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At least 1,279 records · Page 71Linked to original sources
PubMed2001

An approach to guideline implementation with GEM.

Implementation of practice guidelines refers to the creation of strategies and systems to operationalize the knowledge and recommendations set forth by guideline developers. We describe an approach to guideline implementation that makes direct use of the guideline document as a knowledge base. The Guideline Elements Model (GEM) provides an XML-based guideline document model that facilitates implementation of guidelines. Knowledge extraction using GEM requires document markup rather than programming and can promote authenticity and consistent knowledge encoding. Knowledge customization for the local enterprise requires addition of meta-information to pertinent components of the GEM hierarchy in a design database. GEM provides an audit trail to track local adaptation. Knowledge integration with patient data can be promoted using information management services. A design goal is to devise a system that can be applied by local clinical domain experts, quality assurance experts, and information systems programmers without requiring trained informaticians and knowledge engineers to serve as intermediaries

Artificial Intelligence↗
PubMed2003

Application of an XML-based document framework to knowledge content authoring and clinical information system development.

The role of XML in health care is evolving rapidly. Coupled with other W3C standards, informaticists can design systems that may be used not only for storage and retrieval of structured knowledge, but also for quick transformation of such knowledge into many different usable formats. At Intermountain Health Care, we are currently developing an XML-based document framework to accommodate both the capture of structured knowledge as well as its transformation into several usable formats. Our objective relies upon the premise that information systems can be implemented using workflows based on structured documents.

Artificial Intelligence↗
PubMed1995

The concept of "template" assisted electronic medical record.

A new design for an electronic medical record with flexible template generation was developed. The "template" in this paper refers to one of the tools that calls a user's attention to entering the data items for each problem or to ordering tests when they are due. The template shows the patient's previous data and guides physicians to record the consistent description. Two kinds of medical data dictionaries are prepared. Data representations of signs, symptoms, laboratory tests, and other examinations are defined in the check items dictionary. The problem dictionary contains the possible patient problems with relation to check items and other kinds of related subjects. This system provides Problem Oriented Medical Record (POMR) and the graphical presentation of various patient data. The system was designed to establish a constant and integrated medical record.

Artificial Intelligence↗
PubMed1997

Health system mines financial data to unearth clinical conclusions, improvements.

Making clinical conclusions from your financial data. Using artificial intelligence to provide cleaner and less biased data, Sentara Health System in Norfolk, VA, has changed the way care is delivered for 25 top inpatient and outpatient conditions and procedures--and saved $4 million in the last three years as a direct result. Here's a look at how Sentara is mining clinical information from financial data.

Algorithms↗
PubMed1994

A proposed computer diagnostic system for malignant melanoma (CDSMM).

This paper describes a computer diagnostic system for malignant melanoma. The diagnostic system is a rule base system based on image analyses and works under the PC windows environment. It consists of seven modules: I/O module, Patient/Clinic database, image processing module, classification module, rule base module and system control module. In the system, the image analyses are automatically carried out, and database management is efficient and fast. Both final clinic results and immediate results from various modules such as measured features, feature pictures and history records of the disease lesion can be presented on screen or printed out from each corresponding module or from the I/O module. The system can also work as a doctor's office-based tool to aid dermatologists with details not perceivable by the human eye. Since the system operates on a general purpose PC, it can be made portable if the I/O module is disconnected.

Algorithms↗
PubMedDate not supplied

Knowledge-based systems, removable partial denture design and the development of RaPiD.

Knowledge-based systems (KBS), otherwise and formerly known as 'expert systems', are computer programs that contain a representation of knowledge that can be used to solve problems normally requiring human intelligence. This article discusses the contributions such systems can make to medicine and dentistry, indicates the range of existing dental KBSs and gives reasons why removable partial denture (RPD) design has attracted so much attention in this respect. A description is also given of the 'RaPiD' system for designing RPDs at the chairside.

Computer-Aided Design↗
PubMed2005

Quantifying the effect of compression hearing aid release time on speech acoustics and intelligibility.

Compression hearing aids have the inherent, and often adjustable, feature of release time from compression. Research to date does not provide a consensus on how to choose or set release time. The current study had 2 purposes: (a) a comprehensive evaluation of the acoustic effects of release time for a single-channel compression system in quiet and (b) an evaluation of the relation between the acoustic changes and speech recognition. The release times under study were 12, 100, and 800 ms. All of the stimuli were VC syllables from the Nonsense Syllable Task spoken by a female talker. The stimuli were processed through a hearing aid simulator at 3 input levels. Two acoustic measures were made on individual syllables: the envelope-difference index and CV ratio. These measurements allowed for quantification of the short-term amplitude characteristics of the speech signal and the changes to these amplitude characteristics caused by compression. The acoustic analyses revealed statistically significant effects among the 3 release times. The size of the effect was dependent on characteristics of the phoneme. Twelve listeners with moderate sensorineural hearing loss were tested for their speech recognition for the same stimuli. Although release time for this single-channel, 3:1 compression ratio system did not directly predict overall intelligibility for these nonsense syllables in quiet, the acoustic measurements reflecting the changes due to release time were significant predictors of phoneme recognition. Increased temporal-envelope distortion was predictive of reduced recognition for some individual phonemes, which is consistent with previous research on the importance of relative amplitude as a cue to syllable recognition for some phonemes.

