bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical pedagogical resources management
Authors: Pouliquen Bruno  , Le Duff Franck  , Delamarre Denis  , Cuggia Marc  , Mougin Fleur  , Le Beux Pierre
Published: February 2025

The main objective of this work is to help the management of training resources for students using a pedagogical network available at the Medical School of Rennes. With the increase of the number of connections and the number of medical documents available on this network, the management of new contents requires a lot of efforts for the webmaster. In order to improve the management of the resources, we implemented an automatic web engine for teachers, able to manage the links for the most interesting resources for their practice.
A Prognostic Model for Temporal Courses that Combines Temporal Abstraction and Case-based Reasoning
Authors: Schmidt Rainer  , Gierl Lothar
Published: February 2025

Since clinical management of patients and clinical research are essentially timeoriented endeavours, reasoning about time has recently become a hot topic in medical informatics. Here we present a method for prognosis of temporal courses, which combines temporal abstractions with Case-based Reasoning. We have applied our method in two programs. The first one deals with multiparametric time course prognosis of the kidney function. The intention of the second program is to compute early warnings against approaching infectious diseases like influenza.
Making Messaging Standards Wirk: From Definition to Interoperability at Runtime
Authors: Oemig Frank  , Bloebel Bernd
Published: February 2025

The synchronisation of data between healthcare IT applications is done by exchanging (in the broader sense) messages which are formatted according to one of many standards that are used in healthcare.
Development of an indexing search engine for the UMVF : Proposal for an indexing method based on Dublin Core and XML
Authors: Mougin Fleur  , Cuggia Marc  , Le Beux Pierre
Published: February 2025

The UMVF (French Virtual Medical University) has many heterogeneous resources hosted by the servers of university partners of the project. One of its objectives is to develop an efficient tool to perform a single search on these resources. We first defined a standardized and interoperable indexing method For each document, an XML file containing information on the fifteen elements of Dublin Core was created We checked its structure and content with a DTD. If the XML file was valid, its data were then integrated into a central database from which the engine carried out a search. We tested our tool successfully with the resources hosted by the Rennes Laboratory of Medical Informatics in cooperation with the Radiology Medical Campus [1]. Our method allows the standardization of the production of information by the various servers and it conforms to the constraints of the semantic Web owing to the technologies chosen.
Comparative assessment of two interfaces for delivering a multimedia medical course in the French-speaking Virtual Medical University (UMVF)
Authors: Brunetaud Jean Marc  , Leroy Nicolas  , Pelayo Sylvia  , Wascat Caroline  , Renard Jean Marie  , Prin Lionel  , Beuscart-Zéphir Marie Catherine
Published: February 2025

The UMVF aims at helping medical students during their normal curriculum via the facilities provided by Internet based techniques This paper describes a comparative assessment of two interfaces .delivering a multimedia course: a conventional web server (WS) and an integrated e-learning platform in the form of a Virtual Campus (VC). Eleven students were arbitrarily divided into two groups. We used a qualitative method for comparing their acceptance of the on line course provided by the two different interfaces. The two groups were globally satisfied However, a decrease in satisfaction was noted at the end of the experimentation in the VC group. This may be explained by a more complex Graphical User Interface (GUI) of the VC and some constraints which do not exist with the WS. The current e-learning platforms are probably not optimised for working conditions where presential and virtual activities are mixed We think that a new type of “light” platforms should be developed for these specific working conditions. Students of the two groups also had limitations about the multimedia environment. They may change their opinion if they get more accustomed with the multimedia environment and if their teachers make a more adequate use of the multimedia techniques.
Similarity study on university teaching hospitals in France
Authors: Houyengah François  , Duhamel Alain  , Alao Omolade  , Grave Cécile  , Renard Jean-Marie  , De La Roque Christine  , Dubreuil Pascale  , Beuscart Régis
Published: February 2025

The recent development of hospital information systems in France presently makes it possible to study similarity between establishments based on an official data source, the AGHN. The AGHN is based on three types of information: medical, structural (personnel and material) and economic. Using the PCA (principal component analysis) tool, we can examine the situation of one regional and\or university hospital with regards to others of the same kind.
A framework for benchmarking hospital performance: application to surgical site infection
Authors: Boëlle Pierre-Yves  , Golliot Franck  , Valleron Alain-Jacques
Published: February 2025

Benchmarking is an approach to quality improvement where practice of leaders are studied to help improve one’s own practice. Here, a framework for designing and implementing an information system for benchmarking is proposed. Participating actors are described by Structure, Process, Outcomes and indicators of case mix. The core of the information system consists in a database of actors descriptions, and in an algorithm combining rules and data on Structures, Outcomes and Case mix to identify, leaders. Results from the benchmark consist in the Processes of the leaders. An example using data from a surgical site infection surveillance network is provided. Actors were hospital surgical departments, Structure consisted in the type of the hospital, specialty and annual number of interventions. The algorithm for selection of leaders was implemented using a decision tree. Using this framework, benchmarking could be facilitated and more easily accepted by professionals.
Impact of Nursing Education in Slovenia on Nurses' Publishing in Their Professional Journal
Authors: Dornik Ema  , Vidmar Gaj
Published: February 2025

