The CardioOP-Data Clas (CDC)

R. Friedl; W. Klas; U. Westermann; T. Rose; J. Tremper; S. Stracke; O. Gödje; A. Hannekum; M. B. Preisack

doi:10.1055/s-0038-1634211

Methods of Information in Medicine, Inhaltsverzeichnis

Methods Inf Med 2003; 42(01): 68-78
DOI: 10.1055/s-0038-1634211

Original article

Schattauer GmbH

The CardioOP-Data Clas (CDC)

Development and Application of a Thesaurus for Content Management and Multi-User Teleteaching in Cardiac Surgery

R. Friedl

¹Dept. of Heart Surgery, University of Ulm, Germany

,

W. Klas

²Institute for Computer Science and Business Informatics, University of Vienna, Austria

,

U. Westermann

²Institute for Computer Science and Business Informatics, University of Vienna, Austria

,

T. Rose

³Institute of Applied Knowledge Processing (FAW), Ulm

,

J. Tremper

⁴Dept. of Heart Surgery, University of Heidelberg

,

S. Stracke

⁵Dept. of Medicine, University of Ulm, Germany

,

O. Gödje

¹Dept. of Heart Surgery, University of Ulm, Germany

,

A. Hannekum

¹Dept. of Heart Surgery, University of Ulm, Germany

,

M. B. Preisack

¹Dept. of Heart Surgery, University of Ulm, Germany

› Institutsangaben

Abstract

Summary

Objectives: Self-directed and customized medical education programs are gaining importance in health care instruction. We prototypically implemented a repository-driven online computer system (CardioOP) for teleteaching in Heart Surgery. It supports authoring and multiple re-use of multimedia data for different user groups in different instructional applications and therefore requires a process of content management.

Methods: We defined objectives for a terminological system to support semantic, cross-media type annotation and retrieval of learning objects: domain completeness, German (natural) language processing, multi-user concepts, extensibility and maintenance, content based annotation and technical implementation. Existing terminologies (ICD10, READ V3, Snomed III, UMLS 1997, MESH) have been analysed according to these objectives.

Results: We found that the analysed terminologies did not meet our criteria sufficiently. Therefore, we developed a domain-specific thesaurus, the CardioOPDataClas (CDC). The application of the CDC within a database-driven authoring process using specifically developed tools is reported.

Conclusions: Metadata play an important role in the effective discovery and search, access, integration and management of educational multimedia data in medicine but so far, there is no terminology to support content management for instructional multimedia. We prototypically designed and applied a thesaurus for the CardioOP educational system. Additional work is needed to evaluate the system in terms of user-friendliness, concept coverage and information retrieval performance.

Keywords

Computer assisted instruction - multimedia - terminology - information management

