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Biomedical subjects

A Rossi-Mori

Publications and source records attributed to A Rossi-Mori.

9 recordsLinked to original sources
PubMed2001

The creation of an ontology of clinical document names.

The efficient use of documents from heterogeneous computer systems is hampered by differences in document-naming practices across organizations. Using an open-consensus method, the Document Ontology Task Force, with support from the Veterans Health Administration, addressed this pervasive problem by developing a clinical document ontology. Based on the analysis of over 2000 clinical document names, the ontology was used to formulate a terminology model which is currently being used to guide the creation of fully-specified document names in LOINC (Logical Observations, Identifiers, Names and Codes). Incorporation into LOINC will enable homogeneous management of documents in a widely distributed environment and will also give rise to a rich polyhierarchy of document names.

Documentation↗
PubMed2000

Relevance of mandates, notifications and threads in the management of continuity of care.

Availability of electronic healthcare records (EHCR) and geographical networks allows nowadays to realise a set of functionalities to support continuity of care. Actual exchange of complete clinical information, common centralised records, common decisions within an agreed protocols are not mandatory. Sub-optimal alternatives, involving easier management, are possible. In fact, the crucial challenge for continuity of care is the mutual awareness of the multiple perspectives by the actors contributing to patient's care. The various actors should timely know changes in the status of: mandates, i.e. who is involved in the care provision and thus is responsible for a "local" record. knowledge about the patient, i.e. active and inactive problems, impressions, relevant findings. provision of healthcare activities, i.e. plans, orders and performed activities. The decisions on the actual implementation depend on the healthcare context, as implemented within the information system. For example, the mechanism for notifications involves decisions on the quality and quantity of information that must be exchanged, as well as on the modalities for the exchange, regulated by individual user's profiles. Each notification could be sent as a message to a central repository, and then each authorized user could select within the repository the pertaining messages. Or a notification could be sent directly to the list of professionals involved in the care of a patient, that asked for it in their profile. Mandates may be used to regulate the access of the users to the patient's information. This approach was embedded in a European standard under development in CEN/TC251 (CONTSYS--"System of concepts to support continuity of care").

Computer Communication Networks↗
PubMed1999

Syntactic-semantic tagging as a mediator between linguistic representations and formal models: an exercise in linking SNOMED to GALEN.

Natural language understanding applications are good candidates to solve the knowledge acquisition bottleneck when designing large scale concept systems. However, a necessary condition is that systems are built that transform sentences into a meaning representation that is independent of the subtleties of linguistic structure that nevertheless underly the way language works. The Cassandra II syntactic-semantic tagging system fulfills this goal partially. Within the GALEN-IN-USE project, it is used to transform linguistic representations of surgical procedure expressions into conceptual representations. In this paper, the proctology chapter of the SNOMED V3.1 procedure axis was used as a testbed to evaluate the usefulness of this approach. A quantitative and qualitative analysis of the data obtained is presented, showing that the Cassandra system can indeed complement the manual modelling efforts being conducted in the GALEN-IN-USE project. The different requirements related to linguistic modelling versus conceptual modelling can partly be accounted for by using an interface ontology, of which the fine tuning will however remain an important effort.

Artificial Intelligence↗
PubMed1990

Converting the representation of medical data: criteria to code the underlying cause of death.

This study deals with a set of coding directives that were conceived for trained coding clerks and rely upon knowledge of their cultural background. These directives were formalized and adapted for computer use and in this form must rely upon a background of explicit medical knowledge. Medical data on death certificates are an invaluable source of information regarding prevention of major causes of death. These causes are coded and tabulated worldwide by means of the International Classification of Diseases (ICD). The ICD manual issues directives to achieve uniformity of coding throughout the world. The coder is required to trace back the flow of events which caused death and to single out the most significant concept from the statistical point of view. After emphasizing the problems encountered in the formalization, the methodological contribution of this work to the identification of a modular architecture for a system which represents and "reshapes" knowledge from medical documents is presented. Therefore we focus on the features of the two kinds of knowledge that must be supplied to a knowledge-based system, in order to enable it to perform semantic conversions on given medical data, namely: i) generic guidelines; ii) detailed medical knowledge.

Cause of Death↗
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↗
PubMedDate not supplied

Evaluation stages and design steps for knowledge-based systems in medicine.

After the early experiments in artificial intelligence a methodology is emerging around advanced systems for the management of medical knowledge. The stress is moving away from the implementation of prototypes to the evaluation. It is possible to adapt and to apply this to field evaluation techniques already developed in similar contexts of knowledge management (books, drugs, epidemiology, consultants, etc.). The time is ready for a further step: to envisage a methodology for the design of real systems that cope with the 'knowledge environment' of the user. Every stage of the evaluation process is re-examined here, and considered as a framework to define goals and criteria about a step of design: (1) the impact of the system on the progress of health care provision (priorities, cost-benefit analysis, share of tasks among different media); (2) effectiveness in the end-user's environment and long-term effects on his behaviour (changes in people's role and responsibilities, improvements in the quality of data, acceptance of the system); (3) the intrinsic efficiency of the system apart from the operational context (correctness of the knowledge base, appropriateness of the reasoning). The need to differentiate the test sample into three classes (obvious, typical, atypical) is emphasized, discussing the influence on both evaluation and design. In particular the difficulty of having 'gold standards' on atypical cases, due to the disagreement among the experts, leads to the definition of two alternative attitudes: the 'standardization mode' and the 'brain-storming mode'.

Expert Systems↗