bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Cost Analysis of two Different Medical Interventions: Educational Implications
Authors: Platis Harris  , Liaropoulos Lycurgus
Published: February 2025

The paper display in a short way the concepts of medical cost and cost - effectiveness analysis and present the educational implications arising from the assessment and the comparison of the Hospital cost of two different therapeutic methods of myocardial revascularization: Coronary Artery Bypass Graft (C.AB.G.) surgery and Percutaneous Transluminal Coronary Angioplasty (P.T.C.A.)
PCASSO: A Secure Architecture for Access to Clinical Data via the Internet
Authors: Masys Daniel R.  , Baker Dixie B.  , Barnhart Robert  , Buss Teresa
Published: February 2025

Patient Centered Access to Secure Systems Online (PCASSO) is a National Information Infrastructure research project funded by the US National Library of Medicine (NLM). PCASSO is specifically designed to address the problem of enabling secure access to health information over the Interne, not just for healthcare providers and medical researchers, but also for patients to view their own medical records..The project is using familiar Web technologies to support the search and retrieval of information, including patient demographics, medications, lab tests, and transcription reports. State-of-the-art security technologies protect patient privacy and the integrity of patient information. This paper describes the security architecture of the PCASSO system.
Organizational & Medical Ontologies for Co-Operative Patient Management
Authors: Falasconi S.  , Stefanelli M.
Published: February 2025

A new research paradigm is emerging based on the Multi-Agent System (MAS) architectural framework, allowing human and software agents to interoperate and thus cooperate within common application areas. In this paper, we discuss an ontological foundation for a prototypical health care MAS, that is, a so-called Distributed Healthcare Information System (D-HIS), viewed as an organization of cognitive agents and making use of an ontological library written in the standard language Ontolingua.
Nurses' Requirements for Information Technology in the Next Millennium
Authors: Marin Heimar F.  , Cunha Isabel C. K.  , Safran Charles
Published: February 2025

The main purpose of this study was to identify nurses' requirements for information technology in the next millennium. We distributed 350 questionnaires in a teaching hospital in Brazil and in the USA. We received 86 from Brazil and 78 from USA. Besides the capabilities of computers to be used in different sectors of human actions, nurses' requirements for information technology can not be considered sophisticated Nurses in Brazil prefer a standalone system. In contrast, in USA they prefer systems that could be integrated to the whole health care system. Also, in the USA, nurses were more comfortable with use of computers than nurses in Brazil. In general terms, nurses in both countries feel that computer systems could make their practice easier and more efficient.
The Asia Pacific Association for Medical Informatics (APAMI) and World Organisation of Family Doctors (WONCA) Consortium on General and Family Practice Informatics - a Statement of Intent
Authors: Liaw ST  , Kidd M  , Cesnik B  , Lun KC  , Goh LG  , Yoo T  , Wun YT
Published: February 2025

This paper describes the establishment of a consortium to advance health and medical informatics in general/family practice in the Asia Pacific Region. The objectives, current activities currently taking place in the region and key activities planned will be outlined.
Telemedicine: Responsibilities and Contractual Framework
Authors: Allaërt François-André  , Dusserre Liliane
Published: February 2025

The rapid growth of telemedicine has created a need for a definition of the responsibilities of the doctors involved. These responsibilities must be analyzed according the tort of negligence as a function of the level of competence of each doctor, their unequal access to the relevant information and their command of the telemedicine system. This analysis leads on to a study of the legal value of the electronic records kept and the ways in which the doctors are remunerated.
CareWeb
Authors: Halamka John D.  , Safran Charles
Published: February 2025

With the advent of Integrated Healthcare Delivery Systems, medical records are increasingly distributed across multiple institutions. Timely access to these medical records is a critical need for healthcare providers. The CareWeb™project provides an architecture for World Wide Web-based retrieval of electronic medical records from heterogeneous data sources. Using Health Level 7 (HL7), web technologies and readily available software components, we consolidated the electronic records of Boston's Beth Israel and Deaconess Hospitals. We report on the creation of CareWeb™(freya.bidmc.harvard.edu/careweb.htm) and propose it as a means to electronically link Integrated Health Care Delivery Systems and geographically distant information resources.
Modelling Human Depth Perception in Binocular Vision: Obtaining the Horizontal Disparity Map
Authors: Lungeanu Diana  , Popa Carmen  , Hotca Sergiu  , Macovievici Gratian
Published: February 2025

The paper presents a computer application developed as a tool for implementing, developing, and testing computational models for stereopsis. Two models for solving the correspondence problem and computing the stereo disparity map have been implemented. One of them is biologically inspired (it models the behaviour of simple and complex cells from the striate cortex) and the paper details the results obtained on random-dot stereograms and on pairs of real images.
Self-Documenting Structured Reports using Open Information Standards
Authors: Kahn, Jr. Charles E.
Published: February 2025

