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PubMed1992

Dynamic arrays for fast, efficient, data manipulation during image analysis: a new software tool for exploratory data analysis.

Memory reallocation is used to construct a run-time data structure for fast/efficient storage of information during collection and analysis. The data structure presented uses dynamic memory but does not require the use of pointers to link nodes of information together. It allows for simple and efficient access to data via array indexing rather than through the use of lists or tree structures and it provides flexibility for competing storage requirements that are determined dynamically. The data structure is developed in the C programming language and a suite of ANSI standard C subroutines that make up a run-time data structure management system is provided.

Abstracting and Indexing↗
PubMed1999

DRGs and inequities among French hospitals: from a new dilemma to another health care policy.

The unpredictable French health care reform of 1995-96 introduced casemix tools to fund French hospitals at a regional level. After two years (1997-98), health care authorities and hospitals are facing great inequities and inefficiencies (1 to 3) in 22 French regions. Only one region (Ile de France, Paris) is above the national casemix index mean, the Index Synthétique d' Activité, and very few are equal to this national mean. The dilemma for most of the 22 regions under this national mean, and within a region like Rhône-Alpes (Saint Etienne), with inequities from 1 to 2, is to decide whether the main goal of the new health care policy is to reduce inequities and inefficiencies.

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PubMed1982

The measurement of hospital case mix.

This paper describes the design and preliminary results of research being conducted by Blue Cross of Western Pennsylvania to measure hospital case mix. The model of patient management used in this research interrelates symptoms, diagnosis and treatment. Analyses of detailed patient data have indicated that patient classifications that are based on discharge diagnosis, singly or in combination with other variables such as secondary or multiple diagnoses, procedure and age, do not necessarily result in patient categories that require similar management or similar hospital services. Patients who are clinically similar, and even the same patient, can have a number of diverse, but appropriate, reasons for being in the hospital, and their use of hospital resources in each hospital episode will differ accordingly. The implications of including all reasons for hospitalizing these patients under the same rubric are clear: the resultant category would not be homogeneous with respect to resource use or hospital costs. Any case-mix index constructed using such categories as its basis could not only be misleading, but could also be financially damaging or extremely profitable to selected hospitals if used in hospital reimbursement. Both the model presented and preliminary analysis will be useful in designing other strategies for research and application in the area of case mix.

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PubMed2005

1 to 100: creating an air quality index in Pittsburgh.

Air pollution indices and other environmental quality indicators have often been subjects of debate. This article presents a case study of the creation and criticism of an air pollution index in Pittsburgh, Pennsylvania. Long known for its industrial production and the resulting pollution, Pittsburgh was home to engineers, scientists, institutions and corporations that developed new air pollution monitoring technologies in the years after World War II. These newly automated instruments were used as a part of a computerized monitoring network built in the late 1960s by the Allegheny County Health Department. County engineers created a daily air pollution index to summarize the information from the network, leading to public debates over the intent, meaning, and representation of air quality data. This case study serves to illustrate the inherent complexity of creating accessible, understandable, and uniformly acceptable indices of environmental quality. It also emphasizes the importance of understanding the social and political context in which data is collected, organized, and interpreted.

Abstracting and Indexing↗
PubMed1994

Learning and discovery from a clinical database: an incremental concept formation approach.

The main interest of this research is to discover clinical implications from a large PTCA (Percutaneous Transluminal Coronary Angioplasty) database. A case-based concept formation model D-UNIMEM, a modified version of Lebowitz's UNIMEM, is proposed for this purpose. In this model, we integrated two kinds of class memberships: the feature-disjunction class membership and the index-conjunction class membership. The former is a polythetic clustering approach and serves at the early stage of concept formation. The latter allows only relevant instances to be placed in the same cluster and serves as the later stage of concept formation. D-UNIMEM could extract interesting correlations among features from the learned concept hierarchy.

Abstracting and Indexing↗
PubMed2005

Caroline Herschel: 'the unquiet heart'.

