A proposal for laboratory data reporting

Changes are proposed regarding the presentation of laboratory information. More definitive statements are required for reference limits, sampling variance (the Clinical Delta Range), and multivariate group analysis of large test batteries. To make this transition possible, laboratory reports should be classed so that the practicing physician has some measure of confidence in the product and its compatability with other sources. The proposal extends to the range of financial reimbursement and suggests that class standing be issued by an accrediting agency and support a structured level of payment.     

A distributed computer system for hierarchical control of a clinical vestibular laboratory

A vestibular testing laboratory with five test stations was implemented as a clinical research and testing facility, automating and adapting tests for patients with inner-ear balance disorders. These were designed to quantitate postural control, and eye movement response to rotational, caloric, and visual (optokinetic) stimuli. Microprocessors were used as satellite processors in a star network under hierarchical control of a host minicomputer. All disk storage was controlled by the host, with data transfer from satellites via parallel interfaces. Network software was designed and implemented to be under control of the host in a foreground-background structure. The practical operation of this laboratory required that technicians at each satellite test station initiate, perform, and complete an individual test independently of other tests. Examples from two test stations are presented. A 2-year data base of test results provides important multitest correlations for use in diagnostic evaluations.     

Extending the capabilities of a laboratory computer system through cooperative processing

The concept of cooperative processing within the context of a hospital or laboratory computer systems environment is introduced. Two examples that produce graphical display of laboratory data are described to illustrate cooperative processing's ability to enhance a system's functionality without placing significant additional burden on system resources.     

Multiprocessing computer system for sensory evoked potentials and EEG spectral analysis for clinical neurophysiology laboratory

A general-purpose minicomputer has been adapted and interfaced for the averaging and analysis of clinical evoked potentials and for compressed spectral arrays (CSA) of the routine EEG. In the first 2 years of operation, over 1,000 routine clinical studies of visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) have been performed with it, as well as over 100 CSAs and a variety of special and research studies. The CSA modality gives comparative frequency-domain pictures of left and right hemisphere power. An attached graphics terminal gives a live cumulative display of the EP and CSA. In addition, the system has automated and comprehensive physician-interactive graphics analysis and report generation capabilities. The reports are finalized versions used in the patient's chart, minimizing clerical efforts.     

A multivariate laboratory data analysis system: Introduction

In an era severely affected by the advanced stages of technocracy, it should not astound anyone that highly sophisticated technologies have metastasized throughout our hospital system. While simplifying many complex problems, the advantages of modern technology also create many interesting conflicts. One such dilemma surfaces as a consequence of clinical laboratories being able to produce a large number of test results in a relatively short time with a high degree of accuracy. Optimization of laboratory information must precede successful utilization of this extensive and expensive wealth of data.     

Use of a small laboratory computer for identification of the Enterobacteriaceae

A commercial time-sharing program for identification of the Enterobacteriaceae was modified to operate on a small computer. Program modification was straightforward, and system performance has been satisfactory. Computer-assisted identification of enteric organisms has been a useful instrument in quality control within the laboratory and has yielded an unexpected benefit as an educational tool. Since many hospital laboratories have access to one or more computers capable of running such a program, these benefits of computer-assisted identification can become more generally available at an attractively low cost.     

A prototype computer decision support system for the management of asthma

Asthma is a chronic disease estimated to affect 6–7% of the total UK population. In addition, a number of studies have shown that asthma has become commoner since the 1970s, especially in children. The diagnosis of asthma can be difficult and its management requires the involvement of patients in a long-term treatment plan, something which general practitioners may be unable to achieve easily in the average 10-min consultation. As a consequence, asthma is underdiagnosed and undertreated. Deaths from the disease are often avoidable with timely and sufficient use of the available medication.^(3,4) In order to support this, the British Thoracic Society (BTS) has published guidelines for asthma management based upon a stepwise approach, in which a patient is categorized as being on one of five steps according to the severity of his or her asthma. The guidelines give “rules of thumb” for deciding when the patient should move up or down the steps. The most recent version of the guidelines also included special rules for children.^(5,6) Within a recent European Community project on Advanced Informatics in Medicien (AIM), we developed a prototype decision support system for asthma management targeted at the primary care setting and based on the British Thoracic Society guidelines. This paper reports this development, and describes the further work needed on the prototype. Plans for evaluation of the knowledge bases and for future full application production are also described.     