Structured reporting systems use standardized data elements and predetermined data-entry formats to record observations. This article describes a system for structured data entry and reporting that generates reports encoded in the Standard Generalized Markup Language (SGML), an open, internationally accepted standard for document interchange. The structured report is self-documenting: it includes a definition of its allowable data fields and values encoded as a report-specific SGML document type definition (DTD). By linking its reporting concepts with those of external vocabularies such as the UMLS Metathesaurus, this system can create open, universally comprehensible structured reports.
Proposal of a new Internet Standard for DICOM: DICOM-QR URL
Authors: Sakusabe Takaya  , Shirchin Baatar  , Kimura Michio
Published: February 2025

This paper proposes a new Internet standard that is combination of two standards in different domain, Internet and medical informatics. The both standards are described briefly in this paper. We describe how to combine them into a Internet standard. With a new standard, there are several advantages for medical information systems. The standard should be established by the following way of the Internet standards.
The Future of Knowledge-Based Components in the Electronic Health Record
Authors: Broverman Carol A.  , Schlesinger Joseph M.  , Sperzel W. David  , Kapusnik-Uner Joan
Published: February 2025

Traditional monolithic healthcare information systems (HIS) no longer meet the requirements of today’s distributed enterprises and the rapidly changing healthcare environment. The ability of applications to communicate, interpret, and act intelligently upon complex healthcare information has assumed paramount importance. The future lies in the development of flexible component-based architectures that can operate seamlessly within the workflow of a healthcare environment. A key design goal is “graceful degradation,” i.e., providing the best decision support possible within the context of available patient data. The First DataBank Drug Toolkit is used as a case study. Several technical challenges associated with building truly plug and play components are discussed.
Siegfried: System for Interactive Electronic Guidelines with Feedback and Resources for Instructional and Educational Development
Authors: Lobach David F.  , Gadd Cynthia S.  , Hales Joseph W.  , Baskaran Prakash
Published: February 2025

The proliferation of clinical practice guidelines (CPGs) has necessitated computerized solutions for guideline distribution and implementation. In this paper we describe a Web-based system that interactively presents CPGs at the point of care. Our system, known as Siegfried, provides a generalized solution for implementing CPGs by maintaining the guideline knowledge base separate from the application that presents the guidelines. As a result of this design, new CPGs can be easily added and existing CPGs can be expeditiously modified without additional programming. This system also solicits feedback from users regarding guideline recommendations and provides hypertext links to relevant Web-based instructional and educational resources.
Review of the New Methodology of Analyzing Receiver Operating Characteristic Curves
Authors: Ikeda Mitsuru  , Ishigaki Takeo  , Yamauchi Kazunobu
Published: February 2025

The Dorfman and Alf algorithm based on the classic model of signal detection theory is most frequently used for the receiver operating characteristic (ROC) analysis. However, several shortcomings of this method were pointed out. On these problems, in recent years, several authors have proposed the new analysis methods of the ROC curve. This paper reviews these new analysis methods, and discusses them. First, we review the general regression methodology for the ROC analysis, proposed by Tosteson and Begg. Secondly, we review the analysis of variance (ANOVA) method, proposed by Dorfman et al; in this method, the jackknife method was applied to ANOVA for analyzing ROC data. Further, we give the illustrative experimental design, and discuss the application of these methods to our illustrative experiment. We indicate that we can make use of these two methods for the evaluation of diagnostic performance in our illustrative experiment.
Present Situation and Characteristics of Traditional Chinese Medical Informatics (TCMI)
Authors: Cheng Shi  , Jinyan Hu  , Huamei Hu  , Benlin You
Published: February 2025

This paper provides an introduction to the present basis for the Traditional Chinese Medical Informatics (TCMI). It also analyzes the contents, the characteristics of the information classification of Traditional Chinese Medicine (TCM) and prospects for TCMI.
From Legacy Systems Towards Modern Health Information Systems
Authors: Bercic Boštjan  , Zelic Igor  , Cerkvenik Gregor  , Slavec Smiljana  , Rems Miran
Published: February 2025

This article describes an approach of transferring legacy hospital information system to a modern HIS, which would support requirements of modern information age. There are several reasons, which force us to perform such a migration: from the weakness of design of legacy system to the need of covering new technologies (such as Inter/intranet) and new business conditions.
Mobile PCIS: Point-of-Care Information Systems with Portable Terminals
Authors: Sasaki Hajime  , Sukeda Hiroko  , Matsuo Hitoshi  , Oka Yuji  , Kaneko Michiko  , Sasaki Shizuo
Published: February 2025

