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At least 127 records · Page 7Linked to original sources

PubMed1997

Post-integration of a tumor documentation system into a HIS via middleware.

Integrating autonomous applications is a difficult task since they usually represent similar informations in different data schemes. Any communication requires an agreement of sender and receiver on a common data representation. The number of interfaces to convert one data representation into another is minimized if all participants of an information system agree on one data representation such as Health Level Seven (HL7) or Edifact. Even more convenient is the use of a middleware solution like the Distributed Healthcare Environment (DHE) that keeps message transfer completely transparent to the integration process. This paper discusses a project that aims at the integration of a cancer registry system into a DHE based Hospital Information System (HIS). The project is a cooperation between the universities of Giessen and Magdeburg within the framework of the European Communities Telematics Research Project HC 1019 HANSA (Healthcare Advanced Networked System Architecture). The concept of a so called 'DHE-Adapter' to integrate existing legacy systems is explained. This adapter converts a data or message format of a legacy system into calls of the DHE programming interface. To develop a DHE-Adapter for our cancer registry system we intend to design a DHE-Adapter-Generator which would be able to produce DHE-Adapters for different systems and export formats, e.g. HL7 or Edifact. That would allow a variety of software vendors to integrate their products into the DHE without entering deeply into the DHE's programming interface.

Computer Communication Networks↗

PubMed1997

Social deprivation and tooth decay in Scottish schoolchildren.

OBJECTIVES: To quantify the association between dental decay in Scottish Schoolchildren & social deprivation as measured by the Carstairs Index from the 1991 census. DESIGN: An ecological study using data from the Scottish Health Boards Dental Epidemiology Programme and The Public Health Common Data set. SETTING: Scottish Health Boards from 1992-3 to 1994-5. SUBJECTS: Random samples of 5,920 five-year-olds, 5,344 12-year-olds and 6,007 14-year-olds across the 15 Health Boards in Scotland. RESULTS: Positive correlations were demonstrated in all age groups; 12-year-olds (r = 0.72) in 1992-3, 5-year-olds (r = 0.8) in 1993-4 and 14-year-olds (r = 0.55) in 1994-5. Dental decay in all age groups was positively and significantly associated with deprivation as measured by the Carstairs index. CONCLUSION: Tooth decay was confirmed as a disease associated with social deprivation in Scotland. The increasing polarisation of decay to socio-economically deprived groups of the population, suggests a 'whole population' approach such as water fluoridation would prevent tooth decay in these deprived groups most effectively. Nevertheless all evidence-based interventions should be used to try to narrow the "Dental Health Divide' by improving the dental health of deprived individuals.

Adolescent↗

PubMed2004

Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials.

BACKGROUND: Quick administration of intravenous recombinant tissue plasminogen activator (rt-PA) after stroke improved outcomes in previous trials. We aimed to analyse combined data for individual patients to confirm the importance of rapid treatment. METHODS: We pooled common data elements from six randomised placebo-controlled trials of intravenous rt-PA. Using multivariable logistic regression we assessed the relation of the interval from stroke onset to start of treatment (OTT) on favourable 3-month outcome and on the occurrence of clinically relevant parenchymal haemorrhage. FINDINGS: Treatment was started within 360 min of onset of stroke in 2775 patients randomly allocated to rt-PA or placebo. Median age was 68 years, median baseline National Institute of Health Stroke Scale (NIHSS) 11, and median OTT 243 min. Odds of a favourable 3-month outcome increased as OTT decreased (p=0.005). Odds were 2.8 (95% CI 1.8-4.5) for 0-90 min, 1.6 (1.1-2.2) for 91-180 min, 1.4 (1.1-1.9) for 181-270 min, and 1.2 (0.9-1.5) for 271-360 min in favour of the rt-PA group. The hazard ratio for death adjusted for baseline NIHSS was not different from 1.0 for the 0-90, 91-180, and 181-270 min intervals; for 271-360 min it was 1.45 (1.02-2.07). Haemorrhage was seen in 82 (5.9%) rt-PA patients and 15 (1.1%) controls (p<0.0001). Haemorrhage was not associated with OTT but was with rt-PA treatment (p=0.0001) and age (p=0.0002). INTERPRETATION: The sooner that rt-PA is given to stroke patients, the greater the benefit, especially if started within 90 min. Our results suggest a potential benefit beyond 3 h, but this potential might come with some risks.

