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At least 163 records · Page 9Linked to original sources

PubMed2004

Using a guideline-centered approach for the design of a clinical decision support system to promote smoking cessation.

Knowledge acquisition for the design of clinical decision support systems can be facilitated when clinical practice guidelines serve as a knowledge source. We describe application of the Guideline Elements Model (GEM) in the design of a decision support system to promote smoking cessation. Following selection of relevant recommendations and markup of knowledge components with the GEM Cutter editor, the Extractor stylesheet was used to create a list of decision variables and actions for further processing. Decision variables and actions that reflect similar concepts were consolidated. Action types were identified. Extracting the critical concepts from the narrative text facilitates clarification of necessary content. The guideline-centric approach promotes accurate translation of guideline knowledge.

Decision Support Systems, Clinical↗

PubMed2001

Long-term working memory in text production.

In reading and other high-level cognitive tasks, Ericsson and Kintsch (1995) proposed that the limited capacity of short-term working memory (STWM) is supplemented by long- term working memory (LTWM) for individuals with a high degree of domain-specific knowledge. In Experiment 1, college students (N = 80) wrote persuasive and narrative texts concerning baseball; domain-specific knowledge about baseball and verbal ability was assessed. The results showed that verbal ability and domain-specific knowledge independently affected writing skill, supporting the view that literacy depends on both knowledge sources and refuting one argument raised in support of the LTWM hypothesis. Experiment 2 (N = 42) replicated this outcome and tested the prediction that a high degree of domain-specific knowledge would lessen interference on a secondary task. The data supported the interference prediction, offering evidence that LTWM plays a role in the production of text.

Adult↗

PubMed2001

Standardized terminological services enabling semantic interoperability between distributed and heterogeneous systems.

The interconnection of heterogeneous computer applications in medicine raises the issue of semantic interoperability, going beyond traditional approaches of terminological standardization in basically three aspects. First, the variety of medical vocabularies that currently coexist in different domains is a major barrier for the integration of autonomously developed applications. Fortunately, with the Unified Medical Language System (UMLS) there are machine-readable terminological sources that cover and integrate most of the existing medical vocabularies. Second, the exchanged data need to be processed by a machine for different purposes like patient data integration, access to literature and knowledge bases as well as clinical audit and research. Medical vocabularies provided as passive dictionaries are no longer sufficient. Software system developers should take advantage of terminological services for refining user queries, for mapping the user's terms to appropriate medical vocabularies etc. Third, the services should be accessible uniformly and transparently. In the CORBAmed initiative a proposal for a standardized interface for querying and accessing computerized medical terminology resources was created. Based on the mentioned principles the MUSTANG system (Medical UMLS based Terminology Server for Authoring, Navigating and Guiding the Retrieval to Heterogeneous Knowledge Sources) has been developed. It is implemented on a Windows NT platform using the ORACLE database management and development software. The terminological services are accessible via multiple interfaces. The MUSTANG-System and the experiences with using terminological services in practice are described. Opposed to other levels of standardization like syntactical message standards there is much more a hesitation in the use of standardized terminology.

Humans↗

PubMed2006

Expert nurses' use of implicit memory in the care of patients with Alzheimer's disease.

AIM: This paper reports a study exploring expert nurses' use of implicit memory in the care of people with Alzheimer's disease. BACKGROUND: Although research has shown the benefits of preserving and using implicit memory in patients with Alzheimer's disease, the literature shows little evidence of how nurses, in particular expert ones, make use of implicit memory with this client group in clinical practice. METHOD: Semi-structured interviews were carried out with a purposive sample of eight nurses (four from Michigan, United States of America and four from Northern Ireland) in 2004. The interviews focused on specific issues, but were deliberately flexible to allow participants to tell their stories as well. A nine-step data analysis process was developed based on a synthesis of methods used by other researchers. FINDINGS: According to the expert nurses interviewed, the effective and meaningful use of the implicit memory of patients with Alzheimer's disease in achieving positive outcomes depended on 'knowing the patient', 'working within the patient's worldview' and 'using sensitive and patient-centred interactional skills'. They explained how their use of implicit memory (drawing from a range of knowledge sources) was underpinned by reflective practice. CONCLUSION: The findings provide a positive profile of expert nurses' use of implicit memory of patients with Alzheimer's disease; however, their use of theoretical and research knowledge could be improved. There is also a need to test interventions based on the use of implicit memories.

Adult↗

PubMedDate not supplied

A blackboard architecture for automating cephalometric analysis.

