Mohammad Al-Ubaydli’s blog

I am one of Courvoisier’s Future 500

Posted in Awards, People / organisations by Dr Mohammad Al-Ubaydli on November 30, 2008

I have been accepted as one of “The Future 500” for Courvoisier’s competition because of the work I am doing at UCL medical school and Patients Know Best. The full list of 500 is published in Today’s Observer newspaper and on Thursday I get to meet them in London.

Launched in 2007, Courvoisier The Future 500 is an exclusive private members network for rising stars across the UK. It is your own private rolodex linking you with talent that ranges from the arts to business.

Selected by a panel of inspirational judges, all members have achieved significant success in their field – be it as an artist, businessman, entrepreneur or activist.

Courvoisier has created a platform for Britain’s brightest talents to connect, share their vision, inspire one another and ultimately collaborate to achieve even greater success…

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Bahrain tops Cochrane league table in the middle east

Posted in Arabs and Arabic, Medicine, People / organisations by Dr Mohammad Al-Ubaydli on November 29, 2008

By October 2008 Bahrain’s Cochrane center had published 10 evidence-based medicine reviews, topping the output of Egypt (8), Pakistan (8), Iran (6) and Saudi Arabia (4). In fact, in the Middle East, only Israel has produced more reviews, with 24 published to date. But Cochrane Bahrain only started publishing in 2004 and with 4 reviews published this year to Israel’s 2 I have high hopes for the future.

Why is this important? Cochrane reviews themselves are important because they represent the medical profession’s consensus evaluation of what treatments work and what other treatments to avoid. Its authors look at all existing research for each disease and treatment. The output of this international body of clinical scientists improves patient care every day.

Bahrain’s performance is important because of what it says about the country’s integration with rigorous international scientific work. But its relative performance to that of its wealthier and larger neighbours is what impresses me the most. If you take reviews per capita, Bahrain manages to top even the output of Israel.

I hope that the Bahraini government increases its funding of Cochrane Bahrain, the only such center in the Arab world and one which is becoming a model for other centers around the world.

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Using Ajax for Cleaner Software

Posted in Articles, Medicine, My publications, Technology by Dr Mohammad Al-Ubaydli on November 22, 2008

Published in UK Health Informatics Today Autumn 2008 edition.
Mohammad Al-Ubaydli, MB BChir Cantab
Founder, Patients Know Best – www.patientsknowbest.com

Ajax is a new web programming technology that solves an old conflict between CIOs and clinicians and eases the use of innovative devices in large organizations.

For IT staff, managing a single server with web browser-based clients is much easier than installing client software on every single computer that clinicians use. But for clinicians, web browser client software is too slow and simple: only clients installed locally on a Windows machine provide the responsive and rich user interface needed for consultations with patients.

Traditionally, this conflict was settled in favour of the clinician. Staff from the IT department had the Sisyphean task of installing software onto every computer, and no sooner had they completed one round before the next one began with a newer version of the software. Furthermore, local software stored data locally, requiring strong security protocols on each computer.

Ajax can end this cycle. It allows web browser-based clients that are fast and powerful in their response to server software, which the IT department may now focus on managing. Ajax is an acronym for Asynchronous JavaScript and XML. XML is the data that is exchanged between client and server, and JavaScript is the browser-based programming language that is powerful enough to support complex user interfaces.

Asynchronous is the clever and recent innovation; it allows the browser to only update the part of the screen that is relevant to the user’s most recent interaction. In other words, rather than redrawing the entire page in response to a user’s click, the web browser can redraw only the relevant part in an Ajax-driven page. The rest of the page can continue to function asynchronously as the XML arrives for the part that the JavaScript is changing.

The release of Google Maps in 2005 was a watershed event in showing the world what Ajax could do. The technology had been in place since 1999 when Microsoft introduced the XMLHttpRequest programming object for asynchronous communication in Internet Explorer, and soon afterwards Mozilla and Opera followed suit with support in their own web browsers. However, few sites made use of the technology and few users understood its significance. But with Ajax, maps on Google’s website loaded quickly and scrolled even more quickly. By contrast, existing map sites had to reload the entire page with each click by the user.

Slowly, mainstream healthcare software developers are integrating this approach into their products. Naturally, it is startups that are first to do so, companies like Tolven Health and Net.Orange. From my conversations with the executives of larger, more entrenched companies, they too are making the switch.

Just as significantly, it is easier to deploy innovative devices because most of them support Ajax in their web browser. Apple’s iPhone, for example, was notorious among developers because the first version only accepted Ajax software. The web browsers of most new smartphones also support Ajax.

This means that clinicians can use operating systems other than Microsoft Windows, something that has so far held back deployments in the NHS.

The switch to Ajax does have security implications. On the one hand, Ajax-powered thin client software is more secure than locally installed thick-client software because the data is only stored on one central server for which security can be maximized. But the ubiquity of the web means developers must abandon previously tolerated but inherently insecure practices.

Most significantly, state data must only be stored on the server, not the clients. Examples of state data include the fact that the end user is a doctor or the identification number of the patient they are looking; these must be maintained centrally even if they are temporarily displayed on a local web browser. Programs that do not have this architecture leave themselves open to manipulation at the local computer level. For example, a malicious end user may easily identify and manipulate their state data by editing the local cache file to identify him- or herself as a doctor.

