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Objective medical decision~making has shown itself to be an emerging discipline which is sufficiently robust to promote its further development. This book identifies many important areas for applications in the field of acute patient care. The different approaches require testing, evaluation and mutual co~parisons to ensure that the right method is used to solve the existing problem. Medical sciences and patient care are increasingly supported by system sciences, resulting in growing multi- and interdisciplinary research and development areas. In this context, system sciences involve the methods, techniques, concepts and approaches obtained f~om disciplines such as mathematics, statistics, stochastic signal theory, fuzzy set theory, systems and control theory, signal analysis, pattern recogni tion, simulation, computer languages, structured programming, data base management and computer sciences. This book contains the papers of a workshop "Objective Medical Decision making f Systems approach in acute disease" which was initia ted and supported by the SWG/COMAC on Biomedical Engineering, Evaluation of Technology, Transfer and Standardization of CRM/CREST of the European Community. In setting up the original programme we have been assisted by a group of experts and for their cooperation we are very gratef.ul to S. Dawids, Copenhagen E. Epple, Tlibingen ; J. Jones, Harrow; L. Lambotte, Brussels C. Marchesi, Pisa and D. Robert, Lyon. The papers have been arranged in four groups, each followed by a brief synopsis. The four groups are : diagnosis, monitoring, therapy and control, and evaluation of criteria and procedures.
Sommario
Keynote papers.- Critical decision-making and simulation.- Fuzzy sets theory for medical decision-making.- Diagnosis.- Pre-operative assessment of 'risk'.- Evaluation of cardiorespiratory function during sleep in infants at risk for sudden infant death syndrome: a computer system for acquisition and analysis.- Evaluation of cardiac function in acute coronary disease by integration of computerized cardiovascular signals.- Evaluation of decision-making by humans and computers in acute abdominal and acute chest pain.- Results of the discussion around the subject "Diagnosis".- Monitoring.- The use of the auditory evoked response to measure graded effects of general anaesthetics.- EEG-analysis in monitoring anesthesia.- An individual microprocessor device for gas exchange monitoring during artificial ventilation.- Man-machine interaction in disease pattern classification.- A data acquisition and display system for improved medical pattern recognition.- Results of the discussion around the subject "Monitoring".- Therapy and control.- Diabetes management: insight from mathematical modelling.- Role of the artificial pancreas in the understanding of the mode of action of insulin.- Towards a generalized approach in clinical control systems.- Measurement and usefulness of flow, volume and airway pressure during mechanical ventilation.- Automatic control system of O2 and CO2 in artificial ventilation.- Model simulation for the prediction of haemodialysis.- Results of the discussion around the subject "Therapy and control".- Evaluation of criteria and procedures.- Human utility index of data used in diagnosis.- Evaluation of techniques for the diagnosis of upper G.I. tract bleeding.- Clinical importance of patterns in the courses of online recorded vital parameters.-Monitoring the respiratory effects of analgesic drugs in the post-operative period.- Automated heart-lung-machine and blood gas data logger.- Numerical simulation of a cardiopulmonary system under therapy, its utilization in computer aided instruction and training.- Results of the discussion around the subject "Evaluation of criteria and procedures".
