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PubMed1995

On the linguistic representation of medical information: natural language, controlled language, and formal language.

Language is indispensable for the representation of medical information. We classified the methods of linguistic representation into three items: natural language, controlled language, and formal language. The characteristics of these are discussed; we focus especially on the preparation of data and data quality. We present the perspective that linguistic research in medical informatics can be considered as an effort to convert natural language into formal language and vice versa. The problems related to the conversion and the role of controlled language in medical linguistics are discussed in detail.

Language↗

PubMedDate not supplied

Making the connection: the VA-Regenstrief project.

The Regenstrief Automated Medical Record System is a well-established clinical information system with powerful facilities for querying and decision support. My colleagues and I introduced this system into the Indianapolis Veterans Affairs (VA) Medical Center by interfacing it to the institution's automated data-processing system, the Decentralized Hospital Computer Program (DHCP), using a recently standardized method for clinical data interchange. This article discusses some of the challenges encountered in that process, including the translation of vocabulary terms and maintenance of the software interface. Efforts such as these demonstrate the importance of standardization in medical informatics and the need for data standards at all levels of information exchange.

Hospital Information Systems↗

PubMed1994

Data compression for medical report archiving.

In a hospital environment, where large numbers of reports are compiled, data compression offers a method for substantially reducing the required disk space whilst protecting the confidentiality of patient data. An analysis is given of the most important parameters that influence compression of free-text data, to realize an efficient implementation of an archiving system for medical reports. An overall reduction of the required disk space by more than 50% can be attained, as well as supplementary level of protection. A slight increase in access time is thereby inevitable, but almost insignificant. Such an archiving system constitutes a necessary component for an intelligent information retrieval system. The access to information contained in medical documents (by means of natural language processing and artificial intelligence techniques) is considered to be one of the key issues in the field of medical informatics for the coming decades.

Archives↗

PubMed2003

Can evaluation studies benefit from triangulation? A case study.

BACKGROUND: Information and communication technologies (ICTs) are increasingly being used in health care. Rigorous evaluations of ICT applications during both introduction and routine use are of great importance for decision makers and users. Within evaluation research, two main (and often rather distinct) traditions can be found: the objectivistic and the subjectivistic tradition. METHODS: The theory of triangulation deals with the integration of methods and approaches as to conduct better evaluation studies. In evaluation research, triangulation in general means the multiple employment of various sources of data, observers, methods, and/or theories in investigations of the same phenomenon. We applied triangulation aspects in the analysis of the effects of a computer-based nursing documentation system. RESULTS: We discuss, based on this case study, what benefits can be obtained from applying triangulation in an evaluation study. We show how both the validation of results and the completeness of results can be supported by triangulation. DISCUSSION: The decision whether triangulation may be useful for a given research question, and how it may be correctly applied, requires-like other evaluation methods-intensive training and methodological experience. Medical informatics evaluation research may profit from this well-established theory.

Documentation↗

PubMed1991

Computer-assisted quality assurance: development and performance of a respiratory care program.

The Departments of Respiratory Care and Medical Informatics at LDS Hospital, Salt Lake City, developed a computer-assisted system (HELP) to monitor the quality assurance (QA) of respiratory care services. The system addresses the immediate needs of patients through a daily medical director's alert report, which allows the medical director to intervene in acute situations as they arise. The department's QA program monitors and evaluates clinical indicators of staff performance in terms of stated policies and procedures. The integrated data base allows functions to be performed without labor-intensive chart reviews.

Hospital Bed Capacity, 500 and over↗

PubMed2006

Predictive data mining in clinical medicine: current issues and guidelines.