We have developed a Point-of-Care Information System (PCIS) that uses portable terminals and supports the entire loop of daily nursing work for the first time. Nursing work includes a great deal of indirect nursing work, such as documenting patient information, conferring with other health-care providers, and so on, as well as direct patient care. The time needed for this indirect work often exceeds the time actually spent directly caring for patients and needs to be reduced Our system was developed with the goal of doing this to make nursing work more efficient. The system consists of personal digital assistants (PDAs) that nurses carry in the hospital wards and a server computer located in the nursing station. The system has three main functions: 1) Data Browsing provides patient information such as a brief history, vital-sign charts, and handwritten notes; 2) Schedule Planning helps nurses organize doctors' instructions and make To-do lists for the day; and 3) Care Management reminds nurses when they should execute the doctors' orders and provides tools for data entry. These three functions cover the entire loop of daily nursing work. The PDAs and the server computer can share up-to-date information by data transmission through telephone lines (low-power cellular phones can be used), infrared devices, or RS-232C cables. Results from a preliminary hospital evaluation showed that use of the system can reduce the time needed for nursing documentation by 60% (a 10% saving of a nurse's total working time), and that more than 80% of the nurses who used the system felt it would make nursing work more efficient.
Plug and Play - Fiction or Reality?
Authors: Schweiger R  , Bürkle T  , Hölzer S  , Tafazzoli AG  , Dudeck J
Published: February 2025

This paper discusses some experiences with the integration of a tumor documentation system into a distributed healthcare environment using a new European middleware technology. Although the middleware already offers a considerable support to the software engineer, further facilities have been suggested and partially implemented in order to accelerate integration scenarios.
Chapter 6: Internet in Telemedicine
Authors: Della Mea Vincenzo
Published: February 2025

This chapter deals with the type of telemedicine that can be carried out using the widely diffused telecommunication channel of Internet. This is accomplished with an analysis of the advantages and limitations and the communication requirements of the medical professional. Personal collaborations through e-mail, group co-operation through newsgroups and mailing lists, multimedia data sharing through World Wide Web are described, with special attention to security and quality of service. A quick review on forthcoming Internet developments complements the issue. Some examples of the Medical use of Internet are included.
Annex XI: A Bit of Maths and Computers
Authors: Ruiz Enriquez E.
Published: February 2025

The basic concept of computer mathematical operations is introduced in this annex in order to be able to understand the complex operations done in cryptography, which are also summarised.
A Regional University Hospital in the framework of a regional Information Network : The experience of Lille
Authors: Beuscart Regis  , Delerue David  , Geib Jean Michel
Published: February 2025

Information is essential for the taking care of the patients and is also a guarantee for the quality of cares. In this objective, the University Hospital of Lille has developed for 10 years a politic based on information and communication divided in 3 phases:
Telematics in Prehospital Emergency Care: The Hector Pilot of Crete
Authors: Askitopoulou Helen
Published: February 2025

Emergency Medicine is considered the neglected speciality of contemporary medicine, although it is widely acknowledged that improvement in the outcome of the acutely and critically ill depends on its timely and effective management during the critical first hour [1], the so called «golden hour». The crucial question therefore is whether Telematics can affect this outcome and in particular how they can assist the existing models of Prehospital Emergency Medical Services (EMS) to meet this goal. The Hector Pilot of Crete tries to give a convincing answer to this question, taking into account the concept and some of the requirements of Emergency Medicine.
A coherent approach to health informatics education: results of the Dutch curriculum project
Authors: Hoekstra Sylvia  , Aarts Jos
Published: February 2025

From the beginning a coherent approach to health informatics education has been aimed for in our project to develop learning materials. The features are the thematic approach of the contents, the interrelationship of the modules and the didactical approach embedded in the learning materials. Following results have been achieved. Learning materials have been developed for the following themes: healthcare policy and management, delivery of professional care (specific for nursing and allied health), more generic themes such as electronic patient record, clinical decision making, classification and coding of healthcare data and knowledge based systems.
Force Measurement of the “Derotation Maneuver”
Authors: Duke K.K.  , Hill D.L.  , Moreau M.J.  , Mahood J.K.  , Raso V.J.  , Budney D.L.
Published: February 2025

Currently surgeons are unable to determine how much force is applied during scoliosis correction. The Gripper is a modified Moss Miami rod rotator with an instrumented sleeve that slips over the handle. This system is able to measure the force and resulting moment applied by the surgeon during the derotation maneuver of scoliosis surgery. The rigid frame of the hand grip is insensitive to the squeezing force and thus only the net forces and torque transmitted by the surgeon are recorded. The strain gauge data was sampled with a data acquisition system (DAQ 1200, National Instruments) and the voltage output was interpreted by MATLAB to calculate the forces and moments. Calibration showed that the system could calculate the forces accurately (R2=0.96) and to within ± 3 N. For scoliosis surgery, data were collected during the derotation of the rod, prior to fixation. Forces and moments were recorded for about 30 seconds at 10 samples per second. This system was tested on 4 subjects. The maximum forces applied by the surgeon ranged from 20 to 50 N with a torque of 4-11 Nm.
Dynamic Treatment of Scoliosis (The Results Of 174 Cases)
Authors: Sastre S.  , Lapuente J.P.  , Santapau C.  , Bueno M.
Published: February 2025

