News Roundup [abridged Versions Appear In The Paper Journal]

News roundup [abridged versions appear in the paper journal]

BMJ 2004; 328 doi: (Published 25 March 2004) Cite this as: BMJ 2004;328:728

Online accessible database of clinical cases of unknown origin

Dear Sir,

the iniziative is very interesting, but we think that not only
oncology could benefit from such a project.

Many patients suffer from pathologies with a difficult nosographic
classification. This fact may cause these patients a damage which can
sometimes lead to death without a certain diagnosis. Autopsy does not
always help to define the etiopathogenesis of the illness; furthermore,
these results are rarely published. The final consequence is often a
medical record buried in an archive from which data may only be retrieved
with difficulty. In order to prevent the dispersion of such information we
think that the creation of a Web accessible database filled by the
international medico-scientific community with clinical cases of unknown
or uncertain nosographic origin could lead to the identification of new
clinical entities or new variants of known diseases.

The NCRI's initiative and our project, that we call ODUCC – Online
Database of Unknown Clinical Cases, remind us of the concept of
‘collective intelligence’, a suggestive theory developed by P. Levy which
aims at establishing a cyberspace anthropology that finds its vital
substance in the advent of the Internet: “Nobody knows everything.
Everyone knows something. Knowledge resides in humanity.” (1)

The introduction of Information Technologies (IT) into Economics has
favoured the emergence of new theories related to Knowledge Management
(KM) that can be transferred to the health care sector. Following one of
the most reliable theories in the economic field, the intellectual capital
present within an organization can be subdivided into human capital,
organizational capital and client capital. Human capital can be defined as
the knowledge that individuals acquire in order to produce goods, services
or ideas in circumstances related to their activities. Organizational
capital is that which creates human capital and that can be used and
reused in order to create value. Client capital is the organization’s
capacity to loyalize its clients. (2)

The initiative that you mention and the implementation of our
proposal would impede the dissipation of human capital by realizing a
permanent knowledge-base that can be re-evaluated and re-utilized by the
whole international scientific community. Its realization would also allow
the organizational capital to be preserved and increased over time by
making possible the creation of further human capital, so realizing a
virtuous cycle of knowledge construction as asset for the medico-
scientific community. (3) The final aim of the project is the increase of
the client capital, which, in the health world, means the possibility of
treating, and therefore of loyalizing, a larger number of patient-clients.

Although the implementation of the ODUCC project is far from simple
and requires a multidisciplinary approach, the current progress of IT, KM
and Data Mining, effective in carrying out data cross-correlations to
determine analogies among apparently un-correlated clinical cases, could
lead to its realization.


1) Levy P. L’intelligence collective: pur une antropologie du
cyberspace. Paris, La Découverte, 1997.

2) Stewart TA. Intellectual Capital: the new wealth of organizations.
London, Nicholas Brealey Publishing, 1997.

3) Nonaka I, Takeuchi H. The Knowledge-creating Company. London,
Oxford University Press, 1995.

Competing interests:
None declared

Competing interests: No competing interests

20 April 2004
Marco Masoni
Maria Renza Guelfi, Antonio Conti, Andrea A. Conti, Gian Franco Gensini
Presidenza Facoltà di Medicina e Chirurgia, Viale Morgagni 85, I-50134, Firenze, Italy