bluuebunny/crossref_metadata_2025 huggingface dataset:
Tailoring Communications for Primary Care Settings
Authors: Glassman B. , Rimer B. K.
Published: March 2018

In more and more medical settings, physicians have less and less time to be effective communicators. To be effective, they need accurate, current information about their patients. Tailored health communications can facilitate positive patient-provider communications and foster behavioral changes conducive to health. Tailored communications (TCs) are produced for an individual based on information about that person. The focus of this report is on tailored print communications (TPCs). TPCs also enhance the process of evaluation, because they require a database and the collection of patient-specific information. We present a Tailoring Model for Primary Care that describes the steps involved in creating TPCs. We also provide examples from three ongoing studies in which TPCs are being used in order to illustrate the kinds of variables used for tailoring the products that are developed and how evaluation is conducted. TPCs offer opportunities to expand the reach of health professionals and to give personalized, individualized massages in an era of shrinking professional contact time.
Communication in Health Care
Authors: Duisterhout J. S. , Branger P. J.
Published: March 2018

For routine communication, care providers still mainly rely on paper documents and paper mail. Evidence exists, however, that this communication can be improved, both by a better content of information exchange and by a more timely deliverance of this information. At present, several alternatives to paper-based communication are available, such as the Fax, the Smart Card, electronic mail, and electronic data interchange. This paper describes existing communication problems, and examines the current state of development and research aimed at improving this communication using electronic communication techniques that are gradually replacing paper-based communication. Applicability and shortcomings of these new techniques are also discussed.
Multi-dimensional Visualisation of Laboratory Findings and Functional Test Results for Analysing the Clinical Course of Disease in Medicine
Authors: Luz C. J. , Giere W. , Lüdecke R. , Jonas D. , Goldschmidt A. J. W.
Published: March 2018

The illustration of a patient’s history by a graphical primitive is discussed. Illustration technology is presented which simultaneously represents quantitative examination findings (e. g., laboratory values) and qualitative findings (e. g., from function diagnostics) by a single geometrical figure. Depending on the medical results, this figure takes on characteristic forms which can be identified as patterns typical for a specific disease. The procedure developed is integrated in a user interface which is implemented in the form of a computerized medical record for use on a pentop computer. This portable computer assists the physician during ward rounds, supplies additional, intelligence-based information, serves quality control, and streamlines working procedures making them more efficient.
The Medical Record: Narration and Story as a Path Through Patient Data
Authors: Kluge E.-H. W.
Published: March 2018

Kay and Purves' proposed narratological model of the medical record is based on the familiar phenomenological insight that the perception of data is conditioned by the conceptual framework of the perceiver. Unfortunately, unless handled very carefully, this approach will make the significance of a medical record unique to the person who constructed it and impermeable to outside scrutiny. However, when integrated into the analog-model of the medical record, the narratological model can be accommodated as the clinician-relative construction of a patient profile within the data that make up the medical record. Some implications for the construction of expert systems and competence analysis are indicated.
An Object-Oriented Class Library for Medical Software Development
Authors: McColligan E. E. , O’Kane K. C.
Published: March 2018

The objective of this research is the development of a Medical Object Library (MOL) consisting of reusable, inheritable, portable, extendable C++ classes that facilitate rapid development of medical software at reduced cost and increased functionality. The result of this research is a library of class objects that range in function from string and hierarchical file handling entities to high level, procedural agents that perform increasingly complex, integrated tasks. A system built upon these classes is compatible with any other system similarly constructed with respect to data definitions, semantics, data organization and storage. As new objects are built, they can be added to the class library for subsequent use. The MOL is a toolkit of software objects intended to support a common file access methodology, a unified medical record structure, consistent message processing, standard graphical display facilities and uniform data collection procedures. This work emphasizes the relationship that potentially exists between the structure of a hierarchical medical record and procedural language components by means of a hierarchical class library and tree structured file access facility. In doing so, it attempts to establish interest in and demonstrate the practicality of the hierarchical medical record model in the modern context of object oriented programming.
Database and Knowledge Base Integration – A Data Mapping Method for Arden Syntax Knowledge Modules
Authors: Shahsavar N. , Åhlfeldt H. , Wigertz O. , Johansson B.
Published: March 2018

One of the most important categories of decision-support systems in medicine are data driven systems where the inference engine is linked to a database. It is, therefore, important to find methods that facilitate the implementation of database queries referred to in the knowledge modules. A method is described for linking clinical databases to a knowledge base with Arden Syntax modules. The method is based on a query meta-database including templates for SQL queries which is maintained by a database administrator. During knowledge module authoring the medical expert refers only to a code in the query meta-database; no knowledge is needed about the database model or the naming of attributes and relations. The method uses standard tools, such as C++ and ODBC, which makes it possible to implement the method at many platforms and to link to different clinical databases in a standardized way.
Use of Information from Clinical Trials for an Integrated Cancer Registry
Authors: Michaelis J. , Kaatsch P.
Published: March 2018

