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Biomedical subjects

W Hersh

Publications and source records attributed to W Hersh.

At least 19 recordsLinked to original sources
PubMed2001

Selective automated indexing of findings and diagnoses in radiology reports.

The recent improvements in capabilities of desktop computers and communications networks give impetus for the development of clinical image repositories that can be used for patient care and medical education. A challenge in the use of these systems is the accurate indexing of images for retrieval performance acceptable to users. This paper describes a series of experiments aiming to adapt the SAPHIRE system, which matches text to concepts in the UMLS Metathesaurus, for the automated indexing of image reports. A series of enhancements to the baseline system resulted in a recall of 63% but a precision of only 30% in detecting concepts. At this level of performance, such a system might be problematic for users in a purely automated indexing environment. However, if the ability to retrieve images in repositories based on content in their reports is desired by clinical users, and no other current systems offer this functionality, then follow-up research questions include whether these imperfect results would be useful in a completely or partially automated indexing environment and/or whether other approaches can improve upon them.

Abstracting and Indexing↗
PubMed2001

Knowledge integration: insight through the E-portal.

Data become information when they can be summarized and organized into logical patterns; information becomes knowledge when it can be manipulated for actionable decision making; knowledge becomes insight when contextually relevant and temporarily appropriate. This article describes how information technology can now be used to provide clinicians with access to both insight and information that is context- and event-sensitive. Collaboration between the American College of Physicians, medical knowledge experts, Oregon Health Sciences University (OHSU), and shared medical systems for framework and infrastructure combine to create the ideal environment of complementary and synergistic competencies. This article describes the research that is under way at OHSU to determine how to deploy medical knowledge derived from these sources and integrate it into the clinical workflow; it also examines a vision of how medical knowledge can be integrated in the future.

Education, Medical, Continuing↗
PubMed2001

Implementation and evaluation of a distance learning introductory course in medical informatics.

CONTEXT: There is a growing interest in and need for continuing education in medical informatics delivered by distance learning. OBJECTIVES: Implement and evaluate a distance learning introductory course in medical informatics. METHODS: A Web-based version of our on-campus "Introduction to Medical Informatics" course was implemented using streaming audio lectures, threaded discussion boards, and several other teaching modalities. Evaluation was performed using an adaptation of our on-campus course evaluation instrument. RESULTS: The course was implemented with no major technological or pedagogical problems. Student satisfaction with teaching modalities and other course modalities was high. CONCLUSIONS: The learning technologies used in this course were implemented successfully and a Graduate Certificate Program is planned to further meet educational needs in medical informatics.

Education, Distance↗
PubMed2000

Assessing thesaurus-based query expansion using the UMLS Metathesaurus.

OBJECTIVES: Assess query expansion using thesaurus relationships and definitions in the UMLS Metathesaurus for improving searching performance. METHODS: The queries from a MEDLINE test collection (OHSUMED) were expanded using synonym, hierarchical, and related term information as well as term definitions from the UMLS Metathesaurus. Documents were retrieved from a word-statistical retrieval system and assessed for recall and precision based on relevance judgments from the test collection. RESULTS: All types of query expansion degraded aggregate retrieval performance as measured by recall and precision, although 38.6% of the queries with synonym expansion and up to 29.7% of the queries with hierarchical expansion showed improvement. CONCLUSIONS: Thesaurus-based query expansion causes a decline in retrieval performance generally but improves it in specific instances. Further research must focus on identifying instances where performance improves and how it can be exploited by real users.

Information Storage and Retrieval↗
PubMed2000

Distance learning techniques for medical informatics

A growing number of health care professionals (e.g., physicians, nurses, librarians, and administrators) desire to enhance their skills and knowledge in medical informatics. These individuals are usually in established careers with limited time as well as inability to relocate to one of the small number of health science universities which offer informatics training. As a result of inquiries about distance learning in medical informatics and a market survey which documented and detailed such interest, a distance learning program was launched by the medical informatics program at Oregon Health Sciences University (OHSU). In the 1999-2000 academic year, two graduate-level medical informatics courses in the OHSU program have been taught by distance learning. In the 2000-2001 academic year, an eight-course certificate program will be launched. Further information can be found at: http://www. ohsu.edu/bicc-informatics/distance/

Journal Article↗
PubMed1999

"A world of knowledge at your fingertips": the promise, reality, and future directions of on-line information retrieval.

