Language barriers and bibliographic retrieval effectiveness: use of MEDLINE by French-speaking end users.
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OBJECTIVE: A study was conducted to determine if bibliographic retrieval performed by French-speaking end users is impaired by English language interfaces. The American database MEDLINE on CD-ROM was used as a model. METHODS: A survey of self-administered questionnaires was performed at two libraries of Victor Segalen Bordeaux 2 University, during a two-month period in 1997. Three study groups were constituted: MEDLINE / Ovid end users, MEDLINE / Ovid librarian-mediated users, and Pascal, a French bibliographic database, end users. RESULTS: Among 191 respondents, only 22% thought English was an obstacle to their bibliographic retrieval. However, the research software was generally underused and the quality of the retrieval weak. The differences were statistically significant between users trained by librarians and the self-trained group, the former performing better. CONCLUSION: Special efforts need to be made to develop curriculum training programs for computerized bibliographic retrieval in medical schools, regardless of the native language of the student. (+info)
Visual simulations, artificial animals and virtual ecosystems.
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This review is about a field that does not traditionally belong to biological sciences. A branch of computer animation has its mission to create active self-powered objects living artificial lives in the theoretical biology zone. Selected work, of particular interest to biologists, is presented here. These works include animated simulations of legged locomotion, flexible-bodied animals swimming and crawling, artificial fish in virtual ecosystems, automated learning of swimming and the evolution of virtual creatures with respect to morphology, locomotion and behaviour. The corresponding animations are available for downloading via the Internet. I hope that watching these intriguing pieces of visual simulation will stimulate digitally oriented biologists to seize the interactive methods made possible by ever-increasing computing power. (+info)
Desiderata for a clinical terminology server.
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Clinical terminology servers are distinguished from more broadly based terminology servers intended for nomenclature development or mediation across classifications. Focusing upon the consistent and comparable entry of clinical observations, findings, and events, key desiderata are enumerated and expanded. These include 1) word normalization, 2) word completion, 3) target terminology specification, 4) spelling correction, 5) lexical matching, 6) term completion, 7) semantic locality, 8) term composition and 9) decomposition. Comparisons of this functionality to previously published models and specifications are made. Experience with a clinical terminology server, Metaphrase, is described. (+info)
A database system for integrated clinical trial management, control, statistical analysis and ICH-compliant reporting.
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Clinical trial management and quality assurance is a complex activity that, when manually executed, is prone to errors and delays, and organizations involved in the conduct of clinical drug trials must rely on database systems to ensure adequate data integrity and timely reporting. We report the design and implementation of an integrated computer system for the management and control of multiple phase II to IV clinical drug trials, and for automated generation of monitoring and statistical analysis reports that are fully compliant with international guidelines. This Windows-based system incorporates a number of third-party software tools and applications, and its major components are COATI (Control, Assessment and Tracking of Therapeutic Investigations), a client-server database application; DART (Data Analysis and Reporting Tool) for automated data abstraction and reporting; and PANDA (Data Analysis Package) for automated statistical analysis. The system is in production for two years and was used in 15 clinical trials in a diversity of medical conditions and study designs. (+info)
An integrated decision support system for diagnosing and managing patients with community-acquired pneumonia.
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Decision support systems that integrate guidelines have become popular applications to reduce variation and deliver cost-effective care. However, adverse characteristics of decision support systems, such as additional and time-consuming data entry or manually identifying eligible patients, result in a "behavioral bottleneck" that prevents decision support systems to become part of the clinical routine. This paper describes the design and the implementation of an integrated decision support system that explores a novel approach for bypassing the behavioral bottleneck. The real-time decision support system does not require health care providers to enter additional data and consists of a diagnostic and a management component. (+info)
Embedding guidelines into direct physician order entry: simple methods, powerful results.
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Kaiser Permanente in the Northwest Region has implemented a comprehensive outpatient computer-based patient record (CPR). Using this system, clinicians electronically order laboratory tests, radiology tests, and prescriptions. Clinicians also use this comprehensive CPR to document encounters, code diagnoses and procedures, maintain problem lists, and to send patient-specific messages and referrals to other medical providers. Healthcare for our entire membership of 440,000 covered lives is now provided through this system [1]. Implementation of a comprehensive CPR with direct physician order-entry provides the opportunity to embed guidelines into the ordering process. This article describes the underlying theme and various simple but effective methods we use to embed guidelines into the ordering process. Our experience demonstrates the powerful effect of these simple methods to reduce unnecessary variation and to reduce cost while maintaining or improving the quality of care delivery. (+info)
Providing a complete online multimedia patient record.
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Seamless integration of all types of patient data is a critical feature for clinical workstation software. The Dept. of Veterans Affairs has developed a multimedia online patient record that includes traditional medical chart information as well as a wide variety of medical images from specialties such as cardiology, pulmonary and gastrointestinal medicine, pathology, radiology, hematology, and nuclear medicine. This online patient record can present data in ways not possible with a paper chart or other physical media. Obtaining a critical mass of information online is essential to achieve the maximum benefits from an integrated patient record system. (+info)
OBJECTIVE: To measure housestaff attitudes towards computer-based decision support and their threshold for having CDSS messages displayed. DESIGN: 770 self-administered surveys were distributed to housestaff physicians. RESULTS: 209 surveys were returned. 63% of respondents agreed or strongly agreed that CDSS would improve quality of care, while 52% agreed or strongly agreed that it would decrease adverse drug events. Respondents were neutral regarding the impact of CDSS on productivity and on their autonomy. Sixty percent approved of a reminder to consider surgical consultation in a patient with abdominal pain, while 88% approved of alerts about hypokalemia. Respondents felt both reminders should be triggered when their PPV exceeded 67%. Attitudes toward POE correlated positively with attitudes toward CDSS (Pearson's rho 0.56; p < 0.0001). Respondents who were dissatisfied with POE had a higher threshold PPV for seeing reminders. CONCLUSION: The majority of housestaff favor the implementation of a CDSS. Housestaff with favorable POE experiences were more likely to endorse CDSS, and those with negative POE experience were more likely to oppose it. The results suggest that a carefully designed CDSS with rules constructed to exceed a threshold PPV would be accepted by housestaff. (+info)