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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 1,297 records · Page 72Linked to original sources
PubMed1998

The Erlangen university hospital communication hub--proprietary and standardised communication.

The University of Erlangen-Nuremberg contains 22 hospitals and 11 autonomous medical departments which are spread out over a large area in the city of Erlangen. The necessary connections of these units and their computer based subsystems to each other and to the medical computer centre via fibre optics cables is complete. The internal cabling of the individual units is largely completed. Based on this network the Erlangen communication hub allows medical subsystems of the Erlangen university hospitals to exchange data by two completely different methods. Since 1995 a communication data base, which is implemented using the relational data base system ADABAS D, contains data from the most important hospital systems. This data can be accessed by other medical systems. Thus the communication data base allows subsystems which do not have a standardised interface to implement proprietary system interconnections via access based on SQL. The capabilities of this interconnection are dependent on both the implementation and the data which is made available by the communication data base. This contains mainly basic patient data and the results of tests performed by various laboratory systems. In addition to this proprietary communication system we have since the end of 1996 a communication server which can also handle standardised message formats such as HL7, EDIFACT, DICOM3. Future subsystems which possess standard interfaces will be connected via this server. The connection of the patient management system IS-H and the central laboratory system to the database has been proceeding since the beginning of 1997.

Computer Communication Networks↗
PubMedDate not supplied

An e-science environment for service crystallography--from submission to dissemination.

The U.K. National Crystallography Service (NCS) has developed a prototype e-science infrastructure for the provision of a small molecule crystallography service from sample receipt to results dissemination. This paper outlines the two strands of this service, which (a) enable a user to contribute in the conduction of an experiment and (b) provide an effective route for the archival and dissemination of the arising results. Access to use the NCS facilities and expertise and a mechanism to submit samples is granted through a secure Grid infrastructure, which seamlessly provides instantaneous feedback and the ability to remotely monitor and guide diffraction experiments and stage the diffraction data to a securely accessible location. Publication of all the data and results generated during the course of the experiment, from processed data to analyzed structures, is then enabled by means of an open access data repository. The repository publishes its content through established digital libraries' protocols, which enable harvester and aggregator services to make the data searchable and accessible.

Crystallography, X-Ray↗
PubMed1997

Web client and ODBC access to legacy database information: a low cost approach.

A new method has been developed for the Department of Orthopaedics of Vanderbilt University Medical Center to access departmental clinical data. Previously this data was stored only in the medical center's mainframe DB2 database, it is now additionally stored in a departmental SQL database. Access to this data is available via any ODBC compliant front-end or a web client. With a small budget and no full time staff, we were able to give our department on-line access to many years worth of patient data that was previously inaccessible.

Computer Communication Networks↗
PubMed2006

Health information exchange on a regional level: dream or reality?

Cooperation between healthcare institutions on the subject of Information Technology in Healthcare is an important main objective in the region Delft Westland Oostland/Nieuwe Waterweg Noord, in the mid-western part of the Netherlands. This is a densely populated area with approximately 1 million inhabitants. In 2004 a project to uniquely identify patients was initiated. The aim was to build a Regional Referral Index, containing only general patient data, which knows where patient information resides, serving as the fundament of a regional Virtual Electronic Patient Record. Initially the Regional Referral Index was filled with the patient files from two hospitals in the region. A connection was made between the Regional Referral Index and the Hospital Information Systems. Since then, the Regional Referral Index has been updated automatically. The patient files have been tested and matched in order to obtain a 'clean' patient index. Since December 2005 the Regional Referral Index is operational and ready for further developments. Precautions are taken to guarantee patient privacy and security of data. Only authorized users will be given access to patient data. Administration and maintenance of this Regional Referral Index is arranged by establishing a Patient Information Point. Currently, patient files of the other care providers in the region are being added and pilot projects to accomplish access to medical patient information are being realised. The regional activities run parallel and in line with national initiatives, aiming to link up with these initiatives over time.

Confidentiality↗
PubMed2003

Can randomised trials rely on existing electronic data? A feasibility study to explore the value of routine data in health technology assessment.

