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PubMed1992

On a common structure of intelligence in biological and technical systems.

This is a survey of the general structure of an electronic computer-implemented, operation-oriented system, designed by the authors, which uses artificial intelligence mechanisms and is intended for the control of technical objects that function both in predictable and random environments. The system is based on processing knowledge, which is stored in a hierarchically arranged Knowledge Bank, and program mechanisms for adapting to and interacting with the External and Internal Worlds. The system has distributed program mechanisms, which are 'designed' with a constant structure. It is independent of the purpose and environment of the system operation and the specific features of the controlled object. None of the program mechanisms are concentrated in any program module. They are distributed in many modules, and therefore there is no single module responsible for the execution of a particular external function. The system is structured into separate program modules by internal procedures. The conceptual organisation of the Knowledge Base presupposes that the framework is structured according to functional, semantic and tier indications, i.e. the structured description of knowledge, by the system, of the external environment and its possible behaviour in it. The possibility of multiple use of the same elements of the lower tiers of the Knowledge Base by higher-tier elements makes the proposed Knowledge Base very efficient. If the cerebrum is considered at a structural level, there appears to be an amazing similarity between the structure and the mechanisms of the above system and the structure of the cerebral cortex, as suggested previously by Edelman and Mountcastle. Each mechanism of the cerebral cortex structure has a structural analogue in the described system.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMed2002

The Knowledge Resource Base: beginning the dialogue.

The Knowledge Resource Base (KRB) is a conceptual approach to the various types of knowledge used to understand and make sense of mental illness. It is an attempt to go beyond the everyday notion that real knowledge is in the hands of clinical experts and that consumers/survivors, families, and the public have little to contribute. There are four components to the KRB, each of which represents a different perspective or type of knowledge about mental illness; medical/clinical, social scientific, experiential, and customary/traditional. The purpose of this paper is to explore the medical/clinical and experiential components of the KRB by initiating a dialogue between consumers/survivors, families, and mental health professionals regarding these components. The strengths and weaknesses of each component are identified through individual interviews and a focus group.

Attitude to Health↗
PubMed2002

Standards for hospital libraries 2002.

The Medical Library Association's "Standards for Hospital Libraries 2002" have been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified librarian who functions as a department head and is a member of the Academy of Health Information Professionals. The standards define the role of the medical librarian and the links between knowledge-based information and other functions such as patient care, patient education, performance improvement, and education. In addition, the standards address the development and implementation of the knowledge-based information needs assessment and plans, the promotion and publicity of the knowledge-based information services, and the physical space and staffing requirements. The role, qualifications, and functions of a hospital library consultant are outlined. The health sciences library is positioned to play a key role in the hospital. The increasing use of the Internet and new information technologies by medical, nursing, and allied health staffs; patients; and the community require new strategies, strategic planning, allocation of adequate resources, and selection and evaluation of appropriate information resources and technologies. The Hospital Library Standards Committee has developed this document as a guideline to be used in facing these challenges.

Consultants↗
PubMed2005

Standards for Hospital Libraries 2002 with 2004 revisions.

The Medical Library Association's Standards for Hospital Libraries 2002 has been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified librarian who functions as a department head and is a member of the Academy of Health Information Professionals. The standards define the role of the medical librarian and the links between knowledge-based information and other functions such as patient care, patient education, performance improvement, and education. In addition, the standards address the development and implementation of the knowledge-based information needs assessment and plan, the promotion and publicity of the KBI services, and the physical space and staffing requirements. The role, qualifications, and functions of a hospital library consultant are outlined. The health sciences library is positioned to play a key role in the hospital. The increasing use of the Internet and new information technologies by medical, nursing, and allied health staffs, patients and the community require new strategies, strategic planning, allocation of adequate resources, and selection and evaluation of appropriate information resources and technologies. The Hospital Library Standards Committee has developed this document as a guideline to be used in facing these challenges together.

Guidelines as Topic↗
PubMed1994

The need for security--a clinical view.

