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The neurological information network of the National Institute of Neurological Diseases and Blindness.

The National Institute of Neurological Diseases and Blindness (NINDB) has the responsibility of trying to alleviate the morbid and mortal effects of all the diseases of the nervous system and the special senses including speech, hearing, and vision. The information problem facing the NINDB is only a fraction of the total information problem of the biomedical community, but it is probably representative. The NINDB information audience has a core of about 19,000 persons, 10 percent of whom are nonclinical research scientists; 10 percent of whom are engaged in patient care, teaching, and some research; 12 percent in training (post doctoral); and 68 percent chiefly involved in the care of patients. In addition, there is an unknown number of other interested scientists. Fifty to eighty thousand journal articles, an unknown number of technical reports, and other items produced each year are potentially valuable to this group. The exact needs of each subgroup must be identified and ways developed to deliver the required information quickly, accurately, and in an easily useable form. NINDB has undertaken a large information program as a service to the biomedical community to help cope with these information problems. This program is to serve the needs of the practicing physician, the research scientist, and NINDB program analysis and planning. The Neurological Information Network is the core effort of the program.The Neurological Information Network envisions large units incorporating both information storage and retrieval and information analysis. These will be in universities with strong biomedical libraries where there are ongoing research programs in some area relevant to NINDB responsibilities. These units are to be integrated and will interact with each other and with the National Library of Medicine to avoid duplication of work. In addition to their own information analysis activities, the major documentation centers will be able to support information analysis satellites at other research centers where specific categorical research programs are underway.

Blindness↗

Natural language storage and retrieval of medical diagnostic information. Experience at the UCLA hospital and clinics over a 10-year period.

A natural language storage and retrieval system initially designed for pathology reports has been in operation for ten years at UCLA Hospital and Clinics. The original system has been improved to provide a thesaurus processor with added capabilities for expanding search request terms and a newly developed set of search programs with user options that make complex and more accurate retrievals possible. Summarized diagnostic statements or impressions from five specialities (Surgical Pathology, Bone Marrow, Autopsy, Nuclear Medicine, and Neuroradiology), are automatically encoded by referencing a master computer dictionary containing a unique numeric code for each English word. Input and retrievals are batch, off-line operations in free text, and are currently processed on the IBM 370/145. User acceptance is high, quality of retrievals improved, and cost is nominal. This paper describes an expanded natural language system which in now providing a viable form of information storage and retrieval for research, medical education, patient care, quality control, statistics and administrative purposes.

California↗

Full-text document storage and retrieval in a clinical information system.

The overall design of the CIS at CPMC is heavily influenced by the decision support component. The type of automated decision support being implemented dictates the need for highly structured or coded data. The value of decision support systems has been well documented. The current reliance on free-text documents is natural and a rewarding first step to a more valuable mix of coded and free text. While the health care provider might find the textual comments of the various reports extremely useful, the capability of an automated system to vigilantly review every data element for trends and anomalies is becoming invaluable in today's ever more complex health care delivery environment. Other approaches such as optical imaging systems would facilitate human decision support, but do not supply data in a format that can be processed by automated decision support systems. The developers of the CIS at CPMC believe that data are most valuable when available for both human and automated decision support.

Clinical Medicine↗

Selective dissemination and indexing of scientific information.

Selective dissemination of information to individuals provides a new and promising method for keeping abreast of current scientific information. Since SDI services are directed to the information needs of each individual, they are a significant step beyond grouporiented services and products, which require considerable expenditure of effort by each user as he sorts useful information from trash. However, SDI systems do require a high degree of precision in matching scientists against documents. They must operate more efficiently and economically than many current systems which occasionally provide a useful item of information to users. To meet these stringent requirements for quality, precision, efficiency, and economy, more research must be devoted to comparing and improving indexing methods, which are the basic component of all information storage and retrieval systems. It is incredible that so much money has been spent on the development and operation of scientific information systems before basic data on the comparative performance of various indexing methods have been gathered, analyzed, and confirmed by multiple investigators. The design of an effective information system would seem to require this type of basic knowledge, just as basic properties of alternative materials must be known before an engineer can design a building, bridge, or factory. Yet, except for the few studies mentioned in the previous section, research on indexing methods has been greatly neglected. Bourne's comment about studies of indexing languages is still an appropriate description of the situation: "In almost all the experimental reports, the investigator worked with an indexing language different than that of other experimenters. Consequently, no one has ever had his test results verified, or expanded, or made more precise by another experimenter" (47). Most existing information systems are based on keyword indexing, with concepts broken into isolated terms during input operations and recombined to synthesize the original concept during search and retrieval. Such systems tend to involve imprecise indexing, with a high level of "noise" in retrieved documents, difficult search strategy involving extensive post-coordination, and lengthy, complex computer manipulations. This situation reflects the fact that many producers of indexed data originally focused the design of their systems on the production of a published product with entries printed under short, concise index headings. Production of magnetic tapes as a by-product of the publication process, and their use for retrospective searching or for SDI services, was a much later development, almost an afterthought. Yet use of these tapes is growing so rapidly that it may be time to redesign the tape-producing systems, with ease of tape use for SDI services and retrospective searching as the primary consideration, and with publication of abstract and index bulletins or title listings relegated to secondary importance (49). The use of keywords to index documents creates a high degree of disorganization in information search and retrieval operations: Information is scattered under the many different terms that can be used to index different aspects of a concept. If the large-scale, comprehensive abstracting and indexing services were based on enumerative classifications with assignment of documents to logical hierarchical categories at the time of initial indexing, then many of the specialized information centers (50) and the 1300 abstracting and indexing services (3) would be unnecessary, and much of the reindexing and reprocessing of documents, the repackaging and reworking of abstracts and index data, and the resulting overlap and duplication characteristic of current information processing could be terminated. Partly because of the disorganization resulting from keyword indexing, the cost of a 5-year retrospective search of information on just one data base on magnetic tapes is a major investment (16). The effort and cost required to find a few items of useful information scattered among 1,285,000 abstracts indexed on 116 full reels of magnetic tape (11 million characters per reel) which will be needed for the 5-year Eighth Collective Index to Chemical Abstracts (1967-1971) (51) staggers the imagination. In contrast, when HICLASS systems based on enumerative hierarchical classifications are used, concepts that might be useful for later retrieval are identified and related items of information are grouped together during the indexing process. These enumerative classifications, with single-hit matching, make it possible to index and retrieve ideas as intact units and to perform simple sequential searches of the very small segment of a file that deals with a given topic (31). The experiments at both the Science Information Exchange and the National Cancer Institute, as described in this article, demonstrate that automated HICLASS systems are feasible and can operate at a very satisfactory level of performance. Although considerable effort may be required for the development and constant updating of detailed enumerative classifications, HICLASS categories may facilitate organization of data at the time of input, improve the precision of matching documents with users, and greatly simplify search logic and computer manipulations. If so, then output savings and performance would more than justify input costs, and the development and use of enumerative classifications would be a better solution to information problems than the current keyword-and-coordination approach. It is time to think beyond the ease of the single input step in information systems and to take a hard look at ways of easing retrieval problems for the multitude of information systems that process the indexed data (52). Indexing effort is expended only once, whereas search and retrieval effort is required by every user of a system. If information were better analyzed and organized during input operations, if more basic research were devoted to the effect of indexing methods on the performance of information systems, and if more emphasis were placed on the quality and usefulness of retrieved information, then the magnitude of problems related to the storage and retrieval of scientific information might be considerably reduced.