Adult↗
PubMedDate not supplied

Molecular level investigations of the inter- and intramolecular interactions of pH-responsive artificial triblock proteins.

Intelligent materials that can undergo physical gelation in response to environmental stimuli have potential impacts in the bioengineering and biomedical fields where the entrapment of cellular or molecular species is desired. Here, we utilize atomic force microscopy (AFM) to perform molecular level investigations of designer artificial proteins that undergo physical gelation. These are engineered as triblock copolymers with independent interchain binding and solvent retention functions, namely, two terminal leucine zipper-like peptide sequences and a central alanylglycine rich sequence, respectively. AFM force measurements between probes and surfaces functionalized with molecules of this triblock protein revealed adhesive interactions that increased in average force and frequency as the pH was lowered from pH 11.2 to 7.4 to 4.5, reflecting an increase in the numbers of interacting molecular strands. In bulk solution, lowering the pH results in a viscous liquid to gel transition. The modular design of the triblock protein was also exploited for single molecule force spectroscopy investigations, which revealed altered intramolecular interactions in response to changes in pH. An increased understanding of the inter- and intramolecular forces involved in biomolecule driven gelation processes is not only of great fundamental interest in the study of the biomolecular systems involved but may also prove key in enabling the rational design of new generations of intelligent hydrogel systems.

Amino Acid Sequence↗
PubMed1983

PUFF: an expert system for interpretation of pulmonary function data.

The application of artificial intelligence techniques to real-world problems has produced promising research results, but seldom has a system become a useful tool in its domain of expertise. Notable exceptions are the DENDRAL (1) and MOLGEN (2) systems. This paper describes PUFF, a program that interprets lung function test data and has become a working tool in the pulmonary physiology lab of a large hospital. Elements of the problem that paved the way for its success are examined, as are significant limitations of the solution that warrant further study.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

Integration of knowledge-based system and database for identification of disturbances in fluid and electrolyte balance.

We describe a knowledge-based system which automatically identifies fluid and electrolyte disorders in intensive care patients. The knowledge-based system was built and interfaced to an existing patient data management system (PDMS) in Kuopio University Central Hospital to evaluate the potential of knowledge-based techniques in information management and decision support in the high dependency environment. Because of the integration, the system does not require any manual data input, and it provides a natural extension and increased performance to a current patient data management system used in clinical practise. The paper discusses design considerations and gives the system description. The evaluation of the experimental system in clinical use showed that it performed almost as well as junior clinicians of the intensive care unit.

Artificial Intelligence↗
PubMed1998

Patient Dependency Knowledge-Based Systems.

The ability of Patient Dependency Systems to provide information for staffing decisions and budgetary development has been demonstrated. In addition, they have become powerful tools in modern hospital management. This growing interest in Patient Dependency Systems has renewed calls for their automation. As advances in Information Technology and in particular Knowledge-Based Engineering reach new heights, hospitals can no longer afford to ignore the potential benefits obtainable from developing and implementing Patient Dependency Knowledge-Based Systems. Experience has shown that the vast majority of decisions and rules used in the Patient Dependency method are too complex to capture in the form of a traditional programming language. Furthermore, the conventional Patient Dependency Information System automates the simple and rigid bookkeeping functions. On the other hand Knowledge-Based Systems automate complex decision making and judgmental processes and therefore are the appropriate technology for automating the Patient Dependency method. In this paper a new technique to automate Patient Dependency Systems using knowledge processing is presented. In this approach all Patient Dependency factors have been translated into a set of Decision Rules suitable for use in a Knowledge-Based System. The system is capable of providing the decision-maker with a number of scenarios and their possible outcomes. This paper also presents the development of Patient Dependency Knowledge-Based Systems, which can be used in allocating and evaluating resources and nursing staff in hospitals on the basis of patients' needs.

Accounting↗
PubMedDate not supplied

System for the automated photothermal treatment of cutaneous vascular lesions.

