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PubMed2001

Evaluation of the suitability of a patient data management system for ICUs on a general ward.

The development of the ICUData patient data management system (PDMS) for intensive care units (ICU), by IMESO GmbH, Hüttenberg, Germany, was based on the assumption that processes and therapies at ICU are the most complex with the highest data density compared with those in other wards. Based on experience with the system and on a survey conducted among users at our pain clinic, we evaluated whether the concept of the present software architecture, which sufficiently reproduces processes and data at an ICU, is suitable as a PDMS for general wards. The highly modular and client-centric approach of the PDMS is founded on a message-based communications architecture (HL7). In the beginning of the year 2000, the system was implemented at the pain management clinic (12 beds) of our hospital. To assess its user friendliness, we conducted a survey of medical staff (n=14). From April 1st 2000 to August 31st 2000, all clinical and administrative data of 658 patients at the pain management clinic were recorded with the PDMS. From the start, all users had access to data and information of other connected data management systems of the hospital (e.g. patient administrative data, patient clinical data). Staff members found the system mostly useful, clearly presented, practical, and easy to learn and use. Users were relatively satisfied with stability and performance of the program but mentioned having only limited knowledge of the program's features. The need for external support during a computer crash was rated negatively. Despite the need for further usage training and improved program performance, the software architecture described seems to be a promising starting point for the construction of a PDMS for general wards.

Attitude of Health Personnel↗

PubMed2005

Evaluation of slower-growing broiler genotypes grown with and without outdoor access: meat quality.

Consumer interest in organic and natural poultry products raised with outdoor access is growing. An experiment was conducted to assess the effects of outdoor access and genotype on meat quality. One slow-growing genotype (S), 2 medium-growing genotypes (M1 and M2), and a commercial fast-growing genotype (F) were raised (straight-run) for 81, 67, or 53 d, respectively. The placement date was staggered in order to achieve a similar final body weight. Each genotype was assigned to 3 pens of 24 birds each and raised in indoor floor pens in a naturally ventilated facility; the S and F genotypes were also assigned to 2 floor pens with outdoor access containing 36 birds each. All birds were provided with the same starter, grower, and finisher feeds, and birds were commercially processed. Pectoralis samples were collected at 6 h postmortem for proximate analysis and evaluation of meat quality. The principal effect of outdoor access was to make the meat more yellow in the case of the S genotype (P < 0.05) although not the F genotype (P > 0.05). Drip loss and cook loss (%) were affected (P < 0.05) by genotype, with the highest losses occurring with the S genotype and the lowest losses occurring with the F and M genotypes. Tenderness was affected (P < 0.05) by gender as well as production system but only in the F birds. Pectoralis dry matter (%), fat (%), and ash (%) were largely unaffected (P > 0.05) by genotype or outdoor access. These data indicate that meat quality differences exist among genotypes with very different growth rates and reared with or without outdoor access.

Animals↗

PubMed1992

Confidentiality issues in the 90's.

Technology, new methods for collecting data, expanding needs and uses of data, all have significantly increased the complexity of maintaining confidentiality of patient information. To safeguard against misuse of, and inappropriate access to, sensitive information, hospitals must develop organization-wide approaches. They should involve all key hospital players in developing such systems, including, but not all limited to, access managers, data processing, administration, medical and nursing staff and health information managers.

Computer Security↗

PubMed1987

Successfully implementing a multihospital cost system.

Addressing the problems of developing a cost accounting system for a multihospital system is never an easy task. Basically, these systems need to have cost data easily accessible to all managers of all institutions in the healthcare system. The need for accurate, cost-effective, and controlled data is necessary to maintain the competitive edge required for organizational success.

Accounting↗

PubMed1999

Vascular access thrombosis: etiology and prevention.

Vascular access thrombosis has been the Achilles heel of patients with end-stage renal disease since the inception of maintenance hemodialysis. Although many factors have been implicated in the etiology of access thrombosis, data indicate that the primary risk factors include an increased use of synthetic polytetrafluoroethylene grafts, lack of surgical expertise in access construction, advanced age, systolic hypotension, and high levels of serum lipoprotein (a). The occurrence and severity of access problems can be modified by ongoing nurse monitoring and prompt intervention to proactively correct evolving problems.

Anemia↗

PubMed1995

Data handling in clinical trials: an ongoing debate.

