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Biomedical subjects

G O Barnett

Publications and source records attributed to G O Barnett.

At least 19 recordsLinked to original sources
PubMed1992

Analysis of physician questions in an ambulatory care setting.

We collected 69 questions generated by physicians based on their active patient medical records. Each question was associated with a single term in a specific record (Key Term). These questions were analyzed with respect to word content and concept content. Concepts were matched to the National Library of Medicine's Metathesaurus (Meta-1). Sixty-eight Key Terms were completely matched by Meta-1 terms. Each question matched to an average of 3.7 Meta-1 terms for a total of 255 concepts. Based on word count, these 255 concepts accounted for 43%, stop words accounted for 36%, and numbers and drug trade names accounted for 3% of the words. The remaining 18% of the words could be matched to 143 concepts not in Meta-1. Review of all concepts showed that they could be divided into medical terms (Noun Concepts), modifiers (Modifier Concepts), and concepts that provided context for the questions (Relation Concepts). The majority of Relation Concepts did not match concepts in Meta-1. A vocabulary of Relation Concepts would provide a useful starting point for a computer system designed to aid physicians in answering these questions.

Ambulatory Care Information Systems↗
PubMed1992

Automated ambulatory medical records systems. An orphan technology.

Automated ambulatory medical records systems (AAMRSs) have been operational for over 20 years but have not been adopted by more than a small fraction of their potential users. This paper presents a detailed analysis of the uses and benefits of the COSTAR-based AAMRS at the Harvard Community Health Plan and of the factors which have inhibited the dissemination of COSTAR. We conclude that AAMRSs have been an orphan technology and cite trends in health care that favor the future development of AAMRSs.

Ambulatory Care Information Systems↗
PubMed1992

Representation of nursing terminology in the UMLS Metathesaurus: a pilot study.

To see whether the National Library of Medicine's Metathesaurus (tm) includes terminology relevant to clinical nursing practice, two widely used nursing vocabularies were matched against the Meta. The two nursing vocabularies are 1) the North American Nursing Diagnosis List of Approved Diagnoses; and 2) the Omaha System, a vocabulary of problems and interventions developed by the Omaha Visiting Nurses Association. First, the terms were scanned against Meta in their "native" form, with phrases and combinations intact. This produced a relatively low percentage of exact matches (12%). Next, the terms were separated into "core concepts" and "modifiers" and the analysis was repeated. The percentage of exact matches to terms in Meta increased to 32%. However, the semantic types of the split terms often were not equivalent to the semantic types of the phrases from which the split terms were derived; also, in some cases, terms returned as exact matches had different meanings in Meta. Automatic scanning for lexical matches is a helpful first step in searching for vocabulary representation in Meta, but term-by-term search for context, semantic type and definition is essential. However, it seems clear that representation of nursing terminology in the Metathesaurus needs to be expanded.

Nursing↗
PubMed1992

Q & A: a query formulation assistant.

Inexperienced users of online medical databases often do not know how to formulate their queries for effective searches. Previous attempts to help them have provided some standard procedures for query formulation, but depend on the user to enter the concepts of a query properly so that the correct search strategy will be formed. Intelligent assistance specific to a particular query often is not given. Several systems do refine the initial strategy based on relevance feedback, but usually do not make an effort to determine how well-formed a query is before actually performing the search. As part of the Interactive Query Workstation (IQW), we have developed an expert system, Questions and Answers (Q&A), that assists in formulating an initial strategy given concepts entered by the user and that determines if the strategy is well-formed, refining it when necessary.

Expert Systems↗
PubMed1992

Interactive query workstation: a demonstration of the practical use of UMLS knowledge sources.

The Interactive Query Workstation (IQW) has been developed to provide clinicians with a uniform program interface for retrieving medical-related information from various computer-based information resources. These resources can vary in content (bibliographic databases, drug information, general medical text databases), function (article retrieval, differential diagnosis, drug interaction detection, or drug dosage and administration information), and media formats (local hard disk, CD-ROM, local area network, or distant telecommunication link). IQW allows modular addition of new resources as well as extension of previously installed resources. The National Library of Medicine's three Unified Medical Language System (UMLS) Knowledge Sources, the Metathesaurus (Meta), the Semantic Network, and the Information Sources Map (ISM) have been incorporated into many aspects of IQW. Meta provides information about medical terminology and aids IQW in isolating the basic concepts from a clinician's question. The Semantic Network provides information about the categorization of concepts and possible relations between concepts. It also assists IQW in determining which queries are appropriate for a set of concepts contained in the clinician's question. The ISM provides information about the content available from a computer-based resources and aids IQW in selecting an appropriate resource from which to collect information. The computer-based resource selection is performed without user intervention. This interactive demonstration shows an environment which increases the accessibility of medical information to clinicians by utilizing the three UMLS Knowledge Sources.

