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At least 1,387 records · Page 77Linked to original sources

[The MEDAN database: patients with abdominal septic shock].

Septic shock still has an unacceptable high mortality rate. To lowering this high mortality rate in the long run, we built a database that is unique in its data amount. Until now we have transferred 282 handwritten patient records into our database. Data were collected retrospectively from 1997 to 2001, based on voluntary cooperation of 62 hospitals. With the preprocessed data of our database we give mainly an epidemiologic overview and make first statistical evaluations. Thereby we noticed that some diagnoses and operations appear significantly higher for deceased patients than for survivors. At the end we discuss the future potential of the database.

Adult↗

The "Phoenix" ADR database of the Drug Commission of the German Medical Profession--a clinically useful approach to optimize evidence-based medicine in Germany.

The innovative "Phoenix" database system of the Drug Commission of the German Medical Profession (AkdA) permits rapid access to data on adverse drug reactions. It enables the user to conduct searches covering a wide variety of questions within a short period of time. No one needs to be an "expert" to extract scientific knowledge from a database that currently already contains some 106,000 reports on adverse drug reactions. While our traditional apprenticeship model of physician training has served us well, an adaptation will be required for the new millennium. New tools are needed to allocate the available resources. Clinical proposals of experts or opinion leaders, guidelines, and highly graded clinical studies, like the use of clinical databases may help to improve safety and efficacy of drug administration. Evidence-based critical care medicine is therefore a potential tool for improving the effectiveness of drug therapy and for the patient's outcome. Over and above, the Phoenix database might be interpreted as an initiative instrument, which is easy to use and contributes to highlight the determinants of clinical decisions.

Databases, Factual↗

How to find evidence when you need it, part 4: Matching clinical questions to appropriate databases.

Practitioners seeking enhancement of clinical care through consideration of research require rapid and efficient point-of-care access to current studies and summaries pertaining to specific clinical queries. MEDLINE and other large databases usually contain the citations relevant to such questions but frequently fall short of the practical requirements of busy clinicians. We present a summary of the knowledge and skills required for physicians to select and use smaller databases appropriate to particular types of questions arising from emergency care. We outline a step-by-step approach that begins at the bedside with the sorting of questions into appropriate categories of knowledge and research design. We identify commonly encountered pitfalls in the process of connecting a particular question to an appropriate database. We illustrate the approach through a set of demonstration questions pertaining to patients presenting to emergency departments with chest pain consistent with acute coronary ischemia. We describe a selection of resources and databases and summarize their performance in locating articles relevant to the demonstration questions.

Algorithms↗

Developing a linked administrative database of health service utilisation by the aging population of metropolitan Perth.

The increasing use of health services by the older population has placed significant stresses on the health system of Western Australia. This is a report of the development of a linked administrative database of health resource utilisation by the aged population of metropolitan Perth. Hospital administrative databases linked to clinical or administrative databases of other health providers are reviewed. Length of stay data is linked to aged care assessments, referrals to nursing homes and community services. The linked databases approach allows the study of resource allocation and can pinpoint systemic stress in aged care. It is a tool for reducing the duplication of services, the pressure on beds in health institutions, and cost by improving efficiencies.

Aged↗

The construction of an EST database for Bombyx mori and its application.

To build a foundation for the complete genome analysis of Bombyx mori, we have constructed an EST database. Because gene expression patterns deeply depend on tissues as well as developmental stages, we analyzed many cDNA libraries prepared from various tissues and different developmental stages to cover the entire set of Bombyx genes. So far, the Bombyx EST database contains 35,000 ESTs from 36 cDNA libraries, which are grouped into approximately 11,000 nonredundant ESTs with the average length of 1.25 kb. The comparison with FlyBase suggests that the present EST database, SilkBase, covers >55% of all genes of Bombyx. The fraction of library-specific ESTs in each cDNA library indicates that we have not yet reached saturation, showing the validity of our strategy for constructing an EST database to cover all genes. To tackle the coming saturation problem, we have checked two methods, subtraction and normalization, to increase coverage and decrease the number of housekeeping genes, resulting in a 5-11% increase of library-specific ESTs. The identification of a number of genes and comprehensive cloning of gene families have already emerged from the SilkBase search. Direct links of SilkBase with FlyBase and WormBase provide ready identification of candidate Lepidoptera-specific genes.

Amino Acid Sequence↗

Identifying proteins from two-dimensional gels by molecular mass searching of peptide fragments in protein sequence databases.

