bluuebunny/crossref_metadata_2025 huggingface dataset:
ICD90CM Claims Data are Insufficient for Influenza Surveillance
Authors: Elkin Peter L.  , Brown Steven H.
Published: February 2025

Influenza and Influenza like illness are representative of a class of epidemic infectious diseases that have important public health implications. Early detection via Biosurveillance can speed life saving public heath responses. In the United States Biosurveillance is typically conducted using ICD9 coded visit diagnoses and uncoded chief complaint data. To determine the accuracy of ICD9 diagnoses using laboratory confirmed cases as the gold standard. We determined the sensitivity and specificity of ICD9 in detecting laboratory confirmed vs unconfirmed Influenza. ICD9-CM had a low 66.2% Positive Predictive Value (precision) for Influenza and a low 45.6% Sensitivity (recall) for Influenza. ICD9-CM proved insufficient alone for use in biosurveillance.
Quality Assurance of LOINC Mapping for Laboratory Tests – A Local Experience with People, Process and Technology
Authors: Mok John  , Ho Ping-Chong  , Tsui Kent  , Ng Louis  , Fung Vicky
Published: February 2025

In Hong Kong Hospital Authority (HA), the Electronic Patient Record (ePR) module of Clinical Management System, implemented since 2003, bring together all the information from various clinical module and hospitals into a single corporate wide, longitudinal, integrated record. Nowadays there are billions of laboratory test results stored in the web-based ePR where laboratory results being shared with the HA clinicians for patient care. In order to produce interoperable laboratory data in the ePR, the HA adopts LOINC (Logical Observation Identifiers Names and Codes) as the reference standard for laboratory tests. Every local test codes have been mapped with LOINC code where possible. Thus, the accuracy of LOINC mapping for laboratory tests in the HA is imperative. This paper describes a quality assurance program of LOINC mapping for laboratory tests conducted in 2011/12. With the use of right people, right process and right technology, we reviewed over 28,000 local test codes and there are around 2,400 distinct LOINC concepts mapped and defined in the system.
Composite Quality of Care Scores, Electronic Health Record Maturity Models, and their Associations; Preliminary Literature Review Results
Authors: Joukes Erik  , de Keizer Nicolette  , Cornet Ronald
Published: February 2025

To accurately assess the association between the use of EHR systems and the quality of healthcare we need (composite) measures for quality of healthcare, and a model to measure the maturity of the EHR. This Medline-based literature study therefore focussed on three topics; (1) methods to compose a measure for quality of care based on individual quality indicators (QI), (2) models to measure EHR maturity, and (3) the association between the former two. Composite quality is most often measured using opportunity-based scores, maturity is measured in functionalities or levels. EHR maturity measures are not used extensively in biomedical literature. Most studies found a positive association between EHR use and the quality of care but almost none of them differentiate in maturity of EHR which hampers firm conclusions about this relation.
A Qualitative Model for Physiology: Apart from Function and Abnormality
Authors: Shinohara Emiko Y.  , Tatsukawa Akimichi  , Kawazoe Yoshimasa  , Imai Takeshi  , Ohe Kazuhiko
Published: February 2025

Physiological knowledge is often described in terms of mathematical models in the domain of bioinformatics, and some ontologies have been developed to integrate these models. However, such models do not explicitly describe clinicians' qualitative knowledge, which is required for clinical applications including decision support and counseling of patients to help them understand their clinical situation. This paper proposes a description framework for a qualitative and context-independent ontology of physiology, QliP, which has three features: 1) It models physiological knowledge qualitatively without mathematical knowledge; 2) The described knowledge is independent of surrounding anatomical entities and abnormality; and 3) It targets physiological components in varying degrees of granularity, from cells to organ systems. An ontology based on this proposed model enables automatic generation of a physiological state transition, starting and ending with a given state.
Monitoring Physicians' Prescription Patterns on Electronic Health Record: The Prescription Pattern around Clinical Event (PACE) Algorithm
Authors: Yoon Dukyong  , Park Inwhee  , Park Man Young  , Hong Seung Kwon  , Park Rae Woong
Published: February 2025

Electronic health records (EHRs) have gained attention as a valuable data source for medical research, as its adoption rate continues to rise. However, no method for the monitoring of physicians' prescription patterns has been established. Since EHR maintain all prescription data as well as clinical events that occur during the care of patients, we hypothesized that a physician's prescription pattern can be monitored from EHR. In this study, we developed a novel algorithm named PACE, Prescription pattern Around Clinical Event. This algorithm analyzes distribution of the prescription of specific drugs around the time of a clinical event. In the proof of concept study, prescription changes with regard to hyperkalemia were well represented by the algorithm, and the observed patterns well correlated with the physician's knowledge on hyperkalemia (Cohen's kappa, 0.457–0.653). We expect that this algorithm can be used to monitor the guideline adherence of physicians.
Promoting Health Informatics for Multidisciplinary Education in Patient Safety: A Master Course Program in Japan
Authors: Zhang Qiyan  , Takeda Hiroshi
Published: February 2025

