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PubMed1998

A graphical tool for ad hoc query generation.

Medical data are characterized by complex taxonomies and evolving terminology. Questions that clinicians, medical administrators, and researchers may wish to answer using medical databases are not easily formulated as SQL queries. In this paper we describe a graphical tool that facilitates formulation of ad hoc questions as SQL queries. This tool manages multiple attribute hierarchies and creates SQL query strings by navigating through the hierarchies. This interactive tool has been optimized using indexing to improve the overall speed of the query building and the data retrieval process. Indexed queries performed 5 to 100 times faster than query strings. However, query string generation time depends on the size of the taxonomies describing the hierarchies, while the index generation time depends on the size of the data warehouse.

Abstracting and Indexing↗

PubMed1998

Towards knowledge-based retrieval of medical images. The role of semantic indexing, image content representation and knowledge-based retrieval.

Medicine is increasingly image-intensive. The central importance of imaging technologies such as computerized tomography and magnetic resonance imaging in clinical decision making, combined with the trend to store many "traditional" clinical images such as conventional radiographs, microscopic pathology and dermatology images in digital format present both challenges and an opportunities for the designers of clinical information systems. The emergence of Multimedia Electronic Medical Record Systems (MEMRS), architectures that integrate medical images with text-based clinical data, will further hasten this trend. The development of these systems, storing a large and diverse set of medical images, suggests that in the future MEMRS will become important digital libraries supporting patient care, research and education. The representation and retrieval of clinical images within these systems is problematic as conventional database architectures and information retrieval models have, until recently, focused largely on text-based data. Medical imaging data differs in many ways from text-based medical data but perhaps the most important difference is that the information contained within imaging data is fundamentally knowledge-based. New representational and retrieval models for clinical images will be required to address this issue. Within the Image Engine multimedia medical record system project at the University of Pittsburgh we are evolving an approach to representation and retrieval of medical images which combines semantic indexing using the UMLS Metathesuarus, image content-based representation and knowledge-based image analysis.

Abstracting and Indexing↗

PubMed2003

Complementary and alternative medicine as represented in the HIV/AIDS body of knowledge: a bibliometric analysis.

Although the HIV/AIDS epidemic began more than twenty years ago, there still is no cure for the disease and no vaccine to prevent infection. As with the general population, individuals with HIV/AIDS have sought care using a variety of traditional and nontraditional approaches. The popularity of complementary and alternative interventions among the HIV/AIDS community continues. To understand better the distribution of the HIV/AIDS body of knowledge concerning complementary and alternative medicine (CAM), this study sought to (1) examine the literature specific to the use of complementary and alternative medicine where HIV/AIDS is concerned to determine publication patterns; (2) determine the degree of overlap among bibliographic citation databases that index the literature concerning the use of CAM practices in treating HIV/AIDS; and (3) facilitate access to this body of literature.

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PubMed2002

World Health Report 2000 "Financial fairness indicator": useful compass or crystal ball?

The World Health Report 2000 generated a huge amount of controversy when it set out to rank the performance of national health systems using data, statistical measures, and an explanatory rationale that were neither well understood nor broadly accepted. This article demystifies the conceptual and empirical underpinnings of the report's "financial fairness index," which resulted in country rankings that often seem counterintuitive. The author concludes that the index is seriously flawed, that rankings produced by the index should not be used, and that future WHO reports should avoid imputing financial fairness scores for countries that do not have real data.

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PubMed1998

Location and indexing of articles written by podiatric physicians.

This study was undertaken to determine which biomedical journals contain articles written by podiatric physicians and in which indexing sources such articles are likely to appear. A survey was conducted of the 20 most frequently published podiatrist authors from a selected group of podiatric journals during the period from 1990 to 1995. Articles published by these authors during the study period were examined to determine where they had appeared. The MEDLINE database was found to contain the largest number of citations to articles written by these podiatric physicians. Both the Podiatry Index and Embase are also very good sources of citations to podiatric medical literature and should be used to supplement MEDLINE searches.

Abstracting and Indexing↗

PubMed1991

Measuring geographic variations in hospitals' capital costs.

The Health Care Financing Administration (HCFA) has proposed incorporating hospital capital payments into the Medicare prospective payment system. HCFA's proposal includes an adjustment to capital payments for geographic differences in capital costs, derived from the prospective payment system area hospital wage index. Alternatively, the geographic adjustment could be based on an area construction cost index. Geographic construction cost indexes calculated from the cost per square foot of finished structures or from construction labor and materials input prices are evaluated in this article.

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PubMed1992

Change in the Medicare case-mix index in the 1980s and the effect of the prospective payment system.

