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MEDINFO 77
BOOK REVIEWS
MEDZNFO 77. Edited by D. S. Shires and H. Wolf, North-Holland Company, The Netherlands, 1977. Price: US $95.00.
259 Publishing
This book contains the proceedings of the Second World Conference on Medical Informatics, held in Toronto in August 1977. The size of the book reflects the size of the Conference, containing as it does over 1000 pages, including more than 100 papers which were presented at the Conference, as well as brief papers based on posters displayed in the foyer. In a brief review it is quite impossible to do more than touch on a few of the aspects raised. The text is reproduced by photolithography from manuscripts submitted by the authors themselves, but is technically very well produced and edited, so that despite the very wide range of type-faces and print sizes, there is only a single paper which is really difficult to read. The papers themselves are inevitably a very mixed bag, many of them ‘duty papers’ and some clearly recognisable as having appeared elsewhere. Nevertheless, this massive collection gives an invaluable overview of the state of the art in 1977. If there is a unifying theme to this Conference it is a preoccupation with ‘the alarming rise in health care expenditure in the U.S.A.‘-and in all the other countries sending delegates to the Conference for that matter. My favourite quote is from the paper on Computerised Management of Hospitals in Japan (Mizuno)--‘even though Japan has created the worst system in the world.. . Japan is actually a bit ahead of the U.S.A. . . .‘. This comes from the first session on Financidl Management Systems with papers presented by Russia, Germany, America, Japan, Sweden and Canada. The session on Advanced Comptiter Technology is a little disappointing, except perhaps for a paper from Japan on A Medical Image Transmission System. The remaining papers are either not very advanced or attempts at a very brief description of very complex software projects. The session on Medical Decision Making has a good review paper by Gremy, followed by a series of rather technical papers which are difficult to understand, unless the reader is already familiar with the field. Particularly interesting is one on the ‘Psychological Analysis of Physician Expertise’. In the brief session on Auxilliary Systems, there is a graphic and interesting review by Peter Hammersley, which suffers a little from the fact that ‘the systems described in this paper are all hypothetical’, and a clear and well documented account of Admission and Discharge Systems by Peterson. In the section on Computer-Aided Medical Practice Oriented towards Diagnosis, there are inevitably brief but quite readable descriptions of the major computer systems in this area. The section on Medical Linguistics, describes mainly pilot studies and hence is often unintelligible. One of the more interesting contributions is a paper on interviewing Immigrant Patients in their own language. There is a good deal of
260
BOOK REVIEWS
discussion of the ‘SNOMED’ system of classification, which lends itself particularly to branching tree structures for displaying menus on VDU terminals. The following section is Health Bibliographical Systems-essentially databases, including such well known ones as Medlars-Medline, and with some flying of the flag for less well known systems, for example the French based International Cancernet. Sometimes the organisers must have had difficulties in fitting the papers submitted into categories to provide a proper balance. Thus, for example, after sections on Computer Aided Practice Oriented toward Prognosis, and a section on Planning and Analysis of Health Service Systems, we find in a section on Computer Systems for the G.P., an interesting discussion of the Relational Data Base approach -admittedly in the context of ‘ambulatory care’, (which presumably means what a G.P. does when he drives around in his motor car!). In the section on Preventive Care, a note on ‘Getting child health records “Off the mark”’ by F. H. Livesey, unfortunately fails to contain any hint of the storm which broke over this subject during 1978. There is a very useful but technical section on Computers in Prosthetics and Rehabilitation, and a set of good papers on Image Processing mostly applied to Radiology and Nuclear Medicine, but also in Psychology. There are sections on Mortality and Morbidity Statistics, and a rather general section on Biomedical Research, including an interesting note on the ‘Com. puterised Detection of Doubtful data; A New Method’. There are subsequent sections on the Legal and Political Aspects of Data Protection, Preventive Care and Biomedical Modelling, together with reviews of Clinical Laboratory Data Processing, including Neurophysiology, Cardiology, Clinical Physiology in the Intensive Care Department and discussions of Computer Aided Teaching.
The sessions on Evaluation are of particular interest because evaluation is universally recognised as being both extremely difficult, and also essential particularly in a time when costs are becoming more and more under scrutiny owing to inflationary pressures. Curiously it is only in the comparatively small section on Education of Health Stag, that the word ‘Informatics’ which figures in the title of the Conference, is mentioned at all ! Finally, there is a brief session on Signal Analysis and Pattern Recognition. In summary, this is a well produced compendious volume, but inevitably very patchy in quality and interest. H. R. A.
