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Autism post-mortem neuroinformatic resource: the autism tissue program (ATP) informatics portal.

The Autism Tissue Program (ATP) was established to oversee and manage brain donations related to neurological research in autism. The ATP Informatics Portal (www.atpportal.org) is an integrated data access system based on Oracle technology, developed to provide access for researchers to information on this rare tissue resource. It also permits sorting of existing cases based on donor ante-mortem history as well as agonal states and post-mortem tissue conditions. Phase II of development established administrative tracking of registrants intending to donate, as well as management of tissue requests and the awarding and tracking of tissue. Phase III is the ongoing assimilation of data sets derived from research on a core group of donors with searchable access by investigators.

Autistic Disorder↗

Training in medical informatics.

A course is described for the training of medical students in medical informatics (other terms: computational medicine, medical computing). The philosophy behind the course is that there are several modes or levels of human interaction in working with computers, running from registrative functions to assistance at diagnosis and therapy. The course, which consists of five full days, contains lessons in the areas of medical data bases, hospital information systems, medical records, biological signal analysis, computer-assisted diagnosis making, and patient simulation by CAI. Each group of two students has a terminal available, connected to a mini- and/or a microcomputer. The microprocessor takes care of signal analysis and the minicomputer is available for data base construction and interactive operations. The article describes the purposes and contents of all different lessons of this course.

Computer-Assisted Instruction↗

Training in medical informatics. The use of computers for diagnostic purposes.

Part of a blockcourse on medical informatics is presented; this course is intended for medical students. It is shown how medical students are introduced to the study of the role of computers for diagnostic purposes. The course consists of an oral presentation which introduces the student to the subject, and of practical work on systems in order to more fully comprehend the topics explained in the oral part of the blockcourse. In the oral presentation the student is introduced to various concepts that are used in computer-aided diagnosis. A critical review of the possibilities of computer use for diagnostic purposes is given. A system is presented, with which the student can work interactively. It consists of a database of patients, referred to the hospital because of suspected congenital heart disorder. Bayes' rule and diagnostic tree decision schemes are available to the student to acquaint himself with the subject. The ways he can work with this system are explained. The course is given regularly (every 4 months) to medical students and is well appreciated.

Computers↗

The professional workstation as enabler: conference recommendations. International Medical Informatics Association.

This paper reports on the Working Conference on Healthcare Professional Workstation sponsored by the International Medical Informatics Association (IMIA) and held in Washington DC, 14-16 June 1993. It sets forth the vision of a health care infostructure in which the workstation acts as enabler, giving professionals access to information when, where, and how it is needed. The paper explains upon the conference methodology and provides the conference cochairs' summary recommendations, both short- and long-term. These recommendations are based upon the work of five breakout groups, which addressed Functional Requirements, User Interfaces, Data and Knowledge Management, Processing, and Sharing and Communications. Presented in detailed and display formats, these summary recommendations address issues in the areas of architecture, linkages, evaluation, security, standards, education, and training. The paper also sets forth immediate next steps for the workstation initiative, including the formation of a formal IMIA Working Group on Workstations.

Computer Communication Networks↗

Image informatics at a national research center.

Image informatics at the Communications Engineering Branch of the Lister Hill National Center for Biomedical Communications (LHNCBC), an R&D division of the National Library of Medicine (NLM), includes document and biomedical images. In both domains, research into computer-assisted methods for information extraction, and the implementation of prototype systems incorporating such methods, is central to our mission. Current document image research focuses on extracting bibliographic data from scanned journal articles. Current biomedical imaging work focuses on content-based image retrieval (CBIR) and related problems in segmentation, indexing, and classifying collections of images of the spine and of the uterine cervix.

Diagnostic Imaging↗

Improving patient safety through informatics tools for shared decision making and risk communication.

This paper describes how informatics tools can support shared decision making and risk communication and thereby play an important role in enhancing patient safety. Using preference elicitation techniques and knowledge on risk communication, such tools can help patients understand their treatment options and associated short- and long-term benefits and risks, assist in the elicitation of patient preferences, and help patients and clinicians in making treatment choices with the highest likelihood of achieving desired patient outcomes. Important features of such tools are proposed, including: (1) Interactive tutorials to improve risk comprehension and prepare patients and clinicians for the decision making task; (2) choices between different presentation modes to meet patients' individual reading levels and presentation preferences; (3) risk calculations that account for individual risk profiles; (4) performance of necessary calculations to reach the actual decision; (5) automatic updates of evidence; and (6) the use of different preference-elicitation techniques.

Decision Making, Computer-Assisted↗

A reference ontology for biomedical informatics: the Foundational Model of Anatomy.

The Foundational Model of Anatomy (FMA), initially developed as an enhancement of the anatomical content of UMLS, is a domain ontology of the concepts and relationships that pertain to the structural organization of the human body. It encompasses the material objects from the molecular to the macroscopic levels that constitute the body and associates with them non-material entities (spaces, surfaces, lines, and points) required for describing structural relationships. The disciplined modeling approach employed for the development of the FMA relies on a set of declared principles, high level schemes, Aristotelian definitions and a frame-based authoring environment. We propose the FMA as a reference ontology in biomedical informatics for correlating different views of anatomy, aligning existing and emerging ontologies in bioinformatics ontologies and providing a structure-based template for representing biological functions.

