bluuebunny/crossref_metadata_2025 huggingface dataset:
International Concerted Action on Collaboration in Telemedicine: G8 sub-project 4
Authors: Lacroix André
Published: February 2025

The main objective of G-7/8 Global Healthcare Applications sub-project 4 is to enable an international concerted action on collaboration in telemedicine. To promote and facilitate the implementation of telemedicine or health telematics networks around the world, it was felt necessary to solve certain key issues. Five thematic solution-seeking FORUMS are each addressing a specific item. The first FORUM held in Montréal, Canada on May 28-30 1998 focussed on Interoperability of telemedicine and telehealth systems. Other FORUMS address other themes such as: Impacts of Telemedicine on health care management (Regensburg, Germany, November 21-23 1998); Evaluation and Cost Effectiveness of Telemedicine (Melbourne, Australia, February 19-20 1999); Clinical and technical quality and standards (Washington, USA, April 29-30 1999); Medico-legal aspects of national and international applications (Oxford, UK, fall 1999).
A Controlled Pilot Study in the Use of Telemedicine in the Community on the Management of Heart Failure - A report of the first three months
Authors: de Lusignan Simon  , Meredith Karen  , Wells Sally  , Leatham Edward  , Johnson Paul
Published: February 2025

This is a controlled pilot study of twenty patients to see if heart failure management can be optimised in the community using telemedicine. The study seeks to examine the feasibility, acceptability and reliability of using telemedicine in this context. Heart failure is a common condition. It is an important cause of mortality and morbidity and has large cost implications for the NHS. Most patients are managed in the U K in General Practice based on clinical assessment by the practitioner. Twenty patients with a mean age of 75.1 years and mean New York Heart Association grade of 1.75 were randomised in to two equal groups (telemonitoring and control) and observed for a period of three months. All twenty patients had a Cardiologist assessment and quality of life measurement at the beginning and end of the study. Patients in the telemedicine group had their blood pressure, pulse and weight data collected daily and undertook a weekly video conference with the nurse. Control patients had their blood pressure, weight and pulse measured at six weekly intervals. The study has been extended for a further six months beyond its initial three-month observation period to see if the initial short term benefit in the telemedicine group is maintained.
3.4 Electronic Health Record
Authors: Mantas John
Published: February 2025

The chapter covers the electronic health record and electronic health record system that facilitates the use of EHR. The EHR is compared with the traditional handwritten health care record. Definition of Electronic Health Records and its association with the terminology, classification and coding is presented. The architecture of the Electronic Health Record is of strong significance as well as its attributes. Strategic approaches of designing systems supporting the use of electronic health records are depicted. A short presentation of current state of implementation and the obstacles for further implementation are given in the final part of the chapter.
Current Security Issues Faced by Health Care Establishments and Resulting Requirements for a Secure Health Information System Architecture
Authors: Blobel Bernd  , Baum-Waidner Birgit
Published: February 2025

As all the other contributions of this volume, the following chapter is based on earlier work like the SEISMED project results concerning comprehensive guidelines elaborated on security in Health Care Establishments' (HCE) information infrastructures. Dealing with current security issues in the healthcare domain, it consists of two parts.
The Health Management Information System of Romania
Authors: Farcas Dan D.
Published: February 2025

In Romania a Health Management Information System (HMIS) project is in progress. The project covers the main activities of the Ministry of Health (MoH), of the 42 District Health Authorities and more than 250 other health care units. The first applications will be implemented at the middle of 1999. The paper shows the context of the HMIS among other Health Information Systems in Romania, its main parts and some organizational issues of the HMIS project, achievements and difficulties encountered.
Telepathology and Imaging Spectroscopy as a New Modality in Histopathology
Authors: Vari Sandor G.  , Müller Gerhard  , Lerner Jeremy M.  , Naber Rolf-Dieter
Published: February 2025

Telemedicine started in the late 1950's by transmitting data on patients' pulse and heart rates. In the 1980's it expanded to radiology and orthopedics. The technology is now expanding to other specialties that can digitally gather patient data. Telepathology comprises the transmission of microscopic images via telecommunication network. Image compression and multiplexing technologies enabled high-resolution telepathology as well as real-time video consultations over international telephone lines. Organ transplantation has become a viable treatment and offers new life to an increasing number of patients suffering from chronic end stage diseases and from irreversible organ failure. Rejection is still a major problem in kidney, liver, and heart transplantation. To gain further insight into the complex interactions within the components of the immune system, it has become increasingly necessary to develop rapid and simple methods to monitor the status of the immune system in patients. Clinical signs suggest organ rejection and abnormal laboratory test results, but only histological signs on biopsy specimens are adequately specific. The financial cost of organ transplant makes it imperative to develop tools for the early identification and treatment of organ rejection. An increasingly sensitive and accurate way of localizing key structures and abnormalities is through spectroscopy of either H&E stained samples or with a fluorescent tag (fluorophore) or by relying on natural fluorescence. The system is based on a unique Prism and Mirror Imaging Spectroscopy System (“PARISS™”), spectrometer originally designed and implemented for remote Earth monitoring from space and aircraft and astronomical imaging spectroscopy. Compact and lightweight both the mirror and prism are presently constructed in inexpensive glass but can also be injection molded in plastic. Any number of vendors anywhere in the world can produce all parts of the assembly. This greatly enhances the chances of future commercial viability. The Interactive Histopathology Consultation Network INTERPATH (PL961121) project integrated of remote control imaging microscopy system, imaging spectroscopy, and communication networks called SPECTROMIC. This telepethology unit will be a useful tool in the Regional and International Integrated Telemedicine Network for Medical Assistance in End Stage Diseases and Organ Transplant, RETRANSPLANT HC 4028 (HC) & IN 4028 (HC).
The Hip Status: A Telemedical Application
Authors: Smrke Dragica  , Cerkvenik Gregor  , Piškur-Kosmaˇ Dunja  , Stankovski Vlado
Published: February 2025