Patient safety topics have been widely presented in undergraduate medical education. Some graduate programs have been developed in North America and typically focused on culture and cognitive factors. The Institute of Medicine (IOM)'s report-Health IT and Patient Safety: Building Safer Systems for Better Care addressed important issues that health IT can lead to safer care as well as introduce new risks. There is an increased need to include such topics in safety education programs. In this study, we aimed at reporting our approach regarding the promotion of health informatics as a core curriculum in a master course program. We compared our curriculum with those in recently published papers and major patient safety resources. Then, we conducted an interim survey by asking the first-year students to rate eight important patient safety topics in comparison with the AHRQ's published categories. Health Information Technology (HIT) was ranked as the most interesting topic (response rate was 100%, n=44).Our initiatives would be useful to establish a stronger link between patient safety informatics education and future HIT adoptions.
Development of a System for Transferring Images via a Network: Supporting a Regional Liaison
Authors: Mihara Naoki  , Manabe Shiro  , Takeda Toshihiro  , Shinichirou Kitamura  , Junichi Murakami  , Kouji Kiso  , Matsumura Yasushi
Published: February 2025

We developed a system that transfers images via network and started using them in our hospital's PACS (Picture Archiving and Communication Systems) in 2006. We are pleased to report that the system has been re-developed and has been running so that there will be a regional liaison in the future. It has become possible to automatically transfer images simply by selecting the destination hospital that is registered in advance at the relay server. The gateway of this system can send images to a multi-center, relay management server, which receives the images and resends them. This system has the potential to be useful for image exchange, and to serve as a regional medical liaison.
Data Governance Frameworks and Change Management
Authors: Egelstaff Richard  , Wells Marilyn
Published: February 2025

Protecting and preserving data stored in electronic form is important, and ensuring that data is available to the correct access level requires consideration of the characteristics of the data and the purpose to which the data will be used. Important questions therefore are raised about what is the right data and who has the right access level. This is the substance of data governance. This paper will discuss the various aspects of data governance frameworks as it pertains to health care systems. The paper will also explore the changes that confront organisations and individuals as they embrace the requirements of data governance.
The Health Informatics Professions
Authors: Grain Heather  , Coote Gaida Anna
Published: February 2025

This chapter identifies the skills, professional challenges and changes needed for health and IT workforce development, to support a team based integrated approach to the development and implementation of successful, cost effective, safe systems in healthcare. This requires an attitude which embraces change and breaks down existing hierarchical structures and responsibilities by recognising the need for different and extended knowledge and skills within each professional area and within any organisational workforce composition.
Impact of Data Governance on a Nation's Healthcare System Building Blocks
Authors: Hovenga Evelyn J.S.
Published: February 2025

This chapter gives an overview of a nation's healthcare system, particularly for those who are familiar with IT but not healthcare or for those working in one area of healthcare who may not be familiar with the system and data requirements across the care continuum. The structure of this chapter uses the World Health Organisation's (WHO) Health systems framework with a focus on the need for data and information governance to achieve a sustainable health system delivering improved health for all, responsively and equitably meeting genuine demands for health services, with social and financial risk protection and overall improved efficiency. It is argued that there is a need to gather the right data and to process these data in a manner that provides good information in order to more fully understand how the health system is working and where and when it isn't working well. This needs to be achieved in the most cost effective manner that doesn't detract from the allocation of resources to healthcare or the clinical workflow required to achieve quality healthcare.
Casemix Systems and Their Applications
Authors: Reid Beth
Published: February 2025

Casemix systems are used in many countries around the world. The reasons for the popularity of casemix systems will be clear once their design features and applications are explained. The specific design issues for acute and other health care settings are discussed, along with their application to paying for care, utilisation review, quality assurance and clinical governance. The quality of the data is important to the integrity of these systems, and the chapter closes with a discussion of the causes of errors in the data and how the quality can be improved.
Sociotechnical Systems as Innovation Systems in the Medical and Health Domain
Authors: Lindgren Helena
Published: February 2025

It is argued that a development of healthcare systems should emerge within a healthcare providing organization and as part of daily practice instead of something implemented by a third party, in order to become successful. This sociotechnical view on system development is shared with new methods developed in the end-user development field. However, is it possible to realize this in practice? This paper explores the obstacles and potentials in the realization, leading to a discussion about sociotechnical systems as innovation systems. We describe two examples of sociotechnical innovation systems, and discuss the results from an end user driven innovation process perspective.
Clinical handover improvement in context: Exploring tensions between user-centred approaches and standardisation
Authors: Wong Ming Chao  , Turner Paul  , Yee Kwang Chien
Published: February 2025

