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At least 883 records · Page 49Linked to original sources
PubMed2005

Designing a framework of intelligent information processing for dentistry administration data.

OBJECTIVES: This study was designed to test a cumulative view of current data in the clinical database at the Faculty of Dentistry, Dalhousie University. We planned to examine associations among demographic factors and treatments. METHODS: Three tables were selected from the database of the faculty: patient, treatment and procedures. All fields and record numbers in each table were documented. Data was explored using SQL server and Visual Basic and then cleaned by removing incongruent fields. After transformation, a data warehouse was created. This was imported to SQL analysis services manager to create an OLAP (Online Analytic Process) cube. RESULTS: The multidimensional model used for access to data was created using a star schema. Treatment count was the measurement variable. Five dimensions--date, postal code, gender, age group and treatment categories--were used to detect associations. Another data warehouse of 8 tables (international tooth code # 1-8) was created and imported to SAS enterprise miner to complete data mining. Association nodes were used for each table to find sequential associations and minimum criteria were set to 2% of cases. Findings of this study confirmed most assumptions of treatment planning procedures. There were some small unexpected patterns of clinical interest. Further developments are recommended to create predictive models. CONCLUSIONS: Recent improvements in information technology offer numerous advantages for conversion of raw data from faculty databases to information and subsequently to knowledge. This knowledge can be used by decision makers, managers, and researchers to answer clinical questions, affect policy change and determine future research needs.

Adolescent↗
PubMed2004

The tissue microarray data exchange specification: implementation by the Cooperative Prostate Cancer Tissue Resource.

BACKGROUND: Tissue Microarrays (TMAs) have emerged as a powerful tool for examining the distribution of marker molecules in hundreds of different tissues displayed on a single slide. TMAs have been used successfully to validate candidate molecules discovered in gene array experiments. Like gene expression studies, TMA experiments are data intensive, requiring substantial information to interpret, replicate or validate. Recently, an open access Tissue Microarray Data Exchange Specification has been released that allows TMA data to be organized in a self-describing XML document annotated with well-defined common data elements. While this specification provides sufficient information for the reproduction of the experiment by outside research groups, its initial description did not contain instructions or examples of actual implementations, and no implementation studies have been published. The purpose of this paper is to demonstrate how the TMA Data Exchange Specification is implemented in a prostate cancer TMA. RESULTS: The Cooperative Prostate Cancer Tissue Resource (CPCTR) is funded by the National Cancer Institute to provide researchers with samples of prostate cancer annotated with demographic and clinical data. The CPCTR now offers prostate cancer TMAs and has implemented a TMA database conforming to the new open access Tissue Microarray Data Exchange Specification. The bulk of the TMA database consists of clinical and demographic data elements for 299 patient samples. These data elements were extracted from an Excel database using a transformative Perl script. The Perl script and the TMA database are open access documents distributed with this manuscript. CONCLUSIONS: TMA databases conforming to the Tissue Microarray Data Exchange Specification can be merged with other TMA files, expanded through the addition of data elements, or linked to data contained in external biological databases. This article describes an open access implementation of the TMA Data Exchange Specification and provides detailed guidance to researchers who wish to use the Specification.

Confidentiality↗
PubMed1998

The factor VIII Structure and Mutation Resource Site: HAMSTeRS version 4.

