bluuebunny/crossref_metadata_2025 huggingface dataset:
Electronic Patient Record for N.N.Burdenko Neurosurgical Institute: on the Verge of Implementation
Authors: Shifrin M.A.  , Kalinina E.E.
Published: February 2025

This presentation is the first report about development of Electronic Patient Record System (EPRS) for N.N.Burdenko Neurosurgical Institute (NSI). This EPR system is the core of Integrated Automatic Information System intended to support all buisness processes running in the Institute. A new technology for developing information systems in poorly formalized subject domains, named IBS/Records, was was created.
Realization of a CPR Using HL7 Queries From Communication Server to Information Server
Authors: Schrader U.  , Zaiss A.W.  , Büchele S.  , Binder M.  , Leupolz U.  , Klar R.
Published: February 2025

A communication server is often used in Germany to interface legacy systems. It handles the translation, duplication, and transmission of messages to all systems that might need this information. Based on the principles of “for every data there is only one master” and “information on demand” we have built an information server that reduces the messages required and simplifies the handling of messages, the update of data already sent compared to a communication server. It also allows to implement a security policy as required by the German data privacy legislature.
Design of the SGML-based electronic patient record system with the use of object-oriented analysis methods
Authors: Kuikka Eila  , Eerola Anne  , Porrasmaa Jari  , Miettinen Ari  , Komulainen Jorma
Published: February 2025

Since a patient record is typically a document updated by many users, required to be represented in many different layouts, and transfered from place to place, it is a good candidate to be represented structured and coded using the SGML document standard. The use of the SGML requires that the structure of the document is defined in advance by a Document Type Definition (DTD) and the document follows it. This paper represents a method which derives an SGML DTD by starting from the description of the usage of the patient record in medical care and nursing.
Document versus Data Centred Approach to EPR
Authors: Robert Baud  , Anne-Marie Rassinoux  , Christian Lovis
Published: February 2025

This paper presents the document centred Electronic Patient Record (EPR) as currently in production in a large university hospital and subject to multiple additional developments in the coming years. A number of basic hypothesis have been developed in order to reach the best medical practice and the success of this application. In addition, the alternative approach of data centred EPR is compared, and different benefits and pitfalls are highlighted. It is not easy to evaluate the consequences of such an initial trend, but changing one’s mind after having a system in daily production is anyway costly and difficult. Therefore, the selection of the right orientation in a given hospital necessitates a scientific debate.
Maintenance of self-consistency of coding tables by statistical analysis of word co- occurrences
Authors: Surján György  , Héja Gergely
Published: February 2025

The author presents a method for maintaining the internal consistency of coding tables. The method was tested on a table used for assisting the daily work of indexing clinical cases to International Classification of Diseases. 300 item were tested selected randomly form a corpus of 3082 clinical diagnoses. The method discovered potential consistency problems in 39 cases, out of which 10 were false positive.
Plea for a Standardised Detailed Clinical Nomenclature
Authors: Momjian Shahan  , Borst François  , de Tribolet Nicolas
Published: February 2025

The choice of a nomenclature for the encoding of the medical information to be stored in an electronic patient record (EPR) is a critical issue. As we are currently developing a neurosurgical EPR, we evaluated three nomenclatures or classifications, Read, ICD-10 and Quick Medical Reference (QMR) for the capture of the detailed concepts referenced in the EPR. We scored the correspondence with 2 for a good match, 1 for a fair match and 0 for no match. The Read nomenclature ranked first with an overall score of 1.21 (max. 2.0), the ICD-10 obtained 0.88 and the QMR 0.74. Some groups of items such as the neurosurgical history and examination were fairly well represented in the three systems. On the opposite, others such as the various neurosurgical clinical and radiological scoring and grading systems and the outcome descriptors were not correctly referenced in any coding system. Although the Read coding system has been advocated to represent the clinical activity in neurosurgery, it still needs an enrichment before being able to completely cover the concepts present in a neurosurgical record. Moreover the development of an international, standardised, detailed nomenclature and classification collecting the advantages of the various coding systems currently in use should be encouraged to be able to exchange and compare medical data.
S.P.I.C. Pedagogical Simulator for Gynecologic Laparoscopy
Authors: Anne-Claire Jambon  , Denis Querleu  , Patrick Dubois  , Christophe Chaillou  , Philippe Meseure  , Sylvain Karpf  , Carmen Geron
Published: February 2025

