Download PDF
Methods Inf Med 2003; 42(01): 68-78
DOI: 10.1055/s-0038-1634211
Original article
Schattauer GmbH

The CardioOP-Data Clas (CDC)

Development and Application of a Thesaurus for Content Management and Multi-User Teleteaching in Cardiac Surgery
R. Friedl
1   Dept. of Heart Surgery, University of Ulm, Germany
,
W. Klas
2   Institute for Computer Science and Business Informatics, University of Vienna, Austria
,
U. Westermann
2   Institute for Computer Science and Business Informatics, University of Vienna, Austria
,
T. Rose
3   Institute of Applied Knowledge Processing (FAW), Ulm
,
J. Tremper
4   Dept. of Heart Surgery, University of Heidelberg
,
S. Stracke
5   Dept. of Medicine, University of Ulm, Germany
,
O. Gödje
1   Dept. of Heart Surgery, University of Ulm, Germany
,
A. Hannekum
1   Dept. of Heart Surgery, University of Ulm, Germany
,
M. B. Preisack
1   Dept. of Heart Surgery, University of Ulm, Germany
› Author Affiliations
Further Information

Publication History

Received: 15 October 2001

Accepted: 19 June 2002

Publication Date:
07 February 2018 (online)

    Permissions and Reprints

Summary

Objectives: Self-directed and customized medical education programs are gaining importance in health care instruction. We prototypically implemented a repository-driven online computer system (CardioOP) for teleteaching in Heart Surgery. It supports authoring and multiple re-use of multimedia data for different user groups in different instructional applications and therefore requires a process of content management.

Methods: We defined objectives for a terminological system to support semantic, cross-media type annotation and retrieval of learning objects: domain completeness, German (natural) language processing, multi-user concepts, extensibility and maintenance, content based annotation and technical implementation. Existing terminologies (ICD10, READ V3, Snomed III, UMLS 1997, MESH) have been analysed according to these objectives.

Results: We found that the analysed terminologies did not meet our criteria sufficiently. Therefore, we developed a domain-specific thesaurus, the CardioOPDataClas (CDC). The application of the CDC within a database-driven authoring process using specifically developed tools is reported.

Conclusions: Metadata play an important role in the effective discovery and search, access, integration and management of educational multimedia data in medicine but so far, there is no terminology to support content management for instructional multimedia. We prototypically designed and applied a thesaurus for the CardioOP educational system. Additional work is needed to evaluate the system in terms of user-friendliness, concept coverage and information retrieval performance.

Keywords

Computer assisted instruction - multimedia - terminology - information management
 

