bluuebunny/crossref_metadata_2025 huggingface dataset:
A Procedure for Comparing Groups of Time-Dependent Measurements
Authors: Prestele H. , Gaus W. , Horbach L.
Published: March 2018

A three stop procedure is proposed for the comparison of groups, where for each individual a process is investigated on the basis of repeated measurements (e.g. 3 up to about 15 time points).

1. A natural cubic spline function is fitted to the time-dependent measurements of each individual. A cubic spline is a function which is composed of piecewise polynomials, continuous up to and including second derivatives; it has a minimal »curvature«, so that a »smooth« curve is generated.

2. For each individual the value of a problem-oriented parameter is estimated from the spline function.

3. The values of the problem-oriented parameter are evaluated with standard, not necessarily longitudinal methods for estimating and hypothesis testing.

The proposed procedure requires neither an equal number of measurements for each individual, nor the same time points of measurement for all individuals, nor equal length of the time intervals. Splines can be fitted to very different patterns of curves. They can be used for a more exact calculation of parameters adequate to the problem concerned. The procedure necessitates the use of a computer; programs are available and do not demand excessive arithmetic precision and computing time.
Reliability Analysis of Medical Imaging Systems Based on Observer Studies
Authors: Goin J. E. , Cook L. T. , Fritz S. L.
Published: March 2018

Statistical methodology is presented which can be used in analyzing the reliability of diagnostic imaging systems in differential diagnosis situations. A reliability criterion is developed along with formulas for estimating its large sample variance. Several hypothetical examples are given to illustrate the methodology.
The Diagnostic Process with Special Reference to Errors
Authors: Good I. J. , Card W. I.
Published: March 2018

An analysis is made of the losses due to errors in the diagnostic process. The basic assumption is that the doctor should try to maximize expected utility, where the utility allows both for the health of the patient and for »costs« of various kinds. This assumption leads to the view that in general the doctor should make use of a diagnostic search tree. Owing to the difficulty of estimating utilities and of back-tracking in a large tree it is convenient for him to use substitutes for utility, called quasi-utilities, such as mean information transfer or expected weight of evidence. After listing a number of such quasi-utilities, the effect on their expectations due to error is considered. The losses can be larger than might have been supposed. Much of the analysis could also be applied to scientific problems other than to medical diagnosis.
Studies on Thalidomide as a Cause of Congenital Malformations
Authors: Knapp K. , Lenz W.
Published: March 2018

In 1961 an increase in certain congenital malformations was noticed in various parts of the Federal Republic of Germany. From the outset, it seemed very probable that a single cause was responsible, since, although these malformations varied, they appeared to belong to one and the same syndrome. For general reasons, such causes as radioactivity, contraceptives, attempted abortions or virus diseases did not provide an acceptable explanation. The epidemiology was, however, suggestive of some chemical substance taken orally.

After thalidomide had been indicated in several histories, suspicion of that drug was aroused and, within one week, intake of it could be proved or was found to be very likely in 17 out of 20 cases, while in the remaining cases it could not be excluded. Though this first result was highly significant, we were at first reluctant to incriminate thalidomide definitely, because there was still some doubt about the reliability of the histories. But within a few weeks, the thalidomide aetiology received support from many sources. Specific studies on limited material are sometimes superior to extensive, broadly planned investigations.
Krebs – zum Fürchten!?
Authors: Schuler U. , Hornemann B.
Published: March 2018

Psychosoziale und psychoonkologische Aspekte finden mittlerweile im Rahmen einer ganzheitlichen Behandlung von Tumor-Patienten, welche körperliche, psychische und soziale Faktoren im Sinne des bio-psychosozialen Verständnisses gleichgewichtig einbezieht, zunehmend Beachtung.

Dieser Beitrag gibt einen Überblick über die psychische Belastung sowie Verteilung von subsyndromalen und Störungsbildern bei Krebs-Patienten mit dem Schwerpunkt Progressionsangst und gibt anhand von Fallvignetten exemplarisch Einblick in häufig thematisierte Probleme im Umgang mit Angst.
Palliativversorgung
Authors: Gramm J.
Published: March 2018

Im Artikel wird der Stand der Palliativversorgung in Deutschland umrissen, wobei ein besonderes Augenmerk auf psychosoziale Aspekte gerichtet wird. Neben Neuerungen durch das Hospiz- und Palliativgesetz (HPG) oder das Konzept des Advance Care Planning (ACP) wird auf Entwicklungen bei Nichttumorerkrankungen und der pädiatrischen Palliativversorgung eingegangen. Auswirkungen des Sterbehilfegesetzes auf die Palliativversorgung werden diskutiert. Kritisch wird die Umsetzung von Multiprofessionalität betrachtet, die zwar innerhalb der Fachgesellschaft kultiviert wird, in der Versorgungsrealität jedoch hinter den Ansprüchen zurückbleibt.
Trends in der ambulanten Versorgung
Authors: Rosenberger C.
Published: March 2018

