Numerical methods are now widely used in the classification of bacteria, and they are also being explored in the field of identification. Identification is the major interest for clinical work, but it should be emphasized that good taxonomies are a prerequisite for satisfactory schemes of identification or diagnosis. Much remains to be done in the taxonomy of bacteria, and for this reason a brief summary of numerical methods of classification will be given before considering diagnosis. First, however, some comments will be made on the collection of laboratory data.
{"title":"Computers in bacteriology.","authors":"P H Sneath","doi":"10.1136/jcp.s2-3.1.87","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.87","url":null,"abstract":"Numerical methods are now widely used in the classification of bacteria, and they are also being explored in the field of identification. Identification is the major interest for clinical work, but it should be emphasized that good taxonomies are a prerequisite for satisfactory schemes of identification or diagnosis. Much remains to be done in the taxonomy of bacteria, and for this reason a brief summary of numerical methods of classification will be given before considering diagnosis. First, however, some comments will be made on the collection of laboratory data.","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.87","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16008154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
More experience in the routine use of computers probably exists in the field of pathology than in any other branch of medicine. Even so, the planning and setting up of a computer system for handling laboratory data presents many difficulties. Definitive answers to many of the problems which arise cannot be expected until a lot more experience has been built up and it will probably be some years before the ideal system emerges and is perfected. However, the undoubted benefits of using a computer make it worth while struggling to overcome the initial difficulties. The problems and benefits discussed here are those which have been experienced at University College Hospital, London, when using an off-line computer to process biochemical data, and when planning for an on-line system which is to embrace all the data-handling activities of the chemical pathology service. Almost without exception, however, the problems and benefits are likely to be the same in all branches of pathology; many are discussed in greater technical detail elsewhere (Flynn, Alexander, Chalmers, Grant, Jenkins, Lapage, Robertson Smith, Squire, Stirland, Whitby, Whitehead, and Wootton, 1968).
{"title":"Problems and benefits of using a computer for laboratory data processing.","authors":"F V Flynn","doi":"10.1136/jcp.s2-3.1.62","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.62","url":null,"abstract":"More experience in the routine use of computers probably exists in the field of pathology than in any other branch of medicine. Even so, the planning and setting up of a computer system for handling laboratory data presents many difficulties. Definitive answers to many of the problems which arise cannot be expected until a lot more experience has been built up and it will probably be some years before the ideal system emerges and is perfected. However, the undoubted benefits of using a computer make it worth while struggling to overcome the initial difficulties. The problems and benefits discussed here are those which have been experienced at University College Hospital, London, when using an off-line computer to process biochemical data, and when planning for an on-line system which is to embrace all the data-handling activities of the chemical pathology service. Almost without exception, however, the problems and benefits are likely to be the same in all branches of pathology; many are discussed in greater technical detail elsewhere (Flynn, Alexander, Chalmers, Grant, Jenkins, Lapage, Robertson Smith, Squire, Stirland, Whitby, Whitehead, and Wootton, 1968).","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.62","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16357798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Machine analysis and reporting has been widely applied to the numerical results of clinical biochemistry and haematology. Few have applied computers to routine bacteriology, although they have been of great value in taxonomy. This is unfortunate but stems, perhaps, from failure to appreciate that although reports may contain several different sorts of information, all of them may be given numerical values. This conversion, however, requires the bacteriologist to conform to a standard methodology to which some might object. Another reason for this delay is probably that most of the available computer languages and compilers tend to be too inflexible for easy adaptation to the diversity of information which clinical bacteriologists may want to analyse. The present investigations were therefore undertaken to discover the suitability of a compiler, designed for survey analysis, for obtaining statistical and epidemiological information from the reports of a hospital bacteriology laboratory. Bacteriology is inseparable from epidemiology with its implied ability to make predictions derived from past experience. At its simplest a knowledge of the prevalence and drug sensitivity of specific pathogenic bacteria should increase the precision of clinical diagnosis and treatment. Within the laboratory, this information could also be used as a form of quality control by drawing attention to changes in reporting practice.
