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PubMed1989

Tropical epidemiology: a system for continuous demographic monitoring of a study population.

Epidemiologists in many developing countries, where official demographic services are unavailable, have to include some demographic functions in their work. The usual method of documenting a study population for epidemiological research in a developing country consists of three stages: mapping, enumeration and vital registration. This paper considers the last element of this process, detailing the development of a suitable data system and explaining how its implementation using microcomputers and a database management system can help in the creation of an on-line continuous vital registration system for a study population as an epidemiological tool. The issues covered are data collection, entry and analysis, and the advantages of such a system for use in epidemiological research in developing countries are also discussed.

Africa, Western↗
PubMedDate not supplied

Structure and software tools of AIDA.

AIDA consists of a set of software tools to allow for fast development and easy-to-maintain Medical Information Systems. AIDA supports all aspects of such a system both during development and operation. It contains tools to build and maintain forms for interactive data entry and on-line input validation, a database management system including a data dictionary and a set of run-time routines for database access, and routines for querying the database and output formatting. Unlike an application generator, the user of AIDA may select parts of the tools to fulfill his needs and program other subsystems not developed with AIDA. The AIDA software uses as host language the ANSI-standard programming language MUMPS, an interpreted language embedded in an integrated database and programming environment. This greatly facilitates the portability of AIDA applications. The database facilities supported by AIDA are based on a relational data model. This data model is built on top of the MUMPS database, the so-called global structure. This relational model overcomes the restrictions of the global structure regarding string length. The global structure is especially powerful for sorting purposes. Using MUMPS as a host language allows the user an easy interface between user-defined data validation checks or other user-defined code and the AIDA tools. AIDA has been designed primarily for prototyping and for the construction of Medical Information Systems in a research environment which requires a flexible approach. The prototyping facility of AIDA operates terminal independent and is even to a great extent multi-lingual. Most of these features are table-driven; this allows on-line changes in the use of terminal type and language, but also causes overhead. AIDA has a set of optimizing tools by which it is possible to build a faster, but (of course) less flexible code from these table definitions. By separating the AIDA software in a source and a run-time version, one is able to write implementation-specific code which can be selected and loaded by a special source loader, being part of the AIDA software. This feature is also accessible for maintaining software on different sites and on different installations.

Database Management Systems↗
PubMed1991

The SADE system: an endoscopic database manager.

The development of the SADE database manager was commenced in 1985 since no commercially available systems were suited for the needs of a large endoscopy unit. Over a period of five years, this database was programmed, revised and enhanced through the joint efforts of gastroenterologists and programmers, the SADE system being implemented for daily use on 1 January 1989. The patient administration and medical record modules are fully implemented and functional, while the statistical module has only recently been finished. The present features of the system are described, and the limitations discussed. Instant report generation and direct access to previous medical data are the most immediate benefits of the system. The initial intention to have structured anamnestic data had to be modified to suit the need for flexibility and ease of free text input by the users.

Computer Systems↗
PubMed1992

Computer databases of medical school curricula.

As the pace of curriculum reform in medical education has accelerated during the past decade, so too have demands on curriculum managers to supply increasingly detailed information about the curriculum. In response, a number of schools have joined together to begin work on designs for computer databases of the curriculum. The authors describe three of the most mature curriculum database prototypes, developed by groups at the medical schools of the University of North Carolina at Chapel Hill (UNC), The University of Maryland, and the University of Miami. All three groups have employed relational database management systems to organize information about each "instructional unit" in the preclinical curriculum, including a set of keywords defining the major concepts presented. The keywords are indexed to a controlled vocabulary, either the Medical Subject Headings (MeSH) or a MeSH derivative. The UNC database also employs a textfile management system to provide users with an overview of the entire curriculum. Future work will focus on identifying a suitable controlled vocabulary; capturing content in greater contextual detail; incorporating alternative learning formats, such as problem-based learning; creating links between content items and examination questions; and capturing information generated by student-patient interactions in clinical settings. As a result of recent collaboration with the Association of American Medical Colleges, work to define a prototype national database has begun and a consortium of interested schools is addressing further development activities.

Abstracting and Indexing↗
PubMed1988

ASSIST: an alternative management information system for social services in health care.

This paper describes a flexible, relational database management system designed explicitly with the needs and realities of social work in health care settings in mind. A variety of broad-based applications as well as organizational factors influencing implementation of automated information system are also discussed.

Decision Support Systems, Management↗
PubMed1988

[Problems of medical documentation in the hospital].

Problems of medical documentation arise from an explosive increase of data-volumes, complexity and multiplicity in data-management. The causality of that development, the possibility of computerized support in repetitive data-management, the economic, organizing and scientific problems are widely discussed. Solving the problems in the hospital a potent middle-ranged computer offers his services under certain circumstances. To obtain an efficient support following details are to take into consideration: reduction in manipulation-time, program-organization under medical demands, safe transfer of data and text by application of modern and potent database management systems as a tool of organizing, combining and retrieving informations.

