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How well do physicians use electronic information retrieval systems? A framework for investigation and systematic review.

OBJECTIVE: Despite the proliferation of electronic information retrieval (IR) systems for physicians, their effectiveness has not been well assessed. The purpose of this review is to provide a conceptual framework and to apply the results of previous studies to this framework. DATA SOURCES: All sources of medical informatics and information science literature, including MEDLINE, along with bibliographies of textbooks in these areas, were searched from 1966 to January 1998. STUDY SELECTION: All articles presenting either classifications of evaluation studies or their results, with an emphasis on those studying use by physicians. DATA EXTRACTION: A framework for evaluation was developed, consisting of frequency of use, purpose of use, user satisfaction, searching utility, search failure, and outcomes. All studies were then assessed based on the framework. DATA SYNTHESIS: Due to the heterogeneity and simplistic study designs, no meta-analysis of studies could be done. General conclusions were drawn from data where appropriate. A total of 47 articles were found to include an evaluation component and were used to develop the framework. Of these, 21 articles met the inclusion criteria for 1 or more of the categories in the framework. Most use of IR systems by physicians still occurs with bibliographic rather than full-text databases. Overall use of IR systems occurs just 0.3 to 9 times per physician per month, whereas physicians have 2 unanswered questions for every 3 patients. CONCLUSIONS: Studies comparing IR systems with different searching features have not shown that advanced searching methods are significantly more effective than simple text word methods. Most searches retrieve only one fourth to one half of the relevant articles on a given topic and, once retrieved, little is known about how these articles are interpreted or applied. These studies imply that further research and development are needed to improve system utility and performance.

Evaluation Studies as Topic↗

Statistical presentation and analysis of ordered categorical outcome data in rheumatology journals.

OBJECTIVE: To assess the appropriateness of presentation of summary measures and analysis of ordered categorical (ordinal) data in three rheumatology journals in 1999, and to consider differences between basic and clinical science articles. METHODS: Six hundred forty-four full-length articles from the 1999 editions of 3 rheumatology journals were evaluated for inclusion of an ordinal outcome. Articles were classified as basic or clinical science, and the appropriateness of presentation and analysis of the ordinal outcome were assessed. Chi-square tests were used to evaluate difference in percentages. RESULTS: Ordinal outcomes were identified in 175 (27.2%) of 644 articles. Only 69 (39.4%) had appropriate data presentation, and 111 (63.4%) had appropriate data analysis. Appropriate presentation was seen less commonly in the basic science rather than the clinical science articles, but differences in the occurrence of appropriate analysis were not seen. CONCLUSION: Ordinal data are common in rheumatology articles, but presentation usually does not conform to recommended guidelines.

Data Collection↗

Reducing the risk of sexually transmitted infections in genitourinary medicine clinic patients: a systematic review and meta-analysis of behavioural interventions.

OBJECTIVES: Are behavioural interventions effective in reducing the rate of sexually transmitted infections (STIs) among genitourinary medicine (GUM) clinic patients? DESIGN: Systematic review and meta-analysis of published articles. DATA SOURCES: Medline, CINAHL, Embase, PsychINFO, Applied Social Sciences Index and Abstracts, Cochrane Library Controlled Clinical Trials Register, National Research Register (1966 to January 2004). REVIEW METHODS: Randomised controlled trials of behavioural interventions in sexual health clinic patients were included if they reported change to STI rates or self reported sexual behaviour. Trial quality was assessed using the Jadad score and results pooled using random effects meta-analyses where outcomes were consistent across studies. RESULTS: 14 trials were included; 12 based in the United States. Experimental interventions were heterogeneous and most control interventions were more structured than typical UK care. Eight trials reported data on laboratory confirmed infections, of which four observed a greater reduction in their intervention groups (in two cases this result was statistically significant, p < 0.05). Seven trials reported consistent condom use, of which six observed a greater increase among their intervention subjects. Results for other measures of sexual behaviour were inconsistent. Success in reducing STIs was related to trial quality, use of social cognition models, and formative research in the target population. However, effectiveness was not related to intervention format or length. CONCLUSIONS: While results were heterogeneous, several trials observed reductions in STI rates. The most effective interventions were developed through extensive formative research. These findings should encourage further research in the United Kingdom where new approaches to preventing STIs are urgently required.