{"title":"Analysis of hospital bacteriological data.","authors":"R M Stirland, V F Hillier, M G Steyger","doi":"10.1136/jcp.s2-3.1.82","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.82","url":null,"abstract":"Machine analysis and reporting has been widely applied to the numerical results of clinical biochemistry and haematology. Few have applied computers to routine bacteriology, although they have been of great value in taxonomy. This is unfortunate but stems, perhaps, from failure to appreciate that although reports may contain several different sorts of information, all of them may be given numerical values. This conversion, however, requires the bacteriologist to conform to a standard methodology to which some might object. Another reason for this delay is probably that most of the available computer languages and compilers tend to be too inflexible for easy adaptation to the diversity of information which clinical bacteriologists may want to analyse. The present investigations were therefore undertaken to discover the suitability of a compiler, designed for survey analysis, for obtaining statistical and epidemiological information from the reports of a hospital bacteriology laboratory. Bacteriology is inseparable from epidemiology with its implied ability to make predictions derived from past experience. At its simplest a knowledge of the prevalence and drug sensitivity of specific pathogenic bacteria should increase the precision of clinical diagnosis and treatment. Within the laboratory, this information could also be used as a form of quality control by drawing attention to changes in reporting practice.","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.82","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16008153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The exponential rise in laboratory requests has made it essential to develop scientific equipment capable of processing more efficiently the large number of repetitive tests. For this purpose, instruments which operate by continuous flow analysis have proved to be eminently successful. Although used primarily in departments of clinical biochemistry, they are also useful in diagnostic haematology in the single-channel mode for haemoglobinometry, serum iron measurement, and antibody screening, and in the multichannel mode for blood group determination and for routine haematological parameters. We have already reported (Nelson and Lamont, 1961) how the introduction of a single channel AutoAnalyzer for haemoglobinometry increased productivity when measured in terms of numbers of tests performed per techniciai per year. However, subsequent studies indicated that something of the order of half of the total work load consisted of four tests, namely, the determination of the haemoglobin, the haematocrit, and the total red and white cell counts. Thus while mechanization of individual tests may make a significant contribution to efficiency, the greatest benefit is likely to be achieved by the 'automation' of the four basic tests. The SMA-4/-7 is a commercially available item of multichannel equipment capable of determining these four basic parameters from a single sample of blood.
{"title":"Multichannel continuous flow analysis on the SMA-4--7A.","authors":"M G Nelson","doi":"10.1136/jcp.s2-3.1.20","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.20","url":null,"abstract":"The exponential rise in laboratory requests has made it essential to develop scientific equipment capable of processing more efficiently the large number of repetitive tests. For this purpose, instruments which operate by continuous flow analysis have proved to be eminently successful. Although used primarily in departments of clinical biochemistry, they are also useful in diagnostic haematology in the single-channel mode for haemoglobinometry, serum iron measurement, and antibody screening, and in the multichannel mode for blood group determination and for routine haematological parameters. We have already reported (Nelson and Lamont, 1961) how the introduction of a single channel AutoAnalyzer for haemoglobinometry increased productivity when measured in terms of numbers of tests performed per techniciai per year. However, subsequent studies indicated that something of the order of half of the total work load consisted of four tests, namely, the determination of the haemoglobin, the haematocrit, and the total red and white cell counts. Thus while mechanization of individual tests may make a significant contribution to efficiency, the greatest benefit is likely to be achieved by the 'automation' of the four basic tests. The SMA-4/-7 is a commercially available item of multichannel equipment capable of determining these four basic parameters from a single sample of blood.","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.20","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16357792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The first step in understanding computer operations is to establish an accurate image of what a computer is and what it does. Physically a computer is some boxes of electronics connected by wires; they consume cards and paper tapes, draw, print, punch, wind magnetic tapes, spin drums and disks, flash lights, and make a certain amount of noise. However, this image may not be very useful in terms of what a computer does. In more abstract and general terms the computer is an automatic logic device which processes information at unimaginable speeds and with remarkable precision. Its capabilities are very flexible, particular jobs being specified as programs of any necessary complexity, and provided that the information which