Since 1996 the HAMSTeRS (Haemophilia A Mutation, Search, Test and Resource Site) WWW site has provided an online resource for access to data on the molecular pathology of haemophilia A, replacing previous text editions of the Haemophilia A Database published in Nucleic Acids Research . This report describes the continued development of the site (version 4), and in particular the expansion of factor VIII (FVIII) structure-related features. Access to the mutation database itself, both for searching the listings and for submission of new mutations, is via custom-designed forms: more powerful Boolean searches of the point mutations in the database are also available. During 1997 a total of 22 novel missense mutations were reported, increasing the total number of unique variants now described to 252 (238 in exonic sequences and 14 at intronic splice junctions). Currently, a total of 586 individual reports with associated phenotypic data are available for searching by any category including phenotype. The FVIII structure section now includes a download of a FVIII A domain homology model in Protein Data Bank format and a multiple alignment of the FVIII amino-acid sequencies from four species (human, murine, porcine and canine) in addition to the virtual reality simulations, secondary structural data and FVIII animation already available. Finally, to aid navigation across this site, a clickable roadmap of the main features provides easy access to the page desired. Our intention is that continued development and updating of the site shall provide workers in the fields of molecular and structural biology with a one-stop resource site to facilitate FVIII research and education. The HAMSTeRS URL is http://europium.mrc.rpms.ac.uk

Amino Acid Sequence↗
PubMed2000

Ethnicity and oral cancer.

Oral squamous-cell carcinoma, the main type of oral cancer, is among the ten most common cancers in the world. The aims of this paper were first, to consider whether there was evidence of marked ethnic variations in the incidence, management, and survival of oral cancer, and then, to review possible explanations for these variations. Evidence from the literature suggests that there is marked, inter-country variation in both the incidence and mortality from oral cancer. There is also growing evidence of intracountry ethnic differences, mostly reported in the UK and USA. These variations among ethnic groups have been attributed mainly to specific risk factors, such as alcohol and tobacco (smoking and smokeless), but dietary factors and the existence of genetic predispositions may also play a part. Variations in access to care services are also an apparent factor. The extent of ethnic differences in oral cancer is masked by the scarcity of information available. Where such data are accessible, there are clear disparities in both incidence and mortality of oral cancer between ethnic groups.

Alcohol Drinking↗
PubMed1996

Complete nucleotide sequence, structural organization, and an alternatively spliced exon of mouse h1-calponin gene.

From a CC1.2 embryonic stem cell genomic library, we isolated and sequenced a 10.4-kb DNA segment (GenBank/EMBL Data Bank accession number L49022) containing the entire gene encoding mouse h1-calponin, an actin-associated smooth muscle-specific protein and a potential modulator of contraction. Sequence data revealed that there are seven exons and six introns in the h1-calponin gene. Determined by primer extension mapping of the RNA transcripts, the transcription of h1-calponin gene initiates at the same site in stomach, urinary bladder and pregnant uterus smooth muscles. The genomic organization suggests that the previously identified alpha- and beta-calponin isoforms are produced by splicing of exon 7 at two alternative acceptor sites. Isolation and structural characterization of the h1-calponin gene provides information to further investigate the expression regulation of this smooth muscle-specific gene.

Alternative Splicing↗
PubMed2002

Projection access order in algebraic reconstruction technique for diffuse optical tomography.

Algebraic reconstruction technique (ART) is one of the popular image reconstruction techniques used in diffuse optical tomography (DOT). We investigate in this note the influence of the order in which data are accessed in ART. Simulations mimicking breast tissues in transmission geometry with contrast agent tumour enhancement were used to evaluate the image quality of the diverse projection access investigated. We show that by selecting proper projection access order, the convergence speed can be significantly improved when ART is used to perform DOT. Moreover, low-contrast detection is improved.

Image Processing, Computer-Assisted↗
PubMed2000

Interactive medical data on demand: a high-performance imaged-based approach across heterogeneous environments.

Medical data in image format continues to increase in both size and complexity. We have integrated advanced techniques in visualization, networked computing, and interface design to improve methods for accessing medical data comprising high-resolution images for reconstructions into three-dimensional volumetric representations. We present two approaches to handle the range of low to high-end client platforms, support visualization functionality, and provide the ability to manipulate very large data over heterogeneous computing and networking environments. We present examples of its use for clinical, research, and educational purposes and discuss future extensions.

Computer Communication Networks↗
PubMed1994

Performance evaluation of a distance learning program.

