bluuebunny/crossref_metadata_2025 huggingface dataset:
Metadata element set in Quality-Controlled Subject Gateway: a step to a health semantic Web
Authors: Thirion Benoit  , Loosli Gaelle  , Douyère Magaly  , Darmoni Stéfan J.
Published: February 2025

Background: Quality-controlled subject gateways are Internet services which apply a selected set of targeted measures to support systematic resource discovery. Considerable manual effort is used to process a selection of resources which meet quality criteria and to display a extensive description and indexing of these resources with standards-based metadata.Objective: Several metadata element sets are proposed to describe, index and qualify health resources to be included in a French quality-controlled health gateway called CISMeF. The main objectives were to enhance Internet health document retrieval and navigation, and to allow interoperability with other Internet services. Results: The Dublin Core metadata element set is used to describe and index all Internet health resources included in CISMeF. For teaching resources, some elements from IEEE1484 Learning Object Metadata are also used For evidenced-base medicine resources, specific metadata are employed which assess the health content quality. The HIDDEL metadata set is used to enhance transparency, trust and quality of health information on the Internet. Conclusion: Comprehensive metadata element sets can be extremely useful to describe, index and assess health resources on the Internet in a quality-controlled subject gateway. Machine-readable metadata creates an Semantic Web which is more efficient for end-users as compared to the current Web.
Design Considerations for a Personalised Patient Education System
Authors: Doupi Persephone  , van der Lei Johan
Published: February 2025

Patient education is a significant factor in the provision of health care services, contributing to improved disease management and health care outcomes. In order to be most effective, patient education should be adapted to the characteristics of the individual recipient. Computer-based approaches have been explored as a possible means of achieving this goal. The success and capabilities of the resulting applications have been restricted by the absence of a direct link to patient data and the reliance on locally produced written material, which is expensive to produce, update and tailor. In our research project STructured Evaluated Personalized Patient Support (STEPPS), we are investigating the potential of a novel strategy for personalized or tailored patient education, based on the integration of electronic patient record data and material derived from online health information and knowledge resources. In this paper we present an overview of the pertinent technical issues and the way we have addressed them in the context of our development work in the domain of burn care. Further, we discuss how the choices made in the design of the system interrelate with the considerations for its implementation in health care practice settings.
Establishing Health Informatics as a Recognised and Respected Profession in the UK National Health Service
Authors: Millen Di
Published: February 2025

The delivery of healthcare is an information dependent process. National government modernisation targets, and drives to improve the effectiveness and efficiency of care delivery systems and processes have the better use of information and IT at their heart. If we are to realise the benefits information and IT developments can bring, we have to ensure we have a suitable cadre of well educated, proactive professional specialists who understand the business of healthcare. The English NHS has an attrition rate of something like 43% amongst its ICT specialists, and there are recruitment and retention problems in a range of other informatics disciplines like medical records, project management and strategic management.
Monitoring the development and diffusion of EHR systems in Denmark
Authors: Nøhr Christian  , Andersen Stig Kjær  , Vingtoft Søren  , Bernstein Knut  , Rasmussen Morten Bruun
Published: February 2025

The Danish EHR Observatory has monitored Danish EHR projects for several years with respect to a number of parameters such as diffusion, diffusion rate, barriers and limitations, and experience gained The results of the 2002 monitoring reveal that investment in IT is relatively low and the diffusion rate is below the estimated level. The EHR projects gain a lot of valuable experience, but the coordination of evaluation results should be improved.
RESHEN, a Best Practice Approach for Secure Healthcare Networks in Europe
Authors: Georgoulas Aggelos  , Bourka Athena  , Kaliontzoglou Alexandras  , Polemi Nineta  , Koutsouris Dimitris
Published: February 2025

Electronic communication of healthcare related information (in the framework of Regional Healthcare Information Networks), introduces a number of security risks with regard to confidentiality, integrity and availability, which can become quite crucial taking into account its sensitive nature. Public Key Infrastructure (PKI) is acknowledged as an appropriate means for dealing with such risks, as long as all the involved critical factors are first practically assessed. This paper presents a best-practice approach for secure regional healthcare networks in Europe, examining all the identified crucial parameters (technical, organisational, legal/regulatory, medical and business). Our approach is conducted at two levels (the regional and the European), including the integration of PKI-aware security mechanisms (strong authentication, encryption, digital signature, time-stamping) in three regional pilot sites in Greece, Finland and Germany and demonstrating their interconnection in a pan-European architecture. Following the above approach, some major conclusions are excluded, pointing out existing open issues and possible steps forward.
A Communication-Theory Based View on Telemedical Communication
Authors: Schall Thomas  , Roeckelein Wolfgang  , Mohr Markus  , Kampshoff Joerg  , Lange Tim  , Nerlich Michael
Published: February 2025

