bluuebunny/crossref_metadata_2025 huggingface dataset:
Warfarin Guide: Co-Design of a Mobile Computer-Assisted Anticoagulant Therapy
Authors: Gerdes Martin  , Martinez Santiago  , Smaradottir Berglind  , Fensli Rune  , Jortveit Jarle
Published: February 2025

Patients with some types of cardiovascular disease are prescribed anticoagulation therapy with Warfarin in order to control the ability of blood clotting. This work presents a co-designed mobile application, called Warfarin Guide, for a computer-assisted anticoagulant therapy. The application addresses the challenges that unexperienced patients may find when having to remember to regularly check their INR values and make temporary adjustments for INR value fluctuations that are not easy to interpret without direct medical advice.
A Patient Centric Nursing Mobile App Redesign
Authors: Navas Hernán  , Dozo Mariano  , Dourado Ezequiel  , Canteros Fernando  , Rung Ingrid
Published: February 2025

Sanatorio Finochietto has a nursing mobile app that allows safely preparing and administering medications. Hospitalized patients care experience is influenced by the system, the care process and nurse response, in this context, technology acts as a facilitator for care and humanized treatment. A “Patient-Centered Management System” would assist caregivers and patients to make individualized decisions about optimal care. This paper describe a paradigm shift to a mobile patient centered nursing application.
Using Human Phenotype Ontology for Phenotypic Analysis of Clinical Notes
Authors: Shen Feichen  , Wang Liwei  , Liu Hongfang
Published: February 2025

Phenotypes are defined as observable characteristics of organisms. To facilitate the translation between genotype and phenotype, Human Phenotype Ontology (HPO) was developed as a semantically computable standardized vocabulary to capture phenotypic abnormalities found in human. In this study, we investigated the use of HPO to annotate phenotypic information in clinical domain by leveraging a corpus of 12.8 million clinical notes created from 2010 to 2015 for 729 thousand patients at Mayo Clinic Rochester campus.
From a Categorical Structure to a Concept Model: The International Classification of Health Interventions (ICHI)
Authors: Rodrigues Jean-Marie  , Kim Sukil  , Aljunid Syed  , Lee Jae Jin  , Ten Napel Huib  , Trombert Béatrice
Published: February 2025

The International Classification of Health Interventions (ICHI) alpha2 2016 Section 1 Interventions on Body Systems and Functions is based on ISO 1828 international standard named categorial Structure (CAST). This is not sufficient to represent the meaning of ICD9-CM Volume 3 labels. We propose to modify it by using the SNOMED CT concept model.
Terminology Adoption in Family Medicine Service – Start of Journey
Authors: Wong Austen  , Lau Maggie  , Fung Vicky  , To Dorothy
Published: February 2025

A proposal on terminology adoption for the Problem and Encounter Reason capturing in the Hong Kong Hospital Authority Family Medicine Module was suggested. Given the complexity of the project, mapping had been conducted as preparatory work in the early phase of development.
Personalizing Longitudinal Care Coordination for Patients with Chronic Kidney Disease
Authors: Cullen Theresa A.  , Kasthurirathne Suranga N.  , Norton Jenna M.  , Narva Andrew S.
Published: February 2025

Chronic care coordination efforts often focus on the needs of the healthcare team and not on the individual needs of each patient. However, developing a personalized care plan for patients with Chronic Kidney Disease (CKD) requires individual patient engagement with the health care team. We describe the development of a CKD e-care plan that focuses on patient specific needs and life goals, and can be personalized according to provider needs.
Decision Support System for Medical Care Quality Assessment Based on Health Records Analysis in Russia
Authors: Taranik Maksim  , Kopanitsa Georgy
Published: February 2025

The paper presents developed decision system, oriented for healthcare providers. The system allows healthcare providers to detect and decrease nonconformities in health records and forecast the sum of insurance payments taking into account nonconformities. The components are ISO13606, fuzzy logic and case-based reasoning concept. The result of system implementation allowed to 10% increase insurance payments for healthcare provider.
The Evaluation of the Health Information Exchange with the Number of Usage and the Introduction of Outpatient to the Hospitals at Nagasaki Japan
Authors: Matsumoto Takehiro  , Honda Masayuki
Published: February 2025

Health Information Exchange (HIE) has been gradually spreading in Japan. But the effect and evaluation of these systems have not been proven. The aim of this study is to examine the effect of the Japanese HIE through the evaluation of the clinical activities in Nagasaki University Hospital. The electric medical records of 5335 patients were shared in the Ajisai-net, which was Japanese HIE in Nagasaki, from 2009 to 2015. And the number of shared patients increased every year, and the annual average number was 762.1. On the other hand, the number of the patients who was introduced from clinics to our hospital and whose medical records were shared in the Ajisai-net increased every year. In conclusion, the usage of Japanese HIE is useful for the clinical consultation and medical care, and these systems have the good effect on the hospital management in Japan.
Integrating Social Networks and Remote Patient Monitoring Systems to Disseminate Notifications
Authors: Ribeiro Hugo A.  , Germano Eliseu  , Carvalho Sergio T.  , Albuquerque Eduardo S.
Published: February 2025

