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.

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.

Knowledge representation in orthopedics: from conceptual modeling to nomenclatures using 'Orthonav'.

Health budget cuts in developed countries have stressed the importance of the valued physician's activity's representation. Therefore, good codification standards have been necessary. Automated translation from information given directly by the physician is our chosen approach. Through conceptual modeling of nomenclatures used in the domain of Orthopedic Surgery in France, the authors show the feasibility, the advantages and the problems encountered using this kind of modeling with Orthonav, an original knowledge base built for codification of patients' records.

A microcomputer teaching and decision-support system for emergency medicine: use of hypermedia and artificial intelligence in combination.

Hospital emergency units are submitted to a continuous intensive and polyvalent practice of medicine. In addition to the few experienced physicians, the medical staff is often made up of young and unskilled students and residents. The ability to reach at any time a wide and flexible knowledge is of the utmost importance to improve the quality of care given to patients and to perfect bedside teaching. The purpose of this work was to present a computerized system, a kind of shell, using, in combination, artificial intelligence and hypertext/hypermedia tools. A modular architecture is presented integrating two entities: an illustrated encyclopedic hypertext network and several expert modules based on production rules concerning well-limited fields of medicine (basic clinical problem-solving, metabolic and acid-base disorders). An interface using the World Wide Web (WWW) will soon be proposed.

A computer-assisted case report and diagnosis system: sharing the knowledge database ADM and using hypermedia techniques.

The practice of medicine is characterized by its great variability and by many rare diseases. When the medical students work in hospital units, they must learn the general medical practice in the care of the patient. The purpose of this work was to present a French multifunction decision aid system using artificial intelligence techniques and Hypercard tools for different modules. Through an ergonomic interface, the system assists the user in the construction of medical observations, suggests diagnostic hypothesis, provides documentation and helps the user perform retrieval tasks. The knowledge comes from senior experts and from the pre-existent and large knowledge database, ADM.

Knowledge acquisition to qualify Unified Medical Language System interconceptual relationships.

Adding automatically relations between concepts from a database to a knowledge base such as the Unified Medical Language System can be very useful to increase the consistency of the latter one. But the transfer of qualified relationships is more interesting. The most important interest of these new acquisitions is that the UMLS became more compliant and medically pertinent to be used in different medical applications. This paper describes the possibility to inherit automatically medical inter-conceptual relationships qualifiers from a disease description included into a database and to integrate them into the UMLS knowledge base. The paper focuses on the transmission of knowledge from a French medical database to an English one.

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.