bluuebunny/crossref_metadata_2025 huggingface dataset:
Benefits, Challenges and Impact of Teleconsultation – A Literature Review
Authors: Frade Samuel  , Rodrigues Hugo
Published: February 2025

Teleconsultation involves the use of technology so that the medical professionals and patients can interact with each other bringing health to where ever it is needed. Although it has been demonstrated to be feasible and effective its sustainability remains an important question. This paper presents the results of a literature review on teleconsultation, based on the Portuguese context. Although Portugal has some successful projects, a national or international conjoint effort would be more fruitful. Technologically it gets lets costly to provide teleconsultation, as pervasive computing grows. The gap of benefits between teleconsultation and regular consultation will diminish as patients grow fonder into technology.The economic value of this type of consultation remains a difficult subject, so a small budget economic analysis, based on a break-even method, is suggested. This analysis conducted on Finland shows that teleconsultation can be cost-effective.
Extracting Risk Modeling Information from Medical Articles
Authors: Deleris Léa A  , Sacaleanu Bogdan  , Tounsi Lamia
Published: February 2025

Risk modeling in healthcare is both ubiquitous and in its infancy. On the one hand, a significant proportion of medical research focuses on determining the factors that influence the incidence, severity and treatment of diseases, which is a form of risk identification. Those studies typically investigate the micro-level of risk modeling, i.e., the existence of dependences between a reduced set of hypothesized (or demonstrated) risk factors and a focus disease or treatment. On the other hand, the macro-level of risk modeling, i.e., articulating how a large number of such risk factors interact to affect diseases and treatments is not widespread, though essential for medical decision support modeling. By exploiting advances in natural language processing, we believe that information contained in unstructured texts such as medical articles could be extracted to facilitate aggregation into macro-level risk models.
Evaluation of Algorithm for Extraction of Lung Regions in CT Exams
Authors: Melo Pedro  , Vasconcelos Germano  , Diniz Paula  , França Cleunio  , Diniz Jéssica  , Novaes Magdala
Published: February 2025

Recently has grown the development of Computer-aided Detection Systems – CAD to improve the diagnosis of diseases identifying it at the initials stages using medical images.
Development of Medical Equipment Alarm Monitoring System
Authors: Yamashita Yoshinori  , Ogaito Tatoku  , Kasamatsu Shingo
Published: February 2025

In a hospital, we use a large number of medical equipment. In these use, I support the safe use by the alarm such as errors from medical equipment. There is the instrument notifying of alarm in communication, but there is the instrument by a sound and the light. For the medical safety management, confirmation of the alarm is important. We thought that stability was improved by integrating alarm from the instrument of the different type. Therefore, we thought that we integrated alarm from medical equipment. We decided to transmit an alarm signal from medical equipment by adding radio module program unit. The type of the radio used IEEE 802.15.4 (ZigBee) at a point of view of low power, International Standard, simple radio equipment. This system deals with only alarm information from medical equipment and does not handle the data. However, we understood that we were helpful very much even if it was only alarm information. We were able to in this way reduce the number of incidents.
Analysis of Family Health History Based Risk Assessment Algorithms: Classification and Data Requirements
Authors: Ranade-Kharkar Pallavi  , Del Fiol Guilherme  , Williams Janet L.  , Hulse Nathan C.  , Haug Peter
Published: February 2025

Family Health History (FHH) is a valuable and potentially low-cost tool for risk assessment and diagnosis in patient-centered healthcare. In this study, we identified and analyzed existing FHH-based risk assessment algorithms (RAAs) for cardio-vascular disease (CVD) and colorectal cancer (CRC) to guide implementers of electronic health record (EHR) systems regarding the data requirements for computing risk using these algorithms. We found a core set of data elements that are required by most RAAs. While some of these data are available in EHR systems, the patients can be empowered to contribute the remainder.
Evaluating Predictive Modeling's Potential to Improve Teleretinal Screening Participation in Urban Safety Net Clinics
Authors: Ogunyem Omolola  , Teklehaimanot Senait  , Patty Lauren  , Moran Erin  , George Sheba
Published: February 2025

Introduction: Screening guidelines for diabetic patients recommend yearly eye examinations to detect diabetic retinopathy and other forms of diabetic eye disease. However, annual screening rates for retinopathy in US urban safety net settings remain low.
Comparing Information Needs of Health Care Providers and Older Adults: Findings from a Wellness Study
Authors: Reeder Blaine  , Le Thai  , Thompson Hilaire J.  , Demiris George
Published: February 2025