Biomedical informatics and biomedical engineering are interdisciplinary sciences that are growing fast and have a significant impact on healhcare delivery. The University Medical Centre in Ljubljana and the Medical Faculty through its institutes have initiated the building of their own telemedicine systems. These systems concern only the medical informatics field. However, in this work a telemedical application that uses a combination of biomedical engineering methods and methods of biomedical informatics is presented. This telemedical application was built at the Department of Surgery and it was named “The Hip Status Application”. Its aims are to provide services of preventive medicine and health promotion for people with potential problems with the hip-joint, guidance for people that have already underwent an operation of implantation of hip endoprosthesis, or have in any other way affected hip-joints, remote system consultation for diagnostic purposes, etc. The application is still under evaluation, and it is meant as a start of a new era of engineering-powered telemedical applications at the Department of Surgery following the trends in the most developed countries of the World.
Real-time Medical Applications and Telecommunications
Authors: Štravs Miroslav
Published: February 2025

Telecommunications play an important role in telemedicine. Many forms of telecommunication services based on different telecommunication technologies are developed for various needs. The paper deals with complex real-time applications which demand high telecommunication requirements. At the beginning, medical applications are categorised and real-time applications qualified as multimedia applications. Requirements for multimedia elements are listed separately. Later on, short introduction of related telecommunication protocols is given. Real-time medical applications can show their ability in case of guaranteed quality of services delivered by telecommunication network as it is explained in the end.
Bias in meta-analysis and funnel plot asymmetry
Authors: Biljana Milicic  , Jelena Marinkovic  , Branislav Jeremic  , Milorad Radotic
Published: February 2025

International experiences reveal the important role played by scientific research and systematic study a problems, in effectively tackling change in the health sector. Meta-analysis was introduced to address the problem of synthesizing the large quanty of information on a particular subject. It is viewed, only as a step in the process of developing better tools to quantify information across studies.
Application of the medical data warehousing architecture Epidware to epidemiological follow-up : data extraction and transformation
Authors: Kerkri Elmostafa  , Quantin Catherine  , Yetongnon Kokou  , Allaert Fa  , Dusserre Liliane
Published: February 2025

In this paper, we present an application of EPIDWARE, medical data warehousing architecture, to our epidemiological follow-up project. The aim of this project is to extract and regroup information from various information systems for epidemiological studies. We give a description of the requirements of the epidemiological follow-up project such as anonymity of medical data information and data file linkage procedure. We introduce the concept of Data Warehousing Architecture. The particularities of data extraction and transformation are presented and discussed.
An Internet Implementation of an International Clinical Study
Authors: Hollingsworth R.A.  , Hay C.  , Richards B.
Published: February 2025

This paper describes a clinical study that is being conducted in 15 countries world-wide via the internet. The study concerns the removal of Factor VIII inhibitors in haemophilic children. The suitability of the Internet for this type of study is explored together with the technology (Active Server Pages, Secure Sockets Layer) that is involved in the creation of such a system.
A Unified Framework for Data Modeling on Medical Information Systems
Authors: Neves José  , Cortez Paulo  , Rocha Miguel  , Abelha António  , Machado José  , Alves Vitor  , Basto Sousa  , Botelho Henrique  , Neves João
Published: February 2025

Medical Information Systems (MIS) are seen as a way of optimizing the use of existing health-care infrastructure, without resorting to new and costly hospital (re)construction. The qualitative (re)design of such an environment requires a basic understanding of patient and doctors related characteristics and capabilities. Patient care, patient education, medical education, and clinical research need to be considered to meet the basic requirements on the level of services desirable, determined on the basis of the patient's length of stay; i.e., used for modeling the significant entities of such a world. The aim is to extract conclusions for the level of services provided to the users. One’s concept will capture, as well as will integrate, the basic design principles under which MIS may be set.
A system for the description of healthcare guidelines
Authors: Grifoni Patrizia  , Luzi Daniela  , Ricci Fabrizio L.
Published: February 2025

