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PubMed2003

Informatics united: exemplary studies combining medical informatics, neuroinformatics and bioinformatics.

OBJECTIVES: Medical informatics, neuroinformatics and bioinformatics provide a wide spectrum of research. Here, we show the great potential of synergies between these research areas on the basis of four exemplary studies where techniques are transferred from one of the disciplines to the other. METHODS: Reviewing and analyzing exemplary and specific projects at the intersection of medical informatics, neuroinformatics, and bioinformatics from our experience in an interdisciplinary research group. RESULTS: Synergy emerges when techniques and solutions from medical informatics, bioinformatics, or neuroinformatics are successfully applied in one of the other disciplines. Synergy was found in 1. the modeling of neurophysiological systems for medical therapy development, 2. the use of image processing techniques from medical computer vision for the analysis of the dynamics of cell nuclei, and 3. the application of neuroinformatics tools for data mining in bioinformatics and as classifiers in clinical oncology. CONCLUSIONS: Each of the three different disciplines have delivered technologies that are readily applicable in the other disciplines. The mutual transfer of knowledge and techniques proved to increase efficiency and accuracy in a manifold of applications. In particular, we expect that clinical decision support systems based on techniques derived from neuro- and bioinformatics have the potential to improve medical diagnostics and will finally lead to a personalized delivery of healthcare.

Computational Biology↗
PubMed2003

GIS based malaria information management system for urban malaria scheme in India.

A GIS based information management system has been developed to help Urban Malaria Control in India. The basic objective is to develop a model to assist planning and implementation of a suitable control measure. The system can help in: (i) identifying high receptive areas in time and space domain; (ii) identifying risk factors for high receptivity; (iii) monitoring and evaluating control measures. To demonstrate this system, information on 33 parameters and malaria cases has been attached to a digitised map of Dindigul, an urban town in Tamil Nadu. Functionalities of the system and its utility are described in this paper. A GIS based information management system ensures that if a localised spurt of the disease occurs, it can be associated rapidly with a likely cause, a specific vector, and a probable human source, so that appropriate preventive action can be taken to arrest any rising trend.

Communicable Disease Control↗
PubMed2004

Pathology informatics questions and answers from the University of Pittsburgh pathology residency informatics rotation.

CONTEXT: Effective pathology practice increasingly requires familiarity with concepts in medical informatics that may cover a broad range of topics, for example, traditional clinical information systems, desktop and Internet computer applications, and effective protocols for computer security. To address this need, the University of Pittsburgh (Pittsburgh, Pa) includes a full-time, 3-week rotation in pathology informatics as a required component of pathology residency training. OBJECTIVE: To teach pathology residents general informatics concepts important in pathology practice. DESIGN: We assess the efficacy of the rotation in communicating these concepts using a short-answer examination administered at the end of the rotation. Because the increasing use of computers and the Internet in education and general communications prior to residency training has the potential to communicate key concepts that might not need additional coverage in the rotation, we have also evaluated incoming residents' informatics knowledge using a similar pretest. DATA SOURCES: This article lists 128 questions that cover a range of topics in pathology informatics at a level appropriate for residency training. These questions were used for pretests and posttests in the pathology informatics rotation in the Pathology Residency Program at the University of Pittsburgh for the years 2000 through 2002. With slight modification, the questions are organized here into 15 topic categories within pathology informatics. The answers provided are brief and are meant to orient the reader to the question and suggest the level of detail appropriate in an answer from a pathology resident. RESULTS: A previously published evaluation of the test results revealed that pretest scores did not increase during the 3-year evaluation period, and self-assessed computer skill level correlated with pretest scores, but all pretest scores were low. Posttest scores increased substantially, and posttest scores did not correlate with the self-assessed computer skill level recorded at pretest time. CONCLUSIONS: Even residents who rated themselves high in computer skills lacked many concepts important in pathology informatics, and posttest scores showed that residents with both high and low self-assessed skill levels learned pathology informatics concepts effectively.

Internship and Residency↗
PubMed2001

Informatics competencies for nurses at four levels of practice.

Valid and comprehensive nursing informatics (NI) competencies currently are lacking. Meanwhile, nursing leaders are emphasizing the need to include NI in nursing curricula, as well as within the roles of practicing nurses in all settings. This article presents the initial work of a team of NI experts toward development of a valid and reliable set of NI competencies. Previous work primarily has focused on computer-related skills, rather than examining a broad definition of informatics competencies. For this current work, NI competencies encompass all skills, not only computer-related skills, as well as knowledge and attitudes needed by nurses. The first two authors created a database of NI competencies from the existing literature. A larger panel of NI experts then affirmed, modified, added, or deleted competencies from this database. Competencies were placed into four distinct skill levels. Definitions of each skill level and an initial master list of competencies are provided.

