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Increase in information content in histopathology reports: a concealed workload for histopathologists.

INTRODUCTION: The workload of histopathologists is traditionally assessed by the total number of specimens handled annually (TSA). Development in medical science has resulted in an increased demand by clinicians for more information in histopathology reports. Inclusion of this information requires more work. Annual information output (AIO) is the total number of specimens handled annually multiplied by the average number of items of information per histopathology report (AIR). An item of information is any pathological feature of prognostic or therapeutic relevance. OBJECTIVE: This study aims to determine whether there has been an increase in annual information output (AIO) during a 17-year period. METHOD: This is a retrospective study in a University Department of Pathology. 200 histopathology reports per year at 4 yearly intervals from 1982 to 1998 were examined. TSA, AIR and AIO were calculated. RESULTS: TSA increased from 2912 in 1982 to 3919 in 1998 (34.6% increase). AIR increased from 1.11 to 3.12 (181.1% increase). AIO increased from 3232.3 to 12227.3 (278.3% increase). CONCLUSION: The increase in AIO was greater than the increase in TSA. Thus the use of TSA alone will not reflect the increase in workload accurately. We recommend the use of AIO rather than TSA to quantify workload and staffing requirements of histopathologists.

Forms and Records Control↗

Skills required for clinical engineering practice: results of a survey.

In order to provide information to individuals conducting or planning educational programs in clinical engineering, a survey of skills required for practice in this field was carried out. A total of 127 responses from university-based (44) and practicing (83) clinical engineers were received. The results were tabulated separately for these two groups. The survey form was divided into two parts: basic skills and clinical engineering skills. The responses indicated an emphasis on medical instrumentation, basic life science (physiology and anatomy) information, and organizational and quipment control skills.

Biomedical Engineering↗

"Not safe" is not enough: smokers have a right to know more than there is no safe tobacco product.

The right to health relevant information derives from the principles of autonomy and self direction and has been recognised in international declarations. Providing accurate health information is part of the basis for obtaining "informed consent" and is a recognised component of business ethics, safety communications, and case and product liability law. Remarkably, anti-tobacco and pro-tobacco sources alike have come to emphasise the message that there is "no safe cigarette" or "no safe tobacco product". We propose that the "no safe" message is so limited in its value that it represents a violation of the right to health relevant information. There is a need to go beyond saying, "there is no safe tobacco product" to indicate information on degree of risks. The "no safe tobacco" message does not contradict, for example, the mistaken belief that so called light or low tar cigarettes are safer choices than higher tar cigarettes. We encourage a kind of "rule utilitarian" ethical position in which the principle of truth telling is observed while trying to produce the greatest good for the greatest number of people. Although harm reduction approaches to easing the burden of tobacco related diseases are founded on science based comparative risk information, the right to health information is independently related to the need to promote health literacy. This right should be respected whether or not harm reduction policies are judged advisable.

Attitude to Health↗

An NIH/Columbia University information system interface.

The National Institutes of Health (NIH) and the Health Sciences of Columbia University have developed an information system interface whereby sponsored research information is routinely forwarded, in machine-readable form, from the NIH to Columbia University. For Columbia University the interface system has materially reduced data input costs, made information available on a more timely basis, improved the quality of its system by the adoption of existing standardized data definitions, and allowed flexible access to NIH's broad data base. For NIH the system permits an improvement in its data base through high-quality and fast feedback from the grantee institution. The promotion of future systems development is enhanced through the adoption of standardized data element designations and definitions.

Humans↗

Detection of speech landmarks: use of temporal information.