Die ambulante psychoonkologische Versorgung von Krebs-Patienten hat sich in den vergangenen zwei Jahrzehnten zu einem fest integrierten Bestandteil der psychosozialen Betreuung von Tumor-Patienten entwickelt. Ambulante Versorgungsmöglichkeiten umfassen psychosoziale Krebsberatungsstellen, Institutsund Hochschulambulanzen sowie psychotherapeutische Versorgung. Das Angebotsspektrum beinhaltet bedarfsgerechte, supportive und interdisziplinär ausgerichtete Beratung bis hin zur Psychotherapie. Wesentliche Ziele sind die Stabilisierung der Patienten, Verminderung sozialer Belastungen sowie die Verbesserung respektive der Erhalt von Lebensqualität. Inhaltliche Schwerpunktentwicklungen lassen sich beispielsweise für die Bereiche junge Erwachsene, schwerstkranke und sterbende Patienten, die Versorgung von Angehörigen oder E-Health definieren.

Darüber hinaus zeigen sich strukturelle Verbesserungen der ambulanten Versorgung. Die Entwicklung konformer Qualitätsstandards soll helfen, das Schnittstellenmanagement zu optimieren, um eine komplikationslose Orientierung zwischen den Versorgungsbereichen zu gewährleisten. Insgesamt betonen transsektorale Ansätze die Verbesserung der psychosozialen Versorgung onkologischer Patienten, um ein flächendeckendes Netz qualifizierter, interdisziplinärer Einrichtungen und Angebote zu schaffen.
Perspektive der Niedergelassenen Psychotherapeuten in der Psychoonkologie
Authors: Prinz-Zaiss M.
Published: March 2018

Der größte Teil der Behandlung von Krebs-Patienten findet ambulant statt. Aus diesem Grunde wird auch die psychoonkologische Behandlung im ambulanten Setting immer wichtiger. Für die psychoonkologische Behandlung durch niedergelassene psychoonkologisch tätige Psychotherapeuten bedarf es besonderer Anforderungen. Diese Anforderungen werden von vielen psychoonkologisch tätigen Psychotherapeuten im niedergelassenen Setting bereits sehr umfänglich geleistet, obwohl eine adäquate Finanzierung noch nicht gewährleistet ist. Daher braucht es dringend eine Berücksichtigung der Spezifika der ambulanten psychoonkologischen Behandlung und eine Einbindung der Psychoonkologie in die Gebührenstruktur.
Zurück in die Zukunft
Authors: Köhler M.
Published: March 2018

Adoleszente und junge Erwachsene (Adolescents and Young Adults, AYA) mit Krebs stellen mit einer Inzidenz von 15 000 Fällen pro Jahr in ihrer Peer Group eine Ausnahme dar. Mittlerweile liegen eine Reihe forschungsbasierter Befunde vor, welche die klinische Bedeutsamkeit des umschriebenen Altersintervalls zwischen dem 15. und 39. Lebensjahr im Vergleich zu Kindern und älteren Erwachsenen kennzeichnen. Darüber hinaus stehen das körperliche und seelische Erleben sowie die individuelle Bewältigung der existenziellen Abhängigkeiten durch den Krebs und die Krebsbehandlung in einem deutlichen Gegensatz zum Charakter der Lebenssituation eines gesund aufwachsenden jungen Erwachsenen. Eine Evidenz zur forschungsbasierten Entwicklung geprüfter Beurteilungsverfahren, Erhebung psychosozialer Beanspruchungen und Wirksamkeitsprüfung personalisierter Interventionsansätze ist bislang allerdings kaum gegeben. Die Anwendung entwicklungspsychologischer Konzepte und familienbasierter Ansätze kann ein professionelles Verständnis im Umgang mit den AYAKrebspatienten und deren existenziell bedrohlichen Herausforderungen fördern.
Existenzielles Leiden und sinnbezogene Interventionen
Authors: Schulz-Kindermann F.
Published: March 2018

Die Befindlichkeit Schwerstkranker wird üblicherweise im Rahmen der multidimensionalen gesundheitsbezogenen Lebensqualität beschrieben. Diese erfasst jedoch nicht Aspekte existenziellen Leidens, wie sie z. B. Eric Cassell definierte. In den vergangenen Jahren entstand eine Vielzahl empirischer Arbeiten zum Erleben von und zur Intervention bei umfassendem Leiden. Mittlerweile konnte überzeugende Evidenz sowohl zur Konzeption von “Leiden” als auch zu dessen Linderung mithilfe psychotherapeutischer Interventionen vorgelegt werden. Sinnorientierte Therapieverfahren liegen sowohl als Einzelals auch als Gruppeninterventionen vor. Ein besonders vielversprechender Ansatz ist die einzeltherapeutische Kurzzeitintervention “Managing Cancer And Living Meaningfully CALM”, deren Prüfung zurzeit in mehreren internationalen RCTs erfolgt.
Medical Informatics and Telemedicine at the Politecnico di Milano
Authors: Pinciroli F.
Published: March 2018

