Navigating to Knowledge

M. S. Tuttle; W. G. Cole; D. D. Sherertz; S. J. Nelson

doi:10.1055/s-0038-1634582

Methods of Information in Medicine, Inhaltsverzeichnis

Methods Inf Med 1995; 34(01/02): 214-231
DOI: 10.1055/s-0038-1634582

Original article

Schattauer GmbH

Navigating to Knowledge

Autor*innen

M. S. Tuttle

¹Lexical Technology, Inc., Alameda, CA, USA
W. G. Cole

²University of Washington, Seattle, W A, USA
D. D. Sherertz

¹Lexical Technology, Inc., Alameda, CA, USA
S. J. Nelson

³Medical College of Georgia, Augusta, GA, USA

Abstract

Abstract:

One way to fulfill point-of-care knowledge needs is to present caregivers with a visual representation of the available “answers”. Using such a representation, caregivers can recognize what they want, rather than have to recall what they need, and then navigate to an appropriate answer. Given selected pieces of information from a computer-based patient record, an interface can anticipate certain knowledge needs by initializing caregiver navigation in a semantic neighborhood of answers likely to be relevant to the patient at hand. These notions draw heavily on two collaborative projects – the U.S. National Library of Medicine Unified Medical Language System^® and the U.S. National Cancer Institute Knowledge Server. Both of these projects support navigation because they make the structure of medical knowledge explicit in a way that can be exploited by human interfaces.

Keywords:

Navigation - Knowledge - Semantic Visualization - Point of Care - Computer-based Patient Record