Studies by Shannon et al. [Science, 270, 303-304 (1995)], Van Tasell et al. [J. Acoust. Soc. Am. 82, 1152-1161 (1987)], and others show that human listeners can understand important aspects of the speech signal when spectral shape has been significantly degraded. These experiments suggest that temporal information is particularly important in human speech perception when the speech signal is heavily degraded. In this study, a system is developed that extracts linguistically relevant temporal information that can be used in the front end of an automatic speech recognition system. The parameters targeted include energy onset and offsets (computed using an adaptive algorithm) and measures of periodic and aperiodic content; together these are used to find abrupt acoustic events which signify landmarks. Overall detection rates for strongly robust events, robust events, and weak events in a portion of the TIMIT test database are 98.9%, 94.7%, and 52.1%, respectively. Error rates increase by less than 5% when the speech signals are spectrally impoverished. Use of the four temporal parameters as the front end of a hidden Markov model (HMM)-based system for the automatic recognition of the manner classes "sonorant," "fricative," "stop," and "silence" results in the same recognition accuracy achieved when the standard 39 cepstral-based parameters are used, 70.1%. The combination of the temporal parameters and cepstral parameters results in an accuracy of 74.8%.

Algorithms↗

The University Integrated Automated Information System at the Uniformed Services University of the Health Sciences.

The Integrated Automation System put into place at the University Services University of the Health Sciences has been said to be 5 years ahead of those employing the most advanced comparable configurations. This automated data processing creation was accomplished without augmentation of manpower or funding. A brief history of this development and some of its features are presented.

Computer Communication Networks↗

[Dentist in an information society].

Many commentators say that at present we are living in an information society, a society in which the main sources of national income are communication and information. This article aims at the question how the dentist's practice will be influenced by the information society. The dentist's role in the information society is described as an information broker between the dental science and the public, the patients. In that role the dentist is confronted with two developments, i.e. 'information overload' and 'rising expectations as to the possibilities of medical help'. The article concludes with a plea for 'good health education'. Against the background of the developments at the side of the public 'good health education' is not to be understood as 'more health information' for the public, but as 'more quality in health information'.

Dentist-Patient Relations↗

Mining chemical structural information from the drug literature.

It is easier to find too many documents on a life science topic than to find the right information inside these documents. With the application of text data mining to biological documents, it is no surprise that researchers are starting to look at applications that mine out chemical information. The mining of chemical entities--names and structures--brings with it some unique challenges, which commercial and academic efforts are beginning to address. Ultimately, life science text data mining applications need to focus on the marriage of biological and chemical information.

Chemistry, Pharmaceutical↗

[The community health diagnosis of life-way disease in Peking University Health Science Center].

OBJECTIVE: To study the basic information of life way disease and the corresponding risk factors of behavior in the community of Peking University Health Science Center, understand the background issue and social support system, and analyze the requirement for community health service so that the critical issue for health can be dealt with and the comprehensive program of prevention and treatment of the disease can be accordingly supplied. METHODS: The random face to face questionnaire about life way disease and risk factors in 1051 residents over 6 years of age in the community of Peking University Health Science Center was conducted according to the typical sampling principle in 1 primary school, 1 middle school, 1 university and its community, and the investigations of health data from the hospital and the police office in the community were also conducted through discussing about life ways risk factors. Accordingly , the data obtained by way of EXCEL were analyzed and processed using SPSS 11.5. RESULTS: Diagnostic data of demography, epidemiology, behavior environment, education and organization were obtained concerning the public health of the Peking University Health Science Center community. CONCLUSION: The key health issue in the Peking University Health Science Center community is significantly influenced by the bad way of life. And some behavior risk factors, such as fatness, lack of outdoor exercise in the community members. Thus, the major necessary health service of Peking University Health Science Center residents is to carry out a comprehensive management program of life way disease for the whole people.

Adolescent↗

Attrition and translation.

The recently published NIH Roadmap proposes that public-sector science should place increased emphasis on the development of new therapeutics and diagnostics based on the fruits of fundamental research. Such "translational research" activities, traditionally the province of the private sector, have long been compromised by high rates of attrition (failure during the course of preclinical or clinical development of therapeutics). Attrition has led to growing financial costs, as well as opportunity costs. The new focus offers a way to reverse these trends, especially if the scientific community can improve on its ability to reconcile molecular genetic research with integrative organ- and organism-based research.

Access to Information↗

Development of visual diagnostic expertise in pathology -- an information-processing study.