Data handling is a crucial phase in controlled clinical trials. In this paper we conceive the process of data handling in a broad sense, encompassing monitoring, analysis and publication of data. We discuss basic ethical principles underlying adequate data handling and suggest some modifications of the Good Clinical Practice guidelines. As to data monitoring, we underline the corporate responsibilities and argue in favour of an independent Data and Safety Monitoring Board (DSMB). Data analysis should be performed in independent institutions, and there is a moral obligation to perform an interim analysis. Regarding accessibility of data, the raw data should be made available to participating researchers and independent scientific institutions, and both positive and negative results should be published, in agreement with a Report on Drug Information by the World Health Organization. To meet these requirements, commercial sponsors should have initiatives for independent DSMBs, interim analysis and complete data availability, and conceive corresponding contracts. The investigators can improve the quality of data handling by forming an Investigators Liaison Panel that represents them in the contacts with the sponsor. Finally, ethics committee and drug regulatory agencies should see to it that newly gained insights are being put into practice.

Clinical Trials as Topic↗

PubMed2001

Developing indicators for emergency medical services (EMS) system evaluation and quality improvement: a statewide demonstration and planning project.

BACKGROUND: The state of California, like every other state, has no system for assessing the quality of prehospital emergency medical services (EMS) care. As part of a statewide project, a process was designed for the evaluation and quality improvement (QI) of EMS in California. Local EMS agency (LEMSA) representatives made a commitment to submit data from both the providers and the hospitals they work with. INDICATOR SELECTION AND DEVELOPMENT: For conditions such as cardiac chest complaints, standardized indicators had already been developed, but for many other areas of interest there was either little literature or little consensus in the literature. Definitional differences were often linked to local-practice protocol differences. A related comparison challenge lay in the fact that care protocols may differ across systems. Some aspects of care may not be offered at all, which may reflect resource shortages or variable medical direction. DATA COLLECTION PROCEDURES: Each indicator was precisely defined, and definition sheets and data troubleshooting report forms were provided to participants in three data-collection rounds. Participants were given 1 month to collect the data, which consisted of summary-level elements (for example, average time to defibrillation for all patients 15 years or older who received defibrillation in 1998). Data were then aggregated, analyzed, and prepared for display in graphs and tables. ACCESS AND MEASUREMENT ISSUES: Numerous data collection problems were encountered. For example, not all participants could actually access data that they thought would be available. Linking data on patients as they travel through the continuum of EMS care (dispatch, field, hospital) and linking EMS data to hospital outcomes was also difficult. Yet even when data were easily available, challenges arose. The need for specificity, the potential misfit between definitions and the available data, and the challenges of data retrieval remained salient for the duration of the project and made cross-LEMSA and cross-provider comparison problematic. RECOMMENDATIONS AND LESSONS LEARNED: The project led to formal policy recommendations regarding development of a state-defined minimum data set of structure, process, and outcome indicators and their associated data elements; provision in the minimum data set for both local-level and statewide indicators; and provision of technical assistance at the local-provider level. EPILOGUE: Since the project's conclusion in June 2000, many regional and local EMS groups have begun to collect data on indicators. Many of the project's recommendations have been incorporated into the work plan of the state's System Review and Data Committee.

Adult↗

PubMed2001

MetaFam: a unified classification of protein families. II. Schema and query capabilities.

MOTIVATION: Protein sequence and family data is accumulating at such a rapid rate that state-of-the-art databases and interface tools are required to aid curators with their classifications. We have designed such a system, MetaFam, to facilitate the comparison and integration of public protein sequence and family data. This paper presents the global schema, integration issues, and query capabilities of MetaFam. RESULTS: MetaFam is an integrated data warehouse of information about protein families and their sequences. This data has been collected into a consistent global schema, and stored in an Oracle relational database. The warehouse implementation allows for quick removal of outdated data sets. In addition to the relational implementation of the primary schema, we have developed several derived tables that enable efficient access from data visualization and exploration tools. Through a series of straightforward SQL queries, we demonstrate the usefulness of this data warehouse for comparing protein family classifications and for functional assignment of new sequences.

Databases, Factual↗

PubMed1996

Computer analysis of qualitative data: the use of ethnograph.