Contained costs and quality of treatment are two elements which have to be considered when planning and controlling both clinical and managerial activities of healthcare structures (HCSs). Each structure has to be marked by a high level of quality of treatment and by specific professional competencies and skills of its operators. It is therefore fundamental to provide a system which supports the management of processes and of guidelines which characterise an healthcare structure. In this paper we present a system able to describe processes of an HCS and in particular clinical guidelines. This system is based on a workflow conceptual model, able to represent clinical and managerial activities carried out in HCSs (the Atreus model).
The holistic architectural approach to integrating the healthcare record in the overall information system
Authors: Ferrara Fabrizio Massimo  , Sottile Pier Angelo
Published: February 2025

The integration and evolution of existing systems represents one of the most urgent problems facing those responsible for healthcare information systems so that the needs of the whole organisation are addressed. The management of the healthcare record represents one of the major requirements in the overall process, however it is also necessary to ensure that the healthcare record and other healthcare information is integrated within the context of an overall healthcare information system. The CEN ENV 12967-1 ‘Healthcare Information Systems Architecture’ standard defines a holistic architectural approach where the various, organisational, clinical, administrative and managerial requirements co-exist and cooperate, relying on a common heritage of information and services. This paper reviews the middleware- based approach adopted by CEN ENV 12967-1 and the specialisation necessary for the healthcare record based on CEN ENV 12265 ‘Electronic Healthcare Record Architecture’.
A method for an automated decomposition of a complex term into its conceptual components
Authors: Barac'h V.  , Burgun A.  , Delamarre D.  , Le Beux P.
Published: February 2025

The paper deals with the improvement of the MAOUSSC model ($\underbar{M}$odèle d'$\underbar{A}$ide et d'$\underbar{O}$rientation d'un $\underbar{U}$tilisateur au $\underbar{S}$ein des $\underbar{S}$ystémes de $\underbar{C}$odage) and system. Its specific purpose is the automation of the description of medical and surgical procedures. We have developed an automatic decomposition method using a linguistic and conceptual approach based on the UMLS knowledge base. This work concerns the processing of 100 procedure wordings from the digestive surgery domain. We introduce a prototype of such a system automating the decomposition through a web interface.
A Real-time CORBA Based System Architecture for Robot Assisted Craniofacial Surgery
Authors: Pernozzoli A.  , Burghart C.  , Brief J.  , Haßfeld S.  , Raczkowsky J.  , Mühling J.  , Rembold U.  , Wörn H.
Published: February 2025

We present the concept of a system architecture for the computer aided craniofacial surgery. The architecture is based on CORBA, an industrial standard specification for the development of distributed applications. Our concept includes a fundamental behaviour oriented communication model and some fundamental software safety considerations. We've developed a standard library for the integration of new services and devices into our system architecture. It decreases development time noticeably. We tested the performance and usability of our concept on an evaluation set up consisting of a surgery robot system, an infrared navigation system, a force-torque sensor and a visualisation software, obtaining excellent results. Future work will consist in the integration of further devices and the extension of our safety concept. An accurate clinical evaluation will take place continuously.
Interactive Medical Data On Demand: A High-Performance Imaged-Based Approach Across Heterogeneous Environments
Authors: Stredney Don  , Agrawal A  , Barber D  , Crawfis R  , Feng Wc  , Hou J  , Panda Dk  , Sadayappan P  , Powell K  , Schmalbrock P  , Sessanna D  , Wiet GJ  , Shareef N  , Bryan Jason
Published: February 2025

Medical data in image format continues to increase in both size and complexity. We have integrated advanced techniques in visualization, networked computing, and interface design to improve methods for accessing medical data comprising high-resolution images for reconstructions into three-dimensional volumetric representations. We present two approaches to handle the range of low to high-end client platforms, support visualization functionality, and provide the ability to manipulate very large data over heterogeneous computing and networking environments. We present examples of its use for clinical, research, and educational purposes and discuss future extensions.
Software Development for Registration of Digital Subtraction Angiography (DSA) Images in Uterine Fibroid Embolization
Authors: Traynor Laura  , Levy Elliot  , Choi Jae Jeong  , Cleary Kevin  , Zeng Jianchao  , Lindisch David
Published: February 2025

The ISIS Center at Georgetown University Medical Center has developed a comprehensive program for image-guided procedures in the spine. As part of this program, ISIS has developed a software application known as I-SPINE (ISIS's Spine Procedure Imaging Navigation Engine). I-SPINE is a Windows NT application, which is based on the Analyze/AVM™libraries. The software architecture follows the Microsoft Foundation Classes (MFC) single document, multiple view paradigm. This has allowed the developers to add new visualization modules to I-SPINE that aid physicians in procedures outside the spine. One such procedure I-SPINE has been expanded for is uterine fibroid embolization. The idea is that by registering and subtracting post-embolization angiographic images from pre-treatment images the resulting image can be used to quantify the embolization effect on the fibroid circulation and predict the treatment response. The I-SPINE digital subtraction angiography (DSA) module allows the interventional radiologist to open a series of pre and post- embolization DSA images that shows the vascular structures of the uterus and the fibroid or fibroids. From these images, the radiologist selects an appropriate image from each series. The selected images are then hand registered using pixel shifting. Once the images are registered, the pixels are subtracted resulting in an image that shows the embolized arteries that were supplying the fibroids.
3D Registration through Pseudo X-ray Image Generation
Authors: Domergue Géraldine  , Viant Warren J
Published: February 2025

