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Biomedical subjects

O Bodenreider

Publications and source records attributed to O Bodenreider.

25 records · Page 2Linked to original sources

Case mix of elderly in-patients in the 29 hospitals in Lorraine in 1994 and 1995.

The creation of regional standardized medical information databases in relation with the French anonymous discharge dataset allows the study of the geriatric case mix processed in the Lorraine region for patients over 69. The age histogram (69 to 107 years) presents a two mode distribution with an important dip centered on 79 years probably in connection with the demography of Lorraine and the consequences of the First World War. These geriatric patients represent 17% of hospitalisations in public and private hospitals participating in the public sector. The case mix is related to the size of the hospital and to its juridical status. The bigger the size of an hospital, the less its activity is concentrated on a small number of disorders. Lung and heart diseases represent the first cause of hospitalisation in all hospitals. It is necessary to underline the limitation of an approach which uses the patients' individual hospitalisations, and which does not allow different stays of a given patient on the same hospital or between different hospitals to be linked. This approach prevents from appreciating the care network for this elderly population suffering from chronic diseases.

Aged↗

Methodology for using the UMLS as a background knowledge for the description of surgical procedures.

The Unified Medical Language System (UMLS) contains and organizes a large number of terms from a variety of biomedical terminology systems. This study examines the relevance of the UMLS content and structures to the specific purpose of the conceptual representation of medical procedures. The MAOUSSC modelling is a compositional formalism with a description of elementary procedures in terms of elementary concept entities and combinations of such descriptions into more complex ones. The UMLS knowledge base is expected to provide semantically categorized medical concepts and interconcept relations. A method to reuse the UMLS has been developed. Quantitative and qualitative results are presented. Some difficulties in reusing the UMLS as a background knowledge are related to the preeminence of some terminology sources and to the instanciation of interconcept links. Other ones suggest that purpose-independence in categorization cannot be achieved.

Artificial Intelligence↗

Knowledge acquisition from the UMLS sources: application to the description of surgical procedures.

The re-usability of lexicons and knowledge in medicine is a crucial challenge. The Unified Medical Language System (UMLS) project has attempted to provide a repository of concepts, semantically categorized for biomedical domain. This paper describes some results about the relevance of UMLS structures for specific purposes. We have focused on the description of surgical procedures. Discussion concerns synonymy of terms, granularity of concepts, and ontology. A preliminary work on the exploitation of interconcept links by a computerized application reveals a heterogeneous implementation of those relationships. However, the UMLS provides a powerful knowledge base for developers.

General Surgery↗

[Coronary artery surgery after 70 years: an analysis of the risk factors of operative mortality].

The risk factors of operative mortality after coronary bypass surgery in patients over 70 years of age were studied in a consecutive series of 109 patients operated in our department between January 1990 and June 1992. The anginal pain was classified stage III or IV in 92 cases. Seventy-nine patients had triple vessel disease, 36 patients had left main stem stenosis and 57 had previous myocardial infarction. Twenty-six patients had ejection fractions of less than 50% and 6 were less than 30%. The average number of bypass grafts was 2.35. Associated procedures included 9 endarteriectomies of the left main coronary, one endarteriectomy of the left anterior descending and right coronary arteries, 2 myotomies involving the left anterior descending artery, 3 ventricular remodeling procedures and 3 carotid endarteriectomies. Non-lethal postoperative complications were mainly pulmonary infections (19 cases). The operative mortality was 5.1% in the group with stable angina. On the other hand, the mortality was 31.2% in the group with unstable angina operated as an emergency or semi-emergency. The causes of death were mainly postoperative low output states (16 cases) and polyarteriopathy (mesenteric infarction: 6 cases). Although age was related to operative risk, the main prognostic factor was the preoperative cardiovascular status. The degree of emergency, unstable angina, left main coronary disease, duration of cardio-pulmonary bypass and the necessity for inotropic or mechanical support in the postoperative phase were significant risk factors for death. Sex, cardiovascular risk factors, previous myocardial infarction and duration of aortic clamping were not correlated to mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

A Web terminology server using UMLS for the description of medical procedures.

The Model for Assistance in the Orientation of a User within Coding Systems (MAOUSSC) project has been designed to provide a representation for medical and surgical procedures that allows several applications to be developed from several viewpoints. It is based on a conceptual model, a controlled set of terms, and Web server development. The design includes the UMLS knowledge sources associated with additional knowledge about medico-surgical procedures. The model was implemented using a relational database. The authors developed a complete interface for the Web presentation, with the intermediary layer being written in PERL. The server has been used for the representation of medico-surgical procedures that occur in the discharge summaries of the national survey of hospital activities that is performed by the French Health Statistics Agency in order to produce inpatient profiles. The authors describe the current status of the MAOUSSC server and discuss their interest in using such a server to assist in the coordination of terminology tasks and in the sharing of controlled terminologies.

Computer Communication Networks↗

Evaluation of the Unified Medical Language System as a medical knowledge source.

OBJECTIVE: The authors evaluated the use of the Unified Medical Language System (UMLS) as a medical knowledge source for the representation of medical procedures in the MAOUSSC system. DESIGN: MAOUSSC, a multiaxial coding system, was used for the representation of 1500 procedures from 15 clinical specialties, using UMLS concepts (augmented by full sources for three new vocabularies being added to the UMLS) and relationships whenever possible. Evaluation criteria for the UMLS included (1) completeness of representation of concepts and of inter-concept relationships, (2) consistency in the categorization of both concepts and inter-concept relationships, and (3) usability, including adaptability of the UMLS to a foreign language (French), its suitability to a geographic region with different medical practices than the USA, and issues relative to the annual update changes in the test vocabularies. RESULTS: During the MAOUSSC trial, the number of missing concepts or relationships identified in the augmented UMLS sources was deemed to be inconsequential relative to overall project goals. "Missing" UMLS inter-concept relationships were identified, although they were small in number. Some inconsistencies in the UMLS were noted, especially in the area of hierarchic relationships. CONCLUSION: After UMLS was used for five years as a knowledge source for representing 1500 complex medical procedures in MAOUSSC, its value is considered significant. Future editions of the UMLS are expected to improve representation of inter-concept relationships and global consistency.

Language↗