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Dental informatics: an emerging biomedical informatics discipline.

Biomedical informatics is a maturing discipline. During the last forty years, it has developed into a research discipline of significant scale and scope. One of its subdisciplines, dental informatics, is beginning to emerge as its own entity. While there is a growing cadre of trained dental informaticians, dental faculty and administrators in general are not very familiar with dental informatics as an area of scientific inquiry. Many confuse informatics with information technology (IT), are unaware of its scientific methods and principles, and cannot relate dental informatics to biomedical informatics as a whole. This article delineates informatics from information technology and explains the types of scientific questions that dental and other informaticians typically explore. Scientific investigation in informatics centers primarily on model formulation, system development, system implementation, and the study of effects. Informatics draws its scientific methods mainly from information science, computer science, cognitive science, and telecommunications. Dental informatics shares many types of research questions and methods with its parent discipline, biomedical informatics. However, there are indications that certain research questions in dental informatics require novel solutions that have not yet been developed in other informatics fields.

Dental Research↗

Using cross-lingual information to cope with underspecification in formal ontologies.

Description logics and other formal devices are frequently used as means for preventing or detecting mistakes in ontologies. Some of these devices are also capable of inferring the existence of inter-concept relationships that have not been explicity entered into an ontology. A prerequisite, however, is that this information can be derived from those formal definitions of concepts and relationships which are included within the ontology. In this paper, we present a novel algorithm that is able to suggest relationships among existing concepts in a formal ontology that are not derivable from such formal definitions. The algorithm exploits cross-lingual information that is implicity present in the collection of terms used in various languages to denote the concepts and relationships at tissue. By using a specific experimental design, we are able to quantify the impact of cross-lingual information in coping with underspecification in formal ontologies.

Algorithms↗

Societal dimensions of third-party evaluation of Internet health content.

Rating and certification of Internet health content have been suggested as strategies to guide citizens to high quality information. Attempts to rate Internet content, however, have been criticised for being unfeasible or undesirable. We created and tested a novel concept and technology to evaluate online health resources. In this paper, we view various societal issues and suggest solutions whenever possible. Rating and certification of Internet content should be preceded by a consideration and discussion that has many societal dimensions.

Access to Information↗

WASP--a generic web-based, interactive, patient simulation system.

Computer based patient case simulation systems have during the recent years been introduced in medical education to allow students to "meet" more cases that are educationally optimized and adapted to the actual learning situation. However, three major problems exist with most computer based case simulation systems today: They are expensive to develop, experienced multimedia developers are needed for the development and teachers/clinicians can not develop and adjust cases to fit their own specific educational needs. The WASP project (Web-Activated Simulation of Patients) tries to solve these three problems, and still allow very realistic and highly-interactive simulations of clinical cases, delivered and edited via the Web. WASP is based on experience from a number of national and international visualization and simulation projects. Most important case simulation features are available, including: interactive history taking, complete physical examination (inspection, auscultation, palpation, percussion, vitals, neurological exams etc.), complete lab section including chemical labs, X-ray, MRI, ultrasound, CT, phys lab, pharmacology lab, pathology lab etc.), diagnosis and differentials, therapy, interactive session feedback and integrated references and online database sources.

Education, Medical, Undergraduate↗

Documenting nursing practice by using ICNP on the Web.

This paper presents the design and implementation of an internet based nursing care planning system which helps nursing professionals and students to study ICNP beta 2 version and to create nursing diagnoses, interventions and outcomes by selecting relevant terms from ICNP. This advanced web-based ICNP browser enables the authentication of the user, and the creation of a type of nursing care plan through the use of ICNP. It provides different ways for creating nursing diagnoses, interventions and outcomes, by selecting relevant ICNP terms through the tree-structure view, index and search components of the tool. The created diagnoses, interventions and outcomes are stored to a secured database. The system provides to the user the facility to build and manage nursing care plans by using both the English and the translated Greek ICNP versions. The first results of the implementation of this internet based nursing care planning system are presented.

Database Management Systems↗

jTerm: an open source terminology server.

The consistent semantic transmission of clinical data between systems, and from system to user, is a key requirement for clinical information systems. The use of terminology servers to provide this functionality has been well articulated (1, 2). We describe here an open source terminology server for use in clinical infrastructures.

Humans↗

Open-source toolkit for simple XML annotation.

