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Medical Bioinformatics

Prof:Rui Alvesralves@cmb.udl.es

973702406Dept Ciencies Mediques Basiques,

1st Floor, Room 1.08Website of the

Course:http://web.udl.es/usuaris/pg193845/Courses/Bioinformatics_2007/ Course: http://10.100.14.36/Student_Server/

What is Medical Informatics?

What is Medical Bioinformatics? Medical informatics has to do with all

aspects of understanding and promoting the effective organization, analysis, management, and use of information in health care. MI emphasizes technology as an integral tool to help organize, analyze, manage, and use information.

What is Medical Informatics?

What REALLY is Medical Bioinformatics? The science of managing information for

health care, research, education, and administration by applying, integrating, and evaluating information technology along with its associated policies, procedures, and organizational cultures.

Three Legs of MI

Policy and Procedures

Technology

Culture

Technology Policy Culture

New database paradigmsNew ways of integrating InformationNew tools

How to organize information in DBsHow to integrate it and create tools for better diagnosticsHow and when to use new tools (e.g. Resource allocation)

How to convince MDs to use the technology

MI assisting in Medicine

Different tools and approaches of MI can help in the decision making process. Regulations/Privacy/Security Database/Literature Searching -- EMB Public Health Informatics Outcomes Research Standards Development Decision Support Electronic Medical Record’s Development Telemedicine Simulation

Tools for literature search/public health applications

Tools for literature search/public health applications

Problems

Changing the culture of medical doctors These tools will become more useful as

more people use them and input data Medical doctors are notorious for not

adapting to new tools that do not have an instant and direct effect on their practice and for not sharing information freely

MI assisting in Medicine

Different tools and approaches of MI can help in the decision making process. Regulations/Privacy/Security Database/Literature Searching -- EMB Public Health Informatics Outcomes Research Standards Development Decision Support Electronic Medical Record’s Development Telemedicine Simulation

Decision Making in Medicine

Decision Making obeys a hierarchy of evidence levels. Anecdotal Accounts Expert Opinion Consensus Opinion Retrospective Analysis Prospective Analysis (Open study) Single Blind Double Blind Placebo Controlled

MI assisting in Decision Making

Working in a clinic is very similar to monitoring a continuous process.

Let physicians do what they do best: Pattern recognition Examine & Interact with patients Collect and filter data Apply the art of medicine

Let computers do what they do best: Provide the physician with the right amount of

information they need WHERE and WHEN they need it

Keep track of ALL the details ALL of the time

The Fundamental Principle of Decision Theory

THE BAYES THOREM[New Knowledge] = [Experimentation] x [Old Knowledge]

Application: Making Diagnosis[Old Knowledge] - we know disease D prevalence, p(D)[New Knowledge] - we need to know if the patient has

disease D if he has symptom S, p(D|S)[Experimentation] - Bayes Theorem builds the Likelihood

Function: L(D|S) = p(S|D) / {p(S|D) p(D) + p(S|’D) p(‘D)}

Now this Likelihood Function modifies the Old Knowledge:p(D|S) = L(D|S) p(D)

Medical Decision Support to mention a few

Clinical SystemsFinancialMedical RecordsComprehensive

Diagnostic SystemsQMR, Iliad, DXPlain, etc.

Pharmaceutical Prescriptions

ResearchData Mining

Health System Modeling

Medical Decision SupportClinical Systems

Computerized Medical Record systems :TMR - CMR from Duke Medical Center

Pharmaceutical System for Multiple DrugTherapy in ICU, Pharm-X

Comprehensive system for VCU HealthSystem

Medical Decision SupportDiagnostic Systems

Knowledge Engineering, Expert Systems, AI

observationsknowledge base

decision mechanism diagnoses

explanations

feedback to adjust observations

UCI Arnau-Vilanova uses decision trees to assist in treatment of pacients, as do other units in the hospital.

Medical Decision SupportHealth Systems Modeling - 1

Primary Care Physician Supply - 1

Medical Decision SupportHealth Systems Modeling - 2

Primary Care Physician Supply - 2

Medical Decision SupportHealth Systems Modeling - 3

Primary Care Physician Supply - 3

Handbook of Medical Informatics

http://www.mieur.nl/mihandbook http://www.mihandbook.stanford.edu/

Handbook of Medical Informatics

Unfortunately lacks the details on the Internet

Next: Ester Vilaprinyo

Different tools and approaches or MI can help in the decision making process. Regulations/Privacy/Security Database/Literature Searching -- EMB Public Health Informatics Outcomes Research Standards Development Decision Support Electronic Medical Record’s Development Telemedicine Simulation