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At least 1,063 records · Page 59Linked to original sources
PubMed1996

Utilizing OODB schema modeling for vocabulary management.

Comprehension of complex controlled vocabularies is often difficult. We present a method, facilitated by an object-oriented database, for depicting such a vocabulary (the Medical Entities Dictionary (MED) from the Columbia-Presbyterian Medical Center) in a schematic way which uses a sparse inheritance network of area classes. The resulting Object Oriented Health Vocabulary repository (OOHVR) allows visualization of the 43,000 MED concepts as 90 area classes. This view has provided valuable information to those responsible with maintaining the MED. As a result, the MED organization has been improved and some previously-unrecognized errors and inconsistencies have been removed. We believe that this schematic approach allows improved comprehension of the gestalt of large controlled medical vocabulary.

Classification↗
PubMed1996

Formal descriptions and adaptive mechanisms for changes in controlled medical vocabularies.

Standard controlled medical vocabularies are typically based on a coding scheme, while medical informatics applications tend to have a more formal conceptual foundation. When such applications attempt to use data coded with standard vocabularies, problems can arise when the standard vocabulary changes over time. A formal taxonomy is presented for describing the semantic changes which can occur in a vocabulary, such as simple addition, refinement, precoordination, disambiguation, redundancy, obsolescence, discovered redundancy, major name changes, minor name changes, code reuse, and changed codes. The taxonomy is described that used to effect change in one concept-based vocabulary (the Medical Entities Dictionary), and the utility of the approach is demonstrated by applying it to the changes appearing in the 1994 release of the International Classification of Diseases, Ninth Edition, with Clinical Modifications (ICD-9-CM).

Classification↗
PubMed1996

A poor precedent.

The single greatest impediment to the successful leveraging of computer-based patient records (CPRs) is the difficulty of creating and maintaining comparable patient descriptions. Specifically, it will be hard to justify the investment required to deploy CPRs widely if the patient descriptions they store are not comparable across successive releases of controlled health-care vocabularies. Thus, it is necessary to solve the controlled health-care vocabulary update problem for CPRs before the comparability of patient descriptions can be sustained. What may seem to be a narrow technical problem of interest only to maintainers of health-care enterprise systems is, instead, a central problem of medical informatics. Cimino's "Formal descriptions and adaptive mechanisms for changes in controlled medical vocabularies" describes a classification of the changes appearing in the 1994 Edition of the International Classification of Diseases (ICD-9-CM). His paper describes the conversion of differences detected between the 1993 and 1994 releases of ICD-9-CM and a conversion of the elements of the classification into the required formal changes to the Medical Entities Dictionary (MED), part of the CPR in use at Columbia Presbyterian Medical Center. Because the process of detecting differences begins with an empirical analysis of the ASCII representations of the 1993 and 1994 releases of ICD-9-CM, it is impossible for a computer program to infer the intent of the changes that caused the differences; instead, a content expert must infer the intent and then update the MED accordingly. A typical task is to infer whether a change in naming also reflects a change in the meaning named. While Cimino's methods and their execution are exemplary in every respect, they nevertheless constitute a kind of "reverse engineering"-an ad hoc attempt to infer intent from details. Reverse engineering of changes to controlled medical vocabularies is a poor precedent. Such methods should be viewed as necessary short-term expedients only, and all parties concerned should work toward an incremental plan by which the intent of changes to controlled health-care vocabularies can be made both explicit and machine processible. Only then can the comparability of patient descriptions be sustained.

Disease↗
PubMed1996

Advocacy: exploring the concept.

