Item Response Theory. Research Report. ETS RR-15-20

ERIC Educational Resources Information Center

Ali, Usama S.; Chang, Hua-Hua; Anderson, Carolyn J.

2015-01-01

Polytomous items are typically described by multiple category-related parameters; situations, however, arise in which a single index is needed to describe an item's location along a latent trait continuum. Situations in which a single index would be needed include item selection in computerized adaptive testing or test assembly. Therefore single…

An Examination of Exposure Control and Content Balancing Restrictions on Item Selection in CATs Using the Partial Credit Model.

ERIC Educational Resources Information Center

Davis, Laurie Laughlin; Pastor, Dena A.; Dodd, Barbara G.; Chiang, Claire; Fitzpatrick, Steven J.

2003-01-01

Examined the effectiveness of the Sympson-Hetter technique and rotated content balancing relative to no exposure control and no content rotation conditions in a computerized adaptive testing system based on the partial credit model. Simulation results show the Sympson-Hetter technique can be used with minimal impact on measurement precision,…

Test Design Optimization in CAT Early Stage with the Nominal Response Model

ERIC Educational Resources Information Center

Passos, Valeria Lima; Berger, Martijn P. F.; Tan, Frans E.

2007-01-01

The early stage of computerized adaptive testing (CAT) refers to the phase of the trait estimation during the administration of only a few items. This phase can be characterized by bias and instability of estimation. In this study, an item selection criterion is introduced in an attempt to lessen this instability: the D-optimality criterion. A…

A Study on Linear Programming Applications for the Optimization of School Lunch Menus. Summation Report.

ERIC Educational Resources Information Center

Findorff, Irene K.

This document summarizes the results of a project at Tulane University that was designed to adapt, test, and evaluate a computerized information and menu planning system utilizing linear programing techniques for use in school lunch food service operations. The objectives of the menu planning were to formulate menu items into a palatable,…

Applications of Measures of Speed of Mental Operations among Children with Intellectual Deficiency.

ERIC Educational Resources Information Center

Loranger, Michel; Blais, Marie Claude; Hopps, Sandra; Pepin, Michel; Boisvert, Jean-Marie; Doyon, Martin

2002-01-01

This study assessed use of five computerized analogy problems as a measure of mental speed with 62 children (ages 3-13) with mild/moderate mental retardation. Results found medium to high correlation between scores on the tasks and other cognitive measures and the adaptive behavior scale. The value of assessing cognitive speed in the cognitive…

A Knowledge-Based Approach for Item Exposure Control in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Doong, Shing H.

2009-01-01

The purpose of this study is to investigate a functional relation between item exposure parameters (IEPs) and item parameters (IPs) over parallel pools. This functional relation is approximated by a well-known tool in machine learning. Let P and Q be parallel item pools and suppose IEPs for P have been obtained via a Sympson and Hetter-type…

The Effects of Judgment-Based Stratum Classifications on the Efficiency of Stratum Scored CATs.

ERIC Educational Resources Information Center

Finney, Sara J.; Smith, Russell W.; Wise, Steven L.

Two operational item pools were used to investigate the performance of stratum computerized adaptive tests (CATs) when items were assigned to strata based on empirical estimates of item difficulty or human judgments of item difficulty. Items from the first data set consisted of 54 5-option multiple choice items from a form of the ACT mathematics…

Evaluation Plan for the Computerized Adaptive Vocational Aptitude Battery

DTIC Science & Technology

1982-05-15

Educational and Psychological Tests published by the American Psychological Association, the American Educational Research Association, and the National...Psychometric Society Meetings, May 1981. References 71 American Psychological Association. Standards for educational and psychological tests . Washington, D.C...Methods Program, Dept. of Psychology , Uni- versity of Minnesota, MN, September, 1981. Koch, W.R. & Reckase, M.D. A live tailored testing comparison study

CAT Procedures for Passage-Based Tests.

ERIC Educational Resources Information Center

Thompson, Tony D.; Davey, Tim

Methods to control the test construct and the efficiency of a computerized adaptive test (CAT) were studied in the context of a reading comprehension test given as a part of a battery of tests for college admission. A goal of the study was to create test scores that were interchangeable with those from a fixed form paper and pencil test. The first…

Adapting the Goddard research and engineering management exercise (GREMEX) to nonspacecraft environments

NASA Technical Reports Server (NTRS)

Wales, R. O.

1973-01-01

A computerized training aid for all levels of research and development managers is presented. The computer model used for NASA training simulates development of a spacecraft. Operation of the model is described together with instructions for changing the input-data cards to alter the nomenclature and response of the model for use in other training environments.

Calibration of an Item Bank for the Assessment of Basque Language Knowledge

ERIC Educational Resources Information Center

Lopez-Cuadrado, Javier; Perez, Tomas A.; Vadillo, Jose A.; Gutierrez, Julian

2010-01-01

The main requisite for a functional computerized adaptive testing system is the need of a calibrated item bank. This text presents the tasks carried out during the calibration of an item bank for assessing knowledge of Basque language. It has been done in terms of the 3-parameter logistic model provided by the item response theory. Besides, this…

Best Design for Multidimensional Computerized Adaptive Testing With the Bifactor Model

PubMed Central

Seo, Dong Gi; Weiss, David J.

2015-01-01

Most computerized adaptive tests (CATs) have been studied using the framework of unidimensional item response theory. However, many psychological variables are multidimensional and might benefit from using a multidimensional approach to CATs. This study investigated the accuracy, fidelity, and efficiency of a fully multidimensional CAT algorithm (MCAT) with a bifactor model using simulated data. Four item selection methods in MCAT were examined for three bifactor pattern designs using two multidimensional item response theory models. To compare MCAT item selection and estimation methods, a fixed test length was used. The Ds-optimality item selection improved θ estimates with respect to a general factor, and either D- or A-optimality improved estimates of the group factors in three bifactor pattern designs under two multidimensional item response theory models. The MCAT model without a guessing parameter functioned better than the MCAT model with a guessing parameter. The MAP (maximum a posteriori) estimation method provided more accurate θ estimates than the EAP (expected a posteriori) method under most conditions, and MAP showed lower observed standard errors than EAP under most conditions, except for a general factor condition using Ds-optimality item selection. PMID:29795848

Post-hoc simulation study to adopt a computerized adaptive testing (CAT) for a Korean Medical License Examination.

PubMed

Seo, Dong Gi; Choi, Jeongwook

2018-05-17

Computerized adaptive testing (CAT) has been adopted in license examinations due to a test efficiency and accuracy. Many research about CAT have been published to prove the efficiency and accuracy of measurement. This simulation study investigated scoring method and item selection methods to implement CAT in Korean medical license examination (KMLE). This study used post-hoc (real data) simulation design. The item bank used in this study was designed with all items in a 2017 KMLE. All CAT algorithms for this study were implemented by a 'catR' package in R program. In terms of accuracy, Rasch and 2parametric logistic (PL) model performed better than 3PL model. Modal a Posteriori (MAP) or Expected a Posterior (EAP) provided more accurate estimates than MLE and WLE. Furthermore Maximum posterior weighted information (MPWI) or Minimum expected posterior variance (MEPV) performed better than other item selection methods. In terms of efficiency, Rasch model was recommended to reduce test length. Simulation study should be performed under varied test conditions before adopting a live CAT. Based on a simulation study, specific scoring and item selection methods should be predetermined before implementing a live CAT.

Implications for the Measurement of Psychopathy in the DSM-5 Using the Computerized Adaptive Test of Personality Disorder.

PubMed

Kavish, Nicholas; Sellbom, Martin; Anderson, Jaime L

2018-06-06

This study investigated the ability of the Computerized Adaptive Test of Personality Disorder (CAT-PD) model to capture psychopathy in a sample consisting of U.S. (n = 565) and Australian (n = 99) undergraduates and a U.S. community sample (n = 210). More specifically, this study examined (a) the association between CAT-PD facets, particularly those consistent with DSM-5 Section III antisocial personality disorder (ASPD), and measures of psychopathy, (b) the extent to which CAT-PD ASPD traits improve on DSM-5 Section II ASPD in measuring psychopathy, and (c) the utility of measuring functional impairment in additional to dimensional traits in assessing psychopathy. Analyses revealed CAT-PD ASPD traits, including traits' associations with Section III psychopathy specifier, were strongly associated with measures of psychopathy. Furthermore, CAT-PD ASPD was found to be an improvement over DSM-5 Section II ASPD in measuring psychopathy, and the dimensional nature of the CAT-PD was found to render the addition of measures of impairment unnecessary. These findings generally support the utility of the CAT-PD in the measurement of psychopathy, particularly as it relates to the dimensional assessment of psychopathy in the DSM-5 alternative model for personality disorder.

e-PTSD: an overview on how new technologies can improve prediction and assessment of Posttraumatic Stress Disorder (PTSD).

PubMed

Bourla, Alexis; Mouchabac, Stephane; El Hage, Wissam; Ferreri, Florian

2018-01-01

Background : New technologies may profoundly change our way of understanding psychiatric disorders including posttraumatic stress disorder (PTSD). Imaging and biomarkers, along with technological and medical informatics developments, might provide an answer regarding at-risk patient's identification. Recent advances in the concept of 'digital phenotype', which refers to the capture of characteristics of a psychiatric disorder by computerized measurement tools, is one paradigmatic example. Objective : The impact of the new technologies on health professionals practice in PTSD care remains to be determined. The recent evolutions could disrupt the clinical practices and practitioners in their beliefs, ethics and representations, going as far as questioning their professional culture. In the present paper, we conducted an extensive search to highlight the articles which reflect the potential of these new technologies. Method : We conducted an overview by querying PubMed database with the terms [PTSD] [Posttraumatic stress disorder] AND [Computer] OR [Computerized] OR [Mobile] OR [Automatic] OR [Automated] OR [Machine learning] OR [Sensor] OR [Heart rate variability] OR [HRV] OR [actigraphy] OR [actimetry] OR [digital] OR [motion] OR [temperature] OR [virtual reality]. Results : We summarized the synthesized literature in two categories: prediction and assessment (including diagnostic, screening and monitoring). Two independent reviewers screened, extracted data and quality appraised the sources. Results were synthesized narratively. Conclusions : This overview shows that many studies are underway allowing researchers to start building a PTSD digital phenotype using passive data obtained by biometric sensors. Active data obtained from Ecological Momentary Assessment (EMA) could allow clinicians to assess PTSD patients. The place of connected objects, Artificial Intelligence and remote monitoring of patients with psychiatric pathology remains to be defined. These tools must be explained and adapted to the different profiles of physicians and patients. The involvement of patients, caregivers and health professionals is essential to the design and evaluation of these new tools.

Three-dimensional Cross-Platform Planning for Complex Spinal Procedures: A New Method Adaptive to Different Navigation Systems.

PubMed

Kosterhon, Michael; Gutenberg, Angelika; Kantelhardt, Sven R; Conrad, Jens; Nimer Amr, Amr; Gawehn, Joachim; Giese, Alf

2017-08-01

A feasibility study. To develop a method based on the DICOM standard which transfers complex 3-dimensional (3D) trajectories and objects from external planning software to any navigation system for planning and intraoperative guidance of complex spinal procedures. There have been many reports about navigation systems with embedded planning solutions but only few on how to transfer planning data generated in external software. Patients computerized tomography and/or magnetic resonance volume data sets of the affected spinal segments were imported to Amira software, reconstructed to 3D images and fused with magnetic resonance data for soft-tissue visualization, resulting in a virtual patient model. Objects needed for surgical plans or surgical procedures such as trajectories, implants or surgical instruments were either digitally constructed or computerized tomography scanned and virtually positioned within the 3D model as required. As crucial step of this method these objects were fused with the patient's original diagnostic image data, resulting in a single DICOM sequence, containing all preplanned information necessary for the operation. By this step it was possible to import complex surgical plans into any navigation system. We applied this method not only to intraoperatively adjustable implants and objects under experimental settings, but also planned and successfully performed surgical procedures, such as the percutaneous lateral approach to the lumbar spine following preplanned trajectories and a thoracic tumor resection including intervertebral body replacement using an optical navigation system. To demonstrate the versatility and compatibility of the method with an entirely different navigation system, virtually preplanned lumbar transpedicular screw placement was performed with a robotic guidance system. The presented method not only allows virtual planning of complex surgical procedures, but to export objects and surgical plans to any navigation or guidance system able to read DICOM data sets, expanding the possibilities of embedded planning software.

Reliability of implant surgical guides based on soft-tissue models.

PubMed

Maney, Pooja; Simmons, David E; Palaiologou, Archontia; Kee, Edwin

2012-12-01

The purpose of this study was to determine the accuracy of implant surgical guides fabricated on diagnostic casts. Guides were fabricated with radiopaque rods representing implant positions. Cone beam computerized tomograms were taken with guides in place. Accuracy was evaluated using software to simulate implant placement. Twenty-two sites (47%) were considered accurate (13 of 24 maxillary and 9 of 23 mandibular sites). Soft-tissue models do not always provide sufficient accuracy for fabricating implant surgical guides.

A survey of simulators for palpation training.

PubMed

Zhang, Yan; Phillips, Roger; Ward, James; Pisharody, Sandhya

2009-01-01

Palpation is a widely used diagnostic method in medical practice. The sensitivity of palpation is highly dependent upon the skill of clinicians, which is often difficult to master. There is a need of simulators in palpation training. This paper summarizes important work and the latest achievements in simulation for palpation training. Three types of simulators; physical models, Virtual Reality (VR) based simulations, and hybrid (computerized and physical) simulators, are surveyed. Comparisons among different kinds of simulators are presented.

High resolution, MRI-based, segmented, computerized head phantom

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

Zubal, I.G.; Harrell, C.R.; Smith, E.O.

1999-01-01

The authors have created a high-resolution software phantom of the human brain which is applicable to voxel-based radiation transport calculations yielding nuclear medicine simulated images and/or internal dose estimates. A software head phantom was created from 124 transverse MRI images of a healthy normal individual. The transverse T2 slices, recorded in a 256x256 matrix from a GE Signa 2 scanner, have isotropic voxel dimensions of 1.5 mm and were manually segmented by the clinical staff. Each voxel of the phantom contains one of 62 index numbers designating anatomical, neurological, and taxonomical structures. The result is stored as a 256x256x128 bytemore » array. Internal volumes compare favorably to those described in the ICRP Reference Man. The computerized array represents a high resolution model of a typical human brain and serves as a voxel-based anthropomorphic head phantom suitable for computer-based modeling and simulation calculations. It offers an improved realism over previous mathematically described software brain phantoms, and creates a reference standard for comparing results of newly emerging voxel-based computations. Such voxel-based computations lead the way to developing diagnostic and dosimetry calculations which can utilize patient-specific diagnostic images. However, such individualized approaches lack fast, automatic segmentation schemes for routine use; therefore, the high resolution, typical head geometry gives the most realistic patient model currently available.« less

The potential of positron emission tomography/computerized tomography (PET/CT) scanning as a detector of high-risk patients with oral infection during preoperative staging.

PubMed

Yamashiro, Keisuke; Nakano, Makoto; Sawaki, Koichi; Okazaki, Fumihiko; Hirata, Yasuhisa; Takashiba, Shogo

2016-08-01

It is sometimes difficult to determine during the preoperative period whether patients have oral infections; these patients need treatment to prevent oral infection-related complications from arising during medical therapies, such as cancer therapy and surgery. One of the reasons for this difficulty is that basic medical tests do not identify oral infections, including periodontitis and periapical periodontitis. In this report, we investigated the potential of positron emission tomography/computerized tomography (PET/CT) as a diagnostic tool in these patients. We evaluated eight patients during the preoperative period. All patients underwent PET/CT scanning and were identified as having the signs of oral infection, as evidenced by (18)F-fludeoxyglucose (FDG) localization in the oral regions. Periodontal examination and orthopantomogram evaluation showed severe infection or bone resorption in the oral regions. (18)F-FDG was localized in oral lesions, such as severe periodontitis, apical periodontitis, and pericoronitis of the third molar. The densities of (18)F-FDG were proportional to the degree of inflammation. PET/CT is a potential diagnostic tool for oral infections. It may be particularly useful in patients during preoperative staging, as they frequently undergo scanning at this time, and those identified as having oral infections at this time require treatment before cancer therapy or surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Effectiveness of a real-time clinical decision support system for computerized physician order entry of plasma orders.

PubMed

Yazer, Mark H; Triulzi, Darrell J; Reddy, Vivek; Waters, Jonathan H

2013-12-01

We investigated the effect of implementing adaptive plasma ordering criteria in the computerized physician order entry (CPOE) system, with alerts that were automatically generated if the recipient's antecedent international normalized ratio (INR) did not meet the institutional criteria. In a regional health care system consisting of 11 hospitals using a common CPOE, data on the number of plasma orders and alerts that were generated were collected over a 4-month period before prescribers were required to select an indication for plasma. When adaptive ordering was implemented prescribers had to choose from prepopulated indications for plasma: INR of 1.6 or greater with bleeding, INR of 1.6 or greater before an invasive procedure, therapeutic exchange, massive transfusion, and other. Regardless of the antecedent INR the alert did not trigger if massive transfusion or plasmapheresis was selected. Information on prescribers and recipients was collected during this 5-month period. In the 4-month period before the adaptive alerts were implemented, 42.9% of the plasma orders generated an alert; in the 5-month period thereafter the alert rate was significantly lower at 27.9% (p < 0.0001). The percentage of heeded alerts increased during the adaptive alert period (24.3% vs. 17.1%, respectively, p = 0.004). A significant percentage (45%) of other plasma orders were for periprocedure or bleeding patients whose antecedent INR was less than 1.6. There were significant differences in prescriber specialties among those who ordered plasma using the other indication compared to all plasma orders. Electronic interventions improve compliance with plasma guidelines but as implemented are not sufficient to completely curtail non-evidence-based ordering. © 2013 American Association of Blood Banks.

I've Fallen and I Can't Get up: Can High-Ability Students Recover from Early Mistakes in CAT?

ERIC Educational Resources Information Center

Rulison, Kelly L.; Loken, Eric

2009-01-01

A difficult result to interpret in Computerized Adaptive Tests (CATs) occurs when an ability estimate initially drops and then ascends continuously until the test ends, suggesting that the true ability may be higher than implied by the final estimate. This study explains why this asymmetry occurs and shows that early mistakes by high-ability…

Adapting to a Computer-Oriented Society: The Leadership Role of Business and Liberal Arts Faculties.

ERIC Educational Resources Information Center

O'Gorman, David E.

The need for higher education to take a proactive rather than a reactive stance in dealing with the impact of the computer is considered. The field of computerized video technology is briefly discussed. It is suggested that disparate groups such as the liberal arts and business faculties should cooperate to maximize the use of computer technology.…

The Relationship of Item-Level Response Times with Test-Taker and Item Variables in an Operational CAT Environment. LSAC Research Report Series.

ERIC Educational Resources Information Center

Swygert, Kimberly A.

In this study, data from an operational computerized adaptive test (CAT) were examined in order to gather information concerning item response times in a CAT environment. The CAT under study included multiple-choice items measuring verbal, quantitative, and analytical reasoning. The analyses included the fitting of regression models describing the…

A Correlational Analysis of Test Anxiety and Response Time on a Computerized Adaptive Math Test among Seventh Grade Students by Gender

ERIC Educational Resources Information Center

Brom, Michael Wayde

2016-01-01

Studies have shown that test anxiety has become more prevalent since the adoption of the No Child Left Behind Act in 2001 and that test anxiety negatively affects student achievement. Early research viewed test anxiety as being a unidimensional construct; however, recent research has purported that test anxiety is a multidimensional construct.…

A contrast enhancement method for improving the segmentation of breast lesions on ultrasonography.

PubMed

Flores, Wilfrido Gómez; Pereira, Wagner Coelho de Albuquerque

2017-01-01

This paper presents an adaptive contrast enhancement method based on sigmoidal mapping function (SACE) used for improving the computerized segmentation of breast lesions on ultrasound. First, from the original ultrasound image an intensity variation map is obtained, which is used to generate local sigmoidal mapping functions related to distinct contextual regions. Then, a bilinear interpolation scheme is used to transform every original pixel to a new gray level value. Also, four contrast enhancement techniques widely used in breast ultrasound enhancement are implemented: histogram equalization (HEQ), contrast limited adaptive histogram equalization (CLAHE), fuzzy enhancement (FEN), and sigmoid based enhancement (SEN). In addition, these contrast enhancement techniques are considered in a computerized lesion segmentation scheme based on watershed transformation. The performance comparison among techniques is assessed in terms of both the quality of contrast enhancement and the segmentation accuracy. The former is quantified by the measure, where the greater the value, the better the contrast enhancement, whereas the latter is calculated by the Jaccard index, which should tend towards unity to indicate adequate segmentation. The experiments consider a data set with 500 breast ultrasound images. The results show that SACE outperforms its counterparts, where the median values for the measure are: SACE: 139.4, SEN: 68.2, HEQ: 64.1, CLAHE: 62.8, and FEN: 7.9. Considering the segmentation performance results, the SACE method presents the largest accuracy, where the median values for the Jaccard index are: SACE: 0.81, FEN: 0.80, CLAHE: 0.79, HEQ: 77, and SEN: 0.63. The SACE method performs well due to the combination of three elements: (1) the intensity variation map reduces intensity variations that could distort the real response of the mapping function, (2) the sigmoidal mapping function enhances the gray level range where the transition between lesion and background is found, and (3) the adaptive enhancing scheme for coping with local contrasts. Hence, the SACE approach is appropriate for enhancing contrast before computerized lesion segmentation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Intelligent Diagnostic Assistant for Complicated Skin Diseases through C5's Algorithm.

PubMed

Jeddi, Fatemeh Rangraz; Arabfard, Masoud; Kermany, Zahra Arab

2017-09-01

Intelligent Diagnostic Assistant can be used for complicated diagnosis of skin diseases, which are among the most common causes of disability. The aim of this study was to design and implement a computerized intelligent diagnostic assistant for complicated skin diseases through C5's Algorithm. An applied-developmental study was done in 2015. Knowledge base was developed based on interviews with dermatologists through questionnaires and checklists. Knowledge representation was obtained from the train data in the database using Excel Microsoft Office. Clementine Software and C5's Algorithms were applied to draw the decision tree. Analysis of test accuracy was performed based on rules extracted using inference chains. The rules extracted from the decision tree were entered into the CLIPS programming environment and the intelligent diagnostic assistant was designed then. The rules were defined using forward chaining inference technique and were entered into Clips programming environment as RULE. The accuracy and error rates obtained in the training phase from the decision tree were 99.56% and 0.44%, respectively. The accuracy of the decision tree was 98% and the error was 2% in the test phase. Intelligent diagnostic assistant can be used as a reliable system with high accuracy, sensitivity, specificity, and agreement.

The diagnostic adaptive behavior scale: evaluating its diagnostic sensitivity and specificity.

PubMed

Balboni, Giulia; Tassé, Marc J; Schalock, Robert L; Borthwick-Duffy, Sharon A; Spreat, Scott; Thissen, David; Widaman, Keith F; Zhang, Dalun; Navas, Patricia

2014-11-01

The Diagnostic Adaptive Behavior Scale (DABS) was constructed with items across three domains--conceptual, social, and practical adaptive skills--and normed on a representative sample of American individuals from 4 to 21 years of age. The DABS was developed to focus its assessment around the decision point for determining the presence or absence of significant limitations of adaptive behavior for the diagnosis of Intellectual Disability (ID). The purpose of this study, which was composed of 125 individuals with and 933 without an ID-related diagnosis, was to determine the ability of the DABS to correctly identify the individuals with and without ID (i.e., sensitivity and specificity). The results indicate that the DABS sensitivity coefficients ranged from 81% to 98%, specificity coefficients ranged from 89% to 91%, and that the Area Under the Receiver Operating Characteristic Curve were excellent or good. These results indicate that the DABS has very good levels of diagnostic efficiency. Copyright © 2014. Published by Elsevier Ltd.