The paper discusses influences of developments in nursing education in Slovenia on the structure and contents of publications in the Slovene journal of the nursing profession – the Review of Nursing. Undergraduate nursing education in Slovenia changed from Associate Degree to Diploma level, while the B.S.N. type programme was of brief duration. Bibliometric data was gathered on all the scientific and technical papers published in the Review of Nursing between 1977 and 2001. Statistical analyses were carried out to study characteristics and inter-relations of authorship, cited references and contents. A positive impact of improved and extended education of nurses on quantity and quality of their publications has been confirmed The paper is part of a larger study on nursing education in Slovenia and its relation to the works published in the Review of Nursing.
BioMeKe : an ontology-based biomedical knowledge extraction system devoted to transcriptome analysis
Authors: Marquet Gwenaëlle  , Burgun Anita  , Moussouni Fouzia  , Guérin Emilie  , Le Duff Franck  , LorÉAl Olivier
Published: February 2025

Semantic interoperability between knowledge bases in medicine, and knowledge base in genomics and molecular biology will lead to advances in fundamental research as well as to improved patient care. DNA chips strategy is used for transcriptome analysis in order to identi deregulated genes in physio-pathological conditions. The objective of the BioMedical Knowledge Extraction project (BioMeKe) is to develop a knowledge warehouse in the context of transcriptome analysis during liver diseases. Knowledge sources include ontologies, related terminologies and annotations linked towards public databases (e.g., SWISSPROT). BioMeKe has been developed to have access to information using systematic investigation upon a concept, gene, gene products, pathology, or any target keyword, and is based on the combination of several relevant resources: UMLS, GeneOntology, MeSH supplementary terms, GOA, and HUGO. Current efforts are focusing on exploiting this ontology-based Knowledge Extractor, to enrich the expression data on genes delivered by a liver specific DNA microarray for better assistance of analysis.
Mathematical modelling for the study of respiratory mechanics
Authors: Botsis Taxiarchis  , Mantas John
Published: February 2025

The target of this study was the development of mathematical models that best describe the behaviour of respiratory parameters.
The Electronic Health Card as a Tool for Seamless Care German Activities to Implement Telematics
Authors: Dietzel Gottfried T.W.
Published: February 2025

Health belongs to the infrastructure and services sectors, which are influenced and restructured by the development and implementation of information and communication technologies. But healthcare itself also gives impulses for the economic and social development which leads to the information and knowledge society. Communication, rationalisation, and quality problems in healthcare are solved. Thus, increases in efficiency, quality improvements, and cost savings result. To achieve these results, a suitable general framework must be created. Important key applications need to be developed.
Open Source in the European Union: A Future Way for Health Applications?
Authors: Paindaveine Yves P.
Published: February 2025

Since 1999, the Open Source movement has aroused the interests of different players of the Information Society. M. E. Liikanen, European Commissioner for Enterprise and Information Society, has publicly expressed an interest for more security through the use of Open Source software. Municipalities deployed desktops and servers based on Open Source software in Spain, France, Austria and Belgium. Some health professionals see in this movement a way of obtaining better software, more secure and interoperable. This presentation explores the context and economical considerations at the basis of the Open Source movement, its rationale in a research programme publicly financed and some of the challenges ahead. It concludes on the observations that Open Source is high on several agendas but needs to quickly become an economical activity to deliver its promises.
The PICNIC Approach to Regional Care Networks
Authors: Bray Brian
Published: February 2025

PICNIC is a pioneering project to develop an architecture for next generation regional healthcare networks. This paper gives an overview of the project and some of the reasoning behind the interrelated technical and business choices.
LifeGuard - Recording, Evaluation and Wireless Transmission of Medical Data
Authors: Arndt Bastian  , Krangemann Robert  , Niklaus Markus  , Ulrich Helmut
Published: February 2025

Early diagnosis is imperative in the quest for cures for or prevention of diseases. Medical doctors nowadays can measure a multiplicity of physical determinants such as blood pressure, insulin levels, etc. The sooner this is done the sooner therapy can begin and the sooner therapy begins the greater the chances of success, no matter what the disease.
Data Analysis Now and Then: Significant Changes in Approaches and Results
Authors: Mohr Markus T.J.  , Redl Heinz
Published: February 2025

Modern data analysis is one of the many prerequisites for telemedical applications. Classical Statistical methods alone are no longer sufficient to fulfill the various demands of modern analytical procedures. Cluster and association analysis among others have filled this gap and are capable of producing more adequate and better suitable results as well as to provide information not detectable in the past.
Surgical Training Using Haptics Over Long Internet Distances
Authors: Gunn Chris  , Hutchins Matthew  , Adcock Matt  , Hawkins Rhys
Published: February 2025

