bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward Normative Expert Systems: Part I The Pathfinder Project
Authors: Heckerman D. E. , Horvitz E. J. , Nathwani B. N.
Published: March 2018

Pathfinder is an expert system that assists surgical pathologists with the diagnosis of lymph-node diseases. The program is one of a growing number of normative expert systems that use probability and decision theory to acquire, represent, manipulate, and explain uncertain medical knowledge. In this article, we describe Pathfinder and our research in uncertain-reasoning paradigms that was stimulated by the development of the program. We discuss limitations with early decision-theoretic methods for reasoning under uncertainty and our initial attempts to use non-decision-theoretic methods. Then, we describe experimental and theoretical results that directed us to return to reasoning methods based in probability and decision theory.
Medical Database Security Policies
Authors: Pangalos G. J.
Published: March 2018

Database security plays an important role in the overall security of medical information systems. Security does not only involve fundamental ethical principles such as privacy and confidentiality, but is also an essential prerequisite for effective medical care. The general framework and the requirements for medical database security are presented. The three prominent proposals for medical database security are discussed in some detail, together with specific proposals for medical database security. A number of parameters for a secure medical database development are presented and discussed, and guidelines are given for the development of secure medical database systems.
Revising a Display of Multidimensional Laboratory Measurements to Improve Accuracy of Perception
Authors: Hoaglin D. C.
Published: March 2018

To display multidimensional laboratory measurements, Hoeke et al. (1991) proposed a technique that uses plotting axes radiating from a point, assigns each test to a separate axis, and links the test results with line segments. A special nonlinear scaling ensures that a patient whose results all fall in the normal range is represented by a regular polygon of middle size, and colored zones emphasize more serious departures from the normal range. Results of research in graphical perception, however, point to potential difficulties in clinical applications. Those results also suggest a revision of the display that should overcome the difficulties. The new version plots the test results on parallel horizontal lines and links the points for adjacent tests by line segments, while retaining the special scaling and the colored bands.
Liquordiagnostik bei Demenzen
Authors: Schipke C. G. , Peters O.
Published: March 2018

Bislang erfolgt die Diagnose einer Demenz-Erkrankung unter Einbeziehung, neuropsychometrischer Testverfahren und einer kraniellen Bildgebung, welche im Ergebnis mit der Diagnose vereinbar sein muss. Die Liquordiagnostik kann jedoch, insbesondere bei der Alzheimer-Erkrankung, wichtige Informationen zur Sicherung der Diagnose beitragen. Im Liquor befinden sich bei einer neurodegenerativen Erkrankung eine Anzahl von Proteinen in veränderter Konzentration. Die erhöhte Rate des neuronalen Zelltodes, die sich bei allen neurodegenerativen Demenzen findet, spiegelt sich meistens in einer Erhöhung der Konzentration des Tau-Proteins im Liquor wider. Differenzialdiagnostisch leistet die Liquordiagnostik wichtige Hilfestellung bei der Abgrenzung gegenüber kognitiven Defiziten, welche im Kontext depressiver Störungen entstehen und keinem neurodegenerativen Prozess zugrunde liegen. Zur Sicherung der Diagnose einer Alzheimer-Erkrankung sollte die Analyse des Amyloidstoffwechsels im Liquor erfolgen. Die Alzheimer-Erkrankung zeigt in sehr frühen Stadien eine erniedrigte Konzentration des Peptides Aβ1-42, wohingegen das Peptid Aβ1-40 unverändert bleibt.
Therapie metabolischer Myopathien
Authors: Debska-Vielhaber G. , Motlagh L , Zierz S. , Vielhaber S. , Lehmann D.
Published: March 2018

Metabolische Myopathien sind seltene Erbkrankheiten die primär die Muskulatur betreffen und hauptsächlich auf Störungen des muskulären Energiestoffwechsels beruhen. Das Krankheitsspektrum beinhaltet Störungen der Fettsäurenoxidation, der Glykogenbzw. Glykolyse und der mitochondrialen Atmungskette des Muskels. Klinisch manifestieren sich diese Erkrankungen mit einer Reihe von Symptomen wie infantile Hypotonie, Myalgien, Belastungsintoleranz, chronische oder akute Muskelschwäche, Muskelkrämpfen und Spasmen bis hin zu schwerwiegenden Komplikationen, meist der fulminanten Rhabdomyolyse. Durch verbesserte Untersuchungsalgorithmen und Einsatz neuer Techniken wie der Next-Generation-Sequenzierung werden einzelne Erkrankungen frühzeitiger diagnostiziert. Dieser Umstand ermöglicht den frühen Einsatz hochwirksamer Therapien wie bei der Pompe-Krankheit. In diesem Beitrag sollen anhand ausgewählter praxisrelevanter Erkrankungen aus dem breiten Spektrum der metabolischen Myopathien die wesentlichen Prinzipien des therapeutischen Managements dargestellt werden.
Therapie der Muskeldystrophien/das Deutsche Muskeldystrophie- Netzwerk (MD-NET)
Authors: Vorgerd M. , Kirschner J. , Walter M. C.
Published: March 2018

