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[Review of the development of ophthalmic informatics].

Digitized information technology, which is rising and permeating into other scientific domains, is a major trend of contemporary science development. The overlap between ophthalmology and informatics creates ophthalmic informatics, a new and developing discipline. Ophthalmic informatics utilizes the computer as the primary tool and with the aid of ophthalmic knowledge, develops a system to analyze patient data and evaluates the accuracy of the system. It also provides a new method for the development of traditional ophthalmology. In order to let more ophthalmologist to handle the knowledge of ophthalmic informatics and to use it in the practice, this article carries a comprehensive review of ophthalmic informatics, with emphasis on the principle, content and method of ophthalmic informatics. Some relevant studies on ophthalmic informatics in China in recent years are enumerated, as well as the basic frame for studying ophthalmic informatics.

Medical Informatics↗

Biomedical and health informatics education at UMIT-approaches and strategies at a newly founded university.

Based on the recommendations of the International Medical Informatics Association (IMIA, ) on education in health and medical informatics and on experiences in founding a new school, the University for Health Informatics and Technology Tyrol (UMIT, ), at Innsbruck, Austria, questions on education in health informatics, medical informatics, and biomedical informatics are discussed. Suggestions are made on (1). appropriate approaches for specialized educational programs in biomedical and health informatics at the university level, on (2). resources and infrastructures needed for running such programs at a high-quality level, and on (3). strategies to be considered for the future development of such educational programs. UMIT strives for an international top position in education and research. It entirely concentrates on areas in research and education in biomedicine and the health sciences. UMIT started in the academic year 2001/2002 with two educational programs. They lead to a B.Sc. degree (3 years) and a M.Sc. degree (1.5-2 years) in medical informatics. In parallel Ph.D. students work in research projects.

Austria↗

An investigation into health informatics and related standards in China.

OBJECTIVE: To describe the current status of and future plans for health informatics and related standards in China and analyze the problems raised in the process of standardization for health informatics. METHODS: Data were collected through investigation and interviews, complemented by a comprehensive review of relevant literatures and regulations/law documents about health informatics and related standards in China. RESULTS: Health informatics has been greatly developed in China. Significant resources were committed to construct and improve the health information system. Approximately 35-40% of hospitals have constructed hospital information system. Over 80% of medical organizations above the county/district level, 27% of town level hospitals and all CDC above the county/district level can transmit real-time epidemic situation reporting through public health information system. However, lack of standards became a bottleneck to utilize and improve health informatics. China has adopted some vocabulary, classification, coding standards and message standards. Moreover, several national standardization actions for health informatics have been taken. In the process of standardization, the main barriers consist of financial, technical, cultural and language problems, legal and ethical concerns and others. CONCLUSIONS: Informatics has the potential to play an important role in China's healthcare reform process and standards are the basis for the information sharing and interoperability. Governments and partners of health informatics have realized the importance of standards and taken the initiatives in trying to solve the problem of lacking standards, but much work still needs to be done.

China↗

On the medical informatics structure.

This paper contributes to the discussion of R. Haux paper on essential aims and tasks of medical informatics. New views on structure of informatics and consequently medical informatics are given. Information is introduced as outside and inside information. Inside information is divided into three different types as data, evidence and knowledge. This terminology slightly differs from the commonly used terminology data, information and knowledge. Based on understanding of information as outside and inside information the field of informatics is divided into four rings, namely Information Basic Ring, Information Methodology Ring, Information Interface Ring and Information Technology Ring. Medical informatics is defined and its structure explained using four information rings. These views on informatics and medical informatics open possibilities to see more clearly where are the essential aims and tasks of medical informatics.

Europe↗

Dental informatics: a work in progress.

