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PubMed1977

The evolution of a functional real-time laboratory records retrieval and archival system.

The vast flood of information resulting from medical record keeping in a clinical laboratory must be cataloged and archived. To deal with this problem we designed an approach employing automated report generation by a laboratory computer, data base management of patient laboratory results, and automated microform generation via computer output microform (COM). This paper documents the steps that led to the system we are currently employing. The system described maintains the availability of current patient laboratory data, creates a microform archive and an on-line index, and serves as the data base for research inquiries. In addition, we have experienced a cost savings over manual procedures and now possess the capability of expansion without the costly addition of personnel.

Archives↗
PubMed2004

Methods for automated concept mapping between medical databases.

The retrieval and exchange of information between medical databases is often impeded by the semantic heterogeneity of concepts contained within the databases. Manual identification of equivalent database elements consumes time and resources, and may often be the rate-limiting technological step in integrating disparate data sources. By employing semantic networks as an intermediary representation of the native databases, automated mapping algorithms can identify equivalent concepts in disparate databases. The algorithms take advantage of the conceptual "context" embodied within a semantic network to produce candidate concept mappings. The performance of automated concept mapping was evaluated by creating semantic network representations for two test laboratory databases. The mapping algorithms identified all equivalent concepts that were present in the databases, and did not leave any equivalent concepts unmapped. The utilization of conceptual context to perform automated concept mapping facilitates the identification of equivalent database concepts and may help decrease the work and costs associated with retrieval and integration of information from disparate databases.

Algorithms↗
PubMed2001

Effective mapping of biomedical text to the UMLS Metathesaurus: the MetaMap program.

The UMLS Metathesaurus, the largest thesaurus in the biomedical domain, provides a representation of biomedical knowledge consisting of concepts classified by semantic type and both hierarchical and non-hierarchical relationships among the concepts. This knowledge has proved useful for many applications including decision support systems, management of patient records, information retrieval (IR) and data mining. Gaining effective access to the knowledge is critical to the success of these applications. This paper describes MetaMap, a program developed at the National Library of Medicine (NLM) to map biomedical text to the Metathesaurus or, equivalently, to discover Metathesaurus concepts referred to in text. MetaMap uses a knowledge intensive approach based on symbolic, natural language processing (NLP) and computational linguistic techniques. Besides being applied for both IR and data mining applications, MetaMap is one of the foundations of NLM's Indexing Initiative System which is being applied to both semi-automatic and fully automatic indexing of the biomedical literature at the library.

Abstracting and Indexing↗
PubMed2000

Radiologist's clinical information review workstation interfaced with digital dictation system.

Efficient access to information systems integrated into the radiologist's interpretation workflow will result in a more informed radiologist, with an enhanced capability to render an accurate interpretation. We describe our implementation of radStation, a radiologist's clinical information review workstation that combines a digital dictation station with a clinical information display. radStation uses client software distributed to the radiologist's workstation and central server software, both running Windows NT (Microsoft, Redmond, WA). The client system has integrated digital dictation software. The bar-code microphone (Boomerang, Dictaphone Corp, Stratford, CT) also serves as a computer input device forwarding the procedure's accession number to the server software. This initiates multiple queries to available legacy databases, including the radiology information system (RIS), laboratory information system, clinic notes, hospital discharge, and operative report system. The three-tier architecture then returns the clinical results to the radStation client for display. At the conclusion of the dictation, the digital voice file is transferred to the dictation server and the client notifies the RIS to update the examination status. The system is efficient in its information retrieval, with queries displayed in about 1 second. The radStation client requires less than 5 minutes of radiologist training in its operation, given that its control interface integrates with the well-learned dictation process. The telephone-based dictation system, which this new system replaced, remains available as a back-up system in the event of an unexpected digital dictation system failure. This system is well accepted and valued by the radiologists. The system interface is quickly mastered. The system does not interrupt dictation workflow with the display of all information initiated with examination bar-coding. This system's features could become an accepted model as a standard tool for radiologists.

Data Collection↗
PubMed2005

Resolving abbreviations to their senses in Medline.