BACKGROUND: The widespread availability of new computational methods and tools for data analysis and predictive modeling requires medical informatics researchers and practitioners to systematically select the most appropriate strategy to cope with clinical prediction problems. In particular, the collection of methods known as 'data mining' offers methodological and technical solutions to deal with the analysis of medical data and construction of prediction models. A large variety of these methods requires general and simple guidelines that may help practitioners in the appropriate selection of data mining tools, construction and validation of predictive models, along with the dissemination of predictive models within clinical environments. PURPOSE: The goal of this review is to discuss the extent and role of the research area of predictive data mining and to propose a framework to cope with the problems of constructing, assessing and exploiting data mining models in clinical medicine. METHODS: We review the recent relevant work published in the area of predictive data mining in clinical medicine, highlighting critical issues and summarizing the approaches in a set of learned lessons. RESULTS: The paper provides a comprehensive review of the state of the art of predictive data mining in clinical medicine and gives guidelines to carry out data mining studies in this field. CONCLUSIONS: Predictive data mining is becoming an essential instrument for researchers and clinical practitioners in medicine. Understanding the main issues underlying these methods and the application of agreed and standardized procedures is mandatory for their deployment and the dissemination of results. Thanks to the integration of molecular and clinical data taking place within genomic medicine, the area has recently not only gained a fresh impulse but also a new set of complex problems it needs to address.

Clinical Medicine↗

PubMed2002

Test-based E-Learning: a new path in training medical students.

TENDO is a project conducted by the Department of Medical Informatics and Statistics of the Ghent University in the field of E-Learning and more specifically E-Testing (Electronic, on line testing). At this stage, the main goal of Tendo is to measure the knowledge of (medical) students making use of the Internet. The on line Tendo E-Testing tool has been used to examine students of the 4th year studying Physical Therapy and Rehabilitation. The aim of this document is to give an overview of the features of E-Testing and more specifically of the Tendo product.

Education, Medical, Undergraduate↗

PubMed1994

[Fatigue and signs of depressive symptoms in general practice in Aquitaine].

UNLABELLED: An epidemiologic study of patients consulting General Practitioners (GPs) was conducted among GPs who usually collaborate on Aquitaine Sentinel Network, supported by the Department of Medical Informatics of the University of Bordeaux II. One day in June and one day in December 1992, each GP who participated in this investigation had to collect age, sex and reason for consulting about every patient who took medical advice. For every patient over 15 year old, on the day of the consultation or the previous week, the GP had to collect signs of depression, dysphoria, loss of interest or pleasure in the daily-living activities, insomnia, fatigue, inappropriate guilt, diminished ability to think or indecisiveness, recurrent thoughts of death... RESULTS: In June, 79 GPs collected data on 1,500 patients and in December 80 GPs interviewed 1,400 patients. The main sign was fatigue (35%). Then, in frequency order, sleep disorders (26.5%), appetite and weight disorders (22.7%), dysphoria (18.7%) and loss of interest or pleasure for daily-living activities (16.7%) have been found. Among patients who present at least one of the signs of depression (more than 50% of the sample), half had associated handicap in every-day life activities. Major depression prevalence rate was respectively 5% in June and 6.3% in December whereas dysthymia was 4.3%.

Adolescent↗

PubMed1997

An information infrastructure for long-term care.

Emerging trends promise to alter the way long-term care is practiced. These include: changing regulation of the nursing home industry with emphasis on outcome and assessment, a trend in medical informatics away from expert systems and toward on-line decision support and reminder systems, and the application of industrial statistical quality management techniques to the realm of human services. Emerging standards such as the Arden Syntax and Unified Medical Language Systems and technologies such as Rapid Application Development Tools will facilitate the use of modern computing to mold and implement these converging trends.

Abstracting and Indexing↗

PubMed2001

Comparing syntactic complexity in medical and non-medical corpora.

With the growing use of Natural Language Processing (NLP) techniques as solutions in Medical Informatics, the need to quickly and efficiently create the knowledge structures used by these systems has grown concurrently. Automatic discovery of a lexicon for use by an NLP system through machine learning will require information about the syntax of medical language. Understanding the syntactic differences between medical and non-medical corpora may allow more efficient acquisition of a lexicon. Three experiments designed to quantify the syntactic differences in medical and non-medical corpora were conducted. The results show that the syntax of medical language shows less variation than non-medical language and is likely simpler. The differences were great enough to question the applicability of general language tools on medical language. These differences may reduce the difficulty of some free text machine learning problems by capitalizing on the simpler nature of narrative medical syntax.