This paper describes a principled attempt to use artificial intelligence methodologies for interpretation of lateral skull X-ray images. Lateral skull X-ray images are routinely used in cephalometric analysis to provide quantitative measurements useful to clinical orthodontists. Manual and interactive methods of analysis are known to be error-prone, and time-consuming. Previous attempts have been made to automate this analysis, using conventional algorithmic approaches. Unfortunately such systems typically fail to capture the expertise and adaptability required to cope with the variability in biological structure and X-ray image quality found in cephalograms. The present system makes use of a blackboard architecture and multiple knowledge sources within an integrated model-based system. A data-gathering system allows models of feature appearance and location to be built from examples. Blackboard and task control modules allow specific knowledge-based modules to act on information available to the blackboard. Knowledge-based modules include location hypothesis, intelligent segmentation, and constraint propagation systems. Results from a working experimental system are given, and compare favourably with previous algorithmic solutions.

Artificial Intelligence↗

PubMed1998

Rural youth: HIV/STD knowledge levels and sources of information.

Though it is recognised that a sound knowledge of HIV/STD transmission is insufficient on its own to ensure that young people practise safer sex, knowledge of this sort is a necessary prerequisite to safe sex behaviours. Research on the HIV/STD knowledge levels of young people has shown that, while they have high levels of HIV knowledge, they generally have little idea about the transmission of other STDs. Moreover, most of this research has been conducted with more accessible youth in large urban centres. The research reported in this paper focused on HIV/STD knowledge levels, awareness of safe and unsafe sexual practices, and the information sources accessed by 1168 young people living in small rural towns in Queensland, Tasmania and Victoria. As with mainstream youth, the participants in this study had high levels of HIV knowledge and very low levels of knowledge about the transmission of other STDs, their names and symptoms. Practical knowledge of the safety of sexual practices was good, although a number of students confused high risk practices with high risk groups. Students mainly accessed informal information sources such as parents, peers and magazines and took little advantage of more formal sources even when they were available in their towns. There were few gender differences in levels of knowledge; however, girls accessed more information sources and knew more names of STDs. The implications of these findings are discussed in relation to young people developing critical attitudes towards more informal sources, and the better use of more formal sources.

Adolescent↗

PubMed1999

Re-engineering the process of surgical informed consent.

We have created a clinical performance support system that transforms surgical informed consent into an interactive process capable of evolving in response to institution-specified, provider-specified and patient-specified needs. The system functions in several capacities, including: (1) a source of standardized and comprehensive content and format the transmission of procedure-related risk and complications; (2) as expert critique, providing cues in an effort to reduce the effects of biased risk appraisal; (3) captures and archives clinician behavior relating to use, modification and disclosure of standardized knowledge sources; (4) provides just-in-time access to procedural descriptions information relating to risks and complications; (5) captures, archives and makes available to the clinician patient use of procedure-related knowledge resources. By design, the system will be used to assess the relationship between clinician perception and heuristics surrounding risk appraisal and disclosure and patient perceptions based on response to the disclosure process. The system prototype is currently being deployed in a breast surgery unit at the Beth Israel Deaconess Medical Center.

Computer Systems↗

PubMed1999

[Effective use of medical-scientific internet resources].

PROBLEM: The Internet is not structured hierarchically and therefore it distinguishes from today's common knowledge sources. The rapidly growing number of medical websites offers comprehensive but not easy to find information resources and continuing education opportunities for ophthalmologists. METHODS AND RESULTS: The efficiency of an Internet search is related to knowledge about existing search strategies. Several search systems are described (search engines, catalogs, databases, indices, etc.). Additional advice about efficient usage (Meta-Search, use of Boolean operators, phrase search, etc.) is provided. The suggested search strategies are evaluated regarding their specific results, update status, and the usability of search engines used. New applications such as SemioMap and Intelligent Agents are described. CONCLUSION: Today the Internet provides practitioners and scientists who are able to use efficient search strategies with easy and fast to use information resources. The total number of scientific-medical documents on the Web is growing very quickly. More and more, their content is related to current problems in patient treatment and future trends in clinical research.

Education, Medical, Continuing↗

PubMed1993

The UMLS Metathesaurus: representing different views of biomedical concepts.

