Titus Schleyer

Methods for the design and administration of web-based surveys.

This paper describes the design, development, and administration of a Web-based survey to determine the use of the Internet in clinical practice by 450 dental professionals. The survey blended principles of a controlled mail survey with data collection through a Web-based database application. The survey was implemented as a series of simple HTML pages and tested with a wide variety of operating environments. The response rate was 74.2 percent. Eighty-four percent of the participants completed the Web-based survey, and 16 percent used e-mail or fax. Problems identified during survey administration included incompatibilities/technical problems, usability problems, and a programming error. The cost of the Web-based survey was 38 percent less than that of an equivalent mail survey. A general formula for calculating breakeven points between electronic and hardcopy surveys is presented. Web-based surveys can significantly reduce turnaround time and cost compared with mail surveys and may enhance survey item completion rates.

Facebook for Scientists: Requirements and Services for Optimizing How Scientific Collaborations Are Established

Background As biomedical research projects become increasingly interdisciplinary and complex, collaboration with appropriate individuals, teams, and institutions becomes ever more crucial to project success. While social networks are extremely important in determining how scientific collaborations are formed, social networking technologies have not yet been studied as a tool to help form scientific collaborations. Many currently emerging expertise locating systems include social networking technologies, but it is unclear whether they make the process of finding collaborators more efficient and effective. Objective This study was conducted to answer the following questions: (1) Which requirements should systems for finding collaborators in biomedical science fulfill? and (2) Which information technology services can address these requirements? Methods The background research phase encompassed a thorough review of the literature, affinity diagramming, contextual inquiry, and semistructured interviews. This phase yielded five themes suggestive of requirements for systems to support the formation of collaborations. In the next phase, the generative phase, we brainstormed and selected design ideas for formal concept validation with end users. Then, three related, well-validated ideas were selected for implementation and evaluation in a prototype. Results Five main themes of systems requirements emerged: (1) beyond expertise, successful collaborations require compatibility with respect to personality, work style, productivity, and many other factors (compatibility); (2) finding appropriate collaborators requires the ability to effectively search in domains other than your own using information that is comprehensive and descriptive (communication); (3) social networks are important for finding potential collaborators, assessing their suitability and compatibility, and establishing contact with them (intermediation); (4) information profiles must be complete, correct, up-to-date, and comprehensive and allow fine-grained control over access to information by different audiences (information quality and access); (5) keeping online profiles up-to-date should require little or no effort and be integrated into the scientist’s existing workflow (motivation). Based on the requirements, 16 design ideas underwent formal validation with end users. Of those, three were chosen to be implemented and evaluated in a system prototype, “Digital|Vita”: maintaining, formatting, and semi-automated updating of biographical information; searching for experts; and building and maintaining the social network and managing document flow. Conclusions In addition to quantitative and factual information about potential collaborators, social connectedness, personal and professional compatibility, and power differentials also influence whether collaborations are formed. Current systems only partially model these requirements. Services in Digital|Vita combine an existing workflow, maintaining and formatting biographical information, with collaboration-searching functions in a novel way. Several barriers to the adoption of systems such as Digital|Vita exist, such as potential adoption asymmetries between junior and senior researchers and the tension between public and private information. Developers and researchers may consider one or more of the services described in this paper for implementation in their own expertise locating systems.

Clinical Computing in General Dentistry

OBJECTIVE Measure the adoption and utilization of, opinions about, and attitudes toward clinical computing among general dentists in the United States. DESIGN Telephone survey of a random sample of 256 general dentists in active practice in the United States. MEASUREMENTS A 39-item telephone interview measuring practice characteristics and information technology infrastructure; clinical information storage; data entry and access; attitudes toward and opinions about clinical computing (features of practice management systems, barriers, advantages, disadvantages, and potential improvements); clinical Internet use; and attitudes toward the National Health Information Infrastructure. RESULTS The authors successfully screened 1,039 of 1,159 randomly sampled U.S. general dentists in active practice (89.6% response rate). Two hundred fifty-six (24.6%) respondents had computers at chairside and thus were eligible for this study. The authors successfully interviewed 102 respondents (39.8%). Clinical information associated with administration and billing, such as appointments and treatment plans, was stored predominantly on the computer; other information, such as the medical history and progress notes, primarily resided on paper. Nineteen respondents, or 1.8% of all general dentists, were completely paperless. Auxiliary personnel, such as dental assistants and hygienists, entered most data. Respondents adopted clinical computing to improve office efficiency and operations, support diagnosis and treatment, and enhance patient communication and perception. Barriers included insufficient operational reliability, program limitations, a steep learning curve, cost, and infection control issues. CONCLUSION Clinical computing is being increasingly adopted in general dentistry. However, future research must address usefulness and ease of use, workflow support, infection control, integration, and implementation issues.

