Biomedical Informatics Commons^™

A Day In The Life Of Pubmed: Analysis Of A Typical Day's Query Log, Jorge R Herskovic, Len Y Tanaka, William Hersh, Elmer V Bernstam

Faculty, Staff and Student Publications

OBJECTIVE: To characterize PubMed usage over a typical day and compare it to previous studies of user behavior on Web search engines. DESIGN: We performed a lexical and semantic analysis of 2,689,166 queries issued on PubMed over 24 consecutive hours on a typical day. MEASUREMENTS: We measured the number of queries, number of distinct users, queries per user, terms per query, common terms, Boolean operator use, common phrases, result set size, MeSH categories, used semantic measurements to group queries into sessions, and studied the addition and removal of terms from consecutive queries to gauge search strategies. RESULTS: The size of …

Imaging Of Pulmonary Embolism And T-Pa Therapy Effects Using Mdct And Liposomal Iohexol Blood Pool Agent: Preliminary Results In A Rabbit Model, Stephen J Burke, Ananth Annapragada, Eric A Hoffman, Emmanuel Chen, Ketan B Ghaghada, Jered Sieren, Edwin J R Van Beek

Faculty, Staff and Student Publications

RATIONALE AND OBJECTIVES: Polyethylene glycol-coated liposomal blood pool contrast agents maintain contrast enhancement over several hours. This study aimed to evaluate (long-term) imaging of pulmonary arteries, comparing conventional iodinated contrast with a liposomal blood pool contrast agent. Also, visualization of the (real-time) therapeutic effects of tissue plasminogen activator (t-PA) on pulmonary embolism (PE) was attempted. MATERIALS AND METHODS: Six rabbits (weight approximately 4 kg) had autologous blood clots injected through the superior vena cava. Imaging was performed using conventional contrast (iohexol, 350 mg I/ml; GE HealthCare, Princeton, NJ) at a dose of 1400 mg I per animal, and after wash-out, …

A Spatial-Temporal Approach To Surveillance Of Prostate Cancer Disparities In Population Subgroups, Chiehwen E. Hsu, Francisco Soto Mas, Jerry A. Miller, Ella T. Nkhoma

Faculty, Staff and Student Publications

BACKGROUND: Prostate cancer mortality disparities exist among racial/ethnic groups in the United States, yet few studies have explored the spatiotemporal trend of the disease burden. To better understand mortality disparities by geographic regions over time, the present study analyzed the geographic variations of prostate cancer mortality by three Texas racial/ethnic groups over a 22-year period.

METHODS: The Spatial Scan Statistic developed by Kulldorff et al was used. Excess mortality was detected using scan windows of 50% and 90% of the study period and a spatial cluster size of 50% of the population at risk. Time trend was analyzed to examine …

Reducing Liver Cancer Disparities: A Community-Based Hepatitis-B Prevention Program For Asian-American Communities, Chiehwen E. Hsu, Louis Chih-Hung Liu, Hee-Soon Juon, Yu-Wen Chiu

Faculty, Staff and Student Publications

OBJECTIVES: Several Asian-American groups are at a higher risk of dying of liver diseases attributable to hepatitis-B infection. This culturally diverse community should be well informed of and protected against liver diseases. The present study assesses the knowledge of hepatitis B before and after a hepatitis-B educational program and determines the infection status of an Asian community.

METHODS: Nine Asian communities of Montgomery County, MD, enrolled in the hepatitis-B prevention program between 2005 and 2006. They attended culturally tailored lectures on prevention, completed self-administered pre- and posttests, and received blood screening for the disease.

RESULTS: More than 800 Asian Americans …

Towards A Hybrid Method To Categorize Interruptions And Activities In Healthcare, Juliana J. Brixey, David J. Robinson, Craig W. Johnson, Todd R. Johnson, James P. Turley, Vimla L. Patel, Jiajie Zhang

Faculty, Staff and Student Publications

ObjectiveInterruptions are known to have a negative impact on activity performance. Understanding how an interruption contributes to human error is limited because there is not a standard method for analyzing and classifying interruptions. Qualitative data are typically analyzed by either a deductive or an inductive method. Both methods have limitations. In this paper a hybrid method was developed that integrates deductive and inductive methods for the categorization of activities and interruptions recorded during an ethnographic study of physicians and registered nurses in a Level One Trauma Center. Understanding the effects of interruptions is important for designing and evaluating informatics …

High-Resolution Vascular Imaging Of The Rat Spine Using Liposomal Blood Pool Mr Agent, K B Ghaghada, K H J Bockhorst, S Mukundan, A V Annapragada, P A Narayana

