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PubMed1987

A new method for measuring continuity of care in family practice residencies.

Continuity of relationship between physician and patient is a fundamental aspect of the health care provided by family physicians. Measurement of continuity has proved difficult, however. Commonly applied measures, usual provider of care (UPC), continuity of care (COC), and the modified continuity index (MCI), either ignore key aspects of continuity or provide misleading results. Consequently, a new measure of continuity, the modified, modified continuity index (MMCI), with a possible range of 0 to 1, was developed to overcome these problems. It was applied to a residency model practice, in which mean MMCI was found to be 0.59 (range 0.3 to 1.0). Mean COC was .41 and a mean MCI was .44. Thus, unlike COC and MCI, MMCI suggests fairly good continuity of care in this practice while still implying possible improvement. The MMCI should be useful for enhancing training and practice of family medicine.

Abstracting and Indexing↗
PubMed1994

The Cochrane Collaboration: the role of the UK Cochrane Centre in identifying the evidence.

This paper attempts to explain why systematic reviews of randomized controlled trials, based on as high a proportion as possible of the relevant studies, are so important in generating reliable information for evidence-based decision making within health care. The preparation, maintenance and dissemination of such reviews is the challenge which has been taken up by the Cochrane Collaboration. The first phase of data collection is the identification of relevant studies. Currently, bibliographic databases are inadequate for this task. MEDLINE searches identify on average only about half of the relevant studies, and until 1994 there were no suitable indexing terms in EMBASE to identify randomized controlled trials. Co-operation between the Cochrane Collaboration and both the National Library of Medicine and Elsevier, however, is already transforming this situation. From January 1994 a new indexing term has been added to EMBASE to help identify randomized controlled trials. From January 1995 a new indexing term will be added to MEDLINE to help identify controlled trials where the method of allocation to treatment or control cannot be described with certainty as being randomized. Also from January 1995 an additional 20,000 reports will be identifiable as randomized controlled trials in MEDLINE. Progress during the first 2 years of the Cochrane Collaboration has been encouraging, but much remains to be done if users of health services are to benefit from the evidence-based health care which they deserve.

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PubMed2006

Improving efficacy of PubMed Clinical Queries for retrieving scientifically strong studies on treatment.

The authors evaluated the retrieval power of PubMed "Clinical Queries," narrow search string, about therapy in comparison with a modified search string to avoid possible retrieval bias. PubMed search strategy was compared to a slightly modified string that included the Britannic English term "randomised." The authors tested the two strings joined onto each of four terms concerning topics of broad interest: hypertension, hepatitis, diabetes, and heart failure. In particular, precision was computed for not-indexed citations. The added word "randomised" improved total citation retrieval in any case. Total retrieval gain for not-indexed citations ranged from 11.1% to 21.4%. A significant number of Randomized Controlled Trial(s) (RCT)s (9.1-18.2%) was retrieved for each of the selected topics. They were often recently published RCTs. The authors think that correction of the Clinical Queries filter (when they focus on therapy and use narrow searches) is necessary to avoid biased search results with loss of relevant and up-to-date scientifically sound information.

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PubMed1992

The comprehensiveness of Medline and Embase computer searches. Searches for controlled trials of homoeopathy, ascorbic acid for common cold and ginkgo biloba for cerebral insufficiency and intermittent claudication.

OBJECTIVE: To assess the comprehensiveness of Medline and Embase computer searches for controlled trials. DESIGN: Comparison of articles found after an exhaustive search of the literature with the yield of a Medline or Embase search. This was performed for controlled clinical trials on the efficacy of three interventions: homoeopathy, ascorbic acid for common cold, and ginkgo biloba for intermittent claudication and cerebral insufficiency. The number of controlled trials found by exhaustive search of the literature was 107, 61 and 45, respectively. RESULTS: For homoeopathy, ascorbic acid and ginkgo the proportion of all trials found by Medline was 17%, 36% and 31% respectively and for Embase 13%, 25% and 58% respectively. After checking of the references in the Medline articles 44%, 79% and 76% of all trials were identified. After checking of the references in the Embase articles 42%, 72% and 93% of all trials were identified. About 20% of the articles was not correctly indexed. Of the best trials 68%, 91% and 83% could be found with Medline and 55%, 82% and 92% of the best trials were identified through Embase. CONCLUSIONS: For the topics mentioned, Medline and Embase searches are sufficient to get an impression of the evidence from controlled trials, but only if references in the articles are followed for further evidence. If one wants to get a more complete picture, additional search strategies make sense. Of course, this picture may be different for other topics.