Caroline Herschel was famous in her own time as the discoverer of eight comets, but of even greater significance was the help she gave her brother William in his exploration of 'the construction of the heavens'. She acted as his amanuensis during night watches, wrote up neat copies of their observing records and prepared his papers for publication. She also compiled an index to John Flamsteed's Star Catalogue, which was published by the Royal Society at its own expense, and after William's death she reorganized his catalogues of nebulae so that his son John could revise his father's work. Yet Caroline's was a hard and largely loveless life, for which she found the recognition that came her way a scant consolation.

Abstracting and Indexing↗
PubMed2005

Normative values for thumb length, girth, and width in the pediatric population.

PURPOSE: To determine the normal relative length, girth, and nail width of the pediatric thumb with respect to the index finger in children ages 1 through 18 years. METHODS: Measurements of relative thumb length, girth, and nail width were performed on 546 hands in 273 volunteers ages 1 through 18 years. At least 22 hands were included for each age group. The data were analyzed by age, gender, and hand, with the thumb compared with the index finger for all measurements. RESULTS: The adducted thumb tip reached an average of 70% of the length of the index finger proximal phalanx and 32% of the length of the index finger from the metacarpophalangeal joint to its tip. The thumb girth and nail width as a percentage of corresponding levels of the index finger girth and nail width were 133% and 105%, respectively. Relative thumb size remained constant with no significant difference in length, width, or girth between age groups. CONCLUSIONS: The relative size of the thumb remains constant during growth. These normative data will allow a more objective assessment of thumb size and appearance.

Abstracting and Indexing↗
PubMed2003

An inventory of publications on computer-based medical records: an update.

OBJECTIVES: In 1998, we reported a steady increase in the number of publications indexed in MedLine with the MeSH term 'Medical Records Systems, Computerized'. No signs indicating an increasing interest of high-impact medical journals to publish on the computer-based patient record could be determined. In this review we provide an update. METHODS: We retrieved and analyzed all English publications indexed before Feb 22, 2002 in PubMed with the MeSH term 'Medical Records Systems, Computerized'. RESULTS: We retrieved a total of 5856 publications, of which 1824 (31%) appeared in a journal with an impact factor in the year of publication. The total impact-score shows an upward trend. CONCLUSIONS: The results show that the earlier observed increase in number of publications did not persist in the second half of the nineteen-nineties. Since the mid-nineties, there has been a steady yearly production of publications indexed with the MeSH term, reflecting a sustained interest in the domain. However, the volume of publications appearing in journals with higher impact factors is increasing. Furthermore, high-impact journals, such as the "British Medical Journal", the "Lancet" and "Annals of Internal Medicine" regularly publish on the subject, reflecting an interest well beyond the medical informatics community.

Abstracting and Indexing↗
PubMed2002

Qualitative and quantitative measures of indexed health sciences electronic journals.

CONTEXT: Little is known about qualitative and quantitative characteristics of indexed health sciences electronic journals (e-journals). METHODS: To determine peer-review practices and qualitative and quantitative characteristics of different types of indexed health sciences e-journals, 3 types of e-journals indexed in MEDLINE were compared (type 1, completely electronic with no print counterpart; type 2, print and electronic versions with the same title but each publishing some unique content; and type 3, print and electronic versions containing equal content). RESULTS: There were 13 type 1 journals, 16 type 2 journals, and 16 type 3 journals. Most journals in each category (85%-94%) imply or state the use of peer review. Significant differences (P<.05, analysis of variance) exist among the e-journals for the inclusion of complex types of publications (clinical trials, randomized controlled trials, meta-analyses, and practice guidelines) (15%-100%), editorials (0%-75%), letters to the editor (10%-88%), and case reports (17%-94%); the average number of items indexed in MEDLINE (22.5-544.5); and the number of complex publication types, editorials, letters, and case reports. CONCLUSIONS: Type 1 e-journals do not have the qualitative or quantitative complexity of traditional print journals. Although editors' statements on editorial peer review are similar, there are differences in number and type of materials included in the 3 different types of e-journals.

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PubMed2002

Can we tell how a community was constructed? A comparison of five evenness indices for their ability to identify theoretical models of community construction.

