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At least 703 records · Page 39Linked to original sources
PubMed1999

Information systems integration in radiology.

Advances in information systems and technology in conjunction with outside forces requiring improved reporting are driving sweeping changes in the practice of radiology. In most academic radiology departments, there can be at least five separate information systems in daily use, a clinical picture archiving and communication system (PACS), a hospital information system (HIS), a radiology information system (RIS), a voice-recognition dictation system, and an electronic teaching/research file system. A PACS will have incomplete, incorrect, and inconsistent data if manual data entry is used. Correct routing of studies for diagnostic reporting and clinical review requires accurate information about the study type and the referring physician or service, often not easily entered manually. An HIS is a hospital-wide information system used to access patient information, reports from various services, and billing information. The RIS is typically a system specifically designed to place radiology orders, to receive interpretations, and to prepare bills for patients. Voice-recognition systems automatically transcribe the radiologist's dictation, eliminating transcription delays. Another system that is needed in a teaching hospital holds images and data for research and education. Integration of diverse systems must be performed to provide the functionality required by an electronic radiology department and the services it supports. Health Level 7 (HL7) and Digital Imaging and Communications in Medicine (DICOM) have enabled sharing of data among systems and can be used as the building blocks for truly integrated systems, but the user community and manufacturers need to specify the types of functionality needed to build clinically useful systems. Although technology development has produced the tools for interoperability for clinical and research/educational use, more work needs to be done to define the types of interaction that needs to be performed to realize the potential of these systems.

Computer Communication Networks↗
PubMed2004

Gene expression profiling in neurological disorders: toward a systems-level understanding of the brain.

Neurological disease arises when a sufficient number of neural cells stop performing their normal functions, lose their ability to respond to local environment, and die. In the last decade, a major technological leap led to the development of efficient and cost-effective high-throughput methods for determining gene expression. This, in turn, resulted in the rapid accumulation of data describing gene expression patterns in the brain of humans and experimental animals. This article reviews several of the most commonly used technologies to retrieve transcriptional information, such as large-scale expressed sequence tag (EST) sequencing, serial analyses of gene experiment, and different DNA microarray platforms. In addition, efforts focusing on data collection, sharing, and standardization are described. A section is devoted to the latest advances in large-scale gene expression in several neurological disorders, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and epilepsy. Finally, the need for integration of different sources of data is discussed in the context of systems biology and how such integration could result in improved diagnostics, therapies, and disease prevention.

Brain↗
PubMed2002

Non-curated distributed databases for experimental data and models in neuroscience.

Neuroscience is generating vast amounts of highly diverse data which is of potential interest to researchers beyond the laboratories in which it is collected. In particular, quantitative neuroanatomical data is relevant to a wide variety of areas, including studies of development, aging, pathology and in biophysically oriented computational modelling. Moreover, the relatively discrete and well-defined nature of the data make it an ideal application for developing systems designed to facilitate data archiving, sharing and reuse. At present, the only widely used forms of dissemination are figures and tables in published papers which suffer from inaccessibility and the loss of machine readability. They may also present only an averaged or otherwise selected subset of the available data. Numerous database projects are in progress to address these shortcomings. They employ a variety of architectures and philosophies, each with its own merits and disadvantages. One axis on which they may be distinguished is the degree of top-down control, or curation, involved in data entry. Here we consider one extreme of this scale in which there is no curation, minimal standardization and a wide degree of freedom in the form of records used to document data. Such a scheme has advantages in the ease of database creation and in the equitable assignment of perceived intellectual property by keeping the control of data in the hands of the experts who collected it. It does, however, require a more sophisticated infrastructure than conventional databases since the software must be capable of organizing diverse and differently documented data sets in an effective way. Several components of a software system to provide this infrastructure are now in place. Examples are presented, showing how these tools can be used to archive and publish neuronal morphology data, and how they can give an integrated view of data stored at many different sites.

Animals↗
PubMed2002

Factors affecting the determination of threshold doses for allergenic foods: how much is too much?

BACKGROUND: Ingestion of small amounts of an offending food can elicit adverse reactions in individuals with IgE-mediated food allergies. The threshold dose for provocation of such reactions is often considered to be zero. However, because of various practical limitations in food production and processing, foods may occasionally contain trace residues of the offending food. Are these very low, residual quantities hazardous to allergic consumers? How much of the offending food is too much? Very little quantitative information exists to allow any risk assessments to be conducted by the food industry. OBJECTIVE: We sought to determine whether the quality and quantity of existing clinical data on threshold doses for commonly allergenic foods were sufficient to allow consensus to be reached on establishment of threshold doses for specific foods. METHODS: In September 1999, 12 clinical allergists and other interested parties were invited to participate in a roundtable conference to share existing data on threshold doses and to discuss clinical approaches that would allow the acquisition of that information. RESULTS: Considerable data were identified in clinical files relating to the threshold doses for peanut, cows' milk, and egg; limited data were available for other foods, such as fish and mustard. CONCLUSIONS: Because these data were often obtained by means of different protocols, the estimation of a threshold dose was very difficult. Development of a standardized protocol for clinical experiments to allow determination of the threshold dose is needed.

