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Results for “Knowledge base”

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At least 1,495 records · Page 83Linked to original sources

PubMed1992

Reliability of AIDS knowledge scales: conceptual issues.

A common approach to evaluating the reliability of AIDS knowledge scales has relied on the demonstration of internal consistency through the use of Kuder-Richardson formula 20 (KR-20) or coefficient alpha. In this study, the argument was made that, in a knowledge-based scale with diverse content (exemplified by AIDS knowledge scales), internal consistency does not make sense conceptually and underestimates the scale's true reliability. It was therefore hypothesized that a split-half approach, in which items in each half were matched for content, would provide superior estimates of reliability when compared to either KR-20 or an odd-even split-half approach. Reliability analyses performed on a knowledge scale developed by the author supported this hypothesis.

Acquired Immunodeficiency Syndrome↗

PubMed1982

Expanding the hospital nursing role: an administrative account.

In reality, role change among staff RNs is a continuous phenomenon. As medical technology increases, patient care regimes follow suit, and the staff RN is constantly called upon to apply a knowledge base in different ways and to acquire new knowledge and behaviors. The nursing administrator who keeps pace with this growth can capitalize on the phenomenon, guiding the change to see that it is progressive, that it assists the nurse in developing a more advanced nursing (as opposed to mini-physician) identity and that it does improve extant nursing practice. Undertaking a new project of this sort on the unit is likely to create a number of beneficial by-products. For example, nurse-physician rapport and communication increase as each group opens professional boundaries in defining and planning the content of role expansion. The unit's traditional operation must also be examined in the course of building in new functions. System critiques stimulate the unit's nursing manager to weed out less than optimal features of the existing nursing care delivery system. The expanded role has favorably affected nursing care at Mercy Hospital. Physicians, nurses, and most important, the patient have reaped the benefits. The nurse is able to function in a more advanced capacity, and physicians see the benefits to their patients; fewer delays in specific aspects of care delivery with a more sophisticated, higher quality of nursing care. What is exciting about this concept is that the principles could apply to virtually any RN work group that gives direct care to a homogeneous patient population.

Chicago↗

PubMed1995

Decision support system for individualized nursing procedures: SAPIEN-Tx.

The present work proposes a Decision Support System for nursing procedures: SAPIEN-Tx. The discussion includes the acquisition, modeling , and implementation of nursing expertise professionals in Renal Transplant. It was developed to obtain better quality healthcare services, as well as an effective contribution to the nursing professional in the global assistance of their clientele. We used the KADS methodology to develop the system knowledge base. This methodology permitted us to perform the knowledge modeling with quality and organization. In opposition to the old method, errors were detected before the implementation, avoiding possible modification on the whole project structure.

Brazil↗

PubMed1996

[Strategies for productive collaboration between science and general practice].

My contribution is a systematic account of strategies for cooperation and feedback between public health sciences and research. A feature both areas have in common is their commitment to empirically based knowledge. "Rational" models of cooperation (or rather, models based on belief in rationality) presume simple linear links between research and its application. Diffusion models, however, seem to be far more adequate for translating public health research into reality. The best model is the "Discourse Model" based on continuous communication and feedback between science and practice. It seems to promote the diffusion of public health innovations most effectively. In the second part I give examples of how to translate the Discourse Model into practical reality. Summing up, its strategic elements are: 1. responsive project shaping, 2. interactive running of projects, 3. shared processing of results, 4. active diffusion of results.

Diffusion of Innovation↗

PubMed2002

The roles of body and mind in abstract thought.

How are people able to think about things they have never seen or touched? We demonstrate that abstract knowledge can be built analogically from more experience-based knowledge. People's understanding of the abstract domain of time, for example, is so intimately dependent on the more experience-based domain of space that when people make an air journey or wait in a lunch line, they also unwittingly (and dramatically) change their thinking about time. Further, our results suggest that it is not sensorimotor spatial experience per se that influences people's thinking about time, but rather people's representations of and thinking about their spatial experience.

Adult↗

PubMed1998

Simulating patients with Parallel Health State Networks.

The American Board of Family Practice is developing a computer-based recertification process to generate patient simulations from a knowledge base. Simulated patients require a stochastically generated history and response to treatment, suggesting a Monte Carlo-like patient generation process. Knowledge acquisition experiments revealed that description of a patient's overall health as a node in a Monte Carlo model was difficult for domain experts to use, severely limited knowledge reusability, and created a plethora of awkwardly defined health states. We explored a model in which patients traverse several parallel health state networks simultaneously, so that overall health is a vector describing the current nodes from every Parallel Network. This model has a reasonable biological basis, more easily defined data, and greatly improved reuse potential, at the cost of more complex simulation algorithms. Experiments using osteoarthritis stages, weight classification, and absence or presence of gastric ulcers as three Parallel Networks demonstrate the feasibility of this approach to simulating patients.