Faculty, Staff and Student Publications

BACKGROUND AND PURPOSE: High-resolution, vascular MR imaging of the spine region in small animals poses several challenges. The small anatomic features, extravascular diffusion, and low signal-to-noise ratio limit the use of conventional contrast agents. We hypothesize that a long-circulating, intravascular liposomal-encapsulated MR contrast agent (liposomal-Gd) would facilitate visualization of small anatomic features of the perispinal vasculature not visible with conventional contrast agent (gadolinium-diethylene-triaminepentaacetic acid [Gd-DTPA]). METHODS: In this study, high-resolution MR angiography of the spine region was performed in a rat model using a liposomal-Gd, which is known to remain within the blood pool for an extended period. The imaging …

Predictive Oncology: A Review Of Multidisciplinary, Multiscale In Silico Modeling Linking Phenotype, Morphology And Growth, Sandeep Sanga, Hermann B. Frieboes, Xiaoming Zheng, Robert Gatenby, Elaine L. Bearer, Vittorio Cristini

Faculty, Staff and Student Publications

Empirical evidence and theoretical studies suggest that the phenotype, i.e., cellular- and molecular-scale dynamics, including proliferation rate and adhesiveness due to microenvironmental factors and gene expression that govern tumor growth and invasiveness, also determine gross tumor-scale morphology. It has been difficult to quantify the relative effect of these links on disease progression and prognosis using conventional clinical and experimental methods and observables. As a result, successful individualized treatment of highly malignant and invasive cancers, such as glioblastoma, via surgical resection and chemotherapy cannot be offered and outcomes are generally poor. What is needed is a deterministic, quantifiable method to enable …

Computer Simulation Of Glioma Growth And Morphology, Hermann B. Frieboes, John S Lowengrub, S Wise, X Zheng, Paul Macklin, Elaine L. Bearer, Vittorio Cristini

Faculty, Staff and Student Publications

Despite major advances in the study of glioma, the quantitative links between intra-tumor molecular/cellular properties, clinically observable properties such as morphology, and critical tumor behaviors such as growth and invasiveness remain unclear, hampering more effective coupling of tumor physical characteristics with implications for prognosis and therapy. Although molecular biology, histopathology, and radiological imaging are employed in this endeavor, studies are severely challenged by the multitude of different physical scales involved in tumor growth, i.e., from molecular nanoscale to cell microscale and finally to tissue centimeter scale. Consequently, it is often difficult to determine the underlying dynamics across dimensions. New techniques …

Accuracy And Self Correction Of Information Received From An Internet Breast Cancer List: Content Analysis, Adol Esquivel, Funda Meric-Bernstam, Elmer V Bernstam

Faculty, Staff and Student Publications

OBJECTIVES: To determine the prevalence of false or misleading statements in messages posted by internet cancer support groups and whether these statements were identified as false or misleading and corrected by other participants in subsequent postings. DESIGN: Analysis of content of postings. SETTING: Internet cancer support group Breast Cancer Mailing List. MAIN OUTCOME MEASURES: Number of false or misleading statements posted from 1 January to 23 April 2005 and whether these were identified and corrected by participants in subsequent postings. RESULTS: 10 of 4600 postings (0.22%) were found to be false or misleading. Of these, seven were identified as false …

Application Of Cognitive Engineering Principles To The Redesign Of A Dichotomous Identification Key For Parasitology, Kimberly A. Smith-Akins, Sharon Mclane, Thomas M. Craig, Todd R. Johnson

Faculty, Staff and Student Publications

Dichotomous identification keys are used throughout biology for identification of plants, insects, and parasites. However, correct use of identification keys can be difficult as they are not usually intended for novice users who may not be familiar with the terminology used or with the morphology of the organism being identified. Therefore, we applied cognitive engineering principles to redesign a parasitology identification key for the Internet. We addressed issues of visual clutter and spatial distance by displaying a single question couplet at a time and by switching to the appropriate next couplet after the user made a choice. Our analysis of …

A Time-Motion Study Of Registered Nurses’ Workflow In Intensive Care Unit Remote Monitoring, Zhihua Tang, Janine Mazabob, Liza Weavind, Eric Thomas, Todd R. Johnson