A rapid method for the identification of known proteins separated by two-dimensional gel electrophoresis is described in which molecular masses of peptide fragments are used to search a protein sequence database. The peptides are generated by in situ reduction, alkylation, and tryptic digestion of proteins electroblotted from two-dimensional gels. Masses are determined at the subpicomole level by matrix-assisted laser desorption/ionization mass spectrometry of the unfractionated digest. A computer program has been developed that searches the protein sequence database for multiple peptides of individual proteins that match the measured masses. To ensure that the most recent database updates are included, a theoretical digest of the entire database is generated each time the program is executed. This method facilitates simultaneous processing of a large number of two-dimensional gel spots. The method was applied to a two-dimensional gel of a crude Escherichia coli extract that was electroblotted onto poly(vinylidene difluoride) membrane. Ten randomly chosen spots were analyzed. With as few as three peptide masses, each protein was uniquely identified from over 91,000 protein sequences. All identifications were verified by concurrent N-terminal sequencing of identical spots from a second blot. One of the spots contained an N-terminally blocked protein that required enzymatic cleavage, peptide separation, and Edman degradation for confirmation of its identity.

Amino Acid Sequence↗

Role of exposure databases in epidemiology.

At present, exposure databases record data primarily for regulatory purposes; they have not focused on serving the needs of epidemiologists or public health. However, the modification of exposure databases could facilitate their use in epidemiology. Characteristics necessary to enhance the use of all databases include easy access by users; documentation of methods, sampling bias, error, and inconsistences; widespread coverage in time and space; and methods and measures for estimating exposure of individuals as well as populations. Also needed are exposure scenarios and models to estimate exposures for geographic areas and time intervals not currently sampled. Multidisciplinary teams are needed to examine current databases, to review strategies for improving data collection, and to suggest and help implement appropriate changes. A long-term goal is to develop and validate data from exposure scenarios and models using data on the relationship of exposure to doses measured in humans.

Databases, Factual↗

The north american control animal database: a resource based on standardized nomenclature and diagnostic criteria.

Historical control data have been shown to be valuable in the interpretation and evaluation of results from rodent carcinogenicity studies. Standardization of terminology and histopathology procedures is a prerequisite for meaningful comparison of control data across studies and analysis of potential carcinogenic effects. Standardization is particularly critical for the construction of a database that includes incidence data from different studies evaluated by pathologists in different laboratories. Standardized nomenclature and diagnostic criteria have been established for neoplasms and proliferative lesions. Efforts of the National Toxicology Program, the Society of Toxicologic Pathology (STP), and the Registry of Industrial Toxicology Animal-data (RITA) have led to a harmonized pathology nomenclature for the rat and the mouse. This nomenclature with detailed descriptions of lesions is available in publications by the STP and International Agency for Research on Cancer (IARC). A listing of these terms is available on the World Wide Web. Utilizing the model established by RITA and working with the International Life Sciences Institute (ILSI), companies with laboratories in North America formed a working group in 1994 to establish and maintain a database of neoplastic and proliferative lesions from control animals in carcinogenicity studies. The rationale for development of the North American Control Animal Database (NACAD), the factors that influence tumor incidence, operation of the database, and the benefits to be realized by using a standardized approach are discussed.

Animals↗

IDEA (Intellectual Disability Exploring Answers): a population-based database for intellectual disability in Western Australia.

Despite the demands it places on individuals, families and the community, intellectual disability (ID) is a neglected area of public health. Accurate estimates of prevalence are sparse and range from 0.5 to 3.0%. The cause of the condition is unknown in at least 50% of cases. This paper describes the Intellectual Disability Exploring Answers (IDEA) database set up in Western Australia to provide an infrastructure for research and to facilitate the planning of service provision for people with ID. Since 1953 a database for ID has been maintained in Western Australia, a state with a population of 1.95 million in an area of 2.52 million km2. The current IDEA database aims to obtain ongoing population-based ascertainment of ID from providers of clinical and educational services, with the potential for linkage to a network of other state databases. The average prevalence of ID for children born in Western Australia over the years 1983-1996 was 15.2 per 1000 live births, with 50% ascertained only through the education system. During this time period 60% of cases were male. Of children with an ID born in Western Australia in 1980-1999 and surviving to 1 year, 30.1% had a birth defect, and the prevalence ratio of birth defects in this group compared to the population with no birth defects was 6.5 (CI 6.3-6.8).

Adolescent↗

Understanding the three national databases on collegiate alcohol and drug use.

An overview of the three major databases used to examine alcohol and other drug use habits of American college students is provided. The databases are compared in terms of purpose, study population, subject selection, method of administration, focus, utility for institutional use, and trend analyses. The authors conclude that no one source of data is "best." Rather, the studies represent three different sources of data. Although information from these databases overlaps to some extent, each database makes a unique contribution to the field.

Alcohol Drinking↗

Development of an exposure database and surveillance system for use by practicing OSH professionals.

