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PubMed2002

Creating knowledge repositories from biomedical reports: the MEDSYNDIKATE text mining system.

MEDSYNDIKATE is a natural language processor for automatically acquiring knowledge from medical finding reports. The content of these documents is transferred to formal representation structures which constitute a corresponding text knowledge base. The system architecture integrates requirements from the analysis of single sentences, as well as those of referentially linked sentences forming cohesive texts. The strong demands MEDSYNDIKATE poses to the availability of expressive knowledge sources are accounted for by two alternative approaches to (semi)automatic ontology engineering. We also present data for the knowledge extraction performance of MEDSYNDIKATE for three major syntactic patterns in medical documents.

Confidence Intervals↗
PubMed2005

Privacy protection for HealthGrid applications.

OBJECTIVES: This contribution aims at introducing the problem of privacy protection in e-Health and at describing a number of existing privacy enhancing techniques (PETs). The recognition that privacy constitutes a fundamental right is gradually entering public awareness. Because healthcare-related data are susceptible to being abused for many obvious reasons, public apprehension about privacy has focused on medical data. Public authorities have become convinced of the need to enforce privacy protection and make considerable efforts for promoting through privacy protection legislation the deployment of PETs. METHODS: Based on the study of the specific features of Grid technology, ways in which PET services could be integrated in the HealthGrid are being analyzed. Grid technology aims at removing barriers between local and remote resources. The privacy and legal issues raised by the HealthGrid are caused by the transparent interchange and processing of sensitive medical information. PET technology has already proven its usefulness for privacy protection in health-related marketing and research data collection. RESULTS: While this paper does not describe market-ready solutions for privacy protection in the HealthGrid, it puts forward several cases in which the Grid may benefit from PETs. CONCLUSION: Early integration of privacy protection services into the HealthGrid can lead to a synergy that is beneficial for the development of the HealthGrid itself.

Access to Information↗
PubMed2005

The Grid as a healthcare provision tool.

OBJECTIVES: This paper presents a survey on HealthGrid technologies, describing the current status of Grid and eHealth and analyzing them in the medium-term future. The objective is to analyze the key points, barriers and driving forces for the take-up of HealthGrids. METHODS: The article considers the procedures from other Grid disciplines such as high energy physics or biomolecular engineering and discusses the differences with respect to healthcare. It analyzes the status of the basic technology, the needs of the eHealth environment and the successes of current projects in health and other relevant disciplines. RESULTS: Information and communication technology (ICT) in healthcare is a promising area for the use of the Grid. There are many driving forces that are fostering the application of the secure, pervasive, ubiquitous and transparent access to information and computing resources that Grid technologies can provide. However, there are many barriers that must be solved. Many technical problems that arise in eHealth (standardization of data, federation of databases, content-based knowledge extraction, and management of personal data ...) can be solved with Grid technologies. CONCLUSIONS: The article presents the development of successful and demonstrative applications as the key for the take-up of HealthGrids, where short-term future medical applications will surely be biocomputing-oriented, and the future of Grid technologies on medical imaging seems promising. Finally, exploitation of HealthGrid is analyzed considering the curve of the adoption of ICT solutions and the definition of business models, which are far more complex than in other e-business technologies such ASP.

Data Collection↗
PubMed2005

Grid requirements for the integration of biomedical information resources for health applications.

OBJECTIVES: The goal of this paper is to identify how Grid technology can be applied for the development and deployment of integration systems, bringing together distributed and heterogeneous biomedical information sources for medical applications. METHODS: The integration of new genetic and medical knowledge in clinical workflows requires the development of new paradigms for information management in which the ability to access and relate disparate data sources is essential. We adopt a requirements perspective based on the user needs we have identified in the development of the INFOGENMED system to assess current Grid technology against those requirements. RESULTS: The gap between Grid features and distributed biomedical information integration needs is characterized. Results from prospective studies are also reported. CONCLUSIONS: Grid infrastructures offer advanced features for the deployment of collaborative computational environments across virtual organizations. New Grid developments are in line with the problem of multiple site information integration. From the INFOGENMED point of view, Grid infrastructures need to evolve to implement structured data access services and semantic content description and discovery.

Computational Biology↗
PubMed2005

Health information exchange networks: understanding stakeholder views.