A Qualitative Investigation of the Content of Dental Paper-based and Computer-based Patient Record Formats

OBJECTIVE Approximately 25% of all general dentists practicing in the United States use a computer in the dental operatory. Only 1.8% maintain completely electronic records. Anecdotal evidence suggests that dental computer-based patient records (CPR) do not represent clinical information with the same degree of completeness and fidelity as paper records. The objective of this study was to develop a basic content model for clinical information in paper-based records and examine its degree of coverage by CPRs. DESIGN We compiled a baseline dental record (BDR) from a purposive sample of 10 paper record formats (two from dental schools and four each from dental practices and commercial sources). We extracted all clinical data fields, removed duplicates, and organized the resulting collection in categories/subcategories. We then mapped the fields in four market-leading dental CPRs to the BDR. MEASUREMENTS We calculated frequency counts of BDR categories and data fields for all paper-based and computer-based record formats, and cross-mapped information coverage at both the category and the data field level. RESULTS The BDR had 20 categories and 363 data fields. On average, paper records and CPRs contained 14 categories, and 210 and 174 fields, respectively. Only 72, or 20%, of the BDR fields occurred in five or more paper records. Categories related to diagnosis were missing from most paper-based and computer-based record formats. The CPRs rarely used the category names and groupings of data fields common in paper formats. CONCLUSION Existing paper records exhibit limited agreement on what information dental records should contain. The CPRs only cover this information partially, and may thus impede the adoption of electronic patient records.

Direct2Experts: A pilot national network to demonstrate interoperability among research-networking platforms

Research-networking tools use data-mining and social networking to enable expertise discovery, matchmaking and collaboration, which are important facets of team science and translational research. Several commercial and academic platforms have been built, and many institutions have deployed these products to help their investigators find local collaborators. Recent studies, though, have shown the growing importance of multiuniversity teams in science. Unfortunately, the lack of a standard data-exchange model and resistance of universities to share information about their faculty have presented barriers to forming an institutionally supported national network. This case report describes an initiative, which, in only 6 months, achieved interoperability among seven major research-networking products at 28 universities by taking an approach that focused on addressing institutional concerns and encouraging their participation. With this necessary groundwork in place, the second phase of this effort can begin, which will expand the networks functionality and focus on the end users.

Social tagging is no substitute for controlled indexing: A comparison of Medical Subject Headings and CiteULike tags assigned to 231,388 papers

Social tagging and controlled indexing both facilitate access to information resources. Given the increasing popularity of social tagging and the limitations of controlled indexing (primarily cost and scalability), it is reasonable to investigate to what degree social tagging could substitute for controlled indexing. In this study, we compared CiteULike tags to Medical Subject Headings (MeSH) terms for 231,388 citations indexed in MEDLINE. In addition to descriptive analyses of the data sets, we present a paper-by-paper analysis of tags and MeSH terms: the number of common annotations, Jaccard similarity, and coverage ratio. In the analysis, we apply three increasingly progressive levels of text processing, ranging from normalization to stemming, to reduce the impact of lexical differences. Annotations of our corpus consisted of over 76,968 distinct tags and 21,129 distinct MeSH terms. The top 20 tags/MeSH terms showed little direct overlap. On a paper-by-paper basis, the number of common annotations ranged from 0.29 to 0.5 and the Jaccard similarity from 2.12% to 3.3% using increased levels of text processing. At most, 77,834 citations (33.6%) shared at least one annotation. Our results show that CiteULike tags and MeSH terms are quite distinct lexically, reflecting different viewpoints/processes between social tagging and controlled indexing.

Dental Informatics: A Work in Progress

Dental informatics is a young scientific discipline that is undergoing continual maturation. Its literature is estimated to consist of approximately 600 papers published between 1975 and 2003, and it is currently growing at a rate of about 50 papers annually. While interest in the discipline is growing, the number of core contributors to dental informatics research remains relatively small. Two major questions for the discipline are: What are the research challenges that dental informatics faces today? and How can the discipline be strengthened and positioned to maximize its success in addressing those challenges? Progress toward research challenges formulated more than ten years ago has been varied. While many new technologies have become available for clinical dental practice, research, and education, many fundamental problems remain to be addressed with informatics research. Recommendations to augment the research capacity in dental informatics include creating a stronger worldwide dental informatics research community, drawing more biomedical informatics researchers to dental research areas, providing career opportunities for dental informatics researchers, addressing grand challenges together as a community, and recruiting subsequent generations of dental informaticians.

