bluuebunny/crossref_metadata_2025 huggingface dataset:
Relevance of mandates, notifications and threads in the management of continuity of care
Authors: Consorti Fabrizio  , Lalle Cecilia  , Ricci Fabrizio L.  , Rossi-Mori Angelo
Published: February 2025

Availability of electronic healthcare records (EHCR) and geographical networks allows nowadays to realise a set of functionalities to support continuity of care. Actual exchange of complete clinical information, common centralised records, common decisions within an agreed protocols are not mandatory. Sub-optimal alternatives, involving easier management, are possible. In fact, the crucial challenge for continuity of care is the mutual awareness of the multiple perspectives by the actors contributing to patient’s care. The various actors should timely know changes in the status of:
AN XML-JAVA SYSTEM FOR HL7-BASED HEALTHCARE INFORMATICS
Authors: Goh Alwyn  , Kum YL  , Mak Sy  , Quek YT
Published: February 2025

Health-Level (HL) 7 message semantics allows effective functional implementation of Electronic Medical Record (EMR)—encompassing both clinical and administrative (ie demographic and financial) information—interchange systems, at the expense of complexity with respect the Protocol Data Unit (PDU) structure and the client-side application architecture. In this paper we feature the usage of the Extensible Markup Language (XML) document-object modelling and Java client-server connectivity towards the implementation of a Web-based system for EMR transaction processing. Our solution features an XML-based description of EMR templates, which are subsequently transcribed into a Hypertext Markup Language (HTML)-Javascript form. This allows client-side user interfaceability and server-side functionality—ie message validation, authentication and database connectivity—to be handled through standard Web client-server mechanisms, the primary assumption being availability of a browser capable of XML documents and the associated stylesheets. We assume usage of the Internet as the interchange medium, hence the necessity for authentication and data privacy mechanisms, both of which can be constructed using standard Java-based building blocks.
CRYPTOGRAPHIC FRAMEWORK FOR DOCUMENT-OBJECTS RESULTING FROM MULTIPARTY COLLABORATIVE TRANSACTIONS
Authors: Goh Alwyn
Published: February 2025

Multiparty transactional frameworks—ie Electronic Data Interchange (EDI) or Health Level (HL) 7—often result in composite documents which can be accurately modelled using hyperlinked document-objects. The structural complexity arising from multiauthor involvement and transaction-specific sequencing would be poorly handled by conventional digital signature schemes based on a single evaluation of a one-way hash function and asymmetric cryptography. In this paper we outline the generation of structure-specific authentication hash-trees for the the authentication of transactional document-objects, followed by asymmetric signature generation on the hash-tree value. Server-side multi-client signature verification would probably constitute the single most compute-intensive task, hence the motivation for our usage of the Rabin signature protocol which results in significantly reduced verification workloads compared to the more commonly applied Rivest-Shamir-Adleman (RSA) protocol. Data privacy is handled via symmetric encryption of message traffic using session-specific keys obtained through key-negotiation mechanisms based on discrete-logarithm cryptography. Individual client-to-server channels can be secured using a double key-pair variation of Diffie-Hellman (DH) key negotiation, usage of which also enables bidirectional node authentication. The reciprocal server-to-client multicast channel is secured through Burmester-Desmedt (BD) key-negotiation which enjoys significant advantages over the usual multiparty extensions to the DH protocol. The implementation of hash-tree signatures and bi/multidirectional key negotiation results in a comprehensive cryptographic framework for multiparty document-objects satisfying both authentication and data privacy requirements.
MedStage - Platform for Information and Communication in Healthcare
Authors: Schüll Hans  , Schmidt Volker
Published: February 2025

This application report describes the technologies and strategies used by MedStage, an open infrastructure for secure telemedical internet applications. The infrastructure includes several technical and application frameworks including a public key infrastructure for providing professional security solutions, like certificate-based authentication, secure transport protocol, strong data encryption and digital signature. The key components are an universal healthcare data repository based on the work of CEN TC 251 with extensions for the storage of multimedia data, an exchangeable authorization management, an exchangeable patient index service based on CORBAmed PIDS and a set of XML-based import and export modules. Additionally there are prototype applications for home-monitoring, telereporting and personal health passport.
’LipTelephone’ A Videophone for the Deaf
Authors: Sarris Nikolaos  , Simitipoulos Dimitrios  , Strintzis Michael G.
Published: February 2025

This paper describes the ‘LipTelephone’ system, which is being developed under a Greek AMEA research project, with the purpose to serve as a videophone that can also be used by lip readers. This system aims to combine model-based with traditional coding techniques in order to exploit the information redundancy in a scene of known content, while achieving high fidelity representation in the specific area of interest, which is the speaker's mouth. The recent MPEG-4 coding standard provides the framework, which is employed, for these purposes.
Analysis of Periapical Lesion Using Statistical Textural Features
Authors: Caputo Barbara  , Gigante G.E.
Published: February 2025

