bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient Specific Physics-based Model for Interactive Visualization of Cardiac Dynamics
Authors: Lin Wei-te  , Robb Richard A.
Published: February 2025

Cardiac disorders result mainly from defects in cardiac structure or failure to generate and regulate electrical impulses. Knowledge of the structure, motion patterns, local deformation, and associated electrical activation patterns of the heart is necessary for precise diagnosis and treatment. Electrical and mechanical performance of the heart is strongly influenced by the anisotropic nature of myocardial tissue. Diffusion-encoded MR imaging provides in vivo myocardial fiber track information that can be used for precise simulation of cardiac conduction and contraction. We propose a method that incorporates such fiber track information with a physics-based deformable model to realistically simulate cardiac contraction and subsequent relaxation. The simulation aims to reproduce the myocardial deformation during the heartbeat. The system allows interactive visualization of dynamic 3-D heart structures during the cardiac cycle. In procedures such as catheter ablation, the interactive 4-D model provides updated anatomy and physiology of the patient's heart simultaneously, and can be used to guide the procedure for efficient targeting of the treatment regions.
Enhanced Video Image Guidance for Biopsy Using the Safety Map
Authors: Nakajima Yoshikazu  , Oyama Hiroshi  , Sawada Akira  , Muroi Katsunobu
Published: February 2025

We present the system design and the methods of video-based guidance to assist with brain tumor biopsy procedures. The system comprises of a three-dimensional (3-D) position sensor, a CCD camera, a liquid crystal display (LCD) and a graphics computer equipped with a video capture board. The markers for positional measurement are attached to the CCD camera, a surgical tool, and the patient head. In order to be integrated into the camera-viewing capacity, 3-D images of the head and guidance indicators are visualized to form a life like video image. For reliable guidance, we also use the surgical plan, called the “safety map”, which is a sphere surface highlighting the covering area of anatomically significant tissues and obstacles around the target for the indication of the biopsy needle's insertion starung-point. The safety map can be visualized in exactly the same way as it would be in a real life situation.
Sensible Human Projects: Haptic Modeling and Surgical Simulation Based on Measurements of Practical Patients with MR Elastography - Measurement of Elastic Modulus
Authors: Suga Mikio  , Matsuda Tetsuya  , Okamoto Jun  , Takizawa Osamu  , Oshiro Osamu  , Minato Kotaro  , Tsutsumi Sadami  , Nagata Izumi  , Sakai Nobuyuki  , Takahashi Takashi
Published: February 2025

To provide realistic surgical simulation, 3D visualization and haptic feedback are important. In the existing surgical simulators, the fidelity of the deformation and haptic feedback is limited because they are based on the subjective evaluation of the expert-user and not on an objective model-based evaluation. To obtain accurate elastic modulus of whole human tissues, we have started a new project called the Sensible Human Project (SHP). This paper deals with establishing the measurement of elastic modulus by the magnetic resonance elastography (MRE) technique, as a first step of the SHP Project.
Digital Library Research and Application
Authors: McCray Alexa T.
Published: February 2025

The last decade has seen an exponential rise in the amount and the nature of information that is available on the Internet. Internet and World Wide Web technology have raised many technical as well as social and economic issues. The paper begins with a description of the recent digital library research initiative funded by the U.S. federal government. Digital library research addresses a host of informatics issues relevant to the current Internet-based environment. The paper continues with a discussion of some problems in information access, including a discussion of the potential of the Unified Medical Language System for navigating among multiple biomedical information systems. Next, some issues in creating Web-accessible resources for health care consumers are addressed, with a focus on recent work at the National Library of Medicine, including a description of the MEDLINE/plus system. The paper ends with a brief discussion of some implications of digital library research for the health informatics community.
The Communicative Function of Clinical Narrative in Radiology Reporting
Authors: Rooksby John  , Kay Stephen
Published: February 2025

Clinical narrative is often taken as a direct representation of real objects and events such as patients, diseases and treatments. We refer to this conceptualisation as the ‘referential junction’ of clinical narrative. We introduce a complimentary perspective, taking clinical narrative as a construction relative to the situated intentions and routines of communication between author and reader. This perspective, that we call the ‘communicative function’, highlights the value of some underused features of clinical narrative. In this paper we bring together models of narrative structure and of communication to present a theory of the communicative function of clinical narrative. We pay particular attention to clinical narrative in radiology reporting.
Role-Based Access to Patients Clinical Data: The InterCare Approach in the Region of Crete
Authors: Potamias G.  , Tsiknakis M.  , Katehakis D.  , Karabela E.  , Moustakis V.  , Orphanoudakis S.
Published: February 2025