Conservative treatment of spine deviations is often prescribed without much enthusiasm or conviction. Many specialists believe that it is a waste of time and money. Encouraged by the results obtained applying the conservative treatment to deviations of the spine, we researched -first in animals (rabbits), later in human beings, both during their growth period- the effects of the conservative, dynamic and instrumentalized treatment: the F.E.D. method. We submit the results obtained with 174 scoliotic patients, of ages ranging 5 and 41, and an average age of 13.4. The average initial Risser was 2.21. Initially, all of them had structured scoliotic curves, with different etiologies, many of them evolutionary, with Cobb angles of between 6 and 66°, and an average Cobb of 23,07°. Vertebral rotation ranged from 2 to 41° (Raimondi). The treatment applied was based on electrotherapy, thermotheraphy (preparatory phase), vertebral traction, use of the F.E.D. unit (with tridimensional fixation of the spine, elongation, derotation and inflexion or inversion of the curves), as well as analytical kinesitherapeutic techniques, hyper and self-corrective kinesthetic consciousness of the orthostatic position, selective for each curve. The results drawn from this study and its analysis, allow us to assure that the therapeutic procedure employed -the F.E.D. method- is effective. The corrections achieved are permanent, it is non-aggressive, well tolerated, and affordable.
A Posture Measurement System for AIS
Authors: Lou E.  , Durdle N. G.  , Raso V. J.  , Hill D. L.
Published: February 2025

A battery powered measurement system was developed to measure topographical features of a trunk. The system consists of one transmitter and two receivers. The position of the receiver relative to the transmitter was calculated. A study on testing the accuracy of the system on four subjects was done. A video camera was used to capture all the back images when specific movement was performed. Measurements from the images were compared to those from the system. The errors on the calculated distance and angle from the system were less than 0.45cm, ranged from 30 to 45cm, and 5 degrees, ranged from 45 to 90 degrees, respectively.
Endoscopic Nonfusion Spinal Hemiepiphysiodesis: Preliminary Studies in a Porcine Model
Authors: Bylski-Austrow D.I.  , Wall E.J.  , Kolata R.J.  , Crawford A.H.
Published: February 2025

The purpose of these pilot studies was to determine the potential of different stapling methods to induce lateral spinal curvature in skeletally immature pigs using an anterior endoscopic approach without fusion. Two methods resulted in no curvature; one method induced a 20° curve in 6 weeks.
Is the estimation of human age derived from ambulatory blood pressure waveform analysis stable over the 24 hours?
Authors: Prentza Andriana  , Imholz Ben PM  , Gizdulich Paolo  , Parati Gianfranco  , Wesseling Karel H
Published: February 2025

In a previous study we developed a method to estimate a person's age based on 10 s episodes of arterial pressure pulsations using a neural net technique. The pulsations were recorded in the morning in supine or semi-reclining position in rest. We wondered if the age estimation techniques would produce systematically different values under ambulatory conditions, during night or day, in other postures, over the 24 hours. We, therefore, analyzed 10 s episodes each half hour over the 24 hours in 12 previously recorded persons aged 19 to 58 years, applying the waveforms to the same neural net as previously developed. We pre-pared averages over the 24 hours, over the day, the night, the morning, and the siesta and compared them to calendar age of the persons. We found no systematic differences between the various estimates and with calendar age. We conclude that neural net estimation of a person's age based on his arterial pulse is stable during the 24 hours.
Teleimmersion for the Doctor's Office
Authors: Kamberova Gerda  , Bajcsy Ruzena  , Schmidt David
Published: February 2025

The purpose of our research is the development of a new technology, teleimmersion, which will make possible 3D visual communication between people distributed over the globe. We are putting together a low-end, PC-based, affordable hardware system, and are developing the software for a teleimmersion node (T-node). The software is based on accurate polynocular stereo. We will describe a testbed for the system, show results, and discuss challenges for future research and implementation.
Interactive Visualization of 3D Fields and Images on Inexpensive Workstations Using VRML
Authors: Marović Branko S.  , Valentino Daniel J.  , Karplus Walter J.  , Jovanović Zoran
Published: February 2025

The visualization of volumetric medical images and static or time-dependent vector fields is performed on personal computers over the Web using an interactive 3D interface based on VRML and Java. The VRML client obtains field information and the surface models of examined objects from a server accessible over the Internet. Various virtual tools enable radiologists and referring physicians to visualize and manipulate complex data sets using a simple interface on low-cost computers.
Telemedicine Based Screening of Infants at Risk for Retinopathy of Prematurity
Authors: Lorenz Birgit  , Bock Markus  , Müller H. Michael  , (Bert) MASSIE N.A.
Published: February 2025

