bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Information Science at the University of Victoria: The First Ten Years
Authors: Protti D. J.
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 40 courses and 4 CO-OP work terms over 4.3 years. The School admits 30 students each September of which 60% are normally female. Seventy-five percent of the students come from British Columbia, ranging in age from 18 to 42 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 5 full-time faculty, 3 professional staff and 4 part-time faculty. The majority of the faculty have health backgrounds, totalling 135 person-years of practising health care experience. As of November 1992, the School had 113 graduates; 75% are employed in British Columbia, 18% are in other parts of Canada and 7% outside the country. Forty-five percent of the graduates work in government departments including community health agencies; 29% work in hospitals; 26% work in management consulting firms, software houses, or computer hardware firms. They work as systems/project analysts, systems consultants, research assistants, planning analysts, system-support staff, trainers/developers and client account representatives. Some are already in senior management positions.
Professional Qualification of German Physicians in Medical Informatics
Authors: Michaelis J.
Published: March 2018

In addition to the medical education in the Federal Republic of Germany which includes a compulsory Medical Informatics course there exists a formal program for professional qualification of physicians in Medical Informatics. After two years of clinical practice and 1.5 years of professional training at an authorized institution, a physician may receive in addition to the medical degree a “supplement Medical Informatics”. The qualification requirements are described in detail. Physicians with the additional Medical Informatics qualification perform responsible tasks in their medical domain and serve as partners for fully specialized Medical Informatics ex-’ perts in the solution of practical Medical Informatics problems. The formal qualification is available for more than 10 years, has become increasingly attractive, and is expected to grow with respect to future Medical Informatics developments.
Summary of the General Discussion
Authors: Douglas J. V. , Leiner F.
Published: March 2018

Five breakout groups at the 1992 International Working Conference on Health/Medical Informatics Education in Heidelberg/Heilbronn compared six programs, located in the United States, Canada, Great Britain, and Germany. Acknowledging the difficulties in comparing programs in different countries and at different degree levels, the groups proposed four different schemata for distinguishing among programs. Despite widely varying approaches, there was consensus on the need for a robust model for health/medical informatics curricula. The viewpoint of the presented summaries is necessarily that of the authors.
Comparison of Examinees’ and Doctors’ Judgement of Health Status Using Data in an AMHTS
Authors: Sekita Y. , Ohta T. , Inoue M. , Takeda H.
Published: March 2018

Judgements of examinees’ health status by doctors and by the examinees themselves are compared applying multiple discriminant analysis. The doctors’ judgements of the examinees’ health status are studied comparatively using laboratory data and the examinees’ subjective symptom data.

This data was obtained in an Automated Multiphasic Health Testing System. We discuss the health conditions which are significant for the judgement of doctors about the examinees. The results show that the explanatory power, when using subjective symptom data, is fair in the case of the doctors’ judgement. We found common variables, such as nervousness, lack of perseverance etc., which form the first canonical axis.
A Method for the Evaluation of Clinical Information, Exemplified for Bleeding Symptoms in Non-Severe von Willebrand’s Disease Type I
Authors: Wahlberg Th. B.
Published: March 2018

Standardized questions with no- or yes-answers are often used for diagnostic purposes. One common approach is to register only positive answers or confirmation of symptoms, while negative findings are ignored. To illustrate the potential diagnostic value of positive and negative symptoms, twenty-two individuals with von Willebrand’s disease (vWd) type I and 50 non-vWd individuals from three families were investigated. From a self-administered questionnaire, mainly covering bleeding tendency, 19 symptoms were evaluated by a statistical method based on predictive values of negative and positive tests (indicators and predictors). Rank orders of negative findings indicating non-vWd and positive findings indicating vWd were calculated.
Bayesian Models for Clinical Studies
Authors: Schneider B.
Published: March 2018

The concept of Bayesian statistics, based on the model of random parameters with appropriate a priori distributions, is discussed and applied to the analysis of clinical studies (i. e. treatment comparisons). It is shown that assumptions about the a priori distribution can be eliminated if analysis is restricted to the class of conjugate prior distributions and the number of data is sufficiently high. For treatment comparisons the concept of “preferences” is introduced, i.e. the a posteriori probability for special rankings of the effect parameters. This concept is an alternative to hypothesis testing and error probabilities which is meaningless in Bayesian models. With this concept it is not necessary to formulate the hypotheses before the study or fix sample size or stopping rules in advance. It is also not necessary to restrict the analysis to the test of one or few hypotheses. On the other hand, the physician will not get error probabilities for his statements but “preferences” of the relevant rankings of the treatments.
Computer Implementation of the New Diabetes Classification Scheme
Authors: Wiener F. , Kanter Y. , Kol S. , Barzilai D.
Published: March 2018

The classification of diabetes and other categories of glucose intolerance developed by the international workgroup sponsored by the National Diabetes Data Group of the NIH has been implemented on the computer, using a system for the simulation of medical reasoning. The system allows the physician to formulate his medical knowledge as a series of logical inferences and to specify those combinations of clinical findings which confirm or reject each inference. Alphabetical lists of the texts of medical statements appearing in the knowledge base are used to specify patient data. A patient status report is produced by comparing the patient data with the medical logic. The report lists patient data, the inferences confirmed and, if necessary, requests additional data to complete the classification. The system has enabled us to computerize the new classification scheme in a relatively short time and with a minimum of effort. The system has correctly classified nearly 100 patients on our ward and in the endocrinology clinics using data routinely recorded. The computer evaluation is now an integral part of the patient record. It assures that the new classification scheme is applied to all patients in an unbiased and consistent manner.
A Monitoring System for Chronic Diseases— Determining the Parameters Involved
Authors: Chen Rina
Published: March 2018

