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PubMedDate not supplied

[Assessment of frontal functions in psychiatric patients during maintenance electroconvulsive therapy].

INTRODUCTION: Previous studies on adverse cognitive effects of electroconvulsive therapy (ECT) have not found any significant alteration of the frontal functions after an acute treatment course. This study aims to assess frontal executive functions in psychiatric patients during maintenance electroconvulsive therapy (M-ECT). SUBJECTS AND METHODS: Thirty two patients treated with M-ECT and 29 psychiatric patients never treated with ECT were evaluated with neuropsychological tests that assessed the following frontal functions: work memory, planning, cognitive flexibility, attention, visuomotor velocity, verbal abstract reasoning and phonetic verbal fluency. RESULTS: Multivariate global analysis did not detect significant frontal function tests differences between both groups. The M-ECT group only scored significantly lower on the FAS test, a test that measures phonetic verbal fluency. A significant correlation between number of previous ECT sessions and performance in the FAS was found. CONCLUSIONS: The M-ECT patient group presented a phonetic verbal fluency alteration that may also be associated to the previous number of ECT sessions. No significant differences in the other frontal functions were detected.

Bipolar Disorder↗
PubMedDate not supplied

Searching for biomedical information on the World Wide Web.

The rapid growth of biomedical information available via the Internet and its most popular retrieval system, the World Wide Web, has fostered active research and development directed toward locating resources that are appropriate for answering specific queries. The goal is to create tools that optimize information retrieval (as measured by two quantities, precision and recall) while minimizing the effort required by the user. Existing Web retrieval tools can be divided into the following groups: manually maintained topical lists; automatically generated word-based indices; software agents and multi-index searching aids; network cataloging methods; and miscellaneous hybrid and newer approaches. Improvements in current methods should arise from further research into: methods of describing objects on the Web; improved ways of searching for (and within) collections of documents as opposed to single documents; the ability to search for fielded documents; and ways to describe resources that span intra- and interdisciplinary as well as cross-cultural linguistic differences. For this last problem, the U.S. National Library of Medicine's Unified Medical Language System (UMLS) will be of great help. As online information retrieval improves, efforts are underway to improve the online information itself; quality control over content is being addressed as the peer-review systems of traditional printed journals migrate into the realm of electronic publication.

Abstracting and Indexing↗
PubMed2004

Defaults, context, and knowledge: alternatives for OWL-indexed knowledge bases.

The new Web Ontology Language (OWL) and its Description Logic compatible sublanguage (OWL-DL) explicitly exclude defaults and exceptions, as do all logic based formalisms for ontologies. However, many biomedical applications appear to require default reasoning, at least if they are to be engineered in a maintainable way. Default reasoning has always been one of the great strengths of Frame systems such as Protégé. Resolving this conflict requires analysis of the different uses for defaults and exceptions. In some cases, alternatives can be provided within the OWL framework; in others, it appears that hybrid reasoning about a knowledge base of contingent facts built around the core ontology is necessary. Trade-offs include both human factors and the scaling of computational performance. The analysis presented here is based on the OpenGALEN experience with large scale ontologies using a formalism, GRAIL, which explicitly incorporates constructs for hybrid reasoning, numerous experiments with OWL, and initial work on combining OWL and Protégé.

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PubMed2004

An implementation of the trigram phrase matching method for text similarity problems.

The representation of texts by term vectors with element values calculated by a TFIDF method yields to significant results in text similarity problems, such as finding related documents in bibliographic or full-text databases and identifying MeSH concepts from medical texts by lexical approach and also harmonizing journal citation in ISI/SciELO references and normalizing author's affiliation in MEDLINE. Our work considered "trigrams" as the terms (elements) of a term vector representing a text, according to the Trigram Phrase Matching published by the NLM's Indexing Initiative and its logarithmic Term Frequency-Inverse Document Frequency method for term weighting. Trigrams are overlapping 3-char strings from a text, extracted by a couple of rules, and a trigram matching method may improve the probability of identifying synonym phrases or similar texts. The matching process was implemented as a simple algorithm, and requires a certain amount of computer resources. An efficiency-focused C-programming was adopted. In addition, some heuristic rules improved the efficiency of the method and made it feasible a regular "find your scientific production in SciELO collection" information service. We describe an implementation of the Trigram Matching method, the software tool we developed and a set of experimental parameters for the above results.

Abstracting and Indexing↗
PubMed2000

[Indexes for the evaluation of scientific publications: what they are and what they are used for].