In this work we present a quantitative study on different regions of periapical images with a series of textural features, extracted using cooccurrence matrices; those features are used for a pattern recognition analysis by means of an artificial neural network. The obtained results show that it is possible to recognize in an objective way changes in bone pattern.
User Requirements in a System Development & Evaluation Context
Authors: Brender Jytte  , McNair Peter
Published: February 2025

The case study presented investigates how the interaction between users and developers changed when introducing a three level User Requirements Specification with a coarse granularity of the lowest (operational) requirements.
Lack of Adequate Medical Involvement in Patient Centred Information Technology
Authors: Colreavy P.
Published: February 2025

A pre-requisite to successful systems, recognised in all industries for many years, is adequate user involvement. However, lack of medical involvement continues to be a major reason for the failure of computerised clinical systems. This paper explores why this is the case. It examines the underlying reasons for lack of involvement by doctors and discusses possible solutions.
A New Generation of Remote Data Entry: Using WAP-Phones in Clinical Trials
Authors: Eikemeier Claus  , Grütter Rolf  , Heitmann Kai
Published: February 2025

This paper presents an introduction to a new approach in the field of clinical trial information technology. During the last years, more and more modern tools have found their ways to the different tasks during the design, the realization and data processing in the clinical trial. Choosing tools depends on a variety of conditions and aspects that have to be considered. Besides issues in the field of trial software, the focus of research also turns over to special hardware used in the trial.
Can factors influencing in-patient treatment in Hodgkin's Disease be identified? - Retrospective analysis of HD6 patients of the GHSG
Authors: Pfistner B.  , Paulus U.  , Glossmann J.-P.  , Walshe R.  , Tesch H.  , Diehl V.
Published: February 2025

Patients receiving chemotherapy for Hodgkin's disease can potentially be treated in the out-patient department. In spite of this the proportion of patients receiving the chemotherapy on in-patient departments is 54 % per chemotherapy cycle in average in the HD6 trial for advanced Hodgkin's disease of the German Hodgkin Study Group (GHSG). The aim of this retrospective analysis is to identify the set of parameters which influence the decision of in- or out-patient treatment for the patients in the HD6 trial. Parameters tested in the univariate analysis are the patient characteristics, the type of chemotherapy, toxicity and the type of treatment institution. The significant parameters are included in a logistic regression model. From this multivariate analysis the type of treatment institution turned out to be the most important factor in the decision of treatment setting. Restricting the analysis to university clinics, the treatment setting of the first two cycles is more influencial than patient dependent parameters.
Identifying Proper Names in Parallel Medical Terminologies
Authors: Bodenreider Olivier  , Zweigenbaum Pierre
Published: February 2025

We propose several criteria to identify proper names in biomedical terminologies. Traditional, pattern-based methods that rely on the immediate context of a proper name are not applicable. However, the availability of translations of some terminologies supports methods based on invariant words instead. A combination of five criteria achieved 86% precision and 88% recall on the 16,401 word forms of the International Classification of Diseases.
Tagging medical texts: a rule-based experiment
Authors: Ruch Patrick  , Bouillon Pierrette  , Robert Gilbert  , Baud Robert  , Rassinoux Anne-Marie
Published: February 2025

In this paper we describe the construction of a part-of-speech tagger for medical document retrieval purposes, therefore we have designed a specific architecture called minimal commitment. The system uses local grammatical rules for conducting the disambiguation task. Four evaluations are conducted, with and without taking unknown words into account. In between each evaluation the modules (lexicon, guesser, rules) of the system are incrementally improved.
Availability and Accuracy of Electronic Patient Data for Medical Practice Assessment
Authors: Prins H  , Kruisinga FH  , Büller HA  , Zwetsloot-Schonk JHM
Published: February 2025

We analyzed availability and accuracy of electronic patient data needed to assess medical practice. A case study was performed in which pediatricians formulated 14 performance indicators that cover aspects of care for children with suspected meningitis. Data items needed to quantify these indicators were listed. Required patient data were gathered from hospital information system and paper medical records. Accuracy of electronically available data was based on comparison with paper data and, when paper data were not available, on how data were recorded at the source, administrative procedures and original goal for which data were recorded.
Multimedia-Based Courseware in the Virtual Learning Center at the Hannover Medical School
Authors: Matthies Herbert K.  , von Jan Ute  , Porth Albert J.  , Tatagiba Marcos  , Stan Alexander C.  , Walter Gerhard F.
Published: February 2025

