Data,information, knowledge and wisdom

The relationship between data, information, knowledge and wisdom is explained. The growth of the Internet is changing the traditional hierarchies of ‘experts’ and changing ways of disseminating information.In the growing area of knowledge management, the Internet is enabling new ways of collecting, organizing and disseminating knowledge. Data mining is the application of improved techniques of data organization and storage and analysis to large datasets and has led to the discovery of previously unknown knowledge and relationships.     

Data,information and knowledge

The relationship between data, knowledge, and wisdom is explained in this article. Codifying knowledge will help to disseminate good practice and provide a sound basis for developing clinical decision-support systems. Stimulated by increasing access to the Internet, there is a tension between traditional sources of knowledge (e.g. books, individuals recognized as experts), and sources facilitated by ready access to the Internet (e.g. wikis, blogs and other social networking resources).     

Information on the Internet about colorectal cancer: patient attitude and potential toward Web browsing. A prospective observational study

Background

Patients with colorectal cancer who seek to improve their knowledge of health and treatment options can now access in a few seconds data that would previously have required hours of research. Our aim was to evaluate the attitudes of patients toward Web browsing for information on colorectal cancer.

Methods

We surveyed all patients attending a colorectal cancer follow-up clinic between January and August 2007 on their use of the Internet to obtain information on colorectal cancer.

Results

In all, 439 patients with mean age of 68.6 years participated in the study. Of these, 24% reported using the Internet to obtain colorectal cancer information. Most participants used the Google search engine. Only 13% of participants confirmed that colorectal cancer information on the Internet was helpful in decision-making. Patients under the age of 65 years were more likely to have Internet access (p < 0.001), more likely to use the Internet to find colorectal cancer information (p = 0.005) and more likely to access a site recommended by a colorectal specialist (p = 0.002). Among Internet users, men were slightly more likely than women to use the Internet, although the difference was not significant (p = 0.20).

Conclusion

The Internet is a useful tool for disseminating information about colorectal cancer. The best sites are still difficult for patients to distinguish from the thousands of sites returned by search engines. This study demonstrates that the level of potential interest is sufficient to justify the development of a departmental or regional colorectal cancer network of websites and indicates areas of interest for patients.     

Data,information, knowledge,wisdom, and understanding

The digital age commenced in the mid-20th century and since we have seen approximately exponential growth in information. This period has also seen the rapid growth of computer technology that has facilitated, for instance, the derivation of whole genomes and automated drug discovery. Data, information, knowledge and wisdom lay the foundations for understanding how experience is formed from evidence and observations. When data are put into context, the resultant information can drive growth and further contribute to increased knowledge. Appreciating the source of data enables us to recognize and hopefully correct for inherent error and bias. Ultimately knowledge discovery can be automated to gain information from data and so on, enhancing our understanding of a given subject and expanding collective wisdom.     

肺癌手术病人疾病知识掌握情况调查

目的了解肺癌病人疾病知识掌握情况,为完善肺癌病人健康教育内容提供依据.方法采用自行设计的肺癌疾病知识量表对108例肺癌病人进行调查.结果 52.78%肺癌病人的总体知识掌握较好,其中疾病危险因素、手术治疗、症状与早期诊断知识得分较高;相对缺乏知识为继续治疗、手术后不适和应对方法、康复保健知识.影响病人疾病知识掌握的因素为文化程度和医疗费支付方式(均P＜0.05).结论专科护士应根据不同病人的特点,针对其薄弱环节有目的地开展健康教育,提高病人疾病知识水平.     

Knowledge management

The relationship between data, knowledge, wisdom and understanding is explained in this article. There is a need to convert implicit knowledge to explicit knowledge to support several projects within the NHS (and elsewhere), to disseminate good practice, and to provide a sound basis for the different levels of developing clinical decision support systems. Stimulated by increasing access to the Internet, there is a tension between traditional sources of knowledge (e.g. books, individuals recognized as experts), and many different and varied sources of information and knowledge (a wide range of online resources that often are freely available).     

