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DITTO - a tool for identification of patient cohorts from the text of physician notes in the electronic medical record.

A number of important applications in medicine and biomedical research, including quality of care surveillance and identification of prospective study subjects, require identification of large cohorts of patients with a specific diagnosis. Currently used methods are either labor-intensive or imprecise. We have therefore designed DITTO - a tool for identification of patients with a documented specific diagnosis through analysis of the text of physician notes in the electronic medical record. Evaluation of DITTO on the example of diabetes mellitus, hypertension and overweight has shown it to be rapid and highly accurate. DITTO processed 170,000 notes/hr with sensitivity ranging from 74 to 96%, and specificity from 86 to 100%. Its accuracy substantially exceeded the performance of currently used techniques for each of the three diseases. DITTO can be adapted for use in another healthcare facility or to detect a different diagnosis. DITTO is an important advancement in the field, and we plan to continue to work to enhance its functionality and performance.

Algorithms↗

[The design and realization of Web-view PACS browser].

This article analyses the system structure and realization model of Web-view PACS browser in combination with the characteristic of PACS, and presents the realizing process of the web-view PACS browser using JSP mode and B/S model.

Computer Communication Networks↗

[JPIP-based wireless transmission and display of high resolution DICOM medical images].

This paper uses JPIP protocol to transmit and display high-resolution medical images through the wireless network. JPIP server extracts medical images from PACS system, transforms the format of medical images, and parses and recomposes the JPEG2000 codestream. Wireless PDA access and display DICOM medical images through accessing the JPIP server.

Computers, Handheld↗

KIWIN(TM): From prototype to product for use.

2005 has seen the birth of the product KIWIN(TM)--an educational technology for nursing students in New Zealand involving web-based technology supported by Pocket PCs in the field. Nursing students use the technology to collect clinically relevant data at the point-of-care and transmit to a secure central server for storage using cradle synchronisation, WiFi or cellular wireless modalities. Later retrieval via the Internet enables collation of details, refinement of work, and construction with print-off of care reports to meet academic requirements. This demonstration will showcase the development to the international community. Critique and review will be welcomed.

Education, Nursing↗

Adoption of information technology enabled innovations by primary care physicians: model and questionnaire development.

A survey instrument was developed based on a model of the substantive factors influencing the adoption of Information Technology (IT) enabled innovations by physicians. The survey was given to all faculty and residents in a Primary Care teaching institution. Computerized literature searching was the IT innovation studied. The results support the role of the perceived ease of use and the perceived usefulness of an innovation as well as the intent to use an innovation as factors important for implementation. The model and survey instruments developed show significant potential to enhance our understanding of the process of implementing IT innovations such that Physicians will adopt them.

Attitude to Computers↗

Is dentistry through with film?

Film is the top choice for a full-mouth radiographic series. While cost and computer dependency are no longer major obstacles to using filmless radiography (FR), many clinicians still are reluctant to adopt the newer method because they are concerned about its diagnostic efficacy. Those concerns are not borne out in recent dental literature. FR's diagnostic capabilities and beneficial properties, which include decreased patient radiation exposure and nominal time needed to view an X-ray image, may have helped it surpass film as the modality of choice for some aspects of dental radiography, particularly procedures requiring selective periapical radiographic analysis.

Computer Graphics↗

Information-seeking behavior of health sciences faculty: the impact of new information technologies.

This paper reports on an ongoing investigation into health sciences faculty's information-seeking behavior, including their use of new information technologies. A survey was administered to all faculty in medicine, nursing, and pharmacy at the University of Illinois at Chicago. It was similar to one administered to the same population in 1991. The survey asked about faculty's use of electronic resources, documented any shift from the use of print to electronic formats, and measured the utilization of library training. The response rate was 48.5% for medicine faculty, 45.0% for nursing, and 62.5% for pharmacy. The study found that use of the print Index Medicus among faculty was in transition: While 30.5% continued to use the print resources, 68.0% of faculty accessed MEDLINE through electronic means. Faculty preferred accessing electronic databases from their offices to doing so from the library. Health sciences faculty used a wide variety of databases, in addition to MEDLINE, to fill their information needs. Most faculty did not take advantage of either in-house or electronic training sessions offered by librarians. The study concluded that the training preferences of faculty need to be further explored.