The registry of childhood malignancies in the F.R.G. is a combination of a population-based and hospital-based cancer registry. A large amount of the collected data originates from multicenter clinical trials which are integrated into the documentation system of the cancer registry. The paper describes the information flow and the system of data storage which consists of a central database on a departmental system at the registry and of several coordinated peripheral databases on microcomputers at the trial centers. Practical experience shows an increased availability and validity of the data in the registry since the implementation of the system. Aspects of data integrity and security are discussed. Although the system was designed according to specific demands of the registry, it may serve as a model for similar tasks of cooperative documentation and information exchange.
Expert Systems for the Prediction of Ovulation: Comparison of an Expert System Shell (Expertech Xi Plus) with a Program Written in a Traditional Language (BASIC)
Authors: Schreiner A. , Chard T.
Published: March 2018

The use of an expert system shell (EXPERTECH Xi Plus) in the construction of an expert system for the diagnosis of infertility has been evaluated. A module was devised for predicting ovulation from the medical history alone. Two versions of this system were constructed, one using the expert system shell, and the other using QuickBASIC. The two systems have been compared with respect to: (1) ease of construction; (2) ease of knowledge base update; (3) help and explanation facilities; (4) diagnostic accuracy; (5) acceptability to patients and clinicians; (6) user-friendliness and ease of use; (7) use of memory space; and (8) run time. The responses of patients and clinicians were evaluated by questionnaires. The predictions made by the computer systems were compared to the conclusions reached by clinicians and to the “gold standard” of day 21 progesterone.

The conclusions of this pilot study are: (1) the construction of this expert system was NOT facilitated by the use of this expert system shell; (2) update of the knowledge base was not facilitated either; (3) the expert system shell offered built-in help and explanation facilities, but as the system increased in complexity these became less useful; (4) after initial adjustment of decision thresholds the diagnostic accuracy of the system equalled that of the clinician; (5) the patient response to computer history-taking was very favorable but much less favorable to computer diagnosis; (6) the clinicians took a positive attitude to computer diagnosis; (7) the systems were easy to use; (8) the expert systems shell required much more memory space and had a much slower response time than the system written in BASIC.
Fitting and Interpreting Loglinear Interactions in Cross-Classifications from Health Policy and Medicine
Authors: Brown M. L.
Published: March 2018

A nontechnical exposition is presented of current statistical techniques for the analysis of multidimensional tables of counted data. Performing an original analysis of a data set of interest to researchers in health policy and medicine, the paper considers what kinds of questions an analysis by loglinear modeling can address, and what kinds of answers it can obtain and how they may be sought. Unlike most previous expository accounts seeking to provide introductions to this field, this paper does not require a background from the reader in either regression or the analysis of variance. By a thoroughgoing use of odds ratios and higher-order odds ratios, it nevertheless provides a technically accurate account of the key concepts of higher-order interactions among variables, and of models being hierarchical.

Statistically more advanced readers are provided with a means of effectively expositing their loglinear modeling methods and conclusions to nonstatisticians; a number of footnotes are directed toward such readers.
Rationale for a Community Strategy in the Field of Information and Communications Technologies Applied to Health Care
Authors: Jensen O. , Bach E. F. , Barber B. , van Bemmel J. H. , Bravar D. , van Eimeren W. , Greinacher C. , Lamberts H. , PuppincklO C. , Puybasset B. , Rienhoff O. , France F. H. , Sachot E. , Zöllner F. K. , Santucci G.
Published: March 2018

The challenge for Europe in the field of information and communications technologies applied to health care is that of addressing positively the problem of the widening gap between the expectations of the citizens of the type of care that can be made available and the limited resources to provide that care. If the expectations of the population are to be fulfilled, it will be necessary to find innovative ways of delivering health services and to do it more efficiently than has yet been the case. Advanced information and communications technologies will be important tools for Member States to achieve the levels of efficiency required. Based on the results of the Community AIM Exploratory Action, further collaborative work is required at EEC level to create an Integrated Health Information Environment (lHE) allowing essentially for integration, modularity and security.
Dazugehören!
Authors: Kölch M. , Fegert J. M.
Published: March 2018

Die Verbesserung von Teilhabe ist zentraler Bestandteil sowohl der UN-Behindertenrechtskonvention als auch der UN-Kinderrechtskonvention. Zentrale Aspekte für Inklusion und Teilhabe sind die Lebensbereiche von Kindern, wie Schule, Einbindung in Freundesbeziehungen und Familie. Derzeit sind in Deutschland die Anspruchsgrundlagen für Maßnahmen zur Reduzierung der Teilhabebeeinträchtigung in den Sozialgesetzbüchern niedergelegt. Dies führt zu Problemen in der Praxis, da Kinder oft mehrfachbehindert sind, und kann für Familien bei der Erlangung von Hilfen schwierig sein. Es wird eine gesetzliche Veränderung diskutiert, die alle Leistungen für alle behinderten Kinder und Jugendlichen unter dem Dach der Jugendhilfegesetzgebung vereint. Die Teilhabebeeinträchtigung muss umfassend strukturiert, aber auch wissenschaftlich evaluiert erfasst werden. Im Beitrag werden einige verwendete Instrumente vorgestellt.
Data Acquisition and Processing in Medicine: Contribution of the Microprocessor
Authors: Werner J. , Graener R.
Published: March 2018

Microprocessor systems facilitate to an increasing extent economical laboratory and process automation in the field of medicine.

