bluuebunny/crossref_metadata_2025 huggingface dataset:
Application Of Space Technologies For Valuation Of A Stress Level
Authors: Mayorov Oleg Yu.  , Baevsky Roman M.
Published: February 2025

The adaptation of large long-term experience of application Heat Rate Variability in space biology and medicine and medical researches is represented. The description of the new approaches is given which are fixed in a basis of diagnostic computer systems “NeuroResercher™5.0” (or System of Computer Vegetology “CardioTensionTest™5.0” as module in the frame of “NeuroResercher™5.0”) and “Varicard”. These systems for thorough clinical and experimental scientific investigations and experimental investigations (for specialists of R&D institutes, doctors of functional diagnosis rooms of hospitals possessing clinical bases of R&D institute and medical university chairs, during clinical and preclinical testing of drugs, medical and biological R&D institutes carrying out Nneurophysiological investigations in the field of labour medicine and sport medicine, development of infantile nervous system, medical education establishments.
Computed Tomography Image Analyzer: Segmentation Applying Active Contour Models - “Snakes”
Authors: Maksimovič Ružica  , Stankovič Srdjan  , Milovanovič Dragorad  , Marinkovič Jelena  , Goldner Branislav  , Janičijevič Miloš  , Seferovič Petar M.
Published: February 2025

Many diagnostic and therapeutic procedures depend on medical images. In order to overcome imperfections of obtained images which are due to acquisition process and to obtain new information from available images, many techniques have been developed. In this study relatively new method of image segmentation, active contour model - “snakes” was applied in analyzing computed tomography (CT) images in patients with acute head trauma. Using this method, lesion to brain (LBR) and ventricle to brain ratio (VBR) were obtained accurately. Quantitative variable LBR, is significantly higher in patients with other pathologic CT findings and who do not survive during hospitalization. Thus, by applying segmentation “snakes” model it is possible to extract maximum information from available CT scans. These variables could be basis for medical decision making in patients with acute head trauma.
Quantitative Data Analysis for Exploring Outcomes in Cardiac Surgery
Authors: Kircher Albert  , Antonsson Johan  , Babic Ankica  , Casimir-Ahn Henrik
Published: February 2025

The article focuses on possibilities of statistical knowledge exploration to predict outcomes of surgical treatments. The outcomes were defined in relation to the measured peri- and intraoperative data, as well as follow-up patient questionnaire. Clinical consequences are expected in terms of a smaller data set with a better ability to predict the surgery outcomes and a better cost performance. The important questions that could discriminate quality of life (QoL) were:
The Need for Evaluation when Managing the IMIA.ORG Web-site
Authors: Kleinoeder Thomas  , Jahn Udo  , Rienhoff Otto
Published: February 2025

The International Medical Informatics Association (IMIA) has built up a web-site to support international scientific exchange and facilitate organizational tasks. Regular monitoring is required to get information on whether the site is actually used and by whom. Main aspects of the evaluation are function, structure and contents. As main evaluation methods the logfile analysis and user questionnaires are used. The number of visits to IMIA's web-site has constantly increased in the last year. In January 1998 the site had 418 visits, in December 1998 there were 6002 visits. The user questionnaire showed that the web-site offers an adequate platform for the members. It is concluded that the members as the main target group are reached by the services and in addition that the growing number of non-members require further development of the public part of the site.
Organization and dissemination of multimedia medical databases on the WWW
Authors: Todorovski Ljupčo  , Ribarič Samo  , Dimec Jure  , Hudomalj Emil  , Lunder Tomaž
Published: February 2025

In the paper, we focus on the problem of building and disseminating multimedia medical databases on the World Wide Web (WWW). The current results of the ongoing project of building a prototype dermatology images database and its WWW presentation are presented. The dermatology database is part of an ambitious plan concerning an organization of a network of medical institutions building distributed and federated multimedia databases of a much wider scale.
The optimization of turnaround time for blood samples in an emergency clinical laboratory
Authors: Prijatelj Vesna  , Vučkovič Andrej  , Černe Darko
Published: February 2025

The University Medical Centre Ljubljana is a 3200-bed general hospital. A laboratory information system, developed to improve the reliability and usefulness of test results, was installed in the emergency laboratory in November 1994. At that time, all test requests received by the laboratory were treated as equally urgent, but in December 1994, a reorganisation took place, which involved the introduction of a priority system. We conducted a study in the period from November 1994 to September 1995. The turnaround time for blood analyses was evaluated by the method of case study. The influence of information technology and organisational changes on individual components of the turnaround time was assessed.
Supporting decisions in diabetic patients management through Case-Based retrieval
Authors: Montani S.  , Bellazzi R.  , Portinale L.  , Fiocchi S.  , D'Annunzio G.  , Stefanelli M.
Published: February 2025

In this paper we present a tool for the intelligent retrieval of past cases to support Insulin Dependent Diabetes Mellitus patients therapy revision. This tool was designed for assisting physicians during periodical monitoring visits. Each case is represented through i) a collection of features that describe the patient’s clinical state at the decision time, i.e. the control visit, ii) the decision taken in terms of therapy revision and iii) the outcome obtained on the metabolic control during the following monitoring period. A new case is first classified into a protypical monitoring situation, and then similar cases are retrieved and shown to the user. This tool is fully integrated in a Web-based distributed system for Diabetes Management, developed within in the EU project T-IDDM.
A Decision Support System for Cholinesterase Genotyping
Authors: Richards B.  , Cadman J.  , France M.
Published: February 2025

