PubMed Health⌕ Search

Biomedical subjects

Marius Fieschi

Publications and source records attributed to Marius Fieschi.

18 recordsLinked to original sources
PubMed2005

Health search engine with e-document analysis for reliable search results.

OBJECTIVE: After a review of the existing practical solution available to the citizen to retrieve eHealth document, the paper describes an original specialized search engine WRAPIN. METHOD: WRAPIN uses advanced cross lingual information retrieval technologies to check information quality by synthesizing medical concepts, conclusions and references contained in the health literature, to identify accurate, relevant sources. Thanks to MeSH terminology [1] (Medical Subject Headings from the U.S. National Library of Medicine) and advanced approaches such as conclusion extraction from structured document, reformulation of the query, WRAPIN offers to the user a privileged access to navigate through multilingual documents without language or medical prerequisites. RESULTS: The results of an evaluation conducted on the WRAPIN prototype show that results of the WRAPIN search engine are perceived as informative 65% (59% for a general-purpose search engine), reliable and trustworthy 72% (41% for the other engine) by users. But it leaves room for improvement such as the increase of database coverage, the explanation of the original functionalities and an audience adaptability. CONCLUSION: Thanks to evaluation outcomes, WRAPIN is now in exploitation on the HON web site (http://www.healthonnet.org), free of charge. Intended to the citizen it is a good alternative to general-purpose search engines when the user looks up trustworthy health and medical information or wants to check automatically a doubtful content of a Web page.

Europe↗
PubMed2005

Designing and implementing health data and information providers.

OBJECTIVES: To model and implement web portals providing access to certified and high-quality information in the domain of health. MATERIAL AND METHODS: The Unified Medical Language System (UMLS) knowledge sources of the U.S. National Library of Medicine and principles of implementation resulting from the previous ARIANE project are described. The XML technology that allows files transformations by the means of XSLT is briefly presented. RESULTS: The design and implementation of software modules that exploit knowledge sources, operate the translation of a user's query to selected information sources, and wrap obtained results are detailed. Querying documentary and factual medical databases are presented. DISCUSSION: Current implementation and wrapping perspectives are discussed in terms of integration and interoperability of health information and data resources.

France↗
PubMed2005

Mapping care processes within a hospital: from theory to a web-based proposal merging enterprise modelling and ISO normative principles.

Today, the economic and regulatory environment, involving activity-based and prospective payment systems, healthcare quality and risk analysis, traceability of the acts performed and evaluation of care practices, accounts for the current interest in clinical and hospital information systems. The structured gathering of information relative to users' needs and system requirements is fundamental when installing such systems. This stage takes time and is generally misconstrued by caregivers and is of limited efficacy to analysts. We used a modelling technique designed for manufacturing processes (IDEF0/SADT). We enhanced the basic model of an activity with descriptors extracted from the Ishikawa cause-and-effect diagram (methods, men, materials, machines, and environment). We proposed an object data model of a process and its components, and programmed a web-based tool in an object-oriented environment. This tool makes it possible to extract the data dictionary of a given process from the description of its elements and to locate documents (procedures, recommendations, instructions) according to each activity or role. Aimed at structuring needs and storing information provided by directly involved teams regarding the workings of an institution (or at least part of it), the process-mapping approach has an important contribution to make in the analysis of clinical information systems.

Computer Simulation↗
PubMed2005

Combining advanced networked technology and pedagogical methods to improve collaborative distance learning.