This paper presents a performance metric which uses a single number to characterize the response time for a non-deterministic client-server application operating over the Internet. When applied to a Macintosh-based distance learning application called the Digital Anatomist Browser, the metric allowed us to observe that "A typical student doing a typical mix of Browser commands on a typical data set will experience the same delay if they use a slow Macintosh on a local network or a fast Macintosh on the other side of the country accessing the data over the Internet." The methodology presented is applicable to other client-server applications that are rapidly appearing on the Internet.

Computer Communication Networks↗
PubMed1999

Ligand-induced structural alterations in human iron regulatory protein-1 revealed by protein footprinting.

Human iron regulatory protein-1 (IRP-1) is a bifunctional protein that regulates iron metabolism by binding to mRNAs encoding proteins involved in iron uptake, storage, and utilization. Intracellular iron accumulation regulates IRP-1 function by promoting the assembly of an iron-sulfur cluster, conferring aconitase activity to IRP-1, and hindering RNA binding. Using protein footprinting, we have studied the structure of the two functional forms of IRP-1 and have mapped the surface of the iron-responsive element (IRE) binding site. Binding of the ferritin IRE or of the minimal regulatory region of transferrin receptor mRNA induced strong protections against proteolysis in the region spanning amino acids 80 to 187, which are located in the putative cleft thought to be involved in RNA binding. In addition, IRE-induced protections were also found in the C-terminal domain at Arg-721 and Arg-728. These data implicate a bipartite IRE binding site located in the putative cleft of IRP-1. The aconitase form of IRP-1 adopts a more compact structure because strong reductions of cleavage were detected in two defined areas encompassing residues 149 to 187 and 721 to 735. Thus both ligands of apo-IRP-1, the IRE and the 4Fe-4S cluster, induce distinct but overlapping alterations in protease accessibility. These data provide evidences for structural changes in IRP-1 upon cluster formation that affect the accessibility of residues constituting the RNA binding site.

Amino Acid Sequence↗
PubMed2003

Benchmarking information needs and use in the Tennessee public health community.

OBJECTIVE: The objective is to provide insight to understanding public health officials' needs and promote access to data repositories and communication tools. METHODS: Survey questions were identified by a focus group with members drawn from the fields of librarianship, public health, and informatics. The resulting comprehensive information needs survey, organized in five distinct broad categories, was distributed to 775 Tennessee public health workers from ninety-five counties in 1999 as part of the National Library of Medicine-funded Partners in Information Access contract. RESULTS: The assessment pooled responses from 571 public health workers (73% return rate) representing seventy-two of ninety-five counties (53.4% urban and 46.6% rural) about their information-seeking behaviors, frequency of resources used, computer skills, and level of Internet access. Sixty-four percent of urban and 43% of rural respondents had email access at work and more than 50% of both urban and rural respondents had email at home (N = 289). Approximately 70% of urban and 78% of rural public health officials never or seldom used or needed the Centers for Disease Control (CDC) Website. Frequency data pooled from eleven job categories representing a subgroup of 232 health care professionals showed 72% never or seldom used or needed MEDLINE. Electronic resources used daily or weekly were email, Internet search engines, internal databases and mailing lists, and the Tennessee Department of Health Website. CONCLUSIONS: While, due to the small sample size, data cannot be generalized to the larger population, a clear trend of significant barriers to computer and Internet access can be identified across the public health community. This contributes to an overall limited use of existing electronic resources that inhibits evidence-based practice.

Attitude to Computers↗
PubMedDate not supplied

Iatrogenic vertebral artery injury during anterior cervical spine surgery.