Computer Literacy↗
PubMed2004

Textpresso: an ontology-based information retrieval and extraction system for biological literature.

We have developed Textpresso, a new text-mining system for scientific literature whose capabilities go far beyond those of a simple keyword search engine. Textpresso's two major elements are a collection of the full text of scientific articles split into individual sentences, and the implementation of categories of terms for which a database of articles and individual sentences can be searched. The categories are classes of biological concepts (e.g., gene, allele, cell or cell group, phenotype, etc.) and classes that relate two objects (e.g., association, regulation, etc.) or describe one (e.g., biological process, etc.). Together they form a catalog of types of objects and concepts called an ontology. After this ontology is populated with terms, the whole corpus of articles and abstracts is marked up to identify terms of these categories. The current ontology comprises 33 categories of terms. A search engine enables the user to search for one or a combination of these tags and/or keywords within a sentence or document, and as the ontology allows word meaning to be queried, it is possible to formulate semantic queries. Full text access increases recall of biological data types from 45% to 95%. Extraction of particular biological facts, such as gene-gene interactions, can be accelerated significantly by ontologies, with Textpresso automatically performing nearly as well as expert curators to identify sentences; in searches for two uniquely named genes and an interaction term, the ontology confers a 3-fold increase of search efficiency. Textpresso currently focuses on Caenorhabditis elegans literature, with 3,800 full text articles and 16,000 abstracts. The lexicon of the ontology contains 14,500 entries, each of which includes all versions of a specific word or phrase, and it includes all categories of the Gene Ontology database. Textpresso is a useful curation tool, as well as search engine for researchers, and can readily be extended to other organism-specific corpora of text. Textpresso can be accessed at http://www.textpresso.org or via WormBase at http://www.wormbase.org.

Abstracting and Indexing↗
PubMed2004

SURGETICA at Grenoble: from computer assisted medical interventions to quality inspired surgery.

Research on "Computer Assisted Medical Interventions" (CAMI) was initiated in Grenoble in 1984, as an attempt to take up the challenge of "Minimally Invasive Interventions", thanks to the introduction of Information and Communication Techniques in the Operating Room. In a first section, we will describe our initial vision. The corresponding achievements will then be presented. A final section will show that the challenge now is to "invert this movement": instead of moving the computer in the Operating Room, we should embed the surgeon (or at least his or her expertise) into the Information Technology based tools he or she uses.

France↗
PubMed1993

Developments in health informatics within the standards associations of Australia and New Zealand.

Activities to support the development and adoption of Standards in health informatics are now well started. The Standards Association of Australia formed a committee (IT/14) on Medical Informatics which met for the first time in February 1991: early in 1992 it changed its name to reflect a broader concern with "Health Informatics" rather than the rather narrower interpretation that many had chosen to place on the term "Medical Informatics". The Standards Association of New Zealand held the inaugural meeting of persons interested in constituting committee SC606 on Health Informatics in August of this year. A growing program of active collaboration between Australia and New Zealand was formalised in July of this year, whereby standards will for the most part be jointly developed and adopted regionally, and whereby the separate committees will be merged wherever practicable to form a single head Joint Technical Committee (JTC) for each domain of involvement. The focus in Australia and New Zealand is at present very much on the need for standards to implement national health information networks. The progressive definition of network standards is prompting increased interest in the standards implemented within the systems and installations that must connect to the networks. The initial implementation of a national health information system in New Zealand is scheduled for 1st July 1993: detailed plans for an Australian health communications network are well advanced although no date for its implementation has been proposed. This paper outlines the general structure of the standards committees in the Antipodes, and of their various sub-committees. It will also outline broad terms of reference of these groups, and the major areas of current interests, activity and developments.

Australia↗
PubMed1995

Integration of nursing informatics in a registered nurse graduate program.

Experienced registered nurses (RNs) are adult learners seeking a program of study in many academic settings to prepare for the advanced practice nursing role. They want a visionary curriculum that builds on their previous experience and develops their creativity in meeting educational goals and objectives [1]. At the Northeastern University College of Nursing in Boston such a program exists. Building on their first foundation course, Professional Development Seminar, RN students are exposed to the Benner Model, From Novice to Expert [2].

Adult↗
PubMed1978

Computer assisted monitoring in intensive medicine.