The general aspects of hardware architecture and the software problems of the microprocessor are briefly demonstrated. Boundary lines to hardware logic on the one hand and to minicomputers on the other hand and the significance and position of the microprocessor in the biomedical EDP spectrum are discussed. As a reasonable concept for biosignal processing and laboratory automation we propose the »distributed microprocessor system« making use of parallel »basic systems«, which may operate independently or may be controlled by a supervisory processor. By way of a concrete example from our laboratory, some of the problems of realization of microprocessor systems are demonstrated.
Logical Thinking and the Diagnostic Process
Authors: John I.
Published: March 2018

A questionnaire was administered to 224 medical students and 16 expert clinicians. The questions were designed to test some elementary thinking processes and basic clinical knowledge.

The results indicated that the students and the experts had similar difficulties in solving logical problems. There was no significant change through, the years of the medical course. All had problems in thinking in terms of negative attributes and of prior probability. Students did not understand the significance of so-called specific features of a condition, but experts were good at this.

Experts were very good at generating new data from early hypothesis formation. This capacity developed slowly through the medical course. More emphasis on the principles of information processing techniques may be a useful contribution to teaching.

Even if logical methods are not necessary for the every day work of the clinician, an understanding of rational thinking may help to improve the accuracy of decision-making.
The Joint Analysis of Survival Times and Response Rates in Clinical Trials on the Treatment of Cancer
Authors: Wahrendorf J.
Published: March 2018

A method is outlined which allows to analyse survival and response data from a clinical trial on the treatment of cancer when the question of interest is whether the somehow defined response to the treatment has an influence on patients’ survival times. This can be done by making use of Cox’s proportional hazards model for survival data together with time-dependent covariates. This allows an appropriate classification of non-respondors and responders by considering the time of diagnosis of response during follow-up. The resulting test can be viewed as a time-dependent logrank test. An example from a clinical trial on gastrointestinal cancer is considered.
Evaluating the Validity of a Bayesian Program for Predicting Stage in Hodgkin’s Disease
Authors: Barnett A. I. , Cynthia J. , Jane F. , Gutensohn Nancy , Davies B.
Published: March 2018

A Bayesian model that provides probabilistic information about the spread of malignancy in a Hodgkin’s disease patient has been developed at the Tufts New England Medical Center. In assessing the model’s reliability, it seemed important to use it to make predictions about patients other than those relevant to its construction. The accuracy of these predictions could then be tested statistically. This paper describes such a test, based on 243 Hodgkin’s disease patients of known pathologic stage. The results obtained were supportive of the model, and the test procedure might interest those wishing to determine whether the imperfections that attend any attempt to make probabilistic forecasts have gravely damaged their accuracy.
Comprehensive Cohort Study: An Alternative to Randomized Consent Design in a Breast Preservation Trial
Authors: Olschewski M. , Scheurlen H.
Published: March 2018

If in a clinical trial only few patients consent to randomization, all those patients meeting the clinical inclusion criteria should be considered for analysis. Prerandomization is shown to be efficient only if patients can be persuaded to accept the prescribed therapy and do not introduce a self-selection bias. Under full informed consent conditions, as, for example, in a breast preservation trial, the first requirement must be questioned for ethical, the second one for methodological reasons. Conventionally randomized trials with the inclusion of patients having therapeutic preferences appear to be preferable. We briefly discuss the way of analysing the data from such a cohort study.
On the Mathematical Basis of Zelen’s Prerandomized Designs
Authors: Brunner E. , Neumann N.
Published: March 2018

The mathematical basis of Zelen’s suggestion [4] of pre randomizing patients in a clinical trial and then asking them for their consent is investigated. The first problem is to estimate the therapy and selection effects. In the simple prerandomized design (PRD) this is possible without any problems. Similar observations have been made by Anbar [1] and McHugh [3]. However, for the double PRD additional assumptions are needed in order to render therapy and selection effects estimable. The second problem is to determine the distribution of the statistics. It has to be taken into consideration that the sample sizes are random variables in the PRDs. This is why the distribution of the statistics can only be determined asymptotically, even under the assumption of normal distribution. The behaviour of the statistics for small samples is investigated by means of simulations, where the statistics considered in the present paper are compared with the statistics suggested by Ihm [2]. It turns out that the statistics suggested in [2] may lead to anticonservative decisions, whereas the “canonical statistics” suggested by Zelen [4] and considered in the present paper keep the level quite well or may lead to slightly conservative decisions, if there are considerable selection effects.
Explanatory Power for Medical Expert Systems: Studies in the Representation of Causal Relationships for Clinical Consultations
Authors: Wallis J. W. , Shortliffe E. H.
Published: March 2018

