ABSTRACT
We analyzed retrospectively the use of Physician Desk Reference Database searches to identify epidemics of tularemia, nephropathy, Pogosta disease, and Lyme disease and compared the searches with mandatory laboratory reports to the National Infectious Diseases Register in Finland during 1995. Continuous recording of such searches may be a tool for early detection of epidemics.
Subject(s)
Communicable Diseases/diagnosis , Databases as Topic , Alphavirus Infections/diagnosis , Guidelines as Topic , Hantavirus Infections/diagnosis , Humans , Lyme Disease/diagnosis , Retrospective Studies , Sindbis Virus , Tularemia/diagnosisABSTRACT
OBJECTIVE: To study the implementation of electronic guidelines designed for general practitioners (GPs). DESIGN: A descriptive 3-year follow-up study. SUBJECTS: All new subscribers to Physician's Desk Reference and Database (PDRD) in 1992. SETTING: Locations of computers, where PDRD software was installed for the first time in 1992. MAIN OUTCOME MEASURES: Expectations of the program and changes in attitudes towards it, getting started with the system, frequency and continuity of use and estimated usefulness of the program. RESULTS: The guidelines were expected to enhance diagnostic accuracy (60% of subscribers), save time (45%), and reduce costs (11%). After 1 year's use, the opinions of the users on these topics had become slightly more positive. Technical problems delayed starting to use the program in 27%. After 1 year 72% were using the program at least weekly. Using frequency was associated with having the computer in the office. The subscribers who renewed their subscription after one year often became regular users. CONCLUSIONS: The study provides insight into the implementation phase of computer-based guidelines in a population of early adopters. Technical support was essential to overcome the barriers associated with computer technology. The perceived need for information was independent of the age and experience of the physicians.
Subject(s)
Decision Support Systems, Clinical , Family Practice/standards , Guideline Adherence , Practice Guidelines as Topic , Primary Health Care/standards , Therapy, Computer-Assisted/organization & administration , Adult , Attitude of Health Personnel , Computer User Training , Databases, Factual , Family Practice/education , Female , Finland , Follow-Up Studies , Humans , Male , Middle Aged , Reference Books , Surveys and QuestionnairesABSTRACT
Physician's Desk Reference and Database is a Finnish collection of computerized primary care guidelines. The program has been in clinical use since 1989. For this study, a function producing a log file of all searches was added to the program. Two hundred twenty-seven users returned log files that contained 15,267 searches. The users made 3.12 (range 1-10.4) searches per day. The average time needed to find and read an article was 4.9 minutes. Sufficient facts were found in 71% of the searches. Dermatology was the most popular field of interest, followed by infectious diseases and cardiology.
Subject(s)
Databases, Factual/statistics & numerical data , Decision Support Systems, Clinical/statistics & numerical data , Practice Guidelines as Topic , Primary Health Care/standards , Adult , Female , Finland , Guideline Adherence , Health Services Research , Humans , Information Services , Male , Primary Health Care/statistics & numerical data , Surveys and QuestionnairesABSTRACT
This article identifies the current stage of development and assessment of computer-assisted decision support systems in the domain of general practice. Physician's Desk Reference and Database (PDRD), an electronic medical database, is presented, and a plan for assessment of PDRD is briefly discussed.
Subject(s)
Decision Making, Computer-Assisted , Family Practice , MEDLINE , Primary Health Care , Artificial Intelligence , Attitude to Computers , CD-ROM , Europe , Finland , Grateful Med , Microcomputers , SoftwareABSTRACT
A method using proteins covalently coupled to glass surfaces has been applied to studies on the differentiation of neuroblasts. Neuroblastoma cells from clones N 18 and NIE 115 adhere to surfaces coated with fibronectin or laminin and extend rapidly growth cone-containing neurites. Some lectin-coated surfaces are also able to support neurite outgrowth, although the activities are lower than those of fibronectin and laminin. We discuss the biochemical requirements of the surface structures capable of inducing a differentiated neuronal morphology to neuroblastoma cells, and also consider the possible relationship of the results to physiological differentiation phenomena.