Systems which process patient health data of any kind are considered to be medical information systems. Some data can be categorized as non-personal, non-identifiable, or non-patient-based such as knowledge bases. Others are considered as highly sensitive because of the 'need to know' to deliver health care to patient. Access is not only justifiable for doctors and nurses, but, for specific purposes to administrative personnel and public health organisations. Of special concern are registers on sexually transmitted diseases, mental health and genetic diseases. In future, patients might gain more autonomy and also have access to some parts of their own record. Telematics allows them to update a data base and to consult a knowledge base. Clearly, physicians in charge of the cases have a responsibility that has been recognised by law in all Western countries. Access to patient's data should take into account this responsibility. Although most health professionals would still believe that confidentiality is the main issue, it appears that data integrity and availability are as important in the context of the 'paperless' electronic record. Information should be complete and correct, to be only accessed by authorized persons. The health care environment is characterised by an open nature of clinics that leaves them vulnerable to theft, damage and unauthorized access. Disclosure of information may affect the patient's social standing as well as their general health. The health professions lack sufficiently well-defined organisational structure, culture and perceptions to support security.

Computer Communication Networks↗
PubMed2004

ISYMOD: a knowledge warehouse for the identification, assembly and analysis of bacterial integrated systems.

MOTIVATION: Complex biological functions emerge from interactions between proteins in stable supra-molecular assemblies and/or through transitory contacts. Most of the time protein partners of the assemblies are composed of one or several domains which exhibit different biochemical functions. Thus the study of cellular process requires the identification of different functional units and their integration in an interaction network; such complexes are referred to as integrated systems. In order to exploit with optimum efficiency the increased release of data, automated bioinformatics strategies are needed to identify, reconstruct and model such systems. For that purpose, we have developed a knowledge warehouse dedicated to the representation and acquisition of bacterial integrated systems involved in the exchange of the bacterial cell with its environment. RESULTS: ISYMOD is a knowledge warehouse that consistently integrates in the same environment the data and the methods used for their acquisition. This is achieved through the construction of (1) a domain knowledge base (DKB) devoted to the storage of the knowledge about the systems, their functional specificities, their partners and how they are related and (2) a methodological knowledge base (MKB) which depicts the task layout used to identify and reconstruct functional integrated systems. Instantiation of the DKB is obtained by solving the tasks of the MKB, whereas some tasks need instances of the DKB to be solved. AROM, an object-based knowledge representation system, has been used to design the DKB, and its task manager, AROMTasks, for developing the MKB. In this study two integrated systems, ABC transporters and two component systems, both involved in adaptation processes of a bacterial cell to its biotope, have been used to evaluate the feasibility of the approach.

ATP-Binding Cassette Transporters↗
PubMed2005

Unveiling health attitudes and creating good-for-you foods: the genomics metaphor, consumer innovative web-based technologies.

This article presents an integrated analysis of three emerging knowledge bases in the nutrition and consumer products industries, and how they may effect the food industry. These knowledge bases produce new vistas for corporate product development, especially with respect to those foods that are positioned as 'good for you.' Couched within the current thinking of state-of-the-art knowledge and information, this article highlights how today's thinking about accelerated product development can be introduced into the food and health industries to complement these three research areas. The 3 knowledge bases are: the genomics revolution, which has opened new insights into understanding the interactions of personal needs of individual consumers with nutritionally relevant components of the foods; the investigation of food choice by scientific studies; the development of large scale databases (mega-studies) about the consumer mind. These knowledge bases, combined with new methods to understand the consumer through research, make possible a more focused development. The confluence of trends outlined in this article provides the corporation with the beginnings of a new path to a knowledge-based, principles-grounded product-development system. The approaches hold the potential to create foods based upon people's nutritional requirements combined with their individual preferences. Integrating these emerging knowledge areas with new consumer research techniques may well reshape how the food industry develops new products to satisfy consumer needs and wants.

Affect↗
PubMedDate not supplied

Appropriateness of care: the case for changing the focus of "quality" measurement.

"Quality" of care has become one of the main foci of the American health care system during the last 20 years. As costs escalated in all areas of health care, the purchasers and consumers of health care have begun to demand accountability for the products they purchase. The initial focus of the system was "quality of care." When a number of research studies and reports highlighted the lack of basic safety in the American health care system, "safety" of health care was added to the discussion. It is the intent of this article to argue that quality of care is at this point in time not measurable, but that "appropriateness" of care is and can be measured based upon knowledge-based guidelines. With the option to use knowledge-based guidelines as sources for appropriateness indicators, the opportunity to add meaning to indicators and their meaning to the many stakeholders interested in this area cannot be ignored.

