Present Situation and Prospect of Medical Knowledge Based Systems in German-speaking Countries

2012 ◽  
Vol 51 (04) ◽  
pp. 281-294 ◽  
Author(s):  
K. Spitzer ◽  
W. Honekamp ◽  
C. Spreckelsen
Keyword(s):  
Medical Informatics ◽  
Working Group ◽  
Online Survey ◽  
Future Prospect ◽  
Medical Decision ◽  
Free Text ◽  
Knowledge Based Systems ◽  
Online Questionnaire ◽  
Knowledge Based ◽  
German Speaking

SummaryBackground: After a decrease of interest in classical medical expert systems, the publication activity concerning the medical application of Artificial Intelligence and the interest in medical decision support have markedly increased. Nonetheless, no systematic exploratory study has yet been carried out, which directly considers the actual fields of applications, exemplary approaches, obstacles, challenges, and future prospect as seen by pioneering users and developers in a given region.Objectives: This paper reports the results of an online survey designed to fill this gap with the “Knowledge Based Systems” working group of the German Society for Medical Informatics, Biometry and Epidemiology (GMDS) in 2010.Methods: The survey was based on an online questionnaire (5 single and multiple choice questions, 8 Likert-scaled items, 7 free text questions) consented to by the working group. The answers were analyzed by descriptive statistics and a qualitative analysis (bottom-up coding). All academic institutions of Medical Informatics in the German-speaking countries and contributors reporting KBS-related projects at the relevant scientific conferences and in a journal specialized in the field were invited to participate.Results: The survey reached a response rate of 33.4%. The results show a gap between the reported obstacles of medical KBS (mainly low acceptance and rare use in clinical practice) and their future prospect as stated by the participants. Problems previously discussed in the literature like low acceptance, integration, and sustainability of KBS projects were confirmed. The current situation was characterized by naming exemplary existing systems and specifying promising fields of application.Conclusions: The field of KBS in medicine is more diversified and has evolved beyond expectations in the German-speaking countries.

scholarly journals 19 “Love The Day Job Still;” ”More Job Satisfaction;” “I Will Never Give Up My GeriGP Job;” - Results of the BGS GeriGP Workforce Survey 2018

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
K Davies ◽  
E Kalmus ◽  
M Keeble ◽  
L Lawn
Keyword(s):  
Older People ◽  
Online Survey ◽  
National Policy ◽  
Models Of Care ◽  
Free Text ◽  
Online Questionnaire ◽  
Policy Makers ◽  
Care Community ◽  
Employment Conditions

Abstract Background In 2017, two GPs decided to form the GeriGP group, for BGS GP members with a particular interest in the care of older people. GPs are increasingly using their holistic approach and expertise in new models of care within the community and the acute setting ("GeriGP" roles), and many no longer work in traditional General Practice. Introduction By late 2018, the group had around 100 members. The committee recognised the vital role GeriGPs could play in the development and delivery of innovative models of care for older people, as recommended in the NHS Long Term Plan1 and 2019 GP Contract2. There was no data available about GeriGP roles, which appeared to have arisen in an ad hoc fashion. An online survey was undertaken with the aim of using the results to engage with national policy makers and to identify pathways into these roles to improve recruitment and retention of the GP workforce.3 Methods We are grateful to the BGS who collated 58 questions for the online questionnaire, which was sent to all GeriGP members between October and December 2018. There were five main categories: role and venue; employment conditions; indemnity; appraisal; qualifications and training. Most questions had space for free-text comments. Results 47/100 GeriGP members responded; 68% respondents held GeriGP roles of whom 62% were practising GPs. 60% of all respondents were over 45 years old. 30 job descriptions covered community frailty hubs, intermediate care, community hospitals, care homes, acute front door, visiting services and memory clinics. 60% were community based. Rates of pay and types of contract varied dramatically. GP appraisal was often difficult due to patients having frailty or dementia, with contradictory advice common. 45% had difficulty accessing training and two-thirds of jobs were gained by word-of-mouth. 87% in GeriGP roles were more likely to continue practicing medicine because of this role, yet career development barriers existed at all levels. Many comments concurred with a plea for a ``primary care geriatrics specialty'', and repeatedly the joy of having time for patient-centred care was the driving force behind experienced GPs opting to continue in GeriGP roles. Conclusions The enthusiasm for GeriGP roles should be seized upon to improve healthcare of older people and bolster the GP workforce. GeriGPs plan to use these results to influence policy makers nationally. References 1. NHS Long Term Plan (https://www.longtermplan.nhs.uk/online-version/overview-and-summary). 2. 2019 GP Contract (https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf). 3. GeriGPs. (https://www.bgs.org.uk/gerigps).