Consumer health informatics technologies have the potential to enhance shared decision-making and communication between older adults, health care providers, and other stakeholders. The objective of this study was to characterize the information needs of these stakeholders to inform the design of informatics tools that support wellness in older adults. We conducted four focus groups with 31 older adults and three focus groups with 10 health care providers to explore information needs, goals, and preferences for information sharing. Analysis of focus group transcripts was performed to identify and compare themes for different stakeholders. We identified four themes related to information activities: perceived goals of others, perceived information needs of others, information sharing by older adults, and role of family members. Older adults, family members and health care providers differ in their information needs. We provide recommendations to facilitate design and adoption of informatics tools that connect these stakeholders. Larger studies are needed to characterize different stakeholder goals, information needs and preferences.
Prediction-based Threshold for Medication Alert
Authors: Kawazoe Yoshimasa  , Miyo Kengo  , Kurahashi Issei  , Sakurai Ryota  , Ohe Kazuhiko
Published: February 2025

This study presents a prediction-based approach to determine thresholds for a medication alert in a computerized physician order entry. Traditional static thresholds can sometimes lead to physician's alert fatigue or overlook potentially excessive medication even if the doses are belowthe configured threshold. To address this problem, we applied a random forest algorithm to develop a prediction model for medication doses, and applied a boxplot to determine the thresholds based on the prediction results. An evaluation of the eight drugs most frequently causing alerts in our hospital showed that the performances of the prediction were high, except for two drugs. It was also found that using the thresholds based on the predictions would reduce the alerts to a half of those when using the static thresholds. Notably, some cases were detected only by the prediction thresholds. The significance of the thresholds should be discussed in terms of the trade-offs between gains and losses; however, our approach, which relies on physicians' collective experiences, has practical advantages.
Functional Requirements for a Central Research Imaging Data Repository
Authors: Franke Thomas  , Gruetz Romanus  , Dickmann Frank
Published: February 2025

The current situation at many university medical centers regarding the management of biomedical research imaging data leaves much to be desired. In contrast to the recommendations of the German Research Foundation (DFG) and the German Council of Sciences and Humanities regarding the professional management of research data, there are commonly many individual data pools for research data in each institute and the management remains the responsibility of the researcher. A possible solution for this situation would be to install local central repositories for biomedical research imaging data. In this paper, we developed a scenario based on abstracted use-cases for institutional research undertakings as well as collaborative biomedical research projects and analyzed the functional requirements that a local repository would have to fulfill. We determined eight generic categories of functional requirements, which can be viewed as a basic guideline for the minimum functionality of a central repository for biomedical research imaging data.
A Unified Medical Language System (UMLS) Based System for Literature-Based Discovery in Medicine
Authors: Gabetta Matteo  , Larizza Cristiana  , Bellazzi Riccardo
Published: February 2025

Literature-Based Discovery (LBD) is a technique that can be used in translational research to connect the very sparse and huge information available in scientific publications in order to extract new knowledge. This paper presents an LBD system based on the open discovery paradigm exploiting NLP techniques and UMLS medical concepts mapping, to provide a set of tools useful to discover unknown relationships. The system has been evaluated on the problem of discovering new candidate genes potentially related to dilated cardiomyopathies (DCM), and can be used in any medical context to connect different type of concepts. The validation of the system involves reproducing the discovery of genes currently associated to DCM. Validation showed that the system is able to discover many gene-disease associations by using the literature available before their first publication in a scientific article.
Determining Scanned Body Part from DICOM Study Description for Relevant Prior Study Matching
Authors: Mabotuwana Thusitha  , Qian Yuechen
Published: February 2025

The typical radiology reporting workflow involves the radiologist first looking at one or more relevant prior studies before interpreting the current study. To improve workflow efficiency, PACS systems can display relevant prior imaging studies, typically based on a study's anatomy as indicated in the Body Part Examined field of the DICOM header. The content of the Body Part Examined field can be very generic. For instance, an imaging study to exclude pancreatitis and another one to exclude renal stones will both have “abdomen” in their body part field, making it difficult to differentiate them. To improve prior study matching and support better study filtering, in this paper, we present a rule-based approach to determine specific body parts contained in the free-text DICOM Study Description field. Algorithms were trained using a production dataset of 1200 randomly selected unique study descriptions and validated against a test dataset of 404 study descriptions. Our validation resulted in 99.94% accuracy. The proposed technique suggests that a rule-based approach can be used for domain specific body part extraction from DICOM headers.
Extending the NegEx Lexicon for Multiple Languages
Authors: Chapman Wendy W.  , Hillert Dieter  , Velupillai Sumithra  , Kvist Maria  , Skeppstedt Maria  , Chapman Brian E.  , Conway Mike  , Tharp Melissa  , Mowery Danielle L.  , Deleger Louise
Published: February 2025

We translated an existing English negation lexicon (NegEx) to Swedish, French, and German and compared the lexicon on corpora from each language. We observed Zipf's law for all languages, i.e., a few phrases occur a large number of times, and a large number of phrases occur fewer times. Negation triggers “no” and “not” were common for all languages; however, other triggers varied considerably. The lexicon is available in OWL and RDF format and can be extended to other languages. We discuss the challenges in translating negation triggers to other languages and issues in representing multilingual lexical knowledge.
Boosting Standard Order Sets Utilization through Clinical Decision Support
Authors: Li Haomin  , Zhang Yinsheng  , Cheng Haixia  , Lu Xudong  , Duan Huilong
Published: February 2025

