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Challenges in implementing a knowledge editor for the Arden Syntax: knowledge base maintenance and standardization of database linkages. 实现Arden语法知识编辑器的挑战:知识库维护和数据库连接的标准化。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Robert A Jenders, Balendu Dasgupta
{"title":"Challenges in implementing a knowledge editor for the Arden Syntax: knowledge base maintenance and standardization of database linkages.","authors":"Robert A Jenders,&nbsp;Balendu Dasgupta","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Context: </strong>Incorporation of research findings into clinical practice lags behind their dissemination in the medical literature. Arden Syntax is a standard that could be used to encode evidence in a clinical decision support system (CDSS). However, dissemination of knowledge is hampered by lack of standard linkages to clinical databases.</p><p><strong>Objective: </strong>To create a knowledge editor that facilitates transfer of knowledge from the medical literature to clinical practice via a CDSS.</p><p><strong>Methods: </strong>Using a Web browser-based application, we implemented linkages to MEDLINE to permit queries on demand and registration of queries to be executed periodically, with results copied into Arden Medical Logic Modules (MLMs). To facilitate standardization of MLMs, database linkages are encoded using emerging HL7 standards such as a data model (virtual medical record).</p><p><strong>Conclusions: </strong>A Web-based application can facilitate transfer of knowledge into clinical practice and knowledge base maintenance through periodic queries and deployment of standards for knowledge representation.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"355-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244416/pdf/procamiasymp00001-0396.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22139776","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}
引用次数: 0
An XML-based system for the flexible classification and retrieval of clinical practice guidelines. 基于xml的临床实践指南灵活分类和检索系统。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
T Ganslandt, M L Mueller, C F Krieglstein, N Senninger, H U Prokosch
{"title":"An XML-based system for the flexible classification and retrieval of clinical practice guidelines.","authors":"T Ganslandt,&nbsp;M L Mueller,&nbsp;C F Krieglstein,&nbsp;N Senninger,&nbsp;H U Prokosch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Beneficial effects of clinical practice guidelines (CPGs) have not yet reached expectations due to limited routine adoption. Electronic distribution and reminder systems have the potential to overcome implementation barriers. Existing electronic CPG repositories like the National Guideline Clearinghouse (NGC) provide individual access but lack standardized computer-readable interfaces necessary for automated guideline retrieval. The aim of this paper was to facilitate automated context-based selection and presentation of CPGs. Using attributes from the NGC classification scheme, an XML-based metadata repository was successfully implemented, providing document storage, classification and retrieval functionality. Semi-automated extraction of attributes was implemented for the import of XML guideline documents using XPath. A hospital information system interface was exemplarily implemented for diagnosis-based guideline invocation. Limitations of the implemented system are discussed and possible future work is outlined. Integration of standardized computer-readable search interfaces into existing CPG repositories is proposed.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"280-4"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244492/pdf/procamiasymp00001-0321.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22139841","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}
引用次数: 0
Analysis of identifier performance using a deterministic linkage algorithm. 使用确定性链接算法分析标识符性能。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Shaun J Grannis, J Marc Overhage, Clement J McDonald
{"title":"Analysis of identifier performance using a deterministic linkage algorithm.","authors":"Shaun J Grannis,&nbsp;J Marc Overhage,&nbsp;Clement J McDonald","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As part of developing a record linkage algorithm using de-identified patient data, we analyzed the performance of several demographic variables for making linkages between patient registry records from two hospital registries and the Social Security Death Master File. We analyzed samples from each registry totaling 6,000 record-pairs to establish a linkage gold-standard. Using Social Security Number as the exclusive linkage variable resulted in substantial linkage error rates of 4.7% and 9.2%. The best single variable combination for finding links was Social Security Number, phonetically compressed first name, birth month, and gender. This found 87% and 88% of the links without any false links. We achieved sensitivities of 90% to 92% while maintaining 100% specificity using combinations of social security number, gender, name, and birth date fields. This represents an accurate method for linking patient records to death data and is the basis for a more generalized de-identified linkage algorithm.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"305-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244404/pdf/procamiasymp00001-0346.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22139846","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}
引用次数: 0
Validation of electronic student encounter logs in an emergency medicine clerkship. 急诊医学实习中电子学生遭遇日志的验证。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Jennifer S Lee, Sanford S Sineff, Walton Sumner