OBJECTIVES: To estimate the feasibility, utility and resource implications of electronically captured routine data for health technology assessment by randomised controlled trials (RCTs), and to recommend how routinely collected data could be made more effective for this purpose. DATA SOURCES: Four health technology assessments that involved patients under care at five district general hospitals in the UK using four conditions from distinct classical specialties: inflammatory bowel disease, obstructive sleep apnoea, female urinary incontinence, and total knee replacement. Patient-identifiable, electronically stored routine data were sought from the administration and clinical database to provide the routine data. REVIEW METHODS: Four RCTs were replicated using routine data in place of the data already collected for the specific purpose of the assessments. This was done by modelling the research process from conception to final writing up and substituting routine for designed data activities at appropriate points. This allowed a direct comparison to be made of the costs and outcomes of the two approaches to health technology assessment. The trial designs were a two-centre randomised trial of outpatient follow-up; a single-centre randomised trial of two investigation techniques; a three-centre randomised trial of two surgical operations; and a single-centre randomised trial of perioperative anaesthetic intervention. RESULTS: Generally two-thirds of the research questions posed by health technology assessment through RCTs could be answered using routinely collected data. Where these questions required analysis of NHS resource use, data could usually be identified. Clinical effectiveness could also be judged, using proxy measures for quality of life, provided clinical symptoms and signs were collected in sufficient detail. Patient and professional preferences could not be identified from routine data but could be collected routinely by adapting existing instruments. Routine data were found potentially to be cheaper to extract and analyse than designed data, and they also facilitate recruitment as well as have the potential to identify patient outcomes captured in remote systems that may be missed in designed data collection. The study confirmed previous evidence that the validity of routinely collected data is suspect, particularly in systems that are not under clinical and professional control. Potential difficulties were also found in identifying, accessing and extracting data, as well as in the lack of uniformity in data structures, coding systems and definitions. CONCLUSIONS: Routine data have the potential to support health technology assessment by RCTs. The cost of data collection and analysis is likely to fall, although further work is required to improve the validity of routine data, particularly in central returns. Better knowledge of the capability of local systems and access to the data held on them is also essential. Routinely captured clinical data have real potential to measure patient outcomes, particularly if the detail and precision of the data could be improved.

Arthroplasty, Replacement, Knee↗
PubMed1990

Hypertension in minority populations. Access to care.

Data from multiple sources confirm the greater risk of morbidity and mortality from cardiovascular disease that is seen in some minority segments of the population of the United States, when those segments are compared with the population as a whole. In most studies, blacks are shown to have the highest overall mortality rate from cardiovascular disease--higher than the rate for Hispanics, and substantially higher than the rate for whites and Asians. In some of these studies, blacks also have higher rates of both hypertension-related stroke and coronary artery disease. In some of the major clinical trials, Hispanic patients have the next-highest death rate from high blood pressure and ischemic heart disease. In other, smaller studies, however, non-Hispanic whites have had comparable or higher age-adjusted death rates. Asians, by contrast, have significantly lower death rates from cardiovascular disease, irrespective of national origin, and they also have correspondingly lower mortality from stroke and other hypertension-related diseases. As in coronary artery disease, issues related to access to care may be implicated in the disproportionate morbidity and mortality rates noted in black and Hispanic patients, as well as among some lower-class segments of the non-Hispanic white population. Access to care may depend upon a number of factors, among them cultural isolation, public awareness, individual and group attitudes, perception of resource availability, actual resources, socioeconomic status, educational level, and peer behavior.

Black or African American↗
PubMedDate not supplied

Medical data-bases-telecommunications issues in the 1980s.

This paper gives a brief description of the telecommunications problems encountered when accessing medical data-bases. In the first part of the article, the authors described how the creation of a special telecommunications working group at IMA (the French MEDLINE Centre) helped to handle and solve these problems. The second part shows how French users will be able to access new European data-bases; and discusses the changes brought about by the development of networks such as TRANSPAC and EURONET. It also compares the communications costs for all access configurations.

France↗
PubMed1973

Protection of privacy and confidentiality.

A multistate, cooperative program seeking to develop better methods for the effective and efficient gathering. storing, analyzing, and utilizing of mental patient records has made a comprehensive effort to protect the confidentiality and privacy of these psychiatric patient records. Administrative, technical, and legal safeguards have been implemented. The discussion of legal safeguards involves two areas: the protection of the system itself, located at Rockland State Hospital; and the specific legal environment of confidentiality and privacy of mental health records and information in the group of cooperating jurisdictions. On the whole, adequate legal and administrative protection can be afforded the confidentiality and privacy of an electronic data system in the mental health field, and access to the records can be restricted for the welfare of the patients. At the same time, access to aggregate data in the system can be allowed, under proper standards, for important research and planning purposes. The methods adopted by MSIS to preserve confidentiality and privacy by limiting access to such records could well prove an important model for the development of protective methods in other electronic data programs-not only those in psychiatry, but those in other fields where the data collected are sensitive and confidential.