Communication theory based analysis sheds new light on the use of health telematics. This analysis of structures in electronic medical communication shows communicative structures with special features. Current and evolving telemedical applications are analyzed. The methodology of communicational theory (focusing on linguistic pragmatics) is used to compare it with its conventional counterpart.
Telemedicine in Extreme Environments: Analogs for Space Flight
Authors: Doarn Charles R.
Published: February 2025

The integration of telecommunications and information Systems into health care delivery in human space flight operations is not new. It has been an integral tool for over 45 years. During these past decades, numerous efforts have been conducted to further develop and promulgate telemedicine. The National Aeronautics and Space Administration (NASA) established a commercial space center in 1997, known as the Medical Informatics and Technology Applications Consortium (MITAC). MITAC has developed and conducted a variety of test beds in several international settings, including Russia, Ecuador and other extreme and remote environments. These test beds have been designed to evaluate and validate technologies and techniques that have application in the delivery and support of health care in unique environments. The characteristics of these test beds are analogous to what might be observed or experienced in low earth orbit or on space-based platform. These include intermittent Communications, low bandwidth, level of competency of the front line health worker, etc. These test beds have led to new approaches for the delivery of health care as well as enhanced education. These experiences have been beneficiai in the promulgation of telemedicine as an effective tool and have provided new ideals for space exploration as well terrestrial medicine. This paper will highlight MITAC’s test beds and their relationship to space exploration.
The Korydallos, Greece, Prisons Telemedicine System Experience: Why Technology Alone is Not a Sufficient Condition
Authors: Anogeianaki Antonia  , Anogianakis George  , Ilonidis George  , Milliaras Spyros
Published: February 2025

In 1999 the Greek Ministry of Justice decided to utilise telemedicine to improve health services in the largest prison in Greece (Korydallos Prison). The Nikea Hospital in Piraeus undertook to support the effort. For 12 months following installation, intensive “hands-on” training on the use of the system was offered to the staff of both the Korydallos Prison and the Nikea Hospital. However serious operational problems related either to prison bureaucracy or to the inflexibility the Greek National Health Service has annulled the effectiveness of the Korydallos Prison telemedicine system. Still, analysis of the system development history reveals that: (1) if freed from bureaucratic and labour related obstacles, prison telemedicine is a viable option. (2) Telemedicine can avert transfers to out-of-prison medical facilities. (3) 1f properly implemented, telemedicine can generate substantial savings and (4) telemedicine can greatly improve the quality of care available to prisoners.
Visualization of the variability of 3D statistical shape models by animation
Authors: Lamecker Hans  , Seebaß Martin  , Lange Thomas  , Hege Hans-Christian  , Deuflhard Peter
Published: February 2025

Models of the 3D shape of anatomical objects and the knowledge about their statistical variability are of great benefit in many computer assisted medical applications like images analysis, therapy or surgery planning. Statistical model of shapes have successfully been applied to automate the task of image segmentation. The generation of 3D statistical shape models requires the identification of corresponding points on two shapes. This remains a difficult problem, especially for shapes of complicated topology. In order to interpret and validate variations encoded in a statistical shape model, visual inspection is of great importance. This work describes the generation and interpretation of statistical shape models of the liver and the pelvic bone.
A Sensorized Human Torso Phantom
Authors: Riener Robert  , Sae-Kee Bundit  , Frey Martin  , Burgkart Rainer
Published: February 2025

Force-torque measuring input devices can significantly enhance the performance of classical simulation environments that are, for example, based on pure passive phantoms. Such devices allow not only the determination of force/torque amplitude and direction but also the contact point on the phantom. The force/torque information can be displayed visually or acoustically, drive a realistic graphical animation environment or it can be saved and compared with a haptic library comprising the force/torque history of any medical specialist. In this paper the technical principle is exemplified by an interactive human torso. A plastic phantom model of a human torso is instrumented with a 6-degree-of-freedom force/torque sensor, thus, allowing an intuitive and interactive use for education of human anatomy.
A Description Logics Approach to CGPs
Authors: Schulz Stefan  , Hahn Udo
Published: February 2025

We develop a formal framework by which clinical guidelines and protocols (CGPs) can be partially represented as a set of terminological concept definitions using standard description logics. There are two benefits in pursuing such an approach. First, it provides a foundation for logic-based CGP fusion and collision detection. Second, it allows for the checking of clinical treatment episodes from the EPR against CGPs.
Modelling Clinical Goals: a Corpus of Examples and a Tentative Ontology
Authors: Fox John  , Alabassi Alyssa  , Black Elizabeth  , Hurt Chris  , Rose Tony
Published: February 2025