Research and training programs in Medical Informatics and Telemedicine offered at the Politecnico di Milano are summarized. The educational pathways refer to the programs of: the (5-years) Laurea Degree, the (3-years) Diploma Universitario Degree, the post-Laurea (3-years) Doctoral Degree, the (1-year) Master’s Degree, and a Continuing Education Program. The research programs focus on databases and extend to optimization of the ‘Visible Human Dataset-Milano Mirror Site’ services. Additional activities relate to standardization at both the Italian and European levels, and to cooperation with hospitals and manufacturers.
Biomedical Informatics for Sustainable Health Systems. Editorial
Authors: Geissbuhler A. , Haux R. , Kulikowski C.
Published: March 2018

To provide an editorial introduction to the 2007 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors.

A brief overview of the main theme of “Biomedical Informatics for Sustainable Health Systems”, and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2007 IMIA Yearbook.

In resonance with the MEDINFO 2007 conference theme “Building Sustainable Health Systems”, this issue of the Yearbook examines the role of healthcare informatics in helping face the challenge of sustainability for our health systems, through a number of original contributions, and selected papers published during the past 12 months.

This timely topic, along with the review and surveys on the main streams of research in medical informatics, offer a complete overview of the development of our field. This current state of affairs is put in the perspective of the fortieth birthday of IMIA, reflecting on the past achievements of the Association, and outlining its potential to continue shaping the world of medical informatics.
Sustainable Health Care Systems
Authors: Lovis C. ,   Managing Editor for the IMIA Yearbook Section on Sustainable Health Care Systems
Published: March 2018

To summarize major current trends and research in the field of sustainable health care systems.

Synopsis of the articles selected for the IMIA Yearbook 2007.

Four excellent articles, four nations and four international peer-reviewed journals representing some important aspects of the research in this field have been selected for the IMIA Yearbook 2007. The first paper focuses on health care spending and use of information technologies in OECD countries; the second paper presents an original model and framework to describe and evaluate the risks and safety of e-health systems; the third paper, a two-part paper, reviews several models to support lifetime personal health records and proposes some original approach to this problem. Finally, the last paper presents the evaluation of feasibility, potential, problems and risks of an Internet-based telemedicine network in developing countries of Africa and challenges and opportunities that IT can bring to developing countries.

Sustainability in health care and information technologies is a young but fast growing domain. This new section of the yearbook is promised to a rich future as illustrated in the variety and the importance of the challenges addressed by this 2007 selection.
Section 4: Sensor, Signal and Imaging Informatics: An Overview of Wearable and Implantable Medical Sensors
Authors: Konstantas D.
Published: March 2018

To give a brief, introductory overview of current developments and trends in miniaturized medical sensors which will be informative to non-specialists in the field.

Summary of the different types of wearable and implantable sensors with examples of current state-of-the-art devices and systems used in medical applications.

After more than a decade of intensive research and development around the world, miniaturized medical sensors are becoming commercially available, allowing increasingly rapid collection of large-scale medical data and its wireless transmission to health care centers. However, most sensor systems are not yet in routine use and still restricted to specialized sites, undergoing validation trials, mostly within research laboratories.

Challenges to routine adoption of medical sensor systems often arise from a combination of lack of awareness of the technology among many medical practitioners, technological limitations of the device systems (artifacts and noise resulting from problems in garment fit or device implantation), and open issues of evaluation and validation for the very broad scope of conditions in home-care and ambient environments over which medical sensors need to operate for routine, reliable, practical use.
Sensors, Medical Image and Signal Processing
Authors: Westphal R. ,   Managing Editor for the IMIA Yearbook Section on Sensor, Signal and Imaging Informatics
Published: March 2018

To summarize current excellent research in the field of sensor, signal and imaging informatics.

Synopsis of the articles selected for the IMIA Yearbook 2007.

The selection process for this yearbook section “Sensor, signal and imaging informatics” results in five excellent articles, representing research in four different nations. Papers from the fields of brain machine interfaces, sound surveillance in telemonitoring, soft tissue modeling, and body sensors have been selected.

The selection for this yearbook section can only reflect a small portion of the worldwide copious work in the field of sensors, signal and image processing with applications in medical informatics. However, the selected papers demonstrate, how advances in this field may positively affect future patient care.
Section 5: Decision Support, Knowledge Representation and Management: Free and Open Source Enabling Technologies for Patient-Centric, Guideline-Based Clinical Decision Support: A Survey
Authors: Leong T. Y. , Kaiser K. , Miksch S.
Published: March 2018

Guideline-based clinical decision support is an emerging paradigm to help reduce error, lower cost, and improve quality in evidence-based medicine. The free and open source (FOS) approach is a promising alternative for delivering cost-effective information technology (IT) solutions in health care. In this paper, we survey the current FOS enabling technologies for patient-centric, guideline-based care, and discuss the current trends and future directions of their role in clinical decision support.