{"title":"Validation of electronic student encounter logs in an emergency medicine clerkship.","authors":"Jennifer S Lee,&nbsp;Sanford S Sineff,&nbsp;Walton Sumner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Handheld electronic patient encounter logs offer opportunities to understand and enhance medical students' clinical experiences. Before using the data, the reliability of log entries needs to be verified. We assessed the sensitivity and specificity of handheld patient encounter logs by comparing documented entries with reliable external data sources. During an Emergency Medicine clerkship, medical students voluntarily recorded their patients' diagnoses in an Electronic Student Encounter Log (E-SEL) on handheld computers. We used patient demographics to match anonymous log entries with medical charts. Most students recorded 60% or more of their patient encounters and on average 60% of their patients' medical problems in the log. The false positive rate was 26% for patient encounters and 19% for patient problems. In general, students recorded more diagnoses in more detail than was available in the patient's ED chart. Improvements in the log's interface and documentation incentives should enhance the log's accuracy and utility.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"425-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244433/pdf/procamiasymp00001-0466.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22140258","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}
引用次数: 0
Crossing the "digital divide:" implementing an electronic medical record system in a rural Kenyan health center to support clinical care and research. 跨越“数字鸿沟”:在肯尼亚农村医疗中心实施电子病历系统，以支持临床护理和研究。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
William M Tierney, Joseph K Rotich, Faye E Smith, John Bii, Robert M Einterz, Terry J Hannan
{"title":"Crossing the \"digital divide:\" implementing an electronic medical record system in a rural Kenyan health center to support clinical care and research.","authors":"William M Tierney,&nbsp;Joseph K Rotich,&nbsp;Faye E Smith,&nbsp;John Bii,&nbsp;Robert M Einterz,&nbsp;Terry J Hannan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To improve care, one must measure it. In the US, electronic medical record systems have been installed in many institutions to support health care management, quality improvement, and research. Developing countries lack such systems and thus have difficulties managing scarce resources and investigating means of improving health care delivery and outcomes. We describe the implementation and use of the first documented electronic medical record system in ambulatory care in sub-Saharan Africa. After one year, it has captured data for more than 13,000 patients making more than 26,000 visits. We present lessons learned and modifications made to this system to improve its capture of data and ability to support a comprehensive clinical care and research agenda.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"792-5"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244335/pdf/procamiasymp00001-0833.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22140717","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}
引用次数: 0
Temporal knowledge representation for scheduling tasks in clinical trial protocols. 临床试验方案调度任务的时态知识表示。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Chunhua Weng, Michael Kahn, John Gennari
{"title":"Temporal knowledge representation for scheduling tasks in clinical trial protocols.","authors":"Chunhua Weng,&nbsp;Michael Kahn,&nbsp;John Gennari","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clinical trial protocols include detailed temporal constraints on treatment and associated tasks. Unlike health-care guidelines, protocols are highly prescriptive. Therefore, informatics applications that enforce such temporal constraints are more directly useful with protocols than with guidelines. Although there are some temporal knowledge representation efforts for health-care guidelines, we find these to be insufficiently expressive for clinical trial protocols. In this paper, we focus on temporal knowledge representation for clinical trial protocols and the task of patient-specific scheduling in protocols. We define a temporal ontology, use it to encode clinical trial protocols, and describe a prototype tool to carry out patient-specific scheduling for the tasks in protocols. We predict that an expressive temporal knowledge representation can support a number of scheduling and management tasks for protocol-based care.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"879-83"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244397/pdf/procamiasymp00001-0920.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22140727","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}
引用次数: 0
Supporting physicians in taking decisions in clinical guidelines: the GLARE "what if" facility. 支持医生在临床指南中做出决定:眩光“如果”设施。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Paolo Terenziani, Stefania Montani, Alesio Bottrighi, Mauro Torchio, Gianpaolo Molino
{"title":"Supporting physicians in taking decisions in clinical guidelines: the GLARE \"what if\" facility.","authors":"Paolo Terenziani,&nbsp;Stefania Montani,&nbsp;Alesio Bottrighi,&nbsp;Mauro Torchio,&nbsp;Gianpaolo Molino","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>GLARE (GuideLine Acquisition, Representation and Execution) is a domain-independent system for the acquisition, representation and execution of clinical guidelines. GLARE is unique in its approach to supporting the decision-making process of users/physicians faced with various alternatives in the guidelines. In many cases, the best alternative cannot be determined on the basis of \"local information\" alone (i.e., by considering just the selection criteria associated with the decision at hand), but must also take into account information stemming from relevant alternative pathways. Exploitation of \"global information\" available in the various pathways is made possible by GLARE through the \"what if\" facility, a form of hypothetical reasoning which allows users to gather relevant decision parameters (e.g., costs, resources, times) from selected parts of the guideline in a semi-automatic fashion. In particular, the extremely complex task of coping with temporal information involves the extension and adaptation of various techniques developed by the Artificial Intelligence (AI) community.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"772-6"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244142/pdf/procamiasymp00001-0813.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22140780","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}