Cholinesterase is a naturally occurring enzyme in the human body. Its importance became apparent when it was recognised that patients undergoing surgery and carrying abnormal genes for this enzyme were unable to recover from a dose of muscle-relaxant. It is therefore important to know the Genotype (the pair of genes) of a patient who might undergo surgery. The computer programme takes laboratory measurements and applies mathematical techniques and clinical judgements to determine the two genes present.
The Electronic Patient Records of the Hannover Medical School
Authors: Porth A.J.  , Niehoff C.  , Matthies H.K.
Published: February 2025

In this paper, the succesfull introduction of a commercially available electronic patient record archiving system at the Hannover Medical School is described. Since 1996, more than 11 million document sheets of 130.000 patient records have been stored electronically. Currently, 100.000 sheets are stored each week.
Structuring clinical information in Healthcare Records
Authors: Mori A.Rossi  , Consorti F.
Published: February 2025

We carried out an analytical study about names of clinical documents, titles of generic sections, names of data elements, to prepare the European Prestandard CEN ENV 13606-2 on “Health Informatics — Communication of Electronic Health Care Record — Part 2: Domain Termlist”. The goal of the standard is to facilitate transmission and/or homogeneous browsing of clinical information from disparate patient records, without any preliminary agreement on coding systems, data elements, record organization.
Professional Knowledge as the Basis of Electronic Patient Record Systems
Authors: Pronkina T.E.  , Shifrin M.A.
Published: February 2025

The presentation is devoted to the role of professional knowledge in the developing of Electronic Patient Record System (EPRS). The main example - EPRS for N.N.Burdenko Neurosurgical Institute (NSI).
Automatic enrichment of the Unified Medical Language System starting from the ADM knowledge base
Authors: Le Duff Franck  , Burgun Anita  , Pouliquen Bruno  , Delamarre Denis  , Le Beux Pierre
Published: February 2025

The Unified Medical Language System (UMLS) project aims to provide a repository of terms, concepts and relationships from several medical classifications. This work describes the possibility to enrich automatically with meaningful links the UMLS database by using description of diseases from another knowledge base, in our case ADM (Aide au Diagnostic Medical). In spite of the constraints and the difficulties to qualify the interconcept links, the results show that it is possible to find and create new links from a french knowledge database to the UMLS one. One of the interests of this work is that the automated learning of the connections could be used with others knowledge databases like expert system databases.
Towards a Multilingual Morpheme Thesaurus for Medical Free-Text Retrieval
Authors: Schulz Stefan  , Romacker Martin  , Franz Pius  , Zaiss Albrecht  , Klar Rüdiger  , Hahn Udo
Published: February 2025

We introduce a methodology for the segmentation of complex compounds into medically plausible morphemes. A tool for thesaurus compilation and management is presented, and design principles for a multilingual morpheme thesaurus are outlined. Our goal is to enhance the quality of medical free-text retrieval by replacing lexically based through morpheme-based search procedures.
The development and testing of information system for community nursing
Authors: Leskovar Robert  , Šušteršič Olga  , Rajkovič Vladislav  , Bitenc Iztok  , Zelič Igor
Published: February 2025

The paper presents the development and testing of information system (IS) for community nursing (CN). The goal of IS is to support CN practice and to encourage research and developement in the field. The development was based on analysis of CN process. Principal functions of CN were analysed. The logical data model and corresponding user interface were designed. A special emphasis in the development process was put on testing in practice and users' training. The developed IS will: increase work efficiency, introduce process-oriented nursing doctrine, support integrated treatment of the subjects and enable data comparison and exchange. An important subsidary goal of the IS development and usage is the harmonisation of concepts and terminology used in Slovenia with those used in the EU. In this framework International Classification of Nursing Practice (ICNP) which was translated into Slovene was introduced and tested.
Failure Analysis of Thyroid Laboratory Diagnostic Module
Authors: Sonicki Zdenko  , Plasaj Tomislav  , Kern Josipa  , Ivanković Davor  , Kusić Zvonko
Published: February 2025

The aim of this paper is to analyse the misclassification patterns of the diagnostic module of Laboratory Information System for thyroid function diagnosis at the Sestre Milosrdnice University Hospital. In order to select misclassified patients the diagnosis of an experienced physician and the diagnostic module were compared. According to the pattern of the laboratory test results, misclassified patients were described and grouped. In conclusion, we have found one obvious module’s mistake but the other misclassification patterns have shown more dubious problem in the thyroid function classification.
Telerehabilitation Services Using Web-based Telecommunication
Authors: Grimes Gary J.  , Dubois Helene  , Grimes Sharon J.  , Greenleaf Walter J.  , Rothenburg Stuart  , Cunningham Donna
Published: February 2025