One of the less effective processes within current Computer Assisted Surgery systems, utilizing pre-operative planning, is the registration of the plan with the intra-operative position of the patient. The technique described in this paper requires no digitisation of anatomical features or fiducial markers but instead relies on image matching between pseudo and real x-ray images generated by a virtual and a real image intensifier respectively. The technique is an extension to the work undertaken by Weese [1].
Human Circulatory System Model Based On Frank's Mechanism
Authors: Palladino Joseph L.  , Ribeiro L. Christine  , Noordergraaf Abraham
Published: February 2025

A new analytical model of the left ventricle as a pump, developed from isolated canine experiments, was adapted to describe each of the four heart chambers in a complete human circulatory system model. Each chamber is embodied as a volume and time dependent isovolumic pressure source, after Otto Frank's classic experiments. Analytical results show that a small set of equations is sufficient to describe the main features of the heart as a pump, including isovolumic and ejecting beats for a wide range of ventricular and circulation conditions. This model allows interactive teaching of cardiovascular system dynamics. Computed results demonstrate that, with additional experiments, a quantitative description of the human circulation for research purposes may emerge from this approach.
A One-Dimensional Fluid Dynamic Model of the Systemic Arteries
Authors: Olufsen Mette S.
Published: February 2025

The systemic arteries can be modeled as a bifurcating tree of compliant tapering vessels while blood flow and pressure can be predicted by solving Navier-Stokes equations for each of the branches. If all branches are included the computational cost will become prohibitively large. Therefore, the tree must be truncated after a limited number of generations and a suitable outflow boundary condition must be applied. To this end we propose a structured tree in which the root impedance is calculated using a semi-analytical approach. In the structured tree the fluid dynamic equations are linearized giving a wave equation, which can be solved analytically for each vessel. This provides a dynamical boundary condition based on physiological principles which is computationally feasible. It exhibits the actual phase lag between flow and pressure as well as accommodating the wave propagation effects for the entire systemic arterial tree. Finally, the model has been compared with a standard and well established model, where outflow at the terminals are determined by attaching a Windkessel type boundary condition.
Measurement of Arterial Compliance In Vivo
Authors: Wiinberg Niels
Published: February 2025

Measurement of arterial compliance is of interest in evaluating patients with atherosclerosis and other diseases which affect the vessels.
Secure Interoperability of Patient Data Cards in Health Networks
Authors: Blobel Bernd  , Spiegel Volker  , Pharow Peter  , Engel Kjeld  , Engelbrecht Rolf
Published: February 2025

In the healthcare area, chip card based information systems occur in the shape of patient data cards providing informational self determination and mobility of the users as well as quality, integrity, accountability, and availability of the data stored on the card, thus improving the shared care of patients. Dealing with sensitive personal medical information, shared care information systems have to provide appropriate security services, only authorised users allowing restricted rights to the patients' data according to the “need to know” principle.
Vital Signs Monitoring from Home with Open Systems
Authors: Pavlopoulos S.  , Anagnostaki A.  , Koutsouris D.  , Lymberis A.  , Levene P.  , Reynolds M.  , Georgiadis N.  , Lambrinoudakis C.  , Gritzalis D.
Published: February 2025

This study investigates the applicability of a novel codification scheme based on two healthcare informatics standards (namely the VITAL (ENV 13734) and DICOM Sup. 30 Waveform Interchange) in addressing the robust interchange of waveform and medical data in remote healthcare applications. To further address system validation and clinical acceptance issues, pilots were set-up between home- monitoring stations and a hospital-based telemedicine consultation center. The pilots focused in assessing applicability, technical feasibility and performance of the proposed codification scheme based on the two standards. This paper presents the system and services requirements as studied for a home-care application, the design goals for the preservation of security stature, the practical issues of validation and the results of integrating these codification schemes into a commercial patient connected device.
Normal ranges of neuropsychological tests for the diagnosis of Alzheimer’s disease
Authors: Berres Manfred  , Monsch Andreas U.  , Bernasconi Florence  , Thalmann Beat  , Stähelin Hannes B.
Published: February 2025

The diagnosis of early stage dementia is a highly complex process involving not only a somatic examination but also a neuropsychological assessment of the patient’s cognitive capability. The American ‘Consortium to Establish a Registry for Alzheimer’s Disease’ (CERAD) has proposed a set of tests in English which has been translated into German. This paper presents the statistical methodology applied to determine normal ranges adjusted for demographic variables for the German CERAD neuropsychological assessment battery (CERAD-NAB).
The user in the design process of an EPR
Authors: van der Meijden M.J.  , Tange HJ.  , Boiten J.  , Troost J.  , Uasman A.
Published: February 2025