Adult↗

[Brazilian scientific journals in speech-language and hearing science: impact indicator].

BACKGROUND: Global value of scientific papers published in national journals of the Brazilian Speech-language and Hearing Science analyzed through the Impact Factor (IF). PURPOSE: To analyze part of the Brazilian Speech-Language and Hearing Science through its scientific journals: characterization of the impact indicator--in this case the Impact Factor (IF). Seven national Speech-language and Hearing Science journals (1986/ 2001) registered in the Brazilian Institute of Information in Science and Technology (Ibict) and with a given International Standard Serial Number (ISSN) were analyzed. In order to calculate the IF of the scientific journals, the lists of bibliographic references of the published papers were consulted and the original formula of Garfield was used, adapting it to the seven journals. Bibliographic references cited in the research papers, in the case studies, in the review and update articles were considered for analyses. Researches which were cited in the summaries like letters to the editors; editorial, abstracts, commentaries and others were excluded. A total of 9,334 bibliographic references of 549 papers were analyzed, excluding self-citations of authors. It was observed that the resulting IFs revealed practically null values. The obtained results demonstrate that the Brazilian Speech-language and Hearing Science needs to develop a few aspects of its editorial and scientific processes--the researches of the Brazilian Speech-language and Hearing Science are being lost, making it necessary for the editors to raise the access and visibility of their journals and for the speech-language and hearing scientists to cite the work of their antecessors and national partners. According to the obtained data, for the Brazilian Speech-language and Hearing Science, the publication of 11.9 papers is necessary for only one of these papers to be cited in another research. It is observed that the IFs of the Brazilian Speech-language and Hearing Science, among these seven journals, have risen since 1999, suggesting a development of this Science. The follow up of this research, analyzing the years subsequent to 2001, is necessary in order to verify the real raise of the impact of these articles.

Bibliometrics↗

Awareness of and attitudes to the new physical activity recommendations--perceptions of attenders of the 5th IOC World Congress on Sport Science.

New evidence suggests that regular moderate intensity physical activity confers substantial health benefits. This information needs to be conveyed to exercise and sports professionals, as they have a potential lead role in broader public education to encourage physical activity. This study reports data from a survey of attenders at a sports medicine/sports science conference in Sydney in November 1999. Of the 292 who responded, only one third had ever heard of the United States Surgeon General's report on physical activity and health, and 43% had heard of the Active Australia initiative. Those who were members of Sports Medicine Australia (SMA), female or younger responders were more likely to recall Active Australia. An understanding of the moderate physical activity message was highest among sports physicians, and those who already perceived physical activity advice to be part of their role, and lowest among exercise and posrts scientists. The study suggests the need for professional education strategies to be developed in this area for exercise and sports scientists.

Australia↗

[Medical decision making: its history and technical terms].

Medical decision making, an application of decision sciences to medicine, has been increasingly recognized as an important clinical armamentarium in the past several decades. Clinical medicine abounds in uncertainties arising from the very nature of clinical data and physicians' judgments. These uncertainties provide room for decision sciences to be widely used in clinical medicine. There are two major research areas in medical decision making, i.e., prescriptive and descriptive approaches. The prescriptive approach, an endeavor to explore how decisions should be made, is quantitative and probabilistic, and employs decision analytical procedures which are designed to maximize expected value or utility. An example of a decision tree is shown as well as such essential technical terms as decision node, chance node, averaging out, folding back, sensitivity, specificity, predictive values, Bayes' theorem, and expected value of clinical information. The descriptive approach, on the other hand, is related to how people behave. In this context, strict meaning of judgment and decision making, some heuristics and psychological pitfalls, and the necessity of elucidating patients' preferences, though difficult, are recapitulated.

Clinical Laboratory Techniques↗

Monitoring clinical research. A report from the Childrens Cancer Study Group.

