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Visual Health Information Profile (VHIP). A quantitative approach for analysing the health status of a population.

A new approach for illustrating and analysing the health status of a given population is presented. The concept takes the multi-dimensional nature of health into account. It is based on a clearly out-lined indicator hierarchy, a decile reference system and a computerised information system. The instrument displays the health status of a population and allows comparisons to be made of various health aspects for a given population at different times and allows comparisons to be made of different populations during given time periods. It is possible to represent quantitative and qualitative aspects of health, to monitor the impact of interventions, and to assess the extent to which objectives in the health field have been achieved. Therefore, it can serve as an instrument for communication between policy makers and scientists to manage and to co-ordinate programs that aim at an improvement of the health status and to assist in the priority setting process. The method was applied to several countries using the World Health Organisation's (WHO) "Health For All Global Indicator Database" as the main data source. Country and region specific health status patterns could be generated showing the practicability of the approach. Using a computerised information system, a high degree of transparency and flexibility with respect to the input data and the choices of measurables was achieved.

Computer Graphics↗

[A feasibility study of an Internet site on health conferences and regional health programs].

With the regulations of April 1996, national and regional health conferences, as well as regional health programmes were created and became mandatory within the health system. In order to promote this multi-disciplinary approach to public health, the Director General for Health and the National School of Public Health wish to distribute, via Internet, all documents developed during these meetings. This data base will be a tool for the groups of regional health programmes and a source of information for both actors in health and consumers. It will be developed in two steps, with the development of a model throughout four regions and then with an overview of the country. This article describes the project approach, the difficulties experienced and the prospects for this data base.

Community Participation↗

Role of clinical trials informatics in the NCI's cancer informatics infrastructure.

A Web-enabled Cancer Informatics Infrastructure (CII) will enable faster, better clinical trials, ultimately improving cancer care. To create the CII, the National Cancer Institute is forming public-private partnerships and building on existing activities. Key innovations include development of standards for cancer patient information and clinical research, management of patients using disease specific "clinical states" and use of drag and drop electronic protocol authoring.

Breast Neoplasms↗

Usability issues in developing a Web-based consumer health site.

ClinicalTrials.gov is a Web-based system intended for a diverse audience, including patients, family members and other members of the public. Throughout the system design and development process, our decisions have been driven by usability concerns. We first describe the overall design of the site, including the home page, which provides a site overview and rapid access to the information contained within it. Next we discuss the data presentation format which has been standardized in spite of data coming to us from many different sources. We provide a detailed description of the search and browse features that are intended to simplify the complexities of medical terminology and support information discovery. We conclude with a review of our evaluation activities and future plans.

Clinical Trials as Topic↗

Retrospective radiographic analysis of sinus graft and implant placement procedures from the Academy of Osseointegration Consensus Conference on Sinus Grafts.

A retrospective quantitative radiographic analysis determined the effect of graft material and smoking status on the maintenance of graft height over 3 years. Analysis of variance models with planned comparison were constructed to compare mean graft change by (1) graft material and (2) smoking status. Maintenance of bone height was significantly greater in intraoral autogenous grafts versus allografts (P < .05). The effect of smoking on implant loss revealed a significant difference in implant survival (P < .05). Autogenous bone generally resulted in a more favorable outcome over a 3-year period. Smoking adversely impacted implant survival in sinus grafts.

Alveolar Ridge Augmentation↗

Oxytocin antagonists for tocolysis in preterm labour -- a systematic review.

BACKGROUND: Oxytocin antagonists have been shown to inhibit uterine contractions and delay preterm delivery. Our objective was to examine the clinical effectiveness and safety of oxytocin antagonists for tocolysis in preterm labour. MATERIAL/METHODS: We searched MEDLINE, EMBASE, the Cochrane Controlled Trials Register and Science Citation Index using the following Medical Subject Headings and textwords: oxytocin (antagonists and inhibitors), atosiban, antocin, oxytocin antagonists, oxytocin receptor antagonists and oxytocin inhibitors. All randomised controlled trials that compared effectiveness and safety of atosiban with a placebo or another tocolytic in women with threatened or actual preterm labour were included. The primary outcome measure was the proportion of women undelivered by 48 hours from the commencement of treatment. RESULTS: Six articles met the inclusion criteria - two compared atosiban to placebo and four atosiban to a beta-agonist. Meta-analysis showed a significant increase in the proportion of women undelivered by 48 hours in women receiving atosiban compared to placebo (RR 1.13, 95%CI 1.02, 1.26). When compared with beta-agonists, atosiban increased the proportion of women undelivered by 48 hours, but this trend did not reach statistical significance (RR 1.07, 95%CI 0.98, 1.17). Side effect profile was substantially better for atosiban compared to beta-agonists. CONCLUSIONS: Oxytocin antagonists appear to be effective and safe for tocolysis in preterm labour.

Clinical Trials as Topic↗

A rule driven bi-directional translation system for remapping queries and result sets between a mediated schema and heterogeneous data sources.