Muskeldystrophien (MD) bilden eine klinisch heterogene Gruppe genetisch determinierter, progredienter Erkrankungen des Muskels. Gemeinsames Symptom aller MD ist eine fortschreitende Muskelschwäche und Muskelatrophie, die sich in Verteilungsmuster und Schweregrad zwischen den MD-Formen deutlich unterscheidet. Die ständig zunehmende Anzahl bekannter Genorte, spezifischer Gene und Genprodukte machen eine exakte Diagnostik schwierig, jedoch ist eine präzise Diagnose wichtig für Verlauf und Prognose der Erkrankung. Bislang stehen überwiegend symptomatische Therapieformen zur Verfügung. Allerdings sind in den letzten Jahren innovative kausale molekulartherapeutische Ansätze entwickelt worden, die hoffentlich in naher Zukunft eine wirksame Therapie ermöglichen. Das deutsche Muskeldystrophie-Netzwerk (MD-NET), eine deutschlandweite vom BMBF geförderte Arbeitsgemeinschaft zur Verbesserung der medizinischen Versorgung von Menschen mit neuromuskulären Erkrankungen, hat es sich seit 2003 zum Ziel gesetzt, zielgerichtete Forschung zu Prävention, Diagnose und Therapie von Muskeldystrophien zu leisten und die medizinische Versorgung von Patienten nachhaltig zu verbessern.
Diagnose und Therapie von chronischen Atmungsstörungen bei neuromuskulären Erkrankungen
Authors: Winterholler M. , Boentert M.
Published: March 2018

Neuromuskuläre Erkrankungen gehen mit einem erhöhten Risiko für die Entwicklung schlafbezogener Atmungsstörungen (SBAS) einher. Hierzu zählen die alveoläre Hypoventilation auf dem Boden einer Zwerchfellparese und die obstruktive Schlafapnoe als Folge einer muskulären Hypotonie des oberen Atemwegs. SBAS treten bei unterschiedlichen neuromuskulären Erkrankungen mit unterschiedlicher Häufigkeit auf und stellen einen klinisch hoch relevanten Faktor für die Morbidität und Mortalität der betroffenen Patienten dar. Der vorliegende Übersichtsartikel beschreibt die gängigen diagnostischen Verfahren zur Messung von Atemmuskelkraft und Atmungsstörungen im Schlaf. Ferner wird auf die nicht invasive Beatmung und die Bedeutung eines qualifizierten Sekretmanagements bei klinisch relevanter Hustenschwäche eingegangen.
A Review of Computer Systems in Blood Banks and Discussion of the Applicability of Mathematical Decision Methods
Authors: Page B.
Published: March 2018

The fast progress of transfusion medicine is leading to higher requirements in blood donor and transfusion services which can only be met by EDP in the long run.

This article gives an overview on the state of EDP system development in blood banks. The emphasis is on EDP systems in blood donor services. However, some transfusion medical EDP applications are also mentioned. The functional application areas of EDP are shown. The cost-benefit ratio of computer systems in this field is discussed and systems in operation or under development are compared in tabulated, form. Of particular interest in this comparison is the aspect of the applicability of mathematical decision methods for providing decision aids in blood banks by the computer.

The cost-efficiency of systems providing improved medical services at the same time leads to the conclusion that a fast growth of EDP applications in blood donor and transfusion services can be expected.
Computer-Linked Memorandum of Pathology System (CLIMPS 7909) for Interactive Storage and Analysis of Surgical Pathology Data
Authors: Takahashi M. , Masuda M. , Isiglo K. , Matsumoto T.
Published: March 2018

A new interactive data base management system for surgical pathology is described which was developed by modification of the previously reported system for autopsy records [23]. As the name implies, it serves as a personal memorandum. Always led by the computer, it is easy to write and read, whenever necessary, without knowledge of programming or data format. The outstanding features are its flexibility of operation and the on-line availability of simple statistical data on some items (diagnoses, topography, histology, age and sex) in response to the specification of search condition so that it provides an opportunity to expand association of ideas during the process of diagnosis and serves as a diagnostic support system. The CLIMPS has been successfully tested with over 770 surgical pathology records. Some problems to be expected in the future are discussed.
Evaluation of Non-invasive Examinations of Coronary Artery Disease Using Information Theory
Authors: Ulm K. , Sauer E. , Sebening H.
Published: March 2018

A method is presented which allows a stepwise selection of relevant variables for a diagnosis and also a sequential allocation bearing in mind the time-sequence and the expense in recording the variables. The method is based on an information-theoretical approach and is suitable for the application of qualitative variables. The method is presented using data concerning patients with suspected coronary artery disease, taking into consideration the fact that the variables are observed at different times.
An Interactive Computerised Protocol for the Management of Hypertension
Authors: Evans A. R. , Wilkes E. R. , Absolon P. J. , Denner T. J. , Kaye G.
Published: March 2018

The management of hypertension using a computer within a hospital environment is well documented [4, 5, 6, 11, 15]. This paper describes the background, structure and use of an interactive care system designed to be used by general medical practitioners in their consulting rooms.

A management plan (protocol) for the care of an “ideal hypertensive” patient was defined by a group of general practitioners. The method by which this plan was adapted and converted for use on the computer is described. The computer handles patient information according to the protocol, prompting and interacting with the physician in attempting to improve the delivery of care to his hypertensive patients.