Healthcare workforce shortage can be compensated by using information and communication technologies. Remote patient monitoring systems allow us to identify and communicate complications and anomalies. Integrating social networking services into remote patient monitoring systems enables users to manage their relationships. User defined relationships may be used to disseminate healthcare related notifications. Hence this integration leads to quicker interventions and may reduce hospital readmission rate. As a proof of concept, a module was integrated to a remote patient monitoring platform. A mobile application to manage relationships and receive notifications was also developed.
Preferred Features of E-Mental Health Programs for Prevention of Major Depression in Male Workers: Results from a Canadian National Survey
Authors: Wang Jian Li  , Ho Kendall
Published: February 2025

The purpose of this study was to estimate and compare the proportions of preferred design features and likely use of e-mental health programs and understand potential barriers to the use of e-mental health programs in working men who were at high risk of a major depressive episode. A cross-sectional survey in 10 provinces in Canada was conducted between March and December 2015 (n = 511). Of the 17 different features assessed, the top three features that were most likely to be used by high-risk men were: “information about improving sleep hygiene” (61.3%), “practice and exercise to help reduce symptoms of stress and depression” (59.5%) and “having access to quality information and resources about work stress issues” (57.8%). E-mental health programs may be a promising strategy for prevention of depression in working men. Development of e-mental health programs should consider men's preferences and perceived barriers to enhance the acceptability of this approach.
Electronic Health Records in the Cloud: Improving Primary Health Care Delivery in South Africa
Authors: Cilliers Liezel  , Wright Graham
Published: February 2025

In South Africa, the recording of health data is done manually in a paper-based file, while attempts to digitize healthcare records have had limited success. In many countries, Electronic Health Records (EHRs) has developed in silos, with little or no integration between different operational systems. Literature has provided evidence that the cloud can be used to ‘leapfrog’ some of these implementation issues, but the adoption of this technology in the public health care sector has been very limited. This paper aims to identify the major reasons why the cloud has not been used to implement EHRs for the South African public health care system, and to provide recommendations of how to overcome these challenges. From the literature, it is clear that there are technology, environmental and organisational challenges affecting the implementation of EHRs in the cloud. Four recommendations are provided that can be used by the National Department of Health to implement EHRs making use of the cloud.
Extracting Sexual Trauma Mentions from Electronic Medical Notes Using Natural Language Processing
Authors: Divita Guy  , Brignone Emily  , Carter Marjorie E.  , Suo Ying  , Blais Rebecca K.  , Samore Matthew H.  , Fargo Jamison D.  , Gundlapalli Adi V.
Published: February 2025

Patient history of sexual trauma is of clinical relevance to healthcare providers as survivors face adverse health-related outcomes. This paper describes a method for identifying mentions of sexual trauma within the free text of electronic medical notes. A natural language processing pipeline for information extraction was developed and scaled to handle a large corpus of electronic medical notes used for this study from US Veterans Health Administration medical facilities. The tool was used to identify sexual trauma mentions and create snippets around every asserted mention based on a domain-specific lexicon developed for this purpose. All snippets were evaluated by trained human reviewers. An overall positive predictive value (PPV) of 0.90 for identifying sexual trauma mentions from the free text and a PPV of 0.71 at the patient level are reported. The metrics are superior for records from female patients.
An Infrared Thermal Images Database and a New Technique for Thyroid Nodules Analysis
Authors: González José R.  , Damião Charbel  , Conci Aura
Published: February 2025

Thyroid nodules diseases are a common health problem and thyroidal cancer is becoming increasingly prevalent. They appear in the neck and bottom neck region, superficially over the trachea. Cancer tissues are characterized by higher temperatures than surrounding tissues. Thermography is a diagnostic tool increasingly used to detect cancer and abnormalities. Artificial intelligence is an approach which can be applied to thyroid nodules classification, but is necessary to have a proper number of cases with proven diagnosis. In this paper, a new database that contain infrared thermal images, clinical and physiological data is presented. The description of each nodule per patient, and the acquisition protocol (based on Dynamic Infrared Thermography approach) is considered as well. A semi-automatic method for image registration was implemented to pre-process the thermograms and a new method for the Region of Interest (ROI) extraction is proposed. Moreover, the obtained ROI results are confirmed by medical specialists and turned available for future comparison with other works.
A Hybrid Method for ICD-10 Auto-Coding of Chinese Diagnoses
Authors: Jia Zheng  , Qin Weifeng  , Duan Huilong  , Lv Xudong  , Li Haomin
Published: February 2025