Involvement in Medical Informatics May Enable Pharmacists to Expand Their Consultation Potential and Improve the Quality of Healthcare

1992 ◽  
Vol 26 (1) ◽  
pp. 100-104 ◽  
Author(s):  
Alise E. Woodruff ◽  
C. Anthony Hunt
Keyword(s):  
Quality Assurance ◽  
Information Systems ◽  
Information Management ◽  
Medical Informatics ◽  
Quality Of Healthcare ◽  
Knowledge Based Systems ◽  
Related Services ◽  
Medical Computing ◽  
Knowledge Based

The outlook for pharmacy-related services foretells more involvement of both computers and information systems. Expert therapeutic systems and databases will enable pharmacists to expand their consultation potential through networks and improve the quality of healthcare that they provide. Therapeutic information management could be the largest pharmacy speciality of the future. As knowledge-based systems and networks become commonplace, there will be an increasing need for new components, system monitoring, and quality assurance. This is an opportunity for pharmacy to bring medical computing, as it relates to therapeutics, into the mainstream of the profession as a new discipline.

A Graph-Grammar Approach to Represent Causal, Temporal and Other Contexts in an Oncological Patient Record

1996 ◽  
Vol 35 (02) ◽  
pp. 127-141 ◽  
Author(s):  
O. Thews ◽  
C. Rohrbach ◽  
M. Sergl ◽  
K. Pommerening ◽  
R. Müller
Keyword(s):  
Pediatric Oncology ◽  
Graph Grammar ◽  
Medical Decision ◽  
Patient Specific ◽  
Free Text ◽  
Oncological Patient ◽  
Knowledge Based ◽  
Temporal Relationships ◽  
Therapeutic Procedures ◽  
Patient Model

AbstractThe data of a patient undergoing complex diagnostic and therapeutic procedures do not only form a simple chronology of events, but are closely related in many ways. Such data contexts include causal or temporal relationships, they express inconsistencies and revision processes, or describe patient-specific heuristics. The knowledge of data contexts supports the retrospective understanding of the medical decision-making process and is a valuable base for further treatment. Conventional data models usually neglect the problem of context knowledge, or simply use free text which is not processed by the program. In connection with the development of the knowledge-based system THEMPO (Therapy Management in Pediatric Oncology), which supports therapy and monitoring in pediatric oncology, a graph-grammar approach has been used to design and implement a graph-oriented patient model which allows the representation of non-trivial (causal, temporal, etc.) clinical contexts. For context acquisition a mouse-based tool has been developed allowing the physician to specify contexts in a comfortable graphical manner. Furthermore, the retrieval of contexts is realized with graphical tools as well.

Identifying Predictors of Patient Satisfaction with Telehealth Consultations in German-Speaking Countries: Standardized Online Questionnaire (Preprint)

2021 ◽  
Author(s):  
Diana Manuela Roccaro-Waldmeyer ◽  
Philippe Schucht ◽  
Winfried Post ◽  
Michael Dahlweid
Keyword(s):  
Patient Satisfaction ◽  
Sample Size ◽  
Healthcare Provider ◽  
Online Survey ◽  
Quality Care ◽  
Patient Empowerment ◽  
Online Questionnaire ◽  
Patient Centered ◽  
German Speaking ◽  
Survey Responses

BACKGROUND Telehealth services can contribute to fulfilling the long-standing promise of patient-centered care, by delivering high-quality care at a location convenient to patients or by increasing patient access to healthcare-related information. In German-speaking countries, telehealth consultations were not particularly widespread before the outbreak of the Covid-19 pandemic. OBJECTIVE We aimed at investigating the experience of patients in German-speaking countries with telehealth consultations, especially with respect to patient satisfaction (expressed as their willingness to have another telehealth consultation, main study outcome) and aspects related to patient empowerment. We hypothesized particularly video consultations to increase patient satisfaction and empowerment related aspects. METHODS A standardized online questionnaire composed of seven quickly answerable questions was used to conduct an online survey in line with published recommendations. To estimate the proportion of patients willing to have another telehealth consultation, the necessary minimum sample size to be studied was determined to be 384 (confidence: 95%; error: 5%; population proportion: 50%, definitive sample size: 411). RESULTS We reached a total of 28,814 followers via social media to obtain more than 5,735 clicks and views, resulting in 411 complete survey responses. 93% of the respondents having had video consultations, but only 32% of those having had phone consultations (66% of all 411) indicated that they would want to have another telehealth consultation again. By far the most important predictor of this main outcome was, whether patients understood the conversation with their healthcare provider. CONCLUSIONS Our results demonstrate a high acceptance of telehealth consultations by patients in German-speaking countries and emphasize the importance of patients to thoroughly comprehend the communication with their healthcare provider, a prerequisite for patient empowerment. They further provide evidence for video consultations to lead to higher patient satisfaction (reflected by a higher willingness to have another telehealth consultation), and to a higher degree of patient empowerment, than phone consultations.

