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PubMedDate not supplied

PACS in practice: the status of the PACS project at the St. Radboud University Hospital. Part B. A digital image archive: information analysis and development.

In accordance with the bottom-up approach in the field of the Picture Archiving and Communication System (PACS), a pilot study was performed with regard to the archiving of digital diagnostic images. A prototype has been developed to determine what information has to be stored in the digital archive and what requirements the users have in accessing these data. Firstly an organization analysis of the department of diagnostic radiology with respect to the archiving of images was performed. A variant of the ISAC method was used for this purpose. This resulted in a set of activity diagrams. Thereafter an information analysis was performed according to the Nijssen Informal Analysis Method (NIAM). This resulted in a Conceptual Schema (CS). Two other prototypes of relational Image Database Management Systems (IDBMS) are described and a description of a general modular structure of an IDBMS is given. By means of a Prototype of a Digital Archive (PDA) the department of diagnostic radiology was shown what might be expected from a digital archive and how the information will be presented to the users.

Database Management Systems↗

PubMed2005

An I/O device driver for bioinformatics tools: the case for BLAST.

There are many bioinformatics tools that deal with input/output (I/O) issues by using filing systems from the most common operating systems, such as Linux or MS Windows. However, as data volumes increase, there is a need for more efficient disk access, ad hoc memory management and specific page-replacement policies. We propose a device driver that can be used by multiple applications. It keeps the application code unchanged, providing a non-intrusive and flexible strategy for I/O calls that may be adopted in a straightforward manner. With our approach, database developers can define their own I/O management strategies. We used our device driver to manage Basic Local Alignment Search Tool (BLAST) I/O calls. Based on preliminary experimental results with National Center for Biotechnology Information (NCBI) BLAST, this approach can provide database management systems-like data management features, which may be used for BLAST and many other computational biology applications.

Algorithms↗

PubMed1997

The digital anatomist information system and its use in the generation and delivery of Web-based anatomy atlases.

Advances in network and imaging technology, coupled with the availability of 3-D datasets such as the Visible Human, provide a unique opportunity for developing information systems in anatomy that can deliver relevant knowledge directly to the clinician, researcher or educator. A software framework is described for developing such a system within a distributed architecture that includes spatial and symbolic anatomy information resources, Web and custom servers, and authoring and end-user client programs. The authoring tools have been used to create 3-D atlases of the brain, knee and thorax that are used both locally and throughout the world. For the one and a half year period from June 1995-January 1997, the on-line atlases were accessed by over 33,000 sites from 94 countries, with an average of over 4000 "hits" per day, and 25,000 hits per day during peak exam periods. The atlases have been linked to by over 500 sites, and have received at least six unsolicited awards by outside rating institutions. The flexibility of the software framework has allowed the information system to evolve with advances in technology and representation methods. Possible new features include knowledge-based image retrieval and tutoring, dynamic generation of 3-D scenes, and eventually, real-time virtual reality navigation through the body. Such features, when coupled with other on-line biomedical information resources, should lead to interesting new ways for managing and accessing structural information in medicine.

Anatomy↗

PubMed2000

Information Management System for Site Remediation Efforts.

/ Environmental regulatory agencies are responsible for protecting human health and the environment in their constituencies. Their responsibilities include the identification, evaluation, and cleanup of contaminated sites. Leaking underground storage tanks (USTs) constitute a major source of subsurface and groundwater contamination. A significant portion of a regulatory body's efforts may be directed toward the management of UST-contaminated sites. In order to manage remedial sites effectively, vast quantities of information must be maintained, including analytical dataon chemical contaminants, remedial design features, and performance details. Currently, most regulatory agencies maintain such information manually. This makes it difficult to manage the data effectively. Some agencies have introduced automated record-keeping systems. However, the ad hoc approach in these endeavors makes it difficult to efficiently analyze, disseminate, and utilize the data. This paper identifies the information requirements for UST-contaminated site management at the Waste Cleanup Section of the Department of Environmental Resources Management in Dade County, Florida. It presents a viable design for an information management system to meet these requirements. The proposed solution is based on a back-end relational database management system with relevant tools for sophisticated data analysis and data mining. The database is designed with all tables in the third normal form to ensure data integrity, flexible access, and efficient query processing. In addition to all standard reports required by the agency, the system provides answers to ad hoc queries that are typically difficult to answer under the existing system. The database also serves as a repository of information for a decision support system to aid engineering design and risk analysis. The system may be integrated with a geographic information system for effective presentation and dissemination of spatial data.

Journal Article↗

PubMed1987

Managing orthodontic data on a small computer.