A World Wide Wide-based telerehabilitation platform has been demonstrated in a laboratory environment. This platform allows a rehabilitation provider to thoroughly evaluate the progress of a patient remotely with the same care and measurement precision that would be possible if the provider and the patient were in the same room. The platform was designed to be Web-based so that the service could be offered at the same price without regard to long distance telecommunication facility charges. The Web-based implementation allows enough bandwidth for a simultaneous video teleconference and a precision data acquisition mode even when the Web connection is a low cost analog modem computer interface at both ends of the connection.
Improvement of Surgical Simulation Using Dynamic Volume Rendering
Authors: Radetzky Arne  , Schröcker Florian  , Auer Ludwig M.
Published: February 2025

In the last years high efforts have been taken to develop surgical simulators for computer assisted training. However, most of these simulators use simple models of the human's anatomy, which are manually created using modeling software. Nevertheless, medical experts need to perform the training directly with the patient's complex anatomy, which can be received, for example, from digital imaging datasets (CT, MR). A common technique to display these datasets is volume rendering. However, even with high-end hardware only static models can be handled interactively. In surgical simulators a dynamic component is also needed because tissues must be deformed and partially removed. With the combination of spring-mass models, which are improved by neuro-fuzzy systems, and the recently developed OpenGL Volumizer, surgical simulation using real-time deformable (or dynamic) volume rendering became possible. As an application example the simulator ROBOSIM for minimally invasive neurosurgery is presented.
A New Research Program in Medical Image Data Processing
Authors: Yoo Terry S.  , Ackerman Michael J.
Published: February 2025

The National Library of Medicine, in partnership with the National Institute for Dental and Craniofacial Research, the National Eye Institute, the National Science Foundation, the National Institute for Deafness and Other Communication Disorders, and the National Cancer Institute, has founded a software consortium to support the creation of a public resource in high-dimension data processing tools. The initial emphasis of this effort is to provide public software tools in 3D segmentation and deformable and rigid registration, capable of analyzing the head-and-neck anatomy of the Visible Human Project data. The eventual goal is for the consortium to provide the cornerstone of a self-sustaining software community in 3D, 4D and higher dimensional data analysis. The consortium is committed to open-source code, public software including open interfaces supporting connections to a broad range of visualization and graphic user interface platforms.
The Left Ventricular Ejection Effect
Authors: Danielsen Michael  , Palladino Joseph L.  , Mulier Jan P.  , Noordergraaf Abraham
Published: February 2025

A recently developed model of the left ventricle, based on experimental data, has been shown to exhibit the main features of the heart's ability to pump. Two special cases during blood ejection, termed pressure deactivation and hyperactivation, were identified. This study proposes an ‘ejection effect’ correction to the model that addresses deactivation, hyperactivation and adjusts the shape of the computed ventricular ejection curve in late systole. Also, a new approach based on new animal experiments is proposed to identify the ejection effect mechanism(s).
11. Using S/MIME for Health Insurance Claims
Authors: Bensen Tim
Published: February 2025

This chapter describes a specific case study which was looking at an alternative approach using a commercially available mail client software to securely transfer health insurance claims from UK doctors to private health insurers. The chapter outlines the background to the search for an alternative approach, the methods used, some summary feedback from the exprience and some conclusions to be drawn. This chapter highlights the importance of sharing experiences on as wide a scale as possible both within health and without in such a complex field.
4. The CoCo Guide to EDI Security
Authors: Grotan Tor Olav
Published: February 2025

This chapter describes the approach and contents of the regional EDI security guidelines developed in the CoCo project. The chapter also presents some Norwegian experiences in view of the guidelines making use also of the TmstHealth 1 recommendations.
8. Security and the RHINE Project
Authors: van der Werff Albert  , Mensch Hubert
Published: February 2025

This chapter provides an introduction to the RHINE project, and looks at the role of security and the need to implement a security policy within the regional environment.
9. The TIDDM Project and Security
Authors: Mossa C.  , Riva A.  , Bellazzi R.
Published: February 2025

This chapter looks at the project TIDDM and its experience in the area of security. It consists of an introduction to the project and an explanation of its context with Telemedicine. The chapter then describes the support architecture, the servers, protocol and the development environment. It identifies the TIDDM needs in the security area and provides an overview of security and cryptography solutions leading to an explanation of the Implementation in TIDDM.
Telemedicinal Virtual Reality for Cognitive Rehabilitation
Authors: Gourlay D  , Lun KC  , Liya Guan
Published: February 2025

Cognitive rehabilitation and assessment of cognitively impaired patients has traditionally been performed using paper and pencil psychometeric tests. These tests are becoming increasingly dated and do not involve real world tasks. This paper describes a virtual reality kitchen designed to help patients relearn important daily living skills. Some important issues concerning virtual reality and the disabled are discussed. Additionally we describe the development of a prototype networked system to enable a doctor to monitor remotely the rehabilitation of a group ofpatients.
New DICOM Extensions for Softcopy and Hardcopy Display Consistency
Authors: Eichelberg Marco  , Riesmeier Jörg  , Kleber Klaus  , Oosterwijk Herman  , Jensch Peter
Published: February 2025

The DICOM standard defines in detail how medical images can be com- municated. However, the rules on how to interpret the parameters contained in a DICOM image which deal with the image presentation were either lacking or not well defined. As a result, the same image frequently looks different when displayed on different workstations or printed on a film from various printers. Three new DICOM extensions attempt to close this gap by defining a comprehensive model for the display of images on softcopy and hardcopy devices: Grayscale Standard Display Function, Grayscale Softcopy Presentation State and Presentation Look Up Table.
Regionalanalyse prognostizierter Krebserkrankungszahlen in Niedersachsen
Authors: Kieschke J.  , Rohde M.  , Wellmann I.
Published: February 2025