The basics of a particular Integrated Electronic Health Record (I-EHR) implementation are presented, as realised by the Patient Clinical Data Directory (PCDD) system. PCDD operates within the context of HYGEIAnet, the Integrated Healthcare Telematics Network of Crete. PCDD is based on a federation of autonomous information systems and provides to its authorized users alternative views of the health record as well as access and retrieval services to its geographically distributed segments. The data model of the PCDD is based on the Subjective Objective Assessment Plan (SOAP) model that originates from the primary healthcare domain. Access to detailed information on particular patients healthcare encounters is delivered via role-based authorisarion privilages and controls. The administration of the national healthcare organizations* business rules, for different user-groups, is made via a specially tailored and developed rule-editor.
DICOM Extensions for Narrow-Band Networks
Authors: Riesmeier Jörg  , Eichelberg Marco  , Lemoine Didier  , Punys Vytenis  , Balogh Nándor  , Jensch Peter
Published: February 2025

DICOM is today's de-facto standard for exchanging medical images. Since new image acquisition devices produce more and more image and non-image data, image compression has become an important part of the standard. However, the compression of non-pixel data also stored in DICOM data sets has been disre- garded up to now. In the scope of an EU research project we have examined a large amount of real-world DICOM images to test whether or not there is a potential for compressing the non-pixel attributes. Especially for use with narrow-band networks extensions as proposed in this paper could be a solution to save valuable bandwidth.
3-D Visualization of the Newborn's Hip Joint using Ultrasound and Automatic Image Segmentation
Authors: von Jan Ute  , Overhoff Heinrich Martin  , Lazovic Djordje
Published: February 2025

Grafs method has been established as a standardized procedure for the diagnostic screening of developmental dysplasia of the hip in newborns. In this procedure, a two dimensional ultrasound image that has to contain standardized landmarks is taken and evaluated interactively to calculate congruence indicators. Since these indicators are only derived from a 2-D scan, they do not reflect the spatial joint structure. In our study, we visualized three dimensional scans of new-borns' hip joints that were obtained using a conventional ultrasound transducer and a commercial localizer system that was fixed to the scanhead. The landmarks were detected by automatic image segmentation to avoid examiner dependent findings. The landmark structures as well as an automatically determined virtual sphere approximating the femoral head were visualized color coded on a computer screen. This kind of visualization was found to be intuitive. The evaluation of the entire joint geometry and the 3-D relations between the acetabulum and the femoral head improves the reliability of the diagnostics.
Atrial Heart Fibrillation Modeling: a tool for adequate choice of signal processing functions
Authors: Glace C.  , Haton J.-P.  , Stoltz J.-F.  , Kohler F.
Published: February 2025

Framingham Study showed that Atrial Fibrillation (AF) exposes the patient to an increased stroke risk and to low cardiac output. It is well known that the mechanism of Atrial Fibrillation is reentry. In order to facilitate AF's studies, we propose a deterministic model that can be used for cardiac signal characterization. The model is based on a linear combination of several “Atrial Flutter-like signals. We obtained AF-close aspects. To demonstrate its usefulness we performed a power spectrum transform (i.e. scalar Fast Fourier Transform) of this model. Thanks to the model we show that this transform cannot be used as is, and may induce errors in results interpretation. We also show based on the same example how to overcome the limitation with help of the model. We expect that this model will help in mathematical transforms relevance evaluation. This may lead to new findings in AF classification, and to improvement in patients’ treatment, follow-up and survival.
Bidirectional Classification Procedures: Double Tree and Double Cluster
Authors: Hecker Hartmut
Published: February 2025

Partition based prediction rules as derived in CART, RECPAM or CBR, relating multivariate predictor variables X to a response variable Y, may be extended to bidirectional classification procedures. Tree or clustering algorithms are simultaneously applied to X and Y resulting in a double partition classification table that should be able to detect existing characteristic patterns of predictor and response values and relate them to each other.
Comparing assessment of appropriateness of diagnostic tests between a human expert and an automated reminder system
Authors: Bindels R.  , Winkens R.A.G.  , van Wersch J.W.  , Pop P.  , Hasman A.
Published: February 2025

This paper describes the validation of the GRIF automated reminder system. The reminder system has been developed to influence diagnostic test ordering of General Practitioners (GPs). It generates critical comments on the basis of accepted guidelines. A retrospective random selection of 253 request forms has been taken. We compared the comments of a human expert to the comments of the reminder system A panel of two independent reviewers judged the requested tests based on the strict interpretation of the guidelines. The sensitivity, specificity and ‘predictive values’ of the comments of the reminder system and the human expert were calculated using the judgement of the two reviewers as ‘gold standard’.
Quality Assurance of Medical Information on the Internet
Authors: Adelhard Klaus
Published: February 2025

Physicians and Laymen use the Internet to answer health related questions. The quality of information is very diverse between the various web sites. Quality assurance is lacking. However, there are several means to rate the quality of information on the internet. For the time being, these mechanisms show some evidence on the provided information. Quality assurance, like peer review for scientific papers, has to be established to make the internet a trustworthy resource for physicians and patients.
Combined Test Procedures in the Meta-Analysis of Controlled Clinical Trials
Authors: Knapp Guido  , Hartung Joachim
Published: February 2025

