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Biomedical subjects

Anderson Spickard

Publications and source records attributed to Anderson Spickard.

12 recordsLinked to original sources

"Where do we teach what?" Finding broad concepts in the medical school curriculum.

BACKGROUND: Often, medical educators and students do not know where important concepts are taught and learned in medical school. Manual efforts to identify and track concepts covered across the curriculum are inaccurate and resource intensive. OBJECTIVE: To test the ability of a web-based application called KnowledgeMap (KM) to automatically locate where broad biomedical concepts are covered in lecture documents in the Vanderbilt School of Medicine. METHODS: In 2003, the authors derived a gold standard set of curriculum documents by ranking 383 lecture documents as high, medium, or low relevance in their coverage of 4 broad biomedical concepts: genetics, women's health, dermatology, and radiology. We compared the gold standard rankings to KM, an automated tool that generates a variable number of subconcepts for each broad concept to calculate a relevance score for each document. Receiver operating characteristic (ROC) curves and area-under-the-curve were derived for each ranking using varying relevance score cutoffs. RESULTS: Receiver operating characteristic curve areas were acceptably high for each broad concept (range 0.74 to 0.98). At relevance scores that optimized sensitivity and specificity, 78% to 100% of highly relevant documents were identified. The best results were obtained with the application of 63 to 1437 subconcepts for a given broad concept. The search time was fast. CONCLUSIONS: The KM tool capably and automatically locates the detailed coverage of broad concepts across medical school documents in real time. Use of KM or similar tools may prove useful for other medical schools to identify broad concepts in their curricula.

Curriculum↗

Identifying UMLS concepts from ECG Impressions using KnowledgeMap.

Electrocardiogram (ECG) impressions represent a wealth of medical information for potential decision support and drug-effect discovery. Much of this information is inaccessible to automated methods in the free-text portion of the ECG report. We studied the application of the KnowledgeMap concept identifier (KMCI) to map Unified Medical Language System (UMLS) concepts from ECG impressions. ECGs were processed by KMCI and the results scored for accuracy by multiple raters. Reviewers also recorded unidentified concepts through the scoring interface. Overall, KMCI correctly identified 1059 out of 1171 concepts for a recall of 0.90. Precision, indicating the proportion of ECG concepts correctly identified, was 0.94. KMCI was particularly effective at identifying ECG rhythms (330/333), perfusion changes (65/66), and noncardiac medical concepts (11/11). In conclusion, KMCI is an effective method for mapping ECG impressions to UMLS concepts.

Abstracting and Indexing↗

How students and faculty interact with a searchable online database of the medical curriculum.

Many medical schools currently provide electronic access to their medical curriculum. In order to better develop and evaluate online curricular databases, knowledge of the interaction of students and faculty with such systems is required. The KnowledeMap application provides a web interface for students, faculty and administrators to perform NLP-assisted searches for documents from the entire medical curriculum. The pilot implementation of KM in a first year anatomy course was evaluated. Data was collected from the web-server log files over two years, a paper survey at the end of the course, and structured interviews with students and faculty members. The data showed complete adoption of KM. Analysis of usage patterns showed that most of the students chose to browse for current course material rather than to search for related medical concepts in future courses. Analysis of the interviews identified key concepts relating to the students' utilization of KM for their learning tasks. The impact of KM on medical pedagogy is discussed in light of our results.

Anatomy↗

Can users estimate their usage of a web-based application? Validating a self-report usage questionnaire.

User surveys are often used to estimate usage of online systems. We asked medical student to estimate their weekly use of KnowledgeMap, an online medical education system, during the previous semester. The information was validated against server log files. The average number of log-on days was significantly different across four categories of self-reported use. Self-reported frequency scales may be used to correctly segregate users into discrete ordinal usage groups.

Curriculum↗

A randomised trial of an online lecture with and without audio.

OBJECTIVE: To determine the impact of adding audio-feed to an online lecture on screening given to medical students who were participating in an outpatient clerkship. DESIGN: Prospective, randomised, controlled study. SETTING: Vanderbilt University School of Medicine, Nashville and Wake Forest Medical School, Winston-Salem. PARTICIPANTS: A total of 59 Years 3 and 4 medical students. MAIN OUTCOME MEASURES: Students' use of time, satisfaction with the lecture experience, and knowledge. Educational intervention The online lecture was developed at Vanderbilt University. At Vanderbilt, 16 Year 4 medical students were randomised to the lecture on screening with audio and 17 Year 4 medical students were randomised to the same lecture without audio. At Wake Forest, 13 Year 3 medical students were randomised to the lecture on screening with audio and 13 Year 3 students were randomised to the same lecture without audio. RESULTS: The audio lecture required 20 more minutes to complete than the non-audio lecture. Students in the audio group were more satisfied with their experience than students in the non-audio group. Students in the audio-feed group achieved a trend for higher post-intervention knowledge scores, with the difference attributed to the students at Vanderbilt. CONCLUSION: Audio narration is an important aspect of an online lecture. The distribution of online lectures to students at different sites and different training levels requires further study.

Analysis of Variance↗

"Understanding" medical school curriculum content using KnowledgeMap.

