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PubMed1995

A simple tool for designing a database: bridging the communication gaps among health care providers, researchers, and programmers.

As databases are used by a greater variety of people, highly technical methods of designing them are giving way to more human, user-centered approaches. The article describes a human approach to designing a complex, multiuse database with limited resources. The article introduces a simple data modeling tool, the entity-relationship (E-R) diagram, that crosses professional boundaries and enables providers, researchers, and programmers to communicate more easily. Constructing an E-R diagram provides a human description of the social health maintenance organization (S/HMO) multisite demonstration project. This project, now in its tenth year, provides integrated acute and community-based in-home services to allow frail elderly HMO members to stay in their homes. After briefly reviewing the three types of databases and three rules of thumb for designing a relational database, the article shows how a simple E-R diagram can clarify the management and research issues of the S/HMO health care model. The article concludes with a brief discussion of the benefits and limits of housing research-related health data in a relational database.

Communication↗
PubMed1993

The evolution of a clinical database to evaluate the treatment of coronary artery disease.

BACKGROUND: The field of invasive cardiology has evolved rapidly since the initial use of catheters for treatment of coronary artery disease in the late 1970's. The pace of this change coupled with the complexity of the clinical setting and proliferation of devices and drugs used for therapy have made it extremely difficult to construct and maintain a viable clinical database. METHODS: Using a standard hardware and software system with the direct clinical input from a multidisciplinary team of physicians, nurses and biostatisticians, a clinical database was developed that is capable of tracking complex in-hospital and longterm follow-up data in patients undergoing treatment of coronary artery disease. RESULTS: The database has provided the basis for in-depth analysis of angioplasty results in patients with vessels and lesions of varying morphology, showing greater than 90% success in most complex lesion morphology using contemporary balloon technology and/or new devices. Longterm analysis (14 years) of patients after angioplasty has demonstrated that 76% survived without major cardiac events. Other analyses of various clinical and morphologic subsets have shown favorable results with angioplasty. The databases for angioplasty and coronary bypass surgery have been combined, showing comparable survival and freedom from cardiac events in multivessel disease patients treated with these procedures. CONCLUSIONS: The development of a dynamic and clinically relevant database that has evolved has contributed valuable information to the understanding and effective management of patients with coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗
PubMed1997

Facilitating higher order thinking skills in nurse education: a prototype database for teaching wound assessment and management skills.

The introduction of university based nurse education in Australia has nursing students spending more time in the classroom and less time in clinical settings. This decrease in clinical exposure may result in reduced opportunities for students to develop pertinent patient assessment and management skills. This is particularly true of skills required for effective wound assessment and management. Computerised databases offer an innovative method of teaching or refining these skills in a cost and time-effective manner without risk to patients or students. Such technology can also provide important grounding in data identification, hypothesis testing, problem solving and clinical decision making skills. This paper explores the underlying pedagogical principles of database use and describes the development of the prototype closed database, DECUBITUS. The prototype database included the following data fields; physical assessment, clinical diagnosis, risk assessment, wound assessment and treatment modality. The introduction of more sophisticated databases will permit the storage of visual images of actual wounds thus providing an additional dimension to the teaching of wound assessment and management.

Australia↗
PubMed1997

A database on pesticides in Italy: a progress report.

An existing database on pesticides, running in the DOS/Windows environment, is operative at the National Institute of Health and has yielded useful informations for several published researches. The database is currently being restructured for the purpose of making it available on the Web. An HTML interface, allowing to formulate queries on the database from the Web is presently under development, and it will be made available, once the problems related to confidentiality of certain parts of the database are solved. The database in its present form is presented and necessary changes foreseen in the Web edition are discussed.

Computer Communication Networks↗
PubMed1997

Medical image databases for CAD applications in digital mammography: design issues.

The evaluation of algorithms' developed for computer assisted diagnosis in digital mammography requires image databases that allow relative comparisons and assessment of algorithms clinical value. A review of the literature indicates that there is no consensus on the guidelines of how databases should be established. Image selection is usually done based on subjective criteria or availability. The generation of common database(s) available to the research community makes relative evaluations of algorithms with similar properties easier. However, questions regarding the "right database size," the "right image resolution," and the "right contents" remain. In this paper, database issues are reviewed and discussed and possible remedies to the various problems are proposed.

Algorithms↗
PubMedDate not supplied

[Microbiological database UNIQEM: problems and prospects].