User-centred approaches in the development and evaluation of health information systems promote the importance of involving users and understanding their social contexts to optimise the quality and safety of these systems for patient care. Simultaneously, the standardisation of clinical practices has also been advocated to improve the quality and safety of patient care. In the context of clinical handover improvement within three different departments in one tertiary teaching hospital, this paper highlights the potential for tensions between these two approaches and explores their implications. Based on a user-centred approach, the paper reports on the unique requirements identified within each of the three departments for an information system to support improved clinical handover. Each department had clinical practices, work cultures and user requirements that needed to be considered and accommodated. This led to the project developing distinct minimum data sets for each of the three departments that posed challenges for efforts to standardise handover practices across the hospital and for building an integrated information system. While on the one hand accommodating unique departmental user requirements was valuable, they revealed the potential for the introduction of quality and safety risks at the organisational level. To resolve these tensions, the project team developed an approach called flexible standardisation that has now been embedded in Australia' s national guidelines on clinical handover improvement.
Modelling the spatial characteristics of a lingnan water town against the background of globalization: The case of Shunde
Authors: Liu Yao
Published: February 2025

With increasing globalization, the key to competition between cities can actually be found in their environmental qualities and cultural resources. Due to its poor image, Shunde occupies a low position in the urban network of the Pearl River Delta and is unable to attract manufacturers and high-income consumers. This paper aims to make spatial characteristics the starting point of a quest to improve the urban and rural image of Shunde by combining cultural elements and spatial elements, shaping the characteristics of the water environment, and highlighting the differences between urban and rural space.
Virtual Laparoscopic Surgical Skills Practice Using a Multi-Degree of Freedom Joystick
Authors: Huang Chun-Kai  , Head Michael J.  , Nelson Carl A.  , Oleynikov Dmitry  , Siu Ka-Chun
Published: February 2025

The objective of this study was to compare three different surgical skills practice environments while performing a virtual laparoscopic surgical training task using a multi-degree of freedom joystick, a commercial manipulator or a training box. Nine subjects performed a virtual peg transfer task and their upper extremity muscle effort and fatigue were measured. The results demonstrated a similar muscle effort and fatigue of the upper extremity among the three training environments. Subjects with medical backgrounds used significantly higher muscle effort when they performed the training task using the joystick than the manipulator, but used similar muscle effort between the joystick and the training box. This study suggests that the multi-degree of freedom joystick could provide more options to practice virtual laparoscopic surgical training tasks with muscle effort and fatigue similar to other traditional training boxes.
Application of a New Adaptable Thyroid Model for Ultrasound and Hands-On Skill Assessment
Authors: Kwan Calvin  , Cohen Elaine  , Pugh Carla
Published: February 2025

The thyroid exam is an important clinical skill that is widely practiced by both primary care and specialty physicians. Despite this, there are few teaching models that allow for practice and assessment of proper examination technique. We developed a sensorized thyroid exam model and accompanying survey to capture clinical decision making and hands-on performance. Two endocrinologists performed the thyroid exam on the models. There was verbal consensus on clinical findings; however estimates on thyroid properties and size differed. Additional experiments with an ultrasound provided feedback on use of the model for hands-on and ultrasound-based examinations.
Computation and Visualization of Risk Assessment in Deep Brain Stimulation Planning
Authors: Bilger Alexandre  , Duriez Christian  , Cotin Stéphane
Published: February 2025

Deep Brain Stimulation is aneurosurgical approach for the treatment of pathologies such as Parkinson's disease. The basic principle consists in placing a thin electrode in a deep part of the brain. To safely reach the target of interest, careful planning must be performed to ensure that no vital structure (e.g. blood vessel) will be damaged during the insertion of the electrode. Currently this planning phase is done without considering the brain shift, which occurs during the surgery once the skull is open, leading to increased risks of complications. In this paper, we propose a method to compute the motion of anatomical structures induced by the brain shift. This computation is based on a biomechanical model of the brain and the cerebro-spinal fluid. We then visualize in a intuitive way the risk of damaging vital structures with the electrode.
Development of a Tele-Anesthesia Preoperative Clinic to Support Distant Military Treatment Facilities for the European Regional Medical Command
Authors: Turabi Ali  , Nessen Shawn C.  , Boedeker David  , Boedeker Ben
Published: February 2025

Landstuhl Regional Medical Center (LRMC) provides primary care services for more than 65,000 beneficiaries and specialty care and hospitalization for 245,000 U.S. Service Members and their Families serving in Europe. These personnel are located in Germany, Italy and Belgium (See Fig 1). Anesthesia preoperative diagnosis/work was done by telemedicine at the distant, end user site, and significant cost savings and enhanced patient service was accomplished. A novel use of existing technologies was implemented to enhance provider and patient satisfaction and create a sustainable, user friendly system.
Routine Data for Disease Surveillance in the Undeveloped Region of the OR Tambo District of the Eastern Cape Province
Authors: Kabuya Chrispin  , Wright Graham  , Odama Anthony  , O'Mahoney Don
Published: February 2025

