Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Knowledge base”

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 595 records · Page 33Linked to original sources
PubMed1993

The knowledge base of health visitors and district nurses regarding products in the proposed formulary for nurse prescription.

The background to the legalization of nurse prescribing is reviewed and a small questionnaire survey of health visitors and district nurses described. Significantly more district nurses than health visitors wanted to become nurse prescribers. Health visitor knowledge of some parasiticidal lotions and antifungal agents was found to be variable and the recommended dose of paracetamol for post-immunization pyrexia was recognized by less than two-thirds of the sample. District nurse knowledge of lactulose was limited in comparison to their knowledge of alginate and hydrocolloid dressings; however, their knowledge of factors other than dressing type which enhance or delay healing was variable. The mean knowledge scores of both the health visitors and district nurses were unacceptably low for prescribing purposes. The majority of the total sample stated that they would like further training, with a preference for such provision in the form of study days.

Clinical Competence↗
PubMed2006

The many secure knowledge bases of psychotherapy.

Psychotherapeutic practice, while it has benefited greatly from scientific research, rests on many further secure epistemic foundations. In the present article, this thesis is argued in two stages. First, a brief review of some elementary epistemological findings is presented. In this review, the generally acknowledged degree of certainty attributed to different knowledge sources, and thus the confidence with which we may believe and act upon them, are recounted. Second, an extended analysis of the ways in which each of these knowledge sources enter into the practice of psychotherapy is developed. In the end, what is proffered here is a demonstration that well conducted psychotherapy is an activity whose judgments and decisions rest on many secure foundations.

Humans↗
PubMed2006

Knowledge-based real-space explorations for low-resolution structure determination.

The accurate and effective interpretation of low-resolution data in X-ray crystallography is becoming increasingly important as structural initiatives turn toward large multiprotein complexes. Substantial challenges remain due to the poor information content and ambiguity in the interpretation of electron density maps at low resolution. Here, we describe a semiautomated procedure that employs a restraint-based conformational search algorithm, RAPPER, to produce a starting model for the structure determination of ligase interacting factor 1 in complex with a fragment of DNA ligase IV at low resolution. The combined use of experimental data and a priori knowledge of protein structure enabled us not only to generate an all-atom model but also to reaffirm the inferred sequence registry. This approach provides a means to extract quickly from experimental data useful information that would otherwise be discarded and to take into account the uncertainty in the interpretation--an overriding issue for low-resolution data.

Algorithms↗
PubMed2004

Clinical knowledge-based inverse treatment planning.

Clinical IMRT treatment plans are currently made using dose-based optimization algorithms, which do not consider the nonlinear dose-volume effects for tumours and normal structures. The choice of structure specific importance factors represents an additional degree of freedom of the system and makes rigorous optimization intractable. The purpose of this work is to circumvent the two problems by developing a biologically more sensible yet clinically practical inverse planning framework. To implement this, the dose-volume status of a structure was characterized by using the effective volume in the voxel domain. A new objective function was constructed with the incorporation of the volumetric information of the system so that the figure of merit of a given IMRT plan depends not only on the dose deviation from the desired distribution but also the dose-volume status of the involved organs. The conventional importance factor of an organ was written into a product of two components: (i) a generic importance that parametrizes the relative importance of the organs in the ideal situation when the goals for all the organs are met; (ii) a dose-dependent factor that quantifies our level of clinical/dosimetric satisfaction for a given plan. The generic importance can be determined a priori, and in most circumstances, does not need adjustment, whereas the second one, which is responsible for the intractable behaviour of the trade-off seen in conventional inverse planning, was determined automatically. An inverse planning module based on the proposed formalism was implemented and applied to a prostate case and a head-neck case. A comparison with the conventional inverse planning technique indicated that, for the same target dose coverage, the critical structure sparing was substantially improved for both cases. The incorporation of clinical knowledge allows us to obtain better IMRT plans and makes it possible to auto-select the importance factors, greatly facilitating the inverse planning process. The new formalism proposed also reveals the relationship between different inverse planning schemes and gives important insight into the problem of therapeutic plan optimization. In particular, we show that the EUD-based optimization is a special case of the general inverse planning formalism described in this paper.