This paper reports on experiments designed to identify and implement mechanisms for enhancing the explanation capabilities of reasoning programs for medical consultation. The goals of an explanation system are discussed, as is the additional knowledge needed to meet these goals in a medical domain. We have focussed on the generation of explanations that are appropriate for different types of system users. This task requires a knowledge of what is complex and what is important; it is further strengthened by a classification of the associations or causal mechanisms inherent in the inference rules. A causal representation can also be used to aid in refining a comprehensive knowledge base so that the reasoning and explanations are more adequate. We describe a prototype system which reasons from causal inference rules and generates explanations that are appropriate for the user.
A Video Information System in an Operating Unit
Authors: Køster N. , Freuchen I. , Østergaard J.
Published: March 2018

A video information system, whose basic principles have been known for many years on airports, brought a considerable alleviation of daily work in a surgical unit where the latter is operated according to the double corridor principle. In such a structure, the »sterile« operative personnel is partly separated from the anaesthesiological department. Communication between the two groups is of fundamental importance and can be satisfactorily maintained with the aid of the video information system.
Digital Picture Analysis as an Integral Part of the Information System for Experimental Oncopathology of the German Cancer Research Center
Authors: Komitowski D. , Zinser G. , Stute C.
Published: March 2018

The information system of experimental pathology of the German Cancer Research Center serves to evaluate substantial amounts of data from animal experiments and to utilize the results in the study of the etiology, pathogenesis and therapy of experimental cancer. The system includes a registry of experimental tumors and programs for computer-supported diagnostics and digital picture analysis.

The purpose of the digital picture analysis program is to obtain objective data in a form allowing comparisons. The aims of the program are to characterize early stages of pathological processes, to provide quantitatively defined subclasses of tumors which are related to their biology and to identify morphological features important for the diagnosis and prognosis of tumors. Because there are specific problems in digital analysis of histological sections, the authors modified the techniques of general purpose digital picture analysis and developed new methods. These utilize segmentation based on dividing images into segments or transforming the images into a polar-coordinate system, structural analysis of chromatin, and three-dimensional analysis of the images of cell nuclei.
Computer-aided Diagnosis of Acute Abdominal Pain when Taking into Account Interactions
Authors: Séroussi Brigitte ,   Séroussi and the arcaurc cooperative group brigitte
Published: March 2018

The assumption of conditional independence between symptoms is commonly used in statistical computer-aided medical diagnosis. It permits to estimate the probability laws on small samples and leads to procedures easy to implement. Data from 6,916 patients suffering from acute abdominal pain were collected by the Arc& Aurc Cooperative Group. The data were analysed with a statistical approach, first under the independence assumption, then with the Lancaster first-order interactions model. The evaluation made on a 1,000-patient test set showed that, when taking into account interactions, results were comparable to clinicians’ . performance. But the comparison with the classical Bayesian independence approach revealed a significant improvement.
A Medical Record and a Computer Program for Diagnosis of Thyroid Diseases
Authors: Cobelli C. , Salvan A.
Published: March 2018

A program for computer-aided diagnosis of thyroid diseases is presented. The program is mainly oriented to an analysis of the current criteria of classification of thyroid diseases. The problem of rare diseases has been considered.

A computer-oriented medical record for thyroid diseases is presented and discussed. The computer program is dimensioned for diagnosis of 30 different diseases with a maximum of 200 symptoms freely chosen from the medical record. The main features of the program are discussed. Results were obtained on a group of rather infrequent thyroid diseases (thyroiditis).
A Computerized Information System for Pathology
Authors: Hercz L. , Laszlo Ch. A. , Reesal M. R.
Published: March 2018

This paper describes a Computerized Information System for Pathology (CISP) capable of storing, retrieving and correlating essential information in pathology reports.

Reports are entered in text form using established diagnostic terms recognizable in the system’s dictionary. Although some pre-editing of the report may be necessary, the comprehensive dictionary minimizes this effort. Dictionaries provide the vocabulary for a language which enables an economic storage of essential information in a compact and easily retrievable form. Reports and dictionaries stored on disk form the system’s data base.

CISP consists of a set of modules shared by a, number of specific load module programs which store reports, retrieve them, and process requests. The system was programmed in PL/I on the IBM 360/75 OS computer system. CISP is operated from terminals situated in hospitals.
Optimal Values for the Parameters of an On-line Algorithm Monitoring the QRS Waveform
Authors: van Eyll Ch. , Strepenne W. , Lefevre J. , Bachy J.-L. , Col J. , Cosyns J. , Charlier A. A.
Published: March 2018

Digital “on-line” QRS detection and classification in monitoring units is often performed by an algorithm using the ECG spatial velocity. Our study was undertaken to provide as well as to justify the choice of the value given to each parameter of such an algorithm (Gerlings et al., Comput. biomed. Res.5: 14—24, 1972). It was made on 5-minute ECG recordings sampled from a single lead on 17 patients. The following parameters were studied and their error function (QRS not detected, badly classified, and detected but non-existent) thoroughly investigated. For the QRS detection which was based on three parameters, para WD (window of derivative), para TD (threshold of derivative) and para TP (threshold of sampled points), the choice of WD at 24 ms was found to be critical and provided the optimal detection at 96.9%. For the QRS classification only para TolP (tolerance of sampled points)was shown to be important; when set at .5 para TolP gave the optimal classification at 97%. The method can also be used to investigate the response of the algorithm to particular QRS and to propose for such cases a specific and optimal value for each parameter.
Der Vorzeichen-Rang-Test nach Pratt
Authors: Buck W.
Published: March 2018