Well-designed standard order sets have the potential to integrate and coordinate care by communicating best practices through multiple disciplines, levels of care, and services. However, there are several challenges which certainly affected the benefits expected from standard order sets. To boost standard order sets utilization, a problem-oriented knowledge delivery solution was proposed in this study to facilitate access of standard order sets and evaluation of its treatment effect. In this solution, standard order sets were created along with diagnostic rule sets which can trigger a CDS-based reminder to help clinician quickly discovery hidden clinical problems and corresponding standard order sets during ordering. Those rule set also provide indicators for targeted evaluation of standard order sets during treatment. A prototype system was developed based on this solution and will be presented at Medinfo 2013.
Integrating the Human Phenotype Ontology into HeTOP Terminology-Ontology Server
Authors: Grosjean Julien  , Merabti Tayeb  , Soualmia Lina F.  , Letord Catherine  , Charlet Jean  , Robinson Peter N.  , Darmoni Stéfan J.
Published: February 2025

The Human Phenotype Ontology (HPO) is a controlled vocabulary which provides phenotype data related to genes or diseases. The Health Terminology/Ontology Portal (HeTOP) is a tool dedicated to both human beings and computers to access and browse biomedical terminologies or ontologies (T/O). The objective of this work was to integrate the HPO into HeTOP in order to enhance both works. This integration is a success and allows users to search and browse the HPO with a dedicated interface. Furthermore, the HPO has been enhanced with the addition of content such as new synonyms, translations, mappings. Integrating T/O such as the HPO into HeTOP is a benefit to vocabularies because it allows enrichment of them and it is also a benefit for HeTOP which provides a better service to both humans and machines.
A Business Process Modeling Experience in a Complex Information System Re-Engineering
Authors: Bernonville Stéphanie  , Vantourout Corinne  , Fendeler Geneviève  , Beuscart Régis
Published: February 2025

This article aims to share a business process modeling experience in a re-engineering project of a medical records department in a 2,965-bed hospital. It presents the modeling strategy, an extract of the results and the feedback experience.
A Proposed Dynamic Dosing Scheme to Secure the Target Plasma Drug Concentrations Based on the Precision of the AUC Estimate
Authors: Tsuruta Harukazu  , Wada Toyofumi
Published: February 2025

To reduce the number of blood samples necessary to estimate the patient's AUC (the area under the plasma drug concentration time-curve), various limited sampling strategies (LSSs) have been developed. We proposed a new LSS for busulfan, in which a curve that best approximates the measured data was searched for from a set of pre-generated theoretical plasma drug concentration time-curves. We evaluated this LSS and proved that it had virtually no bias and better precision compared with conventional LSSs. However, further study revealed that the precision of our new accurate LSS was still insufficient to secure the target concentration. To solve this problem, we proposed a new dosing scheme, in which the amount of dose was adjusted dynamically according to the estimated precision of the AUC estimator.
Coordination Considerations of Healthcare Information Technology
Authors: Kuziemsky Craig E.  , Bush Pam
Published: February 2025

While health information technology (HIT) may be designed to support specific tasks the integrated nature of healthcare delivery often requires HIT to play various coordination roles. While studies have shown that coordination issues with HIT can cause adverse impacts there is little research that has looked at the specific types of coordination that HIT need to support. This paper uses a longitudinal study of a perioperative information system to identify and discuss different categories of HIT coordination. The findings can help the design and evaluation of HIT to support the coordination needs of healthcare delivery.
Fidelity in clinical simulation: how low can you go?
Authors: Jensen Sanne  , Nøhr Christian  , Rasmussen Stine Loft
Published: February 2025

Clinical simulation may be used to identify user needs for context sensitive functionalities in e-Health. The objective with this paper is to describe how user requirements and use cases in a large EHR-platform procurement may be validated by clinical simulation using a very low-fidelity prototype without any existing test data. Instead of using test scenarios and use cases, the healthcare professionals who are participating in the clinical simulation are generating both scenario and patient data themselves. We found that this approach allows for an imaginative discussion, not restricted by known functionalities and limitations, of the ideal EHR-platform. Subsequently, we discuss benefits and challenges of using an extremely low fidelity environment and discuss the degree of fidelity necessary for conducting clinical simulation.
The Role of Human Factors when Evaluating Information Accountability for eHealth Systems
Authors: Gajanayake Randike  , Sahama Tony  , Lane Bill
Published: February 2025