Making educational material be available on a network cannot be reduced to merely implementing hypermedia and interactive resources on a server. A pedagogical schema has to be defined to guide students for learning and to provide teachers with guidelines to prepare valuable and upgradeable resources. Components of a learning environment, as well as interactions between students and other roles such as author, tutor and manager, can be deduced from cognitive foundations of learning, such as the constructivist approach. Scripting the way a student will to navigate among information nodes and interact with tools to build his/her own knowledge can be a good way of deducing the features of the graphic interface related to the management of the objects. We defined a typology of pedagogical resources, their data model and their logic of use. We implemented a generic and web-based authoring and publishing platform (called J@LON for Join And Learn On the Net) within an object-oriented and open-source programming environment (called Zope) embedding a content management system (called Plone). Workflow features have been used to mark the progress of students and to trace the life cycle of resources shared by the teaching staff. The platform integrated advanced on line authoring features to create interactive exercises and support live courses diffusion. The platform engine has been generalized to the whole curriculum of medical studies in our faculty; it also supports an international master of risk management in health care and will be extent to all other continuous training diploma.

Cooperative Behavior↗
PubMed2005

Applicability of textual clinical practice guidelines: impact of physician interpretation.

OBJECTIVES: 1) Determine whether textual Clinical Practice Guidelines (CPGs) are interpreted accurately and unequivocally by targeted physicians. 2) Specify audience and perception of the CPGs. METHOD: Comparative analysis of answers given by a panel of general practitioners to a series of questions and clinical case studies related to three textual CPGs produced and published by the French National Agency for Accreditation and Evaluation in Health (ANAES). RESULTS: 68 to 96% of physicians are aware of the existence of the CPGs studied. Less than 50% state having read them. On average, 38% of physician interpretations of CPGs are incorrect (i.e., not in agreement with expert interpretation). Furthermore, there is disagreement among physicians responses. CONCLUSION: This study credits the argument of disparities in practice which derive from inaccurate and discordant CPGs' interpretations. The results should prompt those responsible for producing such decision-making support to design documents that are better structured, less ambiguous, and more precise. In a model which facilitates their computerisation the expression of CPGs provides a solution that should be included upstream in the publication process.

Awareness↗
PubMed2005

Refinement of an automatic method for indexing medical literature--a preliminary study.

OBJECTIVES: to rank according to their significance MeSH terms automatically extracted from Internet sites in the framework of a French project, VUMeF, a contribution to the NLM' UMLS project. MATERIAL AND METHODS: scores are affected to key-words of a given document on the basis of the Semantic Network of the UMLS and frequencies of co-occurring major terms in the Medline literature. If N is the number of major terms of a document, and n is the number of major terms retrieved in the N first terms ranked in descending order according to their scores, the measure of the achievement of the method is n/N. RESULTS: a set of 1444 randomized documents have been extracted from Medline. For each document we computed the retrieved major terms among the first N terms with two methods: a statistical method using only frequencies given by co-occurrences, and our method that uses furthermore the UMLS semantic network. In 34% of cases corresponding to documents indexed by about 16 key-words, about 3 major terms among them, our method produces a better precision (7%) than the statistical method. DISCUSSION: the rough calculation of the proportion of retrieved major terms should be enhanced by the use of a probability law allowing to enlarge the list of terms to select taking into account both the number of major terms and the total number of key-words used to index each document.

Humans↗
PubMed2004

Coupling computer-interpretable guidelines with a drug-database through a web-based system--The PRESGUID project.

BACKGROUND: Clinical Practice Guidelines (CPGs) available today are not extensively used due to lack of proper integration into clinical settings, knowledge-related information resources, and lack of decision support at the point of care in a particular clinical context. OBJECTIVE: The PRESGUID project (PREScription and GUIDelines) aims to improve the assistance provided by guidelines. The project proposes an online service enabling physicians to consult computerized CPGs linked to drug databases for easier integration into the healthcare process. METHODS: Computable CPGs are structured as decision trees and coded in XML format. Recommendations related to drug classes are tagged with ATC codes. We use a mapping module to enhance computerized guidelines coupling with a drug database, which contains detailed information about each usable specific medication. In this way, therapeutic recommendations are backed up with current and up-to-date information from the database. RESULTS: Two authoritative CPGs, originally diffused as static textual documents, have been implemented to validate the computerization process and to illustrate the usefulness of the resulting automated CPGs and their coupling with a drug database. We discuss the advantages of this approach for practitioners and the implications for both guideline developers and drug database providers. Other CPGs will be implemented and evaluated in real conditions by clinicians working in different health institutions.