Evenness indices provide a simple measure of community structure. It might therefore be possible to use them to identify the process by which a community has been assembled. To test whether this is practicable, we constructed simulated community samples using five stochastic models of community construction, proposed by Tokeshi. We then examined the ability of five evenness indices to identify the model under which the community samples were produced. Each model produced samples with a range of evenness values, but mean evenness differed between the models. The dominance decay (DD) model produced community samples with the greatest evenness, followed by MacArthur fraction (MF). Evenness was lowest under the dominance pre-emption (DP) model. The differences between models were quite consistent across indices and consistent between 5-species and 15-species communities. Samples produced under the DD and MF models varied least in evenness between 5-species and 15-species samples, and those produced under the random assortment (RA) model varied most, irrespective of the evenness index used. Evenness varied considerably between replicate samples, as expected with stochastic processes. In 5-species communities, the greatest robustness in evenness across replicates was seen using indices O or E'. In 15-species communities, O and E(Q) were the most robust. The index best able to identify the model which had generated the sample differed between models and with species richness. If the model of interest is not known in advance, the best index for identifying the generating model is E(var) for communities of more than 10 species for RF, RA and DP models and O for other communities. The number of samples required in a data set before it could be effectively identified was, for example, more than 30 for 5-species samples produced under the random fraction (RF) model, and 3 for 15-species RF samples. In contrast, a 5-species DD data set could be effectively identified when it contained 15 or more samples. We conclude that evenness can be used to identify the process by which the community has been constructed, out of the five models considered here. The best evenness index for doing this varies with the species richness and the evenness of the community but we can suggest the use of O without knowing the model because its the more stable one against species richness and the more robust and unbiased against simulated samples and it encompass a good discriminating power between the models in most of the cases studied.

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PubMed1990

Medicaid prospective payment: case-mix increase.

South Carolina Medicaid implemented prospective payment by diagnosis-related group (DRG) for inpatient care. The rate of complications among newborns and deliveries doubled immediately. The case-mix index for newborns increased 66.6 percent, which increased the total Medicaid hospital expenditure 5.5 percent. Outlier payments increased total expenditure further. DRG distribution change among newborns has a large impact on spending because newborn complication DRGs have high weights. States adopting a DRG-based payment system for Medicaid should anticipate a greater increase in case mix than Medicare experienced.

Abstracting and Indexing↗
PubMed1991

Measuring hospital input price increases: the rebased hospital market basket.

The input prices indexes used in part to set payment rates for Medicare inpatient hospital services in both prospective payment system (PPS) and PPS-excluded hospitals were rebased from 1982 to 1987 beginning with payments for fiscal year 1991. In this article, the issues and evidence used to determine the composition of the revised hospital input price indexes are discussed. One issue is the need for a separate market basket for PPS-excluded hospitals. Also, the payment implications of using hospital-industry versus economywide measures of wage rates as price proxies for the growth in hospital wage rates are addressed.

Abstracting and Indexing↗
PubMed1992

Words, concepts, or both: optimal indexing units for automated information retrieval.

What is the best way to represent the content of documents in an information retrieval system? This study compares the retrieval effectiveness of five different methods for automated (machine-assigned) indexing using three test collections. The consistently best methods are those that use indexing based on the words that occur in the available text of each document. Methods used to map text into concepts from a controlled vocabulary showed no advantage over the word-based methods. This study also looked at an approach to relevance feedback which showed benefit for both word-based and concept-based methods.

Abstracting and Indexing↗
PubMed2004

[German language articles on controlled trials in oral and maxillofacial surgery].

Various authors have shown that only a part of all reports of randomized controlled trials (RCTs) and controlled clinical trials (CCTs) are accessible in Medline. However, the validity of systematic reviews and meta-analyses heavily depends on the completeness of the identified studies published for a particular clinical problem. Therefore, an additional manual search in dental/medical journals is often indispensable. The major purpose of the present article was to identify all published reports of RCTs and CCTs dealing with topics covered by the discipline oral and maxillofacial surgery. The journals Deutsche Zahnärztliche Zeitschrift, Schwetzer Monatsschrift für Zahnmedizin, Mund-, Kiefer- und Gesichtschirurgie, Stomatologie, and Stomatologie der DDR were manually searched. The publication type of the identified clinical trial reports was determined and compared with Medline. Among the 14,860 articles perused, 202 RCTs and 396 CCTs were identified. 74 RCTs (36.6%) and 104 CCTs (26.2%) referred to topics related to oral and maxillofacial surgery. Of the 74 RCT reports, 44 are included in Medline, and 14 are indexed with the correct publication type term. The majority of RCTs were carried out in the field of oral and maxillofacial surgery. Unfortunately, only a part of German-language reports of dental clinical trials are accessible in Medline. Therefore, a literature search restricted to this database is likely to be incomplete, possibly leading to biased results.

