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ONTOFUSION: ontology-based integration of genomic and clinical databases.

ONTOFUSION is an ontology-based system designed for biomedical database integration. It is based on two processes: mapping and unification. Mapping is a semi-automated process that uses ontologies to link a database schema with a conceptual framework-named virtual schema. There are three methodologies for creating virtual schemas, according to the origin of the domain ontology used: (1) top-down--e.g. using an existing ontology, such as the UMLS or Gene Ontology--, (2) bottom-up--building a new domain ontology-- and (3) a hybrid combination. Unification is an automated process for integrating ontologies and hence the database to which they are linked. Using these methods, we employed ONTOFUSION to integrate a large number of public genomic and clinical databases, as well as biomedical ontologies.

Data Collection↗

Tomaso Poggio.

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Career Choice↗

Health dialog systems for patients and consumers.

There is a growing need for automated systems that can interview patients and consumers about their health and provide health education and behavior change interventions using natural language dialog. A number of these health dialog systems have been developed over the last two decades, many of which have been formally evaluated in clinical trials and shown to be effective. This article provides an overview of the theories, technologies and methodologies that are used in the construction and evaluation of these systems, along with a description of many of the systems developed and tested to date. The strengths and weaknesses of these approaches are also discussed, and the needs for future work in the field are delineated.

Communication↗

Simulation of cardiac excitation patterns in a three-dimensional anatomical heart atlas.

Computerized anatomical atlas systems enable interactive investigation of digital body models. Here we present a three-dimensional atlas of the human heart, based on image data provided in the Visible Human Project. This heart atlas consists of multiple kinds of cardiac tissues and offers unlimited possibilities for its visual exploration. A temporal dimension is added to the underlying heart model by simulation of cardiac excitation spreading. For this purpose a second generation cellular automata algorithm is adapted to the excitation kinetics of cardiac tissue. The presented system is shown as a successful method for the visualization-based investigation of cardiac excitation.

Algorithms↗

The Human Brain Project: neuroinformatics tools for integrating, searching and modeling multidisciplinary neuroscience data.

What is neuroinformatics? What is the Human Brain Project? Why should you care? Supported by a consortium of US funding agencies, the Human Brain Project aims to bring to the analysis of brain function the same advantages of Internet-accessible databases and database tools that have been crucial to the development of molecular biology and the Human Genome Project. The much greater complexity of neural data, however, makes this a far more challenging task. As a pilot project in this new initiative, we review some of the progress that has been made and indicate some of the problems, challenges and opportunities that lie ahead.

Brain↗

Developers and evaluation of interactive health communication applications. The Science Panel on Interactive Communications and Health.

BACKGROUND: Developers of Interactive Health Communication (IHC) are capable of providing great benefit by creating interactive programs that serve to protect and improve health. Conducting proper evaluation of these programs will ensure that they achieve these goals more successfully. CONCLUSIONS: This article seeks to inform developers of IHC about which types of evaluation are most important to include as a part of the development process and to examine the ways in which such evaluation can be implemented to benefit the producers--and ultimately, the consumers--of IHC.

Community Participation↗

Multiple representations and multi-modal reasoning in medical diagnostic systems.

The paper examines the motivations for developing medical diagnostic systems exploiting multiple representations and multi-modal reasoning. The analysis is carried on by revisiting the architectural choices of the CHECK system (developed in late 1980s) which combined heuristic and causal knowledge. The results in the theory of diagnosis and in model-based reasoning (MBR) obtained in early 1990s are used for providing a formal characterization of the notion of diagnosis and of the reasoning mechanisms used in CHECK. The paper addresses also the problem of replacing heuristic knowledge provided by human experts with operational knowledge automatically derived from the deep model. In particular, the pros and cons of knowledge compilation and of the integration of case-based reasoning (CBR) with MBR are discussed by summarizing the experience gained in developing AID and ADAPtER. The problem of using an explicit representation of time in diagnostic systems is analyzed and recent work on the different characterizations of diagnosis arising when the temporal dimension is considered is reported. Finally, the implications of the results obtained in MBR and in temporal reasoning on the future of medical diagnostic systems are briefly discussed.

Artificial Intelligence↗

Architecture for networked electronic patient record systems.

There have been two major approaches to the development of networked electronic patient record (EPR) architecture. One uses object-oriented methodologies for constructing the model, which include the GEHR project, Synapses, HL7 RIM and so on. The second approach uses document-oriented methodologies, as applied in examples of HL7 PRA. It is practically beneficial to take the advantages of both approaches and to add solution technologies for network security such as PKI. In recognition of the similarity with electronic commerce, a certificate authority as a trusted third party will be organised for establishing networked EPR system. This paper describes a Japanese functional model that has been developed, and proposes a document-object-oriented architecture, which is-compared with other existing models.

Computer Communication Networks↗

User requirements specifications: a hierarchical structure covering strategical, tactical and operational requirements.

