Donald A. B. Lindberg

The Information Age in Concept and Practice at the National Library of Medicine

The evolution of todays information age is mirrored in the growth of the National Library of Medicines bibliographic services: from the pioneering work of the Library in the last century to develop Index Medicus, to developing the innovative computerized MEDLARS system in the early 1960s, to the easily searchable on-line data bases now available to health professionals. This evolution has not come about without controversy, however, as tension developed between the public sector, where the information was viewed as a social benefit, and the private sector, where it was viewed as a source of profit. The Library has fostered research and development in biomedical communications in the laboratories of its Lister Hill Center and through grants to assist in establishing the field of medical informatics. The future of biomedical communications will be profoundly affected by work now being carried out by the Library: in fields such as biotechnology, through integrative methodologies such as the Unified Medical Language System now under development, and by a grant program to improve the infrastructure for information within academic health science centers.

A statewide medical information system

Abstract It is premature to look for a state-wide medical information system. Inherent in such a project are the following major social questions: absence of a simple explanation of the purpose of such a system; protection of personal privacy; justification for the depersonalization of automated systems; and the necessarily great financial costs. Technical obstacles include: absence of good patient identification; poor medical terminology; unknown problems of very big, complex files; and computer hardware unreliability. These difficulties suggest that single function, multi-computer networking may be a more appropriate conceptual model than the traditional large computer scheme.

Diffusion of medical information systems technology in the United States

The development of computer-based medical information systems (MISs) has been a central concern of American medical informatics workers for over 20 years. Despite many apparent successes, the technology is not now even close to universally used, even in our larger hospitals. The present report will define MIS, present an analytic framework with which to describe the current state of the art of MISs, and will discuss the obstacles to diffusion of this technology. Definition. An MIS is a set of formal arrangements by which facts concerning the health or health care of individual patients are stored and processed in computers.

Estimatability of blood chemistry variables based on a two-compartmented thermodynamic model☆

Abstract A two-compartment thermodynamic model was developed to analyze blood chemistry data in order to hypothesize acceptable values for physiologic variables that are not easily accessible during the usual clinical examination. The operation of the model, which determines the distribution of chemical components in the blood at steady state based on electrochemical potential, was successfully simulated by a linear regression model with four observation variables: plasma Na, K, Cl, and HCO 3 concentrations. The regression model yielded a number of indices and characteristics of biomedical relationships; i.e., (i) Na and K concentrations in the red cell are difficult to estimate, while free energy parameters of active transport of these species can be estimated; (ii) plasma K is unique in its independence of many species in plasma, etc.

Demonstration of ai/rheum, an expert clinical consultant system in rheumatology

The AI/RHEUM project is a collaborative effort among the Information Science Group and the Division of Immunology/Rheumatology at the University of Missouri School of Medicine, and the Department of Computer Science at Rutgers University.

Closing remarks at FASEB conference on the computer as a research tool in the life sciences

The variety and scope of the papers presented at this meeting do not permit a technical summary. There are, however some general impressions which we might consider.

Shwartzman studies in rabbits conducted in the absence of the kidneys

Abstract Rabbits were exposed to E. coli endotoxin following ablation of both kidneys. The extrarenal manifestations of the traditional Shwartzman reaction were identical in the nephrectomized and in the intact animals exposed to endotoxin. Nephrectomized rabbits also exhibited local dermal necrosis at the site of injection and the production of heparin-cold precipitable plasma fraction following endotoxemia. The resemblance of the extrarenal histological changes to changes seen in human patients is discussed.