The physicians’ acceptance of and compliance with such a care system is examined, and the implications for the future are discussed.
Medical Literature Searches -How Many Bibliographic Databases are Needed for Sufficient Retrieval in Medical Topics?
Authors: John K.
Published: March 2018

As many bibliographic services in medicine are offered, literature searches in eight databases at DIMDI were performed to find out which database is most important in medicine. The distribution of publications from members of the medical faculty of Frankfurt University was examined. No save prediction is possible as to which database will yield most articles. Overlapping from different databases is often rather low. The selection of an appropriate database mix for sufficient recall and in a cost-effective manner.is a task for an experienced searcher.
Kernel Estimation Techniques for the Analysis of Clinical Curves
Authors: Müller H.-G. , Ihm P.
Published: March 2018

Kernel estimation procedures for the comparison of samples of longitudinal clinical curves are discussed. We show how samples of curves can be compared by means of “empirical parameters” and how a typical longitudinal curve can be defined by “longitudinal averaging”. This method allows to summarize the information in a sample of monotonous curves and to derive local confidence bands for the longitudinal mean curve. Under specific assumptions, this procedure is strongly consistent.

As an example, we analyze and compare the long-term behavior of two types of heart pacemakers. Special consideration is given to the practically relevant choice of kernels and of bandwidths (smoothing parameters).
Knowledge Representation and Utilisation in a Man-Machine Dialogue with a Medical Decision Aid System
Authors: Joubert M. , Fieschi M. , Fieschi D. , Roux M.
Published: March 2018

This study presents the man-machine communication procedure, called MEDIUM, with the medical decision aid system SPHINX. The knowledge processed by this procedure is concerned with the entities of the medical discourse, that is the signs, the symptoms and the results of clinical and paraclinical examinations. At first level, the knowledge is constituted by the definitions of the entities and their specific properties. At a second level, the knowledge is constituted by logical formulas which translate the relations that link entities. Part of the coherence of the discourse is judged with regard to the definitions of the entities. The coherence is completely established by evaluating the truth values of the formulas according to the data already stored during the session. Parts of sessions with the procedure MEDIUM are presented and results are discussed.
Comments on Lindberg’s Correction for the Effects of Observer Variation on Probabilistic Diagnosis
Authors: Spiegelhalter D. J.
Published: March 2018

Lindberg [2] proposes an adjustment of a probabilistic system for diagnosis in the light of known observer variation in the eliciting of symptoms and signs. He finds that his proposal leads to somewhat diffident predictions. We show that such an adjustment is only appropriate when the system is implemented with observers who are less reliable than those who created the data-base. In this case, with certain assumptions, an adjustment may be made that is less radical than that of Lindberg. A simple numerical solution for binary symptoms is provided.
On Multivariate Methods in Data Reduction and Detection of High Order Interactions—Application to Factors Causing the Large Fetus
Authors: Moussa M. A. A. , Hathout H. , Labib N. S. , Kasraoui R. A. , Kasim O.
Published: March 2018

Multivariate statistical methods needed for selecting a good subset of variables in complex medical surveys as well as searching for high order interactions are described. This includes 1.) the discriminant function based on a mixture of discrete and continuous variables with allowance to empty states; 2.) stepwise logistic regression and stepwise discriminant analysis; 3.) iterative proportional fitting of the data to the appropriate configuration of log-linear models for testing and ordering the importance of interactions. The methods are applied to a data set based on a study recently conducted in the Principal Maternity Hospital in Kuwait to investigate the large fetus phenomenon. It was concluded that parity and associated maternal illness are the most influencing factors in birth weight while maternal age, previous abortions and consanguinity play a lesser role.
Group Theory Approach to Computer Translation of Medical German
Authors: Moore G. W. , Riede U. N. , Polacsek R. A. , Miller R. E. , Hutchins G. M.
Published: March 2018

Computer translators have been studied for almost four decades, but recent advances in speed and storage capabilities have made such translators accessible to small computer users. We obtained the computer typesetting file for a German language medical textbook and wrote computer software sufficient to obtain a draft quality English language translation of the entire book, at a speed of 9,671 words per hour. This translator uses two external tables, namely a word and idiom list and a list of grammatical rules, which completely specify the behavior of the translator. The grammatical rule table satisfies the properties of a mathematical group, and the inverse operation for this group allows one in principle to convert this German to English translator into an English to German translator. For the larger problem of creating multilingual computer translators, the group theory inversion property may allow one to substantially reduce the effort of creating a separate translator for each language pair. Future development of computer translators will depend upon the wider availability of computer-readable documents and will be aided by use of vocabulary and grammatical rule tables with group theory properties which permit the invertability between language pairs.
A Method of Medical Knowledge Base Augmentation
Authors: Lester S. , Rada R.
Published: March 2018