Retinopathy of Prematurity (ROP) is a major risk for permanent visual loss in extreme prematures. In stage 3+ (zone I and II), defined as threshold disease, the risk for retinal detachment with subsequent blindness is about 50% without treatment, compared to only a few percent with laser photoablation. Visualisation and interpretation of the critical retinal changes requires a high degree of expertise. Therefore, screening by general ophthalmologists will not identify all cases at threshold necessary to prevent blindness in as many infants as possible. The development of a new digital wide-field camera system (RetCam 120) allows documentation of nearly the entire retina within minutes. Recently, sensitivity, specificity, positive predictive power and negative predictive power have been evaluated to be high. Data collection is also possible by trained staff of the neonatal care units. Data can be transferred electronically, even though it could be transferred through physical transport. Analyzing the data in a central reading center specialized in the treatment of ROP will allow optimal timing of treatment and thus salvage vision in more infants. In additon, unnecessary referrals that are not only expensive but put also stress on the very vulnerable prematures can be avoided.
Lesson learnt from a halt of the hospital information system
Authors: Mazzoleni M.C.  , Baiardi P.  , Giorgi L
Published: February 2025

The present paper deals with an experience of blackout of the hospital information system at our Medical Centre, trying to evaluate the impact on internal users (physicians, nurses, clerks) and patients population. Limited inconveniences have occurred to out-patients in terms of delay in collecting medical reports after diagnostic test execution. As regards direct users, impact was evaluated through a structured interview. Administrative personnel, that have been using computer-based system for at least ten years, have not declared particular inconveniences, accepting the overtime or the extra-work as simply unavoidable. On the contrary, health-care personnel reported a heavy negative impact of the system failure on their activity. After a great effort to achieve the system acceptance and direct physicians usage, the blackout of the system has pointed out that the situation has changed since a few years ago: now the HIS, and particularly its clinical core, is considered mission critical.
Electronic consultations and referrals in Kymenlaakso Hospital District
Authors: Läike Erkki  , Koivu Timo  , Järvinen Riitta  , Ahtola Aarni
Published: February 2025

The meaning of this paper is to introduce the medical network which has been taken to Kymenlaakso Hospital District and the primary experiences in utilizing. Actual numeral results are not ready because of short time. First results will be ready in August 1999.
End-user point of view to establish real-time broadband ATM connection over Europe
Authors: Loula Pekka  , Lummevaara Timo  , Ilola Jouni  , Aarnio Pertti
Published: February 2025

There have so far been few discussions about how the international broadband services will be created in practice. In this paper we concentrate on two separate international telemedicine trials in which Satakunta Central Hospital took part in the HIM project. In these trials we tested real-time video consultation over the international point-to-point ATM network connection between hospitals in Finland, Portugal and Germany. The quality of the consultations were clinically first-rate in both trials. The technological lesson learned from these trials was valuable for the operators in establishing broadband connections in Europe. The network connection was analysed based on transmission capabilities of the network connection.
Can a database be anonymous?
Authors: Quantin Catherine  , Allaert François-André  , D'Athis Philippe  , Dusserre Liliane
Published: February 2025

Sensitive data are most often indirectly identifiable and so need to be rendered anonymous in order to ensure privacy. Statistical methods to provide anonymity require data perturbation and so generate data processing difficulties. Encryption methods, while preserving confidentiality, do not require data modification.
A prototype of an information system for assessing the health status of prison inmates
Authors: Duhamel A.  , Archer E.  , Devos P.  , Nuttens M.C.  , Beuscart R.
Published: February 2025

A research-action program was established in 1996 between the Loos- Lez-Lille prison psychiatric unit and the Department of Medical Informatics of the University Hospital of Lille (France) : - (1) to investigate the health status and the general characteristics of the prison population - (2) to develop an Information System for improving the prison health care and to facilitate social rehabilitation of convicts. Starting off 1988, all new prisoners are interviewed on their arrival using a standard questionnaire. The transfer of all the information recorded in this questionnaire into a computer base was initiated in 1996, when the research action program began. A statistical analysis was performed on 15200 records (1989-1995) to identify the most informative parameters : 50% of inmates were less than 24 years old; 57% were unemployed; 60% had no professional qualification. 31% of inmates had a psychiatric history and 16% had made a previous suicide attempt. The rate of drug abuse has increased from 24% in 89 to 53% in 95. To analyze the time trends of these parameters, a prototype of Information System was then developed. The system uses the database to product standard reports in real time.
Data warehousing as a basis for web-based documentation of data mining and analysis
Authors: Karlsson Johan  , Eklund Patrik  , Hallgren Carl-Gunnar  , Sjödin Jan-Gunnar
Published: February 2025

In this paper we present a case study for data warehousing intended to support data mining and analysis. We also describe a prototype for data retrieval. Further we discuss some technical issues related to a particular choice of a patient record environment.
Applying Data Mining in Healthcare: An Info- Structure for Delivering ‘Data-Driven’ Strategic Services
Authors: Abidi Syed Sibte Raza
Published: February 2025

