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Utzon J, Hansen CCT, Andreasen J, Ottesen BS. [The Danish Hysterectomy Database seen from a public health-economic perspective]. Ugeskr Laeger 2005; 167:3170-4. [PMID: 16117916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
INTRODUCTION National clinical databases are a tool for quality improvement in clinical divisions. Furthermore, they can be used to make the quality of health care contributions visible to the population, as part of the free choice of hospital. Using data from one of the Danish nationwide databases, this article is the first to illustrate the potential economic resource gains from the use of these databases. MATERIALS AND METHODS The calculations performed are based on the Danish Hysterectomy Database. This database has selected quality indicators and measures for quality improvements for a three years period and include reduction of complications to one in three (from 18% to 6%), reduction of admission to one in two (from 4 to 2 days) and reduction of rehospitalisation and reoperation to one in two (from 6% to 3%). RESULTS Provided the proposed improvements are achieved, the expected resource gain will be approximately Dkr. 22 million (depending on the method of calculation). In-bed per day charges and "hotel charges" may vary considerably among hospitals. DISCUSSION Every year, Dkr. 15 million are allocated to the national clinical databases, and in 2003, 34 different databases received financial support. The maximum amount that each database can receive is Dkr. 500,000. The amount currently allocated to quality monitoring is small compared to the potential resource gains from these databases and the annual expenditures by the Danish health care sector, which amount to a total of Dkr. 48 billion.
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Affiliation(s)
- Jan Utzon
- Nationalt Kompetencecenter for Landsdaekkende, Kliniske Kvalitetsdatabaser, region øst (KCØ), Forskningscenter for Forebyggelse og Sundhed, Københavns Amt, Amtssygehuset i Glostrup, Glostrup.
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Cuticchia AJ, Silk GW. Sale of public databases puts biological data at risk. Nature 2005; 435:1028. [PMID: 15973381 DOI: 10.1038/4351028c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Greenbaum D, Douglas SM, Smith A, Lim J, Fischer M, Schultz M, Gerstein M. Computer security in academia-a potential roadblock to distributed annotation of the human genome. Nat Biotechnol 2005; 22:771-2. [PMID: 15175700 DOI: 10.1038/nbt0604-771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Dov Greenbaum
- Department of Genetics, Yale University, New Haven, Connecticut 06520, USA
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Abstract
A critical barrier to entry into structure-based virtual screening is the lack of a suitable, easy to access database of purchasable compounds. We have therefore prepared a library of 727,842 molecules, each with 3D structure, using catalogs of compounds from vendors (the size of this library continues to grow). The molecules have been assigned biologically relevant protonation states and are annotated with properties such as molecular weight, calculated LogP, and number of rotatable bonds. Each molecule in the library contains vendor and purchasing information and is ready for docking using a number of popular docking programs. Within certain limits, the molecules are prepared in multiple protonation states and multiple tautomeric forms. In one format, multiple conformations are available for the molecules. This database is available for free download (http://zinc.docking.org) in several common file formats including SMILES, mol2, 3D SDF, and DOCK flexibase format. A Web-based query tool incorporating a molecular drawing interface enables the database to be searched and browsed and subsets to be created. Users can process their own molecules by uploading them to a server. Our hope is that this database will bring virtual screening libraries to a wide community of structural biologists and medicinal chemists.
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Affiliation(s)
| | - Brian K. Shoichet
- * Corresponding author phone: (415)514–4126; fax: (415)502–1411; e-mail:
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Affiliation(s)
- Catherine A Ball
- Department of Biochemistry, Stanford University School of Medicine, 269 Campus Drive, Stanford, CA 94305-5307, USA
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Filippi A, Vanuzzo D, Bignamini AA, Sessa E, Brignoli O, Mazzaglia G. Computerized general practice databases provide quick and cost-effective information on the prevalence of angina pectoris. Ital Heart J 2005; 6:49-51. [PMID: 15773273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND The aim of this study was to compare the prevalence of angina pectoris (AP) using self-reported information and primary care databases. METHODS A comparison between the prevalence of AP in 730,586 subjects from the Health Search Database (HSD) and 119,799 individuals from a Health Interview Survey (HIS) was performed. The age-specific prevalence was calculated by dividing the detected cases by the total number of individuals in each age group. The age-standardized prevalence was estimated by direct standardization performed using the Italian standard population. RESULTS The HSD reported a higher crude prevalence of AP than the HIS, both in males (1374/100,000 vs 1006/100,000) and females (1449/100,000 vs 1007/100,000). In the HSD the age-specific prevalence was lower for patients aged <65 years, whilst higher estimates were reported for older patients. Age standardization slightly reduced the prevalence in both samples, although the HSD always reported higher estimates. CONCLUSIONS Prescription data from general practice databases may be a valid, simple, and cost-effective method to evaluate and serially monitor the prevalence of AP.
