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At least 1,279 records · Page 71Linked to original sources
PubMed1993

Digitized doctoring. A healthy mix of medicine and computers.

Computers, these days, are almost smaller than a bread box. They sit unobtrusively atop a desk, silently awaiting the next command. And yet, for such a small package, these microelectronic-based, information-processing devices have profoundly affected mankind in the second half of the 20th century. Computer technology has radically altered how -- and how fast -- the world changes.

Computers↗
PubMedDate not supplied

Framemed, a prototypical medical knowledge base of unusual design.

Carefully structured medical knowledge can be used for a variety of purposes, including medical records, drug and test ordering, and differential diagnosis. The Framemed system divides medical information into 26 domains and arranges the items in a hierarchical sequence. The knowledge in the system resides in descriptive, relational, and conditional records created by experts in the various domains, who must sign and date each record as it is developed and are entirely responsible for its contents. Formation of the hierarchies requires careful attention to concepts and yields a logical framework for a standardized terminology that is in the public domain.

Artificial Intelligence↗
PubMed1995

Open standards in medical informatics.

Over the last few years, there has been a major effort devoted to formalizing standards for healthcare. It is vital that such standards are fully "open," whether developed by formal standards bodies or otherwise. This paper discusses the various standards developed and in the process of being developed, including information on the standards process with particular reference to medical informatics. It also discusses a recent initiative in the United Kingdom National Health Service to ensure that formal standards are specified in procurements.

Europe↗
PubMed1995

Cognitive design for sharing medical knowledge models.

By building a medical conceptual model inside the galen project, a methodology has been defined to deal with both operative goals and deep and unsolved problems about knowledge. This knowledge sharing oriented approach exploits existing medical coding systems such as knowledge sources and enables us to represent their concepts in a wider cognitive context referring to ontological theories. The tasks of cognitive ergonomy, quasi-naturalness of language, versatility, and flexibility seem to be supported through some functions, such as viewpoint, context, and sign, which act as spin-off points to knowledge or information which is not modeled.

Artificial Intelligence↗
PubMed1995

Evidence-based periodontal treatment. II. Predictable regeneration treatment.

Clinical experience, technical ability, and intuition are indispensable but are no longer sufficient as the sole clinical skills necessary to provide the best outcomes from periodontal and peri-implant regeneration treatment. This article describes a comprehensive and rigorous methodologic framework to assess the available evidence contained within the literature. This assessment tool is referred to as the evidence-based method. The methodology was used by a series of task forces convened to evaluate three common areas of clinical regenerative treatment. The major goals of these task forces were: (1) to increase the strength of the inference that practitioners can derive from the base of knowledge contained within the literature, (2) to develop algorithms to improve the predictability of regeneration treatment, and (3) to determine methods that can be used to predictably transfer the value of therapy to the patient.

Algorithms↗
PubMed1995

Periodontal regeneration of intrabony defects: an evidence-based treatment approach.

A task force of periodontists established clinical and histologic outcomes (goals) for the treatment of intrabony defects and researched the literature for techniques that would most predictably achieve these goals. The group also identified factors that could influence predictability. The treatment outcomes selected by the task force included regeneration of a true attachment apparatus; gain in bone and probing attachment levels; reduction in probing pocket depth; minimal gingival recession; increased patient comfort; esthetic appearance and state of wellness; and maintenance of health, comfort, and function over time. Based on evidence, it was concluded that guided tissue regeneration, guided tissue regeneration combined with the use of decalcified freeze dried bone allografts and freeze-dried bone allografts alone are the most predictable regenerative procedures for achieving selected treatment outcomes. Various factors, such as patient characteristics, the morphology of the defect, and the surgical technique can influence the healing response of intrabony defects. Patient factors, such as plaque control, compliance, and cigarette smoking, can directly affect predictability of periodontal regeneration. Defect selection is critical, and deep and narrow defects are the most predictable response to regenerative procedures. The number of remaining bony walls is important in grafting procedures, but their influence is questionable in guided tissue regeneration. Various technical procedures, such as flap design, defect debridement, and wound protection, may influence the predictability of regeneration.

Alveolar Bone Loss↗
PubMed1995

Successful regeneration of mandibular Class II furcation defects: an evidence-based treatment approach.