Medical knowledge resources are increasingly available in electronic form, particularly on the World Wide Web. The promise of this medium is that it offers a vast "world of knowledge at your fingertips." The reality, however, is somewhat different, as information systems are not well integrated into clinical practice, prove difficult to find specific information in, and contain content of varying quality. The continued evolution of the medium in the future should, however, be beneficial, as synthesized evidence-based resources become available and these resources are integrated into electronic medical record systems.

Education, Medical↗
PubMed1999

The quality of information on the World Wide Web.

How can a healthcare provider or patient evaluate the quality of information available on the Internet? The credibility and interests of the host should be considered and a filter that screens sites might help. In the end, however, there is no substitute for the experience of a qualified practitioner.

Dentistry↗
PubMed1999

Maintaining a catalog of manually-indexed, clinically-oriented World Wide Web content.

With no quality controls and a highly distributed means of posting information, finding high-quality, clinically-oriented content on the World Wide Web can be difficult. Maintaining a catalog of such information can be equally challenging. CliniWeb is a catalog of quality-filtered and clinically-oriented content on the Web designed to enhance access to such information. This paper describes a group of semi-automated tools have been developed to maintain the CliniWeb database. One allows easier identification of content by utilizing Web crawling techniques from high-level pages. Another allows easier selection of content for inclusion and its indexing. A final one checks links to help keep the database current. These are augmented by general plans to adopt more detailed metadata and linkages into the medical literature.

Abstracting and Indexing↗
PubMed1999

Automated semantic indexing of imaging reports to support retrieval of medical images in the multimedia electronic medical record.

This paper describes preliminary work evaluating automated semantic indexing of radiology imaging reports to represent images stored in the Image Engine multimedia medical record system at the University of Pittsburgh Medical Center. The authors used the SAPHIRE indexing system to automatically identify important biomedical concepts within radiology reports and represent these concepts with terms from the 1998 edition of the U.S. National Library of Medicine's Unified Medical Language System (UMLS) Metathesaurus. This automated UMLS indexing was then compared with manual UMLS indexing of the same reports. Human indexing identified appropriate UMLS Metathesaurus descriptors for 81% of the important biomedical concepts contained in the report set. SAPHIRE automatically identified UMLS Metathesaurus descriptors for 64% of the important biomedical concepts contained in the report set. The overall conclusions of this pilot study were that the UMLS metathesaurus provided adequate coverage of the majority of the important concepts contained within the radiology report test set and that SAPHIRE could automatically identify and translate almost two thirds of these concepts into appropriate UMLS descriptors. Further work is required to improve both the recall and precision of this automated concept extraction process.

Abstracting and Indexing↗
PubMed1998

Information retrieval at the millenium.

Information retrieval systems were among the first medical informatics applications, yet their use has changed substantially in this decade with the growth of end-user computers and the Internet. While early challenges revolved around how to increase the amount of information available in electronic form, more recent challenges center on how to manage the growing volume. Traditional information retrieval issues--such as how to organize and index information to make it more retrievable as well as how to evaluate the effectiveness of systems--are still as pertinent as ever.

Abstracting and Indexing↗
PubMed1998

MCM generator: a Java-based tool for generating medical metadata.

In a previous paper we introduced the need to implement a mechanism to facilitate the discovery of relevant Web medical documents. We maintained that the use of META tags, specifically ones that define the medical subject and resource type of a document, help towards this goal. We have now developed a tool to facilitate the generation of these tags for the authors of medical documents. Written entirely in Java, this tool makes use of the SAPHIRE server, and helps the author identify the Medical Subject Heading terms that most appropriately describe the subject of the document. Furthermore, it allows the author to generate metadata tags for the 15 elements that the Dublin Core considers as core elements in the description of a document. This paper describes the use of this tool in the cataloguing of Web and non-Web medical documents, such as images, movie, and sound files.