The Medical Subject Headings (MeSH) of the National Library of Medicine may be viewed as a semantic network. The relationships in this semantic network are of a broader-than/narrower-than type. A knowledge base of this type may be augmented by adding new terms and new relationships to the network. The Current Medical Information and Terminology (CMIT) of the American Medical Association represents a rich source of relationships for the disease terms of MeSH. A subset of MeSH was augmented with the knowledge from a subset of CMIT using a matching and similarity strategy. The matching portion of the experiment showed that about half of CMIT may be directly merged with MeSH based on exact and partial matches and utilization of alternate and synonym terms from CMIT. The similarity portion of the experiment showed that a method of merging based on similarity of features is a workable approach to incorporating knowledge into MeSH when lexical matches are not available. Evaluation of the resulting merged knowledge base suggested that the etiology property of CMIT was the most highly inherited property. The augmented knowledge base was used as a basis for an automatic indexer. The indexer was less accurate after augmentation than before. One key difficulty stemmed from the way that CMIT was encoded into MeSH. More powerful encodings of CMIT into MeSH are being pursued. Building on MeSH, CMIT, and other such knowledge bases that already exist on the computer is one way to try to develop intelligent medical computer systems.
Estimating Relative Risk from Heterogeneous Strata
Authors: Ahlborn W. , Tuz H.-J. , Überla K.
Published: March 2018

The uncritical use of risk estimators can lead to serious bias. The estimation of overall risk ratios for heterogeneous strata and the weights used have been discussed recently. This paper starts with the definition of relative risk in the population, considering heterogeneous strata and a cofactor, using weight functions. From this general formula four different weight functions leading to four different overall measures of relative risk (RR1, RR1, RR3, RR4
) are. derived as special cases. The estimability of the parameters in relation to the underlying sampling design is investigated. Consistent estimators are provided and the asymptotic distributions of the estimators are given for prospective cohort studies, case control studies with fixed strata and case control studies with given sample sizes. For some of the estimates the . asymptotic variances are given. It is shown that for case control studies with fixed strata neither the Mantel-Haenszel estimator nor another estimator of this class is consistent. An extension to more than two risk levels is provided and the relationships between various risk measures and other implications are commented on. A way is described to improve risk estimation by using information from the population. An example for cohort studies is given. Generally we propose to use RR3
, which lies between RR1
and RR2
and can be estimated more precisely using the sometimes available distribution of the cofactor in the population. If the relative risk across strata is heterogeneous, logistic models for the construction of a single risk indicator have some drawbacks.
Pro. M. D. - A Diagnostic Expert System Shell for Clinical Chemistry Test Result Interpretation
Authors: Pohl B. , Trendelenburg Chr.
Published: March 2018

The history and main features of the diagnostic expert system Pro. M. D. are presented. An illustrative case report from a knowledge base for the evaluation of disorders of lipid metabolism helps to explain Pro. M. D.’s functions. The knowledge representation syntax is explained for the different types of rules. Knowledge bases currently in development are outlined. A new concept of probability reasoning and other recent improvements are discussed briefly. Implementation details are described with special regard to the inference function. Evaluation problems are discussed and Pro. M. D. is compared to other known diagnostic computer systems.
Occupational Risks: A Follow-up Method Based on Individual Work History Records Including the Environmental Aspects of the Workplace
Authors: Martin J. M. , Robaux P.
Published: March 2018

This article analyzes the Curriculum Laboris or career reconstruction as a means of studying the occupational risks of employees. A type of Curriculum Laboris which makes the established record easier to use has been suggested. The authors point out some advantages to be expected from the proposed computerized method. The usefulness of the proposed Curriculum Laboris is largely conditioned by lack of standards for guiding data collection by physicians. Finally, the Curriculum Laboris has been considered as an element of a larger information system.
Tropical Epidemiology: A System for Continuous Demographic Monitoring of a Study Population
Authors: Stephens J. , Alonso P. L. , Byass P. , Snow R. W.
Published: March 2018

Epidemiologists in many developing countries, where official demographic services are unavailable, have to include some demographic functions in their work. The usual method of documenting a study population for epidemiological research in a developing country consists of three stages: mapping, enumeration and vital registration. This paper considers the last element of this process, detailing the development of a suitable data system and explaining how its implementation using microcomputers and a database management system can help in the creation of an on-line continuous vital registration system for a study population as an epidemiological tool. The issues covered are data collection, entry and analysis, and the advantages of such a system for use in epidemiological research in developing countries are also discussed.
Identification and Retrieval of Personal Records from a Statistical Data Bank
Authors: Schlörer J.
Published: March 2018

From a statistical data bank containing anonymous but individual records which may be evaluated by dialogue—e.g., by entering logical conditions which the system answers by returning absolute frequencies—personal records may often be retrieved. First a user has to identify the record in question, using previous knowledge. An experiment with authentic data is described providing some information on the amount of preknowledge needed for identification. Once identified, parts or the whole of a record may be retrieved by various techniques. The efficiency of a technique already known is studied. A new technique permitting retrieval of complete personal records is described, which is resistant to conventional output restrictions. It becomes feasible as soon as AND plus at least one of the logical operations NOT and OR are available. Some possible countermeasures are discussed.
A Pre-Printed Reporting System for Multiple Data in Clinical Bacteriology
Authors: Graevenitz A. v.
Published: March 2018

A system is presented which enables the Bacteriology Laboratory to report pure or mixed cultures with quantitations and antimicrobial sensiti vities on ‘ one final form. It consists of a Requisition Slip, listing patient data and specimen sources, and a Report Form - both of which catry at least one carbon or NCR paper copy. The Report Form contains a blank for a mount of the Requisition Slip, a list of bacteria with quantities and sensitivities for each organism, and a flow sheet for the workUp. The forms may be completed with a pen or designed as punchards.
Biometrie der Abstammung (Zum biostatistischen Vaterschaftsbeweis)
Authors: Hummel K.
Published: March 2018