The Chinese Version of Classification and Codes of Diseases (CCD) is an expanded version of ICD-10. Hospitals are required to assign CCD codes to discharge diagnoses in China. To handle the contradiction between a shortage of skilled CCD coders and increasing coding efficiency, a CCD auto-coding method is urgently needed. In this study a hybrid auto-coding method was proposed based on the lexical characteristics obtained through the analysis of a corpus of 1537 diagnoses with normative CCD code. It combines the rule-based approach, the Chinese characters-based distributed semantic similarity and the dictionary-based approach. The rule-based approach was proved to be efficient and precise at the cost of time and manpower. The semantic similarity approach shows poor performance. The old-fashioned dictionary-based approach ends in leading significance. The final accuracy of this hybrid approach is 96.9% in the test.
Development of a Deep Learning Algorithm for Automatic Diagnosis of Diabetic Retinopathy
Authors: Raju Manoj  , Pagidimarri Venkatesh  , Barreto Ryan  , Kadam Amrit  , Kasivajjala Vamsichandra  , Aswath Arun
Published: February 2025

This paper mainly focuses on the deep learning application in classifying the stage of diabetic retinopathy and detecting the laterality of the eye using funduscopic images. Diabetic retinopathy is a chronic, progressive, sight-threatening disease of the retinal blood vessels. Ophthalmologists diagnose diabetic retinopathy through early funduscopic screening. Normally, there is a time delay in reporting and intervention, apart from the financial cost and risk of blindness associated with it. Using a convolutional neural network based approach for automatic diagnosis of diabetic retinopathy, we trained the prediction network on the publicly available Kaggle dataset. Approximately 35,000 images were used to train the network, which observed a sensitivity of 80.28% and a specificity of 92.29% on the validation dataset of ~53,000 images. Using 8,810 images, the network was trained for detecting the laterality of the eye and observed an accuracy of 93.28% on the validation set of 8,816 images.
Lack of Training for a Downtime Procedure: End User's Perceptions of an Electronic Health Record Contingency Plan
Authors: Cano Rodrigo  , Bejarano Brenda  , Vidal Mercedes  , Luna Daniel  , Benítez Sonia
Published: February 2025

The implementation of an Electronic Health Record has many benefits; but when it is not available, it can impact patient continuity of care. If there is no support, or a failure to guarantee the continuity of services, contingency plans have to be implemented to overcome the information disruption. End users are in direct contact with the information system, and are responsible for documenting patient clinical information. Focusing on them, we propose the design, development, and validation of a survey to evaluate the beliefs, knowledge, and perceptions of end users, about the Electronic Health Record contingency plan. Preliminary results showed that even when there were less downtime periods, end users perceived that they did not have adequate training or information about how to go through the downtime event.
A Combined Collaborative Information Behaviour (CIB) and Continuity of Care Framework for Modeling Complexity in Colorectal Cancer Screening Access
Authors: Champion Caitlin  , Affleck Ewan  , Alvarez Gonzalo G.  , Kuziemsky Craig
Published: February 2025

Colorectal cancer screening access within a rural and remote health care environment represents a complex systems problem. Existing modeling approaches are inadequate in their representation of health system complexity. A combined Collaborative Information Behavior (CIB) and Continuity of Care framework was developed to model the health care processes involved in screening access over time. This framework highlighted necessary information behavior supports and system gaps in screening access, supporting development of targeted informatics solutions to improve screening access and cancer outcomes.
OpenClinic GA Open Source Hospital Information System Enabled Universal Health Coverage Monitoring and Evaluation in Burundian Hospitals
Authors: Karara Gustave  , Verbeke Frank  , Ndabaniwe Evelyne  , Mugisho Etienne  , Nyssen Marc
Published: February 2025

The Universal Health Coverage (UHC) is at the center of the 2030 Sustainable Development Goals agenda. In this study, the authors made an evaluation of the patient health coverage indicators in eight Burundian hospitals from 2011 to 2016. The relevant UHC indicators were calculated on the basis of patient administrative and health insurance data, collected via OpenClinic GA, an information and communication technology (ICT) supported health management information system (HMIS). The results show that the patient health services coverage rate was 70.8% for inpatients and 46.0% for outpatients. The patient health services payment rate as the proportion of total health service costs was above the 25% threshold recommended by WHO for inpatients (30.2%) and for outpatients (43.1%). The patient out-of-pocket payment was below the threshold of 180USD per patient per year for public hospitals. This study demonstrated the possibility to assess the degree of UHC in developing countries, by using routine data extracted automatically from the electronic HMIS.
P-Care BPJS Acceptance Model in Primary Health Centers
Authors: Markam Hosizah
Published: February 2025

Electronic Medical Records (EMR) are increasingly adopted in healthcare facilities. Recently, implementation failure of electronic information systems is known to be caused by not only the quality of technical aspects, but also the user's behavior. It is known as applying the Technology Acceptance Model (TAM). This research aimed to analyze the acceptance model of p-care BPJS in the primary health centers. A total sample of 30 p-care BPJS users was drawn by multistage random sampling in which of these 30 primary health centers participated. Data analysis used both descriptive and inferential statistics. In the phase of structural model, it indicated that p-care BPJS acceptance model in the primary health centers was formed by Perceived Ease of Use (PEOU) and Perceived Usefulness (PU) through Attitude towards use of p-care BPJS and Behavioral Intention to use p-care BPJS.
Patient Portal Adoption Rates: A Systematic Literature Review and Meta-Analysis
Authors: Fraccaro Paolo  , Vigo Markel  , Balatsoukas Panagiotis  , Buchan Iain E.  , Peek Niels  , van der Veer Sabine N.
Published: February 2025