Dental informatics is a young scientific discipline that is undergoing continual maturation. Its literature is estimated to consist of approximately 600 papers published between 1975 and 2003, and it is currently growing at a rate of about 50 papers annually. While interest in the discipline is growing, the number of core contributors to dental informatics research remains relatively small. Two major questions for the discipline are: What are the research challenges that dental informatics faces today? and How can the discipline be strengthened and positioned to maximize its success in addressing those challenges? Progress toward research challenges formulated more than ten years ago has been varied. While many new technologies have become available for clinical dental practice, research, and education, many fundamental problems remain to be addressed with informatics research. Recommendations to augment the research capacity in dental informatics include creating a stronger worldwide dental informatics research community, drawing more biomedical informatics researchers to dental research areas, providing career opportunities for dental informatics researchers, addressing grand challenges together as a community, and recruiting subsequent generations of dental informaticians.

Dental Records↗

Medical informatics in an undergraduate curriculum: a qualitative study.

BACKGROUND: There is strong support for educating physicians in medical informatics, and the benefits of such education have been clearly identified. Despite this, North American medical schools do not routinely provide education in medical informatics. METHODS: We conducted a qualitative study to identify issues facing the introduction of medical informatics into an undergraduate medical curriculum. Nine key informants at the University of Toronto medical school were interviewed, and their responses were transcribed and analyzed to identify consistent themes. RESULTS: The field of medical informatics was not clearly understood by participants. There was, however, strong support for medical informatics education, and the benefits of such education were consistently identified. In the curriculum we examined, medical informatics education was delivered informally and inconsistently through mainly optional activities. Issues facing the introduction of medical informatics education included: an unclear understanding of the discipline; faculty and administrative detractors and, the dense nature of the existing undergraduate medical curriculum. CONCLUSIONS: The identified issues may present serious obstacles to the introduction of medical informatics education into an undergraduate medicine curriculum, and we present some possible strategies for addressing these issues.

Academic Medical Centers↗

The use and interpretation of quasi-experimental studies in medical informatics.

Quasi-experimental study designs, often described as nonrandomized, pre-post intervention studies, are common in the medical informatics literature. Yet little has been written about the benefits and limitations of the quasi-experimental approach as applied to informatics studies. This paper outlines a relative hierarchy and nomenclature of quasi-experimental study designs that is applicable to medical informatics intervention studies. In addition, the authors performed a systematic review of two medical informatics journals, the Journal of the American Medical Informatics Association (JAMIA) and the International Journal of Medical Informatics (IJMI), to determine the number of quasi-experimental studies published and how the studies are classified on the above-mentioned relative hierarchy. They hope that future medical informatics studies will implement higher level quasi-experimental study designs that yield more convincing evidence for causal links between medical informatics interventions and outcomes.

Evaluation Studies as Topic↗

Informatics training in pathology residency programs: proposed learning objectives and skill sets for the new millennium.

CONTEXT: To be successful in tomorrow's health care environment, to make the most appropriate decisions for their laboratories, to optimize training and continuing medical education opportunities, and to advance pathology as a professional specialty, pathologists must possess basic informatics knowledge and proficiency. Traditional areas of anatomic and clinical pathology residency training employ learning objectives, knowledge expectations, and skill sets, but such items have not been as well developed or widely implemented for pathology informatics training. OBJECTIVE: We present a proposal that defines a standard and specific set of learning (knowledge) objectives and skill set (proficiency) expectations for resident training in pathology informatics. DESIGN: The proposal includes a comprehensive and detailed set of knowledge applications and proficiencies that will assist residency programs in developing basic pathology informatics training for residents. The content of the proposal is based on and compiled from existing successful pathology informatics training programs. Learning objectives include those related to general and enterprise computing as well as objectives related specifically to pathology informatics. Skill set expectations include the ability to use software that facilitates and adds value to the work of pathologists, including the use of a laboratory information system and of productivity software and other tools. Other topics include guidelines for evaluating residents' informatics competency, suggestions regarding curriculum structure and implementation, and recommendations for residents' computing infrastructure. CONCLUSION: This proposal provides a foundation for building effective and standard curricula for residency training in pathology informatics. These curricula will be able to meet increasing expectations and needs for pathologists to contribute to clinical information management.