Algorithms↗

PubMed2000

An overview of risk in community mental health care.

Management of risk in mental health nursing is a complex practice and policy issue, and has an impact on mental health policy, the law and service response. The knowledge base and awareness of all those working in situations of potential risk need to be improved, and training has a crucial role to play in developing practitioners' knowledge and skills base. How the concept of risk relates to mental health is the subject of research and evaluation, which will help develop tools to facilitate prediction and assessment. This article provides an overview of the different views of risk in community mental health services, and comments on the relevance of the legal, social, cultural and psychological aspects of risk to practitioners and users.

Community Mental Health Services↗

PubMed2003

Computer-assisted detection of mammographic masses: a template matching scheme based on mutual information.

The purpose of this study was to develop a knowledge-based scheme for the detection of masses on digitized screening mammograms. The computer-assisted detection (CAD) scheme utilizes a knowledge databank of mammographic regions of interest (ROIs) with known ground truth. Each ROI in the databank serves as a template. The CAD system follows a template matching approach with mutual information as the similarity metric to determine if a query mammographic ROI depicts a true mass. Based on their information content, all similar ROIs in the databank are retrieved and rank-ordered. Then, a decision index is calculated based on the query's best matches. The decision index effectively combines the similarity indices and ground truth of the best-matched templates into a prediction regarding the presence of a mass in the query mammographic ROI. The system was developed and evaluated using a database of 1465 ROIs extracted from the Digital Database for Screening Mammography. There were 809 ROIs with confirmed masses (455 malignant and 354 benign) and 656 normal ROIs. CAD performance was assessed using a leave-one-out sampling scheme and Receiver Operating Characteristics analysis. Depending on the formulation of the decision index, CAD performance as high as A(zeta) = 0.87 +/- 0.01 was achieved. The CAD detection rate was consistent for both malignant and benign masses. In addition, the impact of certain implementation parameters on the detection accuracy and speed of the proposed CAD scheme was studied in more detail.

Algorithms↗

PubMed2005

MediClass: A system for detecting and classifying encounter-based clinical events in any electronic medical record.

MediClass is a knowledge-based system that processes both free-text and coded data to automatically detect clinical events in electronic medical records (EMRs). This technology aims to optimize both clinical practice and process control by automatically coding EMR contents regardless of data input method (e.g., dictation, structured templates, typed narrative). We report on the design goals, implemented functionality, generalizability, and current status of the system. MediClass could aid both clinical operations and health services research through enhancing care quality assessment, disease surveillance, and adverse event detection.

Artificial Intelligence↗

PubMedDate not supplied

Query-handling in MLM-based decision support systems.

Arden Syntax for Medical Logic Modules is a standard specification for creation and sharing of knowledge bases. The standard specification focuses on knowledge that can be represented as a set of independent Medical Logic Modules (MLMs) such as rules, formulas and protocols. The basic functions of an MLM are to retrieve patient data, manipulate the data, come to some decision, and possibly perform an action. All connections to the world outside an MLM are collected in the data-slot of the MLM. The institution specific parts of these connections are inside the notation of curly brackets ([]) to facilitate sharing of MLM between institutions. This paper focuses on some of the problems that occur in relation to Arden Syntax and connections to a patient database such as database queries. Problems related to possibilities of moving one or several module(s) are also discussed, with emphasis on database connections. As an example, an MLM based Decision Support System (DSS) developed at Linköping University is described.

Artificial Intelligence↗

PubMed2002

Do short courses in evidence based medicine improve knowledge and skills? Validation of Berlin questionnaire and before and after study of courses in evidence based medicine.

OBJECTIVE: To develop and validate an instrument for measuring knowledge and skills in evidence based medicine and to investigate whether short courses in evidence based medicine lead to a meaningful increase in knowledge and skills. DESIGN: Development and validation of an assessment instrument and before and after study. SETTING: Various postgraduate short courses in evidence based medicine in Germany. PARTICIPANTS: The instrument was validated with experts in evidence based medicine, postgraduate doctors, and medical students. The effect of courses was assessed by postgraduate doctors from medical and surgical backgrounds. INTERVENTION: Intensive 3 day courses in evidence based medicine delivered through tutor facilitated small groups. MAIN OUTCOME MEASURE: Increase in knowledge and skills. RESULTS: The questionnaire distinguished reliably between groups with different expertise in evidence based medicine. Experts attained a threefold higher average score than students. Postgraduates who had not attended a course performed better than students but significantly worse than experts. Knowledge and skills in evidence based medicine increased after the course by 57% (mean score before course 6.3 (SD 2.9) v 9.9 (SD 2.8), P<0.001). No difference was found among experts or students in absence of an intervention. CONCLUSIONS: The instrument reliably assessed knowledge and skills in evidence based medicine. An intensive 3 day course in evidence based medicine led to a significant increase in knowledge and skills.

