Robert Galen - Academia.edu (original) (raw)
Papers by Robert Galen
Cleveland Clinic quarterly, 1986
Amer J Obstet Gynecol, 2007
Obstetrics & Gynecology, 2006
To estimate patterns of total hCG and inhibin A levels in the late first trimester of Down syndro... more To estimate patterns of total hCG and inhibin A levels in the late first trimester of Down syndrome pregnancies, compare them with that of free beta-hCG, and assess screening performance of these markers individually and in combination with pregnancy-associated plasma protein-A (PAPP-A) and nuchal translucency. Seventy-nine matched case-control sets of maternal serum samples (each Down syndrome case matched to 5 controls) from 11 through 13 completed weeks of gestation were taken from the sample bank of the First and Second Trimester Evaluation of Risk Consortium, a population-based study, and assayed for levels of free beta-hCG, total hCG, and inhibin A. Distribution characteristics and correlations of the multiples of the median values were estimated in cases and controls. Screening performance for each marker, alone and in combination with PAPP-A, nuchal translucency, and maternal age, was calculated. Median multiples of the median levels of free beta-hCG, total hCG, and inhibin A in cases were more elevated as gestation increased from 11 to 13 weeks, with univariate detection rates of 31%, 23%, and 29%, respectively, at a 5% false-positive rate. At 12 weeks, the multivariate detection rates at a 5% false-positive rate for nuchal translucency and PAPP-A (with maternal age) with either free beta-hCG, total hCG, or inhibin A were 84%, 83%, and 85%, respectively. The improvement in performance from nuchal translucency and PAPP-A to any of the three-marker tests was significant, while performance of any of the three-marker combinations was not significantly different from each other. Although levels of free beta-hCG in affected pregnancies were higher earlier than the levels of either total hCG or inhibin A, there was no significant difference in screening performance when either of the three markers was used with nuchal translucency and PAPP-A at 11-13 weeks of pregnancy. II-2.
Clinical Biochemistry, 2004
Objectives: Elevated plasma lipoprotein(a) [Lp(a)] is a significant risk factor for vascular dise... more Objectives: Elevated plasma lipoprotein(a) [Lp(a)] is a significant risk factor for vascular disease. Standardization of Lp(a) mass measurement is complicated by the heterogeneity of apolipoprotein(a) [apo(a)]. We investigated whether Lp(a) cholesterol measurement, which is not influenced by apo(a) size, is a viable alternative to measuring Lp(a) mass.
American Journal of Obstetrics and Gynecology, 2007
The purpose of this study was to compare free  and intact human chorionic gonadotropin in first ... more The purpose of this study was to compare free  and intact human chorionic gonadotropin in first trimester screening with pregnancy-associated plasma protein-A and nuchal translucency.
MLO: medical laboratory observer
National Conference on Artificial Intelligence, 1987
Diabetes technology & therapeutics, 2003
Current diabetes management requires the collection of a large volume of data by the patient for ... more Current diabetes management requires the collection of a large volume of data by the patient for analysis by his or her provider. There are numerous practical and technical barriers to doing this effectively and efficiently. In addition, the calculation of the correct insulin dose is complex because it requires considering anticipated carbohydrate consumption and exercise in addition to the current blood glucose level. A Diabetes Management and Communication System (DMCS) has been developed using a Compaq iPAQ Pocket PC with a Sprint PCS wireless AirCard. This system circumvents the problem of multiple proprietary programs for each brand of meter and permits the accurate determination of the proper insulin dose. Privacy is maintained by using only the iPAQ serial number as the patient identifier with access to the website protected by unique patient and provider passwords. The iPAQ was programmed with formulas that included: insulin sensitivity factor, current glucose level, amount ...
Health matrix, 1989
Readmission rates are used by the Health Care Financing Administration (HCFA) as an indicator of ... more Readmission rates are used by the Health Care Financing Administration (HCFA) as an indicator of a hospital's quality of care. Specifically, HCFA seeks to relate readmission to complications of the primary admission. A recent study at the Cleveland Clinic Foundation examined patients readmitted within 30 days of dismissal during two non-consecutive months to the cardiovascular surgery, cardiology, and gastroenterology services at this 1,008 bed hospital, accounting for 31% (1640-5342) of all hospital discharges. Only 17% (25/149) of readmissions were due to a complication of the previous hospital admission. Examining those who were readmitted for complications of their primary admission, we found that 36% (9/25) of such readmitted patients had infections that occurred during their primary admission. Otherwise stated, 5.4% (9/149) of readmissions were for nosocomial infections. These patients were compared with 20 retrospectively matched, non-readmitted patients chosen randomly f...
