A web-based teaching resource to prepare for final undergraduate examination: a French pilot study.

Access to accurate and quality-controlled health information on the Internet for medical students is not an easy task. CISMeF is the search tool of a MeSH-indexed directory of medical Internet resources in French. Since 2004, a new French Pre-Residency Examination (PRE) is compulsory for all medical students in the 6th year of the curriculum. The goal of this study is to evaluate CISMeF as a tool to provide teaching resources available on the Internet covering PRE material. The CISMeF terminology and the PRE CISMeF module are described. To assess the CISMeF performance in covering PRE program, its precision (number of relevant resources/number of overall resources extracted by CISMeF) and coverage (number of PRE questions covered by at least one resource in the CISMeF gateway) were computed. The CISMeF module for the new French Pre-Residency Examination is efficient as it already covers 95.7% of the program with a precision of 82.2%. Our data demonstrates that CISMeF is acceptable to guide students' learning and should be a useful teaching resource for the preparation of the French Pre-Residency Examination.

UMLF: a unified medical lexicon for French.

Medical Informatics has a constant need for basic medical language processing tasks, e.g. for coding into controlled vocabularies, free text indexing and information retrieval. Most of these tasks involve term matching and rely on lexical resources: lists of words with attached information, including inflected forms and derived words, etc. Such resources are publicly available for the English language with the UMLS Specialist Lexicon, but not in other languages. For the French language, several teams have worked on the subject and built local lexical resources. The goal of the present work is to pool and unify these resources and to add extensively to them by exploiting medical terminologies and corpora, resulting in a unified medical lexicon for French (UMLF). This paper exposes the issues raised by such an objective, describes the methods on which the project relies and illustrates them with experimental results.

Enhancing the MeSH thesaurus to retrieve French online health resources in a quality-controlled gateway.

The amount of health information available on the Internet is considerable. In this context, several health gateways have been developed. Among them, CISMeF (Catalogue and Index of Health Resources in French) was designed to catalogue and index health resources in French. The goal of this article is to describe the various enhancements to the MeSH thesaurus developed by the CISMeF team to adapt this terminology to the broader field of health Internet resources instead of scientific articles for the medline bibliographic database. CISMeF uses two standard tools for organizing information: the MeSH thesaurus and several metadata element sets, in particular the Dublin Core metadata format. The heterogeneity of Internet health resources led the CISMeF team to enhance the MeSH thesaurus with the introduction of two new concepts, respectively, resource types and metaterms. CISMeF resource types are a generalization of the publication types of medline. A resource type describes the nature of the resource and MeSH keyword/qualifier pairs describe the subject of the resource. A metaterm is generally a medical specialty or a biological science, which has semantic links with one or more MeSH keywords, qualifiers and resource types. The CISMeF terminology is exploited for several tasks: resource indexing performed manually, resource categorization performed automatically, visualization and navigation through the concept hierarchies and information retrieval using the Doc'CISMeF search engine. The CISMeF health gateway uses several MeSH thesaurus enhancements to optimize information retrieval, hierarchy navigation and automatic indexing.

Using CISMeF MeSH "Encapsulated" terminology and a categorization algorithm for health resources.

INTRODUCTION: CISMeF is a Quality Controlled Health Gateway using a terminology based on the Medical Subject Headings (MeSH) thesaurus that displays medical specialties (metaterms) and the relationships existing between them and MeSH terms. OBJECTIVE: The need to classify the resources within the catalogue has led us to combine this type of semantic information with domain expert knowledge for health resources categorization purposes. MATERIAL AND METHODS: A two-step categorization process consisting of mapping resource keywords to CISMeF metaterms and ranking metaterms by decreasing coverage in the resource has been developed. We evaluate this algorithm on a random set of 123 resources extracted from the CISMeF catalogue. Our gold standard for this evaluation is the manual classification provided by a domain expert, viz. a librarian of the team. RESULTS: The CISMeF algorithm shows 81% precision and 93% recall, and 62% of the resources were assigned a "fully relevant" or "fairly relevant" categorization according to strict standards. DISCUSSION: A thorough analysis of the results has enabled us to find gaps in the knowledge modeling of the CISMeF terminology. The necessary adjustments having been made, the algorithm is currently used in CISMeF for resource categorization.