it processes has been reduced to the form of discrete symbols, which means letters, numbers, punctuation marks, or binary digits, it can in principle do with data anything which can be done with data. This of course is an awe-inspiring claim liable to daunt the irresolute so this general image ofcomputer functions may not be more useful than the physical image. Therefore we may prefer a more homely alternative and describe the capabilities of the various boxes in terms of the three Rs; most of their operations can indeed be considered to be aspects of reading, writing, and arithmetic. However, a little care is needed in the use of each term. First our 'arithmetic' must include some logic, in particular the evaluation of whether a statement is true or false, so that it may serve as the basis of decisions. Second we should realize that reading and writing, in computer terms, are simply aspects of copying from one place to another and that in fact nothing is ever written without being read, or read without being written. Conventionally, the programmer imagines himself to be sitting in the box known as the 'processor' and 'reading' is the term applied to incoming copying and 'writing' the term applied to outgoing copying. This is different from the conventional imagery of using a desk calculator where we do not normally think of ourselves as reading with our fingers. 52 These are minor points unlikely in fact to confuse, but a more fundamental difference between the desk calculator and the computer is that, while the first executes each operation as it is specified (by pressing the button), the computer accepts and stores the whole sequence of instructions given to it, and it does not obey the first one until the last one has been accepted. Computers are sometimes described specifically as 'stored-program' machines. However, once it does begin to obey them, it obeys them in order without pause, except when one of the instructions says that it should jump onwards and skip a bit of program, or jump backwards and do some of it again. The data are accepted by the machine after the program has been started, and the order in which items of data are read, calculations performed, and storage, or print, operations carried out is a matter for
{"title":"Computer operations and the structure of information.","authors":"E G Knox","doi":"10.1136/jcp.s2-3.1.52","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.52","url":null,"abstract":"The first step in understanding computer operations is to establish an accurate image of what a computer is and what it does. Physically a computer is some boxes of electronics connected by wires; they consume cards and paper tapes, draw, print, punch, wind magnetic tapes, spin drums and disks, flash lights, and make a certain amount of noise. However, this image may not be very useful in terms of what a computer does. In more abstract and general terms the computer is an automatic logic device which processes information at unimaginable speeds and with remarkable precision. Its capabilities are very flexible, particular jobs being specified as programs of any necessary complexity, and provided that the information which it processes has been reduced to the form of discrete symbols, which means letters, numbers, punctuation marks, or binary digits, it can in principle do with data anything which can be done with data. This of course is an awe-inspiring claim liable to daunt the irresolute so this general image ofcomputer functions may not be more useful than the physical image. Therefore we may prefer a more homely alternative and describe the capabilities of the various boxes in terms of the three Rs; most of their operations can indeed be considered to be aspects of reading, writing, and arithmetic. However, a little care is needed in the use of each term. First our 'arithmetic' must include some logic, in particular the evaluation of whether a statement is true or false, so that it may serve as the basis of decisions. Second we should realize that reading and writing, in computer terms, are simply aspects of copying from one place to another and that in fact nothing is ever written without being read, or read without being written. Conventionally, the programmer imagines himself to be sitting in the box known as the 'processor' and 'reading' is the term applied to incoming copying and 'writing' the term applied to outgoing copying. This is different from the conventional imagery of using a desk calculator where we do not normally think of ourselves as reading with our fingers. 52 These are minor points unlikely in fact to confuse, but a more fundamental difference between the desk calculator and the computer is that, while the first executes each operation as it is specified (by pressing the button), the computer accepts and stores the whole sequence of instructions given to it, and it does not obey the first one until the last one has been accepted. Computers are sometimes described specifically as 'stored-program' machines. However, once it does begin to obey them, it obeys them in order without pause, except when one of the instructions says that it should jump onwards and skip a bit of program, or jump backwards and do some of it again. The data are accepted by the machine after the program has been started, and the order in which items of data are read, calculations performed, and storage, or print, operations carried out is a matter for ","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.52","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16357796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Investigation of an individual patient consists of three essential