Medical Informatics: Searching for Underlying Components

2002 ◽  
Vol 41 (01) ◽  
pp. 12-19 ◽  
Author(s):  
M. A. Musen
Keyword(s):  
Problem Solving ◽  
Computer Science ◽  
Medical Informatics ◽  
Theoretical Basis ◽  
Basic Research ◽  
Knowledge Based Systems ◽  
The Core ◽  
Knowledge Based ◽  
Domain Ontologies ◽  
Unifying Principles

Abstract Objective: To discuss unifying principles that can provide a theory for the diverse aspects of work in medical informatics. If medical informatics is to have academic credibility, it must articulate a clear theory that is distinct from that of computer science or of other related areas of study. Results: The notions of reusable domain ontologies and problem-solving methods provide the foundation for current work on second-generation knowledge-based systems. These abstractions are also attractive for defining the core contributions of basic research in informatics. We can understand many central activities within informatics in terms defining, refining, applying, and evaluating domain ontologies and problem-solving methods. Conclusion: Construing work in medical informatics in terms of actions involving ontologies and problem-solving methods may move us closer to a theoretical basis for our field.

scholarly journals Heterogenous use of misoprostol for induction of labour: results of an online survey among midwives in German-speaking countries

2021 ◽  
Author(s):  
Verena Bossung ◽  
Werner Rath ◽  
Achim Rody ◽  
Christiane Schwarz
Keyword(s):  
Castor Oil ◽  
Online Survey ◽  
Induction Of Labour ◽  
Alternative Methods ◽  
Online Questionnaire ◽  
Oral Misoprostol ◽  
Maximum Daily Dose ◽  
Wide Range ◽  
Unfavourable Cervix ◽  
German Speaking

Abstract Purpose This online survey looked at the experiences and general perceptions of midwives concerning induction of labour and the specific use of misoprostol. Methods We published an online questionnaire with 24 questions in German on midwives’ experiences and perceptions of different methods of induction of labour. Results The online survey was answered by 412 midwives between February 2016 and February 2017. At least 20% of the 24 questions were answered in 333 questionnaires, which were included in this analysis. Oral misoprostol was the most common induction method for primipara and for women with a previous vaginal birth and an unfavourable cervix. Apart from alternative methods for induction of labour like castor oil and complementary/alternative methods, oral misoprostol was the preferred method of induction of labour by midwives. Midwives described a wide range of dosage schedules concerning application intervals, starting doses, and the maximum daily dose of misoprostol. Approximately 50% of the participants of this study described prescriptions of more than 200 µg misoprostol daily for induction of labour. Conclusion Misoprostol is widely used in Germany and was one of the three preferred methods of induction of labour among midwives in our study next to castor oil and complementary/alternative methods. The preparation and dosage of misoprostol vary significantly among hospitals and do not adhere to international guidelines. Midwives voiced their concerns about inconsistent indications and heterogenous use of different methods and dosages of induction. They wished for more patience with late-term pregnancies and individualized shared decision-making between pregnant women and obstetricians.

Book review: Introduction to Knowledge Based Systems

IEE Review ◽  
1988 ◽  
Vol 34 (1) ◽  
pp. 36
Author(s):  
S.H. Lavington
Keyword(s):  
Knowledge Based Systems ◽  
Knowledge Based

An Integrated Approach for a Knowledge-based Clinical Workstation: Architecture and Experience

1998 ◽  
Vol 37 (01) ◽  
pp. 16-25 ◽  
Author(s):  
P. Ringleb ◽  
T. Steiner ◽  
P. Knaup ◽  
W. Hacke ◽  
R. Haux ◽  
...  
Keyword(s):  
Decision Support ◽  
Information Systems ◽  
Patient Care ◽  
Hospital Information Systems ◽  
Medical Decision ◽  
Daily Routine ◽  
Functional Requirements ◽  
Support Functions ◽  
Knowledge Based ◽  
Clinical Workstation

Abstract:Today, the demand for medical decision support to improve the quality of patient care and to reduce costs in health services is generally recognized. Nevertheless, decision support is not yet established in daily routine within hospital information systems which often show a heterogeneous architecture but offer possibilities of interoperability. Currently, the integration of decision support functions into clinical workstations is the most promising way. Therefore, we first discuss aspects of integrating decision support into clinical workstations including clinical needs, integration of database and knowledge base, knowledge sharing and reuse and the role of standardized terminology. In addition, we draw up functional requirements to support the physician dealing with patient care, medical research and administrative tasks. As a consequence, we propose a general architecture of an integrated knowledge-based clinical workstation. Based on an example application we discuss our experiences concerning clinical applicability and relevance. We show that, although our approach promotes the integration of decision support into hospital information systems, the success of decision support depends above all on an adequate transformation of clinical needs.

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