Analog computer analysis of dispersion of indicator in the circulation.
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Biomedical subjects
Publications and source records attributed to H R Warner.
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OBJECTIVE: Develop a model for structured and encoded representation of medical information that supports human review, decision support applications, ad hoc queries, statistical analysis, and natural-language processing. DESIGN: A medical information representation model was developed from manual and semiautomated analysis of patient data. The key assumption of the model is that medical information can be represented as a series of linked events. The event representation has two main components. The first component is a frame or template definition that specifies the attributes of the event. The second component is a structured vocabulary, the terms of which are taken as the values of the slots in the event template structure. Individual event instances are linked by specific named relationships. RESULTS: The proposed model was used to represent a chest-radiograph report. CONCLUSIONS: The event model of medical information representation provides a mechanism for formal definition of the logical structure of medical data and allows explicit time-oriented and associative relationships between event instances.
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Statistical pattern-recognition techniques have been frequently applied to the problem of medical diagnosis. Sequential Bayesian approaches are appealing because of the possibility of generating the underlying sensitivities, specificities, and prevalence statistics from the estimates of medical experts. The accuracy of these estimates and the consequences of inaccuracies carry implications for the future development of this type of system. In an effort to explore these subjects, the authors used statistics derived from a clinical database to revise the diagnostic logic in a Bayesian system for generating a differential diagnostic list. Substantial changes in estimated a priori probabilities, sensitivities, and specificities were made to correct for significant under- and overestimations of these values by a group of medical experts. The system based on the derived values appears to perform better than the original system. It is concluded that the statistics used in a Bayesian diagnostic system should be derived from a database representative of the patient population for which the system is designed.
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Hospital characteristics vary greatly across a geographic area such as a state. Hospital peer groups internally exhibit similar characteristics and can be used as a basis for the analysis of data, the dissemination of information, and the adoption of continuous quality improvement project results. This paper reflects the efforts made toward the identification of hospital peer groups within the state of Michigan. Hospital characteristics data for fiscal year 1992 were obtained from the American Hospital Association's Annual Survey of Hospitals and the Health Care Financing Administration's MEDPRO database. Thirteen peer group clusters have been identified, reviewed, and commented on by the state's hospital association and have met general approval by hospital administrators across the state. The established peer groups are being used to identify the differences in patterns of care among hospitals in the state. The peer groups also are being used for the feedback of comparable data and the identification of hospitals for participation in continuous quality improvement projects. The next research objective is to experiment with other clustering techniques and other inpatient populations. The consistency of the peer groupings across all clustering techniques and across both Medicare and total inpatient populations will be studied.
It is now recognized that apoptosis plays an important role in many physiological processes, including aging and age-related diseases. Apoptosis plays both positive and negative roles in aging, and some of these roles are reviewed here. Of particular importance are the roles of apoptosis in reducing cancer incidence, and in promoting neurodegenerative disease. Therefore, the regulation of apoptosis is an inviting target for therapeutic interventions in aging and age-related disease.
An equation of conditional probability is derived to express the logical process used by a clinician in making a diagnosis based on clinical data. Solutions of this equation take the form of a differential diagnosis. The probability that each disease represents the correct diagnosis in any particular patient can be calculated. Sufficient statistical data regarding the incidence of clinical signs, symptoms, and electrocardiographic findings in patients with congenital heart disease have been assembled to allow application of this approach to differential diagnosis in this field. This approach provides a means by which electronic computing equipment can be used to advantage in clinical medicine.
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