Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium最新文献

{"title":"Telematics in the neonatal ICU and beyond: improving care for high-risk newborns and their families.","authors":"J Gray,&nbsp;P C Jones,&nbsp;M Phillips,&nbsp;P Gertman,&nbsp;D Veroff,&nbsp;C Safran","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Beth Israel-Deaconess has recently been awarded one of 19 contracts from the National Library of Medicine (NLM) to develop, implement and test a telemedicine application to support the care of Very Low Birth Weight Infants. This project is the only one to focus on the care of newborns. We believe that this project will provide a new national approach to managing the care of high-risk newborns by leveraging evolving communication technology.</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"413-7"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233440/pdf/procamiaafs00001-0450.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20288075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Documenting the information content of images.","authors":"W D Bidgood","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A standards-based message and terminology architecture has been specified to enable large-scale open and non-proprietary interchange of imaging-procedure descriptions and image-interpretation reports providing semantically-rich linkage of linguistic and non-linguistic information. The DICOM Structured Reporting Supplement, now available for trial use, embodies this interdependent message/terminology architecture. A DICOM structured report object is a self-describing information structure that can be tailored to support diverse clinical observation reporting applications by utilization of templates and context-dependent terminology from an external message/terminology mapping resource such as the SNOMED DICOM Microglossary (SDM), HL7 Vocabulary, or Terminology Resource for Message Standards (TeRMS).</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"424-8"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233520/pdf/procamiaafs00001-0460.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20288077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing computers in ambulatory care: implications of physician practice patterns for system design.","authors":"C E Aydin,&nbsp;D E Forsythe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper presents pre-implementation data from the internal medicine division of a large physician group practice scheduled to implement an electronic medical record (EMR). Data were gathered through short-term participant observation and interviews. Findings indicate that (1) most physicians anticipate enough benefits to be willing to use the system; (2) computers must be accessible, easy to log into, and provide for physician movement and interrupted sessions; (3) many physicians are concerned about losing eye contact with patients; (4) it is unrealistic to expect even good typists to enter their own long notes; (5) staged implementation, with order entry introduced first, may help physicians adapt gradually; and (6) training should include protected time for instructional sessions for physicians, simulated patient encounters to help physicians adapt their practice patterns, and tutors available to answer questions in the clinical setting.</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"677-81"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233569/pdf/procamiaafs00001-0711.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20288436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a visualization-based approach to functional brain mapping.","authors":"B Modayur,&nbsp;R Jakobovits,&nbsp;K Maravilla,&nbsp;G Ojemann,&nbsp;J Brinkley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We describe a method for mapping stimulation data, obtained at the time of neurosurgery for intractable epilepsy, onto a 3D MRI-based neuroanatomic model of the individual patient. The mapping is done by comparing an intraoperative photograph of the exposed cortical surface with a computer-based MR visualization of the surface, interactively indicating corresponding stimulation sites, and recording 3-D MR machine coordinates of the indicated sites. Repeatability studies were performed to validate the accuracy of the mapping technique. Six observers--a neurosurgeon, a radiologist, and four computer scientists, independently mapped 218 stimulation sites from 12 patients. The mean distance of the six locations from the mean location of each site was 2.07 mm, with a standard deviation of 1.5 mm, or within 5.07 mm with 95% confidence. Since the surgical sites are accurate within approximately 1 cm, these results show that the visualization-based approach is accurate within the limits of the stimulation maps. When incorporated within the kind of information system envisioned by the Human Brain Project, this anatomically-based method will not only provide a key link between non-invasive and invasive approaches to understanding language organization, but will also provide the basis for studying the relationship between language function and anatomical variability.</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"429-33"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233533/pdf/procamiaafs00001-0465.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20288600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WWW-available conceptual integration of medical terminologies: the ONIONS experience.","authors":"D M Pisanelli,&nbsp;A Gangemi,&nbsp;G Steve","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present the most applicable aspects of our research in the conceptual integration of terminologies. From past experience, we claim that the conceptualizations provided for terminological ontologies need to be philosophically and linguistically grounded. We developed ONIONS, a methodology for integrating domain terminologies by exploiting a library of generic ontologies. Our current focus is on flexible and cooperative modelling of terminological ontologies. We adopt modular and negotiable architectures of ontologies and some WWW-oriented tools, such as Ontolingua and Ontosaurus.</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"575-9"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233421/pdf/procamiaafs00001-0610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20288613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A virtual repository approach to clinical and utilization studies: application in mammography as alternative to a national database.","authors":"L Ohno-Machado,&nbsp;A A Boxwala,&nbsp;J Ehresman,&nbsp;D N Smith,&nbsp;R A Greenes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A national mammography database was proposed, based on a centralized architecture for collecting, monitoring, and auditing mammography data. We have developed an alternative architecture relying on Internet-based distributed queries to heterogeneous databases. This architecture creates a \"virtual repository\", or a federated database which is constructed dynamically, for each query and makes use of data available in legacy systems. It allows the construction of custom-tailored databases at individual sites that can serve the dual purposes of providing data (a) to researchers through a common mammography repository and (b) to clinicians and administrators at participating institutions. We implemented this architecture in a prototype system at the Brigham and Women's Hospital to show its feasibility. Common queries are translated dynamically into database-specific queries, and the results are aggregated for immediate display or download by the user. Data reside in two different databases and consist of structured mammography reports, coded per BIRADS Standardized Mammography Lexicon, as well as pathology results. We prospectively collected data on 213 patients, and showed that our system can perform distributed queries effectively. We also implemented graphical exploratory analysis tools to allow visualization of results. Our findings indicate that the architecture is not only feasible, but also flexible and scaleable, constituting a good alternative to a national mammography database.