The importance of a picture archiving and communications system (PACS) manager for large-scale PACS installations. (1/326)

Installing a picture archiving and communication system (PACS) is a massive undertaking for any radiology department. Facilities making a successful transition to digital systems are finding that a PACS manager helps guide the way and offers a heightened return on the investment. The PACS manager fills a pivotal role in a multiyear, phased PACS installation. PACS managers navigate a facility through the complex sea of issues surrounding a PACS installation by coordinating the efforts of the vendor, radiology staff, hospital administration, and the information technology group. They are involved in the process from the purchase decision through the design and implementation phases. They can help administrators justify a PACS, purchase and shape the request for proposal (RFP) process before a vendor is even chosen. Once a supplier has been selected, the PACS manager works closely with the vendor and facility staff to determine the best equipment configuration for his or her facility, and makes certain that all deadlines are met during the planning and installation phase. The PACS manager also ensures that the infrastructure and backbone of the facility are ready for installation of the equipment. PACS managers also help the radiology staff gain acceptance of the technology by serving as teachers, troubleshooters, and the primary point-of-contact for all PACS issues. This session will demonstrate the value of a PACS manager, as well as point out ways to determine the manager's responsibilities. By the end of the session, participants will be able to describe the role of a PACS manager as it relates to departmental operation and in partnership with equipment vendors, justify a full-time position for a PACS manager, and identify the qualifications of candidates for the position of PACS manager.  (+info)

Away with words: commentary on the Atlan-Cohen essay 'Immune information, self-organization and meaning'. (2/326)

Drawing on metaphors from linguistics and information theory, Atlan and Cohen challenge us to take a very different view of the immune system, one that engages in constant chatter among the constituents and allows the immune system to arrive at a decision about what to, and not to, destroy. Our commentary responds to this challenge and points out many logical biological flaws in their view. We seem to agree that specificity is important, and that there is some kind of somatic selection process at work to distinguish self from non-self. Our analysis of models depends on the basis of how self and non-self are separated. There are only two possibilities, time or space; and space-based models are all but ruled out. There are two major kinds of time-based model, one based on the time taken for an organism to develop from embryo to adult, the other based on the time taken for a cell to differentiate from one state to another. With so many ambiguities in the metaphors and so little attention to mechanism, the Atlan and Cohen challenge is, we suspect, based on time measured in cell differentiation units. They also make the common mistake of assuming repertoires that are transcendental in size (>10(10)), making it impossible to have a functional immune system in animals smaller than a rabbit--a feature that does not instill confidence in the biological relevance of such models.  (+info)

Splice-site mutations in atherosclerosis candidate genes: relating individual information to phenotype. (3/326)

BACKGROUND: Nucleotide variants in several genes for lipid and methionine metabolism influence the risk of premature atherosclerosis. Ten percent of single nucleotide substitutions in these genes involve mRNA splice sites. The effects of some of these changes on splicing and on phenotypic severity are not inherently obvious. METHODS AND RESULTS: Using an information theory-based model, we measured the individual information content (R(i), in bits) of splice sites adjacent to 289 mutations (including 31 splice-site mutations) in the atherosclerosis candidate genes APOAII, APOB, APOCII, APOE, CBS, CETP, LCAT, LIPA, LDLR, and LPL. The predictions of information analysis were then corroborated by published mRNA analyses. The R(i) values of mutant sites were consistent with either complete (n=17) or partial (n=8) inactivation of these sites. Seven mutations were predicted to activate cryptic splice sites. Predicted inactive mutant sites were associated with either "average" or "severe" dyslipidemia and commensurate reductions in protein levels or activity, whereas mutations expected to exhibit residual splicing had average or "mild" effects on lipid and protein expression. CONCLUSIONS: Information analysis of splice-junction variants in atherosclerosis candidate genes distinguishes inactive from leaky splice sites and identifies activated cryptic sites. Predicted changes in splicing were related to phenotypic severity.  (+info)

Exploring the UMLS: a rough sets based theoretical framework. (4/326)

