Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Medical Informatics Computing”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed1987

Computer-aided quality assurance. A critical appraisal.

Computerized information systems hold the promise of overcoming problems in the management of clinical information Many of the claims of the creators and promoters of these systems, however, are not based on sound clinical studies. To determine the ability of computer information systems to improve the quality of medical care, we applied methodologic criteria to published articles in the field. Only 30 (22%) of 135 articles reported preplanned investigations, and only half of these met minimal criteria for scientific investigations. Fourteen studies were well designed and executed. All studies reported improvements in the process of care. However, patient outcomes were not measured, not affected, or only minimally influenced. While computer information systems show increasing potential, more work is required to enhance their effect on the quality of care and thus on patient outcomes.

Evaluation Studies as Topic↗
PubMed1999

Laparoscopy in the new century.

Minimally invasive surgery already has established itself as a useful tool in the management of trauma. The future holds exciting possibilities for this field, borne and fostered by innovative developments in imaging, computer technology, and artificial intelligence. The next millennium may witness the disappearance of trauma surgery as it is known today.

Artificial Intelligence↗
PubMed1998

Computer-facilitated collaboration: experiences building SNOMED-RT.

Collaborative development involving both individuals and groups is often less efficient than independent development because of communication overhead and integration costs. Despite the decreased development efficiency, collaborations promise more general-purpose products because of the opportunity for integration, with negotiation and reconciliation of diverse perspectives. Collaborations are also perhaps less costly when considered in contexts where there is significant duplication of effort. Computer-facilitated collaboration can reduce the communication and integration burden such that the increased effort required to manage a successful collaboration focuses primarily on the development of shared conceptual model among the developers by requiring that the work product be independently reproducible. This reproducibility requirement incorporates formal quality assurance processes into the development process. In this paper, we describe our initial experiences developing SNOMED-RT using such a computer-facilitated collaborative process. We quantify the extra costs incurred to achieve consistency in our efforts and reproducibility of our results.

Cooperative Behavior↗
PubMed1991

A multicenter study of data collection and communication at primary health care centers.

Health care delivery is information intensive. As computer applications make information available to the decision maker with speed and accuracy, informatics applications will strengthen the infrastructure. This paper is the second part of a multicenter systems analysis study to design a common application software to support primary health care focused on information flow. We present the questionnaire analysis and observations from a field study of a district health site. Analyses using contingency tables revealed differences, some statistically significant. The field study confirmed that minor differences exist even within a district health site. Development of a common application software on the basis of information flow studies is feasible. However, to make optimum use of computer implementation, revision of the health information systems was recommended. It was suggested that application software be developed with the core data set required by the care providers to deliver and administrators to manage a vertical health program.

Communication↗
PubMed2001

An elementary introduction to Bayesian computing using WinBUGS.

Bayesian statistics provides effective techniques for analyzing data and translating the results to inform decision making. This paper provides an elementary tutorial overview of the WinBUGS software for performing Bayesian statistical analysis. Background information on the computational methods used by the software is provided. Two examples drawn from the field of medical decision making are presented to illustrate the features and functionality of the software.

Bayes Theorem↗
PubMed1996

Computers, communication and confidentiality: tales of Baron Munchausen.

The aim was to examine the use of computer and paper based systems in accident and emergency (A&E) departments in the management of patients who are frequent attenders. More than half of the A&E consultants in the Thames regions who were sent a questionnaire responded (44 of the 80). 82% of the respondents use such systems predominantly to monitor violent patients, those with Munchausen syndrome, and children on the "at risk" register. Systems currently in use fail to fulfil many of the functions that would be required of an ideal system. When using computers to store and communicate clinical data, several ethical problems were identified but these appeared to be outweighed by the practical need and were also present with paper based systems. Safeguards could also be built into computer based systems to reduce some of the ethical problems. Computer systems should be deliberately chosen and implemented in response to a specific management problem. The potential benefits should be weighed against possible damaging side effects, such as a breach of confidentiality.

Confidentiality↗
PubMed2001

Gene expression profiles for monitoring radiation exposure.