We searched PubMed, major biomedical informatics websites, and the web in general for papers and links related to FOS health care IT systems. We also relied on our background and knowledge for specific subtopics. We focused on the functionalities of guideline modeling tools, and briefly examined the supporting technologies for terminology, data exchange and electronic health record (EHR) standards.

To effectively support patient-centric, guideline-based care, the computerized guidelines and protocols need to be integrated with existing clinical information systems or EHRs. Technologies that enable such integration should be accessible, interoperable, and scalable. A plethora of FOS tools and techniques for supporting different knowledge management and quality assurance tasks involved are available. Many challenges, however, remain in their implementation.

There are active and growing trends of deploying FOS enabling technologies for integrating clinical guidelines, protocols, and pathways into the main care processes. The continuing development and maturation of such technologies are likely to make increasingly significant contributions to patient-centric, guidelinebased clinical decision support.
Biomedical Informatics Training at the University of Wisconsin-Madison
Authors: Pape L. , Page C. D. , Shavlik J. W. , Phillips G. N. , Brennan P. , Severtson D. J.
Published: March 2018

The purpose of this paper is to describe biomedical informatics training at the University of Wisconsin-Madison (UW Madison).

We reviewed biomedical informatics training, research, and faculty/trainee participation at UW-Madison.

There are three primary approaches to training 1) The Computation & Informatics in Biology & Medicine Training Program, 2) formal biomedical informatics offered by various campus departments, and 3) individualized programs. Training at UW-Madison embodies the features of effective biomedical informatics training recommended by the American College of Medical Informatics that were delineated as: 1) curricula that integrate experiences among computational sciences and application domains, 2) individualized and interdisciplinary cross training among adiverse cadre of trainees to develop key competencies that he or she does not initially possess, 3) participation in research and development activities, and 4) exposure to a range of basic informational and computational sciences.

The three biomedical informatics training approaches immerse students in multidisciplinary training and education that is supported by faculty trainers who participate in collaborative research across departments. Training is provided across a range of disciplines and available at different training stages. Biomedical informatics training at UW-Madison illustrates how a large research University, with multiple departments across biological, computational and health fields, can provide effective and productive biomedical informatics training via multiple bioinformatics training approaches.
IMIA Presidential Retrospectives on Medical Informatics
Authors: Ball M.J. , van Bemmel J.H. , Kaihara S.
Published: March 2018

The International Medical Informatics Association (IMIA) celebrates its 40th anniversary in 2007. Three IMIA Presidents from three continents were invited to give their personal retrospectives on the world’s largest organization in medical informatics.

Reports, based on personal reminiscenses.

IMIA was established in the 1970s by individuals already active in medical informatics in their home countries. It has evolved into a strong international organization based on the mutual trust and friendship of members throughout the world. IMIA serves as a ‘bridge’ organization both within an inter organizational context and within the broader context of IMIA’s professional aims. Being a driving motor for successive waves of change in the field, IMIA helps to significantly improve health care by building bridges across regions, disciplines, and professions, to bridge the distances around the globe.

Geissbuhler A, Haux R, Kulikowski C, editors. IMIA Yearbook of Medical Informatics 2007.
IMIA: Coalescing Medical Informatics Worldwide for 40 Years
Authors: Kulikowski C. A.
Published: March 2018

To summarize and highlight the role of IMIA in the past 40 years in becoming the international professional organization that brings together researchers, practitioners, and educators in the field of medical informatics, and more broadly biomedical, nursing, and health informatics

Outlining developments of medical informatics related to IMIA from 1967 to 2007 in a time-line and comparative topic and geographical distribution analyses over selected MEDINFOs from 1980 and selected Yearbooks from 1992 onwards. This illustrates how IMIA, through the global reach of its activities, has helped advance the science and development of informatics across the entire spectrum of biomedical and health care research, education, and practice.

The contribution of IMIA over the past 40 years has been to sponsor and coordinate international conferences and promote interchange and collaborations in biomedical and health informatics by linking national and regional societies, organizing meetings, high quality publications, and working groups. These have helped the coalescing of the discipline worldwide, promoting full participation and a broad interdisciplinary scope that fulfills the hopes of the pioneers in the field.
IMIA: The Global Informatics Perspective for Good Health
Authors: Haux Reinhold , Reichertz Peter ,   (President of IMIA 2007-2010)
Published: March 2018

Objective:
To report on IMIA, the International Medical Informatics Association, and on what has been achieved in the period 2007-2010.

Method:
Summarizing IMIA’s activities, discussions and decisions, in particular with respect to its Board and General Assembly meetings; looking at recent progress of biomedical and health informatics through IMIA’s Yearbook.