As the number of online biomedical data sources increases, so too do the number of ways to access such data. The research described herein focuses on creating a data access system that provides bi-directional translation and mapping of data between heterogeneous databases and a mediated schema. Semantic mapping rules stored in a knowledge base are used by our generalized software to convert XML query results obtained from each data source to a common schema representing a single ontology. We apply this approach to the domain of online genetic databases, demonstrating the system's scalability and integratability.

Databases as Topic↗

An assessment of the visibility of MeSH-indexed medical web catalogs through search engines.

Manually indexed Internet health catalogs such as CliniWeb or CISMeF provide resources for retrieving high-quality health information. Users of these quality-controlled subject gateways are most often referred to them by general search engines such as Google, AltaVista, etc. This raises several questions, among which the following: what is the relative visibility of medical Internet catalogs through search engines? This study addresses this issue by measuring and comparing the visibility of six major, MeSH-indexed health catalogs through four different search engines (AltaVista, Google, Lycos, Northern Light) in two languages (English and French). Over half a million queries were sent to the search engines; for most of these search engines, according to our measures at the time the queries were sent, the most visible catalog for English MeSH terms was CliniWeb and the most visible one for French MeSH terms was CISMeF.

Abstracting and Indexing↗

Use of on-line evidence-based resources at the point of care.

BACKGROUND AND OBJECTIVES: The utility of on-line evidence-based summary databases for answering clinical questions at the point of care is not well understood. Our objectives were to determine if family physician faculty could answer their questions using on-line resources and the proportion of answers that influenced patient care. METHODS: This was a prospective study in which clinical faculty in an urban residency training office recorded their clinical questions and their search results. RESULTS: Faculty asked 92 questions. Therapy, prognosis, and epidemiology questions were the most common types of inquiries. Fifty-four percent of the questions were fully or partially answered by use of an on-line resource; obtaining an answer required 5-10 minutes of searching. Physicians reported that 62% of the obtained answers modified their opinion, influenced the care of the current patient 56% of the time, and would affect the care of future patients 70% of the time. Slow Internet connection and interruptions were the most frequent barriers reported. DISCUSSION: Practicing physicians inexperienced in the use of on-line evidence-based resources answered a proportion of their clinical questions that was comparable to reports of more-experienced searchers; however, the time required to find answers limits the practical use of these databases during patient care time. On-line summary databases such as those used in this study show promise in providing answers that influence care during the patient's visit. With faster Internet connection (or handheld devices) and improved navigability, such resources have the potential to optimize health care in the primary care setting.

Clinical Competence↗

List update processing (LUP)--solving the sequence database update problem.

Sequence databases of today require frequent updating. Mirror procedures to copy incrementally updated databases as cumulative sets are the preferred method and can be implemented by straightforward scripting. However, limited bandwidth of networks and the increase of data require more powerful paradigms to reduce the workload reliably. We suggest the List Update Processing (LUP) principle. The system has been implemented on an experimental basis to update the Swiss EMBnet Node (BioComputing Basel, CH) with data from the European Bioinformatics Institute (EMBL Outstation, Hinxton Hall, UK). The results obtained from the prototype suggest to expand the system to several sites.

CD-ROM↗

Ubiquitous distributed objects with CORBA.

Database interoperation is becoming a bottleneck for the research community in biology. In this paper, we first discuss the question of interoperability and give a brief overview of CORBA. Then, an example is explained in some detail: a simple but realistic data bank of STSs is implemented. The Object Request Broker is the media for communication between an object server (the data bank) and a client (possibly a genome center). Since CORBA enables easy development of networked applications, we meant this paper to provide an incentive for the bioinformatics community to develop distributed objects.

Base Sequence↗

An approach to detection of protein structural motifs using an encoding scheme of backbone conformations.

This paper presents an approach to detection of protein structural motifs. In our approach, first all protein backbone conformations are converted into character strings using an encoding scheme. Then we use the Smith-Waterman local alignment algorithm to detect common structural motifs. By comparing results with the PROSITE regular expression patterns, our method can detect several motifs which the PROSITE patterns fail to detect.

Amino Acid Sequence↗

Using the radial distributions of physical features to compare amino acid environments and align amino acid sequences.

We have performed a comprehensive analysis of the microenvironments surrounding the twenty amino acids. Our analysis includes comparison of amino acid environments with random control environments as well as with each of the other amino acid environments. We describe the amino acid environments with a set of 21 features summarizing atomic, chemical group, residue, and secondary structural features. The environments are divided into radial shells of 1 A thickness to represent the distance of the features from the amino acid C beta atoms. We make the results of our analysis available graphically over the world wide web. To illustrate the validity and utility of our analysis, we used the amino acid comparative profiles to construct a substitution matrix, the WAC matrix, based on a simple summary of the computed environmental differences. We compared our matrix to BLOSUM62 and PAM250 in BLAST searches with query sequences selected from 39 protein families found in the PROSITE database. Although BLOSUM62 was the most sensitive matrix overall, our matrix was more sensitive for some families, and exhibited overall performance similar to PAM250. Our results suggest that the radial distribution of biochemical and biophysical features is useful for comparing amino acid environments, and that similarity matrices based on the geometric distribution of features around amino acids may produce improved search sensitivity.

Amino Acid Sequence↗