The UNIQEM database, designed to accumulate microbiological data of a general nature, is currently used to store and make available information about microorganisms studied and maintained at the Institute of Microbiology, Russian Academy of Sciences. UNIQEM is composed of two related databases. The first one is a catalogue database, used to accumulate and maintain list-form information on a wide range of microorganisms. The second one is a property database, which facilitates collecting, processing, and publishing diverse data having to do with these microorganisms and their properties. The database supports the retrieval of microorganisms by specifying an arbitrary set of their properties and has the potential for eventually evolving into a computer instrument for unattended identification of microorganisms.

Classification↗
PubMed2000

[Monitoring utilization of hypolipemic agents using an insurance company database].

Databases of health insurance companies can provide information on the motion of a drug in the society. The present paper examines several databases of health insurance companies and analyzes the development of the consumption of hypolipidemic agents in 1994 through 1998. So-called evaluation databases making it impossible to identify a particular patient and the prescribing physician were prepared for the evaluation. They were obtained from the VZP central health insurance office, VZP district health insurance offices in Hradec Králové and Kladno, and the Zamĕstnanecká pojistovna Skoda (Employees Health Insurance Company Skoda). It was not necessary to blind the data in the first cohort, in the second one it was carried out by shortening the identification numbers, and in others by introducing artificial identification codes. The consumption was expressed in DDD and in the relative representation in the group. The consumption of the principal groups of hypolipidemic agents (fibrates, statins, sequestrants of bile acids, and derivatives of nicotinic acid) and the individual medicinal substances was evaluated. Relative values of consumption were obtained by calculation to the magnitude of the denominator--the number of the insured, or the number of patients to whom a hypolipidemic agent was prescribed. The consumption was on the increase in all three databases, in four years increasing from approx. 0.4-4DDD/1000 of the insured/day to 16-24DDD/1000 of the insured/day. At the beginning, the main share in the consumption of hypolipidemic agents was represented by fibrates, approx. 90%, but in four years this share decreased to only 60%, whereas in the period under study the share of statins increased up to 30%. Databases of health insurance companies do not significantly differ in the consumption of hypolipidemic agents, which may give evidence of their validity. In the course of the study, an increase in the consumption of hypolipidemic agents, primarily statins, was found. The shift in the consumption of statins corresponds with the available information about the evidence of their therapeutic effectiveness. The average consumption per one patient does not reach 1DDD, which is a signal that probably very few patients receive long-term treatment and that new patients emerge during the year.

Czech Republic↗
PubMedDate not supplied

Navigation in medical Internet image databases.

The world wide web (WWW) changes common ideas of database access. Hypertext Markup Language allows the simultaneous presentation of information from different sources such as static pages, results of queries from) databases or dynamically generated pages. 'Therefore, the metaphor of the WWW itself as a database was proposed by Mendelzon and Nlilo in 1998. Against this background the techniques of navigation within WWW-databases and the semantic types of their queries has e been analysed. Forty eight image repositories of different types and content, but all concerning medical essence, have been found by search-engines. Many different techniques are offered to enable navigation ranging from simple HTML-link-lists to complex applets. The applets in particular promise an improvement for navigation. Within the meta-information for querying, only ACR- and UMLS-encoding were found, but not standardized vocabularies like ICD10 or Terminologia Anatomica. UMLS especially shows that a well defined thesaurus can improve navigation. However, of the analysed databases only the UMLS 'metathesaurus' is currently implemented without providing additional navigation support based on the UMLS 'semantic network'. Including the information about relationships between the concepts of the metathesaurus or using the UMLS semantic network could provide a much easier navigation within a network of concepts pointing to multimedia files stored somewhere in the WWW.

Anatomy, Cross-Sectional↗
PubMed2002

RADARS, a bioinformatics solution that automates proteome mass spectral analysis, optimises protein identification, and archives data in a relational database.