This report describes an evaluative approach in assessing study quality in clinical trials. The size of the data set required is defined using decision analysis methods. Assuming entry of eligible patients, the minimum data set required in determining study quality includes: the treatment agent, the protocol stipulated treatment time, and the actual time of administration. While toxicity, complication and response data are primary for the resolution of the scientific issues, they are secondary for study performance questions. Separation of study performance and scientific questions simplifies the design and execution of complex, multimodal, multidisciplinary clinical trials. Application of separate criteria for study performance and scientific questions enhances understanding of protocol requirements by data managers, physicians, and nurses. Once study performance issues are resolved, the scientific issues addressed by the protocol can be considered in detail. The usual practice of focusing on science and study performance simultaneously precludes efficient consideration of either data set. The distinction between analyses of study performance and of scientific questions is illustrated using data from Childrens Cancer Study Group protocol CCG-551. This study is a controlled trial of therapies for non-Hodgkin's lymphoma. The protocol provides an example of modern diagnostic and therapeutic management complexities.

Antineoplastic Combined Chemotherapy Protocols↗

Success, failures and costs of implementing standards in the USA--lessons for infection control.

In the US, extensive standards for performance and 'guidelines for practice' have been instituted by a number of governmental and non-governmental agencies. New governmental plans for health care depend heavily on practice guidelines, and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has been especially enthusiastic about continuous quality improvement. Monitoring the appropriateness of care and altering physician practice appeals to insurance carriers and health care management organizations. Some initial data exist to show that the quality of health care has been enhanced by these regulations. The total cost for health care administration in 1990 in the USA was 24.8% of each hospital's spending for health care. Much of this was associated with spending for new initiatives in practice guidelines, physician profiling, quality assurance, and the like. Few data exist to show that the quality of health care or hospital infection control has been enhanced by these expenditures. Regulations and guidelines also have proliferated in infection control. Guides from the JCAHO have been expanded, and recent mandates from the Occupational Health and Safety Administration (OSHA) for protecting employees from blood-borne and respiratory pathogens promise to be especially costly for health care organizations to implement. Little data exist to show that the quality of infection control has been enhanced by these regulations. Standards are difficult to develop, because the science to back them up often is lacking, interpretation of validating data is imprecise, and inherent biological variation makes exceptions common. Seven lessons are important for those developing standards today. These include focusing on objective measures of the impact of the standard, clearly indicating the degree of scientific validity, making the development process inclusive, allowing for local variation, making sure that funding is provided for mandated standards, considering non-scientific implications of standards, and remaining involved in the process after the guideline is developed. Infection control workers should make sure that standards developed take the lessons above into account before they are promulgated.

Financial Support↗

Safety Profile of the Non-steroidal Anti-inflammatory Drug Celecoxib in the Short-Term Management of Acute Non-cancer Pain: A Systematic Review with Meta-analysis of Randomised Controlled Trials.