Die zur Berechnung der Vaterschaftswahrschsinlichkeit aus serologischen Befunden herangezogene Formel von Essen-Möller läßt sich auf das Bates sehe Theorem zurückführen. Die A-priori-Wahrscheinlichkeit wird für die Beurteilung des Einzelfalles als 0,5 gesetzt. Die aus den errechneten Wahrscheinlichkeitswerten (W-Werten) hervorgehende »Zutreffenswahrscheinlichkeit« (bzw. »Irrtumswahrscheinlichkeit«) bezieht sich dann auf ein gleichgroßes Kollektiv Väter und Nichtväter. Benutzt man eine der Wirklichkeit entsprechende A-priori-Wahrscheinlidikeit, z. B. aus der Väter-Nichtväter-Relation eines gerichtlichen Aktenmaterials, dann erhält man realistische Zutreffensbzw. Irrtumswahrscheinlichkeiten. Betrachtet man den »kritischen Wert« der EssEN-MöLLER-Formel Y/X als Likelihood-Verhältnis, dann lassen sich lg Y/X-Verteilungen für Väter und Nichtväter empirisch oder rechnerisch aufstellen, in die sich der lg Y/X-Wert eines zu beurteilenden Mannes einordnet und sich, je nach Standort, als mehr oder weniger »typisch« für Väter bzw. Nichtväter erweist. — Von dem zu erwartenden neuen Unehelichengesetz der Bundesrepublik Deutschland wird es abhängen, welche Bedeutung den biostatistischen Befunden für die Vaterschaftsfeststellung zukommt.
KEYWORD-INDEX. A Computer oriented personal reference retrieval system
Authors: Smith J. E. , Butler J. , Grosvenor D.
Published: March 2018

In order to facilitate organization of personal reference systems a computer oriented retrieval system, KEYWORD-INDEX, has been developed. Using this system, the computer is used to generate a keyword listing of an investigator’s private files with an associated index. This system has a great deal of flexibility which is not available with traditional reference cards.
Zur Erfassung und Verarbeitung medizinischer Daten mittels Computer
Authors: Giere W.
Published: March 2018

Die Möglichkeiten der formalen Fehlerkontrolle, die sich aus der Art der Datenerhebung mit dem Datenerfassungs- und Speicherprogramm (DUSP) ergeben, werden beschrieben. Die Festle.gbarkeit »zulässiger« Inhalte durch den Text der Erhebungsbögen erlaubt wirksame Prüfungen auf Fehler, d. h. »unzulässige« Inhalte. Die Standardisierbarkait der Kontrollroutinen gestattet weitgehende Programmvereinfachungen. Wegen der Benutzung von Standardunterprogrammen kann sich die Programmierung auf die Definition der »zulässigen« Inhalte beschränken.
A Model of a Hospital’s Patient Medical Information System)
Authors: Dixon R. A.
Published: March 2018

Although the retrospective linkage of medical records and the prospective compilation of cumulative health records are continually being urged, even a single hospital has difficulty in integrating all patient-oriented records while simultaneously maintaining an effective information system required to carry out routine procedures dependent on patient data. One underlying problem common to all data systems studies is the need for a computer-assisted technique for data-gathering and analysis by the systems analysis team and the consequent difficulties of communication among the members of the team. The use of such a technique (DATAFLOW) in a hospital environment is described. Completeness and consistency of a model of the system are checked and control points in the system identified. Documentation on the model of system changes is possible both at the design stage and as the system develops. The interface between the data system and expert or physical activities not documented within the data system is preserved, as is that between the data system and the system governing the movement of materials (X-ray films, blood samples, etc.). A model of this system can be documented in a similar way to the data system. Formalisation of data systems analysis promises to further its transformation from an art to a science.
An Approach to Retrieval of Narrative Text in Case Records: The Psychiatric Case History Event System (PsvCHES)
Authors: Eiduson B. T.
Published: March 2018

The Psychiatric Case History Event System (PsyCHES) is a generalized information processing system for conversion of case history data into computer-acceptable form for subsequent retrieval and analysis. Since its first reporting in 1964, the Psychiatric Case History Event System has been implemented on a large scale in a study of the decision making process in psychiatric diagnosis. The details of the processing of data from the point of transcription to computer output are presented in this paper. In so doing the logic of the system and the definition of its conceptual unit, the Event, are made evident. Also, the generality of the PsyCHES System for application in a wide variety of clinical and research endeavors involving narrative textual data is suggested.
Ein Auswertungsprogramm für sequentielle Datenbestände
Authors: BAUER P. , GRABNER H. , SCHEIBER V.
Published: March 2018

Es wird ein Auswertungsprogramm für sequentielle Archive vorgestellt. Das Programm ermöglicht Auszählungen nach logistischen Relationen, selektives Umspeichern und die Berechnung von Mittelwerten, Standardabweichungen und Korrelationen in eingeschränkten Kollektiven, aus denen man sich auch zusätzlich Informationen ausdrucken lassen kann.
The Reprint Requester as a Source of Medical Information
Authors: LEONARD D.
Published: March 2018

