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Biomedical subjects

Maged N Kamel Boulos

Publications and source records attributed to Maged N Kamel Boulos.

At least 19 recordsLinked to original sources

Wikis, blogs and podcasts: a new generation of Web-based tools for virtual collaborative clinical practice and education.

BACKGROUND: We have witnessed a rapid increase in the use of Web-based 'collaborationware' in recent years. These Web 2.0 applications, particularly wikis, blogs and podcasts, have been increasingly adopted by many online health-related professional and educational services. Because of their ease of use and rapidity of deployment, they offer the opportunity for powerful information sharing and ease of collaboration. Wikis are Web sites that can be edited by anyone who has access to them. The word 'blog' is a contraction of 'Web Log' - an online Web journal that can offer a resource rich multimedia environment. Podcasts are repositories of audio and video materials that can be "pushed" to subscribers, even without user intervention. These audio and video files can be downloaded to portable media players that can be taken anywhere, providing the potential for "anytime, anywhere" learning experiences (mobile learning). DISCUSSION: Wikis, blogs and podcasts are all relatively easy to use, which partly accounts for their proliferation. The fact that there are many free and Open Source versions of these tools may also be responsible for their explosive growth. Thus it would be relatively easy to implement any or all within a Health Professions' Educational Environment. Paradoxically, some of their disadvantages also relate to their openness and ease of use. With virtually anybody able to alter, edit or otherwise contribute to the collaborative Web pages, it can be problematic to gauge the reliability and accuracy of such resources. While arguably, the very process of collaboration leads to a Darwinian type 'survival of the fittest' content within a Web page, the veracity of these resources can be assured through careful monitoring, moderation, and operation of the collaborationware in a closed and secure digital environment. Empirical research is still needed to build our pedagogic evidence base about the different aspects of these tools in the context of medical/health education. SUMMARY AND CONCLUSION: If effectively deployed, wikis, blogs and podcasts could offer a way to enhance students', clinicians' and patients' learning experiences, and deepen levels of learners' engagement and collaboration within digital learning environments. Therefore, research should be conducted to determine the best ways to integrate these tools into existing e-Learning programmes for students, health professionals and patients, taking into account the different, but also overlapping, needs of these three audience classes and the opportunities of virtual collaboration between them. Of particular importance is research into novel integrative applications, to serve as the "glue" to bind the different forms of Web-based collaborationware synergistically in order to provide a coherent wholesome learning experience.

Audiovisual Aids↗

Web GIS in practice IV: publishing your health maps and connecting to remote WMS sources using the Open Source UMN MapServer and DM Solutions MapLab.

Open Source Web GIS software systems have reached a stage of maturity, sophistication, robustness and stability, and usability and user friendliness rivalling that of commercial, proprietary GIS and Web GIS server products. The Open Source Web GIS community is also actively embracing OGC (Open Geospatial Consortium) standards, including WMS (Web Map Service). WMS enables the creation of Web maps that have layers coming from multiple different remote servers/sources. In this article we present one easy to implement Web GIS server solution that is based on the Open Source University of Minnesota (UMN) MapServer. By following the accompanying step-by-step tutorial instructions, interested readers running mainstream Microsoft(R) Windows machines and with no prior technical experience in Web GIS or Internet map servers will be able to publish their own health maps on the Web and add to those maps additional layers retrieved from remote WMS servers. The 'digital Asia' and 2004 Indian Ocean tsunami experiences in using free Open Source Web GIS software are also briefly described.

Geographic Information Systems↗

Map of dermatology: 'first-impression' user feedback and agenda for further development.

BACKGROUND: Map of Dermatology (http://healthcybermap.org/dermap/) is a free web resource that enables users to search for images of skin conditions by body region and morphology rather than by condition name, which is much more useful and natural in answering questions about unknown clinical presentations/diagnoses, especially for non-specialists. OBJECTIVES AND METHODS: This paper presents responses received from twelve users, including specialist dermatologists, non-specialists (some with interests in health informatics), and lay persons, who provided their 'first-impression' feedback on Map of Dermatology by responding to a very short e-mail questionnaire covering service usefulness and interface usability. The paper also provides a brief review of the gaps in current online dermatology information service provision in general. RESULTS: The overall user feedback received was very positive. An exploratory discussion of the arguments and possibilities for radically improving Map of Dermatology to produce 'the ultimate web-based dermatology diagnostic tool' is also provided, together with some desiderata and preliminary 'design and feature specifications' for such a tool based on users' suggestions, the gaps highlighted in other existing online dermatology tools, and the author's own reflections and experience. CONCLUSIONS: When successfully developed, the proposed tool is expected to have significant potential for efficiently and effectively addressing many of the currently unmet educational needs of clinicians.

