疾病领域本体模型构建研究

针对当前疾病知识组织和检索系统存在的问题,本文提出基于本体思想组织疾病领域知识,利用Protégé3.4.4构建工具,依据七步法尝试构建了疾病领域本体,初步建立了一个疾病领域本体模型;最后研究了如何进化疾病领域本体,为实现疾病领域资源的有序组织和有效利用提供了一定的实践经验。     

我国医学领域本体研究热点分析—共词可视化视角

利用CNKI(《中国学术期刊网络出版总库》、《中国优秀硕士学位论文全文数据库》、《中国博士学位论文全文数据库》、《中国重要会议论文全文数据库》)、CBM(中国生物医学文献数据库)、万方为数据情报源检索国内医学领域本体相关文献,检索时间为1990-2010/06。以共词分析法为主要研究方法,利用BICOMB软件、SAS9.1.3统计工具对这些文献的关键词进行分析,以探讨我国医学领域本体研究现状与热点领域,以期为本体在医学领域的进一步研究提供借鉴和参考。     

医学论文统计设计语义模型与元数据创建

目的将统计设计的基本理论、基本知识整合成为计算机可识别的语义模型、语义槽及元数据,为语义网计算机推理提供知识本体。方法知识本体的建立以公认的医学统计理论为依据,采用知识本体编辑工具Prot啨g啨构建语义模型的层级结构,定义概念与概念之间的关系以及语义槽的专业词汇和其他元数据的规范描述。结果构建了包含试验设计基本要素、实验设计基本原则的语义模型,创建了19个语义槽和元数据,3个医学期刊论文研究设计的实例。结论构建计算机可识别和处理的统计知识本体,是计算机自动对网络信息进行逻辑推理操作的基础。根据统计设计语义模型中统计知识的电子化表示,医学研究者可自己创建实例或定义关于医学论文统计设计的描述文档,不需要使用复杂繁琐的本体语言。     

基于医学本体的电子病历系统研究

尽管电子病历在临床医学中已广泛应用,但传统模版生成方式的病历与临床思维逻辑存在吻合度问题,因此笔者提出基于医学本体的电子病历系统,系统地探讨了电子病历较纸质病历的优势并对本体相关知识内容进行介绍,探索建立基于医学本体的电子病历系统。在电子病历本体构建过程中,将大量的临床医学知识有机地组织并重用。系统实际应用过程表明,基于医学本体的电子病历系统能够有效缓解临床病历描述主观性强、模糊引争议等现象的发生,提高临床数据质量。     

临床实验室检验知识的数据挖掘和表达

目的探索基于自组织映射（SOM）的数据挖掘方法从历史积累的临床实验室检验数据中发现知识的能力,并尝试利用本体方法将该领域相关知识进行标准化表达。方法本研究的基本思想是采用自组织映射神经网络技术,从过去积累的数据中挖掘出专家经验基础上的临床检验项目的应用规律（知识）。以2009--2011年西安市两所综合医院的内科门诊患者就诊资料为训练样本,采用自组织映射方法建立门诊患者的聚类模型。采用通用的本体构建原则和方法,提取领域内相关概念及相互关系,建立临床实验室检验领域本体框架。结果SOM网络将就诊患者聚为8个类别,每个类别都具有较明显的临床意义,即每个类别中的患者具有相似的临床实验室检验项目的应用规律。聚类结果可以涵盖69．73％的患者。患者性别、年龄、3年累计临床检验项目数、疾病特征对聚类模型的贡献较大。构建了临床实验室检验领域本体框架,该框架的构建过程符合本体的建立准则,本体中的概念及其关系相对完整。结论自组织映射方法对门诊患者聚类效果较好,说明采用数据挖掘方法从历史数据中发现临床实验室检验项目的应用规律是可行的。采用本体方法将该领域知识进行标准化表达是一种有益的尝试。     

基于医学本体的电子病历结构化数据采集研究

目的：对临床描述性信息结构化录入程序（SDE）进行再开发，建立基于医学本体的临床信息结构化采集模型和应用框架。方法：使用0penSDE建立临床医学信息域本体模型，主要是患者病程病史、检查检验等医学术语概念及它们的内容描述，并建立树型结构框架。结果：建立了基于医学本体模型的可扩展临床电子数据采集系统。结论：其结构化可选式数据录入对基于电子病历的临床决策有重要意义。     

