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At least 217 records · Page 12Linked to original sources
PubMed1996

Libraries and the R&D strategy: a way forward.

As guest editor for the December 1994 issue of Health Libraries Review, I chose the theme of Evidence-Based Practice. In my editorial I suggested that Evidence-based Practice offered tremendous opportunities for NHS librarians to demonstrate their skills in supporting a knowledge-based NHS, because many clinicians had complained that they did not have time, retrieval skills of knowledge of relevant information resources to be effective at finding scientific evidence. Librarians, on the other hand have advanced online searching skills, rapid document retrieval and delivery services, and up-to-date knowledge of the world's medical information resources and networks. These skills mean that librarians are not only well-placed to support clinicians in finding and sifting scientific evidence, but also in teaching clinicians how to search for and store information themselves. NHS librarians have not been slow to recognize these opportunities and innovative professional development programmes have appeared to help hone their skills, such as the Librarian of the 21st Century Programme in the Anglia and Oxford region. The success of NHS librarians in supporting evidence-based health care has led to their formal development in evidence-based medicine workshops for clinicians in a number of regions. In March 1996, as NHS Library Adviser. I was asked to prepare a paper for the R&D Board of the NHS Executive about how this library support could be formally integrated into the R&D Strategy. My paper was unanimously endorsed by the Board and later by the Central R&D Committee of the NHS Executive. It suggests principles of library provision in support of R&D and is reprinted below.

Databases, Factual↗
PubMed2006

Decomposition of surface EMG signals.

This report describes an early version of a technique for decomposing surface electromyographic (sEMG) signals into the constituent motor unit (MU) action potential trains. A surface sensor array is used to collect four channels of differentially amplified EMG signals. The decomposition is achieved by a set of algorithms that uses a specially developed knowledge-based Artificial Intelligence framework. In the automatic mode the accuracy ranges from 75 to 91%. An Interactive Editor is used to increase the accuracy to > 97% in signal epochs of about 30-s duration. The accuracy was verified by comparing the firings of action potentials from the EMG signals detected simultaneously by the surface sensor array and by a needle sensor. We have decomposed up to six MU action potential trains from the sEMG signal detected from the orbicularis oculi, platysma, and tibialis anterior muscles. However, the yield is generally low, with typically < or = 5 MUs per contraction. Both the accuracy and the yield should increase as the algorithms are developed further. With this technique it is possible to investigate the behavior of MUs in muscles that are not easily studied by needle sensors. We found that the inverse relationship between the recruitment threshold and the firing rate previously reported for muscles innervated by spinal nerves is also present in the orbicularis oculi and the platysma, which are innervated by cranial nerves. However, these two muscles were found to have greater and more widespread values of firing rates than those of large limb muscles.

Action Potentials↗
PubMed2005

PsychMate: providing psychology majors the tools to do real experiments and learn empirical methods.

PsychMate is a set of software tools for undergraduate psychology students to run, develop, and analyze computerized experiments. It includes 30 psychological experiments in the areas of perception, cognition, social psychology, human factors, and cognitive neuroscience. Students run experiments themselves and see basic results immediately. The automatic spreadsheet analysis forms allow them to aggregate data and create analyses, presentations, and Web pages with a single click. Students can use the Psychology Experiment Authoring Kit experiment editor to create their own experiments in minutes and run experiments with other students using Web-based experiment-management tools. The BrainTutor and BrainViewer applications teach brain anatomy and permit students to analyze fMRI brain imaging data from subjects who have performed the same memory experiments in which they participated. PsychMate has been used in 83 classes in which 1,533 students submitted 5,464 completed experiments with few (less than 1%) requests for help and a very positive rating of the research experience.

Brain↗
PubMed2001

Croatian Medical Journal introduces culture, control, and the study of research integrity.

Culture, control, and the study of research integrity represents the future goals of the Croatian Medical Journal. This article will highlight research integrity as experienced in the USA by the Office of Research Integrity (ORI) and discuss the framework being developed in Croatia. First, the Croatian Medical Journal seeks to promote a research culture that is aware of research integrity. This will be accomplished through the education and training of Croatian researchers interested in publishing their results in international scientific journals. To facilitate this goal, the Croatian Medical Journal introduces, what it believes to be, the first Research Integrity Editor. Second, the Croatian Medical Journal intends to facilitate the development of an Office of Research Integrity based on ORI model. The Croatian office of research integrity would be authorized to develop regulations to define scientific misconduct, investigate, and develop administrative actions against those found to have committed scientific misconduct. Furthermore, the office would be responsible for developing national education standards for promoting research integrity and the responsible conduct of research. Third, the Croatian Medical Journal is developing a science-based research agenda. This new research agenda will examine topics similar to those presented recently at the first Research Conference on Research Integrity held in Bethesda, Maryland, USA (November, 2000). The initial research topics would include studying those variables and mechanisms that help to promote research integrity and honorable research practices. This Editorial represents the first step towards achieving this goals, by establishing a collaborative relationship between ORI and the Croatian Medical Journal.