The UMLS Metathesaurus is a compilation of names, relationships, and associated information from a variety of biomedical naming systems representing different views of biomedical practice or research. The Metathesaurus is organized by meaning, and the fundamental unit in the Metathesaurus is the concept. Differing names for a biomedical meaning are linked in a single Metathesaurus concept. Extensive additional information describing semantic characteristics, occurrence in machine-readable information sources, and how concepts co-occur in these sources is also provided, enabling a greater comprehension of the concept in its various contexts. The Metathesaurus is not a standardized vocabulary; it is a tool for maximizing the usefulness of existing vocabularies. It serves as a knowledge source for developers of biomedical information applications and as a powerful resource for biomedical information specialists.

MEDLINE↗

PubMed2004

Effects of profession and facility type on research utilization by rehabilitation professionals.

Information about the use of research by rehabilitation professionals to make clinical decisions in everyday practice is limited. This study compared perceived research use and knowledge sources across professions, practice situations, and work environments. Participants were 165 randomly selected Canadian occupational therapists, physical therapists, and speech-language pathologists. Self-report ratings during an interview, an interviewer rating, and questionnaire scores (Edmonton Research Orientation Survey, General Use of Research, Knowledge Acquisition Survey) were compared. Speech-language pathologists had the most education and the highest research use ratings. Research use was highest during program planning. Programs to encourage research use must consider the research available to guide practice and therapists' education level. Facility size and location (rural, urban) do not affect perceived research use.

Alberta↗

PubMed2006

A web-based system for supporting collaboration towards resolving oncology issues.

The coordinated consideration of diverse perspectives and knowledge sources in medical decision-making contexts is undoubtedly of crucial importance, in that it augments the quality of both the overall process and decisions to be made. Towards this end, this study presents a web-based system that aims at the exploitation of personalized knowledge through a structured process of collaborative and argumentative resolution of issues raised in such settings. By using the system, a consensus emerges through the process of collaboratively considering alternative interpretations of the issue under consideration. Using an illustrative example of collaboration between a group of experts deciding on the most appropriate treatment for a particular case of breast cancer, we present the design rationale, features and functionality of the proposed system. Much attention is also paid to the associated knowledge management issues. The system can be used for distributed, asynchronous collaboration, allowing users to surpass the requirements of working at the same place and time.

Breast Neoplasms↗

PubMed2000

Validity of adolescent and young adult self-report of Papanicolaou smear results.

OBJECTIVE: To assess the validity of adolescent and young adult report of Papanicolaou smear results and to determine sociodemographic, cognitive, and behavioral factors associated with incorrect reporting. METHODS: We conducted a cross-sectional study of 477 female subjects aged 12 to 24 years who attended an adolescent clinic and had a previous Papanicolaou smear. Subjects completed a self-administered survey assessing self-report of Papanicolaou smear results, knowledge about Papanicolaou smears and human papillomavirus (HPV), attitudes about Papanicolaou screening and follow-up, and risk behaviors. The sensitivity, specificity, positive predictive value, and negative predictive value of self-reported results were calculated using the cytology report as the standard. Variables significantly associated with incorrect reporting were entered into logistic regression models controlling for age and race to determine independent predictors for incorrect reporting. RESULTS: Of the 477 participants, 128 (27%) had abnormal cytology reports and 66 (14%) had incorrect self-reports. Sensitivity of self-report was 0.79, specificity 0.89, positive predictive value 0.72, negative predictive value 0.92, and kappa (kappa) 0.66. The adjusted odds ratios (OR) and 95% confidence intervals (CI) of the variables comprising a logistic regression model predicting incorrect reporting were an HPV knowledge source of zero (OR 2.4, CI 1.0, 5.8), low perceived communication with the provider (OR 2.1, CI 1.1, 4.0), and no contraception at last intercourse (OR 5.5, CI 2.7, 11.0). CONCLUSION: The validity of adolescent and young adult self-reported Papanicolaou smear result is high, except among those who lack knowledge of HPV, perceive poor communication with the provider, and use contraception inconsistently.

Adolescent↗

PubMed1998

The decision support system for telemedicine based on multiple expertise.

This paper discusses the application of artificial intelligence in telemedicine and some of our research results in this area. The main goal of our research is to develop methods and systems to collect, analyse, distribute and use medical diagnostics knowledge from multiple knowledge sources and areas of expertise. Use of modern communication tools enable a physician to collect and analyse information obtained from experts worldwide with the help of a decision support medical system. In this paper we discuss a multilevel representation and processing of medical data using a system which evaluates and exploits knowledge about the behaviour of statistical diagnostics methods. The presented technique is able to acquire semantically-essential information from the complex dynamics of quasi-periodical medical signals by applying recursively-ordinary statistical tools. A method and an algorithm are elaborated to select automatically the most appropriate diagnostics method for each case under consideration. We suggest the use of a voting-type technique to search for consensus among the different opinions of medical experts. Research results can be applied in the development of a telediagnostics expert medical system and medical teleconsulting support system.

