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Biomedical subjects

Alan Rector

Publications and source records attributed to Alan Rector.

5 recordsLinked to original sources

An Ontology driven collaborative development for biomedical terminologies: from the French CCAM to the Australian ICHI coding system.

The CCAM French coding system of clinical procedures was developed between 1994 and 2004 using, in parallel, a traditional domain expert's consensus method on one hand, and advanced methodologies of ontology driven semantic representation and multilingual generation on the other hand. These advanced methodologies were applied under the framework of an European Union collaborative research project named GALEN and produced a new generation of biomedical terminology. Following the interest in several countries and in WHO, the GALEN network has tested the application of the ontology driven tools to the existing reduced Australian ICHI coding system for interventions presently under investigation by WHO to check its ability and appropriateness to become the reference international coding system for procedures. The initial results are presented and discussed in terms of feasibility and quality assurance for sharing and maintaining consistent medical knowledge and allowing diversity in linguistic expressiveness of end users.

Australia↗

Granularity, scale and collectivity: when size does and does not matter.

Bridging levels of "granularity" and "scale" are frequently cited as key problems for biomedical informatics. However, detailed accounts of what is meant by these terms are sparse in the literature. We argue for distinguishing two notions: "size range," which deals with physical size, and "collectivity," which deals with aggregations of individuals into collections, which have emergent properties and effects. We further distinguish these notions from "specialisation," "degree of detail," "density," and "connectivity." We argue that the notion of "collectivity"--molecules in water, cells in tissues, people in crowds, stars in galaxies--has been neglected but is a key to representing biological notions, that it is a pervasive notion across size ranges--micro, macro, cosmological, etc.--and that it provides an account of a number of troublesome issues including the most important cases of when the biomedical notion of parthood is, or is not, best represented by a transitive relation. Although examples are taken from biomedicine, we believe these notions to have wider application.

Animals↗

Rapid application design of an electronic clinical skills portfolio for undergraduate medical students.

The aim was to find how to use information and communication technology to present the clinical skills content of an undergraduate medical curriculum. Rapid application design was used to develop the product, and technical action research was used to evaluate the development process. A clinician-educator, two medical students, two computing science masters students, two other project workers, and a hospital education informatics lead, formed a design team. A sample of stakeholders took part in requirements planning workshops and continued to advise the team throughout the project. A university hospital had many features that favoured fast, inexpensive, and successful system development: a clearly defined and readily accessible user group; location of the development process close to end-users; fast, informal communication; leadership by highly motivated and senior end-users; devolved authority and lack of any rigidly imposed management structure; cooperation of clinicians because the project drew on their clinical expertise to achieve scholastic goals; a culture of learning and involvement of highly motivated students. A detailed specification was developed through storyboarding, use case diagramming, and evolutionary prototyping. A very usable working product was developed within weeks. "SkillsBase" is a database web application using Microsoft Active Server Pages, served from a Microsoft Windows 2000 Server operating system running Internet Information Server 5.0. Graphing functionality is provided by the KavaChart applet. It presents the skills curriculum, provides a password-protected portfolio function, and offers training materials. The curriculum can be presented in several different ways to help students reflect on their objectives and progress towards achieving them. The reflective portfolio function is entirely private to each student user and allows them to document their progress in attaining skills, as judged by self, peer and tutor assessment, and examinations. Training materials include web links and materials developed locally using pedagogic principles developed by the SkillsBase team. Although the usability of SkillsBase has been proven, uptake of software that has arisen 'bottom-up' from within the curriculum has proved slow. We plan to incorporate the SkillsBase services into a more comprehensive virtual managed learning environment, anticipating that presenting the functionality in an environment that is routinely used by students and teachers will increase uptake and use.

Clinical Competence↗

A linkable identity privacy algorithm for HealthGrid.

The issues of confidentiality and privacy have become increasingly important as Grid technology is being adopted in public sectors such as healthcare. This paper discusses the importance of protecting the confidentiality and privacy of patient health/medical records, and the challenges exhibited in enforcing this protection in a Grid environment. It proposes a novel algorithm to allow traceable/linkable identity privacy in dealing with de-identified medical records. Using the algorithm, de-identified health records associated to the same patient but generated by different healthcare providers are given different pseudonyms. However, these pseudonymised records of the same patient can still be linked by a trusted entity such as the NHS trust or HealthGrid manager. The paper has also recommended a security architecture that integrates the proposed algorithm with other data security measures needed to achieve the desired security and privacy in the HealthGrid context.

Algorithms↗

A formal representation for messages containing compositional expressions.

Clinically useful controlled vocabularies should represent healthcare concepts completely and with high reliability. Anticipating and pre-coordinating all possible expressions (e.g. 'fracture of the left femur' and 'fracture of the right femur') is not feasible. Variation in practice styles, requirements for the granularity of content, the exponential growth of terminology size, and increased cost of maintaining pre-coordinated terminologies lead us to conclude that no enumerated terminology can ever be truly comprehensive. Compositional terminologies are one potential solution to the problem of content completeness, but carry a risk of generating expressions whose equivalency cannot be easily determined. In order for post-coordinated expressions to be comparable, a sufficiently detailed formal mechanism for information representation is necessary. Comparable data for post-coordinated expressions requires normalization of both the contents and the semantics of the contents of the terminology with the information captured in post-coordinated expressions. In addition, comparable data requires a storage and messaging paradigm robust enough to faithfully represent the information contained within arbitrarily complex compositional expressions. We present a formalism for storing, and sending messages containing compositional expressions using a large-scale reference terminology. It is our intent that this formalism be used to algorithmically determine whether or not messages contain comparable data. In addition, we advocate transmitting the upward transitive closure of subsumption of all concepts, to improve comparability of data and to decrease reliance on locally stored versions of the underlying reference terminology.

Abstracting and Indexing↗