Ethics, Medical↗
PubMed1987

Providing census data for general practice. 1. Feasibility.

The availability of census data to general practice is limited by the form of publication, restricted access to computerized data and the technical difficulties of linking computerized information to a practice population. In a feasibility study it is shown how a population registered with a general practice may be linked through postcodes to computerized enumeration district data. Examples of the data available are discussed together with current problems of postcode/enumeration district mismatch. Suggestions are made for ensuring that general practitioners have access to the 1991 census data.

Catchment Area, Health↗
PubMed2004

Security of health care records in Belgium. Application in a University Hospital.

Access rules to electronic patient records (EPR) have been issued by the Belgian Council of Physicians. Access to identifiable data of the EPR is restricted to anyone responsible for diagnosis, treatment and continuity of care of the patient. By delegation, associated personnel, like secretaries, can also be authorised to have access. A new perspective is given by the availability in 2003 of a national identification card allowing electronic signature of patients. It could not only authorise but also forbid some accesses. A law in 2002 gives right to patients to access to their own record. Health personnel can also be identified by cards but the system is not yet implemented. In the meantime, local measures have been made. We describe practical solutions that have been taken as priorities in a University Hospital. It was felt more important to allow access to lifesaving EPR data than to restrict its access by too strictly theoretical rules. A pilot study (S3 project) is also in progress for interinstitutional communication in Belgium, using the unique identification number of the patient and a "third server".

Belgium↗
PubMed1998

IMGT/LIGM-DB: a systematized approach for ImMunoGeneTics database coherence and data distribution improvement.

IMGT, the international ImMunoGeneTics database (http:(/)/imgt.cnusc.fr:8104), created by Marie-Paule Lefranc, Montpellier, France, is an integrated database specializing in antigen receptors and MHC of all vertebrate species. IMGT includes LIGM-DB, developed for Immunoglobulins and T-cell-receptors. LIGM-DB distributes high quality data with an important increment value added by the LIGM expert annotations. LIGM-DB accurate immunogenetics data is based on the standardization of biological knowledge related to keywords, annotation labels and gene identification. The management of such data resulting from biological research requires an high flexible implementation to quickly reflect up-to-date results, and to integrate new knowledge. We developed a systematized approach and defined LIGM-DB systems which manage and realize the major tasks for the database survey. In this paper, we will focus on the coherence system, which became absolutely crucial to maintain data quality as the database is growing up and as the biological knowledge continues to improve, and on the distribution system which makes LIGM-DB data easy to access, download and reuse. Efforts have been done to improve the data distribution procedures and adapt them to the current bioinformatics needs. Recently, we have developed an API which allows Java programmers to remotely access and integrate LIGM-DB data in other computer environments.

Animals↗
PubMed1978

Response to transient disturbances during intentional forearm flexion in man.

Steps of torque were applied to the human forearm during intentional flexion movements with peak velocities of 40-500 degrees/sec and during ballistically initiated flexion movements. The question asked was whether or not the motor ouput to both agonist and antagonist muscles is independent of sensory input data or is accessible and influenced by these inputs. The data obtained demonstrate unequivocally that the applied perturbation affects the motor output, irrespective of the speed of the movement. The time of onset of the reflex changes in motor output and their maxima are related to the movement's parameters. Data are presented which indicate that the source for the reflex changes observed are the muscle spindles.

Afferent Pathways↗
PubMed1990

Questioning the status quo: sickness absence research so far claims more than it should!

This article is in the nature of a cautionary tale for those working alongside any group of medics who are required to collect epidemiological data, or plan based upon data collected by medical experts without having access to that data. The field of work is occupational health and the specialised area is the relationship between socio-economic variables and absence from work due to sickness. The over-riding criticism of the sickness absence literature to date is that the use of analytical statistics is poor or in most cases almost non-existent and that there is very little understanding of the epidemiological concepts of 'confounding' and 'effect modification'. An example is given of one particular statistical procedure, multi-variate hierarchical log-linear modelling, which if used by future researchers could prevent the recurrence of some of the previous problems.

Absenteeism↗
PubMed2005

DIAL: a web-based server for the automatic identification of structural domains in proteins.