Today, medicine lives the paradigm of Evidence-Based Medicine, which integrates the most recent discoveries of Research in day-to-day Clinical Practice. Simultaneously, there is an exponential growth in biomedical scientific knowledge, and, with it, of the number of scientific papers and biomedical journals. Currently, the assessment of the quality of biomedical scientific information is based on the peer review method, which also has different types of bias. In this setting, quantitative indexes are increasingly being used to assess it. Three of these indexes are the quotation rate, the impact factor and the Immediacy Index that, despite their objectivity, have several limitations. The impact factor, which is a valid tool to estimate the quality of a scientific journal, is not suited to evaluate single articles, scientists or research groups. In these cases, the best methodology is quotation analysis. No method, however, can replace the individual reading and study of the contents of the scientific work. Of the new potentialities of biomedical information, the possibility of discussing scientific articles before their publication is particularly promising. With this purpose, the netprints servers, which are new sites on the Internet, were created. Other sites where we can have access to databases with summaries of guidelines have also been created in an attempt to reduce the gap between research and clinical practice.

Abstracting and Indexing↗
PubMed1990

[Registration of detailed data in the medical record or how to translate "impressions" into measurable observations].

Every medical case record represents a mass of data (texts, pictures, figures, etc.) in an unstructured form. The physician needs to retrieve this data via several access routes: temporal (dependent on date or sequences of events), type of data (diagnostic, treatment, clinical signs, laboratory findings, image descriptors, all with their interrelationships), or depending on the severity of the disease, etc. Retrieval of this data fulfils several functions: circulation of a case record among specialists, assistance in summarizing a long and complex clinical course, comparison of patients, research, and teaching. Three projects are described which have the same aim: structuring of the case record in order to retrieve detailed data on patients as individuals and describe clinical courses on the basis of measurable observations. This structure must be understandable to a computer (directly or indirectly) so that searches and comparisons can be performed automatically. The first project, entitled "indexed paragraph prototype" reproduces the structure of the problem-oriented case record and is designed to input the Medical Outpatients Department's follow-up notes into the computer. The second, "automatic language analysis", aims to exploit two characteristics of medical language, its omnipresence in the case record and its reliability, in view of its status as the spontaneous vehicle of communication between physicians. The third, "collection of clinical signs during consultation", is based on a prospective collection of all elements of clinical observation, structured temporally consultation by consultation. The purpose of precise collection of detailed and measurable observations in individual patients is to identify those among the clinical signs which display the greatest power of discrimination, i.e. those which best serve to predict the case's evolution.

Abstracting and Indexing↗
PubMed1992

Computer databases of medical school curricula.

As the pace of curriculum reform in medical education has accelerated during the past decade, so too have demands on curriculum managers to supply increasingly detailed information about the curriculum. In response, a number of schools have joined together to begin work on designs for computer databases of the curriculum. The authors describe three of the most mature curriculum database prototypes, developed by groups at the medical schools of the University of North Carolina at Chapel Hill (UNC), The University of Maryland, and the University of Miami. All three groups have employed relational database management systems to organize information about each "instructional unit" in the preclinical curriculum, including a set of keywords defining the major concepts presented. The keywords are indexed to a controlled vocabulary, either the Medical Subject Headings (MeSH) or a MeSH derivative. The UNC database also employs a textfile management system to provide users with an overview of the entire curriculum. Future work will focus on identifying a suitable controlled vocabulary; capturing content in greater contextual detail; incorporating alternative learning formats, such as problem-based learning; creating links between content items and examination questions; and capturing information generated by student-patient interactions in clinical settings. As a result of recent collaboration with the Association of American Medical Colleges, work to define a prototype national database has begun and a consortium of interested schools is addressing further development activities.

Abstracting and Indexing↗
PubMed2002

Free-text medical document retrieval via phrase-based vector space model.

Many information retrieval systems are based on vector space model (VSM) that represents a document as a vector of index terms. Concepts have been proposed to replace word stems as the index terms to improve retrieval accuracy. However, past research revealed that such systems did not outperform the traditional stem-based systems. Incorporating conceptual similarity derived from knowledge sources should have the potential to improve retrieval accuracy. Yet the incompleteness of the knowledge source precludes significant improvement. To remedy this problem, we propose to represent documents using phrases. A phrase consists of multiple concepts and word stems. The similarity between two phrases is jointly determined by their conceptual similarity and their common word stems. The document similarity can in turn be derived from phrase similarities. Using OHSUMED as a test collection and UMLS as the knowledge source, our experiment results reveal that phrase-based VSM yields a 16% increase of retrieval accuracy compared to the stem-based model.

Abstracting and Indexing↗
PubMedDate not supplied

Building a relational database for a physician document index.

We show how three existing medical knowledge bases: Medical Subject Headings (MeSH), Standardized Nomenclature of Medicine (SNOMED) and Current Medical Information and Technology (CMIT) are mapped into a relational data model and stored on an Apollo workstation and an Intelligent Database Machine. Since two of these knowledge bases have been used in the indexing of medical literature and patient records, they can be useful not only as direct views on the organization of medical concepts but also as tools for the retrieval of documents. In order that the concepts from one knowledge base can be connected to those of the other knowledge base, a method has been developed for the semi-automatic merging of MeSH, SNOMED and CMIT. This method takes advantage of the relational model and the synonyms that are given in SNOMED and CMIT, in order to recommend concepts to be merged. An expert interacts with the system to accept or reject the recommendations of the computer. The method would apply equally well to other knowledge bases and is particularly well-suited for knowledge bases that contain tens of thousands of concepts.