Adaptive Tutorials Versus Web-Based Resources in Radiology: A Mixed Methods Comparison of Efficacy and Student Engagement.

PubMed

Wong, Vincent; Smith, Ariella J; Hawkins, Nicholas J; Kumar, Rakesh K; Young, Noel; Kyaw, Merribel; Velan, Gary M

2015-10-01

Diagnostic imaging is under-represented in medical curricula globally. Adaptive tutorials, online intelligent tutoring systems that provide a personalized learning experience, have the potential to bridge this gap. However, there is limited evidence of their effectiveness for learning about diagnostic imaging. We performed a randomized mixed methods crossover trial to determine the impact of adaptive tutorials on perceived engagement and understanding of the appropriate use and interpretation of common diagnostic imaging investigations. Although concurrently engaged in disparate blocks of study, 99 volunteer medical students (from years 1-4 of the 6-year program) were randomly allocated to one of two groups. In the first arm of the trial on chest X-rays, one group received access to an adaptive tutorial, whereas the other received links to an existing peer-reviewed Web resource. These two groups crossed over in the second arm of the trial, which focused on computed tomography scans of the head, chest, and abdomen. At the conclusion of each arm of the trial, both groups completed an examination-style assessment, comprising questions both related and unrelated to the topics covered by the relevant adaptive tutorial. Online questionnaires were used to evaluate student perceptions of both learning resources. In both arms of the trial, the group using adaptive tutorials obtained significantly higher assessment scores than controls. This was because of higher assessment scores by senior students in the adaptive tutorial group when answering questions related to topics covered in those tutorials. Furthermore, students indicated significantly better engagement with adaptive tutorials than the Web resource and rated the tutorials as a significantly more valuable tool for learning. Medical students overwhelmingly accept adaptive tutorials for diagnostic imaging. The tutorials significantly improve the understanding of diagnostic imaging by senior students. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

On the structure of personality disorder traits: conjoint analyses of the CAT-PD, PID-5, and NEO-PI-3 trait models.

PubMed

Wright, Aidan G C; Simms, Leonard J

2014-01-01

The current study examines the relations among contemporary models of pathological and normal range personality traits. Specifically, we report on (a) conjoint exploratory factor analyses of the Computerized Adaptive Test of Personality Disorder static form (CAT-PD-SF) with the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and NEO Personality Inventory-3 First Half, and (b) unfolding hierarchical analyses of the three measures in a large general psychiatric outpatient sample (n = 628; 64% Female). A five-factor solution provided conceptually coherent alignment among the CAT-PD-SF, PID-5, and NEO-PI-3FH scales. Hierarchical solutions suggested that higher-order factors bear strong resemblance to dimensions that emerge from structural models of psychopathology (e.g., Internalizing and Externalizing spectra). These results demonstrate that the CAT-PD-SF adheres to the consensual structure of broad trait domains at the five-factor level. Additionally, patterns of scale loadings further inform questions of structure and bipolarity of facet and domain level constructs. Finally, hierarchical analyses strengthen the argument for using broad dimensions that span normative and pathological functioning to scaffold a quantitatively derived phenotypic structure of psychopathology to orient future research on explanatory, etiological, and maintenance mechanisms.

Convergent and discriminant validity of alternative measures of maladaptive personality traits.

PubMed

Crego, Cristina; Widiger, Thomas A

2016-12-01

The purpose of the current study was to test empirically the convergent and discriminant validity of 3 recently developed, alternative measures of maladaptive personality traits: the Personality Inventory for Diagnostic and Statistical Manual for Mental Disorders-Fifth Edition (DSM-5, PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012), the Computerized Adaptive Test-Personality Disorder Static Form (CAT-PD-SF; Simms et al., 2011), and Five Factor Model Personality Disorder scales (FFMPD; Widiger, Lynam, Miller, & Oltmanns, 2012). These measures were constructed with different rationales and methods, yet the result was highly congruent. The PID-5 and CAT-PD-SF were administered to 286 community adults with current or a history of mental health treatment; the CAT-PD-SF and FFMPD scales to 262 such adults; and the PID-5 and FFMPD scales to 266. The results indicated good to excellent internal consistency, as well as good to excellent convergent and discriminant validity for most scales with a few notable exceptions. Suggestions for future research are provided, including the potential benefits of scales that are unique to a respective instrument, replication of a dependency factor, and exploration as to the basis for instances of questionable convergent or discriminant validity. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Automated identification of abnormal metaphase chromosome cells for the detection of chronic myeloid leukemia using microscopic images

NASA Astrophysics Data System (ADS)

Wang, Xingwei; Zheng, Bin; Li, Shibo; Mulvihill, John J.; Chen, Xiaodong; Liu, Hong

2010-07-01

Karyotyping is an important process to classify chromosomes into standard classes and the results are routinely used by the clinicians to diagnose cancers and genetic diseases. However, visual karyotyping using microscopic images is time-consuming and tedious, which reduces the diagnostic efficiency and accuracy. Although many efforts have been made to develop computerized schemes for automated karyotyping, no schemes can get be performed without substantial human intervention. Instead of developing a method to classify all chromosome classes, we develop an automatic scheme to detect abnormal metaphase cells by identifying a specific class of chromosomes (class 22) and prescreen for suspicious chronic myeloid leukemia (CML). The scheme includes three steps: (1) iteratively segment randomly distributed individual chromosomes, (2) process segmented chromosomes and compute image features to identify the candidates, and (3) apply an adaptive matching template to identify chromosomes of class 22. An image data set of 451 metaphase cells extracted from bone marrow specimens of 30 positive and 30 negative cases for CML is selected to test the scheme's performance. The overall case-based classification accuracy is 93.3% (100% sensitivity and 86.7% specificity). The results demonstrate the feasibility of applying an automated scheme to detect or prescreen the suspicious cancer cases.

Transforming to a computerized system for nursing care: organizational success within Magnet idealism.

PubMed

Lindgren, Carolyn L; Elie, Leslie G; Vidal, Elizabeth C; Vasserman, Alex

2010-01-01

In reaching the goal for standardized, quality care, a not-for-profit healthcare system consisting of seven institutional entities is transforming nursing practice guidelines, patient care workflow, and patient documents into electronic, online, real-time modalities for use across departments and all healthcare delivery entities of the system. Organizational structure and a strategic plan were developed for the 2-year Clinical Transformation Project. The Siemens Patient Care Document System was adopted and adapted to the hospitals' documentation and information needs. Two fast-track sessions of more than 100 nurses and representatives from other health disciplines were held to standardize assessments, histories, care protocols, and interdisciplinary plans of care for the top 10 diagnostic regulatory groups. Education needs of the users were addressed. After the first year, a productive, functional system is evidenced. For example, the bar-coded Medication Administration Check System is in full use on the clinical units of one of the hospitals, and the other institutional entities are at substantial stages of implementation of Patient Care Documentation System. The project requires significant allocation of personnel and financial resources for a highly functional informatics system that will transform clinical care. The project exemplifies four of the Magnet ideals and serves as a model for others who may be deciding about launching a similar endeavor.

Magnetic resonance imaging in precision radiation therapy for lung cancer

PubMed Central

Bainbridge, Hannah; Salem, Ahmed; Tijssen, Rob H. N.; Dubec, Michael; Wetscherek, Andreas; Van Es, Corinne; Belderbos, Jose; Faivre-Finn, Corinne

2017-01-01

Radiotherapy remains the cornerstone of curative treatment for inoperable locally advanced lung cancer, given concomitantly with platinum-based chemotherapy. With poor overall survival, research efforts continue to explore whether integration of advanced radiation techniques will assist safe treatment intensification with the potential for improving outcomes. One advance is the integration of magnetic resonance imaging (MRI) in the treatment pathway, providing anatomical and functional information with excellent soft tissue contrast without exposure of the patient to radiation. MRI may complement or improve the diagnostic staging accuracy of F-18 fluorodeoxyglucose position emission tomography and computerized tomography imaging, particularly in assessing local tumour invasion and is also effective for identification of nodal and distant metastatic disease. Incorporating anatomical MRI sequences into lung radiotherapy treatment planning is a novel application and may improve target volume and organs at risk delineation reproducibility. Furthermore, functional MRI may facilitate dose painting for heterogeneous target volumes and prediction of normal tissue toxicity to guide adaptive strategies. MRI sequences are rapidly developing and although the issue of intra-thoracic motion has historically hindered the quality of MRI due to the effect of motion, progress is being made in this field. Four-dimensional MRI has the potential to complement or supersede 4D CT and 4D F-18-FDG PET, by providing superior spatial resolution. A number of MR-guided radiotherapy delivery units are now available, combining a radiotherapy delivery machine (linear accelerator or cobalt-60 unit) with MRI at varying magnetic field strengths. This novel hybrid technology is evolving with many technical challenges to overcome. It is anticipated that the clinical benefits of MR-guided radiotherapy will be derived from the ability to adapt treatment on the fly for each fraction and in real-time, using ‘beam-on’ imaging. The lung tumour site group of the Atlantic MR-Linac consortium is working to generate a challenging MR-guided adaptive workflow for multi-institution treatment intensification trials in this patient group. PMID:29218271

Impact of mounting methods in computerized axiography on assessment of condylar inclination.

PubMed

Schierz, Oliver; Wagner, Philipp; Rauch, Angelika; Reissmann, Daniel R

2017-08-30

Valid and reliable recording is a key requirement for accurately simulating individual jaw movements. Horizontal condylar inclination (HCI) and Bennett's angle were measured using a digital jaw tracker (Cadiax® Compact 2) in 27 young adults. Three mounting methods (paraocclusal tray adapter, periocclusal tray adapter, and tray adapter with mandibular clamp) were tested. The mean values of the HCI differed by up to 10° between the mounting methods; however, the values for Bennett's angle did not differ substantially. While the intersession reliability of the Bennett's angle assessment did not depend on the mounting method, the reliability of the HCI assessment was only fair to good for the paraocclusal mounting method but poor for both periocclusal mounting methods. For attaching the tracing bow of jaw trackers to the mandible, a paraocclusal tray adapter should be applied, to achieve the most reliable results.

CT diagnosis of a clinically unsuspected acute appendicitis complicating infectious mononucleosis.

PubMed

Zissin, R; Brautbar, O; Shapiro-Feinberg, M

2001-01-01

Acute appendicitis is a rare complication of infectious mononucleosis (IM). We describe a patient with IM and splenic rupture with a computerized tomography (CT) diagnosis of acute appendicitis during the acute phase of the infectious disease. Diagnostic imaging features of acute appendicitis were found on an abdominal CT performed for the evaluation of postoperative fever. Histologic examination confirmed the CT diagnosis of the clinically unsuspected acute appendicitis. Our case is unique both for the rarity of this complication and the lack of clinical symptoms.

Adapting a Computerized Medical Dictation System to Prepare Academic Papers in Radiology.

PubMed

Sánchez, Yadiel; Prabhakar, Anand M; Uppot, Raul N

2017-09-14

Everyday radiologists use dictation software to compose clinical reports of imaging findings. The dictation software is tailored for medical use and to the speech pattern of each radiologist. Over the past 10 years we have used dictation software to compose academic manuscripts, correspondence letters, and texts of educational exhibits. The advantages of using voice dictation is faster composition of manuscripts. However, use of such software requires preparation. The purpose of this article is to review the steps of adapting a clinical dictation software for dictating academic manuscripts and detail the advantages and limitations of this technique. Copyright © 2017 Elsevier Inc. All rights reserved.

Benchmarking Diagnostic Algorithms on an Electrical Power System Testbed

NASA Technical Reports Server (NTRS)

Kurtoglu, Tolga; Narasimhan, Sriram; Poll, Scott; Garcia, David; Wright, Stephanie

2009-01-01

Diagnostic algorithms (DAs) are key to enabling automated health management. These algorithms are designed to detect and isolate anomalies of either a component or the whole system based on observations received from sensors. In recent years a wide range of algorithms, both model-based and data-driven, have been developed to increase autonomy and improve system reliability and affordability. However, the lack of support to perform systematic benchmarking of these algorithms continues to create barriers for effective development and deployment of diagnostic technologies. In this paper, we present our efforts to benchmark a set of DAs on a common platform using a framework that was developed to evaluate and compare various performance metrics for diagnostic technologies. The diagnosed system is an electrical power system, namely the Advanced Diagnostics and Prognostics Testbed (ADAPT) developed and located at the NASA Ames Research Center. The paper presents the fundamentals of the benchmarking framework, the ADAPT system, description of faults and data sets, the metrics used for evaluation, and an in-depth analysis of benchmarking results obtained from testing ten diagnostic algorithms on the ADAPT electrical power system testbed.

Strategies for adding adaptive learning mechanisms to rule-based diagnostic expert systems

NASA Technical Reports Server (NTRS)

Stclair, D. C.; Sabharwal, C. L.; Bond, W. E.; Hacke, Keith

1988-01-01

Rule-based diagnostic expert systems can be used to perform many of the diagnostic chores necessary in today's complex space systems. These expert systems typically take a set of symptoms as input and produce diagnostic advice as output. The primary objective of such expert systems is to provide accurate and comprehensive advice which can be used to help return the space system in question to nominal operation. The development and maintenance of diagnostic expert systems is time and labor intensive since the services of both knowledge engineer(s) and domain expert(s) are required. The use of adaptive learning mechanisms to increment evaluate and refine rules promises to reduce both time and labor costs associated with such systems. This paper describes the basic adaptive learning mechanisms of strengthening, weakening, generalization, discrimination, and discovery. Next basic strategies are discussed for adding these learning mechanisms to rule-based diagnostic expert systems. These strategies support the incremental evaluation and refinement of rules in the knowledge base by comparing the set of advice given by the expert system (A) with the correct diagnosis (C). Techniques are described for selecting those rules in the in the knowledge base which should participate in adaptive learning. The strategies presented may be used with a wide variety of learning algorithms. Further, these strategies are applicable to a large number of rule-based diagnostic expert systems. They may be used to provide either immediate or deferred updating of the knowledge base.

Development and Standardization of the Diagnostic Adaptive Behavior Scale: Application of Item Response Theory to the Assessment of Adaptive Behavior.

PubMed

Tassé, Marc J; Schalock, Robert L; Thissen, David; Balboni, Giulia; Bersani, Henry Hank; Borthwick-Duffy, Sharon A; Spreat, Scott; Widaman, Keith F; Zhang, Dalun; Navas, Patricia

2016-03-01

The Diagnostic Adaptive Behavior Scale (DABS) was developed using item response theory (IRT) methods and was constructed to provide the most precise and valid adaptive behavior information at or near the cutoff point of making a decision regarding a diagnosis of intellectual disability. The DABS initial item pool consisted of 260 items. Using IRT modeling and a nationally representative standardization sample, the item set was reduced to 75 items that provide the most precise adaptive behavior information at the cutoff area determining the presence or not of significant adaptive behavior deficits across conceptual, social, and practical skills. The standardization of the DABS is described and discussed.

Privacy considerations in the context of an Australian observational database.

PubMed

Duszynski, K M; Beilby, J J; Marley, J E; Walker, D C; Pratt, N L

2001-12-01

Observational databases are increasingly acknowledged for their value in clinical investigation. Australian general practice in particular presents an exciting opportunity to examine treatment in a natural setting. The paper explores issues such as privacy and confidentiality--foremost considerations when conducting this form of pharmacoepidemiological research. Australian legislation is currently addressing these exact issues in order to establish clear directives regarding ethical concerns. The development of a pharmacoepidemiological database arising from the integration of computerized Australian general practice records is described in addition, to the challenges associated with creating a database which considers patient privacy. The database known as 'Medic-GP', presently contains more than 950,000 clinical notes (including consultations, pathology, diagnostic imaging and adverse reactions) over a 5-year time period and relates to 55,000 patients. The paper then details a retrospective study which utilized the database to examine the interaction between antibiotic prescribing and patient outcomes from a community perspective, following a policy intervention. This study illustrates the application of computerized general practice records in research.

Contrast-enhanced multidetector computerized tomography for odontogenic cysts and cystic-appearing tumors of the jaws: is it useful?

PubMed

Kakimoto, Naoya; Chindasombatjaroen, Jira; Tomita, Seiki; Shimamoto, Hiroaki; Uchiyama, Yuka; Hasegawa, Yoko; Kishino, Mitsunobu; Murakami, Shumei; Furukawa, Souhei

2013-01-01

The purpose of this study was to investigate the usefulness of computerized tomography (CT), particularly contrast-enhanced CT, in differentiation of jaw cysts and cystic-appearing tumors. We retrospectively analyzed contrast-enhanced CT images of 90 patients with odontogenic jaw cysts or cystic-appearing tumors. The lesion size and CT values were measured and the short axis to long axis (S/L) ratio, contrast enhancement (CE) ratio, and standard deviation ratio were calculated. The lesion size and the S/L ratio of keratocystic odontogenic tumors were significantly different from those of radicular cysts and follicular cysts. There were no significant differences in the CE ratio among the lesions. Multidetector CT provided diagnostic information about the size of odontogenic cysts and cystic-appearing tumors of the jaws that was related to the lesion type, but showed no relation between CE ratio and the type of these lesions. Copyright © 2013 Elsevier Inc. All rights reserved.

[Some approaches to the countermeasure system for a mars exploration mission].

PubMed

Kozlovskaia, I B; Egorov, A D; Son'kin, V D

2010-01-01

In article discussed physiological and methodical principles of the organization of training process and his (its) computerization during Martian flight in conditions of autonomous activity of the crew, providing interaction with onboard medical means, self-maintained by crew of the their health, performance of preventive measures, diagnostic studies and, in case of necessity, carrying out of treatment. In super long autonomous flights essentially become complicated the control of ground experts over of crew members conditions, that testifies to necessity of a computerization of control process by a state of health of crew, including carrying out of preventive actions. The situation becomes complicated impossibility of reception and transfer aboard the necessary information in real time and emergency returning of crew to the Earth. In these conditions realization of problems of physical preventive maintenance should be solved by means of the onboard automated expert system, providing management by trainings of each crew members, directed on optimization of their psychophysical condition.

Factor Structure and Incremental Validity of the Enhanced Computer- Administered Tests

DTIC Science & Technology

1992-07-01

performance in the mechanical maintenance specialties. 14. SUBJECT TERMS Aptitude tests, ASVAB (Armed services vocational aptitude battery), CAT ...Code 11) Attn: Dir, Personnel Systems (Code 12) Attn: Dir, Testing Systems (Code 13) Attn: CAT /ASVABPMO FJB1 COMNAVCRUITCOM FT1 CNET V8 CG MCRD...test, a computerized adaptive testing version of the ASVAB ( CAT -ASVAB), the psychomotor portion of the General Aptitude Test Battery (GATB), and the

Interrater and Intrarater Reliability of the Balance Computerized Adaptive Test in Patients With Stroke.

PubMed

Chiang, Hsin-Yu; Lu, Wen-Shian; Yu, Wan-Hui; Hsueh, I-Ping; Hsieh, Ching-Lin

2018-04-11

To examine the interrater and intrarater reliability of the Balance Computerized Adaptive Test (Balance CAT) in patients with chronic stroke having a wide range of balance functions. Repeated assessments design (1wk apart). Seven teaching hospitals. A pooled sample (N=102) including 2 independent groups of outpatients (n=50 for the interrater reliability study; n=52 for the intrarater reliability study) with chronic stroke. Not applicable. Balance CAT. For the interrater reliability study, the values of intraclass correlation coefficient, minimal detectable change (MDC), and percentage of MDC (MDC%) for the Balance CAT were .84, 1.90, and 31.0%, respectively. For the intrarater reliability study, the values of intraclass correlation coefficient, MDC, and MDC% ranged from .89 to .91, from 1.14 to 1.26, and from 17.1% to 18.6%, respectively. The Balance CAT showed sufficient intrarater reliability in patients with chronic stroke having balance functions ranging from sitting with support to independent walking. Although the Balance CAT may have good interrater reliability, we found substantial random measurement error between different raters. Accordingly, if the Balance CAT is used as an outcome measure in clinical or research settings, same raters are suggested over different time points to ensure reliable assessments. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Development of a Conceptual Framework to Measure the Social Impact of Burns.

PubMed

Marino, Molly; Soley-Bori, Marina; Jette, Alan M; Slavin, Mary D; Ryan, Colleen M; Schneider, Jeffrey C; Resnik, Linda; Acton, Amy; Amaya, Flor; Rossi, Melinda; Soria-Saucedo, Rene; Kazis, Lewis E

Measuring community reintegration following burn injury is important to assess the efficacy of therapies designed to optimize recovery. This project aims to develop and validate a conceptual framework for understanding the social impact of burn injuries in adults. The framework is critical for developing the item banks used for a computerized adaptive test. We performed a comprehensive literature review and consulted with clinical experts and burn survivors about social life areas impacted by burn injury. Focus groups with burn survivors and clinicians were conducted to inform and validate the framework. Transcripts were coded using grounded theory methodology. The World Health Organization's International Classification of Functioning, Disability and Health, was chosen to ground the content model. The primary construct identified was social participation, which contains two concepts: societal role and personal relationships. The subdomains chosen for item development were work, recreation and leisure, relating with strangers, and romantic, sexual, family, and informal relationships. Qualitative results strongly suggest that the conceptual model fits the constructs for societal role and personal relationships with the respective subdomains. This conceptual framework has guided the implementation of a large-scale calibration study currently underway which will lead to a computerized adaptive test for monitoring the social impacts of burn injuries during recovery.

Diagnostic Algorithm Benchmarking

NASA Technical Reports Server (NTRS)

Poll, Scott

2011-01-01

A poster for the NASA Aviation Safety Program Annual Technical Meeting. It describes empirical benchmarking on diagnostic algorithms using data from the ADAPT Electrical Power System testbed and a diagnostic software framework.

Anismus: the cause of constipation? Results of investigation and treatment.

PubMed

Duthie, G S; Bartolo, D C

1992-01-01

Anismus, or failure of the somatic sphincter apparatus to relax at defecation, has been implicated as a major contributor to the problem of obstructed defecation. Current diagnostic methods depend on laboratory measurements of attempted defecation and the most complex, dynamic proctography has been the mainstay of diagnosis. Using a new computerized ambulatory method of recording sphincter function in these patients at home, we report an 80% reduction in our diagnostic rate suggesting that conventional tests fail to accurately diagnose this condition, probably because they poorly represent the natural physiology of defecation. Treatment of this distressing condition is more complex and a variety of surgical and pharmacological measures have failed. Biofeedback retraining of anorectal function of these patients has been very successful and represents the management of choice.

Neuropsychological Measures in the Diagnosis of ADHD in Preschool: Can Developmental Research Inform Diagnostic Practice?

PubMed

Merkt, Julia; Siniatchkin, Michael; Petermann, Franz

2016-03-22

The diagnosis of ADHD in preschool is challenging. Behavioral ratings are less reliable, but the value of neuropsychological tests in the diagnosis of ADHD has been debated. This article provides an overview of neuropsychological measures utilized in preschoolers with ADHD (3-5 years). In addition, the manuscript discusses the extent to which these measures have been tested for their diagnostic capacity. The diagnostic utility of computerized continuous performance tests and working memory subtests from IQ-batteries has been demonstrated in a number of studies by assessing their psychometric properties, sensitivity, and specificity. However, findings from developmental and basic research attempting to describe risk factors that explain variance in ADHD show the most consistent associations of ADHD with measures of delay aversion. Results from developmental research could benefit studies that improve ADHD diagnosis at the individual level. It might be helpful to consider testing as a structured situation for behavioral observation by the clinician. © The Author(s) 2016.