Presently, there is a growing demand from the healthcare community to leverage upon and transform the vast quantities of healthcare data into value-added, ‘decision-quality’ knowledge, vis-à-vis, strategic knowledge services oriented towards healthcare management and planning. To meet this end, we present a Strategic Knowledge Services Info-structure that leverages on existing healthcare knowledge/data bases to derive decision-quality knowledge—knowledge that is extracted from healthcare data through services akin to knowledge discovery in databases and data mining.
The Electronic Learning Zone in health informatics
Authors: Bryant John  , Olsson Thomas
Published: February 2025

This paper outlines developments in health informatics education arising from the rapid development of the Internet and the growing importance of lifelong learning. The drivers for change in educational delivery are examined and examples of related uses of the Internet are given. The development of the Electronic Learning Zone at the University of Surrey is described and the paper concludes with the probable future extensions to support lifelong learning.
Medical Informatics in the Medical Curriculum - When?
Authors: Kern Josipa
Published: February 2025

Undergraduate teaching of medical informatics (MI) at the Medical School University of Zagreb has been changing its position in the medical curriculum. Nowadays, this subject is positioned in the second year of the medical curriculum. The aim of this paper is to find out what the students of the second year (S2Y) and of the sixth year (S6Y) think about the position of MI in the medical curriculum. The results of students' opinions have shown that MI should be positioned: in the last two years (63% of S2Y, 36% of S6Y), in the middle (11% of S2Y, 21% of S6Y), and at the beginning of the medical curriculum (26% of S2Y, 43% of S6Y) . However, analysing this question according to previous experience of the students of both groups, it can be concluded that: the S6Y with more previous experience shift the subject towards the end of the medical curriculum, and the S2Y with more previous experience shift the subject towards the beginning of the medical curriculum. According to our long-term experience and students' opinion, the most relevant MI subjects, any kind of medical application, should necessarily come at the end of the medical curriculum.
Automatization of Physicians’ Phone-in Hours
Authors: Turunen Jari  , Loula Pekka  , Soininen Heikki
Published: February 2025

In this paper we present a computer-based system that is designed to reduce the number of patient calls in physicians' phone-in hours. Simultaneously it will offer a parallel alternative channel for the patients to listen to their laboratory results. The system requirements were reliability, security and the low costs. The results showed after a two-month test period that the tailored system proved extremely successful. The average time that the physician saved by using this system was over 4 minutes and doctors can leave the messages to the server also outside the phone-in hours.
A micropopulational modelling of a viral epidemic by using a special neural network
Authors: Zaharia C.N.  , Cristea Al.
Published: February 2025

A general forward neural network was adapted for a simulation of viral epidemics. This involves the introduction of a strongly dependence upon history, upon the cumulated values of the corresponding neuron (individual) activations (states of infection) specifying the activation (health) states of the contaminated individuals, represented by the activated neurons and the dynamic parameters of the neural network: the matrix of the synaptic connection and the vector of the activation thresholds (corresponding to the matrix of the viral transfers between the various individuals and to the vector of the minimal individual contamination doses of virus). The recurrence relations and the learning procedures were also adapted to these processes. This methodology was used for the study of the micropopulational spreading of viral epidemics in various epidemiological situations.
A Probabilistic Approach to Improved Antibiotic Therapy
Authors: de Bruijn Nicolette  , Lucas Peter  , Schurink Karin  , Hoepelman Andy
Published: February 2025

PTA is a decision-theoretic expert system that aims to assist clinicians in diagnos- ing and treating patients with pneumonia in the intensive care unit. Its underlying probabilistic network model includes knowledge for diagnosing pneumonia on the basis of the likelihood of tracheobronchial-tree colonisation by pathogens, and symptoms and signs actually present in the patient. Optimal antibiotic therapy is selected by balancing the expected efficacy of treatment, which is related to the likelihood of pathogen-specific pneumonias, against costs and side effects of treatment. In this article, the model underlying the system and results of a preliminary evaluation are described.
QUALIDIAB: Implementation of the Diabcare project in the french-speaking environment: regional, national and international issues
Authors: Beuscart R.  , Vanhoecke M.P.  , Devos P.  , Allouche R.  , Kleinebreil L.
Published: February 2025

Diabcare is an international Project devoted to the evaluation of the Quality of Care [1] in the population of diabetic patients. As Diabetes is one of the most frequent chronic illnesses, the management of its treatment has a strong impact on the public health policy both regional and national [2]. Funded by the European Commission, initiated by WHO and the International Diabetes Federation (IDF), this Project is now recognised as a Pilot Project throughout the world as an example of a large international collaboration for the surveillance of quality of care in a typical chronic disease.
Validation of a European Message Standard for Electronic Health Records
Authors: Markwell David  , Fogarty Leo  , Hinchley Andrew
Published: February 2025

A European Standard message for communication of the contents of Electronic Health Records is currently at a late stage in development and is due to be adopted during 1999. This paper reports on the development and content of this message and on current work to clinically validate this message. The validation process involves a new method based on an instantiation of the proposed message in the Extensible Markup Language. This method allows the message to be viewed and compared with the same record on the source system.
Computerised Patient Record with Distributed Objects
Authors: Gornik Tomaž  , Orel Andrej  , Roblek Dominik  , Verhovšek Roman
Published: February 2025