The purpose of the present evidence-based critical review was to define goals and outcomes for regenerative therapy of Class II furcation defects and rank the efficacy of current regenerative procedures based on the available literature. Meta-analysis was employed to quantitate the mean overall expected changes and compare various techniques. The evidence presented in the literature was used to determine factors affecting regeneration of Class II furcation defects. These factors were used to establish decision-making trees to enhance success and highlight potential shortcomings of the technique. Guided tissue regeneration, used alone or in combination with bone replacement grafts, had the highest overall ranking. Mean reduction in probing depths and gains in vertical and horizontal attachment levels were all statistically significant at 6 months. Similar results were obtained in the 12-month studies. Compared to flap debridement, guided tissue regeneration resulted in greater reduction in probing depths and greater gains in vertical and horizontal attachment levels. Guided tissue regeneration provided almost identical results whether used with or without root conditioning, suggesting that root conditioning does not offer an adjunctive effect. A combination of guided tissue regeneration and bone replacement grafts yielded better results than did guided tissue regeneration alone in reducing probing depths and increasing vertical attachment levels. The decision-making trees derived from analysis of these results may assist the clinician in improving success and predictability of guided tissue regeneration procedures in Class II furcation defects.

Bibliographies as Topic↗
PubMed1995

Guided bone regeneration of bone defects associated with implants: an evidence-based outcome assessment.

Guided bone regeneration is a new technique that evolved following the guided tissue regeneration procedure for regeneration of lost periodontium. The objective of guided bone regeneration is to promote bone formation in osseous deformities either before or in conjunction with endosseous implant placement. Osseous defects consist mainly of extraction sites, dehiscences or fenestrations, and localized ridge deformities. In addition, bone defects may either provide natural spacemaking or be nonspacemaking. A plethora of publications indicate that the guided bone regeneration technique can be used successfully in all types of defects. Nonspacemaking defects usually require bone graft materials to assist in space maintenance and enhance bone formation. Fixation pins are also used, either with or without graft materials, in this regard. The scientific literature on guided bone regeneration was reviewed by a task force to determine techniques proven to increase predictability relative to successful patient outcomes and to develop specific evidence based diagnostic and treatment decision trees.

Alveolar Bone Loss↗
PubMed1996

New premises and new tools for medical care and education.

New information tools enable us to leave behind a world of medical practice in which providers of all sorts have been allowed to operate in the face of avoidable ignorance-ignorance of many relevant details from the medical literature as well as ignorance of details about a given patient. Furthermore, the new tools release providers and patients alike from the "predictable and undesirable internal constraints" of the unaided human mind as it tries to process vast amounts of information in the course of everyday medical care.

Computer-Assisted Instruction↗
PubMed1996

The challenge of managing laboratory information in a managed care environment.

This article considers some of the major changes that are occurring in pathology and pathology informatics in response to the shift to managed care in the United States. To better understand the relationship between information management in clinical laboratories and managed care, a typology of integrated delivery systems is presented. Following this is a discussion of the evolutionary trajectory for the computer networks that serve these large consolidated healthcare delivery organizations. The most complex of these computer networks is a community health information network. Participation in the planning and deployment of community health information networks will be important for pathologists because information management within pathology will be inexorably integrated into the larger effort by integrated delivery systems to share clinical, financial, and administrative data on a regional basis. Finally, four laboratory information management challenges under managed care are discussed, accompanied by possible approaches to each of them. The challenges presented are (1) organizational integration of departmental information systems such as the laboratory information system; (2) weakening of the best-of-breed approach to laboratory information system selection; (3) the shift away from the centralized laboratory paradigm; and (4) the development of rule-based systems to monitor and control laboratory utilization.

Community Networks↗
PubMed1996

Evidence-based periodontal regenerative therapy.

Periodontal health care has progressed into a new era. It is distinguished by a rapidly expanding volume of literature, rapid influx of new technologies, and need for new skills to perform increasingly complex procedures. Correspondingly, practice management changes are required to adapt to the extensive follow-up care associated with some of these new treatments. This must be accomplished while also acknowledging the deepening concern for escalating costs and increased attention to the quality of care provided. As with most change, clinicians can fight it by continuing to rely on old ways of doing things and hope to keep these issues at bay, but history would say they are unlikely to succeed. Instead, clinicians can embrace these changes and adapt to them by adding new tools, such as evidence-based methodology, to their armamentarium. The evidence-based approach offers a "bridge" from science to clinical practice. It can strengthen the foundation by providing a framework for integrating patient preferences, scientific knowledge, clinical judgment, and personal experience. By adapting the way treatment decisions are made in daily practice to an evidence-based approach, clinicians can deliver the highest quality care to their patients and be in better control of their own destiny. These new challenges can be perceived as problems or as opportunities--it is a choice!

Bibliographies as Topic↗