Results:
Over the last three years, decisions have been made and steps have been initiated which will lead to significant changes for IMIA. In addition to its continuing activities in being involved (1) in organizing conferences, with Medinfo 2010 as this year’s highlight, (2) in publication, and (3) in working/special interest group activities, new steps were (4) extending IMIA’s conference portfolio, leading to a biennial Medinfo cycle from 2015 on, (5) launching the journal Applied Clinical Informatics as a bridge from informatics theory to applications, (6) endorsing and publishing White Papers, such as the revised IMIA recommendations on education, (7) strengthening ties with WHO, and (8) establishing the Middle East Association of Health Informatics (MEAHI) as an IMIA region in order to start formalising regional organization and health and biomedical informatics activities in the Middle East. Last, but not least, IMIA’s internal organization is being adapted in order to better meet future demands.

Conclusions:
Finding the right balance between continuity and transition, in order to appropriately support, stimulate, and, to some extent, enable high-quality translational communication, research, education, and practice in biomedical and health informatics continues to be a key challenge of IMIA.
Health Informatics: Building Capacity Worldwide. Editorial
Authors: Kulikowski C. A. , Geissbuhler Antoine
Published: March 2018

Objectives:
To provide an editorial introduction to the 2010 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors.

Methods:
A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2010 IMIA Yearbook.

Results:
This 2010 issue of the IMIA Yearbook highlights important developments in the building of workforce capacity in medical informatics worldwide, covering activities in research, education and practice in this interdisciplinary field. Progress towards educating and keeping professionals in the field up-to-date is complemented by outreach to the wide range of disciplines and biomedical and health specialties that are covered by this very broad field, identified from the recent literature, illustrated by selected papers published during the past 12 months.xs

Conclusion:
Reviews and Surveys of the main research sub-fields in biomedical informatics in the Yearbook provide an overview of progress and current challenges across the spectrum of the discipline.
A Bio-medical Informatics Perspective on Human Factors
Authors: Meyer R. ,   Section Editor for the IMIA Yearbook Section on Human Factors
Published: March 2018

Objectives:
to select and summarize excellent research papers published in 2009 in the field of human factors in bio-medical informatics.

Methods:
we attempt to derive a synthetic overview of the activity and new trends in this field, from a selection of research papers published in 2009.

Results:
it is possible to identify commonalities in this diverse domain: healthcare information technologies (HIT) adoption still occupies a central role in the fieldwith research focused mainly on measuring impact and influence of this adoption.

Conclusion:
The HIT community is giving birth to interdisciplinary research and clear methods to optimize implementation and subsequent achievement of managerial objectives. It also tries to synthesize the major findings in workshops, meetings and networks. The best paper selection of articles on human factors shows examples of excellent research on methods concerning original options to assess the importance of healthcare personnel psycho-sociology when confronted to the adoption of new tools and process which still does not prevent failures but will help learning from them.
Distributed Biomedical Terminology Development: From Experiments to Open Process
Authors: Chute C. G.
Published: March 2018

Objective:
Can social computing efforts materially alter the distributed creation and maintenance of complex biomedical terminologies and ontologies; a review of distributed authoring history and status.

Background:
Social computing projects, such as Wikipedia, have dramatically altered the perception and reality of large-scale content projects and the labor required to create and maintain them. Health terminologies have become large, complex, interdependent content artifacts of increasing importance to biomedical research and the communities understanding of biology, medicine, and optimal healthcare practices. The question naturally arises as to whether social computing models and distributed authoring platforms can be applied to the voluntary, distributed authoring of high-quality terminologies and ontologies.

Methods:
An historical review of distributed authoring developments.

Results:
The trajectory of description logic-driven authoring tools, group process, and web-based platforms suggests that public distributed authoring is likely feasible and practical; however, no compelling example on the order of Wikipedia is yet extant. Nevertheless, several projects, including the Gene Ontology and the new revision of the International Classification of Disease (ICD-11) hold promise.
Education and Consumer Informatics
Authors: Boyer C. ,   Section Editor for the IMIA Yearbook Section on Education and Consumer Informatics
Published: March 2018

Objectives:
To evaluate the extent to which the Internet is accessed for health information and perceived as useful to varying groups classified primarily according to age.

Method:
Synopsis of the articles on education and consumer health informatics selected for the IMIA Yearbook of Medical Informatics 2010.

Results:
A growing number of individuals are actively seeking health information through a varying selection of resources. The Internet is now seen as a major source of health information alongside with books and other means of paper-based literature. However, it is not clear how the Internet is perceived by varied groups such as those coming from differing age groups.

Conclusion:
The papers selected attempt to obtain a better understanding about how the public perceives and uses the Internet as an information gathering tool—especially for health information. The papers also explore into how the Internet is used by different groups of people. As all online health information is not of uniform quality, it is important to access and rely on quality medical information. This issue is also dealt with, where the popularity of Wikipedia is measured with the popularity of reliable web sources such as Medline Plus and NHS Direct.
Health Capacity Development Through Telemedicine in Africa
Authors: Mars M.
Published: March 2018

Objective:
The aim of this paper is to identify and report the issues facing human capacity development through the use of telemedicine in Sub-Saharan Africa.

Methods:
Data were obtained through literature review and personal observation.