A literature survey of file management, relational database management, and network/hierarchical database management systems led to selection of dBASE III to manage patient records on an IBM PC in the Department of Orthodontics at the Louisiana State University School of Dentistry. The versatility of this system's internal language enables ad hoc analysis of clinical and personal data to meet both anticipated and unanticipated management and scientific needs.

Computers↗

PubMed2000

DataFoundry: information management for scientific data.

Data warehouses and data marts have been successfully applied to a multitude of commercial business applications. They have proven to be invaluable tools by integrating information from distributed, heterogeneous sources and summarizing this data for use throughout the enterprise. Although the need for information dissemination is as vital in science as in business, working warehouses in this community are scarce because traditional warehousing techniques do not transfer to scientific environments. There are two primary reasons for this difficulty. First, schema integration is more difficult for scientific databases than for business sources, because of the complexity of the concepts and the associated relationships. While this difference has not yet been fully explored, it is an important consideration when determining how to integrate autonomous sources. Second, scientific data sources have highly dynamic data representations (schemata). When a data source participating in a warehouse changes its schema, both the mediator transferring data to the warehouse and the warehouse itself need to be updated to reflect these modifications. The cost of repeatedly performing these updates in a traditional warehouse, as is required in a dynamic environment, is prohibitive. This paper discusses these issues within the context of the DataFoundry project, an ongoing research effort at Lawrence Livermore National Laboratory. DataFoundry utilizes a unique integration strategy to identify corresponding instances while maintaining differences between data from different sources, and a novel architecture and an extensive meta-data infrastructure, which reduce the cost of maintaining a warehouse.

Computer Systems↗

PubMed1999

Where does IT fit in your practice? Information technology trends.

The future role of information technology in the medical industry is never clear, but we can identify some trends, such as electronic medical records and database management systems. Many of these trends can boost productivity for practices, but all managers need to carefully analyze their needs and understand the products to see how they may or may not help their individual practice.

Computer Communication Networks↗

PubMed1992

A prototype radiation oncology clinical information processing system on a personal computer (network).

Software has been developed that facilitates prospective computer entry of the clinical contents of a radiation oncology chart in a way that assists in retrospective analyses. This software, which has been operational since 1988, now contains detailed clinical information on over 500 patients treated since that time, and limited information on over 3000 children treated since 1970. The system has been programmed using the FoxPro database management system, and may be run on an IBM compatible or Macintosh personal computer either alone or in a networked environment. Information is transcribed as routine patient dictations that require no extra personnel for entry. Standard printouts are the conventional notes compatible with the existing paper chart. Exportation of patient records is facilitated by means of built-in facsimile. The software has been designed to generate detailed reports automatically, including the statuses of selected patients or groups, lists of those who are behind in follow-up, and reports of specific events (e.g., mucositis) that occur before, during, or after therapy using free-text searches. Complete reconstruction of the patient's clinical radiation oncology chart is also included. Other abilities include calculation of Kaplan-Meier survival, relapse-free survival, and local control rates, statistical comparison between survival curves, and radiation dose-response. Exportation of data to statistical and graphics packages is also possible. For pediatric patients, a program to predict stature loss has been incorporated. Use of this system can enhance one's ability not only to follow patients but also to monitor and report their outcome continually. With the need to report institutional experiences and increasing demands to monitor quality assurance, such a system can be of great benefit.

Electronic Data Processing↗

PubMed1998

A virtual university Web system for a medical school.

This paper describes a Virtual Medical University Web Server. This project started in 1994 by the development of the French Radiology Server. The main objective of our Medical Virtual University is to offer not only an initial training (for students) but also the Continuing Professional Education (for practitioners). Our system is based on electronic textbooks, clinical cases (around 4000) and a medical knowledge base called A.D.M. ("Aide au Diagnostic Medical"). We have indexed all electronic textbooks and clinical cases according to the ADM base in order to facilitate the navigation on the system. This system base is supported by a relational database management system. The Virtual Medical University, available on the Web Internet, is presently in the process of external evaluations.

Computer-Assisted Instruction↗

PubMed1994

Developing an information resources management strategy for regulatory veterinary medicine: a national imperative.

Lack of a standardized information technology management strategy has resulted in state and federal information systems evolving separately, rather than in tandem. Absence of an information management strategy will eventually affect regulatory program management, epidemiologic research, and domestic and international livestock trade. Producers will ultimately pay the price for the lack of regulatory coordination of US animal health and disease information. The longer the development of state and federal information technology management strategies is postponed, the more cost-, labor-, and time-intensive correcting the deficiency will be. Development of a national information resources management environment is the first step in constructing state and federal information technology strategies.

Animal Diseases↗

PubMed2004

Using computers for intensive care unit research.