Volltext

Referenzen

References
1 Safran C. An Electronic Medical Record that Helps Care for Patients with HIV Infections. Symposium on Computer Applications in Medical Care Safran C. (ed) 1993; 224-8.
2 Klein MS, Ross FV, Adams DL, Gilbert CM. Effect of Online Literature Searching on Length of Stay and Patient Care Costs. Academic Medicine 1994; 69 (06) 489-95.
3 Safran C. Searching for Answers on a Clinical Information System. Meth Inform Med 1995; 34: 79-84.
4 De Bliek R, Friedman DP, Wildemuth BM, Martz JM, Twarog RG, File D. Information Retrieved from a Database and the Augmentation of Personal Knowledge. J American Medical Informatics Association 1994; 1: 328-38.
5 Lindberg DAB, Humphreys BL, McCray AT. The Unified Medical Language System. Meth Inform Med 1993; 32: 281-91.
6 Tuttle MS, Sherertz DD, Fagan LM, Cole WG, Schipma PB, Nelson SJ, Carlson RW. Toward a Patient-Centred Knowledge-Server Standard for CPRs. Proceedings of the 1994 Healthcare Information Management Systems Society 115-28.
7 Blois MS. Clinical Judgment and Computers. New England Journal of Medicine 1980; 303: 192-7.
8 McCray AT, Srinivasan S, Browne AC. Lexical Methods for Managing Variation in Biomedical Terminologies. Symposium on Computer Applications in Medical Care. Ozbolt J. (ed) 1994 (to appear).
9 Nelson SJ, Olson NE, Fuller LF, Tuttle MS, Cole WG, Sherertz DD. Identifying Concepts in Medical Knowledge, submitted to MEDINFO ’95.
10 UMLS Knowledge Sources Documentation, National Library of Medicine, 5th Experimental Edition. 1994
11 Tuttle MS, Nelson SJ, Fuller LF, Sherertz DD, Erlbaum MS, Sperzel WD, Olson NE, Suarez-Munist ON. The Semantic Foundations of the UMLS Metathesaurus. MEDINFO ’92. Lun KC. et al. (eds). Elsevier, North Holland: MEDINFO; 1992: 1506-11.
12 McCray AT, Nelson SJ. The representation of meaning in the UMLS. Meth Inform Med 1995; 34: 193-201.
13 Nelson SJ, Tuttle MS, Cole WG, Sherertz DD, Sperzel WD, Erlbaum MS, Fuller LF, Olson NE. From Meaning to Term: Semantic Locality in the UMLS Metathesaurus. Clayton PD. (ed). Symposium on Computer Applications in Medical Care 1991; 209-13.
14 Tuttle MS, Olson NE, Campbell KE, Sherertz DD, Nelson SJ, Cole WG. Formal Properties of the Metathesaurus, to appear in Symposium on Computer Applications in Medical Care. Ozbolt J. (ed) 1994
15 Rector AL, Solomon WD, Nolan W A, Rush TW. A Terminology Server for Medical Language and Medical Information Systems. Meth Inform Med 1995; 34: 147-57.
16 Rossi Moori A. Co-operative development of a shared ontology for medicine in CEN/TC251/WG2. Meth Inform Med. (to appear).
17 Read JD. The Read Codes, CEN/TC251/WG2/N62. Copenhagen: CEN/TC251/WG2/N62; 1992
18 Rothwell D. SNOMED-based Knowledge Representation. Meth Inform Med 1995; 34: 209-13.
19 Gersenovic M. The Role of ICD and Its Family of Classifications in Medical Informatics. Meth Inform Med 1995; 34: 172-5.
20 Sherertz DD, Fagan LM, Tuttle MS, Carlson RW, Schipma PB. Speech-Driven, Patient-Centered Access to Three Oncology Knowledge Sources: How Might it Work? (Theater Demonstration). Safran C. (ed). Symposium on Computer Applications in Medical Care 1993; 966.
21 Acuff RD, Fagan LM, Rindfleisch TC, Carlson RW, Tuttle MS, Sherertz DD. Mobile Access to Oncology Knowledge (Abstract). AMIA Spring Congress 1994; 49.
22 Acuff RD, Fagan LM, Rindfleisch TC, Carlson RW, Tuttle MS, Sherertz DD. Integration of Pen-based Computer Technology in Clinical Settings (Demonstration Abstract), to appear in Symposium on Computer Applications in Medical Care. 1994
23 Blois MS, Tuttle MS, Cole WG, Nelson SJ. The Structure of Medical Descriptions (Tutorial). Symposium on Computer Applications in Medical Care, mid-1980s.
24 Blois MS. Information and Medicine: The Nature of Medical Descriptions. Berkeley: University of California Press; 1984
25 Blois MS. Medicine and the Nature of Vertical Reasoning. New England Journal of Medicine 1988; 318: 847-51.
26 Tuttle MS. The Position of the Canon Group: A Reality Check (Invited Ediorial). Journal American Medical Informatics Association 1994; 1: 298-9.
27 Cimino JJ. Guest Editor. Reports from the Canon Group. Journal American Medical Informatics Association 1994; 1: 296-7.
28 Standing L, Conezio J, Haber RN. Perception and memory for pictures: Single-trial learning of 2560 visual stimuli. Psychonomic Science 1970; 19: 73-4.
29 Shepard RN. Recognition memory for words, sentences, and pictures. Journal of Verbal Learning and Verbal Behavior 1967; 6: 156-63.
30 Davis R, Sutherland NS, Judd BR. Information content in recognition and recall. Journal of Experimental Psychology 1961; 61: 422-9.
31 Patel VL, Arocha JF. Cognitive Models of Clinical Reasoning and Conceptual Representation. Meth Inform Med 1995; 34: 47-56.
32 Szolovits P. Uncertainty and Decisions in Medical Informatics. Meth Inform Med 1995; 34: 111-21.
33 Winograd T, Flores F. Understanding Computers and Cognition: A New Foundation for Design. Massachusetts: Addison-Wesley; 1987