Auf der Grundlage der altersspezifischen Inzidenzraten des epidemiologischen Krebsregisters des Saarlands der Jahre 1991 bis 1995 und der regionalen Vorausschätzung der Bevölkerung des Niedersächsischen Landesamtes für Statistik (NLS) wird ein Anstieg der Kjebserkrankungszahlen für die Jahre 1993 bis 2011 von 36,7 % bei Männern und 15,3 % von Frauen in Niedersachsen prognostiziert. Dabei zeigen sich deutliche regionale Unterschiede. Mit dem Clusterindex Moran's I wird eine regionale Häufung der Gebiete mit einem besonders hohen Anstieg in der (prognostizierten) Erkrankungszahl nachgewiesen. Mit einer hohen Zunahme an Krebserkrankungsfällen ist insbesondere in der ländlichen Weser-Ems-Region und in den angrenzenden Landkreisen um die Großstädte Hamburg, Hannover, Bremen und Braunschweig zu rechnen. Dies ist bei der Planung von Versorgungsstrukturen entsprechend zu berücksichtigen.
Utilisation of Computerised Clinical guidance in General Practice Consultations
Authors: Wilson Robert G  , Purves Ian N  , Smith Dow
Published: February 2025

This paper reports on the results of a series of focus groups held during the Phase 1 pilot intervention period of a NHS decision-support system (PRODIGY), which aims to offer contextual clinical guidance in general practice consultations. The aim of the focus groups was to collect qualitative data about users' interaction with the pilot system as part of a wider evaluation.
Individualisierung der Therapie am Beispiel der Antibiotikadosierung
Authors: Steffen Dagmar  , Gierl Lothar
Published: February 2025

Die Pharmakotherapie zielt darauf ab, ein hohes Maß an therapeutischem Erfolg bei gleichzeitiger Minimierung unerwünschter Nebenwirkungen zu erreichen. Deshalb kommt dem Messen der Blut- oder Serumspiegel nach Einnahme bestimmter Pharmaka eine große Bedeutung hinsichtlich der erfolgreichen Behandlung der Patienten zu. Nur, wenn der therapeutische Bereich erreicht und gehalten, die minimale Toxidität nicht überschritten wird, ist eine erfolgreiche Behandlung möglich. Um eine Konzentration im therapeutischen Bereich schnell zu erreichen, ist eine Initialdosis erforderlich und Applikationsintervalle und Folgedosen müssen bestimmt werden. Dies sind Größen, die beispielsweise vom Gewicht des Patienten und seiner Leber- und Nierentätigkeit beeinflußt werden. Bei einer Reihe von Chemotherapeutika ist der therapeutische Bereich schnell und möglichst genau einzustellen, um eine toxische Wirkung auf die Krankheitserreger ohne toxische Wirkung auf den Patienten zu erzielen. Ist eine Fallbasis vorhanden, können durch fallbasiertes Schließen im Akutfall neben der kalkulierten Antibiotikatherapie individualisierte Dosen und Intervals vorgeschlagen werden. Dies ermöglicht eine optimale Behandlung der Patienten.
CIM Explorer - Intelligent Tool for Exploring The ICD Romanian Version
Authors: Filip Floriana  , Haras Consuela
Published: February 2025

The CIM Explorer software provides us with an intelligent interface for exploring the Romanian version of the International Classification of Diseases (in Romanian Clasificarea Internationala a Maladiilor - CIM). The ICD was transposed from its initial appearance as a printed document into a database. The classification can be accessed in two modes: “Navigation” and “Code” and queried in the “Key words” mode. In the last mode CIM Explorer program searches for the right content of the ICD records starting from naturally written expressions which it “understands”. As a results it returns all the records containing the key words regardless their grammatical form. This program implements the specificity of the Romanian language where the words are made up from a root and a flexional termination.
Agent-Oriented Captology for Medical Informatics
Authors: Bârbat Boldur E.  , Zamfirescu Constantin B.  , Costache Gabriel
Published: February 2025

Considering that neither captology nor agent-orientation, are applied in medical informatics, as they could be, the paper presents a broad-spectrum gene- ric architectural framework to support developing adaptive medical applications, based on synergistic correlation between persuasive interfaces and intelligent agents. Their main features are adapted for medical informatics. Lying on this groundwork, the design space for agent-oriented persuasive applications is defined and several guidelines for its main dimensions are given. The approach is instantiated through an agent-based test-bench application, having the purpose to persuade to quit smoking.
Anbindung eines Anästhesie-Informations-Management-Systems an das Patienten-Daten- Management-System einer Intensivstation
Authors: Fuchs C.  , Benson M.  , Michel A.  , Junger A.  , Brammen D.  , Marquardt K.  , Hempelmann G.
Published: February 2025

