Evaluation of the usefulness of 'Marvin'; a computerized assessment tool for investigative interviewers of children

This study examined the usefulness of a computerized developmental assessment tool, designed to provide investigative interviewers with knowledge about children's understanding of spatial, temporal, numerical, and color terms that may be relevant to the forensic setting. Specifically, the effect of the computer program (compared to a standard verbal and no assessment) was examined on 4- to 5-year-old children's recall of an independent event and their enjoyment of the interview process. In addition, children's performance on the computerized and verbal developmental assessment was compared with their performance when recalling the independent event. Overall, the children rated the assessment conducted on computer more favorably than the verbal assessment. Further, the verbal assessment elicited responses that were more consistent with their responses about the event than the computerized assessment. However, there was no difference in the accuracy and detail of children's responses about the independent event, irrespective of whether the children received the computerized or verbal assessment, or no assessment. Directions for future research are discussed.

A method for tracking rats in a complex and completely dark environment using computerized video analysis

The automated tracking of rodents in open field environments has become a standard laboratory technique for the investigation of the effects of drugs, novel therapeutic interventions and genetic mutations on behavior. Here, we develop an extension of this technique that permits tracking in full darkness through a complex (‘enriched’) environment comprising naturalistic structures such as tunnels and hides. To eliminate unwanted light reflections and tape noise, we developed a unique video filter that combines the advantages of differential and non-differential filtering. This filter enabled the tracking of albino rats against a relatively dark background to an accuracy of approximately 97% compared to hand tracking of the same animal, irrespective of whether the rat was inside a hide box or tunnel or out in the open field. The system as a whole can be easily deployed using standard PCs and inexpensive infrared cameras and lights.

A computerized method for objective measurement of muscle tone

This article is concentrated on the objective computerizing method of measuring of muscle tone using compressive and decompressive deformation of superficial skeletal muscle of wrist in vivo. Four indices were highly recommended for complex analysis of muscle tone.

A new computerized adaptive test advancing the measurement of health-related quality of life (HRQoL) in children: the Kids-CAT

Purpose: Assessing health-related quality of life (HRQoL) via Computerized Adaptive Tests (CAT) provides greater measurement precision coupled with a lower test burden compared to conventional tests. Currently, there are no European pediatric HRQoL CATs available. This manuscript aims at describing the development of a HRQoL CAT for children and adolescents: the Kids-CAT, which was developed based on the established KIDSCREEN-27 HRQoL domain structure. Methods: The Kids-CAT was developed combining classical test theory and item response theory methods and using large archival data of European KIDSCREEN norm studies (n = 10,577–19,580). Methods were applied in line with the US PROMIS project. Item bank development included the investigation of unidimensionality, local independence, exploration of Differential Item Functioning (DIF), evaluation of Item Response Curves (IRCs), estimation and norming of item parameters as well as first CAT simulations. Results: The Kids-CAT was successfully built covering five item banks (with 26–46 items each) to measure physical well-being, psychological well-being, parent relations, social support and peers, and school well-being. The Kids-CAT item banks proved excellent psychometric properties: high content validity, unidimensionality, local independence, low DIF, and model conform IRCs. In CAT simulations, seven items were needed to achieve a measurement precision between.8 and.9 (reliability). It has a child-friendly design, is easy accessible online and gives immediate feedback reports of scores. Conclusions: The Kids-CAT has the potential to advance pediatric HRQoL measurement by making it less burdensome and enhancing the patient–doctor communication.

Erratum to: A new computerized adaptive test advancing the measurement of health-related quality of life (HRQoL) in children: the Kids-CAT

Abstract
Purpose
Assessing health-related quality of life (HRQoL) via Computerized Adaptive Tests (CAT) provides greater measurement precision coupled with a lower test burden compared to conventional tests. Currently, there are no European pediatric HRQoL CATs available. This manuscript aims at describing the development of a HRQoL CAT for children and adolescents: the Kids-CAT, which was developed based on the established KIDSCREEN-27 HRQoL domain structure.
Methods
The Kids-CAT was developed combining classical test theory and item response theory methods and using large archival data of European KIDSCREEN norm studies (n=10,577–19,580). Methods were applied in line with the US PROMIS project. Item bank development included the investigation of unidimensionality, local independence, exploration of Differential Item Functioning (DIF), evaluation of Item Response Curves (IRCs), estimation and norming of item parameters as well as first CAT simulations.
Results
The Kids-CAT was successfully built covering five item banks (with 26–46 items each) to measure physical well-being, psychological well-being, parent relations, social support and peers, and school well-being. The Kids-CAT item banks proved excellent psychometric properties: high content validity, unidimensionality, local independence, low DIF, and model conform IRCs. In CAT simulations, seven items were needed to achieve a measurement precision between .8 and .9 (reliability). It has a child-friendly design, is easy accessible online and gives immediate feedback reports of scores.
Conclusions
The Kids-CAT has the potential to advance pediatric HRQoL measurement by making it less burdensome and enhancing the patient–doctor communication.