Clinical Competence↗

PubMed1995

One framework, two systems: flexible abductive methods in the problem-space paradigm applied to antibody identification and biopsy interpretation.

Our goal is to build flexible knowledge-based systems which can use a variety of problem-solving methods and additional task knowledge, without altering the method or task representation. For this purpose, we use a problem-space architecture which allows opportunistic adaptation of problem-solving methods based on the particular goal, situation and knowledge available. Within this framework, we have developed an opportunistic problem-solving method for flexible abductive problem solving. The basic method was specified in terms of potential subgoals and preferences regarding the order of subgoals. This technique avoids specification of any unnecessary procedural commitments, making the resulting method very general and robust. We then developed two systems using this basic abductive method with additional domain-dependent search-control and task knowledge. The additional knowledge alters/overrides some of the minimal knowledge provided by the basic method. Behavior of these systems can change quite dramatically depending on the added increments of knowledge. Knowledge available at runtime shapes the method and hence the behavior. Moreover, even in the absence of strong domain knowledge, due to the wide coverage of the basic abductive method and the general architecture it is based on, the systems are always able to perform some problem solving--they are not brittle. The specific systems implemented are RedSoar and LiverSoar in the domain of red blood cell antibody identification and liver biopsy interpretation, respectively. We discuss the designs, implementations and evaluations of these systems, emphasizing the role the flexible abductive problem-solving method plays.

Antibodies↗

PubMed2005

The CONTENT project: a problem-oriented, episode-based electronic patient record in primary care.

In order to obtain a proper knowledge base in primary care, a form of electronic patient record is needed that takes into account the specific characteristics of the doctor-patient encounter, the patient population, the presentation of diseases and the associated prevalences. However, in real life this has not happened for several reasons. For the most part, existing patient records are determined by invoicing requirements rather than by endeavours to meet the intrinsic needs of primary care. CONTENT (CONTinuous morbidity registration Epidemiologic NeTwork) is an ambitious scientific project in Germany to establish a system for adequate record keeping and analysis in primary care. Based on a classification system designed for the special situation of primary care, a scientific network is being established consisting of participating surgeries, general practitioners, computer scientists and statisticians. The project is supported by the German Federal Ministry of Education and Research. The aims are strictly scientific and the underlying hypothesis is that the knowledge-gaining process can be accelerated by combining the experience of many, especially with respect to complex interactions of factors and the analysis of rare events. Aside from maintaining a morbidity registry, within the CONTENT framework various prospective and retrospective studies on particular epidemiological and health economic research topics will be conducted.

Episode of Care↗

PubMed2004

Conducting translation research in the home care setting: lessons from a just-in-time reminder study.

BACKGROUND: Home care organizations are relatively isolated from academic health centers, university-based schools of nursing, and centers of health services research that have advanced the knowledge base for quality improvement. Thus limited information exists about how best to promote evidence-based practice in this setting. AIMS: This article examines research and translation issues posed by the decentralized home care setting and considers how these issues compare to issues in other settings. METHODS: A case study approach is used to frame a discussion of the contextual and practical factors that can influence the design and future acceptance of different translation strategies in the home care setting. Use of a recently concluded randomized trial that tested the effectiveness of two interventions designed to improve the adoption of evidence-based practices by home health nurses has been made to inform this discussion. DISCUSSION: Effective translation interventions in home health care need to address the unique nature of this setting including the dispersed, generalist workforce that serves a diverse patient population and lacks strong peer contact or on-site support and supervision. Proactive push translation strategies such as reminders that have been effective in other settings show promise in this service area but had a differential effect across conditions. Significantly, the cost-effectiveness analysis of this intervention showed that net patient care costs actually increased for one condition. IMPLICATIONS: The study described in this article demonstrates that rigorous translation research can be conducted in highly decentralized practice settings. It also points to the value of assessing different levels of intensity of interventions in a single study, looking at process measures and patient outcomes, and conducting a cost-effectiveness analysis. To encourage broader adoption of translation strategies, additional incentives from purchasing or regulatory agencies may be needed.