In der Abteilung Anaesthesiologie und Operative Intensivmedizin der JLU Gießen erfolgt die Narkosedokumentation bereits seit 1995 mit einem Anasthesie-Informations-Management-System [1]. Seit Januar 1999 wird darüber hinaus auf 14 Routinebetten der Operativen Intensivstation die komplette Patientenakte mit dem neuentwickelten Patienten-Daten-Management-System (PDMS) “ICUdata” (Imeso GmbH, Huttenberg) erfaßt. Da eine wesentliche Forderung an eine digitale Patientenakte die vollständige Integration aller zum Patienten erhobenen Befunde ist, sollte eine vollautomatische Konnektion der beiden Dokumentationssysteme mit der Übernahme aller relevanten Daten in die entsprechenden Befundkategorien des PDMS realisiert werden. Die Applikation “NarkoBatch” (Imeso GmbH, Hüuttenberg) überprüft die AIMS-Datenbank jede Minute, ob ein Protokoll mit einer neuen Operations-ID eingefügt wurde. Ist dies der Fall, wird ein definierter Auszug des Anasthesieprotokolls aus den Datenbankeintragen zusammengestellt und als HL7-Nachricht über einen zusätzlichen Serverdienst in die äquivalenten Felder der PDMS-Datenbank geschrieben. Die Verbindung zweier Daten-Management-Systeme unterschiedlicher Struktur konnte so durch ein zusätzliches Programmodul erreicht werden, welches die Vermittlung zwischen den Datenbanken der Systeme automatisiert. Seit der Einführung des Importmoduls im Juni 1999 sind die Daten aus mehr als 13.000 Narkoseprotokollen in das PDMS integriert worden und stehen bei Aumahme des entsprechenden Patienten zur Verfügung. Der automatisierte Datenimport aus dem Narkoseprotokoll erhöht die Datenqualität, stellt eine Erleichterung für das Personal der Intensivstation dar und vermeidet eine redundante Dateneingabe.
Mehrfacherfassungen von Patienten in Patientendatenmanagementsystemen
Authors: Brenk P  , Gansert UA  , Fahlbusch T
Published: February 2025

Mehrfacherfassungen von Patienten in Patientendatenmanagementsystemen (PDMS) entstehen, wenn ein bereits erfaßter Patient bei einer weiteren Aufnahme durch fehlerhafte Eingaben, mangelnde Intelligenz des PDMS oder ungiinstig gewählte Suchparameter nicht gefunden und erneut angelegt wird. Aus Mehrfacherfassungen resultierten juristische, medizinische und finanzielle Probleme. Das PDMS eines grofien Krankenhauses wurde hinsichtlich Ursachen und Häufigkeiten von Mehrfacherfassungen untersucht.
DiasNet - an Internet Tool for Communication and Education in Diabetes
Authors: Hejlesen Ole K.  , Plougmann Søren  , Cavan David A.
Published: February 2025

Although studies have shown that intensive diabetes treatment with the goal of maintaining blood glucose concentrations close to the normal range lead to a substantial reduction of the rate of the complications (e.g. blindness, kidney failure, amputations and circulatory diseases), this can be difficult to achieve using conventional means. It is recognised that a number of patients may have poor control despite specialist care, and this along with devolution of care to non-specialists suggests that alternative interventions should be developed. DiasNet, which is used by patients as a tool for education and communication, is based on a well documented decision support system used by clinicians to give advise on insulin dose. In DiasNet the patients can experiment with their own data, adjusting insulin doses or meals sizes, and thereby learning how to cope with various situations. The system can run both as an ordinary application on a standard PC, and as an Internet application using a standard web browser. The latter enables a new way of communication between patient and clinician. DiasNet is currently being tested on a small group of diabetes patients.
WEB-BASED MULTIMEDIA COURSEWARE FOR EMERGENCY CARDIAC PATIENT MANAGEMENT SIMULATIONS
Authors: Ambrosiadou V.  , Compton Tony  , Panchal Trushar  , Polovina Simon
Published: February 2025

This is a multidisciplinary inter-departmental/faculty project between the departments of computer science, electronic, communications and electrical engineering and nursing and paramedic sciences. The objective is to develop a web based multimedia front end to existing simulations of cardiac emergency scenaria. It will be used firstly in the teaching of nurses.
An Object-Oriented Approach for Structuring the Electronic Medical Record
Authors: Banhart Friedemann  , Lohmann Rüdiger
Published: February 2025

We implemented a framework for modelling the electronic medical record on top of an object- oriented model. Clinical patient data are structured in a uniform way through the use of a comprehensive data model. The meaning of the information elements is explicitly determined by a medical data dictionary. The data structures of both, medical record and data dictionary are implemented, using a semantically rich, object-oriented data model. We examined several possibilities for the graphical preparation of the inherently recursive data structures. Again, we use object-oriented frameworks for the implementation of flexible user interfaces to the electronic medical record with a consistent look-and-feel.
Transforming XML-Based Electronic Patient Records for Use in Medical Case Based Reasoning Systems
Authors: Abidi Syed Sibte Raza  , Manickam Selvakumar
Published: February 2025