Abstracting and Indexing↗
PubMed2001

Using metadata to create navigation paths in the HealthInsite Internet gateway.

The objective of this study was to evaluate the HealthInsite topic query technique, which uses a dynamic database search to assign resources to a topic. It is an alternative to the explicit classification technique, which relies on the classification of each resource using a predefined classification scheme. We performed a recall-precision analysis on all topics within the broad topic area of Child Health. Recall and precision errors were checked to determine which part of the information retrieval process was at fault. We then compared the topic query technique with the explicit classification technique. The results show errors or problems at every stage of the information retrieval process. This has initiated a review of all the tools used in the process, from indexing guidelines to the search engine. While many errors could be corrected, there were still features of the explicit classification technique that could not be achieved by the topic query technique. In conclusion, the topic query technique has the advantage of flexibility, but close co-operation between the different information retrieval specialists is needed to get the best results. The HealthInsite topic navigation structure should be regarded as an organized set of predefined searches rather than a full classified listing.

Abstracting and Indexing↗
PubMed2004

FigSearch: a figure legend indexing and classification system.

UNLABELLED: FigSearch is a prototype text-mining and classification system for figures from any corpus of full-text biological papers. The system allows users to search for figures that contain genes of interest and illustrate protein interactions. The retrieved figures are ranked by a score representing the likelihood to be of a certain type, in this case, schematic illustrations of protein interactions and signaling events. The system contains a Web interface for search, a module for classification of figures based on vector representations of figure legends and a module for indexing gene names. In a preliminary validation, the FigSearch system showed satisfactory performance according to domain experts in providing the most relevant graphical representations. This strategy may be easily extended to other figure types. Moreover, as more full-text data become available, such a system will find increased usefulness in identifying and presenting compressed biological knowledge. AVAILABILITY: A searchable Web interface, FigSearch, is accessible via http://pubgeneserver.uio.no/figsearch/ for all figures from the available corpus.

Abstracting and Indexing↗
PubMed1982

Reliability and validity in hospital case-mix measurement.

There is widespread interest in the development of a measure of hospital output. This paper describes the problem of measuring the expected cost of the mix of inpatient cases treated in a hospital (hospital case-mix) and a general approach to its solution. The solution is based on a set of homogeneous groups of patients, defined by a patient classification system, and a set of estimated relative cost weights corresponding to the patient categories. This approach is applied to develop a summary measure of the expected relative costliness of the mix of Medicare patients treated in 5,576 participating hospitals. The Medicare case-mix index is evaluated by estimating a hospital average cost function. This provides a direct test of the hypothesis that the relationship between Medicare case-mix and Medicare cost per case is proportional. The cost function analysis also provides a means of simulating the effects of classification error on our estimate of this relationship. Our results indicate that this general approach to measuring hospital case-mix provides a valid and robust measure of the expected cost of a hospital's case-mix.

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PubMed1999

Comparison of literature searches on quality and costs for health technology assessment using the MEDLINE and EMBASE databases.

Biomedical databases are an important source of information for health technology assessment. However, there is considerable variation in the costs of accessing commercial databases. We sought to measure the quality, amount of overlap, and costs of information retrieved from two of the main database sources--MEDLINE and EMBASE. Librarians at two health technology assessment agencies ran a total of eight literature searches on various medical technologies, using both databases. All search results were independently reviewed by two researchers. The researchers were asked to identify relevant references and to rank each of these according to a level of evidence scale. The results were tabulated to show the number of references identified by each database, the number of relevant references ranked by level of evidence, and the number of these references that were unique to one or the other database. The cost of retrieving references from each source was also calculated. Each database contained relevant references not available in the other. Because of the longer time lag for indexing in MEDLINE, many of the references that originally appeared to be unique to EMBASE were subsequently available in MEDLINE as well. Since our study was conducted, MEDLINE has been made available worldwide, free of charge, via the Internet. Hence, the cost difference between the databases is now even greater. However, notwithstanding the costs, it appears that literature searches that rely on only one or the other database will inevitably miss pertinent information.

Abstracting and Indexing↗
PubMed2002

Creating a Web-based bibliography database: AJR volumes 1-95.

