bluuebunny/crossref_metadata_2025 huggingface dataset:
A Fuzzy Logical Model of Computer-Assisted Medical Diagnosis
Authors: Adlassnig K.-P.
Published: March 2018

A model of a computer-assisted diagnostic system using fuzzy subsets has been developed. The physician documents symptom—diagnosis presence relationships and symptom—diagnosis conclusiveness relationships by means of labels of the fuzzy subsets never, almost never, very very seldom, very seldom, seldom, more or less seldom, not known, more or less often, often, very often, very very often, almost always, always.

Symptoms are regarded as fuzzy subsets of reference sets. The reference set includes all values the symptom may assume. The degree of membership of a value in the fuzzy subset of a symptom is calculated when the patient’s symptom pattern is available. By means of compositions of fuzzy relations, four different diagnostic indications are determined for every diagnosis under consideration: presence indication, conclusiveness indication, non-presence indication and non-symptom presence indication.

By performing the diagnostic process, the system provides the physician with proven diagnoses, excluded diagnoses and diagnostic hints, including reasons for the diagnoses displayed. Proposals for further investigations may also be requested.
The Impact of an Explanation Capability for a Computer Consultation System
Authors: Erdman H. P.
Published: March 2018

The impact of a computer consultation program including explanations for its decisions was examined. The consultation program was designed as a decision aid for non-psychiatrists regarding the treatment of depression. Both psychiatrists and non-psychiatrists were used to evaluate the system, with different results for the two groups. Explanations improved the non-psychiatrists’ attitudes towards the computer recommendations, while for psychiatrists the impact of explanation depended on the specific content of the recommendations and explanations. The results for psychiatrists were consistent with the view that explanations are important for computer consultation systems because they may help physicians decide whether or not the computer’s advice is reasonable.
Graphical Access to Medical Expert Systems: I. Design of a Knowledge Engineer’s Interface
Authors: Tsuji S. , Shortliffe E. H.
Published: March 2018

Optimal construction of medical expert systems demands a powerful interactive environment for knowledge base management by knowledge engineers. Key requirements include techniques for (a) examining existing information, (b) adding new knowledge and editing preexisting data structures, and (c) examining dynamic internal system behavior to facilitate debugging during consideration of actual cases. This article addresses design considerations in the development of such knowledge engineering tools. The emphasis is on the use of professional workstations with high density graphics interfaces since that technology is rapidly becoming a predominant environment for knowledge engineering activities. To illustrate the points made, examples are drawn from an experimental knowledge base management tool designed for knowledge engineers constructing the knowledge base of ONCOCIN, an expert system to advise in the management of cancer patients.
The Measurement of Performance in Probabilistic Diagnosis
Authors: Habbema J. D. F. , Hilden J. , Bjerregaard B.
Published: March 2018

Owing to the inherent uncertainty of diagnostic tasks, diagnostic advice should be offered in a probabilistic, rather than deterministic form. Since the late fifties a lot of effort has been invested in constructing probabilistic diagnosis rules. Much less has been done to devise rational tools for evaluating them ; conventional error rates reflect but one aspect of performance in a rather crude way. The aim of this paper and its successors is to offer a body of evaluation tools. After defining a general framework and stating its limitations we apply some graphical techniques to the acute abdominal pain data that will serve as illustration in the next papers as well: dot diagrams, the triangular diagram for the three-disease case, and three tabular representations based on categorization of the probabilities, viz. the usual (forced) classification matrix, from which various classification rates are read off; the classification matrix with doubt, in which uncertain and confident diagnoses are distinguished; and the exclusion matrix, which spots diseases that are judged improbable. Together these matrices give a good first impression of the behaviour of a probabilistic diagnosis system. The outlined techniques of later papers are needed for a more complete analysis.
Medical Informatics Training and Research at Rennes University School of Medicine
Authors: Beux P. , Burgun A. , Jarno P. , Siregar P.
Published: March 2018