Concerning the actual significance level, we investigate the commonly used combined test procedures of meta-analysis, which contain the choice of the model, in which the analysis is carried out, and the commonly used tests for treatment effect in the fixed and random effects model, and some new combined test procedures, which use an alternative test statistic in the random effects model or the t-distribution as test distribution of the commonly used test statistics. A simulation study indicates that the new combined test procedures are better with respect to a prescribed significance level.
Meta-Analysis: Different Methods - Different Conclusions?
Authors: Böckenhoff Annette  , Hartung Joachim
Published: February 2025

Different estimation methods for covariance parameters in meta-analyses can result in conflicting p-values concerning the test of treatment effect. We propose a valid method to overcome this problem at least partially by introducing a new estimator for the standard deviation of the common treatment difference.
Anwenderzufriedenheit von Patienten-Daten-Management-Systemen (PDMS) in der Intensivmedizin
Authors: Junger A.  , Benson M.  , Quinzio L.  , Fuchs C.  , Michel A.  , Marquardt K.  , Hempelmann G.
Published: February 2025

Im Rahmen der Evaluierung eines validierten Fragebogens zur Erfassung der Zufiiedenheit und Erwartungen der Anwender von Patienten-Daten-Management-Systemen (PDMS) wurde eine erste umfangreiche Version an vier operativen Intensivstationen in Kliniken der Maximalversorgung versandt. In dieser Arbeit sollen erste Ergebnisse dieser Befragung präsentiert werden. Im Dezember 1998 wurde ein Fragebogen mit 207 Fragen erstellt (Version 1), der allgemeine Fragen zur Person, zum PC-Arbeitsplatz, zur Anwenderoberflache ebenso wie spezielle Fragen zum Einfluß des Computersystems auf pflegerische, ärztliche und administrative Tätigkeiten enthält. Insgesamt wurden 84 Fragebögen ausgewertet. Die Rücklaufquote der beantworteten Fragebögen von den einzelnen Kliniken war sehr unterschiedlich (22-70%). 60,2% der Fragebögen wurden von Männern und 39,8% von Frauen beantwortet. 45,7% waren Pflegekräfte und 52,4% aus dem ärztlichen Bereich. Die Erfahrung mit der Arbeit an einem Computer wurde wie folgt angegeben: bis 2 Jahre 23,5%, 3 bis 7 Jahre 29,6% und über 7 Jahre 46,9%. Die Frage, ob die allgemeinen Erwartungen an ein Dokumentationssystem erfüllt wurden, beantworteten die Anwender überwiegend negativ. Bei den Fragen zu dem bestehenden PDMS bewerteten die Befragten die Systeme als nicht überflüssig und fanden sie leicht erlernbar. Die Anwender beurteilten die Aspekte Efiizienz, Arbeitserleichterung, Übersichtlichkeit und Zeiterspamis eher negativ; Fragen nach dem Arbeitsplatz und der Hardware wurden positiv beantwortet. Mit der Bildschirmauflösung, der Programmstabilität, der Bedienung mit Tastatur und Maus waren die Befragten zufrieden, jedoch nicht mit der Performance der Programme. Bei der Erhebung der Wünsche und Erwartungen an ein neues PDMS standen eine einfachere Präsentation der Ergebnisse, eine schnelle Behebung von Fehlem, die Bedienerfreundlichkeit, die Arbeitserleichterung sowie die Zeiterspamis im Vordergrund. Durchweg hoch bewertet wurde vor allem der Datenimport unterschiedlichster Parameter aus anderen DV-Systemen sowie die automatische Dateniibemahme aus verschiedenen technischen Geräten.
Czech National Data Standards Implementations in ORCA Electronic Patient Record in Cardiology
Authors: Přibík Vladimír  , Grünfeldová Hana  , Hanzíček Petr  , Peleška Jan  , Zvárová Jana
Published: February 2025

In the paper we describe the situation concerning Czech data standards and requirements on health care providers. Further we compare the nowadays possibilities of the multimedia electronic patient record ORCA and its extension to fulfill Czech data standards and requirements.
A caching approach for XML based medical data
Authors: Vakali Athena I.  , Pombortsis Andreas S.
Published: February 2025

This paper discusses the representation and caching of medical data structured and stored as XML documents. Caching of XML medical data is proposed towards improving the medical data accessibility and availability. The representation of XML medical data is a tree like structure and the caching process is guided by frequency of access of the XML medical data records. Experimentation is carried out for an artificial workload of patient records and both cache and byte hit ratios are evaluated. The proposed caching scheme is proven to be quite effective and beneficial for accessing the medical data.
Decision Support for infectious diseases - a working prototype
Authors: Joch J  , Bürkle T  , Dudeck J
Published: February 2025

