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CHARTLINE: providing bibliographic references relevant to patient charts using the UMLS Metathesaurus Knowledge Sources.

A successful medical informatics program helps its users to match their information needs as closely and efficiently as possible to the capabilities of the system. CHARTLINE is a computer program whose input is a free text, "natural language" patient chart in ASCII format. Using the UMLS Metathesaurus Knowledge Sources, CHARTLINE can suggest bibliographic references relevant to the patient case described in the chart. The program does not attempt to "understand" the natural language content of the chart. CHARTLINE only recognizes UMLS Metathesaurus Main Concept terms (or their synonyms) as they occur in the medical text, since those terms represent the tokens used to index the literature. The program depends on user feedback to determine which topics of a large number of potentially relevant subjects are of interest to the user.

Diagnosis, Computer-Assisted↗

SmartQuery: context-sensitive links to medical knowledge sources from the electronic patient record.

Physicians have many unmet information needs that arise in the course of patient care. Many clinical questions could potentially be answered by streamlined access to medical literature, textbooks, and clinical guidelines in the context of the electronic medical record. We designed and implemented SmartQuery, a prototype application to provide context-sensitive links from an electronic patient record to relevant medical knowledge sources, then performed a preliminary user evaluation. Our results suggest that such an application may be clinically useful, and provide some insight into problems and priorities for future development.

Expert Systems↗

The PDA as a portal to knowledge sources in a wireless setting.

Two recent parallel developments, the widespread deployment of wireless networks and increased use of handheld devices like the personal digital assistant (PDA), have contributed to the development of mobile access to the Internet. Recent surveys show that approximately 25% or more of physicians use PDAs. Although used mainly for personal information management and static medical applications, PDAs have capabilities to connect to the Internet. We studied the use of handheld devices to access MEDLINE and other knowledge sources in a wireless setting.

Attitude of Health Personnel↗

Using MEDLINE as a knowledge source for disambiguating abbreviations and acronyms in full-text biomedical journal articles.

Biomedical abbreviations and acronyms are widely used in biomedical literature. Since many of them represent important content in biomedical literature, information retrieval and extraction benefits from identifying the meanings of those terms. On the other hand, many abbreviations and acronyms are ambiguous, it would be important to map them to their full forms, which ultimately represent the meanings of the abbreviations. In this study, we present a semi-supervised method that applies MEDLINE as a knowledge source for disambiguating abbreviations and acronyms in full-text biomedical journal articles. We first automatically generated from the MEDLINE abstracts a dictionary of abbreviation-full pairs based on a rule-based system that maps abbreviations to full forms when full forms are defined in the abstracts. We then trained on the MEDLINE abstracts and predicted the full forms of abbreviations in full-text journal articles by applying supervised machine-learning algorithms in a semi-supervised fashion. We report up to 92% prediction precision and up to 91% coverage.

Artificial Intelligence↗

WRAPIN: new generation health search engine using UMLS knowledge sources for MeSH term extraction from health documentation.

To realize the potential of the Internet as a source of valuable healthcare information, for the general public, patients or practitioners, it is imperative to establish a validation system based on standards of quality. The WRAPIN project (World-wide online Reliable Advice to Patients and Individuals) from the European Community has this ambitious goal. WRAPIN is a federating system for medical information with an editorial policy of intelligently sharing quality and professional information. The WRAPIN project has two main axes: the efficient and intelligent search of information and the assertion of the trustworthiness of content. This article presents the scientific challenges involved in extracting the knowledge from text-based information in order to better manage the knowledge and the rest of the retrieval proc-ess. Our innovative approach is to efficiently extract MeSH terms from the analyzed documents exploiting UMLS knowledge sources. A benefit has been measured when comparing extraction results. Even if the evaluation is made with a limited corpus, this research work proposes heuristics that can be validated to the whole biomedical domain, and possibly enhanced by the adjunction of other methods.

Abstracting and Indexing↗

Contraceptive methods: knowledge sources rated by women and men.

People today live amid a welter of information regarding contraception, and health care professionals have been the most prominent sources to which people turn. This study evaluates the relative importance of various information sources and ascertains the position of the physicians among them. Random samples (393 women and 395 men) were drawn from the Finnish population. Response rates were 56% for women and 45% for men. The respondents were asked to estimate the amount of knowledge they had obtained from various sources on a visual analog scale. The three most important sources for women were literature, physicians, and women's journals. For men, literature and the spouse/partner were the most prominent. The youngest age groups--women and men alike--had received more information from the school nurse and the teacher than older groups. Physicians have a central role as information sources. They should be aware of other information sources in the community and should adapt their own work accordingly.

Adolescent↗

Knowledge sources for Natural Language Processing.

This paper aims at reviewing the problem of feeding Natural Language Processing (NLP) tools with convenient linguistic knowledge in the medical domain. A syntactic approach lacks the potential to solve a number of typical situations with ambiguities and is clearly insufficient for quality treatment of natural language. On the other hand, a conceptual approach relies on some modelling of the domain, of which the elaboration is d long-term process and where the ultimate solutions are far from being recognised and universally accepted. In-between is the beauty of the compromise. How can we significantly improve the coverage of linguistic knowledge in the years to come?