Despite the increasing availability of online patient portals that provide access to electronic health records, little is known about their adoption by patients. We systematically reviewed the literature to investigate adoption of patient portals across studies. We searched MEDLINE and Scopus to identify relevant papers. We included 40 studies: 24 were controlled experiments, with prospective data collection in an actively recruited population; 16 were real-world experiments, with adoption being evaluated retrospectively after system deployment in clinical practice. Our meta-analysis showed an overall mean adoption rate of 52% (95% Confidence Interval [CI], 42 to 62%). Rates differed markedly between study types: controlled experiments yielded a mean adoption rate of 71% (95% CI 64 to 79%), compared to 23% (95% CI, 13 to 33%) in real-world experiments. This difference was confirmed in a meta-regression analysis of the influence of study characteristics on adoption rates. Our findings suggest that adoption rates reported in controlled studies do not reflect those in everyday clinical practice. Until we understand how to effectively increase adoption, patient portals are unlikely to consistently lead to improvements in care processes and health outcomes.
Green Turning Brown – Domain Engineering for Social and Health Services in Finland
Authors: Suomi Reima  , Nykänen Pirkko  , Vepsäläinen Tapio  , Hiltunen Riina
Published: February 2025

Being able to design information systems to an untouched domain, without the burden of existing information systems, especially legacy systems, is often seen as a dream of most information system professionals. Uncharted domains are anyway scarce, and often such greenfield projects turn into brownfield projects, also to projects where existing structures severely constrain the development of new systems. In this article we discuss the concepts of greenfield and brownfield domain engineering and software development, and reflect their possible messages to the re-engineering of the Finnish health- and social care ecosystem currently under way. In our fieldwork we could identify a lot of need and wish for greenfield domain engineering in the Finnish health and social services delivery. As well we found a lot of brownfield elements inhibiting change. Our proposal for the future is a ecosystem approach, where new and established elements could live together in a self-governed balance.
Trends in Fetal Medicine: A 10-Year Bibliometric Analysis of Prenatal Diagnosis
Authors: Dhombres Ferdinand  , Bodenreider Olivier
Published: February 2025

The objective is to automatically identify trends in Fetal Medicine over the past 10 years through a bibliometric analysis of articles published in Prenatal Diagnosis, using text mining techniques. We processed 2,423 full-text articles published in Prenatal Diagnosis between 2006 and 2015. We extracted salient terms, calculated their frequencies over time, and established evolution profiles for terms, from which we derived falling, stable, and rising trends. We identified 618 terms with a falling trend, 2,142 stable terms, and 839 terms with a rising trend. Terms with increasing frequencies include those related to statistics and medical study design. The most recent of these terms reflect the new opportunities of next-generation sequencing. Many terms related to cytogenetics exhibit a falling trend. A bibliometric analysis based on text mining effectively supports identification of trends over time. This scalable approach is complementary to analyses based on metadata or expert opinion.
cHRV Uncovering Daily Stress Dynamics Using Bio-Signal from Consumer Wearables
Authors: Hao Tian  , Chang Henry  , Ball Marion  , Lin Kun  , Zhu Xinxin
Published: February 2025

Knowing the dynamics of one's daily stress is essential to effective stress management in the context of smart and connected health. However, there lacks a practical and unobtrusive means to obtain real-time and longitudinal stress information. In this paper, we attempt to derive a convenient HRV-based (heart rate variability) biomarker named cHRV, which can be used to reliably reflect stress dynamics. cHRV's key advantage lies in its low maintenance and high practicality. It can be efficiently calculated only using data from photoplethysmography (PPG) sensors, the mainstream heart rate sensor embedded in most of the consumer wearables like Apple Watch. Benefiting from the proliferation of wearables, cHRV is ideal for day-to-day stress monitoring. To evaluate its feasibility and performance, we have conducted 14 in-lab controlled experiments. The result shows that the proposed cHRV has strong correlation with the stress dynamics (r > 0.95), therefore exhibits great potential for continuous stress assessment.
Profitability Consideration of Corrugated Paperboard Production Based on Carbon Footprint Reduction and the Improvement of Overall Equipment Effectiveness
Authors: Nguyen Long Giang  , Hansuebsai Aran
Published: February 2025