Artificial Intelligence↗

PubMed1995

Physician's information customizer (PIC): using a shareable user model to filter the medical literature.

The practice of medicine is information-intensive. From reviewing the literature to formulating therapeutic plans, each physician handles information differently. Yet rarely does a representation of the user's information needs and preferences--a user model--get incorporated into information management tools, even though we might reasonably expect better acceptance and effectiveness if the tools' presentation and processing were customized to the user. We developed the Physician's Information Customizer (PIC), which generates a shareable user model that can be used in any medical information-management application. PIC elicits the stable, long-term attributes of a physician through simple questions about her specialty, research focus, areas of interest, patient characteristics (e.g., ages), and practice locale. To show the utility of this user model in customizing a medical informatics application, PIC custom-filters and ranks articles from Medline, using the user model to determine what would be most interesting to the user. Preliminary evaluation on all 99 unselected articles from a recent issue of six prominent medical journals shows that PIC ranks 66% of the articles as the user would. This demonstrates the feasibility of using easily acquired physician attributes to develop a user model that can successfully filter articles of interest from a large undifferentiated collection. Further testing and development is required to optimize the custom filter and to determine which characteristics should be included in the shareable user model and which should be obtained by individual applications.

Algorithms↗

PubMed1978

Graduate education in computer systems in medicine--a conceptual model. Canadian Organization for Advancement of Computers in Health.

A conceptual model of the graduate educational programme in medical informatics is discussed. Problems involved in different types of informatics training can be avoided by stressing the integrative aspects of a systems approach. This programme is designed to lessen the gulf between a higher level of hardware capability and the ability to use it. The increasing educational demands in medical information systems have put more pressure on educational establishments to respond more expertly.

Biomedical Engineering↗

PubMed1986

Education for health sciences/biomedical librarianship: past, present, future.

This paper offers an analysis of and some predictions for the fields of library education and medical librarianship. The recent past of education for medical/health sciences librarianship is outlined, with emphasis on the changing nature of the library school, its faculty, and its students. The present situation is described, with specific reference to faculty, curriculum, and accreditation issues. A future agenda is proposed, identifying the need for interdisciplinary and cooperative efforts within the larger realms of medical informatics, high technology, a variety of health professions, and the community of contemporary library practice.

Education↗

PubMed1995

IPI, MEDICOM and DICOM: relations and possible future.

In October 1993, DICOM (Digital Imaging and Communications in Medicine) Version 3.0 was approved by the ACR-NEMA committee as an ACR-NEMA standard for medical image interchange. At about the same time, IPI (Image Processing and Interchange) was approved as an ISO standard for general imaging. Within the European Committee for Standardisation, CEN, work on a European standard for medical image interchange, MEDICOM, has been going on for the last few years. It has been decided within the CEN Technical Committee for Medical Informatics (CEN/TC 251) that such a European standard should be based on IPI. In December 1993 it was also agreed that CEN would use DICOM 3.0 as a starting point in this work. Joint meetings between CEN/TC 251 Working Group 4 (Medical Imaging and Multimedia) and ACR-NEMA have been held held during 1994 and continue in 1995. This paper points to some of the reasons, both technical and economical, why IPI is suitable for medical imaging. It also shows how DICOM and IPI are complementary and that they could be used together to cover the requirements of future applications in medical imaging.

Cardiology↗

PubMed1999

The clinical skills resource: a review of current practice.