34 Dreyfus HL. What Computers Still Can’t Do: A Critique of Artificial Reason. Cambridge, MA: MIT Press; 1992
35 Stefik M, Smoliar S. The Commonsense Reviews (editorial). Artificial Intelligence 1993; 61: 37-40.
36 Tang PC, Patel VL. Major issues in user interface design for health professional workstations: summary and recommendations. International Journal of Bio-Medical Computing, Special Issue, Health Care Professional Workstation, Proceedings of the working conference sponsored by the International Medical Informatics Association. Ball MJ, Silva J. et al. (eds). Washington: DC, USA: 1994: 139-48.
37 Clancey WJ. The Learning Process in the Epistemology of Medical Information. Meth Inform Med 1995; 34: 122-30.
38 Tuttle MS, Nelson SJ. The Role of the UMLS in “Storing” and “Sharing” Across Systems. International Journal of Bio-Medical Computing, Special Issue, Health Care Professional Workstation, Proceedings of the working conference sponsored by the International Medical Informatics Association. Ball MJ, Silva J. et al. (eds). Washington, DC, USA: 1994: 207-37.
39 Chute CC. New Medical Knowledge from Patient Data Repositories: Applied Clinical Epidemiology at Mayo. Meth Inform Med 1995; 34: 104-10.
40 Van der Lei J, Musen MA. The separation of reviewing knowledge from medical knowledge. Meth Inform Med 1995; 34: 131-49.
41 West TG. In the Mind’s Eye. Buffalo: Prometheus Books; 1991
42 Pinker S. The Language Instict: How the Mind Creates Language. Morrow; NY: 1994
43 Shortliffe EH, Hubbard SM. Information systems in oncology. Cancer: Principles and Practice of Oncology. Third Edition.. De Vita VT, Hellman S, Rosenberg SA. (eds). Philadelphia: Lippincott; 1989
44 Shortliffe EH, Wulfman CE, Rindfleisch TC, Carlson RW. Final Report: An Integrated Oncology Workstation. Bethesda, MD: National Cancer Institute; 1992
45 Tu SW, Kemper CA, Lane NM, Carlson RW, Musen MA. A methodology for determining patient’s eligibility for clinical trials. Meth. Inform. Med. 1993; 32 (04) 317-25.
46 Wulfman CE. Graphical Access to Medical Expert Systems V: Integration with Continuous Speech Recognition. Meth. Inform. Med. 1993; 32: 33-46.
47 Isaacs EA. et al. Graphical Access to Medical Expert Systems IV: Experiments to Design a Spoken Interface. Met. Inform. Med. 1993; 32: 18-32.
48 Sherertz D, Tuttle M, Cole W, Erlbaum M, Olson N, Nelson S. A HyperCard Implementation of Meta-1: The First Version of the UMLS Metathesaurus. Kingsland LC. (ed). Symposium on Computer Applications in Medical Care 1989; 1017-8.
49 Nelson SJ, Sherertz DD, Tuttle MS, Erlbaum MS. Using MetaCard: A HyperCard Browser for Biomedical Knowledge Sources. Miller RA. (ed). Symposium on Computer Applications in Medical Care 1990; 151-4.
50 Sherertz DD. A Demonstration of MetaCard: The World’s Largest HyperCard Application. The Fifth ACM Conference on HYPERTEXT (Interactive Demonstrations) 1993; 18.
51 Kingsland LC, Harbourt AM, Syed EJ, Schuyler PL. Coach: applying UMLS Knowledge Sources in an expert searcher environment. Bulletin of the Medical Library Association April 1993; 8 (12) 178-83.
52 Harbourt AM, Syed EJ, Hole WT, Kingsland LC. In: The Ranking Algorithm of the Coach Browser for the UMLS Metathesaurus. Safran C. (ed). Symposium on Computer Applications in Medical Care 1993; 720-4.
53 Nelson SJ, Sherertz DD, Tuttle MS. In: Issues in the Development of an Information Retrieval System: The Physician’S Information Assistant. Lun KC. et al. (eds). Elsevier, North Holland: MEDINFO; 1992: 371-5.
54 Physicians Data Query. National Cancer Institute; 1990
55 McKusick VA. Mendelian Inheritance in M’an, Ninth Edition. Baltimore: Johns Hopkins University; 1990
56 Nelson SJ, Sherertz DD, Erlbaum MS, Tuttle MS. Representing Medical Knowledge in the Form of Structured Text: the Development of Current Disease Descriptions. Kingsland LC. (ed). Symposium on Computer Applications in Medical Care 1989; 66-9.
57 NCSA Mosaic. National Center for Supercomputer Applications. Champagne, Illinois, USA.:
58 Poltrock SE. Hypertext ’93 Proceedings. The Fifth ACM Conference on HYPERTEXT. ACM Press; 1993
59 Gronbaek K, Trigg RH. editors. HYPERMEDIA. Special Issue of the Communications of the ACM February 1994 37. 2.
60 Illustra Information Technology. Oakland, California, USA.:
61 Wiederhold G. Mediators in the Architecture of Future Information Systems. Computer March 1992; 38-49.
62 Riecken Dough. Guest Editor. Intelligent Agents. Special Issue of Communications of the ACM July 1994 37. 7.
63 McCray AT, Razi A. The UMLS Knowledge Source Server, submitted to MEDINFO ’95.
64 Barnett O, Shortliffe EH. et al. Patient Care Applications on the Internet (Theater Demonstration). Ozbolt J. (ed). Symposium on Computer Applications in Medical Care. 1994 (to appear).
65 Degoulet P, Fieschi M, Chatellier G. Decision support systems from the standpoint of knowledge representation. Meth Inform Med 1995; 34: 202-8.