Volltext

Referenzen

References
1 Parboosingh J. Credentialing physicians: challenges for continuing medical education. J Contin Educ Health Prof 2000; 20: 188-90.
2 Leist JC, Green JS. A continuing medical education summit with implications for the future. J Contin Educ Health Prof 2000; 20: 247-51.
3 Eysenbach G. Consumer health informatics. BMJ 2000; 320: 1713-6 (Review).
4 Herxheimer A, McPherson A, Miller R, Shepperd S, Yaphe J, Ziebland S. Database of patients’ experiences (DIPEx): a multimedia approach to sharing experiences and information. Lancet 2000; 355: 1540-3.
5 Lewis D. Computer-based approaches to patient education: a review of the literature. J Am Med Inform Assoc 1999; 6: 272-82 (Review).
6 Richards B, Colman AW, Hollingsworth RA. The current and future role of the Internet in patient education. Int J Med Inf 1998; 50: 279-85.
7 Zucker S, White JA, Fabri PJ, Khonsari LS. Instructional intranets in graduate medical education. Acad Med 1998; 73: 1072-5.
8 Gorman PJ, Meier AH, Rawn C, Krummel TM. The future of medical education is no longer blood and guts, it is bits and bytes. Am J Surg 2000; 180: 353-6.
9 Dunnington GL, DaRosa DA. Changing surgical education strategies in an environment of changing health care delivery systems. World J Surg 1994; 18: 734-7 (Review).
10 Summers AN, Rinehart GC, Simpson D, Redlich PN. Acquisition of surgical skills: a randomised trial of didactic, videotape, and computer-based training. Surgery 1999; 126: 330-6.
11 Devitt P, Cehic D, Palmer E. Computers in medical education 2. Use of a computer package to supplement the clinical experience in a surgical clerkship: an objective evaluation. Aust N Z J Surg 1998; 68: 428-31.
12 Lewis D. Computer-based approaches to patient education: a review of the literature. J Am Med Inform Assoc 1999; 6: 272-82 (Review).
13 Mehrabi A, Gluckstein C, Benner A, Hashemi B, Herfarth C, Kallinowski F. A new way for surgical education–development and evaluation of a computer-based training module. Comput Biol Med 2000; 30: 97-109.
14 Lyon Jr HC, Healy JC, Bell JR. et al. Significant efficiency findings while controlling for the frequent confounders of CAI research in the PlanAlyzer project’s computer-based, self-paced, case-based programs in anemia and chest pain diagnosis. J Med Syst 1991; 15: 117-32.
15 Klar R, Bayer U. Computer-assisted teaching and learning in medicine. Int J Biomed Comput 1990; 26: 7-27 (Review).
16 Downes S. Learning Objects [published online. at www.atl.ualberta.ca/downes/naweb/Learning_Objects.htm accessed 4. 10. 2001
17 Klas W, Greiner C, Friedl R. CardioOP: Gallery of Cardiac Surgery. ICMCS, 1999; 2: 1092-5.
18 Friedl R, Preisack M, Schefer M. et al. CardioOp: an integrated approach to teleteaching in cardiac surgery. Stud Health Technol Inform 2000; 70: 76-82.
19 Wheatley DJ. Cardiothoracic surgery in Europe: politics, pressures and practice. Eur J Cardiothorac Surg 1999; 16: 593-601.
20 The International Statistical Classification of Diseases and Related Health Problems. tenth revision (ICD-10) [published online at www.who.int/whosis/icd10/index.html accessed 4.10.2001].
21 The Read Codes [published online at www.cams.co.uk/readcode.htm accessed 4.10.2001].
22 The Systematized Nomenclature of Human and Veterinary Medicine (SNOMED) [published online at www.snomed.org accessed 4.10.2001].
23 Unified Medical Language System (UMLS) [published online at www.nlm.nih.gov/pubs/factsheets/umls.html accessed 4.10.2001].
24 Lindberg DA, Humphreys BL, McCray AT. The Unified Medical Language System. Methods Inf Med 1993; 32: 281-91.
25 Campbell KE, Oliver DE, Spackman KA, Shortliffe EH. Representing thoughts, words, and things in the UMLS. J Am Med Inform Assoc 1998; 5: 421-31.
26 Medical Subject Headings (MESH) [published online at www.nlm.nih.gov/mesh/mesh-home.html accessed 4.10.2001].
27 de Keizer NF, Abu-Hanna A, ZwetslootSchonk JHM. Understanding terminological Systems. I: Terminology and typology. Methods Inf Med 2000; 39: 16-21.
28 de Keizer NF, Abu-Hanna A. Understanding terminological systems. II: Experience with conceptual and formal representation of structure. Methods Inf Med 2000; 39: 22-9.
29 ISO TC 215 [published online at www.standards.nhsia.nhs.uk/isotc215/wg3 accessed 4.10.2001].
30 CEN TC 251 [published online at at: www.centc251.org accessed 4. 10. 2001].
31 European prestandard. Medical informatics – Categorical structures of systems of concepts – Model for representation of semantics. Brussel: CEN; 1997
32 Boll S, Klas W. ZYX – A Multimedia Document Model for Reuse and Adaptation. Transactions on Knowledge and Data Engineering. In: DS-8 Special Issue, Vol 13, No 3,. IEEE Computer Society; 2001: 361-382.
33 Westermann U, Klas W. Architecture of a DataBlade Module for the Integrated Management of Multimedia Assets. Proceedings of the First International Workshop on Multimedia Intelligent Storage and Retrieval Management (MISRM). Orlando, Florida: 1999: 255-90.
