OBJECTIVE: To evaluate the performance of tools for authoring patient database queries. DESIGN: Query by Review, a tool that exploits the training that users have undergone to master a result review system, was compared with AccessMed, a vocabulary browser that supports lexical matching and the traversal of hierarchical and semantic links. Seven subjects (Medical Logic Module authors) were asked to use both tools to gather the vocabulary terms necessary to perform each of eight laboratory queries. MEASUREMENTS: The proportion of queries that were correct; intersubject agreement. RESULTS: Query by Review had better performance than AccessMed (38% correct queries versus 18%, p = 0.002), but both figures were low. Poor intersubject agreement (28% for Query by Review and 21% for AccessMed) corroborated the relatively low performance. Subjects appeared to have trouble distinguishing laboratory tests from laboratory batteries, picking terms relevant to the particular data type required, and using classes in the vocabulary's hierarchy. CONCLUSION: Query by Review, with its more constrained user interface, performed somewhat better than AccessMed, a more general tool. Neither tool achieved adequate performance, however, which points to the difficulty of formulating a query for a clinical database and the need for further work.

Artificial Intelligence↗

PubMedDate not supplied

AlaHA's living legacy. Favorite memories from those who have lived our healthcare history.

Explore the source record for details and available documents.

Alabama↗

PubMedDate not supplied

An unmanaged computer system can stop you dead.

Many businesses today are discovering that technology alone will not ensure the success of their information systems. In fact, the growing availability of computer-driven technology has made it harder for many companies to keep pace, and some have already fallen behind. Complicating this grim picture is a growing shortage of trained personnel. Such serious problems jeopardize not only the computer systems but the very existence of some companies, says Brandt Allen. Senior executives must become closely involved with their information systems to reassess and perhaps reorganize their computer resources. He details some measures for first aid and long-term care of the information system that should help to avert life-threatening situations.

Computers↗

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Successful treatment of acute allograft failure using pneumatic biventricular assistance.

A 61-year-old man underwent orthotopic heart transplantation complicated by acute allograft failure. Management entailed placement of two ventricular assist devices, and there was subsequent hemodynamic stabilization. Ventricular assistance continued for 8 days, at which time graft recovery resulted in successful explanation of the devices. Subsequent recovery was uneventful, and the patient was discharged on the 28th postoperative day. Methods of optimizing interoperative device cardiac output and synchronous-mode weaning are discussed.

Cardiomyopathy, Dilated↗

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Utilization of diagnostic resources for meningoencephalitis in the pediatric ICU.

To determine whether a Pediatric Critical Care team has an evolution of medical practice that decreases the utilization of diagnostic tests and consults, we examined the records of 69 patients admitted for meningitis or meningoencephalitis at Women and Children's Hospital in Charleston, W.Va., a university-affiliated, teaching hospital. The study was conducted from August 1990 to August 1994. We found that utilization of diagnostic resources (UDR) decreased over the four years, and there was a direct relationship between an increase in severity of illness and an increase in UDR. When adjusted per severity of illness, UDR decreased by $423 per year. The presence of a consult was a factor leading to an increase in resources, which were associated with an increased utilization of diagnostic tests and length of stay. The consultation rate was independent of the severity of illness and experienced a decrease over the years.

Analysis of Variance↗

PubMedDate not supplied

Effects of others' drinking as perceived by community members.

A 1994 survey of adults from a northern Ontario city contained questions about alcohol consumption, problems experienced as a result of others' drinking, and opinions concerning solutions to such problems. The 180-question survey was administered to about 900 respondents, the vast majority of whom said they had consumed alcohol within the previous 12 months. At least one in five said they had been bothered by three types of experience caused by other drinkers: loudness, humiliation, and arguments. Young adults stood out as the group most likely to experience each type of problem caused by other drinkers. There was a robust level of support for most solutions proposed, with the exception of a city ban on drinking in indoor public places. The data suggest that comprehensive prevention efforts may be more effective than those focused on a single approach geared towards only one group or person.

Adult↗