Aged↗

PubMed2001

A meta-analysis of the effect of glucagon-like peptide-1 (7-36) amide on ad libitum energy intake in humans.

Seven studies have now been published pertaining to the acute effect of iv administration of glucagon-like peptide-1 (7-36) amide on ad libitum energy intake. In four of these studies energy intake was significantly reduced following the glucagon-like peptide-1 infusion compared with saline. In the remaining studies, no significant effect of glucagon-like peptide-1 could be shown. Lack of statistical power or low glucagon-like peptide-1 infusion rate may explain these conflicting results. Our aim was to examine the effect of glucagon-like peptide-1 on subsequent energy intake using a data set composed of subject data from previous studies and from two as yet unpublished studies. Secondly, we investigated whether the effect on energy intake is dose dependent and differs between lean and overweight subjects. Raw subject data on body mass index and ad libitum energy intake were collected into a common data set (n = 115), together with study characteristics such as infusion rate, duration of infusion, etc. From four studies with comparable protocol the following subject data were included if available: plasma concentrations of glucagon-like peptide-1, subjective appetite measures, well-being, and gastric emptying rate of a meal served at the start of the glucagon-like peptide-1 infusion. Energy intake was reduced by 727 kJ (95% confidence interval, 548-908 kJ) or 11.7% during glucagon-like peptide-1 infusion. Although the absolute reduction in energy intake was higher in lean (863 kJ) (634-1091 kJ) compared with overweight subjects (487 kJ) (209-764 kJ) (P = 0.05), the relative reduction did not differ between the two groups (13.2% and 9.3%, respectively). Stepwise regression analysis showed that the glucagon-like peptide-1 infusion rate was the only independent predictor of the reduction in energy intake during glucagon-like peptide-1 (7-36) amide infusion (r = 0.4, P < 0.001). Differences in mean plasma glucagon-like peptide-1 concentration on the glucagon-like peptide-1 and placebo day (n = 43) were related to differences in feelings of prospective consumption (r = 0.40, P < 0.01), fullness (r = 0.38, P < 0.05), and hunger (r = 0.26, P = 0.09), but not to differences in ad libitum energy intake. Gastric emptying rate was significantly lower during glucagon-like peptide-1 infusion compared with saline. Finally, well-being was not influenced by the glucagon-like peptide-1 infusion. Glucagon-like peptide-1 infusion reduces energy intake dose dependently in both lean and overweight subjects. A reduced gastric emptying rate may contribute to the increased satiety induced by glucagon-like peptide-1.

Adult↗

PubMed2000

Sentinel practices in dentistry: a preliminary evaluation.

The objectives of this study were to compare the socioeconomic make-up and the dental caries and dental treatment patterns of a general dental practice (GDP) population of five-year-old children with those of the total resident population of five-year-old children in a specific locality, and, secondly, to examine the process of gathering information on oral healthcare needs in primary dental care. The study was set in Halton, North Cheshire. Data were collected retrospectively from the patient records of four GDP sentinel' practices using a common data abstraction form. The socioeconomic profiles of the GDP population and the 1995/6 NHS child dental health survey population were compared using the Super Profiles geodemographic classification by plotting frequency distributions. The dmft of each population was compared by calculating 95% confidence intervals. The GDP population showed a slight over-representation in the more affluent groupings of the Super Profiles Lifestyle categories and a more dramatic under-representation in two of the more deprived groupings. The confidence intervals for dt and dmft of the GDP data did not include the mean figures produced by the NHS survey, indicating a significant difference at the P < 0.05 level. These differences may be accounted for by the differences in the socioeconomic make-up of the two populations. Local practice policies on patient selection may also have a consequential effect on population disease estimates derived from primary dental care. Data on population disease experience from primary dental care could only be produced by hand-sorting through patient records, which was time-consuming and inefficient. Standardised electronic systems will need to be developed to make GDP data-collection a viable proposition. Information from primary dental care has the potential to make a major contribution to locality oral health needs assessment and it should be seen as being complementary to information gathered from epidemiological surveys.

Child, Preschool↗

PubMedDate not supplied

A general software package for the handling of medical images.