34 Standard Generalized Markup Language (SGML) [published online at http://clover.slavic.pitt.edu/~djb/sgml.html accessed 4. 10. 2001].
35 Lalonde J. Online CME trends. MD education hits the fast track. MD Comput 2000; 17: 25-6.
36 Mizoguchi R, Sinitsa K, Ikeda M. Task Ontology Design for Intelligent Educational/Training Systems. Position Paper for ITS’96 Workshop on Architectures and Methods for Designing Cost-Effective and Reusable ITSs, Montreal, June 10th 1996. [also published online at http://advlearn.lrdc.pitt.edu/its-arch/papers/mizoguchi.html accessed 4.10.2001].
37 Schatz S. Paradigm Shifts and Challenges for Instructional Designers. An Introduction to Meta Tags and Knowledge Bits. [published online at www.imsproject.org/feature/kb/knowledgebits.html accessed 4. 10. 2001].
38 Eysenbach G, Diepgen T, Lampe K, Brickley D. EU-project medCERTAIN: Certification and Rating of Trustworthy and Assessed Health Information on the Net. Stud Health Technol Inform 2000; 77: 279-83.
39 Dublin Core Metadata Initiative. [published online at http://dublincore.org accessed 4. 10. 2001].
40 Malet G, Munoz F, Appleyard R, Hersh W. A model for enhancing Internet medical document retrieval with “medical core metadata”. J Am Med Inform Assoc 1999; 6: 163-72.
41 Draft Standard for Learning Object Metadata (IEEE P1484.12/D6.1): [published online at http://ltsc.ieee.org/doc/wg12/LOM_WD6-1_without_tracking.htm accessed 4. 10. 2001].
42 ARIADNE (Alliance of Remote Instructional Authoring and Distribution Networks for Europe) [published online at http://ariadne.unil.ch accessed 4. 10. 2001].
43 Health Education Assets Library (HEAL) [published online at www.healcentral.org accessed 4. 10. 2001].
44 Resource Description Framework (RDF) (published online at www.w3.org/RDF accessed 01. 04. 2002).
45 Extensible Markup Language (XML) (published online at www.w3.org/XML accessed 01. 04. 2002).
46 ISO/IEC WD 15938-2. Information Technology – Multimedia Content Description Interface (MPEG-7) – Part 2: Description Definition Language. Working Draft. ISO/IEC, 2000
47 Topic Maps (published online at www.topicmaps.org/xtm/1.0 accessed 01. 04. 2002).
48 Ontology Inference Layer (OIL) (published online at www.ontoknowledge.org/oil accessed 01. 04. 2002).
49 DARPA Agent Markup Language (DAML) (published online at www.daml.org accessed 01.04.2002).
50 Chute CG, Cohn SP, Campbell KE, Oliver DE, Campbell JR. The content coverage of clinical classifications. For The Computer-Based Patient Record Institute’s Work Group on Codes & Structures. J Am Med Inform Assoc 1996; 3: 224-33.
51 Humphreys BL, McCray AT, Cheh ML. Evaluating the coverage of controlled health data terminologies: report on the results of the NLM/AHCPR large scale vocabulary test. J Am Med Inform Assoc 1997; 4: 484-500.
52 Brown PJB, O’Neil M, Price C. Semantic definition of disorders in version 3 of the Read Codes. Methods Inf Med 1998; 37: 415-9.
53 Lipscomb CE. Medical Subject Headings (MeSH). Bull Med Libr Assoc 2000; 88: 265-6.
54 Deutsches Institut für Medizinische Dokumentation und Information (DIMDI) [published online at www.dimdi.de/germ/klassi/mesh/fr-mesh.htm accessed 4.10.2001].
55 Oliver DE, Shahar Y. Change management of shared and local versions of health-care terminologies. Methods Inf Med 2000; 39: 278-90 (Review).
56 Cimino JJ. Formal descriptions and adaptive mechanisms for changes in controlled medical vocabularies. Methods Inf Med 1996; 35: 202-10.
57 Suarez-Munist ON, Tuttle MS, Olson NE. et al. MEME-II supports the cooperative management of terminology. Proc AMIA Annu Fall Symp. 1996: 84-8.
58 Robinson D, Schulz E, Brown P, Price C. Updating the Read Codes: user-interactive maintenance of a dynamic clinical vocabulary. J Am Med Inform Assoc 1997; 4: 465-72.
59 Rector AL. Clinical terminology: why is it so hard?. Methods Inf Med 1999; 38: 239-52.
60 Sittig DF. Grand challenges in medical informatics?. J Am Med Inform Assoc 1994; 1: 412-3.
61 Cimino JJ. Review paper: coding systems in health care. Methods Inf Med 1996; 35: 273-84 (Review).
62 Cimino JJ. Desiderata for controlled medical vocabularies in the twenty-first century. Methods Inf Med 1998; 37: 394-403 (Review).
63 Cimino JJ, Clayton PD, Hripcsak G, Johnson SB. Knowledge-based approaches to the maintenance of a large controlled medical terminology. J Am Med Inform Assoc. 1994; 1: 35-50.
64 Campbell JR, Carpenter P, Sneiderman C, Cohn S, Chute CG, Warren J. Phase II evaluation of clinical coding schemes: completeness, taxonomy, mapping, definitions, and clarity. CPRI Work Group on Codes and Structures. J Am Med Inform Assoc 1997; 4: 238-51.
65 de Keizer NF, Abu-Hanna A, Cornet R, Zwets-loot-Schonk JH, Stoutenbeek CP. Analysis and design of an ontology for intensive care diagnoses. Methods Inf Med 1999; 38: 102-12.
66 Chute CG, Elkin PL, Sherertz DD, Tuttle MS. Desiderata for a clinical terminology server. Proc AMIA Symp. 1999: 42-6.
67 The Galen in Use Project (GALEN) [published online at www.cs.man.ac.uk/mig/giu accessed 4. 10. 2001].