BACKGROUND CONTEXT: Iatrogenic injury to the vertebral artery during an anterior cervical decompression is a rarely mentioned but potentially catastrophic complication. PURPOSE: This study was designed to examine the incidence and management of iatrogenic vertebral artery injury (IVAI) in a large database. STUDY DESIGN/SETTING: This was a retrospective study performed at a large teaching institution over a 7-year period (1994-2001). PATIENT SAMPLE: All anterior cervical spinal procedures performed for herniated or degenerative disc disease, or cervical spondylosis were identified, as were incidences of IVAI. Anterior cervical procedures performed for trauma, neoplasia, or infection were excluded from this study. OUTCOME MEASURES: Neurological and associated morbidity as well as mortality were recorded. METHODS: Data were accessed through an institution-wide electronic medical record search through the operative reports of 10 spine surgeons. Hospital and clinical charts of IVAI cases were subsequently reviewed. Demographic data and intraoperative strategies for repair were recorded. RESULTS: A total of 1,976 patients underwent anterior cervical spinal procedures in the review period. Six cases of IVAI were identified. In three of the six patients, arterial bleeding was controlled with hemostatic agents. Of these three, two suffered complications. The initial management of controlling arterial bleeding is by hemostatic agents; however, one must also consider repair or ligation. The remaining three patients were treated with primary repair or ligation, and no complications were noted. CONCLUSIONS: IVAI is a rare complication (0.3%) of anterior cervical procedures. The arterial bleeding can usually be controlled with topical hemostatic agents, but mortality may occur in instances where it cannot be adequately addressed in a timely fashion.

Cervical Vertebrae↗
PubMed1976

Medical economics survey-methods study: design, data collection, and analytical plan.

This paper describes the background, methodology, data collection, and analytical plan of a pilot investigation conducted under contract for the National Center for Health Statistics during 1975. The objective was to determine the cost effectiveness of a variety of strategies under consideration for national application to develop previously unavailable information on utilization of, and the costs and payments for, health care. Detailed data on health care utilization and expenditures were collected periodically from a panel of 691 Maryland households over a six-month interval. Issues to be tested through a random experimental design include whether periodicity (monthly vs bimonthly interviews) and type of contact (in-person vs telephone) are significant factors in the cost effectiveness of this type of survey. An extensive record check involving all providers and third-party payers identified in the household survey was carried out. Record information will be used to 1) provide a basis for measuring accuracy of household data, 2) fill gaps in household knowledge, and 3) determine whether a subset of the record sources can provide adequate information for correcting household data. The household survey resulted in an initial response rate of 77.5 per cent with a subsequent attrition rate over six months of 13.6 per cent. Signed permission to access record data was obtained for 84.9 per cent of the individuals completing the entire survey. The most intensive survey strategy, monthly, mostly in-person contact, resulted in the lowest participation. The analytical plan presents details of the approaches to be taken in making judgments on the relative accuracy and completeness of data obtained by the various survey strategies and the contribution made by availability of data from record sources.

Adolescent↗
PubMed2006

An informatics model for tissue banks--lessons learned from the Cooperative Prostate Cancer Tissue Resource.

BACKGROUND: Advances in molecular biology and growing requirements from biomarker validation studies have generated a need for tissue banks to provide quality-controlled tissue samples with standardized clinical annotation. The NCI Cooperative Prostate Cancer Tissue Resource (CPCTR) is a distributed tissue bank that comprises four academic centers and provides thousands of clinically annotated prostate cancer specimens to researchers. Here we describe the CPCTR information management system architecture, common data element (CDE) development, query interfaces, data curation, and quality control. METHODS: Data managers review the medical records to collect and continuously update information for the 145 clinical, pathological and inventorial CDEs that the Resource maintains for each case. An Access-based data entry tool provides de-identification and a standard communication mechanism between each group and a central CPCTR database. Standardized automated quality control audits have been implemented. Centrally, an Oracle database has web interfaces allowing multiple user-types, including the general public, to mine de-identified information from all of the sites with three levels of specificity and granularity as well as to request tissues through a formal letter of intent. RESULTS: Since July 2003, CPCTR has offered over 6,000 cases (38,000 blocks) of highly characterized prostate cancer biospecimens, including several tissue microarrays (TMA). The Resource developed a website with interfaces for the general public as well as researchers and internal members. These user groups have utilized the web-tools for public query of summary data on the cases that were available, to prepare requests, and to receive tissues. As of December 2005, the Resource received over 130 tissue requests, of which 45 have been reviewed, approved and filled. Additionally, the Resource implemented the TMA Data Exchange Specification in its TMA program and created a computer program for calculating PSA recurrence. CONCLUSION: Building a biorepository infrastructure that meets today's research needs involves time and input of many individuals from diverse disciplines. The CPCTR can provide large volumes of carefully annotated prostate tissue for research initiatives such as Specialized Programs of Research Excellence (SPOREs) and for biomarker validation studies and its experience can help development of collaborative, large scale, virtual tissue banks in other organ systems.

