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PubMedDate not supplied

Use of general-purpose negation detection to augment concept indexing of medical documents: a quantitative study using the UMLS.

OBJECTIVES: To test the hypothesis that most instances of negated concepts in dictated medical documents can be detected by a strategy that relies on tools developed for the parsing of formal (computer) languages-specifically, a lexical scanner ("lexer") that uses regular expressions to generate a finite state machine, and a parser that relies on a restricted subset of context-free grammars, known as LALR(1) grammars. METHODS: A diverse training set of 40 medical documents from a variety of specialties was manually inspected and used to develop a program (Negfinder) that contained rules to recognize a large set of negated patterns occurring in the text. Negfinder's lexer and parser were developed using tools normally used to generate programming language compilers. The input to Negfinder consisted of medical narrative that was preprocessed to recognize UMLS concepts: the text of a recognized concept had been replaced with a coded representation that included its UMLS concept ID. The program generated an index with one entry per instance of a concept in the document, where the presence or absence of negation of that concept was recorded. This information was used to mark up the text of each document by color-coding it to make it easier to inspect. The parser was then evaluated in two ways: 1) a test set of 60 documents (30 discharge summaries, 30 surgical notes) marked-up by Negfinder was inspected visually to quantify false-positive and false-negative results; and 2) a different test set of 10 documents was independently examined for negatives by a human observer and by Negfinder, and the results were compared. RESULTS: In the first evaluation using marked-up documents, 8,358 instances of UMLS concepts were detected in the 60 documents, of which 544 were negations detected by the program and verified by human observation (true-positive results, or TPs). Thirteen instances were wrongly flagged as negated (false-positive results, or FPs), and the program missed 27 instances of negation (false-negative results, or FNs), yielding a sensitivity of 95.3 percent and a specificity of 97.7 percent. In the second evaluation using independent negation detection, 1,869 concepts were detected in 10 documents, with 135 TPs, 12 FPs, and 6 FNs, yielding a sensitivity of 95.7 percent and a specificity of 91.8 percent. One of the words "no," "denies/denied," "not," or "without" was present in 92.5 percent of all negations. CONCLUSIONS: Negation of most concepts in medical narrative can be reliably detected by a simple strategy. The reliability of detection depends on several factors, the most important being the accuracy of concept matching.

Abstracting and Indexing↗
PubMed2004

A hierarchical biology concept framework: a tool for course design.

A typical undergraduate biology curriculum covers a very large number of concepts and details. We describe the development of a Biology Concept Framework (BCF) as a possible way to organize this material to enhance teaching and learning. Our BCF is hierarchical, places details in context, nests related concepts, and articulates concepts that are inherently obvious to experts but often difficult for novices to grasp. Our BCF is also cross-referenced, highlighting interconnections between concepts. We have found our BCF to be a versatile tool for design, evaluation, and revision of course goals and materials. There has been a call for creating Biology Concept Inventories, multiple-choice exams that test important biology concepts, analogous to those in physics, astronomy, and chemistry. We argue that the community of researchers and educators must first reach consensus about not only what concepts are important to test, but also how the concepts should be organized and how that organization might influence teaching and learning. We think that our BCF can serve as a catalyst for community-wide discussion on organizing the vast number of concepts in biology, as a model for others to formulate their own BCFs and as a contribution toward the creation of a comprehensive BCF.

Biology↗
PubMed2004

Effect of simultaneous thawing of multiple 0.5-mL straws of semen and sequence of insemination on conception rate in dairy cattle.

The objectives of this study were to determine 1) the effect of simultaneous thawing of multiple 0.5-mL straws of semen and sequence of insemination (first, second, third, or fourth) on conception rates in dairy cattle, 2) whether the conception rates achieved following AI by professional AI (PAI) technicians and herdsman-inseminators (HI) differed, and 3) the effect of elapsed time from initiation of thawing straws of semen to seminal deposition on conception rates in dairy cattle. Four dairies with PAI and four with HI participated in the study. Initial data recorded included beginning thaw time, cow identification number, and time of seminal deposition. Herd records were retrieved following pregnancy diagnosis. Conception rates of dairy cows (n = 1025) were not affected by sequence of insemination (first, second, third, or fourth). Conception rates for herds using PAI were 40, 47, 41, and 50%. Conception rates for herds using HI were 24, 20, 33, and 30%. Average conception rates of dairy cows differed between PAI and HI (45 vs. 27%, respectively). The difference in mean conception rate achieved by PAI and HI was not attributable to milk production, parity, service number or stage of lactation. The elapsed time from initial thaw to completion of fourth AI was shorter for PAI than for HI, 7.6 vs. 10.9 min, respectively. Although the average conception rate differed between PAI and HI, elapsed time from initial thaw to completion of fourth AI and sequence of insemination (first, second, third, or fourth) had no effect on conception rate within inseminator group.

