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Biomedical subjects

G A Gorry

Publications and source records attributed to G A Gorry.

At least 19 recordsLinked to original sources
PubMed1992

IAIMS development at Baylor College of Medicine.

At Baylor College of Medicine, we are developing the technical and intellectual resources needed to realize the Integrated Academic Information Management System (IAIMS) concept fully. The substantial technical, organizational, and financial commitments involved demand that we align our efforts with the strategic purposes of the college. The support of science, therefore, has become the principal, but not exclusive, focus of Baylor's IAIMS effort. Even so, the information technology architecture we have created for biomedical research is proving valuable in other settings as well. And the infrastructure we are creating--the communications architecture and the linkages to information resources--serves many purposes in addition to those of research. The architecture accommodates a diversity of workstations, networks, and informational and computational servers. This will be the greatest possible chance of transferring the fruits of our Phase III development to other academic medical centers.

Academic Medical Centers↗
PubMed1992

The MEDLINE Retriever.

Baylor College of Medicine has developed the MEDLINE Retriever, a tool to query MEDLINE, the data-base of medical literature at the National Library of Medicine. The MEDLINE Retriever communicates via the Internet to achieve excellent response time for MEDLINE queries. It uses the X Window System and the Motif toolkit, and employs the Knowbot Operating Environment developed by the Corporation for National Research Initiatives. We discuss the architecture of the MEDLINE Retriever, focusing on the graphical user interface that we have developed, as well as our experiences in developing and deploying the MEDLINE Retriever at Baylor. The MEDLINE Retriever is an extension of Baylor's IAIMS design concept that brought forth the Virtual Notebook System, and fits well with Baylor's aims with regard to the High Performance Computing Initiative.

Computer Communication Networks↗
PubMed1992

Medical informatics and institutional strategy.

Programs in medical informatics can help academic medical centers make effective use of information technology. But to achieve the greatest strategic benefits from these programs, an institution must forge proper linkage between informatics and its overall effort to deploy computing in research, education and patient care. Here we explore this linkage and the ways in which it can be established and managed.

Education, Medical↗
PubMed1988

A Virtual Notebook for biomedical work groups.

During the past several years, Baylor College of Medicine has made a substantial commitment to the use of information technology in support of its corporate and academic programs. The concept of an Integrated Academic Information Management System (IAIMS) has proved central in our planning, and the IAIMS activities that we have undertaken with funding from the National Library of Medicine have proved to be important extensions of our technology development. Here we describe our Virtual Notebook system, a conceptual and technologic framework for task coordination and information management in biomedical work groups. When fully developed and deployed, the Virtual Notebook will improve the functioning of basic and clinical research groups in the college, and it currently serves as a model for the longer-term development of our entire information management environment.

Computer Communication Networks↗
PubMed1979

Scientific publications of a medical school faculty.

To characterize patterns of scientific productivity in a medical school faculty, the authors assessed the quantity and apparent scientific quality of publications by a large sample of the full-time faculty at Baylor College of Medicine. The apparent quality of an article in a given journal was taken to be the average extent to which articles in that journal are cited. Productivity varied greatly among the faculty members; a few prolific authors produced 10 times as much as the average of their colleagues, and a substantial fraction of the faculty published nothing in a four-year period. When productivity was related to length of academic career, two peaks of scientific accomplishment were noted. The first was for young faculty members whose relatively few publications were of high apparent quality. The second was for more mature faculty whose high productivity was attributable to more publications of less apparent quality.

Faculty, Medical↗
PubMed1978

The diagnostic importance of the normal finding.

When a diagnostic test is reported as normal, the clinician generally uses it only to rule out certain diseases. However, if properly interpreted, the normal value may help to differentiate among diagnoses that yield normal results with different frequencies. A simple method permits the extraction of such information. The physician estimates the probability of various diagnoses and then combines these estimates with the anticipated frequency of negative results for each disease under consideration.

Adult↗
PubMed1978

Capturing clinical expertise. A computer program that considers clinical responses to digitalis.