引用次数: 0
The lexical properties of the gene ontology. 基因本体的词法特性。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Alexa T McCray, Allen C Browne, Olivier Bodenreider
{"title":"The lexical properties of the gene ontology.","authors":"Alexa T McCray, Allen C Browne, Olivier Bodenreider","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Gene Ontology (GO) is a construct developed for the purpose of annotating molecular information about genes and their products. The ontology is a shared resource developed by the GO Consortium, a group of scientists who work on a variety of model organisms. In this paper we investigate the nature of the strings found in the Gene Ontology and evaluate them for their usefulness in natural language processing (NLP). We extend previous work that identified a set of properties that reliably identifies natural language phrases in the Unified Medical Language System (UMLS). The results indicate that a large percentage (79%) of GO terms are potentially useful for NLP applications. Some 35% of the GO terms were found in a corpus derived from the MEDLINE bibliographic database, and 27% of the terms were found in the current edition of the UMLS.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"504-8"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244431/pdf/procamiasymp00001-0545.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22138398","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}
引用次数: 0
A generic computerized method for estimate of familial risks. 一种估计家族风险的通用计算机方法。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Isabelle Colombet, Yigang Xu, Marie-Christine Jaulent, Daniel Desages, Patrice Degoulet, Gilles Chatellier
{"title":"A generic computerized method for estimate of familial risks.","authors":"Isabelle Colombet,&nbsp;Yigang Xu,&nbsp;Marie-Christine Jaulent,&nbsp;Daniel Desages,&nbsp;Patrice Degoulet,&nbsp;Gilles Chatellier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Most guidelines developed for cancers screening and for cardiovascular risk management use rules to estimate familial risk. These rules are complex, difficult to memorize, and need to collect a complete pedigree. This paper describes a generic computerized method to estimate familial risks and its implementation in an internet-based application. The program is based on 3 generic models: a model of the family; a model of familial risk; a display model for the pedigree. The model of family allows to represent each member of the family and to construct and display a family tree. The model of familial risk is generic and allows easy update of the program with new diseases or new rules. It was possible to implement guidelines dealing with breast and colorectal cancer and cardiovascular diseases prevention. First evaluation with general practitioners showed that the program was usable. Impact on quality of familial risk estimate should be more documented.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"175-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244401/pdf/procamiasymp00001-0216.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22138389","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}
引用次数: 0
Quality management practices in telehealth programs: a stakeholder accountability framework. 远程医疗方案的质量管理实践:利益相关者问责框架。
Proceedings. AMIA Symposium Pub Date : 2002-01-01
Kathryn H Dansky, Larry D Gamm
{"title":"Quality management practices in telehealth programs: a stakeholder accountability framework.","authors":"Kathryn H Dansky,&nbsp;Larry D Gamm","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Improved technologies, distances between providers and patients, and an emphasis on cost-containment have encouraged the use of telehealth as a method of service delivery. Despite the increased use of this technology, few studies have been conducted on management of telehealth programs. Research on quality management is essential for disseminating and generalizing information on best practices in telehealth programs. This study focused on quality management practices used in telehealth programs, using a Stakeholder Accountability Framework. We propose that different indicators of quality are employed to satisfy the expectations of different internal and external stakeholders. A national survey of telehealth programs (N=93) was conducted in January, 2001. Wide variations in practices were found, with the most notable differences between not-for-profit and proprietary programs. The dimensions illustrated in the Stakeholder Accountability Framework were supported empirically. Implications of differences are examined as they relate to advancing quality in telehealth.</p>","PeriodicalId":79712,"journal":{"name":"Proceedings. AMIA Symposium","volume":" ","pages":"190-4"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244224/pdf/procamiasymp00001-0231.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22138392","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}
引用次数: 0
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