A procedure for determining the parameters required for implementing a recently suggested monitoring system is described. A table of these parameters is also presented. While the parameters originally suggested were determined so as to increase the efficiency of a single analysis, the parameters presented here are aimed at the early detection of slightly increased rates of occurrences within a number of analyses.
The Design and Testing of a New Approach to Computer-aided Differential Diagnosis
Authors: Ludwig Dana , Heilbronn D.
Published: March 2018

An algorithm is presented for making diagnostic inferences on the basis of a causal network model of medical knowledge. The algorithm is based on Bayes Rule, but is unique in the way that it accounts for the presence of conditional non-independence of observations and for the presence of multiple diseases in the same patient. An evaluation of the system is performed on a database of patients with chest pain. In this evaluation, the diagnostic accuracy of the system is found to be inferior to that of a logistic regression model and comparable to that of a linear discriminant function. In a review of selected cases from this database, the system can be shown to provide inferences that are not possible with other simpler statistical models. The practicality of this and other computer aids to medical diagnosis is discussed.
Dutch Respelling Rules for English and German Medical Word Lists
Authors: Offerhaus G. J. A. , Tersmette A. C. , Hershey Johanna , Polacsek R. A. , Moore G. W.
Published: March 2018

Computer translation programs for foreign language texts have recently become available commercially and in the public domain, but large medical lexicons for these programs are not readily available. It has been shown that many English words can be “respelled” to form their corresponding translations in other Western European languages. We have used lists of 139,451 English and 185,137 German medical terms to generate respeliings in the Dutch language. The English list yielded 39,035 Dutch respeliings, and the German list yielded 56,683 respeliings. Medical respelling rules can substantially lower the effort of installing and maintaining a medically oriented computer translation program.
Medical Databases
Authors: Davidson J. , Roberts R. , Champeaux D.
Published: March 2018

An entity relationship level design is given for medical information systems. This design is aimed at-conceptual-integration of hospital information systems, patient history record keeping systems, future diagnosis systems, etc. In particular, it lays out a foundation for distributed databases.
Self-Learning for a. Bayesian Knowledge Base: How Long Does It Take for the Machine to Educate Itself?
Authors: Chard T.
Published: March 2018

A model system has been described which generates “cases” of vaginal discharge. The system was used to define a knowledge base for the application of Bayes’ theorem to the diagnosis of individual cases; this simulation is equivalent to self-learning in an expert system. By using different numbers of cases to define the knowledge base, it was possible to estimate the minimum size of knowledge base required for consistent and accurate diagnosis. The minimum size was found to vary according to the aspect of diagnosis examined. Thus, for overall correct diagnoses at least 200 cases were required, while failure to identify “non-specific” cases was eliminated with only 20 cases in the knowledge base. A simulation of this type is of potential practical value in determining the number of cases required in the knowledge base for a Bayesian system.
Influence of Sampling Variation and Analytical Errors on the Performance of the Multivariate Reference Region
Authors: Linnet K.
Published: March 2018

The effects of sampling variation, of deviations from normality of data distributions, and of analytical errors on the performance of the parametric multivariate 0.95 reference region are studied. The standard error of the proportion being included in the region is similar to that of the univariate interval, i.e. 0.016 for N = 100. Deviations from normality cause a moderate decrease of the proportion included in the region.

The region is very sensitive to an increase of the analytical imprecision occurring after the region has been established. E.g., for a dimension of 20, an increase of the total standard deviation of each analyte distribution by a factor of 1.25 decreases the included proportion from 0.95 to 0.54. Analytical inaccuracy may have a strong impact when the variables are correlated. In conclusion, stable analytical methods and efficient quality control systems are important to ensure a reasonable performance of a multivariate reference region.
The Relationship Between the MAXABS and the RMS Error
Authors: van Oosterom A. , Uijen G. J. H.
Published: March 2018

Results from mathematical statistics are applied to the analysis of the ratio R between the element having the highest magnitude MAXABS in a sample of size η taken from a Gaussian distribution and the standard deviation RMS of the same sample. Numerically computed . probability density functions of MAXABS are shown for several values of n. For large values of η these density functions are compared with analytical expressions for their asymptotic equivalents. The expectation and variance of MAXABS and RMS are derived and tabulated for different values of n.