Atlases as Topic↗

Web GIS in practice III: creating a simple interactive map of England's Strategic Health Authorities using Google Maps API, Google Earth KML, and MSN Virtual Earth Map Control.

This eye-opener article aims at introducing the health GIS community to the emerging online consumer geoinformatics services from Google and Microsoft (MSN), and their potential utility in creating custom online interactive health maps. Using the programmable interfaces provided by Google and MSN, we created three interactive demonstrator maps of England's Strategic Health Authorities. These can be browsed online at http://www.healthcybermap.org/GoogleMapsAPI/ - Google Maps API (Application Programming Interface) version, http://www.healthcybermap.org/GoogleEarthKML/ - Google Earth KML (Keyhole Markup Language) version, and http://www.healthcybermap.org/MSNVirtualEarth/ - MSN Virtual Earth Map Control version. Google and MSN's worldwide distribution of "free" geospatial tools, imagery, and maps is to be commended as a significant step towards the ultimate "wikification" of maps and GIS. A discussion is provided of these emerging online mapping trends, their expected future implications and development directions, and associated individual privacy, national security and copyrights issues. Although ESRI have announced their planned response to Google (and MSN), it remains to be seen how their envisaged plans will materialize and compare to the offerings from Google and MSN, and also how Google and MSN mapping tools will further evolve in the near future.

Editorial↗

Using software agents to preserve individual health data confidentiality in micro-scale geographical analyses.

Confidentiality constraints often preclude the release of disaggregate data about individuals, which limits the types and accuracy of the results of geographical health analyses that could be done. Access to individually geocoded (disaggregate) data often involves lengthy and cumbersome procedures through review boards and committees for approval (and sometimes is not possible). Moreover, current data confidentiality-preserving solutions compatible with fine-level spatial analyses either lack flexibility or yield less than optimal results (because of confidentiality-preserving changes they introduce to disaggregate data), or both. In this paper, we present a simulation case study to illustrate how some analyses cannot be (or will suffer if) done on aggregate data. We then quickly review some existing data confidentiality-preserving techniques, and move on to explore a solution based on software agents with the potential of providing flexible, controlled (software-only) access to unmodified confidential disaggregate data and returning only results that do not expose any person-identifiable details. The solution is thus appropriate for micro-scale geographical analyses where no person-identifiable details are required in the final results (i.e., only aggregate results are needed). Our proposed software agent technique also enables post-coordinated analyses to be designed and carried out on the confidential database(s), as needed, compared to a more conventional solution based on the Web Services model that would only support a rigid, pre-coordinated (pre-determined) and rather limited set of analyses. The paper also provides an exploratory discussion of mobility, security, and trust issues associated with software agents, as well as possible directions/solutions to address these issues, including the use of virtual organizations. Successful partnerships between stakeholder organizations, proper collaboration agreements, clear policies, and unambiguous interpretations of laws and regulations are also much needed to support and ensure the success of any technological solution.

Computer Security↗

Introducing the National Library for Health Skin Conditions Specialist Library.

BACKGROUND: This paper introduces the new National Library for Health Skin Conditions Specialist Library http://www.library.nhs.uk/skin. DESCRIPTION: The aims, scope and audience of the new NLH Skin Conditions Specialist Library, and the composition and functions of its core Project Team, Editorial Team and Stakeholders Group are described. The Library's collection building strategy, resource and information types, editorial policies, quality checklist, taxonomy for content indexing, organisation and navigation, and user interface are all presented in detail. The paper also explores the expected impact and utility of the new Library, as well as some possible future directions for further development. CONCLUSION: The Skin Conditions Specialist Library is not just another new Web site that dermatologists might want to add to their Internet favourites then forget about it. It is intended to be a practical, "one-stop shop" dermatology information service for everyday practical use, offering high quality, up-to-date resources, and adopting robust evidence-based and knowledge management approaches.