As the National Health Information Infrastructure (NHII) gains momentum, regional health information exchange networks are developing as a means to support this structure. While successful networks exist, their sustainability is complicated by the existence of multiple stakeholders with differing incentives for participation. Interviews conducted regarding the development of the NMESH network produced several key areas of stakeholder focus, an important step in creating network sustainability.

Delivery of Health Care↗
PubMed2006

Bridging clinical information systems and grid middleware: a Medical Data Manager.

This paper describes the effort to deploy a Medical Data Management service on top of the EGEE grid infrastructure. The most widely accepted medical image standard, DICOM, was developed for fulfilling clinical practice. It is implemented in most medical image acquisition and analysis devices. The EGEE middleware is using the SRM standard for handling grid files. Our prototype is exposing an SRM compliant interface to the grid middleware, transforming on the fly SRM requests into DICOM transactions. The prototype ensures user identification, strict file access control and data protection through the use of relevant grid services. This Medical Data Manager is easing the access to medical databases needed for many medical data analysis applications deployed today. It offers a high level data management service, compatible with clinical practices, which encourages the migration of medical applications towards grid infrastructures. A limited scale testbed has been deployed as a proof of concept of this new service. The service is expected to be put into production with the next EGEE middleware generation.

Databases as Topic↗
PubMed1991

A Medical Text Analysis System for German--syntax analysis.

Much information about patients is stored in free text. Hence, the computerized processing of medical language data has been a well-known goal of medical informatics resulting in different paradigms. In Göttingen, a Medical Text Analysis System for German (abbr. MediTAS) has been under development for some time, trying to combine and to extend these paradigms. This article concentrates on the automated syntax analysis of German medical utterances. The investigated text material consists of 8,790 distinct utterances extracted from the summary sections of about 18,400 cytopathological findings reports. The parsing is based upon a new approach called Left-Associative Grammar (LAG) developed by Hausser. By extending considerably the LAG approach, most of the grammatical constructions occurring in the text material could be covered.

Electronic Data Processing↗
PubMed1994

The need for requirements engineering in the development of clinical decision-support systems: a qualitative study.

Insufficient requirements analysis has recently been suggested as a problem in clinical decision-support systems development. Therefore, to explore knowledge, practices and attitudes, key professionals in the area from four countries were interviewed regarding the early phases in the development process. For data collection, semi-structured interviews were performed and video-taped. As reference, documentation of the Action Design requirements engineering methodology was used. Two separate qualitative analyses of the data were made. The first was to identify central concepts and attitudes related to requirements engineering. In the second analysis, concrete circumstances surrounding decisions to use requirements engineering methods were investigated. This paper reports the results of the analyses and discusses changes in the planning and management of clinical decision-support projects in general, and it comments on development methods, using Action Design as reference. It is concluded that studies are needed to further investigate the problems real decision-support projects have to deal with. This knowledge can then be used to develop methods and tools which support design practices where existing structural, procedural and, building on this, technical obstacles are overcome.

Decision Support Techniques↗
PubMed1993

New trends of postgraduate education in public health in Slovakia (the first experiences of the school of public health in Bratislava).

The School of Public Health (SPH) in Bratislava was established on 1 July 1991, as an organisational unit of the Post-graduate Medical School, directly subordinated to the Ministry of Health of the Slovak Republic. The SPH performs both postgraduate and continuing education of specialists in individual public health branches. It participates in the research activities within the field of public health. Our SPH is engaged in the network of European schools of public health, in association with the Association of Schools of Public Health in the European Region (ASPHER). In coordination with these schools, the SPH elaborates on a system of training Europe-wide a comparable qualification degree in Master of Public Health (MPH). In collaboration with the World Health Organization (WHO), the SPH also organizes training courses and seminars with international participation. The SPH entered into the school year 1992/93 with its 5 departments and sub-departments in the following organisational structure: 1. Department of Health Strategy with sub-departments: Health Legislation Health Education Health Sociology 2. Department of Medical Informatics 3. Department of Health Management 4. Department of Medical Education 5. Department of Preventive Medicine with sub-departments: Epidemiology Hygiene of Children and Adolescents Environmental Hygiene Nutrition Preventive Occupational Health Health Protection against Ionization

Education, Graduate↗
PubMedDate not supplied

Computer use among medical students in an institution in southern India.