Previous demonstrations that the dose, dose rate, radiation quality, and elapsed time since ionising radiation exposure result in variations in the response of stress genes suggest that gene expression signatures may be informative markers of radiation exposure. Defining sets of genes that ate specific for different outcomes of interest will be key to such an approach. A generalised post-exposure prolile may identify exposed individuals within a population, while more specific fingerprints may reveal details of a radiation exposure. Changes in gene expression in human cell lines occur after as little as 0.02 Gy rays, and in peripheral blood lymphocytes alter as little as 0.2 Gy. Diverse genes are also elevated in vivo in mice 24 h after 0.2 Gy irradiation. Ongoing microarray analyses meanwhile continue to identify large numbers of potential biomarkers from varied irradiation protocols. Development of computation-intensive informatics analysis methods will be needed for management of the complex gene expression profiles resulting from such experiments. Although the preliminary data are encouraging, significant work remains before meaningful correlations with risk or practical assessment of exposure can be made by gene expression profiling.

Gene Expression↗
PubMed1999

Nursing informatics. Issues for critical care medicine.

The demands of today's health care arena have forced the issue of automation and computerization. Nursing, as the major stakeholder in the collecting, managing, processing, transforming, and communicating of information regarding the patient, has developed a new approach to these tasks. Nursing informatics, which is the application of computer science and information science, is being used to manage and process the data, information, and knowledge necessary in the discipline. Although still in its infancy, nursing informatics has started to have a major effect on health care information gathering and clinical practice despite the multiple barriers to its advancement. Critical care is a data-rich environmental that can benefit from better management and processing of the data derived from the critically ill patient. Nursing and medical informatics joining together to organize the data, coupled with the introduction of good DSS and the addition of information retrieval systems at the bedside and the on-line medical record, will have a positive effect on the critical care environment and on the critical care patient outcomes.

Critical Care↗
PubMed1999

Toward a framework for computer-mediated collaborative design in medical informatics.

The development and implementation of enabling tools and methods that provide ready access to knowledge and information are among the central goals of medical informatics. The need for multi-institutional collaboration in the development of such tools and methods is increasingly being recognized. Collaboration involves communication, which typically involves individuals who work together at the same location. With the evolution of electronic modalities for communication, we seek to understand the role that such technologies can play in supporting collaboration, especially when the participants are geographically separated. Using the InterMed Collaboratory as a subject of study, we have analyzed their activities as an exercise in computer- and network-mediated collaborative design. We report on the cognitive, sociocultural, and logistical issues encountered when scientists from diverse organizations and backgrounds use communications technologies while designing and implementing shared products. Results demonstrate that it is important to match carefully the content with the mode of communication, identifying, for example, suitable uses of E-mail, conference calls, and face-to-face meetings. The special role of leaders in guiding and facilitating the group activities can also be seen, regardless of the communication setting in which the interactions occur. Most important is the proper use of technology to support the evolution of a shared vision of group goals and methods, an element that is clearly necessary before successful collaborative designs can proceed.

Communication↗
PubMedDate not supplied

Accuracy of on-site data entry in a rural primary care research network.

OBJECTIVE: This study examined how accurately research data can be entered into a database by rural research network members with little computer training and no data-entry experience. METHODS: A rural primary care research network in the Upper Peninsula of Michigan collected data from a study, and each practice entered its data on a standard database. The data were then sent electronically to the main research center where they were downloaded and analyzed. Accuracy of data entry was evaluated by comparing data received at the center with data on the original questionnaire. RESULTS: Accuracy of the data, entered by practice coordinators (nurses) with little or no computer experience, was completed with an error rate of one error per 220 keystrokes or .22 errors per 1,000 keystrokes. CONCLUSIONS: Results indicate that remote data entry in research networks can be accomplished accurately and reliably with little training.

Electronic Data Processing↗
PubMedDate not supplied

The Australian Medicines Handbook and its controlling vocabularies.

The Australian Medicines Handbook is intended to serve as an independent peer-reviewed knowledge resource for health care providers. A printed handbook is planned first, followed by electronic products. Information about medication will be dissected and entered into a detailed database, whose elemental nature should make it "computer understandable." The terms used in the database will be cross-referenced to preferred terms. Thus, the vocabulary will be controlled. The handbook will be printed directly from the database with use of database publishing techniques.

Australia↗
PubMed1997

Surveillance of antimicrobial resistance: the WHONET program.

