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Biomedical subjects

A L Rector

Publications and source records attributed to A L Rector.

At least 37 records · Page 2Linked to original sources
PubMed1996

The PEN&PAD data entry system: from prototype to practical system.

This paper describes some of the issues addressed in the transition of the PEN&PAD from prototype clinical workstation to practical data entry system for use by general practitioners in the UK. Background and motivation of the PEN&PAD and GALEN projects are presented before the operation of the PEN&PAD user interface is described. A number of issues which have arisen in the development of the PEN&PAD Data Entry System are discussed.

Humans↗
PubMed1995

Multilingual natural language generation as part of a medical terminology server.

Re-usable and sharable, and therefore language-independent concept models are of increasing importance in the medical domain. The GALEN project (Generalized Architecture for Languages Encyclopedias and Nomenclatures in Medicine) aims at developing language-independent concept representation systems as the foundations for the next generation of multilingual coding systems. For use within clinical applications, the content of the model has to be mapped to natural language. A so-called Multilingual Information Module (MM) establishes the link between the language-independent concept model and different natural languages. This text generation software must be versatile enough to cope at the same time with different languages and with different parts of a compositional model. It has to meet, on the one hand, the properties of the language as used in the medical domain and, on the other hand, the specific characteristics of the underlying model and its representation formalism. We propose a semantic-oriented approach to natural language generation that is based on linguistic annotations to a concept model. This approach is realized as an integral part of a Terminology Server, built around the concept model and offering different terminological services for clinical applications.

Language↗
PubMed1995

A Terminology Server for medical language and medical information systems.

GALEN is developing a Terminology Server to support the development and integration of clinical systems through a range of key terminological services, built around a language-independent, re-usable, shared system of concepts--the CORE model. The focus is on supporting applications for medical records, clinical user interfaces and clinical information systems, but also includes systems for natural language understanding, clinical decision support, management of coding and classification schemes, and bibliographic retrieval. The Terminology Server integrates three modules: the Concept Module which implements the GRAIL formalism and manages the internal representation of concept entities, the Multilingual Module which manages the mapping of concept entities to natural language, and the Code Conversion Module which manages the mapping of concept entities to and from existing coding and classification schemes. The Terminology Server also provides external referencing to concept entities, coercion between data types, and makes its services available through a uniform applications programming interface. Taken together these services represent a new approach to the development of clinical systems and the sharing of medical knowledge.

Artificial Intelligence↗
PubMed1994

The GALEN project.

The GALEN project is developing language independent concept representation systems as the foundations for the next generation of multilingual coding systems. It aims to support the flexibility required to cope with the diversity amongst medical applications, while ensuring the coherence necessary for integration and re-use of terminologies. GALEN is developing a fully compositional and generative formal system for modelling concepts: the GALEN Representation and Integration Language (GRAIL) Kernel. Its goal is to overcome many of the problems with traditional coding and classification systems, in particular the combinatorial explosion of terms in enumerative systems and the generation of nonsensical terms in partially compositional systems. It will also provide a clean separation between the concept model and linguistic mechanisms which interpret that model (i.e., the words in a specific language, syntax, alternative phrasings, etc.) in order to allow the development of multilingual systems. GRAIL aims to be formally sound and produce models that are verifiable and contain no contradictions or ambiguities, with realistic human effort. A Coding Reference (CORE) Model of medical terminology covering is being developed which aims to represent the core concepts in for example pathology, anatomy and therapeutics, that have widespread applicability in medical applications. It should also provide the basis for specialist extensions according to the formal principles of GRAIL. The main results of GALEN will be delivered as a Terminology Server (TeS) which encapsulates and coordinates the functionality of the concept module, multilingual module, and code conversion module, and also provides a uniform applications programming interface and network services for use by external applications.

Databases, Bibliographic↗
PubMed1994

From terminology to terminology services.

Terminologies have traditionally been considered as static datasets held in books or databases. The GALEN Terminology Server presents a prototype for a new view of terminologies delivered as a set of functions and services provided to other applications. This facilitates their development and integration as part of a strategy for sharing and re-using information and knowledge. The essential features of the Terminology server are the functions which it can perform; questions which it can answer and statements which it can be told. The GALEN Terminology Server supports these operations through a modular architecture and uniform applications programming interface which allows client applications to ignore the internal structure and simply use the Server for terminological, coding, and linguistic functions.

Computer Systems↗
PubMed1993

Models for representation of terminologies and coding systems in medicine.

Unification of medical coding systems is a perceived need involving a long-term task. Standards will support convergence of present coding systems towards a coherent set of tools. The Project Team "Model for Representation of Semantics" (CEN/TC251/PT003-MOSE) modeled existing tools to obtain a vocabulary apt to describe coding systems and terminologies. Requirements on faithfulness and safety, usefulness and purposiveness, coherence and integration were worked out, and the MOSE's 10 key principles for Standards in Medical Semantics were established.

Disease↗
PubMed1993

Goals for concept representation in the GALEN project.

The GALEN project aims to develop language independent concept representation systems as the foundations for the next generation of multilingual coding systems. Traditional coding schemes have reached the limits of what can be maintained and managed, and a shift to formal compositional systems is now essential. GALEN is developing one such scheme and an associated concept model, together with criteria for their evaluation. It should provide the flexibility required to cope with the diversity amongst medical applications, whilst ensuring the coherence necessary for integration and re-use of terminologies.