OBJECTIVE: To identify key features contributing to trainees' development of expertise in microscopic pathology diagnosis, a complex visual task, and to provide new insights to help create computer-based training systems in pathology. DESIGN: Standard methods of information-processing and cognitive science were used to study diagnostic processes (search, perception, reasoning) of 28 novices, intermediates, and experts. Participants examined cases in breast pathology; each case had a previously established gold standard diagnosis. Videotapes correlated the actual visual data examined by participants with their verbal "think-aloud" protocols. MEASUREMENTS: Investigators measured accuracy, difficulty, certainty, protocol process frequencies, error frequencies, and times to key diagnostic events for each case and subject. Analyses of variance, chi-square tests and post-hoc comparisons were performed with subject as the unit of analysis. RESULTS: Level of expertise corresponded with differences in search, perception, and reasoning components of the tasks. Several discrete steps occur on the path to competence, including development of adequate search strategies, rapid and accurate recognition of anatomic location, acquisition of visual data interpretation skills, and transitory reliance on explicit feature identification. CONCLUSION: Results provide the basis for an empirical cognitive model of competence for the complex tasks of microscopic pathology diagnosis. Results will inform the development of computer-based pedagogy tools in this domain

Analysis of Variance↗

Triplex-forming molecules for modulation of DNA information processing.

The design of specific DNA ligands is an important challenge in biological and biomedical sciences. Targeting the source of genetic information may allow highly efficient gene-directed modulation of cell function. Triplex-forming molecules specifically recognize oligopyrimidine/oligopurine sequences by hydrogen bonding interactions. In cell cultures they have been used successfully to downregulate or upregulate transcription in a gene-specific manner or to induce site-directed mutagenesis and recombination. For biotechnological applications, triplex-forming molecules are powerful tools for gene-specific chemistry.

Animals↗

The hazard evaluation system and information service: a physician's resource in toxicology and occupational medicine.

Hazard evaluation is an emerging science. The Hazard Evaluation System and Information Service (HESIS), part of California's program in preventive occupational health, is a resource for clinicians who wish to stay abreast of the relationship between toxicology and occupational health. For example, advances in assays for cancer or reproductive effects in test animals enable us to identify with greater confidence significant cancer or reproductive hazards among the increasing variety of workplace exposures. Occupational experiences with dibromochloropropane (DBCP), Kepone, bis(chloromethyl) ether, benzidine and vinyl chloride demonstrate the shortcomings of relying on human data. The latency period of cancer, limited sensitivity of epidemiologic studies and severity of effects require us to use animal test data to evaluate the potential cancer and reproductive risks of workplace substances. HESIS gives appropriate weight to experimental data in hazard evaluations of chemicals such as ethylene oxide, ethylene dibromide, polychlorinated biphenyls and the glycol ethers. A similar approach is apparent in the California Department of Health Services' recently released Carcinogen Identification Policy.

Abnormalities, Drug-Induced↗

A checklist to help students analyze published articles in basic medical sciences.

Because critical analysis of published information is an essential component of scientific life, it is important that students be trained in its practice. Undergraduate students who are more accustomed to reading textbooks and taking lecture notes find it difficult to appreciate primary publications. To help such students, we have developed a checklist that helps them analyze different components of a research article in basic biomedical sciences. Students used the checklist to analyze critically a published article. The students were assigned an article and asked to write a paper (maximum 2 pages of single-spaced type) assessing it. This assignment has been found useful to both undergraduate and graduate students in pharmacology and physiology. Student responses to a questionnaire were highly favorable; students thought the exercise provided them with some of the essential skills for life-long learning.

Education, Medical, Undergraduate↗

Nutrition and food science go genomic.

The wealth of genomic information and high-throughput profiling technologies are now being exploited by scientists in the disciplines of nutrition and food science. Diet and food components are prime environmental factors that affect the genome, transcriptome, proteome and metabolome, and this life-long interaction defines the health or disease state of an individual. For the first time the interaction of foods, and individual food constituents, with the biological systems can be defined on a molecular basis. Profiling technologies are used in basic-science applications for identifying the mode of action of foods or particular ingredients, and are similarly taken into the science-driven development of foods with a defined biofunctionality. Biomarker profiles and patterns derived from genomics applications in humans should guide nutrition and food science in developing evidence-based dietary recommendations and health-promoting foods.

Food↗