The commercial use of the World Wide Web causes an extensive change in information technology. Web browser are becoming the universal front- end for all kinds of client-server applications. The possibilities of telematics offer a base for multimedia applications, for instance telelearning. Learning is not limited by geography and does not cause pressure of time by the user. The development of such multimedia information and communication systems demands cooperative working teams of authors, who are able to master several areas of medical knowledge as well as the presentation of these using different multimedia facilities. A very important part of graphic design in the context of multimedia applications is the creation and interactive use of images (still, moving). The growth and the complexity of medical knowledge as well as the need for continuous, fast, and economically feasible maintenance impose requirements on the media used for medical education and training. Web-based courseware in the Virtual Learning Center at the Hannover Medical School is an innovative education resource for medical students and professionals.
The French Virtual Medical University
Authors: Beux Pierre  , Duff Franck  , Fresnel Annie  , Berland Yvon  , Beuscart Régis  , Burgun Anita  , Brunetaud Jean Marc  , Chatellier Gilles  , Darmoni Stephan  , Duvauferrier Régis  , Fieschi Marius  , Gillois Pierre  , Guillé François  , Kohler François  , Pagonis Daniel  , Pouliquen Bruno  , Soula Gerard  , Weber Jacques
Published: February 2025

This paper is the description of a French Virtual Medical University based on the federation of existing or currently being developed resources in several Medical Schools in France. The objectives of the project is not only to share experiences across the country but also to integrate several resources using the New Information and Communication Technologies to support new pedagogical approaches for medical students and also for continuing medical education. The project includes : A virtual Medical Campus using secure access from several sites, The Integration of new interactive resources based on pedagogical methods, Implementation of new indexing and search engines based on medical vocabularies and ontologies, The definition of general and specific portals, the evaluation of the system for ergonomics and contents
The Development of a New Information Model for a Pediatric Cancer Registry on Late Treatment Sequelae in the Netherlands
Authors: Jaspers M.W.M.  , Caron H.  , Behrendt H.  , van den Bos C.  , Bakker P.  , Van Leeuwen F.
Published: February 2025

Worldwide, the need is felt for life time follow up of survivors of childhood cancer and for the establishment of registries of the late effects of pediatric oncology treatments. There is however little consensus about how this all should take place. For example, agreement on the nature of this follow up and the type of data to be collected in view of the earlier diagnosis and treatment of the patient is lacking. In a close collaboration between the ‘Late Effects Study Group’ (consisting of the Pediatric Oncology department of the Emma Children's Hospital and the department of Medical Oncology at the Academic Medical Center), the Netherlands Cancer institute/Antoni van Leeuwenhoek Hospital, and the department of Medical Informatics of the University of Amsterdam, consensus was reached on a new dataset on adverse late effects of pediatric oncology treatment. This dataset was used in developing an information model for the design of a computerized documentation system, PLEKsys. PLEKsys covers both standardized documentation of all relevant data items for evaluating late effects and review facilities on individual patient basis and on patient cohorts. We will install PLEKsys at all Dutch pediatric oncology centers and use the information model as a starting point in developing a National Pediatric Oncology Follow up Registry. A national programme encompassing all Dutch pediatric oncology centers has already been set up to co-ordinate the construction of this national registry.
Implementing an ICU-CIS integrated to a HIS in Latin America
Authors: Espinosa Amado
Published: February 2025

The hospital has been the main target for Medical Informatics since the beginning of its development. Ancillary and clinical systems entered into the scene first when the financial issues were covered. From those kind of applications the Intensive Care Unit (ICU) represents perhaps the most important challenge to achieve where there is a representative subset of the organization with most variables under control to show the performance of the institution. At the ICU, information technology defines many of the tasks which are performed and enable the proffesionals to process and interpret the great quantities of data that is generated about the patients and the system in which they receive their treatment and quality assurance (QA) is now almost completely dependent upon information technology in pretty much facets of medical care.
Distributed Information System Architecture For Primary Health Care
Authors: Grammatikou M.  , Stamatelopoulos F.  , Maglaris B.
Published: February 2025

We present a distributed architectural framework for Primary Health Care (PHC) Centres. Distribution is handled through the introduction of the Roaming Electronic Health Care Record (R-EHCR) and the use of local caching and incremental update of a global index. The proposed architecture is designed to accommodate a specific PHC workflow model. Finally, we discuss a pilot implementation in progress, which is based on CORBA and web-based user interfaces. However, the conceptual architecture is generic and open to other middleware approaches like the DHE or HL7.
Chapter 3.1 - Prototypes and Applications in Neurotelemedicine
Authors: Penzel Thomas
Published: February 2025

The ENN project was able to develop internet based applications for sleep medicine and prototypes of multimedia tutorials for headache, epilepsy and headache. Telematic technologies were used throughout all workpackages of the European Neurological Network. This overview presents the conceptual links between expert systems, the multimedia database, CD-ROM based tutorials and software tools in order to support neurological diagnostic and therapeutic practice in sleep, headache and epilepsy.
Future of Security and Privacy in Medical Information
Authors: Wiederhold Gio
Published: February 2025