Laparoscopic surgery has numerous advantages, but this technique is difficult and requires specific training. This paper presents a simulator for gynecologic laparoscopic surgery called S.P.I.C. (Pedagogical Simulator for Gynecologic Laparoscopic Surgery), specifically designed for teaching. It includes a rail with 3 trocars already in place, and a computer monitor. Training using the simulator is divided into tasks and steps in order of increasing difficulty. Each step consists of training exercises and evaluations. Learning with the simulator is guided by software that allows instructors to personalize their lessons. This prototype has allowed us to put into place training for spatial localization and manipulation of surgical instruments in the abdominal cavity. An evaluation at a clinical site has allowed us to determine the improvements to be made on this prototype. Training with a simulator is part of a resident's regular curriculum and is not meant to replace on site hospital experience. Some imperfections in imaging still exist, due to inevitable technical limitations. Our initial choice was to emphasize realism and “real time”, rather than the “aesthetic quality” of the images. Furthermore, by limiting our graphic expectations, we have been able to create a simulator at a reasonable overall price. The S.P.I.C. training tool remains experimental and is still in the process of being developed.
Intraoperative Tremor Monitoring for Vitreoretinal Microsurgery
Authors: Gomez-Blanco Mario  , Riviere Cameron N.  , Khosla Pradeep K.
Published: February 2025

An instrument for intraoperative sensing of surgeons' hand tremor during vitreoretinal microsurgery has been developed. The instrument uses inertial sensing to detect tremor in six degrees of freedom. Instrument tip velocity is computed using the sensor data. The displacement amplitude of the tremor is then approximated analytically by modeling the velocity as sinusoidal. The instrument presently estimates oscillations at physiological tremor frequencies with error of less than 7%.
Eine Public-Key Infrastruktur für Demonstratoren der Health Professional Card
Authors: Pharow Peter  , Blobel Bernd
Published: February 2025

Das neue Jahrtausend bringt sehr vielschichtige und teilweise konträre Anforderungen an das Gesundheits- und Sozialwesen Europas mit sich. Gut informierte und aufgeklärte Patienten erwarten zunehmend eine qualitativ hochwertige Versorgung auf dem neuesten Stand des medizinischen Wüssens und der Medizintechnik. Gleichzeitig müssen die Leistungserbringer durch sozialpolitische Forderungen, aber auch durch die aktuelle Lage am Arbeitsmarkt bedingt mit sinkenden Budgets auskommen.
Pilot Study of Total Knee Arthroplasty Planning by Use of 3-D Ultrasound Image Volumes
Authors: Macher Christian  , Liebing Marco  , Lazovic Djordje  , Overhoff Heinrich Martin
Published: February 2025

The incidence of Total Knee Arthroplasties (TKA) is increasing. The main problem is the correct placement of especially the femoral prosthesis. Pre-operative planning and intra-operative realization relies on lower limb X-rays and extra- or intramedullary devices. This may lead to implant displacements. We generated virtual models of the distal femur for 10 knee joints. In a free-hand sweep we recorded 3-D US image volumes, which typically took 90 sec. The bony structures were detected automatically in the US-images and then appeared as curvilinear lines. Spatially arranged these lines formed femur models, which were used for the placement of a femoral prosthesis in an interactive computer-based 3-D planning. The automatic image segmentation took about 45 minutes. Its analysis showed correct detection of the bone surface. The interactive planning took 5-10 minutes. The investigation demonstrates that 3-D US can provide data of position and size of bony structures. Bone models created by analysis of 3-D US image volumes are useable for simulation of TKA implantations.
Cost-Effectiveness of Drug Resistance Testing for the Adaptation of Treatment in HIV-infected Patients
Authors: Muhlberger N.  , Corzillius M.  , Sroczynski G.  , Siebert U.  , Peeters J.  , Wasem J.
Published: February 2025

1. Background: HIV is a disease with increasing prevalence in Germany. Up to now a final life saving therapy has not been found. In recent years antiretrovial therapy is becoming increasingly successful; it is threatened, however, by drug resistance of patients. Testing for resistance is available and can be used to guide therapeutic decisions.
EU-Project medCERTAIN: Certification and Rating of Trustworthy and Assessed Health Information on the Net
Authors: Eysenbach Gunther  , Diepgen Thomas  , Lampe Kristian  , Brickley Dan
Published: February 2025

med-CERTAIN (MedPICS Certification and Rating of Trustworthy Health Information on the Net, http://www.medpics.org/medcertain/) is a recently launched project funded under the EU Action Plan for safer use of the Internet It will provide the technical infrastructure for an international system of “quality seals” for Internet health information. Digital “quality seals” may be evaluative metainformation (using standards such as PICS=Platform for Internet Content Selection, now being replaced by RDF/XML) assigned by trusted third- party raters. The project will also enable and encourage self-labelling with descriptive metainformation by web authors. Together these measures will help consumers to identify high-quality information on the Internet. Med-CERTAIN will establish a fully functional demonstrator for a self- and third-parry rating system enabling patients and consumers to filter harmful health information and to positively identify and select high quality information. We aim to provide a system allow European citizens to place greater trust in networked information, exemplified in the domain of health information, whilst also making a significant contribution for similar projects with different target domains. The project will demonstrate how PICS-based content rating and filtering technologies can automate and exploit value-adding resource description services. The proposed technology strategy combines a pragmatic use of simple existing technologies for data acquisition with a future-oriented standards policy intended to lead rather than follow the evolution of definitions for information- mediation services.
RESIS-3D - ein Krankenhaus- Geoinformationssystem zur Aus-breitungsüberwachung für resistente Erreger
Authors: Ihracky D.  , Steffen D.  , Gierl L.
Published: February 2025