Intensive Medicine is always associated with the problem of handling the mass and assuring the quality of information on vital signs, fluid and blood balance, laboratory data, physiological calculations, etc., required in patient care. A computer based monitoring system for intensive care was introduced in 1973 at the Academic Hospital in Leuven. The basic software was developed at the Peter Bent Brigham Hospital of the Harvard Medical School and the medical division of the Hewlett Packard Company; the computer used was a H.P. 2100 central processor with 32K of core memory. Initially, the program allowed mainly acquisition, storage and retrieval of bedside monitored and manual data of cardiac and circulatory function. Very soon however, the software was extended and modified by the division of "Medical Informatics" in order to meet new or different requirements. In the present situation our vision on the use of computer-assisted monitoring has changed and our present program has been extended as follows : 1. On-line collection and retrieval of bedside monitored data including heart rate, arterial blood pressure (systolic-diastolic-mean) left atrial pressure, central venous pressure, pulmonary artery pressure, intracranial pressure. Trend analysis of those data, with calculation of mean values, standard variation and corresponding t-tests. 2. Computer assistance in performing time consuming calculations on off-line data such as : -- clearance-values (renal function), -- temperature-correction of blood-gasvalues, -- hour-to-hour fluid balance, including calculation of in-sensible losses, -- blood-balance. 3. Data transmission of laboratory results as soon as available in the central laboratory through a direct link between laboratory and I.T.U. 4. Computer assisted E.C.G. analysis. The three first objectives are realised, on-line E.C.G.-analysis is being developed. The same computer serves the remotely located medical and coronary care units and one bed in the emergency department. An assessment of computer assistance in intensive therapy, on nursing labor and on quality of patient care is made.

Clinical Laboratory Techniques↗
PubMed1997

Demonstrating minimal invasive therapy over the Internet.

Use of the Internet for multimedia conferencing began in the early 1990s. Multimedia conferencing allows people at multiple, distributed locations to communicate using audio, video and shared workspace programs; the Multicast Backbone of the Internet (MBONE) provides the technical solution to make the most efficient use of the limited Internet bandwidth for such interactions. The scope for using this technology in medical applications was recognised by the MICE project which, in November 1994, used Sun SPARC workstations connected to the MBONE to send video and commentary of live operations from Sweden and San Francisco to a workshop held in London. These sessions were marred by severe congestion experienced on the networks on the day, but the consensus of those organising and attending the workshop was that the exercise was worthwhile. The main lessons learnt from this first transmission were the need to provide better quality links and to ensure confidentiality. In December 1995, the MERCI project, funded by the European Union under the TELEMATICS for Research programme, began work to refine and further propagate the use of the multimedia conferencing software. Part of this work is to provide these improved facilities to transmit operations to two more workshops scheduled for 1997. MERCI will offer confidentiality through encryption facilities built into the conferencing programs, improved programs which cope better with adverse network conditions, use of the new high-speed JAMES network and access to a multimedia server from which recordings of operations and medical instrumentation can be delivered to the workshop participants.

Computer Communication Networks↗
PubMedDate not supplied

Lifelong learning: skills and online resources.

OBJECTIVE: Advances in information technology enable the practicing psychiatrist's quest to keep up-to-date with new discoveries in psychiatry, as well as to meet recertification requirements. However, physicians' computer skills do not always keep up with technology, nor do they take advantage of online search and continuing education services. This article describes the rationale for using electronic databases and training, as well as basic computer skills, computer equipment, and important online resources for psychiatrists to meet their continuing education and recertification needs quickly, easily, and conveniently. METHOD: A literature review was performed using PUBMED and Google to find articles related to recertification, physician's technology adoption and computer skills, evidence-based medicine, and basic approaches to lifelong learning using computers and the Internet, and resources for lifelong learning. RESULTS: Psychiatrists are required to master a discrete set of information for board certification, and to maintain that knowledge for recertification. Surveys have shown that although most physicians use computers, the majority use them for personal or business purposes, and not for accessing Continuing Medical Education (CME) programs (1). The Council on Graduate Medical Education requires the acquisition of medical informatics skills for the Undergraduate Medical Education for the 21st Century (UME-21) curriculum project (2). There is a growing body of literature outlining basic computer skills and competencies for physicians to access online textbooks, databases, journals, and CME programs. CONCLUSIONS: Psychiatrists can benefit from learning how to use computers and the Internet to keep current with the advances in the field. Skills now being taught in medical school and residency are equally important for practicing psychiatrists to learn and master.

Clinical Competence↗
PubMed2004

Gaining support from health disciplines and other stakeholders.

The Health industry employs health professionals from many disciplines all of whom need to have a basic understanding of health informatics principles and how information technologies may be used to improved health service delivery and patient/community/population health outcomes. This is not well understood by the workforce as a whole resulting in a low demand for health informatics education. Many health service managers and policy makers do not appreciate the power and potential usefulness of all health related information and the many technologies now available. This impacts on decisions regarding their acquisition, implementation and staff training/education support. This chapter includes recommended strategies on how to best overcome such knowledge deficits so that greater support for Health Informatics education is achieved.