These results are applied to the analysis of the residual error resulting from an orthogonal expansion of recorded body surface potentials.
A Strategy for Analysing Multiple Risk Factors with Application to Cervical Pain Syndrome
Authors: Dartigues J. F. , Peytour Ph. , Puymirat E. , Henry P. , Gagnon M. , Commenges D.
Published: March 2018

When studying the possible effects of several factors in a given disease, two major problems arise: (1) confounding, and (2) multiplicity of tests. Frequently, in order to cope with the problem of confounding factors, models with multiple explanatory variables are used. However, the correlation structure of the variables may be such that the corresponding tests have low power: in its extreme form this situation is coined by the term “multicollinearity”. As the problem of multiplicity is still relevant in these models, the interpretation of results is, in most cases, very hazardous. We propose a strategy - based on a tree structure of the variables - which provides a guide to the interpretation and controls the risk of erroneously rejecting null hypotheses. The strategy was applied to a study of cervical pain syndrome involving 990 subjects and 17 variables. Age, sex, head trauma, posture at work and psychological status were all found to be important risk factors.
Place of Occurrence of Injury Events in New Zealand Compared with the Available ICD Codes
Authors: Langley John D. , Chalmers David J.
Published: March 2018

The distribution of the place of occurrence of selected injury events in New Zealand was compared with the allocation of place of occurrence codes in the International Classification of Disease (ICD). National injury mortality and morbidity data for 1984 were upgraded to provide more specific information on the location of injury events than is allowed by the ICD codes. This highlighted a number of shortcomings in the ICD codes. For example, whereas only 0.1% of the injury morbidity occurred in a mine or quarry, 57 times that amount occurred on a rugby league ground. Despite this, mines and quarries have a unique code and rugby grounds are included under the general code “place for recreation and sport”. Several modifications to existing codes are proposed. The lack of mutually exclusive categories, the confusion of activity with place of occurrence, and restrictions in the recommended use of the codes are discussed.
Automatisierte Katalogherstellung unter Verwendung eines Beleglesersystems
Authors: Majer Z. , Maneval R.
Published: March 2018

Von der Universitätsbibliothek Ulm (Medizinisch-Naturwissensehaftliche Hochschule) wurde in Zusammenarbeit mit dem Rechenzentrum der Universität ein Programmsystem zur Erstellung der Katalogkarten für Formal- und Sachkataloge entwickelt. Das System benutzt zur Datenerfasstmg einen Klarschriftleser CDC 955, zur Aufbereitung der Daten eine TR 440 und zum Druck der Katalogkarten einen Data Printer 300, der am Großrechner angeschlossen und in der Bibliothek aufgestellt ist. Das System arbeitet für kleine bis mittelgroße Bibliotheken sehr kostengünstig.
Ein Datenerfassungsbogen für die Leistungsmedizin
Authors: HÜLLEMANN K.-D. , BRINKHUS H. , STAHLHEBER R.
Published: March 2018

Der EDV-gerechte Erhebungsbogen des Labors »Klinische Physiologie« der Universität Heidelberg dient der Erfassung aller routinemäßig anfallenden spirographischen Daten, die entweder im Zusammenhang mit ergometrischen Untersuchungen bei Patienten mit kardiovaskulären Erkrankungen oder bei Hochleistungssportlern erhoben werden. Er ergänzt als Teil D den früher in dieser Zeitschrift [3] beschriebenen 8seitigen Bogen mit den Teilen A, B und C. Optisch hebt er sich durch seine grüne Farbe ab.

Der lseitige »Ärztliche Formbericht« über die leistungs-medizinischen Untersuchungen dient einem beschleunigten Informationsfluß zwischen den Ärzten der Untersuchungsstelle und anderen Kollegen. Das Verfahren der Meßwertgewinnung bei Herzinfarktpatienten und Hochleistungssportlern ist unterschiedlich; durch Stempeleindruck läßt sich der Formbericht entsprechend modifizieren.
Der Response-Vortest, ein Teil der Planung epidemiologischer Untersuchungen
Authors: BROCK R. R.
Published: March 2018

Die Aussagekraft von Ergebnissen epidemiologischer Studien ist weitgehend vom jeweiligen Response abhängig. Dieser ist bei Untersuchungen auf der Basis von Freiwilligkeit trotz großen Einsatzes der Untersucher häufig ungenügend. Um Anhaltspunkte für die generelle Teilnahmebereitschaft zu einer epidemiologischen Studie bereits vor ihrem Beginn zu gewinnen, schlägt Verfasser die Durchführung von Response-Vortests vor, aus denen sich zusätzlich Anhaltspunkte für die Intensität der einzusetzenden Werbung und die Größe der zu ziehenden Stichprobe ergeben. — In einem differenzierten Response-Vortest kann auch erfaßt werden, wer zur Teilnahme bereit ist und wer nicht. So ließen sich, falls notwendig, Hinweise für eine gezielte (!) Werbung zur Teilnahme und/oder eine Schichtung des Kollektivs gewinnen. Darüber hinaus kann man auch Anhaltspunkte für die Zusammensetzung des späteren Nonresponse erhalten, wodurch es möglich wird, mit kleineren Stichproben zu arbeiten.

In einem Großbetrieb in Nordbaden wurde 1968/69 ein psychologisch begründeter differenzierter Response-Vortest durchgeführt. Dabei ließ sich feststellen, daß 85% der Befragten zur Teilnahme an epidemiologischen Untersuchungen bereit waren. Es zeigte sich aber, daß hier ein signifikanter Unterschied zwischen gesunden Angestellten und Arbeitern bestand. Letztere waren zur Teilnahme weniger bereit. Mögliche Hintergründe dieses Verhaltens werden diskutiert, ebenfalls die Konsequenzen.
Paarweise Gruppierung von chronischen, unspezifischen Lungenkranken mit und ohne fürsorgerische Betreuung
Authors: van der WEELE L. Th. , JANCIK H. E.
Published: March 2018