Abstracting and Indexing↗

Graph kernels for chemical informatics.

Increased availability of large repositories of chemical compounds is creating new challenges and opportunities for the application of machine learning methods to problems in computational chemistry and chemical informatics. Because chemical compounds are often represented by the graph of their covalent bonds, machine learning methods in this domain must be capable of processing graphical structures with variable size. Here, we first briefly review the literature on graph kernels and then introduce three new kernels (Tanimoto, MinMax, Hybrid) based on the idea of molecular fingerprints and counting labeled paths of depth up to d using depth-first search from each possible vertex. The kernels are applied to three classification problems to predict mutagenicity, toxicity, and anti-cancer activity on three publicly available data sets. The kernels achieve performances at least comparable, and most often superior, to those previously reported in the literature reaching accuracies of 91.5% on the Mutag dataset, 65-67% on the PTC (Predictive Toxicology Challenge) dataset, and 72% on the NCI (National Cancer Institute) dataset. Properties and tradeoffs of these kernels, as well as other proposed kernels that leverage 1D or 3D representations of molecules, are briefly discussed.

Anticarcinogenic Agents↗

Surgical informatics is a useful management tool.

BACKGROUND: Management of surgery in the largest health care system in the country depends upon readily available and valid data. Use of an administrative data base had not fulfilled these requirements. An information program based upon the computerized operating room log and scheduling program presented a possible remedy. METHODS: Data elements previously appearing in the computerized operating room log were expanded to include outcomes. Reports essential to the surgical management of VA surgery were developed through an advisory panel. Necessary changes were added to the surgical computer program and computers installed in each operating room throughout the system. RESULTS: The work load information to manage a surgical service was determined to include the total number of operations performed, both major and minor, and a description of the patient population including the American Society of Anesthesiologists (ASA) classification. The breakdown into the individual surgical specialties, information regarding index operations, extent of resident supervision, and incidence of postoperative occurrences completed the required information. CONCLUSIONS: The information provided by this report is an example of the importance of the use of surgical informatics in the management of VA surgery. The ability to obtain valid information for analysis and dissemination is a direct result of the computer-generated information taken directly from the surgical log of each of the 126 VA Medical Centers.

Hospitals, Veterans↗

An infrastructure for high-throughput microscopy: instrumentation, informatics, and integration.

High-throughput, image-based cell assays are rapidly emerging as valuable tools for the pharmaceutical industry and academic laboratories for use in both drug discovery and basic cell biology research. Access to commercially available assay reagents and automated microscope systems has made it relatively straightforward for a laboratory to begin running assays and collecting image-based cell assay data, but doing so on a large scale can be more challenging. Challenges include process bottlenecks with sample preparation, image acquisition, and data analysis as well as day-to-day assay consistency, managing unprecedented quantities of image data, and fully extracting useful information from the primary assay data. This chapter considers many of the decisions needed to build a robust infrastructure that addresses these challenges. Infrastructure components described include integrated laboratory automation systems for sample preparation and imaging, as well as an informatics infrastructure for multilevel image and data analysis. Throughout the chapter we describe a variety of strategies that emphasize building processes that are scaleable, highly efficient, and rigorously quality controlled.

Animals↗

Program management and health care informatics: defining relationships.

The program management (PM) structure is a relatively well-known organizational model for hospitals. A variation of the matrix structure, it allows for an interdisciplinary team of health care providers to facilitate patient care delivery. However, providing such focused care results in a complex, highly information-dependent operational environment. To meet the information needs of such an environment, careful planning in selecting and implementing technology is required. Along with supporting patient care, the technology will also help in managing costs, human resources, quality and utilization, as well as in monitoring performance and outcomes measurement. Focusing specifically on the information technology environment, this article addresses health care informatics (the diverse categories of information and systems) needed to support clinical program managers, executives and others in a PM organization. Examples from both a university-affiliated and a community-based program managed hospital illustrate their approach to PM and information technology.

Decision Support Systems, Management↗

Environmental biotechnology informatics.

Environmental biotechnology informatics is in its infancy and is growing fast. Computer and information science can assist environmental biotechnology by developing biological databases and building mathematical models of biological systems. Funding and training limitations in this field may, however, hinder its future growth.

Biodegradation, Environmental↗

Protein informatics towards function identification.

The study of structural genomics and structural proteomics has determined the tertiary structures of many hypothetical proteins, whose molecular functions could not be understood using conventional methods. In order to infer the geometrical location of the functional site, the biochemical function and the biological function of the hypothetical protein, much effort has been made in protein informatics. The importance of heterogeneous databases and various descriptors of amino acid sequences, tertiary structures and pathways on the proteome scale has been emphasised.

Binding Sites↗

Biomedical informatics: the future for drug development.