This paper describes a collaborative surgical training prototype using haptics, which has been able to operate across the world. It allows two users to collaboratively manipulate a simulation of pliable human body organs, as well as guide each other's ‘hands’ over 22,000 km of internet connection. It uses a force impulse collection mechanism feeding haptics data to a single physics server program. The server runs a ‘pseudo’ physics model that is resilient to latency.
Real time estimation of physical activity and physiological performance reserves of players during a game of soccer
Authors: Anastasiadis Savas  , Anogeianaki Antonia  , Anogianakis George  , Koutsonikolas Dimitris  , Koutsonikola Panayiota
Published: February 2025

The need for ever increasing achievements in athletic performance is pushing the acquisition costs and salaries of top performers to unprecedented heights. Individual talent, good physical condition and relentless training, however, do not by themselves guarantee success of the team effort. Team performance is determined by game strategy and team coordination. Ideally, during a game, the team coach should be able to gauge the instantaneous physical condition and performance reserves of each player on the team and direct game strategy accordingly. Our experimental setup explores the feasibility of objectively estimating, in real time, the intensity of physical activity and the physiological performance reserves of each and every player on the team during a game of soccer.
Virtual Reality based System for Training on Knee Arthroscopic Surgery
Authors: Heng Pheng-Ann  , Cheng Chun-Yiu  , Wong Tien-Tsin  , Xu Yangsheng  , Chui Yim-Pan  , Chan Kai-Ming  , Tso Shiu Kit
Published: February 2025

Surgical training systems based on virtual reality (VR) and simulation techniques offer a cost-effective and efficient alternative to traditional training methods. This paper describes a virtual reality system for training arthroscopic knee surgery. The virtual model used in this system is constructed from the Visual Human Project dataset. The system simulates the real-time deformation of soft tissue with topological change using finite element analysis. To offer the realistic tactile feedback, we construct a specialized force feedback hardware.
Hybrid-Reality: Collaborative Biomedical Data Exploration Exploiting 2-D and 3-D Correspondence
Authors: Antonijuan Tresens Marc  , Kuester Falko
Published: February 2025

Doctors and radiologists are trained to infer and interpret three-dimensional information from two-dimensional images. Traditionally, they analyze sets of two-dimensional images obtained from imaging systems based on x-rays, computed tomography, and magnetic resonance. These images correspond to slices or projections to a single plane. With the resolution of the scanners increasing in all directions, so is the complexity of the data that can be used for diagnostic purposes. Using volume rendering techniques, massive stacks of image slices can be combined into a single image and important features stressed, increasing the doctor's ability to extract useful information from the image. A hybrid visualization approach combining 2D slices and 3D visuals is presented, drawing from the best features of both of these approaches. 2D slices emulate conventional medical images while 3D images provide additional information, such as better spatial location of the features in the surrounding structures as well as the 3D shape of features.
Ensuring the Usability of a Knee Arthroscopy Simulator
Authors: Moody Louise  , Waterworth Alan  , Arthur John G.  , Zivanovic Aleksandar  , Dibble Edward
Published: February 2025

There is limited research considering the usability of medical virtual environments. Usability evaluation is an essential validation phase that considers the extent to which a product achieves its specific goals, with effectiveness, efficiency and satisfaction. A four-stage iterative approach is adopted to enhance usability in the development of a knee arthroscopy training system. This process has drawn attention to issues that may impede system usability for example non-conformity to platform conventions, and visibility of the system status. The process highlights features that computer scientists can overlook when working closely with a system but that are essential to user acceptance and effective application.
A Flexible Virtual Reality Tutorial for the Training and Assessment of Arthroscopic Skills
Authors: Moody Louise  , Waterworth Alan
Published: February 2025

Through definition of a comprehensive tutorial model, the Warwick, Imperial and Sheffield Haptic Knee Arthroscopy Training System (WISHKATS) aims to provide independent, flexible and consistent training and assessment. The intention is to satisfy user acceptance by limiting the constraints by which the system can be utilised, as well as demonstrating validity and reliability. System use can either be under the guidance and feedback offered by the system or. of a senior surgeon. Objective metrics are defined for performance feedback and formal assessment.
Manipulation of Volume Data to Manufacture Vascular Replicas
Authors: Bailey Mike  , Knox Kim  , Kerber Chuck  , Singel S.A.  , Imbesi S.G.
Published: February 2025

There are three reasons to create physical replicas of human anatomy: (1) to be able to better visualize the shape of a single organ, or a section of anatomy; (2) to be able to visualize the spatial relationships in three-dimensions; and (3) to use accurate replicas to practice or rehearse otherwise high-risk clinical procedures in the laboratory. This paper describes a project to fabricate a carotid artery. It discusses the gathering of data, the conversion to a volume, and the subsequent conversion to a manufacturable form.
BIRD: Bio-Image Referral Database. Design and Implementation of a New Web Based and Patient Multimedia Data Focused System for Effective Medical Diagnosis and Therapy
Authors: Pinciroli Francesco  , Masseroli Marco  , Acerbo Livio A.  , Bonacina Stefano  , Ferrari Roberto  , Marchente Mario
Published: February 2025

