Terminology issues in user access to Web-based medical information.
(49/2017)
We conducted a study of user queries to the National Library of Medicine Web site over a three month period. Our purpose was to study the nature and scope of these queries in order to understand how to improve users' access to the information they are seeking on our site. The results show that the queries are primarily medical in content (94%), with only a small percentage (5.5%) relating to library services, and with a very small percentage (.5%) not being medically relevant at all. We characterize the data set, and conclude with a discussion of our plans to develop a UMLS-based terminology server to assist NLM Web users. (+info)
Methodology for the analysis and representation of the medical information about drugs in the Summary of Product Characteristics (SPC).
(50/2017)
We present a methodology for the representation of the medical knowledge in the drug SPCs. It includes four steps, the two first of which are automated. All instances of a particular SPC text are gathered into a single file. Lexical analysis of the content of this file is performed and a lexicon with the occurrence of words and groups of words is built. Semantic analysis is carried out considering the concepts underlying each word of the lexicon and the most important concepts are kept. This semantic analysis results in a list of attributes which are then included in an object-oriented model. We have used this method to structure drug indications. This application clearly illustrates the advantages of this method over purely manual analysis. This method could be generalized for all categories of medical information about drugs. (+info)
Applying temporal joins to clinical databases.
(51/2017)
Clinical databases typically contain a significant amount of temporal information, information that is often crucial in medical decision-support systems. Most recent clinical information systems use the relational model when working with this information. Although these systems have reasonably well-defined semantics for temporal queries on a single relational table, many do not fully address the complex semantics of operations involving multiple temporal tables. Such operations can arise frequently in queries on clinical databases. This paper describes the issues encountered when joining a set of temporal tables, and outlines how such joins are far more complex than non-temporal ones. We describe the semantics of temporal joins in a query management system called Chronus II, a system we have developed to assist in evaluating patients for clinical trials. (+info)
Decision support for clinical trial eligibility determination in breast cancer.
(52/2017)
We have developed a system for clinical trial eligibility determination where patients or primary care providers can enter clinical information about a patient and obtain a ranked list of clinical trials for which the patient is likely to be eligible. We used clinical trial eligibility information from the National Cancer Institute's Physician Data Query (PDQ) database. We translated each free-text eligibility criterion into a machine executable statement using a derivation of the Arden Syntax. Clinical trial protocols were then structured as collections of these eligibility criteria using XML. The application compares the entered patient information against each of the eligibility criteria and returns a numerical score. Results are displayed in order of likelihood of match. We have tested our system using all phase II and III clinical trials for treatment of metastatic breast cancer found in the PDQ database. Preliminary results are encouraging. (+info)
Intelligent split menus for data entry: a simulation study in general practice medicine.
(53/2017)
A compelling notion in menu design is that a few of the most frequently selected items should be placed as a hot list at the top of the menu. A few researchers have explored this type of interface control, known as a split menu, and have investigated the identification of the hot-list items by statistical analysis of past data. We extend the technique to automated development of dynamic hot-lists for entry of medication data in a General Practice setting. Using clinical data from 113,000 visits, a statistical model is developed and evaluated by simulated data entry of cases held back from training. Simulated SOAP note entry shows 12-item hot lists to hold over 70% of desired drug and diagnosis selections. Intelligent split menus should improve user efficiency if current selection methods require 3 seconds or more per item. A demonstration prototype can be downloaded over the Web. (+info)
Security architecture for multi-site patient records research.
(54/2017)
A security system was developed as part of a patient records research database project intended for both local and multi-site studies. A comprehensive review of ethical foundations and legal environment was undertaken, and a security system comprising both administrative policies and computer tools was developed. For multi-site studies, Institutional Review Board (IRB) approval is required for each study, at each participating site. A sponsoring Principal Investigator (PI) is required at each site, and each PI needs automated enforcement tools. Systems fitting this model were implemented at two academic medical centers. Security features of commercial database systems were found to be adequate for basic enforcement of approved research protocols. (+info)
Bringing a virtual library to a small group classroom.
(55/2017)
A small group case discussion class would seem to be the ideal setting for a virtual library. Two courses at the Albert Einstein College of Medicine were observed. One hour of observation was of groups with no computer available, one hour of groups with a computer available "incidentally", and two hours of groups with computer integrated case material. Across all groups, at least one student was using a reference source (paper or computer) 55% of the time. In a room with no computer, paper references were used 59% of the time. In a room with a computer, references were used 53% of the time (18% computer only, 13% paper only, 22% both). While the amount of data is insufficient for detecting statistically significant difference, this study does provide important baseline data not previously available concerning reference use behavior for electronic and paper sources. (+info)
Initial experiences with building a health care infrastructure based on Java and object-oriented database technology.
(56/2017)
A multi-tiered telemedicine system based on Java and object-oriented database technology has yielded a number of practical insights and experiences on their effectiveness and suitability as implementation bases for a health care infrastructure. The advantages and drawbacks to their use, as seen within the context of the telemedicine system's development, are discussed. Overall, these technologies deliver on their early promise, with a few remaining issues that are due primarily to their relative newness. (+info)