Databases as Topic↗
PubMed2004

Evidence that intrauterine and postnatal androgens affect the development of pyloric stenosis.

BACKGROUND: It is rather well established that the causal antecedents of pyloric stenosis (PS) contain both genetic and environmental factors. However, in spite of substantial quantities of epidemiological data, no widespread environmental causal agent has yet been established. There have been recent extensions of our knowledge of the endocrine consequences of fetal growth restriction and of the endocrine determinants of sex ratio. It seemed worth reviewing the epidemiological data on PS in the light of these new developments to see whether this would provide a basis for a plausible hypothesis on these suspected environmental causes of PS. METHODS AND RESULTS: The search terms "pyloric stenosis" and ("epidemiology" or "risk factors") were combined on the Ovid Medline data base for the years 1966 onwards. The data from the resulting papers were augmented by notes occasioned by almost daily reading at the Library of the Royal Society of Medicine (London) for the past 25 years. (Electronic data retrieval systems do not access incidentally recorded data such as sib sex ratios). CONCLUSIONS: It is hypothesized that high intrauterine and early postnatal androgen levels constitute an environmental cause of PS.

Androgens↗
PubMed1990

Risk factors for adverse drug reactions--epidemiological approaches.

Age by itself is not an important risk factor for ADRs. Age-related changes are the consequence of a number of individual factors, for example morbidity associated with polypharmacy, decline in renal or liver function in the elderly, hypoalbuminaemia, reduced body weight, etc. The relationship between gastrointestinal bleeding and non-steroidal anti-inflammatory drugs can be assessed globally in large cohort studies with access to computerized data, but complete accuracy requires access to the original patient records. The increase in the risk of GI bleeding in users of NSAIDs and aspirin was 50% above that in non-users. About a quarter of ADRs in hospitalized patients seem not to arise from purely pharmacological mechanisms. They are mainly due to allergic, anaphylactoid, or idiosyncratic reactions and to intolerance. In such non-pharmacological reactions, the time of exposure, reaction time, and even dosage may be important factors in identification of the causal drug. The use of benzodiazepines can be optimized by taking into account potency, time of action and the different syndromes encountered after withdrawal. Following long-term use problems of relapse and rebound are being increasingly recognized, in addition to organic withdrawal symptoms. In psychiatric patients extrapyramidal disorders due to neuroleptics are common. The rates of these ADRs differ markedly between various drugs, even after dosages and co-medications are taken into account. Epidemiological screening for potentially carcinogenic drugs can only be done in large cohorts of patients with pre-recorded full information sets as may be found in an HMO (Health Maintenance Organization). The findings of several such studies have been published in specialist cancer journals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

The relationship between the quality of prescribing and practice appointment rates with asthma management data in those admitted to hospital due to an acute exacerbation.