Radiation levels and image quality in patients undergoing chest X-ray examinations

NASA Astrophysics Data System (ADS)

de Oliveira, Paulo Márcio Campos; do Carmo Santana, Priscila; de Sousa Lacerda, Marco Aurélio; da Silva, Teógenes Augusto

2017-11-01

Patient dose monitoring for different radiographic procedures has been used as a parameter to evaluate the performance of radiology services; skin entrance absorbed dose values for each type of examination were internationally established and recommended aiming patient protection. In this work, a methodology for dose evaluation was applied to three diagnostic services: one with a conventional film and two with digital computerized radiography processing techniques. The x-ray beam parameters were selected and "doses" (specifically the entrance surface and incident air kerma) were evaluated based on images approved in European criteria during postero-anterior (PA) and lateral (LAT) incidences. Data were collected from 200 patients related to 200 PA and 100 LAT incidences. Results showed that doses distributions in the three diagnostic services were very different; the best relation between dose and image quality was found in the institution with the chemical film processing. This work contributed for disseminating the radiation protection culture by emphasizing the need of a continuous dose reduction without losing the quality of the diagnostic image.

Supervisory control and diagnostics system for the mirror fusion test facility: overview and status 1980

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

McGoldrick, P.R.

1981-01-01

The Mirror Fusion Test Facility (MFTF) is a complex facility requiring a highly-computerized Supervisory Control and Diagnostics System (SCDS) to monitor and provide control over ten subsystems; three of which require true process control. SCDS will provide physicists with a method of studying machine and plasma behavior by acquiring and processing up to four megabytes of plasma diagnostic information every five minutes. A high degree of availability and throughput is provided by a distributed computer system (nine 32-bit minicomputers on shared memory). Data, distributed across SCDS, is managed by a high-bandwidth Distributed Database Management System. The MFTF operators' control roommore » consoles use color television monitors with touch sensitive screens; this is a totally new approach. The method of handling deviations to normal machine operation and how the operator should be notified and assisted in the resolution of problems has been studied and a system designed.« less

Development of an item bank for computerized adaptive test (CAT) measurement of pain.

PubMed

Petersen, Morten Aa; Aaronson, Neil K; Chie, Wei-Chu; Conroy, Thierry; Costantini, Anna; Hammerlid, Eva; Hjermstad, Marianne J; Kaasa, Stein; Loge, Jon H; Velikova, Galina; Young, Teresa; Groenvold, Mogens

2016-01-01

Patient-reported outcomes should ideally be adapted to the individual patient while maintaining comparability of scores across patients. This is achievable using computerized adaptive testing (CAT). The aim here was to develop an item bank for CAT measurement of the pain domain as measured by the EORTC QLQ-C30 questionnaire. The development process consisted of four steps: (1) literature search, (2) formulation of new items and expert evaluations, (3) pretesting and (4) field-testing and psychometric analyses for the final selection of items. In step 1, we identified 337 pain items from the literature. Twenty-nine new items fitting the QLQ-C30 item style were formulated in step 2 that were reduced to 26 items by expert evaluations. Based on interviews with 31 patients from Denmark, France and the UK, the list was further reduced to 21 items in step 3. In phase 4, responses were obtained from 1103 cancer patients from five countries. Psychometric evaluations showed that 16 items could be retained in a unidimensional item bank. Evaluations indicated that use of the CAT measure may reduce sample size requirements with 15-25% compared to using the QLQ-C30 pain scale. We have established an item bank of 16 items suitable for CAT measurement of pain. While being backward compatible with the QLQ-C30, the new item bank will significantly improve measurement precision of pain. We recommend initiating CAT measurement by screening for pain using the two original QLQ-C30 pain items. The EORTC pain CAT is currently available for "experimental" purposes.

[Utility of methoxy isobutyl isonitrile (MIBI) scintigraphy, ultrasound and computerized axial tomography in preoperative topographic diagnosis of hiperparathyroidism].

PubMed

Gómez Palacios, Angel; Gómez Zábala, Jesús; Gutiérrez, María Teresa; Expósito, Amaya; Barrios, Borja; Zorraquino, Angel; Taibo, Miguel Angel; Iturburu, Ignacio

2006-12-01

1. To assess the sensitivity of scintigraphy using methoxy isobutyl isonitrile (MIBI). 2. To compare its resolution with that of ultrasound (US) and computerized axial tomography (CAT). 3. To use its diagnostic reliability to determine whether selective approaches can be used to treat hyperparathyroidism (HPT). A study of 76 patients who underwent surgery for HPT between 1996 and 2005 was performed. MIBI scintigraphy and cervical US were used for whole-body scanning in all patients; CAT was used in 47 patients. Intraoperative and postoperative biopsies were used for final evaluation of the tests, after visualization and surgical extirpation. The results of scintigraphy were positive in 65 patients (85.52%). The diagnosis was correct in all of the single images. Multiple images were due to hyperplasia and parathyroid adenomas with thyroid disease (5.2%). Three images, incorrectly classified as negative (3.94%), were positive. The sensitivity of US was 63% and allowed detection of three MIBI-negative adenomas (4%). CAT was less sensitive (55%), but detected a further three MIBI-negative adenomas (4%). 1. The sensitivity of MIBI reached 89.46%. In the absence of thyroid nodules, MIBI diagnosed 100% of single lesions. Pathological thyroid processes produced false-positive results (5.2%) and there were diagnostic errors (4%). 2. MIBI scintigraphy was more sensitive than US and CAT. 3. Positive, single image scintigraphy allows a selective cervical approach. US and CAT may help to save a further 8% of patients (with negative scintigraphy).

Computerized Lung Sound Analysis as diagnostic aid for the detection of abnormal lung sounds: a systematic review and meta-analysis

PubMed Central

Gurung, Arati; Scrafford, Carolyn G; Tielsch, James M; Levine, Orin S; Checkley, William

2011-01-01

Rationale The standardized use of a stethoscope for chest auscultation in clinical research is limited by its inherent inter-listener variability. Electronic auscultation and automated classification of recorded lung sounds may help prevent some these shortcomings. Objective We sought to perform a systematic review and meta-analysis of studies implementing computerized lung sounds analysis (CLSA) to aid in the detection of abnormal lung sounds for specific respiratory disorders. Methods We searched for articles on CLSA in MEDLINE, EMBASE, Cochrane Library and ISI Web of Knowledge through July 31, 2010. Following qualitative review, we conducted a meta-analysis to estimate the sensitivity and specificity of CLSA for the detection of abnormal lung sounds. Measurements and Main Results Of 208 articles identified, we selected eight studies for review. Most studies employed either electret microphones or piezoelectric sensors for auscultation, and Fourier Transform and Neural Network algorithms for analysis and automated classification of lung sounds. Overall sensitivity for the detection of wheezes or crackles using CLSA was 80% (95% CI 72–86%) and specificity was 85% (95% CI 78–91%). Conclusions While quality data on CLSA are relatively limited, analysis of existing information suggests that CLSA can provide a relatively high specificity for detecting abnormal lung sounds such as crackles and wheezes. Further research and product development could promote the value of CLSA in research studies or its diagnostic utility in clinical setting. PMID:21676606

Computerized lung sound analysis as diagnostic aid for the detection of abnormal lung sounds: a systematic review and meta-analysis.

PubMed

Gurung, Arati; Scrafford, Carolyn G; Tielsch, James M; Levine, Orin S; Checkley, William

2011-09-01

The standardized use of a stethoscope for chest auscultation in clinical research is limited by its inherent inter-listener variability. Electronic auscultation and automated classification of recorded lung sounds may help prevent some of these shortcomings. We sought to perform a systematic review and meta-analysis of studies implementing computerized lung sound analysis (CLSA) to aid in the detection of abnormal lung sounds for specific respiratory disorders. We searched for articles on CLSA in MEDLINE, EMBASE, Cochrane Library and ISI Web of Knowledge through July 31, 2010. Following qualitative review, we conducted a meta-analysis to estimate the sensitivity and specificity of CLSA for the detection of abnormal lung sounds. Of 208 articles identified, we selected eight studies for review. Most studies employed either electret microphones or piezoelectric sensors for auscultation, and Fourier Transform and Neural Network algorithms for analysis and automated classification of lung sounds. Overall sensitivity for the detection of wheezes or crackles using CLSA was 80% (95% CI 72-86%) and specificity was 85% (95% CI 78-91%). While quality data on CLSA are relatively limited, analysis of existing information suggests that CLSA can provide a relatively high specificity for detecting abnormal lung sounds such as crackles and wheezes. Further research and product development could promote the value of CLSA in research studies or its diagnostic utility in clinical settings. Copyright © 2011 Elsevier Ltd. All rights reserved.

To ID or Not to ID? Changes in Classification Rates of Intellectual Disability Using "DSM-5"

ERIC Educational Resources Information Center

Papazoglou, Aimilia; Jacobson, Lisa A.; McCabe, Marie; Kaufmann, Walter; Zabel, T. Andrew

2014-01-01

The "Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition" ("DSM-5") diagnostic criteria for intellectual disability (ID) include a change to the definition of adaptive impairment. New criteria require impairment in one adaptive domain rather than two or more skill areas. The authors examined the diagnostic…

Web-based automation of green building rating index and life cycle cost analysis

NASA Astrophysics Data System (ADS)

Shahzaib Khan, Jam; Zakaria, Rozana; Aminuddin, Eeydzah; IzieAdiana Abidin, Nur; Sahamir, Shaza Rina; Ahmad, Rosli; Nafis Abas, Darul

2018-04-01

Sudden decline in financial markets and economic meltdown has slow down adaptation and lowered interest of investors towards green certified buildings due to their higher initial costs. Similarly, it is essential to fetch investor’s attention towards more development of green buildings through automated tools for the construction projects. Though, historical dearth is found on the automation of green building rating tools that brings up an essential gap to develop an automated analog computerized programming tool. This paper present a proposed research aim to develop an integrated web-based automated analog computerized programming that applies green building rating assessment tool, green technology and life cycle cost analysis. It also emphasizes to identify variables of MyCrest and LCC to be integrated and developed in a framework then transformed into automated analog computerized programming. A mix methodology of qualitative and quantitative survey and its development portray the planned to carry MyCrest-LCC integration to an automated level. In this study, the preliminary literature review enriches better understanding of Green Building Rating Tools (GBRT) integration to LCC. The outcome of this research is a pave way for future researchers to integrate other efficient tool and parameters that contributes towards green buildings and future agendas.

Testing R&D and Planned Applications to Enlisted Personnel Selection and Classification: Proceedings of a Topical Area Review, Held in Alexandria, Virginia on December 8-9, 1988

DTIC Science & Technology

1989-03-01

on reverse If neceasary and Identify by block number) FIELD GROUP SUB-GROUP CAT -ASVAB, testing, computerized adaptive testing, Armed Service Vocational...129 John J. Pass, Navy Personnel Research and Development Center Accelerated CAT -ASVAB Project...133 William A. Sands, Navy Personnel Research and DevelopmerLt Center Accelerated CAT -ASVAB Program Psychometric Accomplishments

Computerized Tailored Intervention for Behavioral Sequelae of Post-Traumatic Stress Disorder in Veterans

DTIC Science & Technology

2012-10-01

pilot tested a viable Internet-based intervention to assist veterans with Post -Traumatic Stress symptoms to progress toward changing negative...veterans’ health and recovery. The three-month feasibility test was designed to assess acceptability and viability of the CTI system and the...aim of the study was to adapt and test the feasibility of a multiple behavior TTM-based CTI designed for the general adult population so that it

Adaptive Computerized Training System (ACTS): A Knowledge Base System for Electronic Troubleshooting

DTIC Science & Technology

1983-12-01

Design Z.3.1 Field System Z.3.e Research System Z.4 Information Flow and Management 2.4.1 Student Performance Recording .4.? Student Operational...could more easily relate to. In addition, many automated management tools were created to assist instructors with courseware authoring, student...ACTS was installed and demonstrated at Ft. Gordon. The training managers , instructors, and SMt’s who participated in those demonstrations provided

Making a structured psychiatric diagnostic interview faithful to the nomenclature.

PubMed

Robins, Lee N; Cottler, Linda B

2004-10-15

Psychiatric diagnostic interviews to be used in epidemiologic studies by lay interviewers have, since the 1970s, attempted to operationalize existing psychiatric nomenclatures. How to maximize the chances that they do so successfully has not previously been spelled out. In this article, the authors discuss strategies for each of the seven steps involved in writing, updating, or modifying a diagnostic interview and its supporting materials: 1) writing questions that match the nomenclature's criteria, 2) checking that respondents will be willing and able to answer the questions, 3) choosing a format acceptable to interviewers that maximizes accurate answering and recording of answers, 4) constructing a data entry and cleaning program that highlights errors to be corrected, 5) creating a diagnostic scoring program that matches the nomenclature's algorithms, 6) developing an interviewer training program that maximizes reliability, and 7) computerizing the interview. For each step, the authors discuss how to identify errors, correct them, and validate the revisions. Although operationalization will never be perfect because of ambiguities in the nomenclature, specifying methods for minimizing divergence from the nomenclature is timely as users modify existing interviews and look forward to updating interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the International Classification of Diseases, Eleventh Revision.

Diagnostic Classification Models and Multidimensional Adaptive Testing: A Commentary on Rupp and Templin

ERIC Educational Resources Information Center

Frey, Andreas; Carstensen, Claus H.

2009-01-01

On a general level, the objective of diagnostic classifications models (DCMs) lies in a classification of individuals regarding multiple latent skills. In this article, the authors show that this objective can be achieved by multidimensional adaptive testing (MAT) as well. The authors discuss whether or not the restricted applicability of DCMs can…

Visuomotor adaptability in older adults with mild cognitive decline.

PubMed

Schaffert, Jeffrey; Lee, Chi-Mei; Neill, Rebecca; Bo, Jin

2017-02-01

The current study examined the augmentation of error feedback on visuomotor adaptability in older adults with varying degrees of cognitive decline (assessed by the Montreal Cognitive Assessment; MoCA). Twenty-three participants performed a center-out computerized visuomotor adaptation task when the visual feedback of their hand movement error was presented in a regular (ratio=1:1) or enhanced (ratio=1:2) error feedback schedule. Results showed that older adults with lower scores on the MoCA had less adaptability than those with higher MoCA scores during the regular feedback schedule. However, participants demonstrated similar adaptability during the enhanced feedback schedule, regardless of their cognitive ability. Furthermore, individuals with lower MoCA scores showed larger after-effects in spatial control during the enhanced schedule compared to the regular schedule, whereas individuals with higher MoCA scores displayed the opposite pattern. Additional neuro-cognitive assessments revealed that spatial working memory and processing speed were positively related to motor adaptability during the regular scheduled but negatively related to adaptability during the enhanced schedule. We argue that individuals with mild cognitive decline employed different adaptation strategies when encountering enhanced visual feedback, suggesting older adults with mild cognitive impairment (MCI) may benefit from enhanced visual error feedback during sensorimotor adaptation. Copyright © 2016 Elsevier B.V. All rights reserved.

Neuroimaging in pediatric traumatic head injury: diagnostic considerations and relationships to neurobehavioral outcome.

PubMed

Bigler, E D

1999-08-01

Contemporary neuorimaging techniques in child traumatic brain injury are reviewed, with an emphasis on computerized tomography (CT) and magnetic resonance (MR) imaging. A brief overview of MR spectroscopy (MRS), functional MR imaging (fMRI), single-photon emission computed tomography (SPECT), and magnetoencephalography (MEG) is also provided because these techniques will likely constitute important neuroimaging techniques of the future. Numerous figures are provided to illustrate the multifaceted manner in which traumatic deficits can be imaged and the role of neuroimaging information as it relates to TBI outcome.

Dynamic, diagnostic, and pharmacological radionuclide studies of the esophagus in achalasia

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

Rozen, P.; Gelfond, M.; Zaltzman, S.

1982-08-01

The esophagus was evaluated in 15 patients with achalasia by continuous gamma camera imaging following ingestion of a semi-solid meal labeled with /sup 99m/Tc. The images were displayed and recorded on a simple computerized data processing/display system. Subsequent cine mode images of esophageal emptying demonstrated abnormalities of the body of the esophagus not reflected by the manometric examination. Computer-generated time-activity curves representing specific regions of interest were better than manometry in evaluating the results of myotomy, dilatation, and drug therapy. Isosorbide dinitrate significantly improved esophageal emptying.

Guided eruption of palatally impacted canines through combined use of 3-dimensional computerized tomography scans and the easy cuspid device.

PubMed

Caprioglio, Alberto; Siani, Lea; Caprioglio, Claudia

2007-01-01

The permanent maxillary canine has a high incidence of impaction. In the clinical treatment of impaction, the first problem is diagnosis and localization. The new diagnostic 3-dimensional systems shown in this article provide valid support in understanding anatomic connections and planning the movements needed for orthodontic correction. Thus, the clinician can reduce the incidence of iatrogenic damage of adjacent structures. This article reviews several biomedical systems for guided eruption of palatally impacted canines and discusses a new device for guided eruption of the surgically disimpacted tooth. This device, called Easy Cuspid, is designed to reduce recognized problems with reaction forces through a simple method. A clinical case of bilateral impaction of the permanent maxillary canines shows the application of the diagnostic method and the biomechanical system, Easy Cuspid.

e-Addictology: An Overview of New Technologies for Assessing and Intervening in Addictive Behaviors.

PubMed

Ferreri, Florian; Bourla, Alexis; Mouchabac, Stephane; Karila, Laurent

2018-01-01

New technologies can profoundly change the way we understand psychiatric pathologies and addictive disorders. New concepts are emerging with the development of more accurate means of collecting live data, computerized questionnaires, and the use of passive data. Digital phenotyping , a paradigmatic example, refers to the use of computerized measurement tools to capture the characteristics of different psychiatric disorders. Similarly, machine learning-a form of artificial intelligence-can improve the classification of patients based on patterns that clinicians have not always considered in the past. Remote or automated interventions (web-based or smartphone-based apps), as well as virtual reality and neurofeedback, are already available or under development. These recent changes have the potential to disrupt practices, as well as practitioners' beliefs, ethics and representations, and may even call into question their professional culture. However, the impact of new technologies on health professionals' practice in addictive disorder care has yet to be determined. In the present paper, we therefore present an overview of new technology in the field of addiction medicine. Using the keywords [e-health], [m-health], [computer], [mobile], [smartphone], [wearable], [digital], [machine learning], [ecological momentary assessment], [biofeedback] and [virtual reality], we searched the PubMed database for the most representative articles in the field of assessment and interventions in substance use disorders. We screened 595 abstracts and analyzed 92 articles, dividing them into seven categories: e-health program and web-based interventions, machine learning, computerized adaptive testing, wearable devices and digital phenotyping, ecological momentary assessment, biofeedback, and virtual reality. This overview shows that new technologies can improve assessment and interventions in the field of addictive disorders. The precise role of connected devices, artificial intelligence and remote monitoring remains to be defined. If they are to be used effectively, these tools must be explained and adapted to the different profiles of physicians and patients. The involvement of patients, caregivers and other health professionals is essential to their design and assessment.

Reporting completeness and transparency of meta-analyses of depression screening tool accuracy: A comparison of meta-analyses published before and after the PRISMA statement.

PubMed

Rice, Danielle B; Kloda, Lorie A; Shrier, Ian; Thombs, Brett D

2016-08-01

Meta-analyses that are conducted rigorously and reported completely and transparently can provide accurate evidence to inform the best possible healthcare decisions. Guideline makers have raised concerns about the utility of existing evidence on the diagnostic accuracy of depression screening tools. The objective of our study was to evaluate the transparency and completeness of reporting in meta-analyses of the diagnostic accuracy of depression screening tools using the PRISMA tool adapted for diagnostic test accuracy meta-analyses. We searched MEDLINE and PsycINFO from January 1, 2005 through March 13, 2016 for recent meta-analyses in any language on the diagnostic accuracy of depression screening tools. Two reviewers independently assessed the transparency in reporting using the PRISMA tool with appropriate adaptations made for studies of diagnostic test accuracy. We identified 21 eligible meta-analyses. Twelve of 21 meta-analyses complied with at least 50% of adapted PRISMA items. Of 30 adapted PRISMA items, 11 were fulfilled by ≥80% of included meta-analyses, 3 by 50-79% of meta-analyses, 7 by 25-45% of meta-analyses, and 9 by <25%. On average, post-PRISMA meta-analyses complied with 17 of 30 items compared to 13 of 30 items pre-PRISMA. Deficiencies in the transparency of reporting in meta-analyses of the diagnostic test accuracy of depression screening tools of meta-analyses were identified. Authors, reviewers, and editors should adhere to the PRISMA statement to improve the reporting of meta-analyses of the diagnostic accuracy of depression screening tools. Copyright © 2016 Elsevier Inc. All rights reserved.

Nonlinear Computerized Methodology. A. Angle of Arrival Estimation. B. Data Modeling and Identification

DTIC Science & Technology

1991-06-10

essentially In the Wianer- Ville distribution ( WVD ). A preliminary analysis indicates that the simple operation of autoconvolution can enhance spectral...many troublesome cases as a supplement to MUSIC (and its adaptations) and as a simple alternative (or representation of) the Wigner - Ville ... WVD is a time-frequency distribution which provides an unbiased spectrum estimate by W(t,W) = f H,(u) X (t - u/2) X (t + u/2) e -iwu du , where the

Computerized Adaptive Testing. A Case Study.

DTIC Science & Technology

1980-12-01

English Contributions Sir Francis Galton (1822-1911) became a principal founder of the scientific study of human differences. He engaged in a variety of...1966. Forrest, D. W., Francis Galton : The Life and Work of a Victorian Genius, Taplinger Publishing, 1974. Heidbreder, Edna, Seven Psychologies, D...ado if noes..mo- old 0901F 6 O" "W"bW) Intelligence Testing Mental Testing AFQT Armed Force Qualification Testing [See page 2] N. A ACT(CONUtEMu 4 veuW

Examining the Construct Validity of the MMPI-2-RF Interpersonal Functioning Scales Using the Computerized Adaptive Test of Personality Disorder as a Comparative Framework.

PubMed

Franz, Annabel O; Harrop, Tiffany M; McCord, David M

2017-01-01

This study aimed to examine the construct validity of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) interpersonal functioning scales (Ben-Porath & Tellegen, 2008/2011 ) using as a criterion measure the Computerized Adaptive Test of Personality Disorder-Static Form (CAT-PD-SF; Simms et al., 2011 ). Participants were college students (n = 98) recruited through the university subject pool. A series of a priori hypotheses were developed for each of the 6 interpersonal functioning scales of the MMPI-2-RF, expressed as predicted correlations with construct-relevant CAT-PD-SF scales. Of the 27 specific predictions, 21 were supported by substantial (≥ |.30|) correlations. The MMPI-2-RF Family Problems scale (FML) demonstrated the strongest correlations with CAT-PD-SF scales Anhedonia and Mistrust; Cynicism (RC3) was most highly correlated with Mistrust and Norm Violation; Interpersonal Passivity (IPP) was most highly correlated with Domineering and Rudeness; Social Avoidance (SAV) was most highly correlated with Social Withdrawal and Anhedonia; Shyness (SHY) was most highly correlated with Social Withdrawal and Anxioiusness; and Disaffiliativeness (DSF) was most highly correlated with Emotional Detachment and Mistrust. Results are largely consistent with hypotheses suggesting support for both models of constructs relevant to interpersonal functioning. Future research designed to more precisely differentiate Social Avoidance (SAV) and Shyness (SHY) is suggested.

