Biomedical subjects

Wanda Pratt

Publications and source records attributed to Wanda Pratt.

8 recordsLinked to original sources

PubMed2006

Patients as actors: the patient's role in detecting, preventing, and recovering from medical errors.

PURPOSE: Patients have the most to gain from reducing medical errors; yet, little research has been done to investigate the role they could or already do play in detecting and preventing errors in their own health care. The purpose of this study is to examine patient's role in detecting, preventing, and recovering from medical errors in outpatient oncology. METHODS: In this paper, we use cognitive work analysis and Rasmussen's taxonomy of human performance to describe five cases of medical errors that occurred in an outpatient, cancer-care setting. We detail the role of the patient in each case, and analyze each role using constructs from previous studies of human behavior and errors. RESULTS: Observational data indicates that patients engage in a range of tasks that identify, prevent, and recover from medical errors in outpatient cancer care. The results of this study point to the importance of considering patients and their work in both the design of patient-care information systems and the structure of clinical-care environments that enable safe and effective health care.

Ambulatory Care↗

PubMed2006

Using statistical and knowledge-based approaches for literature-based discovery.

The explosive growth in biomedical literature has made it difficult for researchers to keep up with advancements, even in their own narrow specializations. While researchers formulate new hypotheses to test, it is very important for them to identify connections to their work from other parts of the literature. However, the current volume of information has become a great barrier for this task and new automated tools are needed to help researchers identify new knowledge that bridges gaps across distinct sections of the literature. In this paper, we present a literature-based discovery system called LitLinker that incorporates knowledge-based methodologies with a statistical method to mine the biomedical literature for new, potentially causal connections between biomedical terms. We demonstrate LitLinker's ability to capture novel and interesting connections between diseases and chemicals, drugs, genes, or molecular sequences from the published biomedical literature. We also evaluate LitLinker's performance by using the information retrieval metrics of precision and recall.

Abstracting and Indexing↗

PubMed2005

The effect of feature representation on MEDLINE document classification.

This work explores the effect of text representation techniques on the overall performance of medical text classification. To accomplish this goal, we developed a text classification system that supports the very basic word representation (bag-of-words) and the more complex medical phrase representation (bag-of-phrases). We also combined word and phrase representations (hybrid) for further analysis. Our system extracts medical phrases from text by incorporating a medical knowledge base and natural language processing techniques. We conducted experiments to evaluate the effects of different representations by measuring the change in classification performance with MEDLINE documents from the OHSUMED dataset. We measured classification performance with information retrieval metrics; precision (p), recall (r), and F1-score (F1). In our experiments, we achieved better classification performance with the hybrid approach (p=0.87, r=0.46, F1=0.60) compared to the bag-of-words approach (p=0.85, r=0.44, F1=0.58) and the bag-of-phrases approach (p=0.87, r=0.42, F1=0.57).

Abstracting and Indexing↗

PubMed2004

Technology, work, and information flows: lessons from the implementation of a wireless alert pager system.

The combination of collaborative work practices and information technology affect the flow of information in clinical settings. The introduction of a new technology into these settings can change not only established work practices but also the information flows. In this paper, we examine the introduction of a wireless alerts pager in a surgical intensive care unit (SICU). Through a qualitative study, we analyze the effects that this new information tool had on both the work practices in the SICU and the information flow in the unit. We describe four challenges that SICU staff members faced with respect to the alerts pagers. We found that the pager provided new routes of information to SICU staff but in doing so disrupted existing work practices and information flows.

Attitude of Health Personnel↗

PubMed2004

Incorporating ideas from computer-supported cooperative work.

Many information systems have failed when deployed into complex health-care settings. We believe that one cause of these failures is the difficulty in systematically accounting for the collaborative and exception-filled nature of medical work. In this methodological review paper, we highlight research from the field of computer-supported cooperative work (CSCW) that could help biomedical informaticists recognize and design around the kinds of challenges that lead to unanticipated breakdowns and eventual abandonment of their systems. The field of CSCW studies how people collaborate with each other and the role that technology plays in this collaboration for a wide variety of organizational settings. Thus, biomedical informaticists could benefit from the lessons learned by CSCW researchers. In this paper, we provide a focused review of CSCW methods and ideas-we review aspects of the field that could be applied to improve the design and deployment of medical information systems. To make our discussion concrete, we use electronic medical record systems as an example medical information system, and present three specific principles from CSCW: accounting for incentive structures, understanding workflow, and incorporating awareness.

Artificial Intelligence↗

PubMed2003

A study of biomedical concept identification: MetaMap vs. people.

Although huge amounts of unstructured text are available as a rich source of biomedical knowledge, to process this unstructured knowledge requires tools that identify concepts from free-form text. MetaMap is one tool that system developers in biomedicine have commonly used for such a task, but few have studied how well it accomplishes this task in general. In this paper, we report on a study that compares MetaMap's performance against that of six people. Such studies are challenging because the task is inherently subjective and establishing consensus is difficult. Nonetheless, for those concepts that subjects generally agreed on, MetaMap was able to identify most concepts, if they were represented in the UMLS. However, MetaMap identified many other concepts that peo-ple did not. We also report on our analysis of the types of failures that MetaMap exhibited as well as trends in the way people chose to identify concepts.

Abstracting and Indexing↗

PubMed2003

Challenges to physicians' use of a wireless alert pager.

Pagers, personal data assistants (PDAs) and other devices that have wireless connectivity are becoming a popular method for delivering patient related information to medical decision makers. Although medical informatics research has emphasized the design, and implementation of pagers as event notification mechanisms, researchers have not paid as much attention to how this technology impacts medical work. We present a case study of physicians in a Surgical Intensive Care Unit (SICU) using wireless alert pagers. The pagers provide a variety of alphanumeric clinical alert messages and are widely used by SICU physicians. However, the use of the pagers has created unanticipated challenges to the physicians' traditional work practices. These challenges include: (1) flattening of hierarchical workflows, (2) coping with information overload and missing context, and (3) lack of feedback. These challenges are tied to both the specific technical design of the system and the traditional structure of medical work.

Attitude of Health Personnel↗

PubMed2002

Asking questions: information needs in a surgical intensive care unit.

Even in the information-rich environment of hospitals, health-care providers face challenges in addressing their various information needs. Through a study of a patient-care team in a tertiary care Surgical Intensive Care Unit (SICU), we expanded our understanding of health-care providers' information needs in two important ways. First, the study focused on a patient-care team instead of individual health-care providers. Second, information needs were examined in a particular organizational setting, the SICU, which had not been previously studied. We found that organizational information was extremely important to SICU team members. Furthermore, the first resource that team members utilized was not electronic or paper but rather human: another team member.

Humans↗