Clinical Trials as Topic↗
PubMed1998

Cooperative problem solving with personal mobile information tools in hospitals.

Health-care professionals have a broad range of needs for information and cooperation while working at different points of care (e.g., outpatient departments, wards, and functional units such as operating theaters). Patient-related data and medical knowledge have to be widely available to support high-quality patient care. Furthermore, due to the increased specialization of health-care professionals, efficient collaboration is required. Personal mobile information tools have a considerable potential to realize almost ubiquitous information and collaborative support. They enable to unite the functionality of conventional tools such as paper forms, dictating machines, and pagers into one tool. Moreover, they can extend the support already provided by clinical workstations. An approach is described for the integration of mobile information tools with heterogeneous hospital information systems. This approach includes identification of functions which should be provided on mobile tools. Major functions are the presentation of medical records and reports, electronic mailing to support interpersonal communication, and the provision of editors for structured clinical documentation. To realize those functions on mobile tools, we propose a document-based client-server architecture that enables mobile information tools to interoperate with existing computer-based application systems. Open application systems and powerful, partially wireless, hospital-wide networks are the prerequisites for the introduction of mobile information tools.

Decision Making, Computer-Assisted↗
PubMed2007

The quality of evidence in health informatics: how did the quality of healthcare IT evaluation publications develop from 1982 to 2005?

OBJECTIVE: To obtain an overview of study designs and study methods used in research evaluating IT in health care, to present a list of quality criteria by which all kinds of reported evaluation studies on IT systems in health care can be assessed, and to assess the quality of reported evaluation studies on IT in health care and its development over time (1982-2005). METHODS: A generic 10-item list of quality indicators was developed based on existing literature on quality of medical and medical informatics publications. It is applicable to all kind of IT evaluation papers and not restricted to randomized controlled trials. One hundred and twenty explanatory papers evaluating the effects of an IT system in health care published between 1982 and 2005 were randomly selected from PubMed, the study designs and study methods were extracted, and the quality indicators were used to assess the quality of each paper by two independent raters. RESULTS: The inter-rater variability of scoring the 10 quality indicators as assessed by a pre-test with nine papers was good (K=0.87). There was a trend towards more multi-centre studies and authors coming more frequently from various departments. About 70% of the studies used a design other than a randomized controlled trial (RCT). Forty percent of the studies combined at least two different data acquisition methods. The quality of IT evaluation papers, as defined by the quality indicators, was only slightly improving in time (Spearman correlation coefficient [rs]=0.19). The quality of RCTs publications was significantly higher than the quality of non-RCT studies (p<0.001). CONCLUSION: The continuous and dominant number of non-RCT studies reflects the various approaches applicable to evaluate IT systems in health care. Despite the increasing discussion on evidence-based health informatics, the quality of published evaluation studies on IT interventions in health care is still insufficient in some aspects. Journal editors and referees should take care that reports of evaluation on IT systems contain all aspects needed for a sufficient understanding and reproducibility of a paper. Publication guidelines should be developed to support more complete and better publications of IT evaluation papers.

Europe↗
PubMed1994

A unified approach to the design of clinical reporting systems.

Computer-based Clinical Reporting Systems (CRS) for diagnostic departments that use structured data entry have a number of functional and structural affinities suggesting that a common software architecture for CRS may be defined. Such an architecture should allow easy expandability and reusability of a CRS. We report the development methodology and the architecture of SISCOPE, a CRS originally designed for gastrointestinal endoscopy that is expandable and reusable. Its main components are a patient database, a knowledge base, a reports base, and screen and reporting engines. The knowledge base contains the description of the controlled vocabulary and all the information necessary to control the menu system, and is easily accessed and modified with a conventional text editor. The structure of the controlled vocabulary is formally presented as an entity-relationship diagram. The screen engine drives a dynamic user interface and the reporting engine automatically creates a medical report; both engines operate by following a set of rules and the information contained in the knowledge base. Clinical experience has shown this architecture to be highly flexible and to allow frequent modifications of both the vocabulary and the menu system. This structure provided increased collaboration among development teams, insulating the domain expert from the details of the database, and enabling him to modify the system as necessary and to test the changes immediately. The system has also been reused in several different domains.

Artificial Intelligence↗
PubMed1998

[Cholinesterases].