66 Scientific American Medicine. Consult. Online Computer Systems. Inc; Germantown, Maryland.:
67 Tuttle MS, Sherertz DD, Nelson SJ, Erlbaum MS, Sperzel WD, Fuller LF, Olson NE, Cimino JJ, Chute CG. Adding Your Terms and Relationships to the UMLS Metathesaurus. Clayton PD. (ed). Symposium on Computer Application in Medical Care 1991; 219-23.
68 Musen MA, Weickert KE, Miller ET, Campbell KE, Fagan LM. Development of a Controlted Medical Terminology: Knowledge Acquisition and Knowledge Representation. Meth Inform Med 1995; 34: 85-95.
69 Cimino JJ. Use of the Unified Medical Language System in Patient Care at the Columbia-Presbyterian Medical Center. 158-64.
70 Campbell KE. Distributed Development of a Logic-based Controlled Medical Terminology. Dissertation Proposal Stanford, California, USA: Stanford University May; 1994
71 Manning PR. Continuing medical education. The next step JAMA Feb. 25 1983; 249 (08) 1042-5.
72 Forsythe DE, Buchanan BG, Osheroff JA, Miller RA. Expanding the Concept of Medical Information: An Observational Study of Physicians Information Needs. Computers and Biomedical Research 1992; 25: 181-200.
73 Tuttle MS, Sherertz DD, Acuff RD, Cole WG, Schipma PB, Nelson SJ, Carlson RW. Bringing Knowledge to the Point of Care. Proceedings of the Healthcare Information Management Systems Society Annual Meeting. February 1995 to appear.
74 Schuyler PL. et al. A test collection for experimentation in bibliographic retrieval. Barber B. et al. (eds). Amsterdam, North Holland: MEDINFO ’89; 1989: 910-2.
75 Nelson SJ, Olson NE, Browne AC, Cole WG, Sherertz DD, Tuttle MS. Recognizing New Medical Knowledge Computationally. Safran C. (ed). Symposium on Computer Applications in Medical Care 1993; 409-13.
76 Cole WG, Cimino JJ, Hammond K, Miller RA, Safran C. Bringing knowledge to the point of care (Panel Discussion). Ozbolt J. (ed). Symposium on Computer Applications in Medical Care. November 1994 (to appear).
77 Sager N, Lyman M, Nhan NT, Tick LJ. Medical Language Processing: Application to Patient Data Representation and Automatic Encoding. Meth Inform Med 1995; 34: 140-6.
78 Zweigenbaum P, Bachimont B, Bouaud J, Charlet J, Boisvieux F. Issues in the Structuration and Acquisition of an Ontology for Medical Language Understanding. Meth Inform Med 1995; 34: 15-24.
79 Wehrli E, Clark R. Natural Language Processing, Lexicon and Semantics. Meth Inform Med 1995; 34: 68-74.
80 Sowa JF. Conceptual Analysis for Knowledge Base Design. Meth Inform Med 1995; 34: 165-71.
81 Kingsland LC, Syed EJ, Lindberg DAB. Coach: an expert searcher program to assist grateful med users searching MEDLINE. Lun KC. et al. (eds). MEDINFO 1992; 382-6.
82 Cherniak C. Undebuggability and Cognitive Science. Communications of the ACM 1988; 31: 402-12.
83 Cherniak C. Minimal Rationality. Cambridge, Massachusetts: MIT Press; 1987
84 Wason PC, Johnson-Laird PN. The Psychology of Reason: Structure and Content. Cambridge, Massachusetts: Harvard University Press; 1972
85 Tuttle MS, Sherertz DD, Erlbaum MS, Olson NE, Nelson SJ. Implementing Meta-1 – The First Version of the UMLS Metathesaurus. Kingsland LC. (ed). Symposium on Computer Applications in Medical Care 1989; 483-7.
86 DeVita VT, Hellman S, Rosenberg SA. CANCER: Principles and Practice of Oncology, 4th Edition. Philadelphia: Lippincott; 1993
87 Weed LL, Lawrence L. Knowledge coupling: new premises and new tools for medical care and education. New York: Springer; 1991
88 Simborg DW, Gabler JM. Re-engineering the traditional medical record: the view from industry. MD Computing 1990; 198-200 272.
89 Esterhay RJ. The Medical Record: Problem or Solution?. MD Computing 1993; 10 (02) 78-80 132.
90 Tuttle MS, Sherertz DD, Fagan LM, Carlson RW, Cole WG, Shipma PB, Nelson SJ. Toward an Interim Standard for Patient-Centered Knowledge Acess. Safran C. (ed). Symposium on Computer Applications in Medical Care 1993; 564-8.
91 Blois MS, Tuttle MS, Sherertz DD. RECONSIDER: A Program for Generating Differential Diagnoses. Heffernan HG. (ed) Symposium on Computer Applications in Medical Care 1981; 263-8.
92 Robertson GG, Card SK, Mackinlay JD. Information Visualization using 3-D interactive animation. Communications of the ACM 1993; 36 (04) 57-71.
93 Pizzo PA, Poplack DG. Principles and Practice of Pediatric Oncology – Second Edition. Philadelphia: JB Lippincott; 1993
94 Nelson SJ, Blois MS, Tuttle MS, Erlbaum MS, Harrison P, Kim H, Winkelman B, Yamashita D. Evaluating RECONSIDER: A Computer Program for Diagnostic Prompting. Journal of Medical Systems 1985; 9: 379-88.
95 Cole WG, Stewart DIG. Human performance evaluation of a metaphor graphic display for respiratory data. Methods Inform Med 1994; 33: 390-6.
96 Esterhay RJ. User Metaphors for health care professional workstations. Ball M. et al. (eds). Special Issue – The Health Care Professional Workstation, International Journal of Bio-Medical Computing 1994; 34: 95-113.