The availability of health information is rapidly increasing; its expansion and proliferation is inevitable. At the same time, breeding of health information silos is an unstoppable and relentless exercise. Information security and privacy concerns are therefore major barriers in the eHealth socio-eco system. We proposed Information Accountability as a measurable human factor that should eliminate and mitigate security concerns. Information accountability measures would be practicable and feasible if legislative requirements are also embedded. In this context, information accountability constitutes a key component for the development of effective information technology requirements for health information system. Our conceptual approach to measuring human factors related to information accountability in eHealth is presented in this paper. Measuring the human factors associated with information accountability can benefit from extant theories from information systems research and business management. However, the application of such theories must clearly address the specialised nature of the application context coupled with the role of the users within the context.
Development of a Virtual Reality Simulator for Natural Orifice Translumenal Endoscopic Surgery (NOTES) Cholecystectomy Procedure
Authors: Ahn Woojin  , Dargar Saurabh  , Halic Tansel  , Lee Jason  , Li Baichun  , Pan Junjun  , Sankaranarayanan Ganesh  , Roberts Kurt  , De Suvranu
Published: February 2025

The first virtual-reality-based simulator for Natural Orifice Translumenal Endoscopic Surgery (NOTES) is developed called the Virtual Translumenal Endoscopic Surgery Trainer (VTESTTM). VTESTTMaims to simulate hybrid NOTES cholecystectomy procedure using a rigid scope inserted through the vaginal port. The hardware interface is designed for accurate motion tracking of the scope and laparoscopic instruments to reproduce the unique hand-eye coordination. The haptic-enabled multimodal interactive simulation includes exposing the Calot's triangle and detaching the gall bladder while performing electrosurgery. The developed VTESTTMwas demonstrated and validated at NOSCAR 2013.
Portable System for Auscultation and Lung Sound Analysis
Authors: Nabiev Rustam  , Glazova Anna  , Olyinik Valery  , Makarenkova Anastasiia  , Makarenkov Anatolii  , Rakhimov Abdulvosid  , Felländer-Tsai Li
Published: February 2025

A portable system for auscultation and lung sound analysis has been developed, including the original electronic stethoscope coupled with mobile devices and special algorithms for the automated analysis of pulmonary sound signals. It's planned that the developed system will be used for monitoring of health status of patients with various pulmonary diseases.
A Framework for Providing Cognitive Feedback in Surgical Simulators
Authors: Sankaranarayanan Ganesh  , Li Baichun  , De Suvranu
Published: February 2025

Providing cognitive feedback in a virtual reality simulator during training is essential for subjects to correct and learn proper techniques. In this work, we have developed a framework to identify key skills and cognitive knowledge required to perform a task and methods to provide to the user. The framework was verified by implementing a test case scenario with the peg transfer task of the FLS.
A Concept for Overlaid-Type Surgical Navigation System with Organ Modification Functions Using Non-Contact Type Surface Measurement
Authors: Suzuki Naoki  , Hattori Asaki
Published: February 2025

Surgical navigation systems are clinically applied in cerebral and otological surgeries but they are only used in parts with minimum surgical transformation in regions in which the organs largely transform, such as in the abdomen. Therefore, we here propose a concept of a surgical navigation system that could be used in the regions such as liver, which largely transforms itself during surgery. We consider a method that measures the changes in the organ surface configuration during surgery and estimates the changes in the tumor and blood vessel structure following the transformation of the organ surface. We also report on the necessary disposition of each process of this method, especially on the basic examination of the organ transformation.
Computer-based Planning System for Mandibular Reconstruction
Authors: Alassaf Manal H.  , Li Wei  , Joshi Arjun S.  , Hahn James K.
Published: February 2025

Mandibular reconstruction is typically performed for traumatic or postsurgical conditions, and may involve the use of autologous osteocutaneous fibula free flaps for large defects. Recreating the native contour of the mandible during reconstructive surgery is challenging. Existed pre-operative planning software has limitations. In this paper we present a novel pre-operative planning system that helps to optimize the number and location of bony osteotomies, and the orientation of the harvested bone segments by specifically prioritizing the position and number of the cutanteous perforators to the osteocutaneous fibula free flap, in order to improve the reliability of the osteocutaneous fibula free flap.
The Effect of the Waiting Times on the Patient Pathways for Patients with Suspected Coronary Artery Disease
Authors: Király Ferenc  , Kósa István  , Vassányi István
Published: February 2025

The paper describes the investigation of the Hungarian public administrative health databases with the aim to identify hidden correspondences in the patients' evaluation pathways for patients with suspected coronary artery disease (CAD). In our current work we investigated the effect of the waiting times of invasive and non-invasive investigations in the evaluation pathways of patients with suspected CAD. We found a considerable correlation between waiting times and the further course of the patients.
A Personal Health Record System for Diabetes Care Conforming to the ISO 16527 Interoperability Requirements
Authors: Cerón Jesús D.  , Gómez Guillermo A.  , López Diego M.  , González Carolina  , Blobel Bernd
Published: February 2025