A computerized clinical information system (CIS) is potentially a very important information tool for research and improving health care processes as well as for optimizing data management and thereby minimizing health care costs. The newest CISs automatically collect patient data from various sources, including monitors, the laboratory, radiology, and patient notes, and make the data highly organized and readily accessible. In the future CISs may be able to conduct signal analysis, assist in care decisions, provide advanced graphical data presentation, and generate warnings to clinicians. Most CIS systems include large databases, and the advent of relational databases has improved data retrieval and manipulation and thus made the data a powerful tool in outcomes research. On the whole CISs collect more frequent and more accurate data than do clinicians using paper-based data collection systems, but research continues on how accurate CIS data is, how to improve that accuracy, and how much data checking and correction is needed. At my institution we have used CIS data to study changes in patients' code status and to evaluate a protocol for arterial blood gas (ABG) testing. The primary challenges to optimizing a CIS are ensuring accurate data entry, learning to query the data so as to avoid misleading conclusions, and to administer and maintain the hardware and software so as to minimize the chance of data loss and system down time. CISs are in a relatively early stage of their development, and engineering improvements will eventually make CIS data highly accurate and easily accessible and queryable so that CISs become even more valuable for research.

Computer Systems↗

PubMed1989

The relational database model and multiple multicenter clinical trials.

The Southwest Oncology Group (SWOG) chose to use a relational database management system (RDBMS) for the management of data from multiple clinical trials because of the underlying relational model's inherent flexibility and the natural way multiple entity types (patients, studies, and participants) can be accommodated. The tradeoffs to using the relational model as compared to using the hierarchical model include added computing cycles due to deferred data linkages and added procedural complexity due to the necessity of implementing protections against referential integrity violations. The SWOG uses its RDBMS as a platform on which to build data operations software. This data operations software, which is written in a compiled computer language, allows multiple users to simultaneously update the database and is interactive with respect to the detection of conditions requiring action and the presentation of options for dealing with those conditions. The relational model facilitates the development and maintenance of data operations software.

Clinical Trials as Topic↗

PubMed2006

Laboratory Information Management Software for genotyping workflows: applications in high throughput crop genotyping.

BACKGROUND: With the advances in DNA sequencer-based technologies, it has become possible to automate several steps of the genotyping process leading to increased throughput. To efficiently handle the large amounts of genotypic data generated and help with quality control, there is a strong need for a software system that can help with the tracking of samples and capture and management of data at different steps of the process. Such systems, while serving to manage the workflow precisely, also encourage good laboratory practice by standardizing protocols, recording and annotating data from every step of the workflow. RESULTS: A laboratory information management system (LIMS) has been designed and implemented at the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) that meets the requirements of a moderately high throughput molecular genotyping facility. The application is designed as modules and is simple to learn and use. The application leads the user through each step of the process from starting an experiment to the storing of output data from the genotype detection step with auto-binning of alleles; thus ensuring that every DNA sample is handled in an identical manner and all the necessary data are captured. The application keeps track of DNA samples and generated data. Data entry into the system is through the use of forms for file uploads. The LIMS provides functions to trace back to the electrophoresis gel files or sample source for any genotypic data and for repeating experiments. The LIMS is being presently used for the capture of high throughput SSR (simple-sequence repeat) genotyping data from the legume (chickpea, groundnut and pigeonpea) and cereal (sorghum and millets) crops of importance in the semi-arid tropics. CONCLUSION: A laboratory information management system is available that has been found useful in the management of microsatellite genotype data in a moderately high throughput genotyping laboratory. The application with source code is freely available for academic users and can be downloaded from http://www.icrisat.org/gt-bt/lims/lims.asp.

Algorithms↗

PubMed1993

The problem of coping as a reason for psychiatric consultation.

To examine those patients referred to psychiatry for the "problem of coping," a structured clinical databased management system--MICRO-CARES--was employed to identify the frequency, demographic characteristics, psychiatric diagnoses, psychosocial interventions, use of psychopharmacology, number of follow-up visits, and discharge placement of these referrals. Consultations totaling 1,157 from July 1, 1988 through January 1, 1990 were divided into two groups and compared: "Not coping" (N = 456, 28.5%) and "others" (N = 701, 61%). Those with a "problem in coping" more often had no Axis I diagnosis (p = 0.001), or were described as adjustment disorders (p = 0.0001). Fewer recommendations were made for those with a coping problem, although lag time (admission date to request for consultation), number of follow-ups, and discharge placement were not significantly different between the two groups. Stepwise logistic regression analyses revealed that the aged had lesser risk for being referred with a coping problem; those who were white, had their own income, experienced greater stress prior to hospitalization (Axis IV), and had higher functioning during the last year (Axis V) were at greater risk.

Adaptation, Psychological↗

PubMed1997

Modeling medical trials in pharmacoeconomics using a temporal object model.

