Search PubMed⌕ Search

Biomedical subjects

H S Waxman

Publications and source records attributed to H S Waxman.

13 recordsLinked to original sources

Continuing medical education: a new vision of the professional development of physicians.

The authors describe their vision of what continuing medical education (CME) should become in the changing health care environment. They first discuss six types of literature (e.g., concerning learning and adult development principles, problem-based/practice-based learning, and other topics) that contribute to ways of thinking about and understanding CME. They then state their view that the Association of American Medical Colleges (AAMC) has made a commitment to helping CME be more effective in the professional development of physicians. In presenting their new vision of CME, the authors describe their interpretation of the nature and values of CME (e.g., optimal CME is highly self-directed; the selection and design of the most relevant CME is based on data from each physician's responsibilities and performance; etc.). They then present seven action steps, suggestions to begin them, and the institutions and organizations they believe should carry them out, and recommend that the AAMC play a major role in supporting activities to carry out these steps. (For example, one action step is the generation and application of new knowledge about how and why physicians learn, select best practices, and change their behaviors). Six core competencies for CME educators are defined. The authors conclude by stating that collaboration among the appropriate academic groups, professional associations, and health care institutions, with leadership from the AAMC, is essential to create the best learning systems for the professional development of physicians.

Education, Medical, Continuing↗

Computer-assisted adult medical diagnosis: subject review and evaluation of a new microcomputer-based system.

Three decades after the conceptual foundation was laid for computer-aided diagnosis, some of its potential has been realized. Systems based on probabilistic reasoning have been developed and applied within limited domains (e.g., acute abdominal pain) and for the general diagnosis of systemic disorders. Less progress has been made in the development and application of diagnostic systems based on "artificial intelligence", reflecting theoretical limits to this application of computers to medicine and the enormity of the task. The presently available probabilistic systems have recently been joined by a new microcomputer-based system, MEDITEL Computer-Assisted Diagnosis, Adult System. The performance of this system was evaluated with both clinical-pathologic conference cases and consecutive admissions with undiagnosed illnesses. The correct diagnosis appeared on the list generated by the system in 80 to 90% of the cases. Experience with this and other systems illustrates current issues in the evaluation of computer systems for aid in diagnosis and of computer-based medical "expert" systems in general. These issues include physician acceptance of these systems and the ethical, legal, and regulatory aspects of computer system application. We conclude that, in appropriately selected cases, the accuracy and efficiency of physician diagnosis can be enhanced with computer assistance, and the risk of overlooking the correct diagnosis can be reduced.

Artificial Intelligence↗

MEDITEL.

Explore the source record for details and available documents.

Diagnosis, Computer-Assisted↗

Stimulation of globin synthesis: relative responsiveness of reticulocytes and nucleated erythroid cells.

The effects of iron, cobalt, hemin, and plasma on hemoglobin synthesis by suspensions of rabbit reticulocytes and nucleated bone marrow cells were studied. L-Leucine-(14)C and sodium pyruvate-3-(14)C were employed to measure globin and heme synthesis, respectively. Normal plasma (or serum) was found to stimulate the rate of globin synthesis in both systems. The stimulatory effects of iron and hemin were additive to those of plasma or serum only in the reticulocytes. Cobaltous ion, at concentrations less than 1.0 mmole/liter, was found to stimulate globin synthesis by reticulocytes as effectively as ferrous ion; cobalt was inhibitory only at concentrations greater than 3.0-5.0 mmoles/liter. Heme synthesis by reticulocytes was inhibited at all concentrations employed (0.2-5.0 mmoles/liter). In bone marrow nucleated erythroid cells, globin synthesis was markedly enhanced by exogenous hemin. In contrast to reticulocytes, however, bone marrow cells were unresponsive to either cobalt or transferrin-bound iron. Possible implications of these findings on regulation of the rate and mechanism of iron uptake and hemoglobin synthesis in vivo are discussed.

Animals↗