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computerized DETECTION OF LOW-LEVEL FETAL SIGNALS IN THE MATERNAL ABDOMINAL ELECTROCARDIOGRAM

COMPUTERS IN BIOLOGY AND MEDICINE 1985年第2期15卷 81-93页

作者： SAINI, VD MAULIK, D UNIV ROCHESTER STRONG MEM HOSP DEPT ELECT ENGN ROCHESTER NY 14642 USA

This paper describes a method for detecting low-level fetal ECG signals in maternal abdominal ECG recordings. Detection is based on a systematic application of the principle that the fetal ECG contains proportionately greater high-frequency components than does the maternal ECG. Adaptive subtraction of the maternal high-frequency components is used to detect the fetal R-waves. The method is found to detect the fetal ECG even in many cases where the maternal and fetal R-waves coincide or occur in close proximity to each other. Recursive time-coherent averaging is then used to significantly improve the signal-to-noise ration of the fetal ECG to the point where the fetal P and T waves may be observed.

关键词： Abdominal electrocardiography Fetal monitoring Signal processing computerized Fetal electrocardiogram Adaptive subtraction

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computerized facial analysis for understanding constricted/blunted affect: Initial feasibility, reliability, and validity data

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SCHIZOPHRENIA RESEARCH 2013年第1-3期148卷 111-116页

作者： Cohen, Alex S. Morrison, Sean C. Callaway, Dallas A. Louisiana State Univ Dept Psychol Baton Rouge LA 70803 USA

Diminished expression is a diagnostic feature of a range of schizophrenia-spectrum disorders/conditions and is often unresponsive to treatment, is present across premorbid, first episode and various clinical states, and is considered a poor prognostic indicator. Surprisingly, little is known about diminished expression. The present study sought to address this issue by evaluating a commercially-available computerized facial analysis software for understanding diminished expressivity. We analyzed natural facial expression from a series of laboratory interaction tasks in 28 individuals with psychometric schizotypy - defined as the personality organization reflecting a putative genetic schizophrenia liability, and 26 matched controls. We evaluated (a) feasibility - defined in terms of the number of video frames recognized by the software, (b) reliability-defined in terms of correlations between facial expression variables across the three laboratory interactions, and (c) construct validity - defined in terms of relationships to clinical variables. For most subjects (similar to 80%), approximately three-quarters of the video frames were analyzable by the software;however, a minority of the videos were essentially unreadable. The facial expression variables showed excellent reliability across interaction conditions. In terms of construct validity, facial expression variables were significantly related to a measure of psychoticism, tapping subjective cognitive concerns and "first-rank" schizophrenia symptoms, but were generally not different between groups. Facial expression variables were generally not significantly related to measures of depression, anxiety, paranoia or, surprisingly, self-reported negative schizotypy. While computerized facial analysis appears to be a reliable and promising method of understanding diminished expressivity across the schizophrenia-spectrum, some work remains. Implications are discussed. (C) 2013 Elsevier B. V. All rights reserved.

关键词： Schizotypy Schizophrenia Constricted Blunted Negative Affect computerized Facial

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computerized tool and interdisciplinary care for older patients with delirium in the emergency department: a novel model in Taiwan

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AGING CLINICAL AND EXPERIMENTAL RESEARCH 2022年第12期34卷 3137-3144页

作者： Tan, Tian-Hoe Yang, Ting-Ya Chen, Yao-Mei Chung, Shiu-Yuan Liu, Hsiao-Hua Yang, Pei-Chi Kao, Pei-Hsin Peng, An-Chi Shu, Yi-Min Chu, Yu-Sheng Tsai, Kang-Ting Hsu, Chien-Chin Ho, Chung-Han Lin, Hung-Jung Huang, Chien-Cheng Chi Mei Med Ctr Dept Emergency Med 901 Zhonghua Rd Tainan 710 Taiwan Southern Taiwan Univ Sci & Technol Dept Senior Serv Tainan Taiwan Chi Mei Med Ctr Dept Nursing Tainan Taiwan Chi Mei Med Ctr Ctr Integrat Med Tainan Taiwan Chi Mei Med Ctr Dept Psychiat Tainan Taiwan Chi Mei Med Ctr Dept Pharm Tainan Taiwan Chi Mei Med Ctr Dept Internal Med Div Geriatr & Gerontol Tainan Taiwan Chi Mei Med Ctr Dept Med Res Tainan Taiwan Southern Taiwan Univ Sci & Technol Dept Informat Management Tainan Taiwan Taipei Med Univ Dept Emergency Med Taipei Taiwan Kaohsiung Med Univ Dept Emergency Med Kaohsiung Taiwan Natl Cheng Kung Univ Coll Med Dept Environm & Occupat Hlth Tainan Taiwan

