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R Cornet

Publications and source records attributed to R Cornet.

9 recordsLinked to original sources

Renal replacement therapy in Europe: the results of a collaborative effort by the ERA-EDTA registry and six national or regional registries.

BACKGROUND: In June 2000 a new ERA-EDTA Registry Office was opened in Amsterdam. This Registry will only collect core data on renal replacement therapy (RRT) through national and regional registries. This paper reports the technical and epidemiological results of a pilot study combining the data from six registries. METHODS: Data from the national renal registries of Austria, Finland, French-Belgium, The Netherlands, Norway, and Scotland were combined. Patients starting RRT between 1980 and 1999 (n=57371) were included in the analyses. Cox proportional hazards regression was used to predict survival. RESULTS: The use of different coding systems for ESRD treatment by the registries made it difficult to merge the data. Incidence and prevalence of RRT showed a continuous increase with a marked variation in rates between countries. The 2-, 5- and 10-year patient survival was 67, 35 and 11% in dialysis patients and 90, 81 and 64% after a first renal allograft. Multivariate analysis showed a slightly better survival on dialysis in the 1990-1994 (RR 0.94, 95% CI 0.90-0.98) and the 1995-1999 cohort (RR 0.88, 95% CI 0.84-0.92) compared to the 1980-1984 cohort. In contrast, there was a much greater improvement in transplant-patient survival, resulting in a 56% reduction in the risk of death within the 1995-1999 cohort (RR 0.44, 95% CI 0.39-0.50) compared to the 1980-1984 cohort. CONCLUSIONS: This study provides support for the feasibility of a "new style" ERA-EDTA registry and the collection of data is now being extended to other countries. The improvement in patient survival over the last two decades has been much greater in transplant recipients than in dialysis patients.

Austria↗

Evaluation of DICE, a terminological system for intensive care.

Evaluative research and the introduction of the Patient Data Management System to support care have increased the need for structured and standardized registration of diagnostic information in Dutch intensive cares (IC). To this end a terminological system to describe diagnoses is needed. A terminological system is a system that denotes terms to concepts in a domain based on specifications of these concepts. During the last two years we have developed DICE (Diagnoses for Intensive Care Evaluation), a terminological system application which includes knowledge about the IC diagnoses domain, such as the anatomical localization, the pathophysiology and the etiology. This paper briefly describes the design of DICE and focus on the preliminary evaluation of DICE. DICE was evaluated on the basis of 126 diagnoses collected. The knowledge modeller as well as the intensivists judged DICE positively. However, there were some points for improvement. The knowledge modeller observed a problem in modelling dependencies between qualifiers of a concept and the intensivists observed some gaps in the knowledge base and were critical about the current interface to compose plural operative procedures.

Critical Care↗

Analysis and design of an ontology for intensive care diagnoses.

Information about the patient's health status and about medical problems in general, play an important role in stratifying a patient population for quality assurance of intensive care. A terminological system which supports both the description of health problems for daily care practice and the aggregation of diagnostic information for evaluative research, is desirable for description of the patient population. This study describes the engineering of an ontology that facilitates a terminological system for intensive care diagnoses. We analyzed the criteria for such an ontology and evaluated existing terminological systems according to these criteria. The analysis shows that none of the existing terminological systems completely satisfies all our criteria. We describe choices regarding design, content and representation of a new ontology on which an adequate terminological system is based. The proposed ontology is characterized by the explicit and formal representation of the domain model, the metaspecification of its concepts, the vocabulary to define concepts and the nomenclature to support the composition of new concepts.

Diagnosis, Computer-Assisted↗

Problems with integrating legacy systems.

The economic and organizational impact of imposing state-of-the-art technology to the large number of proprietary legacy systems operational in most hospitals requires integrated clinical professional workstations to provide flexible encapsulation mechanisms for these systems rather than reengineering these systems to this new technology. In this paper the implications of different input/output and translation models of legacy systems for their integration into a clinical workstation is described. Examples of legacy systems that have been integrated in the HERMES clinical workstation are presented as examples of the range of difficulties one might encounter. The features that an integrated workstation should offer for integrating a broad range of legacy systems are also addressed in this paper.

Computer Systems↗

HERMES: a health care workstation integration architecture.

An architecture is described that facilitates integration of existing databases and applications without modifying them. By means of this architecture, data from different sources dispersed in a network can be combined and directly used in existing applications or applications that have been developed specially for integration. This feature of combining data from different sources into one workstation is viewed as the enabling technology on which computer-based patient records can be built. The abstraction of computer-, network- and application-specific details is completely dealt with by the integration architecture. This integration architecture has been developed with extendibility and flexibility in mind, and allows for a growth-path towards application of the open system paradigm in medicine.

Computer Communication Networks↗

A cooperative model for integration in a cardiology outpatient clinic.

With the increasing amount of digitally stored patient information, such as images and findings, the possibility and need arise for a system which is able to both store and display this information in a structured, user-friendly way. In the common situation where different information systems are used within one department, this means that the various information systems have to be integrated. However, integration requires more complex management of data, processes and windows. This management can be handled by a Workspace Manager, which controls inter-application tasks, and interaction with the user. Furthermore, this Workspace Manager supports the user with the definition of complex tasks such as collecting problem-related patient information from the various remote systems. In an outpatient clinic for cardiology this architecture is used to achieve cooperative integration of an open Computer Patient Record with a range of information-specific services.

Ambulatory Care Facilities↗

[Not Available].

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Belgium↗