To optimise the development and implementation process of an electronic patient record, attitudes toward computers in health care and satisfaction with paper records of nurses and physicians of a department in an academic hospital were determined For this purpose participants received two questionnaires. These results were supplemented with eight semi-structured in-depth interviews. Users who considered themselves as experienced computer users had more positive attitudes. Inexperienced users were more satisfied with the nursing paper record, while no significant differences existed for the paper medical record.
Is WorkFlow technology suitable to represent and manage clinical trials?
Authors: Fazi Paola  , Grifoni Patrizia  , Luzi Daniela  , Ricci Fabrizio L.  , Vignetti Marco
Published: February 2025

The clinical trial has to be rigidly followed because it identifies a uniform clinical behaviour, which has to be adopted by the different physicians carrying out the test. The life cycle of the clinical trial is therefore based on a planning and definition phase, a next experimental phase connected with its diffusion to the involved centres and finally an evaluation phase of the results. An information system, which supports the users in the different phases of the clinical trial life cycle, has to take into account the different characteristics of each phase. The aim of this paper is to illustrate the role of WF technology as a component of an information system which supports the life cycle of a clinical trial also on the basis of the experience of the Italian Group for Haematological Disease of Adults (GIMEMA).
Verblindete Fallzahlanpassung in Äquivalenzstudien
Authors: Tim Friede  , Meinhard Kieser
Published: February 2025

Bei der Planung klinischer Studien besteht häufig Unsicherheit über die GröBe der Variabilität innerhalb der Behandlungsgruppen. Dies trifft sowohl für den Nachweis von Therapieunterschieden wie auch für Äquivalenzfragestellungen zu. In der Situation des Tests auf Unterschied haben Wittes und Brittain [1] das Design der Internal Pilot Study vorgeschlagen, das eine Varianzschätzung nach Rekrutierung einiger Patienten mit anschließender Fallzahlanpassung vorsieht. Dieser Ansatz besitzt im wesentlichen zwei Schwachen: (i) der Test in der finalen Auswertung hält nicht das vorgegebene Niveau ein (ii) für die Varianzschatzung ist eine Entblindung notwendig. In der jüngsten Vergangenheit sind einige Arbeiten erschienen, die das Design mit interner Pilotstudie wieder aufnehmen. Dort wird die Berechnung der Wahrscheinlichkeit für einen Fehler l.Art beschrieben, wodurch die Kontrolle der Fehlerwahrscheinlichkeit ermöglicht wird [2-5]. Außerdem sind verschiedene Vorschlage für eine verblindete Varianzschätzung gemacht worden [6-8]. Wir greifen nun einige dieser Vorschläge auf und stellen ein Konzept zur verblindeten Fallzahlanpassung mit Kontrolle des Signifikanzniveaus bei klinischen Studien mit ein- und zweiseitiger Äquivalenzfragestellung vor. Dabei gehen wir in der Situation normalverteilter Daten auf Äquivalenz bezogen sowohl auf die Differenz wie auch den Quotienten der beiden Erwartungswerte ein. Die Resultate werden diskutiert und an einem Beispiel veranschaulicht.
A New Approach to Adjust for Multivariate Confounders in Small Randomized Studies Applied to Dendritic Cell Vaccination Data
Authors: Wittkowski Knut M.
Published: February 2025

In small studies, randomization alone is unlikely to eliminate confounding. In linear models, confounding can be addressed by including additional dependent variables, adding covariates, or stratifying the data for the analysis. When the functional relation between observed variables and underlying (latent) factors is unknown, however, methods based on ranks may be more appropriate than ANOVA. It is demonstrated, how the marginal likelihood principle can be used to provide objective and intrinsically valid procedures to adjust for (multiple) confounders when the assumptions of the linear model cannot be justified.
Neural Network Prediction of Polyproline Type II Secondary Structures
Authors: Siermala Markku  , Juhola Martti  , Vihinen Mauno
Published: February 2025

This study considers detection of polyproline type II secondary structures from protein sequences. This difficult problem was handled with multilayer perceptron neural networks, which were found to be useful for such bioinformatics studies. Polyproline II secondary structures have not previously been tried to be predicted from sequences.
Structured Clinical Documentation for the Assessment of Medical Care
Authors: Hölzer Simon  , Wächter Werner  , Altmann Udo  , Schweiger Ralf  , Dudeck Joachim
Published: February 2025