Die Autoren beschreiben eine Methode zur Aufgliederung einer Gruppe von Individuen in zwei Teilgruppen derart, daß je eine Person der einen Teilgruppe mit je einer Person der anderen ein in ihren charakteristischen Kennzeichen möglichst gut übereinstimmendes Paar bildet. Diese Methode wurde bei einer Patientengruppe mit chronischen unspezifischen Lungenerkrankungen angewandt. Die günstigen Ergebnisse dieser Aufteilung zeigten, daß die beschriebene Methode als zufriedenstellend bezeichnet werden kann.
Ein Datenerfassungssystem für die Leistungsmedizin)
Authors: HÜLLEMANN K.-D. , GREULICH B. , LIST M.
Published: March 2018

Unter dem Blickpunkt präventiver und rehabilitativer Kardiologie sowie der Sportmedizin wurde ein 10-seitiger Erhebungsbogen entwickelt, der alle routinemäßig anfallenden spiroergometrischen Daten erfaßt, ebenso Daten, die bei biotelemetrisdien Untersuchungen während der unstandardisierten Alltagssituation gewonnen werden. Die bei diesem Erhebungsbogen verwendeten Schlüssel für Spezialuntersuchungen, Sportarten und Medikamente werden vorgestellt.

Die Dateiführung geschieht auf einem Direktzugriffspeicher (Platte) im index-sequentiellen Modus. Dieser Modus bietet die beste Möglichkeit, neué Daten ohne Umorganisation der bestehenden Datei logisch direkt an die richtige Stelle zu schieiben bzw. vorhandene Daten zu korrigieren. Vor der Auswertung, die sowohl nach personellen als auch nach sachlichen Gesichtspunkten möglich ist,, finden umfangreiche Fehlerprüfungen statt.
Kritische Bemerkungen zur Erfassung und Auswertung des Spermiogramms Vergleich zweier in den Jahren 1970 und 1971 durchgeführter andrologischer Gemeinschaftserhebungen
Authors: Schirren J. M.
Published: March 2018

Der Arbeitskreis »Dermatologie« der Deutschen Gesellschaft für Medizinische Dokumentation und Statistik (GMDS) hat 1970 einen multiklinischen Versuch zur Spermiogramm-Erfassung und -Auswertung durchgeführt; Aufgrund der bei dieser Erhebung gewonnenen Befunde wurde ein verbesserter Erhebungsbogen entwickelt, der 1971 in einer weiteren Gemeinschaftserhebung getestet wurde. Bei einem Teil der Laboratoriumsergebnisse konnte mit dem verbesserten Erhebungsbogen eine bessere Übereinstimmung erzielt werden; bei anderen Bestimmungen bestehen weiterhin erhebliche Differenzen. Möglichkeiten der Erzielung einer besseren Vergleichbarkeit bei diesen Methoden werden diskutiert.
Dokumentationsmögliclikeit statischer Röntgenbilder mittels elektronischer Datenverarbeitung (EDV)
Authors: Riedleb L.
Published: March 2018

Es wird ein möglicher Weg zur automatischen Dokumentation (Befundung, Aufbewahrung, Wiederbeschaffung) des Thorax-Übersichtsröntgenbildes mittels EDV beschrieben. Die Grundlage der Befundung besteht im Vergleich von Hell-Dunkelgrenzen eines digital gespeicherten Normbildes mit dem zu untersuchenden Patientenbild. Die Speicherung oder Aufbewahrung der Bilder geschieht durch ein elektronisches Abbildungssystem auf Magnetplatten; die Wiederbeschaffung erfolgt durch Aufscheinenlassen des Bildes imd/oder des Befundes auf einem Sichtgerät mit der Möglichkeit der Bildfotografierung.
Imprecision of Laboratory Determinations and Diagnostic Accuracy: Theoretical Considerations
Authors: Lindbebo D. A. B. , Watson Fr. R.
Published: March 2018

Recent studies suggest the determinations of clinical laboratories must be made more precise than at present. This paper presents a means of examining benefits of improvement in precision. To do this we use a mathematical model of the effect upon the diagnostic process of imprecision in measurements and the influence upon these two of Importance of Diagnosis and Prevalence of Disease. The interaction of these effects is grossly non-linear. There is therefore no proper intuitive answer to questions involving these matters. The effects can always, however, be calculated.

Including a great many assumptions the modeling suggests that improvements in precision of any determination ought probably to be made in hospital rather than screening laboratories, unless Importance of Diagnosis is extremely high.
The Karolinska Hospital Information System
Authors: Mellner Ch. , Selajstder H. , Wolodakski J.
Published: March 2018

The paper gives a report on the Karolinska Hospital Information System in three parts.

In part I, the information problems in health care delivery are discussed and the approach to systems design at the Karolinska Hospital is reported, contrasted, with the traditional approach.

In part II, the data base and the data processing system, named T1—J 5, are described.

In part III, the applications of the data base and the data processing system are illustrated by a broad description of the contents and rise of the patient data base at the Karolinska Hospital.
Epidemiology and Health Statistics in the United Kingdom
Authors: Ebbing H. C.
Published: March 2018

From 6 October to 8 December 1962 the writer of the present report visited medical authorities, universities, research institutes and statistics offices in Great Britain. The journey, which had been sponsored by the European Office of the World Health Organization, was carried out under the technical guidance of the British Ministry of Health. The General Register Office (GRO) for England and Wales welcomed the writer as a colleague and rendered assistance during his stay, while practical questions where handled by the British Council.