Use of Extensible Markup Language (XML) is increasingly prevalent among medical informatics projects. Many of these projects involve, at some point, the interaction between a researcher and specialized XML documents for the purpose of annotating the XML data. We offer a simple toolkit to assist these researchers. Our solution is a simple, yet fully functional, annotation system that can easily be adapted to the needs of the researcher. All of the materials for this toolkit are freely available.

Algorithms↗

The SQLX system: generating explanations for clinical rules encoded in SQL.

We have developed a system to provide case-specific explanations for SQL query results. The explanation facility, called SQLX, is intended to improve user acceptance of clinical rules that are encoded in the SQL query language and are triggered by updates to a relational database. Our design goal is to combine the efficiency and familiarity of the SQL query model with a more intuitive and case-specific display of query results. SQLX defines an augmented SQL syntax that allows the incorporation of explanation text directly into query specifications. A query analyzer determines which retrieved data logically contribute to rule firing, and combines the data with explanation text to generate a case-specific explanation. Although features of the SQL query model limit the use of this method as a general-purpose rule-explanation facility, the current design accommodates a wide range of SQL query formulations and can provide efficient processing and intuitive explanations of many clinical rules.

Anesthesiology↗

The MEDLINE Button.

We have developed a computerized method for performing bibliographic searches directly from patient data involving five steps: 1) identifying specific patient data which raises a question in the mind of the user, 2) selection (from a list of generic questions) of a small number of questions which fit the selected patient data, 3) automated translation of the patient data into appropriate terms used for bibliographic indexing, 4) conversion of the question selected by the user into a search strategy, and 5) transfer of the search strategy to a search engine for a bibliographic database. We have modified the Columbia-Presbyterian Clinical Information System to experiment with this method. The first implementation converts patient diagnoses and procedures coded in ICD9-CM into Medical Subject Headings (MeSH) and searches Medline using BRS/Onsite. Challenges include development of a useful set of generic questions and translation from ICD9-CM to MeSH using the Unified Medical Language System (UMLS).

Diagnosis, Computer-Assisted↗

Pocket computers in anesthesiology.

Pocket computers are a new technology in academic anesthesia practice. These computers are inexpensive, portable, easy to use and can store large amounts of data, but the limited ability to program them and the length of time necessary to enter data can be disadvantages.

Anesthesiology↗

The PICNIC approach to regional care networks.

PICNIC is a pioneering project to develop an architecture for next generation regional healthcare networks. This paper gives an overview of the project and some of the reasoning behind the interrelated technical and business choices.

Computer Communication Networks↗

Legal and social implications of health telematics in the EU.

Health telematics involve the processing of data concerning health. The European Directive 95/46/EC constitutes a general prohibition of processing this special category of data. Exemptions to that principle are found in the data subject's consent, vital interests and professional obligation to secrecy. These exemptions, however, do not sufficiently secure legal grounds for health data protection in practice. It is for that reason, that the member states must establish a harmonised legal basis for telematics services. Multinational working groups, such as EHTEL, need respective support.

European Union↗

Health telematics and telemedicine for improving patients' care.

Current problems and solutions to establish health telematics and telemedicine for patient's seamless care have been analysed referring to experiences of advanced institutions especially in, but not restricted to, the USA. In that context, problems at institutional boundaries as well as technical and personal problems for communication and co-operation have been explored. Entering coded clinical data and the ubiquitous access to that information are crucial challenges to be met.

Access to Information↗

Concerted actions for an interoperable health telematics platform in Germany.

In Germany many commitments have been made to build a telematics infrastructure. The Centre for Telematics in Healthcare first published the concept for such a platform in 2001. This concept is introduced amongst others and information is given about the actions and initiatives of the last two years in Germany.

Germany↗

Information technology in action: the example of Norway.

In Europe, Norway has played since the 1990 a pioneering role in applying telemedicine in healthcare services. 4.5 millions occupy a country nearly as large as the former West Germany with a coast line as long as the equator and stretching 2500 km from the south to the north. The most northern counties are very sparsely populated. Therefore the government decided to build a national research centre for telemedicine at the regional hospital of Tromsø north of the polar circle with the aim of exploring the new telemedicine techniques in the different branches of medicine. Later political support was based on the wish to increase quality and safety of diagnostic and therapeutic procedures and of saving costs.

Medical Informatics Applications↗

Italian telematics initiatives and achievements.

Depending on their legislation, the European countries have different telematics initiatives and different scenarios. Cultural roots cause differences even within a country or a region, and different organisational structures can cause further problems. With regard to the Italian telematics approach, the author intends to explain the basis and the main achievements in Italy and especially in the Lombaria region.

Computer Communication Networks↗