This paper presents a low cost software platform prototype supporting health care personnel in retrieving patient referral multimedia data. These information are centralized in a server machine and structured by using a flexible eXtensible Markup Language (XML) Bio-Image Referral Database (BIRD). Data are distributed on demand to requesting client in an Intranet network and transformed via eXtensible Stylesheet Language (XSL) to be visualized in an uniform way on market browsers. The core server operation software has been developed in PHP Hypertext Preprocessor scripting language, which is very versatile and useful for crafting a dynamic Web environment
An Active Constraint Environment for Minimally Invasive Heart Surgery: early experience of a cutting operation
Authors: Borelli Joao  , Bello Fernando  , Rodriguez y Bena Ferdinando  , Davies Brian
Published: February 2025

Master/slave telemanipulator systems can be applied in minimally invasive heart surgery. However, due to the beating heart and difficulties of finding inner points inside the heart, a surgical task operation such as cutting can be very difficult. In order to avoid surgical error, the "active constraint" concept can be applied. This paper shows an example of an "active constraint" environment used for minimally invasive heart surgery. Experiments have been carried out for a 2-DOF master and the preliminary results validate the present approach.
In Vivo Robots for Laparoscopic Surgery
Authors: Rentschler Mark E.  , Hadzialic Adnan  , Dumpert Jason  , Platt Stephen R.  , Farritor Shane  , Oleynikov Dmitry
Published: February 2025

Laparoscopic techniques have allowed surgeons to perform operations through small incisions. However, the benefits of laparoscopy are still limited to less complex procedures because of losses in imaging and dexterity compared to conventional surgery. This project is developing miniature robots to be placed within the abdominal cavity to assist the surgeon. These remotely controlled in vivo robots provide the surgeon with an enhanced field of view from arbitrary angles as well as provide dexterous manipulators not constrained by small incisions in the abdominal wall.
Occam's Approach to Video Critical Behavior Detection: A Practical Real Time Video In-Vehicle Alertness Monitor
Authors: Steffin Morris  , Wahl Keith
Published: February 2025

Driver and pilot fatigue and incapacitation are major causes of injuries and equipment loss. A method is proposed for constant invehicle monitoring of alertness, including detection of drowsiness and incapacitation. Novel features of this method include increases in efficiency and specificity that allow real time monitoring in the functional environment by practicable and affordable hardware. The described approach should result in a generally deployable system with acceptable sensitivity and specificity and with capability for operator alarms and automated vehicle intervention to prevent injuries caused by reduced levels of operator performance.
A Preliminary Study of Presence in Virtual Reality Training Simulation for Medical Emergencies
Authors: Viciana-Abad Raquel  , Reyes-Lecuona Arcadio  , García-Berdonés Carmen  , Díaz-Estrella Antonio
Published: February 2025

In this paper, a preliminary study of presence in a training simulation for medical emergency based on virtual reality is presented. We explore the influence of interaction mechanisms, as well as the complexity of behaviours in the subjective sense of presence. As expected, it has been found that as the type of interaction is more natural, and the patient behaviour modelling is more complex, the achieved sense of presence is greater. However our results also show that the degree of presence depends more upon the complexity of patient modelling than on how natural the interaction is. Hence, we postulate that a proper patient modelling could elicit a high degree of presence, even with traditional interaction mechanisms.
Haptic Rendering of Tissue Cutting with Scissors
Authors: Weiss David J.  , Okamura Allison M.
Published: February 2025

Current surgical simulations that involve cutting with scissors lack display of forces “between the fingers” of the operator. The objective of this work is to develop a fast, realistic haptic rendering technique for scissor cutting that can be easily integrated into soft tissue models commonly used in surgical simulators. A virtual environment was created for combined graphic and haptic display of cutting. Two 2-dimensional deformable mass-spring-damper models were developed: The first is a large mesh that is used to calculate translational forces. The second is a smaller, one-element-thick mesh that is used to calculate cutting (angular) forces. This technique was implemented on the haptic scissors, a haptic interface that allows motion and force feedback in translation and cutting.
Visualization of Two Image Variables Simultaneously using Cardinal Directions of Color Vision
Authors: Elsner Ann E.  , Cheney Michael C.  , Weber Anke  , Miura Masahiro
Published: February 2025

Visualization of medical image information can be achieved by using color scales to enhance aspects of the data. We have used the cardinal directions of color to make a continuous and representation of phase data that wraps around every 360 deg, and added in another dimension using luminance to illustrate amplidute.
Communicating the Logic of a Treatment Plan Formulated in Asbru to Domain Experts
Authors: Aigner Wolfgang  , Miksch Silvia
Published: February 2025

This paper presents an interactive visualization for medical treatment plans that are formulated in the plan representation language Asbru.
Mark-up based analysis of narrative guidelines with the Stepper tool
Authors: Růžička Marek  , Svátek Vojtěch
Published: February 2025