Development and preliminary testing of a computerized adaptive assessment of chronic pain.

PubMed

Anatchkova, Milena D; Saris-Baglama, Renee N; Kosinski, Mark; Bjorner, Jakob B

2009-09-01

The aim of this article is to report the development and preliminary testing of a prototype computerized adaptive test of chronic pain (CHRONIC PAIN-CAT) conducted in 2 stages: (1) evaluation of various item selection and stopping rules through real data-simulated administrations of CHRONIC PAIN-CAT; (2) a feasibility study of the actual prototype CHRONIC PAIN-CAT assessment system conducted in a pilot sample. Item calibrations developed from a US general population sample (N = 782) were used to program a pain severity and impact item bank (kappa = 45), and real data simulations were conducted to determine a CAT stopping rule. The CHRONIC PAIN-CAT was programmed on a tablet PC using QualityMetric's Dynamic Health Assessment (DYHNA) software and administered to a clinical sample of pain sufferers (n = 100). The CAT was completed in significantly less time than the static (full item bank) assessment (P < .001). On average, 5.6 items were dynamically administered by CAT to achieve a precise score. Scores estimated from the 2 assessments were highly correlated (r = .89), and both assessments discriminated across pain severity levels (P < .001, RV = .95). Patients' evaluations of the CHRONIC PAIN-CAT were favorable. This report demonstrates that the CHRONIC PAIN-CAT is feasible for administration in a clinic. The application has the potential to improve pain assessment and help clinicians manage chronic pain.

Multiattribute health utility scoring for the computerized adaptive measure CAT-5D-QOL was developed and validated.

PubMed

Kopec, Jacek A; Sayre, Eric C; Rogers, Pamela; Davis, Aileen M; Badley, Elizabeth M; Anis, Aslam H; Abrahamowicz, Michal; Russell, Lara; Rahman, Md Mushfiqur; Esdaile, John M

2015-10-01

The CAT-5D-QOL is a previously reported item response theory (IRT)-based computerized adaptive tool to measure five domains (attributes) of health-related quality of life. The objective of this study was to develop and validate a multiattribute health utility (MAHU) scoring method for this instrument. The MAHU scoring system was developed in two stages. In phase I, we obtained standard gamble (SG) utilities for 75 hypothetical health states in which only one domain varied (15 states per domain). In phase II, we obtained SG utilities for 256 multiattribute states. We fit a multiplicative regression model to predict SG utilities from the five IRT domain scores. The prediction model was constrained using data from phase I. We validated MAHU scores by comparing them with the Health Utilities Index Mark 3 (HUI3) and directly measured utilities and by assessing between-group discrimination. MAHU scores have a theoretical range from -0.842 to 1. In the validation study, the scores were, on average, higher than HUI3 utilities and lower than directly measured SG utilities. MAHU scores correlated strongly with the HUI3 (Spearman ρ = 0.78) and discriminated well between groups expected to differ in health status. Results reported here provide initial evidence supporting the validity of the MAHU scoring system for the CAT-5D-QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

A novel algorithm to detect glaucoma risk using texton and local configuration pattern features extracted from fundus images.

PubMed

Acharya, U Rajendra; Bhat, Shreya; Koh, Joel E W; Bhandary, Sulatha V; Adeli, Hojjat

2017-09-01

Glaucoma is an optic neuropathy defined by characteristic damage to the optic nerve and accompanying visual field deficits. Early diagnosis and treatment are critical to prevent irreversible vision loss and ultimate blindness. Current techniques for computer-aided analysis of the optic nerve and retinal nerve fiber layer (RNFL) are expensive and require keen interpretation by trained specialists. Hence, an automated system is highly desirable for a cost-effective and accurate screening for the diagnosis of glaucoma. This paper presents a new methodology and a computerized diagnostic system. Adaptive histogram equalization is used to convert color images to grayscale images followed by convolution of these images with Leung-Malik (LM), Schmid (S), and maximum response (MR4 and MR8) filter banks. The basic microstructures in typical images are called textons. The convolution process produces textons. Local configuration pattern (LCP) features are extracted from these textons. The significant features are selected using a sequential floating forward search (SFFS) method and ranked using the statistical t-test. Finally, various classifiers are used for classification of images into normal and glaucomatous classes. A high classification accuracy of 95.8% is achieved using six features obtained from the LM filter bank and the k-nearest neighbor (kNN) classifier. A glaucoma integrative index (GRI) is also formulated to obtain a reliable and effective system. Copyright © 2017 Elsevier Ltd. All rights reserved.

Linking Existing Instruments to Develop an Activity of Daily Living Item Bank.

PubMed

Li, Chih-Ying; Romero, Sergio; Bonilha, Heather S; Simpson, Kit N; Simpson, Annie N; Hong, Ickpyo; Velozo, Craig A

2018-03-01

This study examined dimensionality and item-level psychometric properties of an item bank measuring activities of daily living (ADL) across inpatient rehabilitation facilities and community living centers. Common person equating method was used in the retrospective veterans data set. This study examined dimensionality, model fit, local independence, and monotonicity using factor analyses and fit statistics, principal component analysis (PCA), and differential item functioning (DIF) using Rasch analysis. Following the elimination of invalid data, 371 veterans who completed both the Functional Independence Measure (FIM) and minimum data set (MDS) within 6 days were retained. The FIM-MDS item bank demonstrated good internal consistency (Cronbach's α = .98) and met three rating scale diagnostic criteria and three of the four model fit statistics (comparative fit index/Tucker-Lewis index = 0.98, root mean square error of approximation = 0.14, and standardized root mean residual = 0.07). PCA of Rasch residuals showed the item bank explained 94.2% variance. The item bank covered the range of θ from -1.50 to 1.26 (item), -3.57 to 4.21 (person) with person strata of 6.3. The findings indicated the ADL physical function item bank constructed from FIM and MDS measured a single latent trait with overall acceptable item-level psychometric properties, suggesting that it is an appropriate source for developing efficient test forms such as short forms and computerized adaptive tests.

Acceptance of New Technology: A Usability Test of a Computerized Adaptive Test for Fatigue in Rheumatoid Arthritis.

PubMed

Nikolaus, Stephanie; Bode, Christina; Taal, Erik; Vonkeman, Harald E; Glas, Cees Aw; van de Laar, Mart Afj

2014-12-04

Little is known about the acceptance and usability of computerized adaptive tests (CATs) among patients with rheumatoid arthritis (RA). The main difference between completing a CAT and a traditional questionnaire concerns item presentation. CATs only provide one item at a time on the screen, and skipping forward or backward to review and change already given answers is often not possible. The objective of this study was to examine how patients with RA experience a Web-based CAT for fatigue. In individual sessions, participants filled in the CAT while thinking aloud, and were subsequently interviewed about their experience with the new instrument. The technology acceptance model (TAM) was used to structure the results. The participants were 15 patients with RA. They perceived the CAT as clear, brief, and easy to use. They were positive about answering one question per screen, the changing response options, layout, progress bar, and item number. There were 40% (6/15) of the participants that also mentioned that they experienced the completion of the CAT as useful and pleasant, and liked the adaptive test mechanism. However, some participants noted that not all items were applicable to everybody, and that the wordings of questions within the severity dimension were often similar. Participants perceived the "CAT Fatigue RA" as easy to use, and also its usefulness was expressed. A 2.0 version has been improved according to the participants' comments, and is currently being used in a validation study before it will be implemented in daily clinical practice. Our results give a first indication that CAT methodology may outperform traditional questionnaires not merely on measurement precision, but also on usability and acceptance valuation.

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.

Can We Improve Structured Sequence Processing? Exploring the Direct and Indirect Effects of Computerized Training Using a Mediational Model

PubMed Central

Smith, Gretchen N. L.; Conway, Christopher M.; Bauernschmidt, Althea; Pisoni, David B.

2015-01-01

Recent research suggests that language acquisition may rely on domain-general learning abilities, such as structured sequence processing, which is the ability to extract, encode, and represent structured patterns in a temporal sequence. If structured sequence processing supports language, then it may be possible to improve language function by enhancing this foundational learning ability. The goal of the present study was to use a novel computerized training task as a means to better understand the relationship between structured sequence processing and language function. Participants first were assessed on pre-training tasks to provide baseline behavioral measures of structured sequence processing and language abilities. Participants were then quasi-randomly assigned to either a treatment group involving adaptive structured visuospatial sequence training, a treatment group involving adaptive non-structured visuospatial sequence training, or a control group. Following four days of sequence training, all participants were assessed with the same pre-training measures. Overall comparison of the post-training means revealed no group differences. However, in order to examine the potential relations between sequence training, structured sequence processing, and language ability, we used a mediation analysis that showed two competing effects. In the indirect effect, adaptive sequence training with structural regularities had a positive impact on structured sequence processing performance, which in turn had a positive impact on language processing. This finding not only identifies a potential novel intervention to treat language impairments but also may be the first demonstration that structured sequence processing can be improved and that this, in turn, has an impact on language processing. However, in the direct effect, adaptive sequence training with structural regularities had a direct negative impact on language processing. This unexpected finding suggests that adaptive training with structural regularities might potentially interfere with language processing. Taken together, these findings underscore the importance of pursuing designs that promote a better understanding of the mechanisms underlying training-related changes, so that regimens can be developed that help reduce these types of negative effects while simultaneously maximizing the benefits to outcome measures of interest. PMID:25946222

Can we improve structured sequence processing? Exploring the direct and indirect effects of computerized training using a mediational model.

PubMed

Smith, Gretchen N L; Conway, Christopher M; Bauernschmidt, Althea; Pisoni, David B

2015-01-01

Recent research suggests that language acquisition may rely on domain-general learning abilities, such as structured sequence processing, which is the ability to extract, encode, and represent structured patterns in a temporal sequence. If structured sequence processing supports language, then it may be possible to improve language function by enhancing this foundational learning ability. The goal of the present study was to use a novel computerized training task as a means to better understand the relationship between structured sequence processing and language function. Participants first were assessed on pre-training tasks to provide baseline behavioral measures of structured sequence processing and language abilities. Participants were then quasi-randomly assigned to either a treatment group involving adaptive structured visuospatial sequence training, a treatment group involving adaptive non-structured visuospatial sequence training, or a control group. Following four days of sequence training, all participants were assessed with the same pre-training measures. Overall comparison of the post-training means revealed no group differences. However, in order to examine the potential relations between sequence training, structured sequence processing, and language ability, we used a mediation analysis that showed two competing effects. In the indirect effect, adaptive sequence training with structural regularities had a positive impact on structured sequence processing performance, which in turn had a positive impact on language processing. This finding not only identifies a potential novel intervention to treat language impairments but also may be the first demonstration that structured sequence processing can be improved and that this, in turn, has an impact on language processing. However, in the direct effect, adaptive sequence training with structural regularities had a direct negative impact on language processing. This unexpected finding suggests that adaptive training with structural regularities might potentially interfere with language processing. Taken together, these findings underscore the importance of pursuing designs that promote a better understanding of the mechanisms underlying training-related changes, so that regimens can be developed that help reduce these types of negative effects while simultaneously maximizing the benefits to outcome measures of interest.

The impact of automation on organizational changes in a community hospital clinical microbiology laboratory.

PubMed

Camporese, Alessandro

2004-06-01

The diagnosis of infectious diseases and the role of the microbiology laboratory are currently undergoing a process of change. The need for overall efficiency in providing results is now given the same importance as accuracy. This means that laboratories must be able to produce quality results in less time with the capacity to interpret the results clinically. To improve the clinical impact of microbiology results, the new challenge facing the microbiologist has become one of process management instead of pure analysis. A proper project management process designed to improve workflow, reduce analytical time, and provide the same high quality results without losing valuable time treating the patient, has become essential. Our objective was to study the impact of introducing automation and computerization into the microbiology laboratory, and the reorganization of the laboratory workflow, i.e. scheduling personnel to work shifts covering both the entire day and the entire week. In our laboratory, the introduction of automation and computerization, as well as the reorganization of personnel, thus the workflow itself, has resulted in an improvement in response time and greater efficiency in diagnostic procedures.

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.

Methodological, technical, and ethical issues of a computerized data system.

PubMed

Rice, C A; Godkin, M A; Catlin, R J

1980-06-01

This report examines some methodological, technical, and ethical issues which need to be addressed in designing and implementing a valid and reliable computerized clinical data base. The report focuses on the data collection system used by four residency based family health centers, affiliated with the University of Massachusetts Medical Center. It is suggested that data reliability and validity can be maximized by: (1) standardizing encounter forms at affiliated health centers to eliminate recording biases and ensure data comparability; (2) using forms with a diagnosis checklist to reduce coding errors and increase the number of diagnoses recorded per encounter; (3) developing uniform diagnostic criteria; (4) identifying sources of error, including discrepancies of clinical data as recorded in medical records, encounter forms, and the computer; and (5) improving provider cooperation in recording data by distributing data summaries which reinforce the data's applicability to service provision. Potential applications of the data for research purposes are restricted by personnel and computer costs, confidentiality considerations, programming related issues, and, most importantly, health center priorities, largely focused on patient care, not research.

Planning guidelines for computerized transaxial tomography (CT)

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

Not Available

1976-11-23

Guidelines to assist local communities in review and decisionmaking related to computerized tomography (CT) 'head' and 'whole body' scanner needs and placement are presented. Although medical benefits for head scanning are well established, the proper role of whole body scanning in relation to other diagnostic procedures has not been determined. It is recommended that a 20 percent weighted consideration could be given to a potential CT scanner applicant's present capabilities in diagnostic 'body' work. The following guidelines for CT are recommended for use in assessing work qualifications of potential CT scanner applicants: (1) The facility must have an active neurosurgicalmore » service, with a geographically full-time board - certified neurosurgeon and at least 50 intracranial procedures performed annually. (2) The facility must have an active neurological service, with a geographically full-time board - certified neurologist. (3) The facility must have on staff a qualified neuroradiologist. It is recommended that the CT scanner utilization level be a minimum of 3,000 examinations per year per unit of new equipment. The applicant must submit financial data and must be committed to providing care to all patients, independent of ability to pay. The applicant must submit letters from area hospitals agreeing to utilize the scanner services. Additional criteria are given for body scanning work and for the number of scanners in a specific area. Detailed information is presented about scanner development and use in southeastern Pennsylvania and neighboring planning areas, and the cost of scanner operations is compared with revenues. The CT scanner committee membership is included.« less

Designs and adaptive analysis plans for pivotal clinical trials of therapeutics and companion diagnostics.

PubMed

Simon, Richard

2008-06-01

Developments in genomics and biotechnology provide unprecedented opportunities for the development of effective therapeutics and companion diagnostics for matching the right drug to the right patient. Effective co-development involves many new challenges with increased opportunity for success as well as delay and failure. Clinical trial designs and adaptive analysis plans for the prospective design of pivotal trials of new therapeutics and companion diagnostics are reviewed. Effective co-development requires careful prospective planning of the design and analysis strategy for pivotal clinical trials. Randomized clinical trials continue to be important for evaluating the effectiveness of new treatments, but the target populations for analysis should be prospectively specified based on the companion diagnostic. Post hoc analyses of traditionally designed randomized clinical trials are often deeply problematic. Clear separation is generally required of the data used for developing the diagnostic test, including their threshold of positivity, from the data used for evaluating treatment effectiveness in subsets determined by the test. Adaptive analysis can be used to provide flexibility to the analysis but the use of such methods requires careful planning and prospective definition in order to assure that the pivotal trial adequately limits the chance of erroneous conclusions.

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.

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.

Computerized Assessment of Competence-Related Abilities in Living Liver Donors: The Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL)

PubMed Central

Freeman, Jason; Emond, Jean; Gillespie, Brenda W.; Appelbaum, Paul S.; Weinrieb, Robert; Hill-Callahan, Peg; Gordon, Elisa J.; Terrault, Norah; Trotter, James; Ashworth, April; Dew, Mary Amanda; Pruett, Timothy

2014-01-01

Background Despite its importance, determination of competence to consent to organ donation varies widely based on local standards. We piloted a new tool to aid transplant centers in donor assessment. Methods We assessed competence-related abilities among potential living liver donors (LDs) in the 9-center A2ALL study. Prospective LDs viewed an educational video, and were queried to assess Understanding, Appreciation, Reasoning, and ability to express a Final Choice using the MacArthur Competence Assessment Tool for Clinical Research, adapted for computerized administration in LDs (“MacLiver”). Videotaped responses were scored by a clinical neuropsychologist (JF). Results Ninety-three LDs were assessed. Mean (standard deviation; domain maximum) scores were: Understanding: 18.1 (2.6; max=22), Appreciation: 5.1 (1.0; max=6), Reasoning: 3.1 (0.8; max=4), and Final Choice: 3.8 (0.5; max=4). Scores did not differ by demographics, relationship to the recipient, eligibility to donate, or eventual donation (p>0.4). Higher education was associated with greater Understanding (p=0.004) and Reasoning (p=0.03). Conclusion Standardized, computerized education with independent ratings of responses may (1) alert the clinical staff to potential donors who may not be competent to donate, and (2) highlight areas needing further assessment and education, leading to better informed decision-making. PMID:23859354

Diagnostic Challenges in Prostate Cancer and 68Ga-PSMA PET Imaging: A Game Changer?

PubMed

Zaman, Maseeh uz; Fatima, Nosheen; Zaman, Areeba; Sajid, Mahwsih; Zaman, Unaiza; Zaman, Sidra

2017-10-26

Prostate cancer (PC) is the most frequent solid tumor in men and the third most common cause of cancer mortality among men in developed countries. Current imaging modalities like ultrasound (US), computerized tomography (CT), magnetic resonance imaging (MRI) and choline based positron emission (PET) tracing have disappointing sensitivity for detection of nodal metastasis and small tumor recurrence. This poses a diagnostic challenge in staging of intermediate to high risk PC and restaging of patients with biochemical recurrence (PSA >0.2 ng/ml). Gallium-68 labeled prostate specific membrane antigen (68Ga-PSMA) PET imaging has now emerged with a higher diagnostic yield. 68Ga-PSMA PET/CT or PET/MRI can be expected to offer a one-stop-shop for staging and restaging of PC. PSMA ligands labeled with alpha and beta emitters have also shown promising therapeutic efficacy for nodal, bone and visceral metastasis. Therefore a PSMA based theranostics approach for detection, staging, treatment, and follow-up of PC would appear to be highly valuable to achieve personalized PC treatment. Creative Commons Attribution License

Engineering integrated digital circuits with allosteric ribozymes for scaling up molecular computation and diagnostics.

PubMed

Penchovsky, Robert

2012-10-19

Here we describe molecular implementations of integrated digital circuits, including a three-input AND logic gate, a two-input multiplexer, and 1-to-2 decoder using allosteric ribozymes. Furthermore, we demonstrate a multiplexer-decoder circuit. The ribozymes are designed to seek-and-destroy specific RNAs with a certain length by a fully computerized procedure. The algorithm can accurately predict one base substitution that alters the ribozyme's logic function. The ability to sense the length of RNA molecules enables single ribozymes to be used as platforms for multiple interactions. These ribozymes can work as integrated circuits with the functionality of up to five logic gates. The ribozyme design is universal since the allosteric and substrate domains can be altered to sense different RNAs. In addition, the ribozymes can specifically cleave RNA molecules with triplet-repeat expansions observed in genetic disorders such as oculopharyngeal muscular dystrophy. Therefore, the designer ribozymes can be employed for scaling up computing and diagnostic networks in the fields of molecular computing and diagnostics and RNA synthetic biology.

Set Shifting Training with Categorization Tasks

PubMed Central

Soveri, Anna; Waris, Otto; Laine, Matti

2013-01-01

The very few cognitive training studies targeting an important executive function, set shifting, have reported performance improvements that also generalized to untrained tasks. The present randomized controlled trial extends set shifting training research by comparing previously used cued training with uncued training. A computerized adaptation of the Wisconsin Card Sorting Test was utilized as the training task in a pretest-posttest experimental design involving three groups of university students. One group received uncued training (n = 14), another received cued training (n = 14) and the control group (n = 14) only participated in pre- and posttests. The uncued training group showed posttraining performance increases on their training task, but neither training group showed statistically significant transfer effects. Nevertheless, comparison of effect sizes for transfer effects indicated that our results did not differ significantly from the previous studies. Our results suggest that the cognitive effects of computerized set shifting training are mostly task-specific, and would preclude any robust generalization effects with this training. PMID:24324717

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.

Characterizing Decision-Analysis Performances of Risk Prediction Models Using ADAPT Curves.

PubMed

Lee, Wen-Chung; Wu, Yun-Chun

2016-01-01

The area under the receiver operating characteristic curve is a widely used index to characterize the performance of diagnostic tests and prediction models. However, the index does not explicitly acknowledge the utilities of risk predictions. Moreover, for most clinical settings, what counts is whether a prediction model can guide therapeutic decisions in a way that improves patient outcomes, rather than to simply update probabilities.Based on decision theory, the authors propose an alternative index, the "average deviation about the probability threshold" (ADAPT).An ADAPT curve (a plot of ADAPT value against the probability threshold) neatly characterizes the decision-analysis performances of a risk prediction model.Several prediction models can be compared for their ADAPT values at a chosen probability threshold, for a range of plausible threshold values, or for the whole ADAPT curves. This should greatly facilitate the selection of diagnostic tests and prediction models.

Early prosthetic aortic valve infection identified with the use of positron emission tomography in a patient with lead endocarditis.

PubMed

Amraoui, Sana; Tlili, Ghoufrane; Sohal, Manav; Bordenave, Laurence; Bordachar, Pierre

2016-12-01

18-Fluorodeoxyglucose positron emission tomography/computerized tomography (FDG PET/CT) scanning has recently been proposed as a diagnostic tool for lead endocarditis (LE). FDG PET/CT might be also useful to localize associated septic emboli in patients with LE. We report an interesting case of a LE patient with a prosthetic aortic valve in whom a trans-esophageal echocardiogram did not show associated aortic endocarditis. FDG PET/CT revealed prosthetic aortic valve infection. A second TEE performed 2 weeks after identified aortic vegetation. A longer duration of antimicrobial therapy with serial follow-up echocardiography was initiated. There was also increased uptake in the sigmoid colon, corresponding to focal polyps resected during a colonoscopy. FDG PET/CT scanning seems to be highly sensitive for prosthetic aortic valve endocarditis diagnosis. This promising diagnostic tool may be beneficial in LE patients, by identifying septic emboli and potential sites of pathogen entry.

Dual and multiple diagnosis among substance using runaway youth.

PubMed

Slesnick, Natasha; Prestopnik, Jillian

2005-01-01

Although research on runaway and homeless youth is increasing, relatively little is known about the diagnostic profile of runaway adolescents. The current study examined patterns of psychiatric dual and multiple diagnosis among a sample (N=226) of treatment-engaged substance-abusing youth (ages 13 to 17) who were residing at a runaway shelter. As part of a larger treatment outcome study, the youths' psychiatric status was assessed using the DSM-IV based computerized diagnostic interview schedule for children [CDISC; (1)]. The majority of the youth in our sample met criteria for dual or multiple diagnosis (60%) with many having more than one substance-use diagnosis (56%). The severity of mental-health and substance-use problems in this sample of substance-abusing runaways suggests the need for continued development of comprehensive services. The range and intensity of diagnoses seen indicates a need for greater focus on treatment development and strategies to address their multiple areas of risk.

Multiparametric ultrasound in the detection of prostate cancer: a systematic review.