Knowledge of clinical goals and the means to achieve them are either not represented in most current guideline representation systems or are encoded procedurally (e.g. as clinical algorithms, condition-action rules). There would be a number of major benefits if guideline enactment systems could reason explicitly about clinical objectives (e.g. whether a goal has been successfully achieved or not, whether it is consistent with prevailing conditions, or how the system should adapt to circumstances where a recommended action has failed to achieve the intended result). Our own guideline specification language, PROforma, includes a simple goal construct to address this need, but the interpretation is unsatisfactory in current enactment engines, and goals have yet to be included in the language semantics. This paper discusses some of the challenges involved in developing an explicit, declarative formalism for goals. As part of this, we report on a study we have undertaken which has identified over 200 goals in the routine management of breast cancer, and outline a tentative formal structure for this corpus.
TimeWrap - A Method for Automatic Transformation of Structured Guideline Components into Formal Process-Representations
Authors: Kaiser Katharina  , Miksch Silvia
Published: February 2025

Guideline and protocol representation languages have reached a level of complexity where auxiliary methods are needed to support the authoring of protocols in the particular language. Several approaches and methods exist that claim high knowledge about both, the medical context and the formal requirements. Therefore, we need knowledge-based methods to facilitate the human plan designer and create the protocols of the particular language as automated as possible. We present a three-step wrapper method, called TimeWrap, to extract information, in particular temporal issues, out of semistructured data and integrate it in a formal representation. We illustrate our approach using the guideline-representation language Asbru and examples from guidelines to treat conjunctivitis.
Web-based Asthma Collaboration Management and Public Awareness
Authors: Glykas Michael  , Chytas Panagiotis
Published: February 2025

Recent studies have shown that long-term monitoring of asthma severity can reduce asthma exacerbations, optimise drug therapy and decrease the cost of asthma management [18]. The management of a chronic patient is a collective and cooperative enterprise that may exploit Information Technologies (IT) to improve the overall quality of care [3]. The aim of this paper is to present a web based asthma tool that significantly enhances public information and awareness to support illness prevention, patients independent living through user profiling and personalisation and collaborative work between health professionals, therapists, caregivers and patients through Tele-Care and Tele-Consultation. The system has been tested through a preliminary survey that took place in UK and Greece.
Telemedicine Models for Primary Care
Authors: Kastania Anastasia N.
Published: February 2025

The provision of healthcare from the distance is extremely important in primary care for all nations in the world and especially as a humanitarian response for developing countries. International experience has demonstrated the clinical value and the technical feasibility of telemedicine-based patient care and service collaboration in primary care. Various models are proposed herein on the basis of the available technological driving forces, arrangements and current practices.
Outcome Measures in Clinical Information Systems Evaluation
Authors: Roderer Nancy K.
Published: February 2025

Systems developed through informatics methods can be evaluated at different levels, depending on the purpose of the evaluation. A key class of measures useful in relating information systems to the quality of patient care is benefit or outcome measures, which reflect differences in the health or welfare of the patient that result from the system being utilized. A framework for describing evaluation measures is presented, definitions are discussed, and the results of a literature review are presented to indicate outcome measures used in medical informatics over several decades. The conclusion suggests that more attention should be given to the standardization of terminology and to outcome measures and methods.
National and Regional Health Information Infrastructures: Making Use of Information Technology to Promote Access to Evidence
Authors: Dykes Patricia  , Bakken Suzanne
Published: February 2025

The vision for national and regional health information infrastructures (HII) includes provision of a framework that is supportive of access and integration of health information with the goal of improving the health and safety of individuals, public health systems, and nations. Internationally, prominent examples of national and regional HIIs exist that provide a means for achievement of this goal. Using the United States' Nation Health Information Infrastructure (NHII) as an example, the authors describe expansion of the conceptual framework to explicitly acknowledge the role of access to evidence at the overlap between the three dimensions of the NHII to create an “evidence-based” link between interrelated components. The role of national measures in setting e-communication goals and evaluating the evolving infrastructure in meeting informational needs of users is discussed. Additionally, automated knowledge management tools such as practice guidelines are presented as a means by which access to critical information is delivered to users, in a format that is appropriatefor their health literacy level and that provides adequate supportfor informed decision making.
Validating National Informatics Policy – the Importance of Operational Consensus to Influence Positive Developments
Authors: Roberts Jean M  , Hayes Glyn
Published: February 2025

The National Health Service in England faces reorganisation of services on a very regular basis. In 2002 a ‘Long Term Review ofHealth Trends’, commissioned by the Chancellor of the Exchequer indicated the need for a substantially larger investment in informatics to support the delivery of better healthcare overall. Subsequent to the issue of this report, the Spending Review confirmed an investment of £2.3 Billion (approximately $3.7Bn) for the period to 2005 for NHS informatics, subject to performance. This paper describes the actions taken by the national representative society (the British Computer Society Health Informatics Committee) to ensure that the views of those in the field were taken into account in facilitating the best possible outcomes from this investment. In addition, the initiative established has confirmed the ongoing priorities for involvement in health informatics, regardless of professional role, in support of healthcare. The outputs and insights gained from two years of this initiative provide useful points for thought about health informatics and health management in other countries and under different models of care to that of the NHS in England.
A Medical Association Hospital Centered Network for Inter-institutional Treatment in a Regional Area, Japan
Authors: Yahata Katsuya  , Higashi Toshiaki  , Koga Michie  , Koike Atsushi  , Iseda Tsukasa  , Kusaba Tomohiro
Published: February 2025