Software for health care analysts: A modular approach

The many concerns about the cost and quality of health care suggest the need to facilitate planners' using existing data bases for utilization review, program evaluation, and technology assessment. Despite both the availability of relevant data and widespread improvements in computing power, integrated computer software to permit analyses by nonspecialists has not previously been developed. This paper discusses the features of a health policy information system which aids working with hospital discharge abstracts, medical claims, cancer registries, and vital statistics files. Analyses of small area utilization, length of stay, in-hospital mortality, and readmissions are facilitated by this package. This information system, named the Health Applications System, includes an analysis module, three information management modules, and a set of record linkage modules. The modules were developed using the macroprocessor in the fourth-generation SAS system. Features of the software and their implications for data analysis are discussed.     

A classifier system for the diagnosis of disease from routine laboratory values

LAB VALUES is an expert system that diagnoses the likelihood of various diseases, given the results of routine blood tests. Its knowledge structure employs bit maps. The similarity between a new case and a bit map in the knowledge base is calculated via a similarity score. The system was tested against published cases with definite diagnostic endpoints, and was found to perform well when compared to these published cases. System performance was not improved by incorporating disease frequency into the results.     

A microcomputer system for clinical signal analysis of vestibular laboratory

A vestibular laboratory system was implemented for clinical testing and medical examination of patients with balance disorders. Programs for analysis of postural control and eye movements were made for a microcomputer. The microcomputer system can be used by a nurse without technical education. The system has now been used for two years at the laboratory.     

医学专业留学生核医学教学体会

在医学专业留学生核医学教学过程中,通过教师自身素质的提高,对培养对象的深入了解、精心备课及采用多种教学方法,使留学生核医学教学收到较好效果。并指出,目前医学专业留学生核医学教学中存在的问题是缺乏统一的英文教材和实习指导。     

Medical data protection: A proposal for a deontology code

In this paper, a proposal for a Medical Data Protection Deontology Code in Greece is presented. Undoubtedly, this code should also be of interest to other countries. The whole effort for the composition of this code is based on what holds internationally, particularly in the EC countries, on recent data acquired from Greek sources and on the experience resulting from what is acceptable in Greece. Accordingly, policies and their influence on the protection of health data, as well as main problems related to that protection, have been considered.     

A proposed computer diagnostic system for malignant melanoma (CDSMM)

This paper describes a computer diagnostic system for malignant melanoma. The diagnostic system is a rule base system based on image analyses and works under the PC windows environment. It consists of seven modules: I/O module, Patient/Clinic database, image processing module, classification module, rule base module and system control module. In the system, the image analyses are automatically carried out, and database management is efficient and fast. Both final clinic results and immediate results from various modules such as measured features, feature pictures and history records of the disease lesion can be presented on screen or printed out from each corresponding module or from the I/O module. The system can also work as a doctor's office-based tool to aid dermatologists with details not perceivable by the human eye. Since the system operates on a general purpose PC, it can be made portable if the I/O module is disconnected.     

A personal computer database system for head and neck cancer records

The computerized database system described was initially developed in 1986 to facilitate analysis of retrospective head and neck cancer data from the Royal Adelaide Hospital Department of Otolaryngology. This has now been expanded to become an on-going patient information management system. It is based on the dBase-III-Plus database package and is implemented on an IBM XT compatible computer. The system was designed to be used by staff without specialist computer skills and is therefore largely “menu-driven.” The main functions include patient record creation, update, and retrieval, and the production of reports including graphical presentations. There is also a powerful but easy to use query facility. The system has already provided much useful epidemiological material but is now beginning to fulfill an even more important role in patient follow-up and in assisting evaluation of alternative treatment protocols.