This review is based on the findings of the Southampton Clinical Skills Project, which was a needs assessment and feasibility study to consider the development of a multiprofessional Clinical Skills Resource at Southampton. The project spanned a period of 18 months and used a range of methods of data collection, including visits to 12 clinical skills facilities in the UK. Most existing clinical skills centres have developed in response to changing healthcare policy, curricular initiatives and increasing emphasis on the quality of assessments and competencies. There is also increasing recognition that clinicians are no longer able to teach effectively all skills to students in the traditional ways, and that clinical skills training and assessment, particularly for undergraduates, is an area of deficiency. The potential scope of clinical skills centres is broad and encompasses not only clinical and communication skills but medical informatics, computer assisted learning, multiprofessional learning and assessment. Skills centres can also promote self directed and lifelong learning methods. The planning of skills centres involves a variety of stakeholders and users, including undergraduates, postgraduates, acute and community Trusts, Postgraduate Deans and medical schools. A successful skills centre needs to be flexible in its design, integral to the curriculum and relevant to educational and training requirements. This requires planning, organization and resources. Different organizational models can be used, depending on local factors. The management of skills centres involves consideration of issues such as security, safety, supervision of learners and staff development, informed by a network of experts and everyday users. The development of skills centres should include ongoing educational evaluation of outcomes and educational research. The use of a clinical skills centre has potential benefits for staff and students, including the provision of a safe environment in which to learn and practise skills before using them in the real clinical setting. This can reduce anxiety in students and protect patients from novice practice. Clinical skills centres provide a setting for structured learning with feedback as well as assessment of competence. The limitations of a skills centre are that it can only provide simulated experiences which are an adjunct to, but can never replace real clinical experience.

Clinical Competence↗

PubMed2003

[Design and realization of HL7 gateway].

With the development of the technology in medical informatics area, Health Level Seven (HL7) Standard for electronic data exchange in all healthcare environments has become a widely used standard. To bring it into practice in China, we developed an HL7 gateway. The gateway is used to connect two different medical information systems, a Hospital Information System (HIS) and a Laboratory Information Management System (LIMS), via the HL7 message exchanging. The system verified the feasibility of HL7 standard and made a good example for further research and development.

Computer Communication Networks↗

PubMed2000

A proposed solution for addressing the challenge of patient cries for help through an analysis of unsolicited electronic mail.

BACKGROUND: Unsolicited electronic mail (e-mail) is e-mail sent to a physician from a person unknown to the physician, who is seeking professional help. The purpose of this project was to analyze unsolicited e-mails sent to a digital textbook author to: 1) characterize the e-mails, 2) determine what resources would be necessary to answer the e-mails, and 3) propose a standard approach to reply to e-mails in a helpful yet medicolegally-responsive manner. MATERIALS AND METHODS: All e-mails (315) sent to a digital textbook author from October 1995 through October 1998 were abstracted. Variables included: date and location, sender type, patient age, subject, medical content, and resources necessary to answer the question. Data frequencies were obtained. RESULTS: The most common location was the.com domain (47.6%). The most common senders were laypersons (66%). Overall, 44.4% of the e-mails concerned children. Detailed, patient-specific information was sent in 63.2% of the e-mails. The most common subjects were overviews of a disease or problem (32.4%), differential diagnosis (16.8%), and therapy/treatment questions (15.9%). The medical content covered a broad range of specialties. Specialists were overwhelmingly the resource necessary to answer the e-mails (74.9%). CONCLUSIONS: Pediatricians with educational information on the Internet can expect an increase in the number of unsolicited e-mails as Internet usage expands. Laypersons regard even short passages to mean the author is an expert in that particular area. Pediatricians need to consider the ethical and medicolegal implications of responding to unsolicited e-mails. A nonpersonalized, standard e-mail reply is proposed that directs the sender to quality information resources that may be of further assistance. unsolicited electronic mail, e-mail, medical informatics, legal issues, ethical issues, digital libraries.

Adolescent↗

PubMedDate not supplied

Trends and pitfalls with nomenclatures and classifications in medicine.

This paper reflects some of the main points in the history and the trends of classifications, nomenclatures and knowledge representation models in medicine. The relations with philosophical background are briefly related. The contributions in this field during the Medical Informatics Europe (MIE) conference in 1997 are presented. International collaborations in the field of lexico-semantic resources and inter-disciplinary partnership in natural language processing technologies are necessary steps to achieve definitive results that will lead to applications in the daily medical practice.

Algorithms↗