The concept of the nurse as the patient's advocate is one that has become popular in the last fifteen years or so in both North America and the United Kingdom, having its basis in nursing theory. The UKCC first embraced the concept, stating in the Code of Professional Conduct that nurses must; 'act always in such a manner so as to promote and safeguard the interests and well being of patients and clients'. This is a laudable principle and one that nurses cannot dispute as there are many members of our society who are weak and vulnerable and may be unable to speak up for themselves. But are nurses always in a position to be an advocate for their patients? As the nature of nursing is so diverse then the nature of advocacy will be different in the multifarious settings in which nurses practise. Can theatre nurses ever be in a position to act as an advocate for a patient who is often anaesthetised? What precisely is advocacy and is the Concise Oxford Dictionary definition of 'one who pleads for another' appropriate in the nursing context? Then there is the position of nurses in the healthcare organisation in which they practise. In advocating for their patients, nurses may find they are pleading a case for a patient, or a group of patients, that could bring the nurse into conflict with their medical colleagues or with the management of the organisation by whom they are employed. Additionally, they may not posses the skills and knowledge to advocate effectively under such circumstances. Nursing is littered with the casualties of such conflicts over the years, the most publicised of whom, in the UK, was probably Graham Pink who lost his job as a charge nurse after drawing public attention to what he considered to be an unacceptable standard of care in the hospital in which he worked.

Clinical Competence↗
PubMedDate not supplied

IAIMS architecture.

An information system architecture defines the components of a system and the interfaces among the components. A good architecture is essential for creating an Integrated Advanced Information Management System (IAIMS) that works as an integrated whole yet is flexible enough to accommodate many users and roles, multiple applications, changing vendors, evolving user needs, and advancing technology. Modularity and layering promote flexibility by reducing the complexity of a system and by restricting the ways in which components may interact. Enterprise-wide mediation promotes integration by providing message routing, support for standards, dictionary-based code translation, a centralized conceptual data schema, business rule implementation, and consistent access to databases. Several IAIMS sites have adopted a client-server architecture, and some have adopted a three-tiered approach, separating user interface functions, application logic, and repositories.

Computer Systems↗
PubMedDate not supplied

[Translation of the English term odds ratio as oportunidad relativa].

In the present work we argue for the translation of the English term odds ratio, a term of formal anti-natural esthetics for the Spanish-speaking and with added phonetic difficulties, for oportunidad relativa. These words respect the English abbreviation OR facilitating the expression of consistent formulations which may be directly translated, as well as communication between users, since the linguistic confusion due to the present abundance of terms used in Spanish, is reduced to one. Our justifications are mainly syntactic and semantic and reflect reasonable comparability between the terms odds ratio and oportunidad relativa. Reviews of some of the most prestigious dictionaries of the English and the Spanish languages lend additional support to our proposition.

Odds Ratio↗
PubMed1997

Aerobiologia 2.0: a software program for processing aeropollen data.

"Aerobiologia 2.0" is a simple computer program created to handle the pollen data collected every 2 hrs and daily by aerobiological monitoring stations equipped with Hirst-type spore traps. "Aerobiologia 2.0" runs on Windows 3.1 and is compatible with other programs that run on this operating system. The program was developed to store and process pollen data through a few straightforward operations. An unlimited calendar automatically calculates the day of the week. The pollen dictionary, which can hold up to 1216 different pollen types, may be modified or changed completely. Concentrations for every pollen type (in pollen grains/m3) are automatically recorded daily and every 2 hrs. 10-day and monthly sums are also calculated. The percentage of selected types, groups, or families of pollen collected each day, every 10 days, and monthly is quickly available. Pollen calendars and spectra in 24-hr, 10-day, monthly, tri-monthly, half-year, and yearly periods are readily produced. As soon as it is entered, the pollen data are saved on hard disk. A year's worth of data can be saved on a single 1.44 M byte floppy disk. Aerobiologia 2.0 is being used successfully to process the aeropollen data collected at the two monitoring stations managed by our Palynological Laboratory.

Air Pollutants↗
PubMed1997

Supporting infobuttons with terminological knowledge.

We have developed several prototype applications which integrate clinical systems with on-line information resources by using patient data to drive queries in response to user information needs. We refer to these collectively as infobuttons because they are evoked with a minimum of keyboard entry. We make use of knowledge in our terminology, the Medical Entities Dictionary (MED) to assist with the selection of appropriate queries and resources, as well as the translation of patient data to forms recognized by the resources. This paper describes the kinds of knowledge in the MED, including literal attributes, hierarchical links and other semantic links, and how this knowledge is used in system integration.