The developing infrastructure for tumour documentation in Germany offers the unique opportunity to provide the physicians with useful clinical information, to evaluate standards of care, and get an impression about the “real-world-effectiveness” of cancer care. In order to compare and evaluate diagnostic and therapeutic approaches in different medical institutions or health care systems, the systematic, patient-oriented, treatment accompanying tumour documentation is a compelling requirement. Our intention is to optimise content and extent of the collected information to characterise the different dimensions of the quality of medical care the best possible. We found that most of the problems are deriving from the contextually and timely correct documentation of medical procedures which includes diagnostic as well as therapeutic interventions. The content of the documentation together with standards of care, such as Clinical Practice Guidelines, should be parallel developed in interdisciplinary co-operation. This way, the fundamental domains of performance, such as appropriateness, availability, continuity, safety, effectiveness, and timeliness of medical care can described and evaluated objectively.
Sharing medication data using the InterCare architecture
Authors: Lodder Herman  , Wolf Leo  , Vernee Jan
Published: February 2025

Since June 1998 more than 20 partners from seven European countries are co-operating in the EC funded InterCare project. The primary objective of the InterCare project is to define, specify and implement cross-border products, called services here, that interoperate with one another in order to support shared care. These products should be based on the results of former European projects and must be validated in actual demonstration sites, one of which is located in the Schiedam region in the Netherlands. In this site the InterCare system is applied to medication information which involves integration of systems at the hospital, pharmacy and the general practitioners office. In this setting special attention is paid to security aspects.
XML structured clinical information: A practical example
Authors: Schweiger R  , Bürkle T  , Hölzer S  , Dudeck J
Published: February 2025

At Giessen university, a drug formulary comprising drug data and treatment guidelines is supplied to clinical users who can access the drug information by an index of drug substances and drug substance groups. The guideline itself is a textual description with related information such as drug substances and drug brand names. Since clinical users also want to access the information by drug names, we had to extract this information from the textual descriptions. The extraction however caused some effort. In order to not repeat this effort in the future, we used the extensible Markup Language (XML) to restructure the information sources. This paper describes our experiences with this kind of legacy to XML conversion and outlines a possible migration path towards the XML technology.
Das klinische Arbeitsplatzsystem als zentrale Komponente eines Klinikinformationssystems
Authors: Trautmann Lutz  , Scherer Armin  , Geib Dieter  , Gräber Stefan
Published: February 2025

Klinische Arbeitsplatzsysteme sind Computersysteme, die Ärzte und Pflegepersonal bei den Aufgaben der Informationsverarbeitung im Rahmen der Patientenversorgung unterstützen. Sie gewinnen zunehmend an Bedeutung, da sie den Zugriff auf alle relevanten Informationen an den patientennahen klinischen Arbeitsplätzen bereitstellen und dadurch eine qualitativ hochwertige Patientenversorgung ermöglichen. Sie verfügen über Schnittstellen zu allen anderen Informationssystemen des Klinikinformationssystems und bilden die Basis zum Aufbau der elektronischen Patientenakte. Die Autoren berichten über die Einführung eines klinischen Arbeitsplatzsystems in den Universitätskliniken des Saarlandes und die dabei gewonnenen Erfahrungen.
Chapter 3.4 - The Diagnostic Headache Diary - A Headache Expert System
Authors: Nielsen Kim Dremstrup  , Rasmussen Cuno  , Russell Michael Bjørn
Published: February 2025

The purpose with the headache expert system was to develop a diagnostic and educational tool for the general practitioners (GP), in order to improve their management of headache disorders. This chapter describes the diagnostic headache diary, an expert system intended for education and diagnosing headache disorders. The diagnostic headache diary can be printed and used by headache patients at home to record their headache attacks and medicine consumption by a day to day basis. It can also be used by the GP at the clinic in order to provide the headache diagnoses. The diagnostic headache diary was written in the programming language Delphi and implemented as a stand-alone Windows 95 program. It was integrated as one of five modules in the headache tutorial described in another chapter of this book. The diagnostic headache diary consists of four modules: Patient data, diary, medication and diagnosis. Configured around a database, the diagnostic headache diary allows entries of several patients and search facilities. The diagnostic headache diary was tested and validated by entering expert-diagnosed data from different headache disorders which where compared to the computer generated diagnoses.
Statistical analysis of the morphology of three- dimensional objects and pathologic structures using spherical harmonics
Authors: Däuber Sascha  , Raczkowsky Jörg  , Brief Jakob  , Hassfeld Stefan  , Wörn Heinz
Published: February 2025

To support diagnosis and therapy, it is a fundamental aim of medical image processing to describe morphological characteristics of pathological structures or image objects in general. Different authors propose quantitative methods of description like bounding boxes[l], fourier descriptors[2] or contour moments [3]. Unfortunately, these methods either don't supply a complete, respectively precise description of the object or only operate on two-dimensional images.
3-D Simulation of Craniofacial Surgical Procedures
Authors: Teschner Matthias  , Girod Sabine  , Girod Bemd
Published: February 2025