Allergens↗
PubMed1975

Mechanization of library procedures in a medium-sized medical library: XVI. Computer-assisted cataloging, the first decade.

After ten years of experimentation in computer-assisted cataloging, the Washington University School of Medicine Library has decided to join the Ohio College Library Center network. The history of the library's work preceding this decision is reviewed. The data processing equipment and computers that have permitted librarians to explore different ways of presenting cataloging information are discussed. Certain cataloging processes are facilitated by computer manipulation and printouts, but the intellectual cataloging processes such as descriptive and subject cataloging are not. Networks and shared bibliographic data bases show promise of eliminating the intellectual cataloging for one book by more than one cataloger. It is in this area that future developments can be expected.

Cataloging↗
PubMed1997

Practical application of non-whole animal alternatives: summary of IRAG workshop on eye irritation testing. Interagency Regulatory Alternatives Group.

In November 1993, the Interagency Regulatory Alternatives Group (IRAG) sponsored a workshop to examine the current scientific status of alternatives to the Draize eye irritation test by assessing the current practical application of methods used to predict in vivo eye irritation. Laboratories from around the world were invited to submit detailed in vitro and in vivo data in parallel according to a specific set of guidelines in a consistent format. In vitro scores were compared with individual tissue scores. Over 60 data sets from 41 laboratories were received for 29 different test methods. Methods were grouped into five categories: organotypic models, chorioallantoic membrane-based assays, cell function-based assays, cytotoxicity assays and other systems. Data submissions and correlation analyses have been used to demonstrate the application of guidelines in method evaluations. Findings are summarized and future directions are indicated. A significant outcome of the workshop was the co-operation demonstrated among representatives of industry, academia and government in sharing test data on more than 2000 chemicals, products and product formulations for evaluation by their peers. Information obtained from this workshop will add to the weight of scientific evidence and scientific consensus about in vitro test methods and will establish credibility for regulatory acceptance of non-whole animal alternatives for ocular irritation.

Animal Testing Alternatives↗
PubMed2003

The human proteome organization (HUPO) and environmental health.

The Human Proteome Organization, or HUPO, was formed to promote research and large-scale analysis of the human proteome. By consolidating national proteome organizations into an international body, HUPO will coordinate international initiatives, biological resources, protocols, standards and data for studying the human proteome. HUPO has identified five key areas to advance study of the human proteome, specifically in bioinformatics, new technologies, the plasma proteome, cell models, and a public antibody initiative. Consideration of three major issue areas may help develop HUPO's strategy for human proteome study. First is the need to distinguish the value of high throughput platforms from discovery platforms in proteomics. Second is the importance for international planning on integrating both transcriptome and proteome data and databases. Last is that effects of the environment from chemical, physical, and biological exposures alter the expression and structure of the proteome, which become manifest in long-term adverse health effects and disease. Environmental health research stands to greatly benefit from the shared resources, data, and vision of the HUPO organization as a valuable resource in exploiting knowledge of the human proteome toward improving public health.

Computational Biology↗
PubMed1982

A prospective study of development of children with sex chromosome anomalies - New Haven study III. The middle years.

This is the third report of a prospective study of children with sex chromosome anomalies identified at birth in New Haven, Connecticut. Previous reports in 1974 [1] and 1979 [2] summarized data from the first 2 1/2 years and the first 9 years of the children's lives, respectively. The present report will focus on progress and evaluations in the years 9-13, concluding with an Appendix of Case Summaries which provide an overview of 6 of the cases. Accumulation of data from such children is increasingly important to assist in genetic counseling. Because of the rarity of sex chromosome aneuploidy (about 1 in 400 newborns), no one center sees enough of these children to feel confident about the validity of results. However, the periodic meeting, sharing of data, and joint publication of results by investigators in several centers, made possible by the March of Dimes provide large enough numbers of children with each karyotype for valid conclusions about range of expected growth and development through the preadolescent years. Therefore, this report is published together with those from other centers, as in the 1979 report [2].

Achievement↗
PubMed2001

Microarrays: lost in a storm of data?