The University of Rennes Medical School has offered Medical informatics training since 1988; at the same time, research in medical informatics was started. This paper describes the teaching programs at both the undergraduate level and at the graduate level. Research topics comprise fundamental research on biomedical models, ontologies for medical knowledge representations, natural language processing, and research for diagnosis and therapeutic aids. We have developed a local area network which communicates between the School of Medicine and the University Hospital, both internally (Intranet) and externally by access to the National Research network (RENA TER) in France, which is connected to the internet.
The Medical Informatics Program at the National - University of Singapore
Authors: Leong T.Y. , Ong Kenneth , Raghavan R. , Pung H.K. , Lun K.C.
Published: March 2018

The Medical Informatics Program at the National University of Singapore was established in September 1996 with a $4 million joint funding from the National Science and Technology Board and the Ministry of Education. The primary aims of the research program are to undertake upstream basic research in medical informatics and to build a critical mass of medical informatics expertise to meet long-term research goals and to effect technology transfer to the health sector of Singapore. Research projects fall into five groups: Clinical Decision Systems, Health Information Systems, Biomedical Datamining Systems, Medical Education Systems and Medical Networking, Applications Development and Integration Systems.
Patient-Computer Dialogue: A Review,
Authors: Slack W.V.
Published: March 2018

Since the first study of communication between patient and computer was performed at the University of Wisconsin in 1965, programs for patient-computer dialogue have been developed, implemented, and studied in numerous settings in the United States and abroad, and the results have been encouraging. This review presents a brief history of patient-computer dialogue together with suggested guidelines for programs in the future.
Patient-centered Information Systems
Authors: Brennan P. , Kuang Y.-S. , Volrathongchai K.
Published: March 2018

Patient-centered information systems augment traditional approaches to health information management with specific functions designed to support patient participation in health care decision making and treatment activities. In addition to computer-based record systems and business management applications, patient-centered information systems must include functionality that support communication between clinician and patient, and that provide information and peer support in a timely fashion to the patient. Current progress in information systems demonstrates the existence and feasibility of consumer health informatics, patient access to computerized clinical records, and technical and organizational solutions to integrating computerized patient information systems. We are now proposing a model of patient -centered system that incorporates all those components, and provides a vision of the future.
Health and Clinical Management - Impact on Clinical Outcome
Authors: Bergmann J. ,   Managing Editor for the IMIA Yearbook Section on Health and Clinical Management
Published: March 2018

To summarize current excellent research in the field of health and clinical management.

Synopsis of the articles selected for the IMIA Yearbook 2007.

Five articles from international peer reviewed journals were selected for the section on health and clinical management of the IMIA Yearbook 2007. They represent outstanding research on computerized provider order entry, computer applications in the field of translational medicine, time efficiency of electronic health records, and deliverance of telemedicine.

In the field of health and clinical management, clinical outcome of computer-supported healthcare, cost-benefit analysis, and barriers and facilitators for technology adoption are still current research topics.
Section 2: Patient Records: Electronic Patient Records: Moving from Islands and Bridges towards Electronic Health Records for Continuity of Care
Authors: Bott Oliver , Kohl Christian , Lovis Christian , Garde Sebastian , Knaup Petra
Published: March 2018

Electronic patient record (EPR) systems are increasingly used and have matured sufficiently so as to contribute to high quality care and efficient patient management. Our objective is to summarize current trends and major achievements in the field of EPR in the last year and to discuss their future prospects.

Integrating health data from a variety of sources in a comprehensive EPR is a major prerequisite for e-health and eresearch. Current research continues to elaborate architectures, technologies and security concepts. To achieve semantic interoperability standards are developed on different levels, including basic data types, messages, services, architectures, terminologies, ontologies, scope and presentation of EPR content. Standards development organisations have started to harmonize their work to arrive at a consensus standard for EPR systems. Integrating the health care enterprise as a whole will optimize efficient use of resources, logistics and scheduling.