The vast spectrum of information and functionality requirements imposed on a Computerised Patient Record (CPR), fuelled by an ever changing and expanding business model demands information system interoperability. The management of information, created across the continuum of care, and associated information system functionality, can not be provided by data interchange to and from monolithic applications. WebDoctor is a Computerised Patient Record (CPR) which is fully used at the Institute of Oncology in Ljubljana, Slovenia - a hospital with 500 beds and more than 200 users, all of them medical professionals. The data are stored in an underlying Oracle hospital data base. For logging the username and password security is used. WebDoctor uses Internationalisation APIs. Currently GUI is currently written in Slovenian language, but can be easily adapted to any other language. It is available in either Metal or Windows look. Search for patients is based on CPR No. or partial data from demographics. All the available patients data can be found on a single screen divided into several tab sections. The tab sections cover general and speciality data. The general data include demographics, admissions and diagnoses, meanwhile the speciality data are divided into Labs where data are represented numerically by date or by type and graphically with the ability of detailed view in separate window, Radiology where results are represented in textual form as well as pictures together with a special viewer to provide detailed analyses and Radioisotopes where results are also being represented in textual form together with a graphical representation. WebDoctor is running on virtually any platform. It achieved the 100% Java Certification which places the application among the firsts if not the first of this kind in the healthcare industry. It excels with a small and light client which doesn't exceed the 150K.
Electronic dissemination media for promoting ICNP in CEE countries
Authors: Moisil Ioana I.  , Jitaru Elena  , Pertache Ioana
Published: February 2025

The TeleNurse ID-ENTITY Inco-Copemicus project, co-ordinated by Randi A. Mortensen, director of the Danish Institute for Health and Nursing Research, is offering to the health informatics community of CEE countries a frame and an opportunity to determine nurses to become active actors in the development of the nursing language and terminology and to promote nursing informatics. This is of great importance, for these countries do not have yet a standard for the electronic patient record and the standard that will be proposed has to incorporate a nursing minimum data set. The ICNP(International Classification of Nursing Practices) classification of nursing phenomena and interventions is a polyhierarchical, multi-axial classification system, allowing different concepts in nursing practice and from different classification systems, to be expressed as combinations of ICNP concepts, located on different axis. The features of ICNP are making it a sound candidate for a standard computerised nursing language. As part of the general strategy for promoting and disseminating ICNP in CEEC, CCSSDM has developed an electronic environment based on Internet and WWW facilities. The main composant and characteristics of this electronic dissemination environment are described in this paper.
7 Secure HL7 Transactions Using Internet Mail (Internet Draft)
Authors: Schadow Gunther  , Tucker Mark  , Rishel Wes  , Engel Kjeld
Published: February 2025

The document describes the applicability of the Internet standardisation efforts on secure electronic data interchange (EDI) transactions for Health Level-7 (HL7), an EDI standard for Healthcare used world-wide [1].
The Virtual Standardized Patient
Authors: Hubal Robert C.  , Kizakevich Paul N.  , Guinn Curry I.  , Merino Kevin D.  , West Suzanne L.
Published: February 2025

We describe the Virtual Standardized Patient (VSP) application, having a computerized virtual person who interacts with medical practitioners in much the same way as actors hired to teach and evaluate patient assessment, diagnosis, and interviewing skills. The VSP integrates technologies from two successful research projects conducted at Research Triangle Institute. AVATALK™ provides natural language processing, emotion and behavior modeling, and composite facial expression and lip-shape modeling for a natural patient-practitioner dialog. Trauma Patient Simulator provides case-based patient history and trauma casualty data, real-time physiological modeling, interactive patient assessment, 3-D scenario simulation, and instructional record-keeping capabilities. The VSP offers training benefits that include enhanced adaptability, availability, and assessment.
Development of a Virtual Reality Arthroscopic Knee Simulator
Authors: Mabrey Jay D.  , Cannon W. Dilworth  , Gillogly Scott D.  , Kasser James R.  , Sweeney Howard J.  , Zarins Bertram  , Mevis Howard  , Garrett William E.  , Poss Robert
Published: February 2025

The virtual reality arthroscopic knee simulator (VR-AKS) consists of a computer platform, a video display, and two force-feedback (haptic) interfaces which also monitor the position of the instruments in the user's hands. The forces that the user would normally apply to the lower limb during arthroscopy are directed through an instrumented surrogate leg. Proprietary software furnishes the mathematical representation of the physical world and replicates the visual, mechanical, and behavioral aspects of the knee while task-oriented programs monitor and record specific areas of user performance. A prototype has demonstrated the feasibility of the system and work on the first, fully functional simulator will begin soon.
Computer Driven Needle Probe Enables Therapy for Painful Neuropathies
Authors: McDonald John S.
Published: February 2025