OBJECTIVE: To summarise the literature regarding the safety of short-term use of the non-steroidal anti-inflammatory drug&#xa0;(NSAID) celecoxib. STUDY DESIGN: Systematic review with meta-analysis of randomised trials. Participants comprised individuals of all ages with acute non-cancer pain. Interventions included celecoxib at 200-400 mg/day for up to 10 days. The comparators were placebo, other NSAIDs (including cyclooxygenase-2 [COX-2] inhibitors and non-selective NSAIDS [nsNSAIDS]), or opioids. DATA SOURCES: Five databases were searched from inception to April 2025: Embase, Web of Science, MEDLINE, Cochrane Central Register of Controlled Trials, and Scopus. Additionally, a registry was searched: ClinicalTrials.gov. DATA SYNTHESIS: Meta-analyses using Mantel-Haenszel and random-effects model were used to calculate risk ratios (RRs) and 95% confidence intervals (CIs) for severe cardiovascular, respiratory, and gastrointestinal adverse events and secondary outcomes. The Cochrane Risk of Bias Tool for randomised trials (RoB-2) was used to assess bias risk. The Grading of Recommendation Assessment, Development and Evaluation (GRADE) was conducted to assess the certainty of evidence of each reported outcome. RESULTS: Title/abstract and full text screening comprised 3976 and 273 studies, respectively. Fifty studies were included with 10,693 participants. The RRs for adverse events were no different between celecoxib and placebo for severe events (3 studies) (RR 0.44 [95% CI 0.10-2.03]), cardiovascular (3 studies) (RR 0.84 [95% CI 0.24-2.92]), respiratory (4 studies) (RR 1.23 [95% CI 0.29-5.26]), and gastrointestinal events (33 studies) (RR 0.96 [95% CI 0.64-1.43]). There was no difference between celecoxib and NSAIDS for gastrointestinal adverse events, RR 0.89 (95% CI 0.68-1.17). Celecoxib had a lower risk compared to opioids for gastrointestinal events, RR 0.34 (95% CI 0.14-0.86), and showed a lower risk of nausea compared with placebo, RR 0.75 (95% CI 0.60-0.93), and nsNSAIDS, RR 0.80 (95% CI 0.64-0.99). Most studies had some risk of bias concerns, and the overall certainty of evidence for most outcomes was very low. Celecoxib appears to be safe for acute non-cancer pain when compared to placebo, NSAIDS, and opioids. It had a lower risk compared to opioids for gastrointestinal adverse events in general, nausea and vomiting, as well as a lower risk for nausea adverse events when compared to placebo and nsNSAIDS. REGISTRATION: PROSPERO-CRD42025642152.

Journal Article↗

Genetics and molecular diagnostics in the clinical laboratory science curriculum.

OBJECTIVE: To determine the nature and extent of education in human genetics and molecular diagnostics in clinical laboratory science (CLS) programs throughout the U.S. DESIGN: A written survey was mailed to 263 CLS programs. Data were expressed as raw numbers and percentages of responses. SETTING: State University of New York, Upstate Medical University. PARTICIPANTS: There were 162 responses and 151 usable surveys. Most respondents (86.8%) were department chairs/CLS program directors; 13.2% were CLS faculty or educational coordinators. MAIN OUTCOME MEASURES: Questions were designed to determine frequency of CLS programs providing education in genetics, specific molecular methods and clinical applications, format of instruction, satisfaction levels with education provided, and perceptions on importance of teaching genetics, molecular diagnostics, and related hands-on experiences. RESULTS: Over 92% of CLS programs teach human genetics and molecular diagnostics in varied formats. Polymerase chain reaction was the most frequently taught molecular method; microorganism detection, the most commonly taught clinical application. More programs teach theory than provide hands-on experience in molecular diagnostics. Only 59 (39.1%) teach related ethical issues. Sixty-seven respondents (44.4%) were dissatisfied with the education they provide, due to lack of time to teach the material (n = 49; 73.1%), lack of knowledgeable faculty (n = 43; 64.2%), and expense of methods (n = 37; 55.2%). Most respondents felt it was important to include human genetics (n = 145; 96%) and molecular diagnostics (n = 149; 98.7%) in their curriculum, and related hands-on experiences in the student laboratory (n = 106; 70.2%) or clinical rotation (n = 135; 89.4%). Over 82% (n = 124) expected instruction of molecular diagnostics to increase in the next five years. CONCLUSION: Most CLS programs include human genetics and molecular diagnostics in their curriculum, and expect the education they provide to increase in the next 5 years. In order to meet this expectation, CLS programs may need to provide opportunities for faculty training, seek funding to cover the cost of methods, and consider innovative curriculum changes.

Curriculum↗

A research role for every nurse.

Knowledge development in an applied discipline consists of extending practical knowledge through scientific investigations (Benner, 1984). Our research commitment began with Ms. Nightingale, who wrote down her observations and used collected data to change practice. All nurses should be committed to the advancement of nursing science through the conduct and utilization of nursing research. Every nurse can participate in problem identification, data collection, research critiques, and in the dissemination of research findings. As the scientific body of nursing knowledge grows, we each must be responsible for facilitating the use of this knowledge in practice ... each of us is accountable to society for the scientific basis of our practice. All nurses should be involved in improving the quality of nursing practice. There is a research role for every nurse.