The research team needed to upsize the solution previously tested so that it could expand the routine data collected via tablet computers. The research team identified the general flow of data within clinics. Data was mainly collected from registers, which were later converted to electronic form and checked for duplication. A database was designed for the collection of demographic data (Patient Master Index), which was aimed at eliminating duplication of patients' data in several registers. Open Data Kit (ODK) Collect was setup on Android tablets for collecting disease related routine data, while ODK Aggregate as the storage and aggregates of data captured by ODK Collect and the Patient Master Index for demographic data, were setup on an Apple Mini Mac server. Data collection is in progress. The expected results include improved data quality, reliability and quick access to summary data. Secondly, instant retrieval of patient demographic details and clinic numbers are included. Thirdly, ability to form standard reporting from the SQL database and lastly exporting data into the TIER.net and DHIS systems via CVS files thus eliminating the need for data capturers are shown.
Ontologies to capture Adverse Events Following Immunisation (AEFI) from real world health data
Authors: Liyanage Harshana  , de Lusignan Simon
Published: February 2025

Immunisation is an important part of health care and adverse events following immunisation (AEFI) are relatively rare. AEFI can be detected through long term follow up of a cohort or from looking for signals from real world, routine data; from different health systems using a variety of clinical coding systems. Mapping these is a challenging aspect of integrating data across borders. Ontological representations of clinical concepts provide a method to map similar concepts, in this case AEFI across different coding systems. We describe a method using ontologies to be flag definite, probable or possible cases. We use Guillain-Barre syndrome (GBS) as an AEFI to illustrate this method, and the Brighton collaboration's case definition of GBS as the gold standard. Our method can be used to flag definite, probable or possible cases of GBS. Whilst there has been much research into the use of ontologies in immunisation these have focussed on database interrogation; where ours looks to identify varying signal strength.
Using the EC Decision on Case Definitions for Communicable Diseases as a Terminology Source - Lessons Learned
Authors: Balkanyi Laszlo  , Heja Gergely  , Nagy Attlia
Published: February 2025

Extracting scientifically accurate terminology from an EU public health regulation is part of the knowledge engineering work at the European Centre for Disease Prevention and Control (ECDC). ECDC operates information systems at the crossroads of many areas – posing a challenge for transparency and consistency. Semantic interoperability is based on the Terminology Server (TS). TS value sets (structured vocabularies) describe shared domains as “diseases”, “organisms”, “public health terms”, “geo-entities” “organizations” and “administrative terms” and others. We extracted information from the relevant EC Implementing Decision on case definitions for reporting communicable diseases, listing 53 notifiable infectious diseases, containing clinical, diagnostic, laboratory and epidemiological criteria. We performed a consistency check; a simplification – abstraction; we represented lab criteria in triplets: as ‘y’ procedural result /of ‘x’ organism-substance/on ‘z’ specimen and identified negations. The resulting new case definition value set represents the various formalized criteria, meanwhile the existing disease value set has been extended, new signs and symptoms were added. New organisms enriched the organism value set. Other new categories have been added to the public health value set, as transmission modes; substances; specimens and procedures. We identified problem areas, as (a) some classification error(s); (b) inconsistent granularity of conditions; (c) seemingly nonsense criteria, medical trivialities; (d) possible logical errors, (e) seemingly factual errors that might be phrasing errors. We think our hypothesis regarding room for possible improvements is valid: there are some open issues and a further improved legal text might lead to more precise epidemiologic data collection. It has to be noted that formal representation for automatic classification of cases was out of scope, such a task would require other formalism, as e.g. those used by rule-based decision support systems.
Automated Detection of Ambiguity in BI-RADS Assessment Categories in Mammography Reports
Authors: Bozkurt Selen  , Rubin Daniel
Published: February 2025

An unsolved challenge in biomedical natural language processing (NLP) is detecting ambiguities in the reports that can help physicians to improve report clarity. Our goal was to develop NLP methods to tackle the challenges of identifying ambiguous descriptions of the laterality of BI-RADS Final Assessment Categories in mammography radiology reports. We developed a text processing system that uses a BI-RADS ontology we built as a knowledge source for automatic annotation of the entities in mammography reports relevant to this problem. We used the GATE NLP toolkit and developed customized processing resources for report segmentation, named entity recognition, and detection of mismatches between BI-RADS Final Assessment Categories and mammogram laterality. Our system detected 55 mismatched cases in 190 reports and the accuracy rate was 81%. We conclude that such NLP techniques can detect ambiguities in mammography reports and may reduce discrepancy and variability in reporting.
Preclinical tests of an Android Based Dietary Logging Application
Authors: Kósa István  , Vassányi István  , Pintér Balázs  , Nemes Márta  , Kámánné Krisztina  , Kohut László
Published: February 2025