Clinical chemistry, 1986
The EXPERT consultation system-building tool, a knowledge-based artificial intelligence program d... more The EXPERT consultation system-building tool, a knowledge-based artificial intelligence program developed at Rutgers University, has been applied to the development of a laboratory consultation system facilitating sequential laboratory testing and interpretation. Depending on the results of a basic panel of laboratory tests, the system requests that specific secondary tests be performed. Input of these secondary findings can result in requests for tertiary testing, to complete the database necessary for interpretation. Interpretation of all results is based upon final inferences from the collected findings through a series of rules, a hierarchical network that yields an efficient production system not easily obtained through conventional programming. The rules included in this model are based upon initial results for total protein, calcium, glucose, total bilirubin, alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase, thyroxin, hemoglobin, mean corpuscular volume...
Medical decision making : an international journal of the Society for Medical Decision Making
The general problem of selecting a battery of tests for diagnostic purposes is discussed and mult... more The general problem of selecting a battery of tests for diagnostic purposes is discussed and multiobjective optimization methodology is applied to solve it, with battery selection being based on performance indices such as sensitivity, specificity, and the cost of testing. For a battery of tests, the extended majority rule is developed and used to interpret the compound test results. The major advantage of the model developed in this paper is that it can generate a set of noninferior batteries without requiring the calculation of all possible combinations of tests. An example in which the method is applied to a real problem--the selection of short-term tests to detect the carcinogenicity of chemicals--is discussed.
Cleveland Clinic journal of medicine
The Lancet, 1970
A number of published reports have drawn attention to the hazard of ototoxicity following the adm... more A number of published reports have drawn attention to the hazard of ototoxicity following the administration of the aminoglycoside antibiotics (neomycin, kanamycin, streptomycin, dihydrostreptomycin, and gentamicin). Auditory damage has been recorded following long-term oral administration in hepatic disease associated with impaired renal function,! colonic irrigation,2 intrabronchial administration,3 and the irrigation of a bedsore.4 Absorption from raw granulating areas treated either by sprays or topical dressings or by direct application to exposed tissues during surgical procedures could be sufficient to produce toxic blood-levels.
Artificial Intelligence, 1990
American Journal of Obstetrics and Gynecology, 2007
Journal of Immigrant and Minority Health, 2009
This study investigated the use of electronic, web-enabled touch-screen information kiosks as a t... more This study investigated the use of electronic, web-enabled touch-screen information kiosks as a tool to provide culturally and linguistically appropriate diabetes information to Latino audiences. Two kiosk models (high privacy sit-down, group enabled stand-up) in two locations (pharmacy, community center) in Northeast Georgia provided bilingual, read-aloud diabetes education and local resource information on health care. Data from public use and interviews with focus group participants showed that users found the kiosks and their functions helpful and usable, though usage was moderated by presence or absence of a peer health educator (promotora); participants also preferred the sit-down, multi-function kiosk model.
Cleveland Clinic quarterly, 1986
Amer J Obstet Gynecol, 2007
Obstetrics & Gynecology, 2006
To estimate patterns of total hCG and inhibin A levels in the late first trimester of Down syndro... more To estimate patterns of total hCG and inhibin A levels in the late first trimester of Down syndrome pregnancies, compare them with that of free beta-hCG, and assess screening performance of these markers individually and in combination with pregnancy-associated plasma protein-A (PAPP-A) and nuchal translucency. Seventy-nine matched case-control sets of maternal serum samples (each Down syndrome case matched to 5 controls) from 11 through 13 completed weeks of gestation were taken from the sample bank of the First and Second Trimester Evaluation of Risk Consortium, a population-based study, and assayed for levels of free beta-hCG, total hCG, and inhibin A. Distribution characteristics and correlations of the multiples of the median values were estimated in cases and controls. Screening performance for each marker, alone and in combination with PAPP-A, nuchal translucency, and maternal age, was calculated. Median multiples of the median levels of free beta-hCG, total hCG, and inhibin A in cases were more elevated as gestation increased from 11 to 13 weeks, with univariate detection rates of 31%, 23%, and 29%, respectively, at a 5% false-positive rate. At 12 weeks, the multivariate detection rates at a 5% false-positive rate for nuchal translucency and PAPP-A (with maternal age) with either free beta-hCG, total hCG, or inhibin A were 84%, 83%, and 85%, respectively. The improvement in performance from nuchal translucency and PAPP-A to any of the three-marker tests was significant, while performance of any of the three-marker combinations was not significantly different from each other. Although levels of free beta-hCG in affected pregnancies were higher earlier than the levels of either total hCG or inhibin A, there was no significant difference in screening performance when either of the three markers was used with nuchal translucency and PAPP-A at 11-13 weeks of pregnancy. II-2.
Clinical Biochemistry, 2004
Objectives: Elevated plasma lipoprotein(a) [Lp(a)] is a significant risk factor for vascular dise... more Objectives: Elevated plasma lipoprotein(a) [Lp(a)] is a significant risk factor for vascular disease. Standardization of Lp(a) mass measurement is complicated by the heterogeneity of apolipoprotein(a) [apo(a)]. We investigated whether Lp(a) cholesterol measurement, which is not influenced by apo(a) size, is a viable alternative to measuring Lp(a) mass.