This report summarizes the development of an occupational exposure database and surveillance system for use by health and safety professionals at Rocky Flats Environmental Technology Site (RFETS), a former nuclear weapons production facility. The site itself is currently in the cleanup stage with work expected to continue into 2006. The system was developed with the intent of helping health and safety personnel not only to manage and analyze exposure monitoring data, but also to identify exposure determinants during the highly variable cleanup work. Utilizing a series of focused meetings with health and safety personnel from two of the major contractors at RFETS, core data elements were established. These data elements were selected based on their utility for analysis and identification of exposure determinants. A task-based coding scheme was employed to better define the highly variable work. The coding scheme consisted of a two-tiered hierarchical list with a total of 34 possible combinations of work type and task. The data elements were incorporated into a Microsoft Access database with built-in data entry features to both promote consistency and limit entry choices to enable stratified analyses. In designing the system, emphasis was placed on the ability of end users to perform complex analyses and multiparameter queries to identify trends in their exposure data. A very flexible and user-friendly report generator was built into the system. This report generator allowed users to perform multiparameter queries using an intuitive system with very little training. In addition, a number of automated graphical analyses were built into the system, including exposure levels by any combination of building, date, employee, job classification, type of contaminant, work type or task, exposure levels over time, exposure levels relative to the permissible exposure limit (PELS), and distributions of exposure levels. Both of these interfaces, allow the user to "drill down" or gradually narrow query criteria to identify specific exposure determinants. A number of other industrial hygiene processes were automated by the use of this database. Exposure calculations were coded into the system to allow automatic calculation of time-weighted averages and sample volumes. In addition, a table containing all the PELs and other relevant occupational exposure limits was built into the system to allow automatic comparisons with the current standards. Finally, the process of generating reports for employee notification was automated. The implementation of this system demonstrates that an integrated database system can save time for a practicing hygienist as well as provide useful and more importantly, timely information to guide primary prevention efforts.

Colorado↗

MEGA-database: one million data since 1972.

MEGA is the chemical workplace exposure database of the Institute for Occupational Safety (BIA) of the German Berufsgenossenschaften (BG) (statutory accident institutions for insurance and prevention). On the legal basis of the social insurance law the inspectorates of the BGs conduct workplace measurements of chemical and biological agents. The BGs have cooperated with BIA within the Berufsgenossenschaftliches Messsystem Gefahrstoffe--BGMG since 1972: measurements are done by the BGs, analyses and data processing are the tasks of BIA. In 1999 31,000 measurements with 68,000 analyses were taken in 4,000 enterprises. All data are stored in the MEGA-database with up to 150 pieces of information (describing type of workplace, working conditions, measured substances, sampling strategy, sampling duration, sampling and analytical method etc.), for each result. MEGA contains today about 1,000,000 measurements of more than 400 substances starting in 1972. MEGA is used by BIA and the BGs for the following purposes: prevention (e.g., identification of hazards, efficiency of exposure reducing measures, determination of technical criteria for exposure limit values), epidemiological questions, and investigations of occupational diseases. In the framework of the measuring and inspection activities and tasks of the inspectorates of the BGs the locations for measurements are not randomly selected, but are based on criteria such as supposed critical exposure situations or testing the efficiency of exposure reducing measures. Nevertheless, a statistical appraisal of the data is possible for different purposes considering the specific determinants of the results, as, for example, classification of enterprises (sectors), workplaces (activities, tasks), used materials, and products. The MEGA-database will be further developed into a multifactorial exposure database with additional data on biological exposure to bacteria and funghi, but also noise and other data.

Databases, Factual↗

Development and initial experience with the new "exposure database of the federal states".

The Workgroup of the State Measuring Authorities for Chemical Occupational Safety (ALMA) was established in 1987 by the State Committee for Occupational Safety and Safety Technology (LASI) for the purpose of exchanging experiences between the measuring institutes and authorities of the federal states supporting the commercial regulation authorities in the field of dangerous materials. A workgroup was assigned by ALMA in 1995 to determine the theoretical and practical basis for the establishment of an exposure database commonly available to the federal states. In the first stage, the theoretical data structure of the planned database was defined. The purpose of this was to ensure the exchange of exposure data between the federal states in the future and to allow common evaluation of the data. In the second stage, the practical benefits of the database were determined in a trial run. This database makes possible and simplifies the documentation of both the exposure measurements of the state measuring authorities and also those of external (private) measuring bodies.

Databases, Factual↗

A synthetic vitreous fiber (SVF) occupational exposure database: implementing the SVF Health and Safety Partnership Program.