Während Wilcoxon Nulldifferenzen im Vorzeichen-Rang-Test vor der Rangzuteilung eliminiert, em-pfiehlt Pbatt, die Nulldifferenzen bei der Rangvergabe mit einzubeziehen, jedoch bei der Prüfgrößen-bestimmung außer acht zu lassen. Da die ΡΒΑΤΤ-Statistik eine andere Verteilungsfunktion als die Wilcoxon-Statistik besitzt, können die kritischen Werte der Wilcoxon-Statistik nicht zur Durch-führung eines ΡΒΑΤΤ-Tests benutzt werden. Daher wurde eme Tabelle der kritischen Werte der Pratt -Statistik für M = 4(1)50 Nichtnulldifferenzen, NO =1(1)50 Nulldifferenzen und die zweiseitigen Überschreitungsniveaus 0.0001, 0.0002, 0.001, 0.002, 0.01, 0.02, 0.05, 0.10, 0.20 berechnet. Für den Fall, daß der Tabellenbereich überschritten wird, ist die asymptotische Formel zur Berechnung der Übertretmigswahrscheinlichkeit über die Normalverteilung angegeben. Der Vergleich des nullenredu-zierten Wilcoxon-Tests mit dem Pratt-Test ergibt, daß der Pratt-Test relativ zum nullenreduzier-ten Wilcoxon-Test sowohl radikal als auch konservativ entscheiden kann.
Das Problem der formalen Wiedererkennung von Informationseinheiten bei der wissenschaftlichen Informationsverarbeitung
Authors: Gerdel W.
Published: March 2018

Mit den Problemen der automatischen Wiedererkennung von Personendaten hat sich die medizinische Befund- und Diagnosendokumentation beschäftigt. Hier geht es um ein Verfahren zur Wiedererkennimg von Literaturinformationen an Hand verschlüsselter Teile der bibliographischen Angaben. Seine theoretischen Grundlagen werden erörtert : Kriterien zur Auswahl von Merlanalen für die Identifikation(möglichst eindeutige Erhebbarkeit, möglichst große Trennfähigkeit), Ableitung des Begriffes der Erkemnuigswahrscheinlichkeit (die Wahrscheinlichkeit, bei der sukzessiven zufälligen Zuordnung von Elementen zu einer viel größeren Anzahl von Klassen eine bisher unbesetzte Klasse anzutreffen) und quantitative Behandlung von Größen, die che Erkemiungswahrscheinlichkeit beeinflussen (Abhängigkeitoder Unabhängigkeit der zur Wiedererkennung herangezogenen Merkmale, Gleichverteilung oder Ungleichverteilung der Merlanalsausprägungen). Für einen Anwendungsfall wird die Leistungsfähigkeitdes beschriebenen Verfahrens mit Hilfe der entwickelten Formel für die Erkennungswahrscheinlichkeit berechnet. Die Vorhersage stimmt gut mit dem empirischen Ergebnis überein.
The Use of Medical Record Linkage for Population and Genetic Studies
Authors: Newcombe H. B.
Published: March 2018

Methods are described for deriving personal and family histories of birth, marriage, procreation, ill health and death, for large populations, from existing civil registrations of vital events and the routine records of ill health. Computers have been used to group together and »link« the separately derived records pertaining to successive events in the lives of the same individuals and families, rapidly and on a large scale. Most of the records employed are already available as machine readable punchcards and magnetic tapes, for statistical and administrative purposes, and only minor modifications have been made to the manner in which these are produced.

As applied to the population of the Canadian province of British Columbia (currently about 2 million people) these methods have already yielded substantial information on the risks of disease: a) in the population, b) in relation to various parental characteristics, and c) as correlated with previous occurrences in the family histories.
A Computer Based Medical Record System
Authors: Buckley J. D. , Gledhill V. X. , Mathews J. D. , Mackay I. R.
Published: March 2018

This paper reports the design and implementation of a computer based medical record system. Clinical data from a 27-bed general medical ward are captured at the point of generation and entered into a computer through a remote terminal. The data stored at present for each patient-admission include the identification, diagnoses, clinical history, findings on physical examination and a problem oriented case synopsis. Commands are available to enter, validate, reformat, and finally store the data permanently on computer files. Other commands locate all or part of specified records, decode and reformat the data for output, and print the output at the remote terminal or on a high speed line printer. Commands are also available for data file maintenance and for statistical research on the stored records. The system has been in operation for two years and over 1,000 records are currently computer-stored.
MEDLARS: Its Utilization in Research, Education and Practice
Authors: Tagliacozzo Renata
Published: March 2018

A study of the utilization of the MEDLARS bibliographic service at one of the regional MEDLARS Centers is described. Data were obtained by sending a questionnaire to a sample of users who had requested bibliographic searches in previous months. The characteristics of the users, their awareness of the service availability, the purposes of their search requests, and their satisfaction with the results of the search were analyzed. The relation between outcome of the search and user’s satisfaction was examined.