Medical statistics are the concern of one General Register Office each for England and Wales, for Scotland, and for Northern Ireland. The Ministry of Health has a statistics division of its own.

Medical statistics are conducted on a larger scale than in a number of other countries. The birth and death records are thoroughly evaluated from an anthropobiological angle. In addition to the statistics on physicians, nursing personnel and hospitals which are compiled in the United Kingdom there also exists a disease reporting system which inter aha includes morbidity statistics, too. A research project on the frequency of hereditary and congenital diseases is in preparation.

The general interest in medical statistics and the value put on them are worthy of emphasis. Courses held for the medical officers of health provide for efficient statistical training. The scientific discipline, epidemiology and health statistics on the one hand and the possibilities of work and research in the field of official statistics on the other are judged in such a way that a number of aims which appear unattainable in Germany at the time being are regarded as natural prerequisites to an efficient health policy. It should be mentioned in this connexion that the recommendations of the World Health Organization and of the European Council have been based on the opportunities provided in the Anglo-Saxon countries.
Digital Computer Use in Medical Bibliography
Authors: Kent A.
Published: March 2018

A brief review has been provided with regard to some approaches to information retrieval that are now under development in the United States. These developments are discussed in terms of the unit operations of documentation: acquisition; analysis (abstracting, indexing, classifying, extracting); terminology control; recording of results of analysis on searchable medium; storage of source documents; question analysis and development of search strategy;conductingofsearch;anddelivery of search results.

At the present time efforts in this field are largely uncoordinated, with decisions on depth of analysis of documents and philosophy of coding system left largely to the desires and opinions of individuals or separate organizations.

Two programs in medjcal documentation at Western Reserve University are discussed: one in communicable diseases; and the other in diabetes. Both programs involve the analysis of the literature in considerable detail, using roles and links, and the control of the meaning of terminology using the technique , of semantic factoring.
Dokumentation in der Jugendpsychiatrie
Authors: Schmidt G.
Published: March 2018

Der Versuch einer das ganze jugendpsychiatrische Krankenblatt umfassenden Dokumentation auf Maschinenlochkarten erwies sich als praktisch nicht durchführbar. Es wurde deshalb ein gestufter Ausbau vorgenommen. Schrittweise wurden Anamneseschema, Formblätter im Krankenblatt, eine aus diesen erstellte Kartei der Zwischenbelege und der Code aufeinander abgestimmt. Das Vorgehen und das Organisationsschema werden dargelegt. Dieser Aufbau ermöglicht es, die Kartei der Zwischenbelege als Zähl- und Suchkartei zu benutzen sowie ihre Übertragung auf Maschinenlochkarten vorzunehmen.
A Natural Language Information Retrieval System
Authors: Jacobs H.
Published: March 2018

This paper describes a system for dealing with a certain kind of textual information. The system has been in operation for about one and a half years. It also indicates the nature of a new and greatly expanded system presently under development.

The first system consists essentially of three parts, of which the most important is a thesaurus processor. The assumption is made that document content depends only on word content and that word relationships are defined by an hierarchical structure. The function of the thesaurus processor is to provide a simple language for developing and changing the thesaurus, whenever change is necessary. The remaining parts of the first system are a document processor for updating document files, and a search processor for batch requests which must scan the entire document file. Some statistics are given on performance of the system.

The second system includes a thesaurus processor of expanded capability. It also includes a newly developed search language, which can be used to scan records for complex patterns of events. Input-output processing of records and of search results is left to the user of the system.
Biomedical Language and Format for Manual and Computer Applications
Authors: Gohdon B. L.
Published: March 2018

The terms »dyspnea« and »breathlessness« have been used synonymously in describing shortness of breath of normal individuals, as following a lively sprint down the avenue. Coincidentally, the terms refer to the shortness of breath in pulmonary disease. In critical reporting, dyspnea should be limited to the designation of difficult breathing of emphysema and/or other chronic pulmonary diseases with evidence of impaired function.

The importance of precise and specific medical terminology is described.
Retrospektive Therapievergleiche bei Karzinompatientinnen
Authors: Lochmüller H. , Bickenbach W. , Dirlich G.
Published: March 2018

In retrospektiven Vergleichsreihen wurden die Ergebnisse verschiedener Behandlungsmethoden bei Krebsen gleicher Lokalisation verglichen. Für jede Patientin mit Corpus-uteri-Karzinom wurden anhand der Krankengeschichten rund 30 Merkmale erhoben. Um bezüglich der wichtigsten Einflußfaktoren homogene Vergleichsreihen zu gewinnen, wurden aus dem inhomogenen Gesamtmaterial Stichproben mit gleichartigen Verteilungen der Merkmale ausgewählt/Hierfür werden zwei Techniken beschrieben, die sich als ausreichend wirksam und bei Verwendung datenverarbeitender Maschinen als wenig aufwendig erwiesen.
Der Krankenblattkopf der Heidelberger Kliniken
Authors: Wagner G. , Immich H. , Köhler C.
Published: March 2018