Community Health Nursing↗

PubMed2005

Pushing the frames of reference in traumatic brain injury rehabilitation.

Cognitive rehabilitation is an empirically based field driven by multiple sources of activities and knowledge bases. Drawing on frames of reference provided by rehabilitation, neuropsychology, and rehabilitation psychology, cognitive rehabilitation has evolved to a point where studies have been generated to qualify for consideration in tables of evidence. At the center of cognitive rehabilitation is the effort to teach people to overcome or adapt to limitations. While rehabilitation has traditionally been focused on activity, a recent trend in the literature is to incorporate the individuals experience into a frame of reference for rehabilitation. Emphasizing the experience of the person in the situation fits into cognitive rehabilitation and raises the bar for rehabilitation not only in viewing rehabilitation as an activity to relieve burdens but also in terms of how rehabilitants come to grips with limitations. Dealing with limitations is an important indicator of mental health.

Brain Injuries↗

PubMed1995

A rationale for mouth care: the integration of theory with practice.

Mouth care is a commonly performed nursing procedure in which the aim is to ensure that patients' mouths are cared for. However, there is evidence that unless dental plaque is removed from the tooth surfaces and the gingival margin, the mouth is in danger of becoming unhealthy and, therefore, uncared for. It appears from the dental literature that the use of a toothbrush is one of the best and most widely used tools in the Western world for removing dental plaque (Addy, Slayne & Wade 1992), other methods being ineffective, dangerous, or poorly researched (Trenter-Roth & Creason 1986). However, a review of the nursing literature indicates that toothbrushes are not the tools of choice for mouth care by nurses (Howarth 1977, Harris 1980). Thus, there appears to be a gulf between the knowledge base from the dental literature and the reality of nursing practice resulting in 'mouth care' becoming a misleading misnomer. The aim in this paper is to present a rationale for mouth care based upon the dental literature and to apply such knowledge to nursing practice, especially in intensive therapy units (ITUs), so that nurses may be in a better position to provide 'mouth care' which lives up to its name.

Clinical Nursing Research↗

PubMed2025

Tribus: semi-automated discovery of cell identities and phenotypes from multiplexed imaging and proteomic data.

MOTIVATION: Multiplexed imaging and single-cell analysis are increasingly applied to investigate the tissue spatial ecosystems in cancer and other complex diseases. Accurate single-cell phenotyping based on marker combinations is a critical but challenging task due to (i) low reproducibility across experiments with manual thresholding, and, (ii) labor-intensive ground-truth expert annotation required for learning-based methods. RESULTS: We developed Tribus, an interactive knowledge-based classifier for multiplexed images and proteomic datasets that avoids hard-set thresholds and manual labeling. We demonstrated that Tribus recovers fine-grained cell types, matching the gold standard annotations by human experts. Additionally, Tribus can target ambiguous populations and discover phenotypically distinct cell subtypes. Through benchmarking against three similar methods in four public datasets with ground truth labels, we show that Tribus outperforms other methods in accuracy and computational efficiency, reducing runtime by an order of magnitude. Finally, we demonstrate the performance of Tribus in rapid and precise cell phenotyping with two large in-house whole-slide imaging datasets. AVAILABILITY AND IMPLEMENTATION: Tribus is available at https://github.com/farkkilab/tribus as an open-source Python package.

Proteomics↗

PubMed2004

Soy isoflavones--phytoestrogens and what else?

The weak estrogen-like properties of isoflavonoids were discovered over 50 y ago. In recent years, the overall effects of the isoflavones in soy on human health have been the subject of lively debate largely based on their presumed estrogenic properties. Missing from our knowledge base is the systematic identification of the cellular and biochemical targets of isoflavones and the mechanisms that they influence. Because of the benign effects of isoflavones on cellular integrity, a concentration of the isoflavones can be reached in cell culture models where almost any process can be modulated. Modern systems biology approaches and high dimensional analysis techniques offer new ways to better understand the function of how cells and integrated biological mechanisms respond to compounds such as isoflavones. Data from experiments using DNA microarray analysis for examining the effects of genistein in the developing rat uterus indicate that genistein alters the expression of 6-8 times as many genes as does a physiological estrogen such as 17 beta-estradiol. Although these new approaches are exciting, their incipient high dimensionality places considerable strain on the quality of experimental design and meaningful statistical interpretation of the resulting data. In another approach using affinity chromatography methods, DING, a novel genistein-binding protein of yet unknown function, was isolated from human breast cancer MCF-7 cells. Its function remains to be established.

Animals↗