Abstracting and Indexing↗

Special programs in medical library education, 1957-1971. II. Analysis of the programs.

In this report, responses to a questionnaire to the directors of the sixteen past and present medical library education programs are presented. The questionnaires indicate a rather wide variety of training programs with emphases that vary from preparation of management personnel to preparation of subject specialists and those skilled in the techniques of information storage and retrieval. The content of the degree programs is fairly evenly divided among general retrieval and outside courses. The internship programs place more emphasis on the work experience than do the degree programs, supplementing this experience with appropriate courses in science, health sciences, management, and information storage and retrieval. Program directors indicated that new or expanded programs are needed in medical library education, although caution is reflected in comments concerning the limited job market. Most of the internship directors stated that they could not accommodate more individuals in their programs without expansion of staff and facilities.

Curriculum↗

A computer based system for collection, storage, retrieval and reporting accession information in a veterinary medical diagnostic laboratory.

Substantial data collected from large numbers of accessions, the need for comprehensive reporting of negative as well as positive laboratory findings, and the necessity for obtaining rapid diagnostic correlations prompted the development of a computer based system of accession data management for collection, storage, rapid retrieval, reporting, concording, and administrative compiling in a state-university Veterinary Medical Diagnostic Laboratory.

Animal Diseases↗

Plasticity and learning in a network of coupled phase oscillators.

A generalized Kuramoto model of coupled phase oscillators with a slow varying coupling matrix is studied. The dynamics of the coupling coefficients is driven by the phase difference of pairs of oscillators in such a way that the coupling strengthens for synchronized oscillators and weakens for nonsynchronized pairs. The system possesses a family of stable solutions corresponding to synchronized clusters of different sizes. A particular cluster can be formed by applying external driving at a given frequency to a group of oscillators. Once established, the synchronized state is robust against noise and small variations in natural frequencies. The phase differences between oscillators within the synchronized cluster can be used for information storage and retrieval.

Artificial Intelligence↗

[Computer-assisted drug information].

Experience with a university hospital based drug information service (DIS) is reported. A total of 501 drug related questions were analyzed during two prospective evaluation periods of 13 and 14 months' duration respectively. Information was requested by physicians and pharmacists chiefly on practical aspects of drug treatment in individual patients (77%), such as drug choice, dosage adaptation, side effects and interactions. Inquiries on drug safety in pregnancy and lactation (8.8%), and questions on pharmaceutical properties (14.2%), including pharmacokinetics, were also frequent. Our experience indicates that a problem-oriented, comprehensive DIS necessitates close cooperation between physicians trained in clinical pharmacology and pharmacists within the same team. The use of electronic media greatly facilitates the collection of drug related information, data retrieval and storage. Drug information services can contribute to improved quality and safety of drug therapy.

Computers↗

Development and implementation of a thesaurus for the visual sciences.

A thesaurus has been developed to serve as the integrating unit for the computerized information storage and retrieval system of the Vision Information Center. The Center maintains records of information in the visual sciences which are available to the user in the forms of computer-assisted instruction, literature retrieval, and patient records. The numerical coding system used in the thesaurus permits seven levels of specificity; this specificity is required for depth of indexing, as well as to limit the retrieval to those bibliographic citations which are relevant to a highly specific search request. The flexible design of the thesaurus facilitates frequent revision and addition of new terminology.

Bibliography of Medicine↗