Humans↗

Seeking advice from NHS direct on common childhood complaints: does it matter who answers the phone?

BACKGROUND: National Health Services (NHS) Direct is a national nurse-led, call-centre based, telephone triage, health information and advice service in the United Kingdom (UK). Forty percent of calls to NHS Direct are about children. There is a need to identify whether there is a difference in the time taken for nurses to triage calls about children. AIM: The aim of the study was to determine if the call length and outcomes of Registered Sick Children's Nurses and Registered Nurses were different when triaging children who presented with 'rash' or 'fever' by telephone. SAMPLE: This study was carried out at NHS Direct, West Midlands, and involved analysis of 1281 calls taken by 22 nurses. METHODS: This study examined the frequency of referral by the two nurse groups to five triage outcome groups. Information about the calls was extracted from routinely collected data generated by the computerized clinical decision support software. The data were used for secondary analysis. DATA ANALYSIS: The data were analysed using Statistics Package for Social Sciences version 10 and nonparametric Mann-Whitney U -tests were performed to compare call lengths of the two groups. The chi-square test was used to analyse differences in frequency of triage to outcome groups. RESULTS: The mean call length of the Registered Sick Children's Nurses was statistically significantly shorter than that of the Registered Nurses (P < 0.001). With the exception of referral for a routine appointment with a general medical practitioner, both Registered Sick Children's Nurses and Registered Nurses referred to other triage outcomes groups with equal frequency. LIMITATIONS: Inaccuracy of call length measurement of less than 1 minute and more than 20 minutes was because of the limitations of the data extraction software. This system-led definition and measured length of a call limits both the analysis and conclusions that could be drawn about the content of NHS Direct nurse consultation. CONCLUSIONS: Registered Sick Children's Nurses take less time than Registered Nurses to triage calls about children presenting with 'rash' or 'fever'. Further investigation is required into the content and consultation process of the nurses, and also the safety and appropriateness of referral.

Adolescent↗

Intravascular ultrasound-guided interventions in coronary artery disease: a systematic literature review, with decision-analytic modelling, of outcomes and cost-effectiveness.

BACKGROUND: Intravascular ultrasound (IVUS) is the generic name for any ultrasound technology used in vivo within the blood vessels. More specifically, intracoronary ultrasound enables imaging of the coronary arteries from within the lumen. This review concentrates on the role of intracoronary ultrasound as an adjunct to interventional cardiology. OBJECTIVES: (1) To identify the literature on IVUS for guiding coronary interventions, and to synthesise evidence about outcomes compared with outcomes when IVUS guidance has not been used. (2) To use this evidence, together with other information about costs and outcomes, to model the cost effectiveness of IVUS guidance. (3) To synthesise the evidence on the reproducibility of measurements of cross-sectional area made using IVUS. METHODS DATA SOURCES: (1) Electronic searches of MEDLINE, EMBASE, Science Citation Index, Index to Scientific and Technical Proceedings, Engineering Compendex, Engineering Page One, Cochrane Library, Inside (British Library), 1990-98. (2) Contacting experts and centres of expertise, 1990-99. (3) Internet search, 1990-99. METHODS STUDY SELECTION: Studies of IVUS-guided coronary interventions performed on humans were included in the review. Non-English language studies were also included when they covered IVUS-guided stenting or angioplasty. Control evidence regarding outcomes without IVUS guidance was sought only from randomised controlled trials (RCTs). Studies investigating the reproducibility of measurements of cross-sectional area were included only if the results were expressed in terms of the mean and standard deviation of paired differences. METHODS DATA EXTRACTION: Checklists that covered study details, patient characteristics and results were completed independently by three reviewers. Consensus was reached on any disagreements. Local data were gathered on the costs of IVUS-guided stenting. METHODS DATA SYNTHESIS: Overall event rates were calculated by pooling patient results from the included studies. A decision-analytic model was used to combine information from the literature with cost estimates, in order to predict cost-effectiveness in terms of cost per restenosis event avoided by the use of IVUS guidance. The analysis was performed from the perspective of the healthcare provider. Sensitivity analysis was undertaken. A simple extrapolation was made to long-term outcome so that cost-utility (using quality-adjusted life years (QALYs)) could be estimated. The minimum detectable change in cross-sectional area was estimated from the reproducibility results. RESULTS: Only one study on IVUS-guided angioplasty satisfied the inclusion criteria, and there were no studies on IVUS-guided atherectomy or other IVUS-guided interventions that satisfied the inclusion criteria. Of the 15 articles on IVUS-guided stenting that satisfied the inclusion criteria, seven presented data on outcomes at 6 months post-intervention. The angiographic restenosis rate was 16 +/- 1%. This compared with 24 +/- 2% derived from five articles on stenting without IVUS guidance. Data for follow-up periods longer than 6 months were presented in only two studies. Data from a total of five studies were included in the decision-analytic model. The cost per restenosis event avoided was 1545 pound sterling. After extrapolation to long-term outcome, the calculated cost per QALY was 6438 pound sterling. The baseline QALY gain was only 0.03 years. Sensitivity analysis resulted in large differences between the best- and worst-case scenarios, for example, from a saving of 5000 pound sterling to a cost of 24,000 pound sterling restenosis event avoided. The smallest changes in cross-sectional area that could be measured were 1.6 mm2 by a single observer and 1.9 mm2 by different observers. CONCLUSIONS: Implications for healthcare: The evidence available is too weak for there to be any reliable implications for clinical practice. (ABSTRACT TRUNCATED)