Clinical Competence↗

Training in pathology informatics: implementation at the University of Pittsburgh.

CONTEXT: Pathology informatics is generally recognized as an important component of pathology training, but the scope, form, and goals of informatics training vary substantially between pathology residency programs. The Training and Education Committee of the Association for Pathology Informatics (API TEC) has developed a standard set of knowledge and skills objectives that are recommended for inclusion in pathology informatics training and may serve to standardize and formalize training programs in this area. OBJECTIVE: The University of Pittsburgh (Pittsburgh, Pa) core rotation in pathology informatics includes most of these goals and is offered as an implementation model for pathology informatics training. DESIGN: The core rotation in pathology informatics is a 3-week, full-time rotation including didactic sessions and hands-on laboratories. Topics include general desktop computing and the Internet, but the primary focus of the rotation is vocabulary and concepts related to enterprise and pathology information systems, pathology practice, and research. The total contact time is 63 hours, and a total of 19 faculty and staff contribute. Pretests and posttests are given at the start and end of the rotation. Performance and course evaluation data were collected for 3 years (a total of 21 residents). RESULTS: The rotation implements 84% of the knowledge objectives and 94% of the skills objectives recommended by the API TEC. Residents scored an average of about 20% on the pretest and about 70% on the posttest for an average increase during the course of 50%. Posttest scores did not correlate with pretest scores or self-assessed computer skill level. The size of the pretest/posttest difference correlated negatively with the pretest scores and self-assessed computing skill level. CONCLUSIONS: Pretest scores were generally low regardless of whether residents were familiar with desktop computing and productivity applications, indicating that even residents who are computer "savvy" have limited knowledge of pathology informatics topics. Posttest scores showed that all residents' knowledge increased substantially during the course and that residents who were computing novices were not disadvantaged. In fact, novices tended to have higher pretest/posttest differences, indicating that the rotation effectively supported initially less knowledgeable residents in "catching up" to their peers and achieving an appropriate competency level. This rotation provides a formal training model that implements the API TEC recommendations with demonstrated success.

Clinical Competence↗

The Informatics Institute: why do we need it?

Why should physician executives care about medical informatics? For that matter, what is medical informatics anyway? Broadly defined, medical informatics is the study of the collection, storage, retrieval, and analysis of data and information in health care to support clinical and administrative decision making. Informatics is important because, in the past 10 years, powerful computer, software, and information technologies have been developed to enable health care organizations to automate some of the work of decision making, for improved quality of care and cost control, and for successful managed care contracting. This new emphasis on informatics in health care was the impetus for the founding by ACPE earlier this year of The Informatics Institute, which will be involved in educational and research activities in the growing area of medical informatics. In this new column in Physician Executive, Dr. Marshall Ruffin, President and CEO of the Institute, will discuss the role of medical informatics in health care delivery and financing and its relation to physician executives.

Academies and Institutes↗

A hypergraphic model of medical informatics: curriculum development guide.

Medical informatics, as a descriptive, scientific study, must be mathematically or theoretically described. Is it important to define a model for medical informatics? The answer is worth pursuing. The medical informatics profession stands to benefit three-fold: first, by clarifying the vagueness of the definition of medical informatics, secondly, by identifying the scope and content for educational programs, and, thirdly, by defining career opportunities for its graduates. Existing medical informatics curricula are not comparable. Consequently, the knowledge and skills of graduates from these programs are difficult to assess. The challenge is to promote academics that develops graduates for prospective employers to fulfill the criteria of the health care industry and, simultaneously, compete with computer science programs that produce information technology graduates. In order to meet this challenge, medical informatics programs must have unique curricula that distinguishes its graduates. The solution is to educate students in a comparable manner across the domain of medical informatics. This paper discusses a theoretical model for medical informatics.