CD-ROM↗

Health information networking via the Internet with the former Soviet Union.

Because of the severe financial hardships associated with the transition to a market economy in the Newly Independent States (NIS) of the former Soviet Union, the Internet has become a major link to health care resources for many health care workers. In 1992, the University of Illinois at Chicago Library of the Health Sciences (UIC LHS) initiated a special support project with goals of enhancing access to international biomedical information and facilitating international professional networking for interested NIS organizations and individuals. Project objectives included an information needs assessment, development of culturally sensitive Internet training applications, information and referral services, and follow-up e-mail consultations for NIS participants. This paper reviews the historical context of the health care partnerships between the United States and the NIS, and of the UIC LHS International Health Information Networking Project. In the context of UIC, international networking cross-cultural observations, teaching techniques, a Russian training experience, and the development of a Web-based course are reported.

Computer Communication Networks↗

Computer assisted management of information in an intensive care unit.

In order to use the capability of computers for handling large amounts of information, we developed a program for the acquisition, handling, storage and retrieval of administrative and clinical information generated in the 20 bedded multidisciplinary critical care unit of a University Hospital. At an initial phase a personal computer (PC) was used to collect information from 4362 patients, that included registration data, coded admission problems, techniques and special treatments, and final diagnosis. This information combined with free text provided a discharge report. Complementary programs allowed calculation and storage of hemodynamic and gas exchange parameters. This experience led to a second phase in which a computer with microprocessor Intel 80386 at 25 MHz, 8 MB RAM, 310 MB hard disk and a streamer for 150 MB cartridge tape back up, using UNIX operating system, permitted multiple users working simultaneously through 1 central console and 7 ASCII terminals. Data input included demographic data, previous and admission problems in coded form, present history and physical examination in free text, list of present problems in coded form, comments on evolution, record of special techniques and treatments, laboratory data, treatment, final diagnosis and facility for using all the information to elaborate the final report. Side modules provide help for drugs dosing, protocols for specific conditions and clerical routines. The system is open for connection to other areas of the Hospital. Data from more than 2000 patients have been included so far.(ABSTRACT TRUNCATED AT 250 WORDS)

Data Collection↗

The UMLS knowledge source server: an object model for delivering UMLS data.

The Unified Medical Language System (UMLS), a project of the National Library of Medicine (NLM), regularly distributes a set of knowledge sources to the research community. These data are made available over the Internet through the UMLS Knowledge Source Server (UMLSKS). The new version of the UMLSKS is a complete redesign of the original system using Java and the Extensible Markup Language (XML) technologies to implement a fast, reliable, flexible, and extensible UMLS data retrieval system that includes an Application Programmer's Interface (API) and an Object Model of each of the Knowledge Sources: the UMLS Metathesaurus, the Semantic Network, and the SPECIALIST Lexicon. In this paper we present the design of the new system, outline each of the system design goals, the UMLS Object Model, and statistics showing the usage of the new UMLSKS and associated data. We conclude with implications for future work.

Information Storage and Retrieval↗

[Animal models of amnesia of alcoholic origin: an amnesia without memory impairment].

Our studies show that chronic alcohol consumption (CAC) in Balb/c mice induces (1) a deficit of spontaneous but not effortful retrieval processes, and (2) a concomitant reduction of anxiety, suggesting a potential interaction between emotional and memory disorders. We have shown that the benzodiazepine agonist, diazepam, induces memory deficits similar to those produced by CAC, whereas administering beta CCM (an inverse agonist of the benzodiazepine receptor) alleviated the memory deficits of alcohol-treated subjects. Parallel neuroanatomical studies have shown that CAC produced cell damage in the mamillary bodies, whereas no major changes were observed in the hippocampus or the frontal cortex, which is involved in long-term consolidation processes. Overall data show that CAC induced amnesia is not due to a dysfunction of the neural networks underlying memory storage processes, but rather results from a difficulty in activating the neural substrates engaged in retrieval processes which depend on emotional, motivational or environmental factors.

Amnesia↗