The Health and Safety Partnership Program is a voluntary workplace safety program for workers involved in the manufacture, fabrication, installation, and removal of glass wool and mineral wool products. This article describes one element of this Partnership Program, the development of an occupational exposure database that characterizes exposures by fiber type, industry sector, product type, and job description. Approximately 6000 exposure samples are included in the database, most of which were collected over the past decade, making it the most extensive and recent exposure data set on record for glass wool and mineral wool. The development of this database, as well as the initial results for exposure measurements segmented by product type and/or job description, are described. The current database shows that most applications and uses of glass wool and mineral wool involve exposures below the voluntary 1 f/cc permissible exposure limit, although some specific product types and job descriptions involve average exposures approaching the 1 f/cc limit.

Databases, Factual↗

Emergency medical services information systems and a future EMS national database.

Since the early 1970s, various publications and legislation have contributed to the development of emergency medical services (EMS) information systems and databases. Yet, even today, EMS systems vary in their ability to collect patient and systems data and to put these data to use. In addition, no means currently exists to easily link disparate EMS databases to allow analysis at local, state, and national levels. For this reason, the National Association of State EMS Directors is working with its federal partners at the National Highway Traffic Safety Administration (NHTSA) and the Trauma and EMS program of the Health Resources and Services Administration's (HRSA's) Maternal and Child Health Bureau to develop a national EMS database. Such a database would be useful in developing nationwide EMS training curricula, evaluating patient and EMS system outcomes, facilitating research efforts, determining national fee schedules and reimbursement rates, and providing valuable information on other issues related to EMS care.

Database Management Systems↗

Advancing disaster epidemiology and response: developing a national disaster-victim database.

BACKGROUND: The need to further disaster preparedness has resulted in a call for more comprehensive disaster research. Past disaster research has, for the most part, been limited by the inability to obtain complete medical data from victims of disasters. A national disaster-victim database (NDVD) can be developed that will facilitate collection and aggregation of disaster-victim medical data from health care facilities. Three aspects of the NDVD are discussed: DATA REQUIREMENTS: Medical records of disaster victims must be standardized before being uploaded from various databases into the NDVD. Existing data dictionaries provide formats in which data elements can become standardized. Once standardized, data sets from different facilities can be pooled and subjected to analyses. Database System. The three tiers of the NDVD system are: 1) medical data are collected at the point of care, 2) medical data are entered into databases and converted into a specific format, and 3) formatted data sets are uploaded to the NDVD. In order for this system to be viable, it must not add burden to health care workers; rather, it must benefit them and their facilities. REAL-TIME COLLECTION OF MEDICAL DATA: Capturing data on victims of a disaster, during a disaster, is ideal. This would allow for more victim data to be studied as well as for more accurate data to be collected. Technologic advancement has encouraged a real-time data-collection model in St. Louis that can act as a model for NDVD implementation.

Databases as Topic↗

Improving the U.S. EPA Toxic Release Inventory database for environmental health research.

In 1986, Congress passed the Emergency Planning and Community Right-to-Know Act (EPCRA) in response to the tragic death of thousands of people in Bhopal, India, following the accidental release of the toxic gas methyl isocyanate (MIC) from a Union Carbide facility. As a component of EPCRA, certain manufacturers are required to report annually the total mass (pounds per year, lb/yr) of toxic chemicals released into the environment (air, water, land, or underground injection), treated on-site, or shipped off-site for further waste treatment. This information is compiled by the U.S. Environmental Protection Agency (EPA) into a publicly accessible database known as the Toxic Release Inventory (TRI). The TRI database is designed to encourage pollution prevention and waste reduction by increasing public access to and knowledge of environmental chemical releases. EPCRA has been generally considered by industry, government, and community representatives as one of the most successful environmental laws in U.S. history. Over the past few years, EPA has initiated a three-phased expansion to EPCRA reporting requirements that will enhance the overall usefulness of the TRI database. The focus of this article is to discuss these changes and highlight several current uses of the TRI database in environmental health research.

Accidents, Occupational↗

XML-based visualization of design and completeness in medical databases.

PURPOSE: mdplot (medical database plot) visualizes both structure and quality of data in medical databases by means of a summary representation of design and completeness in XML format. The goal is to identify attributes suitable for evaluation and to aid in creating open data models. METHODS: A three-stage visualization approach is applied. First, an overview of all classes in a database, second a detailed view of a specific class and third an analysis of individual attributes. Missing data is identified to enable specific efforts to improve data quality prior to analysis. For each class number of patients, attributes, and records per patient are provided. A condensed bar chart for each category of attributes (categorical, numerical, text and other) visualizes available content: The abscissa corresponds to the sequence of attributes; the ordinate represents completeness per attribute. By selection of a specific class, a detailed description is provided including mean completeness in each category as well as completeness per attribute. To analyse attributes that are collected at several time points per patient, a frequency distribution of records per patient can be generated. RESULTS: The new methodology was applied to two clinical research databases consisting of 292 attributes (955 patients) and 224 attributes (610 patients), respectively, and resulted in major restructuring of the systems. A public website is provided for generation of mdplots.

Data Collection↗