Environment friendly production is an emerging trend in industrial production. Enhancing environmental protection and ensuring company's profitability have gained great attention from any manufacturers. The use of Overall Equipment Effectiveness (OEE) to reflect efficiency of production has been widely applied in the manufacturing process. However, the full advantage of OEE as a measure to simultaneously facilitate reduction of carbon dioxide (CO2) emissions and to sustain the existing profitability has not been utilized. This study aimed to investigate the use of OEE to improve the manufacturing process of corrugated paper production using two indicators including CO2emission and profitability. The research showed a model of measuring OEE, CO2emission and Profitability. The obtained results indicated that impact 1 and impact 2 could maintain the same profitability (9%) but OEE and CFP from impact 1 (37% and 26%, respectively) were higher than those from impact 2 (12% and 8%, respectively). The overall results revealed that when improving OEE, CO2emission per product (1m2) could be significantly reduced while profitability could be increased in the production of corrugated paper.
Customer Experience Evaluation in the Omnichannel Environment
Authors: Föhr Janne  , Hietanen Hannes  , Khvatov Artem  , Lepistö Toni  , Liukka Niko  , Dahanayake Ajantha
Published: February 2025

The omnichannel strategy allows the customer to have the same experience through multiple different channels, which can greatly improve the customer experience and thus benefit businesses. This research paper studies the evaluation of customer experience in the omnichannel environment. Very little research about it exists as it is quite a new business model. Therefore, a systematic literature review was conducted to find as much relevant data as possible and analyse the results systematically. 42 channels, 97 customer experience factors and 34 tools or methods are found from 19 different studies and categorized accordingly. All the connections between the extracted data are discovered by processing it with a relations visualizing tool. This way it enables to see how everything is connected and which topics are the most common in the included studies. Finally, from the findings, this research proposes a conceptual model linking all the parts of this research together to create a basic outline for customer experience evaluation in the omnichannel environments.
Components of an Intelligent Preprocessing Agent for Data Mining: Extensibility Viewpoint
Authors: Vattulainen Markus
Published: February 2025

Understanding of data quality problems, algorithms to reduce their impact on data mining and the preprocessing process in general has accumulated to the point that intelligent applications are emerging to automate previously manual preprocessing work. Application development efforts have been, however, constrained by gaps in the identification of system components especially regarding extensibility. The research question addressed is: what are the components of an intelligent data preprocessing agent? The task environment of the agent is characterized against five principal criteria by drawing from empirical studies in the business performance measurement system domain and component candidate feasibility is assessed. A component model consisting of autonomous components and their interactions is presented with design alternatives. Although execution time was unsatisfying without long-term memory component, the partially implemented model provided near-optimal results. The presented model is found to be a useful support in the design and study of intelligent data preprocessing agents.
Study the Effect of Ammonia by Image Analysis on Healthiness Detection for Coral Quality of LifeTitle
Authors: Hansuebsai Aran  , Rungsupa Sompop  , Kiyoki Yasushi  , Sasaki Shiori  , Chawakitchareon Petchporn
Published: February 2025

This research deals with the monitoring techniques using normal and multi-spectrum cameras to detect coral healthiness. The Acropora Corals were investigated in laboratory experiment. Parameter of investigation is Ammonia contamination from 0.01 ppm to 10.0 ppm. Under these conditions, the images of coral were captured and analyzed. An Entropy and coral indices of the obtained images were proposed. The important finding in this study is the feature extraction of coral healthiness: (1) event detection, (2) % degradation and (3) relationship between coral index and entropy. For event detection, the trends of water quality parameters such as temperature and salinity was considered. The obtained entropy values gave % degradation of coral. It was also found that GRCI index related with the relevant entropy values of coral images.
Concept Recognition in European and National Law
Authors: Nanda Rohan  , Siragusa Giovanni  , Di Caro Luigi  , Theobald Martin  , Boella Guido  , Robaldo Livio  , Costamagna Francesco
Published: February 2025

This paper presents a concept recognition system for European and national legislation. Current named entity recognition (NER) systems do not focus on identifying concepts which are essential for interpretation and harmonization of European and national law. We utilized the IATE (Inter-Active Terminology for Europe) vocabulary, a state-of-the-art named entity recognition system and Wikipedia to generate an annotated corpus for concept recognition. We applied conditional random fields (CRF) to identify concepts on a corpus of European directives and Statutory Instruments (SIs) of the United Kingdom. The CRF-based concept recognition system achieved an F1 score of 0.71 over the combined corpus of directives and SIs. Our results indicate the usability of a CRF-based learning system over dictionary tagging and state-of-the-art methods.
Automatic Recognition of Epileptiform EEG Abnormalities
Authors: Brenner Alexander  , Kutafina Ekaterina  , Jonas Stephan M.
Published: February 2025

Long term EEG examinations, for example during epilepsy diagnosis, can be performed more efficiently with support of automated abnormality detection. Currently, these methods are usually developed based on one specific database, which limits the possibilities of generalizations. Here, we present a machine learning solution for detection of interictal abnormal EEG segments optimized on the publically available TUH Abnormal EEG Corpus. The classifier is further re-trained and tested on several combinations of publicly available data sets. The results achieved internally on the datasets are comparable to the known state of the art, while training and testing on different sources produced accuracy in the range of 67.51% to 99.50%. Lower accuracy is achieved when the training data set is highly preprocessed and relatively small.
Patient Stratification Using Longitudinal Data – Application of Latent Class Mixed Models
Authors: Geifman Nophar  , Lennon Hannah  , Peek Niels
Published: February 2025