Abstracting and Indexing↗
PubMed1999

A strategy for statistical Master Person Index linking.

A linking program used by Connecticut Healthcare Information Management and Exchange to maintain the Master Person Index for its large, state-wide patient data repository is being stretched beyond its limits by the growing size and complexity of the database. This paper presents the early work into developing a second-generation linking program. Like the original program, the new linker will use a unique multi-step process to allow effective linking of data from a large number of dissimilar data sources. The new linker will use parallel multi-processing to allow improved performance and scalability. These changes will also make possible more sophisticated statistical methods of defining link confidence. The system is implemented using a scalable collection of inexpensive, PC based systems running the Linux operating system, a freely available database engine, and the Java programming language.

Abstracting and Indexing↗
PubMed2006

Chemical structure indexing of toxicity data on the internet: moving toward a flat world.

Standardized chemical structure annotation of public toxicity databases and information resources is playing an increasingly important role in the 'flattening' and integration of diverse sets of biological activity data on the Internet. This review discusses public initiatives that are accelerating the pace of this transformation, with particular reference to toxicology-related chemical information. Chemical content annotators, structure locator services, large structure/data aggregator web sites, structure browsers, International Union of Pure and Applied Chemistry (IUPAC) International Chemical Identifier (InChI) codes, toxicity data models and public chemical/biological activity profiling initiatives are all playing a role in overcoming barriers to the integration of toxicity data, and are bringing researchers closer to the reality of a mineable chemical Semantic Web. An example of this integration of data is provided by the collaboration among researchers involved with the Distributed Structure-Searchable Toxicity (DSSTox) project, the Carcinogenic Potency Project, projects at the National Cancer Institute and the PubChem database.

Abstracting and Indexing↗
PubMed2003

Level of evidence and citation index in current neurosurgical publications.

Systematic clinical reviews or meta-analyses offer scientifically valid sources of clinical information. They provide information in a concise form and can contribute to clinical quality management. Such studies, however, are only able to reflect the quality of the articles reviewed. The aim of this study was to evaluate the quality of the neurosurgical literature according to evidence-based medicine (EBM) standards. We reviewed all articles published in 1999 in three major neurosurgical journals. These articles were subdivided according to the level of evidence (LOE) scale (from 0 to V), article type, and citation index. Nine hundred eighty-two articles were published in these journals in 1999. Of these, 346 (35%) were clinical studies, 287 (29%) case reports, 153 (16%) experimental studies, 122 (13%) technical reports, and 74 ( 8%) other types. Subdivision according to LOE was: Ia 0.3%, Ib 2.5%, IIa 0.2%, IIb 4.3%, IIc 9.5%, IIIa 0.1%, IIIb 3.9%, IV 22.4%, and V 1.6%. Fifty-five percent of all published studies were case reports, experimental studies, technical reports, or others and thus could not be subdivided according to the EBM standards. The number of articles published with high LOE seems to be rather low in 1999. If these data reflect overall publication practice, it seems unclear whether enough articles with high LOE are published to propose scientifically sound clinical treatment suggestions according to EBM standards.

Abstracting and Indexing↗
PubMed1986

Indexing civil commitment in psychiatric emergency rooms.

A reliable prototype index, Three Ratings of Involuntary Admissibility (TRIAD), was developed to reflect the way psychiatric emergency room clinicians apply legal criteria for involuntary commitment. The interrater reliability coefficients--Pearson's r--of the TRIAD system for rating patients are 0.94, danger-to-self score; 0.89, danger-to-other score; 0.77, grave-disability score; and 0.89, total-admissibility score. TRIAD scores accounted for 82 percent of 89 disposition decisions in two metropolitan county hospital psychiatric emergency rooms. Study results indicate that (1) psychiatric emergency room clinicians shared constructs of danger to self, danger to others, and grave disability; (2) these constructs are reliably applied in actual cases; (3) TRIAD is a valid reflection of these constructs; and (4) case disposition is predictable from the severity of the patient's status with regard to these criteria.

Abstracting and Indexing↗
PubMed2006

"Brimful of STARLITE": toward standards for reporting literature searches.