计算机化临床实践指南的研究和实现

目的：探讨基于本体的计算机化临床实践指南开发模式．为实现医疗信息系统中的警示／提醒、数据共享、循证医学和临床决策提供技术支持。方法：分析指南交换框架（GLIF）的结构和领域本体．根据中国脑血管病防治指南和神经疾病本体对GLIF进行扩展。结果以急性脑梗死静脉溶栓治疗为例．建立包括版本描述元数据、药物数据项列表、证据强度说明、适应证判断步骤、禁忌证判断步骤和用药选择步骤等在内的计算机化的中文神经内科疾病治疗指南。结论：将计算机化的临床实践指南和临床信息系统以及电子病历结合在一起,对于临床路径优化和决策支持具有重要意义。     

本体在电子病历检索中的研究与探索

目的电子病历在临床诊断与治疗中的应用日益广泛,如何有效地利用电子病历系统中大量的数据,辅助医生进行分析与诊断是一个非常重要的问题。传统的基于文本关键字的检索方法已不能满足对大型电子病历数据库检索的需要,将基于本体的检索方法引入到医学数据库中进行研究是一项非常有意义的工作。方法在分析传统电子病历检索方法不足的基础上,本文结合模糊本体的概念,提出了一种基于模糊本体的电子病历分析方法。该方法充分利用了模糊本体中隶属度的概念,对查询语句和电子病历关键词向量空间模型进行模糊本体概念映射,概念相似度计算。结果通过数值实验对该方法在查全率和查准率方面进行了性能分析,实验证明该方法具有良好的检索性能。     

医学情报在卫生防疫中的作用

在信息社会里,情报是金钱,情报是财富,这对大家已不再陌生。在医疗卫生领域,情报就是生命,这也不算过分。但,目前人们对医学情报的作用还没有一个清晰的认识,以至于医学情报的各项工作还没有走上规范化、标准化的历程,影响了卫生防疫站职能的充分发挥。为提高医学情报的利用     

略论新世纪医学情报综合型人才的培养

本文通过对医院图书馆医学情报人才现状的分析,提出了要适应21世纪医学领域科学技术发展的需要,必须通过有计划、有目的、多途径地迅速培养一支高智能、懂得多学科知识的跨世纪医学情报复合型、开拓型人才,以保证医学图书馆情报事业的稳步发展。     

Building an Ontology for Identity Resolution in Healthcare and Public Health

Integration of disparate information from electronic health records, clinical data warehouses, birth certificate registries and other public health information systems offers great potential for clinical care, public health practice, and research. Such integration, however, depends on correctly matching patient-specific records using demographic identifiers. Without standards for these identifiers, record linkage is complicated by issues of structural and semantic heterogeneity.Objectives: Our objectives were to develop and validate an ontology to: 1) identify components of identity and events subsequent to birth that result in creation, change, or sharing of identity information; 2) develop an ontology to facilitate data integration from multiple healthcare and public health sources; and 3) validate the ontology’s ability to model identity-changing events over time.Methods: We interviewed domain experts in area hospitals and public health programs and developed process models describing the creation and transmission of identity information among various organizations for activities subsequent to a birth event. We searched for existing relevant ontologies. We validated the content of our ontology with simulated identity information conforming to scenarios identified in our process models.Results: We chose the Simple Event Model (SEM) to describe events in early childhood and integrated the Clinical Element Model (CEM) for demographic information. We demonstrated the ability of the combined SEM-CEM ontology to model identity events over time.Conclusion: The use of an ontology can overcome issues of semantic and syntactic heterogeneity to facilitate record linkage.     

