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Building cross-thesauri with the support of UMLS.

The absence of a robust system of descriptors (cross-thesaurus) hampers the development of combinatorial terminological systems. We developed a tool (I-BROWSE) to produce a cross-thesaurus by analyzing terminological corpora. To facilitate the work of experts and to produce re-usable results, our application interacts via the Internet with the UMLS Knowledge Sources Server. We applied our tool on 2999 dissections on surgical procedures produced in the project GALEN-IN-USE, as a part of the internal Quality Assurance program. Support from UMLS seems mostly promising about descriptors on , , and . Additional assistance can be given to domain experts on less frequent descriptors on pervasive modifiers. We plan to apply our tool also to production of terminological standards in CEN, as a part of a worldwide process of gradual convergence and transformation of coding systems into second-generation systems and terminological services.

Artificial Intelligence↗

Influence of the Digital Anatomist Foundational Model on traditional representations of anatomical concepts.

A principled and logical representation of the structure of the human body has led to conflicts with traditional representations of the same knowledge by anatomy textbooks. The examples which illustrate resolution of these conflicts suggest that stricter requirements must be met for semantic consistency, expressivity and specificity by knowledge sources intended to support inference than by textbooks and term lists. These next-generation resources should influence traditional concept representation, rather than be constrained by convention.

Anatomy↗

MedSynDiKATe--design considerations for an ontology-based medical text understanding system.

MedSynDiKATe is a natural language processor for automatically acquiring knowledge from medical finding reports. The content of these documents is transferred to formal representation structures which constitute a corresponding text knowledge base. The general system architecture we present integrates requirements from the analysis of single sentences, as well as those of referentially linked sentences forming cohesive texts. The strong demands MedSynDiKATe poses to the availability of expressive knowledge sources are accounted for by two alternative approaches to (semi)automatic ontology engineering.

Evaluation Studies as Topic↗

[Historian and physician as researchers of the history of medical sciences].

It can be observed that recently the historiography of medical sciences has anew searched for its own identity and its place among other medical and historical sciences. On the one hand, the researchers in this field are not physicians exclusively any longer but more and more frequently the representatives of other medical professions and professional historians, as well. On the other hand, the major direction of interest to the history of medical sciences, i.e. cultivating the traditions of medical professions and molding the attitudes of environments related with them is not sufficient in the long run. The variety of extra source knowledge, shared in the community of researches, diverse research approaches, hierarchy of problems worth studying and, finally scientific traditions individual research groups derive from have produced a significant ferment in the medical environments. At last disputes have been held, although quite often unofficially during various scientific meetings, on professional qualification of a historian of medical sciences and sometimes on the scope of his or her discipline. The author analyzes in detail the divergence in the features of individual study approaches for both groups and their consequences. The author's standpoint is that it is necessary to be aware of the diverse study approaches and hierarchy of problem eligible for studying to break the distinction and create interdisciplinary units. This will allow an interparadigmatic dialog, a professional division of work and search for the area of common interest, while retaining methodological autonomic features.

Historiography↗

Towards a semantic medical Web: HealthCyberMap's tool for building an RDF metadata base of health information resources based on the Qualified Dublin Core Metadata Set.

BACKGROUND: HealthCyberMap (http://healthcybermap.semanticweb.org/) aims at mapping Internet health information resources in novel ways for enhanced retrieval and navigation. This is achieved by collecting appropriate resource metadata in an unambiguous form that preserves semantics. MATERIAL/METHODS: We modelled a qualified Dublin Core (DC) metadata set ontology with extra elements for resource quality and geographical provenance in Prot g -2000. A metadata collection form helps acquiring resource instance data within Prot g . The DC subject field is populated with UMLS terms directly imported from UMLS Knowledge Source Server using UMLS tab, a Prot g -2000 plug-in. The project is saved in RDFS/RDF. RESULTS: The ontology and associated form serve as a free tool for building and maintaining an RDF medical resource metadata base. The UMLS tab enables browsing and searching for concepts that best describe a resource, and importing them to DC subject fields. The resultant metadata base can be used with a search and inference engine, and have textual and/or visual navigation interface(s) applied to it, to ultimately build a medical Semantic Web portal. Different ways of exploiting Prot g -2000 RDF output are discussed. CONCLUSIONS: By making the context and semantics of resources, not merely their raw text and formatting, amenable to computer 'understanding,' we can build a Semantic Web that is more useful to humans than the current Web. This requires proper use of metadata and ontologies. Clinical codes can reliably describe the subjects of medical resources, establish the semantic relationships (as defined by underlying coding scheme) between related resources, and automate their topical categorisation.

Humans↗

Fearing to give life.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

Methodologic Issues in Neuropsychological Testing.

OBJECTIVE: To familiarize athletic trainers with methodologic issues regarding the development and implementation of neuropsychological tests used in programs for monitoring sport-related cerebral concussion. DATA SOURCES: Knowledge base and MEDLINE and PsychLit searches from 1980-2000 using the terms sports, athletes, concussion, and brain. DATA SYNTHESIS: Neuropsychological testing is a proven method for evaluating symptoms of concussion that results from a variety of different causes. These tests have been shown to be effective in evaluating symptoms of subtle cognitive dysfunction in a number of patient groups. Applying these tests in an athletic population has required some procedural modifications, including the use of brief test batteries, collection of preseason baseline data, and evaluation of subtle postconcussive changes in test scores over time. New methods are now being used for improved evaluation of the reliability and validity of neuropsychological tests in athletes. Proper scientific analysis of the psychometric properties of neuropsychological tests and the ultimate value of their use in the sport setting will require years of detailed study on large numbers of athletes with and without symptoms of concussion. CONCLUSIONS/RECOMMENDATIONS: Athletic trainers and related personnel need to be aware of the training and methodologic issues associated with neuropsychological testing. Knowledge of the scientific properties of these tests, their advantages, and current limitations will ultimately enhance the athletic trainer's ability to use information from neuropsychological testing in an effective manner.

