Identifying Research-Active Specialists at an Academic Medical Center: A Case Study.

How might one identify, via publicly accessible websites, research-active specialists at an academic medical center? As a case study, health-informatics specialists were identified at two academic medical centers: University of Colorado, Anschutz Medical Campus, and University of Maryland-Baltimore. Four types of data about researchers were sought: frequency of publication, frequency of citations, money from grants, and patents. Based on frequency of published articles, one center favored bioinformatics and cardiology, whereas the other produced more results in nursing and radiology. Interestingly, different patterns were found across different data sets. This bibliometric method contrasted with the method of searching for active researchers via a web portal showing board-certified specialists at a particular institution. This alternative approach was tried for informatics and sleep medicine, and the bibliometric method seemed to produce better recall and precision.

Patient data access and online sleep apnea communities.

PURPOSE: To show that some patients with sleep apnea on positive airway pressure therapy show an interest in obtaining further monitoring data with the support of online patient communities. METHODS: A case study is presented in which a patient struggles to comply with his therapy and interacts with an online patient community. Next, a content analysis is described in which sleep apnea online communities are identified, an indexing language for patients' messages is developed, and patient messages are indexed into concepts from the indexing language. RESULTS: The case study patient substantially benefits from the guidance of other online patients about obtaining and interpreting monitoring and treatment data. In the content analysis of online communities, patients spend more time discussing long-term management than any other top-level concept and particularly focus on the role of data in long-term management. CONCLUSIONS: For certain patients, regularly accessing and interpreting their own detailed, monitoring data with support from other patients online seems important. Patients report that proprietary data formats from durable medical equipment manufacturers hinder patient access to their own data.

Knowledge-guided mutation in classification rules for autism treatment efficacy.

Data mining methods in biomedical research might benefit by combining genetic algorithms with domain-specific knowledge. The objective of this research is to show how the evolution of treatment rules for autism might be guided. The semantic distance between two concepts in the taxonomy is measured by the number of relationships separating the concepts in the taxonomy. The hypothesis is that replacing a concept in a treatment rule will change the accuracy of the rule in direct proportion to the semantic distance between the concepts. The method uses a patient database and autism taxonomies. Treatment rules are developed with an algorithm that exploits the taxonomies. The results support the hypothesis. This research should both advance the understanding of autism data mining in particular and of knowledge-guided evolutionary search in biomedicine in general.

Obstructive sleep apnea and head and neck neoplasms.

OBJECTIVE: To elaborate the relationship between obstructive sleep apnea (OSA) and head and neck neoplasms (HNN). STUDY DESIGN AND SETTING: A systematic review of the MEDLINE literature. RESULTS: Thirty of 34 articles indexed under OSA and HNN were about neoplasms that presented first as OSA. Four of the articles were about treatment of HNN causing OSA and gave incidences varying from 8% to 92%. Quality of life surveys confirm that patients with malignant HNN have sleep problems. Xerostomia may contribute to these sleep problems, and the role of salivary mucins deserves consideration. CONCLUSIONS: This review of the literature raises several new research questions about the clinical and biological relationships between OSA and HNN.

A case study of a retracted systematic review on interactive health communication applications: impact on media, scientists, and patients.

BACKGROUND: In October 2004, a flawed systematic review entitled "Interactive Health Communication Applications for People with Chronic Disease" was published in the Cochrane Library, accompanied by several press releases in which authors warned the public of the negative health consequences of interactive health communication applications, including the Internet. Within days of the review's publication, scientists identified major coding errors and other methodological problems that invalidated the principal conclusions of the study and led to a retraction. While the original study results and their negative conclusions were widely publicized in the media, the retraction seemed to go unnoticed. OBJECTIVE: This paper aims to document an unprecedented case of misinformation from a Cochrane review and its impact on media, scientists, and patients. As well, it aims to identify the generic factors leading to the incident and suggest remedies. METHODS: This was a qualitative study of the events leading to the retraction of the publication and of the reactions from media, scientists, and patients. This includes a review and content analysis of academic and mass media articles responding to the publication and retraction. Mass media articles were retrieved in May 2005 from LexisNexis Academic and Google and were classified and tallied. The extended case method is employed, and the analysis is also applied to comparable publishing events. RESULTS: A search on LexisNexis Academic database with the query "Elizabeth Murray AND health" for the period of June 2004 to May 2005 revealed a total of 15 press reports, of which only 1 addressed the retraction. Google was searched for references to the review, and the first 200 retrieved hits were analyzed. Of these, 170 pages were not related to the review. Of the remaining 30 pages, 23 (77%) were reports about the original publication that did not mention the retraction, 1 (3%) was a bibliography not mentioning the retraction, and 6 (20%) addressed the retraction, of which only 1 was a non-Cochrane-related source. CONCLUSIONS: Analyzed retrievals showed that the mass media gave more coverage to the Cochrane review than to the retraction or to a related systematic review with a similar scope but a different conclusion. Questionable results were prematurely disseminated, oversimplified, and sensationalized, while the retraction was hardly noticed by the public. Open commentary by scientists and patients helped to rapidly identify the errors but did not prevent or correct the dissemination of misinformation.