Aufbauend auf den mit dem »Allgemeinen Krankenblattkopf« gewonnenen Erfahrungen wurde ein modifizierter Krankenblattkopf entwickelt, der seit Januar 1966 bei den Kliniken der Universitäten Heidelberg und Mannheim in Gebrauch ist. — Nach kritischer Stellungnahme zu den Punkten der Originalempfehlung von 1961, die sich nicht bewährt haben, beschreiben Verff. Form und Inhalt der neuen Version sowie die Methodik der Verarbeitung der hierin erfaßten Basisinformationen über den Patienten. Abschließend werden einige Ergänzungs- bzw. Änderungsvorschläge diskutiert, die bei zukünftigen Planungen berücksichtigt werden sollten.
Ein einfaches Verschlüsselungssystem für Handlochkarten
Authors: Nyibi M. , Juhäsz Vera
Published: March 2018

Es wird ein einfaches Dokumentationssystem mittels einreihiger Randlochkarten beschrieben, das sich zur Erfassung der Literatur in einer mit der UDK arbeitenden Fachbibliothek mittlerer Größe bewährt hat. Der Vorzug des Systems liegt darin, daß es mit verhältnismäßig wenigen Schlüsselzahlen auskommt und trotzdem die Erfassung einer großen Anzahl von Merkmalen gestattet.
Enhancement of Clinical Predictive Ability by Computer Consultation)
Authors: Dannenberg A. L. , Shapiro A. R. , Fries J. F.
Published: March 2018

Clinical predictive ability was assessed in 21 physicians and medical students. Each was provided a standard set of twenty case histories in random sequence and asked to predict tlje probability of five standard outcome events for each case. Predictions were scored against the actual known outcomes of the patients. For these same patients, computer predictions were derived from analysis of data bank experience of the most similar prior patients. Physicians and medical students were provided with the computer predictions after making their initial judgments and were allowed to make revised predictions incorporating this new information.

Revised predictions after computer consultation were significantly (p < .05) improved from initial values. Computer predictions initially scored approximately midrange among specialty physicians. Groups of physicians scored better than single physicians. Subjects scoring less than the computer uniformly improved their predictive accuracy after computer consultation. All subjects receiving computer consultation information modified their predictive estimates toward those of the computer. Subsequent modification of computer procedures for selection of more similar patients improved computer predictive accuracy. Availability of prognostic information derived from computer data banks can modify physician behavior and, if accurate, can enhance prognostic accuracy of physicians.
On a Vaccination Model for Non-fatal Rare Infectious Diseases; with Emphasis on Rubella in Kuwait
Authors: Moussa M. A. A.
Published: March 2018

An immunization model for non-fatal rare contagious diseases in non-fixed size communities (developing countries) is proposed. It reveals the demographic and epidemiological data needed in a country to decide upon the best strategy of vaccination. The approach is illustrated with reference to rubella in Kuwait population. Comparisons between rubella vaccination strategies of the U.S.A., U.K. and a recently suggested one for Kuwait are carried out.
The Making of an RNA Phage Bibliography with Personal Information Retrieval by Microcomputer
Authors: Van Styvendaele B. J. H.
Published: March 2018

The article describes a microcomputer-based system designed for personal storage and retrieval of information. Document description, conversion of data elements into machine-readable form, a bibliographic record structure that can be adapted according to individual requirements together with the necessary routines for document entry, error correction, storage, updating, sorting, searching and retrieval of information is presented. These methods were used in the development of a computergenerated bibliography as illustrated by samples of the final print-outs from different data files. The implementation of a microcomputer-based system for documentary information processing and management at a price and level of complexity which many users can afford is likely to solve problems of information volume, loss, inefficient retrieval and ineffective filing.
Zur Problematik des angemessenen Klassifikationsverfahrens
Authors: Wiohmann H. E. , Köppen L. , Spechtmeyer H. , Gross R.
Published: March 2018

Bei 5 Zuordnungsregeln wird anhand eines speziellen Datensatzes der Einfluß der Anzahl betrachteter Variablen, Patienten und Krankheiten auf die Klassifikationsergebnisse untersucht. Für die /verwendeten Daten aus der Hämatologie liefern die einfacheren Verfahren (Bayes-Verfahren für quantitative und qualitative Variablen, lineare Diskriminanzanalyse) bessere Resultate als die mathematisch anspruchsvolleren Methoden (Diskriminanzanalyse für qualitative Daten bei Berücksichtigung von Wechselwirkungen 1. Ordnung, nichtlineare Diskriminanzanalyse), und der modellbedingte Fehler erweist sich bei der vorliegenden Datenstruktur als weniger schwerwiegend als der Fehler bei der Parameterschätzung. Während bei qualitativen Daten die Berücksichtigung von mehr als 30 Variablen vorteilhaft sein kann, verbessern bei quantitativen Daten Variablenzahlen über 10 die Ergebnisse nicht nennenswert, verschlechtern jedoch die Stabilität der Schätzungen. In einer Tabelle werden für 3 Verfahren Mindestpatientenzahlen angegeben, die bei den vorliegenden Daten zu stabilen Ergebnissen führen. Die Untersuchungen zeigen, daß die Kreuzvalidisierung eine weitgehend verzerrungsfreie Bewertung von Klassifikationsergebnissen erlaubt. Demgegenüber ist die Reklassifizierung in den meisten Fällen hierfür nicht geeignet.
Triceps Tendon Anatomic Repair Utilizing the “Suture Bridge” Technique
Authors: Edelman David , Ilyas Asif
Published: March 2018

Triceps tendon ruptures are uncommon injuries, but they typically require surgical repair. Multiple primary repair techniques are available, including transosseous, suture anchor, and anatomic repairs. The technique described here, the “suture bridge” repair, provides an anatomic repair of the distal triceps tendon to its footprint. It has the potential advantages of increased load to failure, better footprint coverage, higher load resistance, and allows for early motion.
Assessment of Dorsal Subluxation in Thumb Carpometacarpal Osteoarthritis
Authors: Miura Toshiki , Ando Maki , Tanaka Shinya , Uehara Kosuke
Published: March 2018

Background Although dorsal subluxation is a typical finding for osteoarthritis of the thumb carpometacarpal (CMC) joint, it is difficult to evaluate the subluxation after trapeziectomy and the significance of its surgical correction combined with trapeziectomy is still controversial. The purpose of this study was to develop a method to evaluate dorsal subluxation without using landmarks on the trapezium.