There was a ratio of 2:1 between high and low satisfaction. A favorable appraisal of the MEDLARS search was found to be prevalent among users who had received large bibliographies. The group of requesters with teaching status also showed a higher proportion of satisfied users than the group of students or trainees.
Mechaniation a Large Register of First Order Patient Data
Authors: Moore Frederick
Published: March 2018

In any medical record system it is necessary to link the present record of a patient to his past records in the same or other institutions. This is usually accomplished by establishing patient registers. We have studied the patient register of the Los Angeles County General Hospital (approximately 1000 000 cases) and found it feasible to mechanize this file. It is therefore realistic to contemplate development of interagency health information systems in metropolitan regions.
Analysis of Electrocardiograms by Digital Computer
Authors: Pipberger H. V.
Published: March 2018

A method for automatic analysis of the P-QRS-T complex of the electrocardiogram by means of digital computers has been described. Three corrected orthogonal ECG leads (FRANK system) are recorded simultaneously on magnetic analog tape. Consequently the data are converted into digital form with a sampling rate of 1,000/sec. In this form records are fed into a digital computer. A number of analytical computer programs for ECG analysis have been developed. Application of these methods to large samples of normal and abnormal records showed that parameters of spatial direction exceeded largely those of magnitude when diagnostic recognition rates were compared. Thus, application of ECG leads which lend themselves to accurate spatial analysis appear mandatory for any improvement of electrocardiography as a diagnostic tool.
Auswertung medizinischer Untersuchungsergebnisse mit Hilfe eines Magnettrommelrechners
Authors: Lange H. J.
Published: March 2018

Es wird über Erfahrungen berichtet, die beim automatisierten Auswerten klinischer, röntgenologischer und spirometrischer Unteisuchungsresultate von etwa 3 000 Männern in den Jahren 1957-1961 gesammelt wurden. Das Ergebnismaterial war für eine elektronische Bearbeitung insofern geeignet, als von jedem einzelnen Fall bis zu 13 spirometrische Meßwerte vorlagen, die als relativ harte Daten bezeichnet werden können. Dem Bestreben, Merkmale durch besondere Meßmethoden zu quantifizieren und dadurch zu härten, sind natürliche Grenzen gesetzt. Bereits zur Vervollständigung der Ausgangswerte, nämlich zum Ermitteln von theoretischen Sollwerten und spirometrischen Indizes, konnte die elektronische Rechenmaschine mit großer Zeitersparnis eingesetzt werden. Ihre hohe Geschwindigkeit bei der Ausführung mathematischstatistischer Rechnungen ermöglicht ein Verfahren, das an das pharmakologische „Screening” erinnert. Der Auswertungsplan — gewissermaßen die Übersetzung der medizinischen in eine statistische bzw. hollerithmäßige Fragestellung — bildete die Grundlage der Programmierung. Er wird in seinen Hauptpunkten erläutert. In den Ergebnistabellen läßt man vorteilhafterweise nicht nur die Endresultate, sondern auch die Zwischenergebnisse herausschreiben. Die Wichtigkeit einer sachlogischen Kritik schon beim Planen der Untersuchung wird betont. Die zahlenlogische Kritik umfaßt das Austesten der Programme sowie das Auffinden von Fehlern, die durch evtl. Mißverständnisse des Programmierers entstehen können.
A Medical Training Game Using a Computer as a Teaching Aid
Authors: Kirsch A. D.
Published: March 2018

The Datatrol Corporation has developed a model for a computerized medical training game to be used as a teaching aid. This training game will utilize a computer capable of generating, from probability tables, synthetic patients who will exhibit symptoms guaranteed possible with an accuracy probability plus or minus a fixed percent. The symptoms of these synthetically generated patients will be presented to medical personnel and / or students for diagnosis. Approximately ten students may play the game simultaneously, each following their individual line of diagnosis. They will be allowed, if they desire, to request past historical data and to conduct laboratory tests and have synthetic results generated. As mentioned in the body of the paper, outside assistance will be sought for the preparation of various tables of probabilities needed for the game. The game is visualized as providing a contribution to medical education that could be used in conjunction with student medical meetings, professional meetings, or a tour of medical school centers. In order to allow this game to be used on the various standard computers that might be available at different medical schools or medical centers, the programs will be written in a generalized computer language such as FORTRAN. Possible fringe benefits of this game would be its use as an experimental research tool.
On Natural Information Systems: Pragmatic Aspects of Information Retrieval
Authors: Kochen M.
Published: March 2018

A natural information system is viewed as a living organism for representing storing and processing cumulated knowledge. Some statistics partially describing mechanisms of document-document coupling, document-author/reader coupling and document-language coupling are compiled. Original results on author/reader behavior from a questionnaire are included.
Direktverschlüsselung von EEG-Befunden für maschinelle Datenverarbeitung
Authors: Bochnik H. J. , Mentzos St.
Published: March 2018

Es wird ein neuer differenzierter Dokumentationsschlüssel für das klinische EEG mitgeteilt, der auf elektronische Datenverarbeitung abgestellt ist.