Comparing HIPAA practices in two multi-hospital systems.

The comparison of HIPAA compliance efforts at two multi-hospital networks (Children's Health System and Carilion Health System) suggests a framework for classifying practices and for facilitating the integration of further case studies into a national library of HIPAA practices.

Entry requirements and membership homogeneity in online patient groups.

The objective was to explore a relationship between the economics of religion and the attributes of online patient groups by testing the hypotheses that (1) the harsher the entry requirements to an online patient group, the more active its members are; and (2) membership homogeneity in a given group is reflected in the educational level of group members. Online groups were randomly chosen from the 'Yahoo groups' category of 'Illnesses'. The hypothesis about entry requirements was narrowed by defining those requirements as either 'Open', 'Register', or 'Closed'. The number of messages over a 4-month period in each of 162 different groups was tallied. The hypothesis about membership homogeneity was refined by counting the citations in messages and by predicting the educational level of members (as reflected in the average word length of messages) based on these citation counts. Across 162 groups, the number of messages was significantly less in Open groups than in Register groups and less in Register groups than in Closed groups. Across 14 groups, the average word length of messages in a group positively correlated with the number of citations in that group. The hypothesis is supported that increased group entry barriers correspond to increased group message activity and members tend to be similar within a group. These attributes could be used to help design effective groups.

Retractions, press releases and newspaper coverage.

OBJECTIVES: To explore how often newspapers cover the retraction of a medical journal article and whether newspaper coverage corresponds with the appearance of a press release about the retraction. METHODS: Fifty citations were identified in PubMed that had been indexed with the Medical Subject Heading 'Retracted Publication'. Next, the archives of LexisNexis's 'Major Newspapers' and EurekAlert's press releases were searched to find references to those retracted publications. RESULTS: Newspaper articles addressed exactly three of the 50 retracted publications, and press releases, exactly four of the 50 retracted publications. All three retracted publications that received newspaper coverage also had a press release. In other words, newspapers only covered a retraction that had been introduced by a press release. CONCLUSION: One would expect that newspaper coverage would increase after a press release, but the suggested relationships among a medical journal article retraction, a press release and newspaper coverage should be further investigated. If the linkage suggested by the data of this study holds, and if newspaper coverage stimulates library patron interest, then a medical library might prepare itself for information requests following a press release.

Characterizing cancer information systems.

The objective is to determine the extent to which information systems (IS) for cancer are unique and necessary. Via an analysis of Medical Subject Headings used to index relevant literature and other bibliometric techniques, cancer IS are compared and contrasted with IS of other specialties. Cancer IS are relatively little discussed and primarily connect radiation equipment with the radiation oncology staff. By contrast, clinical laboratory and radiology IS are frequently discussed and connect specialized equipment to the hospital. A "Specialty Need" model accounts for these patterns and says that the "need for a specialty IS" is proportional to the "uniqueness of the specialty tools" plus the "degree to which the information from those tools is needed throughout the particular health care entity".

The aging of a clinical information system.

The senescence of a clinical information system is more likely to have administrative than technical bases. Supporting this claim is a case study of one aging oncology information system. The case study is qualitative, as behooves the subject matter. Content analysis of several documents suggests that the change in job description of the data coordinator led to a workflow breakdown. Next, twenty-two individuals were interviewed. Notes from the interviews were coded, and the resulting patterns led to partial support for the workflow breakdown conjecture, refutation of the hypothesis that users disliked the character-based, human-computer interface, support of the conjecture that political rather than technical factors drive the usage patterns of the system, and evidence that 'political' activity will determine the future of the information system. A stakeholder matrix is proposed that addresses administrative concerns. Also, the issue of the uniqueness of any oncology clinical information system is linked to the plans for this legacy system.