Electronic patient records (EPR) can be regarded as an implicit source of clinical behaviour and problem-solving knowledge, systematically compiled by clinicians. We present an approach, together with its computational implementation, to pro-actively transform XML-based EPR into specialised Clinical Cases (CC) in the realm of Medical Case Base Systems. The ‘correct’ transformation of EPR to CC involves structural, terminological and conceptual standardisation, which is achieved by a confluence of techniques and resources, such as XML, UMLS (meta-thesaurus) and medical knowledge ontologies. We present below the functional architecture of a Medical Case-Base Reasoning Info-Structure (MCRIS) that features two distinct, yet related, functionalities: (1) a generic medical case-based reasoning system for decision-support activities; and (2) an EPR-CC transformation system to transform typical EPR’s to CC.
Dimension Reduction for Highdimensional Online-Monitoring Data in Intensive Care
Authors: Bauer Marcus  , Fried Roland  , Gather Ursula  , Imhoff Michael
Published: February 2025

Nowadays high dimensional data in intensive care medicine can be captured, stored, and retrieved with the help of clinical information systems. Intelligent alarm systems are needed for an adequate bedside decision support, in the course of which the detection of qualitative patterns in physiologic monitoring data such as outliers, level changes, or trends aims at a proper classification of the patients state. Statistical time series techniques have already been applied successfully to the analysis of single physiological variables. The simultaneous online analysis of the multivariate patient curve yields further challenges. We describe methods for reducing the dimension and for keeping the computational efforts necessary for monitoring low. We present preliminary results of an ongoing study on monitoring critically ill patients.
Convergence Diagnosis for Gibbs Sampling Output
Authors: Mansmann Ulrich
Published: February 2025

Gibbs sampling is a technique to calculate a complex posterior distribution as steady state measure of a Markov chain. The fundamental problem of inference from Markov chain simulation is that there will always be areas of the target distribution that have not been covered by the finite chain. Deciding when to stop the chain in order to have reached enough coverage of the support of the target distribution is an important matter. Techniques based on one long single chain and on multiple chains are discussed in the framework of a linear mixed effects model. The diagnostics used do not provide a consistent view on the convergence. Practical consequences on the estimates are shown.
Einsatz von standardisierten Pflegeplänen in rechnerbasierten Pflegedokumentationssystemen
Authors: Pohl U.  , Eichstädter R.  , Spies-Holusa R.  , Ammenwerth E.  , Haux R.
Published: February 2025

Bei der Einführung rechnerbasierter Pflegedokumentation spielen standardisierte Pflegepläne eine entscheidende Rolle. Dieser Beitrag zeigt auf, wie standardisierte Pflegepläne entwickelt werden können und wie ihre Nufzung iiber ein rechnerbasiertes Pflegedokumentationssystem in den Pflegeprozeß integriert werden kann. Hierbei setzt sich der Beitrag auch mit der “International Classification for Nursing Practice” (ICNP) auseinander.
Eine Dokumentenanalyse herkömmlicher Patientenakten im Hinblick auf das Design einer digitalen Patientenakte
Authors: Wegmann U.  , Veltmann U.  , Joos U.K.  , Prokosch H.U.
Published: February 2025

Die nachfolgende Arbeit beschreibt eine Dokumentenanalyse herkömmlicher ambulanter und stationärer Akten als Grundlage für Designkriterien elektronischer Patientenakten. Anhand einer Dokumentenklassifikation werden traditionelle Akten aus der Mund- und Kiefer-Gesichtschirurgie der Universitätsklinik Münster analysiert. Mit Hilfe dieser Ergebnisse werden dann die Anforderungen an das Design einer elektronischen Krankenakte, bezogen auf die Dokumentendarstellung, formuliert.
Dissemination of the use of the electronic patient record in high-quality workmanship: The regional IT consultant for primary care doctors
Authors: Demkjœr Karin  , Lehrmann Tove  , Bové Troels
Published: February 2025

The number of general practitioners in Denmark with electronic patient record systems is rising. More than 80% of all GP practices now have computerised patient record systems. These medical practices communicate electronically with hospitals, laboratories, pharmacies and county councils. With the procurement of electronic patient record systems and connection to the Danish Healthcare Data Network, the vast majority of patient data in medical practices is now held in electronic form. This offers good opportunities for the data to be used not just in the consultation situation but for quality development and the monitoring of quality targets in general practice as well.
Chapter 3.2 - Sleep Atlas and Multimedia Database
Authors: Penzel Thomas  , Kesper Karl  , Mayer Geert  , Zulley Jürgen  , Peter Jörg-Hermann
Published: February 2025

The ENN sleep atlas and database was set up on a dedicated server connected to the internet thus providing all services such as WWW, ftp and telnet access. The database serves as a platform to promote the goals of the European Neurological Network, to exchange patient cases for second opinion between experts and to create a case-oriented multimedia sleep atlas with descriptive text, images and video-clips of all known sleep disorders. The sleep atlas consists of a small public and a large private part for members of the consortium. 20 patient cases were collected and presented with educational information similar to published case reports. Case reports are complemented with images, video-clips and biosignal recordings. A Java based viewer for biosignals provided in EDF format was installed in order to move free within the sleep recordings without the need to download the full recording on the client.
Our Wealth, Our Health – Bellwether Industries for Decision Tools and Symbiotic Stewardships
Authors: Wooldridge Jean A.
Published: February 2025