Genes expressing resistance to each antimicrobial agent emerged after each agent became widely used. More than a hundred such genes now spread selectively through global networks of populations of bacteria in humans or animals treated with those agents. Information to monitor and manage this spread exists in the susceptibility test results of tens of thousands of laboratories around the world. The comparability of those results is uncertain, however, and their storage in paper files or in computer files with diverse codes and formats has made them inaccessible for analysis. The WHONET program puts each laboratory's data into a common code and file format at that laboratory, either by serving as or by translating from its own computer reporting system. It then enables each medical center to analyze its files in ways that help it monitor and manage resistance locally and to merge them with files of other centers for collaborative national or global surveillance of resistance.

Bacteria↗
PubMedDate not supplied

Ten years of medical informatics. Introduction.

The discussions of the Tenth Anniversary of the Symposium on Computer Applications in Medical Care (SCAMC) are summarized. Eight different subject areas are addressed: Medical informatics and medical education; Decision making, medical artificial intelligence, modelling and simulations; Image processing, 3-D graphics, and computer networks; Reimbursement policy, legal and regulatory issues; Encoding and representation of medical meaning; Ambulatory medical records systems; Hospital information systems; and Software environments for developing medical information systems. The activities of the 10th SCAMC consisted of Tutorials, Panel Discussions, a Plenary Session, Scientific Demonstrations, and an International Student Paper Competition in Medical Informatics.

Computer Communication Networks↗
PubMed1992

Quality control methods for data entry in pathology using a computerized data management system based on an extended data dictionary.

In pathology, computerized data management systems have been used increasingly to facilitate a more efficient supply of information. Since data entry precedes data utilization, the reliability of the information stored strongly depends on the quality of data input. Despite its potential capability, most personal computer-based database software does not provide versatile and user-friendly data validation procedures. Therefore, we developed a data dictionary-driven data management system that enables the user to perform extensive validation routines without the need for hard programming. Using examples from an existing database for endometrial carcinomas, different types of data errors and their error traps are explained. It is pointed out that data type definitions, defaults, templates, or picture clauses are suitable means to avoid formal errors. Validations on data domains and ranges test whether data fall into a predefined scope. Relational checks control data validity within a context of different data items, whereas process routines provide automatic data computation, thereby circumventing user input. By exploiting the facilities of an extended data dictionary, a powerful tool is made available to secure various aspects of data integrity simultaneously with input. In this way, computerized data quality control can improve the efficiency and reliability of data management tasks in pathology.

Medical Informatics Computing↗
PubMed2001

Induction of gene expression as a monitor of exposure to ionizing radiation.

The complex molecular responses to genotoxic stress are mediated by a variety of regulatory pathways. The transcription factor TP53 plays a central role in the cellular response to DNA-damaging agents such as ionizing radiation, but other pathways also play important roles. In addition, differences in radiation quality, such as the exposure to high-LET radiation that occurs during space travel, may influence the pattern of responses. The premise is developed that stress gene responses can be employed as molecular markers for radiation exposure using a combination of informatics and functional genomics approaches. Published studies from our laboratory have already demonstrated such transcriptional responses with doses of gamma rays as low as 2 cGy, and in peripheral blood lymphocytes (PBLs) irradiated ex vivo with doses as low as 20 cGy. We have also found several genes elevated in vivo 24 h after whole-body irradiation of mice with 20 cGy. Such studies should provide insight into the molecular responses to physiologically relevant doses, which cannot necessarily be extrapolated from high-dose studies. In addition, ongoing experiments are identifying large numbers of potential biomarkers using microarray hybridization and various irradiation protocols including expression at different times after exposure to low- and high-LET radiation. Computation-intensive informatics analysis methods are also being developed for management of the complex gene expression profiles resulting from these experiments. With further development of these approaches, it may be feasible to monitor changes in gene expression after low-dose radiation exposure and other physiological stresses that may be encountered during manned space flight, such as the planned mission to Mars.

Gene Expression↗
PubMed2004

Toward clinically relevant standardization of image quality.

