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PubMed1994

The organization of statistical activities at medical research institutions.

In this paper, we discuss the organizational structure for the conduct of statistical activities at medical Colleges and Universities. Here, we have particularly focused on two significant statistical activities, i.e., statistical consultation and research. The consulting service for medical researchers consists of practical statistical analysis, instruction on computer manipulation and software, response to reviewer's comments and statistical design of prospective studies. From our various experiences, we describe the actual implementation of statistical consultations for medical researchers. It has played an important role in supporting medical research. In addition, we also outline some research, with respect to new ways of applying statistics in medical science. This paper concludes that it may be practical for the existing computer center or department of medical informatics, in charge of the computing service, to conduct statistical activities until formal organizations are established at the academic institution. To realize the conduct of statistical activities by Department of Medical Informatics, it needs a team of biostatisticians, data analysts and computer personnel.

Computer Systems↗
PubMed2004

Protecting the patient by promoting end-user competence in health informatics systems-moves towards a generic health computer user "driving license".

The effectiveness and quality of health informatics systems' support to healthcare delivery are largely determined by two factors-the suitability of the system installed, and the competence of the users. However, the profile of users of large-scale clinical health systems is significantly different from the profile of end-users in other enterprises such as the finance sector, insurance, travel or retail sales. Work with a mental health provider in Ireland, who was introducing a customized electronic patient record (EPR) system, identified the strong legal and ethical importance of adequately skills for the health professionals and others, who would be the system users. The experience identified the need for a clear and comprehensive generic user qualification at a basic but robust level. The European computer driving license (ECDL) has gained wide recognition as a basic generic qualification for users of computer systems. However, health systems and data have a series of characteristics that differentiate them from other data systems. The logical conclusion was the recognition of a need for an additional domain-specific qualification-an "ECDL Health Supplement". Development of this is now being progressed.

Computer Literacy↗
PubMed1995

Bridging theory and practice: cognitive science and medical informatics.

Medical informatics has experienced dramatic growth, both as an applied and as a research discipline in recent years. In this paper, we argue that there is a need to expand the research base to characterize the cognitive dimension of informatics. Theories and methods from cognitive science can provide an effective counterpart to traditional medical informatics in addressing issues of usability of the systems, the processing of information, and the training of physicians. In the first part of the paper, we address the problems inherent in applying basic theories to practice and suggest some potential solutions. The second section deals with epistemological issues that are fundamental to cognitive science research and medical informatics. We then discuss two areas of application of cognitive scientific theories and methods to medical informatics: cognitive evaluation of human computer interface and intelligent medical decision support systems. The paper addresses the progress that has been made thus far and discusses how future cognitive research can facilitate further growth in the development of these applications.

Artificial Intelligence↗
PubMed1995

A theoretical approach to artificial intelligence systems in medicine.

The various theoretical models of disease, the nosology which is accepted by the medical community and the prevalent logic of diagnosis determine both the medical approach as well as the development of the relevant technology including the structure and function of the A.I. systems involved. A.I. systems in medicine, in addition to the specific parameters which enable them to reach a diagnostic and/or therapeutic proposal, entail implicitly theoretical assumptions and socio-cultural attitudes which prejudice the orientation and the final outcome of the procedure. The various models -causal, probabilistic, case-based etc. -are critically examined and their ethical and methodological limitations are brought to light. The lack of a self-consistent theoretical framework in medicine, the multi-faceted character of the human organism as well as the non-explicit nature of the theoretical assumptions involved in A.I. systems restrict them to the role of decision supporting "instruments" rather than regarding them as decision making "devices". This supporting role and, especially, the important function which A.I. systems should have in the structure, the methods and the content of medical education underscore the need of further research in the theoretical aspects and the actual development of such systems.

Artificial Intelligence↗
PubMed2003

Putting your course on the Web: lessons from a case study and systematic literature review.

BACKGROUND: Education via the Internet offers enormous potential, but many online courses are pedagogically or technically weak and many good projects are never mainstreamed. METHOD: In drawing up our recommendations to address the issues around putting a course on the web, we drew on 3 main sources of data: an extensive in-depth course evaluation; a systematic review of the literature, and questions raised by participants on our training-the-trainers courses. RECOMMENDATIONS: For any web-based course to succeed, 10 overlapping and iterative areas of activity must be addressed. These are: the market for the course; course aims and intended learning outcomes; choice of software platform; staff training needs; writing high quality study materials; design features for active learning; technical and administrative challenges; evaluation and quality improvement; mainstreaming the course within the institution, and financial viability.

Computer-Assisted Instruction↗
PubMed2000

[Current responsibility of information processing in gynecology].

Rapid development and innovative research in medical computer science influences physicians work. Not only new hardware but also network implementation changed the way of decision making techniques in medicine. The main reason for acceptance and distribution of the internet is the possibility to present information in a reasonable and contemporary way. A self-labeling of medical information by web authors and systematic critical appraisal of health-related internet information by third parties may help to filter harmful health information and to positively identify and select high quality information. The German Work Group for Information Technologies in Gynecology and Obstetrics (AIG) informs physicians about health care issues related to computer science.