Munakata Medical Association Hospital is leading the way with its liaison system for electronic medical records and sharing medical information system in Munakata area clinics.
Computer Simulation of Pathogen Transmission in the Medical Intensive Care Unit: A Comparison of Two Probabilistic Methods
Authors: Triola Marc M.  , Holzman Robert S.
Published: February 2025

The quantitative evaluation of pathogen transmission in the medical intensive care unit (MICU) is difficult given the small number of patients and the complexity and severity of illness. We sought to evaluate the suitability of a probabilistic computer model of our MICU, with which we could rapidly simulate infection control measures and other clinical interventions that would be impossible to perform in the real clinical setting.
A Framework of Interruptions in Distributed Team Environments
Authors: Rukab Jamie A.  , Johnson-Throop Kathy A.  , Malin Jane  , Zhang Jiajie
Published: February 2025

In this study, we developed a framework for the study of interruptions in distributed team environments from the perspectives of distributed cognition and activity theory. The core of this framework is the Action Coding System (ACS) that provides a language for the description, representation, categorization, and analysis of interruptions at the level of activities that are meaningful for team performance. We demonstrated the practical utility and theoretical significance of ACS in its application to a real-world, complex, dynamic, and mission critical environment - the Biomedical Engineer (BME) console in the Mission Control Center at NASA's Johnson Space Center. We discussed the potentials of our framework for the design of interruption management systems that could potentially eliminate some interruptions by information redesign, delegate others to autonomous agents, and help human agents to better manage the rest.
Cognitive Evaluation of an Innovative Psychiatric Clinical Knowledge Enhancement System
Authors: Cohen Trevor  , Kaufman David  , White Thomas  , Segal Gerald  , Staub Amy Bennett  , Patel Vimla  , Finnerty Molly
Published: February 2025

Psychiatric Clinical Knowledge Enhancement System (PSYCKES) is an innovative information system that presents patient medication history in tabular and graphical form. The system is designed to support therapeutic decision making. In this paper, we present a multifaceted cognitive evaluation of this system. The evaluation includes a cognitive walkthrough which is a task-analytic method for usability evaluation. We also conducted cognitive studies of two trainee and two attending psychiatrists using the system. One of the attending subjects is presented as a case study. An objective of this research is to characterize the way PSYCKES mediates reasoning. The study found that clinicians were able to use the system effectively to extract and coordinate information and draw appropriate inferences. The expert clinicians were better able to construct a coherent patient representation. The study also documented a few usability problems pertaining to the temporal integration of patient data. PSYCKES is a multifaceted tool that can significantly enhance therapeutic decision making.
Assessing the impact of change in the organization of a technical support system for an Health Information Systems (HIS)
Authors: Baum Analía  , Figar Silvana  , Severino Jorge  , Assale Diego  , Schachner Bibiana  , Otero Paula  , Luna Daniel  , de Quirós Fernáu Gonzalez Bernaldo
Published: February 2025

Objective: Evaluate the impact of the implementation of a new model of Help Desk and technical support in HIS users of the hospital.
The NLM Indexing Initiative’s Medical Text Indexer
Authors: Aronson Alan R.  , Mork James G.  , Gay Clifford W.  , Humphrey Susanne M.  , Rogers Willie J.
Published: February 2025

The Medical Text Indexer (MTI) is a program for producing McSH®indexing recommendations. It is the major product of NLM's Indexing Initiative and has been used in both semi-automated and fully automated indexing environments at the Library since mid 2002. We report here on an experiment conducted with MEDLINE®indexers to evaluate MTI's performance and to generate ideas for its improvement as a tool for user-assisted indexing. We also discuss some ltering techniques developed to improve MTI's accuracy for use primarily in automatically producing the indexing for several abstracts collections.
Coping with the Variability of Medical Terms
Authors: Baud Robert H  , Ruch Patrick  , Gaudinat Arnaud  , Fabry Paul  , Lovis Christian  , Geissbuhler Antoine
Published: February 2025

Objectives: To cope with medical terms, which present a high variability of expression through a single natural language, in the sense that any term may be reformulated in hundred of different ways. Methods: A typology of term variants is presented as a systematic approach in order to favour the implementation of an exhaustive solution. Then, an algorithm able to handle all variants is designed. Results: Using MetaMap, single terms are analyzed with a success rate varying between 68 and 88 %; the algorithm presented in this paper improves this situation. Conclusions: This experience shows that a semantic driven method, based on a thesaurus, provides a satisfactory solution to the problem of variability of a single term. The presented typology is representative of most variants in a language.
Nursing in the Information Age: Status Quo and Future of ICT use in German Hospitals
Authors: Hübner Ursula  , Sellemann Björn
Published: February 2025