In den vergangenen beiden Dekaden ließ sich ein deutlicher Anstieg von Antibiotikaresistenzen hinsichtlich ihrer Häufigkeit und des Spektrums an Mikroorganismen, bei denen diese Resistenzen auftraten, verzeichnen. Die rasche Ausbreitung von Antibiotikaresistenzen bei einer Vielzahl von Bakterien beruht im Wesentlichen auf der Lokalisation der Resistenzgene auf mobilen genetischen Elementen wie Plasmiden und Transposons. Mit RESIS-3D wurde ein Informationssystem für die räumliche und zeitliche Auswertung der Resistenzdaten entwickelt. Damit steht den Ärzten des Rostocker Universitätsklinikums ein optimales Werkzeug zur Antibiotikaberatung zur Verfügung, hygienische Maßnahmen können gezielt durchgeführt werden.
Identification in Healthcare Is there a place for Unique Patient Identifiers? Is there a place for the Master Patient Index?
Authors: Freriks Gerard
Published: February 2025

The Unique Patient Identifier is debated. This presentation will present the problems associated with this concept. The unique number is used for identification of persons and documents and thereby creates a severe security risk.
Detecting predictors of new-born survival by fuzzy sets based machine learning system
Authors: Lukačić Zoran  , Kern Josipa  , Težak-Benčić Marija
Published: February 2025

Machine learning system based on fuzzy sets was used for detecting predictors of new-born survival within the first 15 days after birth. The system processed real-life medical data of 566 new-boms; 528 survived and were classified as “alive”, the remaining 38 did not survive and were classified as “died”. The state of each new-born was described by values of 112 attributes. The system detected five of the attributes as the best predictors for survival (asphyxia, apnoea, birth weight, reanimation and gestation age). To evaluate are the selected attributes relevant for prediction, the following procedure was used: 566 new- borns were divided into two groups by random selection; 396 (70%) randomly selected new-borns formed the learning group, the remaining 170 new-borns formed the test group. The system acquired prediction knowledge by processing data of the learning group new-borns. Using the knowledge thus acquired, the system predicted survival for each new-born from the test group several times, each time using another set of attributes: once, using all 112 attributes; once, using attributes detected by the system as the best predictors; once, using remaining attributes without the best predictors. After the predictions for all new-borns from the test group had been finished, classification accuracy, sensitivity (accuracy for “alive”) and specificity (accuracy for “died”) were calculated as measures of prediction success with particular sets of attributes.
Decision Support in Medicine: A Survey of Problems of User Acceptance
Authors: Wendt T.  , Knaup-Gregori P.  , Winter A.
Published: February 2025

Computer-based clinical decision support systems (CDSSs) are still today not in widespread use, although there has been extensive research and development for several decades. We have, based on the literature of the last years, summarised some of the problems that may lead to low user acceptance and that should be addressed more extensive in future developments of CDSSs
Purpose and Structure of Strategic Plans for Information Management in Hospitals
Authors: Winter Alfred  , Brigl Birgit  , Buchauer Anke  , Dujat Carl  , Gräber Stefan  , Hasselbring Wilhelm  , Haux Reinhold  , Heinrich Andreas  , Janssen Henning  , Kock Ingo  , Winter Andreas
Published: February 2025

Information management in hospitals requires a strategic plan that gives directives for the construction and development of a hospital information system. The paper describes the purpose and a suggested structure for those strategic plans. This structure is a central component for a guideline that may be used for creating and updating strategic plans.
MedlDok - An Intranet Tool for XML-based Data Modelling in Medicine
Authors: Dugas M.  , Überla K.
Published: February 2025

Integration of administrative, clinical and scientific documentation in medicine is a challenge because of the complexity and dynamics of the underlying data models. At least 50 items per procedure are necessary for clinically adequate documents. Extensive fine tuning is required to achieve acceptance by physicians, thus rapid prototyping is important. The results of this modelling process should be provided independently of specific implementations for reasons of portability.
Speech and Language Technologies, Intelligent Content Management and Intelligent Assistants
Authors: Lernout Jo
Published: February 2025

This chapter focuses on Speech and Language Technologies, Intelligent Content Management and Intelligent Assistants. It describes impact of these technologies on healthcare assuming a 10-year scope.
Defining the Future of Health Technology: Biomechatronics
Authors: Bushko Renata G.
Published: February 2025