Medical resources for the anesthesiologist on the Internet

BACKGROUND AND OBJECTIVES: The Internet may be the most powerful information tool currently available to medical professionals. The first article in this Internet series (Reg Anesth Pain Med 1999;24:369-374) served as an introduction to the World Wide Web, while this article describes specific resources available to anesthesiologists searching for medical information. EDITOR'S NOTE: This series of articles on information technology describes a number of resources. Inclusion in this article does not imply endorsement or support by the American Society of Regional Anesthesia and Pain Medicine (ASRA-PM). Each reader is encouraged to personally evaluate specific websites because of the rapidly changing content and location of information on the Internet. This article is available on the ASRA-PM website (www.ASRA.com) with updated links to websites in this article.     

Information access for the new millennium: publishers and portals

The rise in Internet access has a number of implications for surgeons, both in terms of their personal use of information and in the accessibility of surgical information to their hospitals and patients. This article outlines some of the opportunities offered by the development of new ways to access information, and suggests that the ability to use the new technologies is now becoming an essential clinical skill.     

Evaluation of knowledge and anxiety level of patients visiting the colorectal pelvic floor clinic

OBJECTIVE: Discussing defaecating disorders is difficult for patients and many view anal physiology investigations (ultrasound, manometry, electromyography and pudendal nerve studies) as distasteful. This pilot study sought to assess whether present information sheets supplied to patients and the visit to the colorectal Pelvic Floor Clinic itself influenced patients' knowledge and anxiety. PATIENTS AND METHODS: Thirty Pelvic Floor Clinic patients from Auckland City Hospital were included. Each patient filled in a questionnaire before and after the clinic. This included objective questions about their knowledge of the structure and function of the pelvic floor and satisfaction with and understanding of the information sheet. Both visual analogue scale (VAS) and multiple choice questions (MCQ) were used. Their subjective and objective knowledge were compared. Anxiety was assessed on a visual analogue anxiety scale (VAAS). Results were expressed as VAS scores or percentage correct and relationships were tested using Fisher's Exact test and paired T-test. RESULTS: Subjective knowledge increased in 93% of the patients. The doctor's explanation led to a greater increase in subjective knowledge than the information sheet (35/100 mm, P<0.001 and 10/100 mm, P=0.01, respectively). Subjective improvement in knowledge did not however, translate into an increase in objective knowledge (P=0.63). The information sheet was read by 87% of the patients. The information sheet had reduced anxiety only in 23% of the patients and increased in 10%. Anxiety levels were not significantly influenced by the information sheet, but reduced significantly by the clinic visit in 87% of patients (P<0.001). The mean anxiety level reduced from 44/100 to 12/100 after the clinic visit. CONCLUSION: Anxiety levels are high in those visiting the Pelvic Floor Clinic. It appears that it is the interaction with the doctor that has a profound influence on anxiety levels and subjective knowledge rather than written information.     

Current status and role of the Japanese Association of Clinical Toxicology

Since its foundation in 1983, the Japanese Association of Clinical Toxicology (JACT) has contributed greatly to the progress of intoxication medicine in Japan. It assists toxicologists and other medical experts in sharing clinical experience, including unusual intoxication cases and those found only in certain regions. As a result, toxicologists no longer must rely on intuition and personal experience. Today, the association focuses on disseminating useful intoxication information among toxicologists and the general public through the Japan Intoxication Information Center. With strong support from JACT, the center is developing a database that will provide useful information to physicians who need to identify poisonous chemicals quickly in their toxic patients. It is also building a system for registering intoxication treatment experts which will be publicly accessible, and an Internet Web site to provide intoxication-related information online. JACT itself is also preparing to establish the Japan Intoxication Analysis Center. JACT is committed to improving intoxication medicine in Japan by continuing to help train toxicologists and the medical specialists who support them, making useful information readily available to them, and assisting them to identify toxic materials.     