DIAL is a web server for the automatic identification of structural domains given the 3D coordinates of a protein. Delineation of the structural domains and their exact boundaries are the starting points for the better realization of distantly related members of the domain families, for the rational design of the experiments and for clearer understanding of the biological function. The current server can examine crystallographic multiple chains and provide structural domain solutions that can also describe domain swapping events. The server can be accessed from http://www.ncbs.res.in/~faculty/mini/DIAL/home.html. The Supplementary data can be accessed from http://www.ncbs.res.in/~faculty/mini/DIAL/supplement.html.

Amino Acid Motifs↗
PubMed2003

Role of exogenous surfactant in acute lung injury.

OBJECTIVES: To outline both the preclinical and clinical data demonstrating surfactant alterations in acute lung injury, which provide the rationale for testing exogenous surfactant administration in this setting. We also review the results of the randomized, controlled clinical trials conducted to date that have evaluated this therapy in patients with acute respiratory distress syndrome, and we review the various factors that may have affected the outcomes of these trials. Future areas for surfactant research will also be addressed. DATA SYNTHESIS AND EXTRACTION: A review of the literature utilizing a MEDLINE search was performed using the key words: surfactant, surfactant administration, acute respiratory distress syndrome, and lung injury. Personal views are presented and references to unpublished clinical data are made based on the authors' access to this data. CONCLUSIONS: Exogenous surfactant administration has proven inconsistent as a therapeutic modality for patients with acute respiratory distress syndrome. This is because of the severity of the injury at the time of treatment and because of the variable surfactant preparations, dosing regimes, and delivery methods used in the different trials. Future research efforts will focus on determining the optimal timing of surfactant administration in patients at risk of developing acute respiratory distress syndrome with the aim of preventing progressive lung dysfunction and determining whether surfactant treatments need to be tailored to the specific patient in question. Moreover, with the recognition that surfactant also plays an important role in host defense, the future for surfactant therapy is exciting.

Clinical Trials as Topic↗
PubMed2006

Metrics in the science of surge.

Metrics are the driver to positive change toward better patient care. However, the research into the metrics of the science of surge is incomplete, research funding is inadequate, and we lack a criterion standard metric for identifying and quantifying surge capacity. Therefore, a consensus working group was formed through a "viral invitation" process. With a combination of online discussion through a group e-mail list and in-person discussion at a breakout session of the Academic Emergency Medicine 2006 Consensus Conference, "The Science of Surge," seven consensus statements were generated. These statements emphasize the importance of funded research in the area of surge capacity metrics; the utility of an emergency medicine research registry; the need to make the data available to clinicians, administrators, public health officials, and internal and external systems; the importance of real-time data, data standards, and electronic transmission; seamless integration of data capture into the care process; the value of having data available from a single point of access through which data mining, forecasting, and modeling can be performed; and the basic necessity of a criterion standard metric for quantifying surge capacity. Further consensus work is needed to select a criterion standard metric for quantifying surge capacity. These consensus statements cover the future research needs, the infrastructure needs, and the data that are needed for a state-of-the-art approach to surge and surge capacity.

Consensus↗
PubMed1997

Randomized clinical trials in periodontology: ethical considerations.

Ethical justification for starting a clinical trial requires at the outset an accurate statement of "no difference" regarding the two or more agents to be compared. This may be expressed as "theoretical equipoise" (no data to support the superiority of one of the agents) or, preferably, as "clinical equipoise" (there are insufficient data to resolve controversy among experts as to which is superior). This presents a problem when a placebo control is proposed, particularly when the outcome measure entails irreversible loss of function; preliminary data often suggest the superiority of the "active agent." Informed consent should ordinarily include the fact that treatment assignments will be accomplished by a process of randomization and, in the case of double-blind designs, that neither the subject nor the investigator will know the subject's treatment assignment until the end of the trial. In general, clinical trials should be monitored by data and safety monitoring boards that have access to unblinded data; they should be guided by stopping rules that should be agreed upon by all concerned before the trial is begun. Women and minorities must be included unless there is strong justification for their exclusion. Care must be taken to balance the competing objectives of validity (the results will be correct), generalizability (the results will be broadly applicable), and efficiency (the study will not be unduly expensive).

Control Groups↗
PubMed2004

Computer access and Internet use among urban youths.

This report presents data on computer access, Internet use, and factors associated with health information seeking on the Internet among a sample of youths aged 15 to 30 years in New York City. Findings from street intercept surveys indicate substantial computer access at home (62%) and frequent (everyday or a few times a week) Internet use (66%). Fifty-five percent of the sample reported seeking health information on the Internet, which was associated with positive beliefs about getting a health checkup and frequent Internet use.

Adolescent↗