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Use of generic software programs in management of patient records and clinical research.

As personal computers become more cost-effective and user-friendly, they are bound to play an increasing role in the practice of medicine. This article is a description of how a commercially available database system adapted for medical record keeping has greatly facilitated the storage and retrieval of information. The designation of a data file for storage of patient records through the use of the systems menus, data entry, and conduct of searches for particular bits of data are described. Unique features such as custom-tailored computer reminders and project-specific programming are recommended as ways to improve the effectiveness of patient care and clinical research. When a single database system is used, the cost in terms of time, money and expertise is dramatically decreased, allowing the physician to optimize all aspects of the practice of medicine of exploiting computer technology with minimal to no knowledge of computer languages and/or programming.

Gynecology↗

Information management for the study of allergies.

Microarrays and other large-scale screening technologies produce quantities of increasingly complex allergy data. These data link molecular and clinical measurements and observations and provide fertile ground for improving our understanding of the processes involved in allergic reactions. Information technology is employed in gathering, storage, retrieval and analysis of these data. The increasing proportion of allergy data are generated from genomics and proteomics approaches. The major activity focuses on characterization of allergens including IgE reactivity, structural properties, and mapping of IgE and T-cell epitopes. Because of the complexity of allergy data, their utilization requires bioinformatics approaches. Allergen data are stored in the general and specialist databases. At least a dozen of important allergen databases and data repositories have been developed to date. These data are analysed using general and specialist bioinformatics tools. The major applications of bioinformatics include support for allergen characterization, assessment of allergenicity, and identification of allergic cross-reactivity. These applications in turn support the development of vaccines and therapies for allergic disease. In this article we review allergen databases and tools for the analysis of allergens, and discuss the new directions in the field supported by large scale screening involving genomics, proteomics, and bioinformatics support.

Allergens↗

[Recommendations for the selection of storage media for archiving digital radiological image data based on the comparison of retrieval times at different PACS archive levels].

PURPOSE: Recommendations for archiving digital radiological image data based on the comparison of retrieval times for different PACS archive levels. MATERIALS AND METHODS: For a large PACS installation (Agfa Impax, Release 4.1), image retrieval times for radiological standard examinations (chest radiographs with 2, MRI with 250, CT with 100 and 1000 images; n = 120, each) from hard disk array, magneto-optical disk (MOD), and magnetic tape archives (TAPE) were examined in high and low network traffic load. RESULTS: Even large CT examinations (1000 images) were available from hard disk arrays within 4.0 +/- 0.8 s, smaller studies within 1.8 +/- 0.3 s. Radiographic image retrieval from MOD (30 +/- 4.7 s) was more then 50 % faster than from TAPE. For typical cross-sectional studies, the velocity gain amounted to 19 %. For both technologies, no significant difference was found for large CT examinations (651 +/- 144 s). For high and low network traffic load scenarios, image retrieval times from hard disk, MOD, and TAPE archives increased by 87 %, 7 %, and 22 %, respectively. CONCLUSION: Hard disk arrays are specifically suited as departmental intermediate storage media because they allow fast access to current and previous examinations within a short time. Performance properties enable both MOD and TAPE systems to serve as long-term archives. However, MOD archives are less flexible in the expansion of storage capacity and at present the medium costs per memory unit are about 2 - 3 times higher than for tape archives. The use of existing MOD-archives may be adequate as intermediate archives. For new PACS installations or system expansions, however, it is recommended to combine a sufficiently large local data memory (RAID) with data storage on tape archives outside the radiological unit that can be used by other departments as well. Future development of hard disk prices will show whether archiving for the whole data retention period may be handled by RAID systems. In any case, prefetching problems and waiting periods for demanded pre-studies would not occur any more.

Humans↗

Use of microcomputer for histopathology: system using IBM PC and dBaseIII.

A microcomputer program for use in the storage and retrieval of histopathology records is described. The program was written using dBaseIII, a commercially available data management system. The program provides for efficient storage and rapid retrieval of pathology reports and facilitates clinical research. Downloading of data on to a mainframe computer is possible.

Computers↗

A program for storage and retrieval of demographic, sample, clinical laboratory, and restriction endonuclease map data.

A program, written in dBASE, is described that manages demographic, sample, clinical laboratory, and restriction endonuclease map data. The program exports migration distances of DNA fragments resulting from specified endonuclease digests to a commercially available, but modified, curve fitting program (CURVE-FITTER) where the fragment sizes in base pairs are calculated. The calculated values are imported back into dBASE files for report generation or later analysis. The program will produce hard copy reports for single or multiple individuals.

Clinical Laboratory Information Systems↗

Databases for genetic services. Current usages and future directions.

Computer-based systems for the management of data in clinical genetics have become increasingly available for patient information storage and retrieval, evaluation and diagnosis, and pedigree data. The need for a national genetic services database has been recognized, and federal grants have provided funds for the development of state and regional databases for the evaluation of genetic services. Continuation of federal funding and the development of data systems that allow local, state, and regional needs to be met are essential for any progress to be made toward a national database.

Database Management Systems↗

Ebbie: automated analysis and storage of small RNA cloning data using a dynamic web server.