PubMed

Postema, Arnoud; Mischi, Massimo; de la Rosette, Jean; Wijkstra, Hessel

2015-11-01

To investigate the advances and clinical results of the different ultrasound modalities and the progress in combining them into multiparametric UltraSound (mpUS). A systematic literature search on mpUS and the different ultrasound modalities included: greyscale ultrasound, computerized transrectal ultrasound, Doppler and power Doppler techniques, dynamic contrast-enhanced ultrasound and (shear wave) elastography. Limited research available on combining ultrasound modalities has presented improvement in diagnostic performance. The data of two studies suggest that even adding a lower performing ultrasound modality to a better performing modality using crude methods can already improve the sensitivity by 13-51 %. The different modalities detect different tumours. No study has tried to combine ultrasound modalities employing a system similar to the PIRADS system used for mpMRI or more advanced classifying algorithms. Available evidence confirms that combining different ultrasound modalities significantly improves diagnostic performance.

The validity and clinical utility of purging disorder.

PubMed

Keel, Pamela K; Striegel-Moore, Ruth H

2009-12-01

To review evidence of the validity and clinical utility of Purging Disorder and examine options for the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V). Articles were identified by computerized and manual searches and reviewed to address five questions about Purging Disorder: Is there "ample" literature? Is the syndrome clearly defined? Can it be measured and diagnosed reliably? Can it be differentiated from other eating disorders? Is there evidence of syndrome validity? Although empirical classification and concurrent validity studies provide emerging support for the distinctiveness of Purging Disorder, questions remain about definition, diagnostic reliability in clinical settings, and clinical utility (i.e., prognostic validity). We discuss strengths and weaknesses associated with various options for the status of Purging Disorder in the DSM-V ranging from making no changes from DSM-IV to designating Purging Disorder a diagnosis on equal footing with Anorexia Nervosa and Bulimia Nervosa.

Determining the Sensitivity of CAT-ASVAB (Computerized Adaptive Testing- Armed Services Vocational Aptitude Battery) Scores to Changes in Item Response Curves with the Medium of Administration

DTIC Science & Technology

1986-08-01

most examinees. Therefore it appears psychometrically ac - ceptable for the CAT -ASVAB project to proceed without item recalibration based on...MEMORANDUM DETERMINING THE SENSITIVITY OF CAT -ASVAB SCORES TO CHANGES IN ITEM RESPONSE CURVES WITH THE MEDIUM OF ADMINISTRATION D. R. Divgi...Subj: Center for Naval Analyses Research Memorandum 86-189 End: (1) CNA Research Memorandum 86-189, "Determining the Sensitivity of CAT -ASVAB

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.

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

Applications of computerized adaptive testing (CAT) to the assessment of headache impact.

PubMed

Ware, John E; Kosinski, Mark; Bjorner, Jakob B; Bayliss, Martha S; Batenhorst, Alice; Dahlöf, Carl G H; Tepper, Stewart; Dowson, Andrew

2003-12-01

To evaluate the feasibility of computerized adaptive testing (CAT) and the reliability and validity of CAT-based estimates of headache impact scores in comparison with 'static' surveys. Responses to the 54-item Headache Impact Test (HIT) were re-analyzed for recent headache sufferers (n = 1016) who completed telephone interviews during the National Survey of Headache Impact (NSHI). Item response theory (IRT) calibrations and the computerized dynamic health assessment (DYNHA) software were used to simulate CAT assessments by selecting the most informative items for each person and estimating impact scores according to pre-set precision standards (CAT-HIT). Results were compared with IRT estimates based on all items (total-HIT), computerized 6-item dynamic estimates (CAT-HIT-6), and a developmental version of a 'static' 6-item form (HIT-6-D). Analyses focused on: respondent burden (survey length and administration time), score distributions ('ceiling' and 'floor' effects), reliability and standard errors, and clinical validity (diagnosis, level of severity). A random sample (n = 245) was re-assessed to test responsiveness. A second study (n = 1103) compared actual CAT surveys and an improved 'static' HIT-6 among current headache sufferers sampled on the Internet. Respondents completed measures from the first study and the generic SF-8 Health Survey; some (n = 540) were re-tested on the Internet after 2 weeks. In the first study, simulated CAT-HIT and total-HIT scores were highly correlated (r = 0.92) without 'ceiling' or 'floor' effects and with a substantial reduction (90.8%) in respondent burden. Six of the 54 items accounted for the great majority of item administrations (3603/5028, 77.6%). CAT-HIT reliability estimates were very high (0.975-0.992) in the range where 95% of respondents scored, and relative validity (RV) coefficients were high for diagnosis (RV = 0.87) and severity (RV = 0.89); patient-level classifications were accurate 91.3% for a diagnosis of migraine. For all three criteria of change, CAT-HIT scores were more responsive than all other measures. In the second study, estimates of respondent burden, item usage, reliability and clinical validity were replicated. The test-retest reliability of CAT-HIT was 0.79 and alternate forms coefficients ranged from 0.85 to 0.91. All correlations with the generic SF-8 were negative. CAT-based administrations of headache impact items achieved very large reductions in respondent burden without compromising validity for purposes of patient screening or monitoring changes in headache impact over time. IRT models and CAT-based dynamic health assessments warrant testing among patients with other conditions.

Review of Current Data Exchange Practices: Providing Descriptive Data to Assist with Building Operations Decisions

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

Livingood, W.; Stein, J.; Considine, T.

Retailers who participate in the U.S. Department of Energy Commercial Building Energy Alliances (CBEA) identified the need to enhance communication standards. The means are available to collect massive numbers of buildings operational data, but CBEA members have difficulty transforming the data into usable information and energy-saving actions. Implementing algorithms for automated fault detection and diagnostics and linking building operational data to computerized maintenance management systems are important steps in the right direction, but have limited scalability for large building portfolios because the algorithms must be configured for each building.

Magnetic resonance imaging for the ophthalmologist: A primer

PubMed Central

Simha, Arathi; Irodi, Aparna; David, Sarada

2012-01-01

Magnetic resonance imaging (MRI) and computerized tomography (CT) have added a new dimension in the diagnosis and management of ocular and orbital diseases. Although CT is more widely used, MRI is the modality of choice in select conditions and can be complimentary to CT in certain situations. The diagnostic yield is best when the ophthalmologist and radiologist work together. Ophthalmologists should be able to interpret these complex imaging modalities as better clinical correlation is then possible. In this article, we attempt to describe the basic principles of MRI and its interpretation, avoiding confusing technical terms. PMID:22824600

Dynamic, diagnostic, and pharmacological radionuclide studies of the esophagus in achalasia: correlation with manometric measurements

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

Rozen, P.; Gelfond, M.; Zaltzman, S.

1982-08-01

The esophagus was evaluated in 15 patients with achalasia by continuous gamma camera imaging following ingestion of a semi-solid meal labeled with /sup 99//sup m/Tc. The images were displayed and recorded on a simple computerized data processing/display system. Subsequent cine' mode images of esophagela emptying demonstrated abnormalities of the body of the esophagus not reflected by the manometric examination. Computer-generated time-activity curves representing specific regions of interest were better than manometry in evaluating the results of myotomy, dilatation, and drug therapy. Isosorbide dinitrate significantly improved esophageal emptying.

Evidence-based development of a diagnosis-dependent therapy planning system and its implementation in modern diagnostic software.

PubMed

Ahlers, M O; Jakstat, H A

2005-07-01

The prerequisite for structured individual therapy of craniomandibular dysfunctions is differential diagnostics. Suggestions for the structured recording of findings and their structured evaluation beyond the global diagnosis of "craniomandibular disorders" have been published. Only this structured approach enables computerization of the diagnostic process. The respective software is available for use in practice (CMDcheck for CMD screening, CMDfact for the differential diagnostics). Based on this structured diagnostics, knowledge-based therapy planning is also conceivable. The prerequisite for this would be a model of achieving consensus on the indicated forms of therapy related to the diagnosis. Therefore, a procedure for evidence-based achievement of consensus on suitable forms of therapy in CMD was developed first in multicentric cooperation, and then implemented in corresponding software. The clinical knowledge of experienced specialists was included consciously for the consensus achievement process. At the same time, anonymized mathematical statistical evaluations were used for control and objectification. Different examiners form different departments of several universities working independently of one another assigned the theoretically conceiveable therapeutic alternatives to the already published diagnostic scheme. After anonymization, the correlation of these assignments was then calculated mathematically. For achieving consensus in those cases for which no agreement initally existed, agreement was subsequently arrived at in the course of a consensus conference on the basis of literature evaluations and the discussion of clinical case examples. This consensus in turn finally served as the basis of a therapy planner implemented in the above-mentioned diagnostic software CMDfact. Contributing to quality assurance, the principles of programming this assistant as well as the interface for linking into the diagnostic software are documented and also published here.

A computational framework for converting textual clinical diagnostic criteria into the quality data model.

PubMed

Hong, Na; Li, Dingcheng; Yu, Yue; Xiu, Qiongying; Liu, Hongfang; Jiang, Guoqian

2016-10-01

Constructing standard and computable clinical diagnostic criteria is an important but challenging research field in the clinical informatics community. The Quality Data Model (QDM) is emerging as a promising information model for standardizing clinical diagnostic criteria. To develop and evaluate automated methods for converting textual clinical diagnostic criteria in a structured format using QDM. We used a clinical Natural Language Processing (NLP) tool known as cTAKES to detect sentences and annotate events in diagnostic criteria. We developed a rule-based approach for assigning the QDM datatype(s) to an individual criterion, whereas we invoked a machine learning algorithm based on the Conditional Random Fields (CRFs) for annotating attributes belonging to each particular QDM datatype. We manually developed an annotated corpus as the gold standard and used standard measures (precision, recall and f-measure) for the performance evaluation. We harvested 267 individual criteria with the datatypes of Symptom and Laboratory Test from 63 textual diagnostic criteria. We manually annotated attributes and values in 142 individual Laboratory Test criteria. The average performance of our rule-based approach was 0.84 of precision, 0.86 of recall, and 0.85 of f-measure; the performance of CRFs-based classification was 0.95 of precision, 0.88 of recall and 0.91 of f-measure. We also implemented a web-based tool that automatically translates textual Laboratory Test criteria into the QDM XML template format. The results indicated that our approaches leveraging cTAKES and CRFs are effective in facilitating diagnostic criteria annotation and classification. Our NLP-based computational framework is a feasible and useful solution in developing diagnostic criteria representation and computerization. Copyright © 2016 Elsevier Inc. All rights reserved.

Computerized screening devices and performance assessment: development of a policy towards automation. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

PubMed

Bartels, P H; Bibbo, M; Hutchinson, M L; Gahm, T; Grohs, H K; Gwi-Mak, E; Kaufman, E A; Kaufman, R H; Knight, B K; Koss, L G; Magruder, L E; Mango, L J; McCallum, S M; Melamed, M R; Peebles, A; Richart, R M; Robinowitz, M; Rosenthal, D L; Sauer, T; Schenck, U; Tanaka, N; Topalidis, T; Verhest, A P; Wertlake, P T; Wilbur, D C

1998-01-01

The extension of automation to the diagnostic assessment of clinical materials raises issues of professional responsibility, on the part of both the medical professional and designer of the device. The International Academy of Cytology (IAC) and other professional cytology societies should develop a policy towards automation in the diagnostic assessment of clinical cytologic materials. The following summarizes the discussion of the initial position statement at the International Expert Conference on Diagnostic Cytology Towards the 21st Century, Hawaii, June 1997. 1. The professional in charge of a clinical cytopathology laboratory continues to bear the ultimate medical responsibility for diagnostic decisions made at the facility, whether automated devices are involved or not. 2. The introduction of automated procedures into clinical cytology should under no circumstances lead to a lowering of standards of performance. A prime objective of any guidelines should be to ensure that an automated procedure, in principle, does not expose any patient to new risks, nor should it increase already-existing, inherent risks. 3. Automated devices should provide capabilities for the medical professional to conduct periodic tests of the appropriate performance of the device. 4. Supervisory personnel should continue visual quality control screening of a certain percentage of slides dismissed at primary screening as within normal limits (WNL), even when automated procedures are employed in the laboratory. 5. Specifications for the design of primary screening devices for the detection of cervical cancer issued by the IAC in 1984 were reaffirmed. 6. The setting of numeric performance criteria is the proper charge of regulatory agencies, which also have the power of enforcement. 7. Human expert verification of results represents the "gold standard" at this time. Performance characteristics of computerized cytology devices should be determined by adherence to defined and well-considered protocols. Manufacturers should not claim a new standard of care; this is the responsibility of the medical community and professional groups. 8. Cytology professionals should support the development of procedures that bring about an improvement in diagnostic decision making. Advances in technology should be adopted if they can help solve problems in clinical cytology. The introduction of automated procedures into diagnostic decision making should take place strictly under the supervision and with the active participation and critical evaluation by the professional cytology community. Guidelines should be developed for the communication of technical information about the performance of automated screening devices by the IAC to governmental agencies and national societies. Also, guidelines are necessary for the official communication of IAC concerns to industry, medicolegal entities and the media. Procedures and guidelines for the evaluation of studies pertaining to the performance of automated devices, performance metrics and definitions for evaluation criteria should be established.

Sliding Mode Fault Tolerant Control with Adaptive Diagnosis for Aircraft Engines

NASA Astrophysics Data System (ADS)

Xiao, Lingfei; Du, Yanbin; Hu, Jixiang; Jiang, Bin

2018-03-01

In this paper, a novel sliding mode fault tolerant control method is presented for aircraft engine systems with uncertainties and disturbances on the basis of adaptive diagnostic observer. By taking both sensors faults and actuators faults into account, the general model of aircraft engine control systems which is subjected to uncertainties and disturbances, is considered. Then, the corresponding augmented dynamic model is established in order to facilitate the fault diagnosis and fault tolerant controller design. Next, a suitable detection observer is designed to detect the faults effectively. Through creating an adaptive diagnostic observer and based on sliding mode strategy, the sliding mode fault tolerant controller is constructed. Robust stabilization is discussed and the closed-loop system can be stabilized robustly. It is also proven that the adaptive diagnostic observer output errors and the estimations of faults converge to a set exponentially, and the converge rate greater than some value which can be adjusted by choosing designable parameters properly. The simulation on a twin-shaft aircraft engine verifies the applicability of the proposed fault tolerant control method.

Investigating the Effectiveness of Classroom Diagnostic Tools

ERIC Educational Resources Information Center

Schultz, Robert K.

2012-01-01

The primary purposes of the study are to investigate what teachers experience while using the Classroom Diagnostic Tools (CDT) and to relate those experiences to the rate of growth in students' mathematics achievement. The CDT contains three components: an online computer adaptive diagnostic test, interactive web-based student reports, and…

Overview and current management of computerized adaptive testing in licensing/certification examinations.

PubMed

Seo, Dong Gi

2017-01-01

Computerized adaptive testing (CAT) has been implemented in high-stakes examinations such as the National Council Licensure Examination-Registered Nurses in the United States since 1994. Subsequently, the National Registry of Emergency Medical Technicians in the United States adopted CAT for certifying emergency medical technicians in 2007. This was done with the goal of introducing the implementation of CAT for medical health licensing examinations. Most implementations of CAT are based on item response theory, which hypothesizes that both the examinee and items have their own characteristics that do not change. There are 5 steps for implementing CAT: first, determining whether the CAT approach is feasible for a given testing program; second, establishing an item bank; third, pretesting, calibrating, and linking item parameters via statistical analysis; fourth, determining the specification for the final CAT related to the 5 components of the CAT algorithm; and finally, deploying the final CAT after specifying all the necessary components. The 5 components of the CAT algorithm are as follows: item bank, starting item, item selection rule, scoring procedure, and termination criterion. CAT management includes content balancing, item analysis, item scoring, standard setting, practice analysis, and item bank updates. Remaining issues include the cost of constructing CAT platforms and deploying the computer technology required to build an item bank. In conclusion, in order to ensure more accurate estimations of examinees' ability, CAT may be a good option for national licensing examinations. Measurement theory can support its implementation for high-stakes examinations.

New paradigm for patient-reported outcomes assessment in foot & ankle research: computerized adaptive testing.

PubMed

Hung, Man; Nickisch, Florian; Beals, Timothy C; Greene, Tom; Clegg, Daniel O; Saltzman, Charles L

2012-08-01

Accurately measuring, reporting and comparing outcomes is essential for improving health care delivery. Current challenges with available health status scales include patient fatigue, floor/ceiling effects and validity/reliability. This study compared Patient Reported Outcomes Measurement Information System (PROMIS)-based Lower Extremity Physical Function Computerized Adaptive Test (LE CAT) and two legacy scales -the Foot and Function Index (FFI) and the sport module from the Foot and Ankle Ability Measure (spFAAM) -for 287 patients scheduled for elective foot and ankle surgery. We documented the time required by patients to complete the instrument, instrument precision, and the extent to which each instrument covered the full range of physical functioning across the patient sample. Average time of test administration: 66 seconds for LE CAT, 130 seconds for spFAAM and 239 seconds for FFI. All three instruments were fairly precise at intermediate physical functioning levels (i.e., Standard Error of Measurement < 0.35), were relatively less precise at the higher trait levels and the LE CAT maintained precision in the lower range while the spFAAM and FFI's had decreased precision. The LE CAT had less floor/ceiling effects than the FFI and the spFAAM. The LE CAT showed considerable advantage compared to legacy scales for measuring patient-reported outcomes in orthopaedic patients with foot and ankle problems. A paradigm shift to broader use of PROMIS-based CATs should be considered to improve precision and reduce patient burden with patient-reported outcome measuremen foot and ankle patients.

Overview and current management of computerized adaptive testing in licensing/certification examinations

PubMed Central

2017-01-01

Computerized adaptive testing (CAT) has been implemented in high-stakes examinations such as the National Council Licensure Examination-Registered Nurses in the United States since 1994. Subsequently, the National Registry of Emergency Medical Technicians in the United States adopted CAT for certifying emergency medical technicians in 2007. This was done with the goal of introducing the implementation of CAT for medical health licensing examinations. Most implementations of CAT are based on item response theory, which hypothesizes that both the examinee and items have their own characteristics that do not change. There are 5 steps for implementing CAT: first, determining whether the CAT approach is feasible for a given testing program; second, establishing an item bank; third, pretesting, calibrating, and linking item parameters via statistical analysis; fourth, determining the specification for the final CAT related to the 5 components of the CAT algorithm; and finally, deploying the final CAT after specifying all the necessary components. The 5 components of the CAT algorithm are as follows: item bank, starting item, item selection rule, scoring procedure, and termination criterion. CAT management includes content balancing, item analysis, item scoring, standard setting, practice analysis, and item bank updates. Remaining issues include the cost of constructing CAT platforms and deploying the computer technology required to build an item bank. In conclusion, in order to ensure more accurate estimations of examinees’ ability, CAT may be a good option for national licensing examinations. Measurement theory can support its implementation for high-stakes examinations. PMID:28811394

Central adaptation to repeated galvanic vestibular stimulation: implications for pre-flight astronaut training.

PubMed

Dilda, Valentina; Morris, Tiffany R; Yungher, Don A; MacDougall, Hamish G; Moore, Steven T

2014-01-01

Healthy subjects (N = 10) were exposed to 10-min cumulative pseudorandom bilateral bipolar Galvanic vestibular stimulation (GVS) on a weekly basis for 12 weeks (120 min total exposure). During each trial subjects performed computerized dynamic posturography and eye movements were measured using digital video-oculography. Follow up tests were conducted 6 weeks and 6 months after the 12-week adaptation period. Postural performance was significantly impaired during GVS at first exposure, but recovered to baseline over a period of 7-8 weeks (70-80 min GVS exposure). This postural recovery was maintained 6 months after adaptation. In contrast, the roll vestibulo-ocular reflex response to GVS was not attenuated by repeated exposure. This suggests that GVS adaptation did not occur at the vestibular end-organs or involve changes in low-level (brainstem-mediated) vestibulo-ocular or vestibulo-spinal reflexes. Faced with unreliable vestibular input, the cerebellum reweighted sensory input to emphasize veridical extra-vestibular information, such as somatosensation, vision and visceral stretch receptors, to regain postural function. After a period of recovery subjects exhibited dual adaption and the ability to rapidly switch between the perturbed (GVS) and natural vestibular state for up to 6 months.

Adaptation of cardiovascular system stent implants.

PubMed

Ostasevicius, Vytautas; Tretsyakou-Savich, Yahor; Venslauskas, Mantas; Bertasiene, Agne; Minchenya, Vladimir; Chernoglaz, Pavel

2018-06-27

Time-consuming design and manufacturing processes are a serious disadvantage when adapting human cardiovascular implants as they cause unacceptable delays after the decision to intervene surgically has been made. An ideal cardiovascular implant should have a broad range of characteristics such as strength, viscoelasticity and blood compatibility. The present research proposes the sequence of the geometrical adaptation procedures and presents their results. The adaptation starts from the identification of a person's current health status while performing abdominal aortic aneurysm (AAA) imaging, which is a point of departure for the mathematical model of a cardiovascular implant. The computerized tomography scan shows the patient-specific geometry parameters of AAA and helps to create a model using COMSOL Multiphysics software. The initial parameters for flow simulation are taken from the results of a patient survey. The simulation results allow choosing the available shape of an implant which ensures a non-turbulent flow. These parameters are essential for the design and manufacturing of an implant prototype which should be tested experimentally for the assurance that the mathematical model is adequate to a physical one. The article gives a focused description of competences and means that are necessary to achieve the shortest possible preparation of the adapted cardiovascular implant for the surgery.

The F-SCAN system of foot pressure analysis.

PubMed

Young, C R

1993-07-01

The age of computerized gait analysis is here. There are several systems available to meet the needs of the podiatric practitioner. This author believes that the F-SCAN technology system makes a significant contribution to the practice of podiatric medicine. The system is user friendly, accurate, reproducible, and affordable. Its graphic display capabilities are colorfully attractive and easily understood. The primary focus of the F-SCAN system is that of peak pressure distribution over time. Vertical plantar pressure dispersion across the plantar surface of the foot is recorded, processed, and graphically displayed in terms of sequential gait changes. The system further allows for the manipulation of the accumulated data to present it in a more comprehensive manner. Future updates on the F-SCAN software are already close at hand and are expected to enhance the diagnostic capabilities of the system further. The four primary areas of clinical application for F-SCAN have been identified and briefly discussed. The recognition of certain biomechanical abnormalities, monitoring preorthotic and postorthotic use, evaluation of the diabetic or neuropathic foot, and presurgical and postsurgical functional examinations constitute this group. The F-SCAN system largely helps to remove some of the unavoidable guess work from essential diagnostic and therapeutic procedures. As we increase our understanding of the pathomechanics of these clinical problems, so too will we improve our management of the associated complications. Years ago, at the time when computerized gait analysis was being introduced to the podiatric profession, a frequently asked question was: What does it tell me that I don't already know or can't see by watching the patient walk?(ABSTRACT TRUNCATED AT 250 WORDS)

Project Among African-Americans to Explore Risks for Schizophrenia (PAARTNERS): Evidence for Impairment and Heritability of Neurocognitive Functioning in Families of Schizophrenia Patients

PubMed Central

Calkins, Monica E.; Tepper, Ping; Gur, Ruben C.; Ragland, J. Daniel; Klei, Lambertus; Wiener, Howard W.; Richard, Jan; Savage, Robert M.; Allen, Trina B.; O'Jile, Judith; Devlin, Bernie; Kwentus, Joseph; Aliyu, Muktar H.; Bradford, L. DiAnne; Edwards, Neil; Lyons, Paul D.; Nimgaonkar, Vishwajit L.; Santos, Alberto B.; Go, Rodney C.P.; Gur, Raquel E.

