Biomedical subjects

P Elkin

Publications and source records attributed to P Elkin.

5 recordsLinked to original sources

PubMed2000

Representation by standard terminologies of health status concepts contained in two health status assessment instruments used in rheumatic disease management.

Health and functional status data have been shown to have clinical utility in predicting outcome. Various metadata registries in the form of patient self-administered health assessment questionnaires have been incorporated into routine clinical care and clinical research of patients with rheumatic disease. Examples of such health assessment instruments are the Clinical Health Assessment Questionnaire (CLINHAQ) and the Modified Health Assessment Questionnaire (MHAQ). These instruments contain concepts that are an integral part of the health and functional status domain. Using an automated indexing tool we examined the clinical content coverage by SNOMED RT and the Unified Medical Language System (UMLS) Metathesaurus for health and functional status concepts identified in the MHAQ and CLINHAQ. Significant differences existed between the overall representational ability of SNOMED and UMLS for concepts identified in the MHAQ (49%, vs. 77% respectively, p < .005) and for concepts identified in the CLINHAQ (30% vs. 64% respectively p < .005). Representational capability by SNOMED-RT and UMLS for concepts in a given health assessment instrument was carried across four semantic classes of "attitudes", "symptoms", "activities", and "social attributes". The conceptual content coverage of health status assessment concepts contained in the MHAQ and CLINHAQ by SNOMED-RT and UMLS was incomplete but better for UMLS with its panoply of vocabulary sources. This observed overall improved representation by UMLS appeared to be due to better representation of concepts in "activities" and "social attributes" semantic classes. Representation of health or functional status concepts in a computerized medical record should be founded on a universally agreed concept model of that domain. Established functional and health status metadata registries can serve as important sources for concepts and candidate classes within that domain.

Health Status↗

PubMed1990

Reconciling demands.

How can hospitals keep a tight rein on their finances while satisfying changing demand? Kevin Richards explains how the hospital planning model helped Coventry HA.

Budgets↗

PubMed1989

Neighbourhood watch.

Explore the source record for details and available documents.

Continuity of Patient Care↗

PubMed1975

Determinants of the choice of rural practice: a study of Yugoslav general practitioners.

A questionnaire study of Yugoslav general practitioners was undertaken to document reasons for the unpopularity of rural practice and to characterize better the GPs who do choose rural practice. Responses indicated that rural GPs were significantly more overworked, had less opportunity for continuing education, had poorer medical facilities, and had less adequate schools for their children than urban GPs. On the other hand, rural work was felt to be more interesting and to provide closer contact with patients. GPs who were happy in rural practice were more likely to have urban backgrounds, to have planned to be rural physicians before entering medical school, and to have undergone GP specialization training than were other GPs in the sample. Relative importances attributed to the various practice location determinants are noted. Possible applications of the study in alleviating rural doctor shortages are discussed.

Attitude of Health Personnel↗

PubMedDate not supplied

Derivation and evaluation of a document-naming nomenclature.

OBJECTIVE: The Computerized Patient Record System is deployed at all 173 Veterans Affairs (VA) medical centers. Providers access clinical notes in the system from a note title menu. Following its implementation at the Nashville VA Medical Center, users expressed dissatisfaction with the time required find notes among hundreds of irregularly structured titles. The authors' objective was to develop a document-naming nomenclature (DNN) that creates informative, structured note titles that improve information access. DESIGN: One thousand ninety-four unique note titles from two VA medical centers were reviewed. A note-naming nomenclature and compositional syntax were derived. Compositional order was determined by user preference survey. MEASUREMENTS: The DNN was evaluated by modeling note titles from the Salt Lake City VA Medical Center (n=877), Vanderbilt University Medical Center (n=554), and the Mayo Clinic (n=42). A preliminary usability evaluation was conducted on a structured title display and sorting application. RESULTS: Classes of note title components were found by inspection. Components describe characteristics of the author, the health care event, and the organizational unit providing care. Terms were taken from VA medical center information systems and national standards. The DNN model accurately described 97 to 99 percent of note titles from the test sites. The DNN term coverage varied, depending on component and site. Users found the DNN title format useful and the DNN-based title sorting and note review application easy to learn and quick to use. CONCLUSION: The DNN accurately models note titles at five medical centers. Preliminary usability data indicate that DNN integration with title parsing and sorting software enhances information access.

Abstracting and Indexing↗