Time is an inherent feature of many medical applications. These applications can also benefit from the support of object database management systems which better capture the semantics of the complex objects that arise in the medical domain. In this paper, we present a uniform behavioral temporal object model which includes a rich and extensible set of types and behaviors to support the various features of a medical application. We concentrate here on the application of pharmacoeconomic medical trials. Pharmacoeconomics is a field of medical economics in which the costs and outcomes of alternative treatments are assessed and compared, in order to establish which is the most appropriate treatment for a particular illness in a particular setting. We describe in detail the histories and timelines features of our temporal model and show how they can effectively be used to model a pharmacoeconomic trial. We then give an instance of a pharmacoeconomic trial as it would appear in the temporal object model and show, using queries, how a series of different behaviors could be used to retrieve various components of the instance. These components could then be used to assess the alternative treatments involved in the trial and determine their cost-effectiveness.

Clinical Trials as Topic↗

PubMed1999

Wrapping SRS with CORBA: from textual data to distributed objects.

MOTIVATION: Biological data come in very different shapes. Databanks are maintained and used by distinct organizations. Text is the de facto Standard exchange format. The SRS system can integrate heterogeneous textual databanks but it was lacking a way to structure the extracted data. RESULTS: This paper presents a CORBA interface to the SRS system which manages databanks in a flat file format. SRS Object Servers are CORBA wrappers for SRS. They allow client applications (visualisation tools, data mining tools, etc.) to access and query SRS servers remotely through an Object Request Broker (ORB). They provide loader objects that contain the information extracted from the databanks by SRS. Loader objects are not hard-coded but generated in a flexible way by using loader specifications which allow SRS administrators to package data coming from distinct databanks. AVAILABILITY: The prototype may be available for beta-testing. Please contact the SRS group (http://srs.ebi.ac.uk).

Computer Systems↗

PubMed2006

New software for computer-assisted dental-data matching in Disaster Victim Identification and long-term missing persons investigations: "DAVID Web".

In 1997 an internally supported but unfunded pilot project at the Victorian Institute of Forensic Medicine (VIFM) Australia led to the development of a computer system which closely mimicked Interpol paperwork for the storage, later retrieval and tentative matching of the many AM and PM dental records that are often needed for rapid Disaster Victim Identification. The program was called "DAVID" (Disaster And Victim IDentification). It combined the skills of the VIFM Information Technology systems manager (VW), an experienced odontologist (JGC) and an expert database designer (JC); all current authors on this paper. Students did much of the writing of software to prescription from Monash University. The student group involved won an Australian Information Industry Award in recognition of the contribution the new software could have made to the DVI process. Unfortunately, the potential of the software was never realized because paradoxically the federal nature of Australia frequently thwarts uniformity of systems across the entire country. As a consequence, the final development of DAVID never took place. Given the recent problems encountered post-tsunami by the odontologists who were obliged to use the Plass Data system (Plass Data Software, Holbaek, Denmark) and with the impending risks imposed upon Victoria by the decision to host the Commonwealth Games in Melbourne during March 2006, funding was sought and obtained from the state government to update counter disaster preparedness at the VIFM. Some of these funds have been made available to upgrade and complete the DAVID project. In the wake of discussions between leading expert odontologists from around the world held in Geneva during July 2003 at the invitation of the International Committee of the Red Cross significant alterations to the initial design parameters of DAVID were proposed. This was part of broader discussions directed towards developing instruments which could be used by the ICRC's "The Missing" project that seeks to identify the victims of civil unrest and other atrocities. The most significant of these recommendations was that the next version of DAVID should be web-based allowing it to be used anywhere in the world and on any computer platform. The original intention that the software should be made available as freeware was strongly reiterated and endorsed. During 2005 these recommendations have been realized. This paper will describe the design parameters of the new software "DAVID web" and compare its features and performance with alternative packages.

Database Management Systems↗

PubMed1993

Clinical laboratory test reference (CLTR).

As the healthcare system undergoes a transformation in scope and funding, there remain many unfinished projects which will be essential for the next generation of automated medical support services. The most demanding and labor intensive tasks for this new frontier deal with the accumulation of knowledge which can be used as a clinical database to support supervisory functions in a physician operated interactive care delivery environment. These databases will contain the worlds accumulated knowledge in specialized areas. They will be organized by topic or clinical service, and have significant impact on the quality of care as well as medical malpractice exposure. This article will describe a clinical pathology database that has been adapted for medical practice. The database contains information about laboratory tests and their interpretation. The data is structured for rapid reading and has references where indicated. The database can be used in a stand alone program or integrated into an information system within an application program. The files are reviewed on a continuing basis and quarterly updates are made available to subscribers.

Clinical Laboratory Information Systems↗