TOWNSEND
MEDZNFO 77. Edited by D. S. Shires and H. Wolf, North-Holland Company, The Netherlands, 1977. Price: US $95.00.
259 Publishing
This book contains the proceedings of the Second World Conference on Medical Informatics, held in Toronto in August 1977. The size of the book reflects the size of the Conference, containing as it does over 1000 pages, including more than 100 papers which were presented at the Conference, as well as brief papers based on posters displayed in the foyer. In a brief review it is quite impossible to do more than touch on a few of the aspects raised. The text is reproduced by photolithography from manuscripts submitted by the authors themselves, but is technically very well produced and edited, so that despite the very wide range of type-faces and print sizes, there is only a single paper which is really difficult to read. The papers themselves are inevitably a very mixed bag, many of them ‘duty papers’ and some clearly recognisable as having appeared elsewhere. Nevertheless, this massive collection gives an invaluable overview of the state of the art in 1977. If there is a unifying theme to this Conference it is a preoccupation with ‘the alarming rise in health care expenditure in the U.S.A.‘-and in all the other countries sending delegates to the Conference for that matter. My favourite quote is from the paper on Computerised Management of Hospitals in Japan (Mizuno)--‘even though Japan has created the worst system in the world.. . Japan is actually a bit ahead of the U.S.A. . . .‘. This comes from the first session on Financidl Management Systems with papers presented by Russia, Germany, America, Japan, Sweden and Canada. The session on Advanced Comptiter Technology is a little disappointing, except perhaps for a paper from Japan on A Medical Image Transmission System. The remaining papers are either not very advanced or attempts at a very brief description of very complex software projects. The session on Medical Decision Making has a good review paper by Gremy, followed by a series of rather technical papers which are difficult to understand, unless the reader is already familiar with the field. Particularly interesting is one on the ‘Psychological Analysis of Physician Expertise’. In the brief session on Auxilliary Systems, there is a graphic and interesting review by Peter Hammersley, which suffers a little from the fact that ‘the systems described in this paper are all hypothetical’, and a clear and well documented account of Admission and Discharge Systems by Peterson. In the section on Computer-Aided Medical Practice Oriented towards Diagnosis, there are inevitably brief but quite readable descriptions of the major computer systems in this area. The section on Medical Linguistics, describes mainly pilot studies and hence is often unintelligible. One of the more interesting contributions is a paper on interviewing Immigrant Patients in their own language. There is a good deal of
260
BOOK REVIEWS
discussion of the ‘SNOMED’ system of classification, which lends itself particularly to branching tree structures for displaying menus on VDU terminals. The following section is Health Bibliographical Systems-essentially databases, including such well known ones as Medlars-Medline, and with some flying of the flag for less well known systems, for example the French based International Cancernet. Sometimes the organisers must have had difficulties in fitting the papers submitted into categories to provide a proper balance. Thus, for example, after sections on Computer Aided Practice Oriented toward Prognosis, and a section on Planning and Analysis of Health Service Systems, we find in a section on Computer Systems for the G.P., an interesting discussion of the Relational Data Base approach -admittedly in the context of ‘ambulatory care’, (which presumably means what a G.P. does when he drives around in his motor car!). In the section on Preventive Care, a note on ‘Getting child health records “Off the mark”’ by F. H. Livesey, unfortunately fails to contain any hint of the storm which broke over this subject during 1978. There is a very useful but technical section on Computers in Prosthetics and Rehabilitation, and a set of good papers on Image Processing mostly applied to Radiology and Nuclear Medicine, but also in Psychology. There are sections on Mortality and Morbidity Statistics, and a rather general section on Biomedical Research, including an interesting note on the ‘Com. puterised Detection of Doubtful data; A New Method’. There are subsequent sections on the Legal and Political Aspects of Data Protection, Preventive Care and Biomedical Modelling, together with reviews of Clinical Laboratory Data Processing, including Neurophysiology, Cardiology, Clinical Physiology in the Intensive Care Department and discussions of Computer Aided Teaching.
The sessions on Evaluation are of particular interest because evaluation is universally recognised as being both extremely difficult, and also essential particularly in a time when costs are becoming more and more under scrutiny owing to inflationary pressures. Curiously it is only in the comparatively small section on Education of Health Stag, that the word ‘Informatics’ which figures in the title of the Conference, is mentioned at all ! Finally, there is a brief session on Signal Analysis and Pattern Recognition. In summary, this is a well produced compendious volume, but inevitably very patchy in quality and interest. H. R. A.
TOWNSEND