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Abstract
A critical barrier to entry into structure-based virtual screening is the lack of a suitable, easy to access database of purchasable compounds. We have therefore prepared a library of 727,842 molecules, each with 3D structure, using catalogs of compounds from vendors (the size of this library continues to grow). The molecules have been assigned biologically relevant protonation states and are annotated with properties such as molecular weight, calculated LogP, and number of rotatable bonds. Each molecule in the library contains vendor and purchasing information and is ready for docking using a number of popular docking programs. Within certain limits, the molecules are prepared in multiple protonation states and multiple tautomeric forms. In one format, multiple conformations are available for the molecules. This database is available for free download (http://zinc.docking.org) in several common file formats including SMILES, mol2, 3D SDF, and DOCK flexibase format. A Web-based query tool incorporating a molecular drawing interface enables the database to be searched and browsed and subsets to be created. Users can process their own molecules by uploading them to a server. Our hope is that this database will bring virtual screening libraries to a wide community of structural biologists and medicinal chemists.
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Affiliation(s)
- John J Irwin
- Department of Pharmaceutical Chemistry, University of California San Francisco, Genentech Hall, 600 16th Street, San Francisco, California 94143, USA
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Jakab F, Szûcs M. [Creation of evidence-based practice guidelines and the monetary charges to access factual databases]. Magy Onkol 2005; 49:89. [PMID: 16130242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Check E. Five-year grant gets bird database off to a flying start. Nature 2004; 431:7. [PMID: 15343301 DOI: 10.1038/431007b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Morgan MJ. Economic applications of an electronic clinical database for nurse practitioner students. Int J Nurs Terminol Classif 2004; 15:79-90. [PMID: 15617373 DOI: 10.1111/j.1744-618x.2004.tb00003.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
PURPOSE To describe the development of a Web-based clinical database that incorporates the standardized nursing languages (SNLs) used by nurse practitioner students, describe outcomes relative to the SNLs, and discuss economic aspects of outcome data. METHODS A mix of retrospective and prospective data of all outcomes for several cohorts (95 students, 17,193 records) comprised the data set. FINDINGS There is wide variation in use of SNLs as well as terminologies from other disciplines. The economic impact of patient encounters could be substantial. CONCLUSIONS A Web-based clinical log provides an opportunity for NP students to collect and analyze data on clinical encounters. Considerable resources must be invested in order to expand the use and sophistication of eClinicaLog.
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Buckingham S. Buying into the knowledge game. Nature 2004; 428:775. [PMID: 15085140 DOI: 10.1038/428775a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Sherlock G, Ball CA. Microarray databases: storage and retrieval of microarray data. Methods Mol Biol 2004; 224:235-48. [PMID: 12710676 DOI: 10.1385/1-59259-364-x:235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gavin Sherlock
- Department of Genetics, Stanford University School of Medicine, Palo Alto, CA, USA
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Rochon PA, Lane CJ, Bronskill SE, Sykora K, Anderson GM, Mamdani MM, Gurwitz JH, Dhalla IA. Potentially Inappropriate Prescribing in Canada Relative to the US. Drugs Aging 2004; 21:939-47. [PMID: 15554752 DOI: 10.2165/00002512-200421140-00004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To explore the prescribing of potentially inappropriate drug therapy in Ontario, Canada where there is a restrictive drug formulary relative to the US where there is no single drug formulary. METHODS A retrospective, cohort study using an administrative database (Ontario, Canada) compared with published survey results (US). All 1,088,680 community-dwelling adults >or=66 years of age in Ontario, Canada compared with published survey results from 2455 community-dwelling older adults in the US in 1996. Patterns of potentially inappropriate drug prescribing were compared between countries using a list of 33 potentially inappropriate drug therapies. These therapies were classified by an expert panel into three categories: (i) those to always avoid; (ii) those which are rarely appropriate; and (iii) those with only some indications to prescribe. RESULTS Among the 33 potentially inappropriate drug therapies, 15 (45%) prescribed in the US were not available through Ontario's drug formulary. Potentially inappropriate drug therapies available through the Ontario Drug Benefit Plan (ODB) and also in the US were frequently prescribed in both Ontario and the US. Differences in prescribing patterns of individual drug therapies were noted between the two countries. Specifically, in the rarely appropriate category, diazepam, a long half-life benzodiazepine, was much more frequently dispensed in Ontario than in the US (3.18% vs 1.37%). In contrast, dextropropoxyphene, an opioid with a poor adverse event profile was more frequently prescribed in the US than in Ontario (6.21% vs 0.74%). CONCLUSION Almost half of the potentially inappropriate drug therapies that are available in the US are unavailable from Ontario's drug formulary. Potentially inappropriate drug therapies that were available through the ODB were frequently prescribed in both countries. Alternative approaches that make information immediately accessible to physicians at the time they make prescribing decisions should be considered to improve prescribing practices.
