Showing papers in "Journal of Medical Informatics in 1981"
TL;DR: The creation of the data-base for the ADM system begun in 1972, rests on a high productivity type of procedure which should be explained and related procedures based on the individual theses and various studies are described as examples.
Abstract: The creation of the data-base for our ADM system begun in 1972, rests on a high productivity type of procedure which we consider should be explained. In organizing and creating our data-bank our routine procedures are: first, the capture of signs, symptoms and pathological data after the text editing of the description of diseases as prepared by medical students under the direction of the Medical Computing Service; second, the control and coding of the data by the personnel of the Medical Computing Service: third, the machine storage of the data and the automated logical controls by the Medical Computing Service; and fourth, the semantic control of the data as well as the availability of each new version.Other related procedures based on the individual theses and various studies are described as examples. From 1972 to 1980 an impressive data-bank was created holding descriptions of 2200 diseases with 22 000 signs and symptoms and 3500 bibliographies. It is now foreseen that between 1980 and 1983, the prot...
20 citations
TL;DR: A computer-based prompt system improved the frequency with which a set of routine laboratory investigations were ordered, and the number of tests not ordered fell in two studies.
Abstract: The study shows how a computer-based prompt system improved the frequency with which a set of routine laboratory investigations were ordered. In the first study the number of tests not ordered fell from 68 to 16, and in a second study from 130 to 19.L'etude montre de quelle facon un systeme informatise ameliore la frequence des prescriptions d'examens complementaires de routine. Dans la premiere etude le nombre de tests non presents passe de 68 a 16, et dans une deuxieme de 130 a 19.
18 citations
TL;DR: It is shown how the degrees of freedom content of the sample of serially correlated data is related to the correlation structure of the variable and how this affects variability of the mean in different sized samples.
Abstract: Many biomedical variables are subject to large short-term fluctuations; so, measurements of the variable requires statistical improvement. Such variables also commonly exhibit longitudinal correlation due to systematic variations contributed by underlying biological mechanisms and sometimes constituting most of the variability. This correlation structure interferes with the operation of statistical procedures, such as longitudinal averaging to improve resolution of the mean value, and manipulations designed to provide objective comparative assessments of data samples.A convenient approach to evaluating and overcoming these problems can be made through the degrees of freedom concept. It is shown how the degrees of freedom content of the sample of serially correlated data is related to the correlation structure of the variable and how this affects variability of the mean in different sized samples. The approach is confirmed both by simulation and by empirical studies on several biomedical variables: various...
9 citations
TL;DR: A community control program for hypertension was instituted during 1972 and 1977 as a major subprogramme of the North Karelia project, and a community-based hypertension register served as a central information system and ensured the continuous follow-up of the hypertensive patients.
Abstract: A community control programme for hypertension was instituted during 1972 and 1977 as a major subprogramme of the North Karelia project. The aim was to reduce the high blood-pressure levels prevalent among the whole population of the county of North Karelia. A community-based hypertension register, established according to the recommendations of the WHO, served as a central information system and ensured the continuous follow-up of the hypertensive patients. During the period May 1972 to April 1977 17 014 hypertensive subjects were registered (9-7% of the total population). The registered subjects were followed-up annually. The build-up of the registration system took two to three years, the system proved to be feasible, the percentage of non-participants during the follow-up was between 14 and 16% and the amount of missing data was insignificant.Un programme de surveillance de la population pour l'hypertension fut mis en place de 1972 a 1977 dans le cadre du projet de Carelie du Nord. Le but etait dedimi...
8 citations
6 citations
TL;DR: A new diagnostic theory for the design of automated medical questioning equipment which tabulates the answers to questions into a form easily understood by physicians, which enumerates data on doubtful diseases and which indicates pertinent medical examinations may come to the aid of patients and physicians is presented.
Abstract: A medical interview is a very important part of medical treatment since it is conducted when a patient is first admitted to a hospital and treatment is decided afterwards. However, these interviews are not always carried out in sufficient detail because physicians have very heavy work-loads. The development of automated medical questioning equipment which tabulates the answers to questions into a form easily understood by physicians, which enumerates data on doubtful diseases and which indicates pertinent medical examinations may come to the aid of patients and physicians. This paper presents a new diagnostic theory for the design of automated medical questioning equipment. Diagnostic theories can be classified into batch and sequential theories; the authors have investigated the sequential one, because decisions are made using minimal data. The techniques supporting this theory are multi-class recognition systems based on independently designed dual-class recognition systems and Wald's Sequential Probability Ratio Test. To discuss the properties inherent in the present theory, classification of three pattern classes was made. These were normal, hypertension and myocardial infarction classes of patients. The mean error probability of classification was found to be 3.08%.