2015-01-01

Objective Neurocognitive impairments in schizophrenia are well replicated and widely regarded as candidate endophenotypes that may facilitate understanding of schizophrenia genetics and pathophysiology. The Project Among African-Americans to Explore Risks for Schizophrenia (PAARTNERS) aims to identify genes underlying liability to schizophrenia. The unprecedented size of its study group (N=1,872), made possible through use of a computerized neurocognitive battery, can help further investigation of the genetics of neurocognition. The current analysis evaluated two characteristics not fully addressed in prior research: 1) heritability of neurocognition in African American families and 2) relationship between neurocognition and psychopathology in families of African American probands with schizophrenia or schizoaffective disorder. Method Across eight data collection sites, patients with schizophrenia or schizoaffective disorder (N=610), their biological relatives (N=928), and community comparison subjects (N=334) completed a standardized diagnostic evaluation and the computerized neurocognitive battery. Performance accuracy and response time (speed) were measured separately for 10 neurocognitive domains. Results The patients with schizophrenia or schizoaffective disorder exhibited less accuracy and speed in most neurocognitive domains than their relatives both with and without other psychiatric disorders, who in turn were more impaired than comparison subjects in most domains. Estimated trait heritability after inclusion of the mean effect of diagnostic status, age, and sex revealed significant heritabilities for most neurocognitive domains, with the highest for accuracy of abstraction/ flexibility, verbal memory, face memory, spatial processing, and emotion processing and for speed of attention. Conclusions Neurocognitive functions in African American families are heritable and associated with schizophrenia. They show potential for gene-mapping studies. PMID:20194479

Fuzzy logic algorithm for quantitative tissue characterization of diffuse liver diseases from ultrasound images.

PubMed

Badawi, A M; Derbala, A S; Youssef, A M

1999-08-01

Computerized ultrasound tissue characterization has become an objective means for diagnosis of liver diseases. It is difficult to differentiate diffuse liver diseases, namely cirrhotic and fatty liver by visual inspection from the ultrasound images. The visual criteria for differentiating diffused diseases are rather confusing and highly dependent upon the sonographer's experience. This often causes a bias effects in the diagnostic procedure and limits its objectivity and reproducibility. Computerized tissue characterization to assist quantitatively the sonographer for the accurate differentiation and to minimize the degree of risk is thus justified. Fuzzy logic has emerged as one of the most active area in classification. In this paper, we present an approach that employs Fuzzy reasoning techniques to automatically differentiate diffuse liver diseases using numerical quantitative features measured from the ultrasound images. Fuzzy rules were generated from over 140 cases consisting of normal, fatty, and cirrhotic livers. The input to the fuzzy system is an eight dimensional vector of feature values: the mean gray level (MGL), the percentile 10%, the contrast (CON), the angular second moment (ASM), the entropy (ENT), the correlation (COR), the attenuation (ATTEN) and the speckle separation. The output of the fuzzy system is one of the three categories: cirrhosis, fatty or normal. The steps done for differentiating the pathologies are data acquisition and feature extraction, dividing the input spaces of the measured quantitative data into fuzzy sets. Based on the expert knowledge, the fuzzy rules are generated and applied using the fuzzy inference procedures to determine the pathology. Different membership functions are developed for the input spaces. This approach has resulted in very good sensitivities and specificity for classifying diffused liver pathologies. This classification technique can be used in the diagnostic process, together with the history information, laboratory, clinical and pathological examinations.

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

Assessing Disease Class-Specific Diagnostic Ability: A Practical Adaptive Test Approach.

ERIC Educational Resources Information Center

Papa, Frank J.; Schumacker, Randall E.

Measures of the robustness of disease class-specific diagnostic concepts could play a central role in training programs designed to assure the development of diagnostic competence. In the pilot study, the authors used disease/sign-symptom conditional probability estimates, Monte Carlo procedures, and artificial intelligence (AI) tools to create…

Diagnostic value of 3D time-of-flight MRA in trigeminal neuralgia.

PubMed

Cai, Jing; Xin, Zhen-Xue; Zhang, Yu-Qiang; Sun, Jie; Lu, Ji-Liang; Xie, Feng

2015-08-01

The aim of this meta-analysis was to evaluate the diagnostic value of 3D time-of-flight magnetic resonance angiography (3D-TOF-MRA) in trigeminal neuralgia (TN). Relevant studies were identified by computerized database searches supplemented by manual search strategies. The studies were included in accordance with stringent inclusion and exclusion criteria. Following a multistep screening process, high quality studies related to the diagnostic value of 3D-TOF-MRA in TN were selected for meta-analysis. Statistical analyses were conducted using Statistical Analysis Software (version 8.2; SAS Institute, Cary, NC, USA) and Meta Disc (version 1.4; Unit of Clinical Biostatistics, Ramon y Cajal Hospital, Madrid, Spain). For the present meta-analysis, we initially retrieved 95 studies from database searches. A total of 13 studies were eventually enrolled containing a combined total of 1084 TN patients. The meta-analysis results demonstrated that the sensitivity and specificity of the diagnostic value of 3D-TOF-MRA in TN were 95% (95% confidence interval [CI] 0.93-0.96) and 77% (95% CI 0.66-0.86), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 2.72 (95% CI 1.81-4.09) and 0.08 (95% CI 0.06-0.12), respectively. The pooled diagnostic odds ratio of 3D-TOF-MRA in TN was 52.92 (95% CI 26.39-106.11), and the corresponding area under the curve in the summary receiver operating characteristic curve based on the 3D-TOF-MRA diagnostic image of observers was 0.9695 (standard error 0.0165). Our results suggest that 3D-TOF-MRA has excellent sensitivity and specificity as a diagnostic tool for TN, and that it can accurately identify neurovascular compression in TN patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

A computerized, self-administered questionnaire to evaluate posttraumatic stress among firefighters after the World Trade Center collapse.

PubMed

Corrigan, Malachy; McWilliams, Rita; Kelly, Kerry J; Niles, Justin; Cammarata, Claire; Jones, Kristina; Wartenberg, Daniel; Hallman, William K; Kipen, Howard M; Glass, Lara; Schorr, John K; Feirstein, Ira; Prezant, David J

2009-11-01

We sought to determine the frequency of psychological symptoms and elevated posttraumatic stress disorder (PTSD) risk among New York City firefighters after the World Trade Center (WTC) attack and whether these measures were associated with Counseling Services Unit (CSU) use or mental health-related medical leave over the first 2.5 years after the attack. Shortly after the WTC attack, a computerized, binary-response screening questionnaire was administered. Exposure assessment included WTC arrival time and "loss of a co-worker while working at the collapse." We determined elevated PTSD risk using thresholds derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and a sensitivity-specificity analysis. Of 8487 participants, 76% reported at least 1 symptom, 1016 (12%) met criteria for elevated PTSD risk, and 2389 (28%) self-referred to the CSU, a 5-fold increase from before the attack. Higher scores were associated with CSU use, functional job impairment, and mental health-related medical leave. Exposure-response gradients were significant for all outcomes. This screening tool effectively identified elevated PTSD risk, higher CSU use, and functional impairment among firefighters and therefore may be useful in allocating scarce postdisaster mental health resources.

Objective research on tongue manifestation of patients with eczema.

PubMed

Yu, Zhifeng; Zhang, Haifang; Fu, Linjie; Lu, Xiaozuo

2017-07-20

Tongue observation often depends on subjective judgment, it is necessary to establish an objective and quantifiable standard for tongue observation. To discuss the features of tongue manifestation of patients who suffered from eczema with different types and to reveal the clinical significance of the tongue images. Two hundred patients with eczema were recruited and divided into three groups according to the diagnostic criteria. Acute group had 47 patients, subacute group had 82 patients, and chronic group had 71 patients. The computerized tongue image digital analysis device was used to detect tongue parameters. The L*a*b* color model was applied to classify tongue parameters quantitatively. For parameters such as tongue color, tongue shape, color of tongue coating, and thickness or thinness of tongue coating, there was a significant difference among acute group, subacute group and chronic group (P< 0.05). For Lab values of both tongue and tongue coating, there was statistical significance among the above types of eczema (P< 0.05). Tongue images can reflect some features of eczema, and different types of eczema may be related to the changes of tongue images. The computerized tongue image digital analysis device can reflect the tongue characteristics of patients with eczema objectively.

Combining technologies: a computerized occlusal analysis system synchronized with a computerized electromyography system.

PubMed

Kerstein, Robert B

2004-04-01

Current advances in computer technologies have afforded dentists precision ways to examine occlusal contacts and muscle function. Recently, two separate computer technologies have been synchronized together, so that an operator can record their separate diagnostic data simultaneously. The two systems are: the T Scan II Occlusal Analysis System and the Biopak Electromyography Recording System. The simultaneous recording and playback capacity of these two computer systems allows the operator to analyze and correlate specific occlusal moments to specific electromyographic changes that result from these occlusal moments. This synchronization provides unparalleled evidence of the effect occlusal contact arrangement has on muscle function. Therefore, the occlusal condition of an inserted dental prosthesis or the occlusal scheme of the natural teeth (before and after corrective occlusal adjustments) can be readily evaluated, documented, and quantified for both, quality of occlusal parameters and muscle activity and the responses to the quality of the occlusal condition. This article describes their synchronization and illustrates their use in performing precision occlusal adjustment procedures on two patients: one who demonstrates occlusal disharmony while exhibiting the signs and symptoms of chronic myofascial pain dysfunction syndrome, and the other who had extensive restorative work accomplished but exhibits occlusal discomfort post-operatively.

Lessons learned: a "homeless shelter intervention" by a medical student.

PubMed

Owusu, Yasmin; Kunik, Mark; Coverdale, John; Shah, Asim; Primm, Annelle; Harris, Toi

2012-05-01

The authors explored the process of implementing a medical student-initiated program designed to provide computerized mental health screening, referral, and education in a homeless shelter. An educational program was designed to teach homeless shelter staff about psychiatric disorders and culturally-informed treatment strategies. Pre- and post-questionnaires were obtained in conjunction with the educational program involving seven volunteer shelter staff. A computerized mental health screening tool, Quick Psycho-Diagnostics Panel (QPD), was utilized to screen for the presence of nine psychiatric disorders in 19 volunteer homeless shelter residents. Shelter staffs' overall fund of knowledge improved by an average of 23% on the basis of pre-/post-questionnaires (p=0.005). Of the individuals who participated in the mental health screening, 68% screened positive for at least one psychiatric disorder and were referred for further mental health care. At the 3-month follow-up of these individuals, 46% of those referred had accessed their referral services as recommended. Medical student-initiated psychiatric outreach programs to the homeless community have the potential to reduce mental health disparities by both increasing access to mental health services and by providing education. The authors discuss educational challenges and benefits for the medical students involved in this project.

Spatial super-resolution of colored images by micro mirrors

NASA Astrophysics Data System (ADS)

Dahan, Daniel; Yaacobi, Ami; Pinsky, Ephraim; Zalevsky, Zeev

2018-06-01

In this paper, we present two methods of dealing with the geometric resolution limit of color imaging sensors. It is possible to overcome the pixel size limit by adding a digital micro-mirror device component on the intermediate image plane of an optical system, and adapting its pattern in a computerized manner before sampling each frame. The full RGB image can be reconstructed from the Bayer camera by building a dedicated optical design, or by adjusting the demosaicing process to the special format of the enhanced image.

Whale Identification

NASA Technical Reports Server (NTRS)

1991-01-01

R:BASE for DOS, a computer program developed under NASA contract, has been adapted by the National Marine Mammal Laboratory and the College of the Atlantic to provide and advanced computerized photo matching technique for identification of humpback whales. The program compares photos with stored digitized descriptions, enabling researchers to track and determine distribution and migration patterns. R:BASE is a spinoff of RIM (Relational Information Manager), which was used to store data for analyzing heat shielding tiles on the Space Shuttle Orbiter. It is now the world's second largest selling line of microcomputer database management software.

[Relevance of big data for molecular diagnostics].

PubMed

Bonin-Andresen, M; Smiljanovic, B; Stuhlmüller, B; Sörensen, T; Grützkau, A; Häupl, T

2018-04-01

Big data analysis raises the expectation that computerized algorithms may extract new knowledge from otherwise unmanageable vast data sets. What are the algorithms behind the big data discussion? In principle, high throughput technologies in molecular research already introduced big data and the development and application of analysis tools into the field of rheumatology some 15 years ago. This includes especially omics technologies, such as genomics, transcriptomics and cytomics. Some basic methods of data analysis are provided along with the technology, however, functional analysis and interpretation requires adaptation of existing or development of new software tools. For these steps, structuring and evaluating according to the biological context is extremely important and not only a mathematical problem. This aspect has to be considered much more for molecular big data than for those analyzed in health economy or epidemiology. Molecular data are structured in a first order determined by the applied technology and present quantitative characteristics that follow the principles of their biological nature. These biological dependencies have to be integrated into software solutions, which may require networks of molecular big data of the same or even different technologies in order to achieve cross-technology confirmation. More and more extensive recording of molecular processes also in individual patients are generating personal big data and require new strategies for management in order to develop data-driven individualized interpretation concepts. With this perspective in mind, translation of information derived from molecular big data will also require new specifications for education and professional competence.

Adaptation of LASCA method for diagnostics of malignant tumours in laboratory animals

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

Ul'yanov, S S; Laskavyi, V N; Glova, Alina B

The LASCA method is adapted for diagnostics of malignant neoplasms in laboratory animals. Tumours are studied in mice of Balb/c inbred line after inoculation of cells of syngeneic myeloma cell line Sp.2/0 Ag.8. The appropriateness of using the tLASCA method in tumour investigations is substantiated; its advantages in comparison with the sLASCA method are demonstrated. It is found that the most informative characteristic, indicating the presence of a tumour, is the fractal dimension of LASCA images.

Evaluating radiographers' diagnostic accuracy in screen-reading mammograms: what constitutes a quality study?

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

Debono, Josephine C, E-mail: josephine.debono@bci.org.au; Poulos, Ann E; Westmead Breast Cancer Institute, Westmead, New South Wales

The aim of this study was to first evaluate the quality of studies investigating the diagnostic accuracy of radiographers as mammogram screen-readers and then to develop an adapted tool for determining the quality of screen-reading studies. A literature search was used to identify relevant studies and a quality evaluation tool constructed by combining the criteria for quality of Whiting, Rutjes, Dinnes et al. and Brealey and Westwood. This constructed tool was then applied to the studies and subsequently adapted specifically for use in evaluating quality in studies investigating diagnostic accuracy of screen-readers. Eleven studies were identified and the constructed toolmore » applied to evaluate quality. This evaluation resulted in the identification of quality issues with the studies such as potential for bias, applicability of results, study conduct, reporting of the study and observer characteristics. An assessment of the applicability and relevance of the tool for this area of research resulted in adaptations to the criteria and the development of a tool specifically for evaluating diagnostic accuracy in screen-reading. This tool, with further refinement and rigorous validation can make a significant contribution to promoting well-designed studies in this important area of research and practice.« less

Aerophagia in children: characterization of a functional gastrointestinal disorder.

PubMed

Chitkara, D K; Bredenoord, A J; Bredenood, A J; Wang, M; Rucker, M J; Talley, N J

2005-08-01

The purpose of this study was to describe presenting symptoms, diagnostic testing, treatments and outcomes in a group of children with a diagnosis of aerophagia. A computerized diagnostic index was used to identify all children between the age of 1 and 17 years diagnosed with aerophagia at a tertiary care medical centre between 1975 and 2003. Individual medical charts were abstracted for information on the demographics, clinical features, co-morbid diagnoses, diagnostic work up and treatment of children with aerophagia. Information on presenting symptoms was also collected for a group of children who were retrospectively classified as having functional dyspepsia for comparison (n = 40). Forty-five children had a diagnosis of aerophagia. The mean duration of symptoms in children with aerophagia was 16 +/- 5 months. The most common gastrointestinal symptoms were abdominal pain, distention and frequent belching. Children with functional dyspepsia had a higher prevalence of nausea, vomiting, abdominal pain and unintentional weight loss compared to children with aerophagia (all P < 0.05). In conclusion, aerophagia is a disorder that is diagnosed in neurologically normal males and females, who can experience prolonged symptoms. Although many children with aerophagia present with upper gastrointestinal symptoms, the disorder appears to be distinct from functional dyspepsia.

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

[The laboratory of tomorrow. Particular reference to hematology].

PubMed

Cazal, P

1985-01-01

A serious prediction can only be an extrapolation of recent developments. To be exact, the development has to continue in the same direction, which is only a probability. Probable development of hematological technology: Progress in methods. Development of new labelling methods: radio-elements, antibodies. Monoclonal antibodies. Progress in equipment: Cell counters and their adaptation to routine hemograms is a certainty. From analyzers: a promise that will perhaps become reality. Coagulometers: progress still to be made. Hemagglutination detectors and their application to grouping: good achievements, but the market is too limited. Computerization and automation: What form will the computerizing take? What will the computer do? Who will the computer control? What should the automatic analyzers be? Two current levels. Relationships between the automatic analysers and the computer. rapidity, fidelity and above all, reliability. Memory: large capacity and easy access. Disadvantages: conservatism and technical dependency. How can they be avoided? Development of the environment: Laboratory input: outside supplies, electricity, reagents, consumables. Samples and their identification. Output: distribution of results and communication problems. Centralization or decentralization? What will tomorrow's laboratory be? 3 hypotheses: optimistic, pessimistic, and balanced.

Sparsely Ionizing Diagnostic and Natural Background Radiations are Likely Preventing Cancer and Other Genomic-Instability-Associated Diseases

PubMed Central

Scott, Bobby R.; Di Palma, Jennifer

2007-01-01

Routine diagnostic X-rays (e.g., chest X-rays, mammograms, computed tomography scans) and routine diagnostic nuclear medicine procedures using sparsely ionizing radiation forms (e.g., beta and gamma radiations) stimulate the removal of precancerous neo-plastically transformed and other genomically unstable cells from the body (medical radiation hormesis). The indicated radiation hormesis arises because radiation doses above an individual-specific stochastic threshold activate a system of cooperative protective processes that include high-fidelity DNA repair/apoptosis (presumed p53 related), an auxiliary apoptosis process (PAM process) that is presumed p53-independent, and stimulated immunity. These forms of induced protection are called adapted protection because they are associated with the radiation adaptive response. Diagnostic X-ray sources, other sources of sparsely ionizing radiation used in nuclear medicine diagnostic procedures, as well as radioisotope-labeled immunoglobulins could be used in conjunction with apopto-sis-sensitizing agents (e.g., the natural phenolic compound resveratrol) in curing existing cancer via low-dose fractionated or low-dose, low-dose-rate therapy (therapeutic radiation hormesis). Evidence is provided to support the existence of both therapeutic (curing existing cancer) and medical (cancer prevention) radiation hormesis. Evidence is also provided demonstrating that exposure to environmental sparsely ionizing radiations, such as gamma rays, protect from cancer occurrence and the occurrence of other diseases via inducing adapted protection (environmental radiation hormesis). PMID:18648608

Development of an Adaptable Display and Diagnostic System for the Evaluation of Tropical Cyclone Forecasts

NASA Astrophysics Data System (ADS)

Kucera, P. A.; Burek, T.; Halley-Gotway, J.

2015-12-01

NCAR's Joint Numerical Testbed Program (JNTP) focuses on the evaluation of experimental forecasts of tropical cyclones (TCs) with the goal of developing new research tools and diagnostic evaluation methods that can be transitioned to operations. Recent activities include the development of new TC forecast verification methods and the development of an adaptable TC display and diagnostic system. The next generation display and diagnostic system is being developed to support evaluation needs of the U.S. National Hurricane Center (NHC) and broader TC research community. The new hurricane display and diagnostic capabilities allow forecasters and research scientists to more deeply examine the performance of operational and experimental models. The system is built upon modern and flexible technology that includes OpenLayers Mapping tools that are platform independent. The forecast track and intensity along with associated observed track information are stored in an efficient MySQL database. The system provides easy-to-use interactive display system, and provides diagnostic tools to examine forecast track stratified by intensity. Consensus forecasts can be computed and displayed interactively. The system is designed to display information for both real-time and for historical TC cyclones. The display configurations are easily adaptable to meet the needs of the end-user preferences. Ongoing enhancements include improving capabilities for stratification and evaluation of historical best tracks, development and implementation of additional methods to stratify and compute consensus hurricane track and intensity forecasts, and improved graphical display tools. The display is also being enhanced to incorporate gridded forecast, satellite, and sea surface temperature fields. The presentation will provide an overview of the display and diagnostic system development and demonstration of the current capabilities.

Neurocognitive findings in compulsive sexual behavior: a preliminary study.

PubMed

Derbyshire, Katherine L; Grant, Jon E

2015-06-01

BACKGROUND AND AIMS :Compulsive sexual behavior (CSB) is a common behavior affecting 3-6% of the population, characterized by repetitive and intrusive sexual urges or behaviors that typically cause negative social and emotional consequences. For this small pilot study on neurological data, we compared 13 individuals with CSB and gender- matched healthy controls on diagnostic assessments and computerized neurocognitive testing. No significant differences were found between the groups. These data contradict a common hypothesis that CSB is cognitively different from those without psychiatric comorbidities as well as previous research on impulse control disorders and alcohol dependence. Further research is needed to better understand and classify CSB based on these findings.

Course and outcome of somatoform disorders in non-referred adolescents.

PubMed

Essau, Cecilia A

2007-01-01

The author examined the course of somatoform disorders in non-referred adolescents. Somatoform disorders were coded from DSM-IV criteria, using the computerized Munich (Germany) version of the Composite International Diagnostic Interview. About 35.9% of the adolescents with somatoform disorders at the index investigation continued to have the same disorders at the follow-up investigation: 26.7% had anxiety, 17.1% had depression, 22% had substance-use disorders, and 53.7% had no psychiatric disorders. Factors related to the chronicity of somatoform disorders included gender, comorbid depressive disorders, parental psychiatric disorders, and negative life events. Somatoform disorders showed a heterogeneous pattern of course.

[Imaging of temporo-mandibular disorders].

PubMed

Felizardo, Rufino; Foucart, Jean-Michel; Pizelle, Christophe

2012-03-01

Dominated for years by standard films (tomographic mouth open and mouth closed X-rays, MRI) radiographs of the TMJ have progressively lost their usefulness to diagnosticians who have progressively increased their reliance on well codified clinical examinations, which suffice in a great majority of cases.The indications for and diagnostic worth of radiological studies and the impact they have on the management of TMJ disorders are today quite low especially when the high cost of procedures like MRI, computerized tomography, and CBCT is taken into account. In this article we discuss the various maladies that dentists might encounter and the situations in which radiological examinations are still indicated. © EDP Sciences, SFODF, 2012.

Practical measures of cognitive function and promotion of their performance in the context of research.

PubMed

Gujski, Mariusz; Juńczyk, Tomasz; Pinkas, Jaroslaw; Owoc, Alfred; Bojar, Iwona

2016-09-01

The aging of the population generates a number of very interesting research questions in the fields of medicine, psychology, sociology, demography, and many others. One of the issues subject to both intensive research by scientists and exploration by practitioners is associated with cognitive functions. The article presents current knowledge regarding practical actions in the field of promoting cognitive function using diagnostic programmes and training using modern technologies. An important aspect presented in this study is also related to the welfare of the maintenance or improvement of cognitive function. Information and communication technologies will contribute to the dissemination of computerized cognitive training, also personalized.