Questionnaires were sent to 280 reprint requesters of an article dealing with subdural hematoma in dialysis patients, a previously unreported complication. Equal responses (32%, 33%, respectively) were obtained from North American and foreign requesters and identified 25 additional cases of subdural hematoma in dialysis patients. The incidence rate of this complication was similar among replies from North America and dialysis units from which a reprint request had not been received. Reprint requesters may be a valuable source of medical information in selected situations.
An Automated Parsing Routine for Diagnostic Statements of Surgical Pathology Reports
Authors: Wong R. L. , Gaynon P.
Published: March 2018

An automated parsing routine was written for extracting the »site«, »diagnostic«, and »modifier« components of the diagnostic statements of the diagnostic summary of surgical pathology reports. Such parsed reports appear to be suitable for input into an information retrieval system for the surgical pathology reports.

Data was input through a key-to-tape device producing a computer compatible magnetic tape with a record size of 870 bytes. The statements were parsed through syntactic and morphological analysis utilizing the common prepositions, the common punctuations and the morphemal constructions common in medical terms. (A total of sixty-two delimiters were used). Certain suffix transformations were performed, converting some »site« adjective to »site« nouns, and some »diagnostic« nouns to »site« nouns. 1,108 diagnostic statements were processed with an error rate of 9.3% for the latest version on the last 493 statements.
Klartextanalyse pathologischer Biopsiebefunde mit Bildschirmabfrage
Authors: GELL G. , BECKER H.
Published: March 2018

Beschreibung eines Klartextsystems zur Dokumentation von Befunden in der Pathologie, das sich seit 1. 1. 1971 im Testbetrieb befindet und bisher 8 000 Biopsiebefundberichte analysiert und gespeichert hat. Der zugrundeliegende Thesaurus verfügt über 39 000 Eingangsworte; weitere 10 000 Worte werden demnächst eingefügt.

Das entwickelte System ist das erste Dokumentationssystem mit Bildschirmabfrage, das in der Pathologie eingesetzt wird.

In der Diskussion werden Hinweise auf den notwendigen Aufwand an Maschinenkonfiguration und Manpower gegeben und die verschiedene Struktur der in der Pathologie verwendeten Thesauri erörtert.

Die Analyse der Möglichkeiten eines Klartextsystems ergibt drei Stufen der Entwicklung von der wortweise erfolgenden Erfassung bis zur Erfassung des Begriffsinhaltes; praktisch alle Klartextsysteme in der Pathologie befinden sich auf der ersten Stufe dieser Entwicklung, ‘
The Patient Data Bank in a Medical Information System – Tasks, Requirements, Planning and Design
Authors: Sauteh K.
Published: March 2018

Tasks, requirements, planning and design of the central data bank in a patient information system are demonstrated by the model of the »Medical System Hanover« (MSH).

The Terms »Information System«, in particular »Patient Information System« and »Data Bank« are defined. Based on the ultimate goals of MSH, the task set is formulated and a catalogue of the most important basic requirements of a data bank management system is given as typical for application in a hospital environment. Finally, various points of view that are of essential importance for system planning and design, such as selection of data and structurization of files, are discussed.
Validity of Simple Indicators of Emotional I11-Health for Use in Epidemiological Studies
Authors: Abramson J. H. , Epstein L. M. , Flug D. , Jarus A.
Published: March 2018

The validity of simple symptom inventories as indicators of emotional ill-health was tested by a comparison with clinical appraisals of emotional health status. The indices tested were the Health Opinion Survey Index, an index based on ten »key« questions from the Cornell Medical Index, and the anxiety index used in the Israel Ischemic Heart Disease Project. The test was conducted in a household sample and a sample of patients attending a psychiatric clinic.

All the indices were found to be of moderate validity as indicators of the presence or absence of emotional disturbance. All were weakly correlated with the degree of disturbance. The indices did not differ significantly in their validity. Educational level significantly affected the responses to the Health Opinion Survey Index.

It was concluded that when superior methods are not feasible, but only then, it is justifiable to use simple indices of this sort for the measurement of emotional health in epidemiological studies. The indices should not be regarded as being of more than moderate validity, and due attention should be paid to the possible confounding influence of factors other than emotional health.
Pathologie Befund System
Authors: Wingert F. , Ries P.
Published: March 2018

Der derzeitige Stand der Klartextverarbeitung in der Pathologie wird kurz diskutiert. Ein On-line-Datenerfassungssystem über Bildschirm für die gesamte Befundungstätigkeit eines pathologischen Instituts wird beschrieben. Das System ist seit einiger Zeit im Routineeinsatz und hat sich prinzipiell bewährt. Es beinhaltet die automatische Erstellung der Arztbriefe, die Führung verschiedener Register und das Schreiben von Mahnlisten.
Use of Information in Thyrotoxicosis Treatment Allocation
Authors: Moore M. F. , Aitchison J. , Parker L. S. , Taylor T. R.
Published: March 2018

Six clinicians were asked to choose one of the three available treatments (antithyroid drugs, surgery and radioiodine) and to rate the appropriateness of each treatment, for 40 patients already diagnosed as thyrotoxic, on the basis of five items of information about each patient. An examination of the extent to which they used this information showed that all effectively used less than five items and that three of them used fewer items in the choice than in the scaling task. Comparison of an individual’s performance on the two tasks gave some insight into his approach to choosing a treatment. It is suggested that choice of treatment should in future be explicitly approached through rating the appropriateness of each treatment.
Planning of a Therapeutic Comparison by Consideration of Objective and Subjective Responses
Authors: von Eiff A. W.
Published: March 2018

Often in drug trialg only the objective or the subjective responsef of the subjects are investigated, depending on the kind of drug. It i s, however, desirable to check both the objective and the subjective responses in every drug trial.