Ethnograph, a code and retrieve software program for computer analysis of qualitative data, was utilized to assist in analyzing the content of in-depth interviews and focus group data. This program requires basic computer hardware and is fairly easy to use. The main advantage of the program is easy access to data dealing with a particular issue and easy retrieval of text for analysis and illustration. However, to get the maximum benefit from this program, documents need to be structured In the format suitable for the software. Among the difficulties encountered were the absence of on-line documents dummy coding, lack of options in printing facility and the tendency for the program to hang whenever there was a printing error.

Anthropology, Cultural↗

PubMed1987

Integrated system brings hospital data together.

Healthcare industry changes during the 1980s--increased competition and alterations in the Medicare payment methodology--place new and more complex demands on a hospital's information systems, which often fall short of meeting those demands. These systems were designed for financial reporting, billing, or providing clinical data, and few of them are capable of linking with other unrelated systems. Today's hospital manager needs timely and simultaneous access to data from a variety of sources within the hospital. All the elements to accomplish this are collected somewhere in the hospital, but finding them and bringing them together is difficult. The key to the efficient management and use of data bases is in understanding the fundamental concept of relational data bases, which is the capability of linking or joining separate data files through a common data element in each file. In this way, data files may be integrated into a "related" data base. Any number of separate files, or tables, may exist within a "relational" data base as long as a series of threads links them. A strategic management information data base includes the information necessary to analyze, understand, and manage the hospital's markets, products, resources, and profitability. The major components of this information system are the case mix and cost accounting, budgeting, and modeling systems. The case mix and cost accounting factors involve managing concrete pieces of data, whereas the budgeting and modeling factors manipulate data to create a scenario. The strategic management information data base is the foundation of a hospital's decision support system, which is rapidly moving into the category of a necessary tool of the hospital manager's trade.

Computer Systems↗

PubMed2000

Web-based research: an innovative method for nursing research.

Although still in its infancy, the World Wide Web presents unparalleled opportunities for harnessing the power of the Internet to collect data from populations of interest in an economical and efficient manner. Web-based surveys offer a number of strengths including access to specific populations, speed of data access, and decreased data collection and data entry costs. These advantages are likely to increase as more people begin to use the Web as their primary means of communication. Nurse researchers who embrace this technology will become the pioneers in the new age of nursing research.

Computer User Training↗

PubMed2003

[Conception and data transfer analysis of an open-source digital image archive designed for radiology].

PURPOSE: Implementation of a self-designed, web-based digital image archive incorporating the existing DICOM infrastructure to assure distribution of digital pictures and reports and to optimize work flow. Assessment after three years. MATERIALS AND METHODS: Open-source software was used to guarantee highest reliability and cost effectiveness. In view of rapidly increasing capacity and decreasing costs of hard discs (HDs), HDs were preferred over slower and expensive magneto-optical disk (MOD) or tape storage systems. The number of installed servers increased from one to 12. By installing HDs with increased capacities, the number of servers should be kept constant. Entry and access of data were analyzed over two 4-month periods (after 1.5 and 2 years of continuous operations). RESULTS: Our digital image archive was found to be very reliable, cost effective and suitable for its designated tasks. As judged from the measured access volume, the average utilization of the system increased by 160 %. In the period from January to April 2002, the users accessed 239.8 gigabyte of the stored 873.7 gigabyte image data (27 %). The volume of the stored data added 20%, mainly due to an increase in cross-section imaging. CONCLUSION: The challenge of developing a digital image archive with limited financial resources resulted in a practicable and expandable solution. The utilization, number of active users and volume of transferred data have increased significantly. Our concept of utilizing HDs for image storage proved to be successful.

Computer Systems↗

PubMed2000

Quality control in databanks for molecular biology.

Using a scientific measurement without an estimate of its error is like lending money to a stranger. Given the explosion in nucleic acid and protein sequence and structural data, what risks are the scientific and medical communities running in using these databases. Is there an 'ombudsman' who speaks for the users of the data? CODATA, the Committee on Data for Science and Technology of the International Council of Scientific Unions was established to improve the quality, reliability, processing, management, and accessibility of data for science and technology. The CODATA Task Group on Biological Macromolecules has surveyed quality control procedures of archival databanks in molecular biology. Our role is 'to advise, to be consulted, and to warn.' This report describes the kinds and extents of errors that may appear in nucleic acid and protein databases, and presents an agenda for future work to improve the quality of these databases. The results of the survey appear on the webhttp://www.codata.org/codata/tgreports/ tg_reps.html.