Aims A computerized tool and interdisciplinary care were implemented to develop a novel model for older patients with delirium in the emergency department (ED). Methods We developed a computerized tool using a delirium triage screen and brief confusion assessment in the hospital information system, performed education for the healthcare providers, and developed a continuous care protocol. Comparisons for outcomes between pre- and post-intervention periods were performed. Results Compared with the pre-intervention period, patients in the post-intervention period had shorter hospitalization stay, lower expenditure of hospitalization, more likely to return home, lower ED revisits of <= 3 days, re-hospitalization of <= 14 days, and mortality of <= 1 month. All mentioned differences were not statistically significant. Conclusions A novel model was successfully developed for delirium management in older patients in the ED. Outcome differences were not significant;however, the result is promising, which gives us an important reference in the future.

关键词： computerized Confusion assessment method Delirium Delirium triage screen Emergency department Interdisciplinary Older

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computerized cognitive performance assessments in the Brooklyn Cognitive Impairments in Health Disparities Pilot Study

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ALZHEIMERS & DEMENTIA 2019年第11期15卷 1420-1426页

作者： Adler, Kerry Apple, Samuel Friedlander, Alison Cheng, Frank Cohen, Carl Levine, Steven R. Lucchesi, Michael Maruff, Paul Reinhardt, Michael Salmieri, Margaret Stevens, David Weingast, Sarah Gustafson, Deborah State Univ New York Downstate Hlth Sci Univ Dept Med Brooklyn NY USA CUNY Hunter Coll New York NY 10021 USA CogState Ltd New Haven CT USA State Univ New York Downstate Hlth Sci Univ Dept Psychiat Brooklyn NY USA State Univ New York Downstate Hlth Sci Univ Dept Neurol Brooklyn NY 11203 USA State Univ New York Downstate Hlth Sci Univ Dept Emergency Med Brooklyn NY USA

Introduction: Detecting cognitive impairment in diverse, health disparities communities is an urgent health care priority. Methods: The Brooklyn Cognitive Impairments in Health Disparities Pilot Study investigated quantitative aspects and liking of a computerized cognitive performance assessment, Cognigram, among individuals > 40 years in traditional and nontraditional primary care settings. Results: Cognigram was piloted in the Emergency Department, Family Medicine, and Geriatric Psychiatry clinics: 58 adults (23 men, 35 women), 67.9 +/- 9.8 years (range 43-91), completed the Cognigram and 5-item liking survey. The observed liking range was 2 to maximum score 5 (67% scored 4-5;no sex or age differences). Discussion: The Cognigram was well liked in waiting rooms of primary care settings. Assistance from a trained adult and clinic endorsement were keys to success. How the Cognigram performs in a geographically compact, population-dense global setting, such as Brooklyn with high vascular disease risk and a plethora of health disparities, is being tested. (C) 2019 The Authors. Published by Elsevier Inc.

关键词： Cognitive performance computerized Early detection Health disparities Minority health Cognigram Rapid detection Cognitive impairment Alzheimer's Disease and Related Dementias (ADRD)

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computerized CEPHALOMETRIC ORTHOGNATHIC SURGICAL SIMULATION, PREDICTION AND POSTOPERATIVE EVALUATION OF PRECISION

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INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY 1992年第4期21卷 199-203页

作者： DONATSKY, O HILLERUP, S BJORNJORGENSEN, J JACOBSEN, PU Department of Oral and Maxillofacial Surgery Copenhagen County Hospital Glostrup DK 2600 Glostrup Denmark

A new computerized, cephalometric, orthognathic surgical program (TIOPS) has been evaluated in surgical simulation, prediction and postoperative assessment of precision. Records of 10 consecutive patients admitted for orthognathic surgical treatment were analysed and prediction plans produced by computerized surgical simulation. Predicted and postoperative positions of maxilla and mandible were compared with linear and angular measurements. No statistically significant differences between predicted and postoperative positions could be demonstrated (p>0.05).