Die Dokumentation erfolgt durch Anstreichen eines vorgedruckten Schlüsselblatts, das einerseits direkt als Beleg für die Erstellung von Maschinenlochkarten dient und das andererseits als systematisch geordneter Befundbericht dient. Die Übertragung auf Lochbelege mit ihren Fehlermöglichkeiten und ihrem Zeitaufwand einschließlich der Prüfung wird dadurch gespart.

Der Kartenentwurf ist ein wertvolles Hilfsmittel einer klinischen Verbundforschung, denn beliebig viele derartige Karten, verbunden durch einen gemeinsamen Schlüsselkopf, können wie eine große Krankengeschichte, die aus vielen Spezialbeiträgen besteht, im Einzelfalle gelesen und in der Gruppe statistisch analysiert werden.
Der Vergleich zweier Prozentsätze und die Analyse von Mehrfeldertafeln auf Unabhängigkeit oder Homogenität und Symmetrie mit Hilfe der Informationsstatistik 2 I
Authors: Sachs L.
Published: March 2018

Die vorliegende Arbeit zeigt an Hand von Beispielen, daß mit Hilfe der Informationsstatistik 2 I und den in den einschlägigen Arbeiten tabelliert vorliegenden 2n · In n Werten der in der therapeutischen Statistik häufige Vergleich von Prozentsätzen schnell und exakt durchgeführt werden kann. Kontingenztafeln können mit dieser Technik elegant auf Unabhängigkeit und Symmetrie geprüft werden. Darüber hinaus lassen sich n-dimensionale Kontingenztafeln praktisch nur über die Informationsstatistik auf Unabhängigkeit oder Homogenität, bedingte Unabhängigkeit und Wechselwirkung prüfen.
Datenerfassung und Katalogherstellung mit Hilfe des FRIDEN-Flexowriter-Selectadata-Systems
Authors: Lauther H.
Published: March 2018

In der Katalogabteilung der Universitätsbibliothek Ulm (Medizinisch-Naturwissenschaftliche Hochschule) wird das System FRIDEN-Flexowriter (2201)-Selectadata (2214) eingesetzt, um die Daten bei der Titelaufnahxne für die spätere elektronische Verarbeitung zu erfassen (Erzeugung eines Lochstreifens) und gleichzeitig auf halbkonventionellem Wege Katalogkarten für Formal- und Sachkataloge herzustellen.

Der Selectadata-Suchleser selektiert zu diesem Zweck die verschiedenen Ordnungsbegriffe automatisch aus dem Text der Titelaufnahme und setzt sie in den Kopf der Katalogkarte. Das Programm wird in Einzelheiten beschrieben.
Lumbosacral disc disease in a cat
Authors: Jaeger G. H. , Early P. J. , Munana K. R. , Hardie E. M.
Published: March 2018

An eight-year-old male castrated domestic shorthair admitted with a two-day history of acute back pain, flaccid tail, and urinary and faecal incontinence. Diagnostic tests, including myelogram, epidurogram, and CT scan revealed an extradural lesion at the L7-S1 disc space. Exploratory surgery and histopathology confirmed a Type II lumbosacral intervertebral disc protrusion. The cat regained neurological function by six weeks after surgery. This is the first case report of a cat with documented lumbosacral disc disease. Lumbosacral disease should be considered as a differential diagnosis in cats with caudal lumbar pain or neurological signs localizable to the S1-S3 spinal cord segments or peripheral nerves.
Three Solutions to Problems of Categorized Medical Nomenclatures
Authors: Dunham G. S. , Henson D. E. , Pacak M. G.
Published: March 2018

Three problems arising with the use and improvement of SNOP are discussed with their solutions: 1.) complete categorical encoding of disease; 2.) dual categorization of nomenclature terms; 3.) coding physiological function and dysfunction as a function and a topography. These solutions entail the expansion of the class of mathematical models for classified nomenclatures from tree hierarchies to partially ordered sets.
Bayesian Method Applied to Decision Making in Neurology — Methodological Considerations
Authors: Salamon R. , Bernadet M. , Samson M. , Derouesne C. , Gremy F.
Published: March 2018

This article presents an analysis of the method used in an experiment in computer-aided diagnosis, applied to the whole field of neurology.

While the method is based on the classical Theorem of Bayes, it nevertheless contains a number of new elements:

— By means of a self-learning procedure, it makes use of the patient sample as it grows in size;

— there is an overall analysis of results as well as an individual analysis of each diagnosis.
Consensus Statement: Feature and Function Recommendations to Optimize Clinician Usability of Direct Interoperability to Enhance Patient Care
Authors: Lane Steven , Miller Holly , Ames Elizabeth , Garber Lawrence , Kibbe David , Schneider Joseph , Lehmann Christoph ,   DirectTrust Clinicians' Steering Group
Published: March 2018

Background Secure clinical messaging and document exchange utilizing the Direct Protocol (Direct interoperability) has been widely implemented in health information technology (HIT) applications including electronic health records (EHRs) and by health care providers and organizations in the United States. While Direct interoperability has allowed clinicians and institutions to satisfy regulatory requirements and has facilitated communication and electronic data exchange as patients transition across care environments, feature and function enhancements to HIT implementations of the Direct Protocol are required to optimize the use of this technology.

