Toward a veterinary informatics research agenda: An analysis of the PubMed-indexed literature

Smith-Akin KA, Bearden CF, Pittenger ST, Bernstam EV. Int J Med Inform. 2006 Mar 25; [Epub ahead of print] PMID: 16569509

PURPOSE: Veterinary medicine and human health are inextricably intertwined. Effective tracking of veterinary information - veterinary informatics - impacts not only veterinary medicine, but also public health, informatics research, and clinical care. However, veterinary informatics has received little attention from the general biomedical informatics community. METHODS: To identify both active and under-researched areas in veterinary informatics, we retrieved Medical Subject Heading (MeSH) descriptors for veterinary informatics-related citations and analyzed them by topic category, animal type, and journal. RESULTS: We found that the categories of veterinary informatics with the most growth were information/bibliographical retrieval, hardware/programming, and radiology/imaging. Less than two articles per year were published in the areas of computerized veterinary medical records, clinical decision support, standards, and controlled vocabularies. Veterinary informatics articles primarily address production animals such as cattle and sheep, and companion animals such as cats and dogs. Six journals account for 31% of the veterinary informatics literature, 35 journals account for 66%. CONCLUSIONS: Veterinary informatics remains an embryonic field with relatively few publications. With the exception of radiology/imaging, published articles are primarily focused on non-clinical areas such as hardware/programming and information retrieval. There are very few publications on controlled vocabularies, standards, methodologies for integrating disparate systems, computerized medical records, clinical decision support systems, and system usability. The lack of publications in these areas may hamper efforts to collect and track animal health data at a time when such data are potentially critical to human health.

Context, automated decision support, and clinical practice guidelines: Does the literature apply to the United States practice environment?

Edmonson SR, Smith-Akin KA, Bernstam EV. Int J Med Inform. 2006 Mar 6; [Epub ahead of print] PMID: 16524767

BACKGROUND: Context - the combined effect of factors such as physician type, clinical setting, and guideline characteristics - influences the ability of automated decision support (ADS) to improve physician compliance with clinical practice guidelines (CPGs). Our goal was to determine whether research about the utility of ADS for promoting CPG compliance is contextually applicable to United States physicians. METHODS: We extracted information about physicians, settings, and guidelines from all articles published in the last 10 years that describe original research about the use of ADS to promote CPG compliance. The extracted information was compared to the range of practice contexts seen in the United States. RESULTS: Nearly two-thirds (65.3%) of papers described studies conducted in an academic setting, but only 11% of physicians report academic affiliations (p<0.0001). Physician reimbursement structure is often not reported. Salaried physicians were explicitly included as subjects in 14% of articles, but make up 45% of US physicians (p<0.0001). There are little data about the generalizability of ADS research to emergency care settings (6% of articles), and nursing home or skilled nursing facilities (10% of articles). Finally, ADS has not been studied at all in several epidemiologically important disease categories. CONCLUSION: The literature does not adequately address some physician, setting, and guideline contexts. Before making policy or spending decisions based on the effectiveness of ADS, additional research is needed to determine whether ADS research can be generalized to under-represented contexts.

Application of cognitive engineering principles to the redesign of a dichotomous identification key for parasitology.

Smith-Akin, K. A., McLane, S., Craig, T. M., & Johnson, T. R. (2006). Application of cognitive engineering principles to the redesign of a dichotomous identification key for parasitology. AMIA Annu Symp Proc, 739-743.

Dichotomous identification keys are used throughout biology for identification of plants, insects, and parasites. However, correct use of identification keys can be difficult as they are not usually intended for novice users who may not be familiar with the terminology used or with the morphology of the organism being identified. Therefore, we applied cognitive engineering principles to redesign a parasitology identification key for the Internet. We addressed issues of visual clutter and spatial distance by displaying a single question couplet at a time and by switching to the appropriate next couplet after the user made a choice. Our analysis of the original paper-based key versus the Web-based approach found that of 26 applicable cognitive engineering principles, the paper key did not meet 4 (15%) and partially met 11 (42%). In contrast, the redesigned key met 100% of 32 applicable cognitive engineering principles.

Note: The online identifcation key can be accessed at this address: www.kimberlysmith-akin.com/IDkey