This chapter examines the tea leaves of emerging technologies for the most fruitful areas of crossover value to health decisions, by spotting bellwether industries of similar information asymmetries. It examines changing tools and roles for growing consumer-centrism in personal finance, healthcare, private aviation, and law. It seeks to understand the technologies of managing and measuring, the transformations of growing transparencies in our processes, and how an increasing sense of collective stewardship forged between people and their machines can lead beyond effectiveness to wisdom, for individuals, communities, and the world.
Impact of Voice- and Knowledge-Enabled Clinical Reporting – US Example
Authors: Bushko Renata G.  , Havlicek Penny L.  , Deppert Edward  , Epner Stephen
Published: February 2025

This study shows qualitative and quantitative estimates of the national and the clinic level impact of utilizing voice and knowledge enabled clinical reporting systems. Using common sense estimation methodology, we show that the delivery of health care can experience a dramatic improvement in four areas as a result of the broad use of voice and knowledge enabled clinical reporting: (1) Process Quality as measured by cost savings, (2) Organizational Quality as measured by compliance, (3) Clinical Quality as measured by clinical outcomes and (4) Service Quality as measured by patient satisfaction [1]. If only 15 percent of US physicians replaced transcription with modern clinical reporting voice-based methodology, about one half billion dollars could be saved. $6.7 Billion could be saved annually if all medical reporting currently transcribed was handled with voice-and knowledge-enabled dictation and reporting systems.
Modeling and Simulation for Space Medicine Operations: Preliminary Requirements Considered
Authors: Dawson David L.  , Billica Roger D.  , McDonald P. Vernon
Published: February 2025

The NASA Space Medicine program is now developing plans for more extensive use of high-fidelity medical simulation systems. The use of simulation is seen as means to more effectively use the limited time available for astronaut medical training. Training systems should be adaptable for use in a variety of training environments, including classrooms or laboratories, space vehicle mockups, analog environments, and in microgravity.
Virtual simulation system for collision avoidance for medical robot
Authors: Gonchar L.  , Engel D.  , Raczkowsky J.  , Wörn H.
Published: February 2025

For the collision avoidance with a medical robot with 6 DOF a virtual simulation system is presented. Manipulator and obstacles are modelled by geometric primitives. Collisions are detected in the Cartesian workspace by hierarchical distance computation based on the given CAD model. The application initially being addressed is maxillofacial surgery, where the safety of the patient is the main requirement, because of the closeness to vital parts. The simulation system allows the surgeon to check up the trajectory of the robot before the current operation begins
Retraining Movement in Patients with Acquired Brain Injury using a Virtual Environment
Authors: Holden Maureen K.  , Dettwiler Annegret  , Dyar Thomas  , Niemann George  , Bizzi Emilio
Published: February 2025

We report preliminary results of an ongoing study in which a virtual environment (VE) system is used to facilitate motor relearning of a pouring task in patients with Acquired Brain Injury (ABI). Four subjects were evaluated pre-and pbst-VE training using virtual-world and real-world tests in which subjects performed a pouring motion while holding a cup. Standard clinical tests of motor and functional ability were also used. Three of four subjects demonstrated improvement in end-point trajectories (cup path) performed during the virtual and real world tests. Clinical test scores also improved. Results indicate that subjects with ABI were able to learn a movement in VE, and generalize this ability to real-world performance of similar and unrelated tasks. VE training appears to be a feasible and promising approach to the rehabilitation of subjects with ABI.
Ghost Imaging in MRI
Authors: Kaufman Leon  , Goldhaber David M  , Kramer David M  , Hawryszko Christine  , Georgian-Smith Dianne  , Haynor David
Published: February 2025

Needle biopsies and other interventions done under MR Fluoroscopy sometimes do not show the target well, either because the rapid sequence does not have adequate contrast or because a contrast agent may have washed out of the target. In these cases, an image that shows the target can be saved and scaled to match the spatial parameters of the fluoroscopic sequence, and used as a virtual or ghost field upon which the fluoroscopic images are superimposed, thus providing a view of the target, useful for needle pre-localization and for monitoring its progress as it is inserted.
Computer Simulation Of Osteotomy Correction
Authors: Krivonos O.  , Moskalenko D.  , Keppler P.  , Kinzl L.  , Hesser J.  , Männer R.
Published: February 2025

This paper describes a novel approach to correct osteotomy deformities of long bones using virtual reality and image processing techniques on personal computers. The discussed method allows to simulate osteotomy corrections by implementing a single cut and a rearrangement of the dissected bone parts. It allows the surgeon to directly control the pre-operative situation and the post-operative result of the simulation by comparing bone-length, angles, and torsion of the bone. In addition, he or she obtains the coordinates and angles of the planned cut relative to anatomical landmarks.
The Representation of Blood Flow in Endourologic Surgical Simulations
Authors: Oppenheimer Peter  , Gupta Arnab  , Weghorst Suzanne  , Sweet Robert  , Porter James
Published: February 2025

An image-based approach has been developed to represent bleeding in a simulator for transurethral resection of prostate (TURP). While previous attempts have simulated bleeding over tissue surfaces or in blood vessels, our approach focused on the macroscopic visualization of bleeding in a fluid environment. TURP is an ideal procedure for simulation-based training because of the dynamic environment and the variety of flow patterns it presents. The first step in the development of the simulator was the generation of blood flow movies which consisted of capturing videos of bleeding vessels in vitro, processing them to separate the actual blood from the background anatomy and organizing the movies into a parametric database. During the running of the simulation, resection of prostate tissue systematically triggers bleeding events and the playback of a blood flow movie. The blood flow movie is texture mapped onto a virtual surface that is positioned oriented, morphed, composited and looped into the virtual scene.
A Survey Study for the Development of Virtual Reality Technologies in Orthopedics
Authors: Riener Robert  , Burgkart Rainer
Published: February 2025

