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Biomedical subjects

D F Sittig

Publications and source records attributed to D F Sittig.

At least 37 records · Page 2Linked to original sources
PubMed1996

Identifying a core set of medical informatics serials: an analysis using the MEDLINE database.

A study was undertaken to test the hypothesis that a core set of medical informatics serials could be identified by using standard bibliometric techniques. All journal articles indexed by the National Library of Medicine between 1990 and 1994 were included. Articles were identified by using the "MEDICAL INFORMATICS" Medical Subject Heading (MeSH) term. Each serial title containing articles was then ranked according to (1) the total number of medical informatics journal articles indexed and (2) the percentage of medical informatics journal articles indexed. Twenty-eight serials had more than 100 articles indexed under the "MEDICAL INFORMATICS" MeSH term. Thirty serials had more than 40% of their articles indexed under the "MEDICAL INFORMATICS" MESH term. A "core" set of fourteen serials had 100 or more medical informatics articles indexed, including more than 70% of all articles they published. The methodology described provides librarians with another tool to use in the difficult task of journal selection. The set of "core" serials identified provides librarians with a ranked list of serials, based on which a medical informatics collection can be developed.

Abstracting and Indexing↗
PubMed1996

WWW-based interfaces to clinical information systems: the state of the art.

Nine WWW-based interfaces to clinical information systems were reviewed. Five have progressed past the proof of concept phase and into alpha testing in the clinical environment. All key features desirable in an advanced clinical information were present in at least one interface, however many implementations were rudimentary. Much human computer interface research and WWW tool development needs to occur before implementation of a WWW-based interface to a clinical information system should be considered for a mission-critical, production environment.

Computer Communication Networks↗
PubMed1995

An innovative dicrotic notch detection algorithm which combines rule-based logic with digital signal processing techniques.

Automated, real-time localization of the dicrotic notch, a component of the arterial pressure waveform, represents a deceptively complex problem in computerized biomedical signal processing. The high-frequency nature of the notch can make it difficult to distinguish from artifactual noise or from other high-frequency physiological components of the waveform. In addition, the contour of the notch varies with vascular status and with propagation through arterial beds, requiring any detection algorithm to recognize various possible notch conformations. Finally, location of the notch along the waveform may vary widely depending on other hemodynamic variables, further complicating detection algorithms. We have reviewed various published algorithms and have implemented a number of them to determine the strengths and shortcomings of each. We then developed a reliable and accurate hybrid algorithm which utilizes the strengths of the various algorithmic approaches reviewed; after analyzing the waveform, the algorithm selects the most appropriate method for accurate notch localization based on a series of waveform features. The application of rule-based logic represents a relatively unique approach to digital signal processing.

Algorithms↗
PubMed1995

Building a data foundation for tomorrow's healthcare information management systems.

Accurate, timely data are a necessary foundation for an effective healthcare information management system. Today's systems do not achieve their potential because they lack this essential ingredient. Technology can reduce the problem by making the data entry task easier, but a complete solution will require new strategies for system implementation and use. Functions must be implemented in a sequence that allows the initial functions to establish a data foundation for subsequent functions. Each atomic data item must be collected separately, with a consistent definition. Data capture strategies must permit data to be collected once, at the source. Finally, the data must be used, reused, and corrected by all members of the healthcare team.

Decision Making, Computer-Assisted↗
PubMed1995

Developing interactive computer-based simulations: an object-oriented development methodology enhances computer-assisted instruction.

The purpose of this research was to investigate the application of object-oriented technology and AI techniques to enhance development of computer-based training simulations. Towards that end, a comprehensive computer-assisted instructional unit was developed to teach the skills and concepts of window-based applications, the OS/2 desktop, and the use of a patient care information system. By taking advantage of sophisticated computer graphics for the visual representation of objects and the behavioral modeling capabilities of the object-oriented language, domain knowledge modeling and human-computer interactions were implemented without complex natural language processing techniques. The results of this research indicate that nurses and physicians are able to learn the basic skills and concepts of computer systems and how to query for patient information. The new methodology described for building these computer-assisted instructional simulations significantly eased the training and teaching of large numbers of nurses and physicians and simplified their transition to a complex, computer-based hospital information system environment.

Computer Graphics↗
PubMed1995

A quantitative ranking of the Biomedical Informatics serials.