Future progress in healthcare and medicine depends on today's investment in research, development, and education. We cannot leave such urgent issues to determine themselves, but rather must actively collaborate to ensure a stable healthcare system. This chapter describes efforts made by leading experts in industry, government, and academia to better ascertain future healthcare management. Such collaboration has occurred during a series of Future Healthcare Technology Summits [1] helping in planning investments in health technology. Deliberating and reviewing plans before taking action will accelerate progress as it will (1) save costs, (2) encourage compliance, (3) improve clinical outcomes, and (4) ensure greater patient satisfaction [2]. What we must resolve is: How can we invest a couple billion dollars to save hundreds of billions and, most importantly, increase human health in the future. A new branch of science, Biomechatronics, with millions of Intelligent Caring Creatures– is the answer.
Thought to Computer Communication
Authors: Warwick Kevin
Published: February 2025

This paper describes some of the implant experimentation presently underway. The basic approach taken is introduced and general techniques are explained. Achievements already attained are summarized and short term plans are expanded. Potential results, as they could impact on healthcare and related issues, are thrown into the arena. The author speculates ‘a little’ on what might be achieved in the future with implant technology.
Measurement and Display of Regional Myocardial Motion During Post Infarct Treatment
Authors: Eusemann Christian D.  , Ritman Erik L.  , Behrenbeck Thomas R.  , Robb Richard A.
Published: February 2025

Quantitative assessment of 3-D regional heart motion has significant potential to provide more specific diagnosis of cardiac malfunction than currently possible. Using functional parametric mapping, regional myocardial motion during a cardiac cycle can be color-mapped onto a deformable heart model to provide better understanding of the structure-to-function relationships in the myocardium, including regional patterns of akinesis or dyskinesis associated with ischemia or infarction. In this study, 3-D reconstructions of human hearts were obtained from Electron-Beam Computed Tomography [1] (EB-CT), comparing stages of treatment after myocardial infarction.
Wireless Vital Sign Telemetry to Hand Held Computers
Authors: Gandsas Alex  , Montgomery Kevin  , Mclntire Katie  , Altrudi Rodolfo
Published: February 2025

Most physicians and other health care providers share/access patient information via hard copy chart records, telephone conversations, or through hospital computer networks. These modalities are cumbersome when physicians are away from the hospital and ground wiring infrastructure is not readily available. In a prior study, we used wireless in-flight telephony and the Internet to transmit vital signs from an airborne Boeing 757 to three remote locations on the ground. However, because all recipient stations relied on an institutional network to receive the information, it was not possible to transfer data to a given location beyond the hospital campus. We now propose an innovative system capable of transmitting telemetry information from any location in the globe to a single portable computer using Wireless Application Protocol (WAP) technology for the Internet. Medical data including blood pressure, pulse, respiratory rate, end tidal CO2, oxygen saturation and EKG tracings were transferred from a G2 (digital cellular) phone linked to a hand held computer to a remote hand held device and were viewed in real time using customized software. Cellular Digital Packet Protocols (CDPD) enabled data transfer speeds up to 19,200 bps. Advances including the Internet and wireless computer technology may revolutionize the way medical information is shared, making it possible for physicians and health allies to directly access patient data from anywhere at any time.
New Graphics Models for PC Based Ocular Surgery Simulator
Authors: Mukai Nobuhiko  , Harada Masayuki  , Muroi Katsunobu  , Hikichi Taiichi  , Yoshida Akitoshi
Published: February 2025

High-end graphics workstations (GWS) have been used for surgical simulators utilizing Computer Graphics (CG) and Virtual Reality (VR) technologies. This is because the simulators need lots of computing power, mainly for collision detection among objects modeled as a set of polygons. In this paper, we propose to use mathematical functions to model objects for collision detectioa However, for graphic display we continue to use polygonal representation. Using the new model, we have developed a PC based ocular surgery simulator, which creates realistic surgery image in real-time. The computation time was found to be much lower than that in the conventional method.
MEDNET: A Medical Simulation Network Grand Challenge
Authors: Myjak Michael D.  , Rosen Joseph
Published: February 2025

The need to improve war-fighter training led to significant advancements in simulator technology. Now, simulator technology is ready to be applied to a new challenge: an evolutionary approach to training military medical personnel that will result in improved combat casualty care. With the exception of the introduction of helicopter evacuation support during the Korean War, changes in combat casualty care have not significantly altered the percentage of wounded soldiers lost in combat since World War II. The introduction of battlefield simulator training has improved strategic planning and combat readiness. It is time to apply these same tools to improve medical planning, military medical readiness and execution of casualty care.
4D Visible and Palpable Simulation Using Dynamic Pressure Model Based on Cardiac Morphology
Authors: Nakao Megumi  , Komori Masaru  , Matsuda Tetsuya  , Takahashi Takashi
Published: February 2025

A goal of this work is proposal and construction of ActiveHeart System: a simulation environment that enables anyone to see and touch heart beat in real time. In this paper, a method to express real-time graphic and haptic behaviour of a beating heart is mentioned. The data for the beating heart model was obtained from ECG-gated 3D MRI of a normal volunteer. The elastic information was assumed as a uniform value with clinically experienced elasticity. Using a real-time 3D graphics and a haptic device, a simulation environment of the beating heart was designed and implemented. After the construction, some cardiovascular surgeons evaluated the implemented system. Its visualization and beating expression were scored excellent, but some details in haptic expression were remained to be improved. Finally, for more realistic cardiovascular surgical simulation, future development of the method is discussed.
Virtual Reality as an assessment tool for arm motor deficits after brain lesions
Authors: Piron Lamberto  , Cenni Federica  , Tonin Paolo  , Dam Mauro
Published: February 2025