Computer Systems↗
PubMed2000

[The current status of information technology publications in gynecology].

In 1997, the Zentralblatt für Gynäkologie introduced a new column named "Computer & Programs" in which articles on information technology of special interest for gynecologists are published. Until today, the Zentralblatt is the only German journal publishing articles of that kind. Even in Anglo-American journals no comparable articles are published, although the US have a leading role in computer and internet technology in general.

Computers↗
PubMed2001

Trends in technology and the future intensive care unit.

As advanced as today's critical care units are, changes in networks, computing platforms, instrumentation, human-machine interfaces, and software infrastructures and work being done in interoperability, process automation, and decision support all promise to alter both the structure and the operation of future critical unit settings. Although, as Yogi Berra said, "It's tough to make predictions, especially about the future," we can gain of a sense of the possibilities by studying emerging trends in each of these information technology-related areas. After describing notional physical and functional architectures for today's critical care units, this article provides a high-level overview of a number of trends in the areas listed above and provides the reader with starting points for further study. Although each of these trends may be fairly unremarkable when taken in isolation, when considered as a whole, the implications for critical care are profound. To that end, a final section of the article speculates on specific ways that these trends are likely to play themselves out in the context of tomorrow's critical care environments.

Computer Communication Networks↗
PubMed2000

A telemedicine management model based on message-trigger service.

A telemedicine system model, based on a message-trigger service, is described. This model distributes system applications on multiple computers and establishes a communication platform to exchange messages among all applications. By broadcasting event messages, an application is able to trigger a set of local and remote services. At the same time, a protocol for message exchange is proposed to fulfill cooperation of applications. To validate the model, a teleconsultation system is designed. The results indicate that the model has good compatibility and that the characteristics are easy to implement.

Computer Communication Networks↗
PubMed2000

Technological changes in the healthcare sector. A method to assess change readiness.

This paper describes the theory, method and recent results of a study developing methods for assessment of change readiness. The empirical focus is on development and implementation of clinical IT systems in the Danish healthcare sector. To assess change readiness, a questionnaire has been developed. The questionnaire has been tested in a hospital department as a part of a pre analysis related to development and implementation of an IT quality assurance system. The study shows a general positive attitude to the IT system and the organisational changes, related to the implementation and use of the system. It also supplies the project organisation with specific information, useful to the project organisation to continue the essential dialogue with the healthcare professionals during the change process. Furthermore it provides a useful tool for planning the ongoing developing processes. Several other healthcare organisations are at the moment entering the study.

Attitude to Computers↗
PubMedDate not supplied

Cables.

If you want to control your own computer installation, get the satisfaction of doing your own maintenance, and compensate for an inept or uninformed vendor, the information in this article will help you achieve these ends. Good luck and good cabling!

Computer Peripherals↗
PubMed1998

Understanding, navigating and communicating knowledge: issues and challenges.

This paper presents a psychological perspective on key issues related to medical vocabularies. There have been rapid advances in the development of computer technology underlying medical information systems. However, in keeping with technological progress, we must also take into account advances in our understanding of human behaviour and learn from failures in human performance. A central issue examined in this paper is the extent to which we can develop generic vocabularies that are also flexible and adaptable to specific situations. Empirical research indicates that variability in human performance is much greater than what current medical classifications take into account. A related challenge is that of how to best develop vocabularies that meet the needs of users. Based on theoretical perspectives and research emerging from the domain of cognitive psychology, we suggest that an understanding of the cognitive mechanisms underlying the comprehension and application of terminology is required. It is argued that rather than beginning with highly specified terminologies, i.e. the normative approach, we might instead begin by examining the natural context of how health care workers acquire, understand and negotiate knowledge in practice.

Artificial Intelligence↗
PubMed2005

A terminological and ontological analysis of the NCI Thesaurus.

OBJECTIVE: The National Cancer Institute Thesaurus is described by its authors as "a biomedical vocabulary that provides consistent, unambiguous codes and definitions for concepts used in cancer research" and which "exhibits ontology-like properties in its construction and use". We performed a qualitative analysis of the Thesaurus in order to assess its conformity with principles of good practice in terminology and ontology design. MATERIALS AND METHODS: We used both the on-line browsable version of the Thesaurus and its OWL-representation (version 04.08b, released on August 2, 2004), measuring each in light of the requirements put forward in relevant ISO terminology standards and in light of ontological principles advanced in the recent literature. RESULTS: We found many mistakes and inconsistencies with respect to the term-formation principles used, the underlying knowledge representation system, and missing or inappropriately assigned verbal and formal definitions. CONCLUSION: Version 04.08b of the NCI Thesaurus suffers from the same broad range of problems that have been observed in other biomedical terminologies. For its further development, we recommend the use of a more principled approach that allows the Thesaurus to be tested not just for internal consistency but also for its degree of correspondence to that part of reality which it is designed to represent.

Computational Biology↗