RADARS, a rapid, automated, data archiving and retrieval software system for high-throughput proteomic mass spectral data processing and storage, is described. The majority of mass spectrometer data files are compatible with RADARS, for consistent processing. The system automatically takes unprocessed data files, identifies proteins via in silico database searching, then stores the processed data and search results in a relational database suitable for customized reporting. The system is robust, used in 24/7 operation, accessible to multiple users of an intranet through a web browser, may be monitored by Virtual Private Network, and is secure. RADARS is scalable for use on one or many computers, and is suited to multiple processor systems. It can incorporate any local database in FASTA format, and can search protein and DNA databases online. A key feature is a suite of visualisation tools (many available gratis), allowing facile manipulation of spectra, by hand annotation, reanalysis, and access to all procedures. We also described the use of Sonar MS/MS, a novel, rapid search engine requiring 40 MB RAM per process for searches against a genomic or EST database translated in all six reading frames. RADARS reduces the cost of analysis by its efficient algorithms: Sonar MS/MS can identifiy proteins without accurate knowledge of the parent ion mass and without protein tags. Statistical scoring methods provide close-to-expert accuracy and brings robust data analysis to the non-expert user.

Amino Acid Sequence↗
PubMed2002

[Yield of a coronary arteriography database. A study of 5.536 registrations at the cardiologic laboratory, Rigshospitalet].

INTRODUCTION: Coronary arteriography (CAG) is an expensive investigation that provides potentially valuable information, but also carries a risk of severe complications. It is therefore natural to examine the usefulness of an existing database on CAG. METHODS: The analysis covers all registrations of CAG entered into the database at the Heart Centre at Rigshospitalet, Copenhagen, from April 1999 to September 2000. RESULTS: Altogether, 5536 CAGs were registered. The indication was stable coronary artery disease in 52.0% and acute ischaemic heart disease in 25.5%. As an example of the medical information available from the data base, it is notable that left main coronary stenosis or three-vessel disease, conditions in which coronary bypass surgery increases long-term survival, was found in 42.4% of patients with angina pectoris in Canadian Cardiovascular Society (CCS) class 4, but also in 24.4% of patients in CCS class 1. DISCUSSION: Clinical databases, such as the one presented, can ensure that all relevant information is stored, and in this case even results in enhanced effectiveness, because data may be directly transformed into other formats, such as charts. The database furthermore provides clinical information, for instance that the severity of angina pectoris cannot identify the most ill patients in whom a CABG is potentially life-prolonging. In addition, the database provides administrative data that is used in the training of doctors, evaluation of referral patterns, surveillance of complications, and in the daily administration and planning.

Adolescent↗
PubMed2002

Estimating pediatric primary care provider visits in a capitated environment: encounter vs. claims databases.

PURPOSE: To evaluate the accuracy of insurance claims data indicating underutilization of primary care visits by children with special health care needs (CSHCN). DESIGN: The study was a retrospective comparison of primary care provider (PCP) utilization by 1,131 CSHCN, using secondary data from electronic claims-and-encounters databases in a Medicaid health maintenance organization (HMO) and a commercial HMO. METHODOLOGY: The study was conducted at the Children's Clinics for Rehabilitative Services (Children's Clinics) in Tucson, Ariz., a provider of specialty care to CSHCN. All the children in the study were eligible for specialty services under Arizona's statewide program for CSHCN and were simultaneously enrolled, from Oct. 1, 1995 through Sept. 30, 1996, in either one or both of the managed care plans for their primary care. Identical PCP-visit information for the same 1-year period was collected from the plans' claims-and-encounters databases, and the number of primary care visits as computed from both databases was compared. PRINCIPAL FINDINGS: Health plan claims data show that only 14 percent of the patients visited a PCP during the course of a year. The encounter data indicate that 59 percent of the same cohort had PCP visits. CONCLUSIONS: Encounter databases capture more information about PCP visits than insurance claims databases in capitated environments.

Arizona↗
PubMed2000

The IMGT/HLA sequence database.

The IMGT/HLA database (wwwebi.ac.uk/imgt/hla/) specialises in sequences of the polymorphic genes of the HLA system, the humanmajor histocompatibility complex (MHC). This complex is located within the 6p213 region on the short arm of human chromosome 6 and contains more than 220 genes of diverse function. Many of the genes encode proteins of the immune system and these include the 21 highly polymorphic HLA genes, which influence the outcome of clinical transplantation and confer susceptibility to a wide range of non-infectious diseases. The database contains sequences for all HLA alleles officially recognised by the WHO Nomenclature Committee for Factors of the HLA System and provides users with online tools and facilities for their retrieval and analysis. These include allele reports, alignment tools, and detailed descriptions of the source cells. The online submission tool allows both new and confirmatory sequences to be submitted directly to the WHO Nomenclature Committee. The latest version (release 1.10.0 April 2001) contains 1329 HLA alleles, 61 HLA related sequences, derived from around 3350 component sequences from the EMBL/ GenBank/DDBJ databases. The IMGT/HLA database provides a model that will be extended to provide specialist databases for polymorphic MHC genes of other species.

