Biomedical subjects

P Le Beux

Publications and source records attributed to P Le Beux.

At least 19 recordsLinked to original sources

PubMed2001

Issues in the design of medical ontologies used for knowledge sharing.

Recent work in Medical Informatics is exploring the development and the use of formal ontologies as a way of specifying content-specific agreements for the sharing and reuse of knowledge among several computer systems. We describe the role of ontologies in supporting knowledge sharing activities in medicine Principles for the design of ontologies have been proposed, mainly in other domains: these principles include parsimony, clarity, representation of categories versus terms, and coherence. We analyze how and why these principles can or cannot be applied from case studies from medical systems. Regarding the fact that most of medical concepts are empirical, selected design decisions are discussed. An alternative representation choice consists in mapping principled general core ontologies and domain ontologies.

Computer Systems↗

PubMed2001

DIAMED: a probabilistic diagnostic aid system on the web.

DIAMED is a system to assist the physicians in the diagnostic process using probabilistic networks as knowledge representation. These networks make it possible to reason on medical data by applying Bayesian methods and to take into account uncertainties of the facts in the resolution of the clinical cases. The proposed model re-uses knowledge contained in an existing knowledge base (ADM). An interface of DIAMED developed on a Web server remotely assists the experts of each medical specialty in updating and validating the knowledge base. Most of the data processing is automated while being based on information preexistent in the ADM base : Constitution of lexicons starting from the existing dictionaries of the ADM system, are then used to work out the requests for selection and update of the knowledge base. One of its assets resides in its pseudo-segmented structure in several layers. The propagation of information is thus limited to only one part of the probabilistic network and calculations are therefore limited.

Artificial Intelligence↗

PubMed2001

A cognitive approach for designing a computer-based learning tool in dentistry: ODONTOS application.

This work emphasises a cognitive approach to build ODONTOS, a computer-based education system in dentistry. It aims at providing for both instructors and students without any particular knowledge in computer programming; a tool dedicated to dental disease learning. For instructors, it implements for knowledge construction e.g. creating and proposing clinical cases according to student learning style, using multimedia technology. For students it is a tool, which privileges their learning style in order to solve uniform and inflexible learning problem. World Wide Web (WWW) technology has allowed us to offer flexible learning program without any pressure of time and place to student. 13 instructors and 84 students tested the ODONTOS prototype via Internet and answered to the questions related to their habit regarding learning style for the students and knowledge construction for the instructors. Although video data have emerged as an important learning support for the students (82 out of 84), their use in knowledge construction still remains unusual comparative with the use of text and picture (10 out of 13 instructors). It appears that, the integration of video data should be more used by instructors (2 out of 13) while textual data are overwhelmingly used in knowledge construction (13 out of 13). We introduce ODONTOS, and discuss the concrete contributions of this work.

Cognition↗

PubMed2001

Design of a CSCL environment for clinical reasoning learning and problem-based learning in medicine.

The medical curriculum is changing, student-centered learning is currently used in medical schools. Problem-based Learning and Clinical Reasoning Learning develop the students' reasoning strategies. CSCW (Computer-Supported Cooperative Work) technology is used in Problem-Based Learning systems. We have designed a CSCL (Computer-Supported Collaborative Learning) environment for improving group coordination and communication in Clinical Reasoning Learning sessions. To support these new educative technologies, a prototype has been developed.

Clinical Medicine↗

PubMed2001

Sharing medical data for patient path analysis with data mining method.

The Agora Data project started in October 1997 in France. The objective was to share medical data between several medical institutions to analysis medical care pathways for patients that suffer from low back pain. The analysis of the medical records decomposed in three steps allowed us to produce knowledge on medical contacts of patients with the health care system. In order to study the relations between these contacts, we created medical path of patients within the framework of the possible contacts we had isolated. This work relates the implementation and the first results of the pilot study.

Confidentiality↗

PubMed2000

HIV/AIDS epidemic in French Guiana: 1979-1997. Groupe d'Etude Clinique de l'Infection VIH en Guyane Française.

The incidence of AIDS in French Guiana remains one of the highest in Latin America and the Caribbean. The annual AIDS incidence rate increased continually from the start of the epidemic until 1995, when it reached 59.3/100,000 population declining thereafter to 26.6 in 1997. The prevalence of HIV in pregnant women was 0.9% in 1993, increasing to 1.3% in 1995, and that in individuals attending sexually transmitted disease (STD) clinics was 2.1% in 1996. We included 224 patients in a study of survival after AIDS diagnosis. The principal AIDS-defining diagnosis was tuberculosis in 20.5% of reported cases. The median duration of survival was 10.2 months. Multivariate analysis showed that, patients > or = 45 years at entry progressed more rapidly to AIDS than younger patients. HIV prevention and access to health care should be developed in the various ethnic communities and adapted to cultural status. The progressive implementation of multiple antiretroviral therapies since 1996 may further reduce progression of the disease but early HIV diagnosis is required to improve the overall prognosis of HIV-infected patients.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Radiology on Internet: advice in consulting websites and evaluating their quality.