Hospital information systems (HIS) should give support to nurses in their clinical and managerial duties. Though there are statistical data on the current use of HIS systems we know only little about the numbers of nursing modules implemented. We therefore conducted a nationwide survey in Germany (n = 2182) on the current state and future plans of HIS modules including nursing applications (response rate of 27.6 %). The findings show that management applications (84 % accounting) are still more frequent than clinical applications, in particular clinical patient record systems (19 %). What applied for HIS modules in general held also true for nursing on a lower level. ‘Whereas 51 %of the hospitals had rostering systems in place only 6 % used care planning software. Priorities and plans for the future reveal no change in the rank órder of systems. We argue that in order for clinical documentation and planning systems to catch up they must be immediately rewarding for the clinicians in their daily need for information.
Synthesis of Elementary Single-Disease Recommendations to Support Guideline-Based Therapeutic Decision for Complex Polypathological Patients
Authors: Georg Gersende  , Séroussi Brigitte  , Bouaud Jacques
Published: February 2025

Situations managed by clinical practice guidelines (CPGs) usually correspond to general descriptions of theoretical patients that suffer from only one disease in addition to the specific pathology CPGs focus on. The lack of decision support for complex multiple-disease patients is usually transferred to computerbased systems. Starting from the GEM-encoded instance of CPGs, we developed a module that automatically generated IFTHEN- WITH decision rules. A two-stage unification process has been implemented. All the rules whose IF part was in partial matching with a patient clinical profile were triggered. A synthesis of triggered rules has then been performed to eliminate redundancies and incoherences. All remaining, eventually contradictory, recommendations were displayed to physicians leaving them the responsibility of handling the controversy and thus the opportunity to control the therapeutic decision.
Evaluating an ICNP Web-based Nursing Documentation System
Authors: Liaskos Joseph  , Mantas John
Published: February 2025

The purpose of this paper is to present the evaluation of a web based nursing documentation system which helps nursing professionals and students to study ICNP Greek beta 2 version and to create nursing diagnoses, interventions and outcomes by selecting relevant terms from ICNP. This advanced web-based ICNP browser enables the authentication of the user, and the creation of a type of nursing care plan through the use of ICNP. It provides different ways for creating nursing diagnoses, interventions and outcomes, by selecting relevant ICNP terms through the tree-structure view, index and search components of the tool. The evaluation of this nursing documentation system is carried out by a survey among nursing professionals working in nursing units in hospitals. The results which have derived from this survey are presented. Moreover, conclusions regarding the future changes that should be made in the system are reported.
Logical Support for Terminological Modeling
Authors: Schlobach Stefan  , Cornet Ronald
Published: February 2025

Terminological modeling, in particular in medical domains, is difficult and has enjoyed growing attention over the recent past. In practice, logical reasoning can play a fundamental role to support the modeling process. Nevertheless, the development of the logical tools is usually driven by computational or theoretical criteria rather than by the direct needs of a modeler. In this paper we attempt to shift this balance and discuss a number of logical reasoning services to support the modeler of a (medical) terminology to construct a formally sound, complete and concise terminology. This modeling support is logical as it is based on reasoning services with respect to formally defined semantics. Practical results of this systematic discussion are formal definitions of several new reasoning tasks.
Identifying Respiratory Findings in Emergency Department Reports for Biosurveillance using MetaMap
Authors: Chapman Wendy W  , Fiszman Marcelo  , Dowling John N  , Chapman Brian E  , Rindflesch Thomas C
Published: February 2025

Clinical conditions described in patients’ dictated reports are necessary for automated detection of patients with respiratory illnesses such as inhalational anthrax and pneumonia. We applied MetaMap to emergency department reports to extract a set of 71 clinical conditions relevant to detection of a lower respiratory outbreak. We indexed UMLS terms in emergency department reports with MetaMap, filtered the indexed output with a specialized lexicon of UMLS terms for the domain, and mapped the clinical conditions of interest to concepts in the lexicon. We compared MetaMap’s ability to accurately identify the conditions against a physician’s manual annotations and evaluated incorrectly indexed features to determine what additional processing is necessary.
Characteristics of Outpatient Clinical Decision Support Systems: A Taxonomic Description
Authors: Berlin Amy  , Sorani Marco  , Sim Ida
Published: February 2025

