Knowledge bases in medicine: a review

Efforts to represent knowledge effectively have been central to progress in various aspects of medical informatics. These efforts range from relatively simple "electronic textbooks" to fairly sophisticated knowledge-based systems, which function as well as, or even better than, human experts faced with similar problems. Knowledge bases have been developed in many fields, but the relatively limited domains and structured language of medicine, as well as the importance of information in the provision of good medical care, have made research in medical knowledge representation an area of intense activity. This paper reviews representative knowledge bases and knowledge-based systems in medicine: electronic textbooks such as PDQ and the Hepatitis Knowledge Base (HKB), rule-based systems such as MYCIN, causal models (e.g., CASNET), and hypothesis- or frame-based systems, exemplified by PIP and INTERNIST-1. The paper describes the relationships among divergent approaches and provides a sense of current and future trends. It examines problems in knowledge-based systems, particularly in knowledge representation and acquisition, and the responses to these challenges. The latter include the use of domain-independent software shells for constructing knowledge bases, the adaptation and use of previously existing knowledge bases, and multiple uses of the same knowledge base for different purposes.     

Serials standards work: the next frontier

Serials, one of the more complicated areas of library technical endeavors, has lacked the benefit of standards for a long time. Even now, with standards beginning to be available, the majority of institutions are not working within standard serials formats. A survey to determine the use of serials standards in libraries was conducted in 1988 by the American Library Association, Resources and Technical Services Division, Serials Section, Committee to Study Serials Standards. In the spring of 1988 a survey was sent to a group encompassing the Association of Research Libraries members, CONSER participants, United States Newspaper Program participants, Microform Project libraries, and some vendors and librarians who attended the Committee meetings on a regular basis. The survey questionnaire assessed the current level of serials standards awareness of librarians and vendors. Topics included the type of serials systems used, standards relevant to serials control and union listing and whether or not they are implemented, types and levels of training staff received in the application of standards, benefits of the standards, and areas where standards are most needed.     

Physician information seeking: improving relevance through research

Health sciences libraries have considerable potential as resources for both formal continuing professional education, as well as the informal continuing education that results from the professional's efforts to solve problems in daily practice. While there is a growing interest in making the resources of health sciences libraries more accessible to practitioners on a routine, day-to-day basis, there also needs to be more awareness of how, when, where, and why professionals look for information in the context of practical problems. This paper reviews recent research that identifies the context in which physicians seek information and advice from external sources, the information sources that physicians access, and the factors that influence which particular sources are sought. The results indicate that physicians vary in their information needs, preferences, motivations, and strategies for seeking information. This diversity suggests that health sciences libraries, in their efforts to be more accessible, should consider "market research" to determine the needs, preferences, and use patterns of the library's targeted users. Libraries may also benefit from exploring alternative methods of improving access to their resources.     

Pennsylvania's transition to enterprise computing as a study in strategic alignment

We theorize about the strategic alignment of computing with organizational mission, using the Commonwealth of Pennsylvania's efforts to pursue digital government initiatives as evidence. To do this we draw on a decade (1995–2004) of changes in Pennsylvania to characterize how a state government shifts from an organizational to an enterprise perspective regarding computing. We document and analyze the strategic and operational aspects of a series of information and communications technology (ICT) planning efforts to highlight the nature and roles of strategic alignment used to achieve this transition. Findings from this analysis mark the importance of combining several approaches to strategic planning regarding the adoption and application of ICT.     

Institutional Repositories: Faculty Deposits,Marketing, and the Reform of Scholarly Communication

This study explores faculty deposits in institutional repositories (IR) within selected disciplines and identifies the diverse navigational paths to IR sites from library Web site homepages. The statistical relationship between the development of an IR and the presence of a Web site dedicated to the reform of traditional scholarly communication is also explored. The implications for the development of institutional repositories are highlighted.     

Expanding rural primary care training by employing information technologies: the need for participation by medical reference librarians

The use of rural sites to train badly needed primary care providers requires access to sophisticated medical information not traditionally available outside of academic health centers. Medical reference librarians can play a key role in the development of primary care training sites in rural settings. Electronic information technologies, with proactive support from medical reference librarians, can provide current and detailed information without concern for distance from the health science center library. This paper discusses recent developments in technology, describes current challenges to the application of this technology in rural settings, and provides policy recommendations for medical reference librarians to enhance rural primary care training.