CONTEXT: Systematic reviews of qualitative research studies extend understanding of health care beyond effectiveness to acceptability and user views. OBJECTIVE: The paper surveys reports of qualitative systematic reviews and, by characterizing techniques used to identify articles for inclusion, proposes standards for reporting of literature searches. DATA SOURCES AND STUDY SELECTION: A search of MEDLINE was performed for qualitative systematic reviews published from 1988 to December 2004, supported by searches of CINAHL, Web of Knowledge (including the Science and Social Sciences Citation Index), and the Cochrane Methodology Register, and Internet searches using the Copernic Agent Professional meta-search agent. Studies were included if they used techniques of qualitative synthesis in reviewing research studies in health care. Narrative reviews were excluded. DATA EXTRACTION: Authors, year of publication, sampling strategy, databases, keywords, and other approaches used were extracted. DATA SYNTHESIS: Sixty-four studies were identified, and forty-three met inclusion criteria for this review. A summary of searching methods was produced and used to construct the STARLITE mnemonic (sampling strategy, type of study, approaches, range of years, limits, inclusion and exclusions, terms used, electronic sources). CONCLUSIONS: Considerable variation exists in search methods for qualitative systematic reviews. While diversity in methods is appropriate during the development of review methodology, major concerns remain about the absence of an accepted standard and the consequent poor quality of reporting.

Abstracting and Indexing↗
PubMed2005

UMLF: a unified medical lexicon for French.

Medical Informatics has a constant need for basic medical language processing tasks, e.g. for coding into controlled vocabularies, free text indexing and information retrieval. Most of these tasks involve term matching and rely on lexical resources: lists of words with attached information, including inflected forms and derived words, etc. Such resources are publicly available for the English language with the UMLS Specialist Lexicon, but not in other languages. For the French language, several teams have worked on the subject and built local lexical resources. The goal of the present work is to pool and unify these resources and to add extensively to them by exploiting medical terminologies and corpora, resulting in a unified medical lexicon for French (UMLF). This paper exposes the issues raised by such an objective, describes the methods on which the project relies and illustrates them with experimental results.

Abstracting and Indexing↗
PubMed1967

The National Library of Medicine's services: initial observations on indexing, interlibrary loan, and reference.

How have the three services-indexing, reference (including history of medicine), and interlibrary loan-been provided throughout the years by NLM, and how have they been used? At the present time of great growth and development, the use of the computer has influenced these services and will continue to figure prominently in plans for the future. NLM's services often have not been well or correctly used by its public, even by librarians. Some of its services, however, need to be provided in more depth and on a higher scale, and they should be publicized more widely. History shows that NLM has been faithful to its basic charge and has gone far beyond it in its service to the medical, educational, and library communities. Medical librarians are most fortunate that such a great national resource exists to provide materials and services to fulfill the needs of their libraries.

Abstracting and Indexing↗
PubMed1993

Measuring prices of Medicare physician services.

This study develops two sets of price indices for Medicare physician services. The first measures price changes, and the second measures geographic price differentials. The indices can be used to adjust Medicare physician spending data to examine growth or variations in the volume and intensity of services. In both instances, it is necessary to apply an index form that reflects both the rapid changes and variability in the mix of physician services received by Medicare beneficiaries and their relative importance. This suggests that an index based on a fixed basket of services (e.g., a Laspeyres index) can produce a biased measure of price. An alternative methodology based on the Fisher's Ideal Index form was used. This index allows service weights to vary over time and across areas. In the case of price change, the index is "chained" to acknowledge the introduction of new services over several years. It is concluded that the Fisher's Ideal approach is essential for cross-sectional price comparisons, in light of the high variability in service mix across areas. In measuring price changes, it was found that "chaining" was more important empirically than allowing the relative importance of services to change between years. During the 1985-1989 study period, Medicare payment rates grew, on average, by 3.5% annually. This rate varied across both time and types of services as a result of differential fee updates and explicit pricing policies implemented by Medicare (e.g., reductions in payments for "overvalued" procedures). Cross-sectionally, our results show that 1988 fees in the highest-priced areas were more than 1.5 times those in the lowest-priced areas.

Abstracting and Indexing↗
PubMed2003

Corpus-based associations provide additional morphological variants to medical terminologies.

Knowledge of morphologically derived words, as provided for medical English by the UMLS Specialist Lexicon, is useful to detect term variants for automated coding and indexing. For most other languages though, no comparable morphological knowledge base is available. We therefore endeavored to design general methods to help collect such knowledge for a given language. We propose here a method for discovering derived words in text corpora and apply it to a French medical corpus. To evaluate this method, we study its ability to suggest derived adjectives for 2,297 nouns found in the SNOMED nomenclature, which itself specifies adjectival equivalents for some of its terms. 74% of the proposed adjectives are judged correct (precision) and cover 16% of these nouns (recall), a larger amount than what SNOMED already specifies. Furthermore, the corpus suggests additional adjectives which can increase SNOMED's by 76%. We conclude that such a method can help speed up the construction of a morphological knowledge base which can increase the number of term variants in an existing controlled vocabulary.

Abstracting and Indexing↗