A Personal Health Record (PHR) is a health information repository controlled and managed directly by a patient or his/her custodian, or a person interested in his/her own health. PHR System's adoption and compliance with international standards is foremost important because it can help to meet international, national, regional or institutional interoperability and portability policies. In this paper, an interoperable PHR System for supporting the control of type 2 diabetes mellitus is proposed, which meets the mandatory interoperability requirements proposed in the Personal Health Record System Functional Model standard (ISO 16527). After performing a detailed analysis of different applications and platforms for the implementation of electronic Personal Health Records, the adaptation of the Indivo Health open source platform was completed. Interoperability functions were added to this platform by integrating the Mirth Connect platform. The assessment of the platform's interoperability capabilities was carried out by a group of experts, who verified the interoperability requirements proposed in the ISO 16527 standard.
Virtual Patients Feedback System – a Concept to Support Students and Educators
Authors: Yilmaz Arzu  , Haag Martin
Published: February 2025

Assessments deliver information about the knowledge level of a student. Formative assessments' main purposes are to identify student's weaknesses and strengths, and support educators in the planning process of their instruction. In this paper a graphical user interface concept is presented to provide feedback with the aid of the editing results of medical students, who train with Virtual Patient, which is a computer-based simulation of patient care.
The Development of an Application for Data Privacy by Applying an Audit Repository based on IHE ATNA
Authors: Bresser Laura  , Köhler Steffen  , Schwaab Christoph
Published: February 2025

It is necessary to optimize workflows and communication between institutions involved in patients' treatment to improve quality and efficiency of the German healthcare. To achieve these in the Metropolregion Rhein-Neckar, a personal, cross-institutional patient record (PEPA) is used. Given the immense sensitivity of health-related information saved in the PEPA, it is imperative to obey the data protection regulations in Germany. One important aspect is the logging of access to personal health data and all other safety-related events. For gathering audit information, the IHE profile ATNA can be used, because it provides a flexible and standardized infrastructure. There are already existing solutions for gathering the audit information based on ATNA. In this article one solution (OpenATNA) is evaluated, which uses the method of evaluation defined by Peter Baumgartner. In addition, a user interface for a privacy officer is necessary to support the examination of the audit information. Therefore, we will describe a method to develop an application in Liferay (an OpenSource enterprise portal project) which supports examinations on the gathered audit information.
Appreciating the Persona Paradox: Lessons from Participatory Design Sessions with HIV+ Gay Men
Authors: Kwon Jae-Yung  , Phillips Craig  , Currie Leanne M.
Published: February 2025

Eliciting user requirements from HIV-positive gay men who smoke can be challenging. This is because of the complex relationship between social stigma and gender identities (e.g., gay, masculine, HIV+, and smoking status). Inspired to engage HIV-positive gay men in the development of a web-assisted tobacco intervention, we used personas as a main communication tool in our participatory design sessions. Personas are characters created by users that embody part of their own behaviours, thoughts, and motivations. In an apparent paradox, this article is a description of how the use of personas to ensure less realistic self-representation provided an impetus for more self-disclosure. Findings and feedbacks from this study reveal that personas are an effective design tool to engage users in sensitive topics. Implications for future work are also discussed.
An Integrated Approach to Safety-driven and ICT-enabled Process Reengineering: Methodological Advice and a Case Study
Authors: Langer M.  , Castellari R.  , Locatelli P.  , Sini E.  , Torresani M.  , Facchini R.  , Moser R.
Published: February 2025

Patient safety is a central concern inside any healthcare environment. With the progress of Information and Communication Technologies (ICTs), new solutions have become available to support care and management processes. Analyzing process risks helps identifying areas of improvement and provides ICT-solutions design with indications on what portions of the process need primary interventions. Understanding the link between process reengineering, technology assessment of enabling technologies and risk management allows user acceptance and patient safety improvements. Fondazione IRCCS Istituto Nazionale dei Tumori (INT), offers a good example of process reengineering driven by the purpose of increasing patient safety, enabled by new technologies. A pillar of the evolution of ICT process support at INT is based on Radio Frequency Identification technologies, implemented to identify and trace items and people across processes. This paper will present an integrated approach, based on process reengineering methodologies and risk assessment studies, and methodological advice applied to a case of surgical kits management procedures.
Detecting Earlier Indicators of Homelessness in the Free Text of Medical Records
Authors: Redd Andrew  , Carter Marjorie  , Divita Guy  , Shen Shuying  , Palmer Miland  , Samore Matthew  , Gundlapalli Adi V.
Published: February 2025

Early warning indicators to identify US Veterans at risk of homelessness are currently only inferred from administrative data. References to indicators of risk or instances of homelessness in the free text of medical notes written by Department of Veterans Affairs (VA) providers may precede formal identification of Veterans as being homeless. This represents a potentially untapped resource for early identification. Using natural language processing (NLP), we investigated the idea that concepts related to homelessness written in the free text of the medical record precede the identification of homelessness by administrative data. We found that homeless Veterans were much higher utilizers of VA resources producing approximately 12 times as many documents as non-homeless Veterans. NLP detected mentions of either direct or indirect evidence of homelessness in a significant portion of Veterans earlier than structured data.
Coordinating Caregiving using Smartphone Technology: a Collaborative Software Prototype Approach
Authors: Lin Zheng-Shuai  , McKinstry Brian  , Anderson Stuart
Published: February 2025