Animals↗
PubMed2000

Representation by standard terminologies of health status concepts contained in two health status assessment instruments used in rheumatic disease management.

Health and functional status data have been shown to have clinical utility in predicting outcome. Various metadata registries in the form of patient self-administered health assessment questionnaires have been incorporated into routine clinical care and clinical research of patients with rheumatic disease. Examples of such health assessment instruments are the Clinical Health Assessment Questionnaire (CLINHAQ) and the Modified Health Assessment Questionnaire (MHAQ). These instruments contain concepts that are an integral part of the health and functional status domain. Using an automated indexing tool we examined the clinical content coverage by SNOMED RT and the Unified Medical Language System (UMLS) Metathesaurus for health and functional status concepts identified in the MHAQ and CLINHAQ. Significant differences existed between the overall representational ability of SNOMED and UMLS for concepts identified in the MHAQ (49%, vs. 77% respectively, p < .005) and for concepts identified in the CLINHAQ (30% vs. 64% respectively p < .005). Representational capability by SNOMED-RT and UMLS for concepts in a given health assessment instrument was carried across four semantic classes of "attitudes", "symptoms", "activities", and "social attributes". The conceptual content coverage of health status assessment concepts contained in the MHAQ and CLINHAQ by SNOMED-RT and UMLS was incomplete but better for UMLS with its panoply of vocabulary sources. This observed overall improved representation by UMLS appeared to be due to better representation of concepts in "activities" and "social attributes" semantic classes. Representation of health or functional status concepts in a computerized medical record should be founded on a universally agreed concept model of that domain. Established functional and health status metadata registries can serve as important sources for concepts and candidate classes within that domain.

Health Status↗
PubMed2005

Using concept mapping to develop a logic model for the Prevention Research Centers Program.

INTRODUCTION: Concept mapping is a structured conceptualization process that provides a visual representation of relationships among ideas. Concept mapping was used to develop a logic model for the Centers for Disease Control and Prevention's Prevention Research Centers Program, which has a large and diverse group of stakeholders throughout the United States. No published studies have used concept mapping to develop a logic model for a national program. METHODS: Two logic models were constructed using the data from the concept mapping process and program documents: one for the national level and one for the local level. Concept mapping involved three phases: 1) developing questions to generate ideas about the program's purpose and function, 2) gathering input from 145 national stakeholders and 135 local stakeholders and sorting ideas into themes, and 3) using multivariate statistical analyses to generate concept maps. Logic models were refined using feedback received from stakeholders at regional meetings and conferences and from a structured feedback tool. RESULTS: The national concept map consisted of 9 clusters with 88 statements; the local concept map consisted of 11 clusters with 75 statements. Clusters were categorized into three logic model components: inputs, activities, and outcomes. Based on feedback, two draft logic models were combined and finalized into one for the Prevention Research Centers Program. CONCLUSION: Concept mapping provides a valuable data source, establishes a common view of a program, and identifies inputs, activities, and outcomes in a logic model. Our concept mapping process resulted in a logic model that is meaningful for stakeholders, incorporates input from the program's partners, and establishes important program expectations. Our methods may be beneficial for other programs that are developing logic models for evaluation planning.

Cluster Analysis↗
PubMedDate not supplied

A reexamination of nursing role conceptions.

This study tested 101 beginning nurses for the relationships of three personality variables, ego development, sex typing, and assertiveness, to role conceptions and role conception combinations. Responses were examined on four self-completion questionnaires. Two research questions guided the study; one examined the relationships of the personality variables to role conceptions and the other examined the contribution of the personality variables to the role conception combinations. The correlation analysis for the first research question indicated that of all the variables examined, the femininity (F) and masculinity-femininity (MF) sex-typing attributes contributed most toward understanding which nurses were likely to hold particular role conceptions. Both of these sex-typing attributes were related to two role conceptions; F was related to professional role and service role conceptions, MF to bureaucratic and service role conceptions. Assertiveness was also significantly related to the professional role conception. The multivariate analysis of variance, used to examine the second research question, indicated that the nurses in the four role combinations (the number of roles held to a high degree) differed in their mean scores on some combination of one or more personality variables. Follow-up analyses indicated the MF score and the androgynous sex-typing category were both significantly higher for nurses who held all three role conceptions to a high degree.

Adult↗
PubMed2006

Can concept sorting provide a reliable, valid and sensitive measure of medical knowledge structure?

