Digital Commons Network^™

An Extended Hierarchical Task Analysis For Error Prediction In Medical Devices

Faculty, Staff and Student Publications

This paper introduces an extended hierarchical task analysis (HTA) methodology devised to evaluate and compare user interfaces on volumetric infusion pumps. The pumps were studied along the dimensions of overall usability and propensity for generating human error. With HTA as our framework, we analyzed six pumps on a variety of common tasks using Norman’s Action theory. The introduced method of evaluation divides the problem space between the external world of the device interface and the user’s internal cognitive world, allowing for predictions of potential user errors at the human-device level. In this paper, one detailed analysis is provided as an …

Rigorously Assessing Whether The Data Backs The Back School

Faculty, Staff and Student Publications

A rigorous between-subjects methodology employing independent random samples and having broad clinical applicability was designed and implemented to evaluate the effectiveness of back safety and patient transfer training interventions for both hospital nurses and nursing assistants. Effects upon self-efficacy, cognitive, and affective measures are assessed for each of three back safety procedures. The design solves the problem of obtaining randomly assigned independent controls where all experimental subjects must participate in the training interventions.

The Physician's Perception Of Medical Error And Its Application To The Development Of An Educational Training Tool

Faculty, Staff and Student Publications

It is becoming clear that if we are to impact the rate of medical errors it will have to be done at the practicing physician level. The purpose of this project was to survey the attitude of physicians in Alabama concerning their perception of medical error, and to obtain their thoughts and desires for medical education in the area of medical errors. The information will be used in the development of a physician education program.

Randomized Comparisons Among Health Informatics Students Identify Hypertutorial Features As Improving Web-Based Instruction

Faculty, Staff and Student Publications

Hypertutorials optimize five features - presentation, learner control, practice, feedback, and elaborative learning resources. Previous research showed graduate students significantly and overwhelmingly preferred Web-based hypertutorials to conventional "Book-on-the-Web" statistics or research design lessons. The current report shows that the source of hypertutorials' superiority in student evaluations of instruction lies in their hypertutorial features. Randomized comparisons between the two methodologies were conducted in two successive iterations of a graduate level health informatics research design and evaluation course. The two versions contained the same text and graphics, but differed in the presence or absence of hypertutorial features: Elaborative learning resources, practice, feedback, …

Encouraging Adolescents Toward Mental Health Careers Via Website Biographies

Faculty, Staff and Student Publications

This project designed, developed, implemented and is currently evaluating the effectiveness of an interactive, multi-media website designed to encourage adolescents to consider careers in mental health. This Web-based learning environment features biographies of mental health scientists. Evaluation is conducted in a systematic, structured way using cognitive achievement, usability (ease of use), and affective scales (e.g., fun to use) as outcome measures

A Reduced Model Clarifies The Role Of Feedback Loops And Time Delays In The Drosophila Circadian Oscillator

Faculty, Staff and Student Publications

Although several detailed models of molecular processes essential for circadian oscillations have been developed, their complexity makes intuitive understanding of the oscillation mechanism difficult. The goal of the present study was to reduce a previously developed, detailed model to a minimal representation of the transcriptional regulation essential for circadian rhythmicity in Drosophila. The reduced model contains only two differential equations, each with time delays. A negative feedback loop is included, in which PER protein represses per transcription by binding the dCLOCK transcription factor. A positive feedback loop is also included, in which dCLOCK indirectly enhances its own formation. The model …

Breast Cancer On The World Wide Web: Cross Sectional Survey Of Quality Of Information And Popularity Of Websites, Frederick C Ames, Merrick I Ross, Henry M Kuerer, Raphael E Pollock, Mark A Musen, S Eva Singletary

Faculty, Staff and Student Publications

OBJECTIVES: To determine the characteristics of popular breast cancer related websites and whether more popular sites are of higher quality.

DESIGN: The search engine Google was used to generate a list of websites about breast cancer. Google ranks search results by measures of link popularity---the number of links to a site from other sites. The top 200 sites returned in response to the query "breast cancer" were divided into "more popular" and "less popular" subgroups by three different measures of link popularity: Google rank and number of links reported independently by Google and by AltaVista (another search engine).

MAIN OUTCOME …

Oral Pathology Report System: Improving An Existing Database System

Faculty, Staff and Student Publications

No abstract provided.

Automated Medical Algorithms: Issues For Medical Errors, Gareth Kantor, Jorge R. Rodriquez

Faculty, Staff and Student Publications

No abstract provided.