The Stepper tool was developed to assist a knowledge engineer in developing a computable version of narrative guidelines. The system is document–centric: it formalises the initial text in multiple user–definable steps corresponding to interactive XML transformations. In this paper, we report on experience obtained by applying the tool on a narrative guideline document addressing unstable angina pectoris. Possible role of the tool and associated methodology in developing a guideline–based application is also discussed.
Enhanced Communication Between Care Professionals and Patients with Hemophilia by Using a Web Enabled Electronic Logbook
Authors: Roosendaal G.  , Drenth E.R.  , Poerschke M.  , Verkerk E.C.M.  , van den Berg H.M.  , Metselaar M.
Published: February 2025

Hemophilia is an X-linked clotting disorder. Treatment consists of intravenous substitution of the missing clotting factor. Although very effective, clotting factor products are very expensive. Most of the clotting factors are administered at home by the patients themselves. Documentation of the amount used and reasons for administrating of these scarce and expensive clotting factors in a paper logbook is a problem. The use of an electronic logbook results in improved compliance in documentation of clotting factor use and therefore in improved quality of treatment of patients with hemophilia.
CFD Modeling of Carotid Bifurcation Flow Based on 3D Ultrasound: Correlations of Wall Shear Stress with Intima Media Thickness in Normo- and Hypertensives
Authors: Augst A.D.  , Barratt D.C.  , Ariff B.  , Thom S.A.  , Hughes A.D.  , Xu X.Y.
Published: February 2025

Atherosclerosis in large arteries has been linked to local haemodynamics. In some arteries, sites of low and oscillating wall shear stress (WSS) appear to coincide with sites of atherosclerotic plaque formation. This may be due to increased particle residence time near the wall and/or haemodynamic effects on the endothelium. Intima media thickness (IMT) of the arterial wall is an indicator of early atherosclerosis. We have studied relationships between WSS and IMT in the carotid arteries in normotensive and hypertensive subjects using realistic CFD models and in vivo measurements.
Extended Possibilities of Pharmaceuticals Delivery to Patients Using Dematerialized Prescriptions
Authors: Urbański Andrzej P.
Published: February 2025

This paper considers the requirement for e-commerce enabled delivery of pharmaceutical prescriptions. First, currently available solutions are critically reviewed and an ideal solution is specified and then the concept of the proposed solution – Dematerialized Prescription (DP), is outlined. Next, the information flows required to enable such a service are considered. The paper then considers a number of possible services which could be made available with DP to deliver medicals to patients. Finally, a proposed solution, which enables physician to fill dematerialized prescriptions online using inexpensive mobile Internet devices is presented in detail, the advantages of such a model are summarized and future research directions are suggested.
COCOON: Building knowledge driven and dynamically networked communities within European healthcare systems
Authors: Savoldelli Alberto  , Bettoni Silvia  , Gadda Lara  , Perdoni Valentina
Published: February 2025

COCOON is an innovative project developed in the e-health area of the Sixth Framework Programme co-financed by European Commission. It is an Integrated Project aimed at supporting health care professional in reducing risk management in their daily practices by building knowledge driven and dynamically adaptive networked communities within European healthcare systems.
A New Model for Home Care for COPD
Authors: Alonso Albert
Published: February 2025

A new model for home care of COPD patients is investigated, as a part of a coordinated provision model across levels of care. In the Spanish pilot of the e-Vital project, relevant vital signs for COPD are closely monitored and used for early detection of deterioration in the state of the patient and all prompt treatment. This can also reduce the need for in-person check-ups and re-admission to hospital. Later analysis aims to determine whether the system has significant economic impact, and whether it will provide more convenience for patients and healthcare professionals.
Implementing MDA-based Distributed, Interoperable, Flexible, Scalable, Portable, and Secure EHR Systems
Authors: Blobel Bernd  , Pharow Peter
Published: February 2025

Electronic Health Record (EHR) systems provide the kernel application of health information systems and health networks which should be independent of complexity, localisation constraints, platforms, protocols, etc. Based on shared care information systems' requirements for high level interoperability, a generic component architecture has been introduced. For implementing, running and maintaining acceptable and useable health information systems components, all views of the ISO Reference Model – Open Distributed Processing have to be considered. Following the Model Driven Architecture paradigm, a reference model as well as concept-representing domain models both independent of platforms must be specified, which are combined and harmonised as well as automatically transferred into platform-specific models using appropriate tools.
From Blackboard to Whiteboard: The Old Style of Classroom Education is Dead
Authors: Uranüs Selman
Published: February 2025