Algorithms↗
PubMed2001

Using narrative literature reviews to build a scientific knowledge base.

This is the first in a series of three articles that examine the role that literature reviews play in rehabilitation research. The authors briefly describe the nature of narrative literature reviews, provides examples and descriptions of narrative literature reviews from the contemporary rehabilitation literature, and examines the limitations of these types of reviews in terms of modifying the prevailing status of knowledge in a particular research area.

Journal Article↗
PubMed2002

Controlling cancer pain in primary care: the prescribing habits and knowledge base of general practitioners.

During recent years, the national policy of the United Kingdom has increasingly recognized the central place of general practitioners (GPs) in the care of cancer patients, from screening and early diagnosis through to palliative care and bereavement. There are, however, continuing reports of poor control of pain and other symptoms in the community. To investigate general practitioners' prescribing habits and knowledge of some key pain control issues in advanced cancer, a postal questionnaire surveyed a random sample of 450 East Anglian GPs. The response rate was 73.3%. Most respondents were familiar with the modern management of cancer pain, including the World Health Organization approach, the use of oral opioids, and the management of bone pain. There was less awareness of the drug options available for more uncommon situations, especially the dose conversion of oral morphine to subcutaneous diamorphine and drugs that may be used in syringe drivers. GPs in the UK are familiar with the management of the more common pain control problems. However, it is not appropriate to expect GPs to know the details of management of more unusual cancer pain problems. Specialist clinicians need to make themselves readily available to advise their generalist colleagues. The educational implications for GPs are discussed.

Adult↗
PubMed1999

A computer-assisted drug prescription system: the model and its implementation in the ATM knowledge base.

Informatisation of drug prescription is an important topic in medical informatics. For several years now, computerized drug databases have been implemented. Usually only a small part of the prescriptions can be stored in prescription systems because of the format of the included information; prescriptions contain essentially free text without any structure and homogeneity of the used vocabulary. In this article a model is presented for knowledge representation in a computerized drug prescription system. The model should be applicable to clinical practice and be didactic for medical students. The problem of standardization of terminology had to be solved. A computer-assisted drug prescription program has been developed. The next step is its validation by clinicians. The program can also be used in a consultation mode.

Database Management Systems↗
PubMed1990

NEOANEMIA: a knowledge-based system emulating diagnostic reasoning.

Medical diagnosis can be modeled in terms of the classical notions of abduction, deduction, and induction. Abduction is making a preliminary guess that allows one to establish a set of plausible diagnostic hypotheses, followed by deduction for exploring their consequences and induction for testing the hypotheses with available patient data or for planning the acquisition of new data. Such a description of diagnostic reasoning at a knowledge level helps the construction of an expert system by fashioning the adopted expert system building tool to reflect the structure of the problem rather than by fitting the problem to the tool. To this aim, reasoning strategies need to be represented abstractly, separate from medical facts and relations, to make the design more transparent and explainable.

Anemia↗
PubMedDate not supplied

Knowledge-based scheduling of duty rosters for physicians.

Applications of artificial intelligence methods to problems of common sense in medicine are rare. Our approach deals with a special class of resource allocation problems concerning fairness in the everyday life in a hospital. We treated the construction of a duty roster in a medical environment. We developed a fairness reasoning machine embedded in the expert system PEP for constructing a duty roster. Furthermore, we elicited and generalized knowledge about fairness between physicians. PEP has been used routinely. We observed a clear short cut of work time of the user in running it, and a 'fair' long-term allocation of physicians in the duty roster.

Efficiency, Organizational↗
PubMed2004

Can an information booklet on an ethnic minority increase the knowledge base of junior doctors?