Designing Human-Centered Distributed Information Systems, Jack W. Smith

Faculty, Staff and Student Publications

Many computer systems are designed according to engineering and technology principles and are typically difficult to learn and use. The fields of human-computer interaction, interface design, and human factors have made significant contributions to ease of use and are primarily concerned with the interfaces between systems and users, not with the structures that are often more fundamental for designing truly human-centered systems. The emerging paradigm of human-centered computing (HCC)-which has taken many forms-offers a new look at system design. HCC requires more than merely designing an artificial agent to supplement a human agent. The dynamic interactions in a distributed system …

Medical Error: Is The Solution Medical Or Cognitive?

Faculty, Staff and Student Publications

Is the solution for medical errors medical or cognitive? In this AMIA2001 panel on medical error, we argued that medical error is primarily an issue for cognitive science and engineering, not for medicine, although the knowledge of the practice of medicine is essential for the research and prevention of medical errors. The three panelists presented studies that demonstrate that cognitive research is the foundation for theories of medical errors and interventions of error reductions.

Controlled Software Evaluation Methodology: Case Simulation And Cognitive User Analysis

Faculty, Staff and Student Publications

Software for use with patient records is challenging to design and difficult to evaluate because of the tremendous variability of patient circumstances. A method was devised by the authors to overcome a number of difficulties. The method evaluates and compares objectively various software products for use in emergency departments and compares software to conventional methods like dictation and templated chart forms. The technique utilizes oral case simulation and video recording for analysis. The methodology and experiences of executing a study using this case simulation are discussed in this presentation.

Redesign And Prototype For The Interface Of A Volumetric Infusion Pump Following The Usability Engineering Lifecycle

Faculty, Staff and Student Publications

No abstract provided.

Toward A Cognitive Taxonomy Of Medical Errors

Faculty, Staff and Student Publications

One critical step in addressing and resolving the problems associated with human errors is the development of a cognitive taxonomy of such errors. In the case of errors, such a taxonomy may be developed (1) to categorize all types of errors along cognitive dimensions, (2) to associate each type of error with a specific underlying cognitive mechanism, (3) to explain why, and even predict when and where, a specific error will occur, and (4) to generate intervention strategies for each type of error. Based on Reason's (1992) definition of human errors and Norman's (1986) cognitive theory of human action, we …

Comparing Communication Technology On Chinese, English, And Spanish Diabetes Web Sites

Faculty, Staff and Student Publications

Technological and cultural factors influence access to health information on the web in multifarious ways. We evaluated structural differences and availability of communication services on the web in three diverse language and cultural groups: Chinese, English, and Spanish. A total of 382 web sites were analyzed: 144 were English language sites (38%), 129 were Chinese language sites (34%), and 108 were Spanish language sites (28%). We did not find technical differences in the number of outgoing links per domain or the total availability of communication services between the three groups. There were differences in the distribution of available services between …

Evaluating The Prevalence, Content And Readability Of Complementary And Alternative Medicine (Cam) Web Pages On The Internet

Faculty, Staff and Student Publications

Complementary and alternative medicine (CAM) use is growing rapidly. As CAM is relatively unregulated, it is important to evaluate the type and availability of CAM information. The goal of this study is to deter-mine the prevalence, content and readability of online CAM information based on searches for arthritis, diabetes and fibromyalgia using four common search engines. Fifty-eight of 599 web pages retrieved by a "condition search" (9.6%) were CAM-oriented. Of 216 CAM pages found by the "condition" and "condition + herbs" searches, 78% were authored by commercial organizations, whose pur-pose involved commerce 69% of the time and 52.3% had no …

Evaluating A Medical Error Taxonomy

Faculty, Staff and Student Publications

Healthcare has been slow in using human factors principles to reduce medical errors. The Center for Devices and Radiological Health (CDRH) recognizes that a lack of attention to human factors during product development may lead to errors that have the potential for patient injury, or even death. In response to the need for reducing medication errors, the National Coordinating Council for Medication Errors Reporting and Prevention (NCC MERP) released the NCC MERP taxonomy that provides a standard language for reporting medication errors. This project maps the NCC MERP taxonomy of medication error to MedWatch medical errors involving infusion pumps. Of …

The Semantic Web And The Integration Of Health Data Resources

Faculty, Staff and Student Publications

No abstract provided.

A History Of Health Informatics In The Texas Medical Center

Faculty, Staff and Student Publications

No abstract provided.

The Feasibility Of Using Propositional Analysis As A Method For Understanding Differences Between Physicians And Nurses Reading Emrs

Faculty, Staff and Student Publications

No abstract provided.

