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R Cornet

Publications and source records attributed to R Cornet.

14 recordsLinked to original sources
PubMed2006

A framework for characterizing terminological systems.

OBJECTIVES: The notion of a terminological system (TS) is complex due to the broad range of systems, applications, and clinical domains. A uniform approach to describe the characteristics of TSs is lacking. This impedes furthering understanding, applicability, mutual comparison and development of TSs. For these reasons we propose a terminological systems characterization framework. METHODS: Relevant issues pertaining to TSs and terminology servers have been extracted from literature describing requirements and functionality of TSs. From these issues, features have been distilled and further refined. A categorization has been developed to provide a convenient arrangement of these features. RESULTS: The framework distinguishes between application-dependent and application-independent features of TSs. Definitions are provided for measures of content coverage, which was identified as the only application-dependent feature. Application-independent features are categorized along two axes: their respective type of TS and the particular element within that system, i.e. the formalism, the content, or the functionality. For each feature we provide an explicit question, the answer to which yields a feature value. The framework has been applied to SNOMED CT and the CLUE browser. CONCLUSIONS: We present and apply a framework to support a feature-based characterization of terminological systems. Standardized methods for content coverage studies reduce the effort of assessing the applicability of a TS for a specific clinical setting. A two-axial categorization provides a convenient arrangement of the large number of application-independent features. Application of the framework increases comparability of terminological systems. This framework may also help TS developers determine how their system can be improved.

Medical Informatics Applications↗
PubMed2005

Methods for evaluation of medical terminological systems--a literature review and a case study.

OBJECTIVES: The usability of terminological systems (TSs) strongly depends on the coverage and correctness of their content. The objective of this study was to create a literature overview of aspects related to the content of TSs and of methods for the evaluation of the content of TSs. The extent to which these methods overlap or complement each other is investigated. METHODS: We reviewed literature and composed definitions for aspects of the evaluation of the content of TSs. Of the methods described in literature three were selected: 1) Concept matching in which two samples of concepts representing a) documentation of reasons for admission in daily care practice and b) aggregation of patient groups for research, are looked up in the TS in order to assess its coverage; 2) Formal algorithmic evaluation in which reasoning on the formally represented content is used to detect inconsistencies; and 3) Expert review in which a random sample of concepts are checked for incorrect and incomplete terms and relations. These evaluation methods were applied in a case study on the locally developed TS DICE (Diagnoses for Intensive Care Evaluation). RESULTS: None of the applied methods covered all the aspects of the content of a TS. The results of concept matching differed for the two use cases (63% vs. 52% perfect matches). Expert review revealed many more errors and incompleteness than formal algorithmic evaluation. CONCLUSIONS: To evaluate the content of a TS, using a combination of evaluation methods is preferable. Different representative samples, reflecting the uses of TSs, lead to different results for concept matching. Expert review appears to be very valuable, but time consuming. Formal algorithmic evaluation has the potential to decrease the workload of human reviewers but detects only logical inconsistencies. Further research is required to exploit the potentials of formal algorithmic evaluation.

Evaluation Studies as Topic↗
PubMed2002

Usability of expressive description logics--a case study in UMLS.

Research in (medical) terminological knowledge representation is showing an increased interest in the family of Description Logics (DLs), as they allow for automatic reasoning. This interest is driven by an increase in demands on the quality of and reasoning ability with medical terminological knowledge. Recent advances in Computer Science have demonstrated the computational decidability and empirical tractability of quite expressive DLs. The question arises whether this expressivity is usable and useful. This paper motivates and describes an exploratory study to address this question by examining the surplus value of individual DL constructors based on an investigation of UMLS terms. Our study indicates that the disjunction and negation operators comprise very valuable extensions to current DLs. The impact of formalization depends on the involved semantic type; "Injury and Poisoning" is one of the semantic types in which a large portion of concepts will benefit from the extension.

Logic↗
PubMed2002

Software engineering in medical informatics: the academic hospital as learning environment.

In 2001, the revised course Software Engineering has been implemented in the Medical Informatics curriculum at the Academic Medical Center, Amsterdam. This 13 weeks, full-time course consists of three parts: internship, theory and project. All parts are provided in problem-oriented manner with special attention for relevant skills such as project management, documentation and presentation. During the internship, students observe how health care professionals at several hospital wards work and how information supply is organized. In the theory part, students study concepts and methods of software engineering by means of case descriptions and self-directed learning. During the project, they apply their acquired knowledge to an observed, clinical information problem and complete several stages of the software engineering process. Evaluation by inquiry showed that, compared to other courses, students spent more time, and distributed their time more evenly, during the whole period of the course. In conjunction with theory, a combination of internship and project in a hospital seems to provide a surplus value compared to a practical in a computer laboratory. The integration of software theory, clinical practice and problem-based approach, contributed to the enthusiastic, intensive and realistic way students learned in this important topic that might be chosen as a future profession.

Curriculum↗
PubMed2001

Renal replacement therapy in Europe: the results of a collaborative effort by the ERA-EDTA registry and six national or regional registries.