  • References

  • 1 Parboosingh J. Credentialing physicians: challenges for continuing medical education. J Contin Educ Health Prof 2000; 20: 188-90.
    CrossrefPubMedGoogle Scholar
  • 2 Leist JC, Green JS. A continuing medical education summit with implications for the future. J Contin Educ Health Prof 2000; 20: 247-51.
    CrossrefPubMedGoogle Scholar
  • 3 Eysenbach G. Consumer health informatics. BMJ 2000; 320: 1713-6 (Review).
    CrossrefPubMedGoogle Scholar
  • 4 Herxheimer A, McPherson A, Miller R, Shepperd S, Yaphe J, Ziebland S. Database of patients’ experiences (DIPEx): a multimedia approach to sharing experiences and information. Lancet 2000; 355: 1540-3.
    CrossrefPubMedGoogle Scholar
  • 5 Lewis D. Computer-based approaches to patient education: a review of the literature. J Am Med Inform Assoc 1999; 6: 272-82 (Review).
    CrossrefPubMedGoogle Scholar
  • 6 Richards B, Colman AW, Hollingsworth RA. The current and future role of the Internet in patient education. Int J Med Inf 1998; 50: 279-85.
    CrossrefPubMedGoogle Scholar
  • 7 Zucker S, White JA, Fabri PJ, Khonsari LS. Instructional intranets in graduate medical education. Acad Med 1998; 73: 1072-5.
    CrossrefPubMedGoogle Scholar
  • 8 Gorman PJ, Meier AH, Rawn C, Krummel TM. The future of medical education is no longer blood and guts, it is bits and bytes. Am J Surg 2000; 180: 353-6.
    CrossrefPubMedGoogle Scholar
  • 9 Dunnington GL, DaRosa DA. Changing surgical education strategies in an environment of changing health care delivery systems. World J Surg 1994; 18: 734-7 (Review).
    CrossrefPubMedGoogle Scholar
  • 10 Summers AN, Rinehart GC, Simpson D, Redlich PN. Acquisition of surgical skills: a randomised trial of didactic, videotape, and computer-based training. Surgery 1999; 126: 330-6.
    CrossrefPubMedGoogle Scholar
  • 11 Devitt P, Cehic D, Palmer E. Computers in medical education 2. Use of a computer package to supplement the clinical experience in a surgical clerkship: an objective evaluation. Aust N Z J Surg 1998; 68: 428-31.
    CrossrefPubMedGoogle Scholar
  • 12 Lewis D. Computer-based approaches to patient education: a review of the literature. J Am Med Inform Assoc 1999; 6: 272-82 (Review).
    CrossrefPubMedGoogle Scholar
  • 13 Mehrabi A, Gluckstein C, Benner A, Hashemi B, Herfarth C, Kallinowski F. A new way for surgical education–development and evaluation of a computer-based training module. Comput Biol Med 2000; 30: 97-109.
    CrossrefPubMedGoogle Scholar
  • 14 Lyon Jr HC, Healy JC, Bell JR. et al. Significant efficiency findings while controlling for the frequent confounders of CAI research in the PlanAlyzer project’s computer-based, self-paced, case-based programs in anemia and chest pain diagnosis. J Med Syst 1991; 15: 117-32.
    CrossrefPubMedGoogle Scholar
  • 15 Klar R, Bayer U. Computer-assisted teaching and learning in medicine. Int J Biomed Comput 1990; 26: 7-27 (Review).
    CrossrefPubMedGoogle Scholar
  • 16 Downes S. Learning Objects [published online. at www.atl.ualberta.ca/downes/naweb/Learning_Objects.htm accessed 4. 10. 2001
    PubMedGoogle Scholar
  • 17 Klas W, Greiner C, Friedl R. CardioOP: Gallery of Cardiac Surgery. ICMCS, 1999; 2: 1092-5.
    PubMedGoogle Scholar
  • 18 Friedl R, Preisack M, Schefer M. et al. CardioOp: an integrated approach to teleteaching in cardiac surgery. Stud Health Technol Inform 2000; 70: 76-82.
    PubMedGoogle Scholar
  • 19 Wheatley DJ. Cardiothoracic surgery in Europe: politics, pressures and practice. Eur J Cardiothorac Surg 1999; 16: 593-601.
    CrossrefPubMedGoogle Scholar
  • 20 The International Statistical Classification of Diseases and Related Health Problems. tenth revision (ICD-10) [published online at www.who.int/whosis/icd10/index.html accessed 4.10.2001].
    PubMed
  • 21 The Read Codes [published online at www.cams.co.uk/readcode.htm accessed 4.10.2001].
    PubMed
  • 22 The Systematized Nomenclature of Human and Veterinary Medicine (SNOMED) [published online at www.snomed.org accessed 4.10.2001].