Persistent increases in the Medicare case-mix index over the 1980s have been ascribed to changes both in medical treatment ("real changes") and in the way medical information is recorded ("coding changes") in hospitals. These changes have been attributed, in the absence of appropriate data and analyses, to the incentives of the Medicare prospective payment system (PPS). Using data for 1980-1986 from 235 hospitals, we estimate the effect on the Medicare case-mix index of a series of variables that reflect medical treatments and coding practices. Each of these underlying real or coding variables was changing prior to PPS and would likely have continued to change even in the absence of PPS. Furthermore, PPS may have had a distinct effect on these variables. These underlying trends and the PPS effects must each be estimated. Thus, the analysis begins by developing separate estimates for each of these real and coding variables (1) in the absence of PPS (autonomous effects) and (2) as a result of PPS (induced effects). Then, changes in the case-mix index are regressed against all of these variables to determine the degree to which specific autonomous real or coding variables or induced real or coding variables actually influenced measured case mix. Results show that real and coding changes each accounted for about half of the change in the Medicare case-mix index between 1980 and 1986, with the influence of coding starting to wane by 1986. PPS-induced factors explain about 80 percent of the change in measured case mix over time, autonomous factors about 20 percent. Especially powerful determinants of case-mix change included PPS-induced substitution of surgical for medical care and PPS-induced improvements in the accuracy of coding that led to assignment of patients to higher-weighted DRGs. Also, stringent Medicare peer review organizations appeared to restrain rises in case-mix indexes for their hospitals. Outpatient substitution for inpatient treatment, which others attributed to PPS, was well underway before PPS was announced.

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PubMed1990

The Quality Assessment Index (QAI) for measuring nursing home quality.

There have been few detailed evaluations of measures of quality of care in nursing homes. This is unfortunate because it has meant that much research on factors affecting nursing home quality has used measures of questionable reliability and validity. Moreover, some measures currently in use have been developed using methodologies not based on solid conceptual grounds, offering little reason to expect them to have much internal or external validity. In this article we suggest characteristics that should be present in measures of nursing home quality, propose a methodology for the development of such measures, propose a specific nursing home quality measure (the Quality Assessment Index or QAI), and report the results of several tests of its validity and reliability.

Abstracting and Indexing↗

PubMed2004

Who gets acknowledged: measuring scientific contributions through automatic acknowledgment indexing.

Acknowledgements in research publications, like citations, indicate influential contributions to scientific work. However, acknowledgements are different from citations; whereas citations are formal expressions of debt, acknowledgements are arguably more personal, singular, or private expressions of appreciation and contribution. Furthermore, many sources of research funding expect researchers to acknowledge any support that contributed to the published work. Just as citation indexing proved to be an important tool for evaluating research contributions, we argue that acknowledgements can be considered as a metric parallel to citations in the academic audit process. We have developed automated methods for acknowledgment extraction and analysis and show that combining acknowledgment analysis with citation indexing yields a measurable impact of the efficacy of various individuals as well as government, corporate, and university sponsors of scientific work.

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PubMed2001

Use of keyword hierarchies to interpret gene expression patterns.

MOTIVATION: High-density microarray technology permits the quantitative and simultaneous monitoring of thousands of genes. The interpretation challenge is to extract relevant information from this large amount of data. A growing variety of statistical analysis approaches are available to identify clusters of genes that share common expression characteristics, but provide no information regarding the biological similarities of genes within clusters. The published literature provides a potential source of information to assist in interpretation of clustering results. RESULTS: We describe a data mining method that uses indexing terms ('keywords') from the published literature linked to specific genes to present a view of the conceptual similarity of genes within a cluster or group of interest. The method takes advantage of the hierarchical nature of Medical Subject Headings used to index citations in the MEDLINE database, and the registry numbers applied to enzymes.

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PubMed2000

The essential endodontic literature: a survey of postgraduate program directors.

Hundreds of new articles are added to the body of knowledge in endodontics each year. However, a comparatively small number of articles have had a disproportionately large influence on the progress and development of the specialty of endodontics. A survey of postgraduate program directors was conducted to attempt to identify a highly selective short list of articles that program directors felt should be included on every postgraduate reading list. The survey results were then compared with the more objective benchmark of citation indexing. The results of this survey suggest that the collective opinion of the postgraduate program directors correlates well with the results obtained from citation analysis.

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PubMed1980

Setting up an outpatient diagnostic index.

Clinical research in ophthalmology benefits particularly from an outpatient diagnostic index. The initial planning of such an index at an eye hospital is described and details are given of how the system was set up and is currently organized.