This paper presents a decision support system for nosocomial infections and its integration in the large HIS of the University Hospital of Giessen. The model comprises five different engines and a data dictionary. It is designed to detect hospital aquired infections even in a situation where only a restricted amount of clinical data is available (the data is split up in different information systems). Furthermore the model prevents time consuming manual data entry.
Redundant Thyroid Laboratory Diagnostic Modules in Laboratory Information System - A Way to Improve the Performance
Authors: Sonicki Zdenko  , Morin Annie  , Plasaj Tomislav  , Sonicki Darija  , Kusić Zvonko
Published: February 2025

In this paper, we introduced an idea of using redundant thyroid laboratory diagnostic modules integrated in laboratory information system. The first module was based on decision tree which was the result of Assistant algorithm applied to thyroid laboratory test results. Instead of improving decision rules, the “second opinion” module was designed based on Spad-S software. Diagnosis obtained with both modules were compared with results before introducing the “second opinion” module. From the first results it was clear that introducing the “second opinion” module decreased the number of misclassified records from the first module. With three or more modules, the final diagnosis could be obtained by voting or more complex procedures.
Integrating specialized application systems into hospital information systems -obstacles and factors for success
Authors: Knaup Petra  , Mludek Volker  , Wiedemann Timm  , Bauer Juliane  , Haux Reinhold  , Kim Lilia  , Schilling Freimut  , Selle Barbara
Published: February 2025

Hospital information systems are often huge and heterogeneous systems. To support physicians with their daily clinical work, application systems are developed which are dedicated to particular medical fields or tasks and which have to be integrated into the hospital information system. The integration process is quite complicated, because it makes the information system’s infrastructure even more heterogeneous. We developed an application system for documentation and therapy planning in pediatric oncology (DOSPO) and we started to introduce it into the Department of Pediatric Oncology of Heidelberg University Hospital. The fact that DOSPO is developed as a universal system for nationwide use made the integration process more difficult. In any case, the introduction of specialized application systems has to be planned systematically in advance, regarding the prevailing information system's infrastructure, available resources and established processes. To simplify the integration process comprehensive electronic patient records for the future should be designed in a way that they can be enhanced easily by new clinical functions.
Chapter 3.7 - Headache Tutorial
Authors: Russell Michael Bjørn  , Nielsen Kim Dremstrup  , Rasmussen Cuno  , Schoenen Jean  , Paiva Teresa
Published: February 2025

The headache multimedia educational tool for the general practitioners, consists of five different modules, i.e. classification, clinical data, headache tutorial, diagnostic headache diary and nomenclature. It is possible to move between the modules both vertically and horizontally. This paper concerns the headache tutorial. It consist of case records that the user can test his diagnostic abilities on. Each case record is subdivided into an interview by the physician, physical and neurological examination, laboratory test, sum of positive diagnostic elements, suggestions of diagnoses and management. A total of 12 case records are provided. The system will be available on a CD-ROM.
Quality Enhancing Conceptual Tools for Medical Decision Making
Authors: Tonfoni Graziella
Published: February 2025

The scientific and the medical communities are among the first asked both to advance highly specialized knowledge and to make it available to a wider community of users, accessing specialized knowledge and searching for single pieces of information for a whole variety of purposes that require diverse information needs and demands. Health advisors may want to update progress in research in a certain field of medicine, to ask experts the right kinds of questions and, even more fundamentally, to be able to describe those health problems they may encounter in their patients’ community with words and expressions that can be both understandable and accurate.
Manipulation of Volumetric Patient Data in a Distributed Virtual Reality Environment
Authors: Dech Fred  , Ai Zhuming  , Silverstein Jonathan C.
Published: February 2025

Due to increases in network speed and bandwidth, distributed exploration of medical data in immersive Virtual Reality (VR) environments is becoming increasingly feasible. The volumetric display of radiological data in such environments presents a unique set of challenges. The shear size and complexity of the datasets involved not only make them difficult to transmit to remote sites, but these datasets also require extensive user interaction in order to make them understandable to the investigator and manageable to the rendering hardware. A sophisticated VR user interface is required in order for the clinician to focus on the aspects of the data that will provide educational and/or diagnostic insight.
Force Models for Needle Insertion Created from Measured Needle Puncture Data
Authors: Hiemenz Holton Leslie L.
Published: February 2025

The focus of this paper is to present a force-feedback model that has been developed for the epidural needle insertion procedure. The model is based on data collected from biomaterials testing studies, and consists of separate force models for each of the tissue types relevant to the epidural needle insertion procedure. These tissue force models were generalized to create force-feedback models to drive haptic devices for needle insertion simulation.
3D Localization of Implanted Radioactive Sources in the Prostate Using Trans-Urethral Ultrasound
Authors: Holmes III David R.  , Davis Brian J.  , Robb Richard A.
Published: February 2025