The present study is a long-term review and follow-up on conclusions and recommendations on the role and contents of a User Requirements Specification Document (URD) from a previous in-depth case study. The follow-up comprises a succession of investigations and two case studies to explore the role and contents of a URD within systems development and assessment, thereby gradually extending and refining the original recommendations. Finally, the recommended three-layered structure and approach for a URD were applied in full scale within a real-life project, in which the URD serves as the basis for a Call for Tender. The preparation was entirely user-driven with the aid of a consultant for four man months. The present paper outlines the essence of the approach and the outcome of applying the recommended structure, with numerous examples of the implications.

Clinical Laboratory Information Systems↗

Cased-Based Reasoning for medical knowledge-based systems.

In this paper we present the results of the MIE/GMDS-2000 Workshop 'Case-Based Reasoning for Medical Knowledge-based Systems'. While in many domains Cased-Based Reasoning (CBR) has become a successful technique for knowledge-based systems, in the medical field attempts to apply the complete CBR cycle are rather exceptional. Some systems have recently been developed, which on the one hand use only parts of the CBR method, mainly the retrieval, and on the other hand enrich the method by a generalisation step to fill the knowledge gap between the specificity of single cases and general rules. And some systems rely on integrating CBR and other problem solving methodologies. In this paper we discuss the appropriateness of CBR for medical knowledge-based systems, point out problems, limitations and possible ways to cope with them.

Artificial Intelligence↗

Evaluation of health information systems-problems and challenges.

OBJECTIVES: Information technology (IT) is emerging in health care. A rigorous evaluation of this technology is recommended and of high importance for decision makers and users. However, many authors report problems during the evaluation of information technology in health care. In this paper, we discuss some of these problems, and propose possible solutions for these problems. METHODS: Based on own experience and backed up by a literature review, some important problems during IT evaluation in health care together with their reasons, consequences and possible solutions are presented and structured. RESULTS AND CONCLUSIONS: We define three main problem areas-the complexity of the evaluation object, the complexity of an evaluation project, and the motivation for evaluation. Many evaluation problems can be subsumed under those three problem areas. A broadly accepted framework for evaluation of IT in healthcare seems desirable to address those problems. Such a framework should help to formulate relevant questions, to find adequate methods and tools, and to apply them in a sensible way.

Attitude to Computers↗

Implementing information technology in a behavioral health setting.

The art and practice of nursing in today's health care arena is becoming increasingly complex. One of the newest challenges in the field of behavioral health is the integration of quality health care with information technology. The authors of this paper examine four emerging aspects of information technology: the electronic medical record, automated medication distribution systems, computerized charting, and hand-held computers. The benefits, costs, uses of these technologies, and the potential problems they can provide in the field of behavioral health are discussed. Implications for nursing practice also are explored.

Behavioral Medicine↗

Evolving telemedicine/ehealth technology.

This paper describes emerging technologies to support a rapidly changing and expanding scope of telemedicine/telehealth applications. Of primary interest here are wireless systems, emerging broadband, nanotechnology, intelligent agent applications, and grid computing. More specifically, the paper describes the changes underway in wireless designs aimed at enhancing security; some of the current work involving the development of nanotechnology applications and research into the use of intelligent agents/artificial intelligence technology to establish what are termed "Knowbots"; and a sampling of the use of Web services, such as grid computing capabilities, to support medical applications. In addition, the expansion of these technologies and the need for cost containment to sustain future health care for an increasingly mobile and aging population is discussed.

Algorithms↗

Mapping variation in brain structure and function: implications for rehabilitation.

The recognition of structural and functional variability of the human brain promoted the development of a system to organize and analyze the rapidly growing body of knowledge acquired among diverse disciplines. The Human Brain Project (HBP) was initiated and has evolved as a means of establishing an information infrastructure through tools related to the emerging science of neuroinformatics. This article will briefly describe the implications that such an endeavor has for the field of traumatic brain injury (TBI) rehabilitation.

Brain↗

Integrated visualization of problemcentric urologic patient records.

The collision of computer-based technologies and the medical environment is resulting in an increasingly electronic multimedia patient record, consisting of not only the traditional types of data (e.g., clinic notes and laboratory reports), but also digital images (e.g., computed tomography and magnetic resonance imaging) and other visual representations of patient data (e.g., pulmonary function graphs and urodynamic charts). Given the increasing amount of data made available to physicians, it is not only critical that the totality of a patient's medical record be accessible to a clinician, but that the diverse data be integrated and presented in a manner conducive to patient management: key information should be easily discovered. This paper describes a problemcentric time-based visualization of urologic conditions, whereby a patient's medical history is automatically organized around a medical problem and presented as a graphic chronology. Urology-related data in the patient medical record is organized in accord with an expert constructed knowledge-base, and plotted on a timeline using iconic representations. The user interface permits the physician to quickly view multimedia data and to visualize relationships between events in the patient's history.

Computer Systems↗