Computer Graphics↗
PubMed2004

WRAPIN: new generation health search engine using UMLS knowledge sources for MeSH term extraction from health documentation.

To realize the potential of the Internet as a source of valuable healthcare information, for the general public, patients or practitioners, it is imperative to establish a validation system based on standards of quality. The WRAPIN project (World-wide online Reliable Advice to Patients and Individuals) from the European Community has this ambitious goal. WRAPIN is a federating system for medical information with an editorial policy of intelligently sharing quality and professional information. The WRAPIN project has two main axes: the efficient and intelligent search of information and the assertion of the trustworthiness of content. This article presents the scientific challenges involved in extracting the knowledge from text-based information in order to better manage the knowledge and the rest of the retrieval proc-ess. Our innovative approach is to efficiently extract MeSH terms from the analyzed documents exploiting UMLS knowledge sources. A benefit has been measured when comparing extraction results. Even if the evaluation is made with a limited corpus, this research work proposes heuristics that can be validated to the whole biomedical domain, and possibly enhanced by the adjunction of other methods.

Abstracting and Indexing↗
PubMed2004

Towards interoperability of heterogeneous health databases: application to a tumor samples bank.

OBJECTIVES: to define principles and methods that allow heterogeneous database in the health sector to be interoperable. MATERIAL AND METHOD: to design a component-based middleware able to provide flexible and efficient means of communication between end-users and databases, and that exploits the standard nomenclatures of the health sector. RESULTS: according to these principles, to implement a prototype of a tumor sample bank in the University hospitals of Marseille, France. DISCUSSION: to discuss the benefits that the approach brings and the progress in prototyping.

Computer Systems↗
PubMed2003

Modeling and implementing a health information provider on the Internet.

OBJECTIVES: To model and implement a medical web portal providing access to well qualified and high-quality information. MATERIAL AND METHODS: The Unified Medical Language System (UMLS) knowledge sources of the U.S. National Library of Medicine and an Information Sources Catalog (ISC) resulting from the ARIANE project are described. The XML technology that allows files transformations by the means of XSLT is briefly presented. RESULTS: The design and implementation of software modules that exploit knowledge sources, operate the translation of a user's query to selected information sources, and wrap obtained results are detailed. DISCUSSION: Current implementation and wrapping perspectives are discussed in terms of integration and interoperability of health information resources.

Humans↗
PubMed2003

Mapping care processes within a hospital: a web-based proposal merging enterprise modelling and ISO normative principles.

Today, the economic and regulatory environment are pressuring hospitals and healthcare professionals to account for their results and methods of care delivery. The evaluation of the quality and the safety of care, the traceability of the acts performed and the evaluation of practices are some of the reasons underpinning current interest in clinical and hospital information systems. The structured collection of users' needs and system requirements is fundamental when installing such systems. This stage takes time and is generally misconstrued by caregivers and is of limited efficacy to analysis. We used a modelling technique designed for manufacturing processes (SADT: Structured Analysis and Design Technique). We enhanced the initial model of activity of this method and programmed a web-based tool in an object-oriented environment. This tool makes it possible to extract the data dictionary from the description of a given process and to locate documents (procedures, recommendations, instructions). Aimed at structuring needs and storing information provided by teams directly involved regarding the workings of an institution (or at least part of it), the process mapping approach has an important contribution to make in the analysis of clinical information systems.

Critical Pathways↗
PubMed2003

A platform to develop and to improve effectiveness of online computable guidelines.