The currently used assessment techniques for measuring neurological deficits are time consuming and may lack of sensibility and repeatability. Previous studies suggested that the cinematic analysis of the movement, might represent a reliable alternative instrument for documenting the degree of motor impairment. To verify this hypothesis we investigated motor/functional progress in 20 post-stroke patients, undergoing rehabilitation therapy, by means of a widely used clinical test (Fugl-Meyer scale), and by evaluating kinematics of arm motion. After rehabilitation therapy, velocity and duration of reaching movements significantly improved with respect to baseline values. Before and after rehabilitation there was a significant correlation between each cinematic parameter and the clinical scale scores. These results, suggests that the cinematic analysis of movement can be proposed as a precise and objective assessment tool to be used in clinical practice.
Multislice CT and Computational Fluid Dynamics: A new technique to visualize, analyze and simulate hemodynamics in aortic aneurysms and stentgrafts
Authors: Pless D.  , Boll D.T.  , Goerich J.  , Fleiter Th. R.  , Scharrer-Pamler R.  , Brambs H.-J.
Published: February 2025

The interest of this study is on analysing blood flow phenomena like velocity, pressure and wall shear stress in the aorta before and after treatment of abdominal aortic aneurysm by placement of an endovascular stentgraft to get a better estimation of risk of rupture of the aneurysm and to optimise the shape of the stentgrafts.
Force-feedback in Web-based Surgical Simulators
Authors: Riding Mark  , John Nigel W.
Published: February 2025

There is a growing requirement in the field of surgical training to allow trainees to practice procedures in a way that does not place patients in any risk. Computer based simulators allow students to gain experience and develop three-dimensional awareness in a safe and controlled environment. Typically systems that have been developed to perform this task are, due to their specialist nature, expensive to buy. With the increasing availability of Force-Feedback devices for the gaming market, is there now a cost-effective alternative for surgical simulations? In this paper we investigate, the possibility of using such a device as a haptic input tool for surgical simulations.
Digital trainer developed for robotic assisted cardiac surgery
Authors: Røtnes Jan Sigurd  , Kaasa Johannes  , Westgaard Geir  , Eriksen Eivind Myrold  , Hvidsten Per Øyvind  , Strøm Kyrre  , Sørhus Vidar  , Halbwachs Yvon  , Elle Ole Jakob  , Fosse Erik
Published: February 2025

Robotic systems for cardiac surgery have been introduced in clinical trials to facilitate minimally invasive techniques. Widespread use of surgical robotics necessitates new training methods to improve skills and continue practicing as the robotic systems are frequently being upgraded. Today, robotic training is performed on expensive animal models. An integration of a digital trainer with the two present robotic systems applied in coronary artery bypass procedures on beating heart requires real time simulation of tissue mechanics, sutures, instruments and bleeding. However, it requires no extra haptic device, since the robotic master is the haptic apparatus itself. By developing new data structures and parametric geometry descriptions we have demonstrated the possibility of obtaining surgical simulation on a standard PC Linux system. This technology is beneficial when simulation is exploited over a network with limited bandwidth, especially when it comes to the handling of soft tissue dynamics.
Haptic palpation of Head and Neck cancer patients - Implications for education and telemedicine
Authors: Stalfors Joacim  , Kling-Petersen Torben  , Rydmark Martin  , Westin Thomas
Published: February 2025

Malignancy in the head and neck area is a disease that often gives high morbidity in functions like speech, eating, breathing and cosmetics. To ensure a treatment of high clinical standard these patients are presented for a multidisciplinary tumor-team at Sahlgren University hospital. The team usually involves ENT-surgeons (Ear, Nose and Throat), oncologists, radiologists, pathologists, plastic surgeon, general surgeon and oral surgeons. The aim of the presentation is to classificate the tumor and suggests a treatment. The patients presented are from the whole western region of Sweden, and therefore some patients have to travel long distances. To minimize travel telemedicine was introduced 1998 with success [1]. One concern, when presenting a patient with telemedicine, has been the lack of possibility to palpate the tumor and the tissue surrounding it.
A VR-Based Multicomponent Treatment For Panic Disorders With Agoraphobia
Authors: Vincelli F.  , Choi Y.H.  , Molinari E.  , Wiederhold B.K.  , Riva G.
Published: February 2025

Agoraphobia consists of a group of fears of public places such as going outside, using public transportation and being in public places, which cause serious interference in daily life.
Software Framework for a Surgical Guidance System using Magnetic Markers
Authors: Bhargava Ankur  , Thober Mark  , Bzostek A.  , Taylor R.H.
Published: February 2025