    PubMed
  • 23 Unified Medical Language System (UMLS) [published online at www.nlm.nih.gov/pubs/factsheets/umls.html accessed 4.10.2001].
    PubMed
  • 24 Lindberg DA, Humphreys BL, McCray AT. The Unified Medical Language System. Methods Inf Med 1993; 32: 281-91.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Campbell KE, Oliver DE, Spackman KA, Shortliffe EH. Representing thoughts, words, and things in the UMLS. J Am Med Inform Assoc 1998; 5: 421-31.
    CrossrefPubMedGoogle Scholar
  • 26 Medical Subject Headings (MESH) [published online at www.nlm.nih.gov/mesh/mesh-home.html accessed 4.10.2001].
    PubMed
  • 27 de Keizer NF, Abu-Hanna A, ZwetslootSchonk JHM. Understanding terminological Systems. I: Terminology and typology. Methods Inf Med 2000; 39: 16-21.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 de Keizer NF, Abu-Hanna A. Understanding terminological systems. II: Experience with conceptual and formal representation of structure. Methods Inf Med 2000; 39: 22-9.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 ISO TC 215 [published online at www.standards.nhsia.nhs.uk/isotc215/wg3 accessed 4.10.2001].
    PubMed
  • 30 CEN TC 251 [published online at at: www.centc251.org accessed 4. 10. 2001].
    PubMed
  • 31 European prestandard. Medical informatics – Categorical structures of systems of concepts – Model for representation of semantics. Brussel: CEN; 1997
    Google Scholar
  • 32 Boll S, Klas W. ZYX – A Multimedia Document Model for Reuse and Adaptation. Transactions on Knowledge and Data Engineering. In: DS-8 Special Issue, Vol 13, No 3,. IEEE Computer Society; 2001: 361-382.
    Google Scholar
  • 33 Westermann U, Klas W. Architecture of a DataBlade Module for the Integrated Management of Multimedia Assets. Proceedings of the First International Workshop on Multimedia Intelligent Storage and Retrieval Management (MISRM). Orlando, Florida: 1999: 255-90.
    Google Scholar
  • 34 Standard Generalized Markup Language (SGML) [published online at http://clover.slavic.pitt.edu/~djb/sgml.html accessed 4. 10. 2001].
    PubMed
  • 35 Lalonde J. Online CME trends. MD education hits the fast track. MD Comput 2000; 17: 25-6.
    PubMedGoogle Scholar
  • 36 Mizoguchi R, Sinitsa K, Ikeda M. Task Ontology Design for Intelligent Educational/Training Systems. Position Paper for ITS’96 Workshop on Architectures and Methods for Designing Cost-Effective and Reusable ITSs, Montreal, June 10th 1996. [also published online at http://advlearn.lrdc.pitt.edu/its-arch/papers/mizoguchi.html accessed 4.10.2001].
    PubMedGoogle Scholar
  • 37 Schatz S. Paradigm Shifts and Challenges for Instructional Designers. An Introduction to Meta Tags and Knowledge Bits. [published online at www.imsproject.org/feature/kb/knowledgebits.html accessed 4. 10. 2001].
    PubMedGoogle Scholar
  • 38 Eysenbach G, Diepgen T, Lampe K, Brickley D. EU-project medCERTAIN: Certification and Rating of Trustworthy and Assessed Health Information on the Net. Stud Health Technol Inform 2000; 77: 279-83.
    PubMedGoogle Scholar
  • 39 Dublin Core Metadata Initiative. [published online at http://dublincore.org accessed 4. 10. 2001].
    PubMedGoogle Scholar
  • 40 Malet G, Munoz F, Appleyard R, Hersh W. A model for enhancing Internet medical document retrieval with “medical core metadata”. J Am Med Inform Assoc 1999; 6: 163-72.
    CrossrefPubMedGoogle Scholar
  • 41 Draft Standard for Learning Object Metadata (IEEE P1484.12/D6.1): [published online at http://ltsc.ieee.org/doc/wg12/LOM_WD6-1_without_tracking.htm accessed 4. 10. 2001].
    PubMed
  • 42 ARIADNE (Alliance of Remote Instructional Authoring and Distribution Networks for Europe) [published online at http://ariadne.unil.ch accessed 4. 10. 2001].
    PubMed
  • 43 Health Education Assets Library (HEAL) [published online at www.healcentral.org accessed 4. 10. 2001].
    PubMed
  • 44 Resource Description Framework (RDF) (published online at www.w3.org/RDF accessed 01. 04. 2002).
    PubMed