Information Storage and Retrieval↗
PubMed1978

Quality assurance through automated monitoring and concurrent feedback using a computer-based medical information system.

A computer-based medical information system (COSTAR) has been used to support a quality assurance program where the data collection is an integral part of the patient care recording activity and, therefore, does not require a separate abstracting or encoding process. This program utilizes concurrent audit to detect deficiencies in patient care, and automatic rapid feedback to the responsible provider in time to allow the provider to correct the deficiency. This system has been demonstrated to improve follow-up of throat cultures, positive for Group A Beta hemolytic streptococcus. It is well accepted by the medical staff whose practice is being audited. Because the data are collected as part of the routine operation of COSTAR, the computer monitoring and feedback have only a small incremental cost.

Boston↗
PubMed1977

MEDINFO--a medical information system.

The MEDINFO (MEDical INFOrmation) system is a general purpose computer-based information storage, retrieval, and analysis system. It is designed for a time sharing, on-line computer system for the rapid and easy creation, maintenance, and analysis of general data files. A wide variety of types of information may be used. These include numeric, categoric, text, date, and multiple-response. The file structure allows several sets of data, including date-orientated data, to be used. MEDINFO permits a study to be created, a description of the data made, data to be entered and updated into records, and for the data to be displayed or analyzed by the investigator without programmer intervention.

Computers↗
PubMed1977

Computer-assisted pathology encoding and reporting system (CAPER).

An on-line computer-assisted pathology encoding and reportying system (CAPER) has been developed by the Department of Pathology and Laboratory of Computer Science of the Massachusetts General Hospital for a department of surgical pathology that processes more than 25,000 specimens yearly. CAPER performs clerical functions, including the accessioning of specimens, monitoring their state of completion, production of log books, billing, statistics, and transfer of diagnoses to other hospital departments. It also permits instantaneous display of all diagnoses rendered within two years, printout within 24 hours of all older diagnoses for any patient, and retrieval of all specimens with any given diagnosis, further defined by any data item (e.g., age) stored in the computer file.

Computers↗
PubMed1977

A computerized prenatal record.

An entirely computerized ambulatory medical record system is operational in a large health maintenance organization. A unique subsystem was designed for use in prenatal care, in which the provider's completion of a single encounter form at the time of visit meets all the information requirements of care delivery, administration, and quality assurance. Instead of using a conventional paper chart, computer-generated summaries and flow charts are automatically provided for scheduled visits and for use as a hospital preadmission record, significantly reducing the provider effort expended on record keeping. On-line inquiry function is also available using terminals at the ambulatory center and the hospital. The computer data base has been used for quality assurance studies in prenatal care. The system is well accepted by providers, is reliable, and is cost effective.

Computers↗
PubMed1976

Malnutrition in cardiac surgical patients. Results of a prospective, randomized evaluation of early postoperative parenteral nutrition.

A randomized evaluation of 44 malnourished patients, wherein 24 were used as controls and 20 received immediate postoperative parenteral hyperalimentation, indicated that five days of nutritional therapy had no notable effect on the morbidity and mortality experienced by the malnourished patients, in comparison to a third, nonmalnourished group of similar patients. Although central venous nutrition was safely administered without complications immediately after cardiac operations, clinical efficacy of this therapy could not be demonstrated. The inability to establish a dose-response relationship, and hence administer the "optimum" amount of nutrients, may have accounted for the negative results reported. Although preoperative malnutrition is associated with a poorer result after cardiac surgery, postoperative repletion of nutrients appears to be ineffective in reversing this relationship.

Cardiac Surgical Procedures↗
PubMed1976

MUMPS--an economical and efficient time-sharing system for information management.

MUMPS, the Massachusetts General Hospital Utility MultiProgramming System, is a compact time-sharing system for information management. This paper discusses the historical development of MUMPS and describes the basic modules found in its implementation. Detailed descriptions of the time-sharing executive, MUMPS language interpreter, input/output file system, and global data base are given, emphasizing their integration into an easy-to-use yet powerful system for application program design, development and maintenance.

Computers↗