[P.A.I.S., a personal medical information system. A comprehensive medical knowledge base]

The electronic medical knowledge data base DOPIS is a compliation of knowledge from various special fields of medicine. Using uniform nomenclature, the data are presented on demand as they would be in a book chapter. Concise updates can be performed at low cost. The primary structure of the concept is the division of medical knowledge into data banks on diagnosis, literature, medication and pharmacology, as well as so-called electronic textbooks. All data banks and electronic textbooks are connected associatively. Visual information is obtained via the image data bank connected to the diagnosis data bank and the electronic books. Moreover, DOPIS has an integrated patient findings system, as well as an image processing and archiving system with research values enabling research functions. The diagnosis and literature data banks can be modified by the user or author, or fed with their own data (a so-called Expert System Shell). For authors from special fields working on the project, an extra Medical Electronic Publishing System has been developed and made available for the electronic textbooks. The model for the knowledge data base has been developed in the field of ENT, the programme implemented and initially ENT data have been stored.

Low-cost acquisition of video images simultaneously with 240 electrophysiological signals

We developed a low-cost system for simultaneous collection and storage of physiological and video signals. The system samples and multiplexes up to 240 low-bandwidth analog channels with a camera video signal, and outputs a standard composite video signal containing analog and video data. The combined signals can be stored on video tape or can be digitized by an inexpensive framegrabber. The circuitry separates horizontal synchronizing pulses from a camera output; the pulses increment a counter that sequentially selects each electrophysiological channel on a sample-and-hold multiplexer. The intensity of each horizontal scan line from the multiplexer output represents the amplitude of one sample of each physiological channel. This signal is then multiplexed with the video signal, such that a portion of each video horizontal line represents the physiological data. The combined output is stored together, providing a means for synchronizing the two signals during analysis. The design allows easy coordination of electrophysiological events with video images from a standard video camera, avoiding the necessity for separate analog to digital circuitry for physiological and video signal storage on computer media, as well as the need for complex synchronization of the data from different media.

A noxious agents information system with state-wide participation of the public health service

With environmental health receiving increased attention by Public Health Services, there is a need to access as efficiently as possible detailed, current, and reliable information of physico-chemical, epidemiological, and toxicological as well as regulatory and legal aspects on this subject. Correspondingly, targets 19 and 35 of WHO's "Health for all 2000" strategy all for information systems to meet these demands. On this basis, a Noxious Agents Information System (NIS) was designed with three components: PC-based information workstations allowing access to portable and online databases; a dedicated modular database system providing "immediate answers" as well as support for more comprehensive information retrieval; and a cooperative network for training, information exchange, and consultation. During 1992-93, the system was introduced in Germany in the State of North Rhine-Westphalia, and 54 of 59 eligible institutions (92%) of the Public Health Service decided to participate, proving a virtually state-wide introduction to be feasible. Details are presented of the NIS concept and its realization, and limitations and future perspectives are discussed.

Constructing a dental electronic information resource (DEIR)

This paper discusses the construction of a dental electronic information resource (DEIR). Development is based on the Internet gopher client/server model. Information is organized in a series of hierarchical menus. A DEIR can be browsed by traversing the menu hierarchy or by performing keyword searches. Searches can result in a menu of found items from across the Internet. Initially, contents of the DEIR will be text files. Electronic copy will be given to an editorial board that will review submissions for conformity to publication standards. A current estimate for electronic storage costs of a DEIR is $1.25/Mb per year. There will be additional costs associated with any purchases of data (e.g. Current Contents), production of data (e.g. development time), and editorial and managerial activities. The DEIR will be accessible from any computer or terminal that can connect to the Internet. Primary user groups will be faculty, staff, and students of dental schools. However, access to the DEIR will be free, and an extensive user community will be encouraged, including practicing dentists, dental associations, public health agencies, and dental insurance companies.

Classifying and identifying servers for biomedical information retrieval

Useful retrieval of biomedical information from network information sources requires methods for organized access to those information sources. This access must be organized in terms of the information content of information sources and in terms of the discovery of the network location of those information sources. We have developed an approach to providing organized access to information sources based on a scheme of hierarchical classifiers and identifiers of the servers providing access to those information sources. This approach uses MeSH tree numbers as both classifiers and identifiers of servers. MeSH tree numbers are used to indicate the information content of servers, and also as OSF/DCE server identifiers. This allows the identity and location of a server providing access to a given information source to be determined from the information classification of that information source.