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PubMed1998

[Tina, a model for a supra-regional expert assessment information system].

A problem common to most medical assessment centres is how to avoid redoing work already done in a similar case? Or, more precisely, how to get knowledge about that similar case? The problem is aggravated by the companies' decentralization and the vast amount of yearly assessments. We present a model of an information system based on a public wide-area network which nevertheless complies with German law in respect of handling personal data. The system neither compiles a full-text data base, nor does it allow access to original documents. Instead, it automatically creates a thesaurus-based index file according to the users' specific queries. Each index points to the requested document giving its author and time of accomplishment. Upon written request the document will be mailed within the company. Internet technology is used, and hardware requirements are modest. As a hybrid system the Tina (thesaurus-based index file system with net access) model system guarantees data safety despite easy data base access. Its information is detailed, and the response time is adequate.

Abstracting and Indexing↗

PubMed2000

Tracing medical information over the Internet.

The Internet became with do doubt a huge and valuable source of information for researchers. The wealth of information on the Internet is second to none and medical information is no exception. Yet with the vast expansion of the Internet and the World Wide Web in specie, to find the kind of information one is looking for, he/she needs to browse thousands of web sites and the experience would be like digging into a stack of hay looking for a needle. That's why search engines and subject indexes, as means to overcome this problem, were introduced and grew so rapidly. In general, there are three approaches to retrieve data from the World Wide Web; the subject directories, search engines and detailed subject indexes. However, there is no single comprehensive search engine or directory and it is recommended to use more than one with different keywords and synonymous.

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PubMed1973

The Mayo Clinic author catalog: a living repository of medical knowledge.

Since 1907 records have been kept of publications by staff members of the Mayo Clinic, and this information has been invaluable. The Author Catalog has proved itself such a useful tool for the Mayo Clinic that other libraries, large and small, may wish to consider adopting such a service. The Mayo medical complex is a large institution with more than 500 staff and faculty members engaged in the publication of clinical, educational, and research findings. The great amount of cross-disciplinary cooperation and interdepartmental research makes essential an up-to-date record of what is going on. The Mayo Clinic Library developed a comprehensive computerized method for identifying research and for identifying and indexing publications of Mayo staff members. At the end of 1971 more than 25,000 citations had been stored on computer tape.

Abstracting and Indexing↗

PubMed1998

Alternative ways for knowledge collection, indexing and robust language retrieval.

Definitions are provided of the key entities in knowledge representation for Natural Language Processing (NLP). Starting from the words, which are the natural components of any sentence, both the role of expressions and the decomposition of words into their parts are emphasized. This leads to the notion of concepts, which are either primitive or composite depending on the model where they are created. The problem of finding the most adequate degree of granularity for a concept is studied. From this reflection on basic Natural Language Processing components, four categories of linguistic knowledge are recognized, that are considered to be the building blocks of a Medical Linguistic Knowledge Base (MLKB). Following on the tracks of a recent experience in building a natural language-based patient encoding browser, a robust method for conceptual indexing and query of medical texts is presented with particular attention to the scheme of knowledge representation.

Abstracting and Indexing↗

PubMed1990

A geographic index of physician practice costs.

This paper develops a geographic index of physician practice costs. A Laspeyres index is derived for each Metropolitan Statistical Area and for the non-metropolitan portion of each state. Relative prices by area are obtained for four practice inputs: physicians' own time, employee wages, office rents, and malpractice insurance. Each input price proxy is weighted by the share of physician gross revenues spent on that input. The index is useful in explaining geographic variation in physician fees. It may be used in reforming the way Medicare pays physicians.

Abstracting and Indexing↗

PubMed2002

Information extraction for enhanced access to disease outbreak reports.

Document search is generally based on individual terms in the document. However, for collections within limited domains it is possible to provide more powerful access tools. This paper describes a system designed for collections of reports of infectious disease outbreaks. The system, Proteus-BIO, automatically creates a table of outbreaks, with each table entry linked to the document describing that outbreak; this makes it possible to use database operations such as selection and sorting to find relevant documents. Proteus-BIO consists of a Web crawler which gathers relevant documents; an information extraction engine which converts the individual outbreak events to a tabular database; and a database browser which provides access to the events and, through them, to the documents. The information extraction engine uses sets of patterns and word classes to extract the information about each event. Preparing these patterns and word classes has been a time-consuming manual operation in the past, but automated discovery tools now make this task significantly easier. A small study comparing the effectiveness of the tabular index with conventional Web search tools demonstrated that users can find substantially more documents in a given time period with Proteus-BIO.

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