The past few years have seen a myriad of developments of EPR systems. However, it is still a long way, until EPR systems can flexibly fulfill all user requirements and an EHR will become broadly accepted. Semantic interoperability will be a key to successful EPR use, especially to avoid double data entries and to better integrate data recording within local workflows. The patient will become an empowered partner, not only by giving him access to his health data. All this will result in enormous quantities of data. Thus, time has come to determine how relevant data can be presented to the stakeholders adequately.
Health Information Systems - Technology and Acceptance
Authors: Bott O. J. ,   Managing Editor for the IMIA Yearbook Section on Health Information Systems
Published: March 2018

To summarize current outstanding research in the field of health information systems (HIS).

Synopsis of the articles selected for the IMIA Yearbook 2007.

Five articles from three international peer reviewed journals were selected for the HIS section of the IMIA Yearbook 2007. They represent outstanding research on new user interfaces for mobile data entry, smart card based approaches for national eHealth projects, generic system architectures for telemedicine services, new approaches for electronic prescriptions based on ubiquitous computing, and telemedical systems for chronic care in COPD.

In the field of health information systems, evaluation and general architectural aspects of telemedical platforms respectively eHealth infrastructures currently is an important research topic as well as establishing acceptance of new technologies from the users and the organizations point of view.
Reflections on the Role of Open Source in Health Information System Interoperability
Authors: Sfakianakis S. , Chiarugi F. , Conforti F. , Katehakis D.G. , Chronaki C.E.
Published: March 2018

This paper reflects on the role of open source in health information system interoperability. Open source is a driving force in computer science research and the development of information systems. It facilitates the sharing of information and ideas, enables evolutionary development and open collaborative testing of code, and broadens the adoption of interoperability standards. In health care, information systems have been developed largely ad hoc following proprietary specifications and customized design. However, the wide deployment of integrated services such as Electronic Health Records (EHRs) over regional health information networks (RHINs) relies on interoperability of the underlying information systems and medical devices.

This reflection is built on the experiences of the PICNIC project that developed shared software infrastructure components in open source for RHINs and the OpenECG network that offers open source components to lower the implementation cost of interoperability standards such as SCP-ECG, in electrocardiography.

Open source components implementing standards and a community providing feedback from real-world use are key enablers of health care information system interoperability.

Investing in open source is investing in interoperability and a vital aspect of a long term strategy towards comprehensive health services and clinical research.
Decision Support, Knowledge Representation and Management: A Balancing Act between Clinical Use and Implementation of Sophisticated Reasoning Techniques?
Authors: Brigl B. ,   Managing Editor for the IMIA Yearbook Section on Decision Support, Knowledge Representation and Management
Published: March 2018

To position the papers selected for the IMIA Yearbook 2007 in the context of current research in decision support, knowledge representation and management.

Synopsis of the articles selected for the IMIA Yearbook 2007.

In the Yearbook 2007 the best paper selection of the section Decision support, Knowledge management in Representation’ shows, that the evaluation of the influence of decision support on medical behavior and outcome is as important as research on new reasoning technologies and methods.

The best paper selection process shows on the one hand that there is still a deep gap between rather small decision support solutions successfully evaluated in clinical environments and more complex decision support systems using sophisticated reasoning techniques, but lack of clinical use. On the other hand the implementation of decision support systems today benefits from research done in the last decades.
Section 6: Education and Consumer Informatics: Education and Consumer Health Informatics
Authors: Mantas J.
Published: March 2018

To report on recent efforts in the field of consumer health informatics (CHI) and education.

A review of the literature we selected on using search engines and Medline with terms from consumer health informatics and education. Twenty two articles match these criteria.

A great diversity of work spans the field of CHI. This relatively new field now faces challenges due to rapidly advancing technologies and the increasing empowerment of citizens connected over the worldwide web.

The benefits of enhancing CIH components within existing medical curricula are already being noted.. Additionally, updated recommendations on health and medical informatics should incorporate CHI.

Geissbuhler A, Haux R, Kulikowski C, editors. IMIA Yearbook of Medical Informatics 2007.
Health Information Systems: a Survey of Frame-works for Developing Countries
Authors: Marcelo A.B.
Published: March 2018

Objectives:
The objective of this paper is to perform a survey of excellent research on health information systems (HIS) analysis and design, and their underlying theoretical frameworks. It classifies these frameworks along major themes, and analyzes the different approaches to HIS development that are practical in resource-constrained environments.