It is well known that the use of tightly focused continuous wave lasers can be an effective treatment of common telangiactasia. In general, the technique requires the skills of a highly dexterous surgeon using the aid of optical magnification. Due to the nature of this approach, it has proven to be largely impractical. To overcome this, we have developed an automated system that alleviates the strain on the user associated with the manual tracing method. The device makes use of high contrast illumination, simple monochromatic imaging, and machine vision to determine the location of blood vessels in the area of interest. The vessel coordinates are then used as input to a two-dimensional laser scanner via a near real-time feedback loop to target, track, and treat. Such mechanization should result in increased overall treatment success, and decreased patient morbidity. Additionally, this approach enables the use of laser systems that are considerably smaller than those currently used, and consequently the potential for significant cost savings. Here we present an overview of a proof-of-principle system, and results using examples involving in vivo imaging of human skin.

Algorithms↗
PubMedDate not supplied

Knowledge acquisition and verification tools for medical expert systems.

Expert systems require large amounts of domain knowledge for non-trivial problem solving. Experience in developing such systems has shown that the processes of acquiring domain knowledge (knowledge acquisition) and of determining whether the knowledge is consistent, complete, and correct (knowledge verification) are major problems. This paper discusses various tools developed to assist in these two processes. These tools bring additional knowledge to bear, or provide better interfaces between a knowledge engineer and the expert system's knowledge.

Artificial Intelligence↗
PubMed1995

The OpenLabs project. A suggested approach for more effective use of information technology in clinical laboratories.

The OpenLabs project is a major European initiative in laboratory medicine with a global audience in mind. OpenLabs aims to improve the efficiency and effectiveness of clinical laboratory services by integrating knowledge-based systems (using OpenLabs modules) with laboratory information systems and equipment. Standards for electronic data interchange between laboratories and other medical systems using the OpenLabs coding system and an open architecture for clinical laboratory information systems are being specified.

Artificial Intelligence↗
PubMed1992

A framework for the knowledge-based interpretation of laboratory data in intensive care units using deductive database technology.

In co-operation with the Institute of Anaesthesiology of the Ludwig-Maximilians-University in Munich a computer-based system for the analysis and interpretation of renal function, fluid and electrolyte metabolism of critical care patients has been developed. This paper focuses on the requirements and implementation aspects of the knowledge-based interpretation for this particular system. Objective of the proposed approach is, to transform an enormous--and constantly increasing--amount of raw data available in modern intensive care units (ICUs) into relevant, patient-oriented information, which is easy to understand by the medical staff. The essential features of a knowledge-based system at an ICU are outlined. A system is described where these features are realized using deductive database technology as a specification paradigm and extended relational databases as an implementation platform. The integration into the hospital information system is highlighted.

Artificial Intelligence↗
PubMedDate not supplied

Integrating model-based decision support in a multi-modal reasoning system for managing type 1 diabetic patients.

We present a multi-modal reasoning (MMR) methodology that integrates case-based reasoning (CBR), rule-based reasoning (RBR) and model-based reasoning (MBR), meant to provide physicians with a reliable decision support tool in the context of type 1 diabetes mellitus management. In particular, we have implemented a decision support system that is able to jointly exploit a probabilistic model of the glucose-insulin system at the steady state, a RBR system for suggestion generation and a CBR system for patient's profiling. The integration of the CBR, RBR and MBR paradigms allows for an optimized exploitation of all the available information, and for the definition of a therapy properly tailored to the patient's needs, overcoming the single approaches limitations. The system has been tested both on simulated and on real patients' data.

Artificial Intelligence↗
PubMedDate not supplied

Bioterrorism.

Although biological agents have been used in warfare for centuries, several events in the past decade have raised concerns that they could be used for terrorism. Revelations about the sophisticated biological-weapons programs of the former Soviet Union and Iraq have heightened concern that countries with offensive-research programs, including those that sponsor international terrorism, might assist in the proliferation of agents, culturing capability, and dissemination techniques, and might benefit in these undertakings from the availability of skilled laboratory technicians. Release of sarin nerve agent in the Tokyo subway system in 1995 by the Aum Shinrikyo cult demonstrated that in the future terrorists might select unconventional weapons. Certain properties of biological pathogens may make them the ideal terrorist weapon, including 1) ease of procurement, 2) simplicity of production in large quantities at minimal expense, 3) ease of dissemination with low technology, and 4) potential to overwhelm the medical system with large numbers of casualties. Dissemination of a biological agent would be silent, and the incubation period allows a perpetrator to escape to great distances from the area of release before the first ill persons seek medical care. Countermeasures include intelligence gathering, physical protection, and detection systems. Medical countermeasures include laboratory diagnostics, vaccines, and medications for prophylaxis and treatment. Public health, medical, and environmental health personnel need to have a heightened awareness, through education, about the threat from biological agents.

Bioterrorism↗