Research

Information Retrieval  Medline QBE   Consumer Informatics  Quality and Accuracy of Online Health Information   Decision Support Guideline Compliance Project Informatics in Clinical and Translational Research Biomedical Informatics Component, Center for Clinical and Translational Sciences at UT-Houston

Medline QBE (Query by Example) Medline is a database of medical literature citations maintained by the National Library of Medicine. Currently Medline contains roughly ten million references. Although Medline is indexed using a controlled vocabulary (MeSH: Medical Subject Headings), studies of Medline searching reveal less than perfect results. Published recall and precision rates vary but are generally in the 30 - 70% range. Studies have shown that, in general, MeSH based queries return better results than keyword searches. Unfortunately, searching using MeSH requires familiarity with MeSH and experience formulating queries. Medline QBE is an interface to Medline which allows query refinement by selecting one or more articles from the original search that the user deems particularly relevant.  Further, the interface allows easy implementation and testing of novel Medline access strategies. in this way, it is a convenient research workbench for Medline information retrieval. Our current projects focus on using citation analysis to improve Medline information retrieval. Numerous algorithms exist to select articles according to similarity to a query or topic, published in a certain journal or written by a given author. However, few if any algorithms exist that identify the most important information on a given topic. As the sheer volume of the biomedical literature increases, it becomes increasingly difficult to identify the key papers in a specific area. In many ways, this is the same problem faced by web surfers. Therefore, we are applying web algorithms to the biomedical literature to identify the key articles that are relevant to a given query. See the Medline QBE project page for more information and links to publications and presentations. This project is funded by the National Library of Medicine (1 K22 LM08306).     Quality and Accuracy of Online Health Information   Despite the potential of the Internet to improve health care delivery, the quality of online health information is problematic.  A variety of quality criteria have been suggested in an attempt to help consumers identify misleading, inaccurate or harmful information. Objective quality criteria which offer a limited number of options are particularly promising since they are easier to assess.  For example, it is easier to determine whether an author is identified than to determine whether the author is qualified. However, even seemingly objective quality criteria have proven unreliable without specific operational definitions. Further, limited evidence supports the claim that these criteria, known as “technical criteria,” actually filter out problematic health information. The few studies that have attempted to evaluate technical criteria have produced conflicting results.  If harmful information can be effectively identified using objective quality criteria, this should be publicized. If, on the other hand, currently available quality criteria cannot identify potentially harmful information, then we should caution consumers and work on finding other ways of identifying problematic information online. The long-term goal of this project is to empower consumers to evaluate online health information for themselves. This project has been funded by the  Robert Wood Johnson Foundation Health-e-Technologies Initiative. See the consumer informatics project page for more information and links to publications and presentations.   Guideline Compliance Project   In this project we investigate clinical decision support in ambulatory care. Multiple studies have demonstrated variation in clinical practice that cannot be scientifically justified. Therefore, attempts to standardize approaches to specific clinical scenarios (clinical practice guidelines) have been published in the print literature by a variety of organizations. However, these have had little effect on changing clinician behavior. If, however, advice based on these guidelines could be incorporated into the clinical workflow, compliance improves. Therefore, many groups have focused on computerized clinical practice guidelines integrated with physician order entry systems and electronic medical records. The goal of this project is to explore the meaning of "compliance" with a guideline and to identify how advice can best be delivered by an e-prescribing system in ambulatory care. This project has been funded by the Medical Letter. See the decision support project page for more information and links to publications and presentations.   Biomedical Informatics Component, Center for Clinical and Translational Sciences at UT-Houston   UT-Houston, in partnership with MD Anderson Cancer Center and Memorial Hermann Hospital System was fortunate to receive one of the 12 first-round NIH Roadmap Clinical and Translational Science Awards (CTSA). The Center for Clinical and Translational Sciences at UT-Houston is funded by our CTSA and includes a number of "core components," one of which is biomedical informatics. I am the co-director of our CTSA biomedical informatics component, represent our site on the national biomedical informatics steering committee and am responsible for daily operations. The long-term goal of this project is to transform clinical and translational research. Within the biomedical informatics component, we are working toward data sharing within the collaborating institutions and with other CTSA grantee institutions. See the CCTS informatics page for more information and links to publications and presentations.