processes: first, taking a history; secondly, examining the patient; and thirdly, undertaking a variety of tests such as x-ray examinations , biochemical estimations, and so on. Whereas in the past history taking and clinical examination were the most important processes of diagnosis, ancillary investigations are now assuming a far greater importance. In considering the uses of computers in handling the medical record it is obvious that the ancillary and special investigations lend themselves most readily to computerization, since essentially they consist of numerical or clearly definable information. Even though laboratory information lends itself more easily to computerization, it must be remembered that careful consideration should be given as to what part of the information collected should be stored, and what subsequent value it may have. Thus, in recording information, for example, on haemoglobin measurements in the treatment of a patient with anaemia, it may be wasteful to store in permanent form each haemoglobin measurement that has been made as, otherwise, the computerized medical record may be overwhelmingly filled with laboratory information. In such instances it is only necessary, perhaps, to record the haemo-globin concentration on admission, the lowesthaemo-globin concentration, and the haemoglobin concentration on discharge. The main purposes for which hospital records are used are: first, in medical care; secondly, for administrative and medico-legal purposes; and thirdly, for research which may be prospective or retrospective. Opinions differ as to the value of medical records for any of these purposes. Hospital notes, after all, are mainly designed to provide a record of the patient's condition to be utilized in treatment and management. The main contents of the case record have been summarized as consisting of (1) an identification sheet containing information on date of admission, date of discharge, etc; (2) the initial history and physical examination recorded in narrative form; (3) laboratory data and results of functional tests, eg, pulmonary function studies, electrocardiograms, etc; (4) consultation reports containing judgments and therapeutic recommendations in narrative form; (5) operation reports usually in narrative form; (6) therapeutic instructions ; (7) follow-up clinical observations; (8) special reports prepared by hospital departments which provide selective services, for example, radiotherapy, physiotherapy, etc; (9) a discharge summary which is a final synthesis of the patient's history, examination , course of treatment, and outcome. We are here concerned largely with the laboratory and the medical record. Before one can draw …
{"title":"The laboratory and patient records.","authors":"W W Holland","doi":"10.1136/jcp.s2-3.1.57","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.57","url":null,"abstract":"Investigation of an individual patient consists of three essential processes: first, taking a history; secondly, examining the patient; and thirdly, undertaking a variety of tests such as x-ray examinations , biochemical estimations, and so on. Whereas in the past history taking and clinical examination were the most important processes of diagnosis, ancillary investigations are now assuming a far greater importance. In considering the uses of computers in handling the medical record it is obvious that the ancillary and special investigations lend themselves most readily to computerization, since essentially they consist of numerical or clearly definable information. Even though laboratory information lends itself more easily to computerization, it must be remembered that careful consideration should be given as to what part of the information collected should be stored, and what subsequent value it may have. Thus, in recording information, for example, on haemoglobin measurements in the treatment of a patient with anaemia, it may be wasteful to store in permanent form each haemoglobin measurement that has been made as, otherwise, the computerized medical record may be overwhelmingly filled with laboratory information. In such instances it is only necessary, perhaps, to record the haemo-globin concentration on admission, the lowesthaemo-globin concentration, and the haemoglobin concentration on discharge. The main purposes for which hospital records are used are: first, in medical care; secondly, for administrative and medico-legal purposes; and thirdly, for research which may be prospective or retrospective. Opinions differ as to the value of medical records for any of these purposes. Hospital notes, after all, are mainly designed to provide a record of the patient's condition to be utilized in treatment and management. The main contents of the case record have been summarized as consisting of (1) an identification sheet containing information on date of admission, date of discharge, etc; (2) the initial history and physical examination recorded in narrative form; (3) laboratory data and results of functional tests, eg, pulmonary function studies, electrocardiograms, etc; (4) consultation reports containing judgments and therapeutic recommendations in narrative form; (5) operation reports usually in narrative form; (6) therapeutic instructions ; (7) follow-up clinical observations; (8) special reports prepared by hospital departments which provide selective services, for example, radiotherapy, physiotherapy, etc; (9) a discharge summary which is a final synthesis of the patient's history, examination , course of treatment, and outcome. We are here concerned largely with the laboratory and the medical record. Before one can draw …","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.57","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16357797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