Though the proportion of older population is growing and the number of people with long-term conditions is increasing, there is unlikely to be enough caregivers for those older people or people with long-term conditions who wish to live at home. Thus how to ensure sufficient caregiving events to meet the growing demand in home healthcare sector becomes a challenge. A collaborative software prototype utilising smartphone technology has been proposed in this study to provide coordinated caregiving. The system in future may both spread the load among family caregivers and professional caregivers while ensuring that the patient's needs are always covered.
Effective Ways for the Transmission of Infection Prevention Data According to German Legal Specifications via the Medical Terminology SNOMED CT used with HL7 CDA Templates
Authors: Dewenter Heike  , Heitmann Kai U.  , Treinat Lars  , Thun Sylvia
Published: February 2025

According to German legal specifications each national federal state is obliged to transmit infection prevention data to the relevant health authority. In case of reasonable suspicion, affection or death by infectious diseases specific information is differently communicated by laboratories and physicians. Proprietary ways of transmission inherit threats like deficient or incomplete availability of data. At least these circumstances imply non-predictable health-related hazards for the population. The international established medical terminology SNOMED CT can contribute semantic interoperability and a highly specific description of diagnoses and procedures. The applicability of SNOMED CT shall be tested in the domain of diagnostic findings respective notifiable infectious agents. In addition, specific hierarchical links from the agents to the associated infectious diseases inside the terminology are expected and verified. As the carrier of the information, HL7's Clinical Document Architecture (CDA) is used by designing appropriate CDA templates to define the contents of the notifiable disease documentation. The results demonstrate that the entirety of the notifiable infectious agents is displayed in the terminology SNOMED CT by relating codes at 100 percent. Furthermore, each single term is hierarchically connected to the relating infectious diseases. The use of SNOMED CT for the purpose of infection prevention in Germany is tied to licensing and license costs. Irrespective of these facts, the use of SNOMED CT shows obvious advantages in this field and an implementation of the terminology can be recommended.
A Framework for Integrating Heterogeneous Clinical Data for a Disease Area into a Central Data Warehouse
Authors: Karmen Christian  , Ganzinger Matthias  , Kohl Christian D.  , Firnkorn Daniel  , Knaup-Gregori Petra
Published: February 2025

Structured collection of clinical facts is a common approach in clinical research. Especially in the analysis of rare diseases it is often necessary to aggregate study data from several sites in order to achieve a statistically significant cohort size. In this paper we describe a framework how to approach an integration of heterogeneous clinical data into a central register. This enables site-spanning queries for the occurrence of specific clinical facts and thus supports clinical research. The framework consists of three sequential steps, starting from a formal data harmonization process, to the data transformation methods and finally the integration into a proper data warehouse. We implemented reusable software templates that are based on our best practices in several projects in integrating heterogeneous clinical data. Our methods potentially increase the efficiency and quality for future data integration projects by reducing the implementation effort as well as the project management effort by usage of our approaches as a guideline.
Spatio-temporal information and knowledge representation of disease incidence and respective intervention strategies
Authors: Davis Matthew  , von Cavallar Stefan  , Wyres Kelly L.  , Reumann Matthias  , Sepulveda Martin J.  , Rogers Priscilla
Published: February 2025

The supplementation of medical data with environmental data offers rich new insights that can improve decision-making within health systems and the healthcare profession. In this study, we simulate disease incidence for various scenarios using a mathematical model. We subsequently visualise the infectious disease spread in human populations over time and geographies. We demonstrate this for malaria, which is one of the top three causes of mortality for children under the age of 5 years in sub-Saharan Africa, and its associated interventions within Kenya. We demonstrate how information can be collected, analysed, and presented in new ways to inform key decision makers in understanding the prevalence of disease and the response to interventions.
Online Dissemination of Clinical Practice Guidelines as Narrative Texts and Structured Pathways: a Case Study with the Treatment of Type 2 Diabetes
Authors: Séroussi Brigitte  , Falcoff Hector  , Ertel-Pau Valérie  , Raimond Véronique  , Bouaud Jacques
Published: February 2025

Recently, National agencies in charge of the development of clinical practice guidelines (CPGs) have started to improve the usual narrative CPGs to provide guidance for different clinical pathways. In France, in conjunction with the development of the type 2 diabetes National CPGs, we have developed the system RecosDoc-Diabète which allows to interactively build a patient-centred pathway and get the appropriate recommendations. National narrative CPGs and RecosDoc-Diabète were published and made available online at the same time (February 2013). A questionnaire was provided to collect visitors' judgement about the system. Between February 12thand December 31st, 2013, 55,203 visitors accessed the narrative CPGs whereas 10,565 accessed the system. Among them, 186 (2%) responded to the questionnaire. One third of the comments were criticisms towards the CPG content. The system was globally positively evaluated although assessments were mixed illustrating that users' needs may be contradictory.
G-quest: a Single Platform for Delivering Questionnaires, Educational Material, and Checklists on Mobile Devices
Authors: Lanzola Giordano  , Ginardi Germana  , Russo Paola  , Quaglini Silvana
Published: February 2025