Many doctors encounter people of different cultural backgrounds for the first time as patients. In Leicester a significant proportion of the area's population comes from a Gujarati and Hindu background. In an attempt to better inform junior doctors about the views and beliefs of their patients, a group of clinicians and administrators developed an information booklet about the beliefs and practices of people from this community. The impact of this booklet on a group of 54 junior doctors' knowledge was investigated over a period of one month. Such an information booklet was found to significantly increase awareness of the cultural background of patients from a minority community and this knowledge was maintained for at least one month after distribution. The study did not investigate impact on attitudes.

Clinical Competence↗
PubMed1994

GAMES II Project: a general architecture for medical knowledge-based systems.

GAMES II aims at developing a comprehensive and commercially viable methodology to avoid problems ordinarily occurring in KBS development. GAMES II methodology proposes to design a KBS starting from an epistemological model of medical reasoning (the Select and Test Model). The design is viewed as a process of adding symbol level information to the epistemological model. The architectural framework provided by GAMES II integrates the use of different formalisms and techniques providing a large set of tools. The user can select the most suitable one for representing a piece of knowledge after a careful analysis of its epistemological characteristics. Special attention is devoted to the tools dealing with knowledge acquisition (both manual and automatic). A panel of practicing physicians are assessing the medical value of such a framework and its related tools by using it in a practical application.

Artificial Intelligence↗
PubMed1996

An expert system for the detection of cervical cancer cells using knowledge-based image analyzer.

Analyzing for abnormalities of cell images in the cervix uteri provides a basis for reducing deaths and morbidity from cervical cancer through detection of potentially cancerous cells, provision of prompt advice and opportunities for follow-up and treatments. However, cytopathology is usually based on subjective interpretation of morphological features. Arbitrary criteria have to be devised for their classifications. Subjective interpretations of such criteria are likely to result in diagnostic shifts and consequently disagreement occurs between different interpreters. This article presents a novel approach to the composition of segmentation and diagnosis processes for biomedical image analysis. A prototype expert system has been developed to provide an objective and reliable tool to gynaecologists. Special image analyzing techniques are used and a set of knowledge sources is designed. The expert system employs a robust control strategy which minimizes the amount of domain-specific control knowledge. It has been proved to work effectively in the detection of cervical cancer.

Artificial Intelligence↗
PubMedDate not supplied

Nursing's knowledge base: does it have to be unique?

An International Seminar held at the University College of Health Sciences, Jonkoping, Sweden, in May 1996, was the stimulus for this article. The purpose of the seminar was to consider the contribution that nursing theory has made to the development of the profession and to identify ways in which this contribution could be enhanced. This article briefly traces the emergence of nursing theory and argues that despite its relatively short history, theory has failed fully to inform practice and is increasingly seen as irrelevant. It is suggested that two trends--the abstract and esoteric nature of much nursing theory and the desire to create a unique' body of nursing knowledge--must be countered before theory can establish its value. It is argued that these are manifestations of professional and academic insecurity which nursing must overcome before it can reach maturity.

Diffusion of Innovation↗
PubMedDate not supplied

A knowledge-based system for real-time quality control and fault diagnosis of multitest analyzers.

A PC-based real-time quality control (QC) system for multitest analyzers has been developed as a prototype. The system is built with use of a relational database management system (DBMS). Control values from the various analytical channels are stored and administrated with use of the DBMS. The control values collected during various stages of control are filtered through statistical control procedures and the control status of the instrument is continuously presented in color-coded fields indicating the possible presence of critically sized systematic or random analytical errors. The knowledge about rational trouble-shooting of a specific instrument is represented in a network structure and stored in relational tables of the DBMS. An inference engine performs alternating backward and forward reasoning in the network and guides the operator in trouble-shooting.

Artificial Intelligence↗
PubMed1988

Knowledge-based information acquisition: norms and the functions of consensus information.

Mill's (1872/1973) method of difference prescribes that the lay scientist should use consensus information as a control condition for the person and distinctiveness information as a control condition for the stimulus when analyzing their causal effects on the occurrence of the target event. However, in studies of information acquisition, subjects have shown a consistent preference for distinctiveness information when answering causal questions about the person, and for consensus information when answering causal questions about the stimulus. To explain this discrepancy, we distinguish between the evaluative, contrastive, and corroborative functions of consensus and distinctiveness information. In addition, we suggest that subjects seek consensus information only if it is relevant to the question posed to them, and if they cannot supply it from their own presupposed knowledge of behavioral norms. We report four information acquisition experiments that provide support for our analysis.