OBJECTIVE: To review current data on butyrylcholinesterase. DATA SOURCES: Search through Medline data bases of articles in French or English. STUDY SELECTION: Original articles and case reports were selected. Letters to editor were excluded. DATA EXTRACTION: The articles were analyzed in order to obtain current data on biochemical structure, action, major pathological variations, especially with regard to the recent informations obtained by molecular biology concerning the identification of genetic variants. DATA SYNTHESIS: Butyrylcholinesterase must be differentiated from acetylcholinesterase, which cannot hydrolyse succinylcholine. The physiological action of butyrylcholinesterase remains unknown, although it can hydrolyse many drugs. Excluding genetical mutations, several physiopathological situations alter butyryl-cholinesterase activity. Butyrylcholinesterase activity assessment does not allow the diagnosis of genetic variants. Whatever the origin, only deficits of more than 50% modify significantly the metabolism of succinylcholine or mivacurium. The diagnosis of a prolonged neuromuscular blockade is obtained with systematic monitoring of the neuromuscular function in case of administration of mivacurium or succinylcholine. Mivacurium should only be re-injected when one response at train of four is obtained. In case of prolonged neuromuscular blockade, the anticholinesterasic agent should not be administered when no response at train of four is obtained. The biochemical methods using inhibitors (dibucaine, fluoride) of the butyrylcholinesterase and a familial study lead to the diagnosis in most cases because the atypical and fluoride variants are the most frequent. When results are doubtful, genetic molecular methods with the use of PCR and restriction enzymes allow a rapid diagnosis.

Acetylcholinesterase↗
PubMed1996

How to get paid for having fun.

As I look back, I am still amazed that I was actually paid to do something I loved and others could describe as work. Yet my situation is no different from that of most scientists who find that they are asked to pursue their innate curiosity to solve puzzles, the solutions to which fortunately are of value to society. I enjoyed the beautiful logic of mathematics in elementary grades and was entranced by the exciting solution of puzzles described by DeKruif. So I drifted into the scientific profession without a clear idea of what to do or how to do it. Each experience prepared my mind and supplied the base for the next job, creating what was for me a smooth flow from scientist to professor to editor to scientist. Fortunately for me and fellow scientists the problems of the world never disappear. "The one who rides the tiger can never get off" is an aphorism that expresses society's dependence on science. Automobiles improve transportation and create pollution, medical advantages prolong life and create over-population, pesticides bring cheaper food and create soil problems. Each advance brings on the need for more science to solve the new problems. Society, which likes to live well, is addicted to the products of science, and fortunately a peculiar set of humans are addicted to solving the problems. I am one of those typical addicts who finds the obstacle course fascinating and the endlessness of the quest utopia.

Biochemistry↗
PubMed2006

Pharmacology and statistics: recommendations to strengthen a productive partnership.

Critical to the discovery, development and rational use of drugs and vaccines are the foundational principles and proper application of statistics. However, in too many cases, there has been misuse of statistics and/or overemphasis on statistical significance (p < 0.05), as though this criterion possessed truth-guaranteeing properties. To clarify confusion about the proper use of statistics in pharmacology, we summarize briefly the foundational principles of probability; the role of statistics in assessment of causality; the three basic uses of statistical methods, especially those employed in hypothesis testing; and current statistical issues in pharmacological research. We then review and provide examples of the meaning of statistical significance, the consequences of lack of randomization in epidemiology/observation studies, the criteria for measurement instrument validation, the problems with subgroup analyses, the need for multiple comparison statistical methods, and how to handle dropouts and missing data. Finally, based on sound experimental and statistical principles, we make a series of recommendations to both experimentalists and journal editors to improve published pharmacological experiments. These include widespread use of blinding and randomization and/or random selection of subjects in both basic and clinical pharmacology, mandatory use of rigorous evidentiary criteria in epidemiology/observation studies claiming causal associations, proper interpretation of statistical versus clinical/pharmacological significance, appropriate interpretation of meta-analyses, meaningful validation of methods, and a more rational statistical approach to subgroup analyses and genetic association studies.

Bias↗
PubMed1996

[The Internet and clinical medicine. An introduction to the biomedical information services available in electronic form on the "net of all nets"].

Clinical users expectations from medical informatics are evolving due to the wide availability of biomedical information services on the Internet. Thanks to hypertexts and advanced browsing tools users with no informatical expertise can travel on the Internet and easily gain access to textual databases. With a multimedia computer other kinds of information can be grabbed: images, sounds and audiovisual documents. Basic Internet services (electronic mail, discussion lists, file transfer protocol, terminal emulation) can be accessed from a wide range of hardware equipment. However, the real power of a world-scale computer network like the Internet will be unleashed only when its global connectivity will be linked to the powerful retrieval ability of existing clinical and related databases. While biomedical journals editors and other medical information providers are in the way to offer electronic versions of their paper-based products, at the leading edge of this world-scale process is the USA National Library of Medicine, with the Internet-compatible version of its Grateful Med software which is expected to be launched during 1996.

Computer Communication Networks↗
PubMed2005

YouthFriends: outcomes from a school-based mentoring program.