Analysis of longitudinal data in medical research is becoming increasingly important, in particular for the identification of patient subgroups, as the focus of medical research is shifting toward personalised medicine. Here we present the use of a statistical learning approach for the identification of subgroups of hypertension patients demonstrating different patterns of response to treatment. This method, applied to large-scale patient-level data, has identified three such groups found to be associated with different clinical characteristics. We further consider the utility of this method in medical research by comparison to the application in two additional studies.
An Empirical Approach to Enhancing Terminology Binding – An HL7 FHIR SNOMED CT Example
Authors: Gøeg Kirstine Rosenbeck  , Hummeluhr Mark
Published: February 2025

Information exchange at the level of semantic interoperability requires that information models and clinical terminologies work well together. In HL7 FHIR resources, terminology binding to standard terminologies such as SNOMED CT are suggested, and even though most are suggestions rather than rules, they still must reflect the clinical domain accurately. In this study, we suggest a method for empirically evaluating whether a terminology binding represents the value sets used in practice. We evaluated the terminology binding associated with the MedicationRequest.reasonCode using the Danish national indication value set which we mapped to SNOMED CT. We found two problems with the terminology binding, namely, that the reason for prophylactic treatment and that medication given as part of a procedure, but not related to the patients' problems per se could not be expressed within the boundary of HL7 FHIR's example terminology binding. Future work will include showing how more complex terminology binding issues could be informed by looking at value sets in use.
Minimal Important Difference in Outcome of Disc Degenerative Disease Treatment: The Patients' Perspective
Authors: Dui Linda Greta  , Cabitza Federico  , Berjano Pedro
Published: February 2025

Evaluation of treatments effectiveness in a context of value-based health care is based on outcomes, and in their assessment. The patient perspective is gaining renovated interest, as demonstrated by the increasing diffusion of Patient Reported Outcome Measure (PROMs) collection initiatives. The concept of Minimal Clinically Important Dif-ference (MID) is generally seen as the basis to estimate the actual effect perceived by the patient after a treatment, like a surgical intervention, but a universally recognized threshold has not yet been established. At the Orthopedic Institute Galeazzi (Milan, Italy) we began a digitized program of PROM collection in spine surgery by means of a digital platform, called Datareg. In this work we aim to investigate MID in the treatment of degenerated disc in terms of patients' perceptions as these are collected through the above electronic registry. We proposed a computation of MID on the basis of two PROM scores, and a critical comparison with a domain expert's proposal.
On Defining Bruxism
Authors: Ceusters Werner  , Smith Barry
Published: February 2025

In a series of recent publications, orofacial researchers have debated the question of how ‘bruxism’ should be defined for the purposes of accurate diagnosis and reliable clinical research. Following the principles of realism-based ontology, we performed an analysis of the arguments involved. This revealed that the disagreements rested primarily on inconsistent use of terms, so that issues of ontology were thus obfuscated by shortfalls in terminology. In this paper, we demonstrate how bruxism terminology can be improved by paying attention to the relationships between (1) particulars and types, and (2) continuants and occurrents.
Supporting Patient Self-Care: Examining Nurses' Practices in a Remote Care Setting
Authors: Grisot Miria  , Moltubakk Kempton Alexander  , Hagen Laila  , Aanestad Margunn
Published: February 2025

The use of information technology in remote care is expected to play an important role in supporting patient self-care. However, there is limited research on how self-care is achieved in practice and what is the role of nurses in supporting patient self-care. In this paper, we present the results from a qualitative case study on the work practices of nurses in remote patient care in Norway. We identify two nurses' practices: self-care as learning analytic skills, and self-care as preventive activation of patients. Our research contributes to the literature on remote care by foregrounding the central role of nurses in patient self-care.
Semi-Automatically Measuring Shoulders' Range of Motion – Objective Measurements with Good Reliability and Accuracy
Authors: Saalfeld Birgit  , Pingel Ilonka  , Wolf Klaus-Hendrik
Published: February 2025

The shoulder's range of motion (ROM) is an important measurement for the diagnostic process and course of treatment for patients with shoulder disorders or injuries. Visual estimation to assess a shoulder's ROM is a fast measuring method, and therefore routinely used in clinical practice. Studies already proved this method as very subjective and unreliable. Misestimating the severity of a patient's disability can lead to improper treatment and should be avoided. Modern technology may help measuring the ROM more reliable, objective, non-invasive and still fast. In this paper we present a computer-based prototype to semi-automatically assess the patient's shoulder ROM. Still photography is one of the most accurate ways to determine the extent to which a shoulder can be moved. Thus, a marker-less motion sensing device is used to capture movements of patient. A study with n=9 healthy adults was conducted to validate the results of the computer-based system against a physician using goniometry. The results show great potential of this technique for abduction, adduction, anteversion and retroversion with an intraclass correlation coefficient ranging between 0.77 and 0.86 for the best measuring method. Using the system would enhance daily practice. Patients could measure their ROM during their waiting time in advance to the visit, optionally supported by a nurse. Due to the more reliable and objective result the physician can instantly start diagnosing the patient or discussing therapy options. Time for investigation is saved and more time to treat the patient with objective and reliable measurement results would be available.
Monitoring and Benchmarking eHealth in the Nordic Countries
Authors: Nøhr Christian  , Koch Sabine  , Vimarlund Vivian  , Gilstad Heidi  , Faxvaag Arild  , Hardardottir Gudrun Audur  , Andreassen Hege K.  , Kangas Maarit  , Reponen Jarmo  , Bertelsen Pernille  , Villumsen Sidsel  , Hyppönen Hannele
Published: February 2025