Method:
Literature review based on PubMed citations and conference proceedings, as well as Internet searches on information systems in general, and health information systems in particular.

Results:
The field of health information systems development has been studied extensively. Despite this, failed implementations are still common. Theoretical frameworks for HIS development are available that can guide implementers.

Conclusion:
As awareness, acceptance, and demand for health information systems increase globally, the variety of approaches and strategies will also follow. For developing countries with scarce resources, a trial-and-error approach can be very costly. Lessons from the successes and failures of initial HIS implementations have been abstracted into theoretical frameworks. These frameworks organize complex HIS concepts into methodologies that standardize techniques in implementation. As globalization continues to impact healthcare in the developing world, demand for more responsive health systems will become urgent. More comprehensive frameworks and practical tools to guide HIS implementers will be imperative.
Imaging Informatics: Toward Capturing and Processing Semantic Information in Radiology Images
Authors: Napel S. , Rubin D. L.
Published: March 2018

Objectives:
To identify challenges and opportunities in imaging informatics that can lead to the use of images for discovery, and that can potentially improve the diagnostic accuracy of imaging professionals.

Methods:
Recent articles on imaging informatics and related articles from PubMed were reviewed and analyzed. Some new developments and challenges that recent research in imaging informatics will meet are identified and discussed.

Results:
While much literature continues to be devoted to traditional imaging informatics topics of image processing, visualization, and computerized detection, three new trends are emerging: (1) development of ontologies to describe radiology reports and images, (2) structured reporting and image annotation methods to make image semantics explicit and machine-accessible, and (3) applications that use semantic image information for decision support to improve radiologist interpretation performance. The informatics methods being developed have similarities and synergies with recent work in the biomedical informatics community that leverage large highthroughput data sets, and future research in imaging informatics will build on these advances to enable discovery by mining large image databases.

Conclusions:
Imaging informatics is beginning to develop and apply knowledge representation and analysis methods to image datasets. This type of work, already commonplace in biomedical research with large scale molecular and clinical datasets, will lead to new ways for computers to work with image data. The new advances hold promise for integrating imaging with the rest of the patient record as well as molecular data, for new data-driven discoveries in imaging analogous to that in bioinformatics, and for improved quality of radiology practice.
Sensors, Medical Images and Signal Processing:
Authors: Depeursinge A. , Müller H. ,   Section Editors for the IMIA Yearbook Section on Sensor, Signal, and Imaging Informatics
Published: March 2018

Objectives
To summarize current excellent research in the field of medical sensor, signal and imaging informatics.

Method:
Synopsis of the articles selected for the IMIA (International Medical Informatics Association) Yearbook 2010.

Results:
Current research in the field of sensor, signal, and imaging informatics is characterized by theoretically sound techniques and evaluations with focus in imaging informatics.

Conclusions:
The best paper selection of articles on sensors, signal, and imaging informatics shows examples of excellent research on methods concerning theoretically sound original development in this field. Research published in 2009 was characterized by the emergence of mature computerized diagnosis aid frameworks with assessment of input and output quality. The purpose of these systems is clearly to bring new image and signal interpretation tools to clinicians.
Knowledge Representation and Management
Authors: Rassinoux A.-M. ,   Section Editor for the IMIA Yearbook Section on Knowledge Representation and Management
Published: March 2018

Objectives:
To summarize current outstanding research in the field of knowledge representation and management.

Method:
Synopsis of the articles selected for the IMIA Yearbook 2010.

Results:
Four interesting papers, dealing with structured knowledge, have been selected for the section knowledge representation and management. Combining the newest techniques in computational linguistics and natural language processing with the latest methods in statistical data analysis, machine learning and text mining has proved to be efficient for turning unstructured textual information into meaningful knowledge. Three of the four selected papers for the section knowledge representation and management corroborate this approach and depict various experiments conducted to. extract meaningful knowledge from unstructured free texts such as extracting cancer disease characteristics from pathology reports, or extracting protein-protein interactions from biomedical papers, as well as extracting knowledge for the support of hypothesis generation in molecular biology from the Medline literature. Finally, the last paper addresses the level of formally representing and structuring informa- tion within clinical terminologies in order to render such information easily available and shareable among the health informatics com- munity.