Microarray expression profiling is instrumental to our understanding of the function of the genome. Resolution of functionally relevant expression patterns will require the analysis of large data sets compiled from multiple investigators. For this and other reasons, I argue that it is crucial for array data to be publicly shared in a format as close to the 'raw data' as possible. Issues such as protection of intellectual property, ensuring quality of the data, and the format and timing for sharing array data are also discussed.

Animals↗
PubMed1993

Data interchange for clinical neurophysiology.

Clinical Neurophysiology is rapidly moving towards complete dependence on digital instrumentation and computer-based systems. ASTM E 1467-92 "Standard Specification for Transferring Digital Neurophysiological Data Between Independent Computer Systems" was developed to allow exchange of multichannel electrophysiological waveforms, embedded textual annotations, results of mathematical processing, and clinical interpretive reports between various instruments and systems. This will permit integration of the neurophysiology laboratory interaction with hospital and clinic informations systems, and sharing of data between institutions for clinical or research purposes.

Computer Systems↗
PubMed2001

Lessons learned while collecting ANA indicator data.

Realizing the importance of linking nursing's contribution to quality patient care, a pilot study was conducted to determine whether data regarding the quality indicators proposed by the American Nurses' Association (ANA) could be collected from five acute-care inpatient units at one medical center that is part of a multisite managed care system. Although it was determined that data regarding the ANA quality indicators could be collected at the study site, a variety of unanticipated findings emerged. These findings reflect both discrepancies and congruities between how the investigative team expected the ANA indicators to operate versus what was actually experienced. The lessons learned while collecting ANA indicator data are shared to assist future users and to advance the evolution of the ANA indicators.

American Nurses' Association↗
PubMed2004

Issues influencing development of the Canadian Cardiovascular Information Network.

The 1995 Consensus Conference of the Canadian Cardiovascular Society on "Indications for and Access to Revascularization" recommended that Canadian centres with invasive cardiovascular facilities should participate in a national observational database that monitors the selection of patients, as well as evaluate outcomes. The Canadian Cardiovascular Society, the Heart and Stroke Foundation of Canada, and Health Canada with IBM as a partner, initiated a process to identify factors influencing the development of the Canadian Cardiovascular Information Network. IBM's "Business Discovery Methodology" was adapted for health care. Structured interviews with representatives of health organizations, cardiovascular databases and research institutes were conducted across Canada, followed by a workshop to identify goals, issues and challenges. Participants identified goals for a cardiovascular database (eg, evidence-based decision-making), project related issues (eg, respecting the integrity of existing databases) and health care related issues (eg, cardiac waiting lists). Challenges included initial mistrust between representatives of provincial cardiovascular databases and national agencies, and a lack of sustained funding. A Project Team was formed to address 'cardiac waiting lists'. Analysis of Alberta and Ontario data identified differences in definitions, such as when the waiting time for bypass surgery began, that impeded detailed comparisons. Development of a centralized national database was not feasible at this time for political, technical and financial reasons. However, provincial cardiovascular database representatives agreed to work together and to share aggregate data and analyses. A first step toward developing a national surveillance system for cardiovascular services will be achieving consensus about standardizing data definitions. This process will require sustained funding.

Canada↗
PubMed1993

Health insurance and the elderly.

The effectiveness of proposed changes to the Medicare program depends on consumers' responses to different market incentives, which vary according to the coverage the elderly possess to supplement their Medicare coverage. This Data Watch explores the extent of supplemental insurance among the elderly, based on a new data set from the Medicare Current Beneficiary Survey. Only 11 percent of Medicare beneficiaries have only Medicare as their source of coverage; the rest of the elderly population is covered by either private coverage (employer-sponsored retiree coverage or individually purchased coverage) or Medicaid. An increase in Medicare cost sharing would likely affect one-third of elderly beneficiaries, which calls into question the effectiveness of this approach to Medicare program reform.

Aged↗
PubMed2005

Perspectives on the molecular epidemiology of aerodigestive tract cancers.