Humans↗
PubMed1993

A framework for modelling the electronic medical record.

This paper presents a model for an electronic medical record which satisfies the requirements for a faithful and structured record of patient care set out in a previous paper in this series. The model underlies the PEN & PAD clinical workstation, and it provides for a permanent, completely attributable record of patient care and the process of medical decision making. The model separates the record into two levels: direct observations of the patient and meta-statements about the use of observations in decision making and the clinical dialogue. The model is presented in terms of "descriptions" formulated in the Structured Meta Knowledge (SMK) formalism, but many of its features are more general than the specific implementation. The use of electronic medical records based on the model for decision support and the analysis of aggregated data are discussed along with potential use of the model in distributed information systems.

Computer Simulation↗
PubMed1991

A patient care workstation based on user centred design and a formal theory of medical terminology: PEN&PAD and the SMK formalism.

The PEN & PAD clinical workstation is for use by clinicians for direct patient care. It is based on a highly structured and detailed medical record but is intended to be simple and intuitive to use, allowing clinicians to summarise and view information in many ways, and quickly enter information through structured forms. It also provides mechanisms for tailoring the system to individual users without compromising its overall integrity. This has been achieved by following a process of user centred design and by developing a novel formalism, Structured Meta Knowledge, to represent the terminological knowledge, the medical record, and pragmatic knowledge about clinical practice.

Ambulatory Care Information Systems↗
PubMed1991

Foundations for an electronic medical record.

Given the many efforts currently under way to develop standards for electronic medical records, it is important to step back and reexamine the fundamental principles which should underlie a model of the electronic medical record. This paper presents an analysis based on the experience in developing the PEN & PAD prototype clinical workstation. The fundamental contention is that the requirements for a medical record must be grounded in its use for patient care. The basic requirement is that it be a faithful record of what clinicians have heard, seen, thought, and done. The other requirements for a medical record, e.g., that it be attributable and permanent, follow naturally from this view. We use the criteria developed to re-examine Weed's Problem Oriented Medical Record and also relate the criteria to secondary uses of the medical record for population data, communications and decision support.

Decision Making↗
PubMed1984

The accuracy of age-sex registers in general practice.

A ;point-prevalent evaluation' of the accuracy of the age-sex register (ASR) was undertaken in 10 general practices. The average ASR inflation rate was 4 per cent when compared with the Family Practitioner Committee (FPC) register (range 2.2-8.3 per cent) and 7.2 per cent when compared with the patients themselves (range 2.6-19.4 per cent). List deflation was no more than 2 per cent overall. There was a wide interpractice variation in the accuracy of the ASR, and two of the factors that may be associated with this are the situation in an inner city renewal area and a large proportion of patients in the 20-40 years age group. When the patients were asked to verify the information contained on the ASR it was found that the address was incorrect for 10 per cent of patients (range 5.0-20.0 per cent) and the date of birth was incorrect for 5 per cent.Before using it for research purposes, the ASR should be checked against the FPC register, and in view of our findings it should also be checked with a sample of the patients themselves to ensure a sufficiently accurate population denominator.

England↗
PubMed1979

Are microcomputers appropriate for your practice?

The overly simplistic view of the process of automation widely presented to physicians needs to be counterbalanced. Computers are becoming cheaper, easier to program, and simpler to operate. However, the physician must be aware of the gap between personal computing and serious use of computers in his practice. To bridge this gap, the physician must analyze his needs to identify appropriate applications to automate, plan the implementation of these applications, and choose the necessary hardware and software resources. To do so it may be valuable for him to seek the help of an expert. Although the physician can certainly perform the necessary tasks, he should be aware that to perform them efficiently there are a number of aspects he should seriously consider.

Computers↗
PubMedDate not supplied

Medical-concept models and medical records: an approach based on GALEN and PEN&PAD.

OBJECTIVES: To investigate the issues raised in applying a preliminary version of the GALEN compositional concept reference (CORE) model to a series of radiographic reports, and to demonstrate that the same underlying concept model could be used in conjunction with both a detailed, fine-grained model of medical records based on that used in the PEN&PAD project and with other more conventional medical-record models. DESIGN: Following analysis and representation of concepts from a set of reports, a single report was taken as a "case study." This report was analyzed in detail in its entirety and represented using each of the medical-record models. RESULTS: The reports were successfully represented within the limits of the study, but a number of significant issues were raised. CONCLUSION: The compositional approach plus the PEN&PAD medical-record model allowed detailed information in the radiographic report to be represented, including information about the inferences and the clinical process. The resulting representation was large, and more compact representations may be necessary for some systems. Alternative encapsulations of the information as might be used in such systems were successfully prepared. The compositional approach avoided many issues that often cause controversy in the design of traditional coding and classification systems, but it raised other issues, including the handling of ambiguity and underspecification, linkage to information not explicitly present in the report, and questions concerning the focus of individual concepts. All work is preliminary and definitive conclusions await further studies and systematic evaluation.

Decision Making, Computer-Assisted↗