1993 market directory supplement

Computers in Healthcare offers a special supplement to the 1993 Market Directory, published in March. This addendum can be pulled out and placed in your regular Computers in Healthcare Market Directory.

User interfaces: where the rubber meets the road

Today's users face a dizzying array of interface tools from which to choose. Keyboard, mouse, voice or touchscreen, Windows, pull-down menus, point-and-click--so many choices, but which is best?

Cooperative image workstation based on explicit models of diagnostic information requirements

A medical image workstation designed to act as a cooperative dialogue partner in diagnostic radiology has been conceived, and a prototype has been made. The system can automatically select relevant information (eg, from current and previous examinations) and generate a meaningful and appropriate image arrangement on the display screen. For a number of routinely performed tasks in radiology, the users' interaction may be as simple as switching from one patient to the next. This is shown to considerably simplify and speed up radiological image access and presentation, saving the user time and effort. The cooperative system response is based on explicit (formalized and computer-accessible) models of diagnostic information requirements. These models are context dependent and take into account that diagnostic information needs vary with radiological work procedures, workstation users, and patient cases. Initial models have been acquired from expert radiologists in two European hospitals and were integrated in a cooperative workstation prototype. For the representation of models, rule-based and object-oriented techniques were applied. The rule base was designed with a distinct modular structure, separating between rule sets for general, task-dependent, and user-dependent information requirements. The installed rule-based mechanism also offers a solution for the automatic prefetching of images to avoid transmission delays in the course of diagnostic work sessions. The first part of the report reviews the objectives for the design of cooperative workstation user interfaces and explains the benefits from the users' point of view. In the second part, the acquisition, structuring, formalization, and representation of context-dependent information requirement models is described. The rule-based model is explained using examples. A layered workstation architecture consisting of model, object, and real-time layers is presented. Difficulties in the implementation of cooperative workstations are discussed that point to future research topics and standardization efforts.

Integrated human-machine intelligence in space systems

This paper presents an artificial intelligence approach to integrated human-machine intelligence in space systems. It discusses the motivations for Intelligent Assistant Systems in both nominal and abnormal situations. The problem of constructing procedures is shown to be a very critical issue. In particular, keeping procedural experience in both design and operation is critical. We suggest what artificial intelligence can offer in this direction. Some crucial problems induced by this approach are discussed in detail. Finally, we analyze the various roles that would be shared by both astronauts, ground operators, and the intelligent assistant system.

Patient cards: storage and input for medical data

The literature concerning the diffusion of innovations reveals that it is not surprising that a promising technology is confronting obstacles in its development and implementation. Alternative technologies also often appear that address the same or similar problems. Better information enables physicians to provide medical care that is less expensive and less error prone. The prescription of medications is reduced in number and cost when the prescribing physician knows the current and previous medications of the patient. The ordering of clinical tests is reduced in number and cost, and the ordering of timely retesting is more likely when physicians have before them information about previous testing of their patient. The challenge is in how the portability of the patient card and its ability to be self-contained can enhance medical practice.

Choosing and using a microcomputer for tropical epidemiology. I. Preliminary considerations

Practical considerations involved in ascertaining data processing requirements, starting with the protocol of an epidemiological study, are discussed. These include assessments of both hardware and software requirements. Throughout the paper special emphasis is placed on the problems of conducting an epidemiological study in a tropical environment, with minimal infrastructural, logistic and expert support. The requirements of a hypothetical study protocol are used as an example. This paper covers aspects of data processing required in preparing a project proposal; its sequel considers getting the project under way.

A comparison of two microcomputer-based programs for bibliographic retrieval and formatting

We evaluated two representative microcomputer-based programs for organizing a biomedical literature filing system. With a bibliography of 100 anesthetic references, a series of benchmark tests was developed to measure the speed and accuracy of typical searching, sorting, and formatting tasks. Each program performed the searching tasks accurately and at about the same speed. One program performed sorting without errors, provided the field order of the template used to enter references was unchanged. Both programs used "punctuation files," that is, templates for controlling author presentation; punctuation to suit style requirements of individual journals; and order of particular fields, such as publisher and year of publication. Each program was able to format journal, book, and chapter references correctly, but the resulting output required some refining in a word processor. Both require a major time commitment to learn and to create custom punctuation files for journals not included in the predesigned punctuation files. Once mastered, both programs are quite competent at organizing reprints and formatting journal references.

[Information storage by the French blood banking community in 1988]

This report presents the results of a survey about computerization of the French Blood Bank Community. Questionnaires issued on the behalf of the French Automation Working Party (G.A.I.T.S.) were sent, then analysed during the second term of 1988. The answers allowed us to obtain a picture of the advance of computerization in the French Blood Transfusion Services.