Results:
Sub-Saharan Africa has a great burden of disease and an extreme shortage of health workers. Its countries are poor and the majority of its population rural. Telemedicine for clinical practice and education of health workers is seen as a possible means of addressing some of the health problems of Africa. A number of factors have been identified that impede the use of telemedicine in sub-Saharan Africa. These include, poverty, shortage of human resources, very limited existing infrastructure, lack of connectivity, high connectivity costs, lack of capacity development and policy issues. Examples of successful use of telemedicine and tele-educational programmes in Africa to develop capacity in health are given.

Conclusions:
Initiatives to develop capacity through tele-education appear to have been well received and are more successful than clinical telemedicine. There is need to raise awareness of telemedicine if it is to assist in developing ehealth capacity in Africa.
mHealth - an Ultimate Platform to Serve the Unserved
Authors: Akter S. , Ray P.
Published: March 2018

Objectives:
To summarize major current developments and research in the field of mobile health (mHealth) services.

Methods:
Reports on the unique characteristics of mHealth platform and its role in delivering health services to the resource poor settings. Also, it evaluates different mHealth applications and identifies key success factors and challenges.

Results and Conclusion:
mHealth, based on the most ubiquitous and widely accepted technology, offers an unprecedented opportunity to serve the unserved by right time medical information services. There is growing evidence that it has already transformed healthcare delivery in many resource poor settings through its low cost, high reach and versatile applications. However, challenges still remain with regard to the development of consumer centric solutions, and services quality in terms of knowledge and competence of the provider, integration of the information systems and interoperability of the information services. Additional problems arise from the collaboration, partnership and regulation perspectives. There are noticeable trends towards solutions for these problems.
Why Medical Informatics (still) Needs Cognitive and Social Sciences
Authors: Declerck G. , Aimé X.
Published: March 2018

Objectives: To summarize current excellent medical informatics research in the field of human factors and organizational issues.

Methods: Using PubMed, a total of 3,024 papers were selected from 17 journals. The papers were evaluated on the basis of their title, keywords, and abstract, using several exclusion and inclusion criteria. 15 preselected papers were carefully evaluated by six referees using a standard evaluation grid.

Results: Six best papers were selected exemplifying the central role cognitive and social sciences can play in medical informatics research. Among other contributions, those studies: (i) make use of the distributed cognition paradigm to model and understand clinical care situations; (ii) take into account organizational issues to analyse the impact of HIT on information exchange and coordination processes; (iii) illustrate how models and empirical data from cognitive psychology can be used in medical informatics; and (iv) highlight the need of qualitative studies to analyze the unexpected side effects of HIT on cognitive and work processes.

Conclusion: The selected papers demonstrate that paradigms, methodologies, models, and results from cognitive and social sciences can help to bridge the gap between HIT and end users, and contribute to limit adoption failures that are reported regularly.
Evidence-Based Clinical Decision Support
Authors: Wright A. , Shiffman R. N.
Published: March 2018

Background: Clinical decision support (CDS) is a key tool for enabling evidence-based medicine and improving the quality of healthcare. However, effective CDS faces a variety of challenges, including those relating to knowledge synthesis, capture, transformation, localization and maintenance. If not properly addressed, these challenges can limit the effectiveness of CDS, and potentially risk inaccurate or inappropriate interventions to clinicians.

Objectives: (1) To describe an approach to CDS development using evidence as a basis for clinical decision support systems that promote effective care; (2) To review recent evidence regarding the effectiveness of selected clinical decision support systems.

Method: Review and analysis of recent literature with identification of trends and best practices.

Results: The state-of-the-art in CDS has advanced significantly, and many recent trials have shown CDS to be effective, although the results are mixed overall. Issues related to knowledge capture and synthesis, problems in knowledge transformation at the interface between knowledge authors and CDS developers, and problems specific to local CDS design and implementation can interfere with CDS development. Best practices, tools and techniques to manage them are described.

Conclusions: CDS, when used well, can be effective, but further research is needed for it to reach its full potential.
Clinical Research Informatics: Survey of Recent Advances and Trends in a Maturing Field
Authors: Embi P. J.
Published: March 2018

Objectives: To provide a survey of the field of clinical research informatics (CRI), focusing in particular on significant developments over the past 3 years and the insights they provide about the progress and state of the field.

Methods: An iterative “scoping review” of the literature published in scientific journals and conference proceedings that are relevant to CRI, from late 2009 to early 2013.

Results: 212 articles were identified, and 64 were selected to illustrate recent advances in the field. Based on those, six categories of CRI activity were identified: Data and Knowledge Management, Discovery and Standards; Clinical Data Re-Use for Research; Researcher Support and Resources; Participant Recruitment; Patients/Consumers and CRI; Policy, Regulatory and Fiscal Matters.