OBJECTIVE: The purpose of this study was to index the contents of the pre-MEDLINE American Journal of Roentgenology into a database that could then be accessed over the World Wide Web. CONCLUSION: The database is composed of more than 8,000 citations from the years 1914 (volume 1) to 1965 (volume 95). Using a Web browser, a user can search the database by year, volume, title word, page, or author. Results are returned sorted by year and page number in a bibliographic format. The database is accessed approximately 200 times per month.

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PubMed2006

Scope and geographical distribution of African medical journals active in 2005.

OBJECTIVES: To identify all African medical journals actively publishing in 2005, and to create a geodatabase of these to evaluate and monitor future journal activity. DESIGN: A search was done for relevant African medical journals on electronic databases, library catalogues and internet sites, and a list was compiled of active journals. A survey was conducted via questionnaire of editors of all listed African medical journals defined as having an editorial base on the continent. RESULTS: One hundred and fifty-eight African medical journals were identified, published in 33 countries. One hundred and fifty-three editors were surveyed via email, post and/or fax. There was a 39% response rate from editors based in 17 countries. Fifty-one journals were published in English, 7 in French and 1 in Portuguese. Most journals were owned by an association or a society and were funded from a combination of sources. Journals covered general medical and specialist medical interest equally. Most (41 of 59 journals) had a circulation below 1 000, and most (52/59) published 4 or fewer issues a year. Almost all the journals included original research, and articles were peer reviewed. Few were indexed on Medline (N = 18) and EMBASE (N = 10). Plotting journal location using Geographic Information Systems (GIS) software provided a snapshot view of current journal activity. CONCLUSIONS: This study is likely to represent the most comprehensive list of current African medical journals. It confirms growth in African health care research and journal activity on the continent. Limited inclusion in international databases and accessibility to African researchers remain challenges in achieving publication of high-quality African research in high-quality African journals.

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PubMed1982

The role of the medical librarian in the use of a MeSH-indexed computerized test question bank.

The University of Missouri-Kansas City School of Medicine utilizes a full-time medical librarian in a non-conventional position as indexer-bibliographer for its computerized Item Library. The responsibilities of the librarian are to edit, index, and reference items for inclusion in the data base; maintain the currency of the Item Library; search the collection; and construct examinations, including a comprehensive quarterly examination, required of all students in this six-year school. Early research in computer-assisted test construction suggested the need for a comprehensive, standard approach to the classification of item content. A professional medical librarian using MeSH descriptors satisfies this need. In existence since 1973, the Item Library is now composed of over 12,000 multiple-choice questions in the basic sciences and clinical medicine. All questions are indexed with up to fifteen MeSH descriptors and referenced to literature sources. The items may be retrieved using any single MeSH term or combination of terms. The collection is available at all times on terminals, and students are encouraged to make use of it for self study. Selected examinations are made available to other institutions by arrangement. Experience has proven both the value of this resource for self study and student evaluation, and the necessity of establishing and continuing the librarian's role.

Abstracting and Indexing↗
PubMedDate not supplied

Structuring medical information into a language-independent database.

We describe one approach for natural language processing and database representation of medical information. The method is based in the semantic analysis of the statements and in the identification of patterns. The processed information is indexed and structured into a frame format containing semantic slots into the database. We tested our method analysing sentences describing symptoms extracted from case reports presented in the volume 328 of the New England Journal of Medicine. The results are: 73.41% of the sentences were formatted; 81.05% of the analysed words were identified; and 95.33% of the medical terms were indexed. We conclude that this semantic approach is not only efficient for processing natural language texts, but it can also be used for the organization of medical information using a language-independent format. This interlingua that is set into the database can be applied to semantic data retrieval; serving as a basis to organize a problem-orientated medical record; displaying simultaneously the DB information into two or more languages; information interchanging among different human languages and computers; and automatic translation, among others.

Abstracting and Indexing↗
PubMed1999

Mapping the literature of dental assisting.