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Affiliation(s)
- Paula A Rochon
- Kunin-Lunenfeld Applied Research Unit, Department of Medicine, University of Toronto, Baycrest Centre for Geriatric Care, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
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Abstract
The purpose of this study was to evaluate the limits and benefits of a visualization system based on public-domain software for contemporary three-dimensional (3-D) endodontic research purposes. Three-dimensional bio-models of six human teeth and of one bone-implant specimen were generated using cross-sectional imaging. To evaluate the overall performance in processing large data sets and in reproducing accurate 3-D morphology, slices with a thickness varying from 100 microm to 10 microm were cut. Auto-outlining and segmenting techniques were tested. The 3-D bio-models represented in accurate detail the different morphological aspects of the specimen. Voxel volumes of 0.116 x 10(-5) mm3 could be realized and were only restricted by the computer hardware limitations. The system is not limited to dental hard tissues. Hypomineralized material and soft tissues as well as bone- and allogeneic-implant material could be visualized. The method presented is valid and meets current requirements applying to endodontic research. The broad-based use of high-quality, public-domain software and the resulting exchange of experience help to manage resources and may contribute to enhancing the in-process quality of research.
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Affiliation(s)
- Thomas Stamm
- Department of Orthodontics, Center for Dental, Oral and Maxillofacial Diseases, University of Münster, Germany
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Ramsey GM, Howard EA. Databases in the biological sciences. A user's guide to the current copyright landscape. Plant Physiol 2003; 132:1131-1134. [PMID: 12857794 PMCID: PMC526266 DOI: 10.1104/pp.103.022541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2003] [Revised: 03/09/2003] [Accepted: 03/09/2003] [Indexed: 05/24/2023]
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McDowell N. Report fuels criticism of UK research council. Nature 2003; 422:461. [PMID: 12673217 DOI: 10.1038/422461a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Affiliation(s)
- Gideon F Smith
- National Botanical Institute of South Africa, Private Bag X101, Pretoria 0002, South Africa. at
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Abstract
Asthma is a common chronic disease resulting in significant morbidity and health resource utilisation, and multiple therapeutic options exist. Clinicians and healthcare providers need accurate information on the clinical and cost- effectiveness of asthma treatments to make informed decisions on management strategies. Randomised, controlled trials demonstrate cause and effect relationships between treatments and outcomes, but their tight entry criteria and strict study protocols mean that their results cannot automatically be generalised or used for economic modelling. There is a need for observational data to examine the effectiveness of alternative interventions in routine practice. Clinical and administrative databases are a possible information source for observational studies, and are increasingly used in asthma clinical, epidemiological and economic research. This paper examines the types of database used, the advantages and limitations of such studies and considers quality markers. High quality database studies can provide important epidemiological and economic information that can be of value in understanding the causes and effective management of asthma.
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Affiliation(s)
- Mike Thomas
- University of Aberdeen, Department of General Practice and Primary Care, Foresterhill Health Centre, Westburn Road, UK.
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Bourne PE. Free access to publicly funded databases is vital. Nature 2003; 421:786. [PMID: 12594481 DOI: 10.1038/421786b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
There is a paucity of image-centric neuroinformatics infrastructure within the individual investigator's laboratory despite the obvious need for automation and integration of experimental results. Yet, solutions can often be readily built using off-the-shelf databases and associated tools. Doing so simplifies day-to-day research operation and increases throughput. Proper construction of in-house solutions may also expedite community-wide integration of private and public data repositories. Here we describe neuroinformatics approaches at different levels of functionality, required expertise, and size of image datasets. The simplest approach offers ease of image browsing and rudimentary searching. More sophisticated systems provide powerful search capabilities, a means of tracking analysis, and even automated serial processing pipelines. In this practicum, we provide guidance in selecting among the different options.