Journal Article↗

Extending a natural language parser with UMLS knowledge.

Over the past several years our research efforts have been directed toward the identification of natural language processing methods and techniques for improving access to biomedical information stored in computerized form. To provide a testing ground for some of these ideas we have undertaken the development of SPECIALIST, a prototype system for parsing and accessing biomedical text. The system includes linguistic and biomedical knowledge. Linguistic knowledge involves rules and facts about the grammar of the language. Biomedical knowledge involves rules and facts about the domain of biomedicine. The UMLS knowledge sources, Meta-1 and the Semantic Network, as well as the UMLS test collection, have recently contributed to the development of the SPECIALIST system.

Information Storage and Retrieval↗

Nutritional intervention in chiropractic clinical practice: the chiropractic student's perspective.

A survey of chiropractic students reveals that they regard chiropractors as a knowledgeable source of information about nutrition. While the dissonance produced by the use of nutrients in clinical practice may be overcome by denying that this constitutes drug therapy, the controversies of appropriate use need to be addressed. The challenge faced by chiropractic undergraduate nutrition education involves identification of justifiable nutritional interventions, selection of effective doses and an awareness of the potential side effects. By resolving to match or better the medical profession as a source of nutritional health care, the future chiropractor has unwittingly embraced the cost-benefit paradigm of medical drug therapy.

Chiropractic↗

Ignorance of family planning methods in India: an important constraint on use.

Interviews wih women in six villages in India and with educated, working women selected to be trained as interviewers in five states, and evidence from formal studies are discussed to support the conclusions that (1) the low overall rates of contraceptive use in India are at least partly due to low levels of knowledge about different methods of birth control, especially of the modern reversible methods; and (2) the low use of all methods except sterilization is a good proxy for lack of knowledge about these methods. It is suggested that, both in the interests of achieving demographic targets and in the interests of the clientele of the family planning program, much greater emphasis must be placed on spreading practical information about reversible contraception. The information dissemination activities of the program so far have tended to concentrate on the why of family planning and neglect the how, except in promoting sterilization.

Contraception↗

Natural language processing of medical texts within the HELIOS environment.

A large number of hospital applications are potentially interested in natural language processing since they currently heavily depend on an efficient use of a huge amount of textual information. The need for systems that are able to accept multiple European languages is of paramount interest, as language barriers can be a strong impediment for large-scale communication in Europe, in particular regarding telemedicine. In the context of the AIM project HELIOS, the Natural Language Processing (NLP) component offers a large variety of medical services according to natural language free input. It allows the multilingual analysis of medical texts (currently in English, French and German) and the storage of the meaning of these texts under a deep knowledge representation that can be queried whenever it is needed. In addition, it provides facilities to handle knowledge source embedded into the conceptual typologies and into the dictionaries. This article aims at describing all these functionalities and their integration into the environment of the HELIOS project.

Artificial Intelligence↗

Lexical methods for managing variation in biomedical terminologies.

Access to biomedical terminologies is hampered by the high degree of variability inherent in natural language terms and in the terminologies themselves. The lexicon, lexical programs, databases, and indexes included with the 1994 release of the UMLS Knowledge Sources are designed to help users manage this variability. We describe these resources and illustrate their flexibility and usefulness in providing enhanced access to data in the UMLS Metathesaurus.

Biology↗

Computer auditing of surgical operative reports written in English.

We developed a script-based scheme for automated auditing of natural language surgical operative reports. Suitable operations (appendectomy and breast biopsy) were selected, then audit criteria and operation scripts conforming with our audit criteria were developed. Our LISP parser was context and expectation sensitive. Parsed sentences were represented by semigraph structures and placed in a textual database to improve efficiency. Sentence ambiguities were resolved by matching the narrative textual database to the script textual database and employing the Uniform Medical Language System (UMLS) Knowledge Sources. All audit criteria questions were successfully answered for typical operative reports by matching parsed audit questions to the textual database.

Appendectomy↗

The Unified Medical Language System.

In 1986, the National Library of Medicine began a long-term research and development project to build the Unified Medical Language System (UMLS). The purpose of the UMLS is to improve the ability of computer programs to "understand" the biomedical meaning in user inquiries and to use this understanding to retrieve and integrate relevant machine-readable information for users. Underlying the UMLS effort is the assumption that timely access to accurate and up-to-date information will improve decision making and ultimately the quality of patient care and research. The development of the UMLS is a distributed national experiment with a strong element of international collaboration. The general strategy is to develop UMLS components through a series of successive approximations of the capabilities ultimately desired. Three experimental Knowledge Sources, the Metathesaurus, the Semantic Network, and the Information Sources Map have been developed and are distributed annually to interested researchers, many of whom have tested and evaluated them in a range of applications. The UMLS project and current developments in high-speed, high-capacity international networks are converging in ways that have great potential for enhancing access to biomedical information.

Information Storage and Retrieval↗