The administration of digitalis by experienced cardiologists has been examined and a prototypical computer program has been developed which captures portions of their expertise. The new program first constructs a patient-specific model upon which to base the determination of dosage and then uses feedback information about a variety of clinical aspects of the patient's response to modify its recommendations. The model reflects both the program's knowledge of pharmacokinetics and those special features of the patient's condition which may alter his response to therapy. The program makes assessments of the therapeutic and the toxic effects of digitalis on the patient, and bases its subsequent recommendations on the "therapeutic-toxic" state which best describes the evolving clinical situation. A clinical trial was performed in which the program "followed" a series of patients managed by clinicians on a cardiology service. That trial demonstrated the feasibility of this type of program in dealing with acutely ill patients, even those who have increased sensitivity to the toxic effects of digitalis. Each patient in the trial in whom toxicity developed had received more digitalis than would have been recommended by the program. This approach to automated clinical consultation should eventually provide a technology for the distribution of clinical expertise.

Aged↗
PubMed1978

Clinical problem solving: a behavioral analysis.

To extend the understanding of the clinical problem-solving process, we have analyzed the tape-recorded behavior of experienced clinicians engaged in "taking the history of the present illness" from a simultated patient. We showed that specific diagnostic hypotheses were generated often with little more information than presenting complaints, that testing of diagnostic hypotheses consisted of various case-building strategies for corroborating and discrediting hypotheses, and that the process of information gathering included techniques to evaluate the validity of data and assess the need for immediate action. Overall strategies were more difficult to discern but included a focused approach, a systemic exploration method, and a chronologic technique. The data have potential value in medical education and in developing computer programs to simulate the diagnostic process.

Diagnosis↗
PubMed1978

Predicting the response time of an urban ambulance system.

Response time, i.e., the time from dispatch of an ambulance to its arrival at the scene of an emergency, is an important measure of performance in an urban ambulance system. We developed a model that predicts the entire distribution of response time, explicitly accounting for the rate and spatial distribution of demand, variable ambulance velocities, and queueing effects. We tested the model using data sampled from 3,936 ambulance runs in Houston and achieved close agreement between empirical and predicted distributions of response time. Our use of probability theory to predict response times yielded a model that complements those previously reported for planning and evaluating urban ambulance systems.

Ambulances↗
PubMed1977

Relationship between plasma lipid concentrations and coronary artery disease in 496 patients.

The relationship between fasting plasma cholesterol and triglyceride concentrations and the frequency and extensiveness of coronary artery disease (CAD) was studied in 496 subjects evaluated for chest pain by coronary arteriography at The Methodist Hospital. One hundred six of the patients had no CAD while 390 had 25% or greater stenosis of one or more major vessels. Ninety-one percent had 75% or greater stenosis of at least one major vessel. Mean age for the group with CAD was 55.7 +/- 8.7 and without disease 49.4 +/- 11.6 (P less than 0.01). Both cholesterol and triglyceride concentrations were higher (P less than 0.001) in the group with CAD. Mean cholesterol concentration in males increased from 195 +/- 36 mg/dl in the group without CAD to 219 +/- 41 in the group with three vessel disease and in females from 207 +/- 40 to 252 +/- 42. A progressive increase in triglyceride values was also detected but was less consistent. At the level of 25% and greater obstruction, the partial correlation coefficients between the number of vessels involved and the cholesterol and triglyceride concentrations, respectively, were +0.201 and +0.181.

Adult↗
PubMed1977

Factors affecting the choice of hospital-based ambulatory care by the urban poor.

This study of patients in the outpatient department at an urban hospital revealed that almost all could have reached a neighborhood center in less time and only a small number came to the hospital rather than a neighborhood center out of medical necessity. When the patients were asked about their willingness to obtain treatment at a neighborhood center, 48 per cent were willing, 52 per cent were not. These responses did not vary by demographic or medical characteristics but rather by the patients' stated priorities regarding medical care. Eighty per cent of those willing to change sites stressed convenience of access as a first priority compared with only 17 per ccent of those not willing to change. Emphasis on quality of care (45 per cent) or on familarity with the site (37 per cent) distinguished the group not willing to change. The findings suggest that successful efforts to persuade patients to utilize a neighborhood center must base their appeal on patients' individual priorities.

Ambulatory Care↗
PubMed1977

Cost-effectiveness of cardiopulmonary resuscitation training programs.

A model is presented to analyze the cost-effectiveness of programs to train large numbers of citizens in the techniques of cardiopulmonary resuscitation (CPR). From a planner's estimates of certain key factors, the model determines the probability of intervention for various numbers of trained citizens and for several allocation strategies and patterns of population density. These key factors are the maximum distance from which a person with CPR training could intervene in an emergency, the cost of training, and loss of skill with time. The model is used to analyze possible training efforts in Houston, Texas.

Cost-Benefit Analysis↗