The paper describes the first, preclinical evaluation of a dietary logging application developed at the University of Pannonia, Hungary. The mobile user interface is briefly introduced. The three evaluation phases examined the completeness and contents of the dietary database and the time expenditure of the mobile based diet logging procedure. The results show that although there are substantial individual differences between various dietary databases, the expectable difference with respect to nutrient contents is below 10% on typical institutional menu list. Another important finding is that the time needed to record the meals can be reduced to about 3 minutes daily especially if the user uses set-based search. Conclusion: a well designed user interface on a mobile device is a viable and reliable way for a personalized lifestyle support service.
Combined Model for Diabetes Lifestyle Support
Authors: Gyuk Peter  , Szabo Istvan  , Vassanyi Istvan  , Kosa Istvan  , Kovacs Levente
Published: February 2025

Treatment of diabetes mellitus is a public health related problem of modern healthcare. Surveys show that current methods to estimate the required amount of insulin are quite inefficient in practice as they are based on experience. This paper offers a new approach to predict the glucose level of people with diabetes. It combines two efficient models of the literature: one for nutrient absorption and one for glucose control. The combination of them tracks the blood sugar level considering nutrition composition, applied insulin and initial glucose level. Compared to already existing mixed meal models, the current version takes into account a more detailed nutrition composition (protein, lipid, monosaccharide, fiber and starch) supported by our expert dietary systems. Although the model gives satisfactory results even with parameter sets taken from literature, parameter training by genetic algorithms yields a better tracking of the patients.
The Internet of Things for Personalized Health
Authors: Schreier Günter
Published: February 2025

Advances in information and communications technologies (ICT) enable new personalized health care concepts which are often characterized by four “P” terms, i.e. personalized, predictive, preventive and participatory. However, real world implementations of the complete 4P spectrum hardly exist today. The Internet of Things (IoT) has been defined as an extension to the current Internet that enables pervasive communication between the physical and the virtual world. Smart devices and enabling elements like Near Field Communication (NFC) and Radio Frequency Identification (RFID) technology already exist and increasingly will be a mainstream element of our lives. This future vision paper attempts to assess if and how the Internet of Things for personalized health (IoT4pH) can help to facilitate the 4P healthcare paradigm and discusses related challenges and opportunities.
Towards the Automated Generation of Expert Profiles for Rare Diseases through Bibliometric Analysis
Authors: Pflugrad Andreas  , Jurkat-Rott Karin  , Lehmann-Horn Frank  , Bernauer Jochen
Published: February 2025

For patients suffering from rare diseases it is often hard to find an expert clinician. Existing registries rely on manual registration procedures and cannot easily be kept up to date. A prototype data collection system for discovering experts on rare diseases using MEDLINE has been successfully deployed. Initial manual analyses demonstrate proof of concept and deliver promising results. Examining the associations between authors, diseases and MeSH-Terms is expected to open up a variety of possibilities beyond expert discovery.
LUMOR: An App for Standardized Control and Monitoring of a Porcine Lung and its Nutrient Cycle
Authors: Lenz Gregor  , Frohner Matthias  , Sauermann Stefan  , Forjan Mathias
Published: February 2025

The outcome of the EU-funded project ElBik has been the lung simulator ‘iLung’, which imitates an actively breathing human lung with a porcine lung. In order to keep the explanted lung in a nearly physiological state during transportation from the slaughterhouse to the ventilation laboratory the tissue needs to be nourished and temperature controlled. The Project AlveoPic designs a mobile transport vehicle implementing an ISO/IEEE 11073-20601 compliant communication interface for the exchange of the physical parameters, alert messages and setpoint-values. An appropriate 11073 domain information model is designed and limitations of the defined services and attributes are identified. For monitoring purposes the Android App LUMOR is implemented providing a user with an easy-to-handle GUI. It was found, that alert capabilities and remote set features are not well supported in ISO/IEEE 11073-20601 at the moment and possible workarounds are discussed.
Cognitive Assessment of Stroke Patients with Mobile Apps: A Controlled Study
Authors: Oliveira Jorge  , Gamito Pedro  , Morais Diogo  , Brito Rodrigo  , Lopes Paulo  , Norberto Lucia
Published: February 2025

Stroke is a major cause of cognitive impairments. New technologies such as virtual reality and mobile apps have opened up new possibilities of neuropsychological assessment and intervention. This paper reports a controlled study assessing cognitive functioning through a mobile virtual reality application. Fifteen stroke patients recruited from a rehabilitation hospital and 15 healthy control subjects underwent neuropsychological evaluation with traditional paper-and-pencil tests as well as with a pilot version of the Systemic Lisbon Battery (SLB). The criterion validity was the performance of stroke patients vs. healthy controls – which was lower both on the neuropsychological tests and on the SLB for patients. The pattern of correlations between neuropsychological tests and the SLB sub-tests for the respective dimensions showed overall moderate correlations in the predicted directions. We conclude that the SLB applications were able to discriminate the dimensions that they were designed to assess.
Validation of VR-based Software for Binge Eating Treatment: Preliminary Data
Authors: Ferrer-Garcia Marta  , Gutiérrez-Maldonado José  , Agliaro-López Mario  , Lobera-Espi Xantal  , Pla Joana  , Vilalta-Abella Ferran
Published: February 2025