We illustrate G-quest, a platform originally meant to deliver questionnaires on mobile devices that supports the accomplishment of studies involving outpatients. However the constructs made available by the platform proved to be useful also for distributing learning material and checklists, after a paradigm shift in their application was adopted. Thus, in addition to questionnaires, we designed a guide for educating patients affected by a rare disease and conducted a small survey to assess this new application context. Presently we are exploiting G-quest for the provision of medical checklists in critical care.
Analysis of the Patients and Physicians Connection Network on an online Health Information Platform
Authors: Aydin Mehmet N.  , Perdahci N. Ziya
Published: February 2025

Social network applications have gained popularity in the health domain as they bring health information seekers (patients and alike) and medication advice providers (physicians and other relevant actors) together. By employing a network science perspective, this research is aimed to understand an information network establishing connections among and between information seekers and providers. We found that such a connection network surfaces most of the essential characteristics of a typical complex network. Furthermore, a detailed structural analysis shows some intriguing relations and connection behaviours in the network. Implications of the findings are discussed from the perspectives of medical informatics and social network analysis.
Increasing Information Accessibility for Patients in Obstetrics-Gynecology domain
Authors: Crişan-Vida Mihaela  , Stoicu-Tivadar Lăcrămioara
Published: February 2025

It is important for the patient to have access to personal medical information in order to manage information for increased quality of medical care and life. The paper presents a module added to an Obstetrics-Gynaecology Department information system (OGD IS) supporting patient empowerment. The patient is accessing the system easily using laptops or mobile devices. The application accessed by the patient is web-based, implemented in Visual Studio. NET, using ASP.NET pages and C# language, and the application is published in the Windows Azure cloud. The solution is user friendly using familiar devices and is ubiquitous using the cloud solution. A module for translating medical terms in colloquial ones is integrated in the system. For certain situations the patient will get information related to life style influencing health status as how and what to eat or what type of exercise it is recommended.
Real-time Monitoring of Clinical Processes using Complex Event Processing and Transition Systems
Authors: Meinecke Sebastian
Published: February 2025

Dependencies between tasks in clinical processes are often complex and error-prone. Our aim is to describe a new approach for the automatic derivation of clinical events identified via the behaviour of IT systems using Complex Event Processing. Furthermore we map these events on transition systems to monitor crucial clinical processes in real-time for preventing and detecting erroneous situations.
Virtual Patient Repositories – A Comparative Analysis
Authors: Küfner Julia  , Kononowicz Andrzej A.  , Hege Inga
Published: February 2025

Virtual Patients (VPs) are an important component of medical education. One way to reduce the costs for creating VPs is sharing through repositories. We conducted a literature review to identify existing repositories and analyzed the 17 included repositories in regards to the search functions and metadata they provide. Most repositories provided some metadata such as title or description, whereas other data, such as educational objectives, were less frequent. Future research could, in cooperation with the repository provider, investigate user expectations and usage patterns.
Using TimeML to Support the Modeling of Computerized Clinical Guidelines
Authors: Wenzina Reinhardt  , Kaiser Katharina
Published: February 2025

The modeling of clinical guidelines in order to apply them in computerized medical tools is a challenging and laborious task. In this project we show that conditional subordination links – a temporal relation concept of TimeML – can be used to describe condition-based activities in a guideline. Therefore, we extend the specification of TimeML concerning events and subordination links. Subsequently, linguistic and semantic rules are developed to automatically generate annotations for these links and classify them as relevant for the clinical care path. Finally, the evaluation of the method shows that this categorization supports the task of the guideline modeling expert.
Crucial Issues in Think Aloud Techniques for Cross Cultural Studies
Authors: Perri Seneca  , Shao Amani  , Swai Ndeniria  , Mitchell Marc  , Staggers Nancy
Published: February 2025

Implementing user-centered design (UCD) principles and conducting usability testing is especially critical in projects where developers do not originate from the deployed environment. However, traditional usability testing techniques in cross-cultural settings can be problematic and may produce unexpected results. Measures should be taken to identify and mitigate any cultural factors that may influence UCD testing and deployment . In this paper, we focus on the think-aloud method. We use a current mHealth development and research project in Tanzania as a case study to highlight issues in UCD in cross-cultural settings. We offer recommendations for UCD methods and cultural considerations for low to middle income countries.
Electronic Processing of Informed Consents in a Global Pharmaceutical Company Environment
Authors: Vishnyakova Dina  , Gobeill Julien  , Oezdemir-Zaech Fatma  , Kreim Olivier  , Vachon Therese  , Clade Thierry  , Haenning Xavier  , Mikhailov Dmitri  , Ruch Patrick
Published: February 2025