</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"369-73"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233552/pdf/procamiaafs00001-0406.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20287534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The CliniCon framework for context representation in electronic patient records.","authors":"R Müller","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A well-known problem of current electronic patient records in that they usually fail to represent the semantic relationships between the involved clinical data. This has to be viewed as a problem especially in the domains characterized by a complex and long-term treatment, as the medical decision making process may not be comprehensible anymore from the data entries themselves. Context representation can overcome these limitations, enabling the record to express causality, revisions, conflicts, or individual heuristics explicitly. This article introduces CLINICON which is a formal framework for domain-independent context representation based on Sowa's conceptual graphs.</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"178-82"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233509/pdf/procamiaafs00001-0216.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20287851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A decision analytic method for scoring performance on computer-based patient simulations.","authors":"S M Downs,&nbsp;C P Friedman,&nbsp;F Marasigan,&nbsp;G Gartner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As computer based clinical case simulations become increasingly popular for training and evaluating clinicians, approaches are needed to evaluate a trainee's or examinee's solution of the simulated cases. We developed a decision analytic approach to scoring performance on computerized patient case simulations. We developed decision models for computerized patient case simulations in four specific domains in the field of infectious disease. The decision models were represented as influence diagrams. A single decision node represents the possible diagnoses the user may make. One chance node represents a probability distribution over the set of competing diagnoses in the simulations. The value node contains the utilities associated with all possible combinations of diagnosis and disease. All relevant data that the user may request from the simulation are represented as chance nodes with arcs to or from the diagnosis node and/or each other. Probabilities in the decision model were derived from the literature, where available, or expert opinion. Utilities were assessed by standard gamble from clinical experts. The process of solving computer based patient simulations involves repeated cycles of requesting data (history, physical examination or laboratory) and receiving these data from the simulations. Each time the user requests clinical data from the simulation, the influence diagram is evaluated with and without an arc from the corresponding chance node to the decision node. The difference in expected utility between the two solutions of the influence diagram represents the expected value of information (VOI) from the requested clinical datum. The ratio of the expected VOI from the data requested and the expected value of perfect information about the diagnosis is a normative measure of the quality of each of the user's data requests. This approach provides a continuous measure of the quality of the user's data requests in a way that is sensitive to the previous data collected. The score distinguishes serious from minor misdiagnoses. And the same influence diagram can be used to evaluate performance on multiple simulations in the same clinical domain.</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"667-71"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233377/pdf/procamiaafs00001-0701.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20288434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compositional and enumerative designs for medical language representation.","authors":"A M Rassinoux,&nbsp;R A Miller,&nbsp;R H Baud,&nbsp;J R Scherrer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Medical language is in essence highly compositional, allowing complex information to be expressed from more elementary pieces. Embedding the expressive power of medical language into formal systems of representation is recognized in the medical informatics community as a key step towards sharing such information among medical record, decision support, and information retrieval systems. Accordingly, such representation requires managing both the expressiveness of the formalism and its computational tractability, while coping with the level of detail expected by clinical applications. These desiderata can be supported by enumerative as well as compositional approaches, as argued in this paper. These principles have been applied in recasting a frame-based system for general medical findings developed during the 1980s. The new system captures the precise meaning of a subset of over 1500 medical terms for general internal medicine identified from the Quick Medical Reference (QMR) lexicon. In order to evaluate the adequacy of this formal structure in reflecting the deep meaning of the QMR findings, a validation process was implemented. It consists of automatically rebuilding the semantic representation of the QMR findings by analyzing them through the RECIT natural language analyzer, whose semantic components have been adjusted to this frame-based model for the understanding task.</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"620-4"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233357/pdf/procamiaafs00001-0655.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20288542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probabilistic predictions of penetrating injury to anatomic structures.","authors":"O Ogunyemi,&nbsp;B Webber,&nbsp;J R Clarke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper presents an interactive 3D graphical system which allows the user to visualize different bullet path hypotheses and stab wound paths and computes the probability that an anatomical structure associated with a given penetration path is injured. Probabilities can help to identify those anatomical structures which have potentially critical damage from penetrating trauma and differentiate these from structures that are not seriously injured.</p>","PeriodicalId":79455,"journal":{"name":"Proceedings : a conference of the American Medical Informatics Association. AMIA Fall Symposium","volume":" ","pages":"714-8"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2233485/pdf/procamiaafs00001-0748.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20289000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}