Recent integration of spatial localization equipment with imaging systems presents more precise methods for the delivery of deep body nerve blocks. This technology builds on the already accepted use of CT as a guide for many currently used nerve blocks by delivering improved control, precision, and visualization of needle placement. This paper discusses the improvements and possibilities this technology brings to the treatment of neuropathies.
Hidden Markov Models of Minimally Invasive Surgery
Authors: Rosen Jacob  , Richards Christina  , Hannaford Blake  , Sinanan Mika
Published: February 2025

A crucial process in surgical education is to evaluate the level of surgical skills. For laparoscopic surgery, skill evaluation is traditionally preformed subjectively by experts grading a video of a procedure performed by a student. By its nature, this process is preformed using fuzzy criteria. The objective of the current study was to develop and assess a skill scale using Discrete Hidden Markov Models (DHMM). Ten surgeons (5 Novice Surgeons - NS; 5 Expert Surgeons - ES) performed a cholecystectomy and Nissen fundoplication in a porcine model. An instrumented laparoscopic grasper equipped with a three-axis force/torque sensor was used to measure the forces/torques at the hand/tool interface synchronized with a video of the tool operative maneuvers. A synthesis of frame-by-frame video analysis and a vector quantization algorithm, defined force/torque signatures for 14 types of tool/tissue interactions. From each step of the surgical procedures, two DHMM were developed representing the performance of 3 surgeons randomly selected from the 5 in the ES and NS groups. The data obtained by the remaining 2 surgeons in each group were used for evaluating the performance scale. The final result was a surgical performance index which represented a ratio of statistical similarity between the examined surgeon's DHMM and the DHMM of NS and ES. The difference between the performance index value, for a surgeon under study, and the NS/ES boundary, was considered to indicate the level of expertise in the surgeon's own group. Using this index, 87.5% of the surgical procedures were correctly classified into the NS and ES groups. The 12.5% of the procedures that were misclassified were preformed by the ES and classified as NS. However, in these cases the performance index values were very close to the NS/ES boundary. Preliminary data suggest that a performance index based on DHMM and force/torque signatures provides an objective means of distinguishing NS from ES. In addition this methodology can be further applied to evaluate haptic virtual reality surgical simulators for improving realism in surgical education.
Net Ergonomics: Information Retrieval in Health Care Domains
Authors: Gamberini Luciano  , Riva Giuseppe
Published: February 2025

The explosion of Internet-based socio-cultural subcontexts and the possibility, horizontally distributed, of handling information on the Net, are transforming information retrieval in a key topic for psychosocial research. However, describing and analyzing how a huge and complex topic can be discussed in the Net and how people's behaviors and attitudes can be influenced by this discussion, is a very complicated task.
Education in Biomedical Engineering: Experience from a European Erasmus Program
Authors: Pallikarakis Nicolas  , Kolitsi Zoi
Published: February 2025

Based on recent advances in biomedical research and the developments of new equipment and techniques, the field of Biomedical Engineering and Health Care Telematics are currently undergoing a rapid evolution characterized by an increasing degree of specialization. This, in turns, imposes new requirements in advanced education, while the changing scene at European level, introduces a major challenge for harmonization and standardization of education with a focus on meeting the emerging needs. At the same time information technologies provide new means and tools supporting the educational and training activities. An initiative for the development of a multinational advanced course in Biomedical Engineering, is implemented in the University of Patras with extended collaboration of European Universities, providing a unique case for achievement of excellency. In order to take full advantage of this potential, a Quality Assurance system has been designed and implemented over the past four years, aiming to provide the appropriate framework for mutual recognition amongst the participating institutions. Additionally, the implementation of new telematic tools is scheduled for the near future, in order to provide the Course with teleconference facilities and allow a much larger number of students to remotely attend the lectures.
Towards a Health Telematics Infrastructure in the European Union
Authors: Iakovidis Ilias
Published: February 2025

Over the last decade information and communication technologies - telematics technologies - have demonstrated their potential to improve the quality, access and efficiency of health care. Health telematics applications are presently revolutionizing the developments not only in diagnosis, treatment, surveillance and rehabilitation of patients, but also on the side of the more collective aspects of health care and health prevention such as clinical trials, epidemiology and health education. Moreover, for the first time in the history of health care the emerging Health Information Infrastructure (HII), i.e. telematics networks together with a set of technologies, health telematics applications and services, is making possible the rapid dissemination and sharing of health information and research results. This is leading to knowledge creation and to promotion of innovative approaches based on evidence collected in medical practice all over the world.
AX.25 amateur packet radio as a possible emergency network
Authors: Petrescu Marius  , Toth Victor
Published: February 2025

In modern society more and more medical applications need a reliable data transfer. In emergency situations, such transfer may not be available because parts of the communications infrastructure may be affected. An alternative way could be the use of the amateur radio packet network, which offers almost global coverage. We analyzed its use as an emergency data transfer support, including transport of real-time medical data.