Such vulnerabilities were always possible with old, thick-client computing models. Security through obscurity made this tolerable because each program had its own security model and fragmented market share. By contrast, the web is much more transparent and information about vulnerabilities is shared
quickly and comprehensively.

If you are working with an experienced programmer who is new to Ajax, the risk is that such a programmer would assume that programming in the web environment is the same as working with Windows. A simple explanation of this vulnerability is typically enough to enable a change in programming habits.

Such changes in habits are well worth the effort. The end results are software that is cleaner to deploy and manage as well as increases in the productivity of IT staff –things from which we can all benefit.

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HealthCamp UK 2008

Posted in Medicine, People / organisations, Technology by Dr Mohammad Al-Ubaydli on November 18, 2008

Want to know what happens to this balloon at HealthCamp UK 2008?

paul-brannigan

Read all about it on the Patients Know Best blog page.

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BabelMeSH and PICO Linguist in Arabic

Posted in Arabs and Arabic, Medicine, My publications, Peer-reviewed papers, Technology by Dr Mohammad Al-Ubaydli on November 10, 2008

For AMIA 2008, Dr. Paul Fontelo and colleagues presented this poster.

BabelMeSH is a multilanguage search for MEDLINE/PubMed. We created a database of Arabic translations of MeSH terms and other medical terms using MySQL and developed a Web interface for searching MEDLINE/PubMed in Arabic. We evaluated the accuracy of BabelMeSH using a list of medical terms from BMJ Clinical Evidence.  The accuracy was 58% (machine scoring) and 65% human review.) The result obtained may be explained by variations in expressing medical terms in Arabic.

My name is down as one of the authors but my contribution is minor relative to those of the others, especially Paul’s, as he has created and championed BabelMeSH for some time now. At any rate, I highly recommend the Arabic language BabelMeSH.

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Now that you can believe in change, what are you going to do?

Posted in Politics, Society by Dr Mohammad Al-Ubaydli on November 6, 2008

I witnessed a wonderful thing on Tuesday with the election of Obama. America’s brilliance is not presidency, but process. It is America’s ability to change. No other nation does this so well and for that it can justly be proud.

Jesse Jackson crying

Read this passage[1] below from the diary of Henry Seward as he journeyed with his wife through Virginia in 1835 and saw ten black children:

Ten naked little boys, between six and twelve years old, tied together, two and two, by their wrists, were all fastened to a long rope, and followed by a tall man, gaunt white man, who, with his long lash, whipped up the sad and weary little procession, drove it to the horse-trough to drink, and thence to a shed, where they lay down on the ground and sobbed and moaned themselves to sleep.

On November 5th 2008, Virginia was one of the states that voted for Obama as president. America was one of the worst countries in the world when it came to treating with dignity those of African descent. It still has a long way to go. We all do. But on Tuesday its citizens took leadership by giving leadership to an African American.

The USA has an extraordinary infrastructure for change. It is well worth listening to Gavin Newsom discuss how he changed San Francisco law to allow gay marriage. America was one of the least progressive in the West for the rights of homosexuals, but individual states are beginning the change. Hearing Robert Klein talk about how Californians voted to provide $3 billion worth of funding for stem cell research taught me about so many initiatives that were not discussed in the press. America had one of the worst policies for stem cell research, but California’s initiative alone meant the USA had world leadership in government funding.

But it is not just that California made progressive choices that I liked. After all, they elected Schwarzenegger, who I hate. Rather, listen to the speakers discuss the opposition they received – strong, vociferous, and passionate – and how they overcame it – with more passion from more people.

Obama captures that passion. “Change we can believe in”, he said, and “Yes we can”, he chanted. And along with millions of Americans he achieved what millions of non-Americans thought was impossible.

So. What are we non-Americans going to do? Will a European country give her highest office to a citizen of color? Perhaps the UK, as a Bahraini doctor and I were discussing on Tuesday, will elect and British Asian. And will Bahrain do something similar? Or more relevantly, will Arab voters be able to vote outside of their tribe or sect? Will we able to vote for the common good and the higher cause?

More immediately, what can we do today? In the UK, there is a crisis of politics as the rich are too scared to give any money to parties, the middle classes refuse to pay, and the working classes occasionally funnel money through the few remaining unions. The major parties are running on deficits and teetering on bankruptcy. And in Bahrain, most of the non-religious candidates have been overwhelmed and over-run. The results in the UK and Bahrain are not the moral majority at work but the apathetic majority failing to work.

Obama has shown that citizens paying $5 can make a $500 million difference. No matter how bad you think your local party or representative is, look at your options, pick the best, and pay them money so they can work better. Turn up to their meetings. Explain to them what you want and help them explain to others what needs to be done.  Yes. We. Can.


[1] I read this quote in the book Team of Rivals: The political genius of Abraham Lincoln. The book describes how, Lincoln, another unlikely lawyer from Illinois became president, running on an anti-slavery platform. It also describes how this brilliant man was so brilliant that he felt confident enough to hire all three of his election rivals (including Henry Seward) into his new cabinet and to use them to steer the nation through difficult times. I wonder who Obama hires.