an extensive central installation must be available with the ability to accept multiple inputs on a timesharing basis, one input terminal being located in the laboratory. Both these approaches are expensive. In the first case, the laboratory must bear the whole cost of the equipment and for practical reasons this may result in the provision of a computer too small adequately to do the rather complex tasks involved. On the other hand, although a large central computer may provide relatively cheap processing power, it is no small task so to design the central system that the laboratory can have unrestricted access at intervals of a few seconds throughout the working day, ie, whenever instrument readings must be recorded or the laboratory records are interrogated. It is likely, therefore, that off-line computers will continue to be used where the input data are collected in the laboratory and sent once or several times daily to a computer for batch processing. This does not even imply that the computer must be within physical reach of the laboratory, since a data link, eg, by telephone wire, may be possible. Of course batch processing laboratory results imposes certain limitations compared with an on-line connexion. These problems have been faced during the last two years in the biochemical laboratories of the Royal Postgraduate Medical School, during which time we have had access to a medium-sized general purpose digital computer. The purpose of this paper is to indicate the areas in which we have found the computer to be valuable and how the disadvantages of off-line working can be
{"title":"Computer processing of biochemical information without going on-line.","authors":"I D Wootton","doi":"10.1136/jcp.s2-3.1.101","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.101","url":null,"abstract":"an extensive central installation must be available with the ability to accept multiple inputs on a timesharing basis, one input terminal being located in the laboratory. Both these approaches are expensive. In the first case, the laboratory must bear the whole cost of the equipment and for practical reasons this may result in the provision of a computer too small adequately to do the rather complex tasks involved. On the other hand, although a large central computer may provide relatively cheap processing power, it is no small task so to design the central system that the laboratory can have unrestricted access at intervals of a few seconds throughout the working day, ie, whenever instrument readings must be recorded or the laboratory records are interrogated. It is likely, therefore, that off-line computers will continue to be used where the input data are collected in the laboratory and sent once or several times daily to a computer for batch processing. This does not even imply that the computer must be within physical reach of the laboratory, since a data link, eg, by telephone wire, may be possible. Of course batch processing laboratory results imposes certain limitations compared with an on-line connexion. These problems have been faced during the last two years in the biochemical laboratories of the Royal Postgraduate Medical School, during which time we have had access to a medium-sized general purpose digital computer. The purpose of this paper is to indicate the areas in which we have found the computer to be valuable and how the disadvantages of off-line working can be","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16357788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The title of this paper is, for the hospital biochemist, synonymous with AutoAnalyzer techniques, and it is with the development and evolution of the AutoAnalyzer that it must inevitably deal. The next paper gives an account of the intensive developments which are taking place in the application of discrete analysis systems. This is perhaps the more difficult task, since, while there are many examples of this type there is effectively only one continuous-flow analytical technique. To the industrial analytical chemist coming into the field of clinical chemistry 18 years ago, it seemed that the methods employed lacked the absolute character which obtain in the industrial field. The reasons implicit in the study of biological material soon became obvious and the work load overwhelming, so that any naive concept of bringing the cold purity of absolute analytical accuracy to bear in this new field was gladly abandoned. It is important, however, to remember this feeling, because there is a tendency to approach automated techniques in a highly critical fashion, examining the performance of this or that system against the yardstick of a sanctified manual system of clinical chemistry which never had any reality. The principles of the single-channel AutoAnalyzer are now widely known, since subsequent changes in design have not fundamentally altered the approach so brilliantly described by Skeggs (1957). It was his recognition of the non-absolute character of clinical chemical methods, to which attention has been drawn above, which is fundamental to the success of the AutoAnalyzer. It was not important or even desirable to produce a machine capable of estimating urea concentration with absolute accuracy. If the machine could be guaranteed to treat every sample in exactly the same way so that standards were treated in the same way as tests, then the approach usual in manual methods would be operative. Indeed since machines have no free will and do not tire, it would be reasonable to expect greater precision.