Databases as Topic↗

On geography and medical journalology: a study of the geographical distribution of articles published in a leading medical informatics journal between 1999 and 2004.

BACKGROUND: Studying the contribution of individual countries to leading journals in a given discipline can highlight which countries have the most impact on that discipline, and also give some idea about the geographical outreach of those journals. This paper examines the number of countries that contributed articles to one leading medical informatics journal, Medical Informatics & the Internet in Medicine, and the amount of their contributions between 1999 and the first half of 2004. METHODS: The PubMed citations of all indexed articles from the chosen journal (n = 128) were retrieved online (up to Volume 29, Number 2/June 2004 issue, the latest indexed issue as at 28 January 2005). The country of corresponding author's affiliation for each retrieved citation was recorded. The five-year-and-half corpus of abstracts retrieved from PubMed was further explored using MetaCarta Geographic Text Search http://www.metacarta.com/. RESULTS: The examined journal has an international outreach, with authors from 24 countries, spanning four continents, contributing to the journal during the studied period. The journal is dominated by a very large number of articles from Europe (81.25% of all articles counted in this study), and in particular from the UK (15.63%) and Greece (15.63%). There were no contributions from Africa or South America. CONCLUSION: A detailed discussion and interpretation of these results and ideas for future analyses are provided. MetaCarta can prove very useful as a bibliometric research tool.

Journal Article↗

Web GIS in practice II: interactive SVG maps of diagnoses of sexually transmitted diseases by Primary Care Trust in London, 1997 - 2003.

BACKGROUND: The rates of Sexually transmitted diseases (STDs) in England have been rising steadily since the mid 1990s, making them a major public health concern. In 2003, 672,718 people were diagnosed with an STD in England, and around one third of those cases were diagnosed in London. RESULTS: Using GeoReveal v1.1 for Windows, we produced Web-based interactive choropleth maps of diagnoses of STDs by Primary Care Trust (PCT) in London for the years from 1997 to 2003 http://healthcybermap.org/PCT/STDs/. These maps are in Scalable Vector Graphics (SVG) format and require a freely available Adobe SVG browser plug-in to be displayed. They are based on data obtained from the House of Commons Hansard Written Answers for 15 October 2004. They show steadily rising rates of STDs in London over the covered seven-year period. Also, one can clearly see on the maps that PCTs located in central London had the highest numbers of STD diagnoses throughout the mapped seven years. A companion bar chart allows users to instantly compare the STD figure of a given PCT for a given year against the average figure for all 25 mapped PCTs for the same year, and also compare those figures across all seven years. The maps offer users a rich set of useful features and functions, including the ability to change the classification method in use, the number of ranges in the map, and the colour theme, among others. CONCLUSIONS: Wizard-driven tools like GeoReveal have made it very easy to transform complex raw data into valuable decision support information products (interactive Web maps) in very little time and without requiring much expertise. The resultant interactive maps have the potential of further supporting health planners and decision makers in their planning and management tasks by allowing them to graphically interrogate data, instantly spot trends, and make quick and effective visual comparisons of geographically differentiated phenomena between different geographical areas and over time.SVG makes an ideal format for such maps. SVG is a World Wide Web Consortium non-proprietary, XML-based vector graphics format, and is an extremely powerful alternative to Macromedia(R) Flash and bitmap graphics.

Journal Article↗

Research protocol: EB-GIS4HEALTH UK - foundation evidence base and ontology-based framework of modular, reusable models for UK/NHS health and healthcare GIS applications.