PICS (portable imaging computer software), is a software system designed for handling and processing a variety of types of medical image. It has been designed to satisfy the following criteria: (a) the software should be portable between different items of hardware with minimal alteration; (b) there should be a simple operator interface to enable use by inexperienced users, while avoiding the need for experienced users to be directed through tedious menu trees; (c) the programming environment should enable simple integration of new data handling protocols. To meet these requirements the software was written in FORTRAN using structured subroutine organization. The software has basic image handling and processing facilities and contains a comprehensive set of nuclear medicine clinical protocols. Other facilities include alignment of images from different modalities with display of superimposed images and ability to handle, analyse and display three-dimensional data sets. Data transfer programs have been written to capture data from gamma camera, CT, MRI, ultrasound and radiographs by converting the images to a common data format. The system provides a hospital with a central digital image handling resource, enabling investigation of the value of digital image processing in potential clinical applications.

Diagnostic Imaging↗

PubMed2003

TopDraw: a sketchpad for protein structure topology cartoons.

SUMMARY: Protein topology cartoons are a representation of structural data commonly used by structural biologists to illustrate the relationship between one-dimensional sequence and three-dimensional structural data in a convenient two-dimensional format. TopDraw is a simple, freely available TCL/Tk based drawing program designed specifically for the production of publication quality topology cartoons in a style commonly presented by structural biologists. AVAILABILITY: TopDraw is freely available under the terms of the GNU General Public License. It can be downloaded from http://stein.bioch.dundee.ac.uk/~charlie/scripts/topdraw.html.

Amino Acid Sequence↗

PubMed2004

Challenges of building clinical data analysis solutions.

Increasingly, owners of clinical information systems are turning to clinical data warehouses (CDWs) to store and to analyze their data. The CDW allows institutions to make better use of their clinical data that has been collected through its information systems. A CDW extracts data from these systems, transforms it into a usable form, and then allows users to view and analyze years of data across a large cross section of patient charts. Although warehouses have existed in healthcare for some time, there are relatively few institutions that maintain patient charts in a CDW. This is, in part, because of the challenges often seen when attempting to warehouse this type of data. These include integrating a diverse set of care practices and a variety of definitions for common data elements like medications, observations, treatments, units of measure, and even unique patient identifiers. In addition, these systems often struggle with a high level of inconsistent and/or incomplete data that must be cleaned up on a regular basis. Unlike other data warehouse systems, CDWs are often expected to gather data around the clock and in a manner that has minimum impact to the performance of the source Clinical Information Systems. Finally, CDWs often have a diverse range of clinical and administrative users. This often leads to a need for a variety of applications and/or tools for viewing and analyzing the data.

Database Management Systems↗

PubMed2001

Relationship between weather and seasonal factors and trauma admission volume at a Level I trauma center.

BACKGROUND: We sought to determine whether trauma patient admission volume to our Level I trauma center was correlated with observable weather or seasonal phenomena. METHODS: Trauma registry data and national weather service data for the period between September 1, 1992, and August 31, 1998, were combined into a common data set containing trauma admission data and weather data for each day. Sequential linear regression models were constructed to determine relationships between variables in the data set. RESULTS: There is a highly significant relationship (p < 0.00001) between maximum daily temperature and trauma admissions (R = 0.22). Rain is associated with a decrease in overall trauma volume. Rain had no effect on the number of admissions because of motor vehicle crash, however. Neither humidity nor snowfall affects trauma admission volume. Trauma admissions are significantly more frequent in July and August, and on Saturdays and Sundays (p < 0.05). Linear regression analysis identified maximum temperature, precipitation, day of week, and month as independent predictors of trauma admission volume (p < 0.001, R = 0.328). CONCLUSION: There is a significant relationship between weather and trauma center activity; temperature and precipitation are independently associated with trauma admission volume at our institution. Statistical models of trauma incidence should consider these phenomena. Evaluation of a larger, population-based data set is needed to confirm these relationships.

Boston↗

PubMed2004

The tissue microarray data exchange specification: implementation by the Cooperative Prostate Cancer Tissue Resource.