Services offered by Internet are increasing continually and 15,000 medical websites covering all the specialties are available presently. Finding relevant information with a spider-web organization is difficult. We recommend starting with hierarchical lists which propose a selection of sites corresponding to medical specialties. We give our selection of important radiological websites dealing with image databases, case reports, radioanatomy and continuing medical education. While surfing the Web, an evaluation of the quality of websites is necessary. We used quality criteria proposed by Darmoni to rate the quality of ten websites. The global quality is good; help pages and external links are the main noticed shortcomings. All webmasters should pay attention to quality criteria and show visible marks of Darmoni criteria on their home page. To be able to foresee which Internet options should be developed, we evaluated our website and sent a questionnaire to our users. Clinical cases are the most requested facilities; they could be used for continuing medical education.

Anatomy↗

PubMed2000

Knowledge acquisition to qualify Unified Medical Language System interconceptual relationships.

Adding automatically relations between concepts from a database to a knowledge base such as the Unified Medical Language System can be very useful to increase the consistency of the latter one. But the transfer of qualified relationships is more interesting. The most important interest of these new acquisitions is that the UMLS became more compliant and medically pertinent to be used in different medical applications. This paper describes the possibility to inherit automatically medical inter-conceptual relationships qualifiers from a disease description included into a database and to integrate them into the UMLS knowledge base. The paper focuses on the transmission of knowledge from a French medical database to an English one.

Artificial Intelligence↗

PubMed1999

CARDIOMEDIA: a communicable multimedia medical record on Intranet and digital optical memory card.

As part of French health reform, French physicians were computerised by the end of 1998. A specific Intranet network will be used to communicate medical data between the health professionals. The objectives of the CARDIOMEDIA project were to develop and evaluate the feasibility of a coronary multimedia data record stored on an optical card and communicable on Intranet within the hospital. Patients treated by angioplasty at the University Hospital of Rennes participated in the experiment. In general, patients are treated in the University Hospital and are followed up by another health care provider closer to their home. The patient leaves the University Hospital with his card, which is directly available elsewhere for emergency or for consultation. This approach is assumed to reduce the number of examinations and to offer a better patient follow-up. The CARDIOMEDIA card is a specialised record including various data types: text, images, image sequences of coronarography and ECG signals. For this purpose an optical card with its large memory is very convenient. We used the DICOM format for image exchange and management. It is combined with CARDIOMEDIA specific compressing software. For the multimedia record the HTML format and web Intranet method are chosen. This provides an intuitive interface which can combine various data types and helper applications like a DICOM image viewer.

Angioplasty↗

PubMed1999

A computer-assisted drug prescription system: the model and its implementation in the ATM knowledge base.

Informatisation of drug prescription is an important topic in medical informatics. For several years now, computerized drug databases have been implemented. Usually only a small part of the prescriptions can be stored in prescription systems because of the format of the included information; prescriptions contain essentially free text without any structure and homogeneity of the used vocabulary. In this article a model is presented for knowledge representation in a computerized drug prescription system. The model should be applicable to clinical practice and be didactic for medical students. The problem of standardization of terminology had to be solved. A computer-assisted drug prescription program has been developed. The next step is its validation by clinicians. The program can also be used in a consultation mode.

Database Management Systems↗

PubMed1999

[Web radiology servers: advices for users, their development and evaluation of the quality of sites].

Sites available on the Internet are constantly increasing and over 15,000 medical websites covering all medical sub-specialties are now available. Finding relevant information on the web may be time consuming and difficult. We suggest that new users begin by accessing servers where lists of available sites are grouped under headings such as medical sub-specialties. We will list a selection of useful radiological websites providing image databases, case reports, radiological anatomy and continuing medical education. While surfing on the web, an evaluation of the quality of the websites is necessary. We used the quality criteria proposed by Darmoni to rate the quality of ten websites. The overall quality was good, but the lack of help options and external links were the main pitfalls that we noted. All webmasters should pay attention to quality criteria and show the Darmoni criteria on their homepage. In order to evaluate which internet options should be developed, we evaluated our own website and submitted a questionnaire to our users. Clinical cases were the most requested feature, they could be used for continuing medical education.

Computer-Assisted Instruction↗

PubMed1999

A method for an automated decomposition of a complex term into its conceptual components.

The paper deals with the improvement of the MAOUSSC model (Modèle d'Aide et d'Orientation d'un Utilisateur au Sein des Systèmes de Codage) and system. Its specific purpose is the automation of the description of medical and surgical procedures. We have developed an automatic decomposition method using a linguistic and conceptual approach based on the UMLS knowledge base. This work concerns the processing of 100 procedure wordings from the digestive surgery domain. We introduce a prototype of such a system automating the decomposition through a web interface.

Artificial Intelligence↗

PubMed1999

Automatic enrichment of the unified medical language system starting from the ADM knowledge base.