Conclusions: This survey demonstrates that the field of CRI has matured and is now well established. The ongoing work is essential to overcome many of the challenges the clinical research enterprise is facing and more work is needed. Even as work continues to establish necessary infrastructure, methods, and best practices, CRI researchers should strive for more rigorous study designs to evaluate the impacts of the work in the field. There is little doubt that the field is poised for rapid growth, and that the CRI literature will continue to reflect that growth in years to come.
Medical Informatics in Morocco
Authors: Bennani Othmani M. , Diouny S. , Bouhaddou O.
Published: March 2018

Objectives: Informatics is an essential tool for helping to transform healthcare from a paper-based to a digital sector. This article explores the state-of-the-art of health informatics in Morocco. Specifically, it aims to give a general overview of the Moroccan healthcare system, the challenges it is facing, and the efforts undertaken by the informatics community and Moroccan government in terms of education, research and practice to reform the country's health sector.

Methods: Through the experience of establishing Medical Informatics as a medical specialty in 2008, creating a Moroccan Medical Informatics Association in 2010 and holding a first national congress took place in April 2012, the authors present their assessment of some important priorities for health informatics in Morocco.

Results: These Moroccan initiatives are facilitating collaboration in education, research, and implementation of clinical information systems. In particular, the stakeholders have recognized the need for a national coordinator office and the development of a national framework for standards and interoperability.

Conclusion: For developing countries like Morocco, new health IT approaches like mobile health and trans-media health advertising could help optimize scarce resources, improve access to rural areas and focus on the most prevalent health problems, optimizing health care access, quality, and cost for Morocco population.
Two Decades of HELINA Conferences: A Historical Review of Health Informatics in Africa
Authors: Korpela M.
Published: March 2018

Objective: Review the history of health informatics in Africa as projected by the HELINA conferences, to draw inferences for the next phase.

Methods and materials: Summarising from the proceedings of HELINA 93, unpublished programmes and reports of later conferences, abstracts and presentations on the web sites of the most recent conferences, and personal recollections of all but one of the conferences. Analysing the e-health situation in Africa in 1993, 2007 and 2011 by mapping software applications presented in the respective conferences on a simplified model of potential spots for e-health use.

Results: The following phases were identified: Pre-phase from 1979; individual scientific papers. Phase 1, the 1993-1999 conferences; carried by the momentum of HELINA 93. Phase 2, interregnum; difficulty to find conference organisers. Phase 3, the 2007-2011 conferences; carried by the HELINA association as IMIA Africa Region. Currently most of the important spots for e-health use are being populated by appropriate software applications, mostly by collaborative open source projects. Phase 4 starting, characterised by the expansion of e-health practice on the continent, the HELINA association as a key organiser, and annual HELINA conferences becoming scientifically stronger and more visible.

Conclusions: Key issues in making health informatics blossom in Africa include local development capacity, community orientation, collaborative design, international collaboration, government support, champions and organised continent-wide collaboration.
Guidelines for diagnosis and therapy of venous ulcers (version 8 2008)
Authors: Gallenkemper Georg
Published: March 2018

Four years after the publication of the latest guidelines on diagnosis and therapy of venous ulcer the German Society of Phlebology defines a completely revised and expanded version after the review of the literature published in the meantime. Particular emphasis was laid on international standards, new chapters are related to socio-economic aspects, the physical perception of the patients and the implementation of the guidelines in clinical practice.
Self-Tracking, Social Media and Personal Health Records for Patient Empowered Self-Care
Authors: Hansen M. , Fernandez-Luque L. , Lau A. Y. S. , Paton C.
Published: March 2018

This paper explores the range of self-tracking devices and social media platforms used by the self-tracking community, and examines the implications of widespread adoption of these tools for scientific progress in health informatics.

A literature review was performed to investigate the use of social media and self-tracking technologies in the health sector. An environmental scan identified a range of products and services which were used to exemplify three levels of self-tracking: self-experimentation, social sharing of data and patient controlled electronic health records.

There appears to be an increase in the use of self-tracking tools, particularly in the health and fitness sector, but also used in the management of chronic diseases. Evidence of efficacy and effectiveness is limited to date, primarily due to the health and fitness focus of current solutions as opposed to their use in disease management.

Several key technologies are converging to produce a trend of increased personal health surveillance and monitoring, social connectedness and sharing, and integration of regional and national health information systems. These trends are enabling new applications of scientific techniques, from personal experimentation to e-epidemiology, as data gathered by individuals are aggregated and shared across increasingly connected healthcare networks. These trends also raise significant new ethical and scientific issues that will need to be addressed, both by health informatics researchers and the communities of self-trackers themselves.
Giving Patients Choice and Control: Health Informatics on the Patient Journey
Authors: Gann B.
Published: March 2018

In modern society, people expect to be actively informed and engaged in decisions about their own health care. Developments in health informatics for patients are increasingly enabling digital solutions to supporting a culture of shared decision making between patients and clinicians. In England, the national patient portal NHS Choices has pioneered patient access to information, with the objectives of achieving significant volumes of use and delivering measurable benefits for patients and the healthcare system.

Opportunities for patients to use online information and transactions exist along the patient pathway, utilising a variety of methods including using online symptom checkers to manage minor ailments, choosing health services informed by metrics about the quality of service provided and patient comments, through to care delivered online.