An integrated system for simulating craniofacial surgical procedures is presented. The system computes nonlinear soft-tissue deformation due to bone realignment. It is capable of simulating bone cutting and bone realignment with integrated interactive collision detection. Furthermore, soft-tissue deformation and cutting due to surgical instruments can be visualized. The system has been tested with several individual patient data sets.
Reconstructing Hierarchical Tetrahedral Mesh Density Models of Bony Anatomy
Authors: Yao Jianhua  , Taylor Russell
Published: February 2025

We proposed an efficient and automatic method to reconstruct hierarchical tetrahedral meshes and build density models for bony anatomy from CT data sets. The mesh is reconstructed from contours extracted in CT images corresponding to the outer bone surfaces and the boundaries between compact bone, spongy bone and medullary cavity. Key problems, such as tiling problem, branching problem, correspondence problem, and constraint problem, have been solved. We then approximated bone density variations by means of continuous density functions in each tetrahedron. The density functions are written as smooth Bernstein polynomial spline expressed in terms of barycentric coordinates associated with each tetrahedron. We further performed the tetrahedral mesh simplification by edge collapsing and built hierarchical structure of multiple resolution meshes. We applied our density model to efficiently generate Digitally Reconstructed Radiographs. This research is part of our effort to build a bone density atlas.
The Virtual Anatomy Lab: A Hands-on Anatomy Learning Environment
Authors: Campbell Bruce  , Rosse Cornelius  , Brinkley J.F.
Published: February 2025

This paper introduces the Virtual Anatomy Lab software platform for coordinating on-line gross anatomy learning sessions over time.
Guide-X – a Step-by-Step, Markup-Based Approach to Guideline Formalisation
Authors: Svátek Vojtěch  , Kroupa Tomáš  , Růžička Marek
Published: February 2025

The main difficulties of converting the original textual form of medical guidelines to a computer-tractable form are connected both with the ambiguity of the natural language text and with the complexity of the resulting formal (and operational) representation. Proceeding directly from one to the other is thus an extremely demanding task. The proposed Guide-X methodology addresses this problem by breaking the whole process of guideline operationalisation into several steps, each of which requires a different mixture of types (medical, knowledge representation, typographical) and degrees of expertise. The principal technology used is that of XML tagging (using both pre-existing and newly developed languages). The result of each step is connected, element-by-element, to the results of previous steps, thus making the verification and revision of the operationalisation process easier. The methodology is currently being tested in the field of hypertension treatment, within the framework of the Medical Guideline Technology project of the EU Fourth Framework Programme.
Training in Medical Informatics: Combining Onsite and Online Instruction
Authors: Ohno-Machado Lucila  , Marin Heimar F.  , Marques Eduardo P.  , Masssad Eduardo  , Greenes Robert A.
Published: February 2025

The Internet is promoting active exchange of teaching materials and discussion among geographically distant collaborators. We envision that training in medical informatics can be better achieved if both onsite and online instruction are combined, provided that cultural and technological barriers are anticipated and the training program is prepared accordingly. We describe our Brazil/USA program in medical informatics, which includes components of onsite and online education, and discuss lessons learned during its ongoing implementation. Three onsite courses and one workshop have been planned, and two online courses are being developed.
Computer-Aided Learning in PBL (CAPBL): A Role of Electronic Medical Recording System
Authors: Hori Ariyuki  , Tsutsumi Mikihiro  , Kuroda Naohiro  , Sugai Susumu  , Suzuki Koji
Published: February 2025

To help students and tutors in PBL, a computerized system is introduced which is connected to an educational server in our school. Educational materials consisting of case records, laboratory data, clinical images including of video and radiological images are transferred to the educational server from medical recording server in our hospital. Students can study each case by retrieving case details and related information from the computer. However, the diagnosis and detailed information are not retrievable unless students follow the prescribed PBL steps, undergoing assessment and problem-based thinking in each step. Eighty percent of medical students and all tutors agreed that CAPBL was helpful to understand cases. CAPBL is helpful tool in PBL tutorial and the electronic medical recording system is also useful for education.
The Cancer Informatics Infrastructure (CII): An Architecture for Translating Clinical Research into Patient Care
Authors: Silva John S.  , Ball Marion J.  , Douglas Judith V.
Published: February 2025

Today, the clinical trial process remains slow and paperbased. The creation of a Cancer Informatics Infrastructure (CII) can provide the architectural base across the continuum of cancer research and cancer care. Recommendations of a Long Range Planning Committee identified near-term activities for the Office of Informatics at the National Cancer Institute (NCI). These include participating in national standards development; fostering oncology-related terminology and standards, e.g., Common Data Elements (CDEs); and leveraging mainstream informatics and Internet technologies, using the successful Internet model that focuses on facilitating stakeholder participation, sponsoring the CII rather than subsidizing it, and providing a test bed as well as an infrastructure. Diffusion tactics include extending the CII concept beyond its “early adopters” to the wider community through recommendations for the near-term and development of a major document defining next phase activities.
Investigation and Evaluation of the Change in the Outpatients Flow before and after the Move of the Hospital
Authors: Irie Masayuki  , Sakurai Mie  , Kubota Hideaki  , Minamie Yukiko  , Ashida Nobuyuki  , Hasegawa Toshitsune
Published: February 2025