Shaping the subject of incontinence. Relating experience to knowledge

In this paper, we empirically analyse the role of experience and its relation to knowledge by working through a case study of a website for people with incontinence. The term “knowledge by experience” may be confusing if experience is framed as “situations someone has lived through” which then come to function as the foundation for experiential knowledge. Foundationalist framing of experiential knowledge leads to problems of “indistinctness”, “incontestability” and “authenticity” of experiential knowledge. The analysis shows how participants structure and process their experiences, for example by collecting, relating and reviewing individual moments and actively interpreting them. Not every experience counts as valid input for “knowledge”. We suggest that in relation to knowledge “experience” is better understood as “having experience with” rather than as “having lived through” something. Experience as “being experienced” is then not something that “grounds” experiential knowledge, but takes the shape of know-how, interpretive possibilities and skills that are not exclusively tied to a particular subject. Interpreting experiential knowledge like this specifies it as a form of practical knowledge that may be contested by (more) experienced others and can be transferred to others still trying to master skills. These skills may help in an attempt to shape experience in new ways.     

医护人员医疗告知知信行问卷的编制及信效度检验

目的编制和验证医护人员医疗告知知信行问卷,用于评估其现状,为针对性干预提供依据。方法以知信行理论为基础,通过文献回顾、质性访谈、小组讨论、德尔菲专家函询、预调查后形成初测问卷,对438名临床医护人员进行调查,修订问卷并进行信效度检验。结果问卷由知识、态度、行为3个维度共31个条目组成;探索性因子分析3个因子累积方差贡献率为71.906%,验证性因子分析各拟合指标均在可接受范围(χ²/df=3.108,RMSEA=0.098,RMR=0.023,IFI=0.924,CFI=0.924);问卷Cronbach′sα系数为0.948;重测信度为0.973;问卷的S-CVI为0.984,各条目的I-CVI为0.860~1.000。结论该问卷具有较好的信效度,适用于医护人员医疗告知知识、态度和行为现状的调查。     

The different neural correlates of action and functional knowledge in semantic memory: an FMRI study

Previous reports suggest that the internal organization of semantic memory is in terms of different "types of knowledge," including "sensory" (information about perceptual features), "action" (motor-based knowledge of object utilization), and "functional" (abstract properties, as function and context of use). Consistent with this view, a specific loss of action knowledge, with preserved functional knowledge, has been recently observed in patients with left frontoparietal lesions. The opposite pattern (impaired functional knowledge with preserved action knowledge) was reported in association with anterior inferotemporal lesions. In the present study, the cerebral representation of action and functional knowledge was investigated using event-related analysis of functional magnetic resonance imaging data. Fifteen subjects were presented with pictures showing pairs of manipulable objects and asked whether the objects within each pair were used with the same manipulation pattern ("action knowledge" condition) or in the same context ("functional knowledge" condition). Direct comparisons showed action knowledge, relative to functional knowledge, to activate a left frontoparietal network, comprising the intraparietal sulcus, the inferior parietal lobule, and the dorsal premotor cortex. The reverse comparison yielded activations in the retrosplenial and the lateral anterior inferotemporal cortex. These results confirm and extend previous neuropsychological data and support the hypothesis of the existence of different types of information processing in the internal organization of semantic memory.     

Use of the Internet by burns patients, their families and friends

INTRODUCTION: The Internet has also become an increasingly important source of health-related information. However, with this exponential increase comes the problem that although the volume of information is huge, the quality, accuracy and completeness of the information are questionable, not only in the field of medicine. Previous studies of single medical conditions have suggested that web-based health information has limitations. The aim of this study was to evaluate Internet usage among burned patients and the people accompanying them to the outpatient clinic. METHODS: A customised questionnaire was created and distributed to all patients and accompanying persons in the adult and paediatric burns clinics. This investigated computer usage, Internet access, usefulness of Internet search and topics searched. RESULTS: Two hundred and ten people completed the questionnaire, a response rate of 83%. Sixty three percent of responders were patients, parents 21.9%, spouses 3.3%, siblings, children and friends the remaining 10.8%. Seventy seven percent of attendees had been injured within the last year, 11% between 1 and 5 years previously, and 12% more than 5 years previously. Seventy four percent had computer and Internet access. Twelve percent had performed a search. Topics searched included skin grafts, scarring and scar management treatments such as pressure garments, silicone gel and massage. DISCUSSION: This study has shown that computer and Internet access is high, however a very small number actually used the Internet to access further medical information. Patients with longer standing injuries were more likely to access the Internet. Parents of burned children were more frequent Internet users. As more burn units develop their own web sites with information for patients and healthcare providers, it is important to inform patients, family members and friends that such a resource exists. By offering such a service patients are provided with accurate, reliable and easily accessible information which is appropriate to their needs.     