The investigation of the objective symptoms which is especially necessary in psycho-pharmacological trials, presents great difficulties. When a bodily function is found which reflects the emotional reactions which it is desired to investigate, it is necessary to plan the trial in a way that allows the results to be seen as proof of the effects of the drugs. Proposals for such a therapeutic trial are made.

In the checking of the subjective responses the questionnaire is reckoned to be the best method. Problems of how the questionnaires are made and how they are used in the trials are discussed.

By checking the subjective reactions, not only the side effects of the drug are demonstrated, but also their therapeutic effects.

The author does not agree with the opinion that the double blind test is better than the single blind test in every case. Appropriate investigations should be made to clarify these questions.
An Automated Clinical Information System
Authors: Yoder D. , Swearingen R. , Schenthal E. , Sweeney W. , Nettleton J.
Published: March 2018

An automated clinical record system must have the following characteristics: as far as the physician is concerned it must operate in natural language on standard sized paper; it must be able to accept information from the physician at a time when he is oriented to clinical terminology and a clinical mode of thinking; it must have an output which is clinically useful for the care and management of a patient; each item of information must be addressable so that it may act as an index for scientific information retrieval; it must be capable of accepting quantative and natural language information.

Clinical information constitutes a mathematical set, only a few members of which are applicable to any particular clinical situation, and to which new members are constantly being added. The members of this set are seldom mutually exclusive. An acceptable system which is capable of processing this type of information has been designed utilizing the concepts of self-encoding forms and variable-field, variable-length records. Applications of these principles will expedite hospital automation, the establishment of drug evaluation information systems, and of regional and nationwide medical record systems.
The Medical Literature Analysis and Retrieval System (MEDLARS) of the U.S. National Library of Medicine
Authors: Taine S. I.
Published: March 2018

MEDLARS is an acronym for the name (Medical Literature Analysis and Retrieval System) which the National Library of Medicine has given to the computer-based bibliographic retrieval and publication system now under development. From the bibliographic viewpoint, MEDLARS embraces the following general objectives: Increased coverage of the current substantive medical literature of the world up to totality; deeper subject analysis of, and broader accessibility to, the bibliographic items aided by additional avenues of approach such as language, and geographic origins of the document; more rapid processing to accelerate the availability of the information contained in the system; the capture and delivery of pinpointed and prescribed segments of the total file in a variety of patterns of selection and arrangement. The paper describes the history, aims and products of the new system.
Computer Evaluation of Statistical Properties of Clinical Information in the Differential Diagnosis of Chest Pain
Authors: Klingemanand J. D. , Cosma J. , Pipbergee H. V.
Published: March 2018

A pilot study was undertaken to determine quantitatively from a large number of signs, symptoms and laboratory tests of patients with, the differential diagnosis of chest pain, which information items could serve as optimal descriptors and/or discriminators of disease. Data were obtained from 1238 patients. For each subject 429 questions of the »yes-no« type were answered and 69 numerical data collected. Incidence rates of signs and symptoms were considered as descriptors. Out of those exceeding an incidence rate of 25 percent, between 60 and 95 percent referred to medical history, depending upon the disease entity under study.

Contingency table analysis and chi-square tests were used first to determine the discriminative power of various items. Historical data predominated again. Out of the total of 498 information items tested only 46 reached a chi-square level of 40 which was considered the minimum for efficient separation of diseases. Many items with high incidence rates contributed little or nothing to disease differentiation.

To test the discriminative power of the identified signs, symptoms and laboratory data, discriminant function analysis was used. The number of items could be further reduced to less than 10. More than 95 percent of the 1000 patients with Coronary Artery Disease and Pneumonia could be classified correctly with this reduced set.

Data reduction and identification of optimal descriptors and discriminators can be considered as one of the most important preliminary steps in computer analysis of clinical information.
Das kybernetische Prinzip in der Biometrie
Authors: Schneider B.
Published: March 2018

Die vorliegende Arbeit soll zeigen, daß die Kybernetik eine formale Theorie der biometrischen Modelle und die biometrischen Modelle Interpretationen des abstrakten kybernetischen Systems darstellen. Als das Prinzip der kybernetischen Methode wird die kanonische Analyse herausgestellt, bei der aus den Input- und Outputgrößen des Systems geeignete, charakteristische Größen berechnet werden. Aus diesen Größen kann in einfacher Form das gesamte Input-Outputverhalten des Systems dargestellt werden (Prediction-Problem). Außerdem drücken diese Größen besonders wichtige, die Gesetzmäßigkeit des Systems kennzeichnende Eigenschaften (kanonische Eigenschaften) aus. Es wird gezeigt, daß dieses kybernetische Prinzip bei den wichtigsten biometrischen Methoden und Fragestellungen eine entscheidende Rolle spielt.
Klinisch-mathematischer Vergleich psychotroper Arzneimittel
Authors: Flegel H. , Bender G. , Bergener M.
Published: March 2018