Specific targeting of patients with a previous asthma hospitalisation could be more focused if predictors could be identified. This study was an observational retrospective analysis using ridge and linear multivariate regression analysis. Patient asthma management data were extracted from the hospital and general practice notes of those that had been admitted with an acute exacerbation of their asthma over a 5-year period. From the prescribing data, the annual doses of preventer (P) and reliever (R) medication were converted to defined daily doses then divided to give a P:R ratio. Preliminary statistical analysis was used to identify any association between either the P:R ratio or for the number of general practitioner (GP) practice appointments (PA) and their asthma management data. Multivariate regression analysis was applied to the P:R ratio and to PA to determine a model between each of these and asthma management data/events. GPs gave consent to access the data of 115 (out of 440) asthmatics, age >5 years, admitted to a district general hospital for asthma exacerbations between 1994 and 1998. The multivariate analysis revealed that PA was associated with oral prednisolone rescue courses (PRCs) and age whilst the P:R ratio was associated to PRCs and more reliever usage but not preventers. Patients with low preventer usage with respect to their reliever medication should be targeted for medication review as these were the patients prescribed more prednisolone courses and their increased PAs reflect this. This could decrease visits to the doctor and acute exacerbations.

Acute Disease↗
PubMed2003

Centralized oversight for clinical performance improvement: a pilot initiative at the Lexington VAMC.

BACKGROUND: In July 2000 the Lexington Veterans Affairs Medical Center (Lexington, Ky) centralized oversight of clinical performance improvement (CPI) activities by creating an office of clinical operations (OCO) to improve patient care and operational efficiency. The OCO was designed to eliminate redundancy of effort, correct resource underuse and overuse, and improve the communication of change initiatives and successes. Before 2000 no formal process existed for creating interdisciplinary CPI teams. Lack of organizational oversight for CPI activities had also led to duplication of effort, mixed accountability, and difficulty in remaining focused on organizational goals. CREATING THE OCO: OCO staff have led and facilitated numerous projects, all of which involved interdisciplinary teams consisting of physician and nurse leaders, users, and support staff. The OCO has also developed a utilization management plan for the entire medical center. The OCO formally interfaces with three major arenas of medical center operation: clinical processes, patient safety, and cost-efficiency. CHALLENGES AND LESSONS LEARNED: A major effort of OCO staff has been to learn about data availability and access and to determine how data can be used in a meaningful way to benefit CPI project teams. The creation of the OCO precipitated the typical cultural integration problems that are often encountered with the introduction of new organizational entities that lack existing turf.

Centralized Hospital Services↗
PubMed2006

Data collection on patients in emergency departments in Canada.

OBJECTIVE: Relatively little is known about the ability of Canadian emergency departments (EDs) and the federal, provincial and territorial governments to quantify ED activity. The objectives of this study were to determine the use of electronic patient data in Canadian EDs, the accessibility of provincial data on ED visits, and to identify the data elements and current methods of ED information system (EDIS) data collection nationally. METHODS: Surveys were conducted of the following 3 groups: 1) all ED directors of Canadian hospitals located in communities of >10,000 people, 2) all electronic EDIS vendors, and 3) representatives from the ministries of health from 13 provincial and territorial jurisdictions who had knowledge of ED data collection. RESULTS: Of the 243 ED directors contacted, 158 completed the survey (65% response rate) and 39% of those reported using an electronic EDIS. All 11 EDIS vendor representatives responded. Most of the vendors provide a similar package of basic EDIS options, with add-on features. All 13 provincial or territorial government representatives completed the survey. Nine (69%) provinces and territories collect ED data, however the source of this information varies. Five provinces and territories collect triage data, and 3 have a comprehensive, jurisdiction-wide, population-based ED database. Thirty-nine percent of EDs in larger Canadian communities track patients using electronic methods. A variety of EDIS vendor options are available and used in Canada. CONCLUSION: The wide variation in methods and in data collected presents serious barriers to meaningful comparison of ED services across the country. It is little wonder that the majority of information regarding ED overcrowding in Canada is anecdotal, when the collection of this critical health information is so variable. There is an urgent need to place the collection of ED information on the provincial and national agenda and to ensure that the collection of this information consistent, comprehensive and mandatory.

Canada↗