Open access - how well do our areas do?

We've discussed quite a few aspects of open access on this blog over the years, so a recent email from BioMed Central (http://www.biomedcentral.com) lead me to looking into our areas of interest - nursing, health informatics, e-learning, etc. - to see how well we scored in the open access stakes.

The 'Open Access Quotient' (OAQ) was introduced on the BioMed Central blog in July 2007 (>>>); the OAQ aims "to quantify just how open a particular research field is – i.e. what fraction of the research in that area is available with open access immediately following publication". It does this through a search of PubMed citations from the past 60 days - a metric you can argue with, but maybe as good as any other.

At the time, I did a quick look on nursing and found it then had an OAQ of only 2.55% - not a very good score, and well below the PubMed average of 6.8% at the time. Well, nursing, as many other areas (>>>), has improved a bit in the past 12 months - it now scores 4.3% - but only, I suspect, due to the effect of the increasing number of BioMed central journals, rather than any conversion to the open access model or philosophy by other publishers.

A comparison with some other subject areas of interest shows:
health informatics = 9.64%
medical informatics = 19.44%
e-learning = 26.67%

However, when 'nursing informatics' returns a result of 66.67%, then I start to suspect the reliability of the algorithm - although it is on a sample of 3 articles.

ClinicalTemplates.org

While the standards world was besotted with terminology over the last 20 years, clinical modelling remained relatively unloved and under-resourced, with the occasional exception (eg GALEN) proving the rule. It may have been obvious that terms would never 'enable' the EPR without some structures to hang them on, but it has taken a while for this to get more serious attention in the informatics mainstream.

Clinical content standards development is now a fast growing area of informatics, and is one where clinical and informatics expertise needs to collaborate closely. In the UK, most recent interest in standards has focussed on openEHR archetypes and templates- eg NHS Clinical Models.

While the standards (and the standardised models) sort themselves out, the world moves on, with everyone and their dogs developing their own content, sometimes sharing it, usually not. Clinical content remains embedded in working systems, often wrapped in licensing agreements preventing sharing and re-use. Standardised tools are used, without any attention to copyright restrictions that might apply.

There has been previous work to address this, for example, 'Tools and Rules', but there is scope for something more long-term and 'open'.

The new ClinicalTemplates.org site has just gone live as an open source portal for various projects working on the collaborative development and sharing of clinical templates and supporting documentation.

The project offers a web ‘shell’ for each collaborative project site, supporting groups, membership, news, blogs, newsfeeds, and wiki. Within that, the project is developing a range of plugins to support template building, mappings and other project-specific tools.

New projects are in preparation and will appear on the site over the next few months- each one is a little different and should build into an interesting collection.

ClinicalTemplates.org aims to become a long-term home or point of access to template development by many groups and in many countries. It is supported by SnowCloud.co.uk a new company setup by Derek Hoy and Nick Hardiker.


[disclosure of interest: I am a lead developer of ClinicalTemplates.org and partner in SnowCloud]

Health 2.0 and Medicine 2.0 - discussion paper

A new peer-reviewed paper just released on JMIR (Journal of Medical Internet Research - www.jmir.org) is titled "Health 2.0 and Medicine 2.0: Tensions and Controversies in the Field" >>>

I have not had chance to read the full paper yet, but it looks like a useful contribute to the ongoing discussions of the nature of the two memes - and hopefully will promote some useful discussion if it is going to be presented at the Medicine 2.0 Congress next month (www.medicine20congress.com). It has a lengthy reference list, which is valuable in itself, pulling together much of the recent discussion, and has used a thematic analysis of the definitions and discussions.

The major findings included:
"Four major tensions or debates between stakeholders were found in this literature, including (1) the lack of clear Medicine 2.0 definitions, (2) tension due to the loss of control over information as perceived by doctors, (3) the safety issues of inaccurate information, and (4) ownership and privacy issues with the growing body of information created by Medicine 2.0."

I will provide an update and further thoughts when I have read the paper. And just a heads-up that Rod and I, amongst others, will be at the Medicine 2.0 Congress in Toronto, and will be blogging it, no doubt.

Video Games Improve Medication Compliance

Play video games can help with pediatric patient medication compliance (16% increase). From the August 2008 issue of Pediatrics, cited in a Yahoo! (Reuters):

In Re-Mission (http://www2.re-mission.net), developed by HopeLab, a Redwood City, California-based non-profit company, players control a tiny robot called Roxxi who moves around in a 3-D environment representing the inside of the body of a young cancer patient. Players can use Roxxi to blast cancer cells and control side effects, and winning the game requires taking chemotherapy drugs and antibiotics, using relaxation techniques, eating food, and keeping up with other types of self-care.

SOURCE: Pediatrics, August 2008.

Source: http://news.yahoo.com/s/nm/20080805/hl_nm/game_cancer_dc;_ylt=Ah1j5t0IB1cChOYyoe4T99Ks0NUE

Nurses and decision support

Peter Murray, on his Release Zero Blog, has published a useful summary and comment piece entitled Nurses' decision making and new technologies: research report related to a major report examining "Factors likely to influence how nurses use new technologies to inform their decision making, in particular through their use of computerised decision support systems (CDSS)."

Peter makes some interesting points about the report and the lack of good evidence - I wonder whether his comments, and the findings of the report will be taken into account?

Patient Opinion mashing up reviews and NHS choices data

Patient Opinion, a not-for-profit social enterprise web site which encourages patients to share their experience of their treatment in the NHS, has become the first organisation to mash up data feeds provided by the Department of Health’s NHS Choices web site, with that already published about local services on Patient Opinion.

This follows the Cabinet Office’s recent release of many government data sets as part of its implementation of the Power of Information Review, published in May 2007 by the Cabinet Office.

This application demonstrates the advantages that can be gained by the use of technology to merge information from various sources to provide something which is greater than "the sum of the parts", and years of campaigning for information which has been paid for by taxpayers to be made more widely available.

The Health Blogosphere: What It Means for Policy Debates and Journalism

Might be of interest?

The Kaiser Family Foundation is sponsoring a discussion about the growing influence of blogs on health news and policy debates. Only in the past few years has the blogosphere become mainstream. In the health policy arena, we now see policymakers, journalists, researchers and interest groups utilizing this new media tool to deliver information to their audiences.
http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2847

Interesting Speech Teletherapy blog

http://tinyeye.wordpress.com/2008/07/23/ashas-position-on-telepractice/