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Access to data: comparing AccessMed with Query by Review.

OBJECTIVE: To evaluate the performance of tools for authoring patient database queries. DESIGN: Query by Review, a tool that exploits the training that users have undergone to master a result review system, was compared with AccessMed, a vocabulary browser that supports lexical matching and the traversal of hierarchical and semantic links. Seven subjects (Medical Logic Module authors) were asked to use both tools to gather the vocabulary terms necessary to perform each of eight laboratory queries. MEASUREMENTS: The proportion of queries that were correct; intersubject agreement. RESULTS: Query by Review had better performance than AccessMed (38% correct queries versus 18%, p = 0.002), but both figures were low. Poor intersubject agreement (28% for Query by Review and 21% for AccessMed) corroborated the relatively low performance. Subjects appeared to have trouble distinguishing laboratory tests from laboratory batteries, picking terms relevant to the particular data type required, and using classes in the vocabulary's hierarchy. CONCLUSION: Query by Review, with its more constrained user interface, performed somewhat better than AccessMed, a more general tool. Neither tool achieved adequate performance, however, which points to the difficulty of formulating a query for a clinical database and the need for further work.

Artificial Intelligence↗
PubMed2005

Coding of stroke and stroke risk factors using international classification of diseases, revisions 9 and 10.

BACKGROUND AND PURPOSE: Surveillance is necessary to understand and meet the future demands stroke will place on health care. Administrative data are the most accessible data source for stroke surveillance in Canada. The International Classification of Diseases, 10th revision (ICD-10) coding system has potential improvements over ICD-9 for stroke classification. Our purpose was to compare hospital discharge abstract coding using ICD-9 and ICD-10 for stroke and its risk factors. METHODS: We took advantage of a switch in coding systems from ICD-9 to ICD-10 to independently review stroke patient charts. From time periods April 2000 to March 2001, 717 charts, and from April 2002 to March 2003, 249 charts were randomly selected for review. Using a before-and-after time period design, the accuracy of hospital coding of stroke (part I) and stroke risk factors (part II) using ICD-9 and ICD-10 was compared. We used careful definitions of stroke and its types based on ICD-9 using the fourth and fifth digit modifier codes. RESULTS: Stroke coding was equally good with ICD-9 (90% [CI95 86 to 93] correct) and ICD-10 [92% (CI95 88 to 95 correct) with ICD-10. There were some differences in coding by stroke type, notably with transient ischemic attack, but these differences were not statistically significant. Atrial fibrillation, coronary artery disease/ischemic heart disease, diabetes mellitus, and hypertension were coded with high sensitivity (81% to 91%) and specificity (83% to 100%). ICD-10 was as good as ICD-9 for stroke risk factor coding. CONCLUSIONS: Passive surveillance using administrative data are a useful tool for identifying stroke and its risk factors using both ICD-9 and ICD-10.

Aged↗
PubMed2000

Missouri HMO decentralizes access to data in system overhaul.

At what point is it cheaper to invest in new technology than suffer along with an antique data system? Officials at RightChoice of Missouri discuss the market and internal pointers that helped them make the decision and share tips that made the transition bearable.

Database Management Systems↗
PubMed2000

Realization of security concepts for DICOM-based distributed medical services.

Exploiting distributed hard- and software resources for telemedicine requires a fast, secure, and platform-independent data exchange. Standards without inherent security mechanisms such as DICOM may ease non-authorized data access. Therefore, exemplary telemedical data streams were analyzed within the Berlin metropolitan area network using specialized magnetic resonance imaging techniques and distributed resources for data postprocessing. For secure DICOM communication both the Secure Socket Layer Protocol and a DICOM-conform partial encryption of patient-relevant data were implemented. Partial encryption exhibited the highest transfer rate and enabled a secure long-term storage. Different data streams between secured and unsecured networks were realized using partial encryption.

Berlin↗
PubMed2002

Accessing genomic data through XML-based remote procedure calls.

As the amount of data in public genomic databases grows, interoperability among them is becoming an increasingly critical feature. The ability for automated systems to mine and integrate data will be crucial to extracting knowledge from sources of data whose volume far exceeds the capabilities of human researchers. The currently dominant paradigm of presenting information as Web pages and using hyperlinks to describe relationships between pieces of information favors usability, but makes interoperability and automated data exchange more difficult. In this paper we describe how SNPper, a web-based system for the retrieval and analysis of Single Nucleotide Polymorphisms (SNPs), was augmented with a Remote Procedure Call interface, allowing client applications to query our program for SNP data and to receive the response as an XML document. Data represented in this form can be easily parsed by the requesting program, and thus reused for other applications. In this paper we describe the implementation of the interface and we show examples of its usage in a number of existing applications.

Databases, Genetic↗