Use of active, optical tracking Surgical Guidance systems provides line of sight problems to the surgeon. We plan to use a new magnetic system, ‘Aurora’ from Northern Digital Inc. (Canada) and Mednetix AG (Switzerland), in intra-operative fluoroscopy to develop an integrated system for surgical guidance. Here we outline the modules developed for use with this system, including a novel registration method.
Multimedia Courseware for Nursing Informatics - Strategies and Implementation -
Authors: Hübner Ursula  , Hassmann Jörg  , Bloom-Schinnerl Margareta
Published: February 2025

It is the aim of the project presented to produce robust multimedia courseware in Nursing Informatics for use in a graduate part time programme in Nursing and Healthcare Management. The courseware was built using a state of the art authoring tool together with other common software tools for processing graphics, video and sound. Experience gained resulted in a procedural model to help novice authors overcome initial problems. The multimedia material is integrated into a navigation framework with typical browser functionality adding features for assisting the student and establishing communication. First practical experience with the courseware could be gained.
Evaluation of Guideline Quality Using GEM-Q
Authors: Agrawal Abha  , Shiffman Richard N.
Published: February 2025

A variety of rating instruments that evaluate the quality of practice guidelines have been published. Application of these instruments can be difficult and time-consuming.
Telehealth Technology: Consequences for Structure Through Use
Authors: Cornford Tony  , Klecun-Dabrowska Ela
Published: February 2025

In recent years the focus of ICTs in healthcare has changed from the ‘back office’ to the front end of patient care. These changes have been brought about by a number of factors including the potential of technologies, pressures for modernisation and administrative reforms, including blurring of the boundaries between different organisations (within and beyond the health sector), and which break down traditional barriers between administration of health services and the practice of medicine In this paper we explore in particular how technology is implicated in such changes, focussing on the consequences of the use of the new telehealth technologies, as seen in a set of linked case studies from an inner city borough in London. The paper addresses the way these technologies, through routine use, become (or not) resources and rules that embody new structures for health care.
The Power Distance between Users of Information Technology and Experts and Satisfaction with the Information System: Implication for Cross Cultural Transfer of IT
Authors: Isaacs Sedick
Published: February 2025

There is a need for research into Information Technology (IT) transfer from one culture to another. Two of the more important cultural factors which affects IT transfer are power distance and uncertainty avoidance. The IT expert, by virtue of specialized knowledge is in a position of power. The user of information technology may or may not accept the authority of the IT professional. When the user and the expert is in agreement on the issue of power-distance the IT systems provided will be viewed in a more positive light. This hypothesis is tested and confirmed in the present study. A list of twelve statements expressing special IT knowledge and authority was constructed and a sample of IT experts and users were asked to rate their level of agreement with these on a scale 0 to 5. The simple sum of respondent rating was used as a measure of acceptance of IT authority and power. Users were also asked to rate their level of satisfaction with the progress of a new Hospital Information System been implemented. The IT acceptance score of users who were satisfied with implementation progress did not differ from IT personnel but differed significantly from users who were not satisfied with progress. This study has implications for cross culture transfer of IT.
Economic Analysis of a Filmless System Based on the Hospital Information System
Authors: Kurihara Yukio  , Yoshida Shoji  , Geshi Hiroyuki  , Kubo Yoshihiko  , Kitazoe Yasuhiro
Published: February 2025

A filmless system (FLS) based on a picture archiving and communication system (PACS) equipped with UNIX workstations and a local area network (LAN) specialized for viewing radiographs has not been deemed acceptable, for reasons of economics. However, personal computers (PCs) have recently become more powerful, to the point where PCs approach UNIX workstations in terms of capabilities. As a result, a PC-based image viewing workstation (IVW) has sufficient functions for practical use. Diagnostic resolution is not equal to that of film, but is comparable. Since the hospital information system (HIS) includes many PC terminals connected by a LAN, the cost problem can be resolved by using these PC terminals as the IVWs. In order to investigate the practicability of this idea, two types of FLSs using HIS facilities were designed: one is a system based on the use of high-resolution cathode ray tubes (H-CRTs), and the other is based on the use of conventional CRTs and radiologist reports, minimizing the number of H-CRTs. The total costs of the two systems were analyzed. As a result, the former FLS was found to be about 15% more expensive than the latter, which was less expensive than a film-based system (FBS). However, whether the FLS is more profitable than the FBS from the viewpoint of hospital management strongly depends on the medical insurance system.
Combining Practice-evaluation with Practice-management in a Breast Services Enhancement Programme (BSEP) for Breast Cancer Nursing
Authors: Keuneman David  , Cannon Andrea  , Byrnes Monica
Published: February 2025

A computer system developed to evaluate the professional practice of Breast Cancer Nurses. Novel in the field, specially adapted as a useful tool for day-to-day Breast Cancer nursing, thereby encouraging completeness of data for research
Enabling Health Online: The Case for Standards
Authors: Klein Gunnar O.
Published: February 2025