This study shows preliminary data on the validity of a new virtual reality-based application for cue-exposure treatment of binge eating in bulimia nervosa and binge eating disorder. Thirty-eight undergraduate students without eating disorders were exposed to several virtual environments with different foods in four different contexts (kitchen, dining-room, bedroom, and bakery/café). Participants were asked to indicate the level of food craving experienced in each situation. They also completed the Spanish version of the State and Trait Food Cravings Questionnaires. The results suggest that virtual reality is an effective technology for eliciting food craving, especially in the case of participants with high reactivity to food cues, and those who were hungry or experienced strong desire to eat during the experiment.
Virtual Humans and Formative Assessment to Train Diagnostic Skills in Bulimia Nervosa
Authors: Gutiérrez-Maldonado José  , Ferrer-Garcia Marta  , Pla Joana  , Andrés-Pueyo Antonio
Published: February 2025

Carrying out a diagnostic interview requires skills that need to be taught in a controlled environment. Virtual Reality (VR) environments are increasingly used in the training of professionals, as they offer the most realistic alternative while not requiring students to face situations for which they are yet unprepared. The results of the training of diagnostic skills can also be generalized to any other situation in which effective communication skills play a major role. Our aim with this study has been to develop a procedure of formative assessment in order to increment the effectiveness of virtual learning simulation systems and then to assess their efficacy.
Shared service components infrastructure for enriching electronic publications with online reading and full-text search
Authors: Houssos Nikos  , Stathopoulos Panagiotis  , Stathopoulou Ioanna-Ourania  , Kalaitzis Andreas  , Soumplis Alexandros
Published: February 2025

A major requirement for electronic publishing systems is the availability of rich and intuitive mechanisms that enhance the user experience of viewing and searching online electronic documents such as books, monographs and journal papers. This work concerns a set of infrastructural components and their utilization for the creation of related coherent services and features for end users. We present a set of sophisticated platforms, tools and mechanisms that have been employed in real-life cases for implementing document viewing and full-text search features, shared among application instances of various types. Challenges encountered and the provided solutions are discussed.
Toward an Integrated Health Data Display for Aging in Place
Authors: Gong Yang  , Chandra Arpita  , Wang Jing
Published: February 2025

In a typical aging-in-place setting, electronic medical record, telemedicine data, and sensor data are used by different groups of decision makers, but the data may not be viewed in a holistic display to promote clinical decision making. Employing a user-centered design and evaluation framework, we analyzed relational data displays of congestive heart failure and provided an in-depth description of user characteristics, preferences, systems functionality, basic tasks and effective representations in such an information distributed setting. As a result, the prototypical design demonstrates our effort toward an integrated data display for chronic disease management in long-term care and clinical decision support which would enhance aging in place.
The Use of Standardized Terminology to Represent Nursing Knowledge: Nursing Interventions relevant to Safety for Patients with Cancer
Authors: Tseng Huichen  , Moorhead Sue
Published: February 2025

The study is to represent knowledge by identifying frequently used nursing interventions in term of standardized nursing terminology (SNT) in the Electronic Health Records (EHRs) relevant to Safety for Patients with Cancer. We include 2,237 patients and found 11,804 nursing interventions in total. There are 100 identical interventions in the study. We identify eleven nursing interventions from four oncology units over 7 month observation. For the most four frequent nursing interventions (Fall Prevention, Infection Control, Infection Protection, and Pressure Management), we also report the mean of age, the mean of length of stay, and their frequency of outcome rating , outcome rating at admission and at discharge that link to outcome. These studies demonstrate the strengths of SNT in clinical practice. The findings are valuable to clinical practice, education and future research.
mHealth Data Collector: An Application to Collect and Report Indicators for Assessment of Cardiometabolic Risk
Authors: Shishido Henrique Yoshikazu  , Alves da Cruz de Andrade Ricardo  , Eler Gabrielle Jacklin
Published: February 2025