Prostate cancer is the most common cancer diagnosed in men in the United States. Many techniques have been developed to diagnose and treat prostate cancer. 3D Trans-Urethral Ultrasound (TUUS) is a new technique for the diagnosis and treatment of prostate disease. This research focuses on the potential of TUUS for therapy-guidance during and after transperineal interstitial permanent prostate brachytherapy (TIPPB). Computed tomography (CT) is currently used to determine the source locations and the effective radiation dose distribution throughout the tissue after the completion of the procedure. TUUS may be a viable alternative to CT for determining source locations within the prostate. Placement of the TUUS catheter into the urethra provides excellent 2D images of the prostate. In addition, the catheter can be used to acquire 3D volumetric data for 3D analysis of the prostate, associated tissue, and radioactive sources.
Computer Assisted Treatment Of Pelvis Fractures
Authors: Krivonos O.  , Gebhard F.  , Keppler P.  , Kinzl L.  , Hesser J.  , Männer R.
Published: February 2025

The presented approach is the realization of a minimal invasive treatment of pelvis fractures using the computer aided surgery (CAS). Main problem of tracking of major bone fragments after reposition is solved by implementing of 3D ultrasound to obtain intraoperative bone surfaces. Preoperative and intraoperative data sets are matched. Major fragments are tracked. The real time navigation is possible.
Virtual Reality Based Surgical Assistance and Training System For Long Duration Space Missions
Authors: Montgomery Kevin  , Thonier Guillaume  , Stephanides Michael  , Schendel Stephen
Published: February 2025

Access to medical care during long duration space missions is extremely important. Numerous unanticipated medical problems will need to be addressed promptly and efficiently. Although telemedicine provides a convenient tool for remote diagnosis and treatment, it is impractical due to the long delay between data transmission and reception to Earth.
3D Visualization and Stereographic Techniques for Medical Research and Education
Authors: Rydmark Martin  , Kling-Petersen Torben  , Pascher Ragnar  , Philip Fiona
Published: February 2025

While computers have been able to work with true 3D models for a long time, the same does not apply to the users in common. Over the years, a number of 3D visualization techniques have been developed to enable a scientist or a student, to see not only a flat representation of an object, but also an approximation of its Z-axis. In addition to the traditional flat image representation of a 3D object, at least four established methodologies exist:
Keeping Sharp: Internet CE Update and Experience
Authors: Tanner T. Bradley  , Metcalf Mary P.  , Coulehan Meghan B.
Published: February 2025

The Internet as a distance-learning tool is evolving rapidly. Most Internet-based Continuing Education (CE) experiences follow a standard didactic approach as demonstrated by lectures, slide presentations, written journals, videotape, and audiotape; however, some Internet-based educators are exploring the full interactive, problem-solving potential of Internet technology. With support from NIMH we are reviewing the state of the art in Internet-based CE and developing CE courses targeted toward primary care providers that aim to alter clinical skills related to depression treatment.
The Interaction of Spatial Ability and Motor Learning in the Transfer of Training From a Simulator to a Real Task
Authors: Tracey Michael R.  , Lathan Corinna E.
Published: February 2025

Virtual Reality (VR) based simulators have been used as a training tool in many settings, although very few studies examine transfer of training from simulators to a real world task, particularly for manipulation tasks. Simulators could play a key role as an enabling technology for manipulation tasks related to teleoperation, and medical procedure training. We investigated the relationship between motor tasks and participants' spatial abilities. This relationship was further examined with respect to learning in a simulator and to transfer of training from the simulator to the real world on a pick-and-place task. Spatial abilities were characterized using a battery of recognition and manipulation figural tests. Subjects with lower spatial abilities demonstrated significant positive transfer from a simulator based training task to a similar real world robotic operation task. Subjects with higher spatial skills did not respond as positively from training in a simulated environment.
Anatomic Modeling from Unstructured Samples Using Variational Implicit Surfaces
Authors: Yoo Terry S.  , Morse Bryan  , Subramanian K.R.  , Rheingans Penny  , Ackerman Michael J.
Published: February 2025

We describe the use of variational implicit surfaces (level sets of an embedded generating function modeled using radial basis interpolants) in anatomic modeling. This technique allows the practitioner to employ sparsely and unevenly sampled data to represent complex biological surfaces, including data acquired as a series of non-parallel image slices. The method inherently accommodates interpolation across irregular spans. In addition, shapes with arbitrary topology are easily represented without interpolation or aliasing errors arising from discrete sampling. To demonstrate the medical use of variational implicit surfaces, we present the reconstruction of the inner surfaces of blood vessels from a series of endovascular ultrasound images.
Automating Dynamic Decision Model Construction to Support Clinical Practice Guideline Development
Authors: Zhu Ai-Ling  , Leong Tze-Yun
Published: February 2025

The role of decision models in supporting automated clinical practice guideline development is gaining importance in recent years. Constructing decision models from scratch, however, is laborious, time-consuming, and knowledge-intensive. This paper presents a new practical methodology to facilitate effective dynamic decision model construction for clinical practice guideline development, updating and customization. The proposed approach uses existing paper-based guidelines in sharable formats as the main information sources, characterizes the information inherent in the decision models and the clinical practice guidelines, establishes the relevant correspondences, reduces the effort needed in decision model construction, and increases the reusability and flexibility of the knowledge captured in the resulting guidelines.
A Survey of Academic and Industry Professionals Regarding the Preferred Skillset of Graduates of Medical Informatics Programs
Authors: Hoffmann Stefan  , Ash Joan
Published: February 2025