Healthcare policies in many countries, in the European Union and of the United Nations stress the importance of using information and communications technology to achieve the goals of improving health for all while controlling accelerating costs. This paper reviews the major areas where standards actions are required on a national, European and global level.
Adding Value to Clinical Data By Linkage to a Public Death Registry
Authors: Pates Robert D.  , Scully Kenneth W.  , Einbinder Jonathan S.  , Merkel Richard L.  , Stukenborg George J.  , Spraggins Thomas A.  , Reynolds Calvin  , Hyman Ronald  , Dembling Bruce P.
Published: February 2025

We describe the methodology and impact of merging detailed statewide mortality data into the master patient index tables of the clinical data repository (CDR) of the University of Virginia Health System (UVAHS). We employ three broadly inclusive linkage passes (designed to result in large numbers of false positives) to match the patients in the CDR to those in the statewide files using the following criteria: a) Social Security Number; b) Patient Last Name and Birth Date; c) Patient Last Name and Patient First Name. The results from these initial matches are refined by calculation and assignment of a total score comprised of partial scores depending on the quality of matching between the various identifiers. In order to validate our scoring algorithm, we used those patients known to have died at UVAHS over the eight year period as an internal control. We conclude that we are able to update our CDR with 97% of the deaths from the state source using this scheme. We illustrate the potential of the resulting system to assist caregivers in identification of at-risk patient groups by description of those patients in the CDR who were found to have committed suicide. We suggest that our approach represents an efficient and inexpensive way to enrich hospital data with important outcomes information.
What Do Patients Do with Access to Their Medical Records?
Authors: Cimino James J.  , Patel Vimla L.  , Kushniruk Andre W.
Published: February 2025

We sought to study the phenomenon of patients having access to their own medical records in order to determine the impact on them and on their relationship with their health care providers. We created the Patient Clinical Information System (PatCIS) to interface with the clinical data repository at New York Presbyterian Hospital to allow patients to add to and review their medical data. We also provided educational resources and automated advice programs. We provided access to the system to thirteen subjects over a nineteen-month period and reviewed their activities in the system's usage log. We also collected data via questionnaire and telephone interview.
The Accessibility of Computer-based Health Information for Patients: Kiosks and the Web
Authors: Jones Ray B.  , Balfour Fay  , Gillies Michelle  , Stobo David  , Cawsey Alison J.  , Donaldson Kerr
Published: February 2025

The Internet is a rich source of health information but it is not as accessible as many claim. This paper brings together three projects to illustrate technical and cost barriers and some options to overcome them. (1) A survey amongst a representative sample of 180 patients in rural Spain showed a marked age gradient in computer access. None over the age of 50 had, and less than 10% planned, access to the Internet whereas a quarter were prepared to use health centre based touchscreen kiosks. (2) Half the commonly used search engines did not include the two most relevant websites for Glasgow colorectal cancer patients in the first ten documents listed, showing the difficulty facing patients in finding relevant information. Selection of information would help patients avoid being overwhelmed with information. (3) One method to improve accessibility is to download websites to kiosks but two projects showed that considerable work is required to reformat the information. Public access computing, such as kiosks, could help make the Internet more accessible. We discuss whether Web sites which structure their information according to method of access, place and person provide a way forward.
Developing Tailored Theory-based Educational Content for WEB Applications: Illustrations from the MI-HEART Project
Authors: Kukafka Rita  , Lussier Yves A.  , Patel Vimla L.  , Cimino James J.
Published: February 2025

This paper describes how theory facilitated the development of educational content for the MI-HEART project, a tailored Web-based intervention designed to favorably influence the appropriateness and rapidity of decision-making in patients suffering from symptoms of acute myocardial infarction. There were five steps involved: 1) formulating the behavioral goal, 2) defining intervention objectives based on an analyses of the determinants of behavior, 3) developing an assessment tool to measure a person’s status on these determinants, 4) creating tailored content that address individual variation on determinants of the health behavior and, 5) developing algorithms and a computer program that link responses from the assessment to specific tailored communication. The approach we describe largely distinguishes Web-based applications that are designed to change health behavior from those that simply impart information. Developers of Web-based applications that propose to improve health status by modifying health-related behaviors need the understanding that although it is said that we live in an "information age", simply increasing knowledge has not been effective in changing behaviors in most instances. Furthermore, the one-size fits all approach to developing educational content cannot address the needs, concerns and interests of different individuals. With informatics technology, our ability to collect information from individuals and provide educational content tailored to the specific information collected is not only possibly, but practical.
Preventing Medical Errors: Social, Ethical, Organizational and Technical Issues
Authors: Anderson James G.  , Balas E. Andrew  , Bates David W.  , Evans R. Scott
Published: February 2025

Medical errors may rank as the eighth leading cause of death in the U.S. Properly designed clinical information systems have the potential to detect and to prevent medical errors. At the same time, a number of issues need to be addressed.
IΦE Workshop Scientific Work of Graduate Students of Medical Informatics
Authors: Limburg Martien  , Gardner Reed  , Gatewood Lael Cranmer  , Schmidt Diana  , Haux Reinhold
Published: February 2025

