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Relevance of the Human Genome Project to inherited metabolic disease.

The Human Genome Project is an international effort to identify the complete structure of the human genome. HUGO, the Human Genome Organization, facilitates international cooperation and exchange of information while the Genome Data Base will act as the on-line information retrieval and storage system for the huge amount of information being accumulated. The clinical register MIM (Mendelian Inheritance in Man) established by Victor McKusick is now an on-line resource that will allow biochemists working with inborn errors of metabolism to access the rapidly expanding body of knowledge. Biochemical and molecular genetics are complementary and should draw together to find solutions to the academic and clinical problems posed by inborn errors of metabolism.

Genetic Diseases, Inborn↗

Fast personal computer based retrieval system for a high-volume database of a radiology information system.

A personal computer system has been used to facilitate search and analysis of a radiology information system database (RADOS) for research purposes. The system enables flexible retrieval of examination data and radiographic findings with subsequent graphical manipulations. With modifications it could be implemented on other radiology information systems.

Medical Records Systems, Computerized↗

The management of medical records.

An optical disk filing system is an efficient approach to storing medical records; however, this system has not yet been put to practical use because it is usually a "stand-alone" type indirectly connected to a hospital information system. We have developed a medical record management system with an optical disk filing system connected to the host computer in the hospital information system. We can retrieve and display the medical records through the CRT (Cathode Ray Tube) terminals of the hospital information system at every ward and outpatient clinic. The patient's clinical information can be sent to several areas in the hospital using the hospital information system.

Computer Communication Networks↗

Computerized information sources in toxicology and their use in a poisons centre.

The increasing volume of calls received by a poisons centre, such as the National Poisons Unit, Guy's Hospital, London is placing the present information services under escalating pressure. Recent developments in the technologies used to store and manipulate data have resulted in a number of public and private computerized systems being made available. In order to maximize the benefit of the new technologies to a Poisons Centre Information Service it would be desirable to create an integrated system to link the currently unrelated systems. Such an integrated system would be capable of retrieving bibliographic information from bibliographic files similar to MEDLINE and EMBASE and data from source information files such as RTECS and ECDIN, with the user only having to make one enquiry. This paper examines the current position with regard to computerized information sources in toxicology and discusses how an integrated system might improve the efficiency of a poisons centre's information retrieval service and outlines some of the obstacles to the development of such a system.

Catalogs as Topic↗

GeneFIND web server for protein family identification and information retrieval.

UNLABELLED: An integrated database and search system has been developed for protein family identification and information retrieval, as an approach to undertake the highly complex, genomic-scale problem of molecular sequence database search and organization. AVAILABILITY: http://diana.uthct.edu CONTACT: wu@uthct.edu

Amino Acid Sequence↗

Diagnostic follow-up to consultant physicians by computer feedback.

A computer follow-up system has been developed which automatically prepares follow-up summaries for consultant physicians. This makes it possible to provide reliable feedback of diagnostic information in place of the traditional but haphazard word-of-mouth process. This system has been tested initially for surgical and autopsy-pathology follow-up of neuroradiology and nuclear medicine consultations using report conclusions available from the UCLA Natural Language Information Storage and Retrieval System.

Computers↗

Development and deployment of a health information system in transitional countries (croatian experience).

Croatian Primary Health Care Information System pilot project, conducted between 2001 and 2003, aimed to develop and deploy a health information system based on the latest technologies which would improve the quality of primary health care and rationalise the consumption. 60 primary health care teams (physician and nurse) were equipped with PCs and connected via central server to the main national health insurer, state treasury and public health institute. Developed information system enabled rapid retrieval of documents, replacement of manual data input and a real-time insight into needed information as well as prompt interventions within the system. The project also introduced electronic smart cards for physicians and nurses, so that at each medical check-up the information system verified both the ensuree's and the physician's or nurse's status and rights.Based on the experiences from the pilot project, plan has been made for comprehensive health information system at national level which would connect primary health care teams, hospitals, laboratories, dentistries, health insurance companies, state treasury, public health institutes and electronic health records database. Its major goals are more rapid diagnostics, accuracy in prescribing therapy, standardisation of the good practice as well as better utilisation of capacities, shorter waiting times and shorter stays in hospitals, which would lead to improvement in overall health care quality and better control over the health care consumption. Estimated 5-year investment for installing such system would be 125 million EUR. However, information system could save substantially more and yield a return of investment in only two years.As information system for primary health care should be a strategic component of every health care reform and development plan, we can recommend our model, based on the results of the pilot project, to other transitional countries.

Delivery of Health Care↗

Lockheed experience in processing large data bases for its commercial information retrieval service.

The last few years have seen the emergence of the information retrieval services industry. This industry consists of three tiers: data base producers, retrieval service vendors, and information centers who service the end user. The experience of Lockheed Information Systems as a retrieval service vendor is recounted as it pertains to its system and to its relationship with the data base suppliers. Government competition is seen as a potential threat to the industry.

Computers↗

The quest for the Holy Grail of systems.

Software agents like Edify can be used to retrieve (and store) information from most online systems, without having to access each system's database. These techniques allow information integration (display) into Windows applications or in new reference and information retrieval applications or Web pages. These techniques can be used to bridge the gap until the Holy Grail of systems is built (and works).

Delivery of Health Care, Integrated↗

A computer based system for collection, storage, retrieval and reporting accession information in a veterinary medical diagnostic laboratory.