Delivery of Health Care↗
PubMed1994

The effect of a materials-based intervention on knowledge of risk-based clinical prevention screening guidelines.

The release of the U.S. Preventive Services Task Force guidelines (GUIDELINES) introduces an opportunity to modify patient expectations about the timing of routine examinations. This randomized, controlled study examines the effect of a materials-based educational intervention on knowledge and beliefs about risk-based preventive screening guidelines. The study was conducted in a large multi-specialty group practice participating in a network model HMO in the upper midwest with over 250,000 members. Subjects were selected from patients of a primary care clinic in a suburban section of a major metropolitan area. A 48-page prevention guidebook based on the GUIDELINES was distributed to a randomly assigned treatment group of 200 patients enrolled in an HMO. A 22-item questionnaire on preventive health services that measured respondents' age-adjusted risks and knowledge of risk-based screening guidelines was sent to both experimental and control groups. A 69% response rate was achieved. chi 2 analysis and t-tests showed that the treatment group was significantly more accurate in identifying recommended GUIDELINES for colon examinations (digital rectal, stool occult, sigmoidoscopy), blood pressure, and Pap tests. No significant differences related to identifying GUIDELINES for mammograms and clinical breast examinations were found between the groups. Communications about new screening guidelines can yield positive but selective changes in knowledge and beliefs about appropriate screening intervals.

Communication↗
PubMed1998

[The use of computer-assisted clinical consultation with expert systems in early pregnancy].

OBJECTIVES: The early pregnancy disorders are most frequent diagnostic problem in a GP-practice. This observation and commonness of the problem inclined the authors to assume eutopic physiological pregnancy, eutopic complicated pregnancy, ectopic pregnancy and trophoblastic diseases as important diagnostic hypotheses for our knowledge based consultation system, intended as decision support tool for first contact physician (GP) when diagnosing early pregnancy disorders. DESIGN: Defining 81 diagnostic tests to be included in the knowledge acquisition process, interviewing clinical experts and developing knowledge base (set of clinical diagnostic rules), implementing the knowledge base for early pregnancy disorders--related amenorrhea patients, in particular: determining clinical importance of symptoms and lab/diagnostic tests. MATERIALS AND METHODS: The clinical knowledge acquisition process has been performed taking into account 81 diagnostic features. Moreover clinical data on 220 cases, including 96 early pregnancy disorders cases, have been collected to enable validation of the knowledge base. ELSA approach to creating environment-self-adjustable medical knowledge bases, developed by Ruszkowski has been applied and the eleven main diagnostic hypotheses have been defined. We believe that the proposed knowledge base and PC-based consultation system offers such an approach for improving GP diagnostic effectiveness. RESULTS AND CONCLUSIONS: 1. The knowledge base and the consultation system could contribute to improving diagnostic effectiveness, when used by a GP for diagnosing early pregnancy disorders such an approach could also be used to determine relative diagnostic power of specific tests or symptoms, 2. The laboratory and diagnostic test confirmed high diagnostic accuracy in early pregnancy disorders. The anamnesis has a low diagnostic effectiveness for particular diagnostic features in ectopic pregnancy patients and physical examination confirmed low diagnostic accuracy in eutopic physiological pregnancy and eutopic complicated pregnancy.

Adult↗
PubMed2002

A knowledge framework for computational molecular-disease relationships in cancer.

Biomedical knowledge is growing at an exponential rate, with new discoveries being published across a range of information sources. A coded, fully-computable, and integrated approach to this information could increase the efficiency of its use, through improved retrieval as well as the eventual ability to apply decision support tools to the knowledge base. Though multiple knowledge bases (KBs) and databases (DBs) concerning gene-disease relationships exist, few present the information in a coded, easily computable form. Focusing on molecular-disease relationships in cancer (gene-disease and protein-disease), we evaluated articles in major biomedical journals, in order to develop both the framework for a knowledge model as well as evaluation criteria. We then used these criteria to evaluate major KBs, DBs, and terminologies. We discovered that although both the high-level as well as the specific molecular-disease relationships present in our test set were mapped in many of the databases, they generally were not applied together in a coded form. We propose a rationale behind a model mediated schema for the integration of these resources.