关键词： ORTHOGNATHIC SURGERY PLANNING PREDICTION computerized

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computerized endoscopic reporting is no more time-consuming than reporting with conventional methods

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EUROPEAN JOURNAL OF INTERNAL MEDICINE 2007年第4期18卷 321-325页

作者： Soekhoe, Jagdiesh K. Groenen, Marcel J. M. van Ginneken, Astrid M. Khaliq, G. Lesterhuis, Wilco van Tilburg, Antonie J. P. Ouwendijk, Rob J. Th. Ikazia Hosp Rotterdam Dept Internal Med & Gastroenterol NL-3083 AN Rotterdam Netherlands Erasmus MC Dept Gastroenterol & Hepatol NL-3015 GD Rotterdam Netherlands Erasmus MC Dept Med Informat NL-3015 GD Rotterdam Netherlands Albert Schweitzer Hosp Dept Gastroenterol & Hepatol NL-3300 AK Dordrecht Netherlands St Franciscus Gasthuis Dept Gastroenterol & Hepatol NL-3045 PM Rotterdam Netherlands

Background: Endoscopists use different methods for reporting their findings after a gastrointestinal endoscopy. These may result in handwritten, dictated, or computerized reports. The time needed to create the report is an important parameter for acceptance of the method used. It is also important to be aware of the possible advantages and disadvantages of these different methods. The aim of this study was to compare time aspects of different methods of report writing. Methods: Three different methods of report writing, i.e., handwritten, dictated, and computerized, were compared. In three different endoscopy departments, one investigator recorded the time needed to compose the report and to send it to the referring doctor. The time needed to describe different diagnoses at endoscopy was compared between the systems. Results: Handwritten reports were completed in an average time of 113 s, free text dictated reports by the endoscopist in 65 s with an additional 172 s allowed for the typist, and computerized, pre-defined reports were completed in 86 s. The incidences of abnormalities found in the reports of the different hospitals were comparable. Conclusion: To a large extent, computerized, pre-defined reports could be composed in almost the same amount of time as handwritten and dictated reports. Free text dictated and computerized, pre-defined reports are both stored in the hospital information system, but only computerized, pre-defined reports including endoscopic pictures are stored in a structured database, which makes statistical analysis possible. (c) 2007 European Federation of Internal Medicine. Published by Elsevier B.V.

关键词： gastrointestinal endoscopy database medical records systems computerized workload organization and administration time management

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computerized COORDINATION ABILITY TESTING

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ACTA NEUROLOGICA SCANDINAVICA 1990年第1期82卷 39-42页

作者： GYNTELBERG, F FLARUP, M MIKKELSEN, S PALM, T RYOM, C SUADICANI, P RIGSHOSP OCCUPAT MED CLIN BLEGDAMSVEJ DK-2100 COPENHAGEN DENMARK SKIVE HOSP DEPT ANAESTHESIOL SKIVE DENMARK

Quantitative measurements of coordination ability were carried out on 76 women with a median age of 37, range 15 to 60. Spacing control, timing control and performance speed were recorded using newly developed computerized equipment, Catsys, presented in this paper. Twenty-three subjects were re-examined 2-3 months after the first measurements. A fair or even high degree of reproducibility of tests were found. Normal values for the entire group and correlation values for the re-examined group are presented. The results from this small study implies that the Catsys may be useful, e.g., in future clinical neurological practice of diagnostics and follow up on patients, in occupational medicine for detection of neurotoxic effects of various neurotoxic substances, in evaluation of drug effects and side effects and for testing people in occupations where normal coordination skills are absoutely necessary.

关键词： computerized coordination ability reproducibility screen/nose pointing hand supination/pronation finger tapping reaction time rhythm

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Utilization of evidence-based computerized order sets in pediatrics

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INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS 2006年第7期75卷 501-512页

作者： McAlearney, Ann Scheck Chisolm, Deena Veneris, Sofia Rich, David Kelleher, Kelly Ohio State Univ Sch Publ Hlth Div Hlth Serv Management & Policy Columbus OH 43210 USA Ohio State Univ Dept Pediat Coll Med & Publ Hlth Columbus OH 43210 USA Columbus Childrens Hosp Inc Columbus OH USA Columbus Childrens Res Inst Columbus OH USA