The Unified Medical Language System (UMLS) project aims to provide a repository of terms, concepts and relationships from several medical classifications. This work describes the possibility to enrich automatically with meaningful links the UMLS database by using description of diseases from another knowledge base, in our case ADM (Aide au Diagnostic Medical). In spite of the constraints and the difficulties to qualify the interconcept links, the results show that it is possible to find and create new links from a french knowledge database to the UMLS one. One of the interests of this work is that the automated learning of the connections could be used with others knowledge databases like expert system databases.

Algorithms↗

PubMed1998

An interactive 3D anisotropic cellular automata model of the heart.

A 3D cellular anisotropic automata model with modifiable geometry is described. The modeling parameters include grain size, fiber orientation, and free-wall and septal thickness. From this modifiable model, three specific models corresponding to normal heart, left ventricular hypertrophy, and ventricular dilatation were generated. Each model is a conduction and propagation model in which the atria, the major atrial vessel bases, the ventricles, and the specialized conduction system are represented. Muscle tissues are modeled as bundles of fibers with anisotropic conduction speed of the activation wavefronts. Regional variations of conduction, refractory gradients, and regional potential gradients can also be specified before each simulation. Each element has adaptive properties with respect to cycle length and to the prematurity of incoming impulses. Action potentials can be specified for each cell and an equivalent source formulation is carried out to simulate the vectorcardiogram and the corresponding 12-standard-lead electrocardiogram.

Arrhythmias, Cardiac↗

PubMed1998

A collaborative approach to building a terminology for medical procedures using a Web-based application: from specifications to daily use.

The MAOUSSC (Model for Assistance in the Orientation of a User within Coding Systems) Web server supports a collaborative work on the description of medical procedures. The specifications for the MAOUSSC application are conceptual modeling, definition of semantically fully described procedures, re-use of an existing vocabulary, the UMLS, and sharability. This paper reports on some difficulties in applying those principles in a networked building and updating of the terminology. The users are physicians who have to represent procedure terms in the MAOUSSC formalism. They must apply the constraints of the underlying model, and re-use the representation of the UMLS knowledge base. In our experience, we found that the implementation of syntactic and semantic constraints was not sufficient. Guidelines for pragmatical aspects in representation are required to make a collaborative approach in terminology building more operational.

Humans↗

PubMed1998

A virtual university Web system for a medical school.

This paper describes a Virtual Medical University Web Server. This project started in 1994 by the development of the French Radiology Server. The main objective of our Medical Virtual University is to offer not only an initial training (for students) but also the Continuing Professional Education (for practitioners). Our system is based on electronic textbooks, clinical cases (around 4000) and a medical knowledge base called A.D.M. ("Aide au Diagnostic Medical"). We have indexed all electronic textbooks and clinical cases according to the ADM base in order to facilitate the navigation on the system. This system base is supported by a relational database management system. The Virtual Medical University, available on the Web Internet, is presently in the process of external evaluations.

Computer-Assisted Instruction↗

PubMed1998

[The virtual university in medicine. Context, concepts, specifications, users' manual].

The widespread use of Web servers, with the emergence of interactive functions and the possibility of credit card payment via Internet, together with the requirement for continuing education and the subsequent need for a computer to link into the health care network have incited the development of a virtual university scheme on Internet. The Virtual University of Radiology is not only a computer-assisted teaching tool with a set of attractive features, but also a powerful engine allowing the organization, distribution and control of medical knowledge available in the www.server. The scheme provides patient access to general information, a secretary's office for enrollment and the Virtual University itself, with its library, image database, a forum for subspecialties and clinical case reports, an evaluation module and various guides and help tools for diagnosis, prescription and indexing. Currently the Virtual University of Radiology offers diagnostic imaging, but can also be used by other specialties and for general practice.

Computer-Assisted Instruction↗

PubMed1998

[Analysis of medical catalog terms using the MAOUSSC model: application to Gyncecology-Obstetrics].

BACKGROUND: The Model of Assistance and Orientation of a User within a System of Coding (MAOUSSC) used to describe activity in human medicine was used to analyse French medical nomenclature in Gynecology and Obstetrics. METHODS: French medical nomenclature for gynecology and obstetrics was translated with the multiaxial model (MAOUSSC) to allow critical analysis. RESULTS: All the 119 medical acts in the French nomenclature involving the female genital tract and obstetrics could be translated with the model. 24% of the acts were imprecise, ambiguous or implicit: the nature of the procedure was not explicit in 7 cases, the surgical route was not given in 86 and the surgical instrumentation not named in 75. Activities involving numerous medical specialties and ambulatory activity can be described with the MOUSSC model. CONCLUSION: The MAOUSSC model is still in the experimental stage. It is however easy to implement, has a high potential for describing various medical acts and is suitable for the description of gynecological and obstetrical activity both in terms of economical and medical efficacy.

Computer Simulation↗