American Journal of Obstetrics and Gynecology, 2007
The purpose of this study was to compare free  and intact human chorionic gonadotropin in first ... more The purpose of this study was to compare free  and intact human chorionic gonadotropin in first trimester screening with pregnancy-associated plasma protein-A and nuchal translucency.
MLO: medical laboratory observer
National Conference on Artificial Intelligence, 1987
Diabetes technology & therapeutics, 2003
Current diabetes management requires the collection of a large volume of data by the patient for ... more Current diabetes management requires the collection of a large volume of data by the patient for analysis by his or her provider. There are numerous practical and technical barriers to doing this effectively and efficiently. In addition, the calculation of the correct insulin dose is complex because it requires considering anticipated carbohydrate consumption and exercise in addition to the current blood glucose level. A Diabetes Management and Communication System (DMCS) has been developed using a Compaq iPAQ Pocket PC with a Sprint PCS wireless AirCard. This system circumvents the problem of multiple proprietary programs for each brand of meter and permits the accurate determination of the proper insulin dose. Privacy is maintained by using only the iPAQ serial number as the patient identifier with access to the website protected by unique patient and provider passwords. The iPAQ was programmed with formulas that included: insulin sensitivity factor, current glucose level, amount ...
Health matrix, 1989
Readmission rates are used by the Health Care Financing Administration (HCFA) as an indicator of ... more Readmission rates are used by the Health Care Financing Administration (HCFA) as an indicator of a hospital's quality of care. Specifically, HCFA seeks to relate readmission to complications of the primary admission. A recent study at the Cleveland Clinic Foundation examined patients readmitted within 30 days of dismissal during two non-consecutive months to the cardiovascular surgery, cardiology, and gastroenterology services at this 1,008 bed hospital, accounting for 31% (1640-5342) of all hospital discharges. Only 17% (25/149) of readmissions were due to a complication of the previous hospital admission. Examining those who were readmitted for complications of their primary admission, we found that 36% (9/25) of such readmitted patients had infections that occurred during their primary admission. Otherwise stated, 5.4% (9/149) of readmissions were for nosocomial infections. These patients were compared with 20 retrospectively matched, non-readmitted patients chosen randomly f...
Clinical chemistry, 1986
The EXPERT consultation system-building tool, a knowledge-based artificial intelligence program d... more The EXPERT consultation system-building tool, a knowledge-based artificial intelligence program developed at Rutgers University, has been applied to the development of a laboratory consultation system facilitating sequential laboratory testing and interpretation. Depending on the results of a basic panel of laboratory tests, the system requests that specific secondary tests be performed. Input of these secondary findings can result in requests for tertiary testing, to complete the database necessary for interpretation. Interpretation of all results is based upon final inferences from the collected findings through a series of rules, a hierarchical network that yields an efficient production system not easily obtained through conventional programming. The rules included in this model are based upon initial results for total protein, calcium, glucose, total bilirubin, alkaline phosphatase, lactate dehydrogenase, aspartate aminotransferase, thyroxin, hemoglobin, mean corpuscular volume...
Medical decision making : an international journal of the Society for Medical Decision Making
The general problem of selecting a battery of tests for diagnostic purposes is discussed and mult... more The general problem of selecting a battery of tests for diagnostic purposes is discussed and multiobjective optimization methodology is applied to solve it, with battery selection being based on performance indices such as sensitivity, specificity, and the cost of testing. For a battery of tests, the extended majority rule is developed and used to interpret the compound test results. The major advantage of the model developed in this paper is that it can generate a set of noninferior batteries without requiring the calculation of all possible combinations of tests. An example in which the method is applied to a real problem--the selection of short-term tests to detect the carcinogenicity of chemicals--is discussed.
Cleveland Clinic journal of medicine
The Lancet, 1970
A number of published reports have drawn attention to the hazard of ototoxicity following the adm... more A number of published reports have drawn attention to the hazard of ototoxicity following the administration of the aminoglycoside antibiotics (neomycin, kanamycin, streptomycin, dihydrostreptomycin, and gentamicin). Auditory damage has been recorded following long-term oral administration in hepatic disease associated with impaired renal function,! colonic irrigation,2 intrabronchial administration,3 and the irrigation of a bedsore.4 Absorption from raw granulating areas treated either by sprays or topical dressings or by direct application to exposed tissues during surgical procedures could be sufficient to produce toxic blood-levels.
Artificial Intelligence, 1990
American Journal of Obstetrics and Gynecology, 2007
Journal of Immigrant and Minority Health, 2009
This study investigated the use of electronic, web-enabled touch-screen information kiosks as a t... more This study investigated the use of electronic, web-enabled touch-screen information kiosks as a tool to provide culturally and linguistically appropriate diabetes information to Latino audiences. Two kiosk models (high privacy sit-down, group enabled stand-up) in two locations (pharmacy, community center) in Northeast Georgia provided bilingual, read-aloud diabetes education and local resource information on health care. Data from public use and interviews with focus group participants showed that users found the kiosks and their functions helpful and usable, though usage was moderated by presence or absence of a peer health educator (promotora); participants also preferred the sit-down, multi-function kiosk model.