Artificial Intelligence↗
PubMed2006

Facilitating cleft palate team participation of culturally diverse families in South Africa.

OBJECTIVE: The Facial Cleft Deformities Clinic, University of Pretoria, Pretoria, South Africa, provides interdisciplinary team services to patients with cleft lip and palate and craniofacial anomalies. They represent the "rainbow nation" of South Africa and reflect the multicultural and multilingual nature of the population, which poses a challenge to effective and accountable service delivery. The aim of this study was to explore some cultural variations that exist in black families that influence their participation in the team approach and to describe the assets of families that may be used to empower them and to enhance service delivery. DESIGN: A descriptive survey research design. A questionnaire-by-interview procedure was utilized during routine visits of 35 black families to the Facial Cleft Deformities Clinic. RESULTS: The results are discussed from an ethnographic perspective of the family and describe the knowledge base of the participants, the diagnosis and treatment of the children's cleft lip and palate, family structure and support systems, family income and education, and the geographical distribution of the participants. Implications for building family partnerships and for improving professionals' cultural competence in order to improve the quality of service delivery are presented. CONCLUSIONS: By viewing cultural differences on a continuum, following the asset-based approach, applying knowledge based on contextually relevant research, and recognizing family uniqueness, families may be empowered to participate fully in the team approach to support their children with cleft lip and palate and craniofacial anomalies in attaining their full potential in the South African context.

Adolescent↗
PubMed2004

Automated soil resources mapping based on decision tree and Bayesian predictive modeling.

This article presents two approaches for automated building of knowledge bases of soil resources mapping. These methods used decision tree and Bayesian predictive modeling, respectively to generate knowledge from training data. With these methods, building a knowledge base for automated soil mapping is easier than using the conventional knowledge acquisition approach. The knowledge bases built by these two methods were used by the knowledge classifier for soil type classification of the Longyou area, Zhejiang Province, China using TM bi-temporal imageries and GIS data. To evaluate the performance of the resultant knowledge bases, the classification results were compared to existing soil map based on field survey. The accuracy assessment and analysis of the resultant soil maps suggested that the knowledge bases built by these two methods were of good quality for mapping distribution model of soil classes over the study area.

Algorithms↗
PubMed2006

A semantically enabled formalism for the knowledge management of Parkinson's disease.

Bio-ontology is a formal representation of biological concepts that is used in the interchange of communication between computers and humans alike. They can then be used in the formulation and retrieval of knowledge. In developing a knowledge-based system for Parkinson's Disease, a procedure of knowledge map was used to capture and harness the intellectual resources of an organization, and new paradigms for knowledge mapping were also formulated. Knowledge bases for symptoms and drugs, physiotherapy, speech and language therapy, and dieting that affect patient care were developed. Finally, the knowledge bases were merged to form a single central repository of knowledge base.

Diet↗
PubMed2000

Ontology acquisition from on-line knowledge sources.

Electronic knowledge representation is becoming more and more pervasive both in the form of formal ontologies and less formal reference vocabularies, such as UMLS. The developers of clinical knowledge bases need to reuse these resources. Such reuse requires a new generation of tools for ontology development and management. Medical experts with little or no computer science experience need tools that will enable them to develop knowledge bases and provide capabilities for directly importing knowledge not only from formal knowledge bases but also from reference terminologies. The portions of knowledge bases that are imported from disparate resources then need to be merged or aligned to one another in order to link corresponding terms, to remove redundancies, to resolve logical conflicts. We discuss the requirements for ontology-management tools that will enable interoperability of disparate knowledge sources. Our group is developing a suite of tools for knowledge-base management based on the Protégé-2000 environment for ontology development and knowledge acquisition. We describe one such tool in detail here: an application for incorporating information from remote knowledge sources such as UMLS into a Protégé knowledge base.

Artificial Intelligence↗
PubMed1991

Computer-aided diagnosis and negligence.