A medical ontology for intelligent web-based skin lesions image retrieval

Researchers have applied increasing efforts towards providing formal computational frameworks to consolidate the plethora of concepts and relations used in the medical domain. In the domain of skin related diseases, the variability of semantic features contained within digital skin images is a major barrier to the medical understanding of the symptoms and development of early skin cancers. The desideratum of making these standards machine-readable has led to their formalization in ontologies. In this work, in an attempt to enhance an existing Core Ontology for skin lesion images, hand-coded from image features, high quality images were analyzed by an autonomous ontology creation engine. We show that by exploiting agglomerative clustering methods with distance criteria upon the existing ontological structure, the original domain model could be enhanced with new instances, attributes and even relations, thus allowing for better classification and retrieval of skin lesion categories from the web.     

What matters to girls and boys in a black primary school in South Africa

This article focuses on the construction of gender identities among young boys and girls in a black primary school. Against the backdrop of food insecurity, young boys' and girls' vulnerability to violence and to using violence as a means of getting food is increased. Violence is a clear manifestation of gender inequalities. Drawing on data derived from an ethnographic exploration of children's gender identities in the first years of primary schooling, this article examines how violence underscores much of social relations amongs boys and girls. The article further illustrates how different forms of masculinities and femininities are constructed. Violence is not the domain of boys only. Girls too take on violent femininities. The implications of recognizing children's gendered and violent cultures are discussed briefly in the concluding part of the paper.     

Implementing information technology in the NHS: the role of narrative.

This paper analyses how groups use narratives in social processes of sensemaking and identity construction and in the pursuit and legitimation of their selfish interests. It does so through an examination of the narrativity of the experiences reported by the developers and users of an information technology (IT) system linking a haematology laboratory and a specialist haematology ward in a large acute hospital. The research contribution the paper makes is twofold. First, it illustrates the importance of group-level narratives in enacting organizational realities and especially in the social construction of IT systems. Second, it suggests that the narrative understanding of groups is a significant domain of organizational inquiry because it is through the spread and acceptance of their narratives that groups exercise their most profound influence.     

A cyborg ontology in health care: traversing into the liminal space between technology and person‐centred practice

Person‐centred practice indubitably seems to be the antithesis of technology. The ostensible polarity of technology and person‐centred practice is an easy road to travel down and in their various forms has been probably travelled for decades if not centuries. By forging ahead or enduring these dualisms, we continue to approach and recede, but never encounter the elusive and the liminal space between technology and person‐centred practice. Inspired by Haraway's work, we argue that healthcare practitioners who critically consider their cyborg ontology may begin the process to initiate and complicate the liminal and sought after space between technology and person‐centred practice. In this paper, we draw upon Haraway's idea that we are all materially and ontologically cyborgs. Cyborgs, the hybridity of machine and human, are part of our social reality and embedded in our everyday existence. By considering our cyborg ontology, we suggest that person‐centred practice can be actualized in the contextualized, embodied and relational spaces of technology. It is not a question of espousing technology or person‐centred practice. Such dualisms have been historically produced and reproduced over many decades and prevented us from recognizing our own cyborg ontology. Rather, it is salient that we take notice of our own cyborg ontology and how technological, habitual ways of being may prevent (and facilitate) us to recognize the embodied and contextualized experiences of patients. A disruption and engagement with the habitual can ensure we are not governed by technology in our logics and practices of care and can move us to a conscious and critical integration of person‐centred practice in the technologized care environments. By acknowledging ourselves as cyborgs, we can recapture and preserve our humanness as caregivers, as well as thrive as we proceed in our technological way of being.     

Ethnography and measurement in mental health: qualitative validation of a measure of continuity of care (CONNECT)

Ethnography contributes to measure development by enhancing validity and providing a basis for qualitative validation. Validating research measures means making cases for their "trustworthiness." The authors argue for the trustworthiness of CONNECT, a measure of continuity of care, by presenting the interpretive logic through which they elaborated continuity for measure construction purposes. They used category construction methods to identify mechanisms of continuity in ethnographic data. Mechanisms suggested five measurement domains: (a) knowledge, (b) flexibility, (c) availability, (d) coordination, and (e) transitions. Validation rationales summarize the ethnographic evidence and explain how the domain relates to continuity. In making explicit the data and the reasoning used, the authors argue for the trustworthiness of their interpretation. The arguments for trustworthiness demonstrate a qualitative validation process.