Today, issues of privacy and confidentiality in healthcare are dealt largely informally. Little legislation exists, and the awkwardness of accessing paper records makes violations of patients’ privacy sporadic. As healthcare institutions move towards a future where all information is kept in an Electronic Medical Record (EMR), the casual attitudes that are prevalent will be in conflict with the desires and expectations of the patients. Legislation has been passed to make the holders of medical data responsible for securely protecting the patients privacy. Specific implementation guidelines are still lacking. There is much institutional resistance to the adoption of rigorous rules, but we expect that in the near future reliable procedures will have to be implemented to comply both with legal guidelines and patient’s expectations.
Cubby: A Unified Interaction Space for Precision Manipulation
Authors: Djajadiningrat J.P.  , Stappers P.J.  , Overbeeke C.J.
Published: February 2025

Precision manipulation in surgical simulation poses special requirements on a VR system. One such requirement is unification, i.e. that the user manipulates a virtual object where it appears. We have designed Cubby, a system of which the visualization part was presented at MMVR97 [3], for precision manipulation and unification. In an experiment Cubby was compared with a single screen head-tracked display, both in a unified and a non-unified version. The results show that subjects could manipulate virtual objects in Cubby with significantly higher accuracy and preferred it to the single screen head-tracked display. Though no significant difference in accuracy between the unified and non-unified conditions could be shown, subjects did prefer the unified over the non-unified condition within both setups.
Spatial Ability and Learning the Use of an Angled Laparoscope in a Virtual Environment
Authors: Eyal Roy  , Tendick Frank
Published: February 2025

Little is known about the cognitive demands that underlie surgical performance. Several studies have suggested that spatial ability plays a substantial role in surgical skill. An example of a skill in which spatial cognition appears to be of importance is the use of the angled laparoscope. This paper describes a virtual environment designed to assess and train the use of the angled laparoscope. The learning rates of novices learning the skill for the first time in the virtual environment were measured. The rates were found to be highly variable and strongly correlated with spatial ability.
Using Immersive VR as a Tool for Preoperative Planning for Minimally Invasive Donor Nephrectomy
Authors: Mastrangelo Jr. Michael J.  , Hoskins James D.  , Nicholls Mathew  , Munch Larry C.  , Johnston Thomas D.  , Ranjan Dinesh  , Witzke Wayne O.  , Park Adrian
Published: February 2025

For surgeons approaching minimally invasive donor nephrectomy it is important to identity variant anatomy preoperatively since this anatomy can vary significantly from patient to patient. The goal of this operation is to preserve the architecture and function of the organ so it can be transplanted and function successfully. The ability of the surgeon to navigate through an individual patient’s anatomy in a virtual three-dimensional (3D) immersive environment augments understanding of anatomical relationships particular to that individual patient and facilitates conveying that information to other physicians and students. Utilizing automated 3D reconstruction of high contrast computed tomography (CT) scan files viewed in this way, surgeons reported a better preoperative understanding of the anatomical variations and encountered fewer surprises at the time of surgery.
Digital Motion Phenomenology of Depression
Authors: Alessi Norman E.  , Huang Milton P.
Published: February 2025

The long-term objective of our project is to use motion capture technology to identify and characterize body alterations in motion associated with depression that have not been previously recognized or characterizable. These motion phenomena will be studied to determine their utility in the nosology and subtyping of depression. Quantitatively, they may have a significant impact in the areas of research, education and the clinical management of depression; and allow the creation of “virtual humans” which manifest depressive digital motion phenomena that can be used to train researchers, trainees and clinicians.
The development of an evaluation framework for the quantitative assessment of computer-assisted surgery and augmented reality accuracy performance
Authors: Viant Warren J
Published: February 2025

The paper describes a framework for the quantitative assessment of errors within a computer assisted surgical system. The framework diagrammatically describes the registration process and simulates the error propagation chain based on the assumption that errors can be described through the use of a normal distribution model. The projection error associated with a fluoroscopic image intensifier is given as an example.
Autocolorization of Three-dimensional Radiological Data
Authors: Chhadia Ankur  , Dech Fred  , Ai Zhuming  , Silverstein Jonathan C.
Published: February 2025