CONTEXT: Evolution from novice to expert is associated with the development of expert-type knowledge structure. The objectives of this study were to examine reliability and validity of concept sorting (ConSort) as a measure of static knowledge structure and to determine the relationship between concepts in static knowledge structure and concepts used during diagnostic reasoning. METHOD: ConSort was used to identify static knowledge concepts and analysis of think-aloud protocols was used to identify dynamic knowledge concepts (used during diagnostic reasoning). Intra- and inter-rater reliability, and correlation across cases, were evaluated. Construct validity was evaluated by comparing proportions of nephrologists and students with expert-type knowledge structure. Sensitivity and specificity of static knowledge concepts as a predictor of dynamic knowledge concepts were estimated. RESULTS: Thirteen first-year medical students and 19 nephrologists participated. Intra- and inter-rater agreement for determination of static knowledge concepts were 1.0 and 0.90, respectively. Reliability across cases was 0.45. The proportions of nephrologists and students identified as having expert-type knowledge structure were 82.9% and 55.8%, respectively (p=0.001). Sensitivity and specificity of ConSort((c)) in predicting concepts that were used during diagnostic reasoning were 96.8% and 27.8% for nephrologists and 87.2% and 55.1% for students. CONCLUSIONS: ConSort is a reliable, valid and sensitive tool for studying static knowledge structure. The applicability of tools that evaluate static knowledge structure should be explored as an addition to existing tools that evaluate dynamic tasks such as diagnostic reasoning.

Alberta↗
PubMed1995

Concept mapping: an effective instructional strategy for diet therapy.

Concept mapping is an instructional strategy that requires learners to identify, graphically display, and link key concepts in instructional reading material. Although proven effective in numerous disciplines as a means to promote critical thinking and self-directed learning, concept mapping has not been tested in diet therapy. The objective of this study was to implement concept mapping as a small-group, cooperative learning strategy in an upper-division diet therapy course and to evaluate student attitudes about the effect of concept mapping on knowledge, self-directed learning, problem-solving, and collaborative skills. Students in the first semester (n = 27) initially learned course material by lecture (4 weeks) followed by an integrated mapping/lecture format (12 weeks); the second semester (n = 25) used an integrated mapping lecture format for the full 16 weeks. At the end of both semesters, students completed a 10-item original survey questionnaire. Responses for first (n = 25) and second (n = 21) semesters were analyzed independently. Results indicated that a majority of students thought participation in concept mapping enhanced knowledge of diet therapy principles (n = 19 of 25; 18 of 21), self-directed learning (n = 14 of 25; 18 of 21), critical thinking (n = 21 of 25; 14 of 21), problem-solving (n = 22 of 25; 16 of 21), and collaboration (n = 24 of 25; 20 of 21) skills. When noncooperation of teammates was a factor, concept mapping was viewed as more frustrating and time consuming than lecture. This study demonstrated concept mapping as an effective learning strategy for diet therapy; it improves students' ability to engage in self-directed learning, critical thinking, collaboration, and creative problem solving. Results suggest that concept mapping is most effective when accompanied with comprehensive training, coordinated lectures, instructor guidance, and long-term practice.

Concept Formation↗
PubMed1998

A common structure for concepts of individuals, stuffs, and real kinds: more Mama, more milk, and more mouse.

Concepts are highly theoretical entities. One cannot study them empirically without committing oneself to substantial preliminary assumptions. Among the competing theories of concepts and categorization developed by psychologists in the last thirty years, the implicit theoretical assumption that what falls under a concept is determined by description ("descriptionism") has never been seriously challenged. I present a nondescriptionist theory of our most basic concepts, "substances," which include (1) stuffs (gold, milk), (2) real kinds (cat, chair), and (3) individuals (Mama, Bill Clinton, the Empire State Building). On the basis of something important that all three have in common, our earliest and most basic concepts of substances are identical in structure. The membership of the category "cat," like that of "Mama," is a natural unit in nature, to which the concept "cat" does something like pointing, and continues to point despite large changes in the properties the thinker represents the unit as having. For example, large changes can occur in the way a child identifies cats and the things it is willing to call "cat" without affecting the extension of its word "cat." The difficulty is to cash in the metaphor of "pointing" in this context. Having substance concepts need not depend on knowing words, but language interacts with substance concepts, completely transforming the conceptual repertoire. I will discuss how public language plays a crucial role in both the acquisition of substance concepts and their completed structure.

Child↗
PubMed1996

Criteria for concept evaluation.