Austria↗
PubMed1986

BACOMP--database of bioactive compounds for structure-activity relationship.

BACOMP database is presented for structure-activity relationship (SAR) investigations; it was realized on a BK-1300 general purpose microcomputer using the MICRO-SETOR network database management system. Some general considerations of database design are given and the models and facilities for a development of a microcomputer-based SAR oriented database are described. The database contains the following information for the bioactive compounds: chemical structures, biological activities, trade names, reference numbers and information sources. For computer representation of chemical structures SAR oriented language is used. The database software includes: system software, data capture and data editing software, information retrieval and data processing applications. The software development is done in FORTRAN IV and MACRO assembly language. The programs are written in a completely interactive mode. The information retrieval software includes 12 functions giving an information for the database as a whole and for a single compound as well. The data processing software includes 8 functions for finding common structural fragments among compounds with similar biological activity and for estimating a structural similarity between different compounds. The functions are selected from corresponding screen MENUs. The function realization results are framed as appropriate screen formats and the receipt of hardcopies is available. The database can be used to develop predictive methods in respect of the investigated biological activity.

Drug Information Services↗
PubMed1989

[Computer-assisted documentation in upper gastrointestinal endoscopy: experiences with routine use at 3 clinics].

The introduction of powerful and inexpensive personal computers (PC) enabled us to develop a documentation system for upper gastrointestinal endoscopy. The system was programmed using the database management system dBASE III. It works on-line, and no computer knowledge or additional staff is needed to run the system. It is now routinely used in the endoscopic units of three different hospitals. Features of performance are a menu-driven data input, automatic report generation and record retrieval, listing according to different criteria as well as other dBASE III facilities. This paper deals with the quality, time effort and user acceptance of the PC-aided system in clinical routine. The analysis showed a good data quality with respect to completeness and adequate use of terminology. Reliability and validity of the documentation were satisfactory considering the methodological problems encountered at their determination. The system was generally judged useful, but time effort was increased compared to conventional documentation.

Documentation↗
PubMed1989

A microcomputer-based clinical trial database incorporated with an 'audit trail' for correction process.

Multicenter clinical trials usually involve several hundred research variables with tens of thousands of records and require mainframe computers for processing. Because of recent advances in hardware and software, it has become possible to support data management and statistical analysis for a complex research project totally on a microcomputer. The Veterans Administration Cooperative Studies Program Coordinating Center (CSPCC) in Hines, IL, U.S.A. has successfully implemented three studies employing the SIR/PC Database Management System (DBMS) on an IBM PC AT. The CSPCC DBMS was designed with a method of verifying data and of updating the database, that leaves a more detailed 'audit trial' of the original data and subsequent modifications than provided by the SIR audit trail facility. Data validation can be done at any time throughout the study to facilitate error identification as early as possible in the data handling process. DBMS operation and maintenance are automated by a system of menus. The utility programs are prestored in a procedure file to optimize performance. The simple design speeds implementation and also reduces the cost of development.

Clinical Trials as Topic↗
PubMed1991

Postmarketing surveillance and other epidemiologic uses of drug prescription data in the United States.

Currently the data resources available for conducting pharmacoepidemiology studies in the United States include spontaneous case reports of adverse reactions, aggregate population-based data resources, computerized collections of data from organized medical care programs, data collected for pharmacoepidemiolgy on an ongoing basis, existing data collected as part of other ad hoc studies, and data collected de novo for pharmacoepidemiology studies. The advantages and disadvantages of each and the particular contributions of drug prescription data to each approach are described.

Adverse Drug Reaction Reporting Systems↗
PubMedDate not supplied

A database design for community health data.

The ability to collect, store, and retrieve community health data is critical to providing health services in a timely and efficient manner. With the widespread availability of computer hardware and software that can assist in this process, the task is becoming easier. One important tool is the database management system (DBMS). A DBMS provides a conceptual framework to assist in organizing data and software that can physically store, maintain and retrieve data. The most popular DBMSs available today support the Relational Data Model, which has a conceptual framework that provides for the organization of data in tables. The authors present a database design, using the Relational Data Model, for a database of community health data.

Community Health Nursing↗
PubMed1986

[Testing an expert system for hypertension].