Virtual reality (VR) technologies have the potential to support medical education and training. In order to orient the development of medical VR applications towards the actual deficiencies and demands in orthopedics, we performed a survey among 56 orthopedic physicians. They were asked to provide information about the kind of physical joint evaluation tests which they perform most often, the importance of physical joint evaluation in comparison to alternative diagnostic methods, and their opinion about current medical education system as well as the prospects of VR applications in orthopedics. The main conclusion of this survey is that VR applications have the potential to improve the lacking medical education and orthopedic training, e.g. by improving the quality of joint evaluation methods, reducing the high number of unhealthy, risky and expensive alternative diagnostic procedures.
A NEW PORTABLE EQUIPMENT FOR DETECTION OF PSYCHOPHYSICAL CONDITIONS
Authors: Rovetta A.  , Cucè A.  , Platania D.  , Solenghi C.
Published: February 2025

This paper deals with the Disease Detector (DDX) that is a virtual reality control system for detection of Parkinson disease.
3D registration through pseudo x-ray image generation
Authors: Viant Warren J  , Barnel Frederic
Published: February 2025

Registration of a pre operative plan with the intra operative position of the patient is still a largely unsolved problem. Current techniques generally require fiducials, either artificial or anatomic, to achieve the registration solution. Invariably these fiducials require implantation and/or direct digitisation. The technique described in this paper requires no digitisation or implantation of fiducials, but instead relies on the shape and form of the anatomy through a fully automated image comparison process. A pseudo image, generated from a virtual image intensifier's view of a CT dataset, is intra operatively compared with a real x-ray image. The principle is to align the virtual with the real image intensifier. The technique is an extension to the work undertaken by Domergue [1] and based on original ideas by Weese [4].
Virtual Reality as Clinical Tool: Immersion and Three-Dimensionality in the Relationship between Patient and Therapist
Authors: Vincelli Francesco  , Molinari Enrico  , Riva Giuseppe
Published: February 2025

VR represents the maximum level of evolution in interaction between man and computer systems. In Clinical Psychology, the virtual cyberspace offers a series of powerful and valid applications for diagnosis and therapy.
Representation Formalisms and Computational Methods for Modeling Guideline-Based Patient Care
Authors: Tu Samson W.  , Musen Mark A.
Published: February 2025

This paper (1) presents a set of patient-care tasks for which a computer-interpretable representation of clinical practice guideline and protocols can provide assistance, (2) surveys the formalisms and computational methods that have been proposed in relation to these tasks, and (3) describes a multi-method paradigm that we have been developing in the EON project to support these patient-care tasks.
Specification, Execution and Management of Clinical Test Ordering Protocols: a Database Approach
Authors: Dube Kudakwashe  , Wu Bing
Published: February 2025

There is general recognition that the use of clinical test ordering protocols supported by Information Technology can enhance quality and proper usage of clinical laboratory resources. This effort aims at addressing the requirement for a generic framework and software environment for the specification, execution and management of clinical test ordering protocols. The approach taken for the representation of clinical test order protocols is based on the event-condition-action (ECA) rule paradigm as defined in active databases. In this paper, a relational database approach to maintaining the protocol specification is discussed. Emphasis is placed on the importance of the efficient and effective management of computer-based test ordering protocol specifications at both schema and instance levels. A framework for the execution and management of clinical test ordering protocols is presented. A distinction and separation is drawn between the static protocol (specification) and the dynamic patient test plan (protocol instance).
PIERCE Program: Informatics Support for Multi-Site Clinical Research: an Environment for Consensual Use of Clinical Protocols and Clinical Trials
Authors: Grant Andrew  , Bensaber Boucif Amar  , Couture Lise  , Tremblay Nicole  , Drapeau Dany  , Blanchette Dany  , Arsenault Steve  , Maheux Pierre  , Gagné Claude  , Gaudet Daniel
Published: February 2025

The PIERCE (Prototyping Informatics and Evaluation for Research in the Clinical Environment) is designed for the Québec, Canada Cardiology Network to enable a single working informatics environment to collect high quality patient and laboratory data within clinical, clinical research and clinical trial protocols, to enable secure data sharing and also sophisticated project tracking and data analysis. This paper describes the implementation of the PIERCE program to support clinical research into triglyceride disorders, an important risk factor for atheromatous heart disease with a strong genetic predisposition in Québec.
The Development of Model Curricula for Health Informatics
Authors: Covvey H. Dominic  , Zitner David  , Bernstein Robert  , MacNeill Janice E.
Published: February 2025

We have developed model Health Informatics (HI) curricula for the education of three categories of professionals: Applied Health Informaticians, the professionals that deploy information technologies, Research and Development Health Informaticians those that develop new concepts, techniques, and solutions, and what we have called Clinician Health Informaticians, providers who use HI capabilities to support their professional work. The curricula specify the competencies that each type of professional must acquire.