One of the roles of qualitative enquiry is the utilization of qualitative methods for the development, refinement or modification of concepts. Yet, to date, there are no criteria for evaluating the adequacy of a concept. In this paper, the anatomy of a concept is presented, methods of concept analysis critiqued, and criteria for evaluation of the level of maturity of a concept suggested. Evaluation of criteria include assessment of: the definition of the concept, the characteristics of the concept, the conceptual preconditions and outcomes, and the conceptual boundaries. The authors argue that evaluation of a concept must necessarily precede concept development research (using a Wilsonian-derived method, a critical analysis of the literature, or qualitative enquiry) and precede more formal research procedures (such as operationalization or identification of the variables).

Concept Formation↗
PubMed1977

The effect of altering self-descriptive behavior on self-concept and classroom behavior.

This research examined the impact of operant reinforcement of positive self-descriptive behavior on the self-concepts and classroom behavior of 60 fifth-grade students. Three groups of 10 male and 10 female low self-concept students wrote a series of eight essays describing their school performance. The first group (P) received written reinforcement for positive self-descriptions of their school performance. The second group (G) received an equal number of reinforcements for general statements. The third group (C) received no reinforcement for written statements. Three areas of self-concept were measured with the Primary Self-Concept Inventory: personal-self, social-self, and intellectual-self. A frequency count was also made of nine classroom behaviors thought to be influenced by self-concept. The P group displayed increases in the frequency of positive self-descriptive statement and in intellectual self-concept but no changes in personal self-concept, social self-concept, or the nine classroom behaviors. The G and C groups showed no change in self-description, self-concept, or the nine classroom behaviors.

Achievement↗
PubMed2003

Exploring self-concepts of persons with brain injury.

BACKGROUND: This study explored the self-concepts of Hong Kong Chinese adults with brain injury. OBJECTIVES: The Adult Source of Self-concept Inventory (ASSEI) Chinese Version was adopted to identify the sources and basis of the self-conceptions of 120 persons with brain injury. METHOD: The Adult Source of Self-Esteem Inventory (ASSEI), a self evaluation tool using open-ended questions and interviewing, was used to identify the sources and basis of the self-concept of persons with and without brain injury. The subjects' important life aspects were identified through interpreting their responses to open-ended questions and interviews. Moreover, a structured questionnaire on their subjective perceptions of importance and satisfaction in different life areas was used to identify the relationships between discrete self-concept variables. The subjects' responses to the 20 items of the ASSEI were also subjected to an exploratory factor analysis. MAIN OUTCOME AND RESULTS: Five self-concept related factors, which accounted for 65.55% of the total variance, were successfully identified. They were family self, physical self, moral self, personal achievement and social self. The self-concept factors match the results of content analysis of the subjects' responses to the open-ended questions. The results showed that family, physical health, work and friends were the most important domains in lives of individuals with brain injury. Brain injury survivors felt good towards their family, work and friends in their daily life. However, the majority expressed the view that they felt bad due to deteriorating physical health, poor family relationships, emotional difficulties and poor working relationship with others. CONCLUSION: Findings from this study identified the self-concept basis of persons with brain injury that can indicate self-concept enhancement strategies to improve their rehabilitation outcomes. Hopefully, they can develop more positive self-images and, thus, achieve better community integration.

Adult↗
PubMed1975

Age differences in life satisfaction as a function of discrepancy between real and ideal self concepts.

Six age groups were compared with respect to discrepancy between real and ideal self concepts and the relationship between life satisfaction and discrepancy in self concepts. The subjects, ranging in age from 20 to 75 years, completed two self descriptive adjective rating scales which assessed real and ideal self concept and a life satisfaction index. Significant differences were found among age groups for real and ideal self concepts, life satisfaction, and discrepancy between real and ideal self concept scores. Age was significantly correlated with real and ideal self concept, discrepancy between real and ideal self concepts and life satisfaction. Life satisfaction was significantly correlated with real self concept and discrepancy between real and ideal self concepts. Trends in the data suggested that the younger subjects (20-25 years) had lower real and ideal self ratings and were less satisfied with their lives than the elderly subjects (60-75 years).

Adult↗
PubMed1995

Exploring the theoretical basis of nursing using advanced techniques of concept analysis.

In this article, the traditional methods of concept development are critiqued, and alternative methods that use qualitative methods of inquiry are presented. Variations of concept development techniques appropriate to the maturity of the concept being explored are then described, including methods for concept delineation, concept comparison, concept clarification, concept correction, and concept identification. To illustrate the application of concept development methods to nursing theory, a research program to delineate the construct of comfort is described.

Concept Formation↗
PubMed1992

Measuring the professional self-concept of nurses: a critical review.