Computer-based clinical decision support systems (CDSSs) have been championed for their potential to improve healthcare quality. However, there has been no systematic study of the types of CDSSs that have been developed. In previous work, we developed the CDSS Taxonomy for comprehensively describing the technical, workflow, and contextual characteristics of CDSSs. We now use the CDSS Taxonomy to describe outpatient CDSSs evaluated in randomized controlled trials published between 1998 and 2002. 31 studies comprising 42 CDSS systems were included in our analysis. The majority of systems used rule-based reasoning engines to “push” explicit, individualized recommendations concerning non-urgent decisions to clinicians or patients, but not both. 71% of the systems required someone to manually enter data into the system or to process the system output for use by the target decision maker. The average kappa for coding agreement was > 0.6. Our findings demonstrate that outpatient CDSSs vary greatly in design and function. Many impose a data entry or output processing burden on clinic staff. More complete reporting of CDSS characteristics is needed in the literature.
Impact of Patient Feedback on Residents’ Handheld Computer Use: A Multi-Site Study
Authors: Berner Eta S.  , Savage Grant T.  , Houston Thomas K.  , Williams Eric S.  , Crawford Myra A.  , Ray Midge N.
Published: February 2025

Handheld computers are being proposed as a resource for ambulatory care, yet physician reluctance to use the devices in the presence of patients is reported to be a barrier to optimal use. This study examined patient attitudes toward the use of handheld computers and the impact of those attitudes on the physicians’ use of the handheld computers in the patient care setting. Most patients hold favorable attitudes toward physician use of handheld computers. Providing these data to physicians, however, did not uniformly lead to significant increases in handheld use in the presence of the patient. More understanding of the factors that influence behavior change and methods that will decrease barriers to the use of handhelds is needed.
The Economics of Integrated Electronic Medical Record Systems
Authors: Chismar William G.  , Thomas Sean M.
Published: February 2025

The decision to adopt electronic medical record systems in private practices is usually based on factors specific to the practice— the cost, cost and timesaving, and impact on quality of care. As evident by the low adoption rates, providers have not found these evaluations compelling. However, it is recognized that the widespread adoption of EMR systems would greatly benefit the health care system as a whole. One explanation for the lack of adoption is that there is a misalignment of the costs and benefits of EMR systems across the health care system. In this paper we present an economic model of the adoption of EMR systems that explicitly represents the distribution of costs and benefits across stakeholders (physicians, hospitals, insurers, etc.). We discuss incentive systems for balancing the costs and benefits and, thus, promoting the faster adoption of EMR systems. Finally, we describe our plan to extend the model and to use real-world data to evaluate our model.
A knowledge based approach for automated signal generation in pharmacovigilance
Authors: Henegar Corneliu  , Bousquet Cédric  , Degoulet Patrice
Published: February 2025

Background: Pharmacovigilance experts detect new adverse drug reactions (ADR) by manually reviewing spontaneous reporting systems. Automated signal generation aims to focus the attention of experts on drug – adverse event associations which are disproportionally present in the database. Although adverse events are coded by means of controlled vocabularies such as the MedDRA dictionary, this semantic information is not taken into account for signal generation.
Dealing with Organizational Change when Implementing EHR Systems
Authors: Høstgaard Anna Marie  , Nøhr Christian
Published: February 2025

Over the past years researchers at Aalborg University have been developing a method for examining change readiness of hospital staff during the implementation of new IT-systems. (CRR; Change readiness-research). The aim is to provide the hospital-management with a tool that will lead to an optimal implementation of new IT-systems. The method has recently been used in department Y at Skejby Hospital, Skejby, Denmark. 81% out of 241 employees answered the distributed questionnaire, and the results showed, that the employees have some expectations to the new EHR- system, which are important to either confirm or reject, on the other hand a great part of the employees lack basic computer skills. Thus the CRR-method has provided the Organization with important information before the implementation of the new EHR-system.
The MeSH Translation Maintenance System: Structure, Interface Design, and Implementation
Authors: Nelson Stuart J.  , Schopen Michael  , Savage Allan G.  , Schulman Jacque-Lynne  , Arluk Natalie
Published: February 2025

The National Library of Medicine (NLM) produces annual editions of the Medical Subject Headings (MeSH®). Translations of MeSH are often done to make the vocabulary useful for non-English users. However, MeSH translators have encountered difficulties with entry vocabulary as they maintain and update their translation. Tracking MeSH changes and updating their translations in a reasonable time frame is cumbersome. NLM has developed and implemented a concept-centered vocabulary maintenance system for MeSH. This system has been extended to create an interlingual database of translations, the MeSH Translation Maintenance System (MTMS). This database allows continual updating of the translations, as well as facilitating tracking of the changes within MeSH from one year to another The MTMS interface uses a Web-based design with multiple colors and fonts to indicate concepts needing translation or review. Concepts for which there is no exact English equivalent can be added. The system software encourages compliance with the Unicode standard in order to ensure that character sets with native alphabets and full orthography are used consistently.
Comparison of Machine Learning Techniques with Classical Statistical Models in Predicting Health Outcomes
Authors: Song Xiaowei  , Mitnitski Arnold  , Cox Jafna  , Rockwood Kenneth
Published: February 2025