In order to estimate the changes in the service for outpatients with hospital movement, patient flow investigation has been performed at both old and new hospitals. IC memory card was handed out to each outpatient, and timestamps and places were recorded on the card at the places that the patient have been by using card writers set at each department.
Evaluation: 16 Powerful Reasons Why Not to Do It - And 6 Over-Riding Imperatives
Authors: Rigby Michael
Published: February 2025

Evaluation is a concept which appears logical, and supplies the evidence which is sought by policy makers and those interested in obtaining and implementing an information system. However, it is difficult to obtain resources or other support to undertake evaluation studies, and indeed active opposition is often encountered. Unless this mistaken attitude is analysed and overcome, it will be impossible to optimise system applications, produce sound information policies, or practice evidence-based decision making in the information field. Experience is drawn from a range of applications in order to analyse the issues.
Security Architecture for HL/7 Message Interchange
Authors: Chen T.S.  , Liao B.S.  , Lin M.G.  , Gough T.G.
Published: February 2025

The promotion of quality medical treatment is very important to the healthcare providers as well as to patients. It requires that the medical resources of different hospitals be combined to ensure that medical information is shared and that resources are not wasted. A computer-based patient record is one of the best methods to accomplish the interchange of the patient's clinical data. In our system, the Health Level/Seven (HL/7) format is used for the interchange of the clinical data, as it has been supported by many healthcare providers and become a ‘standard’. The security of the interchange of clinical data is a serious issue for people using the Internet for data communication. Several international well-developed security algorithms, models and secure policies are adopted in the design of a security handler for an HL/7 architecture. The goal of our system is to combine our security system with the end-toend communication systems constructed from the HL/7 format to establish a safe delivery channel. A suitable security interchange environment is implemented to address some shortcomings in clinical data interchange.
Analysis of Patient Flows Via Data Mining
Authors: Pagnoni Anastasia  , Parisi Salvatore  , Lombardo Sisto
Published: February 2025

The paper presents DoMiner™, a data mining tool for the analysis of patient flows among public hospitals and care units. DoMiner™ is based on the theory of rough sets, and allows for the extraction of association rules from data base tables. The paper describes both the clustering and rule extraction algorithm of DoMiner™, and illustrates an introductory analysis example.
Patient Empowerment via ‘Pushed’ Delivery of Personalised Healthcare Educational Content Over the Internet
Authors: Abidi Syed Sibte Raza  , Han Chong Yong  , Abidi Samina Raza
Published: February 2025

We present an Internet-based Personalised Healthcare Information (PHI) dissemination system. Information personalisation is guided by the individual's current health profile as recorded in his/her EMR. A PHI package is composed by intelligently selecting and synthesizing various topic-specific documents, each corresponding to some health parameter noted in the EMR. To ensure medical consistency, constraint satisfaction techniques are employed during the information selection phase. The resultant PHI package—covering both long-term and immediate health-maintenance requirements—can be proactively pushed to the individual via email, thereby ensuring the timely availability of situation-specific health maintenance information. The featured work is in line with the Malaysian Multimedia Super Corridor Telemedicine initiative and can serve as a test-bed to evaluate the effectiveness of PHI, system design and operational considerations for larger-scale deployment.
An Experimental Health Smart Home and Its Distributed Internet-based Information and Communication System: First Steps of a Research Project
Authors: Rialle Vincent  , Noury Norbert  , Hervé Thierry
Published: February 2025

We present a study and whole experimental tele-monitoring and medical tele-surveillance system for maintaining patients at home. The project features networked sensors, in a fully equipped apartment, operated by an advanced information and communication system based on Internet, Java, and object oriented modeling. The sensors are connected, mainly wirelessly, with a in-home software module devoted to signals analysis and detection of critical situation such as falls, sickness, sudden palsy, stroke, hypothermia, etc. This module communicates, either via modem or ethernet network, with a remote medical control station in charge of appropriate response to received information and alarms. The system is designed to be a powerful information and communication tools for medical and social workers. It offers a series of functions such as medical file management, user profiles and rights management, drafting and management of ordinances and visit notes, confidentiality of medical information, and management of scenarios of detectable events. The access to the system is allowed to authorized users only (physicians, emergentists, social workers, etc.), and is available on as much authorized computers as needed, by means of a Java applet invoked from any traditional web browsers.
Expression and Meaning of Medical Language: Building an Epistemological Framework for the Study of Semantic Distance
Authors: Bousquet Cédric  , Jaulent Marie-Christine  , Chatellier Gilles  , Degoulet Patrice
Published: February 2025

The use of language for communication purposes introduces a semantic gap in data processing. We have developed a new tool called semantic distance to overcome this gap. A previous presentation of our tool was based on an empirical approach. Here, we examine the properties and theoretical foundation of semantic distance from a rationalistic perspective. We present an epistemological framework to explain the meaning of semantic distance.