OBJECTIVE: To describe the development and evaluation of computational tools to identify concepts within medical curricular documents, using information derived from the National Library of Medicine's Unified Medical Language System (UMLS). The long-term goal of the KnowledgeMap (KM) project is to provide faculty and students with an improved ability to develop, review, and integrate components of the medical school curriculum. DESIGN: The KM concept identifier uses lexical resources partially derived from the UMLS (SPECIALIST lexicon and Metathesaurus), heuristic language processing techniques, and an empirical scoring algorithm. KM differentiates among potentially matching Metathesaurus concepts within a source document. The authors manually identified important "gold standard" biomedical concepts within selected medical school full-content lecture documents and used these documents to compare KM concept recognition with that of a known state-of-the-art "standard"-the National Library of Medicine's MetaMap program. MEASUREMENTS: The number of "gold standard" concepts in each lecture document identified by either KM or MetaMap, and the cause of each failure or relative success in a random subset of documents. RESULTS: For 4,281 "gold standard" concepts, MetaMap matched 78% and KM 82%. Precision for "gold standard" concepts was 85% for MetaMap and 89% for KM. The heuristics of KM accurately matched acronyms, concepts underspecified in the document, and ambiguous matches. The most frequent cause of matching failures was absence of target concepts from the UMLS Metathesaurus. CONCLUSION: The prototypic KM system provided an encouraging rate of concept extraction for representative medical curricular texts. Future versions of KM should be evaluated for their ability to allow administrators, lecturers, and students to navigate through the medical curriculum to locate redundancies, find interrelated information, and identify omissions. In addition, the ability of KM to meet specific, personal information needs should be assessed.

Abstracting and Indexing↗

The KnowledgeMap project: development of a concept-based medical school curriculum database.

We developed the KnowledgeMap (KM) system as an online, concept-based database of medical school curriculum documents. It uses the KM concept indexer to map full-text documents and match search queries to concepts in the Unified Medical Language System (UMLS). In this paper, we describe the design of KM and report the first seven months of its implementation into a medical school. Despite being emphasized in only two first year courses and one fourth year course, students from all four classes used KM to search and browse documents. All faculty members involved with courses piloting KM used the system to upload and manage lecture documents. Currently, we are working with eight course directors to transition their courses to KM for next year.

Abstracting and Indexing↗

Adequacy of representation of the National Drug File Reference Terminology Physiologic Effects reference hierarchy for commonly prescribed medications.

The National Drug File Reference Terminology contains a novel reference hierarchy to describe physiologic effects (PE) of drugs. The PE reference hierarchy contains 1697 concepts arranged into two broad categories; organ specific and generalized systemic effects. This investigation evaluated the appropriateness of the PE concepts for classifying a random selection of commonly prescribed medications. Ten physician reviewers classified the physiologic effects of ten drugs and rated the accuracy of the selected term. Inter reviewer agreement, overall confidence, and concept frequencies were assessed and were correlated with the complexity of the drug's known physiologic effects. In general, agreement between reviewers was fair to moderate (kappa 0.08-0.49). The physiologic effects modeled became more disperse with drugs having and inducing multiple physiologic processes. Complete modeling of all physiologic effects was limited by reviewers focusing on different physiologic processes. The reviewers were generally comfortable with the accuracy of the concepts selected. Overall, the PE reference hierarchy was useful for physician reviewers classifying the physiologic effects of drugs. Ongoing evolution of the PE reference hierarchy as it evolves should take into account the experiences of our reviewers.

Drug Therapy↗

Formative evaluation to guide early deployment of an online content management tool for medical curriculum.

KM is a Web-accessible, comprehensive database that organizes course materials (at the level of full lectures, not just outlines or syllabi) from the Vanderbilt School of Medicine curriculum. KM uses natural language processing techniques to analyze educational documents for biomedical concepts. Lecture handouts and Microsoft PowerPoint presentations are indexed and available online for students, faculty and administrators to search for individual or interrelated concepts across the medical school curriculum.

Anatomy↗

Learning about screening using an online or live lecture: does it matter?

OBJECTIVE: To determine the impact of an online lecture versus a live lecture on screening given to medical students who are participating in an outpatient clerkship. DESIGN: Prospective, randomized, controlled study. PARTICIPANTS AND SETTING: Ninety-five senior medical students in a primary care medicine clerkship based at university and distant clinic sites. INTERVENTION AND MEASUREMENTS: Forty-eight medical students were randomized to the live lecture on screening (live lecture group), and forty-seven medical students were randomized to the online lecture on screening (online lecture group). Outcome measures included students' knowledge, use of time, and satisfaction with the lecture experience. RESULTS: Compared to students in the live lecture group, students in the online lecture group demonstrated equal post-intervention knowledge of screening (P =.91) and expended 50 minutes less time to complete the lecture. Online lecture students who used the audio feed of the lecture were equally satisfied with the lecture as the live lecture students. Without the audio feed, online lecture students were less satisfied. CONCLUSIONS: An online lecture on screening is a feasible, efficient, and effective method to teach students on outpatient clerkships about principles of screening.

Adult↗