Computers↗

Applications of informatics in veterinary medicine.

This study used the peer-reviewed biomedical literature to define the veterinary informatics knowledgebase and associated subspecialties, and assesses the level of activity in the field over the thirty-year period from 1966 through 1995. Grateful Med was used to search the MEDLINE bibliographic database for articles that shared one or more Medical Subject Headings (MeSH) keywords from the veterinary and medical informatics subject headings. Each of ninety-five MeSH medical informatics terms was assigned to one of twelve veterinary informatics subspecialties. The number of articles retrieved by each MeSH keyword and subspecialty was calculated. A total of 611 articles were retrieved, representing the contributions of 1,338 authors published in 153 journals. The field experienced slow growth over the twenty-year period from 1966 through 1985. In the following decade, the cumulative number of veterinary informatics articles almost tripled and the percentage of veterinary-related articles that included an informatics component increased almost two-and-one-half fold. Despite this recent growth, the number of veterinary-related articles with an informatics component has never exceeded 1% of either the veterinary or medical informatics literature over the past thirty years, and representation of veterinary subspecialties in the literature varied widely.

Animals↗

Medical informatics: between science and engineering, between academia and industry.

OBJECTIVE: To analyze the nature and appropriate role of the Medical Informatics research and practice area in the 21st Century, and to determine its links to academic environments versus industrial companies and health-care organizations. METHODS: A qualitative analysis of the state of the art of Medical Informatics, based on observation of current medical informatics programs and research in academic and industrial sites. RESULTS AND CONCLUSIONS: Medical Informatics is definitely a scientific and technological area of endeavor, although somewhat ill-defined in scope. It is situated between science and engineering, but much closer to the engineering world, and its multidisciplinary nature fits well the engineering paradigm. It is better viewed as a specialization of the informatics field rather than as a basic medical science. However, there are good arguments as to why Medicine should be the first among equals to have its own informatics domain. Medical Informatics must have extensions to both academia and industry to survive. Medical informaticians, whether implicitly or explicitly, exist in three different environments: academic, clinical (user), and industrial (informatics developer); all three environments must be considered when trying to predict the future of this new multidisciplinary area.

Engineering↗

Factors influencing medical informatics examination grade--can biorhythm, astrological sign, seasonal aspect, or bad statistics predict outcome?

AIM: To investigate whether and to what extent various parameters, such as individual characteristics, computer habits, situational factors, and pseudoscientific variables, influence Medical Informatics examination grade, and how inadequate statistical analysis can lead to wrong conclusions. METHODS: The study included a total of 382 second-year undergraduate students at the Rijeka University School of Medicine in the period from 1996/97 to 2000/01 academic year. After passing the Medical Informatics exam, students filled out an anonymous questionnaire about their attitude toward learning medical informatics. They were asked to grade the course organization and curriculum content, and provide their date of birth; sex; study year; high school grades; Medical Informatics examination grade, type, and term; and describe their computer habits. From these data, we determined their zodiac signs and biorhythm. Data were compared by the use of t-test, one-way ANOVA with Tukey's honest significance difference test, and randomized complete block design ANOVA. RESULTS: Out of 21 variables analyzed, only 10 correlated with the average grade. Students taking Medical Informatics examination in the 1998/99 academic year earned lower average grade than any other generation. Significantly higher Medical Informatics exam grade was earned by students who finished a grammar high school; owned and regularly used a computer, Internet, and e-mail (p< or =0.002 for all items); passed an oral exam without taking a written test (p=0.004), or did not repeat the exam (p<0.001). Better high-school students and students with better grades from high-school informatics course also scored significantly better (p=0.032 and p<0.001, respectively). Grade in high-school mathematics, student's sex, and time of year when the examination was taken were not related to the grade, and neither were pseudoscientific parameters, such as student zodiac sign, zodiac sign quality, or biorhythm cycles, except when intentionally inadequate statistics was used for data analysis. CONCLUSION: Medical Informatics examination grades correlated with general learning capacity and computer habits of students, but showed no relation to other investigated parameters, such as examination term or pseudoscientific parameters. Inadequate statistical analysis can always confirm false conclusions.