Substantial data collected from large numbers of accessions, the need for comprehensive reporting of negative as well as positive laboratory findings, and the necessity for obtaining rapid diagnostic correlations prompted the development of a computer based system of accession data management for collection, storage, rapid retrieval, reporting, concording, and administrative compiling in a state-university Veterinary Medical Diagnostic Laboratory.

Animal Diseases↗

Using external data sources to improve audit trail analysis.

Audit trail analysis is the primary means of detection of inappropriate use of the medical record. While audit logs contain large amounts of information, the information required to determine useful user-patient relationships is often not present. Adequate information isn't present because most audit trail analysis systems rely on the limited information available within the medical record system. We report a feature of the STAR (System for Text Archive and Retrieval) audit analysis system where information available in the medical record is augmented with external information sources such as: database sources, Light-weight Directory Access Protocol (LDAP) server sources, and World Wide Web (WWW) database sources. We discuss several issues that arise when combining the information from each of these disparate information sources. Furthermore, we explain how the enhanced person specific information obtained can be used to determine user-patient relationships that might signify a motive for inappropriately accessing a patient's medical record.

Computer Security↗

Evaluation of online documentation.

The University of Iowa Hospitals and Clinics (UIHC) implemented an online documentation system for patient care orders in 1994-1996. Developed entirely in-house, the INFORMM NIS (Information Network for Online Retrieval & Medical Management Nursing Information System) features order-generated task lists, defaulted charting responses, computer-generated chart forms, and graphical data displays. To measure the impact of automation on user perceptions, and documentation compliance, completeness, time, and location, a team of nursing and information systems representatives captured data before and after implementation. Staff surveys show more positive user perceptions. Documentation results indicate increased compliance and completeness, and a decrease or no change in time. Online documentation occurs mainly at unit workstations.

Attitude of Health Personnel↗

ACMES: fast multiple-genome searches for short repeat sequences with concurrent cross-species information retrieval.

We have developed a web server for the life sciences community to use to search for short repeats of DNA sequence of length between 3 and 10,000 bases within multiple species. This search employs a unique and fast hash function approach. Our system also applies information retrieval algorithms to discover knowledge of cross-species conservation of repeat sequences. Furthermore, we have incorporated a part of the Gene Ontology database into our information retrieval algorithms to broaden the coverage of the search. Our web server and tutorial can be found at http://acmes.rnet.missouri.edu.

Algorithms↗

ADM-INDEX: an automated system for indexing and retrieval of medical texts.

ADM-INDEX is a system for indexing and retrieval of Patients Discharge Summaries (PDSs) by using linguistic methods (morphologic, syntaxic and semantic processing). The ADM-INDEX knowledge base is a restructuring of a diagnostic aid knowledge base (ADM) in order to allow the linguistic analysis of medical texts. The ADM system is a comprehensive medical knowledge base which has been developed since 1972 at the University Hospital of Rennes and which has been the first professional videotex medical diagnostic aid in France. After linguistic analysis, ADM-INDEX build the index table with thesaurus wording, medical words, concepts and phrases, unknown words contained in each PDS. The benefit of using those different elements is to improve information retrieval. Although our system is constructed with the ADM dictionary, it can be easily applied to other medical nomenclature or thesaurus. In this paper, we present on the one hand the ADM-INDEX knowledge base which is constituted by rules, a dictionary and a thesaurus, and on the other hand, the process of indexing and retrieval information.

Abstracting and Indexing↗

A generic concept for the implementation of medical image retrieval systems.

This paper presents a technical framework to support the development and installation of system for content-based image retrieval in medical applications (IRMA). A strict separation of feature extraction, feature storage, feature comparison, and the user interfaces is suggested. This allows to reuse implemented components in different retrieval algorithms, which improves software quality, shortens the development cycle for applications, and allows to introduce standardized end-user interfaces. Based on the proposed framework, the IRMA engine has been established, which is currently used to evaluate content-based retrieval methods on a collection of 20,000 medical and 135,000 non-medical images.

Algorithms↗

Use of guidelines in primary care--practitioners' perspectives.

BACKGROUND AND OBJECTIVES: Concern about the inadequate take-up of guidelines in general practice has concentrated on problems arising from the process of their development and implementation. However, these perspectives fail to take account of the needs, attitudes and problems of GPs themselves. In this study we aimed to identify barriers to the use of guidelines and opportunities for tackling them, from the point of view of the GP, so that future guideline development and policy could be more sensitive to the needs of GPs in the environment in which they work. METHOD: Twenty in-depth semi-structured interviews were audiotaped with GPs from within the Avon Health Authority area, representing GPs with different backgrounds and working environments. The transcribed data collected were analysed using a grounded theory approach. RESULTS: Utilization of guideline information is complex. GPs' appraisals of the value of guidelines interact with prior knowledge and beliefs, practicalities of existing information storage and retrieval systems, and individual working practices. Conditions where guidelines are most likely to be referred to may be those either very rarely or very commonly presenting in general practice. Key issues for the uptake of guidelines in the consultation are: general preference for certain formats of presentation; reputability and ownership; use of guidelines in shared decision-making; scope for computer-based systems; and GPs' attitudes to time pressures on information-seeking in relation to tolerance of uncertainty. CONCLUSION: Local initiatives might usefully explore the possibilities of supporting development of guideline-retrieval systems customized for individual GPs or practices. Novel means of stimulating 'ownership' and demonstrating reputability should be sought. The analysis provides a framework for understanding the complexities of the processes of GPs' use of guidelines in practice which can be useful in explaining the results of trials of guideline effectiveness. Guideline implementation occurs in the context of conflicting pressures for clinical autonomy and professional standardization and quality improvement.

Attitude of Health Personnel↗