Choice Behavior↗
PubMed1996

"Phase examination" an assessment of consultation skills and integrative knowledge based in general practice.

The undergraduate medical curriculum at Linköping was changed and problem-based learning introduced in 1986. As a consequence the need for new examinations arose. To assess the students' consultation skills, ability to use theory in practice and skills in problem-based learning, a new examination called 'phase examination' was designed and introduced. The examination results of a 4-year student cohort are presented here, including descriptive statistics and correlations between phase examinations 1 and 2, as well as a semester examination consisting of modified essay questions and an objective structured clinical examination. The construct validity of the phase examination was tested by factor analysis. In general, low correlation between the three examinations were found, and interpreted as a result of inter-case and inter-rater variability. The factor analysis identified two factors in both phase examinations--one representing the solving of a learning task, the other consultation skills. The variables concerning the use of knowledge had an intermediate position, more connected to the solving factor in phase 1 and the consultation factor in phase 2. With the close connection of theory and practice in the phase examination, both by its design and the pairing of examiners (one general practitioner and one basic scientist), these examinations can be an important learning experience for both students and teachers. The deficiencies in the reliability of the phase examinations is, in our view, compensated by its directing and supporting effect on students' learning and its face and construct validity.

Clinical Competence↗
PubMed2003

Trace element biology: the knowledge base and its application for the nutrition of individuals and populations.

Impressive strides are being made in the understanding of trace element metabolism and function. This is underscored by the many contributions in these proceedings. However, not so impressive are: i) the precise recognition of mild trace element deficiencies and how to establish their functional consequences, possibly confounded by concurrent trace element inadequacies, are difficult to assess, ii) approaches to the quantitative determination of requirements for trace elements remain unsatisfactory and archaic, in so many ways, iii) our understanding of the extent of the biological basis for the variation in requirements among apparently similar individuals is poor, and iv) much needs to be learned about the quantitative extent to which genetic, epigenetic and dietary factors interact to determine the nutritional phenotype. Some ideas are presented as to how we might embrace, in the context of a reconstructive approach, the exciting new knowledge and related techniques emerging during the postgenome era and develop new paradigms for assessing trace element needs and status, and for establishing effective nutrient intake under different conditions of complex genotype-environment interactions. Metabolites are functional cellular entities and I also urge a vigorous application of metabolomics and of metabolic profiling that is closely linked with genomics, proteomics, trace element kinetics and system analysis, as components of the new integrative paradigm. We need to understand the system and its strategy, not only the molecular details of its component parts and its individual controls. An interdisciplinary research and teaching enterprise will be necessary to best achieve this aim. All of this is related to our common goal to promote, through expanded biological knowledge and its effective application, the enhanced role of trace elements for human well-being.

Animals↗
PubMed2006

In silico classification of HERG channel blockers: a knowledge-based strategy.

The blockage of the hERG potassium channel by a wide number of diverse compounds has become a major pharmacological safety concern as it can lead to sudden cardiac death. In silico models can be potent tools to screen out potential hERG blockers as early as possible during the drug-discovery process. In this study, predictive models developed using the recursive partitioning method and created using diverse datasets from 203 molecules tested on the hERG channel are described. The first model was built with hERG compounds grouped into two classes, with a separation limit set at an IC50 value of 1 microm, and reaches an overall accuracy of 81%. The misclassification of molecules having a range of activity between 1 and 10 microM led to the generation of a tri-class model able to correctly classify high, moderate, and weak hERG blockers with an overall accuracy of 90%. Another model, constructed with the high and weak hERG-blocker categories, successfully increases the accuracy to 96%. The results reported herein indicate that a combination of precise, knowledge management resources and powerful modeling tools are invaluable to assessing potential cardiotoxic side effects related to hERG blockage.

Drug Design↗