Traditional population surveys use paper forms that are filled manually by an interviewer. This process can take a long time; in comparison, computerizing the process reduces time, promotes safety and accuracy of data, improves patient care, and offers better control over the compiled information. From this perspective, it can be argued that mobile health supports mechanisms for the diagnosis, control, and prevention of metabolic diseases. In recent years, mobile devices have been applied in several health areas, such as remote monitoring, data logging, clinical decision-making, and with applications that can help maintain or initiate practices beneficial to individual health and wellbeing. However, there is a lack of applications for conducting population surveys. Thus, this work presents an application called mHealth Data Collector (mHDC) as a model for applications used in population surveys that contain such data as Body Mass Index (BMI), health-related issues, and health habit indicators. The design of this system occurred through interviews with health professionals who utilized a prototyping method to extract requirements. To develop this mobile app, the Android platform was adopted and the SQLite database was used to store patients' health data. The JExcelAPI and AchartEngine were also employed to generate spreadsheets and charts. The mHDC was tested using a case study in a Brazilian city. The results indicated that the health team took half the time to interview patients. In addition, the system has reduced the use of paper; centered and organized data; and allowed quick data recovery and standardization to improve the readability of data input. The mHDC proved efficient at collecting, analyzing, and safely exporting the results, thus reducing time collecting and analyzing the population survey.
A Cloud Computing Based Platform for Sleep Behavior and Chronic Diseases Collaborative Research
Authors: Kuo Mu-Hsing  , Borycki Elizabeth  , Kushniruk Andre  , Huang Yueh-Min  , Hung Shu-Hui
Published: February 2025

The objective of this study is to propose a Cloud Computing based platform for sleep behavior and chronic disease collaborative research. The platform consists of two main components: (1) a sensing bed sheet with textile sensors to automatically record patient's sleep behaviors and vital signs, and (2) a service-oriented cloud computing architecture (SOCCA) that provides a data repository and allows for sharing and analysis of collected data. Also, we describe our systematic approach to implementing the SOCCA. We believe that the new cloud-based platform can provide nurse and other health professional researchers located in differing geographic locations with a cost effective, flexible, secure and privacy-preserved research environment.
EMR Database Upgrade from MUMPS to CACHE: Lessons Learned
Authors: Alotaibi Abduallah  , Emshary Mshary  , Househ Mowafa
Published: February 2025

Over the past few years, Saudi hospitals have been implementing and upgrading Electronic Medical Record Systems (EMRs) to ensure secure data transfer and exchange between EMRs.This paper focuses on the process and lessons learned in upgrading the MUMPS database to a the newer Caché database to ensure the integrity of electronic data transfer within a local Saudi hospital. This paper examines the steps taken by the departments concerned, their action plans and how the change process was managed. Results show that user satisfaction was achieved after the upgrade was completed. The system was stable and offered better healthcare quality to patients as a result of the data exchange. Hardware infrastructure upgrades improved scalability and software upgrades to Caché improved stability. The overall performance was enhanced and new functions were added (CPOE) during the upgrades. The essons learned were: 1) Involve higher management; 2) Research multiple solutions available in the market; 3) Plan for a variety of implementation scenarios.
Mapping Biomedical Vocabularies: A Semi-Automated Term Matching Approach
Authors: Ofoghi Bahadorreza  , Lopez-Campos Guillermo H.  , Martin Sanchez Fernando Jose  , Verspoor Karin
Published: February 2025

Biomedical vocabularies vary in scope, and it is often necessary to utilize multiple vocabularies simultaneously in order to cover the full range of concepts relevant to a given biomedical application. However, as the number and size of these resources grow both redundancy (i.e., different vocabularies containing similar terms) and inconsistency (i.e., different terms in multiple vocabularies referring to the same entity) between the vocabularies increase. Therefore, there is a need for automatically aligning vocabularies. In this paper, we explore and propose new methods for detecting probable matches between two vocabularies. The methods build upon existing string similarity functions, enhancing these functions for the context of semi-automated vocabulary matching.
Are Web-based Surveys the New Epidemiological Mode For Healthcare Research? - The Saudi Perspective
Authors: Bahkali Salwa  , Almaiman Ahmad  , Al-Nasser Lubna  , Elmetwally Ashraf  , Househ Mowafa
Published: February 2025

Web-based surveys (WBS) are gaining popularity as simple, cost-effective and rapid tools for data collection in healthcare research. The purpose of this exploratory study is to summarize the role of website-based survey (WBS) in gathering data for epidemiological research and review challenges facing WBSs in healthcare research. Electronic search in related literature for advantages, characteristics and performance of WBS was conducted. Special focus was placed on WBSs use in the Saudi context. The results indicated that WBSs are being employed increasingly in Healthcare research because of their accessibility, rapidity, reduced cost, less need for human resources and elimination of human errors. However, Paper-based surveys still possess higher response rates, accuracy and are more applicable for probability-sampling methods. Selection bias favoring young, educated and professional participants is associated with WBSs. Most Saudi studies sampled either healthcare professionals or students as the target population. Challenges specific to WBSs include: accessibility, representativeness of sampled population and multiple responses/unintended participants. Although WBSs do appear to be a contemporary alternative to traditional paper-based survey tools, more research is needed to optimize their applicability in different cultural contexts and for diverse pools of participants.
The Impact of Software Quality Characteristics on Healthcare Outcome: A Literature Review
Authors: Aghazadeh Sakineh  , Pirnejad Habibollah  , Moradkhani Alireza  , Aliev Alvosat
Published: February 2025