Industry, teach us about research!

At the time of writing, it is barely a week since the European Wound Management Association conference in Brussels. For me, one of the highlights of these events is the opportunity to meet so many readers and get feedback on the journal. It was also great to see EWMA and other wound-care associations, industry representatives and practitioners all working together to achieve the shared goal of disseminating information on best practice. A perfect example of tripartite working.     

Burns first aid information on the Internet

The Internet is an increasingly important source of health-related information. However, the growth of the Internet and its use as a medical delivery tool should be viewed with caution. One of the key concerns is that although the volume of information is huge, the quality, accuracy and completeness of the information is questionable. The aim of this study was to evaluate burns first aid information on the Internet. The search term used was "first aid for burns" and the first 25 hits from each search engine were analysed by one of the observers. We gathered basic information on the web sites--such as the country of origin, language in which the information was offered, accessibility, relevance and whether the site was commercial, organisational or academic. Quality and technicality of the web sites were assessed and scored. The mean quality score was 4.7/15 (31.5%) The mean technical score was 6.1 of 12 (51.1%). When the total score was categorised by percentage, none of the web sites ranked in the excellent category, 1 was very good, 4 were good, 6 were fair and the majority, 36, were poor. Based on the quality score only, two web sites were in the excellent category and two were very good. For technicality one web site was excellent and three were very good. This study has shown first aid information on the Internet is largely of poor quality, that the technical information provided is inadequate and that the sites include a significant amount of grossly inaccurate information. The few sites that contain excellent technical information make up a very small proportion of what is available. Therefore, the average Internet user may not encounter these resources, instead gaining knowledge from sites of questionable value.     

Twinning in paediatric oncology - an African experience

Developing twinning programmes in paediatric oncology between African countries is possible, encouraging and rewarding. The development of centres of excellence in Africa could serve as a means of disseminating the knowledge and channelling international support for the surrounding countries in their effort to cure children's cancer.     

护士知识继续社会化认知状况的调查分析

目的 探讨护士知识继续社会化的认知状况，寻求提高护士知识社会化水平的方法和途径。方法 采用随机抽样的方法对506名护士进行问卷调查。结果 91．1％的护士认为护理工作好坏对医院形象有较大影响，52．2％的护士对具备护理知识和技能就能做好护理工作持正面评价，88．3％的护士认为应该不断学习，83．0％的护士认为护士有必要开展科研；90．0％以上的护士比较需要和非常需要接受继续教育；不同年龄、学历、职务、职称的护士对接受继续教育的认知一致，经统计学处理，χ^2=34.3、11．1、8．7、9．5，均P＞0．05，差异无显著性意义。结论 目前护士知识社会化程度并不高，知识继续社会化的任务仍然很重，医院应有计划、有组织抓好护士知识继续社会化工作，为护士继续教育提供更好的条件。     

Evaluating the content and quality of information about premature ejaculation on the Internet: what are men being exposed to ?

Premature ejaculation is one of the most common male sexual dysfunctions; however, only a few patients with premature ejaculation are seeking professional help or advice. Internet has become an important source of knowledge, and thus, more patients are looking online for health information. According to our best knowledge, no study has evaluated the content and quality of websites on premature ejaculation. We, therefore, aimed to evaluate the content and quality of currently available Internet‐based information on premature ejaculation. A sample was obtained comprising the 50 top sites retrieved from Google, Bing and Yahoo search engines using the terms ‘premature ejaculation’. Each site then was reviewed based on some predefined evaluation criteria to determine the general quality, condition‐specific content quality, popularity index and ownership. The websites reviewed were differed highly in terms of quality and ownership. Only a few sites provided comprehensive medical and complete information on premature ejaculation. The online information available is often of uncertain calibre; therefore, men are being exposed to information about premature ejaculation with a highly variable degree quality. This fact should be considered both by health professionals and website owners, and better online resources should be provided for these patients.