We have developed a quantitative serial ranking system based on multiple citation analysis techniques, library use statistics, expert opinion, and selected distinguishing publication characteristics. Evaluation criteria categories include: average Science Citation Index (Impact Factor, Immediacy Index, Total citations) rankings from 1987 to 1992; citation source counts of multiple "core" biomedical informatics publications; a questionnaire sent to American College of Medical Informatics Fellows; publication delay; distinguishing characteristics (e.g., subscription cost, total circulation, year established, places indexed, affiliation with a professional society, major biomedical resource library holdings); and the total number of interlibrary loan requests to the U. S. National Library of Medicine. The top serials were Computers and Biomedical Research, MD Computing, Methods of Information in Medicine, Medical Decision Making and Computers in Biology and Medicine.

Abstracting and Indexing↗
PubMed1995

The role of the information architect at King Faisal Specialist Hospital and Research Centre.

Successful implementation of integrated clinical information system requires modification of the institution's long range strategic plans and its personnel's behavior. The changes warrant a concerted effort on the part of many different individuals; this paper describes the role of the Information Architect whose primary functions are to steer the process to fulfill stated objectives and build consensus where divergent forces are at work. The workings of the Architect is presented in context of a unique Middle-Eastern institution currently undergoing automation of clinical information.

Academic Medical Centers↗
PubMed1995

Determining educational needs for the biomedical library customer: an analysis of end-user searching in MEDLINE.

The analysis of CD Plus usage logs provides an opportunity to determine specific areas where searchers are "missing opportunities" by misusing, or failing to use, system specific features. This paper describes a methodology, based on transaction log analysis, to provide automated, continuous analysis of end-user searching. The data collected in this process can then be used to enhance and provide insight into the educational needs of users.

CD-ROM↗
PubMed1995

A quantitative method for measuring clinical user journal needs: a pilot study using CD Plus MEDLINE usage statistics.

OBJECTIVE: To develop a quantitative method for measuring clinical user journal needs based on an analysis of bibliographic search results. DESIGN: Retrospective bibliometric comparison of citation selections generated by clinical users on shared workstations throughout the Medical Center. MEASURES: Number of times each journal was identified by clinical users during multiple bibliographic search sessions. RESULTS: Clinical users identified 2,078 journal articles. The top 200 journal titles accounted for 55% of the clinical users' journal needs. Of the 901 unique journal titles identified, 489 (54%) were identified only once. CONCLUSION: Our pilot study demonstrates that analysis of bibliographic search results can be used to identify clinical user journal needs. Such a method could also be used to estimate user requirements for on-line, full-text medical journals.

CD-ROM↗
PubMed1995

A citation analysis of medical informatics journals.

Citation analysis is an unbiased, quantitative method for evaluating the usefulness of a particular scientific article, or the journal containing that article, based on the number of citations it receives. We performed a citation analysis of the medical informatics journals and compared them to several general medical and science journals. There was no clear-cut "best" medical informatics journal based on these rankings. Comparison with the general medical and science journals showed that our field is at least an order of magnitude smaller than these fields.

Bibliometrics↗
PubMed1994

Randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome.

The impact of a new therapy that includes pressure-controlled inverse ratio ventilation followed by extracorporeal CO2 removal on the survival of patients with severe ARDS was evaluated in a randomized controlled clinical trial. Computerized protocols generated around-the-clock instructions for management of arterial oxygenation to assure equivalent intensity of care for patients randomized to the new therapy limb and those randomized to the control, mechanical ventilation limb. We randomized 40 patients with severe ARDS who met the ECMO entry criteria. The main outcome measure was survival at 30 days after randomization. Survival was not significantly different in the 19 mechanical ventilation (42%) and 21 new therapy (extracorporeal) (33%) patients (p = 0.8). All deaths occurred within 30 days of randomization. Overall patient survival was 38% (15 of 40) and was about four times that expected from historical data (p = 0.0002). Extracorporeal treatment group survival was not significantly different from other published survival rates after extracorporeal CO2 removal. Mechanical ventilation patient group survival was significantly higher than the 12% derived from published data (p = 0.0001). Protocols controlled care 86% of the time. Average PaO2 was 59 mm Hg in both treatment groups. Intensity of care required to maintain arterial oxygenation was similar in both groups (2.6 and 2.6 PEEP changes/day; 4.3 and 5.0 FIO2 changes/day). We conclude that there was no significant difference in survival between the mechanical ventilation and the extracorporeal CO2 removal groups. We do not recommend extracorporeal support as a therapy for ARDS. Extracorporeal support for ARDS should be restricted to controlled clinical trials.