We present an electronic capture tool to process informed consents, which are mandatory recorded when running a clinical trial. This tool aims at the extraction of information expressing the duration of the consent given by the patient to authorize the exploitation of biomarker-related information collected during clinical trials. The system integrates a language detection module (LDM) to route a document into the appropriate information extraction module (IEM). The IEM is based on language-specific sets of linguistic rules for the identification of relevant textual facts. The achieved accuracy of both the LDM and IEM is 99%. The architecture of the system is described in detail.
Understanding Data Collection Behaviour of Mental Health Practitioners
Authors: Rezaei-Yazdi Ali  , Buckingham Christopher D.
Published: February 2025

Failure to detect patients at risk of attempting suicide can result in tragic consequences. Identifying risks earlier and more accurately helps prevent serious incidents occurring and is the objective of the GRiST clinical decision support system (CDSS). One of the problems it faces is high variability in the type and quantity of data submitted for patients, who are assessed in multiple contexts along the care pathway. Although GRiST identifies up to 138 patient cues to collect, only about half of them are relevant for any one patient and their roles may not be for risk evaluation but more for risk management.
Filtering mfVEP signals using Wiener filter
Authors: Ortiz del Castillo M.  , de Santiago L.  , Fernández A.  , García-Luque J.R.  , Sánchez-Morla E.M.  , Boquete L.
Published: February 2025

The multifocal visual-evoked-potential (mfVEP) signals are filtered using the Wiener filter combined with a Fast Fourier Transform and their signal-to-noise ratios are compared against those of unfiltered signals (RAW data) and those of signals filtered using the traditional method (FFT data). The Wiener filter improves the original signals' SNR by 37.49%, while the FFT improves the SNR by 20.41%. This gain is achieved by selecting the best channel in each sector of the visual field. In conclusion, filtering using the Wienerś method improves the quality of mfVEP signal pre-processing when compared against the original signals, or against filtering using the FFT.
A cloud based architecture to support Electronic Health Record
Authors: Zangara Gianluca  , Corso Pietro Paolo  , Cangemi Francesco  , Millonzi Filippo  , Collova Francesco  , Scarlatella Antonio
Published: February 2025

We introduce a novel framework of electronic healthcare enabled by a Cloud platform able to host both Hospital Information Systems (HIS) and Electronic Medical Record (EMR) systems and implement an innovative model of Electronic Health Record (EHR) that is not only patient-oriented but also supports a better governance of the whole healthcare system.
Affine registration of [123I]FP-CIT SPECT brain images
Authors: Salas-Gonzalez Diego  , Górriz Juan M.  , Ramírez Javier  , A. Illán Ignacio  , Padilla Pablo  , Martínez-Murcia Francisco J.  , Lang Elmar W.
Published: February 2025

In this work, we perform a comparison between the spatial normalization of [123I]FP-CIT SPECT brain images when a FP-CIT SPECT and a MRI template are used. A 12-parameters affine registration model is calculated by the optimization of a sum of squares cost function. When the images are registered to a FP-CIT template, the intersubject variation is found to be lower than when the MRI template is used, specially in the striatum, which is the most relevant part of the brain in FP-CIT SPECT brain images.
Valuing National Effects of Digital Health Investments: An Applied Method
Authors: Hagens Simon  , Zelmer Jennifer  , Frazer Cassandra  , Gheorghiu Bobby  , Leaver Chad
Published: February 2025

This paper describes an approach which has been applied to value national outcomes of investments by federal, provincial and territorial governments, clinicians and healthcare organizations in digital health. Hypotheses are used to develop a model, which is revised and populated based upon the available evidence. Quantitative national estimates and qualitative findings are produced and validated through structured peer review processes. This methodology has applied in four studies since 2008.
Sociotechnical Design of an Electronic Tool for Managing Transient Ischemic Attack in the Emergency Department
Authors: Lau Francis  , Partridge Colin  , Penn Andrew  , Stanley Dana  , Votova Kristine  , Bibok Maximilian  , Harris Devin  , Lu Linghong
Published: February 2025

This paper describes the adoption of a prototype electronic decision support tool for managing transient ischemic attack (TIA) in the Emergency Department (ED) of a health region in Canada. A clinician-driven sociotechnical design approach is used to develop, test and implement the prototype with the aim to improve TIA management in the ED. In this study, we worked closely with ED staff to: identify issues and needs in TIA management; build/test/refine prototype versions of the electronic TIA decision support tool; and explore strategies to implement the tool for routine use in the ED. A blood protein biomarker test under development will also be incorporated as part of this tool in a subsequent phase. Thus far the prototype has demonstrated the potential to improve triage, risk stratification, and disposition decisions based on historical TIA and mimic cases. A prospective multi-site clinical utility study is planned for spring of 2016.