Several machine learning techniques (multilayer and single layer perceptron, logistic regression, least square linear separation and support vector machines) are applied to calculate the risk of death from two biomedical data sets, one from patient care records, and another from a population survey. Each dataset contained multiple sources of information: history of related symptoms and other illnesses, physical examination findings, laboratory tests, medications (patient records dataset), health attitudes, and disabilities in activities of daily living (survey dataset). Each technique showed very good mortality prediction in the acute patients data sample (AUC up to 0.89) and fair prediction accuracy for six year mortality (AUC from 0.70 to 0.76) in individuals from epidemiological database surveys. The results suggest that the nature of data is of primary importance rather than the learning technique. However, the consistently superior performance of the artificial neural network (multi-layer perceptron) indicates that nonlinear relationships (which cannot be discerned by linear separation techniques) can provide additional improvement in correctly predicting health outcomes.
Experiments in cross-language medical information retrieval using a mixing translation module
Authors: Tran Tuan Due  , Garcelon Nicolas  , Burgun Anita  , Le Beux Pierre
Published: February 2025

Given the ever-increasing scale and diversity of medical literature widely published in English on the Internet, improving the performance of information retrieval by cross-language is an urgent research objective. Cross-language medical information retrieval (CLMIR) consists of providing a query in one language and searching medical document collections in one or more different languages. Our users of CLMIR are users who are able to read biomedical texts in English, but have difficulty formulating English queries. This paper proposes a French/English CLMIR system as a mixing model for supporting the retrieval of English medical documents. Methods fall into the category of query translation approach in which we use a hybrid machine translation that combines a pattern-based module with a rule-based translator and includes three steps from pre- to- post-translation. In parallel to this hybrid machine translation, we use multilingual UMLS Methasaurus as a complementary translator. The results show that using a mixing translation module outperforms machine translation-based method and thesaurus-based method used separately.
An Open Source Mobile Platform for Psychophysiological Self Tracking
Authors: Gaggioli Andrea  , Cipresso Pietro  , Serino Silvia  , Pioggia Giovanni  , Tartarisco Gennaro  , Baldus Giovanni  , Corda Daniele  , Riva Giuseppe
Published: February 2025

Self tracking is a recent trend in e-health that refers to the collection, elaboration and visualization of personal health data through ubiquitous computing tools such as mobile devices and wearable sensors. Here, we describe the design of a mobile self-tracking platform that has been specifically designed for clinical and research applications in the field of mental health. The smartphone-based application allows collecting a) self-reported feelings and activities from pre-programmed questionnaires; b) electrocardiographic (ECG) data from a wireless sensor platform worn by the user; c) movement activity information obtained from a tri-axis accelerometer embedded in the wearable platform. Physiological signals are further processed by the application and stored on the smartphone's memory. The mobile data collection platform is free and released under an open source licence to allow wider adoption by the research community (download at: http://sourceforge.net/projects/psychlog/).
A Non-Photorealistic Surgery Simulation System
Authors: Hu Rui  , Barner Kenneth E.  , Yu Jingyi  , Steiner Karl V.
Published: February 2025

Surgery simulation plays an important role in surgery planning, surgeon training, and telemedicine. A long-standing problem in this region is how to integrate coherent visual illustrations to deformation. In this paper, we present a new non-photorealistic surgery simulation system that combines force visualization and dynamic pencil-stroke illustration. We estimate the elastic force field in real-time and integrate it with the contact force to form a combined force map. Then, our rendering module is able to dynamically compute the principal directions on deforming organ models and apply color coded, pencil-style strokes onto the model for illustrating deformations. We implement these modules on GPU using NVidia's CUDA. Our system can faithfully and coherently reveal geometric deformation of organs under the force field.
A Simple Master-Slave Control Mapping Setup to Learn Robot-Assisted Surgery Manipulation
Authors: Punak Sukitti  , Kurenov Sergei
Published: February 2025

A simple, but yet effective application for learning and testing instrument manipulation of available (and future) master-slave control robot-assisted surgical systems has been created. As an example, the paper describes a simple mapping of da Vinci surgical system master-slave control with two haptic devices acts as the master control.
The BioDigital Human: A Web-based 3D Platform for Medical Visualization and Education
Authors: Qualter John  , Sculli Frank  , Oliker Aaron  , Napier Zachary  , Lee Sabrina  , Garcia Julio  , Frenkel Sally  , Harnik Victoria  , Triola Marc
Published: February 2025

NYU School of Medicine's Division of Educational Informatics in collaboration with BioDigital Systems LLC (New York, NY) has created a virtual human body dataset that is being used for visualization, education and training and is accessible over modern web browsers.
Virtual Skin Biopsy with Gabor Domain Optical Coherence Microscopy
Authors: Rolland Jannick P.  , Lee Kye-Sung  , Khoudeir Laura  , Meemon Panomsak  , Thompson Kevin P.  , Huang Jinxin  , Yao Jianing  , Ibrahim Sherrif F.
Published: February 2025