Nursing literature strongly suggests that the self-concept of nurses is an important concept for academics, administrators and clinicians to consider in the development of the profession. Many valuable research projects have added to the data base on the subject, yet there still remain some questions to be answered. This paper explores the notion of self-concept as it relates to the professional working in nursing. In particular, the paper examines nursing research relating to the professional self-concept of nursing, arguing that the 'professional' self-concept of nurses is unique and different from that of the self-concept (while inextricably linked); and that there is room for a new instrument which measures the dimensions of the professional self-concept of nurses. Suggestions for future research include replication and further validation and reliability studies of a new instrument; a cross-cultural study using samples from different countries; testing with various samples from different branches of nursing and further exploring the differences between self-concept and professional self-concept.

Education, Nursing↗
PubMed2005

Enhancing methodological clarity: principle-based concept analysis.

AIMS: The aim of this paper is to operationalize the principle-based method of concept analysis. BACKGROUND: While nursing has embraced the use of concept analysis as a valid and significant entree into an area of research, methodological development has created strategies of inquiry that vary in purpose and in the nature of their findings. DISCUSSION: We propose that, as the primary utility of concept analysis is to determine the existing state of the science so that further work may be strategically and appropriately planned, the method described as principle-based concept analysis is superior in providing evidence to support subsequent inquiry into the concept of interest. Three problematic issues are discussed in an effort to clarify and procedurally explicate the strategies employed in this approach: selecting disciplinary literatures for inclusion in the analysis; conceptually-driven sampling issues; and within- and across-discipline analytic techniques. CONCLUSION: In this form of concept analysis, each principle contributes to an understanding of the strengths and limitations of the present state of the concept in the scientific literature. We believe that this perspective will enable nursing to begin to harness the power of concept analysis for advancing science rather than simply imagining what a concept could be or constructing what we believe it should be.

Concept Formation↗
PubMed2006

Clarifying the concepts in knowledge transfer: a literature review.

AIM: The aim of this paper is to examine the concepts of opinion leaders, facilitators, champions, linking agents and change agents as described in health, education and management literature in order to determine the conceptual underpinnings of each. BACKGROUND: The knowledge utilization and diffusion of innovation literature encompasses many different disciplines, from management to education to nursing. Due to the involvement of multiple specialties, concepts are often borrowed or used interchangeably and may lack standard definition. This contributes to confusion and ambiguity in the exactness of concepts. METHODS: A critical analysis of the literature was undertaken of the concepts opinion leaders, facilitators, champions, linking agents and change agents. A literature search using the concepts as keywords was conducted using Medline, CINAHL, Proquest and ERIC from 1990 to March 2003. All papers that gave sufficient detail describing the various concepts were included in the review. Several 'older' papers were included as they were identified as seminal work or were frequently cited by other authors. In addition, reference lists were reviewed to identify books seen by authors as essential to the field. FINDINGS: Two similarities cut across each of the five roles: the underlying assumption that increasing the availability of knowledge will lead to behaviour change, and that in essence each role is a form of change agent. There are, however, many differences that suggest that these concepts are conceptually unique. CONCLUSIONS: There is inconsistency in the use of the various terms, and this has implications for comparisons of intervention studies within the knowledge diffusion literature. From these comparisons, we concluded that considerable confusion and overlap continues to exist and these concepts may indeed be similar phenomena with different labels. All concepts appear to be based on the premise that interpersonal contact improves the likelihood of behavioural change when introducing new innovations into the health sector.

Concept Formation↗
PubMed1990

Some antecedents of academic self-concept: a longitudinal study.

The influence of cognitive, achievement, and family background variables on academic self-concept was examined for 435 students participating in a major longitudinal study in New Zealand. Family background variables included mother's marital status at the birth of the child, family socio-economic status at the time the child was born, and family environment when the child was 7 years and 9 years of age. These factors were not significantly related to academic self-concept at ages 9 and 11. In addition, the general emotional status of mothers when their child was 3 years and 5 years old was not significantly related to academic self-concept at ages 9 and 11. Mother's intelligence when the child was 3 years, and mother's expectations for school performance when the child started school at age 5 were not significantly related to academic self-concept. Similarly, cognitive and intellectual functioning at ages 3, 5, 7, and 9 years were not significantly related to academic self-concept at ages 7 and 9 years. Rather, academic self-concept at age 11 appeared to be influenced primarily by reading achievement and academic self-concept at age 9, and academic self-concept at age 9 was influenced primarily by reading achievement at age 7. It was concluded that academic self-concept is mainly a product of school achievement, and that any influence home background factors may have are likely to occur by means of their effect on school achievement.

Achievement↗