Improving laboratory techniques and the greater availability of genetic data have led to a flurry of publications from molecular epidemiologic studies on aerodigestive tract cancers. Inconsistent results have been observed in studies of sequence variants, due to limitations such as small sample size, possible detection of false positives, moderate prior probabilities that each SNP confers a substantial increase in cancer risk, and publication bias. Meta- and pooled-analyses were shown to be effective in elucidating modest increases in aerodigestive tract cancer risk attributable to sequence variants. Phenotypic assays developed to quantify an individual's DNA repair capacity have been applied to epidemiological studies on aerodigestive tract cancers. Epigenetic events have also been studied in tumor progression and as susceptibility factors for aerodigestive tract cancers, in smaller scale studies. It is imperative that limitations of previous studies are addressed for future research in the molecular epidemiology of aerodigestive tract cancers. Some recommendations for future research are to: (i) incorporate multiple markers of different types (ex. genotype and phenotype data), (ii) enhance statistical power by conducting studies with larger sample size, and developing consortia to coordinate research efforts, (iii) improve marker selection via a hybrid strategy of incorporating data on evolutionary biology and physico-chemical properties of amino acids, with haplotype/tag SNP data, (iv) employ novel statistical methods such as hierarchical modeling with Bayesian adjustments, false positive reporting probability and modeling of complex pathways. Consortia have been initiated for head and neck cancer (International Head and Neck Cancer Epidemiology Consortium (INHANCE)) and lung cancer (International Lung Cancer Consortium (ILCCO)) with the aim to share comparable data, to focus on rare subgroups such as nonsmokers and to coordinate laboratory analyses. Such collaborative efforts and integration across disciplines will be essential in contributing to the elucidation of genetic susceptibility to aerodigestive tract cancers.

Carcinogens↗
PubMed2000

The power of survivor advocacy: making car trunks escapable.

Survivor advocates are powerful workers for injury prevention. Some of the major prevention successes have been due in large part to their efforts. This case history examines the four year campaign to prevent entrapment in car trunks (or boot) through the routine installation of interior trunk releases. It traces how a life altering event began a cluster of activities leading to product redesign and regulation to prevent injury. The following elements were key: data and the lack thereof, identification of possible solutions, newsworthy tragedies and media advocacy, politics and sympathetic lawmakers, an agency with regulatory authority, manufacturers, and trade associations. Survivors can assist the injury field because the personal and the professional complement each other in advocacy. Public health professionals can assist survivor advocates by sharing research, data and organizational skills, and by helping to secure grants.

Adolescent↗
PubMed1994

A practice-based information system for multi-disciplinary care of chronically ill patients: what information do we need? The Community Care Coordination Network Database Group.

Primary care physicians provide longitudinal care for chronically ill individuals in concert with many other community-based disciplines. The care management of these individuals requires data not traditionally collected during the care of well, or acutely ill individuals. These data not only concern the patient, in the form of patient functional status, mental status and affect, but also pertain to the caregiver, home environment, and the formal community health and social service system. The goal of the Community Care Coordination Network is to build a primary care-based information system to share patient data and communicate patient related information among the community-based multi-disciplinary teams. One objective of the Community Care Coordination Network is to create a Community Care Database for chronically ill individuals by identifying those data elements necessary for efficient multi-disciplinary care.

Chronic Disease↗
PubMed1997

The promise of object technology: what's in it for healthcare?

This article focuses on the application of a new business computing model--Objects. Although Object Technology is not new, its widespread use in healthcare information management executives struggle with the integration demands of the new enterprise, Object Technology will unleash the true power of desktop computing and lessen the many quandaries faced with the integration and aggregation of strategic enterprise data. As we move forward, the new healthcare business model will attempt to create the "virtual enterprise." This new enterprise, will be lean and nimble and allow the Integrated Delivery System (IDS) to deliver care to a broader population with fewer requirements for expensive and scarce resources. To do this, the IDS must possess the technology to share key data, with partners and providers, that will allow faster and more accurate decision making. This article presents the "natural fit" of Object Technology and its ability to solve the complex computing issues of the new healthcare enterprise.

Computer Simulation↗
PubMed2003

Using organizational assessment surveys for improvement in neonatal intensive care.

BACKGROUND: Problems with organizational culture, lack of or poor team communications, and conflict are often seen as barriers to improvement efforts. METHODS: A survey measuring aspects of organizational culture was administered twice to staff in neonatal intensive care units participating in the Neonatal Intensive Care Unit Quality Improvement Collaborative Year 2000 collaborative. The surveys provided comparative data on coordination, teamwork and leadership, conflict management, unit leadership and unit culture. These data were summarized and fed back to NICU teams with guidance on their use. Interviews on the use of the survey were held with 12 medical directors and patient care leaders in 9 different NICUs. RESULTS: The findings indicated that all the units contacted saw themselves as committed to undertaking the organizational survey and using the results. Some units shared the data widely and initiated changes. Other units limited the distribution of data to the unit leadership. There was no apparent relationship between scores on the survey and activities undertaken. Several respondents credited the survey with helping to promote discussions about organizational and team issues. CONCLUSIONS: Future use of the survey should include additional materials to assist in disseminating the results to staff.

Data Collection↗