DIAMED: a probabilistic diagnostic aid system on the web.

DIAMED is a system to assist the physicians in the diagnostic process using probabilistic networks as knowledge representation. These networks make it possible to reason on medical data by applying Bayesian methods and to take into account uncertainties of the facts in the resolution of the clinical cases. The proposed model re-uses knowledge contained in an existing knowledge base (ADM). An interface of DIAMED developed on a Web server remotely assists the experts of each medical specialty in updating and validating the knowledge base. Most of the data processing is automated while being based on information preexistent in the ADM base : Constitution of lexicons starting from the existing dictionaries of the ADM system, are then used to work out the requests for selection and update of the knowledge base. One of its assets resides in its pseudo-segmented structure in several layers. The propagation of information is thus limited to only one part of the probabilistic network and calculations are therefore limited.

[An experience in teaching pharmacology on the internet]. / Une expérience d'enseignement de la pharmacologie par Internet.

Internet and Intranet are omnipresent in the University world. We developed an easy-access website (www.med.univ-rennes1.fr/etud/pharmaco) devoted to teaching pharmacology and report here our experience after 4 years of use. Our objective was to determine the value of this new teaching tool in the medical coursus. The site is entirely free and presents approximately 50 topics and diaporamas discussing various themes: the cell, the receptor, general pharmacology, clinical research, population research, drug classes, etc. Harbored by the Medical Informatics Laboratory of the University of Rennes Medical School, this site serves as a reference for medical students and others. More than 100 visits are recorded daily, approximately half from visitors outside France. The advantages of this new teaching tool, which operates within the framework of a Virtual Medical University project, are evident for students and professors alike. Its impact on the quality of drug therapy by future doctors remains to be determined.

Radiology on Internet: advice in consulting websites and evaluating their quality.

Services offered by Internet are increasing continually and 15,000 medical websites covering all the specialties are available presently. Finding relevant information with a spider-web organization is difficult. We recommend starting with hierarchical lists which propose a selection of sites corresponding to medical specialties. We give our selection of important radiological websites dealing with image databases, case reports, radioanatomy and continuing medical education. While surfing the Web, an evaluation of the quality of websites is necessary. We used quality criteria proposed by Darmoni to rate the quality of ten websites. The global quality is good; help pages and external links are the main noticed shortcomings. All webmasters should pay attention to quality criteria and show visible marks of Darmoni criteria on their home page. To be able to foresee which Internet options should be developed, we evaluated our website and sent a questionnaire to our users. Clinical cases are the most requested facilities; they could be used for continuing medical education.

The French Virtual Medical University.

This paper is the description of a French Virtual Medical University based on the federation of existing or currently being developed resources in several Medical Schools in France. The objectives of the project is not only to share experiences across the country but also to integrate several resources using the New Information and Communication Technologies to support new pedagogical approaches for medical students and also for continuing medical education. The project includes: A virtual Medical Campus using secure access from several sites, The Integration of new interactive resources based on pedagogical methods, Implementation of new indexing and search engines based on medical vocabularies and ontologies, The definition of general and specific portals, the evaluation of the system for ergonomics and contents.

[Web radiology servers: advices for users, their development and evaluation of the quality of sites]. / Les serveurs web de radiologie: conseils pour leur consultation, leur réalisation et mesure de la qualité des sites.

Sites available on the Internet are constantly increasing and over 15,000 medical websites covering all medical sub-specialties are now available. Finding relevant information on the web may be time consuming and difficult. We suggest that new users begin by accessing servers where lists of available sites are grouped under headings such as medical sub-specialties. We will list a selection of useful radiological websites providing image databases, case reports, radiological anatomy and continuing medical education. While surfing on the web, an evaluation of the quality of the websites is necessary. We used the quality criteria proposed by Darmoni to rate the quality of ten websites. The overall quality was good, but the lack of help options and external links were the main pitfalls that we noted. All webmasters should pay attention to quality criteria and show the Darmoni criteria on their homepage. In order to evaluate which internet options should be developed, we evaluated our own website and submitted a questionnaire to our users. Clinical cases were the most requested feature, they could be used for continuing medical education.

A first evaluation of a pedagogical network for medical students at the University Hospital of Rennes.

A pedagogical network has been developed at University Hospital of Rennes from 1996. The challenge is to give medical information and informatics tools to all medical students in the clinical wards of the University Hospital. At first, nine wards were connected to the medical school server which is linked to the Internet. Client software electronic mail and WWW Netscape on Macintosh computers. Sever software is set up on Unix SUN providing a local homepage with selected pedagogical resources. These documents are stored in a DBMS database ORACLE and queries can be provided by specialty, authors or disease. The students can access a set of interactive teaching programs or electronic textbooks and can explore the Internet through the library information system and search engines. The teachers can send URL and indexation of pedagogical documents and can produce clinical cases: the database updating will be done by the users. This experience of using Web tools generated enthusiasm when we first introduced it to students. The evaluation shows that if the students can use this training early on, they will adapt the resources of the Internet to their own needs.

A virtual university Web system for a medical school.

This paper describes a Virtual Medical University Web Server. This project started in 1994 by the development of the French Radiology Server. The main objective of our Medical Virtual University is to offer not only an initial training (for students) but also the Continuing Professional Education (for practitioners). Our system is based on electronic textbooks, clinical cases (around 4000) and a medical knowledge base called A.D.M. ("Aide au Diagnostic Medical"). We have indexed all electronic textbooks and clinical cases according to the ADM base in order to facilitate the navigation on the system. This system base is supported by a relational database management system. The Virtual Medical University, available on the Web Internet, is presently in the process of external evaluations.

A network of web multimedia medical information servers for a medical school and university hospital.

Modern medicine requires a rapid access to information including clinical data from medical records, bibliographic databases, knowledge bases and nomenclature databases. This is especially true for University Hospitals and Medical Schools for training as well as for fundamental and clinical research for diagnosis and therapeutic purposes. This implies the development of local, national and international cooperation which can be enhanced via the use and access to computer networks such as Internet. The development of professional cooperative networks goes with the development of the telecommunication and computer networks and our project is to make these new tools and technologies accessible to the medical students both during the teaching time in Medical School and during the training periods at the University Hospital. We have developed a local area network which communicates between the School of Medicine and the Hospital which takes advantage of the new Web client-server technology both internally (Intranet) and externally by access to the National Research Network (RENATER in France) connected to the Internet network. The address of our public web server is http:(/)/www.med.univ-rennesl.fr.

Computer assisted medical diagnosis using the Web.

The ADM (Aide au diagnostic Medical) project was started 15 years ago and was the first telematic project for physicians in France using the MINITEL terminal. The knowledge base contains information on more than 10000 diseases from all pathological fields, using more than 100000 signs or symptoms. The ADM system has two main functionalities for physicians: consultation of diseases descriptions and list of diseases containing one or more symptoms. The ADM knowledge base is supported by a relational database management system (DBMS ORACLE) and we developed a Web interface using the Perl language to produce HTML pages for the web server. We will describe our experience on redesigning a large existing medical knowledge base for diffusion on the web Internet.

Using World Wide Web multimedia in medicine.

The development of the Internet [1] has given us many types of information servers in the research and academic communities: anonymous FTP [2], Gopher [3], Wais [4], News [5], and the World Wide Web [6], which is now the most used multimedia information system on the Internet. It is user-friendly and can be used to interface existing information systems and to build new information services in the medical field. We propose to investigate (not exhaustively) the functionalities and applications of the system in medicine; we also present our own experiences of using WWW to distribute medical information.