Astrology↗

Metropolis redux: the unique importance of library skills in informatics.

OBJECTIVES: The objective is to highlight the important role that librarians have in teaching within a successful medical informatics program. Librarians regularly utilize skills that, although not technology dependent, are essential to conducting computer-based research. The Metropolis analogy is used to introduce the part librarians play as informatics partners. Science fiction is a modern mythology that, beyond a technical exterior, has lasting value in its ability to reflect the human condition. The teaching of medical informatics, an intersection of technology and knowledge, is also most relevant when it transcends the operation of databases and systems. Librarians can teach students to understand, research, and utilize information beyond specific technologies. METHODS: A survey of twenty-six informatics programs was conducted during 2002, with specific emphasis on the role of the library service. RESULTS: The survey demonstrated that librarians currently do have a central role in informatics instruction, and that library-focused skills form a significant part of the curriculum in many of those programs. In addition, librarians have creative opportunities to enhance their involvement in informatics training. As a sample program in the study, the development of the informatics course at the Massachusetts College of Pharmacy and Health Sciences is included. CONCLUSIONS: Medical informatics training is a wonderful opportunity for librarians to collaborate with professionals from the sciences and other information disciplines. Librarians' unique combination of human research and technology skills provides a valuable contribution to any program.

Education, Continuing↗

Education in health and nursing informatics.

This chapter focused on some of the key issues of Health and Nursing Informatics Education. First an historical overview of Health and Nursing Informatics Education is presented. We also describe briefly the activities in the domain of Nursing Informatics Education across Europe. The Special Projects for Health and Nursing Informatics in Europe are presented. Because of the variety of educational systems, the International Medical Informatics Association (IMIA) felt the need to develop international recommendations in health and medical informatics education. From a nursing informatics perspective, the IMIA recommendations in Nursing Informatics Education are discussed.

Curriculum↗

Evolution of medical informatics societies in the United States.

Medical informatics, the application of computers to medicine, was supported by engineering groups in the 1950s, by biomedical engineering societies in the 1960s, and by medical informatics organizations in the 1970s and 1980s. Because of the highly specialized and technical nature of medical informatics, the dissemination of early articles on the subject was largely dependent on publication of the proceedings and transactions of meetings of professional organizations. The American Medical Informatics Association (AMIA) was recently formed from the merger of three professional organizations, each dedicated to medical informatics: the American Association for Medical systems and Informatics (AAMSI), the American College for Medical Informatics (ACMI), and the Symposium on Computer Applications in Medical Care (SCAMC). An increase in professional interest and activity in medical informatics is anticipated in the 1990s.

Directories as Topic↗

Identifying a core set of medical informatics serials: an analysis using the MEDLINE database.

A study was undertaken to test the hypothesis that a core set of medical informatics serials could be identified by using standard bibliometric techniques. All journal articles indexed by the National Library of Medicine between 1990 and 1994 were included. Articles were identified by using the "MEDICAL INFORMATICS" Medical Subject Heading (MeSH) term. Each serial title containing articles was then ranked according to (1) the total number of medical informatics journal articles indexed and (2) the percentage of medical informatics journal articles indexed. Twenty-eight serials had more than 100 articles indexed under the "MEDICAL INFORMATICS" MeSH term. Thirty serials had more than 40% of their articles indexed under the "MEDICAL INFORMATICS" MESH term. A "core" set of fourteen serials had 100 or more medical informatics articles indexed, including more than 70% of all articles they published. The methodology described provides librarians with another tool to use in the difficult task of journal selection. The set of "core" serials identified provides librarians with a ranked list of serials, based on which a medical informatics collection can be developed.

Abstracting and Indexing↗