Faculty, Staff and Student Publications

Utilizing advanced information technology, Intensive Care Unit (ICU) remote monitoring allows highly trained specialists to oversee a large number of patients at multiple sites on a continuous basis. In the current research, we conducted a time-motion study of registered nurses’ work in an ICU remote monitoring facility. Data were collected on seven nurses through 40 hours of observation. The results showed that nurses’ essential tasks were centered on three themes: monitoring patients, maintaining patients’ health records, and managing technology use. In monitoring patients, nurses spent 52% of the time assimilating information embedded in a clinical information system and 15% on …

Using Citation Data To Improve Retrieval From Medline, Elmer V Bernstam, Jorge R Herskovic, Yindalon Aphinyanaphongs, Constantin F Aliferis, Madurai G Sriram, William R Hersh

Faculty, Staff and Student Publications

OBJECTIVE: To determine whether algorithms developed for the World Wide Web can be applied to the biomedical literature in order to identify articles that are important as well as relevant. DESIGN AND MEASUREMENTS A direct comparison of eight algorithms: simple PubMed queries, clinical queries (sensitive and specific versions), vector cosine comparison, citation count, journal impact factor, PageRank, and machine learning based on polynomial support vector machines. The objective was to prioritize important articles, defined as being included in a pre-existing bibliography of important literature in surgical oncology. RESULTS Citation-based algorithms were more effective than noncitation-based algorithms at identifying important articles. …

Mapping Concepts In Medical Error Taxonomies, Min Zhu, Yong Huang, Yang Gong, Juliana J. Brixey, Jiajie Zhang, James P. Turley

Faculty, Staff and Student Publications

No abstract provided.

Hispanic Physicians' Tobacco Intervention Practices: A Cross-Sectional Survey Study, Francisco G. Soto Mas, Richard L. Papenfuss, Holly E. Jacobson, Chiehwen E. Hsu, William M. Kane

Faculty, Staff and Student Publications

Background U.S. Hispanic physicians constitute a considerable professional collective, and they may be most suited to attend to the health education needs of the growing U.S. Hispanic population. These educational needs include tobacco use prevention and smoking cessation. However, there is a lack of information on Hispanic physicians' tobacco intervention practices, their level of awareness and use of cessation protocols, and the type of programs that would best address their tobacco training needs. The purpose of this study was to assess the tobacco intervention practices and training needs of Hispanic physicians.

Methods Data was collected through a validated survey instrument …

A Web Services Architecture For Umls Knowledge Sources, Parsa Mirhaji, Narendra Kunapareddy, Yanko Michea, Arunkumar Srinivasan

Faculty, Staff and Student Publications

A web service is a collection of industry standards to enable reusability of services and interoperability of heterogeneous applications. The UMLS Knowledge Source (UMLSKS) Server provides remote access to the UMLSKS and related resources. We propose a Web Services Architecture that encapsulates UMLSKS-API and makes it available in distributed and heterogeneous environments. This is the first step towards intelligent and automatic UMLS services discovery and invocation by computer systems in distributed environments such as web.

Interruptions In Workflow For Rns In A Level One Trauma Center, Juliana J. Brixey, David J. Robinson, Zhihua Tang, Todd R. Johnson, Jiajie Zhang, James P. Turley

Faculty, Staff and Student Publications

An understanding of interruptions in healthcare is important for the design, implementation, and evaluation of health information systems and for the management of clinical workflow and medical errors. The purpose of this study is to identify and classify the types of interruptions experienced by Emergency Department(ED) nurses working in a Level One Trauma Center. This was an observational field study of Registered Nurses (RNs) employed in a Level One Trauma Center using the shadowing method. Results of the study indicate that nurses were both recipients and initiators of interruptions. Telephones, pagers, and face-to-face conversations were the most common sources of …

Guideview: Structured Multi-Modal Delivery Of Clinical Guidelines, M Sriram Iyengar, Subhajit Sarkar, Kira Bacal, Gregory Defouw, Phyllis Mcculley, Victor Hurst

Faculty, Staff and Student Publications

GuideView is a system designed for structured, multi-modal delivery of clinical guidelines. Clinical instructions are presented simultaneously in voice, text, pictures or video or animations. Users navigate using mouse-clicks and voice commands. An evaluation study performed at a medical simulation laboratory found that voice and video instructions were rated highly.