The International Partnership in Health Informatics Education is a cooperation of the universities of Amsterdam, Heidelberg, Heilbronn, Minnesota and Utah. As well as organization of yearly Master Classes, one of the aims of the cooperation is to offer graduate students of Medical Informatics the possibility for exposure to an international audience. In this workshop students will present results of their own scientific work. Issues identified and addressed by the newly graduated students will be discussed with attendees. Participants from different health disciplines are invited to attend and contribute to a stimulating exchange of ideas and views from different backgrounds and different levels of experience.
Modeling Data and Knowledge in the EON Guideline Architecture
Authors: Tu Samson W.  , Musen Mark A.
Published: February 2025

Compared to guideline representation formalisms, data and knowledge modeling for clinical guidelines is a relatively neglected area. Yet it has enormous impact on the format and expressiveness of decision criteria that can be written, on the inferences that can be made from patient data, on the ease with which guidelines can be formalized, and on the method of integrating guideline-based decision-support services into implementation sites’ information systems. We clarify the respective roles that data and knowledge modeling play in providing patient-specific decision support based on clinical guidelines. We show, in the context of the EON guideline architecture, how we use the Protégé-2000 knowledge-engineering environment to build (1) a patient-data information model, (2) a medicalspecialty model, and (3) a guideline model that formalizes the knowledge needed to generate recommendations regarding clinical decisions and actions. We show how the use of such models allows development of alternative decision-criteria languages and allows systematic mapping of the data required for guideline execution from patient data contained in electronic medical record systems.
Groupware for Case Management and Inter-Organizational Collaboration:The Virtual Rehabilitation Team
Authors: Bång Magnus  , Hagdahl Anneli  , Eriksson Henrik  , Timpka Toomas
Published: February 2025

This paper presents LINDA, a prototype system designed to support virtual rehabilitation teams. LINDA enables professionals from different welfare-state agencies to collaborate in case management. Our approach to supporting teamwork involves the sharing of minimal case sets across organizational borders needed to provide a shared situation assessment among team members. The system provides a shared workspace for the team; a lightweight client-database, visualization of case histories and plans, and means to communicate effectively in the team using yellow sticker-notes. We present LINDA and discuss how we approached the problem to design groupware to support work under changing and uncertain conditions.
XML Transcription Method for Biomedical Acoustic Signals
Authors: Modegi Toshio
Published: February 2025

We have proposed applying MIDI technology to coding of biomedical acoustic signals such as heart sounds used in medical diagnosis for constructing medical audio databases. According to our several experiments, we could correspond encoded MIDI event data or musical notes with heart sound components used for clinical diagnosis. However, precise discrimination among abnormal heart sounds and murmurs was difficult owing to insufficiency of analysis precision in our proposed method. Then we have improved its coding precision and supported harmonic or formant analysis in order to extend our application to multimedia low bit-rate audio coding, especially representation of vocal sounds by MIDI codes. In these efforts, we can describe precisely heart-sound components with MIDI codes and segment converted MIDI codes into heart sound components; about 80% automatically in 55 cases. In this paper, we are going to describe our novel heart sound automatic XML transcription method. This XML document includes MIDI data reflecting numerical detailed information for each segmented heart sound component and can reproduce heart sound signals by a browser and MIDI sequencer plug-in.
Reading Factor: A Bibliometric Tool to Manage a Virtual Library
Authors: Thirion B.  , Darmoni S.J.  , Benichou J.
Published: February 2025

Among the many bibliometric criteria used to evaluate biomedical journals, the impact factor is the most commonly used. Despite its limitations, it quantifies the influence of a journal on secondary publications. It does not however evaluate the practical usefulness of primary documents. Usefulness is field-related and varies greatly among specialities. We introduce a new bibliographic criterion, the “reading factor”, and define it as the ratio between the number of electronic consultations of a particular journal (i.e., number of clicks on a hyper-link) and the mean number of electronic consultations of all the journals studied (itself calculated by dividing the total number of electronic accesses by the number of journals in the database). We describe its observed distribution, relative to that of the impact factor, based on electronic consultation records from our University Hospital medical digital library, where full-text electronic versions of 45 major biomedical journals have been available since December 1997. From this analysis we found no correlation between the 1999 reading factor and the 1998 impact factor of these 45 journals, and we observed a dramatic change in the hierarchy of journals upon using the reading factor as the yardstick rather than the impact factor. Moreover, we describe how using the reading factor has helped in managing the collection of our University Hospital’s virtual library. The selection of journals to be discarded from the virtual library for the year 2001 was based on journals' RF values and this process will repeated over the coming years. The reading factor also permits a cost-analysis of a virtual library. Conclusion: The measurement of the reading factor is highly automated, practical and efficient. It appears as a new tool for electronic collection management by librarians, well fitting with economical data.