Attitude to Computers↗
PubMed2005

Technological innovations in clinical assessment and psychotherapy.

In this paper the application of computer technology and the use of the Internet in mental health care are critically reviewed. A number of on-line screening devices have been developed for anxiety disorders, mood disorders, and substance abuse disorders, with great potential for clinical practice. On line assessment is generally equivalent to clinical assessment. A number of studies have shown that self-help treatment programmes on stand-alone computers are as effective as routine clinical care. The Internet enhances the therapeutic possibilities of computers by offering feedback of therapists and more tailor-made treatment. A number of randomized clinical trials (RCTs) have shown that Internet-based treatment is more effective than no-treatment and as effective as face-to-face treatment. Research so far has been limited to anxiety disorders, burn-out, depression, headache, insomnia, tinnitus and obesity. Further, exposure through virtual reality has been found effective in a number of RCTs in specific phobias, but results with respect to the effects of the use of virtual reality techniques to other disorders are inconclusive. It is concluded that computer-driven assessment and treatment has many advantages and few disadvantages. A number of reasons are discussed which will preclude large-scale implementation of computer-driven assessment and therapy in the near future.

Anxiety Disorders↗
PubMed1994

Case-based telematic systems towards equity in health care. Introduction to the symposium.

The theme of this International Symposium, co-sponsored by EFMI (the European Federation for Medical Informatics) and WHO-Eur (the European Office of the World Health Organisation) is made of four components: (1) an ethical principle: equity in health care, that aims to social justice; (2) measurements of equity that should be case-based/population related; (3) communication of this information at a wide scale, using telematics, e.g. integrated computer systems at distance; (4) actions to improve health care and equity in its delivery by using resource management tools and developing quality of care. The combination of these four elements is recommended as a coherent scheme for future actions of public authorities in health care. They were therefore associated in the somewhat complex title of the symposium. A special attention is given to the present degree of availability of a large number of case based/population related data sources in Europe, as well as on the need to develop generic models in telematics, rather than too strict standards at the user level. These information systems can be made easily accessible to clinicians and epidemiologists as an aid to their decision making in the European region.

Computer Communication Networks↗
PubMed1986

Future programs at the National Library of Medicine.

The future of the National Library of Medicine will be shaped by a number of scientific, technical, and social influences. Among these are the continuing rapid development of computer technology and storage systems. Artificial intelligence techniques, factual databases, the emergence of medical informatics as a formal discipline, and the development of Integrated Academic Information Management Systems (IAIMS) are also important influences on the direction of the library. Public policy issues will influence the future of NLM--among them, sharing of scientific information between nations and the role of federal agencies in dissemination of information domestically. The formal, long-range plan now being prepared for the library by panels of expert advisers will be a guide for future programs and goals.

Artificial Intelligence↗
PubMed2003

Reflections on an arranged marriage between bioinformatics and health informatics.

OBJECTIVE: To compare the discussions of two workshops held during 2001 by two Canadian organisations, HEALNet, a Network of Centres of Excellence for research in health information applications, and Genome Canada, a national research funding agency for genomics and proteomics, in collaboration with the Institute of Genetics of the Canadian Institutes of Health Research, to examine strategic research development in Health Informatics and Bioinformatics respectively. METHODS: Invited workshops with structured debate. Concept analysis of preparative material and debates. RESULTS: A predominantly common set of concepts was discerned from both workshops. Analysis of published definitions showed an inability to distinguish a definition that would suggest that health informatics and bioinformatics are separate disciplines. In both workshops there was evidence of deep concerns of identity, the lack of clear structures to support research funding as well as uncertainty in distinguishing between service and research. CONCLUSIONS: Many deep issues currently inhibit the recognition and funding of research in health and bioinformatics in Canada and elsewhere. Some of these issues are common to both health and bioinformatics. The overlap in prevailing definitions, research concerns and methodological content in the respective domains suggest that common research needs should be better identified and reinforced for the benefit of both.

Biomedical Research↗
PubMed2003

Deriving design recommendations through discount usability engineering: ethnographic observation and thinking-aloud protocol in usability testing for computer-based teaching cases.

Usability engineering often involves experimental evaluation designs carried out in special usability laboratories. Though becoming more popular in medical informatics, the approach is little used. Possibly this is because of the expense involved in set-up, data collection, and data analysis. Excellent results may be obtained, however, by employing discount usability engineering and qualitative methods of data collection and analysis to generate recommendations to improve usability. A prototype computer-based teaching case was evaluated in a discount usability engineering approach by combining modified ethnographic observation with simplified thinking aloud protocol. Data was collected and analyzed using standard approaches for qualitative data. This approach led to helpful recommendations for designing teaching cases. The project team believes this economical approach to usability testing may be helpful to others engaged in interface design.

Computer Literacy↗