[Information interaction of the man-aircraft system as a problem in aviation medicine]

The importance of psychophysiological optimization of information interaction in the man--flying vehicle system is discussed having in view maintenance of good health and enhancement of efficiency and reliability of pilots. Several examples are presented that show the necessity of taking into consideration psychophysiological mechanisms, which regulate pilot's activities, in order to develop modified methods of information presentation and display.

The REF52 protein database. Methods of database construction and analysis using the QUEST system and characterizations of protein patterns from proliferating and quiescent REF52 cells

The construction and analysis of protein databases using the QUEST system is described, and the REF52 protein database is presented. A protein database provides the means to store and compare quantitative and descriptive data for up to 2000 proteins from many experiments that employ computer-analyzed two-dimensional gel electrophoresis. The QUEST system provides the tools to manage, analyze, and communicate these data. The REF52 database contains experiments with normal and transformed rat cell lines. In this report, many of the proteins on the REF52 map are identified by name, by subcellular localization, and by mode of post-translational modification. The quantitative experiments analyzed and compared here include 1) a study of the quantitative reproducibility of the analysis system, 2) a study of the clonal reproducibility of REF52 cells, 3) a study of growth-related changes in REF52 cells, and 4) a study of the effects of labeling cells for varying lengths of time. Of the proteins analyzed from REF52 cells, 10% are nuclear, 6% are phosphoproteins, and 4% are mannose-labeled glycoproteins. The mannose-labeled proteins are more prominent in patterns from quiescent cells, while the synthesis of cytoskeletal proteins is generally repressed at quiescence. A small set of proteins, selected for elevated rates of synthesis is generally repressed at quiescence. A small set of proteins, selected for elevated rates of synthesis in quiescent versus proliferating cells includes one of the tropomyosin isoforms, a myosin light chain isoform, and several prominent glycoproteins. These proteins are thought to be characteristic of the differentiated state of untransformed REF52 cells. Proteins induced early versus late after refeeding quiescent cells show very different patterns of growth regulation. These studies lay the foundations of the REF52 database and provide information needed to interpret the experiments with transformed REF52 cells, which are reported in the accompanying paper (Garrels, J., and Franza, B. R., Jr. (1989) J. Biol. Chem. 264, 5299-5312).

The QUEST system for quantitative analysis of two-dimensional gels

The strategies and methods used by the QUEST system for two-dimensional gel analysis are described, and the performance of the system is evaluated. Radiolabeled proteins, resolved on two-dimensional gels and detected using calibrated exposures to film, are quantified in units of disintegrations per minute or as a fraction of the total protein radioactivity applied to the gel. Spot quantitation and resolution of overlapping spots is performed by two-dimensional gaussian fitting. Pattern matching is carried out for groups of gels called matchsets, and within each matchset every gel is matched to every other gel. During the matching process, spots are automatically added to each pattern at positions where unmatched spots were detected in other patterns. This results in enhanced accuracy for both spot detection and for matching. The spot fitting procedure is repeated after matching. Tests show that up to 97% of spots in each pattern can be matched and that fewer than 1% of the spots are matched inconsistently. Approximately 2000 proteins are detected from typical gels. Of these 1600 are high quality spots. Tests to measure the coefficient of variation of spot quantitation versus spot quality show that the average coefficient of variation for high quality spots is 21%. The intensities of the detected proteins range from 4 to 20,000 ppm of total protein synthesis. The QUEST analysis system has been used to build a quantitative database for the proteins of normal and transformed REF52 cells, as presented in the accompanying reports (Garrels, J., and Franza, B. R., Jr. (1989) J. Biol. Chem. 264, 5283-5298, 5299-5312).

[Simplified monitoring of the drinking water supply using electronic data processing]

A documentation system was set up at the Wiesbaden Public Health Office using a personal computer to monitor individual drinking water supply plant. The data sets of the databank, the relevant recording codes and the possibilities of data recovery are presented. The conditions governing such a system are described.

[Computer-assisted documentation in dermatohistology]

We describe the hardware and software components of the computer system used for the storage and handling of data in our dermatopathological laboratory. It consists of a Siemens MX2 microcomputer operated by the Unix-based Sinix operating system and the Informix relational data base system. On the basis of a dermatopathology thesaurus with more than 200 different diagnoses, the system allows quick access to diagnostic and patient data and supplies rapid seaching and sorting facilities. In addition, the system can optimize the productivity of a laboratory like that.