Algorithms↗

Digital biology: an emerging and promising discipline.

This article examines the role of computation and quantitative methods in modern biomedical research to identify emerging scientific, technical, policy and organizational trends. It identifies common concerns and practices in the emerging community of computationally-oriented bio-scientists by reviewing a national symposium, Digital Biology: the Emerging Paradigm, held at the National Institutes of Health in Bethesda, Maryland, November 6th and 7th 2003. This meeting showed how biomedical computing promises scientific breakthroughs that will yield significant health benefits. Three key areas that define the emerging discipline of digital biology are: scientific data integration, multi-scale modeling and networked science. Each area faces unique technical challenges and information policy issues that must be addressed as the field matures. Here we summarize the emergent challenges and offer suggestions to academia, industry and government on how best to expand the role of computation in their scientific activities.

Computational Biology↗

Unraveling the Clinical Spectrum of DNASE1L3 Deficiency: Insights from Case Series and Systematic Literature Review.

BACKGROUND: DNASE1L3 deficiency is a rare monogenic cause of lupus and lupus-like autoimmunity resulting from impaired extracellular DNA clearance and sustained immune activation. Although most reported patients present with early-onset systemic lupus erythematosus (SLE), emerging evidence suggests broader phenotypic variability, including vasculitic and overlap manifestations. Whether these presentations represent distinct clinical entities or a continuum of DNASE1L3-associated immune dysregulation remains unclear. We aimed to define the clinical spectrum of DNASE1L3 deficiency and examine the relationship between recurrent pathogenic variants and disease severity. METHODS: We conducted a combined pediatric case series and systematic literature review. Four children with genetically confirmed biallelic DNASE1L3 variants followed at a tertiary pediatric rheumatology centre were retrospectively analysed for clinical, immunological, genetic, treatment, and outcome data. In parallel, a systematic search of PubMed/MEDLINE, Scopus, and Web of Science identified previously reported patients with confirmed biallelic pathogenic or likely pathogenic DNASE1L3 variants and extractable patient-level clinical data. To facilitate cross-case comparison, we applied an exploratory three-tier descriptive framework reflecting increasing disease severity: vasculitic or organ-limited disease (G1), systemic lupus or overlap phenotypes without irreversible organ damage (G2), and severe systemic organ-damaging disease (G3). The assigned grades were descriptive rather than permanent categories, as some patients may meet the criteria for a higher grade if broader systemic manifestations or irreversible organ damage develop during follow-up. FINDINGS: Fifteen reports provided extractable patient-level data, corresponding to 45 unique previously reported patients after accounting for known or probable overlapping reports. Combined with four patients from our centre, the analysis included 49 genetically confirmed individuals. SLE-dominant disease was the most frequent phenotype (27 [60%] of 45), followed by hypocomplementaemic urticarial vasculitis/HUVS-dominant disease (10 [22.2%]) and overlap phenotypes (8 [17.8%]). Renal involvement was reported in 30 (66.7%) of 45 patients, and disease onset occurred by age 3&#xa0;years in 20 (44.4%). Persistent hypocomplementemia affecting C3 and C4 was frequently reported across the spectrum. Recurrent DNASE1L3 variants were observed across multiple phenotypic and severity grades. Variants such as p.Asn191Ser and p.Thr97Ilefs*2 occurred in patients spanning organ-limited vasculitic disease, lupus overlap phenotypes, and severe multisystem lupus with major organ involvement. CONCLUSION: DNASE1L3 deficiency was associated with a broad clinical spectrum of immune-mediated disease rather than a single clinicopathological entity. The occurrence of identical pathogenic variants across distinct phenotypic and severity states argues against a simple genotype-phenotype model and suggests that additional modifiers influence disease expression.

