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Biomedical subjects

B G Buchanan

Publications and source records attributed to B G Buchanan.

At least 37 records · Page 2Linked to original sources

Induction of rules for biological macromolecule crystallization.

X-ray crystallography is the method of choice for determining the 3-D structure of large macromolecules at a high enough resolution. The rate limiting step in structure determination is the crystallization itself. It takes anywhere between a few weeks to several years to obtain macromolecular crystals that yield good diffraction patterns. The theory of forces that promote and maintain crystal growth is preliminary, and crystallographers systematically search a large parameter space of experimental settings to grow good crystals. There is a wealth of experimental data on crystal growth most of which is in paper laboratory notebooks. Some of the data has been gathered in electronic form, e.g., the Biological Macromolecular Crystallization Database (BMCD) which is a repository of successful experimental conditions for growing over 800 different macromolecules (Gilliland 1987). Crystallographers are in need of computational tools to gather and analyze past data to design new crystal growth trails. We are building the Crystallographer's Assistant (CA) to help crystallographers record and maintain experimental context in electronic form, offer suggestions on experimental conditions that are likely to be successful, and provide explanations for failed experiments. As an initial step in this project, we have applied RL, an inductive learning program, to the BMCD. In this paper we report initial experiments and findings in applying RL to the BMCD. From the point of view of crystallography, we have discovered possibly significant new empirical relationships in crystal growth. From the point of view of machine learning, our work suggests refinements of existing methods for incorporating detailed domain knowledge into inductive analysis techniques.

Animals↗

Protein secondary structure prediction using two-level case-based reasoning.

We have developed a two-level case-based reasoning architecture for predicting protein secondary structure. The central idea is to break the problem into two levels: first, reasoning at the object (protein) level, and using the global information from this level to focus on a more restricted problem space; second, decomposing objects into pieces (segments), and reasoning at the internal structures level; finally, synthesizing the pieces back to the objects. The architecture has been implemented and tested on a commonly used data set with 69.3% predictive accuracy. It was then tested on a new data set with 67.3% accuracy. Additional experiments were conducted to determine the effects of using different similarity matrices.

Amino Acid Sequence↗

Expanding the concept of medical information: an observational study of physicians' information needs.

Obtaining and managing clinically relevant information constitutes a major problem for physicians, for which the development of automated tools is often proposed as a solution. However, designing and implementing appropriate automated solutions presumes knowledge of physicians' information needs. We describe an empirical study of information needs in four clinical settings in internal medicine in a university teaching hospital. In contrast to the retrospective data often used in previous studies, this research used ethnographic techniques to facilitate direct observation of communication about information needs. On the basis of this experience, we address two main issues: how to identify and interpret expressions of information needs in medicine and how to broaden our conception of "information needs" to account for the empirical data.

Computer Systems↗

Involving patients in health care: explanation in the clinical setting.

The long-term goal of our research is to improve the overall effectiveness of physicians' time, by improving the information exchange between physicians and chronic-care patients, initially migraine patients. The computer system we are constructing has a partial knowledge base about migraines, common therapies, and common side effects of those therapies. The system consists of two main programs: data collection and explanation. The design of our system is based on empirical data concerning patients' information needs.

Humans↗

Physicians' information needs: analysis of questions posed during clinical teaching.

OBJECTIVE: To describe information requests expressed during clinical teaching. SETTING: Residents' work rounds, attending rounds, morning report, and interns' clinic in a university-based general medicine service. SUBJECTS: Attending physicians, medical house staff, and medical students in a general medicine training program. METHODS: An anthropologist observed communication among study subjects and recorded in field notes expressions of a need for information. We developed a coding scheme for describing information requests and applied the coding scheme to the data recorded. Based on assigned codes, we created a subset of strictly clinical requests. MEASUREMENTS: Five hundred nineteen information requests recorded during 17 hours of observed clinical activity were selected for detailed analysis. These requests related to the care of approximately 90 patients by 24 physicians and medical students. Sixty-five requests were excluded because they were not strictly clinical, leaving a subset of 454 clinical questions for analysis. MAIN RESULTS: On average, five clinical questions were raised for each patient discussed. Three hundred thirty-seven requests (74%) concerned patient care. Of these 337 questions, 175 (52%) requested a fact that could have been found in a medical record. Seventy-seven (23%) of these questions, motivated by the needs of patient care, were potentially answerable by a library, a textbook, a journal, or MEDLINE. Eighty-eight (26%) of the questions asked for patient care required synthesis of patient information and medical knowledge. CONCLUSIONS: Clinicians in the study settings requested information frequently. Many of these information needs required the synthesis of patient information and medical knowledge and thus were potentially difficult to satisfy. A typology is proposed that characterizes information needs as consciously recognized, unrecognized, and currently satisfied.

Education, Medical↗

Broadening our approach to evaluating medical information systems.

Evaluation in medical informatics tends to follow the paradigm of controlled clinical trials. This model carries with it a number of assumptions whose implications for medical informatics deserve examination. In this paper, we describe the conventional wisdom on evaluation, pointing out some of its underlying assumptions and suggesting that these assumptions are problematic when applied to some aspects of evaluation. In particular, we believe that these assumptions contribute to the problem of user acceptance. We then suggest a broader approach to evaluation, offering some conceptual and methodological distinctions that we believe will be of use to the medical informatics community in rethinking this issue.