Information Storage and Retrieval↗
PubMed1997

Development of a change model for a controlled medical vocabulary.

Managing change in controlled medical vocabularies is labor intensive and costly, but change is inevitable if vocabularies are to be kept up to date. The changes that are appropriate for a controlled medical vocabulary depend on the data stored for that vocabulary, and those data in turn depend on the needs of users. The set of change operations is the change model; the data stored about concepts comprise the concept model. Because the change model depends directly on the concept model, a discussion of the former necessitates a discussion of the latter. In this paper, we first present a set of tasks that we believe controlled medical vocabularies should handle. Next, we describe our concept model for a controlled medical vocabulary. Then, we review the literature on changes in existing vocabulary systems. Finally, we present our change model. We call our system, which incorporates the concept model and change model, the General Online Dictionary of Medicine (GOLDMINE).

Models, Theoretical↗
PubMed1997

Controlled vocabulary and design of laboratory results displays.

Traditional data-review displays are driven by the ancillary systems that produced the data. A different paradigm is being used at Columbia-Presbyterian Medical Center (CPMC) where a controlled medical vocabulary-the Medical Entities Dictionary (MED) is the driving force behind laboratory data-review displays. Using hierarchical and semantic networks the authors have constructed a Web-based tool that considerably simplifies the MED-editing task required to create new displays. The tool uses knowledge in the MED to extract contextually relevant hierarchic and semantic sub-nets from the MED. The tool has a sensitivity of 92.2% and a relevance of 94.7% for retrieval of terms from the MED. Based on these results and given sufficient domains' structure within controlled vocabularies, we conclude that similar algorithms will enable applications to design and generate customized displays on-the-fly.

Algorithms↗
PubMed1997

Definite-clause grammars for the analysis of cis-regulatory regions in E. coli.

Based on an extensive collection of sigma 70 associated regulatory mechanisms, a grammatical model has been constructed that define the functional positions and combinations of sites within DNA regulatory regions. The syntactic rules and the dictionary implemented in a Prolog program were coupled to consensus matrices used as "sensors" to integrate a syntactic recognizer. A systematic comparison between the syntactic recognizer and the standard weight matrix methodology is presented using 12 regulatory proteins and the whole collection of about 130 sigma 70 DNA regulatory regions. On the average an increased sensitivity of 5 to 10 fold is obtained with this novel approach.

Binding Sites↗
PubMed1997

TRANSFAC database as a bridge between sequence data libraries and biological function.

The TRANSFAC database contains information about regulatory DNA sequences and the proteins (transcription factors) binding to and acting through them. It may thus serve as a dictionary for the biological meaning of these sequence elements. Moreover, the TRANSFAC data can be used to describe these elements, to define consensi and matrices for elements of certain function, and thus to provide means of identifying regulatory signals in newly unravelled genomic sequences.

Base Sequence↗
PubMed1997

Mycetismus in Hamadan, of west Iran.

Mycetismus or mushroom poisoning is defined in Anisworth and Brisby's Dictionary of the Fungi as distress resulting from the consumption of a fungal organism. This is in contrast to mycotoxicosis where the fungus, usually a hyphomycete, acts on some foodstuff of humans or animals and alters it. The paper describes three incidents of poisoning by the mushroom Amanita virosa in the Hamadan region of Iran. Two poisoning incidents occurred in adults and one in a child. All patients were associated with severe gastrointestinal symptoms including profuse diarrhea, vomiting and intestinal pain. For identification of A. virosa, in addition to the case history and the symptoms, examination of kitchen waste was done and mushroom remains examined with 2% aqueous KOH, Melzer's reagent, using the identification keys of Bresinsky. Because this fungus is likely to be confused with edible mushrooms and mushroom hunting is a popular endeavor in some areas of the Hamadan region, it is important to educate people about the dangers involved.