The aim of this study was to discover the effect of software quality characteristics on healthcare quality and efficiency indicators. Through a systematic literature review, we selected and analyzed 37 original research papers to investigate the impact of the software indicators (coming from the standard ISO 9126 quality characteristics and sub-characteristics) on some of healthcare important outcome indicators and finally ranked these software indicators. The results showed that the software characteristics usability, reliability and efficiency were mostly favored in the studies, indicating their importance. On the other hand, user satisfaction, quality of patient care, clinical workflow efficiency, providers' communication and information exchange, patient satisfaction and care costs were among the healthcare outcome indicators frequently evaluated in relation to the mentioned software characteristics. Regression Logistic Method was the most common assessment methodology, and Confirmatory Factor Analysis and Structural Equation Modeling were performed to test the structural model's fit. The software characteristics were considered to impact the healthcare outcome indicators through other intermediate factors (variables).
Patients' Satisfaction Evaluation with the Health Center of Elis Province
Authors: Karavida Angeliki  , Stamouli Maria-Aggeliki  , Balis Charalampos
Published: February 2025

Patient satisfaction related to the provided health services is a key indicator of the quality of the health sector. The SERVQUAL model was employed as a way of measuring the level of patient satisfaction with the services of the Health Center of Elis Province. Although certain aspects such as “Assurance” and “Empathy” meet the users' needs, improvements like a detailed medical record and an overhaul of the equipment need to be introduced.
Building a Multicenter Telehealth Network to Advance Chronic Disease Management
Authors: Khairat Saif  , Wijesinghe Namal  , Wolfson Julian  , Scott Rob  , Simkus Ray
Published: February 2025

The use of telehealth solutions has proved to improve clinical management of chronic diseases, expand access to healthcare services and clinicians, and reduce healthcare-related costs. The project aims at improving Heart Failure (HF) management through the utilization of a Telemedicine and Personal Health Records systems that will assist HF specialist in Colombo, Sri Lanka to monitor and consult with remote HF patients. A telehealth network will be built at an international site that connects five remote telehealth clinics to a central clinic at a major University Hospital in Sri Lanka where HF specialists are located. In this study, 200 HF patients will be recruited for nine months, 100 patients will be randomly selected for the treatment group and the other 100 will be selected for the control group. Pre, mid, and post study surveys will be conducted to assess the efficacy and satisfaction levels of patients with both care models. Moreover, clinical outcomes will be collected to evaluate the impact of the intervention on the treatment patients compared to control patients. The research aims at enhancing Heart Failure management through eliminating current health challenges and healthcare-related financial burdens.
Mobile Tele-Medicine Systems in the Multidisciplinary Approach of Diabetes Management : The Remote Prevention of Diabetes Complications
Authors: Mammas Constantinos S.  , Geropoulos Spyros  , Markou Georgia  , Saatsakis George  , Lemonidou Chryssa  , Tentolouris Nikolaos
Published: February 2025

Aim: Evaluation of feasibility and reliability of Mobile-Telemedicine Systems (M-TS) in the remote prevention of diabetes related complications. Material and Methods: A feasibility-reliability evaluation based on a simulating experimentation by ten specialists (N=10) who examined a diabetic patient on the electronic space of a mobile experimental telemedicine system (MU-Exp.-TS). Results: I. Remote prevention of diabetic foot and other diabetes related complications is feasible (acceptability: 89-100%). II. Remote ulcer classification and diabetic foot amputation risk estimation: Accuracy=89%. Conclusion: The proposed MU-TS based multidisciplinary approach and prevention of diabetes related complications is feasible while that of diabetic foot is both feasible and reliable.
Deviation based Safety Analysis and Justification of Clinical Services
Authors: Despotou George  , Jones Richard  , Rae Andrew  , White Sean  , Ryan Mark  , Kelly Tim
Published: February 2025

The paper describes safety analysis and justification of a clinical service (accidents and emergencies), using a deviation based approaches
Health of the Elderlies and Healthy Ageing: Challenge for Europe
Authors: Ricciardi Walter  , Specchia Maria Lucia  , Marino Marta
Published: February 2025

Population ageing is a major challenge for European Union (EU) society and economy, particularly for Italy, which is the oldest country in Europe. According to the World Health Organization, two-thirds of European citizens who have reached the retirement age suffer from at least two chronic conditions, with a strong pressure on healthcare systems. Moreover, EU countries already spend, on average, more than a quarter of their gross domestic product on social protection, above all pensions, health and long term care. The current financial crisis is putting a strain on this system. In this context, it becomes increasingly necessary to promote a healthy and independent ageing, by improving outcomes for patients and society while ensuring health systems sustainability. To this purpose a proactive approach to chronic diseases prevention (primary, secondary and tertiary) as well as an integrated healthcare approach and also patients' empowerment are required so as to make daily life more age-friendly. It is also necessary to share health and social best practices, adopt policies really effective against elderly social exclusion and strengthen older people participation in society. A joint effort of all key stakeholders is needed to create a society in which older people can play an active role.