EB-GIS4HEALTH UK aims at building a UK-oriented foundation evidence base and modular conceptual models for GIS applications and programmes in health and healthcare to improve the currently poor GIS state of affairs within the NHS; help the NHS understand and harness the importance of spatial information in the health sector in order to better respond to national health plans, priorities, and requirements; and also foster the much-needed NHS-academia GIS collaboration. The project will focus on diabetes and dental care, which together account for about 11% of the annual NHS budget, and are thus important topics where GIS can help optimising resource utilisation and outcomes. Virtual e-focus groups will ensure all UK/NHS health GIS stakeholders are represented. The models will be built using Protege ontology editor http://protege.stanford.edu/ based on the best evidence pooled in the project's evidence base (from critical literature reviews and e-focus groups). We will disseminate our evidence base, GIS models, and documentation through the project's Web server. The models will be human-readable in different ways to inform NHS GIS implementers, and it will be possible to also use them to generate the necessary template databases (and even to develop "intelligent" health GIS solutions using software agents) for running the modelled applications. Our products and experience in this project will be transferable to address other national health topics based on the same principles. Our ultimate goal is to provide the NHS with practical, vendor-neutral, modular workflow models, and ready-to-use, evidence-based frameworks for developing successful GIS business plans and implementing GIS to address various health issues. NHS organisations adopting such frameworks will achieve a common understanding of spatial data and processes, which will enable them to efficiently and effectively share, compare, and integrate their data silos and results for more informed planning and better outcomes.

Journal Article↗

British internet-derived patient information on diabetes mellitus: is it readable?

BACKGROUND: Sizeable proportions of Western populations have limited language and math skills, making it difficult for them to fully and safely understand and act upon online health information. METHODS: We used the Flesch Reading Ease and Flesch-Kincaid Grade Level formulae to test the readability of 20 representative Web documents from 15 trustworthy sites/providers of British origin, providing consumer information on diabetes mellitus. RESULTS: The corresponding average and median U.K. reading ages of the tested material were found to be 14.2 and 14.65 years of age, respectively (range, 11-16.9 years). The most readable pages in our study (about one-third of all tested pages) had a Flesch Reading Ease score above 60 (range, 60.4-73.3) and a Flesch-Kincaid Grade Level of 8.0 or lower (range, 6.0-8.0), corresponding to a U.K. reading age of 11-13 years. These readability levels are well above the estimated reading age of the U.K. population in general (9 years). CONCLUSIONS: These results point to a chronic and often forgotten information quality problem. Though quick and easy to use, and certainly better than nothing, readability formulae are not without their limitations. These should be recognised, and any health information quality benchmarking checklist in use should be supplemented with some testing for content readability (e.g., suitable readability formulae as a bare minimum and, if possible, feedback from a panel of readability experts and representative lay reviewers). Online health information providers need to ensure that their written material is pitched at a level appropriate to their intended lay audience. Providers should also consider other means of delivering health education and promotion programmes, so that no one is left behind.

Comprehension↗

A synchronous communication experiment within an online distance learning program: a case study.

Student-teacher and student-student interactions in purely asynchronous distance learning courses are much lacking compared to similar interactions found in face-to-face teaching, causing learners to experience feelings of isolation, thus reducing motivation and increasing dropout rates. We used PalTalk, an Internet text and audio chat client from AVM Software, Inc. (New York, NY), to offer our students live virtual classroom sessions within a unit of our online distance learning M.Sc. program in Healthcare Informatics. On-demand replays of audio excerpts from the sessions were also provided to accommodate absenteeism and for student review. Five students completed an evaluation questionnaire. Our results highlighted the potential merits of using synchronous conferencing to assist in fostering a sense of belonging to one supportive learning community among distance learners and improve educational outcomes. Students were very positive toward the real-time human interaction and voted for a 95/5 (asynchronous/synchronous percentages) blended delivery approach for a typical unit in our program. They also praised PalTalk's voice quality and ease of use. This paper presents educational and technological perspectives about this experiment in the form of a state-of the- art review, without intending to be statistically rigorous. However, robust research evidence is still required to convince educators fully about the benefits of synchronous communication tools and help them decide on the most suitable solutions for their particular circumstances.

Attitude to Computers↗

Web GIS in practice: an interactive geographical interface to English Primary Care Trust performance ratings for 2003 and 2004.