Little is known about utilization of different evidence-based order sets within computerized physician order entry (CPOE) systems. We designed a retrospective study of resident and attending physician order set utilization to evaluate the use of three evidence-based computerized order sets (asthma, post- appendectomy care, and community-acquired pneumonia (CAP)), and examine patient and admission characteristics associated with order set utilization in pediatrics. We studied all 529 asthma patients, 277 appendectomy patients, and 210 CAP patients admitted between 1 November 2001 and 30 November 2003 during implementation of standardized order sets at a large, independent, not-for-profit pediatric institution. We analyzed order set utilization for the three order sets and tested the relationship between order set use and potential factors associated with utilization. Order set utilization varied by condition (X-2 = 339.2, p < 0.001), with the asthma order set use rate highest (88.1%), followed by appendectomy order set utilization (79.4%), and substantially lower CAP order set use (21.1%). We found that trends in order set utilization also varied by condition. Only the asthma order set showed a trend of increasing use after implementation (z = -3.02, p = 0.002). In addition, factors associated with order set utilization varied. Uses of the asthma and post-appendectomy order sets were associated with factors such as admission unit and case complexity. CAP order set utilization was associated with case complexity but not admission source. We conclude that health services organizations looking to implement computerized order sets to reduce unnecessary practice variation while promoting best practices must consider the different factors that may influence the use of each order set rather than relying on a one-size-fits-all implementation strategy. Further, issues such as the level of physician involvement in order set development and consensus around order set content ma

关键词： computerized physician order entry hospital information systems medical records systems computerized medical informatics

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Effects of a computerized decision support system on pressure ulcers and malnutrition in nursing homes for the elderly

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INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS 2011年第9期80卷 607-617页

作者： Fossum, Mariann Alexander, Gregory L. Ehnfors, Margareta Ehrenberg, Anna Univ Agder Fac Hlth & Sport Sci Ctr Caring Res So Norway N-4898 Grimstad Norway Univ Orebro Sch Hlth & Med Sci Orebro Sweden Univ Missouri Sinclair Sch Nursing Columbia MO 65211 USA Dalarna Univ Sch Hlth & Social Studies Falun Sweden

Background: computerized decision support systems (CDSSs) have been shown to help health care professionals to avoid errors and improve clinical practice and efficiency in health care. Little is known about its influence on nursing practice and outcomes for residents in nursing homes. Aim: The aim of this study was to evaluate the effects on the risk for and prevalence of pressure ulcers (PUs) and malnutrition of implementing a CDSS to improve prevention and care of PUs and also to improve nutrition in the elderly in nursing homes. Design setting and participants: The study used a quasi-experimental design with two intervention groups and one control group. A convenience sample of residents from 46 units in 15 nursing homes in rural areas in Norway was included. A total of 491 residents participated at baseline in 2007 and 480 residents at follow-up in 2009. Methods: The intervention included educational sessions in prevention of PUs and malnutrition for registered nurses (RNs) and nursing aides (NAs) in the two intervention groups. In addition, one intervention group (intervention group 1) had a CDSS integrated into the electronic healthcare record (EHR) based on two research-based risk assessment instruments: the Risk Assessment Pressure Scale (RAPS) for PU risk screening and the Mini Nutritional Assessment (MNA (R)) scale for screening nutritional status. In each participating nursing home trained RNs and NAs examined all residents who consented to participate on the RAPS and the MNA (R) scale. This examination included a skin assessment and details about PUs were collected. Results: The proportion of malnourished residents decreased significantly in intervention group 1 between the two data collection periods (2007 and 2009). No other significant effects of the CDSS on resident outcomes based on the RAPS and MNA (R) scores were found. Conclusion: CDSSs used by RNs and NAs in nursing homes are still largely unexplored. A CDSS can be incorporated into the EHR to i

关键词： computerized Decision support system Electronic health record Intervention Malnutrition Nursing home Pressure ulcer Risk assessment

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computerized adaptive testing with multiple-form structures

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APPLIED PSYCHOLOGICAL MEASUREMENT 2004年第3期28卷 147-164页

作者： Armstrong, RD Jones, DH Koppel, NB Pashley, PJ Rutgers State Univ Management Sci & Informat Syst Newark NJ 07102 USA

A multiple-form structure (MFS) is an ordered collection or network of testlets (i.e., sets of items). An examinee's progression through the network of testlets is dictated by the correctness of an examinee's answers, thereby adapting the test to his or her trait level. The collection of paths through the network yields the set of all possible test forms, allowing test specialists the opportunity to review them before they are administered. Also, limiting the exposure of an individual MFS to a specific period of time can enhance test security. This article provides an overview of methods that have been developed to generate parallel MFSs. The approach is applied to the assembly of an experimental computerized Law School Admission Test (LSAT).

关键词： computerized adaptive testing item response theory multiple-form structures automated test assembly

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