An Expert System (ES) has been connected to a database management system for the management and follow-up of hypertensive patients. The patient data base, called Artemis, contains approximately 18,000 medical records. About 90% of the initial informations used by the ES is contained in the medical records of the Artemis data base. The knowledge base consists of 870 rules. A first group of rules allows the description of knowledge structures (hierachies, graphs and mutual exclusions). The second group consists of production rules which describe the dynamic reasoning of the expert. The inference engine uses a combination of forward and backward chaining. The ES produce diagnostic hypotheses (possible causes of hypertension) and therapeutic suggestions before and after requiring additional information (patient supplementary interrogation, biological or radiological investigations). The evaluation of the diagnostic performance of the ES was made on 40 confirmed cases of secondary hypertension (SH) and 40 cases of essential hypertension (EH). The initial initial diagnosis, just after the forward chaining step, was correct in 17 cases of SH and 32 cases of EH. The final diagnosis proposed after several steps of forward and backward chaining was correct in 37 cases (92%) of SH and 36 (90%) of EH. Averages of 5 (EH) and 8 (SH) questions were formulated by the ES to reach the final diagnosis. The integration of the ES to the database is expected to facilitate the validation of the knowledge base and to enhance its overall acceptability. Whether or not such an integration will be useful and accepted as a complementary tool by physicians remains however an open question.

Decision Making, Computer-Assisted↗
PubMedDate not supplied

PACS in practice: the status of the PACS project at the St. Radboud University Hospital. Part B. A digital image archive: information analysis and development.

In accordance with the bottom-up approach in the field of the Picture Archiving and Communication System (PACS), a pilot study was performed with regard to the archiving of digital diagnostic images. A prototype has been developed to determine what information has to be stored in the digital archive and what requirements the users have in accessing these data. Firstly an organization analysis of the department of diagnostic radiology with respect to the archiving of images was performed. A variant of the ISAC method was used for this purpose. This resulted in a set of activity diagrams. Thereafter an information analysis was performed according to the Nijssen Informal Analysis Method (NIAM). This resulted in a Conceptual Schema (CS). Two other prototypes of relational Image Database Management Systems (IDBMS) are described and a description of a general modular structure of an IDBMS is given. By means of a Prototype of a Digital Archive (PDA) the department of diagnostic radiology was shown what might be expected from a digital archive and how the information will be presented to the users.

Database Management Systems↗
PubMed1987

Managing orthodontic data on a small computer.

A literature survey of file management, relational database management, and network/hierarchical database management systems led to selection of dBASE III to manage patient records on an IBM PC in the Department of Orthodontics at the Louisiana State University School of Dentistry. The versatility of this system's internal language enables ad hoc analysis of clinical and personal data to meet both anticipated and unanticipated management and scientific needs.

Computers↗
PubMed1992

A prototype radiation oncology clinical information processing system on a personal computer (network).

Software has been developed that facilitates prospective computer entry of the clinical contents of a radiation oncology chart in a way that assists in retrospective analyses. This software, which has been operational since 1988, now contains detailed clinical information on over 500 patients treated since that time, and limited information on over 3000 children treated since 1970. The system has been programmed using the FoxPro database management system, and may be run on an IBM compatible or Macintosh personal computer either alone or in a networked environment. Information is transcribed as routine patient dictations that require no extra personnel for entry. Standard printouts are the conventional notes compatible with the existing paper chart. Exportation of patient records is facilitated by means of built-in facsimile. The software has been designed to generate detailed reports automatically, including the statuses of selected patients or groups, lists of those who are behind in follow-up, and reports of specific events (e.g., mucositis) that occur before, during, or after therapy using free-text searches. Complete reconstruction of the patient's clinical radiation oncology chart is also included. Other abilities include calculation of Kaplan-Meier survival, relapse-free survival, and local control rates, statistical comparison between survival curves, and radiation dose-response. Exportation of data to statistical and graphics packages is also possible. For pediatric patients, a program to predict stature loss has been incorporated. Use of this system can enhance one's ability not only to follow patients but also to monitor and report their outcome continually. With the need to report institutional experiences and increasing demands to monitor quality assurance, such a system can be of great benefit.

Electronic Data Processing↗
PubMed1989

The relational database model and multiple multicenter clinical trials.

The Southwest Oncology Group (SWOG) chose to use a relational database management system (RDBMS) for the management of data from multiple clinical trials because of the underlying relational model's inherent flexibility and the natural way multiple entity types (patients, studies, and participants) can be accommodated. The tradeoffs to using the relational model as compared to using the hierarchical model include added computing cycles due to deferred data linkages and added procedural complexity due to the necessity of implementing protections against referential integrity violations. The SWOG uses its RDBMS as a platform on which to build data operations software. This data operations software, which is written in a compiled computer language, allows multiple users to simultaneously update the database and is interactive with respect to the detection of conditions requiring action and the presentation of options for dealing with those conditions. The relational model facilitates the development and maintenance of data operations software.

Clinical Trials as Topic↗
PubMed1991

[The forensic medicine data bank--the Dresden model].

A data bank of forensic medicine is reported, which recreation is possible without any separate treatment. Informations available by computer-aided writing of autopsy-protocols are recorded automatically by a special programme. Coding is made by the SNOMED and METAS systems.

Autopsy↗