Awareness of Medical Fitness to Drive Guidelines among Occupational Physicians and Psychiatrists.

Irrespective of national guidelines for medical fitness to drive, this study investigated the cumulative expert wisdom of clinicians regarding minimum periods of driving cessation required for patients suffering from conditions that can impair driver capability. Occupational Physicians (196) and Psychiatrists (103) completed an online questionnaire. For private motorists, the modal response for anxiety and depression favoured clinical discretion, followed by three month cessations for hypomania, acute psychosis, schizophrenia and alcohol dependence and six weeks for alcohol misuse/dependence. For professional drivers the modal value for anxiety and depression was three months, rising to six months for hypomania, psychosis and schizophrenia and 12 months for both alcohol misuse/dependence. Chi-square test results indicated statistically significant differences in clinical opinion between Occupational Physicians and Psychiatrists regarding driving cessation times for drivers suffering from psychiatric and alcohol misuse conditions except for alcohol dependence. Further studies are warranted to investigate these issues in more depth.

Usability issues in developing a Web-based consumer health site.

ClinicalTrials.gov is a Web-based system intended for a diverse audience, including patients, family members and other members of the public. Throughout the system design and development process, our decisions have been driven by usability concerns. We first describe the overall design of the site, including the home page, which provides a site overview and rapid access to the information contained within it. Next we discuss the data presentation format which has been standardized in spite of data coming to us from many different sources. We provide a detailed description of the search and browse features that are intended to simplify the complexities of medical terminology and support information discovery. We conclude with a review of our evaluation activities and future plans.

Terminology issues in user access to Web-based medical information.

We conducted a study of user queries to the National Library of Medicine Web site over a three month period. Our purpose was to study the nature and scope of these queries in order to understand how to improve users' access to the information they are seeking on our site. The results show that the queries are primarily medical in content (94%), with only a small percentage (5.5%) relating to library services, and with a very small percentage (.5%) not being medically relevant at all. We characterize the data set, and conclude with a discussion of our plans to develop a UMLS-based terminology server to assist NLM Web users.

Consultation-liaison referrals to the north Dublin old age psychiatry service.

107 elderly acute hospital in-patients were referred to the North Dublin Old Age Psychiatry Service during an eighteen month period. Cognitive impairment was present in 54%, 25% had functional psychiatric disorders and 19% had no psychiatric diagnosis. The main reason for referral in 47% of cases was advice on placement. This reflects the deficiency in residential care in North Dublin and supports other recently compiled data. The implications of this situation for both elderly people and the acute hospitals are discussed.