Focusing Feedback On Interpersonal Skills: Practice Makes Perfect A Web-Based Tutorial For Standardized Patients, Craig W. Johnson

Faculty, Staff and Student Publications

Focusing Feedback on Interpersonal Skills: Practice Makes Perfect is a Web-Based learning environment enabling standardized patients (SPs) to develop, practice and enhance constructive feedback skills. The Web-based training environment for SPs features realistic professional healthcare provider/patient video scenarios, graphics, audio and immediate feedback in a student-centered self-instructional environment. SPs, who are trained to simulate an illness and portray a patient in a realistic and consistent way, subsequently provide feedback from a patient's perspective to students undergoing communication and interpersonal skills training in health science fields like medicine and nursing.

Prognostic Model For Terminally Ill Cancer Patients On Laboratory Data, Blaz Zupan, Kim Dunn, William Jack Schull, Tsuguya Fukui

Faculty, Staff and Student Publications

No abstract provided.

Persistent Productive Epstein‐Barr Virus Replication In Normal Epithelial Cells In Vivo

Faculty, Staff and Student Publications

Productive Epstein‐Barr virus (EBV) replication characterizes hairy leukoplakia, an oral epithelial lesion typically occurring in individuals infected with human immunodeficiency virus (HIV). Serial tongue biopsy specimens were obtained from HIV‐infected subjects before, during, and after valacyclovir treatment. EBV replication was detected by Southern hybridization to linear terminal EBV genome fragments, reverse‐transcriptase polymerase chain reaction amplification of EBV replicative gene transcripts, immunohistochemical detection of EBV replicative protein, and in situ hybridization to EBV DNA. EBV replication was detected in both hairy leukoplakia and normal tongue tissues. Valacyclovir treatment completely abrogated EBV replication in vivo, resulting in resolution of hairy leukoplakia when …

Cognitive Differences In Chart Reading: A Comparison Of Nurses And Physicians

Faculty, Staff and Student Publications

This pilot study compares the mental models of a patient constructed by nurses and physicians while reading an electronic medical record. Preliminary results suggest that the participants' summaries were both quantitatively and qualitatively different. The physician made more inferences and focused on deeper relationships in the record, whereas the nurse focused on the descriptive surface structure of the record.

Focus Group Evaluation For Web-Based Courses

Faculty, Staff and Student Publications

No abstract provided.

Preliminary Evaluation Of A Guideline Classification System, Edward H. Shortliffe, Robert A. Greenes

Faculty, Staff and Student Publications

In a previous paper, we presented a proposed expansion of the National Guideline Clearing-house (NGC) classification1. We performed a preliminary evaluation of the classification based on 100 guidelines randomly selected from the NGC collection. We found that 89 of the 100 guidelines could be assigned to a single guideline category. To test inter-observer agreement, twenty guidelines were also categorized by a second investigator. Agreement was found to be 40-90% depending on the axis, which compares favorably with agreement among MeSH indexers (30-60%)2. We conclude that categorization is feasible. Further research is needed to clarify axes with poor inter-observer agreement.

Dental Postgraduates Prefer Hypertutorial Statistics Lessons In Randomized Web Course Comparisons

Faculty, Staff and Student Publications

No abstract provided.

Long-Term Regulation Of Neuronal High-Affinity Glutamate And Glutamine Uptake In Aplysia, D G. Brabham

Faculty, Staff and Student Publications

An increase in transmitter release accompanying long-term sensitization and facilitation occurs at the glutamatergic sensorimotor synapse of Aplysia. We report that a long-term increase in neuronal Glu uptake also accompanies long-term sensitization. Synaptosomes from pleural-pedal ganglia exhibited sodium-dependent, high-affinity Glu transport. Different treatments that induce long-term enhancement of the siphon-withdrawal reflex, or long-term synaptic facilitation increased Glu uptake. Moreover, 5-hydroxytryptamine, a treatment that induces long-term facilitation, also produced a long-term increase in Glu uptake in cultures of sensory neurons. The mechanism for the increase in uptake is an increase in the V(max) of transport. The long-term increase in Glu uptake …

Controlled Comparison Of Emergency Department Charting Software With A Case Simulation Comparator Model

Faculty, Staff and Student Publications

No abstract provided.

Comparison Of Abbreviated Injury Scale (Ais) And International Classification Of Diseases In Severe Trama Patients, John B. Holcomb, Matthew J. Wall, Richard W. Cone, Robert Beck

Faculty, Staff and Student Publications

No abstract provided.