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Affiliation(s)
- William Bug
- Department of Neurobiology & Anatomy, Drexel College of Medicine, Philadelphia, PA 19129, USA
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Romano M. Stockpiling patient data. As the AMGA (American Medical Group Association) builds its medical information repository, citing benefits for patients and providers, privacy remains a concern. Mod Healthc 2002; 32:24-6. [PMID: 12037923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Affiliation(s)
- J Norberto W Dachs
- Division of Health and Human Development, Public Policy and Health Program, Pan American Health Organization, Washington, D.C., USA.
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Fitzmaurice JM, Adams K, Eisenberg JM. Three decades of research on computer applications in health care: medical informatics support at the Agency for Healthcare Research and Quality. J Am Med Inform Assoc 2002; 9:144-60. [PMID: 11861630 PMCID: PMC344572 DOI: 10.1197/jamia.m0867] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The Agency for Healthcare Research and Quality and its predecessor organizations-collectively referred to here as AHRQ-have a productive history of funding research and development in the field of medical informatics, with grant investments since 1968 totaling $107 million. Many computerized interventions that are commonplace today, such as drug interaction alerts, had their genesis in early AHRQ initiatives. This review provides a historical perspective on AHRQ investment in medical informatics research. It shows that grants provided by AHRQ resulted in achievements that include advancing automation in the clinical laboratory and radiology, assisting in technology development (computer languages, software, and hardware), evaluating the effectiveness of computer-based medical information systems, facilitating the evolution of computer-aided decision making, promoting computer-initiated quality assurance programs, backing the formation and application of comprehensive data banks, enhancing the management of specific conditions such as HIV infection, and supporting health data coding and standards initiatives. Other federal agencies and private organizations have also supported research in medical informatics, some earlier and to a greater degree than AHRQ. The results and relative roles of these related efforts are beyond the scope of this review.
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Nolen RS. FARAD gets new life in 2002. J Am Vet Med Assoc 2002; 220:6-7. [PMID: 12680437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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Krieger N, Waterman P, Lemieux K, Zierler S, Hogan JW. On the wrong side of the tracts? Evaluating the accuracy of geocoding in public health research. Am J Public Health 2001; 91:1114-6. [PMID: 11441740 PMCID: PMC1446703 DOI: 10.2105/ajph.91.7.1114] [Citation(s) in RCA: 165] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study sought to determine the accuracy of geocoding for public health databases. METHODS A test file of 70 addresses, 50 of which involved errors, was generated, and the file was geocoded to the census tract and block group levels by 4 commercial geocoding firms. Also, the "real world" accuracy of the best-performing firm was evaluated. RESULTS Accuracy rates in regard to geocoding of the test file ranged from 44% (95% confidence interval [CI] = 32%, 56%) to 84% (95% CI = 73%, 92%). The geocoding firm identified as having the best accuracy rate correctly geocoded 96% of the addresses obtained from the public health databases. CONCLUSIONS Public health studies involving geocoded databases should evaluate and report on methods used to verify accuracy.
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Affiliation(s)
- N Krieger
- Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
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Powledge TM. Changing the rules? The agreement between Celera and Science magazine concerning Celera's publication of its human genome sequence is upsetting many researchers in bioinformatics. EMBO Rep 2001; 2:171-2. [PMID: 11266353 PMCID: PMC1083851 DOI: 10.1093/embo-reports/kve055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
The 7th International HUGO Mutation Database Meeting was held on October 19, 1999 in conjunction with the annual meeting of the American Society of Genetics in San Fransisco, California, U.S.A. Meeting highlights are described, including discussions of topics such as the ethical aspects of variation databases, ethical guidelines which should be established immediately, data protection laws which may affect access to data, and plans to make variation databases financially self-sustaining. A resolution was passed which encourages HUGO and Mutation database Initiative (MDI) collaboration (under the name HUGO-MDI) to provide an integrated, properly funded system of variation databases.