Objective To describe and address this gap, we developed a prioritized list of recommended features and functions desired by clinicians to utilize Direct interoperability for improved quality, safety, and efficiency of patient care. This consensus statement is intended to inform policy makers and HIT vendors to encourage further development and implementation of system capabilities to improve clinical care.

Methods An ad hoc group of interested clinicians came together under the auspices of DirectTrust to address challenges of usability and create a consensus recommendation. This group drafted a list of desired features and functions that was published online. Comments were solicited from interested parties including clinicians, EHR and other HIT vendors, and trade organizations. Resultant comments were collected, reviewed by the authors, and incorporated into the final recommendations.

Results This consensus statement contains a list of 57 clinically desirable features and functions categorized and prioritized for support by policy makers, development by HIT vendors, and implementation and use by clinicians.

Conclusion Fully featured, standardized implementation of Direct interoperability will allow clinicians to utilize Direct messaging more effectively as a component of HIT and EHR interoperability to improve care transitions and coordination.
The Requirements of an Electronic Medical Record to Suit all Clinical Disciplines
Authors: Hayes G.
Published: March 2018

The design of the electronic medical record is becoming increasingly Sophisticated as techniques develop to improve the understanding of user requirements. Such techniques must develop as it becomes increasingly important to improve the use and uptake of such records. An outstanding question is whether the same electronic medical record can fulfil the requirements of users in different clinical disciplines. To evaluate such a requirement it is necessary to understand the different information management the needs of different clinical disciplines.

Only once these differing needs are understood, will it become possible to consider whether a common record is feasible in terms of both data modelling and the user interface. This paper describes the move towards a better understanding of user requirements. It outlines the differences between the requirements of various disciplines and discusses the implications. It concentrates on the differences between the requirements for hospital specialists and family medicine as an example of the problems.
Communication in Health Care
Authors: Branger P. J. , Duisterhout J. S.
Published: March 2018

For routine communication, care providers still rely on paper documents and paper mail. At present, new technologies are emerging that have considerable potential for improving communication in health care. This paper reviews existing communication problems, and discusses electronic communication techniques that are gradually replacing paper-based communication.
Graduate Program in Medical Informatics at the University of Utah
Authors: Warner H.R.
Published: March 2018

The graduate student program in medical informatics at the University of Utah described in this paper comprises a Master of Science degree (since 1976) and a Ph.D. degree (since 1962). The average program length is 2 years for M.Sc. and 3-5 years for Ph.D. The aims of the program are to prepare graduates for careers in medical informatics in academic; hospital or industrial settings. There are several different courses of study, or tracks, within the department ranging from Expert Systems, Genetic Epidemiology, Health Care Quality, Hospital Information Systems, Medical Imaging, Medical Physics, to an intensive one year M.Sc. degree course for physicians. After the first three quarters the students are require 4 to take a qualifying examination in which they qualify for a -Masters or Ph.D. degree. The program covers the total spectrum of medical informatics. About 10 students are admitted each year. There are 14 full-time faculty and 9 adjunct faculty. The total number of graduates is 151.
Electronic Patient Records and Clinical Research
Authors: Safran C.
Published: March 2018

The digitalization of patient records promises clinicians researchers, health administrators, and politicians new tools to transform data into information, information into knowledge, and perhaps even knowledge into wisdom. This paper will review the status of clinical databases that can be derived from electronic patient records, discuss how databases derived from routine clinical care are being used, and outline the pitfalls and limitations of using electronic patient records for clinical research.
Health Informatics at the University of Victoria
Authors: Fisher P. , Protti D.
Published: March 2018

The University of Victoria has the only program in Canada offering a Bachelor of Science degree in Health Information Science. To meet the requirements of the degree, students must complete 60 units of course work (normally 40 courses) and 4 CO-OP work terms over 4.3 years. The School admits approximately 30 students each year. Seventy-five percent of the students come from British Columbia, ranging in age from 18 to 50 years with the average age being 26 years. In addition to recent high school graduates, over 40% have previous degrees or diplomas, and 65% have over 5 years of work experience. The School’s teaching team consists of 4 full-time faculty, 2 professional staff, 2 clerical staff, 7 adjunct faculty and a variable number of sessional teaching staff. The majority of the faculty have health backgrounds, totalling 150 person-years of health care experience. As of November 1995, the School had 168 graduates 75% of whom are employed in British Columbia, 17% in other parts of Canada and 8% outside the country. Sixty-five percent of the graduates work in government departments including community health agencies; 10% work in hospitals, 20% work for management consulting firms, software houses, or computer hardware firms, and 5% are otherwise employed. Almost 100% of the graduates are gainfully employed in professional positions in which their health information science degree is valued. They work as systems analysts, system designers/developers, consultants, research assistants, health-care planners, information system-support staff/trainers and client-account representatives. Some are already in senior management positions.