5 citations
4 citations
TL;DR: A new interpretation of so-called clinical normal ranges which have recently been shown to have a wide range in comparison to the narrow individual physiological fluctuations is presented, based on a newly introduced concept "individual difference quotient" of clinical laboratory data.
Abstract: This article presents a new interpretation of so-called clinical normal ranges which have recently been shown to have a wide range in comparison to the narrow individual physiological fluctuations, based on a newly introduced concept "individual difference quotient" of clinical laboratory data. This quotient is defined as the ratio of inter- or intra-individual dispersion within the framework of a random-effects one-way analysis of variance model and can be used as a useful criterion to compare the degrees of individual differences of clinical laboratory tests with different measurement units. Further, as a function of this quotient the probability that a test result for a specific person falls within the normal range of this person can be derived. The derived probability can be expected to play a significant role in assessing an individual's state of health.
4 citations
TL;DR: It was found that for most cases, the homeostatic model gives the most reliable estimates in individual's level from the comparison of the chi-square values between the observations and estimations made for the individual's successive test results.
Abstract: Three statistical models of the individual's physiological variations, proposed by Dr Eugene K. Harris, were applied to the long-term series of individual test results in our health control system. It was found from this study that, in most cases, the homeostatic model shows the best fit to the population level from comparing correlation coefficients between the observations and estimations made based on Harris's three models. It was also found that for most cases, the homeostatic model gives the most reliable estimates in individual's level from the comparison of the chi-square values between the observations and estimations made for the individual's successive test results. Further, for a group of members with hyperglycaemia, the proportion of individuals in whom the random-walk model produced the most accurate predictions was increased to the proportion in the normal group. In the age group under 39 years of age, the autoregressive model showed a relatively high degree of predictive success, while the homeostatic model showed a relatively low degree in comparison with the results found in other age groups. From these investigations, it was found that the physiologically normal state shows strict homeostatic stability.
4 citations
TL;DR: A probability theorem is described which identifies the factors to be considered when applying the principle of logical elimination to probabilistic diagnosis and can be used to assess their suitability for interpretation in a logical manner.
Abstract: A probability theorem is described which identifies the factors to be considered when applying the principle of logical elimination to probabilistic diagnosis. The proof is based only on the multiplication, addition and universal bound axioms of probability. When new-tests are being designed from knowledge of disease mechanisms, criteria based on the theorem can be used to assess their suitability for interpretation in a logical manner. A simple convention is adopted to allow probabilities to be substantiated in terms of observed frequencies.l'article decrit un theoreme de probabilitye qui identifie les facteurs a considerer lorsqu'on applique le principe de l'elimination logique au diagnostic probabiliste. La preuve est basee uniquement sur la multiplication, l'addition et les axiomes universellement lies a la probabilitye. Lorsque de nouvelles epreuves sont creees a měme les connaissances des mechanismes pathologiques, des criteres bases sur le theoreme peuvent servir A evaluer leur convenance a une int...
4 citations
TL;DR: A data-model is presented which allows the representation and manipulation of complex time-dependent relationships among data, but which imposes sufficient limits to allow efficient corrections and deletions.
Abstract: Long-term computer-held clinical records present new problems for data organization and for the protection of patients' privacy. To maintain clarity and to protect confidentiality, it is important that most information becomes less accessible and less prominent with time. A data-model is presented which allows the representation and manipulation of complex time-dependent relationships among data, but which imposes sufficient limits to allow efficient corrections and deletions. One useful consequence of the model is a natural analogy and potential link to the methods of production systems and 'expert systems' currently being developed by workers in artificial intelligence.
TL;DR: The effects of serial correlation structure of biomedical data on the statistical-sampling variability of power estimates is investigated and the degrees of freedom content for power DFp in a k-point sample is shown to be dependent on the serial-correlation structure in a generally different way from the DFk, the corresponding measure for the mean.