At the Department of Surgery of the Karl-Franzens University Hospital, a number of programs are available that use new technologies for training of students, interns and residents. The first project, the Virtual Medical Campus Graz (vmc.uni-graz.at) is one of the “New Media in Teaching at Austrian Universities” projects. The general objectives of this initiative are innovation in teaching, intensification of contacts and easier access to education: The second project is virtual laparoscopy and surgical training. Unlike the traditional training modalities, computer-based training provides efficient and effective learning through an objective training tool that can assess learners' performance. It is to be expected that new media and technologies will continue to provide innovative approaches to learning and that the competition between new and traditional systems will continue to enliven the educational scene.
Health Captology – Application of Persuasive Technologies to Health Care
Authors: Chan Albert S.
Published: February 2025

Professionals in industries such as advertising and sales have used techniques of persuasion to enhance the efficacy of marketing campaigns and sales revenues. In contrast, health care has traditionally relied on the persuasive power of facts and evidence to encourage healthy behavior. The evidence suggests, however, that this current approach is failing. Health care experts and opinion leaders cite overwhelming evidence of an epidemic in diseases such as obesity and diabetes, despite numerous initiatives to educate the public how to prevent morbidity and mortality. Health captology, the application of persuasive technology to health care, attempts to leverage proven persuasive techniques to improve clinical outcomes.
Evaluating Consumer Informatics: Learning from Health Campaign Research
Authors: Logan Robert A.
Published: February 2025

This paper suggests that some conceptual models used in health communication campaigns as well as the “uses and gratifications” approach might be successfully integrated into the evaluation of consumer informatics. These models and tools are especially pertinent when the desired outcomes of media health interventions are therapeutic changes in public knowledge, motivations, attitudes andpatient behavior.
Towards Responsive IT-Infrastructures - Assessment of a Health Information System
Authors: Blaser Rainer  , Kuhn Klaus A.  , Overath Martin  , Dietz Frank  , Opitz Egbert  , Lenz Richard
Published: February 2025

Marburg University Medical Center has been introducing a comprehensive health information system since 1999, using a single-vendor application framework with an integrated generator tool for the development of clinical applications. To find out if this architecture and our participative software engineering approach can be considered a step towards a responsive infrastructure, we compared the situation after the first deployment phase (basically a holistic approach) with the situation after the system was further developed and adapted to the users' needs using the generator tool approach. We collected system statistics and conducted user satisfaction surveys in 2001/02 and 2003 using standardized measurements. The survey results showed that user involvement as well as system content were judged significantly higher after the second deployment phase. Insofar, we could demonstrate the feasibility of our approach. However, definite statements concerning the superiority of the generator tool approach to other concepts are not yet possible. We will continue our assessment, and we strongly suggest further studies in other institutions introducing comparable clinical functionality.
Analysis of Web Access Logs for Surveillance of Influenza
Authors: Johnson Heather A.  , Wagner Michael M.  , Hogan William R.  , Chapman Wendy  , Olszewski Robert T  , Dowling John  , Barnas Gary
Published: February 2025

The purpose of this study was to determine whether the level of influenza in a population correlates with the number of times that internet users access information about influenza on health-related Web sites. We obtained Web access logs from the Healthlink Web site. They contain information about the user and the information the user accessed, and are maintained electronically by most Web sites, including Healthlink. We developed weekly counts of the number of accesses of selected influenza-related articles on the Healthlink Web site and measured their correlation with traditional influenza surveillance data from the Centers for Disease Control and Prevention (CDC) using the cross-correlation function (CCF). We defined timeliness as the time lag at which the correlation was a maximum. There was a moderately strong correlation between the frequency of influenza-related article accesses and the CDC's traditional surveillance data, but the results on timeliness were inconclusive. With improvements in methods for performing spatial analysis of the data and the continuing increase in Web searching behavior among Americans, Web article access has the potential to become a useful data source for public health early warning systems.
Evaluating Provider Adherence in a Trial of a Guideline-Based Decision Support System for Hypertension
Authors: Chan A.S.  , Coleman R.W.  , Martins S.B.  , Advani A.  , Musen M.A.  , Bosworth H.B.  , Oddone E.Z.  , Shlipak M.G.  , Hoffman B.B.  , Goldstein M.K.
Published: February 2025

Measurement of provider adherence to a guideline-based decision support system (DSS) presents a number of important challenges. Establishing a causal relationship between the DSS and change in concordance requires consideration of both the primary intention of the guideline and different ways providers attempt to satisfy the guideline. During our work with a guidelinebased decision support system for hypertension, ATHENA DSS, we document a number of subtle deviations from the strict hypertension guideline recommendations that ultimately demonstrate provider adherence. We believe that understanding these complexities is crucial to any valid evaluation of provider adherence. We also describe the development of an advisory evaluation engine that automates the interpretation of clinician adherence with the DSS on multiple levels, facilitating the high volume of complex data analysis that is created in a clinical trial of a guideline-based DSS.
Privacy-Preserving Data Releases for Health Report Generation
Authors: Boyens Claus  , Krishnan Ramayya  , Padman Rema
Published: February 2025