BACKGROUND: Tissue Microarrays (TMAs) have emerged as a powerful tool for examining the distribution of marker molecules in hundreds of different tissues displayed on a single slide. TMAs have been used successfully to validate candidate molecules discovered in gene array experiments. Like gene expression studies, TMA experiments are data intensive, requiring substantial information to interpret, replicate or validate. Recently, an open access Tissue Microarray Data Exchange Specification has been released that allows TMA data to be organized in a self-describing XML document annotated with well-defined common data elements. While this specification provides sufficient information for the reproduction of the experiment by outside research groups, its initial description did not contain instructions or examples of actual implementations, and no implementation studies have been published. The purpose of this paper is to demonstrate how the TMA Data Exchange Specification is implemented in a prostate cancer TMA. RESULTS: The Cooperative Prostate Cancer Tissue Resource (CPCTR) is funded by the National Cancer Institute to provide researchers with samples of prostate cancer annotated with demographic and clinical data. The CPCTR now offers prostate cancer TMAs and has implemented a TMA database conforming to the new open access Tissue Microarray Data Exchange Specification. The bulk of the TMA database consists of clinical and demographic data elements for 299 patient samples. These data elements were extracted from an Excel database using a transformative Perl script. The Perl script and the TMA database are open access documents distributed with this manuscript. CONCLUSIONS: TMA databases conforming to the Tissue Microarray Data Exchange Specification can be merged with other TMA files, expanded through the addition of data elements, or linked to data contained in external biological databases. This article describes an open access implementation of the TMA Data Exchange Specification and provides detailed guidance to researchers who wish to use the Specification.

Confidentiality↗

PubMed2005

PICNIC Technology.

A key objective of the Professionals and Citizen Network for Integrated Care (PICNIC) project was to provide products for a European and potentially worldwide software market. The approach followed was through the delivery of a number of Open Source (OS) components, to be integrated into applications that deliver similar services across the participating regions, aiming at their exploitation by other regions and the industry. This chapter describes the technology developed during the lifecycle of the PICNIC project, focusing on the three core services of Clinical Messaging, Access to Patient Data, and Collaboration. For each service, the entire process of how to turn its functional specifications into reusable components and common data sets in order to support Information Technology (IT) services for the next generation of secure, user-friendly healthcare networks is presented by means of common documentation tools. Security and privacy issues are also addressed.

Cooperative Behavior↗

PubMed1993

A software program for exchanging MR data.

In an MR multicenter project, data exchange is a problem because most MR scanners do not use the same data format or have data export facilities. In the COMAC-BME Concerted Action on Tissue Characterization by MRS and MRI, a subgroup of seven MR centers had a need for data exchange in the form of digital MR images of the human brain. Because there was no common data format, software package was developed for data exchange. This article describes the basic features of the developed software. The software package was written in the language of C and was successfully tested on an IBM-6150 UNIX workstation. The software is currently being tested on the following series of UNIX workstations: SUN SPARC, IBM RS6000, and HP 9000/700.

Animals↗

PubMedDate not supplied

Interactive point-based rendering of higher-order tetrahedral data.

Computational simulations frequently generate solutions defined over very large tetrahedral volume meshes containing many millions of elements. Furthermore, such solutions may often be expressed using non-linear basis functions. Certain solution techniques, such as discontinuous Galerkin methods, may even produce non-conforming meshes. Such data is difficult to visualize interactively, as it is far too large to fit in memory and many common data reduction techniques, such as mesh simplification, cannot be applied to non-conforming meshes. We introduce a point-based visualization system for interactive rendering of large, potentially non-conforming, tetrahedral meshes. We propose methods for adaptively sampling points from non-linear solution data and for decimating points at run time to fit GPU memory limits. Because these are streaming processes, memory consumption is independent of the input size. We also present an order-independent point rendering method that can efficiently render volumes on the order of 20 million tetrahedra at interactive rates.

Journal Article↗

PubMedDate not supplied

The Italian Heart Transplant Project: organization of a multicenter program.

The Italian Heart Transplant Project is a national program coordinated by the Health Ministry and involves eight cardiac surgery centers, two coordination centers for organ procurement, and one national registry. An intercenter network for the solution of logistic problems regarding organ procurement and assignment has been built up. Preintervention and clinical follow-up data are recorded in each center and in a national registry by the implementation of a computerized data base. This is realized by employing low cost and diffuse software and hardware. The complex goal of common data collection and standardization is also being pursued for collateral areas such as cardiac pathology and immunologic surveillance. Data collection is useful for clinical monitoring and also for costs and/or requirements analysis.

Data Collection↗

PubMed2004

Data mining in bioinformatics using Weka.