Adult↗
PubMed1994

A quantitative method for measuring library user journal needs: a pilot study using CD plus MEDLINE usage statistics.

OBJECTIVE: To develop a quantitative method for measuring library user journal needs based on an analysis of bibliographic search results. DESIGN: Retrospective bibliometric comparison of citation selections generated by users in the library. MEASURES: Number of times each journal was identified by library users during multiple bibliographic search sessions. RESULTS: Library users identified 4907 journal titles. The top 200 journal titles accounted for 55% of the library user journal needs. Of the 1380 unique titles identified, 652 were selected once. CONCLUSION: Our pilot study demonstrated that analysis of bibliographic search results can be used to identify library user journal needs. Such a method could also be used to estimate user requirements for online, full-text scientific journals.

Bibliometrics↗
PubMed1994

Computer tools to support collaborative organization design: definition and analysis of the work at the Vanderbilt University Hospital and Clinic.

In November, 1993 The Vanderbilt University Hospital and Clinic (VUH/TVC) convened a 10-member Collaborative Organization Design (COD) team that represented a diagonal slice through the organization. This team, lead by Gelinas & James, an outside consulting firm, was charged to develop, recommend, and implement a new organizational design which would promote a stronger patient focus, increased efficiency, and lower costs. The COD process is structured to inspire and enable employees to rebuild their organization so that it can respond to the challenges and opportunities that exist within their environment, to customer needs, and their own aspirations. This manuscript describes several of the computer tools which were utilized in the definition and analysis of the work of patient care at VUH/TVC. Specific examples of the findings from this phase of the work are utilized to illustrate their use and value.

Computers↗
PubMed1993

A graphical user interface to facilitate patient-specific drug dosing.

This paper describes the development of a graphical user-interface (GUI) designed to facilitate the process of generating patient-specific drug doses using bayesian modelling software. The graphical user interface was developed in Visual Basic (Microsoft, Inc.) and runs under the Windows 3.1 (Microsoft, Inc.) operating system. Patient demographic data are stored in a relational database (Access, Microsoft, Inc.). The GUI and the database communicate via dynamic data exchange links. The largely object-oriented nature of the language allowed us to change the entire look and feel of the system with a few simple changes to the underlying code. Use of the relational database to store patient demographic information allows greater flexibility in searching for and displaying patient specific information. The GUI reduces the time required to enter data. The prototype has allowed us to experiment with different presentation methods, greatly improving the clinical acceptance of the dosing programs.

Computer Simulation↗
PubMed1993

Building an information management infrastructure in the 90s: the Vanderbilt experiment.

The course that an organization takes to create a competitive information management infrastructure is determined by a series of decisions, each of which balances tradeoffs. Key success factors include sequencing projects to reflect data requirements; obtaining benefits as cost is incurred; establishing an architecture that permits integration of applications; managing project scope; and establishing a data friendly culture.

Academic Medical Centers↗
PubMed1993

A planning process for a fast track to IAIMS.

The strategic planning process that is part of Vanderbilt University's fast track to IAIMS is evolving based on feedback from the process itself. Led by a committee of VUMC's top management, broad-based sub-committees for administration, education, patient care, and research worked initially on the following strategic issues: identifying key external pressures that constrain and provide opportunities, visioning how VUMC might operate in the future, and establishing a mission and high-level goals for information management. Next steps include identifying the critical mass of function that will prompt daily use of the IAIMS by everyone at VUMC and adding groups to focus on information and technology architectures and developing academic informatics. This manuscript gives detailed, practical information about the evolution of the planning process, committees' responsibilities, working relationships, and lessons learned.

Academic Medical Centers↗
PubMed1993

Work-sampling: a statistical approach to evaluation of the effect of computers on work patterns in healthcare.

An increasing number of health-care institutions are in the process of implementing clinical computing systems. The need for an accurate assessment of the clinical, administrative, social, and financial effects of such systems has been recognized. Techniques have been developed to evaluate these effects on the work patterns of health-care workers including: time-motion analysis, subjective evaluations, review of departmental statistics, personal activity records, and work-sampling. This study reviews these techniques, discusses both positive and negative aspects, and presents a step-by-step description of work-sampling.

Humans↗