Bias↗

Heuristic refinement method for the derivation of protein solution structures: validation on cytochrome b562.

A method is described for determining the family of protein structures compatible with solution data obtained primarily from nuclear magnetic resonance (NMR) spectroscopy. Starting with all possible conformations, the method systematically excludes conformations until the remaining structures are only those compatible with the data. The apparent computational intractability of this approach is reduced by assembling the protein in pieces, by considering the protein at several levels of abstraction, by utilizing constraint satisfaction methods to consider only a few atoms at a time, and by utilizing artificial intelligence methods of heuristic control to decide which actions will exclude the most conformations. Example results are presented for simulated NMR data from the known crystal structure of cytochrome b562 (103 residues). For 10 sample backbones an average root-mean-square deviation from the crystal of 4.1 A was found for all alpha-carbon atoms and 2.8 A for helix alpha-carbons alone. The 10 backbones define the family of all structures compatible with the data and provide nearly correct starting structures for adjustment by any of the current structure determination methods.

Computer Systems↗

Validation of the first step of the heuristic refinement method for the derivation of solution structures of proteins from NMR data.

A new method for the analysis of NMR data in terms of the solution structure of proteins has been developed. The method consists of two steps: first a systematic search of the conformational space to define the region allowed by the initial set of experimental constraints, and second, the narrowing of this region by the introduction of additional constraints and optional refinement procedures. The search of the conformational space is guided by heuristics to make it computationally feasible. The method is therefore called the heuristic refinement method and is coded in an expert system called PROTEAN. The paper describes the validation of the first step of the method using an artificial NMR data set generated from the known crystal structure of sperm whale carbon monoxymyoglobin. It is shown that the initial search procedure yields a low-resolution structure of the myoglobin molecule, accurately reproducing its main topological features, and that the precision of the structure depends on the quality of the initial data set.

Expert Systems↗

Computer-assisted decision making in medicine.

This article reviews the strengths and limitations of five major paradigms of medical computer-assisted decision making (CADM): (1) clinical algorithms, (2) statistical analysis of collections of patient data, (3) mathematical models of physical processes, (4) decision analysis, and (5) symbolic reasoning or artificial intelligence (AI). No one technique is best for all applications, and there is recent promising work which combines two or more established techniques. We emphasize both the inherent power of symbolic reasoning and the promise of artificial intelligence and the other techniques to complement each other.

Computers↗

Antimicrobial selection by a computer. A blinded evaluation by infectious diseases experts.

An evaluation of a computer-based consultation system called MYCIN was made. Eight independent evaluators with special expertise in the management of meningitis compared MYCIN's choice of antimicrobials with the choices of nine human prescribers for ten test cases of meningitis. MYCIN received an acceptability rating of 65% by the evaluators; the corresponding ratings for acceptability of the regimen prescribed by the five faculty specialists ranged from 42.5% to 62.5%. The system never failed to cover a treatable pathogen while demonstrating efficiency in minimizing the number of antimicrobials prescribed. The study design may be useful in assessing the performance of other computer-based clinical decision-making systems.

Adult↗

Evaluating the performance of a computer-based consultant.

The performance of a computer-based clinical consultation system is evaluated. The program, called MYCIN, is designed to function as an aid for infectious disease diagnosis and therapy selection, with an initial emphasis on bacteremias. The evaluation methodology is discussed, as well as the difficulties encountered in attempting to evaluate clinical judgments. Specialists in infectious diseases judged MYCIN's final therapy recommedation, and intermediate conclusions about the significance of the infection and identity of infecting organisms. The evaluation techniques described may be useful in assessing the performance of other clinical decision aids. Results of the evaluation show that the program's therapy recommedations meet Stanford experts' standards of acceptable practice 90.9% of the time (table 2), with some variation noted both among individual experts and between Stanford experts and others (tables 1, 2).

Animals↗

Computerized consultation system for selection of antimicrobial therapy.

Mycin, a computer-based consultation system which provides to physicians antimicrobial therapy recommendations for patients with bacterial infections, is described. The consultation program arrives at therapeutic decisions using a built-in knowledge base as well as patient data entered by the physician. The system is capable of explaining its recommendations and answering questions about its reasoning process. The system's knowledge can be updated and corrected easily by infectious disease experts. At present the system is operational within a research setting; its routine use in a clinical setting will require further evaluation of its reliability and effectiveness.

Anti-Infective Agents↗

Designing medical informatics research and library--resource projects to increase what is learned.

Careful study of medical informatics research and library-resource projects is necessary to increase the productivity of the research and development enterprise. Medical informatics research projects can present unique problems with respect to evaluation. It is not always possible to adapt directly the evaluation methods that are commonly employed in the natural and social sciences. Problems in evaluating medical informatics projects may be overcome by formulating system development work in terms of a testable hypothesis; subdividing complex projects into modules, each of which can be developed, tested and evaluated rigorously; and utilizing qualitative studies in situations where more definitive quantitative studies are impractical.

Evaluation Studies as Topic↗