MO-AB-210-00: Diagnostic Ultrasound Imaging Quality Control and High Intensity Focused Ultrasound Therapy Hands-On Workshop

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

NONE

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrationsmore » with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS080949 and Philips Healthcare research grant C32.« less

Noninvasive Medical Diagnostics & Treatment Using Ultrasonics

NASA Technical Reports Server (NTRS)

Bar-Cohen, Y.; Siegel, R.; Grandia, W.

1998-01-01

In parallel to the industrial application of NDE to flaw detection and material property determination, the medical community has succesfully adapted such methods to the noninvasaive diagnostics and treatment of many conditions and disorders of the human body.

The clinical chemistry and immunology of long-duration space missions.

PubMed

Wu, A H; Taylor, G R; Graham, G A; McKinley, B A

1993-01-01

Clinical laboratory diagnostic capabilities are needed to guide health and medical care of astronauts during long-duration space missions. Clinical laboratory diagnostics, as defined for medical care on Earth, offers a model for space capabilities. Interpretation of laboratory results for health and medical care of humans in space requires knowledge of specific physiological adaptations that occur, primarily because of the absence of gravity, and how these adaptations affect reference values. Limited data from American and Russian missions have indicated shifts of intra- and extracellular fluids and electrolytes, changes in hormone concentrations related to fluid shifts and stresses of the missions, reductions in bone and muscle mass, and a blunting of the cellular immune response. These changes could increase susceptibility to space-related illness or injury during a mission and after return to Earth. We review physiological adaptations and the risk of medical problems that occur during space missions. We describe the need for laboratory diagnostics as a part of health and medical care in space, and how this capability might be delivered.

[The compensatory and adaptive e reactions of the respiratory system as the diagnostic criteria for histological studies in forensic medicine].

PubMed

Os'minkin, V A; Os'minkin, S V

2015-01-01

The objective of the present study was to characterize the structural changes in the respiratory system equivalent to its compensatory and adaptive reactions in response to the action of various factors under the normal and extreme conditions for the assessment of the possibility of their further use for the purpose of diagnostics. The action of various factors on the tissues obtained from the human respiratory system for forensic medical examination was shown to cause combined histomorphological alterations that refelect a wide spectrum of protective, compensatory, and adaptive reactions. The range of potential morphological and functional changes in the respiratory system depends on the characteristics of endogenous and exogenous factors influencing the organism of the affected subjects. It is concluded that the use of the proposed approach to morphological diagnostics may be useful for the development of criteria for the evaluation of various variants of tanatogenesis with their objective confirmation by mathematical models.

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.

The design and evaluation of a peripheral device for use with a computer game intended for children with motor disabilities.

PubMed

Scardovelli, Terigi Augusto; Frère, Annie France

2015-01-01

Many children with motor impairments cannot participate in games and jokes that contribute to their formation. Currently, commercial computer games there are few options of software and sufficiently flexible access devices to meet the needs of this group of children. In this study, a peripheral access device and a 3D computerized game that do not require the actions of dragging, clicking, or activating various keys at the same time were developed. The peripheral access device consists of a webcam and a supervisory system that processes the images. This method provides a field of action that can be adjusted to various types of motor impairments. To analyze the sensitivity of the commands, a virtual course was developed using the scenario of a path of straight lines and curves. A volunteer with good ability in virtual games performed a short training with the virtual course and, after 15min of training, obtained similar results with a standard keyboard and the adapted peripheral device. A 3D game in the Amazon forest was developed using the Blender 3D tool. This free software was used to model the characters and scenarios. To evaluate the usability of the 3D game, the game was tested by 20 volunteers without motor impairments (group A) and 13 volunteers with severe motor limitations of the upper limbs (group B). All the volunteers (group A and B) could easily execute all the actions of the game using the adapted peripheral device. The majority positively evaluated the questions of usability and expressed their satisfaction. The computerized game coupled to the adapted device will offer the option of leisure and learning to people with severe motor impairments who previously lacked this possibility. It also provided equality in this activity to all the users. Copyright © 2014. Published by Elsevier Ireland Ltd.

The Manchester Uveitis Clinic: the first 3000 patients--epidemiology and casemix.

PubMed

Jones, Nicholas P

2015-04-01

To demonstrate the demography, anatomical, and diagnostic classification of patients with uveitis attending the Manchester Uveitis Clinic (MUC), a specialist uveitis clinic in the northwest of England, UK. Retrospective retrieval of data on a computerized database incorporating all new referrals to MUC from 1991 to 2013. A total of 3000 new patients with uveitis were seen during a 22-year period. The anatomical types seen were anterior 46%; intermediate 11.1%; posterior 21.8%; and panuveitis 21.1%. The most common diagnoses were Fuchs heterochromic uveitis (11.5% of total), sarcoidosis-related uveitis (9.7%), idiopathic intermediate uveitis (7.9%), idiopathic acute anterior uveitis (7.0%), and toxoplasmosis (6.9%). Syphilis and tuberculosis-associated uveitis increased markedly in frequency during the study period. The uveitis casemix in this region reflects a predominantly white Caucasian population in a temperate country, but with changing characteristics owing to increasing immigration, enhanced diagnostic techniques, changes in referral pattern, and some real changes in disease incidence.

Autoadaptivity and optimization in distributed ECG interpretation.

PubMed

Augustyniak, Piotr

2010-03-01

This paper addresses principal issues of the ECG interpretation adaptivity in a distributed surveillance network. In the age of pervasive access to wireless digital communication, distributed biosignal interpretation networks may not only optimally solve difficult medical cases, but also adapt the data acquisition, interpretation, and transmission to the variable patient's status and availability of technical resources. The background of such adaptivity is the innovative use of results from the automatic ECG analysis to the seamless remote modification of the interpreting software. Since the medical relevance of issued diagnostic data depends on the patient's status, the interpretation adaptivity implies the flexibility of report content and frequency. Proposed solutions are based on the research on human experts behavior, procedures reliability, and usage statistics. Despite the limited scale of our prototype client-server application, the tests yielded very promising results: the transmission channel occupation was reduced by 2.6 to 5.6 times comparing to the rigid reporting mode and the improvement of the remotely computed diagnostic outcome was achieved in case of over 80% of software adaptation attempts.

The Relation between Intellectual Functioning and Adaptive Behavior in the Diagnosis of Intellectual Disability

ERIC Educational Resources Information Center

Tassé, Marc J.; Luckasson, Ruth; Schalock, Robert L.

2016-01-01

Intellectual disability originates during the developmental period and is characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. In this article, we present a brief history of the diagnostic criteria of intellectual disability for both…

Item response theory, computerized adaptive testing, and PROMIS: assessment of physical function.

PubMed

Fries, James F; Witter, James; Rose, Matthias; Cella, David; Khanna, Dinesh; Morgan-DeWitt, Esi

2014-01-01

Patient-reported outcome (PRO) questionnaires record health information directly from research participants because observers may not accurately represent the patient perspective. Patient-reported Outcomes Measurement Information System (PROMIS) is a US National Institutes of Health cooperative group charged with bringing PRO to a new level of precision and standardization across diseases by item development and use of item response theory (IRT). With IRT methods, improved items are calibrated on an underlying concept to form an item bank for a "domain" such as physical function (PF). The most informative items can be combined to construct efficient "instruments" such as 10-item or 20-item PF static forms. Each item is calibrated on the basis of the probability that a given person will respond at a given level, and the ability of the item to discriminate people from one another. Tailored forms may cover any desired level of the domain being measured. Computerized adaptive testing (CAT) selects the best items to sharpen the estimate of a person's functional ability, based on prior responses to earlier questions. PROMIS item banks have been improved with experience from several thousand items, and are calibrated on over 21,000 respondents. In areas tested to date, PROMIS PF instruments are superior or equal to Health Assessment Questionnaire and Medical Outcome Study Short Form-36 Survey legacy instruments in clarity, translatability, patient importance, reliability, and sensitivity to change. Precise measures, such as PROMIS, efficiently incorporate patient self-report of health into research, potentially reducing research cost by lowering sample size requirements. The advent of routine IRT applications has the potential to transform PRO measurement.

Item usage in a multidimensional computerized adaptive test (MCAT) measuring health-related quality of life.

PubMed

Paap, Muirne C S; Kroeze, Karel A; Terwee, Caroline B; van der Palen, Job; Veldkamp, Bernard P

2017-11-01

Examining item usage is an important step in evaluating the performance of a computerized adaptive test (CAT). We study item usage for a newly developed multidimensional CAT which draws items from three PROMIS domains, as well as a disease-specific one. The multidimensional item bank used in the current study contained 194 items from four domains: the PROMIS domains fatigue, physical function, and ability to participate in social roles and activities, and a disease-specific domain (the COPD-SIB). The item bank was calibrated using the multidimensional graded response model and data of 795 patients with chronic obstructive pulmonary disease. To evaluate the item usage rates of all individual items in our item bank, CAT simulations were performed on responses generated based on a multivariate uniform distribution. The outcome variables included active bank size and item overuse (usage rate larger than the expected item usage rate). For average θ-values, the overall active bank size was 9-10%; this number quickly increased as θ-values became more extreme. For values of -2 and +2, the overall active bank size equaled 39-40%. There was 78% overlap between overused items and active bank size for average θ-values. For more extreme θ-values, the overused items made up a much smaller part of the active bank size: here the overlap was only 35%. Our results strengthen the claim that relatively short item banks may suffice when using polytomous items (and no content constraints/exposure control mechanisms), especially when using MCAT.

Psychometric evaluation of an item bank for computerized adaptive testing of the EORTC QLQ-C30 cognitive functioning dimension in cancer patients.

PubMed

Dirven, Linda; Groenvold, Mogens; Taphoorn, Martin J B; Conroy, Thierry; Tomaszewski, Krzysztof A; Young, Teresa; Petersen, Morten Aa

2017-11-01

The European Organisation of Research and Treatment of Cancer (EORTC) Quality of Life Group is developing computerized adaptive testing (CAT) versions of all EORTC Quality of Life Questionnaire (QLQ-C30) scales with the aim to enhance measurement precision. Here we present the results on the field-testing and psychometric evaluation of the item bank for cognitive functioning (CF). In previous phases (I-III), 44 candidate items were developed measuring CF in cancer patients. In phase IV, these items were psychometrically evaluated in a large sample of international cancer patients. This evaluation included an assessment of dimensionality, fit to the item response theory (IRT) model, differential item functioning (DIF), and measurement properties. A total of 1030 cancer patients completed the 44 candidate items on CF. Of these, 34 items could be included in a unidimensional IRT model, showing an acceptable fit. Although several items showed DIF, these had a negligible impact on CF estimation. Measurement precision of the item bank was much higher than the two original QLQ-C30 CF items alone, across the whole continuum. Moreover, CAT measurement may on average reduce study sample sizes with about 35-40% compared to the original QLQ-C30 CF scale, without loss of power. A CF item bank for CAT measurement consisting of 34 items was established, applicable to various cancer patients across countries. This CAT measurement system will facilitate precise and efficient assessment of HRQOL of cancer patients, without loss of comparability of results.

A new computerized adaptive test advancing the measurement of health-related quality of life (HRQoL) in children: the Kids-CAT.

PubMed

Devine, J; Otto, C; Rose, M; Barthel, D; Fischer, F; Mühlan, H; Mülhan, H; Nolte, S; Schmidt, S; Ottova-Jordan, V; Ravens-Sieberer, U

2015-04-01

Assessing health-related quality of life (HRQoL) via Computerized Adaptive Tests (CAT) provides greater measurement precision coupled with a lower test burden compared to conventional tests. Currently, there are no European pediatric HRQoL CATs available. This manuscript aims at describing the development of a HRQoL CAT for children and adolescents: the Kids-CAT, which was developed based on the established KIDSCREEN-27 HRQoL domain structure. The Kids-CAT was developed combining classical test theory and item response theory methods and using large archival data of European KIDSCREEN norm studies (n = 10,577-19,580). Methods were applied in line with the US PROMIS project. Item bank development included the investigation of unidimensionality, local independence, exploration of Differential Item Functioning (DIF), evaluation of Item Response Curves (IRCs), estimation and norming of item parameters as well as first CAT simulations. The Kids-CAT was successfully built covering five item banks (with 26-46 items each) to measure physical well-being, psychological well-being, parent relations, social support and peers, and school well-being. The Kids-CAT item banks proved excellent psychometric properties: high content validity, unidimensionality, local independence, low DIF, and model conform IRCs. In CAT simulations, seven items were needed to achieve a measurement precision between .8 and .9 (reliability). It has a child-friendly design, is easy accessible online and gives immediate feedback reports of scores. The Kids-CAT has the potential to advance pediatric HRQoL measurement by making it less burdensome and enhancing the patient-doctor communication.

Comparing species decisions in a dichotomous choice task: adjusting task parameters improves performance in monkeys.

PubMed

Prétôt, Laurent; Bshary, Redouan; Brosnan, Sarah F

2016-07-01

In comparative psychology, both similarities and differences among species are studied to better understand the evolution of their behavior. To do so, we first test species in tasks using similar procedures, but if differences are found, it is important to determine their underlying cause(s) (e.g., are they due to ecology, cognitive ability, an artifact of the study, and/or some other factor?). In our previous work, primates performed unexpectedly poorly on an apparently simple two-choice discrimination task based on the natural behavior of cleaner fish, while the fish did quite well. In this task, if the subjects first chose one of the options (ephemeral) they received both food items, but if they chose the other (permanent) option first, the ephemeral option disappeared. Here, we test several proposed explanations for primates' relatively poorer performance. In Study 1, we used a computerized paradigm that differed from the previous test by removing interaction with human experimenters, which may be distracting, and providing a more standardized testing environment. In Study 2, we adapted the computerized paradigm from Study 1 to be more relevant to primate ecology. Monkeys' overall performance in these adapted tasks matched the performance of the fish in the original study, showing that with the appropriate modifications they can solve the task. We discuss these results in light of comparative research, which requires balancing procedural similarity with considerations of how the details of the task or the context may influence how different species perceive and solve tasks differently.

Validity and reliability of the Diagnostic Adaptive Behaviour Scale.

PubMed

Tassé, M J; Schalock, R L; Balboni, G; Spreat, S; Navas, P

2016-01-01

The Diagnostic Adaptive Behaviour Scale (DABS) is a new standardised adaptive behaviour measure that provides information for evaluating limitations in adaptive behaviour for the purpose of determining a diagnosis of intellectual disability. This article presents validity evidence and reliability data for the DABS. Validity evidence was based on comparing DABS scores with scores obtained on the Vineland Adaptive Behaviour Scale, second edition. The stability of the test scores was measured using a test and retest, and inter-rater reliability was assessed by computing the inter-respondent concordance. The DABS convergent validity coefficients ranged from 0.70 to 0.84, while the test-retest reliability coefficients ranged from 0.78 to 0.95, and the inter-rater concordance as measured by intraclass correlation coefficients ranged from 0.61 to 0.87. All obtained validity and reliability indicators were strong and comparable with the validity and reliability coefficients of the most commonly used adaptive behaviour instruments. These results and the advantages of the DABS for clinician and researcher use are discussed. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Contrast Dose and Radiation Dose Reduction in Abdominal Enhanced Computerized Tomography Scans with Single-phase Dual-energy Spectral Computerized Tomography Mode for Children with Solid Tumors

PubMed Central

Yu, Tong; Gao, Jun; Liu, Zhi-Min; Zhang, Qi-Feng; Liu, Yong; Jiang, Ling; Peng, Yun

2017-01-01

Background: Contrast dose and radiation dose reduction in computerized tomography (CT) scan for adult has been explored successfully, but there have been few studies on the application of low-concentration contrast in pediatric abdominal CT examinations. This was a feasibility study on the use of dual-energy spectral imaging and adaptive statistical iterative reconstruction (ASiR) for the reduction of radiation dose and iodine contrast dose in pediatric abdominal CT patients with solid tumors. Methods: Forty-five patients with solid tumors who had initial CT (Group B) and follow-up CT (Group A) after chemotherapy were enrolled. The initial diagnostic CT scan (Group B) was performed using the standard two-phase enhanced CT with 320 mgI/ml concentration contrast, and the follow-up scan (Group A) was performed using a single-phase enhanced CT at 45 s after the beginning of the 270 mgI/ml contrast injection using spectral mode. Forty percent ASiR was used for the images in Group B and monochromatic images with energy levels ≥60 keV in Group A. In addition, filtered back-projection (FBP) reconstruction was used for monochromatic images <60 keV in Group A. The total radiation dose, total iodine load, contrast injection speed, and maximum injection pressure were compared between the two groups. The 40 keV and 60 keV spectral CT images of Group A were compared with the images of Group B to evaluate overall image quality. Results: The total radiation dose, total iodine load, injection speed, and maximum injection pressure for Group A were decreased by 19%, 15%, 34.4%, and 18.3%, respectively. The optimal energy level in spectral CT for displaying the abdominal vessels was 40 keV. At this level, the CT values in the abdominal aorta and its three branches, the portal vein and its two branches, and the inferior vena cava were all greater than 340 hounsfield unit (HU). The abdominal organs of Groups A and B had similar degrees of absolute and relative enhancement (t = 0.36 and −1.716 for liver, −0.153 and −1.546 for pancreas, and 2.427 and 0.866 for renal cortex, all P > 0.05). Signal-to-noise ratio of the abdominal organs was significantly lower in Group A than in Group B (t = −8.11 for liver, −7.83 for pancreas, and −5.38 for renal cortex, all P < 0.05). However, the subjective scores for the 40 keV (FBP) and 60 keV (40% ASiR) spectral CT images determined by two radiologists were all >3, indicating clinically acceptable image quality. Conclusions: Single-phase, dual-energy spectral CT used for children with solid abdominal tumors can reduce contrast dose and radiation dose and can also maintain clinically acceptable image quality. PMID:28345547

Contrast Dose and Radiation Dose Reduction in Abdominal Enhanced Computerized Tomography Scans with Single-phase Dual-energy Spectral Computerized Tomography Mode for Children with Solid Tumors.

PubMed

Yu, Tong; Gao, Jun; Liu, Zhi-Min; Zhang, Qi-Feng; Liu, Yong; Jiang, Ling; Peng, Yun

2017-04-05

Contrast dose and radiation dose reduction in computerized tomography (CT) scan for adult has been explored successfully, but there have been few studies on the application of low-concentration contrast in pediatric abdominal CT examinations. This was a feasibility study on the use of dual-energy spectral imaging and adaptive statistical iterative reconstruction (ASiR) for the reduction of radiation dose and iodine contrast dose in pediatric abdominal CT patients with solid tumors. Forty-five patients with solid tumors who had initial CT (Group B) and follow-up CT (Group A) after chemotherapy were enrolled. The initial diagnostic CT scan (Group B) was performed using the standard two-phase enhanced CT with 320 mgI/ml concentration contrast, and the follow-up scan (Group A) was performed using a single-phase enhanced CT at 45 s after the beginning of the 270 mgI/ml contrast injection using spectral mode. Forty percent ASiR was used for the images in Group B and monochromatic images with energy levels ≥60 keV in Group A. In addition, filtered back-projection (FBP) reconstruction was used for monochromatic images <60 keV in Group A. The total radiation dose, total iodine load, contrast injection speed, and maximum injection pressure were compared between the two groups. The 40 keV and 60 keV spectral CT images of Group A were compared with the images of Group B to evaluate overall image quality. The total radiation dose, total iodine load, injection speed, and maximum injection pressure for Group A were decreased by 19%, 15%, 34.4%, and 18.3%, respectively. The optimal energy level in spectral CT for displaying the abdominal vessels was 40 keV. At this level, the CT values in the abdominal aorta and its three branches, the portal vein and its two branches, and the inferior vena cava were all greater than 340 hounsfield unit (HU). The abdominal organs of Groups A and B had similar degrees of absolute and relative enhancement (t = 0.36 and -1.716 for liver, -0.153 and -1.546 for pancreas, and 2.427 and 0.866 for renal cortex, all P> 0.05). Signal-to-noise ratio of the abdominal organs was significantly lower in Group A than in Group B (t = -8.11 for liver, -7.83 for pancreas, and -5.38 for renal cortex, all P< 0.05). However, the subjective scores for the 40 keV (FBP) and 60 keV (40% ASiR) spectral CT images determined by two radiologists were all> 3, indicating clinically acceptable image quality. Single-phase, dual-energy spectral CT used for children with solid abdominal tumors can reduce contrast dose and radiation dose and can also maintain clinically acceptable image quality.

Cutting efficiency of instruments with different movements: a comparative study.

PubMed

Tocci, Luigi; Plotino, Gianluca; Al-Sudani, Dina; Rubini, Alessio Giansiracusa; Sannino, Gianpaolo; Piasecki, Lucila; Putortì, Ermanno; Testarelli, Luca; Gambarini, Gianluca

2015-01-01

The aim of the present study was to evaluate the cutting efficiency of two new reciprocating instruments, Twisted File Adaptive and WaveOne Primary. 10 new Twisted File Adaptive (TF Adaptive) (SybronEndo, Glendora, CA, USA) and 10 new WaveOne Primary files (Dentsply Maillefer, Ballaigues, Switzerland) were activated using a torque-controlled motor, respectively TFA motor (SybronEndo, Glendora, CA, USA) and Silver motor (VDW, Munich, Germany). The device used for the cutting test consisted on a mainframe to which a mobile plastic support for the hand-piece is connected and a stainless-steel block containing a Plexiglas block against which the cutting efficiency of the instruments was tested. The length of the block cut in 1 minute was measured in a computerized program with a precision of 0.1 mm. Mean and standard deviations of each group were calculated and data were statistically analyzed with one-way ANOVA and Bonferroni t test (P < 0.05). TF Adaptive displayed significantly greater maximum penetration depth than WaveOne Primary (P < 0.05). In fact, TF Adaptive instruments (Group 1) cut the Plexiglas block to a mean depth of 8.7 (SD 0.5) mm, while WaveOne Primary instruments cut the Plexiglas block to a mean depth of 6.4 (SD 0.3) mm. Twisted File Adaptive instruments demonstrated statistically higher cutting efficiency than WaveOne instruments.

Cutting Efficiency of Instruments with Different Movements: a Comparative Study

PubMed Central

Plotino, Gianluca; Al-Sudani, Dina; Rubini, Alessio Giansiracusa; Sannino, Gianpaolo; Piasecki, Lucila; Putortì, Ermanno; Testarelli, Luca; Gambarini, Gianluca

2015-01-01

ABSTRACT Objectives The aim of the present study was to evaluate the cutting efficiency of two new reciprocating instruments, Twisted File Adaptive and WaveOne Primary. Material and Methods 10 new Twisted File Adaptive (TF Adaptive) (SybronEndo, Glendora, CA, USA) and 10 new WaveOne Primary files (Dentsply Maillefer, Ballaigues, Switzerland) were activated using a torque-controlled motor, respectively TFA motor (SybronEndo, Glendora, CA, USA) and Silver motor (VDW, Munich, Germany). The device used for the cutting test consisted on a mainframe to which a mobile plastic support for the hand-piece is connected and a stainless-steel block containing a Plexiglas block against which the cutting efficiency of the instruments was tested. The length of the block cut in 1 minute was measured in a computerized program with a precision of 0.1 mm. Mean and standard deviations of each group were calculated and data were statistically analyzed with one-way ANOVA and Bonferroni t test (P < 0.05). Results TF Adaptive displayed significantly greater maximum penetration depth than WaveOne Primary (P < 0.05). In fact, TF Adaptive instruments (Group 1) cut the Plexiglas block to a mean depth of 8.7 (SD 0.5) mm, while WaveOne Primary instruments cut the Plexiglas block to a mean depth of 6.4 (SD 0.3) mm. Conclusions Twisted File Adaptive instruments demonstrated statistically higher cutting efficiency than WaveOne instruments. PMID:25937877

MO-AB-210-03: Workshop [Advancements in high intensity focused ultrasound

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

Lu, Z.