In recent years, notable progress has been made on standardization of medical image presentations in the definition and implementation of the Digital Imaging and Communications in Medicine (DICOM) Grayscale Standard Display Function (GSDF). In parallel, the American Association of Physicists in Medicine (AAPM) Task Group 18 has provided much needed guidelines and tools for visual and quantitative assessment of medical display quality. In spite of these advances, however, there are still notable gaps in the effectiveness of DICOM GSDF to assure consistent and high-quality display of medical images. In additions the degree of correlation between display technical data and diagnostic usability and performance of displays remains unclear. This article proposes three specific steps that DICOM, AAPM, and ACR may collectively take to bridge the gap between technical performance and clinical use: (1) DICOM does not provide means and acceptance criteria to evaluate the conformance of a display device to GSDF or to address other image quality characteristics. DICOM can expand beyond luminance response, extending the measurable, quantifiable elements of TG18 such as reflection and resolution. (2) In a large picture archiving and communication system (PACS) installation, it is critical to continually track the appropriate use and performance of multiple display devices. DICOM may help with this task by adding a Device Service Class to the standard to provide for communication and control of image quality parameters between applications and devices, (3) The question of clinical significance of image quality metrics has rarely been addressed by prior efforts. In cooperation with AAPM, the American College of Radiology (ACR), and the Society for Computer Applications in Radiology (SCAR), DICOM may help to initiate research that will determine the clinical consequence of variations in image quality metrics (eg, GSDF conformance) and to define what constitutes image quality from a diagnostic perspective. Implementation of these three initiatives may further the reach and impact of DICOM toward quality medicine.

Data Display↗
PubMed2000

Evolutionary computation in medicine: an overview.

The term evolutionary computation encompasses a host of methodologies inspired by natural evolution that are used to solve hard problems. This paper provides an overview of evolutionary computation as applied to problems in the medical domains. We begin by outlining the basic workings of six types of evolutionary algorithms: genetic algorithms, genetic programming, evolution strategies, evolutionary programming, classifier systems, and hybrid systems. We then describe how evolutionary algorithms are applied to solve medical problems, including diagnosis, prognosis, imaging, signal processing, planning, and scheduling. Finally, we provide an extensive bibliography, classified both according to the medical task addressed and according to the evolutionary technique used.

Algorithms↗
PubMed2005

An adaptive prediction and detection algorithm for multistream syndromic surveillance.

BACKGROUND: Surveillance of Over-the-Counter pharmaceutical (OTC) sales as a potential early indicator of developing public health conditions, in particular in cases of interest to biosurvellance, has been suggested in the literature. This paper is a continuation of a previous study in which we formulated the problem of estimating clinical data from OTC sales in terms of optimal LMS linear and Finite Impulse Response (FIR) filters. In this paper we extend our results to predict clinical data multiple steps ahead using OTC sales as well as the clinical data itself. METHODS: The OTC data are grouped into a few categories and we predict the clinical data using a multichannel filter that encompasses all the past OTC categories as well as the past clinical data itself. The prediction is performed using FIR (Finite Impulse Response) filters and the recursive least squares method in order to adapt rapidly to nonstationary behaviour. In addition, we inject simulated events in both clinical and OTC data streams to evaluate the predictions by computing the Receiver Operating Characteristic curves of a threshold detector based on predicted outputs. RESULTS: We present all prediction results showing the effectiveness of the combined filtering operation. In addition, we compute and present the performance of a detector using the prediction output. CONCLUSION: Multichannel adaptive FIR least squares filtering provides a viable method of predicting public health conditions, as represented by clinical data, from OTC sales, and/or the clinical data. The potential value to a biosurveillance system cannot, however, be determined without studying this approach in the presence of transient events (nonstationary events of relatively short duration and fast rise times). Our simulated events superimposed on actual OTC and clinical data allow us to provide an upper bound on that potential value under some restricted conditions. Based on our ROC curves we argue that a biosurveillance system can provide early warning of an impending clinical event using ancillary data streams (such as OTC) with established correlations with the clinical data, and a prediction method that can react to nonstationary events sufficiently fast. Whether OTC (or other data streams yet to be identified) provide the best source of predicting clinical data is still an open question. We present a framework and an example to show how to measure the effectiveness of predictions, and compute an upper bound on this performance for the Recursive Least Squares method when the following two conditions are met: (1) an event of sufficient strength exists in both data streams, without distortion, and (2) it occurs in the OTC (or other ancillary streams) earlier than in the clinical data.

Algorithms↗