Conclusions:
Delivering common powerful tools able to automati- cally extract meaningful information from the huge amount of elec- tronically unstructured free texts is an essential step towards promot- ing sharing and reusability across applications, domains, and institutions thus contributing to building capacities worldwide.
Closing the Genotype-phenotype Gap
Authors: Yip Y. L. ,   Section Editor for the IMIA Yearbook Section on Bioinformatics
Published: March 2018

Objectives:
To summarize current excellent research in the field of bioinformatics.

Method:
Synopsis of the articles selected for the IMIA Yearbook 2010.

Results:
The selection process for this yearbook’s section on Bioinformatics results in five excellent articles highlighting the progress made in advancing the understanding of genotypephenotype relationship, and their concrete application in clinical settings. First, next generation sequencing techniques have allowed the discovery of an ever larger number of genetic variations at a greater resolution, and methods were developed to ensure accurate data analysis. Second, innovative approaches were applied to gene expression data to allow its link to a wider phenotypic spectrum and to enhance its use for disease understanding. Third, there is a notable trend in visualizing diseases as network rather than individual entities, and this has provided new insights for disease interpretation. The progress mentioned above is further aided by continual development in bio-ontologies which provide means for semantic, and thus phenotype, comparison.

Conclusions:
The current literature showed a tightening link between genotype and phenotype, placing us one step closer to a better disease classification, patient stratification as well as the development of personalized medicine.
Medical Informatics in China: Healthcare IT Trends, Academic and Research Developments
Authors: Luo S. , Zhang K. , Li B.
Published: March 2018

Objective:
Describing the challenges and advances in medical informatics in China from the perspectives of hospital information systems, workforce, and academic, and research advances.

Methods:
The paper summarizes information from the CMIA (China Medical Informatics Association and findings reported by CHIMA (China Hospital Information Management Association), including a White Paper on China Hospital Information Systems.

Results:
Biomedical and Health Informatics has grown considerably during the past decade in China, and is an important component of proposed government planning that includes development of healthcare cards, clinical workflow path rules, and rural medicine. CMIA has strengthened as an organization promoting education, research and academic activities, while CHIMA has sponsored many hospital-based activities, including workshops on technical and workforce IT priorities related to proposed reforms of China’s healthcare system.

Conclusions:
China’s challenges and opportunities in biomedical informatics and healthcare IT are considerable, with the former requiring greater promotion of academic research and educational opportunities through CMIA to support the burgeoning development of healthcare IT systems throughout the country. National and international collaboration and exchanges could lead to very useful comparative studies, Recommendations by CHIMA to the national government and academia focus on organizational and workforce standards, roles, and defining career paths for HIT professionals as well as CME education in healthcare informatics at the graduate university.
Is Healthcare Information Technology Based on Evidence?
Authors: Koppel R.
Published: March 2018

Is healthcare information technology (HIT) based on evidence of efficacy? Are the trillions of dollars already devoted and in the pipeline for HIT implementations based on systematic evaluations? If evaluated, would those evaluations focus on patient safety, return on investment, clinical efficiency, improved clinician satisfaction, and/or workflow integration? Do we have reliable evidence of usable interfaces, of successful implementations, of data standards allowing interoperability, of continuous improvement, of responsiveness to clinician feedback?

While measurement of HIT's efficacy is extraordinarily difficult—complicated by a myriad of other factors involved in providing healthcare and in organizational dynamics—it is not impossible. But is such evidence required before most implementations? Any implementation? Or are the goals of patient safety and efficiency so self-evident, profoundly desired, and laudable that HIT's beneficence is accepted without rigorous data? Note that lack of systematic evidence does not mean HIT is ineffective. HIT may provide untold benefits even if there is no hard proof of those benefits.