The Nordic eHealth Research Network, a subgroup of the Nordic Council of Ministers eHealth group, is working on developing indicators to monitor progress in availability, use and outcome of eHealth applications in the Nordic countries. This paper reports on the consecutive analysis of National eHealth policies in the Nordic countries from 2012 to 2016. Furthermore, it discusses the consequences for the development of indicators that can measure changes in the eHealth environment arising from the policies. The main change in policies is reflected in a shift towards more stakeholder involvement and intensified focus on clinical infrastructure. This change suggests developing indicators that can monitor understandability and usability of eHealth systems, and the use and utility of shared information infrastructure from the perspective of the end-users – citizens/patients and clinicians in particular.
Clarifying Diagnoses to Laymen by Employing the SNOMED CT Hierarchy
Authors: van Mens Hugo J.Th.  , de Keizer Nicolette F.  , Nienhuis Remko  , Cornet Ronald
Published: February 2025

Patient access to electronic health records (EHRs) is associated with improved efficiency, self-management, and patient engagement. However, the EHR contains medical language that can be difficult to comprehend by patients. In Dutch hospitals, the Diagnosethesaurus (DT) is used as an interface terminology to register diagnoses, but it does not contain patient-friendly terms. Fortunately, the DT is partly mapped to SNOMED CT and there is a proportionately small set of patient-friendly terms available in the Dutch SNOMED CT release. The purpose of this study was, therefore, to investigate if SNOMED CT can be used to generate clarifications of diagnoses for patients. Only 1.2% of the DT diagnoses that were already mapped to SNOMED CT had patient-friendly synonyms that were different from the diagnoses descriptions. However, by generalizing diagnoses to SNOMED CT concepts with patient-friendly terms, this number could be increased to 71%. In conclusion, we showed that a high percentage of diagnoses could be clarified to at least some extent with the relatively small set of patient-friendly terms. Future research will involve the further optimization of the clarifications, and evaluation with clinicians and patients.
Cleansing and Imputation of Body Mass Index Data and Its Impact on a Machine Learning Based Prediction Model
Authors: Jauk Stefanie  , Kramer Diether  , Leodolter Werner
Published: February 2025

Background: A challenge of using electronic health records for secondary analyses is data quality. Body mass index (BMI) is an important predictor for various diseases but often not documented properly.
Nurses' Attitude for Using Barcode Medication Administration System in a Developing Country
Authors: Sheikhtaheri Abbas  , Saravani-Aval Samane
Published: February 2025

Medication errors are common in healthcare settings. To prevent these errors, use of modern technology is suggested. Improvement of medication administration system particularly at the time of drug administration is mandated in Iran. Barcode medication administration (BCMA) systems are useful in this regard. This study was conducted to assess nurses' attitude for the use of BCMA systems. To this end, 283 randomly selected nurses working in teaching hospitals were surveyed using a five point Likert scale questionnaire. The most positive attitudes were related to the role of BCMA in reducing medication errors (4.02±0.8), improving performance (3.8±0.99), productivity (3.8±0.97) and making patient care easier (3.83±0.9). Only 9.9 percent of nurses did not like to use the technology. There was no significant difference between nurses in terms of their age, experience, education, and hospitals. In conclusion, nurses' attitude about BCMA was in a relatively good level. However, there is a need to train nurses for the use of this technology.
Improving Patient Safety by Reusing Clinical Routine Data – An Expert Survey on Patient Safety Indicators
Authors: Schaller Michael  , Hackl Werner O.  , Ammenwerth Elske
Published: February 2025

Background: Patient safety is an important issue and receiving increasing attention. Information technology (IT) and IT-based strategies as the secondary use of already existing data within hospital information systems can help to improve patient safety.
Is Austria Ready for Telemonitoring? A Readiness Assessment Among Doctors and Patients in the Field of Diabetes
Authors: Muigg Domenik  , Kastner Peter  , Modre-Osprian Robert  , Haluza Daniela  , Duftschmid Georg
Published: February 2025

Background: Telemonitoring offers new opportunities in the treatment of chronically ill patients and could help to improve their quality of life while reducing healthcare costs.
Challenges of a HL7 CDA Guideline for Telehealth Based DMP Systems
Authors: Tanjga Nikola  , Baranyi René  , Grechenig Thomas  , Gossy Christian  , Welte Stefan  , Kastner Peter  , Modre-Osprian Robert
Published: February 2025