Using Incomplete Citation Data For Medline Results Ranking, Jorge R Herskovic, Elmer V Bernstam

Faculty, Staff and Student Publications

Information overload is a significant problem for modern medicine. Searching MEDLINE for common topics often retrieves more relevant documents than users can review. Therefore, we must identify documents that are not only relevant, but also important. Our system ranks articles using citation counts and the PageRank algorithm, incorporating data from the Science Citation Index. However, citation data is usually incomplete. Therefore, we explore the relationship between the quantity of citation information available to the system and the quality of the result ranking. Specifically, we test the ability of citation count and PageRank to identify "important articles" as defined by experts …

Persuasive Email Messages For Patient Communication, Muhammad Walji, Kathy Johnson-Throop, Todd Johnson, Elmer Bernstam, Jiajie Zhang

Faculty, Staff and Student Publications

To improve health and reduce costs, we need to encourage patients to make better health care decisions. Since email is widely available, it may be useful for patient-directed interventions. However, we know little about how the contents of an email message can influence a health-related decision. We propose a model to understand how patients may process persuasive email messages.

Predicting Childhood Sexual Or Physical Abuse: A Logistic Regression Geo-Mapping Approach To Prevention, Roland K. Tadoum, Kamila Smolij, Michelle A. Lyn, Craig W. Johnson

Faculty, Staff and Student Publications

This study investigates the degree to which gender, ethnicity, relationship to perpetrator, and geomapped socio-economic factors significantly predict the incidence of childhood sexual abuse, physical abuse and non- abuse. These variables are then linked to geographic identifiers using geographic information system (GIS) technology to develop a geo-mapping framework for child sexual and physical abuse prevention.

Using Technology To Teach Technology: Design And Evaluation Of Bilingual Online Physician Education About Electronic Medical Records, Sarah R. Edmonson, Adol Esquivel, Pallavi Mokkarala, Craig W. Johnson, Cynthia L. Phelps

Faculty, Staff and Student Publications

The "EMR Tutorial" is designed to be a bilingual online physician education environment about electronic medical records. After iterative assessment and redesign, the tutorial was tested in two groups: U.S. physicians and Mexican medical students. Split-plot ANOVA revealed significantly different pre-test scores in the two groups, significant cognitive gains for the two groups overall, and no significant difference in the gains made by the two groups. Users rated the module positively on a satisfaction questionnaire.

Regulatory Role Of Glycogen Synthase Kinase 3 For Transcriptional Activity Of Add1/Srebp1c, Kang Ho Kim, Min Jeong Song, Eung Jae Yoo, Sung Sik Choe, Sang Dai Park, Jae Bum Kim

Faculty, Staff and Student Publications

Adipocyte determination- and differentiation-dependent factor 1 (ADD1) plays important roles in lipid metabolism and insulin-dependent gene expression. Because insulin stimulates carbohydrate and lipid synthesis, it would be important to decipher how the transcriptional activity of ADD1/SREBP1c is regulated in the insulin signaling pathway. In this study, we demonstrated that glycogen synthase kinase (GSK)-3 negatively regulates the transcriptional activity of ADD1/SREBP1c. GSK3 inhibitors enhanced a transcriptional activity of ADD1/SREBP1c and expression of ADD1/SREBP1c target genes including fatty acid synthase (FAS), acetyl-CoA carboxylase 1 (ACC1), and steroyl-CoA desaturase 1 (SCD1) in adipocytes and hepatocytes. In contrast, overexpression of GSK3beta down-regulated the transcriptional …

Efficacy Of Quality Criteria To Identify Potentially Harmful Information: A Cross-Sectional Survey Of Complementary And Alternative Medicine Web Sites, Muhammad Walji, Smitha Sagaram, Deepak Sagaram, Funda Meric-Bernstam, Craig Johnson, Nadeem Q Mirza, Elmer V Bernstam

Faculty, Staff and Student Publications

BACKGROUND: Many users search the Internet for answers to health questions. Complementary and alternative medicine (CAM) is a particularly common search topic. Because many CAM therapies do not require a clinician's prescription, false or misleading CAM information may be more dangerous than information about traditional therapies. Many quality criteria have been suggested to filter out potentially harmful online health information. However, assessing the accuracy of CAM information is uniquely challenging since CAM is generally not supported by conventional literature. OBJECTIVE: The purpose of this study is to determine whether domain-independent technical quality criteria can identify potentially harmful online CAM content. …

Cognitive Impact Of Interactive Multimedia, Yanko F. Michea,

Dissertations and Theses (Open Access)

Technology has been gradually introduced in heath education. One of the most attractive features of this technology-based education is the use of multimedia. In this article we explore the research evidence about the role that multimedia is playing in education. From that analysis we describe the most relevant features of this technology to prepare a common ground of discussion about the evaluation of its impact on educational outcomes. As part of this analysis, we organize current research evidence on the use of technology in medical education, distinguishing diverse variables involved in the process, like knowledge (declarative, procedural), learner characteristics, curricular …