The Unified Medical Language System (UMLS) [1] has a unique and leading position in the evolution of thesauri and metathesauri. Features that set it apart are: its composition from more than fifty component health care vocabularies; the sophisticated UMLS ontology linking the Metathesaurus with structures such as the Semantic Network and the SPECIALIST lexicon; and the high level of social collaboration invested in its construction and growth. It is our thesis that in order to successfully harness such a complex vocabulary for text retrieval we need sophisticated methods derived from a deeper understanding of the UMLS system. Thus we propose a theoretical framework based on the theory of rough sets, that supports the systematic and exploratory investigation of the UMLS Metathesaurus for text retrieval. Our goal is to make it more feasible for individuals such as patients and health care professionals to access relevant information at the point of need.  (+info)

Influences of the Unified Service Action Model on the HL7 Reference Information Model. (5/326)

Modeling information for the electronic medical record (EMR) builds on a century of study on information and its relationship to cost and quality improvement. An initiative to examine the focus of cost and quality improvement and its relationship to information modeling resulted in the development of the Unified Service Action Model of healthcare processes, which focuses on the action as the center of cost accounting, quality accounting and privacy management. The application of this model to the HL7 Reference Information Model produced a simplification of the HL7 model at the cost of increased reliance on vocabulary terms for actions.  (+info)

Diagnosis of myocardial infarction: integration of serum markers and clinical descriptors using information theory. (6/326)

OBJECTIVE: We examine the use of information theory applied to a single cardiac troponin T (cTnT) (first generation monoclonal; Boehringer Mannheim Corp., Indianapolis, Indiana) used with the character of chest pain, electrocardiography (ECG) and serial ECG changes in the evaluation of acute myocardial infarction (AMI). We combined a single measure of cTnT (blinded to the investigators) with a creatine kinase MB isoenzyme (CK-MB) measurement to discover the best decision value for this test in a study of 293 consecutive patients presenting to the emergency department with symptoms warranting exclusion of AMI. METHODS: The decision value for determining whether cTnT is positive or negative was determined independently of the final diagnosis by examining the information in the cTnT and CKMB data. Using information theory, an autocorrelation matrix with a one-to-one pairing of the CKMB and troponin T was constructed. The effective information, also known as Kullback entropy, assigned the values for troponin T and for CKMB that have the lowest frequency of misclassification error. The Kullback entropy is determined by subtracting the data entropy from the maximum entropy of the data set in which the information has been destroyed. The assignment of the optimum decision values was made independently of the clinical diagnoses without the construction of a receiver-operator characteristic curve (ROC). The final diagnosis of AMI was independently determined by the clinicians and entered into the medical record. RESULTS: The decision value for cTnT was 0.1 ng/ml as determined by the the information in the data. The method was validated within the same study by mapping the results so obtained into the diagnoses obtained independently by the clinicians using all of the methods at their disposal. The cTnT was different in AMI (n = 60) compared with non-AMI patients (n = 233) (2.08 +/- 0.21 vs. 0.07 +/- 0.10; p < .0001). CONCLUSION: Information theory provides a strong framework and methodology for determining the decision value for cTnT which minimizes misclassification errors at 0.1 ng/ml. The result has a strong correlation with other features in detecting AMI in patients presenting with chest pain.  (+info)

The labile brain. II. Transients, complexity and selection. (7/326)

The successive expression of neuronal transients is related to dynamic correlations and, as shown in this paper, to dynamic instability. Dynamic instability is a form of complexity, typical of neuronal systems, which may be crucial for adaptive brain function from two perspectives. The first is from the point of view of neuronal selection and self-organizing systems: if selective mechanisms underpin the emergence of adaptive neuronal responses then dynamic instability is, itself, necessarily adaptive. This is because dynamic instability is the source of diversity on which selection acts and is therefore subject to selective pressure. In short, the emergence of order, through selection, depends almost paradoxically on the instabilities that characterize the diversity of brain dynamics. The second perspective is provided by information theory.  (+info)

The labile brain. III. Transients and spatio-temporal receptive fields. (8/326)

In this paper we consider an approach to neuronal transients that is predicated on the information they contain. This perspective is provided by information theory, in particular the principle of maximum information transfer. It is illustrated here in application to visually evoked neuronal transients. The receptive fields that ensue concur with those observed in the real brain, predicting, almost exactly, functional segregation of the sort seen in the visual system. This information theoretical perspective can be reconciled with a selectionist stance by noting that a high mutual information among neuronal systems and the environment has, itself, adaptive value and will be subject to selective pressure, at any level one cares to consider.  (+info)