Methods Thirty patients with thumb CMC arthritis and 13 normal patients were included in this study. Dorsal subluxation of the CMC joint was evaluated by measuring the distance between the volar tip of the thumb metacarpal base and dorsoradial border of the index metacarpal base (M1M2 overlap) on the X-ray true lateral view of the thumb as well as previously reported methods. Intraclass correlation coefficient (ICC) was used to assess inter- and intraobserver reliability for the measurement of M1M2 overlap by six examiners of different level of expertise. Dorsal subluxation was also evaluated after trapeziectomy with ligament reconstruction.

Results There were almost perfect interobserver (ICC = 0.94) and intraobserver (ICC = 0.95 for an expert and 0.97 for a novice) reliabilities for the measurement of M1M2 overlap. There was a weak correlation between our method and previously reported methods. M1M2 overlap of the normal patients and the patients were 4.6 ± 1.2 mm and 2.3 ± 2.3 mm (mean ± SD), respectively. M1M2 overlap was corrected significantly after trapeziectomy with ligament reconstruction.

Conclusion Dorsal subluxation of the thumb CMC joint could be evaluated by M1M2 overlap before and after trapeziectomy.
Crisis of Meaning and Medical Informatics Education: A Burden and/or a Relief?
Authors: Grémy F.
Published: March 2018

Starting with the quotation by Paul Ricoeur: Man needs love indeed; he needs justice still more; but most of all he needs meaning, this paper states that in this present situation medical education does not prepare students to deal with human needs, neither their own nor those of their patients. This is due to the almost exclusive devotion to hard sciences, contaminated by unscientific ideological drift, which tends to negate subjectivity and to suppress any significance of human destiny. Although medical informatics, by definition, eliminates meaning and knowledge, it can - if properly used as a complement and not as a competitor of human intelligence - help to renovate medical education, introduce true humanistic dimensions, and restore the element of human subjectivity.
The Implications of Cognitive Psychology for Computer-Assisted Instruction
Authors: Walsh S.
Published: March 2018

An information processing model is used to describe the learning process. The implications of some of these cognitive concepts are examined in the context of computer-assisted instruction.
Comments on the Use of the Systematized Nomenclature of Pathology
Authors: Graepel P. H. , Henson D. E. , Pratt A. W.
Published: March 2018

Any discussion of the use of the Systematized Nomenclature of Pathology (SNOP) requires comprehension of the principles of organization of SNOP.

SNOP is a categorized nomenclature which lists »names« of elements and concepts of pathology. SNOP contains four lists of pathology names and concepts known as TOPOGRAPHY, MORPHOLO-GY, ETIOLOGY and FUNCTION. ‘

Clearly, SNOP is not a diagnostic code or a coded medical terminology ; to use SNOP the user must specify the coding structure. Thus SNOP is a basis for building a medical data code. The advantage of a categorized nomenclature is that it is possible to construct a well-defined information space for medical data based on the semantic value of the data and apart from some predetermined numeric code where terms are assigned as a function of the number structure.

Thus it has been possible to explore the automatic processing of pathology language data. An automatic encoding capability has been used at NIH to encode surgical pathology data. These encoded data were used to study the deficiencies of SNOP and to evaluate new structures for a truly categorized nomenclature of medicine.

This new lexical structure can only be achieved if the pathologists waive traditional practices of assigning names to concepts of pathology and allow for new dimensions of medical ways of thinking which go beyond pure morphology.
Restructuring Routinely Collected Patient Data: ORCA Applied to Andrology
Authors: van Ginneken A. M. , Timmers’ T. , Stam H. , Weber R. F. A. , Pierik F. H.
Published: March 2018

Hospital information systems do not always cover all required detail per specialty. This may lead to scattering of data over disparate systems and the paper record. The ORCA (Open Record for CAre) CPR offers a generic structure for record sharing, and record keeping tailored to specific needs. We studied whether a semantic integration of existing and new data was possible, using the ORCA structure. Existing andrology data, originating from separate sources, were utilized for this purpose. During normalization, validation and explication steps, latent problems in the source data were exposed and removed, followed by a merge with new data items. By conversion of source data to ORCA, a unique representation of medical concepts in the database was attained, facilitating retrieval of univocal data for multiple purposes. We conclude that the expansion to the andrology domain, including transparent integration of existing data, provides support for the generality of ORCA.
The Clinic-specific Thesaurus: a Means of “Lean Documentation in Pediatric Surgery
Authors: Osada N. , Kopeke W. , Schaarschmidt K.
Published: March 2018

