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Computer Communication Networks↗

An object-oriented taxonomy of medical data presentations.

A variety of methods have been proposed for presenting medical data visually on computers. Discussion of and comparison among these methods have been hindered by a lack of consistent terminology. A taxonomy of medical data presentations based on object-oriented user interface principles is presented. Presentations are divided into five major classes-list, table, graph, icon, and generated text. These are subdivided into eight subclasses with simple inheritance and four subclasses with multiple inheritance. The various subclasses are reviewed and examples are provided. Issues critical to the development and evaluation of presentations are also discussed.

Audiovisual Aids↗

Knowledge representation and indexing using the unified medical language system.

Ontologies and semantic frameworks can be used to improve the accuracy and expressiveness of natural language processing for the purpose of extracting meaning from technical documents. This is especially true when a rich ontology such as the Unified Medical Language System (UMLS) is available. This paper reports on some tools being developed to make this possible and on some experience with a user interface based on ontologies and semantic networks that allows for interactive knowledge exploration.

Abstracting and Indexing↗

A systematic approach to the assessment of user satisfaction with health care systems: constructs, models and instruments.

In this paper an overview is given about research in the field of user satisfaction with health care systems and a new systematic model is set up. The model distinguishes between system-independent and system-dependent factors, the latter characterised by satisfaction with the content, the interface and the organisation. Evaluated instruments for assessing user satisfaction are classified according to the model and recommendation for an appropriate use are given.

Computer Simulation↗

A unified framework for data modeling on medical information systems.

Medical Information Systems (MIS) are seen as a way of optimizing the use of existing health-care infrastructure, without resorting to new and costly hospital (re)construction. The qualitative (re)design of such an environment requires a basic understanding of patient and doctors related characteristics and capabilities. Patient care, patient education, medical education, and clinical research need to be considered to meet the basic requirements on the level of services desirable, determined on the basis of the patient's length of stay; i.e., used for modeling the significant entities of such a world. The aim is to extract conclusions for the level of services provided to the users. One's concept will capture, as well as will integrate, the basic design principles under which MIS may be set.

Artificial Intelligence↗

Technology development and implementation in the public health institutions: a strategic and pedagogical task for the learning organization.

The article presents two overall problem issues for IT in the health sector. A strategic problem: Which organization structure and which work routines should be enhanced by technology? A pedagogical problem: How does the personnel learn to think, act and express work through IT-tools? The suggested solution is to put technology development and implementation together within a theoretical frame for the learning organization where reciprocal demands and terms exist for both the IT-tools and the personnel. The personnel makes demands to which goals should be reached through technology and technology demands that the personnel is acquainted with hardware and software. As a communication system, technology offers new possibilities of realizing other forms of cooperation. The suggested solution is a synthesis between the strategy for organization development through technology and the implementation of IT as a learning process for the personnel. The synthesis between the mutual demands of the organization and its personnel provides for IT-tools which are in concordance with the principal values of the health practice rather than merely economic and management values. The analysis builds on a qualitative, in-depth investigation of IT-implementation in the secondary sector. The investigation indicated that the use of IT is a learning process which requires three types of knowledge and that continued IT-development in the organization requires a new fourth knowledge.

Attitude to Computers↗

Knowledge engineering the UMLS.

In order to transform a major portion of the Unified Medical Language System (UMLS) into a formally sound description logics system we have developed a four-step knowledge engineering approach. We report on experiments with a Loom knowledge base which consists of 164,000 concepts and 76,000 relations covering human anatomy and pathology. We discuss the fully automatized as well as interactive semiautomatic steps. The latter ones focus on the manual work necessary to render the formal target representation structures complete and adequate.

Artificial Intelligence↗

The need for open geographical information systems in medicine.

This paper presents a promising approach of using component-oriented geographical information systems (GIS) to facilitate improved medical and ecological applications. The integration of administrative geographical and medical data (map overlay) allows sophisticated and advanced analysis. This can serve as a basis to detect undiscovered relationships. We hope to increase the usage of geographical information by the creation of a general framework. This approach is mainly supported by two advances in recent years. Geographical data (e.g. administrative areas) is up-to-date, consistent and covers Germany completely. In addition, enormous technological improvements in the area of high-bandwidth networks and component-based software development have been made. These advances allowed to define our general framework for the integration of GIS functions into existing and already accepted applications.

Germany↗

Validation of expert systems: examples and considerations.

The problem of a medical expert system validation is generally complex. It requires a rigorous methodology of validation and must show proof of its practical competency in order to be used currently. Validation concerns the quality of conclusions provided by the system, the quality of the deductive process leading to these conclusions as well as the validity of its utilization. In this paper, some reflections, questions, and requirements are exposed that must be addressed to proceed to the validation of a knowledge base system in the field of medicine, especially the psychiatric field.

Computer Systems↗

Assigning value to clinical information--a major limiting factor in the implementation of decision-support systems.

This paper deals with a major difficulty and potential limiting factor in present-day decision support-that of assigning precise value to an item (or group of items) of clinical information. Historical determinist descriptive thinking has been challenged by current concepts of uncertainty and probability, but neither view is adequate. Four equations are proposed outlining factors which affect the value of clinical information, which explain some previously puzzling observations concerning decision support. It is suggested that without accommodation of these concepts, computer-aided decision support cannot progress further, but if they can be accommodated in future programs, the implications may be profound.

Decision Support Techniques↗

Medical computing in Mississippi.

As our society enters the information age, physicians are finding an ever growing role for computers in the practice of medicine. Computers are used for education, research, medical record keeping, communications and as a powerful reference resource. They have even served as electronic consultants to assist in diagnosis and medical decision making. Mississippians have been pioneers in the use of computers in research and education and have taken a very progressive view of the future of medical computing in our state. Resources such as the Mississippi Health Sciences Information Network have served to connect rural health practitioners to academic centers and other informational resources and improve the quality of patient care throughout the state. Internet users will find that there are many Mississippi medical institutions that have home pages on the world wide web that also connects us to the global medical community. Computers are rapidly becoming one of the most important new tools in the black bag of the modern physician.

Computer Communication Networks↗

Concepts, knowledge and language in healthcare information systems: follow-up 30 months later.

The paper reviews the last IMIA-WG6 recommendations, issued along two themes: (1) how to better share common results and (2) how to conduct new research and development efforts. Some of the major discrepancies in the field are reviewed. The paper intends to offer insight into two areas, first, in the issue of knowledge representation and, second, in the science of meaning, incorporating the broad intersection of computational linguistics, semantics, conceptual approach, and denotation. The Ogden-Richards meaning triangle is used as a convenient organizing principle to maximize the scope of understanding among the different schools, particularly in areas of linguistics and semantics on the one side and denotation and conceptual approach on the other. In conclusion, there is a need for clarification and for more scientific pragmatism.

Artificial Intelligence↗

How groups co-ordinate their concepts and terminology: implications for medical informatics.

Conceptual and terminological systems are established and maintained by the communities who use them. This paper reports experiments which investigate the role of communication and interaction in the process. The experiments show that isolated pairs of communicators and virtual communities of interacting pairs naturally converge on their own conceptual and terminological systems when confronted with a common task. The results also indicate that the system converged on is optimal for that particular group engaged in that particular task. These findings are discussed in relation to the increasing use of tightly coordinated medical teams and its implications for getting them to adopt standardized medical terminologies.

Concept Formation↗