摘要:

AbstractA major obstacle to establishing a computer-stored medical record is the lack of “standards” that would permit government, care providers, insurance companies, and medical computer system developers to share patient data easily. In this position paper, the Board of Directors of the American Medical Informatics Association recommends specific approaches to standardization in the areas of patient, provider, and site of care identifiers; computerized health care message exchange; medical record content and structure, and medical codes and terminologies. The key concept developed in this position paper is that developers and users of computer-stored medical records must embrace existing and tested approaches, despite their imperfections, to progress quickly. This approach to standardization is being coordinated with the American National Standards Institute's Health Informatics Standards Planning Panel. The development of standards is a long-term process involving continued refinement. The proposed standards are an important step toward the goal of better and more efficient health care.

ISSN:1527-974X    

DOI:10.1136/jamia.1994.95236133

出版商:BMJ Group    

年代:1994

数据来源: BMJ

摘要:

AbstractArticles about medical diagnostic decision support (MDDS) systems often begin with a disclaimer such as, “despite many years of research and millions of dollars of expenditures on medical diagnostic systems, none is in widespread use at the present time.” While this statement remains true in the sense that no single diagnostic system is in widespread use, it is misleading with regard to the state of the art of these systems. Diagnostic systems, many simple and some complex, are now ubiquitous, and research on MDDS systems is growing. The nature of MDDS systems has diversified overtime. The prospects for adoption of large-scale diagnostic systems are better now than ever before, due to enthusiasm for implementation of the electronic medical record in academic, commercial, and primary care settings. Diagnostic decision support systems have become an established component of medical technology. This paper provides a review and a threaded bibliography for some of the important work on MDDS systems over the years from 1954 to 1993.

ISSN:1527-974X    

DOI:10.1136/jamia.1994.95236141

出版商:BMJ Group    

年代:1994

数据来源: BMJ

摘要:

AbstractCareful study of medical informatics research and library-resource projects is necessary to increase the productivity of the research and development enterprise. Medical informatics research projects can present unique problems with respect to evaluation. It is not always possible to adapt directly the evaluation methods that are commonly employed in the natural and social sciences. Problems in evaluating medical informatics projects may be overcome by formulating system development work in terms of a testable hypothesis; subdividing complex projects into modules, each of which can be developed, tested and evaluated rigorously; and utilizing qualitative studies in situations where more definitive quantitative studies are impractical.

ISSN:1527-974X    

DOI:10.1136/jamia.1994.95236134

出版商:BMJ Group    

年代:1994

数据来源: BMJ

摘要:

AbstractObjective: Develop a knowledge-based representation for a controlled terminology of clinical information to facilitate creation, maintenance, and use of the terminology.Design: The Medical Entities Dictionary (MED) is a semantic network, based on the Unified Medical Language System (UMLS), with a directed acyclic graph to represent multiple hierarchies. Terms from four hospital systems (laboratory, electrocardiography, medical records coding, and pharmacy) were added as nodes in the network. Additional knowledge about terms, added as semantic links, was used to assist in integration, harmonization, and automated classification of disparate terminologies.Results: The MED contains 32,767 terms and is in active clinical use. Automated classification was successfully applied to terms for laboratory specimens, laboratory tests, and medications. One benefit of the approach has been the automated inclusion of medications into multiple pharmacologic and allergenic classes that were not present in the pharmacy system. Another benefit has been the reduction of maintenance efforts by 90%.Conclusion: The MED is a hybrid of terminology and knowledge. It provides domain coverage, synonymy, consistency of views, explicit relationships, and multiple classification while preventing redundancy, ambiguity (homonymy) and misclassification.

ISSN:1527-974X    

DOI:10.1136/jamia.1994.95236135

出版商:BMJ Group    

年代:1994

数据来源: BMJ

摘要:

AbstractObjective: Assess the performance of the SAPHIRE automated information retrieval system.Design: Comparative study of automated and human searching of a MEDLINE test collection.Measurements: Recall and precision of SAPHIRE were compared with those attributes of novice physicians, expert physicians, and librarians for a test collection of 75 queries and 2,334 citations. Failure analysis assessed the efficacy of the Metathesaurus as a concept vocabulary; the reasons for retrieval of nonrelevant articles and nonretrieval of relevant articles; and the effect of changing the weighting formula for relevance ranking of retrieved articles.Results: Recall and precision of SAPHIRE were comparable to those of both physician groups, but less than those of librarians.Conclusion: The current version of the Metathesaurus, as utilized by SAPHIRE, was unable to represent the conceptual content of one-fourth of physician-generated MEDLINE queries. The most likely cause for retrieval of nonrelevant articles was the presence of some or all of the search terms in the article, with frequencies high enough to lead to retrieval. The most likely cause for nonretrieval of relevant articles was the absence of the actual terms from the query, with synonyms or hierarchically related terms present instead. There were significant variations in performance when SAPHIRE's concept-weighing formulas were modified.

ISSN:1527-974X    

DOI:10.1136/jamia.1994.95236136

出版商:BMJ Group    

年代:1994

数据来源: BMJ

摘要:

AbstractObjective: To analyze the terms used by nurses in a variety of data sources and to test the feasibility of using SNOMED III to represent nursing terms.Design: Prospective research design with manual matching of terms to the SNOMED III vocabulary.Measurements: The terms used by nurses to describe patient problems during 485 episodes of care for 201 patients hospitalized forPneumocystis cariniipneumonia were identified. Problems from four data sources (nurse interview, intershift report, nursing care plan, and nurse progress note/flowsheet) were classified based on the substantive area of the problem and on the terminology used to describe the problem. A test subset of the 25 most frequently used terms from the two written data sources (nursing care plan and nurse progress note/flowsheet) were manually matched to SNOMED III terms to test the feasibility of using that existing vocabulary to represent nursing terms.Results: Nurses most frequently described patient problems as signs/symptoms in the verbal nurse interview and intershift report. In the written data sources, problems were recorded as North American Nursing Diagnosis Association (NANDA) terms and signs/symptoms with similar frequencies. Of the nursing terms in the test subset, 69% were represented using one or more SNOMED III terms.

ISSN:1527-974X    

DOI:10.1136/jamia.1994.95236137

出版商:BMJ Group    

年代:1994

数据来源: BMJ

ISSN:1527-974X    

DOI:10.1136/jamia.1994.95236138

出版商:BMJ Group    

年代:1994

数据来源: BMJ

ISSN:1527-974X    

DOI:10.1136/jamia.1994.95236139

出版商:BMJ Group    

年代:1994

数据来源: BMJ

ISSN:1527-974X    

DOI:10.1136/jamia.1994.95236140

出版商:BMJ Group    

年代:1994

数据来源: BMJ