Regional healthcare initiatives seek to improve the quality of healthcare by collecting, analyzing, and disseminating information about chronic diseases such as diabetes. The data required to support such initiatives comes from several organizations such as insurers, physicians, hospitals, pharmacies and labs each of which gather and maintain data for the purpose of healthcare delivery. In this paper, we focus on mediator-based architectures and the privacy problems that arise in the healthcare context owing to the linkage of information about patients, physicians, and diseases enabled by the mediator. In particular, we examine privacy issues for the two separate steps of the actual data release. First, raw data is released to the (not necessarily trustworthy) mediator and second, the mediator creates and releases the health report. For both steps, we present a technical solution that permits the final report to be useful to the user while respecting the data owners' privacy.
Development and Pilot Evaluation of User Acceptance of Advanced Mass-Gathering Emergency Medical Services PDA Support Systems
Authors: Chang Polun  , Hsu Yueh-Shuang  , Tzeng Yuann-Meei  , Hou I-Ching  , Sang Yiing-Yiing
Published: February 2025

The support systems for the Emergency Medical Services (EMS) in the mass gatherings, such as the local marathon or the large international baseball games, had been underdeveloped. The purposes for this study were to develop triage-based EMS Personal Digital Assistant (PDA) support systems for the mass-gatherings and to evaluate users' perceived ease of use and usefulness of the systems in terms of Davis' Technology Acceptance Model (TAM). The systems were developed based on an established intelligent triage PDA support system and two other forms the general EMS form from the Taipei EMT and the customer-made Mass Gathering Medical form used by a medical center. 23 nurses and 6 physicians in the medical center, who had ever served in the mass gatherings, were invited to examine the new systems and answered the TAM questionnaire. The results showed that the PDA systems included as many 450 information items inside 42 screens under 6 categories and the great potential of using triage-based PDA systems in the mass gatherings. Overall, most of the subjects agreed with that the systems were easy to use and useful for the mass gatherings, and they were willing to accept the systems.
Life Sign Decision Support Algorithms
Authors: Savell c. Thomas  , Borsotto Maurizio  , Reifman Jaques  , Hoyt Reed W.
Published: February 2025

There is a pressing need in the military for a system that interprets data from a suite of wearable physiological sensors to infer a soldier's current clinical state on the battlefield. The Warfighter Physiology Status Monitoring (WPSM) concept is envisioned by the U.S. Army to address this need. Life sign detection is a key component. In the future the WPSM will consist of an array of biosensors embedded in the soldier's uniform all connected to a central processing control unit containing a computer chip with firmware for assessing the soldier's status. The unit will diagnose and transmit the Dead, Alive or Unknown physiological state to the field medic or elsewhere for status monitoring.
Trial Bank Publishing: Phase I Results
Authors: Sim Ida  , Carini Simona  , Olasov Ben  , Jeng Sophia
Published: February 2025

Randomized clinical trials (RCTs) are an important source of evidence for clinical practice, but finding and applying RCT reports to care is time consuming. Publishing RCTs directly into machine-understandable “trial banks” may allow computers to deliver RCT evidence more selectively and effectively to clinicians. Methods: Authors of eligible RCTs published in JAMA or the Annals of Internal Medicine between January 2002 and July 2003 were invited to co-publish their trial in RCT Bank, an electronic knowledge base containing details of trial design, execution, and summary results. Trial bank staff used Bank-a-Trial, a web-based trial-bank entry tool, to enter information from the manuscript into RCT Bank, obtaining additional information as necessary from the authors. Results: The author participation rate rose from 38% to 76% after the first co-published trial was available as an example. Seven diverse RCTs are now co-published, with 14 in progress. Conclusions: We have demonstrated proof of concept for co-publishing RCTs with leading journals into a structured knowledge base. Phase II of trial bank publishing will introduce direct author submission to RCT Bank.
Child Health Improvement through Computer Automation: The CHICA System
Authors: Anand Vibha  , Biondich Paul G.  , Liu Gilbert  , Rosenman Marc  , Downs Stephen M.
Published: February 2025

Clinical guidelines are prevalent but frequently not used. Computer reminder systems can improve adherence to guidelines but have not been widely adopted. We present a computer-based decision support system that combines these elements: 1) pediatric preventive care guidelines encoded in Arden Syntax; 2) a dynamic, scannable paper user interface; and 3) a HL7-compliant interface to existing electronic medical record systems. The result is a system that both delivers “just in time” patient-relevant guidelines to physicians during the clinical encounter and accurately captures structured data from all who interact with the system. The system performs these tasks while remaining sensitive to the workflow constraints of a busy outpatient pediatric practice.
Embedding Clinical Indicators into Nursing Documentation
Authors: Browne Jennifer Allan  , Covington Barbara G
Published: February 2025

