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Information system, data bases, and on-line services of the Japan Information Center of Science and Technology (JICST).

The JICST information processing system consists of the data-base production system, authority file management system, bibliographic retrieval system, and printed issue compiling system. The bibliographic retrieval service based on the JICST On-line Information System (JOIS-I) has been available through leased line since 1976 and now also through dial-up line, which covers five data bases: the JICST bibliographic and on-going research information files, CA Condensates, MEDLARS, and TOXLINE files. The on-line output in Japanese kanji is also available. The newly revised JOIS-II system is now being developed.

Forecasting↗

Holographic image archive.

This paper presents an associative technique for content-based retrieval into image archive, based on a computing paradigm called Multidimensional Holographic Associative Computing (MHAC). Unlike any prior Artificial Associative Memory (AAM), MHAC has the unique ability fo focus on any subject of pixels in the sample image and retrieve learned images based on the similarity of the visual objects. In addition, MHAC is adaptive, graciously accommodative of imprecision, efficient, parallelizable, scalable and optically realizable. Together, these excellent properties of MHAC offer a promising novel approach to a content-based search into massive image archives. The paper presents the necessary transformational steps to incorporate this new mechanism into a complete image archival and retrieval system. This is the first associative search approach for content-based retrieval in image repository. The results show that this search system is capable of retrievals by using pattern objects as small as 10-15% of the query image frame at better than 90% accuracy. This demonstrates the potential of MHAC for handing contest-based image applications far beyond the capability of current associative memories. The design, methodology and performance of this system have been illustrated in this paper through its application in managing a Medical Image Archive (MEDIA).

Algorithms↗

Image storing system for radiation therapy (radiation oncology information system: ROIS) as a branch of diagnostic PACS; implementation and evaluation.

We have implemented the new system that is called as ROIS for storing medical images of the patients underwent radiotherapy as a branch of medium-scale diagnostic PACS. It was estimated that, for about nine years, we can store all medical images of the patients who received radiation therapy under the on-line storage condition. Further, we can retrieve all medical images of the radiotherapy patients on ROIS faster than conventional film library or on the diagnostic PACS, even if the patient had been treated many years ago. Implementation of ROIS provided us a great help in our clinical work.

Computer Communication Networks↗

Incorporating out-patient data from CD-R into the local PACS using DICOM worklist features.

With the introduction of digital imaging in radiology, CD-Rs are increasingly used to distribute patient materials. This study investigates the application of a new software package and work protocol to integrate out-hospital data into the local PACS (picture archive and communication system) archive, which is hampered by differences in patient numbers. A one-month trial was started to import CD-Rs from two departments (radiotherapy and radiology). Seventy CD-Rs were collected from 20 different hospitals holding data of eight different modality types and published by eight different software packages from different vendors. All CD-Rs were successfully transferred into the PACS. The new software and work protocol provide an easy way of introducing the out-hospital data into the PACS. CD-Rs can be destroyed after transfer to PACS, eliminating physical storage. Furthermore, all data can now be viewed and reported using the default viewers of the hospital and no additional training of staff is required.

CD-ROM↗

[A computer-aided image diagnosis and study system].

The revolution in information processing, particularly the digitizing of medicine, has changed the medical study, work and management. This paper reports a method to design a system for computer-aided image diagnosis and study. Combined with some good idea of graph-text system and picture archives communicate system (PACS), the system was realized and used for "prescription through computer", "managing images" and "reading images under computer and helping the diagnosis". Also typical examples were constructed in a database and used to teach the beginners. The system was developed by the visual developing tools based on object oriented programming (OOP) and was carried into operation on the Windows 9X platform. The system possesses friendly man-machine interface.

Diagnosis, Computer-Assisted↗

Data management and analysis for gene expression arrays.

Microarray technology makes it possible to simultaneously study the expression of thousands of genes during a single experiment. We have developed an information system, ArrayDB, to manage and analyse large-scale expression data. The underlying relational database was designed to allow flexibility in the nature and structure of data input and also in the generation of standard or customized reports through a web-browser interface. ArrayDB provides varied options for data retrieval and analysis tools that should facilitate the interpretation of complex hybridization results. A sampling of ArrayDB storage, retrieval and analysis capabilities is available (www.nhgri.nih.gov/DIR/LCG/15K/HTML/ ), along with information on a set of approximately 15,000 genes used to fabricate several widely used microarrays. Information stored in ArrayDB is used to provide integrated gene expression reports by linking array target sequences with NCBI's Entrez retrieval system, UniGene and KEGG pathway views. The integration of external information resources is essential in interpreting intrinsic patterns and relationships in large-scale gene expression data.

Computer Communication Networks↗

Automated storage and retrieval of thin-section CT images to assist diagnosis: system description and preliminary assessment.

A software system and database for computer-aided diagnosis with thin-section computed tomographic (CT) images of the chest was designed and implemented. When presented with an unknown query image, the system uses pattern recognition to retrieve visually similar images with known diagnoses from the database. A preliminary validation trial was conducted with 11 volunteers who were asked to select the best diagnosis for a series of test images, with and without software assistance. The percentage of correct answers increased from 29% to 62% with computer assistance. This finding suggests that this system may be useful for computer-assisted diagnosis.

Databases, Factual↗

[A computer program for the geographic distribution of fluvial mollusks of medical interest in Cuba].

The need to know the distribution of mollusks considered to play an important medical role in Cuba through a geographic representation motivated us to develop a software capable of acting as a system for the retrieval of geographic information in which the requested data would be presented in maps. The system has been called DMIM and it is a useful tool for malacological studies, and assessment and planning of programs for the control of intermediate host mollusks, as well as for teaching purposes.