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PubMed1966

The recurring bibliographies program of MEDLARS.

Recurring bibliographies are by-products of the MEDLARS system which are prepared by the National Library of Medicine in collaboration with nonprofit scientific and professional societies and institutions and government agencies that represent a specialty area of biomedical research or practice. The sponsor generally assumes responsibility for the costs of publication and distribution. At present MEDLARS has a planned capacity of fifty such recurring bibliographies. The subject parameters and format are defined by the representatives of the sponsoring organization and the NLM Search, MeSH, and Index staffs. As citations are regularly put into the MEDLARS store, each one that qualifies for a recurring bibliography is identified and tagged by the computer with the number assigned to the pertinent RB. The MEDLARS store is searched for citations for a particular recurring bibliography according to the schedule specified by the sponsoring organization, and the output is printed from a GRACE tape.

Abstracting and Indexing↗
PubMed1985

Classification of ambulatory care using patient-based, time-oriented indexes.

This paper presents a new approach to the classification of ambulatory care into isoresource consumption groups. In contrast to classification schemes based on visits, this case-mix approach creates an index based on resources used by diagnostic categories by a patient during a year. An application of this method to a primary care, group practice data base produced resource consumption groups with coefficients of variation in an acceptable range compared with the coefficients of variation of the diagnosis-related groups used to classify inpatient care.

Abstracting and Indexing↗
PubMed2000

The information problem in women's health: a piece of the solution.

Researchers and practitioners in the women's health field frequently express difficulty in locating information about sex and gender differences in medicine. This study hypothesized that a major reason for this is that when sex and gender differences are reported in the literature, they are not indexed in a way that facilitates locating the information. Search strategies were devised for the MEDLINE database to create three bibliographies related to women in each of six clinical areas. At one end of the spectrum, the strategy maximized precision (a high number of articles found were relevant). At the other end, recall was maximized (a high number of the known relevant articles were found). One intermediate strategy was formulated in an attempt to find the best combination. Precision and recall were measured for each strategy by performing the searches (18 total) and then randomly selecting 10 retrieved references. First, the abstracts were judged for relevance. Whenever it was not clear from the abstract that the article was relevant, women in the field of women's health evaluated the original article. The criterion for relevance was provision of clinically useful information about the health of women. The results show that it is possible to devise an efficient MEDLINE strategy to retrieve on average 64% of articles reporting sex or gender differences. This is consistent with the results of other studies of retrieval in MEDLINE. Strategies for effective searching are recommended.

Abstracting and Indexing↗
PubMed2004

RAD and the RAD Study-Annotator: an approach to collection, organization and exchange of all relevant information for high-throughput gene expression studies.

MOTIVATION: Gene expression array technology has become increasingly widespread among researchers who recognize its numerous promises. At the same time, bench biologists and bioinformaticians have come to appreciate increasingly the importance of establishing a collaborative dialog from the onset of a study and of collecting and exchanging detailed information on the many experimental and computational procedures using a structured mechanism. This is crucial for adequate analyses of this kind of data. RESULTS: The RNA Abundance Database (RAD; http://www.cbil.upenn.edu/RAD) provides a comprehensive MIAME-supportive infrastructure for gene expression data management and makes extensive use of ontologies. Specific details on protocols, biomaterials, study designs, etc. are collected through a user-friendly suite of web annotation forms. Software has been developed to generate MAGE-ML documents to enable easy export of studies stored in RAD to any other database accepting data in this format (e.g. ArrayExpress). RAD is part of a more general Genomics Unified Schema (http://www.gusdb.org), which includes a richly annotated gene index (http://www.allgenes.org), thus providing a platform that integrates genomic and transcriptomic data from multiple organisms. This infrastructure enables a large variety of queries that incorporate visualization and analysis tools and have been tailored to serve the specific needs of projects focusing on particular organisms or biological systems.

Abstracting and Indexing↗