UNLABELLED: The Weka machine learning workbench provides a general-purpose environment for automatic classification, regression, clustering and feature selection-common data mining problems in bioinformatics research. It contains an extensive collection of machine learning algorithms and data pre-processing methods complemented by graphical user interfaces for data exploration and the experimental comparison of different machine learning techniques on the same problem. Weka can process data given in the form of a single relational table. Its main objectives are to (a) assist users in extracting useful information from data and (b) enable them to easily identify a suitable algorithm for generating an accurate predictive model from it. AVAILABILITY: http://www.cs.waikato.ac.nz/ml/weka.

Algorithms↗

PubMed2005

Development of a multicenter peripheral arterial interventional database: the PVD-QI2.

BACKGROUND: The number of peripheral vascular intervention (PVI) procedures performed is steadily increasing in the United States. PVD-QI 2 is a prospective, multicenter observational study designed to improve the quality of care for patients undergoing PVI and to better understand the effectiveness and appropriateness of PVI in improving outcomes of peripheral arterial disease. The registry aims to elucidate which comorbid conditions and procedure-related variables are associated with beneficial or adverse outcomes after vascular interventions. METHODS: Five centers are currently prospectively collecting data on consecutive PVIs performed at their institutions and will include patients with both claudication and critical limb ischemia. A common data collection form and a standard set of definitions were developed during several planning meetings. Information on patient demographics, clinical history, comorbid conditions, treatment approaches, and in hospital outcomes are being collected. Patients will be followed up at 30 days, 6 months, and 1 year after each procedure to identify recurrent vascular events, medication use, lifestyle modifications (regular exercise, dietary modification), self-reported walking scores, and mortality. Data validity will be assured through review of data form accuracy by a trained nurse, by automatic database diagnostic routines, and by site visits that include review of angiography suite logs and randomly selected charts. CONCLUSIONS: The development of a quality-controlled PVI registry requires the commitment and collaboration of clinician-investigators and hospital systems devoted to understanding factors that contribute to quality outcomes. Central to achievement of this goal is the creation of a careful diagnostic and data quality assessment system. This registry will provide important clinical insights into patient demographic and clinical characteristics, procedural characteristics, and current practice patterns that foster or impede achievement of long-term quality-based clinical outcomes for patients with peripheral arterial disease.

Databases, Factual↗

PubMed2006

caGrid: design and implementation of the core architecture of the cancer biomedical informatics grid.

MOTIVATION: The complexity of cancer is prompting researchers to find new ways to synthesize information from diverse data sources and to carry out coordinated research efforts that span multiple institutions. There is a need for standard applications, common data models, and software infrastructure to enable more efficient access to and sharing of distributed computational resources in cancer research. To address this need the National Cancer Institute (NCI) has initiated a national-scale effort, called the cancer Biomedical Informatics Grid (caBIGtrade mark), to develop a federation of interoperable research information systems. RESULTS: At the heart of the caBIG approach to federated interoperability effort is a Grid middleware infrastructure, called caGrid. In this paper we describe the caGrid framework and its current implementation, caGrid version 0.5. caGrid is a model-driven and service-oriented architecture that synthesizes and extends a number of technologies to provide a standardized framework for the advertising, discovery, and invocation of data and analytical resources. We expect caGrid to greatly facilitate the launch and ongoing management of coordinated cancer research studies involving multiple institutions, to provide the ability to manage and securely share information and analytic resources, and to spur a new generation of research applications that empower researchers to take a more integrative, trans-domain approach to data mining and analysis. AVAILABILITY: The caGrid version 0.5 release can be downloaded from https://cabig.nci.nih.gov/workspaces/Architecture/caGrid/. The operational test bed Grid can be accessed through the client included in the release, or through the caGrid-browser web application http://cagrid-browser.nci.nih.gov.

Biomarkers, Tumor↗

PubMedDate not supplied

What can go wrong when you assume that correlated data are independent: an illustration from the evaluation of a childhood health intervention in Brazil.

The key analytical challenge presented by longitudinal data is that observations from one individual tend to be correlated. Although longitudinal data commonly occur in medicine and public health, the issue of correlation is sometimes ignored or avoided in the analysis. If longitudinal data are modelled using regression techniques that ignore correlation, biased estimates of regression parameter variances can occur. This bias can lead to invalid inferences regarding measures of effect such as odds ratios (OR) or risk ratios (RR). Using the example of a childhood health intervention in Brazil, we illustrate how ignoring correlation leads to incorrect conclusions about the effectiveness of the intervention.

Age Factors↗