We find that HIT is seldom objectively measured, and that evidence of its efficacy is at best spotty, and often influenced by self-promotion. Most measures, especially those associated with cost-benefit analyses, are aspirational or hubris transubstantiated into numbers.
Evidence Based Health Informatics: 10 Years of Efforts to Promote the Principle
Authors: Ammenwerth E. , Beuscart-Zephir M.-C. , Brender J. , Hyppönen H. , Melia S. , Nykänen P. , Talmon J. , de Keizer N. , Rigby M.
Published: March 2018

Objectives: To present the importance of Evidence-based Health Informatics (EBHI) and the ethical imperative of this approach; to highlight the work of the IMIA Working Group on Technology Assessment and Quality Improvement and the EFMI Working Group on Assessment of Health Information Systems; and to introduce the further important evaluation and evidence aspects being addressed.

Methods: Reviews of IMIA, EFMA and other initiatives, together with literature reviews on evaluation methods and on published systematic reviews.

Results: Presentation of the rationale for the health informatics domain to adopt a scientific approach by assessing impact, avoiding harm, and empirically demonstrating benefit and best use; reporting of the origins and rationale of the IMIA- and EQUATOR-endorsed Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI) and of the IMIA WG's Guideline for Good Evaluation Practice in Health Informatics (GEP-HI); presentation of other initiatives for objective evaluation; and outlining of further work in hand on usability and indicators; together with the case for development of relevant evaluation methods in newer applications such as telemedicine. The focus is on scientific evaluation as a reliable source of evidence, and on structured presentation of results to enable easy retrieval of evidence.

Conclusions: EBHI is feasible, necessary for efficiency and safety, and ethically essential. Given the significant impact of health informatics on health systems, care delivery and personal health, it is vital that cultures change to insist on evidence-based policies and investment, and that emergent global moves for this are supported.
eHealth in Europe – Status and Challenges
Authors: Hackl W. O. , Hofdijk J. , Van Gemert-Pijnen L. , Ammenwerth E. , Nykänen P. , Hoerbst A. , Moen A.
Published: March 2018

Objectives: To present European reflections on the concept of eHealth and emerging challenges related to further development of eHealth in Europe.

Methods: A survey with 10 questions was distributed to representatives of the national member associations of the European Federation of Medical Informatics (EFMI).

Results: The results document a shift from a constricting ICT-orientation to development of the entire health system where eHealth strategies, organizational change, and appropriate technological infrastructure are singled out as important aspects.

Conclusion: There are urgent needs to ensure that eHealth strategies and policies for further design and deployment of eHealth applications support sociable services and innovations in health care.
Use of Open Source Software in Health Care Delivery – Results of a Qualitative Field Study
Authors: Heinze O. , Bergh B. , Schmuhl H.
Published: March 2018

Objectives: To assess and analyze the attitude of health IT executives towards the utilization of specialized medical Open Source software (OSS) in Germany's and other European countries' health care delivery.

Methods: After an initial literature review a field study was carried out based on semi-structured expert interviews. Eight German and 11 other European health IT executives were surveyed. The results were qualitatively analyzed using the grounded theory approach. Identified concepts were reviewed using SWOT analysis.

Results: In total, 13 strengths, 11 weaknesses, 3 opportunities, and 8 threats of the utilization of OSS in a clinical setting could be identified. Additionally, closely related aspects like general software procurement criteria, the overall attitude of health IT executives, users, and management towards OSS and its current and future use could as well be assessed.

Conclusions: Medical OSS is rarely used in health care delivery. In order to capitalize the unique advantages of OSS in a clinical setting, complex requirements need to be addressed. Shortcomings of OSS describe an attractive breeding ground for new commercial offerings and services that need yet to be seen.
Health Information Systems
Authors: Cuggia M. , Toubiana L.
Published: March 2018

Objectives: Summarize excellent current research in the field of Health Information Systems.

Method: Synopsis of the articles selected for the IMIA Yearbook 2013.

Results: Five papers from international peer reviewed journals have been selected for the section on health information systems.

