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An entity-relation model for a tocho-gynaecology service.

There is a trend, both at national and European levels, towards the use of standards in hardware, software and communications. This implies a common root for the design of unified databases which will result in the homogeneity and interchangeability of data and knowledge. The technological solution exists and is imposed. The problem then is not the tools to be used as information support but how this information is organized and structured. According the the standards proposed by the Plan de Dotación Informática para la Asistencia Sanitaria (DIAS), and with respect to the problem of computer coverage of specialties, we present in this work an entity-relation model for a generic service within our project of integrally computerizing a tocho-gynaecology area. It is a multidisciplinary job between doctors and physicists where we use a planning strategy in order to identify the functions, processes and activities, making the traditional clinical management structure compatible with the one proposed. This means that if we want the introduction of the system to be effective, we have to make all the clinical and sanitary staff participate in the project. We must induce the need for change and carry out the process of change gradually, so that only a change in the support, and not in the organization, is initially perceived.

Algorithms

Feasibility of interactive videodisc technology to teach minority youth about preventing HIV infection.

Hispanic and African American adolescents are more likely than white Anglo youth to harbor misconceptions about acquired immunodeficiency syndrome (AIDS) and are also more likely to engage in intravenous drug use and sexual intercourse. This paper describes the development of an AIDS prevention curriculum that uses an interactive videodisc program to teach skills for interventions. Focus group and expert panel studies yielded suggests for intervention vignettes and scenes relevant to Hispanic and African American adolescents. The authors then developed and produced a sample curriculum, specifically designed for Hispanic youth. Content was designed to build knowledge, attitudes, and skills in handling situations where young persons are at risk for human immunodeficiency virus (HIV) infection. The feasibility of the finished pilot product was tested with adolescents and with professionals who serve ethnic and racial minority youth. Adults and Hispanic adolescent viewers rated the videodisc as enjoyable, interesting, and likely to achieve positive effects with the intended target population. Findings suggest that the interactive videodisc is a useful way to interest and help Hispanic adolescents learn ways of reducing their risk of contracting and spreading HIV infection through lifestyle practices. This developmental research in the use of interactive videodisc also provides a basis for further investigation.

Adolescent

An intelligent computer-assisted instruction system designed for rural health workers in developing countries.

This paper describes an intelligent computer-assisted instruction system that was designed for rural health workers in developing countries. This system, called Consult-EAO, includes an expert module and a coaching module. The expert module, which is derived from the knowledge-based decision support system Tropicaid, covers most of medical practice in developing countries. It allows for the creation of outpatient simulations without the help of a teacher. The student may practice his knowledge by solving problems with these simulations. The system gives some initial facts and controls the simulation during the session by guiding the student toward the most efficient decisions. All student answers are analyzed and, if necessary, criticized. The messages are adapted to the situation due to the pedagogical rules of the coaching module. This system runs on PC-compatible computer.

Computer Simulation

Structured reporting of medical findings: evaluation of a system in gastroenterology.

A system using structured reporting of findings was developed for the preparation of medical reports and for clinical documentation purposes in upper abdominal sonography, and evaluated in the course of routine use. The evaluation focussed on the following parameters: completeness and correctness of the entered data, the proportion of free text, the validity and objectivity of the documentation, user acceptance, and time required. The completeness in the case of two clinically relevant parameters could be compared with an already existing database containing freely dictated reports. The results confirmed the hypothesis that, for the description of results of a technical examination, structured data reporting is a viable alternative to free-text dictation. For the application evaluated, there is even evidence of the superiority of a structured approach. The system can be put to use in related areas of application.

Attitude to Computers

LIED--liver: information, education and diagnosis.

In this paper we describe LIED (Liver: Information, Education and Diagnosis), a diagnostic expert system devoted to medical education in the field of hepatology. LIED combines the facilities of a traditional expert system for clinical diagnosis with several modules designed for educational purposes. The goal of such modules is to train physicians, in particular as regards the improvement of their problem solving ability (at the end of their curricula students in medicine usually lack experience in organizing an efficient and accurate diagnostic process). Training on real and simulated cases has been widely recognized as a proper approach to clinical experience. The architecture of the diagnostic system is introduced, which forms the core of LIED, and which has been derived from our previous experience, and the various educational functions are discussed that were developed on top of the basic architecture.

Computer Simulation

Pick from thousands: a collaborative processing model for coded data entry.

Methods for optimizing coded data entry in clinical systems are a frequent topic of system design. We have developed a new mechanism for this type of data entry that we call "Pick From Thousands" (PFT). It combines several known methods, including menu selection, keyword entry, and initial character matching, but adds a new string matching algorithm. The PFT method is more selective than initial character matching for a given number of keystrokes if entries in the coded list have more than one word. Collaborative processing between a PC workstation and the central HELP system computer is used to optimize ease of maintenance and increase the flexibility and performance of the system.

Algorithms

Collaborative development of a uniform graphical interface.

A uniform graphical user interface to informational databases is evolving at the University of Washington through a collaborative development process. The interface, called WILLOW, has grown from model analysis and preliminary design to working prototype. The design replicates a natural flow of search retrieval. Development continues in a spiral of test and linear improvements based on user analysis. WILLOW's internal structure is built on a Unix client-server model communicating over the campus TCP/IP backbone network. Its external structure is an X-Windows/Motif visual presentation emphasizing a simple, consistent, graphical face to disparate information databases. The WILLOW collaborators have grown from an initial group composed of the Health Sciences Library & Information Center and Computing & Communications' Information Systems to the University Libraries, Computing & Communications divisions, Medical Center Information Systems, and departments throughout the health sciences.

Information Systems

Integrating the UMLS into VNS Retriever.

We are developing a networked resource for the National Library of Medicine's Unified Medical Language System. We call this resource the UMLS Retriever, which is an instance of our VNS Retriever architecture. Our prototype user interface makes use of the Virtual Notebook System Browser. The development of a networked UMLS service will result in numerous advantages to our user community.

Computer Communication Networks