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Probability estimation for biomedical classification problems.

Suppose that we wish to know the probability that an object belongs to a class. For example, we may wish to estimate the probability that a patient has a particular disease, given a set of symptoms, or we may wish to know the probability that a novel peptide binds to a receptor, given the peptide's amino-acid composition. The conventional approach is to first use a classification algorithm to find partitions in feature space and to assign each partition to a class, and then to estimate the conditional probabilities as the proportion of patients or peptides that are correctly and incorrectly classified in each partition. Unfortunately, this estimation method often gives probability estimates that are in error by 20% or more, and thus can cause incorrect decisions. We have implemented and compared alternative methods. In Monte Carlo simulations the alternative methods are substantially more accurate than is the current method.

Epidemiology

Quality control in a medical information system.

Quality assurance techniques provide an opportunity to identify sources of error and to provide the feedback necessary to prevent their repetition. The authors outline an effort to define the steps required for effective quality management procedures in a computerized medical information system (MIS). The computerized management of medical information can be used not only to enhance current quality management activities but also to extend the realm of quality assurance to areas that have heretofore resisted management. Quality-management techniques have the potential for measuring and improving medical decision making processes central to patient care.

Abstracting and Indexing

Identification of drugs in physiological fluids following on-line liquid chromatographic purification and analysis.

This paper describes the application of an automated algorithm for drug identification following the liquid chromatographic on-line separation and purification of drugs in physiological fluids. Two hundred fifty-seven (257) drugs and 45 drug metabolites were assembled for testing. Two internal standards were used which monitored different columns in the multi-step analytical separation. Retention reproducibility over a nine month period was 4 p. cent or less for most drugs. The algorithm for matching unknown peaks against the stored library utilized relative retention, lambda maxima, normalized spectral overlays, wavelength ratios and zero-intercepts from the second derivative in a combined forward-reverse search. Most of the drugs which could not be unambiguously identified were sedatives which eluted in the first minutes of the chromatogram. Diasteromers were partially resolved. Repetitive analysis of 200-400 micrograms/l of amphetamine, diphenhydramine, imipramine and morphine were evaluated to establish an absorption cutoff of 12 mAbs, above which at least 95% of peaks were correctly identified. This corresponded to a signal-to-noise ratio of 12 for the scanning UV detector which was evaluated.

Algorithms

The South Dakota Med-Fax network.

Health sciences librarians established a statewide medical information network in South Dakota to provide rural physicians with database access and rapid document delivery. A private grant funded equipment for interactive simultaneous remote searching (ISRS) and telefacsimile transmission, as well as for a coordinator for training and follow-up support. In less than one year, telefacsimile technology has become an integral part of library information transfer among sixteen network sites, and ISRS is gaining acceptance among physicians who lack local access to online databases.

Copying Processes

Computers in the medical workplace.

Whether your greatest need is to have a neatly typed letter or an accurately aged accounts receivable report, or it's critical that you create an electronic medical record for decision support, the computer in the medical workplace should: 1. Save time for staff and patients. 2. Be convenient to use. 3. Respond quickly to the user. 4. Be flexible. 5. Free staff for intelligent work. 6. Minimize or eliminate redundancy. 7. Allow retrospective retrieval. If your computer and software produces the above results, you've chosen appropriate software and right equipment for your specific needs and your work place.

Computers

Development and assessment of a computerized index of clinical disease activity in systemic lupus erythematosus. Members of the British Isles Lupus Assessment Group (BILAG).

Five centres in Great Britain and the Republic of Ireland have collaborated to produce a computerized index of clinical disease activity in systemic lupus erythematosus, based on the principle of the physician's intention to treat. The index assesses separately eight organ-based systems. The index has proved quick and easy to use despite a comprehensive database and compares favourably with two other indices of disease activity. It has great potential for use in multicentre studies of disease outcome and new therapies in systemic lupus erythematosus.

Humans

The synergism of Health Information Science/Health Informatics.

The purpose of this paper is threefold: to review the status of Health Information Science (Health Informatics) as reported in the literature; to suggest a taxonomy to integrate the many varied concepts being discussed under the rubric of Health Information Science; and to propose a framework into which research can be classified and potential research hypotheses generated. It is suggested that such a framework is needed if generalizations are to be made to the end that the knowledge produced from research efforts may be cumulative with that from other studies. A framework for research is needed if the field is to become an established academic discipline; whether or not it takes on the mantel of a "science" is another matter.

Humans