Humans↗

The interpretation of averages in health professions research. An empirical examination.

A potential misinterpretation regarding measures of central tendency was identified in several health sciences textbooks presenting basic statistical procedures. The misinterpretation involves measures of central tendency derived from skewed unimodal sample distributions. The reviewed textbooks state or imply that in asymmetrical distributions the median is always located between the mode and mean. An example is presented illustrating the fallacy of this assumption. The mean and median will always be to the right of the mode in a positively skewed unimodal distribution and to the left of the mode in a negatively skewed distribution, but the order of the mean and median is impossible to predict or generalize. The assumption that the median always falls between the mode and mean in the calculation of coefficients of skewness has implications for the interpretation of health sciences research.

Data Interpretation, Statistical↗

Establishing a large DNA data bank using the PowerPlex 1.1 and 2.1 systems.

In the early 1990's, the importance of establishing a DNA Data Bank of convicted sex offender samples for comparison to unsolved cases became apparent to the Virginia Division of Forensic Science to help identify potential perpetrators. Ultimately, through the expansion of the data basing law to include all convicted offenders and juveniles convicted of a crime that would be considered a felony if tried as an adult, the Division has successfully used the DNA Data Bank to aid the law enforcement community in solving crimes where the victim was unable to identify the perpetrator. As the number of offender sample analyses has increased, in combination with the number of analyses of cases where a suspect could not be identified, the number of DNA Data Bank hits has also significantly increased. Initially, in 1997, when the Division converted its DNA Data Bank program from the restriction fragment length polymorphism technology to the short tandem repeat technology, one offender hit occurred on average for every 2,900 convicted offender samples that were entered into the Data Bank. However, by December 31, 2000, one DNA Data Bank hit occurred on average for every 700 samples entered into the Data Bank.

Criminology↗

Subject knowledge in the health sciences library: an online survey of Canadian academic health sciences librarians.

OBJECTIVES: This study investigated whether Canadian academic health sciences librarians found knowledge of the health sciences to be important and, if so, how they acquired and maintained this knowledge. METHODS: Data were gathered using a Web-based questionnaire made available to Canadian academic health sciences librarians. RESULTS: Respondents recognized the need for subject knowledge: 93.3% of respondents indicated that subject knowledge was "very important" or "somewhat important" to doing their job. However, few respondents felt that holding a degree in the health sciences was necessary. Respondents reported devoting on average more than 6 hours per week to continuing education through various means. Reading or browsing health sciences journals, visiting Websites, studying independently, and participating in professional associations were identified by the largest number of participants as the best ways to become and stay informed. CONCLUSIONS: Although more research needs to be done with a larger sample, subject knowledge continues to be important to Canadian academic health sciences librarians. Continuing education, rather than formal degree studies, is the method of choice for obtaining and maintaining this knowledge.

Canada↗