Amino Acid Sequence↗

PubMedDate not supplied

A searching and reporting system for relational databases using a graph-based metadata representation.

Relational databases are the current standard for storing and retrieving data in the pharmaceutical and biotech industries. However, retrieving data from a relational database requires specialized knowledge of the database schema and of the SQL query language. At Anadys, we have developed an easy-to-use system for searching and reporting data in a relational database to support our drug discovery project teams. This system is fast and flexible and allows users to access all data without having to write SQL queries. This paper presents the hierarchical, graph-based metadata representation and SQL-construction methods that, together, are the basis of this system's capabilities.

Computer Simulation↗

PubMed1998

[The costs of schizophrenia].

Schizophrenia is regarded as the most expensive mental illness because of its specific symptoms and characteristics (e.g. early onset, often chronic course, high rates of readmission to hospital treatment, high rate of disabilities and extensive rehabilitative interventions), which prove to be extremely costly. Despite this, studies on the financial aspects of schizophrenia or the provision of care for schizophrenic patients has become an issue of psychiatric research only since the beginning of the reform of mental healthcare. Early cost studies had been conducted in the United States (US) during the fifties. Since then, they have grown in number not only in the US and in Great Britain, but also on the Continent of Europe. On an international level, comprehensive literature concerning methodology has attempted to establish cost studies as an integral part of mental health services research. Germany, however, is far behind international developments. Although the fundamental lack of empirical data on costs both in psychiatry as a whole and in schizophrenia had already been ascertained in a large national survey called "Psychiatrie-Enquête" in the mid-seventies, little has changed since then. One reason for these possibly great methodological problems is associated with the assessment of cost data in fragmented community mental health care networks, which in Germany include the additional obstacle--unlike abroad--of non-availability of access to data from case registers. Psychiatric case registers are not permitted in Germany because of very strict data protection laws. Despite the problems in methodology, there is an urgent need in Germany to remedy the lack of cost data for schizophrenic-patient care. The pressure of curbing costs in health care will probably force the German mental health care services to provide detailed cost data with regular reports in the future.

Humans↗

PubMedDate not supplied

[Diabetes mellitus educational software for health professionals: stages of design and development].

This research aimed at creating a software about Diabetes mellitus in order to stimulate the continuing education of health professionals as well as educative practices. The system was developed using Delphi application, through a data bank utilizing key-words and the Pascal language. The software includes key-words searching tools, improving the process of accessing the data bank.

Computer-Assisted Instruction↗

PubMed2001

An approach for integrating heterogeneous information sources in a medical data warehouse.

In recent years, medical professionals are witnessing an explosive growth in data collected by various organizations and institutions. At the same time, the ongoing developments of networking technologies provide doctor with the capability to access these data across the boundaries of interconnected computers. In this paper we present a medical data warehousing methodology that aims to use data semantics to regroup and merge patients' medical data from different health information systems, which may be autonomous and heterogeneous. The proposed solution takes into account European laws concerning the security and anonymity of personal data.

Database Management Systems↗

PubMed2000

Text entry on handheld computers by older users.

Small pocket computers offer great potential in workplaces where mobility is needed to collect data or access reference information while carrying out tasks such as maintenance or customer support. This paper reports on three studies examining the hypothesis that data entry by older workers is easier when the pocket computer has a physical keyboard, albeit a small one, rather than a touch-screen keyboard. Using a counter-balanced, within-subjects design the accuracy and speed with which adults over 55 years of age could make or modify short text entries was measured for both kinds of pocket computer. The keyboard computer was the Hewlett Packard 360LX (HP), but the touch-screen computers varied across studies (experiment 1: Apple Newton and PalmPilot; experiment 2: Philips Nino; experiment 3: Casio E10). All studies showed significant decrements in accuracy and speed when entering text via the touch-screen. Across studies, most participants preferred using the HP's small physical keyboard. Even after additional practice with the touch screen (experiments 2 and 3) many entries still contained errors. Experiment 3 showed that younger people were faster but not more accurate than older people at using the touch-screen keyboard. It is concluded that satisfactory text entry on palm-size computers awaits improvements to the touch-screen keyboard or alternative input methods such as handwriting or voice. Interface developments that assist older people typically benefit younger users too.

Aged↗