This evaluation explores the effectiveness of school-based mentoring as a universal prevention strategy. The impact of mentoring on students displaying risk factors is also addressed. The evaluation of YouthFriends, a school-based mentoring program, employed a pretest-posttest control group design. Students (n = 170) across five school districts provided data on eight dependent variables. At posttest, there was a statistically significant difference favoring YouthFriends over controls on sense of school membership. In addition, for students who had low scores at baseline, results indicated a statistically significant improvement unique to YouthFriends on community connectedness and goal-setting. Analyses of students' academic performance also indicated a positive effect for those YouthFriends who had low grades at baseline. Editors' Strategic Implications: Important lessons are provided for school administrators and mentoring program staff and evaluators. As a universal prevention program, school-based mentoring may produce few (and small) short-term effects. A greater understanding of the effects of dosage and quality of the mentoring is needed as we seek to evaluate the efficacy of school-based mentoring across a variety of student risk levels.

Female↗
PubMed1993

Publication bias: the problem that won't go away.

Conclusions about the efficacy and safety of medical interventions are based on data presented in the scientific literature. The validity of these conclusions is threatened if publication bias results from investigators or editors making decisions about publishing study results on the basis of the direction or strength of the study findings. This paper reports meta-analyses performed using data from four prospective investigations in which a total of 997 initiated studies were followed to learn of study results, publication status, and reasons for nonpublication. The analysis indicates that there is a positive association between "significant" study results and publication (OR = 2.88; 95% confidence interval [CI] 2.13 to 3.90). When the analysis was restricted to controlled trials (n = 280), an even stronger relationship between "significant" results and publication was observed (OR = 6.15; 95% CI 2.24 to 16.92), with randomized trials (n = 200) apparently no less susceptible to publication bias than controlled trials in general (OR = 8.72; 95% CI 1.91 to 39.81). In every case, failure to publish was investigator-based, and not due to editorial decisions. The results of clinical trials should not be suppressed in this way. Development of registration systems for randomized trials is essential if this problem is to be minimized in future.

Bias↗
PubMed2004

A framework for modeling health behavior protocols and their linkage to behavioral theory.

With the rise in chronic, behavior-related disease, computerized behavioral protocols (CBPs) that help individuals improve behaviors have the potential to play an increasing role in the future health of society. To be effective and widely used CBPs should be based on accepted behavioral theory. However, designing CBPs while at the same time specifying their linkages to behavioral theory and developing reusable CBP components (interventions) are challenges to developers of CBPs. Having an ontology with which to describe CBPs could help with these issues. As a first step towards creating such an ontology, we modeled PACE-Adolescent, a theory-based behavioral protocol that uses the Stages of Change Model and Social Cognitive Theory, using PROTEGE-2000, an ontology editor and knowledge acquisition system. We created a three-part knowledge model. Two sub-ontologies described behavioral interventions and psychological theories. The third component, implemented using Guideline Interchange Format (GLIF3), provided a way to describe the structure of a protocol and to link intervention resources and groups of actions to elements of psychological theory. Using this framework, we formally described the PACE-Adolescent protocol. Creating knowledge models such as this may lead to improvements in the design and evaluation of computerized health behavior protocols.

Adolescent↗
PubMed2005

Ridom TraceEdit: a DNA trace editor and viewer.

Ridom TraceEdit is a cross-platform graphical DNA trace viewer and editor. TraceEdit displays the chromatogram files from Applied Biosystems automated sequencers and files in the Staden SCF format. Incorrect base calls can be edited and saved.

Algorithms↗
PubMed1986

GENEUS, a computer system for DNA and protein sequence analysis containing an information retrieval system for the EMBL data library.

We describe a comprehensive computer system, GENEUS, for extensive DNA, RNA and protein sequence analysis. The analysis system is developed for the DEC VAX/VMS computer and uses the EMBL Nucleic Acid Sequence Data Library. Help information is available on-line on terminal screen. To speed up system handling, a qualifier oriented user communication is employed. All results are stored on files making them accessible to the computer editor. An information retrieval system for the EMBL Nucleotide Sequence Data Library is also described. A defined data-base interface allows connection to other analysis programs.+

Amino Acid Sequence↗
PubMed2005

Pharmaceutical care in community pharmacies: practice and research from around the world.

Pharmaceutical care models and practices differ in various countries. Reimbursement for cognitive services, for example, varies across countries in Europe, Asia, and the Americas. Practice-based research has blossomed in many countries, with different emphases and challenges. This international series will describe the organization of community pharmacy within the healthcare system and report the status of practice-based research. Each paper will focus on one country. The series will conclude with a summary by the series editors describing the key themes across the papers, outlining milestones yet to be achieved, and proposing a research agenda for community pharmacy practice.

Patient Education as Topic↗