Algorithms↗

PubMed1995

Cognitive design for sharing medical knowledge models.

By building a medical conceptual model inside the galen project, a methodology has been defined to deal with both operative goals and deep and unsolved problems about knowledge. This knowledge sharing oriented approach exploits existing medical coding systems such as knowledge sources and enables us to represent their concepts in a wider cognitive context referring to ontological theories. The tasks of cognitive ergonomy, quasi-naturalness of language, versatility, and flexibility seem to be supported through some functions, such as viewpoint, context, and sign, which act as spin-off points to knowledge or information which is not modeled.

Artificial Intelligence↗

PubMed1995

Sexual knowledge, behavior and sources of information among deaf and hard of hearing college students.

A sexual health knowledge, behavior and sources of sexual health information survey was administered to 134 deaf and hard of hearing college students. Results indicated the students in this sample were not particularly well informed about sexual health and sexuality issues, were engaging in high risk sexual behaviors and relied primarily on peers for sexual health information. The need for the development of psychometrically sound measurement instruments for use with deaf populations as well as areas for future sexual health research are discussed.

Adult↗

PubMed1995

Managed care organizations: the new research partners.

The current "accountability movement" in managed care demands many of the same components as good research methodology: both issues depend on comprehensive data sources, knowledgeable data manipulation, and credible reporting of the results. As a result, some plans that have earmarked resources and institutional support to good accounting practices are also forming centers of research. The following is an overview of these managed care organizations and their studies, which investigate questions most relevant to their populations and data sources. This article summarizes this expanding area of health services research and identifies the key institutional components of the plans that support this work.

Decision Making, Organizational↗

PubMed2006

NeuroScholar's electronic laboratory notebook and its application to neuroendocrinology.

Scientists continually relate information from the published literature to their current research. The challenge of this essential and time-consuming activity increases as the body of scientific literature continues to grow. In an attempt to lessen the challenge, we have developed an Electronic Laboratory Notebook (ELN) application. Our ELN functions as a component of another application we have developed, an open-source knowledge management system for the neuroscientific literature called NeuroScholar (http://www. neuroscholar. org/). Scanned notebook pages, images, and data files are entered into the ELN, where they can be annotated, organized, and linked to similarly annotated excerpts from the published literature within Neuroscholar. Associations between these knowledge constructs are created within a dynamic node-and-edge user interface. To produce an interactive, adaptable knowledge base. We demonstrate the ELN's utility by using it to organize data and literature related to our studies of the neuroendocrine hypothalamic paraventricular nucleus (PVH). We also discuss how the ELN could be applied to model other neuroendocrine systems; as an example we look at the role of PVH stressor-responsive neurons in the context of their involvement in the suppression of reproductive function. We present this application to the community as open-source software and invite contributions to its development.

Animals↗

PubMed2006

Genepi: a blackboard framework for genome annotation.

BACKGROUND: Genome annotation can be viewed as an incremental, cooperative, data-driven, knowledge-based process that involves multiple methods to predict gene locations and structures. This process might have to be executed more than once and might be subjected to several revisions as the biological (new data) or methodological (new methods) knowledge evolves. In this context, although a lot of annotation platforms already exist, there is still a strong need for computer systems which take in charge, not only the primary annotation, but also the update and advance of the associated knowledge. In this paper, we propose to adopt a blackboard architecture for designing such a system RESULTS: We have implemented a blackboard framework (called Genepi) for developing automatic annotation systems. The system is not bound to any specific annotation strategy. Instead, the user will specify a blackboard structure in a configuration file and the system will instantiate and run this particular annotation strategy. The characteristics of this framework are presented and discussed. Specific adaptations to the classical blackboard architecture have been required, such as the description of the activation patterns of the knowledge sources by using an extended set of Allen's temporal relations. Although the system is robust enough to be used on real-size applications, it is of primary use to bioinformatics researchers who want to experiment with blackboard architectures. CONCLUSION: In the context of genome annotation, blackboards have several interesting features related to the way methodological and biological knowledge can be updated. They can readily handle the cooperative (several methods are implied) and opportunistic (the flow of execution depends on the state of our knowledge) aspects of the annotation process.

Algorithms↗