Nurses' Use of Computerized Clinical Guidelines to Improve Patient Safety in Hospitals.

Computerized clinical guidelines are frequently used to translate research into evidence-based behavioral practices and to improve patient outcomes. The purpose of this integrative review is to summarize the factors influencing nurses' use of computerized clinical guidelines and the effects of nurses' use of computerized clinical guidelines on patient safety improvements in hospitals. The Embase, Medline Complete, and Cochrane databases were searched for relevant literature published from 2000 to January 2013. The matrix method was used, and a total of 16 papers were included in the final review. The studies were assessed for quality with the Critical Appraisal Skills Program. The studies focused on nurses' adherence to guidelines and on improved patient care and patient outcomes as benefits of using computerized clinical guidelines. The nurses' use of computerized clinical guidelines demonstrated improvements in care processes; however, the evidence for an effect of computerized clinical guidelines on patient safety remains limited.

Classification of electrocardiogram and auscultatory blood pressure signals using machine learning models

In this paper, two real-world medical classification problems using electrocardiogram (ECG) and auscultatory blood pressure (Korotkoff) signals are examined. A total of nine machine learning models are applied to perform classification of the medical data sets. A number of useful performance metrics which include accuracy, sensitivity, specificity, as well as the area under the receiver operating characteristic curve are computed. In addition to the original data sets, noisy data sets are generated to evaluate the robustness of the classifiers against noise. The 10-fold cross validation method is used to compute the performance statistics, in order to ensure statistically reliable results pertaining to classification of the ECG and Korotkoff signals are produced. The outcomes indicate that while logistic regression models perform the best with the original data set, ensemble machine learning models achieve good accuracy rates with noisy data sets.

Validation of a computerized use of time recall for activity measurement in advanced-aged adults

BACKGROUND: The Multimedia Activity Recall for Children and Adults (MARCA) is a computerized recall instrument that records use of time during 24 hr the previous day and has been developed to address limitations of current self-report physical activity measures for those in advanced age. METHODS: Test-retest reliability and convergent validity of the adult MARCA were assessed in a sample of 45 advanced-age adults (age 84.9 SD ± 1.62 yr) as a subsample of the Life and Living in Advanced-Age Cohort Study New Zealand (LiLACS NZ). Test-retest methods required participants to recall the previous day's activity using the MARCA twice within the same day. Convergent validity was assessed against accelerometry. RESULTS: Test-retest reliability was high, with ICCs greater than .99 for moderate to vigorous physical activity (MVPA) and physical activity level (PAL). Compared with accelerometry, the MARCA demonstrated validity comparable to other self-report instruments with Spearman's coefficients of .34 and .59 for time spent in nonsedentary physical activity and PAL. CONCLUSION: The MARCA is a valid and reliable self-report tool for physical activity behaviors in advanced-age adults.

Doubly labeled water validation of a computerized use-of-time recall in active young people

OBJECTIVE: Low levels of daily energy expenditure (insufficient physical activity and increased sedentary time) have been associated with adverse health outcomes in young people. The Multimedia Activity Recall for Children and Adolescents (MARCA) is a computerized, self-report, use-of-time tool that can assess daily energy expenditure. The study aim was to validate the MARCA for the estimation of energy expenditure in young people, using the criterion standard doubly labeled water. MATERIALS/METHODS: Over a 15 day assessment period, 32 participants (10-18 years) completed the MARCA and underwent a doubly labeled water protocol. Indirect calorimetry was used to assess resting metabolic rate. Total daily energy expenditure (TEE) and activity-related energy expenditure (AEE) were estimated from both the MARCA and doubly labeled water. Association and agreement between methods for TEE and AEE were assessed using Spearman correlations and Bland-Altman plots, respectively. RESULTS: Compared to doubly labeled water, the MARCA over-estimated TEE by an average of 50 kcal/day (limits of agreement -1 589 to 1 490 kcal/day) and under-estimated AEE 105 kcal/day (limits of agreement -1 404 to 1 614 kcal/day). The MARCA showed strong correlation with doubly labeled water for TEE (rho=0.70, p<0.0001) and moderate correlation for AEE (rho=0.56, p=0.0009). CONCLUSIONS: Overall, the MARCA indicated moderate validity for the assessment of daily TEE and AEE. The wide limits of agreement indicate the MARCA has greater utility for group-level rather than individual-level estimates.