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Affiliation(s)
- O Horaitis
- Mutation Research Centre, St. Vincent's Hospital, Melbourne, Victoria, Australia
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Siegal HA, Carlson RG, Kenne DR, Starr S, Stephens RC. The Ohio Substance Abuse Monitoring Network: constructing and operating a statewide epidemiologic intelligence system. Am J Public Health 2000; 90:1835-7. [PMID: 11111251 PMCID: PMC1446437 DOI: 10.2105/ajph.90.12.1835] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Working with the Ohio Department of Alcohol and Drug Addiction Services (ODADAS) and researchers at the University of Akron, Wright State University's Center for Interventions, Treatment, and Addictions Research developed the Ohio Substance Abuse Monitoring (OSAM) Network to provide a statewide summary of substance abuse trends. Ten key informants across the state collect qualitative and statistical data on substance abuse trends in their regions and prepare biannual reports. The OSAM network has a rapid response capability through which key informants can investigate special issues related to substance abuse identified by ODADAS and provide policymakers with timely, statewide reports. Within 12 months after operations began, the key informants produced reports on drug abuse trends and rapid response issues for the state. These reports prepared policymakers to respond more effectively to prevention and substance abuse treatment needs.
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Affiliation(s)
- H A Siegal
- Center for Interventions, Treatment, and Addictions Research, School of Medicine, Wright State University, Dayton, USA. harvey.siegal@a wright.edu
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Charatan F. AMA sells its membership database. BMJ 2000; 321:1307. [PMID: 11090508 PMCID: PMC1119060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Abstract
Access to information about clinical trials is important to researchers, health care professionals, and patients. Many have argued for the establishment of clinical trials registries, citing their substantial benefits. Although some registries do exist, it has been difficult to create comprehensive, easily accessible systems. This paper briefly reviews existing registries, discusses the challenges in building registries, and reviews some of their benefits. The paper concludes with a description of a new, extensive Web-based registry called ClinicalTrials.gov (http://clinicaltrials. gov/), which was developed at the National Institutes of Health (NIH) by the National Library of Medicine as a result of recent legislation calling for a comprehensive, publicly accessible registry of clinical trials. The first version of the system became available in late February 2000 and contains information about approximately 5000 trials. The first release contains primarily NIH-sponsored trials, and new trials are regularly added to the system. Subsequent versions will contain information about trials sponsored by other federal agencies and by the private sector. The system was developed in accordance with basic informatics principles, including adherence to standards, usability considerations, and iterative testing and evaluation.
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Affiliation(s)
- A T McCray
- National Library of Medicine, Bethesda, Maryland 20894, USA.
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Abstract
Identifying a control group when cases come from a specialized hospital is a challenge for epidemiologists. The authors compared controls recruited by using a commercial database with those recruited by random digit dialing in the context of a hospital-based case-control study of ovarian cancer. This part of the study was conducted in 1997-1998 among women aged 18 years or older who resided in the New York metropolitan area. A mailing list owner grouped cases into "lifestyle" clusters based on US zip+4 postal code microneighborhoods and generated a random sample of potential controls with the same distribution across the clusters. Controls recruited from the commercial database (n = 82) and from random digit dialing (n = 90) were similar in age and race. Women from the commercial database had somewhat more education and higher incomes and were more similar to the cases on these measures. The control groups resembled each other closely in terms of oral contraceptive use, nulliparity, and religion and differed from the cases on these measures. Response rates were similar for the two groups. Only 28% of the cases were included on the mailing list, indicating that it did not reflect the source population of the cases. Use of a commercial database provided a control group whose socioeconomic factors were similar to those of cases at a lower cost than when random digit dialing was used but did not result in a higher response rate.
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Affiliation(s)
- S H Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Blanchfield BB, Randall E. Data sources to study uncompensated care provided by hospitals. Policy Anal Brief W Ser 2000; 3:1-4. [PMID: 11764820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
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USDA authorizes funding for scrapie eradication. J Am Vet Med Assoc 2000; 216:1711. [PMID: 10844956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Abstract
The routine acquisition and archiving of microbiological data is undertaken for two reasons. The first is the development of historical microbiological profiles of foods, ingredients, or processes in order to determine or verify that microorganisms of concern are being controlled to the level desired. The second reason is data concerning the pathogenicity or virulence of foodborne pathogens and their behavior in foods in order to develop strategies and criteria for assuring microbiological safety. Both types of microbiological data are essential to effective food safety programs. A firm understanding of the uses and limitations of both is essential to correct acquisition, interpretation, and use of such data.
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Affiliation(s)
- R L Buchanan
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, Washington, DC 20204, USA.