Artificial Intelligence↗

Terminologia anatomica: considered from the perspective of next-generation knowledge sources.

This report examines the semantic structure of Terminologia Anatomica, taking one page as an example. The focus of analysis is the meaning imparted to an anatomical term by virtue of its location within the structured list. Terminologia's structure, expressed through hierarchies of headings, varied typographical styles, indentations, and an alphanumeric code, implies specific relationships among the terms embedded in the list. Together, terms and relationships can potentially capture essential elements of anatomical knowledge. The analysis focuses on these knowledge elements and evaluates the consistency and logic in their representation. Most critical of these elements are class inclusion and part-whole relationships. Since these are implied, rather than explicitly modeled, by Terminologia, the use of the term list is limited to those who have some knowledge of anatomy; computer programs are excluded from navigating through the terminology. Assuring consistency in the explicit representation of anatomical relationships would facilitate adoption of Terminologia as the anatomical standard by the various controlled medical terminology (CMT) projects. These projects are motivated by the need to computerize the patient record, and their aim is to generate machine-understandable representations of biomedical concepts, including anatomy. Because of the lack of a consistent and explicit representation of anatomy, each of these CMTs has generated its own anatomy model. None of these models is compatible with any other, yet each is consistent with textbook descriptions of anatomy. The analysis of the semantic structure of Terminologia Anatomica leads to some suggestions for enhancing the term list in ways that would facilitate its adoption as the standard for anatomical knowledge representation in biomedical informatics.

Anatomy↗

Perceived trustworthiness of knowledge sources: the moderating impact of relationship length.

Prior meta-analytic evidence has indicated no association between relationship length and perceived trustworthiness. Viewing trustors as information processors, the authors propose a model in which relationship length, although having no direct effect on perceived trustworthiness, moderates the association between perceived trustworthiness and the basis on which people decide to trust each other. Specifically, as trustors learn about others, they base their trust on different kinds of information (demographic similarity, trustworthy behavior, and shared perspective). Hierarchical multiple regression analyses of a field survey of supervisors and subordinates from 3 companies (N = 88) provide evidence consistent with this prediction: Perceived trustworthiness is associated with demographic similarity in newer relationships, with trustworthy behavior in relationships that are neither brand new nor old but in-between, and with shared perspective in older relationships.

Attitude↗

Molecular model-building of amylin and alpha-calcitonin gene-related polypeptide hormones using a combination of knowledge sources.

Amylin is the major component of the amyloid found in the pancreases of noninsulin-dependent diabetics (type 2 diabetes). It is a 37 amino acid polypeptide and has been shown to have 46% sequence identity with the neuropeptide alpha-calcitonin gene-related peptide (alpha-CGRP). Both amylin and alpha-CGRP are known to be potent inhibitors of glycogen synthesis in stripped rat soleus muscle. Secondary structure prediction and tertiary structure model-building show the two polypeptides to have an alpha-helix/beta-strand motif similar to that observed in the insulin B-chain. The results have been supported by CD spectroscopy, although there is no sequence similarity between insulin and amylin/alpha-CGRP. Aggregation states have been predicted based on the dimeric and hexameric arrangements seen in porcine insulin. Rat and hamster amylin have a changed sequence motif in the beta-strand which results in lack of amyloid formation and type 2 diabetes. This, we propose, is caused by disruption of hydrogen bonding which prevents the formation of the dimer.

Algorithms↗

Protein structural domain parsing by consensus reasoning over multiple knowledge sources and methods.

Domain parsing, or the detection of signals of protein structural domains from sequence data, is a complex and difficult problem. If carried out reliably it would be a powerful interpretive and predictive tool for genomic and proteomic studies. We report on a novel approach to domain parsing using consensus techniques based on Hidden Markov Models (HMMs) and BLAST searches built from a training set of 1471 continuous structural domains from the Dali Domain Dictionary (DDD). Validation on an independent test sample of family-matched structural domain sequences from the Scop database yields a consensus prediction performance rate of 75.5%, well above the 58% obtained by simple agreement of methods.

Algorithms↗

Enhancements of anatomical information in UMLS knowledge sources.

Although anatomical terminology forms a part of biomedical structured vocabularies, available sources lack the requisite granularity, semantic types and relationships for comprehensively and consistently representing anatomical concepts in machine readable form. Thoracic angiology was selected as a proof of concept experiment for in depth representation of symbolic information in gross anatomy through the enhancement of semantic types, concepts and relationships in UMLS. Provided the representation of concepts is comprehensive, hierarchies generated with four types of simple relationships are capable of displaying anatomical information from the systemic view point with sufficient detail to meet the needs of applications in basic science education and in the practice of surgical subspecialties.

Anatomy↗