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Gero-informatics and the Internet: locating gerontology information on the World Wide Web (WWW).

The Internet, and in particular the World Wide Web (WWW), are growing at a tremendous rate. Information useful to researchers and practitioners in gerontology is scattered and hard to locate, even for experts in the use of the WWW. In order to locate and organize access to this material, a WWW server was developed for gerontologists, using state-of-the-art Internet search techniques. This report provides background on the WWW, reasons for its growth, its potential usefulness to gerontologists, and the results of an exhaustive search of over 300 potential sites. Relevant information was discovered in 5 general categories of gerontology-related information: academic institutions, government agencies, biomedical and health research institutions, general interest sites and data archives.

Aged↗

An approach to establishing a health information market.

The Tempus CME project "Regional Network for Healthcare Management" was aiming to perform a feasibility study for a communication network dedicated to the healthcare field. The needs assessment survey as well as the debates during the working sessions and during the conference on how communication can support a better healthcare delivery, substantiated the approach for achieving the Romanian health information market. The proposed communication network can be considered as a national information infrastructure offering good links between health, education, research and industry and a unique frame for information providers and users, for the estate and private companies. The network should also provide support and guidance for the development of new educational fields as applied informatics in healthcare.

Computer Communication Networks↗

[Documentation concepts in MedNet-Rheuma (competence network "Inflammatory-rheumatic systemic diseases")].

Concepts of documentation rely not only on the contents required and technical demands, but the procedures covered and in medical applications especially security aspects are also matters of critical concern. Even though the need for effective documentation (i.e., adequate in content, availability, feasibility and easy to retrieve analysis) is not a question, tasks and aims (for example, quality of patient care) deserve attention and establishing efforts have to be analyzed regarding their structural and personal prerequisites and implications before particular tools for documentation can be developed.

Computer Security↗

Steering through the murky waters of a scientific conflict: situated and symbolic models of clinical cognition.

The situated action perspective, which embraces a diversity of views, challenges several of the fundamental assumptions of the symbolic information-processing framework underlying cognitive science and artificial intelligence. In this paper, we consider the following issues; symbolic representations, plans and actions, distributed cognition, and the transfer of learning. We evaluate each of these issues in terms of research and theories in clinical cognition and examine the implications for education and training, and for the integration of intelligent systems in medical practice. We argue for a reconceptualization of the symbolic framework in terms of the way the role of internal representations and cognitive activities are perceived. However, symbolic representations are integral to medical cognition and should continue to be central in any theoretical framework. A re-examination of cognitive science in medicine in terms of the relationship among physicians, technology, and the workplace could prove to be constructive in bridging the gap between theory and practice.

Artificial Intelligence↗

The HELP hospital information system: update 1998.

The HELP hospital information system has been operational at LDS Hospital since 1967. The system initially supported a heart catheterization laboratory and a post open heart Intensive Care Unit. Since the initial installation the system has been expanded to become an integrated hospital information system providing services with sophisticated clinical decision-support capabilities to a wide variety of clinical areas such as laboratory, nurse charting, radiology, pharmacy, etc. The HELP system is currently operational in multiple hospitals of LDS Hospital's parent health care enterprise--Intermountain Health Care (IHC). The HELP system has also been integrated into the daily operations of several other hospitals in addition to those at IHC. Evaluations of the system have shown: (1) it to be widely accepted by clinical staff; (2) computerized clinical decision-support is feasible; (3) the system provides improvements in patient care; and (4) the system has aided in providing more cost-effective patient care. Plans for making the transition from the 'function rich' HELP system to more modern hardware and software platforms are also discussed.

Computer Systems↗

EDGAR: extraction of drugs, genes and relations from the biomedical literature.

EDGAR (Extraction of Drugs, Genes and Relations) is a natural language processing system that extracts information about drugs and genes relevant to cancer from the biomedical literature. This automatically extracted information has remarkable potential to facilitate computational analysis in the molecular biology of cancer, and the technology is straightforwardly generalizable to many areas of biomedicine. This paper reports on the mechanisms for automatically generating such assertions and on a simple application, conceptual clustering of documents. The system uses a stochastic part of speech tagger, generates an underspecified syntactic parse and then uses semantic and pragmatic information to construct its assertions. The system builds on two important existing resources: the MEDLINE database of biomedical citations and abstracts and the Unified Medical Language System, which provides syntactic and semantic information about the terms found in biomedical abstracts.

Algorithms↗

An Internet implementation of an international clinical study.

This paper describes a clinical study that is being conducted in 15 countries world-wide via the internet. The study concerns the removal of Factor VIII inhibitors in haemophilic children. The suitability of the Internet for this type of study is explored together with the technology (Active Server Pages, Secure Sockets Layer) that is involved in the creation of such a system.

Child↗

Mining association rules with improved semantics in medical databases.

The discovery of new knowledge by mining medical databases is crucial in order to make an effective use of stored data, enhancing patient management tasks. One of the main objectives of data mining methods is to provide a clear and understandable description of patterns held in data. We introduce a new approach to find association rules among quantitative values in relational databases. The semantics of such rules are improved by introducing imprecise terms in both the antecedent and the consequent, as these terms are the most commonly used in human conversation and reasoning. The terms are modeled by means of fuzzy sets defined in the appropriate domains. However, the mining task is performed on the precise data. These "fuzzy association rules" are more informative than rules relating precise values. We also introduce a new measure of accuracy, based on Shortliffe and Buchanan's certainty factors [Shortliffe E, Buchanan B. Math Biosci 1975;23:351-79]. Also, the semantics of the usual measure of usefulness of an association rule, called support are discussed and some new criteria are introduced. Our new measures have been shown to be more understandable and appropriate than ordinary ones. Several experiments on large medical databases show that our new approach can provide useful knowledge with better semantics in this field.

Databases, Factual↗

Utilization of a paediatric link collection by health professionals and laypersons.

The Internet is an evolving resource for health-care information. However little information exists on providers' and other web patrons' usage of the 'medical' Internet. This study aims to characterize the users of a large paediatric link collection, describe their objectives and track their use of the information provided by the site. We utilized a paediatric link collection called the Pediatric Points of Interest (POI) and a combination of a questionnaire, unique user identifier and link-tracking system to collect data about POI patrons' demographics and Internet resource utilization. During a five week period, 5216 individuals visited the POI and requested 36,187 links. The majority of users had less than one year of Internet experience and were first-time visitors to the POI. More than 83% of users were from North America. Medical professionals were more likely to return to the POI during the study period and reported visiting the POI mainly for 'medical education', 'research', 'resource identification', and 'disease specific information'; they proceeded primarily to the resource categories 'Medical Institutions and Agencies' (32%) and 'Professional Education and Resources' (28%). Laypersons expressed the greatest interest in 'disease specific information' and 'patient education' and most frequently visited the category. 'Patient Education' (42%). On average, users were able to identify resources related to their stated goals within one level of searching. Health care providers and other web patrons are actively utilizing Internet sites to seek medical information and are able to identify resources with a minimum of searching.

Adolescent↗

Pacing and computing.

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Cardiac Pacing, Artificial↗