Identification of the skills needed by graduates of medical informatics masters degree programs is needed so that students will know what is desired in the workplace and curriculum designers can assure that courses cover relevant areas. We conducted a mail survey of representatives of the informatics job market to discover what they think is most important. A survey instrument was designed after analyses of job ads and curricula in the U.S. and interviews with representative employers. The survey was mailed to 1000 randomly selected members of AMIA and HIMMS plus EMR vendors. Respondents were asked to rank skills and groups of skills according to perceived utility. The results indicate higher rankings for organizational and interpersonal skills than for more technical credentials. Statistical analysis indicates the existence of relatively few underlying constructs to the skill list.
Informatics for Peru in the New Millennium
Authors: Karras Bryant Thomas  , Kimball Ann Marie  , Gonzales Virginia  , Pautler Nedra A.  , Alarcón Jorge  , Garcia Patricia J.  , Fuller Sherrilynne
Published: February 2025

Introduction: As efforts continue to narrow the digital divide between the North and South, a new biomedical and health informatics training effort has been launched in Peru. This report describes the first year of work on this collaborative effort between the University of Washington (Seattle) Universidad Peruana Cayetano Heredia and Universidad Nacional de San Marcos (Peru)
Developing CD-ROM based Multimedia Digital Textbook of ‘San-Yin-Jiao(SP-6) Pressure for Reducing the Labor Pain and Shortening the Labor Time’
Authors: Kim Jeongeun  , Jang Soonbok  , Kim Younglan  , Lee Sunkyung  , Song Jueun
Published: February 2025

The computer-based textbook is a new educational tool that promises to play a prominent role in the coming years. Classical instructional technologies, such as video, stills, audio files and computer programs with a textbook orientation, have been merged into one multimedia computer system and have created additional opportunities for learning in medical, dental and nursing education. The authors developed a hypermedia textbook of ‘San-Yin-Jiao pressure for reducing the labor pain and shortening the labor time’ using a personal computer with hypermedia software that contains texts, images, videos, audios and literature citations. The target population of this educational CD-ROM would be nurse-midwives, clinical nurses working for the obstetric units, and faculty members who teach the Maternity and Women's Health Nursing. Valuable and practical experiences were obtained and shared.
The Coming of Age of Computerized ECG Processing: Can it Replace the Cardiologist in Epidemiological Studies and Clinical Trials?
Authors: Kors Jan A.  , van Herpen Gerard
Published: February 2025

In spite of decades of research and widespread use of computer programs for the analysis of electrocardiograms (ECGs), the accuracy and usefulness of computerized ECG processing has been questioned. To determine whether ECG computer programs can replace cardiologists in epidemiological studies and clinical trials, we reviewed the literature for evidence, concentrating on one influential ECG measurement, viz. QT interval duration, and one classification method, the Minnesota Code, which is the de facto standard for ECG coding. We compared interobserver variabilities of cardiologists with differences between computer programs and cardiologists, in order not to prejudice against the computer. Studies that contain this type of information indicate that interobserver variabilities are at least as large as differences between computer and cardiologist. This suggests that ECG computer programs perform at least equally well as human observers in ECG measurement and coding, and can replace the cardiologist in epidemiological studies and clinical trials.
Studies on Improved Model for Cerebrovascular Blood Circulation
Authors: Guozheng Qian  , Youfa Li  , Guiqing Wang  , Yifeng Cao
Published: February 2025

For the elastic cavity model adopted in the existing cerebrovascular hemodynamics analyzers was too simple, we developed the improved model for cerebrovascular blood circulation to describe more exactly the physiologic nature of both sides cerebrovascular blood circulation and the relation between them (Willis Circle). It was a network consisting of 2 inputs, 9 arteries and 4 terminal flow resistances. For two cases, constantflow and pulsating flow, the further improved models for calculability were analyzed and the mathematical equations describing the model was obtained; some algorithms were given to solve the positive and negative problems to the mathematical functions; the physiologic means to parameters in the model were defined; at last, the possible applications of the models in basic research and clinic about cerebrovascular disease were stated as well. In the paper, we compared our portable cerebrovascular hemodynamics analyzer with the improved model to other analyzers with the elastic cavity model, and concluded that because of providing additional M-style ultrasonic detector for measuring the diameters of blood vessels and improving the Doppler ultrasonic detector for measuring the velocity of blood flow of the internal carotid artery we could accept the improved model to obtain more exact and more details and the relation about cerebrovascular blood circulation and hemodynamics.
Comparison of Three Databases with a Decision Tree Approach in the Medical Field of Acute Appendicitis
Authors: Zorman Milan  , Eich Hans-Peter  , Kokol Peter  , Ohmann Christian
Published: February 2025