BACKGROUND: In June 2000 a new ERA-EDTA Registry Office was opened in Amsterdam. This Registry will only collect core data on renal replacement therapy (RRT) through national and regional registries. This paper reports the technical and epidemiological results of a pilot study combining the data from six registries. METHODS: Data from the national renal registries of Austria, Finland, French-Belgium, The Netherlands, Norway, and Scotland were combined. Patients starting RRT between 1980 and 1999 (n=57371) were included in the analyses. Cox proportional hazards regression was used to predict survival. RESULTS: The use of different coding systems for ESRD treatment by the registries made it difficult to merge the data. Incidence and prevalence of RRT showed a continuous increase with a marked variation in rates between countries. The 2-, 5- and 10-year patient survival was 67, 35 and 11% in dialysis patients and 90, 81 and 64% after a first renal allograft. Multivariate analysis showed a slightly better survival on dialysis in the 1990-1994 (RR 0.94, 95% CI 0.90-0.98) and the 1995-1999 cohort (RR 0.88, 95% CI 0.84-0.92) compared to the 1980-1984 cohort. In contrast, there was a much greater improvement in transplant-patient survival, resulting in a 56% reduction in the risk of death within the 1995-1999 cohort (RR 0.44, 95% CI 0.39-0.50) compared to the 1980-1984 cohort. CONCLUSIONS: This study provides support for the feasibility of a "new style" ERA-EDTA registry and the collection of data is now being extended to other countries. The improvement in patient survival over the last two decades has been much greater in transplant recipients than in dialysis patients.

Austria↗
PubMed2000

Evaluation of DICE, a terminological system for intensive care.

Evaluative research and the introduction of the Patient Data Management System to support care have increased the need for structured and standardized registration of diagnostic information in Dutch intensive cares (IC). To this end a terminological system to describe diagnoses is needed. A terminological system is a system that denotes terms to concepts in a domain based on specifications of these concepts. During the last two years we have developed DICE (Diagnoses for Intensive Care Evaluation), a terminological system application which includes knowledge about the IC diagnoses domain, such as the anatomical localization, the pathophysiology and the etiology. This paper briefly describes the design of DICE and focus on the preliminary evaluation of DICE. DICE was evaluated on the basis of 126 diagnoses collected. The knowledge modeller as well as the intensivists judged DICE positively. However, there were some points for improvement. The knowledge modeller observed a problem in modelling dependencies between qualifiers of a concept and the intensivists observed some gaps in the knowledge base and were critical about the current interface to compose plural operative procedures.

Critical Care↗
PubMed1999

Analysis and design of an ontology for intensive care diagnoses.

Information about the patient's health status and about medical problems in general, play an important role in stratifying a patient population for quality assurance of intensive care. A terminological system which supports both the description of health problems for daily care practice and the aggregation of diagnostic information for evaluative research, is desirable for description of the patient population. This study describes the engineering of an ontology that facilitates a terminological system for intensive care diagnoses. We analyzed the criteria for such an ontology and evaluated existing terminological systems according to these criteria. The analysis shows that none of the existing terminological systems completely satisfies all our criteria. We describe choices regarding design, content and representation of a new ontology on which an adequate terminological system is based. The proposed ontology is characterized by the explicit and formal representation of the domain model, the metaspecification of its concepts, the vocabulary to define concepts and the nomenclature to support the composition of new concepts.

Diagnosis, Computer-Assisted↗
PubMed1995

Problems with integrating legacy systems.

The economic and organizational impact of imposing state-of-the-art technology to the large number of proprietary legacy systems operational in most hospitals requires integrated clinical professional workstations to provide flexible encapsulation mechanisms for these systems rather than reengineering these systems to this new technology. In this paper the implications of different input/output and translation models of legacy systems for their integration into a clinical workstation is described. Examples of legacy systems that have been integrated in the HERMES clinical workstation are presented as examples of the range of difficulties one might encounter. The features that an integrated workstation should offer for integrating a broad range of legacy systems are also addressed in this paper.

Computer Systems↗
PubMed1994

HERMES: a health care workstation integration architecture.

An architecture is described that facilitates integration of existing databases and applications without modifying them. By means of this architecture, data from different sources dispersed in a network can be combined and directly used in existing applications or applications that have been developed specially for integration. This feature of combining data from different sources into one workstation is viewed as the enabling technology on which computer-based patient records can be built. The abstraction of computer-, network- and application-specific details is completely dealt with by the integration architecture. This integration architecture has been developed with extendibility and flexibility in mind, and allows for a growth-path towards application of the open system paradigm in medicine.

Computer Communication Networks↗
PubMed1994

A cooperative model for integration in a cardiology outpatient clinic.

With the increasing amount of digitally stored patient information, such as images and findings, the possibility and need arise for a system which is able to both store and display this information in a structured, user-friendly way. In the common situation where different information systems are used within one department, this means that the various information systems have to be integrated. However, integration requires more complex management of data, processes and windows. This management can be handled by a Workspace Manager, which controls inter-application tasks, and interaction with the user. Furthermore, this Workspace Manager supports the user with the definition of complex tasks such as collecting problem-related patient information from the various remote systems. In an outpatient clinic for cardiology this architecture is used to achieve cooperative integration of an open Computer Patient Record with a range of information-specific services.

Ambulatory Care Facilities↗
PubMed1983

[Not Available].

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Belgium↗