Alleles↗
PubMed2003

[Construction of online medical parasites database].

We aim to construct a online medical parasites database from which information can be retrieved through key words, ASP program and SQL language. The connection between the web pages and the database was established to enable relevant web page searching and parasitological information retrieval on the basis of the database files. A method for online searching through the database is elaborated in this paper by introducing the construction of the medical parasites database.

Databases, Bibliographic↗
PubMed2002

[Establishment of comprehensive fingerprint database of traditional Chinese herbs].

Quality control of traditional Chinese herbs by fingerprint is being paid close attention in these years. A database software has been designed and built to store these fingerprints and other relevant information. The use of this database is very simple and convenient for ordinary analysts who have no experience on professional database software. This software could be used under many kinds of operation systems such as Windows 95, 98, 2000 and Windows NT 4.0, 5.0. By now, nearly 30 fingerprints and their relevant information of ten kinds of traditional Chinese herbs have been input into this database, and the number of fingerprints in this base will be continuously increased in the future. This database is helpful for the analysis and quality control of traditional Chinese herbs.

Chromatography, Gas↗
PubMed2001

[Construction of rice dwarf virus genome database].

Secondary database construction is an important subject in the field of bioinformatics. As the full genomic sequences of some organisms are being completed and followed by structural and functional studies, construction of secondary database becomes essential on the agenda. The rice dwarf virus (RDV) is a pathogen infecting rice in China, Japan and the Southeastern Asia region and leading to considerable economic loss. Based on the data generated from recent genomic research and earlier biochemical studies scattered in various primary databases and scientific journals, we have constructed a compact, user-friendly and non-redundant job-oriented secondary database. This work will provide compiled useful information for plant molecular biologists as well as in achieving preliminary experiences in secondary database construction.

Databases, Factual↗
PubMed2003

Internet-accessible radiographic database of Vietnam War casualties for medical student education.

RATIONALE AND OBJECTIVES: The purpose of this study was to determine the feasibility of archiving radiographic images from Vietnam era conflict casualties into a personal computer-based electronic database of text and images and displaying the data using an Internet-accessible database for preservation and educational purposes. MATERIALS AND METHODS: Thirty-two patient cases were selected at random from a pool of 1,000 autopsy reports in which radiographs were available. A total of 74 radiographs from these cases were digitized using a commercial image scanner and then uploaded into an Internet accessible database. The quality of the digitized images was assessed by administering an image-based test to a group of 12 medical students. RESULTS: No statistically significant (p > 0.05) differences were found between test scores when using the original radiographs versus using the digitized radiographs on the Internet-accessible database. CONCLUSION: An Internet-accessible database is capable of effectively archiving Vietnam era casualty radiographs for educational purposes.

Databases, Factual↗
PubMed1992

The development of a virtual database to provide on-line access to a large archive of clinical data.

The archival database of the HELP Hospital Information System at LDS Hospital is too large to be stored on line. The archival data are important for clinical and research applications. Demountable disk packs have been used to store the archival database. This method of storage has four significant disadvantages. A virtual database was developed to overcome the limitations of this data-management scheme. This virtual database enables the transparent use of appropriate low-cost network-based storage technology to provide on-line availability of the entire archive of clinical data. The virtual database successfully resolves the problems associated with disk packs, and opens the door to enhanced use of the data for clinical and research applications.

Computer Storage Devices↗
PubMed2003

[Glaucoma Service Database].

We present the common problems related to clinical databases. The Glaucoma Service Database created in our clinic is an attempt of developing the optimal medical database. The system organizes our repository of clinical data. It consist of 3 modules: 1) the users list with predefined privileges and rights, 2) lists of coded data for further use, that facilitate filling in the fields, 3) clinical details of all patients. The user interface of our database is very simply, thus it is very easy to use it even by unskilled staff. The accuracy of data is protected by system's internal algorithms. It could be used to investigate clinical epidemiology, risk assessment, post-marketing surveillance of drugs, practice variation and decision analysis. Data from Glaucoma Service Database can also help in the management of health service.

Databases, Factual↗