MOTIVATION: Biological literature contains many abbreviations with one particular sense in each document. However, most abbreviations do not have a unique sense across the literature. Furthermore, many documents do not contain the long forms of the abbreviations. Resolving an abbreviation in a document consists of retrieving its sense in use. Abbreviation resolution improves accuracy of document retrieval engines and of information extraction systems. RESULTS: We combine an automatic analysis of Medline abstracts and linguistic methods to build a dictionary of abbreviation/sense pairs. The dictionary is used for the resolution of abbreviations occurring with their long forms. Ambiguous global abbreviations are resolved using support vector machines that have been trained on the context of each instance of the abbreviation/sense pairs, previously extracted for the dictionary set-up. The system disambiguates abbreviations with a precision of 98.9% for a recall of 98.2% (98.5% accuracy). This performance is superior in comparison with previously reported research work. AVAILABILITY: The abbreviation resolution module is available at http://www.ebi.ac.uk/Rebholz/software.html.

Abbreviations as Topic↗
PubMed2003

Rapid prototyping strategy for a surgical data warehouse.

OBJECTIVES: Healthcare processes typically generate an enormous volume of patient information. This information largely represents unexploited knowledge, since current hospital operational systems (e.g., HIS, RIS) are not suitable for knowledge exploitation. Data warehousing provides an attractive method for solving these problems, but the process is very complicated. This study presents a novel strategy for effectively implementing a healthcare data warehouse. METHODS: This study adopted the rapid prototyping (RP) method, which involves intensive interactions. System developers and users were closely linked throughout the life cycle of the system development. The presence of iterative RP loops meant that the system requirements were increasingly integrated and problems were gradually solved, such that the prototype system evolved into the final operational system. RESULTS: The results were analyzed by monitoring the series of iterative RP loops. First a definite workflow for ensuring data completeness was established, taking a patient-oriented viewpoint when collecting the data. Subsequently the system architecture was determined for data retrieval, storage, and manipulation. This architecture also clarifies the relationships among the novel system and legacy systems. Finally, a graphic user interface for data presentation was implemented. CONCLUSIONS: Our results clearly demonstrate the potential for adopting an RP strategy in the successful establishment of a healthcare data warehouse. The strategy can be modified and expanded to provide new services or support new application domains. The design patterns and modular architecture used in the framework will be useful in solving problems in different healthcare domains.

Colorectal Surgery↗
PubMedDate not supplied

Automated data entry and retrieval for health-care management.

The development and implementation of a unique system for medical information management are described. An automated, optically scanned data entry system (OpScan) was combined with a generalized, interactive, storage and retrieval system, the Medical Information Management System (MIMS). OpScan-MIMS operates via a time-share system and requires minimal acquisition and maintenance of hardware. The primary advantages of OpScan-MIMS are its efficient and rapid method for data entry, lack of requirement for technical skills, user-generated programs, and cost-effectiveness. OpScan-MIMS has been utilized in a clinic for sexually transmitted diseases for immediate audit of medical records, monitoring of quality-assurance systems, retrieval of data for statistical analysis and clinic management, and as a teaching instrument for medical and paramedical trainees. Further applications to other systems of health-care management are being developed.

Community Health Centers↗
PubMed2003

Method for automatic management of the semantic network ambiguity in the UMLS: possible application for information retrieval on the Web.

The Unified Medical Language System (UMLS) is an extensive collection of terms and concepts. The UMLS includes biomedical terms from standard classifications. The semantic network (SN) links the concepts, sometimes ambiguously. In this paper we try, on one hand to describe the relationship between concepts more efficiently and on the other hand to find new relationships. Assuming that re-usability and automatic extraction of knowledge from existing thesaurus enables an improvement of the metatheasaurus, we cross the SN with linked concepts from the ADM (Assisted Medical Diagnosis). Results are presented and our discussion concerns firstly the use of the SN only; secondly the improvement that allows pre-selection of linked concepts, and thirdly the possibility to coincide with other developments that improve the metathesaurus.

Electronic Data Processing↗
PubMed1996

Radical improvements in the display of clinical microbiology results: a Web-based clinical information system.