The quality criteria of guidelines are identified. Taking these criteria into account we have built a platform to improve computable guideline effectiveness and facilitate their production. Our implementation is based on the GLIF Model (GuideLine Interchange Format). We have designed software components to edit, test, index, perform and present guidelines in a user-friendly Web architecture. These components are based on XML specifications in order to preserve their shareability and their re-usability. Several guidelines have been developed using our approach. We discuss the advantages of such an implementation and future evolutions so as to improve guideline integration within the clinician's workflow.

Decision Support Systems, Clinical↗
PubMed2003

A full XML-based approach to creating hypermedia learning modules in web-based environments: application to a pathology course.

Nowadays, web-based learning services are a key topic in the pedagogical and learning strategies of universities. While organisational and teaching requirements of the learning environment are being evaluated, technical specifications are emerging, enabling educators to build advanced "units of learning". Changes, however, take a long time and cost-effective solutions have to be found to involve our institutions in such actions. In this paper, we present a model of the components of a course. We detail the method followed to implement this model in hypermedia modules with a viewer that can be played on line or from a CD-ROM. The XML technology has been used to implement all the data structures and a client-side architecture has been designed to build a course viewer. Standards of description of content (such as Dublin Core and DocBook) have been integrated into the data structures. This tool has been populated with data from a pathology course and supports other medical contents. The choice of the architecture and the usefulness of the programming tools are discussed. The means of migrating towards a server-side application are presented.

CD-ROM↗
PubMed2002

Experimenting with new paradigms for medical education and the emergence of a distance learning degree using the internet: teaching evidence-based medicine.

This paper is focused on designing and developing a teaching environment associated with an introductory course in evidence-based medicine designed for undergraduates. Attempting to break away from the traditional educational model based on acquisition of factual knowledge, we developed a software tool centred on content management, student assessment and feedback. We ran this course on an educational website, using chat rooms and electronic mail for trainer-trainee communication over one academic year. The website served as a repository for knowledge and information and presented freestanding web-based interactive study modules and a non-interactive degree course. Trainers and trainees responded favourably to the computer applications and the Internet. This project demonstrated the feasibility of computer-aided learning and the advantages of distance teaching over the Internet.

Computer-Assisted Instruction↗
PubMed2002

Towards elicitation of users requirements for hospital information system: from a care process modelling technique to a web based collaborative tool.

Growing attention is being given to the use of process modeling methodology for user requirements elicitation. In the analysis phase of hospital information systems, the usefulness of care-process models has been investigated to evaluate the conceptual applicability and practical understandability by clinical staff and members of users teams. Nevertheless, there still remains a gap between users and analysts in their mutual ability to share conceptual views and vocabulary, keeping the meaning of clinical context while providing elements for analysis. One of the solutions for filling this gap is to consider the process model itself in the role of a hub as a centralized means of facilitating communication between team members. Starting with a robust and descriptive technique for process modeling called IDEF0/SADT, we refined the basic data model by extracting concepts from ISO 9000 process analysis and from enterprise ontology. We defined a web-based architecture to serve as a collaborative tool and implemented it using an object-oriented database. The prospects of such a tool are discussed notably regarding to its ability to generate data dictionaries and to be used as a navigation tool through the medium of hospital-wide documentation.

Health Personnel↗
PubMed2002

Enhancing a medical e-learning environment: the adaptive DI2@DEM approach.

Current medical e-learning tools suffer from a variability of student user. Students are different in terms of motivations, training backgrounds, technical skills and learning objectives. It is obvious that these students do not accede relevant information if their educational resources access is misadapted. Adaptive environments propose to take the user into account in order to provide him or her with the most relevant educational resources. We present the adaptive DI(2)ADEM approach, which enhances the MEDIDACTE e-learning environment of the Faculty of Medicine in Marseille. DI(2)ADEM objective is to select the most relevant information and offer it to the user in an adaptive manner. Adaptability is based on management of knowledge regarding both the user and resources distributed. A match is made between student's profile and knowledge of resources organization and semantics.

Computer Simulation↗