Independent evaluation of NHS Choices has indicated that the website is effective in reducing primary care consultations for minor ailments through providing information on appropriate self care. Further research is demonstrating that the collective voice of patients, expressed through online ratings and comments on care received, has a good correlation with more objective, quantitative measures of provider quality.

NHS Choices has achieved high volumes of public use (15 million visits a month) and positive impacts for patients and the health care system. A new information strategy for health and social care in England published in 2012 sets the way ahead for the future of informatics for patients and the public.
Mobilizing Older Adults: Harnessing the Potential of Smart Home Technologies
Authors: Thompsonb H. J. , Demiris G.
Published: March 2018

This paper highlights the potential of smart home applications to not only assess mobility determinants for older adults in the home environment but also provide the opportunity for tailored interventions.

We present a theoretical framework for assessing mobility parameters and utilizing this information to enable behavior change based on the Health Belief Model. We discuss examples that showcase the potential of smart home systems to not only measure but also improve mobility for community dwelling older adults.

Mobility is a complex construct that cannot be addressed with a single monitoring approach or a single intervention. Instead, tailored interventions that address specific needs and behaviors of individuals and take into consideration preferences of older adults and potentially their social network are needed to effectively enforce positive behavior change. Smart home systems have the ability to capture details of one’s daily living that could otherwise not be easily obtained; however, such data repositories alone are not sufficient to improve clinical outcomes if appropriate mechanisms for data mining and analysis, as well as tailored response systems are not in place.

Unleashing the potential of smart home applications to measure and improve mobility has the potential of transforming elder care and providing potentially cost-effective tools to support independence for older adults. A technologically driven smart home application can maximize its clinical relevance by pursuing interactive features that can lead to behavior change.
Unlocking the Potential of Electronic Health Records for Translational Research
Authors: Yip Y. L. ,   Section Editor for the IMIA Yearbook Section on Bioinformatics and Translational Informatics
Published: March 2018

To review current excellent research and trend in the field of bioinformatics and translational informatics with direct application in the medical domain.

Synopsis of the articles selected for the IMIA Yearbook 2012.

Six excellent articles were selected in this Yearbook’s section on Bioinformatics and Translational Informatics. They exemplify current key advances in the use of patient information for translational research and health surveillance. First, two proof-of-concept studies demonstrated the cross-institutional and -geographic use of Electronic Health Records (EHR) for clinical trial subjects identification and drug safety signals detection. These reports pave ways to global large-scale population monitoring. Second, there is further evidence on the importance of coupling phenotypic information in EHR with genotypic information (either in biobank or in gene association studies) for new biomedical knowledge discovery. Third, patient data gathered via social media and self-reporting was found to be comparable to existent data and less labor intensive. This alternative means could potentially overcome data collection challenge in cohort and prospective studies. Finally, it can be noted that metagenomic studies are gaining momentum in bioinformatics and system-level analysis of human microbiome sheds important light on certain human diseases.

The current literature showed that the traditional bench to bedside translational research is increasing being complemented by the reverse approach, in which bedside information can be used to provide novel biomedical insights.
The Development of AI in Medicine and the Research Environment of the SPHINX Project at the Start of the 1980s
Authors: Fieschi M.
Published: March 2018

To review the history of AI in Medicine in the 1980’s, placing the SPHINX system in the context of other research in this field.

Summarize the main systems for AI in medicine devel- oped in the 1970-1980 decade and their relationship to the de- velopment of clinical decision-making and consultation systems.

The approaches taken by AI in medicine research groups is compared and contrasted to those of others using statistical and logical methods for representing clinical inferences, and the different AI approaches are summarized, and related to the archi- tecture and systems implementation of SPHINX.

The SPHINX system combined a number of advanced representational and inference choices from AI in designing a de- cision-support system for clinical consultation in the 1980s. The context within which the system was developed is outlined and related to the historical evolution of AI in medicine during that decade.
Aktive Systemtherapie bei Hirnmetastasen
Authors: Arnheim Katharina
Published: March 2018

Für die beim Melanom häufigen Hirnmetastasen zeichnen sich neue Perspektiven ab: Neben der Lokaltherapie haben sich jetzt die Immuntherapie mit Nivolumab in Kombination mit Ipilimumab und die Kombination Dabrafenib/Trametinib als sehr effektiv erwiesen.
Bei niedrigem Rezidivrisiko reichen 3 Monate adjuvante Therapie
Authors: Arnheim Katharina
Published: March 2018

Bei etlichen Patienten mit einem Kolonkarzinom im Stadium III kann die adjuvante Oxaliplatin-basierte Therapie verkürzt werden: Laut einer Analyse von 6 Phase-IIIStudien ist die 3-monatige Therapie bei Patienten mit niedrigem Rückfallrisiko ebenso effektiv wie die 6-monatige Behandlung und verursacht erheblich weniger Neuro-pathien.