BACKGROUND: This cross-sectional, descriptive study was conducted in Pondicherry from May to October 2002 to assess computer and internet use among medical students. METHODS: The participants were four batches of undergraduate students, one batch of interns and two batches of postgraduate students. A pre-tested questionnaire was used to collect data from 394 subjects. Written informed consent was obtained from all the participants. RESULTS: Computer knowledge was found to be higher among postgraduates (93.3%) compared to undergraduates (84.5%). Students learnt computers by self-learning, attending classes and using manuals. Writing letters was the most common use of the computer (postgraduates [100%] and undergraduates [87.5%]). Seventy-one per cent of the postgraduates and 43% of the undergraduates used English language dictionaries. About 61% of the undergraduates used computers for playing games. Students also used computer for watching movies. MS Office was the most commonly used software (postgraduates [100%] and undergraduates [72.2%]). The use of software for visual designing and drawing was low. Undergraduates used audio players more often than postgraduates. Most students used the internet for e-mail (postgraduates [100%] and undergraduates [97.3%]). Undergraduate students used the internet for chatting and entertainment. Online banking was also used to some extent. Most of the students were willing to undergo training. All the groups unanimously felt that the institute should provide free training in medical informatics. CONCLUSION: This study revealed high computer use among medical students in an institution with good computer facilities. The majority expressed their willingness to undergo further training.

Computer Literacy↗
PubMedDate not supplied

Automated translation between medical terminologies using semantic definitions.

Automatic translation of medical terms from one controlled vocabulary into another is essential to the integration of diverse medical informatics systems. We have developed a strategy in which medical terms are represented in a standard format that provides semantic description of the terms. We demonstrate the representational power of our method by showing that a subset of medical terms (procedures) from diverse vocabularies can be described in this manner. We assess the potential usefulness of our approach for facilitating automatic translation by finding the closest match for MeSH cardiovascular procedures with ICD-9 procedures.

MEDLARS↗
PubMed1997

[Informatics support to medical diagnosis. General information obtained from a first structured contact with the patient].

BACKGROUND: The methods and characteristics of clinical data gathered at the initial steps of development of a computerized system to aid medical diagnosis are reported. The objectives of the study were as follows: to describe the overall method and to set a framework for developing an intellectual model of the medical diagnosis procedure. MATERIAL AND METHODS: A structured medical interview and physical examination using an informatic program on PC compatible portable computers were completed in a sample 1,238 patients attending the outpatient clinics of our institution. Data obtained were compared with information in the patient's medical record taking as reference pattern the record of physicians in charge of the patients. Diagnosis were codified according to WHO International Classification of Diseases (ICD-9-CM). RESULTS: The distribution of symptoms and signs corresponding to the different organs and systems was analyzed. Each subdivision afforded a range of 1.3 to 3.9 abnormal findings per patient. A total of 3,571 diagnoses were codified for the whole group 1,238 patients with a mean (standard deviation) of 3 (2) diagnoses per patient (range 0-12). The distribution of diagnostic groups varied depending on the consideration of the main diagnosis or the concomitant diagnoses that defined the patient's clinical context. The most frequent main diagnoses included tumors, cardiovascular diseases, gastrointestinal disorders, and genitourinary tract diseases. CONCLUSIONS: As shown by results obtained in a sample of 1,238 patients, there is a very complex situation in clinical practice due to the simultaneous occurrence of several clinical patterns. This finding should be taken into account when developing clinical decision making support systems. The use of a structured medical interview or a structured and standard medical visit may be an adequate tool to clarify this matter and to contribute to standardization of clinical concepts and situations.

Decision Trees↗
PubMed1998

The next-generation emergency department.

The greatest advances in medicine over the next two decades will result from application of the tools and principles of informatics to the problems of clinical medicine. New developments in medical informatics will drive advances in clinical care administration, research, and education. Information flow in the emergency department a decade hence will be characterized by a transformation from a "hunter-gatherer" information model to a "publisher-subscriber" model in which the right information will always be available at the right time. In large part, information will be gathered automatically rather than manually. Computers will be ubiquitous and almost invisible. Invasive and attached monitoring and testing will yield to new remote and noninvasive technologies. Information will be shared and modified as needed, rather than recreated and reentered by each caregiver. Eventually, the use of information technologies in the emergency medicine workplace will enhance our traditional role as hands-on providers of direct patient care.

Emergency Service, Hospital↗