Decision trees have been successfully used for years in many medical decision making applications. Transparent representation of acquired knowledge and fast algorithms made decision trees one of the most often used symbolic machine learning approaches. This paper concentrates on the problem of separating acute appendicitis, which is a special problem of acute abdominal pain from other diseases that cause acute abdominal pain by use of an decision tree approach. Early and accurate diagnosing of acute appendicitis is still a difficult and challenging problem in everyday clinical routine. An important factor in the error rate is poor discrimination between acute appendicitis and other diseases that cause acute abdominal pain. This error rate is still high, despite considerable improvements in history-taking and clinical examination, computer-aided decision-support and special investigation, such as ultrasound. We investigated three different large databases with cases of acute abdominal pain to complete this task as successful as possible. The results show that the size of the database does not necessary directly influence the success of the decision tree built on it. Surprisingly we got the best results from the decision trees built on the smallest and the biggest database, where the database with medium size (relative to the other two) was not so successful. Despite that we were able to produce decision tree classifiers that were capable of producing correct decisions on test data sets with accuracy up to 84%, sensitivity to acute appendicitis up to 90%, and specificity up to 80% on the same test set.
GALEN Ten Years On: Tasks and Supporting Tools
Authors: Rogers Jeremy  , Roberts Angus  , Solomon Danny  , van der Haring Egbert  , Wroe Christopher  , Zanstra Pieter  , Rector Alan
Published: February 2025

The GALEN technology has matured over more than a decade of use. We describe a set of software tools and associated methodologies that together are supporting ontological engineering in a production, rather than a research setting.
Health Informatics: Managing Information to Deliver Value
Authors: Ball Marion J.  , Douglas Judith V.  , Lillis Jennifer
Published: February 2025

Can informatics improve health? This paper answers yes, exploring its components, benefits, and effect on a wide variety of health-related activities. We first examine how information technology enables health informatics, supporting information management and knowledge creation through its four cornerstones. Success factors in using informatics are covered next, including human factors, the role of trained health informaticians, and the importance of matching informatics initiatives with business goals and establishing and measuring value. We demonstrate the potential effect of the Internet on health services through such e-health applications as enterprisewide patient records, state-of-the-art call centers, and data repositories. For current evidence that informatics is already improving health, we turn to such topics as disease management, telehealth, patient safety, and decision support. As more organizations move informatics from theory into practice and realize its value, they will transform inefficient processes and improve care for all.
Impact of a Modelization of the Task Allocation Problem on the Design of a Prescription Management Software for Intensive Care Units
Authors: Renard Jean-Marie  , Souf Nathalie  , Brunetaud Jean-Marc  , Beuscart Régis
Published: February 2025

After having studied the coordination in Intensive care Units we have proposed a dynamic model for improving coordination in respect of human control over the work. We have performed simulations for analysing the impact of different strategies on coordination and we have found that our task centred coordination model could be efficient to improve the health care actors coordination and the efficiency of care delivery. We have built a first prototype based on this model. This implementation uses Internet technologies.
A Neural Network Approach for Predicting and Modelling the Dynamical Behaviour of Cardiac Ventricular Repolarisation
Authors: EI Dajani Rajai  , Miquel Maryvonne  , Rubel Paul  , Maison-Blanche Pierre  , Fayn Jocelyne  , Forlini Marie-Claire
Published: February 2025

Physiological signals are usually patient specific, and they are difficult to predict, especially for the cardiovascular system. New methods capable to be adapted to each case and to learn the singular behavior of heart functions should be developed to support physicians in their decisionmaking. One of the most widely studied relations is the QTRR one, between the total duration of the ventricle activation and inactivation, and the heart rate. In the past, different studies were made to approach this relation in the steady state. In this paper, a new method for modeling and predicting the transient dynamic behaviour of QT interval in relation to changing RR intervals is presented using artificial neural networks.
Medical Records and Electronic Documents: A Proposal
Authors: Laforest Frédérique  , Flory André
Published: February 2025

This article presents a global view of our proposal for a medical information system of the future. This information system focuses on patient medical records management. As most of the existing systems, it proposes to store information from patient records in a database. But records capture is different: we propose to use weakly-structured documents. Such documents contain paragraphs with some specific constraints represented by XML tags. The end-user writes new information under the form of weakly-structured documents. An internal system translates theses documents into new data for the internal database. Such a documentbased user interface provides much more freedom to the end-user, and certainly reduces the distance between the physicians ‘ way of working and the capture system.
Extracting Clinical Cases from XML-Based Electronic Patient Records for Use in Web-based Medical Case Based Reasoning Systems
Authors: Manickam Selvakumar  , Abidi Syed Sibte Raza
Published: February 2025