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Ferguson TB, Dziuban SW, Edwards FH, Eiken MC, Shroyer AL, Pairolero PC, Anderson RP, Grover FL. The STS National Database: current changes and challenges for the new millennium. Committee to Establish a National Database in Cardiothoracic Surgery, The Society of Thoracic Surgeons. Ann Thorac Surg 2000; 69:680-91. [PMID: 10750744 DOI: 10.1016/s0003-4975(99)01538-6] [Citation(s) in RCA: 188] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Society of Thoracic Surgeons (STS) established the National Database (NDB) for Cardiac Surgery in 1989. Since then it has grown to be the largest database of its kind in medicine. The NDB has been one of the pioneers in the analysis and reporting of risk-adjusted outcomes in cardiothoracic surgery. METHODS AND RESULTS This report explains the numerous changes in the NDB and its structure that have occurred over the past 2 years. It highlights the benefits of these changes, both to the individual member participants and to the STS overall. Additionally, the vision changes to the NDB and reporting structure are identified. The individuals who have participated in this effort since 1989 are acknowledged, and the STS owes an enormous debt of gratitude to each of them. CONCLUSIONS Because of their collective efforts, the goal to establish the STS NDB as a "gold standard" worldwide for process and outcomes analysis related to cardiothoracic surgery is becoming a reality.
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Affiliation(s)
- T B Ferguson
- Department of Surgery, LSU School of Medicine, New Orleans, LA 70112-2822, USA.
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Abstract
MOTIVATION The public web-based biological database infrastructure is a source of both wonder and worry. Users delight in the ever increasing amounts of information available; database administrators and curators worry about long-term financial support. An earlier study of 153 biological databases (Ellis and Kalumbi, Nature Biotechnol., 16, 1323-1324, 1998) determined that near future (1-5 year) funding for over two-thirds of them was uncertain. More detailed data are required to determine the magnitude of the problem and offer possible solutions. METHODS This study examines the finances and use statistics of a few of these organizations in more depth, and reviews several economic models that may help sustain them. RESULTS Six organizations were studied. Their administrative overhead is fairly low; non-administrative personnel and computer-related costs account for 77% of expenses. One smaller, more specialized US database, in 1997, had 60% of total access from US domains; a majority (56%) of its US accesses came from commercial domains, although only 2% of the 153 databases originally studied received any industrial support. The most popular model used to gain industrial support is asymmetric pricing: preferentially charging the commercial users of a database. At least five biological databases have recently begun using this model. Advertising is another model which may be useful for the more general, more heavily used sites. Microcommerce has promise, especially for databases that do not attract advertisers, but needs further testing. The least income reported for any of the databases studied was $50,000/year; applying this rate to 400 biological databases (a lower limit of the number of such databases, many of which require far larger resources) would mean annual support need of at least $20 million. To obtain this level of support is challenging, yet failure to accept the challenge could be catastrophic. CONTACT lynda@tc.umn. edu
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Affiliation(s)
- L B Ellis
- Department of Laboratory Medicine and Pathology and Department of Applied Economics, University of Minnesota, Minneapolis, MN 55455, USA
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Sirio CA. The risks of lowering the cesarean-delivery rate. N Engl J Med 1999; 341:54; author reply 54-5. [PMID: 10391758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Nolen S. Increased funding bolsters FARAD; hotline to return. J Am Vet Med Assoc 1999; 214:1742. [PMID: 10382010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Neumann CL, Blouin AS, Byrne EM. Achieving success: assessing the role of and building a business case for technology in healthcare. Front Health Serv Manage 1999; 15:3-28. [PMID: 10346251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
As the healthcare market continues to evolve, technology will play an increasingly important role in an integrated delivery system's ability to provide high-quality, cost-effective care. Healthcare leaders must be proactive and forward thinking about their technology investments. The financial investment for technology innovation can be significant. Therefore, it is important that healthcare executives deliberately design the role of technology and develop a consistent method for evaluating, identifying, and prioritizing technology investments. The article begins by describing technology's role in a healthcare organization as a window to the organization, a key driver of business strategy, and a high-performance enabler, and it develops a seven-step process for building a business case to ensure that an organization's technology investments are wise, well-reasoned, and will provide value to its customers. In addition, the article discusses the importance of combining people and process reengineering with new technology to exponentially increase the value to an organization. Healthcare leaders must understand the multiple roles of technology and consistently develop a business case when making technology investment decisions. Organizations driven by such an understanding will have a robust infrastructure of enabling technology designed to integrate people and process elements with technology to achieve the goals and initiatives of the organization. These organizations will lead the healthcare industry into the next millennium.
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