It requires skill, effort, and time to visualize desired anatomic structures from radiological data in three-dimensions. There have been many attempts at automating this process and making it less labor intensive. The technique we have developed is based on mutual information for automatic multi-modality image fusion (MIAMI Fuse, University of Michigan). The initial development of our technique has focused on the autocolorization of the liver, portal vein, and hepatic vein. A standard dataset in which these structures had been segmented and assigned colors was created from the full color Visible Human Female (VHF) and then optimally fused to the fresh CT Visible Human Female. This semi-automatic segmentation and coloring of the CT dataset was subjectively evaluated to be reasonably accurate. The transformation could be viewed interactively on the ImmersaDesk, in an immersive Virtual Reality (VR) environment. This 3D segmentation and visualization method marks the first step to a broader, standardized automatic structure visualization method for radiological data. Such a method, would permit segmentation of radiological data by canonical structure information and not just from the data’s intrinsic dynamic range.
Implementation and Evaluation of a Distance Learning Introductory Course in Medical Informatics
Authors: Hersh William  , Junium Katherine  , Mailhot Mark  , Tidmarsh Patricia
Published: February 2025

Context: There is a growing interest in and need for continuing education in medical informatics delivered by distance learning.
Project-based Teaching in Health Informatics: A Course on Health Care Quality Improvement
Authors: Moehr Jochen R.  , Berenji G. Reza  , Green Carolyn J.  , Kagolovsky Yuri
Published: February 2025

Teaching the skills and knowledge required in health informatics [1] is a challenge because the skill of applying knowledge in real life requires practice. We relate the experience with introducing a practice component to a course in “Health Care Quality Improvement”. Working health care professionals were invited to bring an actual quality problem from their place of work and to work alongside students in running the problem through a quality improvement project lifecycle. Multiple technological and process oriented teaching innovations were employed including project sessions in observation rooms, video recording of these sessions, generation of demonstration examples and distance education components. Both students and their collaborators from the work place developed proficiency in applying quality improvement methods as well as in experiencing the realities of group processes, information gaps and organizational constraints. The principles used to achieve high involvement of the whole class, the employed resources and technical support are described. The resulting academic and practical achievements are discussed in relation to the alternative instructional modalities, and with respect to didactic implications for similar endeavors and beyond to other fields such as systems engineering.
Investigating Physician Order Entry in the Field: Lessons Learned in a Multi-Center Study
Authors: Ash Joan  , Gorman Paul  , Lavelle Mary  , Lyman Jason  , Fournier Lara
Published: February 2025

The progress of studies by this team of researchers concerning computerized physician order entry (POE), beginning with a mail survey and moving to qualitative multi-center studies, is reviewed, with emphases on lessons learned and future directions. While mail surveys were appropriate to answer initial research questions about diffusion of POE in the U.S., multiple qualitative methods became the methods of choice for answering more complex questions. Results of the latter include articulation of multiple perspectives on both positive and negative aspects of POE and a description of what may be important for successful implementation of POE in the future. The present economic environment of hospitals may be inhibiting widespread diffusion of POE, not only because of the direct cost, but also indirectly by affecting relations with practitioners. Analysis of successful past implementations can provide guidance when the time is right.
Computerised Clinical Pathway as Process Quality Improvement Tool
Authors: Chu Stephen
Published: February 2025

Experiences from other industries show that process quality improvement (PQI) is far more effective than product quality assurance in ensuring quality outputs and cost savings. The PQI approach is becoming more important to the healthcare industry as healthcare professionals struggle to cope with increasing demands for productivity gains, the raising patient acuity and need to curtail the large number of adverse medical events. This paper presents a continuous process quality improvement operational model for healthcare quality improvement and operationalization of the model through the implementation of a computerised clinical pathway management system (CCPMS). It also reports on a small-scale evaluative study conducted to assess the effectiveness of the PQI approach using the CCMPS prototype.
A System for Evaluating Inpatient Care Cost-Efficiency in a Hospital
Authors: Li Jianli  , Hawkins John
Published: February 2025

The cost-efficiency evaluation is one important aspect in the health care organization performance assessment. This paper introduces the ratio of exact cost to Relative Intensity Weights, cost per case weight, as one indicator.
A Methodology for Web-Enabling a Computer-based Patient Record with Contributions from Cognitive Science
Authors: Webster Charles
Published: February 2025

Cognitive science is a rich source of insight for creative use of new Web technologies by medical informatics workers. I outline a project to Web-enable an existing computer-based patient record (CPR) in the context of ideas from philosophy, linguistics, artificial intelligence, and cognitive psychology. Web prototypes play an important role (a) because Web technology lends itself to rapid prototype development, and (b) because prototypes help team members bridge among disparate medical, computing, and business ontologies. Six Web-enabled CPR prototypes were created and ranked. User scenarios were generated using a user communication matrix. Resulting prototypes were compared according to the degree to which they satisfied medical, computing, and business constraints. In a different organization, or at different time, candidate prototypes and their ranking might have been different. However, prototype generation and comparison are fundamentally influenced by factors usefully understood in a cognitive science framework.
The Use of Consequential Reasoning in Cancer Chemotherapy
Authors: Hudson Donna L.  , Cohen Maurice E.  , Hudson Samuel E.
Published: February 2025

