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At least 955 records · Page 53Linked to original sources
PubMed1999

Recurrent tuberculosis: definitions and treatment regimens.

Within the National Tuberculosis Control Programme of Malawi, misunderstandings sometimes occur about the diagnosis and management of recurrent tuberculosis (TB). Patients with smear-positive pulmonary tuberculosis (PTB) who have had a previous, treated episode of smear-negative TB may be registered as 'new cases' rather than relapse cases, and thus denied the benefits of a retreatment regimen. Patients with a recurrent episode of smear-negative PTB or extra-pulmonary TB (EPTB) may also be wrongly registered as 'new cases' rather than recurrent cases. International guidelines about the treatment of recurrent smear-negative PTB and EPTB are not explicit, resulting in confusion about how best to manage these cases. It is suggested that all such cases be considered for re-treatment regimen because of concerns about acquired drug resistance. WHO and IUATLD guidelines on the diagnosis and management of recurrent and relapse TB need to be improved, and operational research studies should be conducted to provide answers to some outstanding questions.

Antitubercular Agents↗
PubMed1999

Knowledge-mediated retrieval of laboratory observations.

Intelligent medical applications including agents, clinical decision support systems, and expert systems can benefit from components that expose the meanings of medical concepts. We have endeavored to create an ontology for laboratory observations and to make the ontology accessible in a distributed environment through a knowledge mediator offering several services. To date we have created two such services, one service to mediate the retrieval of laboratory observations and an auxiliary service to facilitate the mapping of units of measure to LOINC property-types. We report progress and insights on the development of our ontology and related knowledge mediator.

Artificial Intelligence↗
PubMed1999

Toward a standard for guideline representation: an ontological approach.

Guidelines for clinical practice are being introduced in an extensive way in more and more different fields of medicine They have the potentialities of improving the quality and cost-efficiency of care in an increasingly complex health care delivery environment. Computerization may increase the effectiveness of both the information retrieval of guidelines and the management of guideline-based care. The scenario is evolving from stand-alone workstations to telematics applications that enable guidelines development and dissemination. However, such a knowledge sharing requires the definition of formal models for guidelines representation. The models should have a clear semantics in order to avoid ambiguities. The role of ontologies is that of making explicit the conceptualizations behind a model. In this paper we present our library of ontologies and point out its role for integrating existing guideline models and defining standard representations.

Humans↗
PubMed1999

Linking the integrated management of childhood illness (IMCI) and health information system (HIS) classifications: issues and options.

Differences in the terms used to classify diseases in the Integrated Management of Childhood Illness (IMCI) guidelines and for health information system (HIS) disease surveillance could easily create confusion among health care workers. If the equivalent terms in the two classifications are not clear to health workers who are following the guidelines, they may have problems in performing the dual activities of case management and disease surveillance. These difficulties could adversely affect an individual's performance as well as the overall effectiveness of the IMCI strategy or HIS surveillance, or both. We interviewed key informants to determine the effect of these differences between the IMCI and HIS classifications on the countries that were implementing the IMCI guidelines. Four general approaches for addressing the problem were identified: translating the IMCI classifications into HIS classifications; changing the HIS list to include the IMCI classifications; using both the IMCI and HIS classification systems at the time of consultations; and doing nothing. No single approach can satisfy the needs of all countries. However, if the short-term or medium-term goal of IMCI planners is to find a solution that will reduce the problem for health workers and is also easy to implement, the approach most likely to succeed is translation of IMCI classifications into HIS classifications. Where feasible, a modification of the health information system to include the IMCI classifications may also be considered.

Case Management↗
PubMed2001

Measuring onset of antidepressant action in clinical trials: an overview of definitions and methodology.

This article discusses 4 critical questions that must be addressed in any valid analysis of comparative onset of therapeutic effect among antidepressant drugs: (1) how is onset defined, (2) how is onset measured, (3) how can the treatment groups be compared statistically with regard to onset of effect, and (4) how do these issues affect protocol design? A rigorous study of differential onset of effect should include an estimation of the portion of patients that respond, the timing of the onset of response, and the duration of response and an examination of the dynamic process of the onset of action. Methods for measuring symptom severity changes over time also will be reviewed.

Antidepressive Agents↗
PubMed2001

Development of the ICD-10 procedure coding system (ICD-10-PCS).

The International Classification of Diseases 10th Revision Procedure Classification System (ICD-10-PCS) has been developed as a replacement for Volume 3 of the International Classification of Diseases 9th Revision. The development of ICD-10-PCS was funded by the U.S. Health Care Financing Administration. ICD-10-PCS has a multi-axial seven character alphanumerical code structure, which provides a unique code for all substantially different procedures and which allows new procedures to be easily incorporated as new codes. ICD-10-PCS was under development for over five years and the initial draft was formally tested and evaluated by an independent contractor. The final version of the ICD-10-PCS was released in the spring of 1998. The design, development and testing of ICD-10-PCS are discussed.

Abstracting and Indexing↗
PubMed2001

[Regulations to prevent zoonoses].

The EU Commission discussed drafts to amend the so-called Zoonoses Directive at expert level. The last proposal provides for a division of the amendment into 1. a Directive on Monitoring and 2. a Regulation on Control. The Monitoring Directive focusses on collecting data and transmitting them to the joint reference centre for zoonoses. In contrast, the Regulation governing control fixes the necessary provisions required for an adequate and effective control of specific zoonoses and zoonoses agents.

Animals↗
PubMed1995

[Not Available].

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Germany↗