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrationsmore » with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS080949 and Philips Healthcare research grant C32.« less

MO-AB-210-02: Ultrasound Imaging and Therapy-Hands On Workshop

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

Sammet, S.

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrationsmore » with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS080949 and Philips Healthcare research grant C32.« less

MO-AB-210-01: Ultrasound Imaging and Therapy-Hands On Workshop

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

Lu, Z.

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrationsmore » with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS080949 and Philips Healthcare research grant C32.« less

Effect of enhanced information, values clarification, and removal of financial barriers on use of prenatal genetic testing: a randomized clinical trial.

PubMed

Kuppermann, Miriam; Pena, Sherri; Bishop, Judith T; Nakagawa, Sanae; Gregorich, Steven E; Sit, Anita; Vargas, Juan; Caughey, Aaron B; Sykes, Susan; Pierce, Lasha; Norton, Mary E

2014-09-24

Prenatal genetic testing guidelines recommend providing patients with detailed information to allow informed, preference-based screening and diagnostic testing decisions. The effect of implementing these guidelines is not well understood. To analyze the effect of a decision-support guide and elimination of financial barriers to testing on use of prenatal genetic testing and decision making among pregnant women of varying literacy and numeracy levels. Randomized trial conducted from 2010-2013 at prenatal clinics at 3 county hospitals, 1 community clinic, 1 academic center, and 3 medical centers of an integrated health care delivery system in the San Francisco Bay area. Participants were English- or Spanish-speaking women who had not yet undergone screening or diagnostic testing and remained pregnant at 11 weeks' gestation (n = 710). A computerized, interactive decision-support guide and access to prenatal testing with no out-of-pocket expense (n = 357) or usual care as per current guidelines (n = 353). The primary outcome was invasive diagnostic test use, obtained via medical record review. Secondary outcomes included testing strategy undergone, and knowledge about testing, risk comprehension, and decisional conflict and regret at 24 to 36 weeks' gestation. Women randomized to the intervention group, compared with those randomized to the control group, were less likely to have invasive diagnostic testing (5.9% vs 12.3%; odds ratio [OR], 0.45 [95% CI, 0.25-0.80]) and more likely to forgo testing altogether (25.6% vs 20.4%; OR, 3.30 [95% CI, 1.43-7.64], reference group screening followed by invasive testing). Women randomized to the intervention group also had higher knowledge scores (9.4 vs 8.6 on a 15-point scale; mean group difference, 0.82 [95% CI, 0.34-1.31]) and were more likely to correctly estimate the amniocentesis-related miscarriage risk (73.8% vs 59.0%; OR, 1.95 [95% CI, 1.39-2.75]) and their estimated age-adjusted chance of carrying a fetus with trisomy 21 (58.7% vs 46.1%; OR, 1.66 [95% CI, 1.22-2.28]). Significant differences did not emerge in decisional conflict or regret. Full implementation of prenatal testing guidelines using a computerized, interactive decision-support guide in the absence of financial barriers to testing resulted in less test use and more informed choices. If validated in additional populations, this approach may result in more informed and preference-based prenatal testing decision making and fewer women undergoing testing. clinicaltrials.gov Identifier: NCT00505596.

The Use of the Autism Diagnostic Interview-Revised with a Latino Population of Adolescents and Adults with Autism

ERIC Educational Resources Information Center

Magana, Sandy; Smith, Leann E.

2013-01-01

Research shows that Latinos are less likely to be diagnosed with autism than their non-Latino counterparts. One factor that may contribute to these differences is that autism diagnostic instruments have not been adapted for the Latino population. The present study compared scores from the Autism Diagnostic Interview-Revised for two groups: 48…

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...

Great Ears: Low-Frequency Sensitivity Correlates in Land and Marine Leviathans.

PubMed

Ketten, D R; Arruda, J; Cramer, S; Yamato, M

2016-01-01

Like elephants, baleen whales produce low-frequency (LF) and even infrasonic (IF) signals, suggesting they may be particularly susceptible to underwater anthropogenic sound impacts. Analyses of computerized tomography scans and histologies of the ears in five baleen whale and two elephant species revealed that LF thresholds correlate with basilar membrane thickness/width and cochlear radii ratios. These factors are consistent with high-mass, low-stiffness membranes and broad spiral curvatures, suggesting that Mysticeti and Proboscidea evolved common inner ear adaptations over similar time scales for processing IF/LF sounds despite operating in different media.

Ontology-based automatic generation of computerized cognitive exercises.

PubMed

Leonardi, Giorgio; Panzarasa, Silvia; Quaglini, Silvana

2011-01-01

Computer-based approaches can add great value to the traditional paper-based approaches for cognitive rehabilitation. The management of a big amount of stimuli and the use of multimedia features permits to improve the patient's involvement and to reuse and recombine them to create new exercises, whose difficulty level should be adapted to the patient's performance. This work proposes an ontological organization of the stimuli, to support the automatic generation of new exercises, tailored on the patient's preferences and skills, and its integration into a commercial cognitive rehabilitation tool. The possibilities offered by this approach are presented with the help of real examples.

Acceptability of a Web-based Community Reinforcement Approach for Substance Use Disorders with Treatment-seeking American Indians/Alaska Natives

PubMed Central

Campbell, Aimee N. C.; Turrigiano, Eva; Moore, Michelle; Miele, Gloria M.; Rieckmann, Traci; Hu, Mei-Chen; Kropp, Frankie; Ringor-Carty, Roz; Nunes, Edward V.

2014-01-01

Longstanding disparities in substance use disorders and treatment access exist among American Indian/Alaska Natives (AI/AN). Computerized, web-delivered interventions have potential to increase access to quality treatment and improve patient outcomes. Prior research supports the efficacy of a web-based version (Therapeutic Education System [TES]) of the Community Reinforcement Approach to improve outcomes among outpatients in substance abuse treatment; however, TES has not been tested among AI/AN. The results from this mixed method acceptability study among a diverse sample of urban AI/AN (N=40) show that TES was acceptable across seven indices (range=7.8 to 9.4 on 0 to 10 scales with 10 indicating highest acceptability). Qualitative interviews suggest adaptation specific to AI/AN culture could improve adoption. Additional efforts to adapt TES and conduct a larger effectiveness study are warranted. PMID:25022913

Acceptability of a web-based community reinforcement approach for substance use disorders with treatment-seeking American Indians/Alaska Natives.

PubMed

Campbell, Aimee N C; Turrigiano, Eva; Moore, Michelle; Miele, Gloria M; Rieckmann, Traci; Hu, Mei-Chen; Kropp, Frankie; Ringor-Carty, Roz; Nunes, Edward V

2015-05-01

Longstanding disparities in substance use disorders and treatment access exist among American Indians/Alaska Natives (AI/AN). Computerized, web-delivered interventions have potential to increase access to quality treatment and improve patient outcomes. Prior research supports the efficacy of a web-based version [therapeutic education system (TES)] of the community reinforcement approach to improve outcomes among outpatients in substance abuse treatment; however, TES has not been tested among AI/AN. The results from this mixed method acceptability study among a diverse sample of urban AI/AN (N = 40) show that TES was acceptable across seven indices (range 7.8-9.4 on 0-10 scales with 10 indicating highest acceptability). Qualitative interviews suggest adaptation specific to AI/AN culture could improve adoption. Additional efforts to adapt TES and conduct a larger effectiveness study are warranted.

Design and implementation of a hospital information system for the Palestine Red Crescent Society in Lebanon.

PubMed

Rossi, L; Materia, E; Hourani, A; Yousef, H; Racalbuto, V; Venier, C; Osman, M

2009-01-01

A case-mix hospital information system was designed and implemented in Palestine Red Crescent Society hospitals in order to support the network of Palestinian hospitals in Lebanon and to improve the health of refugees in the country. The system is based on routine collection of essential administrative and clinical data for each episode of hospitalization, relying on internationally accepted diagnostic codes. It is a computerized, user-friendly information system that is a stepping-stone towards better hospital management and evaluation of quality of care. It is also a useful model for the development of hospital information systems in Lebanon and in the Near East.

Data Mining on Distributed Medical Databases: Recent Trends and Future Directions

NASA Astrophysics Data System (ADS)

Atilgan, Yasemin; Dogan, Firat

As computerization in healthcare services increase, the amount of available digital data is growing at an unprecedented rate and as a result healthcare organizations are much more able to store data than to extract knowledge from it. Today the major challenge is to transform these data into useful information and knowledge. It is important for healthcare organizations to use stored data to improve quality while reducing cost. This paper first investigates the data mining applications on centralized medical databases, and how they are used for diagnostic and population health, then introduces distributed databases. The integration needs and issues of distributed medical databases are described. Finally the paper focuses on data mining studies on distributed medical databases.

Sickle cell-induced ischemic colitis.

PubMed

Stewart, Camille L; Ménard, Geraldine E

2009-07-01

Sickle cell-induced ischemic colitis is a rare yet potentially fatal complication of sickle cell anemia. Frequent pain crises with heavy analgesia may obscure and prolong this important diagnosis. Our patient was a 29-year-old female with sickle cell disease who was admitted with left lower quadrant abdominal pain. A diagnostic workup, including chemistries, complete blood count, blood cultures, chest x-ray, computerized tomography scanning, and colonoscopy, was performed to identify the etiology of her symptoms. This case highlights the importance of differentiating simple pain crisis from more serious and life-threatening ischemic bowel. A review of the literature compares this case to others reported and gives a method for diagnosing and treating this complication of sickle cell disease.

Acoustic heart. Interpretation of Phonocardiograms by computer

NASA Astrophysics Data System (ADS)

Granados, J.; Tavera, F.; Velázquez, J. M.; López, G.; Hernández, R. T.; Morales, A.

2015-01-01

In the field of Cardiology have been identified several heart pathologies associated with problems in valves and narrowing in veins. Each case is associated with a specific sound emitted by the heart, detected in cardiac auscultation. On the Phonocardiogram, sound is visualized as a peak in the wave. In the Optics Laboratory of the Universidad Autonoma Metropolitana - Azcapotzalco, we have developed a simulation of the Phonocardiograms of heart sounds associated with the main pathologies and a computer program of recognition of images that allows you to quickly identify the respective diseases. This is a novel way to analyze Phonocardiograms and the foundation for building a portable non-invasive cardiac diagnostic computerized analyzer system.

Heidelberg Retina Tomography Analysis in Optic Disks with Anatomic Particularities

PubMed Central

Alexandrescu, C; Pascu, R; Ilinca, R; Popescu, V; Ciuluvica, R; Voinea, L; Celea, C

2010-01-01

Due to its objectivity, reproducibility and predictive value confirmed by many large scale statistical clinical studies, Heidelberg Retina Tomography has become one of the most used computerized image analysis of the optic disc in glaucoma. It has been signaled, though, that the diagnostic value of Moorfieds Regression Analyses and Glaucoma Probability Score decreases when analyzing optic discs with extreme sizes. The number of false positive results increases in cases of megalopapilllae and the number of false negative results increases in cases of small size optic discs. The present paper is a review of the aspects one should take into account when analyzing a HRT result of an optic disc with anatomic particularities. PMID:21254731

Advance in diagnosis of female genital tract tumor with laser fluorescence

NASA Astrophysics Data System (ADS)

Ding, Ai-Hua; Tseng, Quen; Lian, Shao-Hui

1998-11-01

In order to improve the diagnostic accuracy of malignant tumors with laser fluorescence, in 1996, our group successfully created the computerized laser fluorescence spectrograph type II with more reliable images shown overshadowing the naked eye method before 74 cases of female genital tract diseases had been examined by the LFS II resulting in 10 positive cases which were also proven pathologically as malignant tumors, without nay false negative, 3 cases presented suspicious positive but all were proven pathologically as non-tumors lesions, the false positive rate was 4 percent. Our work showed that the method of LFS II can provide a more rapid and accurate diagnosis for the clinical malignant tumors.

Direct Reading of Bona Fide Barcode Assays for Diagnostics with Smartphone Apps.

PubMed

Wong, Jessica X H; Li, Xiaochun; Liu, Frank S F; Yu, Hua-Zhong

2015-06-30

The desire to develop new point-of-care (POC) diagnostic tools has led to the adaptation of smartphones to tackle limitations in state-of-the-art instrumentation and centralized laboratory facilities. Today's smartphones possess the computer-like ability to image and process data using mobile apps; barcode scanners are one such type of apps. We demonstrate herein that a diagnostic assay can be performed by patterning immunoassay strips in a bona fide barcode format such that after target binding and signal enhancement, the linear barcode can be read directly with a standard smartphone app. Quantitative analysis can then be performed based on the grayscale intensities with a customized mobile app. This novel diagnostic concept has been validated for a real-world application, i.e., the detection of human chorionic gonadotropin, a pregnancy hormone. With the possibility of multiplex detection, the barcode assay protocol promises to boost POC diagnosis research by the direct adaptation of mobile devices and apps.

Direct Reading of Bona Fide Barcode Assays for Diagnostics with Smartphone Apps

PubMed Central

Wong, Jessica X. H.; Li, Xiaochun; Liu, Frank S. F.; Yu, Hua-Zhong

2015-01-01

The desire to develop new point-of-care (POC) diagnostic tools has led to the adaptation of smartphones to tackle limitations in state-of-the-art instrumentation and centralized laboratory facilities. Today’s smartphones possess the computer-like ability to image and process data using mobile apps; barcode scanners are one such type of apps. We demonstrate herein that a diagnostic assay can be performed by patterning immunoassay strips in a bona fide barcode format such that after target binding and signal enhancement, the linear barcode can be read directly with a standard smartphone app. Quantitative analysis can then be performed based on the grayscale intensities with a customized mobile app. This novel diagnostic concept has been validated for a real-world application, i.e., the detection of human chorionic gonadotropin, a pregnancy hormone. With the possibility of multiplex detection, the barcode assay protocol promises to boost POC diagnosis research by the direct adaptation of mobile devices and apps. PMID:26122608

Refining a complex diagnostic construct: subtyping Dysthymia with the Shedler-Westen Assessment Procedure-II.

PubMed

Huprich, Steven K; Defife, Jared; Westen, Drew

2014-01-01

We sought to determine whether meaningful subtypes of Dysthymic patients could be identified when grouping them by similar personality profiles. A random, national sample of psychiatrists and clinical psychologists (n=1201) described a randomly selected current patient with personality pathology using the descriptors in the Shedler-Westen Assessment Procedure-II (SWAP-II), completed assessments of patients' adaptive functioning, and provided DSM-IV Axis I and II diagnoses. We applied Q-factor cluster analyses to those patients diagnosed with Dysthymic Disorder. Four clusters were identified-High Functioning, Anxious/Dysphoric, Emotionally Dysregulated, and Narcissistic. These factor scores corresponded with a priori hypotheses regarding diagnostic comorbidity and level of adaptive functioning. We compared these groups to diagnostic constructs described and empirically identified in the past literature. The results converge with past and current ideas about the ways in which chronic depression and personality are related and offer an enhanced means by which to understand a heterogeneous diagnostic category that is empirically grounded and clinically useful. © 2013 Published by Elsevier B.V.

Direct Reading of Bona Fide Barcode Assays for Diagnostics with Smartphone Apps

NASA Astrophysics Data System (ADS)

Wong, Jessica X. H.; Li, Xiaochun; Liu, Frank S. F.; Yu, Hua-Zhong

2015-06-01

The desire to develop new point-of-care (POC) diagnostic tools has led to the adaptation of smartphones to tackle limitations in state-of-the-art instrumentation and centralized laboratory facilities. Today’s smartphones possess the computer-like ability to image and process data using mobile apps; barcode scanners are one such type of apps. We demonstrate herein that a diagnostic assay can be performed by patterning immunoassay strips in a bona fide barcode format such that after target binding and signal enhancement, the linear barcode can be read directly with a standard smartphone app. Quantitative analysis can then be performed based on the grayscale intensities with a customized mobile app. This novel diagnostic concept has been validated for a real-world application, i.e., the detection of human chorionic gonadotropin, a pregnancy hormone. With the possibility of multiplex detection, the barcode assay protocol promises to boost POC diagnosis research by the direct adaptation of mobile devices and apps.

Interest level in 2-year-olds with autism spectrum disorder predicts rate of verbal, nonverbal, and adaptive skill acquisition.

PubMed

Klintwall, Lars; Macari, Suzanne; Eikeseth, Svein; Chawarska, Katarzyna

2015-11-01

Recent studies have suggested that skill acquisition rates for children with autism spectrum disorders receiving early interventions can be predicted by child motivation. We examined whether level of interest during an Autism Diagnostic Observation Schedule assessment at 2 years predicts subsequent rates of verbal, nonverbal, and adaptive skill acquisition to the age of 3 years. A total of 70 toddlers with autism spectrum disorder, mean age of 21.9 months, were scored using Interest Level Scoring for Autism, quantifying toddlers' interest in toys, social routines, and activities that could serve as reinforcers in an intervention. Adaptive level and mental age were measured concurrently (Time 1) and again after a mean of 16.3 months of treatment (Time 2). Interest Level Scoring for Autism score, Autism Diagnostic Observation Schedule score, adaptive age equivalent, verbal and nonverbal mental age, and intensity of intervention were entered into regression models to predict rates of skill acquisition. Interest level at Time 1 predicted subsequent acquisition rate of adaptive skills (R(2) = 0.36) and verbal mental age (R(2) = 0.30), above and beyond the effects of Time 1 verbal and nonverbal mental ages and Autism Diagnostic Observation Schedule scores. Interest level at Time 1 also contributed (R(2) = 0.30), with treatment intensity, to variance in development of nonverbal mental age. © The Author(s) 2014.

A Computerized, Self-Administered Questionnaire to Evaluate Posttraumatic Stress Among Firefighters After the World Trade Center Collapse

PubMed Central

Corrigan, Malachy; McWilliams, Rita; Kelly, Kerry J.; Niles, Justin; Cammarata, Claire; Jones, Kristina; Wartenberg, Daniel; Hallman, William K.; Kipen, Howard M.; Glass, Lara; Schorr, John K.; Feirstein, Ira

2009-01-01

Objectives. We sought to determine the frequency of psychological symptoms and elevated posttraumatic stress disorder (PTSD) risk among New York City firefighters after the World Trade Center (WTC) attack and whether these measures were associated with Counseling Services Unit (CSU) use or mental health–related medical leave over the first 2.5 years after the attack. Methods. Shortly after the WTC attack, a computerized, binary-response screening questionnaire was administered. Exposure assessment included WTC arrival time and “loss of a co-worker while working at the collapse.” We determined elevated PTSD risk using thresholds derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and a sensitivity-specificity analysis. Results. Of 8487 participants, 76% reported at least 1 symptom, 1016 (12%) met criteria for elevated PTSD risk, and 2389 (28%) self-referred to the CSU, a 5-fold increase from before the attack. Higher scores were associated with CSU use, functional job impairment, and mental health–related medical leave. Exposure–response gradients were significant for all outcomes. Conclusions. This screening tool effectively identified elevated PTSD risk, higher CSU use, and functional impairment among firefighters and therefore may be useful in allocating scarce postdisaster mental health resources. PMID:19890176

Computerized method to compensate for breathing body motion in dynamic chest radiographs

NASA Astrophysics Data System (ADS)

Matsuda, H.; Tanaka, R.; Sanada, S.

2017-03-01

Dynamic chest radiography combined with computer analysis allows quantitative analyses on pulmonary function and rib motion. The accuracy of kinematic analysis is directly linked to diagnostic accuracy, and thus body motion compensation is a major concern. Our purpose in this study was to develop a computerized method to reduce a breathing body motion in dynamic chest radiographs. Dynamic chest radiographs of 56 patients were obtained using a dynamic flat-panel detector. The images were divided into a 1 cm-square and the squares on body counter were used to detect the body motion. Velocity vector was measured using cross-correlation method on the body counter and the body motion was then determined on the basis of the summation of motion vector. The body motion was then compensated by shifting the images based on the measured vector. By using our method, the body motion was accurately detected by the order of a few pixels in clinical cases, mean 82.5% in right and left directions. In addition, our method detected slight body motion which was not able to be identified by human observations. We confirmed our method effectively worked in kinetic analysis of rib motion. The present method would be useful for the reduction of a breathing body motion in dynamic chest radiography.

Improving perceptions of empathy in patients undergoing low-yield computerized tomographic imaging in the emergency department.

PubMed

Lin, Michelle P; Probst, Marc A; Puskarich, Michael A; Dehon, Erin; Kuehl, Damon R; Wang, Ralph C; Hess, Erik P; Butler, Katie; Runyon, Michael S; Wang, Hao; Courtney, D Mark; Muckley, Brandon; Hobgood, Cherri D; Hall, Cassandra L; Kline, Jeffrey A

2018-04-01

We assessed emergency department (ED) patient perceptions of how physicians can improve their language to determine patient preferences for 11 phrases to enhance physician empathy toward the goal of reducing low-value advanced imaging. Multi-center survey study of low-risk ED patients undergoing computerized tomography (CT) scanning. We enroled 305 participants across nine sites. The statement "I have carefully considered what you told me about what brought you here today" was most frequently rated as important (88%). The statement "I have thought about the cost of your medical care to you today" was least frequently rated as important (59%). Participants preferred statements indicating physicians had considered their "vital signs and physical examination" (86%), "past medical history" (84%), and "what prior research tells me about your condition" (79%). Participants also valued statements conveying risks of testing, including potential kidney injury (78%) and radiation (77%). The majority of phrases were identified as important. Participants preferred statements conveying cognitive reassurance, medical knowledge and risks of testing. Our findings suggest specific phrases have the potential to enhance ED patient perceptions of physician empathy. Further research is needed to determine whether statements to convey empathy affect diagnostic testing rates. Copyright © 2017 Elsevier B.V. All rights reserved.

Dark adaptation during systemic hypoxia induced by chronic respiratory insufficiency.

PubMed

Thylefors, Joakim; Piitulainen, Eeva; Havelius, Ulf

2009-03-01

To investigate dark adaptation during hypoxia in patients with chronic respiratory failure. At three visits, dark adaptation was recorded by computerized dark adaptometry in 13 patients with chronic respiratory insufficiency treated by long-term oxygen therapy. At visits 1 and 3, the patients were administered their usual oxygen supplement. At visit 2, no oxygen was given. At each visit, an analysis of arterial blood gases measured pH, partial pressure of O(2) (Pao(2)), partial pressure of CO(2) (Paco(2)), base excess (BE), standard bicarbonate (HCO(3)), and arterial oxygen saturation. Pulse oximetry (POX) was also recorded. Significant differences were recorded between visits 1 and 2 and between visits 2 and 3 for Pao(2), arterial oxygen saturation, and POX; no differences were found for pH, Paco(2), BE, or HCO(3). No differences were seen between visits 1 and 3 for any of the laboratory parameters. All patients had normal and unchanged dark adaptation at the three visits. Hypoxia in chronic respiratory insufficiency was associated with normal dark adaptation, in contrast to hypoxia in healthy persons at high altitudes, which is known to produce impaired dark adaptation. The result may partly reflect the influence of Paco(2) on the lumen of choroidal and retinal vessels. At high altitudes, with hypocapnic vasoconstriction the oxygen supply to the retina is further compromised, resulting in reduced dark adaptation. The authors hypothesize that respiratory insufficiency with hypercapnia or normocapnia will have larger choroidal and retinal vessel lumens, added to by further dilation of retinal vessels during hypoxia. The tentative net effect would be preserved dark adaptation.

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.