Evaluating The Disparity Of Female Breast Cancer Mortality Among Racial Groups - A Spatiotemporal Analysis, Chiehwen E. Hsu, Holly Jacobson, Francisco Soto Mas

Faculty, Staff and Student Publications

Background The literature suggests that the distribution of female breast cancer mortality demonstrates spatial concentration. There remains a lack of studies on how the mortality burden may impact racial groups across space and over time. The present study evaluated the geographic variations in breast cancer mortality in Texas females according to three predominant racial groups (non-Hispanic White, Black, and Hispanic females) over a twelve-year period. It sought to clarify whether the spatiotemporal trend might place an uneven burden on particular racial groups, and whether the excess trend has persisted into the current decade.

Methods The Spatial Scan Statistic was employed …

Detecting Spatiotemporal Clusters Of Accidental Poisoning Mortality Among Texas Counties, Us, 1980 – 2001, Ella T. Nkhoma, Chiehwen E. Hsu, Victoria I. Hunt, Ann M. Harris

Faculty, Staff and Student Publications

Background Accidental poisoning is one of the leading causes of injury in the United States, second only to motor vehicle accidents. According to the Centers for Disease Control and Prevention, the rates of accidental poisoning mortality have been increasing in the past fourteen years nationally. In Texas, mortality rates from accidental poisoning have mirrored national trends, increasing linearly from 1981 to 2001. The purpose of this study was to determine if there are spatiotemporal clusters of accidental poisoning mortality among Texas counties, and if so, whether there are variations in clustering and risk according to gender and race/ethnicity. The Spatial …

Genetic Polymorphisms Of The Interleukin-1 Gene And Early Marginal Bone Loss Around Endosseous Dental Implants, Hitomi Shimpuku, Yasuhiro Nosaka, Tatsuya Kawamura, Yoichi Tachi, Mitsuko Shinohara, Kiyoshi Ohura

Faculty, Staff and Student Publications

Dental implant surgery commonly proceeds in two stages. It is generally accepted that bone loss around implants does not occur at stage-II surgery because implants do not receive mechanical loading. However, early marginal bone loss around implants occasionally does occur during the healing period. Genetic polymorphisms in the interleukin-1 (IL-1) gene have been reported to be important for bone homeostasis and susceptibility to bone disease. We therefore investigated whether the idiopathic early marginal bone loss around implants is related to polymorphisms in the IL-1 gene. We performed a case-control study. Patients demonstrating marginal bone loss around implants at stage-II surgery …

Effects Of Information Display On The Construction Of Clinician Mental Models, Constance M. Johnson

Dissertations and Theses (Open Access)

Objective: To determine how a clinician’s background knowledge, their tasks, and displays of information interact to affect the clinician’s mental model. Design: Repeated Measure Nested Experimental Design Population, Sample, Setting: Populations were gastrointestinal/internal medicine physicians and nurses within the greater Houston area. A purposeful sample of 24 physicians and 24 nurses were studied in 2003. Methods: Subjects were randomized to two different displays of two different mock medical records; one that contained highlighted patient information and one that contained non-highlighted patient information. They were asked to read and summarize their understanding of the patients aloud. Propositional analysis was used to …

A Process For Achieving Comparable Data From Heterogeneous Databases, Rachel L. Richesson

Dissertations and Theses (Open Access)

The current state of health and biomedicine includes an enormity of heterogeneous data ‘silos’, collected for different purposes and represented differently, that are presently impossible to share or analyze in toto. The greatest challenge for large-scale and meaningful analyses of health-related data is to achieve a uniform data representation for data extracted from heterogeneous source representations. Based upon an analysis and categorization of heterogeneities, a process for achieving comparable data content by using a uniform terminological representation is developed. This process addresses the types of representational heterogeneities that commonly arise in healthcare data integration problems. Specifically, this process uses a …

Rigorously Assessing Whether The Data Backs The Back School, David T. Vinh, Craig W. Johnson, Cynthia L. Phelps

Faculty, Staff and Student Publications

A rigorous between-subjects methodology employing independent random samples and having broad clinical applicability was designed and implemented to evaluate the effectiveness of back safety and patient transfer training interventions for both hospital nurses and nursing assistants. Effects upon self-efficacy, cognitive, and affective measures are assessed for each of three back safety procedures. The design solves the problem of obtaining randomly assigned independent controls where all experimental subjects must participate in the training interventions.