OBJECTIVE: To evaluate the performance of a novel computerized system for reporting clinical microbiology results. The new system provides a summarized overview of a patient's current (or past) microbiological status, with the option to selectively explore in greater depth. It is deployed using World Wide Web technology, which supports virtually any kind of computer and allows physicians to obtain results via the internet using personal computers in the office or at home. METHODS: In an unblinded crossover study at a university-affiliated medical center, participants used both the new system and a conventional display system to retrieve selected microbiology results for two actual patients, according to standardized questionnaires, with balanced allocation of sequence of system use. Participants also subjectively rated the two systems. The participants were 16 physician, pharmacist, and nurse volunteers. Outcome measures included completion time and number of errors (categorized as major and minor) associated with results retrieval, and participants' ratings of the new system. RESULTS: Mean completion time was 45% shorter (13.9 versus 25.5 minutes; P < 0.001), and there were fewer associated major errors (0 versus 13; P = 0.01) and minor errors (10 versus 21; P = 0.003) with the summarized display system. All participants rated the new system as easier to learn and use than the conventional system. CONCLUSIONS: A system that appropriately summarizes and groups microbiology results can significantly shorten retrieval times and reduce interpretive errors, while providing users with information needed for cost-effective therapy. Such a system can be deployed by leveraging the rapidly evolving technology of the World Wide Web.

Academic Medical Centers↗
PubMed1997

Dynamic organization of search results using the UMLS.

When people search the medical literature, they often are overwhelmed by the large number of documents retrieved. Many systems try to solve this problem by helping the user formulate a more specific search strategy. However, when users do not have a more specific question, they need tools to help them explore and understand the results, rather than to eliminate a portion of those results. This paper describes an approach that addresses this need by automatically grouping the results of a broad search into meaningful categories based on the user's query. This approach combines the main benefit of clustering techniques with the main benefit of classification techniques by taking advantage of the domain knowledge present in the UMLS. I present a preliminary evaluation that demonstrates that a categorization produced by this approach corresponds reasonably well to a physician's categorization.

Computer Systems↗
PubMed2004

Population-based incremental interactive concept learning for image retrieval by stochastic string segmentations.

We propose a method for concept-based medical image retrieval that is a superset of existing semantic-based image retrieval methods. We conceive of a concept as an incremental and interactive formalization of the user's conception of an object in an image. The premise is that such a concept is closely related to a user's specific preferences and subjectivity and, thus, allows to deal with the complexity and content-dependency of medical image content. We describe an object in terms of multiple continuous boundary features and represent an object concept by the stochastic characteristics of an object population. A population-based incrementally learning technique, in combination with relevance feedback, is then used for concept customization. The user determines the speed and direction of concept customization using a single parameter that defines the degree of exploration and exploitation of the search space. Images are retrieved from a database in a limited number of steps based upon the customized concept. To demonstrate our method we have performed concept-based image retrieval on a database of 292 digitized X-ray images of cervical vertebrae with a variety of abnormalities. The results show that our method produces precise and accurate results when doing a direct search. In an open-ended search our method efficiently and effectively explores the search space.

Algorithms↗
PubMed2001

Managing predefined templates and macros for a departmental speech recognition system using common software.

The authors have developed a networked database system to create, store, and manage predefined radiology report definitions. This was prompted by complete departmental conversion to a computer speech recognition system (SRS) for clinical reporting. The software complements and extends the capabilities of the SRS, and 2 systems are integrated by means of a simple text file format and import/export functions within each program. This report describes the functional requirements, design considerations, and implementation details of the structured report management software. The database and its interface are designed to allow all radiologists and division managers to define and update template structures relevant to their practice areas. Two key conceptual extensions supported by the template management system are the addition of a template type construct and allowing individual radiologists to dynamically share common organ system or modality-specific templates. In addition, the template manager software enables specifying predefined report structures that can be triggered at the time of dictation from printed lists of barcodes. Initial experience using the program in a regional, multisite, academic radiology practice has been positive.

Computer Peripherals↗
PubMed1989

Image management and communication in patient care: perspectives on implementation and impact.

Image management and communication (IMAC) systems are automated and integrated systems that capture digital medical images and related patient information and transmit them electronically, display them for interpretation, and store them for future retrieval. The IMAC system concept includes images and relevant information from all clinical sources. The First International Conference on Image Management and Communication in Patient Care (IMAC 89) provides a forum for expert presentations, poster sessions, and discussion and debate among all attendees interested in the implementation and impact of IMAC systems. Plenary sessions provide an international perspective and explore the role of image-based information in patient care, approaches to improved IMAC systems, current technical barriers, quality of care issues, evaluation approaches, and scenarios for the future. Invited participants are from North America, Europe, Japan, Australia, and the WHO. Conference organizers are working with numerous professional organizations and representatives of meetings which focus on IMAC-related technology to complement, and not duplicate, the contribution of other groups.

Delivery of Health Care↗