The phrase 'expert system' has been widely used to describe computer systems which are capable of performing at or near to the level of an expert. Expert systems may be recognized by their construction or by their performance. Structurally, expert systems usually comprise a knowledge-base, an inference engine and an interface with the user as shown in Figure 1. The knowledge-base contains the raw material of the expert system; the rules and facts representing the expertise. An important part of that knowledge-base usually will be heuristic in nature and this is particularly so with respect to expert systems in medicine. A large amount of a specialist's knowledge is informal and experimential in nature and this heuristic knowledge is often what sets the specialist apart from the general practitioner or indeed sets the latter apart from the medical student. The inference engine is a computer program which attempts to resolve the user's enquiries by operating on and interacting with the knowledge-base. Finally, the interface with the user serves two purposes: first, to make the system relatively easy to use and second, and very importantly, to provide an explanation and justification for the results, advice and suggestions obtained from using the system (Winfield, 1982). There will be other parts to an expert system which are used to refine and modify the knowledge-base. The performance of an expert system is of utmost importance and it is the most fundamental test for whether a computer system falls into this classification. d'Agapeyeff (1984) defines expert systems as being: a) programmed to a significant extent, from an explicit representation of empirical human knowledge; b) readable by those who provided the knowledge and, potentially, by similarly knowledgeable users and managers; c) able to provide explanations of their reasoning on demand; d) quickly alterable with (comparatively) low risk of unwanted side effects.' d'Agapeyeff describes the knowledge-base as being empirical, suggesting that it is informal or heuristic knowledge rather than comprising clear and formal rules as written in textbooks. This does not preclude the inclusion of formal knowledge in the expert system but it is clear that heuristic knowledge occupies a key role in the development of expert systems. Much medical knowledge is heuristic in nature; for example, an experienced doctor might use a rule in diagnosis such as: 'If symptoms A and B are observed then C is plausible but certainly not D'. In the field of medicine, expert systems will enable specialist expertise (a rare commodity) to be available to non-specialists such as general practitioners.(ABSTRACT TRUNCATED AT 400 WORDS)

Diagnosis, Computer-Assisted↗
PubMed2003

Rasmussen's model of human behavior in laparoscopy training.

AIMS: Compared to aviation, where virtual reality (VR) training has been standardized and simulators have proven their benefits, the objectives, needs, and means of VR training in minimally invasive surgery (MIS) still have to be established. The aim of the study presented is to introduce Rasmussen's model of human behavior as a practical framework for the definition of the training objectives, needs, and means in MIS. METHODS: Rasmussen distinguishes three levels of human behavior: skill-, rule-, and knowledge-based behaviour. The training needs of a laparoscopic novice can be determined by identifying the specific skill-, rule-, and knowledge-based behavior that is required for performing safe laparoscopy. Future objectives of VR laparoscopy trainers should address all three levels of behavior. RESULTS: Although most commercially available simulators for laparoscopy aim at training skill-based behavior, especially the training of knowledge-based behavior during complications in surgery will improve safety levels. However, the cost and complexity of a training means increases when the training objectives proceed from the training of skill-based behavior to the training of complex knowledge-based behavior. CONCLUSION: In aviation, human behavior models have been used successfully to integrate the training of skill-, rule-, and knowledge-based behavior in a full flight simulator. Understanding surgeon behavior is one of the first steps towards a future full-scale laparoscopy simulator.

Algorithms↗
PubMed1993

Integrating order and distance relationships from heterogeneous maps.

There is no automatic mechanism to integrate information between heterogeneous genome maps. Currently, integration is a difficult, manual process. We have developed a process for knowledge base design, and we use this to integrate order and distance relationships between genetic linkage, radiation hybrid, and physical maps. Until now, the only way to develop a persistent, knowledge-intensive application was to either develop a new knowledge base from scratch or coerce the application to fit an existing knowledge base. This was not from lack of interest by the knowledge base or database community, but merely from a lack of theoretical tools powerful enough to tackle the problem. We import formalisms from knowledge representation, natural language semantics, programming language research, and databases. These form a strong, theoretical foundation for knowledge base design upon which we have implemented the knowledge base design tool called WEAVE.

Artificial Intelligence↗