Abstract: The effect of serial-correlation structure of biomedical data on the statistical-sampling variability of power estimates is investigated, extending a previous study of mean value estimates. The degrees of freedom content for power DFp in a k-point sample is shown to be dependent on the serial-correlation structure in a generally different way from the DFk, the corresponding measure for the mean. The sampling distribution of power is also investigated. The influence of serial correlation structure on the behaviour of traditional small-sample statistical tests is also of interest; in the case of the t-test the effects can be severe but can be compensated, leading to a new variable, ct, which for correlated data, behaves rather like t for uncorrelated data. The approach is applied to the case of long-term records of systolic blood-pressure data.
TL;DR: It is necessary to develop and evaluate hospital information systems based on a firm understanding of data-base systems to determine whether they are suitable for use in the medical industry.
Abstract: (1981). Developing and evaluating hospital information systems based on a firm understanding of data-base systems. Medical Informatics: Vol. 6, No. 4, pp. 251-263.
TL;DR: This paper examines acquisition of continuous physiological signals by small dedicated computers in an attempt to separate these processes and to provide guidelines for computer selection, design and development.
Abstract: For many years, physiological investigations have utilized the power and speed of analogue, digital and hybrid computers. Complex protocols often require the recording of large amounts of data in short periods, typically with simultaneous fine control of multiple experimental variables. Current systems often include data analysis in the same program which controls data acquisition. Although this is convenient from a package point of view, acquisition and analysis routines have different and sometimes conflicting purposes and requirements. This paper examines acquisition of continuous physiological signals by small dedicated computers in an attempt to separate these processes and to provide guidelines for computer selection, design and development.
TL;DR: The data-bank of signs and symptoms and classes of diseases developed for the computer-assisted medical diagnostic system (ADM) allows us to develop a series of interesting byproducts, among the most interesting one by-product that helps teach physical diagnosis, one for therapeutics, and one for assistance in decision-making in various specialized medical functions.
Abstract: The data-bank of signs and symptoms and classes of diseases developed for the computer-assisted medical diagnostic system (ADM) allows us to develop a series of interesting byproducts. Some by-products are utilitarian: the inverted file and lexicon subset of signs, symptoms and diseases organized by medical discipline. Other by-products in the area of operational research serve to increase the quality and productivity of medical practice. Among the most interesting we note one by-product that helps teach physical diagnosis, one for therapeutics, one for the partial automation of observations, and one for assistance in decision-making in various specialized medical functions. The number and importance of these by-products demonstrates the powerful potential of the computer-assisted diagnostic system (ADM).La banque de donnees semiologiques et nosologiques developpee pour le systeme ADM permet d'etablir de nombreux derives interessants. II y a des derives utilitaires; les fichiers inverses et les sous-lexiq...
TL;DR: The study describes the objectives and the characteristics of a system based on a simulation program using the file of the data-base from the Rennes Hospital and discusses the programming of the system.
Abstract: Computer-assisted instruction permits a student to work individually and at his own pace. His learning occurs by interactive dialogue with a conversational type terminal. The system comprises the following programs: tutorial, conversational and simulation. The study describes the objectives and the characteristics of a system based on a simulation program using the file of the data-base from the Rennes Hospital. Furthermore it describes in detail the steps that the student must take and discusses the programming of the system. The recording of the various lessons is subjected to statistical analyses to make the teaching exercises better and to adapt the conversation to the behaviour of the students facing the system.
TL;DR: The screening of renovascular hypertensive patients can be performed on the basis of the blood-pressure response of the patients to saralasin (Sarenin) infusion using autoregressive time series models, and the results are encouraging.
Abstract: The screening of renovascular hypertensive patients can be performed on the basis of the blood-pressure response of the patients to saralasin (Sarenin) infusion. A new approach is proposed here for the screening. The blood-pressure responses to the saralasin are modelled first, using autoregressive time series models. The constant parameters of the models are then used as the features for classifying the hypertensive patients. A linear classifier is constructed to perform the dichotomy between the angiotensin II dependent hypertensive and the rest of the hypertensive patients. Computational results on the testing of the method are presented. Although the sample size available for this study was small, the results are encouraging.Le depistage des malades souffrant d'hypertension renovasculaire peut ětre accompli base sur la tension arterielle repondant a une infusion de saralasine (Sarenine). Nous proposons ici une nouvelle methode de depistage. Les changements de la tension arterielle en reponse a la sara...