A one-hundred percent documentation rate of diagnoses and patient data is unfeasible and should not be pursued. Therefore, a “lean documentation” of diagnoses and basic patient data was introduced. Coding is done by a clinic-specific list of diagnoses (thesaurus) with a minimum of diagnostic codes, combined with optional free text. By recording the frequency of diagnoses for two years, a thesaurus of 188 diagnostic codes was developed. Bedside coding by treating physicians reduced medical and semantic mistakes of documentation. Cooperation of the clinicians was obtained by shortening the time required for coding to less than two minutes per patient. A documentation assistant supplemented incomplete data in collaboration with the treating surgeons. During a ten-year testing period 93.7% of the hospital-specific codes of our thesaurus were required for documentation, as compared to 13.1% if the same patients were coded by ICD-9. Consequently, coding by a clinic-specific code thesaurus is quick, flexible and accurate.
Body Surface Laplacian Mapping of Bioelectrical Activity
Authors: Yu X. , Wu D. , Mehdi N. , He B.
Published: March 2018

A method is described to process and interpret multi-channel bioelectrical signals. The bioelectrical signals were recorded noninvasively over the body surface of human subjects at 120 sites. The body surface Laplacian maps were then constructed from the multi-channel bioelectrical potential measurement. The method was evaluated by means of computer simulations, and applied to imaging cardiac electrical activity. The present investigation suggests body surface Laplacian mapping provides an important means in interpreting bioelectrical signals.
Causal Probabilistic Network and Power Spectral Estimation Used in Sleep Stage Classification
Authors: Kjaer A. , Jensen W. , Dyrby T. , Andreasen L. , Andersen J. , Andreassen S. , Nielsen K. D.
Published: March 2018

A new method for sleep-stage classification using a causal probabilistic network as automatic classifier has been implemented and validated. The system uses features from the primary sleep signals from the brain (EEG) and the eyes (AOG) as input. From the EEG, features are derived containing spectral information which is used to classify power in the classical spectral bands, sleep spindles and K-complexes. From AOG, information on rapid eye movements is derived. Features are extracted every 2 seconds. The CPN-based sleep classifier was implemented using the HUGIN system, an application tool to handle causal probabilistic networks. The results obtained using different training approaches show agreements ranging from 68.7 to 70.7% between the system and the two experts when a pooled agreement is computed over the six subjects. As a comparison, the interrater agreement between the two experts was found to be 71.4%, measured also over the six subjects.
Classification of Acceleration Waveforms during Walking by Wavelet Transform
Authors: Sekine M. , Ogawa M. , Togawa T. , Fukui Y. , Tamura T.
Published: March 2018

In this study we have attempted to classify the acceleration signal, while walking both at horizontal level, and upstairs and downstairs, using wavelet analysis. The acceleration signal close to the body’s center of gravity was measured while the subjects walked in a corridor and up and down a stairway. The data for four steps were analyzed and the Daubecies 3 wavelet transform was applied to the sequential data. The variables to be discriminated were the waveforms related to levels -4 and -5. The sum of the square values at each step was compared at levels -4 and -5. Downstairs walking could be discriminated from other types of walking, showing the largest value for level -5. Walking at horizontal level was compared with upstairs walking for level -4. It was possible to discriminate the continuous dynamic responses to walking by the wavelet transform.
On-line Analysis of AEP and EEG for Monitoring Depth of Anaesthesia
Authors: Filligoi G. C. , Makovec B. , Gagliardi M. , Henneberg S. W. , Lindholm P. , Cerutti S. , Capitanio L. , Jensen E. W.
Published: March 2018

Achieving and monitoring adequate depth of anaesthesia is a challenge to the anaesthetist. With the introduction of muscle relaxing agents, the traditional signs of awareness are often obscured or difficult to interpret. These signs include blood pressure, heart rate, pupil size, etc. However, these factors do not describe the depth of anaesthesia, (DA), in a cerebral activity sense, hence there is a desire to achieve a better measure of the DA. Auditory Evoked Potentials (AEP) provide two aspects relevant to - anaesthesia: (1) they have identifiable anatomical significance and, (2) their characteristics reflect the way in which the brain reacts to a stimulus. However, AEP is embedded in noise from the ongoing EEG background activity. Hence, processing is needed to improve the signal to noise ratio. The methods applied were moving time averaging (MTA) and ARX-modeling. The EEG was collected from the left hemisphere and analysed by FFT to 1 sec epochs and the spectral edge frequency was calculated. Both the changes in ARX extracted AEP and the spectral edge frequency of the EEG correlated well with the time interval between propofol induction and onset of anaesthesia measured by clinical signs (i.e., cessation of eye-lash reflex). The MTA extracted AEP was significantly slower in tracing the transition from consciousness to unconsciousness.
Visualization of EEG Using Time-Frequency Distributions
Authors: Stiber B. , Sato S.
Published: March 2018

The EEG is a time-varying or nonstationary signal. Frequency and amplitude are two of its significant characteristics, and are valuable clues to different states of brain activity. Detection of these temporal features is important in understanding EEGs. Commonly, spectrograms and AR models are used for EEG analysis. However, their accuracy is limited by their inherent assumption of stationarity and their trade-off between time and frequency resolution. We investigate EEG signal processing using existing compound kernel time-frequency distributions (TFDs). By providing a joint distribution of signal intensity at any frequency along time, TFDs preserve details of the temporal structure of the EEG waveform, and can extract its time-varying frequency and amplitude features. We expect that this will have significant implications for EEG analysis and medical diagnosis.