Cataloging↗
PubMed1998

Towards knowledge-based retrieval of medical images. The role of semantic indexing, image content representation and knowledge-based retrieval.

Medicine is increasingly image-intensive. The central importance of imaging technologies such as computerized tomography and magnetic resonance imaging in clinical decision making, combined with the trend to store many "traditional" clinical images such as conventional radiographs, microscopic pathology and dermatology images in digital format present both challenges and an opportunities for the designers of clinical information systems. The emergence of Multimedia Electronic Medical Record Systems (MEMRS), architectures that integrate medical images with text-based clinical data, will further hasten this trend. The development of these systems, storing a large and diverse set of medical images, suggests that in the future MEMRS will become important digital libraries supporting patient care, research and education. The representation and retrieval of clinical images within these systems is problematic as conventional database architectures and information retrieval models have, until recently, focused largely on text-based data. Medical imaging data differs in many ways from text-based medical data but perhaps the most important difference is that the information contained within imaging data is fundamentally knowledge-based. New representational and retrieval models for clinical images will be required to address this issue. Within the Image Engine multimedia medical record system project at the University of Pittsburgh we are evolving an approach to representation and retrieval of medical images which combines semantic indexing using the UMLS Metathesuarus, image content-based representation and knowledge-based image analysis.

Abstracting and Indexing↗
PubMed1995

The SAPHIRE server: a new algorithm and implementation.

SAPHIRE is an experimental information retrieval system implemented to test new approaches to automated indexing and retrieval of medical documents. Due to limitations in its original concept-matching algorithm, a modified algorithm has been implemented which allows greater flexibility in partial matching and different word order within concepts. With the concomitant growth in client-server applications and the Internet in general, the new algorithm has been implemented as a server that can be accessed via other applications on the Internet.

Abstracting and Indexing↗
PubMed1995

Information retrieval in medicine: the SAPHIRE experience.

Information retrieval systems are proliferating in biomedical settings, but many problems in indexing, retrieval, and evaluation of systems continue to exist. The SAPHIRE Project was undertaken to seek solutions to these problems. This paper summarizes the evaluation studies that have been done with SAPHIRE, highlighting the lessons learned and laying out the challenges ahead to all medical information retrieval efforts.

Abstracting and Indexing↗
PubMed1994

Use of a multi-application computer workstation in a clinical setting.

The goal of this study was to assess the usage frequency, user satisfaction, and quality of literature searchers for a multi-application computer workstation in a university-based general medicine clinic. A computer with medical literature searching, textbook searching, and a decision-support program was deployed in the workroom of the clinic and made available for routine use. Data were collected for ten months. More than three quarters of the study participants used the computer, with use increasing by level of medical training. Despite physicians' known preferences for nonjournal sources of information, literature searching was the application used most frequently, followed by textbooks and decision support. The literature searches were replicated by experienced clinician and librarian searchers using first full MEDLINE and then text-word-only searching, to compare the quantities of relevant references retrieved. Novice searchers retrieved a larger number of relevant references than did the experienced searchers, but they also retrieved more nonrelevant references. For both groups of experienced searchers, the full MEDLINE feature set conferred little benefit over searching with only text words. These searching results call into question the value of traditional searching methods for both novice and experienced physicians.

Attitude to Computers↗
PubMed1991

Evaluation of SAPHIRE: an automated approach to indexing and retrieving medical literature.

An analysis of SAPHIRE, an experimental information retrieval system featuring automated indexing and natural language retrieval, was performed on MEDLINE references using data previously generated for a MEDLINE evaluation. Compared with searches performed by novice and expert physicians using MEDLINE, SAPHIRE achieved comparable recall and precision. While its combined recall and precision performance did not equal the level of librarians, SAPHIRE did achieve a significantly higher level of absolute recall. SAPHIRE has other potential advantages over existing MEDLINE systems. Its natural language interface does not require knowledge of MeSH, and it provides relevance ranking of retrieved references.

Abstracting and Indexing↗