The purpose of this study was to identify core journals and the databases that provide access to these journals for the field of dental assisting. This study was completed as a part of the Medical Library Association (MLA) Nursing and Allied Health Resources Section's project to map the literature of allied health. There were three original journals selected for analysis using the prescribed methodology, Dental Assistant, the journal of the American Dental Assistants Association; Journal of the CDAA, the journal of the Canadian Dental Assistants' Association; and Dental Teamwork, published by the American Dental Association. Dental Teamwork ceased publication in December 1996; however, it was considered a necessary part of the analysis due to its extensive coverage of dental assisting as well as its numerous scientific articles with references. In Dental Assistant, there were 16 source articles, containing 206 citations. In Dental Teamwork, there were 31 source articles with 308 citations. In Journal of the CDAA, there were only 3 source articles with 14 citations. Bradford's Law of Scattering was applied to the journal citations. Four databases, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, EMBASE/Excerpta Medica, and HEALTH were analyzed for their coverage of these cited journals. This study may encourage the dental assisting profession to take a close look at its existing journals and to consider enhancing the content of these journals or the publication of additional journals in the field. Dental assistants of today need substantive literature that deals with all aspects of their chosen profession in order to meet the challenges of providing dental health care in the future.

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PubMed1995

Searching for information on chemical substances in selected biomedical bibliographic databases.

A method was developed which allows effective searching for information on chemical substances in databases. Several searches for chemicals in bibliographic databases were carried out to analyse the method of indexing chemical names. The recall rates of documents were compared to evaluate information resources as well as searching strategies. Recall rates of documents searched with the CAS Nos. were compared to those searched with substance name. It turned out that searching for substances is most specific and fastest with CAS Nos. They should always be used whenever possible. However, this is not sufficient in many BDs, making an additional search using chemical names necessary. Specific search options that have to be considered for each database are reported.

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PubMed1999

MEDTAG: tag-like semantics for medical document indexing.

Medical documentation is central in health care, as it constitutes the main means of communication between care providers. However, there is a gap to bridge between storing information and extracting the relevant underlying knowledge. We believe natural language processing (NLP) is the best solution to handle such a large amount of textual information. In this paper we describe the construction of a semantic tagset for medical document indexing purposes. Rather than attempting to produce a home-made tagset, we decided to use, as far as possible, standard medicine resources. This step has led us to choose UMLS hierarchical classes as a basis for our tagset. We also show that semantic tagging is not only providing bases for disambiguisation between senses, but is also useful in the query expansion process of the retrieval system. We finally focus on assessing the results of the semantic tagger.

Abstracting and Indexing↗
PubMed1999

CISMeF: cataloque and index of French speaking health resources.

In 1999, the Internet has become a major source of health information. The objective of CISMeF is to catalogue and index the main French-speaking sites and documents concerning health. Currently, the number of resources already totalled over 6,100 with a mean of 75 new sites each week. CISMeF contains a thematic index, including medical specialities and an alphabetic index. CISMeF uses two standard tools for organising information: the MeSH (Medical Subject Heading) thesaurus from the Medline bibliographic database (National Library of Medicine) and the Dublin Core metadata format. A brief description of the site is systematically added. CISMeF respects the Net Scoring, criteria to assess the quality of health information on the Internet. The CISMeF project fulfils a valuable tool for the French-speaking health community: 2,500 machines visit the Web site each working day.

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PubMed1996

Research review: A comparison of levels of job satisfaction between traditional hospital coders and coders using computerized encoders.

Computerized encoders that assist medical record department coders in making ICD-9-CM disease and operative code selections have been available for approximately 10 years but there have been no studies to evaluate job satisfaction among coders using this technology. The purpose of this study was to determine whether there is a difference in job satisfaction between coders who use computerized encoders and those who do not. The Job Descriptive Index was mailed to hospital medical record departments in Cleveland, Columbus, and Cincinnati, Ohio; the return rate was 93.5 percent. Results indicated that individuals in these three cities coding by the traditional manual method were more satisfied with their jobs than those who used computer technology. The coders in the traditional group were more challenged by their jobs and had more positive interactions with their peers and supervisors. Also traditional coders were satisfied with the pay they received; coders using computerized encoders believed that their pay was inadequate.

Abstracting and Indexing↗
PubMed1997

The I2Cnet service architecture paradigm.

The main objective of the Image Indexing by Content network (I2Cnet) is to provide network-transparent content-based access to medical image archives based on a collection of interoperable Internet/intranet added-value services. This paper discusses I2Cnet, focusing on its service architecture paradigm. I2Cnet services such as image annotation, processing, description, and content-based retrieval, as well as the on-line collaboration service are presented. Exemplary user sessions are used to illustrate how virtual workspaces facilitate the interoperation of I2Cnet services, following the "network computer" approach to information management.

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