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Biomedical subjects

Joel Saltz

Publications and source records attributed to Joel Saltz.

7 recordsLinked to original sources

caGrid: design and implementation of the core architecture of the cancer biomedical informatics grid.

MOTIVATION: The complexity of cancer is prompting researchers to find new ways to synthesize information from diverse data sources and to carry out coordinated research efforts that span multiple institutions. There is a need for standard applications, common data models, and software infrastructure to enable more efficient access to and sharing of distributed computational resources in cancer research. To address this need the National Cancer Institute (NCI) has initiated a national-scale effort, called the cancer Biomedical Informatics Grid (caBIGtrade mark), to develop a federation of interoperable research information systems. RESULTS: At the heart of the caBIG approach to federated interoperability effort is a Grid middleware infrastructure, called caGrid. In this paper we describe the caGrid framework and its current implementation, caGrid version 0.5. caGrid is a model-driven and service-oriented architecture that synthesizes and extends a number of technologies to provide a standardized framework for the advertising, discovery, and invocation of data and analytical resources. We expect caGrid to greatly facilitate the launch and ongoing management of coordinated cancer research studies involving multiple institutions, to provide the ability to manage and securely share information and analytic resources, and to spur a new generation of research applications that empower researchers to take a more integrative, trans-domain approach to data mining and analysis. AVAILABILITY: The caGrid version 0.5 release can be downloaded from https://cabig.nci.nih.gov/workspaces/Architecture/caGrid/. The operational test bed Grid can be accessed through the client included in the release, or through the caGrid-browser web application http://cagrid-browser.nci.nih.gov.

Biomarkers, Tumor↗

Distinct proteome features of plasma microparticles.

Plasma microparticles (MPs) are spherical cell membrane fragments derived from either apoptotic or activated cells. Characterized by a rich phospholipid moiety and many protein constituents, MPs normally circulate in the blood and contribute to numerous physiological processes. In disease states, MPs derived from the injured organ likely contain valuable markers for determining the site, type, and extent of disease pathology. However, the basic protein characteristics of plasma MPs have yet to be described. In this study, MPs from a pooled plasma sample derived from 16 healthy donors, all of group A blood type, were prepared by ultracentrifugation. Flow cytometry confirmed that a majority of these MPs are smaller than 1 microm. Factor Xa generation assay revealed the presence of tissue factor activity in these MPs, confirming MPs' role in initiating blood coagulation. The MP proteome was analyzed by two-dimensional (2-D) gel electrophoresis performed in triplicate, and compared with a 2-D gel of pooled whole plasma and blood platelets. Overall, plasma MPs displayed distinct protein features and a greater number of protein spots (1021-1055) than that detected in whole plasma (331-370). Protein spots expressed in high abundance in the MP proteome were then excised and submitted for protein identity determination. This process provided protein identification for 169 protein spots and reported their relative protein quantities within the MP proteome. These 169 protein spots represented 83 different proteins and their respective isoforms. Thirty of these proteins have never before been reported in previous proteome analyses of human plasma. These results provide unprecedented information on the MP proteome and create a basis for future studies to understand MP biology and pathophysiology.

Adolescent↗

The virtual microscope.

We present the design and implementation of the Virtual Microscope, a software system employing a client/server architecture to provide a realistic emulation of a high power light microscope. The system provides a form of completely digital telepathology, allowing simultaneous access to archived digital slide images by multiple clients. The main problem the system targets is storing and processing the extremely large quantities of data required to represent a collection of slides. The Virtual Microscope client software runs on the end user's PC or workstation, while database software for storing, retrieving and processing the microscope image data runs on a parallel computer or on a set of workstations at one or more potentially remote sites. We have designed and implemented two versions of the data server software. One implementation is a customization of a database system framework that is optimized for a tightly coupled parallel machine with attached local disks. The second implementation is component-based, and has been designed to accommodate access to and processing of data in a distributed, heterogeneous environment. We also have developed caching client software, implemented in Java, to achieve good response time and portability across different computer platforms. The performance results presented show that the Virtual Microscope systems scales well, so that many clients can be adequately serviced by an appropriately configured data server.

Computer Graphics↗

Information warehouse as a tool to analyze Computerized Physician Order Entry order set utilization: opportunities for improvement.

A Computerized Physician order entry (CPOE) system was successfully implemented at the Ohio State University Medical Center (OSUMC) in February 2000. The electronic entry and use of order sets is designed to standardize patient care and improve efficiency and patient safety. To evaluate the effectiveness of the CPOE system and to maximize its benefits, one needs to easily access and analyze the data. Since the CPOE system is not equipped to support such on demand analysis, the data from the system is extracted daily into the OSUMC's Information Warehouse (IW). This allows the CPOE data to be linked with other clinical and financial patient information in the IW to provide detailed and comprehensive analysis. Our focus in this paper is the use of the IW as a tool to analyze order set usage patterns and the opportunities such analysis provides for improvements in education, resource utilization and patient care.

Academic Medical Centers↗

Order sets utilization in a clinical order entry system.

An order set is a predefined template that has been utilized in the standard care of hospitals for many years. While in the past, it took the form of pen and paper, today, it is, indeed, electronic. Within order sets are distinct ordering patterns that may yield fruitful results for clinicians and informaticians, alike. Protocols like there electronic counterpart, order sets, provide an 'indication' identifying the clinical scenario of the patient's condition when the ordering event occurred. This 'indication' is rarely captured by individual orders, and provides difficult challenges to developers of information systems. While mandating an 'indication' be entered for every medication or lab order makes the job much more tasking on the physician provider, it is appealing to researchers and accountants. We have attempted to bypasses that consideration by identifying ordering patterns that predict diagnostic related codes (DRGs) and diagnostic codes which would greatly facilitate the information gathering process and still provide a flexible and user friendly physician interface.

Forms and Records Control↗

Proteomic patterns analysis: a new era of screening cancers.

Cancer is the second leading cause of death among Americans. It is estimated that 1.28 million new Americans are diagnosed with cancer annually (1). The estimated overall annual cost of cancer being $171 Billion (1). Decreasing the costs of the screening and diagnostic tests will automatically decrease the total cost of cancer by limiting not only the direct medical costs but also by containing the indirect costs of morbidity and mortality. New screening and diagnostic tests are obviously needed. Screening methods are emerging in the evaluation of proteomic patterns. In proteomic pattern analysis, we can screen for not only one cancer but a chip may be able to screen for multiple cancers. New screening and diagnostic methods (2) investigated by NCI and FDA (3) (4) are correlating gene and protein expression patterns for early detection of cancer. Many papers have been published in the last 12 months (3) (4) (5) utilizing this new technique of molecular analysis in screening and diagnosing cancers with high sensitivity and specificity.

Health Care Costs↗

Impact of CPOE order sets on lab orders.

Introduction of the computerized physician order (CPOE) is intended to promote best practices, decrease practice variation among practitioners, and optimize the utilization of resources consistent with evidence based practice guidelines. Implicit in the use of CPOE is the assumption that the use of order sets might decrease utilization of resources such as the ordering of unnecessary laboratory tests. Conversely compliance with practice guidelines may necessitate ordering of certain tests that are deemed to be consistent with the good practice of medicine. In order to develop an understanding of these issues, we compared the utilization of laboratory orders prior to and following implementation of order sets in CPOE. In addition, we analyzed the impact of CPOE on the timely placement of certain orders based on critical levels of some laboratory results, in this instance potassium.

Academic Medical Centers↗