Supporting Emerging Disciplines with e-Communities: Needs and Benefits

Background Science has developed from a solitary pursuit into a team-based collaborative activity and, more recently, into a multidisciplinary research enterprise. The increasingly collaborative character of science, mandated by complex research questions and problems that require many competencies, requires that researchers lower the barriers to the creation of collaborative networks of experts, such as communities of practice (CoPs). Objectives The aim was to assess the information needs of prospective members of a CoP in an emerging field, dental informatics, and to evaluate their expectations of an e-community in order to design a suitable electronic infrastructure. Methods A Web-based survey instrument was designed and administered to 2768 members of the target audience. Benefit expectations were analyzed for their relationship to (1) the respondents’ willingness to participate in the CoP and (2) their involvement in funded research. Two raters coded the respondents’ answers regarding expected benefits using a 14-category coding scheme (Kappa = 0.834). Results The 256 respondents (11.1% response rate) preferred electronic resources over traditional print material to satisfy their information needs. The most frequently expected benefits from participation in the CoP were general information (85% of respondents), peer networking (31.1%), and identification of potential collaborators and/or research opportunities (23.2%). Conclusions The competitive social-information environment in which CoPs are embedded presents both threats to sustainability and opportunities for greater integration and impact. CoP planners seeking to support the development of emerging biomedical science disciplines should blend information resources, social search and filtering, and visibility mechanisms to provide a portfolio of social and information benefits. Assessing benefit expectations and alternatives provides useful information for CoP planners seeking to prioritize community infrastructure development and encourage participation.

Computer-Assisted Guidance for Dental Office Tobacco-Cessation Counseling: A Randomized Controlled Trial

BACKGROUND Decreases in smoking prevalence from recent decades have slowed, and national goals to reduce tobacco use remain unmet. Healthcare providers, including those in physician and dental teams, have access to evidence-based guidelines to help patients quit smoking. Translation of those guidelines into practice, however, remains low. Approaches that involve screening for drug use, brief intervention, and referral to treatment (SBIRT) are a promising, practical solution. PURPOSE This study examined whether dentists and dental hygienists would assess interest in quitting, deliver a brief tobacco intervention, and refer to a tobacco quitline more frequently as reported by patients if given computer-assisted guidance in an electronic patient record versus a control group providing usual care. DESIGN A blocked, group-randomized trial was conducted from November 2010 to April 2011. Randomization was conducted at the clinic level. Patients nested within clinics represented the lowest-level unit of observation. SETTING/PARTICIPANTS Participants were patients in HealthPartners dental clinics. INTERVENTION Intervention clinics were given a computer-assisted tool that suggested scripts for patient discussions. Usual care clinics provided care without the tool. MAIN OUTCOME MEASURES Primary outcomes were post-appointment patient reports of the provider assessing interest in quitting, delivering a brief intervention, and referring them to a quitline. RESULTS Patient telephone surveys (72% response rate) indicated that providers assessed interest in quitting (control 70% vs intervention 87%, p=0.0006); discussed specific strategies for quitting (control 26% vs intervention 47%, p=0.003); and referred the patient to a tobacco quitline (control 17% vs intervention 37%, p=0.007) more frequently with the support of a computer-assisted tool integrated into the electronic health record. CONCLUSIONS Clinical decision support embedded in electronic health records can effectively help providers deliver tobacco interventions. These results build on evidence in medical settings supporting this approach to improve provider-delivered tobacco cessation. TRIAL REGISTRATION This study is registered at ClinicalTrials.govNCT01584882.

Collaboratories: Leveraging Information Technology for Cooperative Research

Economic, organizational, and societal pressures, as well as the desire to reach shared goals more efficiently and effectively, are driving an increase in collaborative research. Research collaborations frequently occur among participants separated by temporal, geographical, organizational, disciplinary, and cultural boundaries. Increasingly complex collaborative projects focus attention on the question of how to facilitate working together. Through so-called collaboratories, information technology can play an important role in addressing this question. A collaboratory can be defined as an information technology infrastructure that supports cooperation among individuals, groups, or organizations in pursuit of a shared goal by facilitating interaction, communication, and knowledge-sharing. Tools such as Web-based collaborative workspaces, Internet discussion lists/newsgroups/real-time chat, screen- and application-sharing, Web-based conferencing, online Web page mark-up, automatic notification, and videoconferencing can be used to implement collaboratories. Collaboratories have significant potential to facilitate cooperative research, but should be evaluated carefully to determine best practices.