Development and usage of Case Based Reasoning (CBR) driven medical diagnostic system requires a large volume of clinical cases that depict the problem-solving methodology of medical experts. Successful usage of CBR based systems in healthcare is constrained by the need for a continuous supply of current and correct clinical cases (in an electronic medium) from medical experts. To address this constraint we present a strategy to pro-actively transform generic Electronic Patient Records (EPR) to Operable CBR-oriented Cases (OCC) that are compliant to specialised CBR-based medical systems. EPR-OCC transformation methodology is based on XML parse-trees, Unified Medical Language Source (UMLS) meta-thesauri and medical knowledge ontologies. The featured work involves the implementation of a Java-based computer system for the automatic transformation of XML-based EPR—originating from heterogeneous EPR repositories accessible over the Internet/WWW—to specialised OCC that can then be seamlessly incorporated within Intelligent CBR-based Medical Diagnostic Systems.
Integration of Clinical Practice Guidelines into a Distributed Regional Electronic Patient Record for Tumour-Patients using XML: A Means for Standardization of the Treatment Processes
Authors: Mludek Volker  , Wolff Astrid Corinna  , Drings Peter  , van der Haak Minne  , Haux Reinhold  , Wannenmacher Michael  , Zierhut Dietmar
Published: February 2025

With the rising efforts to guarantee a high quality treatment in medicine and to reduce the costs in the health care system, Clinical Practice Guidelines (CPG) have developed into a very important reference in medicine. CPGs are especially useful for the standardization of multiprofessional treatment processes like the care for patients with malignant diseases.
Standard Protocol for Exchange of Health-checkups based on SGML: The Healthcheckups Data Markup Language (HDML)
Authors: Sugimori Hiroki  , Hara Shoichiro  , Yoshid Katsumi  , Furumi Katsuhiko  , Tofukuji Ikuo  , Kubodera Takeshi  , Yoda Takashi  , Masaki Kawai
Published: February 2025

This research aims to provide the protocol to achieve efficient information exchange by electric means between the health-checkup (HCs) facilities. Joint Working Group of JMHTS (Japan Society of Multiphasic Health Testing and Service) and JAHIS (Japanese Association of Healthcare Information Systems Industry vender) developed a health/medical data interchange model that is based on the markup information structure. Our data encoding language, HDML (Health-checkups Data Markup Language), was based on SGML, which has context free grammar. HDML had the standard DTD which defined anamnesis, physical examination, laboratory examination, summary findings, and judgment of total health status, etc. The laboratory examination contains the following items: item’s name, method, unit, device, company name, product name, principle, and standard reference value. (Fig.1) We take into account the interchangeability of data with HL7 and other international standard protocols. As a preliminary study, we carried out an experimental trial in October 1999, which transferred laboratory data by translating into HDML, from 2 HCs facilities to other 2 HCs facilities. We have succeeded in transferring almost all laboratory data appropriately by using the HDML protocol software between the HCs facilities. Moreover, we could convert and standardize the laboratory data properly from the attribute information written in the DTD.(Fig.2) We propose the HDML protocol to standardize health/medical data that will make available for multi-health facilities on the basis of the standardization of data exchange regarding HCs. We found this HDML protocol worked effectively in using the actual health/medical data.
Design of an Adapter to Support XML Queries Against Existing Pharmacy Systems
Authors: Tripp Bryan  , Tio Abraham
Published: February 2025

Information about a single patient may be scattered among repositories at multiple institutions. A complete health record can be provided by a system that distributes standardized queries directly to the systems with which the required information was collected. Source systems that do not accommodate this approach can be augmented with an adapter that translates standard queries into systemspecific queries. The authors have prototyped an XML-based query adapter for use with pharmacy systems.
Economic Motives to Use a Participatory Design Approach in the Development of Public-Health Information Systems
Authors: Vimarlund Vivian  , Eriksson Henrik  , Timpka Toomas
Published: February 2025

Within public health, there is a tradition of co-operation between researchers and communities in planning and implementation of health promotion programs. As a consequence, public-health organizations are characterized by having complex multidisciplinary structure and dynamic organizational goals. In this paper, we discuss the economic impacts from the use of Participatory Design for development of public-health information systems. Creation of systems that have both utility and usability is suggested to be highlighted as the central goal. The identified prerequisites for a positive impact are that the new system should be of high quality, appropriate to the nature of the health promotion tasks, and to how activities are coordinated and integrated both between and within the stakeholder groups involved. We argue further that a method that minimizes the information asymmetry in the development process is necessary for avoiding market failures. The conclusion is that participatory design will diminish transaction costs, will help to avoid sunk costs, and will contribute to rich efficient use of human and economic resources in public-health organizations.
Replacement of Hospital Information System and the Risk: A Survey in National University Hospitals in Japan
Authors: Miyamoto Masaki  , Sako Masao  , Sakamaki Tetsuo
Published: February 2025

In Japan, hospital information systems (HIS) introduced at national university hospitals, are already evolved into second to third generations. Recently, some university hospitals experienced many troubles. We made a questionnaire survey to analyze Chat the problems are. In most cases, the length of time from the signing of a contract to the beginning of using new system was too short. Some hospitals experienced their worst problems because of inadequate completion of the custom software, incompatibilities in data and so on. If ample preparation time is not available, the current contracting procedure must actively be reviewed.