Beim gegenwärtigen Stand der psychopharmakologischen Forschung sind Exaktifizierung der klinischen Methoden unerläßlich. Diese Studie beschreibt zunächst, wie man die Versuchsbehandlung eines Falles mit seinem eigenen „Vorverlaufsoptimum” vergleicht. Derartige Vergleichswerte werden für je eine klinische Versuchsserie mit einem Phenothiazin- und einem Butyrophenonderivat verschiedener neuroleptischer Potenz einem nichtparametrischen Signifikanztest für zwei kleine Stichproben unterzogen. Dafür müssen umfängliche Kombinationen errechnet werden. Diese Berechnungen wurden nach Fortran 4 programmiert und mit der elektronischen Rechenanlage IBM 7090 durchgeführt. Nach dem Ergebnis der hier exemplifizierten Untersuchungen unterscheiden sich das neuroleptisch hochpotente Phenothiazin- und das mittelpotente Butyrophenon-Derivat hinsichlich antipsychotischer Wirksamkeit nicht signifikant, Das negative Untersuchungsergebnis interessiert angesichts so vieler optimistischer Vergleichsuntersuchungen herkömmlicher Methodik — der Optimismus gilt dabei den differentialtherapeutischen Indikationsmöglichkeiten. Den hiesigen Ergebnissen zufolge wird man hinsichtlich unterschiedlicher antipsychotischer Wirksamkeit der Neuroleptika Zurückhaltung üben.
Gefährdung der Dokumentation durch menschliche Unzulänglichkeiten
Authors: Olbhich E.
Published: March 2018

Es wird auf eine Reihe von Irrtumsmöglichkeiten bei der Lochkartendokumentation hingewiesen, Gründe für das Auftreten solcher »Fehler« werden angeführt und Präventivmaßnahmen dagegen vorgeschlagen.
Publication by Grace
Authors: Redmeh Paul
Published: March 2018

GRACE (Graphic Arts Composing Equipment) is a computer photatypesetter used in MEDLARS, a bibliographic publication and retrieval system in operation at the National Library of Medicine in Bethesda, Maryland. MEDLARS objectives in the publication of Index Medicus and other bibliographies required the development of new high speed electronic and opTficSF’equipment to expose film copy for printing. The characteristics and limitations of the GRACE equipment are described in this article. Computer programs and operating procedures used in the production of MEDLARS publications by GRACE are discussed. Operational experience demonstrates that GRACE is a successful application of computer technology to bibliographic publication.
Computer-Based Monitoring and Data Management in Critical Care
Authors: Wiener F. , Weil M. H.
Published: March 2018

A monitoring system which has the dual role of delivering patient care and providing a facility for clinical research requires extensive capabilities for data management, storage, and display. The system developed for the Critical Care Ward in USC's Center for the Critically 111 is described. The patient data file was designed to make maximum use of available space while maintaining flexibility and easy access for data retrieval. The contents of each patient's file is defined by the patient data outline which comprises the first record in his file. The file consists of a series of data summaries each of which combines a set of data elements logically interconnected or measured simultaneously. Disk sectors are allocated to a patient's file as the need arises. The file is concatenated by a series of location pointers. The patient data file is shared by the records of patients being monitored and those recalled from tape for data searches, with the former taking precedence when the available space is limited. The use of the patient data file in clinical research is illustrated and anticipated improvements are discussed.
Nichtparametrischer Nachweis von homeo- und heteropoetischen Behandlungswirkungen in geschichteten Uberkreuzungsplänen
Authors: Lienert G. A.
Published: March 2018

Es werden zwei niclitparametrische Tests empfohlen, um zwei verschiedene Typen von Behandlmigswirkungen in stratifizierten Patienten-Stichproben nachzuweisen. Die Tests basieren auf Überkreuzungsplänen, in welchen jeder Patient daraufhin beurteilt wird, ob er besser auf eine neue als auf eine Standardbehandlung angesprochen hat. Reagieren die Patienten aller Schichten in gleicher Weise, wird eine homeopoetische Beliandhmgswirkung nachgewiesen; reagieren sie jedoch je nach Schichtzugehörigkeit imterschiedlich, wird eine heteropoetische Wirkung nachgewiesen. Die x2-Versionen der beiden Tests und das auf sie gründende Entscheidungsverfahren werden an einem numerischen Beispiel aus der Psychopharmakologie illustriert.
The Computerization of Histopathological Data in Toxicological Laboratory Studies Using SNOP
Authors: Naylor D. C.
Published: March 2018

A computerized system, based on the Systematized Nomenclature of Pathology (SNOP), for the recording, storage and retrieval of histopathological findings in animal toxicity studies, is described. The system is novel in that every diagnostic term used is given a precise definition agreed upon by the pathologists concerned, and which can be revised whenever necessary. It has resulted in standardization of terminology, greater speed in association with improved accuracy and presentation of reports, and the establishment of a data bank from which in-house values can be readily retrieved. Finally, it has led to an enormous saving hi the time of both pathologists and secretaries.