Knowledge-based decision support systems traditionally rely on condition-action rule structures, an adequate representation for simple decisions. In complex domains an important part of decision-making includes analysis of the consequences of a decision. Consequential reasoning is particularly important in medicine as potential risk and/or benefit can be included. In this paper, a knowledge structure and inference engine is described that permits the representation and analysis of consequential reasoning in a computer-assisted decision support system. The use of consequential reasoning is then illustrated in an application designed to assist in cancer chemotherapy decisions. The result is a method that is sensitive to individual patient reactions to chemotherapy agents, permitting an individualized approach to therapy. Individualized drug therapy is becoming increasingly feasible due to advances made in the field of genomics. The system is structured so that new information can be incorporated easily. Although the application shown here is to chemotherapy, the general methodology can be used in any area in which the consequences should significantly influence the decision.
Design of a Consumer Health Record for Supporting the Patient-centered Management of Chronic Diseases
Authors: de Clercq Paul A.  , Hasman Arie  , Wolffenbuttel Bruce H.R.
Published: February 2025

This paper describes and discusses the design and usage of a shareable consumer health record system to investigate whether these systems can assist in the management of chronic diseases. This web-based system that can be used both by care providers and patients contains medical and patient information, provides access to websites that contain quality information, provides guideline-based advice, allows discussion between patients and allows us to interrogate both patients and care providers on a regular basis in order to get a good impression of the utility of such a consumer record for both chronic patients and the physicians and nurses. A health record system that was developed for the area of Diabetes is presented as an example.
A Framework for Improving the Quality of Health Information on the World-Wide-Web and Bettering Public (E-)Health: The Medcertain Approach
Authors: Eysenbach Gunther  , Köhler Christian  , Yihune Gabriel  , Lampe Kristian  , Cross Phil  , Brickley Dan
Published: February 2025

There has been considerable debate about the variable quality of health information on the world-wide-web and its impact on public health. While central authorities to regulate, control, censor, or centrally approve information, information providers or websites are neither realistic nor desirable, public health professionals are interested in making systems available that direct patient streams to the best available information sources. National governments and medical societies have also recognized their responsibility to help users to identify “good quality” information sources. But what constitutes good quality, and how can such a system be implemented in a decentralized and democratic manner? This paper presents a model which combines aspects of consumer education, encouragement of best practices among information providers, self-labeling and external evaluations. The model is currently being implemented and evaluated in the MedCERTAIN project, funded by the European Union under the Action Plan for Safer Use of the Internet. The aim is to develop a technical and organisational infrastructure for a pilot system that allows consumers to access metainformation about websites and health information providers, including disclosure information from health providers and opinions of external evaluators. The paper explains the general conceptual framework of the model and presents preliminary experiences including results from an expert consensus meeting, where the framework was discussed.
Using the Internet in Patient-centred Diabetes Care for Communication, Education, and Decision Support
Authors: Hejlesen Ole K.  , Plougmann Søren  , Ege Bernhard M.  , Larsen Ole V.  , Bek Toke  , Cavan David
Published: February 2025

The present paper describes two systems for communication, education, and decision support in patient-centred diabetes care. Both systems are developed under the assumption that while the clinical resources in the health care sector are limited, patients' resources and new information technology may be able to play a much more central role. With DiasNet patients can experiment with their own data. They can, retrospectively, adjust insulin doses or meals sizes, and thereby learn how to cope with various situations. DiabVision, brings together algorithms for detection of retinal lesions in digital images and for aligning time series of retinal images. While the former algorithms are aimed at automated procedures for screening for diabetic retinopathy, the latter can be used to enable motivated patients to see the actual retinal lesions in their own eyes, illustrating how the changes appear, and perhaps disappear, as a consequence of changes in lifestyle and glycaemic control. One of the long-term goals of our work is to assess the potential of integrating all health related information for patients with diabetes and other major chronic diseases. One solution to these problems would be to organise data and information as one virtual database, which then could be accessed by both health professionals and by patients. This structure would facilitate easy access, a clear overview, and quality control. A web site taking the first step in this process has been launched.
Telemedicine Applications using International Standard-based Videoconferencing
Authors: Okada Yoshikazu  , Haruki Yasuo  , Keough Erin  , Lacroix André  , Ogushi Yoichi  , Osamura Yoshiyuki  , Kurokawa Kiyoshi
Published: February 2025

Standard-based videoconferencing equipment is employed to develop economical global network for medical education and consultation. We had 169 domestic multipoint seminars, 11 international multipoint seminars, 16 pathological consultations and five clinical conferences.
The Doctor-Patient-Computer Interaction - How New Technology Can Be an Aid and a Barrier In Clinical Practice
Authors: Kidd Michael  , Mendis Kumara  , McPhee Wendy
Published: February 2025