Animals↗

Adapting a commercially available software program to improve ADR reporting.

To facilitate the long-term storage, retrieval, and analysis of adverse drug reaction (ADR) data, the drug information service at the University of Texas Health Science Center at San Antonio selected a computer software program with the capability to compile sets of relational databases. Five subsets were created to form the ADR database--patient demographics, medications, American Hospital Formulary Service classifications, adverse reactions, and case reports. This computerized system allows for quick information retrieval as well as the generation of monthly ADR reports. With such information, trends in ADRs can be identified and targeted for intervention programs to improve patient care and to comply with JCAHO requirements.

Adverse Drug Reaction Reporting Systems↗

Temporal representation of clinical algorithms using expert-system and database tools.

The HyperLipid Advisory System combines a rule-based implementation of a clinical algorithm (the NIH Cholesterol Education Program Expert Panel recommendations) with a temporal representation that facilitates reasoning over time while maintaining efficient storage in a standard database. The temporal representation consists of objects that model point events such as visits and interval events such as specific therapies. These objects are combined into abstractions called phases, which correspond to higher level clinical concepts such as a diet or drug treatment. The time-oriented data objects are referenced in the rules using a custom-tailored operator query language. Between user sessions relevant clinical data are stored in external files. When the advisory system is reconsulted, this information is retrieved and mapped back into an object-oriented format. Use of a commercially available expert-system shell for such tasks allows algorithm implementation in standard personal computing environments.

Algorithms↗

Learning to leverage existing information systems: Part 1. Principles.

BACKGROUND: The success of performance improvement efforts depends on effective measurement and feedback regarding clinical processes and outcomes. Yet most health care organizations have fragmented rather than integrated data systems. Methods and practical guidance are provided for leveraging available information sources to obtain and create valid performance improvement-related information for use by clinicians and administrators. CASE VIGNETTE: At Virginia Mason Health System (VMHS; Seattle), a vertically integrated hospital and multispecialty group practice, patient records are paper based and are supplemented with electronic reporting for laboratory and radiology services. Despite growth in the resources and interest devoted to organization-wide performance measurement, quality improvement, and evidence-based tools, VMHS's information systems consist of largely stand-alone, legacy systems organized around the ability to retrieve information on patients, one at a time. By 2002, without any investment in technology, VMHS had developed standardized, clinic-wide key indicators of performance updated and reported regularly at the patient, provider, site, and organizational levels. LEVERAGING EXISTING SYSTEMS: On the basis of VHMS's experience, principles can be suggested to guide other organizations to explore solutions using their own information systems: for example, start simply, but start; identify information needs; tap multiple data streams; and improve incrementally.

Data Collection↗

PACS databases and enrichment of the folder manager concept.

Current challenges facing picture archiving and communication systems (PACS) center around database design and functionality. Workflow issues and folder manager concepts such as autorouting, prefetching, hanging protocols, and hierarchical storage management are driven by a properly designed database that ultimately directly impacts the clinical utility of a PACS. The key issues in PACS database design that enable radiologist-friendly, cost-effective, and data-secure systems will be discussed, including database difficulties of the DICOM standard, HIS/RIS/PACS (hospital information system/radiology information system) connectivity, and database issues in data acquisition, data dissemination, and data display.

Databases as Topic↗

[Value of automated medical indexing of an image database and a digital radiological library].

We indexed the contents of a radiology server on the web to facilitate access to research documents and to link reference texts to images contained in radiology databases. Indexation also allows case reports to be transformed with no supplementary work into formats compatible with computer-assisted training. Indexation was performed automatically by ADM-Index, the aim being to identify the medical concepts expressed within each medical text. Two types of texts were indexed: medical imaging reference books (Edicerf) and case reports with illustrations and captions (Iconocerf). These documents are now available on a web server with HTML format for Edicerf and on an Oracle database for Iconocerf. When the user consults a chapter of a book or a case report, the indexed terms are displayed in the heading; all reference texts and case reports containing the indexed terms can then be called up instantaneously. The user can express his search in natural language. Indexation follows the same process allowing instantaneous recall of all reference texts and case reports where the same concept appears in the diagnosis or clinical context. By using the context of the case reports as the search index, all case reports involving a common medical concept can be found. The context is interpreted as a question. When the user responds to this question, ADM-Index compares this response with the answer furnished by the reference texts and case reports. Correct or erroneous responses can thus be identified, converting the system into a computer-assisted training tool.

Abstracting and Indexing↗

A minirecord: an aid to continuity of care.

A simple, low cost computerized minirecord system (minimal essential record) has been in full operation for two years in the Medical Clinic of The Johns Hopkins Hospital. The primary objective of the minirecord system is to permit rapid retrieval of current information concerning Medical Clinic patients. The system provides a computer-printed listing of problems and medications in the front of each chart and on-line display of this information at strategically located computer terminals. The information is generated via existing simple systems with minimal additional effort and with the use of any terminology deemed appropriate. Chart review revealed that minirecords were actually present in 92% of the charts and that significant improvement occurred in the recognition of a subsequent visit of clearly defined problems and therapies noted on the initial minirecord. Current modifications will replace the separate minirecord and encounter form (registration and visit note) with a single form that will facilitate completion an updating. The rapid availability of this information provides a mechanism for coordinating continuing care in a university hospital system that is otherwise inevitably fragmented and composed of multiple health care providers.

Comprehensive Health Care↗