BACKGROUND: On 21 July 2004, the Healthcare Commission http://www.healthcarecommission.org.uk/ released its annual star ratings of the performance of NHS Primary Care Trusts (PCTs) in England for the year ending March 2004. The Healthcare Commission started work on 1 April 2004, taking over all the functions of the former Commission for Health Improvement http://www.chi.nhs.uk/, which had released the corresponding PCT ratings for 2002/2003 in July 2003. RESULTS: We produced two Web-based interactive maps of PCT star ratings, one for 2003 and the other for 2004 http://healthcybermap.org/PCT/ratings/, with handy functions like map search (by PCT name or part of it). The maps feature a colour-blind friendly quadri-colour scheme to represent PCT star ratings. Clicking a PCT on any of the maps will display the detailed performance report of that PCT for the corresponding year. CONCLUSION: Using our Web-based interactive maps, users can visually appreciate at a glance the distribution of PCT performance across England. They can visually compare the performance of different PCTs in the same year and also between 2003 and 2004 (by switching between the synchronised 'PCT Ratings 2003' and 'PCT Ratings 2004' themes). The performance of many PCTs has improved in 2004, whereas some PCTs achieved lower ratings in 2004 compared to 2003. Web-based interactive geographical interfaces offer an intuitive way of indexing, accessing, mining, and understanding large healthcare information sets describing geographically differentiated phenomena. By acting as an enhanced alternative or supplement to purely textual online interfaces, interactive Web maps can further empower organisations and decision makers.

Journal Article↗

Is NHS dentistry in crisis? 'Traffic light' maps of dentists distribution in England and Wales.

BACKGROUND: 'Traffic light' (red-yellow-green) maps are potentially powerful tools for 'at a glance' problem detection, for optimising resource allocation/reallocation, setting priorities, and targeting interventions to areas most in need. The maps can be also used for administrative area comparisons and performance monitoring over time. Interactive Web versions of the maps can be generated with many handy features to further empower organisations and decision makers. Methodological issues to consider when creating 'traffic light' maps include hue thresholding, data timeliness and stability of administrative boundaries. RESULTS: We used 'traffic light' maps to study the distribution of dentists per 1,000 population in all 304 English Primary Care Trusts (PCTs) and 22 Welsh Local Health Boards (LHBs) using datasets of dentist numbers per PCT (as at 31 December 2002) and LHB (as at 26 February 2004) from the Dental Practice Board, and 2001 Census population figures for PCTs and LHBs from the Office for National Statistics. The overall NHS dentists per 1,000 population figures for England (0.374) and Wales (0.359) are low compared to many other countries, with less than 0.3 dentist per 1,000 people available to 24.1% of the total population of England (81 PCTs or 26.6% of all PCTs) and 26.1% of the total population of Wales (6 LHBs or 27.3% of all LHBs). A general shortage of NHS dentists can be observed at a glance across England and Wales on all the 'traffic light' maps in our study, even on those using a more "tolerant" classification and an additional orange-yellow class. The distribution of NHS dentists in England and Wales was also found to be not uniform, with some PCTs/LHBs, especially those located in some of the deprived or less populated urban and rural communities, suffering significantly more shortage of dentists than others (see http://healthcybermap.org/PCT/dentists/). These results confirm recent media reports of a shortage of NHS dentists in various parts of England and Wales. CONCLUSION: Suitable programmes are urgently needed to increase the numbers of NHS dentists across England and Wales. We have included a set of recommendations to dental health policymakers and planners, in addition to ideas for further work.

Journal Article↗

Towards evidence-based, GIS-driven national spatial health information infrastructure and surveillance services in the United Kingdom.

The term "Geographic Information Systems" (GIS) has been added to MeSH in 2003, a step reflecting the importance and growing use of GIS in health and healthcare research and practices. GIS have much more to offer than the obvious digital cartography (map) functions. From a community health perspective, GIS could potentially act as powerful evidence-based practice tools for early problem detection and solving. When properly used, GIS can: inform and educate (professionals and the public); empower decision-making at all levels; help in planning and tweaking clinically and cost-effective actions, in predicting outcomes before making any financial commitments and ascribing priorities in a climate of finite resources; change practices; and continually monitor and analyse changes, as well as sentinel events. Yet despite all these potentials for GIS, they remain under-utilised in the UK National Health Service (NHS). This paper has the following objectives: (1) to illustrate with practical, real-world scenarios and examples from the literature the different GIS methods and uses to improve community health and healthcare practices, e.g., for improving hospital bed availability, in community health and bioterrorism surveillance services, and in the latest SARS outbreak; (2) to discuss challenges and problems currently hindering the wide-scale adoption of GIS across the NHS; and (3) to identify the most important requirements and ingredients for addressing these challenges, and realising GIS potential within the NHS, guided by related initiatives worldwide. The ultimate goal is to illuminate the road towards implementing a comprehensive national, multi-agency spatio-temporal health information infrastructure functioning proactively in real time. The concepts and principles presented in this paper can be also applied in other countries, and on regional (e.g., European Union) and global levels.