Many general practitioners/family doctors are concerned about the impact that using a computer will have on their relationships with their patients. Questions remain about the optimal ways to use a computer during a consultation in primary medical care without having the technology get in the way of the doctor-patient communication necessary for quality clinical care. The education, training and support needs of clinicians have often been neglected in the process of clinical computerisation.
Life Informatics: Its Principles and Applications in Medical Informatics
Authors: Ren Gong-Yue  , Li Zong-Rong  , Tian Ai-Jing  , Rikli Arthur E.  , Lin Yu-Lin
Published: February 2025

This workshop focuses on the youngest member of medical informatics family, life informatics, including its concepts, principles, methodology, and applications in health and medical informatics.
E-Glue: Integrating Heterogeneous Health Systems
Authors: Ball Marion J.  , Walker Holly  , Douglas Judith V.  , Fright Gay A.
Published: February 2025

An integrated enabling technological infrastructure is mission critical to health systems. The integration of disparate legacy systems carries great risk, and failures or dislocations are not uncommon. Best practices for system integration at all systems of the systems life cycle can reduce these risks, as can attention to human factors within a change management framework. Systems integration remains a transitional solution at best. To reduce medical errors and improve the health care system, future systems must provide the interoperability that vendors of new applications architectures promise.
Challenges in the Development and Testing of a Reference Terminology Model for Nursing Interventions
Authors: Button Patricia S.  , Androwich Ida  , Mead Charles N.  , Zingo Christine  , Konicek Debra  , Campbell Keith E.
Published: February 2025

The purpose of this paper is to report the work of the Interventions Group of the first Nursing Terminology Summit (1999) and to describe the challenges and insights of this group as they have evolved a reference terminology model for nursing interventions. When the group began its work as part of the first meeting of the Nursing Terminology Summit, it had the overall objective of proposing the intervention component of a reference terminology model for nursing. Although there is not a definitive proposal for this to date, the group’s exploration and analysis has clarified and explicated both the types of models of clinical information and the current “state of the art” of formal representations of nursing interventions as well as the relationship of nursing languages to these formal representations. In addition, it is our perspective that the work of this group is representative of the process and challenges facing many similar groups currently engaged in modeling efforts. Consequently, critical success factors of such efforts are identified and discussed. This paper reports both the specific outputs of the group related to progress in defining a terminology model of nursing interventions and observations and lessons learned regarding consensus modeling work.
Sharable Computer-based Clinical Practice Guidelines: Rationale, Obstacles, Approaches, and Prospects
Authors: Greenes Robert A.  , Peleg Mor  , Boxwala Aziz  , Tu Samson  , Patel Vimla  , Shortliffe Edward H.
Published: February 2025

Clinical practice guideline automation at the point of care is of growing interest, yet most guidelines are authored in unstructured narrative form. Computer-based execution depends on a formal structured representation, and also faces a number of other challenges at all stages of the guideline lifecycle: modeling, authoring, dissemination, implementation, and update. This is because of the multiplicity of conceptual models, authoring tools, authoring approaches, intended applications, implementation platforms, and local interface requirements and operational constraints. Complexity and time required for development and structure are also huge obstacles. These factors argue for convergence on a common shared model for representation that can be the basis of dissemination. A common model would facilitate direct interpretation or mapping to multiple implementation environments. GLIF (GuideLine Interchange Format) is a formal representation model for guidelines, created by the InterMed Collaboratory as a proposed basis for a shared representation. GLIF currently addresses the process of authoring and dissemination; the InterMed team's major focus now is on tools to facilitate these tasks and the mapping to clinical information system environments. Because of limitations in what can be done by a single team with finite resources, however, and the variety of additional perspectives that need to be accommodated, the InterMed team has determined that further development of a shared representation would be best served as an open process in which the world community is engaged. Under the auspices of the HL7 Decision Support Technical Committee, a GLIF Special Interest Group has been established, which is intended to be a forum for collaborative refinement and extension of a standard representation that can support the needs of the guideline lifecycle. Significant areas for future work will need to include demonstrations of effective means for incorporating guidelines at point of care, reconciliation of functional requirements of different models and identification of those most important for supporting practical implementation, improved means for authoring and management of complexity, and methods for automatically analyzing and validating syntax, semantics, and logical consistency of guidelines.
A Virtual Intranet and Data-warehousing for Healthcare Co-operation
Authors: Kerkri El Mostafa  , Quantin Catherine  , Grison Thierry  , Allaert François André  , Tchounikine Anne  , Yétongnon Kokou
Published: February 2025

As patient's medical data is disseminated in different health structures, developing a medical or epidemiological patient-oriented data warehouse has some specific requirements compared to intra healthcare structure datawarehousing projects. The difference is that the healthcare structures implicated in a patient-oriented data warehouse project require some considerations about the confidentiality of the patient data and of the activities of healthcare structures.
Representation of Adolescent Health States within a Computer-Based Clinical Decision Support System
Authors: Liu Gilbert C.  , Downs Stephen M.
Published: February 2025