  • 45 Extensible Markup Language (XML) (published online at www.w3.org/XML accessed 01. 04. 2002).
    PubMed
  • 46 ISO/IEC WD 15938-2. Information Technology – Multimedia Content Description Interface (MPEG-7) – Part 2: Description Definition Language. Working Draft. ISO/IEC, 2000
    PubMedGoogle Scholar
  • 47 Topic Maps (published online at www.topicmaps.org/xtm/1.0 accessed 01. 04. 2002).
    PubMed
  • 48 Ontology Inference Layer (OIL) (published online at www.ontoknowledge.org/oil accessed 01. 04. 2002).
    PubMed
  • 49 DARPA Agent Markup Language (DAML) (published online at www.daml.org accessed 01.04.2002).
    PubMed
  • 50 Chute CG, Cohn SP, Campbell KE, Oliver DE, Campbell JR. The content coverage of clinical classifications. For The Computer-Based Patient Record Institute’s Work Group on Codes & Structures. J Am Med Inform Assoc 1996; 3: 224-33.
    CrossrefPubMedGoogle Scholar
  • 51 Humphreys BL, McCray AT, Cheh ML. Evaluating the coverage of controlled health data terminologies: report on the results of the NLM/AHCPR large scale vocabulary test. J Am Med Inform Assoc 1997; 4: 484-500.
    CrossrefPubMedGoogle Scholar
  • 52 Brown PJB, O’Neil M, Price C. Semantic definition of disorders in version 3 of the Read Codes. Methods Inf Med 1998; 37: 415-9.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 53 Lipscomb CE. Medical Subject Headings (MeSH). Bull Med Libr Assoc 2000; 88: 265-6.
    PubMedGoogle Scholar
  • 54 Deutsches Institut für Medizinische Dokumentation und Information (DIMDI) [published online at www.dimdi.de/germ/klassi/mesh/fr-mesh.htm accessed 4.10.2001].
    PubMed
  • 55 Oliver DE, Shahar Y. Change management of shared and local versions of health-care terminologies. Methods Inf Med 2000; 39: 278-90 (Review).
    Article in Thieme ConnectPubMedGoogle Scholar
  • 56 Cimino JJ. Formal descriptions and adaptive mechanisms for changes in controlled medical vocabularies. Methods Inf Med 1996; 35: 202-10.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 57 Suarez-Munist ON, Tuttle MS, Olson NE. et al. MEME-II supports the cooperative management of terminology. Proc AMIA Annu Fall Symp. 1996: 84-8.
    PubMedGoogle Scholar
  • 58 Robinson D, Schulz E, Brown P, Price C. Updating the Read Codes: user-interactive maintenance of a dynamic clinical vocabulary. J Am Med Inform Assoc 1997; 4: 465-72.
    CrossrefPubMedGoogle Scholar
  • 59 Rector AL. Clinical terminology: why is it so hard?. Methods Inf Med 1999; 38: 239-52.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 60 Sittig DF. Grand challenges in medical informatics?. J Am Med Inform Assoc 1994; 1: 412-3.
    CrossrefPubMedGoogle Scholar
  • 61 Cimino JJ. Review paper: coding systems in health care. Methods Inf Med 1996; 35: 273-84 (Review).
    Article in Thieme ConnectPubMedGoogle Scholar
  • 62 Cimino JJ. Desiderata for controlled medical vocabularies in the twenty-first century. Methods Inf Med 1998; 37: 394-403 (Review).
    Article in Thieme ConnectPubMedGoogle Scholar
  • 63 Cimino JJ, Clayton PD, Hripcsak G, Johnson SB. Knowledge-based approaches to the maintenance of a large controlled medical terminology. J Am Med Inform Assoc. 1994; 1: 35-50.
    CrossrefPubMedGoogle Scholar
  • 64 Campbell JR, Carpenter P, Sneiderman C, Cohn S, Chute CG, Warren J. Phase II evaluation of clinical coding schemes: completeness, taxonomy, mapping, definitions, and clarity. CPRI Work Group on Codes and Structures. J Am Med Inform Assoc 1997; 4: 238-51.
    CrossrefPubMedGoogle Scholar
  • 65 de Keizer NF, Abu-Hanna A, Cornet R, Zwets-loot-Schonk JH, Stoutenbeek CP. Analysis and design of an ontology for intensive care diagnoses. Methods Inf Med 1999; 38: 102-12.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 66 Chute CG, Elkin PL, Sherertz DD, Tuttle MS. Desiderata for a clinical terminology server. Proc AMIA Symp. 1999: 42-6.
    PubMedGoogle Scholar
  • 67 The Galen in Use Project (GALEN) [published online at www.cs.man.ac.uk/mig/giu accessed 4. 10. 2001].
    PubMed