Journal Article↗

Descriptive review of geographic mapping of severe acute respiratory syndrome (SARS) on the Internet.

From geographic mapping at different scales to location-based alerting services, geoinformatics plays an important role in the study and control of global outbreaks like severe acute respiratory syndrome (SARS). This paper reviews several geographic mapping efforts of SARS on the Internet that employ a variety of techniques like choropleth rendering, graduated circles, graduated pie charts, buffering, overlay analysis and animation. The aim of these mapping services is to educate the public (especially travellers to potentially at-risk areas) and assist public health authorities in analysing the spatial and temporal trends and patterns of SARS and in assessing/revising current control measures.

Journal Article↗

A first look at HealthCyberMap medical semantic subject search engine.

HealthCyberMap (http://healthcybermap.semanticweb.org) is a Semantic Web project that aims at mapping selected parts of health information resources in cyberspace in novel semantic ways to improve their retrieval and navigation. This paper describes HealthCyberMap semantic subject search engine methodology and early prototype which attempt to overcome the limitations of conventional free text search engines. Explicit concepts in resource metadata map onto a brokering domain ontology (a clinical terminology or classification) allowing a Semantic Web search engine to infer implicit meanings (synonyms and semantic relationships) not directly mentioned in either the resource or its metadata. Similarly, user queries would map to the same ontology allowing the search engine to infer the implicit semantics of user queries and use them to optimise retrieval. Related issues of metadata, clinical terminologies and automatic vs. manual indexing of medical Web resources are also discussed, together with future methodological directions, which include the use of a true terminology server as an intelligent broker between user queries and HealthCyberMap pool of resource metadata. A comparative evaluation of the new engine based on relevance metrics is also proposed.

Humans↗

Geographic information systems and the spiritual dimension of health: a short position paper.

The WHO's well known definition of health stressed the indivisibility of human well-being, physical and otherwise, by stating that health is "not merely the absence of disease or infirmity". The spiritual dimension of health is well covered in the medical literature. Different locations on Earth are associated with different interrelated profiles: physical, biological, environmental, socio-economic, cultural, and also spiritual profiles, that do affect and are affected by health (including its spiritual dimension), disease, healthcare, and pastoral care. A number of reviews have been recently published covering the use of Geographic Information Systems (GIS) in understanding and harnessing the importance of location in the health sector. However, no publication so far has discussed the role of GIS in relation to the spiritual dimension of health. This position paper is an attempt to fill in this gap without going into deep details. GIS role in pastoral care ranges from assisting in pattern and trend detection, and in informed decision-making and resource management, to providing routing and educational functions, and even assessing the impact of missionary radio broadcasts. A review of some of the software tools that are currently available in this field is also provided. GIS are ideal tools for improving and coordinating the integration of the health (physical), social, and spiritual/ pastoral dimensions of individual and community care. However to achieve the full potential of GIS in these areas, we still need to combat many cultural and organisational barriers, while making the tools cheaper and much easier to learn and use.

Journal Article↗

The use of interactive graphical maps for browsing medical/health Internet information resources.

As online information portals accumulate metadata descriptions of Web resources, it becomes necessary to develop effective ways for visualising and navigating the resultant huge metadata repositories as well as the different semantic relationships and attributes of described Web resources. Graphical maps provide a good method to visualise, understand and navigate a world that is too large and complex to be seen directly like the Web. Several examples of maps designed as a navigational aid for Web resources are presented in this review with an emphasis on maps of medical and health-related resources. The latter include HealthCyberMap maps http://healthcybermap.semanticweb.org/, which can be classified as conceptual information space maps, and the very abstract and geometric Visual Net maps of PubMed http://pubmed.antarcti.ca/start. Information resources can be also organised and navigated based on their geographic attributes. Some of the maps presented in this review use a Kohonen Self-Organising Map algorithm, and only HealthCyberMap uses a Geographic Information System to classify Web resource data and render the maps. Maps based on familiar metaphors taken from users' everyday life are much easier to understand. Associative and pictorial map icons that enable instant recognition and comprehension are preferred to geometric ones and are key to successful maps for browsing medical/health Internet information resources.

Journal Article↗