Daily Archives: January 28, 2017

Alternatives to the Amyloid Cascade Hypothesis

Stylised Diagram of the Hippocampus - Frank Gaillard

Diagram showing Hippocampus, an area affected by Alzheimer’s Disease (credits Appendix A)

In his paper on the Amyloid Cascade Hypothesis, Professor Hardy references two alternative hypotheses which are worth bearing in mind

(a) The Presenilin inhibition hypothesis. The Presenilins genes have been clearly linked to Alzheimer’s Disease and so understanding of the function of their phenotypes (the translation of the gene into molecule product) is important.  The Presenilin inhibition hypothesis states that the Presenilins, as subunits of an enzyme are inhibited in their actions. Professor Hardy identifies some critiques of this model.

(b) The Double Hit hypothesis states that as well as changes in the Amyloid Precursor Protein there is a second independent step which leads to changes in the tau protein in late-onset disease. Again Professor Hardy identifies difficulties with this hypothesis.

Appendix A – Credits

Picture by FG Designs. Creative Commons License.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

A Literature Review of 40 Years of SNOMED

reviewbysvklimkin

Cornet and de Keizer have written an article on SNOMED ‘40 years of SNOMED: A literature review‘ under a Creative Commons 2.0 license. The article was written in 2008 and SNOP (the SNOMED-RT and SNOMED-CT precursor) was created in 1965 so they are referencing just over 40 years of literature.

This a nice article to gain an overview of the field.  After excluding irrelevant papers

The remaining 250 Medline indexed papers on SNOMED have been published in 80 different journals‘.

and

The first paper on SNOP having an abstract in PubMed was published in 1975

and

SNOMED was the main object of study in 163 papers‘.

The results however are slightly disappointing.

Fewer studies are available on the usage of SNOMED in clinical practice. The use of SNOMED as described in these papers largely involves coding information and retrieval/aggregation based on SNOMED codes

and putting this into context

Literature gives no indication of the use of SNOMED for direct care purposes such as decision support. As decision support relies on formal representation, which was introduced in SNOMED RT, studies investigating this aspect can now be performed

So in summary, the authors have reviewed the literature and identified a reasonably large number of papers. On closer examination, many of these papers do not answer questions about how SNOMED versions are used in practice nor do they focus on how the SNOMED architecture can be used to support clinicians in decision making.

The authors clearly identify a way forwards.

Appendix A – Other Posts in the Series on Health Information Exchanges

Arizona Statewide Health Information Exchange

A History of The Health Information Exchange in Pennsylvania

The Arkansas Health Information Exchange – SHARE

The California Health Information Exchange – Cal Index

Creating a Health Information Exchange in Arizona

Health Information Exchanges

Health Information Exchanges and Chronic Conditions

HIPPA and Health Information Exchanges

ICD-11 and SNOMED CT®

ICD-SNOMED-CT® Harmonisation

Körner Data and SNOMED: A Snapshot from 1988

Mapping ICD 9 (or 10) to SNOMED CT®

Over 1 Million Relationships: SNOMED CT ®

Standardisation of Health Information Technology in New Zealand

Why Do We Need Electronic Record Systems to Talk to Each Other

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.