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Biomedical subjects

Michel Joubert

Publications and source records attributed to Michel Joubert.

14 recordsLinked to original sources
PubMed2006

Awareness of mother-to-child transmission of human T-cell lymphotropic virus (HTLV) type I through breastfeeding in a small group of HTLV-positive women in Maripasoula and Papaïchton, French Guiana.

The aim of this study was to assess the awareness of human T-cell lymphotropic virus (HTLV) transmission, especially through breastfeeding, in a small group of 40 HTLV-seropositive women in French Guiana and to examine the public health policies in place to reduce transmission. The results show that the majority of HTLV-positive women were aware of having a blood virus, diagnosed antenatally, and were advised to avoid breastfeeding. This advice was followed in the majority of cases despite financial difficulty. Participants were largely unaware of other modes of transmission. Public awareness was low, leading to increased stigmatising of people with HTLV, more so than HIV. Health policies in place to reduce transmission of HTLV are focused on vertical transmission, with women being routinely tested antenatally and advised to avoid breastfeeding. There was no further advice routinely given on other modes of transmission. There was no routine follow-up of HTLV-positive women. Suggestions include public education programmes such as those that are in place for HIV, education of healthcare workers, and setting up a network for systematic follow-up and support of HTLV patients.

Adult↗
PubMed2006

Construction of a semi-automated ICD-10 coding help system to optimize medical and economic coding.

INTRODUCTION: In order to measure the medical activity in hospitals, physicians are required to code manually information concerning a patient's stay using ICD-10. This requires trained staff and a lot of time. We propose to help speed up and facilitate the tedious task of coding patient information. METHODS: we show two methods. First, we propose an automated ICD-10-based coding help system using an automated MeSH-based indexing system and a mapping between MeSH and ICD-10 extracted from the UMLS metathesaurus. Secondly, we propose the use of drug prescriptions to complete the previous coding with the use of a mapping between a given prescription drug and the relevant ICD-10 codes (in compliance with the drug approval). RESULTS: the results of a preliminary experiment indicate that the precision of the indexing system is 40% and the recall is 30% when we compare to an economic rules-based coding and to a descriptive coding. DISCUSSION: moreover, we show that the use of prescription coding is relevant as the recall reaches 68% when the Vidal tool is used. CONCLUSION: Then, it is very interesting to complete the coding obtained automatically by the indexing/mapping system by the coding obtained from the prescriptions.

Automation↗
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

New insights in HTLV-I phylogeny by sequencing and analyzing the entire envelope gene.

The HTLV-I envelope plays a major role in the process of target cell infection. It is implied in the recognition of the viral receptor(s), penetration of the viral genetic material, and induction of host immunity to the virus. It is thus important to study the genetic variability of the viral env gene as well as its variation in terms of evolution. In a new approach to these features, we sequenced the entire env gene of 65 HTLV-I isolates originating from Gabon, French Guiana, West Indies, and Iran, such isolates representing all major HTLVI phylums but the Australo-Melanesian one. The sequences obtained and all PTLV-I (HTLV-I and STLV-I) env sequences available in the literature were analyzed. Phylogenetic studies using different algorithms (minimum evolution, neighbor joining, maximum parsimony, and maximum likelihood) gave the same clear-cut results. Newly sequenced HTLV-I isolates described in this report allocated in three well-defined subtypes: Cosmopolitan, Central African, and a new distinct one that we termed "Maroni" subtype (present in the Maroni Basin, French Guiana, and West Indies). Clearly, the most divergent PTLV-I strains present in Asia- Australo-Melanesia as well as African and Asian STLV-I derived from the same node in the phylogenetic tree as isolates of the Central African subtype. In addition, we showed that within each PTLV-I subtype, groups of isolates may be characterized by nonrandom and systematically associated mutations.

Amino Acid Sequence↗
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

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 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

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↗