BACKGROUND: DNA sequencing is used ubiquitously: from deciphering genomes to determining the primary sequence of small RNAs (smRNAs). The cloning of smRNAs is currently the most conventional method to determine the actual sequence of these important regulators of gene expression. Typical smRNA cloning projects involve the sequencing of hundreds to thousands of smRNA clones that are delimited at their 5' and 3' ends by fixed sequence regions. These primers result from the biochemical protocol used to isolate and convert the smRNA into clonable PCR products. Recently we completed a smRNA cloning project involving tobacco plants, where analysis was required for approximately 700 smRNA sequences. Finding no easily accessible research tool to enter and analyze smRNA sequences we developed Ebbie to assist us with our study. RESULTS: Ebbie is a semi-automated smRNA cloning data processing algorithm, which initially searches for any substring within a DNA sequencing text file, which is flanked by two constant strings. The substring, also termed smRNA or insert, is stored in a MySQL and BlastN database. These inserts are then compared using BlastN to locally installed databases allowing the rapid comparison of the insert to both the growing smRNA database and to other static sequence databases. Our laboratory used Ebbie to analyze scores of DNA sequencing data originating from an smRNA cloning project. Through its built-in instant analysis of all inserts using BlastN, we were able to quickly identify 33 groups of smRNAs from approximately 700 database entries. This clustering allowed the easy identification of novel and highly expressed clusters of smRNAs. Ebbie is available under GNU GPL and currently implemented on http://bioinformatics.org/ebbie/. CONCLUSION: Ebbie was designed for medium sized smRNA cloning projects with about 1,000 database entries. Ebbie can be used for any type of sequence analysis where two constant primer regions flank a sequence of interest. The reliable storage of inserts, and their annotation in a MySQL database, BlastN comparison of new inserts to dynamic and static databases make it a powerful new tool in any laboratory using DNA sequencing. Ebbie also prevents manual mistakes during the excision process and speeds up annotation and data-entry. Once the server is installed locally, its access can be restricted to protect sensitive new DNA sequencing data. Ebbie was primarily designed for smRNA cloning projects, but can be applied to a variety of RNA and DNA cloning projects.

Algorithms↗

[Evaluation of vital statistics for the study of causes of death in Latin America].

"The present article attempts to take a deeper look at the most relevant aspects of the problems presented by the data on adult mortality and causes of death in Latin America.... Statistical coverage of registered deaths by age and sex is analysed, finding important differences among the countries and higher coverage in the registration of adult deaths than of younger ones.... Data quality on causes of death...showed some improvement during the period studied.... Reference is made to topics related to the analysis of causes of death [that] generally complicate the work, such as the heterogeneity of coverage and data quality at subnational levels, the compatibility among different revisions of the ICD, the use of ill-defined causes and, finally, access and management of basic information." (SUMMARY IN ENG)

Adult↗

An off-line system for in-time analysis of cardiac catheterization data and for establishment of a cardiological database for retrospective studies.

The system described may be divided in two major parts: (i) automatic analysis of cardiac catheterization data running off-line on a Siemens 305 computer; (ii) storage and retrieval of the results from these analyses and additional data from related departments (thoracic surgery, internal medicine and clinical physiology) in a cardiological database on an IBM 370/155 computer. The first part is described with special regard to (i) operation and control during the phases of data collection, pre-processing, processing and storage of results; (ii) the presentation of the results in a complete and readable form and (iii) the modular design of the software. The results of an evaluation of the computer methods versus manual methods are also presented. The second part has been described with regard to the type of data entered in the cardiological database. The structure of the database and the programs used for storage and retrieval have not been described in detail in the present publication.

Analog-Digital Conversion↗

A system for the management of clinical information in orthopaedics.

Clinical research in orthopedics is especially dependent upon long-term patient studies. The meticulous, time consuming record keeping which such studies require is often prohibitive. Primarily to resolve this dilemma, but also to improve the organization and use of published biomedical literature in an academic, orthopedic department, a Clinical Information System is useful. The system is coordinated by a medical librarian with experience in information management. Computers are used to optimize the storage and retrieval of both patient generated data and biomedical publications data. Most significantly, the system allows for the orderly collection and storage of clinical data for prospective studies while minimizing the amount of time which the orthopedist must devote to such activities. The overall impact of a Clinical Information System is the spawning of a clinical environment which stresses the importance of documented evidence in patient care and which encourages participation in activities which produce such documentation.

Humans↗

Computer-assisted collection and analysis of pathology data.

At the National Center for Toxicological Research, long-term experiments with mice requiring the collection, storage, retieval, and analysis of an inordinate amount of data necessitated the development of an automated pathology information system. The system included automatic collection of mouse body and organ weights and hematologic findings; the use of mark-sensitive forms for the collection of gross and microscopic findings; and the use of computers for the storage, retrieval, and analysis of pathology data.

Animals↗

The medical heritage concept: a model for assuring comparable laboratory results in long-term longitudinal studies.

The success of a three or four decade health monitoring program depends upon the constancy and stability of the laboratory measurement data. This paper describes a prospective model which has been implemented as part of a 30-year health care program developed for the benefit of a particular group of residents who have lived for more than two years within five miles of an industrial plant which processed uranium metal and contaminated the surrounding area. Effective long-term laboratory monitoring (20 to 40 years) requires (1) a stable analytical base to establish comparability of all data collected, (2) innovative computer based record keeping, and (3) two selected reference populations which reflect method bias and widespread population change bias. To meet this need for comparability, the long-term Medical Heritage comparability concept was developed. This is an approach to the determination, storage, and retrieval of the laboratory data obtained on each specific participant in such a manner that all of that participant's data are internally comparable and continually traceable to definitive and/or reference methods developed by the National Institute for Standards and Technology and the Centers for Disease Control and the National Committee for Clinical Laboratory Standards. Systematic long-term documentation differentiates the Medical Heritage 30 to 40 year concept from the current short-term two- to three-year data continuity systems. As a model for long-term medical monitoring, the Medical Heritage comparability concept gives validity to individual patient care monitoring decisions.

Adult↗