Background. A decade of research into adolescent health care has demonstrated that the health threats for today's American adolescents are predominantly behavioral rather that biomedical. The greatest mortality, morbidity and health care costs among adolescents are associated with unintentional injuries, homicide, suicide, alcohol and tobacco use, pregnancy, and sexually transmitted infections. Adolescents should be screened for behaviors associated with these health risks during routine health care, and receive appropriate counseling. Challenges to such screening and counseling include lack of physician knowledge about guidelines for adolescent preventive services, time constraints in clinic settings, and physicians' feeling uncomfortable or insufficiently trained to provide adolescent preventive services.
Doc'CISMeF: A Search Tool Based on “Encapsulated” MeSH Thesaurus
Authors: Darmoni Stefan J.  , Thirion Benoit  , Leroy Jean Philippe  , Douyère Magaly  , Lacoste Benoit  , Godard Christophe  , Rigolle Isabelle  , Brisou Martial  , Videau Stéphane  , Goupy Eric  , Piot Josette  , Quéré Myriam  , Ouazir Saïda  , Abdulrab Habib
Published: February 2025

In the year 2000, the Internet became a major source of health information for the health professional and the Netizen. The objective of Doc'CISMeF (D'C) was to create a powerful generic search tool based on an structured information model which ‘encapsulates’ the MeSH thesaurus to index and retrieve quality health resources on the Internet. To index resources, D'C uses four sections in its information model: ‘meta-term’, keyword, subheading, and resource type. Two search options are available: simple and advanced. The simple search requires the enduser to input a single term or expression. If this term belongs to the D'C information structure model, it will be exploded. If not, a full-text search is performed. In the advanced search, complex searches are possible combining Boolean operators with meta-terms, keywords, subheadings and resource types. D’C uses two standard tools for organising information: the MeSH thesaurus and the Dublin Core metadata format. Resources included in D’C are described according to the following elements: title, author or creator, subject and keywords, description, publisher, date, resource type, format, identifier, and language.
Development of an Intelligent Laboratory Information System for Community Health Promotion Center
Authors: Chae Young Mon  , Lim Hwan-Sub  , Lee Ju Hon  , Bae Mi Young  , Kim Gyu Hyung  , Bae Jin Hee  , Ahn Jae-ouk
Published: February 2025

This study aimed to develop an Intelligent Laboratory Information System (ILIS) for the community health promotion center in Kwachun city to help process an increasing number of laboratory test data in an efficient manner, and to support the clinical decision-making of public health doctors. A sample of 170 cases was used for validation of the system. Overall, the system correctly predicted 92.5% of the cases. This paper also analyzed the economic feasibility of the ILIS based on the Information Economics approach. The results showed that the ILIS not only helps screen more people by increasing the capacity of a health promotion center, but also brings in more revenue to the center.
Influence of Missing Values on Artificial Neural Network Performance
Authors: Ennett Colleen M.  , Frize Monique  , Walker C. Robin
Published: February 2025

The problem of databases containing missing values is a common one in the medical environment. Researchers must find a way to incorporate the incomplete data into the data set to use those cases in their experiments. Artificial neural networks (ANNs) cannot interpret missing values, and when a database is highly skewed, ANNs have difficulty identjing the factors leading to a rare outcome. This study investigates the impact on ANN performance when predicting neonatal mortality of increasing the number of cases with missing values in the data sets.
Enhancing Communications and Connectivity in Africa: The Multilateral Initiative on Malaria (MIM) Model
Authors: Siegel Elliot R.  , Royall Julia  , Bennett Mark
Published: February 2025

The U.S. National Library of Medicine, working in concert with the Multilateral Initiative on Malaria (MIM), has developed and implemented a unique organizational and technical strategy to connect malaria research sites to the Internet for purposes of facilitating North-South scientific communications and access to electronic information resources on the Web. The model employs microwave and VSAT technologies, and shares bandwidth and costs among participating malaria research sites and their respective research funders in Mali, Kenya, Ghana, Tanzania and other sub-Saharan locations affiliated with MIM. The concept of institutional partnership is an essential element of this information technology capacity building effort, which may find applicability in other developing regions of the world with similar communications and research networking needs and capabilities.
Problem of Incomplete Record Classification by Diagnostic Modules in Thyroid Laboratory Information System
Authors: Sonicki Zdenko  , Morin Annie  , Plasaj Tomislav  , Sonicki Darija  , Kusić Zvonko
Published: February 2025

Introduction of Spad-S diagnostic module into the laboratory IS adds a possibility to deal with incomplete patients records. Out of 1001 records in random sample, 42 records were misclassified, and just 19 were incomplete records. Predictive accuracy of incomplete records classification is 90,65.