The Methodist Healthcare System of San Antonio audits completeness and accuracy of nursing assessments. Between 1996 and 2001, regardless of software enhancements and education, completeness of risk assessments hovered at 80% or less. Accuracy of risk scores were in question due to paste functionality. In review, it became apparent that many risk assessment indicators were already an intrinsic part of nursing systems assessment. This project embedded weighted indicators invisibly within systems assessment. Risk scores then automatically calculate and display. This approach decreased documentation queries and increased accuracy of risk assessments. Results were validated using concurrent manual review. Skin assessment demonstrated a 97% accuracy rate with 100% completeness of documentation. Fall assessment resulted in a 2.5% miss rate and 100% completeness of record. 100% of high risk patients identified had appropriate care plan problems. Recommendations are to further explore embedded indicators in software design. The study demonstrated a) decrease in nursing documentation queries b) increase in completeness of record c) increase in accuracy of record and d) increase in accuracy of care plan.
Evolution of a Foundational Model of Physiology: Symbolic Representation for Functional Bioinformatics
Authors: Cook Daniel L.  , Mejino Jose L.V.  , Rosse Cornelius
Published: February 2025

We describe the need for a Foundational Model of Physiology (FMP) as a reference ontology for “functional bioinformatics”. The FMP is intended to support symbolic lookup, logical inference and mathematical analysis by integrating descriptive, qualitative and quantitative functional knowledge. The FMP will serve as a symbolic representation of biological functions initially pertaining to human physiology and ultimately extensible to other species. We describe the evolving architecture of the FMP, which is based on the ontological principles of the BioD biological description language and the Foundational Model of Anatomy (FMA).
A Relation-Centric Query Engine for the Foundational Model of Anatomy
Authors: Detwiler Landon T.  , Chung Emily  , Li Ann  , Mejino Jr. José L.V.  , Agoncillo Augusto V.  , Brinkley James F.  , Rosse Cornelius  , Shapiro Linda G.
Published: February 2025

The Foundational Model of Anatomy (FMA), a detailed representation of the structural organization of the human body, was constructed to support the development of software applications requiring knowledge of anatomy. The FMA's focus on the structural relationships between anatomical entities distinguishes it from other current anatomical knowledge sources. We developed Emily, a query engine for the FMA, to enable users to explore the richness and depth of these relationships. Preliminary analysis suggests that Emily is capable of correctly processing real world anatomical queries provided they have been translated into a constrained form suitable for processing by the query engine.
Challenges in Precisely Aligning Models of Human Anatomy Using Generic Schema Matching
Authors: Mork Peter  , Pottinger Rachel  , Bernstein Philip A.
Published: February 2025

This paper describes how we used generic schema matching algorithms to align the Foundational Model of Anatomy (FMA) and the GALEN Common Reference Model (CRM), two large models of human anatomy. We summarize the generic schema matching algorithms we used to identify correspondences. We present sample results that highlight the similarities and differences between the FMA and the CRM. We also identify uses of aggregation, transitivity, and reification, for which generic schema matching fails to produce an accurate mapping and present manually constructed solutions for them.
Real World Performance of Approximate String Comparators for use in Patient Matching
Authors: Grannis Shaun J.  , Overhage J. Marc  , McDonald Clement
Published: February 2025

Medical record linkage is becoming increasingly important as clinical data is distributed across independent sources. To improve linkage accuracy we studied different name comparison methods that establish agreement or disagreement between corresponding names. In addition to exact raw name matching and exact phonetic name matching, we tested three approximate string comparators. The approximate comparators included the modified Jaro-Winkler method, the longest common substring, and the Levenshtein edit distance. We also calculated the combined root-mean square of all three. We tested each name comparison method using a deterministic record linkage algorithm. Results were consistent across both hospitals. At a threshold comparator score of 0.8, the Jaro-Winkler comparator achieved the highest linkage sensitivities of 97.4% and 97.7%. The combined root-mean square method achieved sensitivities higher than the Levenshtein edit distance or longest common substring while sustaining high linkage specificity. Approximate string comparators increase deterministic linkage sensitivity by up to 10% compared to exact match comparisons and represent an accurate method of linking to vital statistics data.
Automated Medical Problem List Generation: Towards a Patient TimeLine
Authors: Bui Alex A. T.  , Taira Ricky K.  , El-Saden Suzie  , Dordoni Alicia  , Aberle Denise R.
Published: February 2025

The problem-oriented electronic medical record has been investigated as an alternative to source-oriented organization of patient data. At the core of a problem-oriented view is the medical problem list. Maintenance of the medical problem list is often manual, making it highly user dependent. We detail the beginnings of an automated medical problem list generator based on ICD-9: given a set of ICD-9 codes associated with a patient record, the system maps the codes (and related data) to an anatomy- centric hierarchy. 1 million patient encounters from an outpatient setting were reviewed to generate a unique set of 7,890 ICD-9 codes. Natural language processing of the ICD-9 string descriptions identified 1,981 anatomical terms, which were subsequently mapped to one of 21 anatomical categories. The output of the medical problem list generator was then used to create a problem-oriented, gestalt view of a patient ‘s medical record. Preliminary evaluation of the generator revealed 100% recall, but only 60% precision. This initial work has highlighted several issues in defining a medical problem list, including questions of granularity and performance trade-offs.