{"title":"Continuous-flow techniques for tests in clinical chemistry.","authors":"D W Neill, J R Doggart","doi":"10.1136/jcp.s2-3.1.39","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.39","url":null,"abstract":"The title of this paper is, for the hospital biochemist, synonymous with AutoAnalyzer techniques, and it is with the development and evolution of the AutoAnalyzer that it must inevitably deal. The next paper gives an account of the intensive developments which are taking place in the application of discrete analysis systems. This is perhaps the more difficult task, since, while there are many examples of this type there is effectively only one continuous-flow analytical technique. To the industrial analytical chemist coming into the field of clinical chemistry 18 years ago, it seemed that the methods employed lacked the absolute character which obtain in the industrial field. The reasons implicit in the study of biological material soon became obvious and the work load overwhelming, so that any naive concept of bringing the cold purity of absolute analytical accuracy to bear in this new field was gladly abandoned. It is important, however, to remember this feeling, because there is a tendency to approach automated techniques in a highly critical fashion, examining the performance of this or that system against the yardstick of a sanctified manual system of clinical chemistry which never had any reality. The principles of the single-channel AutoAnalyzer are now widely known, since subsequent changes in design have not fundamentally altered the approach so brilliantly described by Skeggs (1957). It was his recognition of the non-absolute character of clinical chemical methods, to which attention has been drawn above, which is fundamental to the success of the AutoAnalyzer. It was not important or even desirable to produce a machine capable of estimating urea concentration with absolute accuracy. If the machine could be guaranteed to treat every sample in exactly the same way so that standards were treated in the same way as tests, then the approach usual in manual methods would be operative. Indeed since machines have no free will and do not tire, it would be reasonable to expect greater precision.","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.39","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16357794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It is rather curious that, although ser for a multitude of constituents in and haematological laboratories, the ter has come to imply almost exclusively the ( of serum for antibodies, and, in part bodies related to microbial diseases serological techniques tend to be regarde as the prerogative of microbiologists. When one considers for how long a extent in biochemical laboratories the of tests for other blood constituent developed, it is a little difficult to unc delay in automating routine tests for Although they may be imperfectly c substances, their physiochemical rea been studied for many years, and rout. well established. It can hardly be that for antibody tests has not been enoul automation an economical propositior at Figure 1 reveals that the number of se for syphilis antibodies each year in pi laboratories alone throughout England has almost doubled over a period of 10 rapidly approaching half a million. To 1
{"title":"Serological techniques.","authors":"C E Taylor","doi":"10.1136/jcp.s2-3.1.14","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.14","url":null,"abstract":"It is rather curious that, although ser for a multitude of constituents in and haematological laboratories, the ter has come to imply almost exclusively the ( of serum for antibodies, and, in part bodies related to microbial diseases serological techniques tend to be regarde as the prerogative of microbiologists. When one considers for how long a extent in biochemical laboratories the of tests for other blood constituent developed, it is a little difficult to unc delay in automating routine tests for Although they may be imperfectly c substances, their physiochemical rea been studied for many years, and rout. well established. It can hardly be that for antibody tests has not been enoul automation an economical propositior at Figure 1 reveals that the number of se for syphilis antibodies each year in pi laboratories alone throughout England has almost doubled over a period of 10 rapidly approaching half a million. To 1","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16357790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Before considering the use of data processing it is appropriate to define the function of the haematology laboratory within the hospital complex. The main function of that laboratory must be the provision of a system to define the haematological state of the patient. The second important function following on the first is the use of the haematologist's special skills in interpreting data presented and initiating further investigative procedures to establish the diagnosis. The first task, that of measuring accurately the haematological parameters of the patients, is very similar to the work of the biochemist. Almost all patients admitted to our group of hospitals have a routine blood count carried out on admission and in my opinion the laboratory must be organized in such a way that this is carried out with the minimum possible delay; whether this is carried out in association with the biochemists in a specially designed screening laboratory or is retained within the haematology laboratory itself is a matter for discussion, but a system must be devised whereby information is returned to the clinician in charge of the case as quickly as possible. The second type of service, consisting of interpretation and further, more sophisticated investigation, raises different problems and I propose to discuss these two aspects of the haematological service separately.
{"title":"A data processing system for haematology.","authors":"D G Chalmers","doi":"10.1136/jcp.s2-3.1.94","DOIUrl":"https://doi.org/10.1136/jcp.s2-3.1.94","url":null,"abstract":"Before considering the use of data processing it is appropriate to define the function of the haematology laboratory within the hospital complex. The main function of that laboratory must be the provision of a system to define the haematological state of the patient. The second important function following on the first is the use of the haematologist's special skills in interpreting data presented and initiating further investigative procedures to establish the diagnosis. The first task, that of measuring accurately the haematological parameters of the patients, is very similar to the work of the biochemist. Almost all patients admitted to our group of hospitals have a routine blood count carried out on admission and in my opinion the laboratory must be organized in such a way that this is carried out with the minimum possible delay; whether this is carried out in association with the biochemists in a specially designed screening laboratory or is retained within the haematology laboratory itself is a matter for discussion, but a system must be devised whereby information is returned to the clinician in charge of the case as quickly as possible. The second type of service, consisting of interpretation and further, more sophisticated investigation, raises different problems and I propose to discuss these two aspects of the haematological service separately.","PeriodicalId":78352,"journal":{"name":"Journal of clinical pathology. Supplement (College of Pathologists)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1969-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jcp.s2-3.1.94","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"16357801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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