Modelisation of consumer health information in a quality-controlled gateway.

The amount of health data accessible on the Web is increasing and Internet has become a major source of health information. Many tools and search engines are available but medical information retrieval remains difficult for both the health professional and the patients. In this paper we describe CISMeF-patients. It is a sub-part of CISMeF, a structured quality-controlled subject gateway. CISMeF-patients has been designed for the patients, their families and the general public who are often unfamiliar with the medical domain and the medical vocabulary. The resources included in CISMeF-patients are described using the Dublin Core metadata format. To index them, CISMeF-patients and CISMeF share the same terminology, which 'encapsulates' the MeSH thesaurus with a layer of synonyms. Unlike Medline-plus and Medline, sharing the same terminology allows to a CISMeF-patients end-user the possibility to extend his query to the CISMeF catalogue (e.g. for searching teaching resources or clinical guidelines).

Metadata element set in a quality-controlled subject gateway: a step to a health semantic Web.

BACKGROUND: Quality-controlled subject gateways are Internet services which apply a selected set of targeted measures to support systematic resource discovery. Considerable manual effort is used to process a selection of resources which meet quality criteria and to display a extensive description and indexing of these resources with standards-based metadata. OBJECTIVE: Several metadata element sets are proposed to describe, index and quality health resources to be included in a French quality-controlled health gateway called CISMeF. The main objectives were to enhance Internet health document retrieval and navigation, and to allow interoperability with other Internet services. RESULTS: The Dublin Core metadata element set is used to describe and index all Internet health resources included in CISMeF. For teaching resources, some elements from IEEE1484 Learning Object Metadata are also used. For evidenced-base medicine resources, specific metadata are employed which assess the health content quality. The HIDDEL metadata set is used to enhance transparency, trust and quality of health information on the Internet. CONCLUSION: Comprehensive metadata element sets can be extremely useful to describe, index and assess health resources on the Internet in a quality-controlled subject gateway. Machine-readable metadata creates an Semantic Web which is more efficient for end-users as compared to the current Web.

Web impact factor: a bibliometric criterion applied to medical informatics societies' web sites.

Several methods are available to evaluate and compare medical journals. The most popular is the journal Impact Factor, derived from averaging counts of citations to articles. Ingwersen adapted this method to assess the attractiveness of Web sites, defining the external Web Impact Factor (WIF) to be the number of external pages containing a link to a given Web site. This paper applies the WIF to 43 medical informatics societies' Web sites using advanced search engine queries to obtain the necessary link counts. The WIF was compared to the number of publications available in the Medline bibliographic database in medical informatics in these 43 countries. Between these two metrics, the observed Pearson correlation was 0.952 (p < 0.01) and the Spearman rank correlation was 0.548 (p < 0.01) showing in both cases a positive and strong significant correlation. The WIF of medicalm informatics society's Web site is statistically related to national productivity and discrepancies can be used to indicate countries where there are either weak medical informatics associations, or ones that do not make optimal use of the Web.

Webmastering in academic institutions: a new job opportunity.

In cyberspace, the health webmaster could be regarded as a virtual editor-in-chief, in charge of content and design. In this circumstance, he/she must follow quality criteria when building any resource. At the Rouen University Hospital (RUH), we have chosen "Net Scoring" as an effective tool to aid the design of a quality Web site. "Net Scoring" contains a list of 49 criteria which fall into eight categories: credibility, content, links, design, interactivity, quantitative aspects, ethics, and accessibility. The webmaster is the key element of the editorial board process. He/she must regularly monitor the Web site in order to retrieve information about whether the site is used and by whom: the method most commonly used is log analysis. At the RUH, an average of 9,000 unique machines visit our Web site each working day. Webmaster is a new job opportunity in academic institutions, in particular for medical informaticians and medical librarians both whom are information science professionals.