Adult↗
PubMed1998

[Problems in the use of personal computers in the military polyclinic].

Problems, connecting with use of the personal computer in military polyclinic and arising at creation of automated working places of medical purpose are analyzed. A role and place of unified medical qualifiers, directories and dictionaries, formalized descriptions is opened. A combined way is supposed, at which through directory the static diagnosis (main and accompanying) is chosen, but the doctor supplements record by the individual characteristics of particular patients. These records fill up the appropriate directories in order of the formalized conclusions. Here in after they can be caused on screen, having reduced sharply hand-operated input. Besides, these data are means of training for doctors with small experience, because information maintenance have been created during development by the experienced experts.

Computer Communication Networks↗
PubMedDate not supplied

A system linking occupation history questionnaire data and magnetic field monitoring data.

A method is presented which links on-site electromagnetic field monitoring data with pre-existing work history data. The linkage is used to estimate cumulative and average annualized magnetic field exposure for a case-control study. On-site electromagnetic field monitoring data for 1,966 volunteer utility employees, at 59 sites in the United States and three other countries, were obtained from a large project (the EMDEX project) designed to collect, analyze, and document 60-Hz electric and magnetic field exposures for a diverse population. These data represent 9 primary work environments, and 16 job classification categories, amounting to 144 unique job categories which were consolidated using the job-exposure matrix presented into 282 three-digit Dictionary of Occupational Title (DOT) codes. The DOT code categories were then linked to lifetime occupational histories from a case-control study of leukemia. The method may be extended to link additional job titles with monitoring information. Job titles linked with electromagnetic field monitoring information provide more specific estimates of exposure intensity than previous ordinal estimates of exposure. Therefore, estimates of cumulative electromagnetic field exposure are achievable, as well as high and low level exposure estimates.

Case-Control Studies↗
PubMed1997

[Dissemination of the Japanese version of the International Chemical Safety Card (ICSC) on the World Wide Web (WWW)].

ge of the Japanese version of the International Chemical Safety Cards (ICSC). We prepared the Japanese text files of ICSC, converted them into HTML files and also prepared the dictionary database for the retrieval system, using programs which we developed. These programs shortened the time of work remarkably. 2D- and 3D-structures of chemicals were also incorporated in each ICSC page. Approximately 900 ICSCs in Japanese are provided at the moment on the homepage.

Computer Communication Networks↗
PubMedDate not supplied

Web technology for emergency medicine and secure transmission of electronic patient records.

The American Heritage dictionary defines the word "web" as "something intricately contrived, especially something that ensnares or entangles." The wealth of medical resources on the World Wide Web is now so extensive, yet disorganized and unmonitored, that such a definition seems fitting. In emergency medicine, for example, a field in which accurate and complete information, including patients' records, is urgently needed, more than 5000 Web pages are available today, whereas fewer than 50 were available in December 1994. Most sites are static Web pages using the Internet to publish textbook material, but new technology is extending the scope of the Internet to include online medical education and secure exchange of clinical information. This article lists some of the best Web sites for use in emergency medicine and then describes a project in which the Web is used for transmission and protection of electronic medical records.

Artificial Intelligence↗
PubMed1998

How critical is chronic critical leg ischaemia?

"Critical" according to the Oxford dictionary means: a "turning point" where an acute change for better or worse may be anticipated. Thus, the meaning of the word "critical" complies with its use in relation to ischaemia. We don't really know, prospectively, what will happen to the critically ischaemic limb, whether it will improve or worsen. The answer to the question "How critical is critical leg ischaemia (CLI)?" must be: "We don't know!" The addition of ankle systolic pressure as an objective haemodynamic measurement has not made the definition of the Second European Consensus Group significantly better than the original Fontaine classification, grade III and IV. For clinical practice the Fontaine classification will be sufficient. For scientific purposes macro- and microcirculatory assessments and information about the patient's risk profile should be added.

Chronic Disease↗