We report in-vivo volumetric optical coherence microscopy images of the skin, with resolution at the cellular level. With resolution of 2 μm both laterally and axially, structures below the skin as deep as 1 mm may be imaged at various anatomic locations. Custom optical instrumentation was designed, built, and integrated to achieve this unprecedented optical imaging resolution, in three dimensions, at clinically feasible configuration and speed.
BodyWindows: Enhancing a Mannequin with Projective Augmented Reality for Exploring Anatomy, Physiology and Medical Procedures
Authors: Samosky Joseph T.  , Wang Bo  , Nelson Douglas A.  , Bregman Russell  , Hosmer Andrew  , Weaver Robert A.
Published: February 2025

Augmented reality offers the potential to radically extend and enhance the capabilities of physical medical simulators such as full-body mannequin trainers. We have developed a system that transforms the surface of a mannequin simulator into both a display screen and an input device. The BodyWindows system enables a user to open, size, and reposition multiple viewports onto the simulator body. We demonstrate a dynamic viewport that displays a beating heart. Similar viewports could be used to display real-time physiological responses to interventions the user applies to the mannequin, such as injection of a simulated drug. Viewport windows can be overlapping and show anatomy at different depths, creating the illusion of “cutting” multiple windows into the body to reveal structures at different depths from the surface. The developed low-cost interface employees an IR light pen and the Nintendo Wiimote. We also report experiments using the Microsoft Kinect computer vision sensor to provide a completely hand-gesture based interface.
Preneoplasia of lung cancer
Authors: Gazdar Adi F.  , Brambilla Elisabeth
Published: February 2025

As with other epithelial cancers, lung cancer develops over a period of several years or decades via a series of progressive morphological changes accompanied by molecular alterations that commence in histologically normal epithelium. However the development of lung cancer presents certain unique features that complicates this evaluation. Anatomically the respiratory tree may be divided into central and peripheral compartments having different gross and histological anatomies as well as different functions. In addition, there are three major forms of lung cancer and many minor forms. Many of these forms arise predominantly in either the central or peripheral compartments. Squamous cell and small cell carcinomas predominantly arise in the central compartment, while adenocarcinomas predominantly arise peripherally. Large cell carcinomas are not a single entity but consist of poorly differentiated forms of the other types and, possibly, some truly undifferentiated “stem cell like” tumors. The multistage origin of squamous cell carcinomas, because of their central location, can be followed more closely than the peripherally arising adenocarcinomas. Squamous cell carcinomas arise after a series of reactive, metaplastic, premalignant and preinvasive changes. However, long term observations indicate that not all tumors follow a defined histologic course, and the clinical course, especially of early lesions, is difficult to predict. Peripheral adenocarcinomas are believed to arise from precursor lesions known as atypical adenomatous hyperplasias and may have extensive in situ growth before becoming invasive. Small cell carcinomas are believed to arise from severely molecularly damaged epithelium without going through recognizable preneoplastic changes. The molecular changes that occur prior to the onset on invasive cancers are extensive. As documented in this chapter, they encompass all of the six classic Hallmarks of Cancer other than invasion and metastasis, which by definition occur beyond preneoplasia. A study of preinvasive lung cancer has yielded much valuable biologic information that impacts on clinical management.
Applying GEP-HI for the Planning of an Evaluation Study: A Case Study Walkthrough (Workshop)
Authors: Nykänen Pirkko  , Brender Jytte  , Ammenwerth Elske  , Talmon Jan  , Rigby Michael
Published: February 2025

A Good evaluation practice in Health Informatics (GEP-HI) Evaluation Practice guideline has been developed through a consensus making process. The guideline lists a set of 60 issues that are relevant for planning, implementation and execution of an evaluation study in the health informatics domain. These issues cover the phases of an evaluation study: Study exploration, first study design, operationalization of methods, detailed study design, execution and finalization of an evaluation study. In this seminar we walk through a case study to present how to plan a health information system evaluation study applying the good evaluation practice guideline.
HL7 CDA in the National ePrescription Efforts of Finland & Greece: a Comparison
Authors: Chronaki Catherine  , Pakarinen Vesa  , Jalonen Marko  , Porrasmaa Jari  , Berler Alexander  , Tarhonen Timo
Published: February 2025

This paper presents an overview and comparison of national efforts on ePrescribing in Finland and Greece focusing on aspects of interoperability and standards. Building on experience of HL7 affiliates in Finland and Greece, the role of HL7 Clinical Document Architecture (CDA) in assuring interoperability within the national and cross-border framework for ePrescription is addressed underlining current use of standards and interoperability challenges for large scale adoption.