Background: Disease management programs (DMP) are a modern way of treating health conditions and are becoming a part of standard care. One telehealth DMP service has been in regular operation since 2017, named “HerzMobil Tirol”.
Improving Fluid Management in Critical Care – Towards the ICU of the Future
Authors: Bergmoser Katharina  , Pflanzl-Knizacek Lucas  , Hafner Matthias  , Schilcher Gernot  , Baumgartner Christian
Published: February 2025

Background: The calculation of daily fluid balances is essential in perioperative and postoperative fluid management in order to prevent severe hypervolemia or hypovolemia in critically ill patients. In this context, modern health information technology has the potential to reduce the workload for health care professionals by not only automating data collection but also providing appropriate decision support.
HAART Prescription Support Tool for Personalized Therapy
Authors: Giannini Barbara  , Giacomini Mauro
Published: February 2025

The importance of decision support systems is highly acknowledged as a key strategy to improve medical safety and quality of care. A strong interoperability between the hospital Electronic Health Record (EHR) and the Clinical Decision Support System (CDSS) is the key to reach a most reliable decision support, that could aid in better diagnosis, reduce medication errors and improve practitioner performances. Interoperability is granted by the use of standards for data representation and for system intercommunication. A CDSS to support HAART (Highly active antiretroviral therapy) prescription in HIV (Human Immunodeficiency Virus) naive patients was developed within the Ligurian HIV Network. GLIF3 (GuideLine Interchange Format) standard was used to represent clinical guidelines in machine interpretable format. HSSP (Healthcare Services Specification Project) DSS (Decision Support System) standard was used to develop the CDSS web service that evaluates patient's data according to the rules emerging from the GLIF representation of the guidelines. Patient's data are extracted from hospital EHR, formatted into standard vMR (virtual Medical Record) documents and sent to the DSS web service to be evaluated. The results are displayed by a client application in an intuitive way to guide physician's decisions.
Patient Decision Aid Systems: An Overview
Authors: Agin Fariba  , Madhani Zahra  , Zahmatkeshan Khorasani Akram  , Zehtab Hanieh  , Aslani Azam
Published: February 2025

Patients often become confused when selecting a therapy. They usually decide not to participate in the selection process due to lack of information, having stress for making the wrong choice or the lack of effective communication with their physician. The aim of patient decision aids (PDAs) are to promote counseling between patients and healthcare providers on the available options as a tool to assist the decision making process. This paper, various PDAs definitions were investigated and their variation were discussed in different formats. Therefore, there are obstacles that are commonly found in patients' decision-making, which can be avoided through PDAs.
FEM-Aided Structural Design of a Natural Fiber Composite Made Skiff
Authors: Moscoloni Claudio  , Fontana Marco  , Passione Biagio  , Cinefra Maria  , Mattiazzo Giuliana
Published: February 2025

In racing boat design, the research is moved to find always the best compromise between performance and safety. The present work focuses on the description of the structural design cycle used by Polito Sailing Team during the realization of its new skiff, a high-performance sailing dinghy, built mainly with natural composite material such as balsa wood and flax fiber. The whole boat was completely designed by students, according to eco-sustainable principles, to participate in a universities competition called 1001VelaCup. To determinate the sandwich composite stratification, a benchmarking of materials was made by mechanical tests run according to ASTM 3039 and 3518 regulations. A finite element (FE) model was built to evaluate the static response of the structure, aiming to obtain a safe and light hull. The fluid (sea) interaction is modeled with a linear springs system. The crew, rig and rigging loads are obtained from a one-dimensional model and hydrodynamics pressure from ISO 12215-5:2014. The outputs obtained are consistent with the physics of the problem and the stresses distribution shows that the maximum stress is in the proximity of the mast base. This work constitutes the first step to obtain a correct, reliable and innovative design tool.
Model Order Reduction by Means of Active Subspaces and Dynamic Mode Decomposition for Parametric Hull Shape Design Hydrodynamics
Authors: Tezzele Marco  , Demo Nicola  , Gadalla Mahmoud  , Mola Andrea  , Rozza Gianluigi
Published: February 2025

We present the results of the application of a parameter space reduction methodology based on active subspaces (AS) to the hull hydrodynamic design problem. Several parametric deformations of an initial hull shape are considered to assess the influence of the shape parameters on the hull wave resistance. Such problem is relevant at the preliminary stages of the ship design, when several flow simulations are carried out by the engineers to establish a certain sensibility with respect to the parameters, which might result in a high number of time consuming hydrodynamic simulations. The main idea of this work is to employ the AS to identify possible lower dimensional structures in the parameter space. The complete pipeline involves the use of free form deformation to parametrize and deform the hull shape, the full order solver based on unsteady potential flow theory with fully nonlinear free surface treatment directly interfaced with CAD, the use of dynamic mode decomposition to reconstruct the final steady state given only few snapshots of the simulation, and the reduction of the parameter space by AS, and shared subspace. Response surface method is used to minimize the total drag.