Does computerized cognitive behavioral therapy help people with inflammatory bowel disease? A randomized controlled trial

BACKGROUND: Cognitive behavioral therapy may be useful for improving health-related quality of life (HRQOL) of at least some patients with inflammatory bowel disease (IBD), especially those with psychiatric comorbidities. However, cognitive behavioral therapy can be difficult to access. These difficulties can be overcome by computerized cognitive behavioral therapy (CCBT). This is a randomized controlled trial of a self-administered CCBT intervention for patients with IBD focused on improving HRQOL. It is hypothesized that CCBT completers will have an improved HRQOL relative to people not allocated to CCBT.

METHODS: Patients with IBD were randomly allocated to CCBT (n = 113) versus treatment as usual (n = 86). The IBD Questionnaire at 12 weeks after baseline was the primary outcome, while generic HRQOL, anxiety, depression, coping strategies, perceived stress, and IBD symptoms were secondary outcomes. Outcomes were also measured at 6 months after baseline. Predictors of dropout were also determined.

RESULTS: Twenty-nine CCBT participants (25.7%) completed the CCBT. The IBD Questionnaire was significantly increased at 12 weeks in CCBT completers compared with treatment-as-usual patients (F = 6.38, P = 0.01). Short Form-12 mental score (F = 5.00, P = 0.03) was also significantly better in CCBT compared with treatment-as-usual patients at 12 weeks. These outcomes were not maintained at 6 months. The predictors of dropout were baseline depression, biological use, lower IBD Questionnaire scores, and not having steroids.

CONCLUSIONS: Improvements at 12 weeks after baseline were not maintained at 6 months. Future research should aim to improve adherence rates. Moreover, CCBT may not work for patients with IBD with comorbid depression.

Fuzzy logic for decision support in chronic care

Computerized clinical guidelines can provide significant benefits in terms of health outcomes and costs, however, their effective computer implementation presents significant problems. Vagueness and ambiguity inherent in natural language (textual) clinical guidelines makes them problematic for formulating automated alerts or advice. Fuzzy logic allows us to formalize the treatment of vagueness in a decision support architecture. In care plan on-line (CPOL), an intranet-based chronic disease care planning system for general practitioners (GPs) in use in South Australia, we formally treat fuzziness in interpretation of quantitative data, formulation of recommendations and unequal importance of clinical indicators. We use expert judgment on cases, as well as direct estimates by experts, to optimize aggregation operators and treat heterogeneous combinations of conjunction and disjunction that are present in the natural language decision rules formulated by specialist teams.

Eliciting children's recall of events: how do computers compare with humans?

This study investigated the usefulness of an interactive computer program in eliciting children's reports about an event. Fifty-four 5–6- and fifty-nine  7–8-year old children participated in an event with their regular class teacher which involved several activities and a mildly negative secret. Four days and again 14 days later, the children were interviewed individually by computer (alone) or by a human interviewer. The computer program incorporated animation and audio whereby an animated figure asked the questions and the children were required to provide a verbal response. The accuracy and detail of the children’s reports was similar across the interview conditions. The children were more willing to review their answers with the computer than the adult interviewer. However, responses to the computer were less consistent across the interviews, and the children were less willing to disclose the secret in the second interview to the computer compared with the human interviewer. Overall, the computer revealed little benefit in eliciting children’s recall of the event over the standard face-to-face interview.

Multi-temporal land use mapping using remotely sensed techniques and the integration of a pollutant load model in a GIS

Estimation of nutrient load production based on multi-temporal remotely sensed land-use data for the Glenelg-Hopkins region in southwest Victoria, Australia, is discussed. Changes in land use were mapped using archived Landsat data and computerized classification techniques. Land-use
change is unparalleled in recent history, with 13% of the region transformed in the last decade. Total nitrogen and phosphorus loading were estimated using an export coefficient model. The analysis demonstrated a disturbing increase in nitrogen and phosphorus loadings from 1995 to 2002. Whilst such increases were suspected from past anecdotal and ad-hoc evidence, our modelling quantitatively estimated such increases and thus demonstrated the enormous potential of using remote sensing and GIS for monitoring land-use change and hence improve land-use management.

Environmental factors associated with adults' participation in physical activity- a review

Background: Promoting physical activity is a public health priority, and changes in the environmental contexts of adults’ activity choices are believed to be crucial. However, of the factors associated with physical activity, environmental influences are among the least understood. Method: Using journal scans and computerized literature database searches, we identified 19 quantitative studies that assessed the relationships with physical activity behavior of perceived and objectively determined physical environment attributes. Findings were categorized into those examining five categories: accessibility of facilities, opportunities for activity, weather, safety, and aesthetic attributes. Results: Accessibility, opportunities, and aesthetic attributes had significant associations with physical activity. Weather and safety showed less-strong relationships. Where studies pooled different categories to create composite variables, the associations were less likely to be statistically significant. Conclusions: Physical environment factors have consistent associations with physical activity behavior. Further development of ecologic and environmental models, together with behavior-specific and context-specific measurement strategies, should help in further  understanding of these associations. Prospective studies are required to identify possible causal relationships.