The problems that exist in drug development are well documented: the limited number of new chemical entities, increased cost of drug development, problems in clinical trials (Phase III), product launches that result in withdrawal, and pressure to reduce the cost of pharmaceuticals from the government. It appears that the promise of genomics has not yet reached its full potential to impact the process. This review identifies the need to develop and implement the area of biomedical informatics for increased success in drug development and healthcare in general.

Aging↗

Cost of an informatics-based diabetes management program.

OBJECTIVES: The relatively high cost of information technology systems may be a barrier to hospitals thinking of adopting this technology. The experiences of early adopters may facilitate decision making for hospitals less able to risk their limited resources. This study identifies the costs to design, develop, implement, and operate an innovative informatics-based registry and disease management system (POPMAN) to manage type 2 diabetes in a primary care setting. METHODS: The various cost components of POPMAN were systematically identified and collected. RESULTS: POPMAN cost 450,000 dollars to develop and operate over 3.5 years (1999-2003). Approximately 250,000 dollars of these costs are one-time expenditures or sunk costs. Annual operating costs are expected to range from 90,000 dollars to 110,000 dollars translating to approximately 90 dollars per patient for a 1,200 patient registry. CONCLUSIONS: The cost of POPMAN is comparable to the costs of other quality-improving interventions for patients with diabetes. Modifications to POPMAN for adaptation to other chronic diseases or to interface with new electronic medical record systems will require additional investment but should not be as high as initial development costs. POPMAN provides a means of tracking progress against negotiated quality targets, allowing hospitals to negotiate pay for performance incentives with insurers that may exceed the annual operating cost of POPMAN. As a result, the quality of care of patients with diabetes through use of POPMAN could be improved at a minimal net cost to hospitals.

Costs and Cost Analysis↗

Combinatorial informatics in the post-genomics ERA.

The multitude of potential drug targets emerging from genome sequencing demands new approaches to drug discovery. A chemogenomics strategy, which involves the generation of small-molecule compounds that can be used both as tools to probe biological mechanisms and as leads for drug-property optimization, provides a highly parallel, industrialized solution. Key to the success of this strategy is an integrated suite of chemi-informatics applications that can allow the rapid and directed optimization of chemical compounds with drug-like properties using 'just-in-time' combinatorial chemical synthesis. An effective embodiment of this process requires new computational and data-mining tools that cover all aspects of library generation, compound selection and experimental design, and work effectively on a massive scale.

Combinatorial Chemistry Techniques↗

Lobar distribution of lesion volumes in late-life depression: the Biomedical Informatics Research Network (BIRN).

White matter hyperintense lesions on T2-weighted images are associated with late-life depression. Little work has been carried out examining differences in lesion location between elderly individuals with and without depression. In contrast to previous studies examining total brain white matter lesion volume, this study examined lobar differences in white matter lesion volumes derived from brain magnetic resonance imaging. This study examined 49 subjects with a DSM-IV diagnosis of major depression and 50 comparison subjects without depression. All participants were age 60 years or older. White matter lesion volumes were measured in each hemisphere using a semiautomated segmentation process and localized to lobar regions using a lobar atlas created for this sample using the imaging tools provided by the Biomedical Informatics Research Network (BIRN). The lobar lesion volumes were compared against depression status. After controlling for age and hypertension, subjects with depression exhibited significantly greater total white matter lesion volume in both hemispheres and in both frontal lobes than did control subjects. Although a similar trend was observed in the parietal lobes, the difference did not reach a level of statistical significance. Models of the temporal and occipital lobes were not statistically significant. Older individuals with depression have greater white matter disease than healthy controls, predominantly in the frontal lobes. These changes are thought to disrupt neural circuits involved in mood regulation, thus increasing the risk of developing depression.

Aged↗

Molecular similarity: a key technique in molecular informatics.

Molecular Informatics utilises many ideas and concepts to find relationships between molecules. The concept of similarity, where molecules may be grouped according to their biological effects or physicochemical properties has found extensive use in drug discovery. Some areas of particular interest have been in lead discovery and compound optimisation. For example, in designing libraries of compounds for lead generation, one approach is to design sets of compounds "similar" to known active compounds in the hope that alternative molecular structures are found that maintain the properties required while enhancing e.g. patentability, medicinal chemistry opportunities or even in achieving optimised pharmacokinetic profiles. Thus the practical importance of the concept of molecular similarity has grown dramatically in recent years. The predominant users are pharmaceutical companies, employing similarity methods in a wide range of applications e.g. virtual screening, estimation of absorption, distribution, metabolism, excretion and toxicity (ADME/Tox) and prediction of physicochemical properties (solubility, partitioning etc.). In this perspective, we discuss the representation of molecular structure (descriptors), methods of comparing structures and how these relate to measured properties. This leads to the concept of molecular similarity, its various definitions and uses and how these have evolved in recent years. Here, we wish to evaluate and in some cases challenge accepted views and uses of molecular similarity. Molecular similarity, as a paradigm, contains many implicit and explicit assumptions in particular with respect to the prediction of the binding and efficacy of molecules at biological receptors. The fundamental observation is that molecular similarity has a context which both defines and limits its use. The key issues of solvation effects, heterogeneity of binding sites and the fundamental problem of the form of similarity measure to use are addressed.

Algorithms↗