The purpose of this work was to develop a computer-based procedure for training technologists in vertebral morphometry. The utility of the resulting interactive, tutorial based training method was evaluated in this study. The training program was composed of four steps: (1) review of an online tutorial, (2) review of analyzed spine images, (3) practice in fiducial point placement and (4) testing. During testing, vertebral heights were measured from digital, lateral spine images containing osteoporotic fractures. Inter-observer measurement precision was compared between research technicians, and between technologists and radiologist. The technologists participating in this study had no prior experience in vertebral morphometry. Following completion of the online training program, good inter-observer measurement precision was seen between technologists, showing mean coefficients of variation of 2.33% for anterior, 2.87% for central and 2.65% for posterior vertebral heights. Comparisons between the technicians and radiologist ranged from 2.19% to 3.18%. Slightly better precision values were seen with height measurements compared with height ratios, and with unfractured compared with fractured vertebral bodies. The findings of this study indicate that self-directed, tutorial-based training for spine image analyses is effective, resulting in good inter-observer measurement precision. The interactive tutorial-based approach provides standardized training methods and assures consistency of instructional technique over time.
The objective of the Willow Project is to develop a uniform search interface that allows a diverse community of users to retrieve information from heterogeneous network-based information resources. Willow separates the user interface from the database management or information retrieval system. It provides a graphic user interface to a variety of information resources residing on diverse hosts, and using different search engines and idiomatic query languages through networked-based client-server and Transmission Control Protocol/Internet Protocol (TCP/IP) protocols. It is based on a "database driver'' model, which allows new database hosts to be added without altering Willow itself. Willow employs a multimedia extension mechanism to launch external viewers to handle data in almost any form. Drivers are currently available for a local BRS/SEARCH system and the Z39.50 protocol. Students, faculty, clinicians, and researchers at the University of Washington are currently offered 30 local and remote databases via Willow. They conduct more than 250,000 sessions a month in libraries, medical centers and clinics, laboratories, and offices, and from home. The Massachusetts Institute of Technology is implementing Willow as its uniform search interface to Z39.50 hosts.
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