Conclusions: The selected articles illustrate current research regarding health information technology (IT) impacts and evaluation and the latest developments in health information exchange.
A Medical Informatics Perspective on Clinical Decision Support Systems
Authors: Lamy J.-B. , Bouaud J.
Published: March 2018

Objective: To summarize excellent research and to select best papers published in 2012 in the field of computer-based decision support in healthcare.

Methods: A bibliographic search focused on clinical decision support systems (CDSSs) and computer provider order entry was performed, followed by a double-blind literature review.

Results: The review process yielded six papers, illustrating various aspects of clinical decision support. The first paper is a systematic review of CDSS intervention trials in real settings, and considers different types of possible outcomes. It emphasizes the heterogeneity of studies and confirms that CDSSs can improve process measures but that evidence lacks for other types of outcomes, especially clinical or economic. Four other papers tackle the safety of drug prescribing and show that CDSSs can be efficient in reducing prescription errors. The sixth paper exemplifies the growing role of ontological resources which can be used for several applications including decision support.

Conclusions: CDSS research has to be continuously developed and assessed. The wide variety of systems and of interventions limits the understanding of factors of success of CDSS implementations. A standardization in the characterization of CDSSs and of intervention trial reporting will help to overcome this obstacle.
The Evidence-base for Using Ontologies and Semantic Integration Methodologies to Support Integrated Chronic Disease Management in Primary and Ambulatory Care: Realist Review
Authors: Liyanage H. , Liaw S.-T. , Kuziemsky C. , Terry A. L. , Jones S. , Soler J. K. , de Lusignan S.
Published: March 2018

Background: Most chronic diseases are managed in primary and ambulatory care. The chronic care model (CCM) suggests a wide range of community, technological, team and patient factors contribute to effective chronic disease management. Ontologies have the capability to enable formalised linkage of heterogeneous data sources as might be found across the elements of the CCM.

Objective: To describe the evidence base for using ontologies and other semantic integration methods to support chronic disease management.

Method: We reviewed the evidence-base for the use of ontologies and other semantic integration methods within and across the elements of the CCM. We report them using a realist review describing the context in which the mechanism was applied, and any outcome measures.

Results: Most evidence was descriptive with an almost complete absence of empirical research and important gaps in the evidence-base. We found some use of ontologies and semantic integration methods for community support of the medical home and for care in the community. Ubiquitous information technology (IT) and other IT tools were deployed to support self-management support, use of shared registries, health behavioural models and knowledge discovery tools to improve delivery system design. Data quality issues restricted the use of clinical data; however there was an increased use of interoperable data and health system integration.

Conclusions: Ontologies and semantic integration methods are emergent with limited evidence-base for their implementation. However, they have the potential to integrate the disparate community wide data sources to provide the information necessary for effective chronic disease management.
Social Media for the Promotion of Holistic Self-Participatory Care: An Evidence Based Approach
Authors: Hansen M. M. , Grajales F. J. , Martin-Sanchez F. , Bamidis P. D. , Miron-Shatz T.
Published: March 2018

Objectives: As health information is becoming increasingly accessible, social media offers ample opportunities to track, be informed, share and promote health. These authors explore how social media and holistic care may work together; more specifically however, our objective is to document, from different perspectives, how social networks have impacted, supported and helped sustain holistic self-participatory care.

Methods: A literature review was performed to investigate the use of social media for promoting health in general and complementary alternative care. We also explore a case study of an intervention for improving the health of Greek senior citizens through digital and other means.

Results: The Health Belief Model provides a framework for assessing the benefits of social media interventions in promoting comprehensive participatory self-care. Some interventions are particularly effective when integrating social media with real-world encounters. Yet not all social media tools are evidence-based and efficacious. Interestingly, social media is also used to elicit patient ratings of treatments (e.g., for depression), often demonstrating the effectiveness of complementary treatments, such as yoga and mindfulness meditation.

Conclusions: To facilitate the use of social media for the promotion of complementary alternative medicine through self-quantification, social connectedness and sharing of experiences, exploration of concrete and abstract ideas are presented here within. The main mechanisms by which social support may help improve health – emotional support, an ability to share experiences, and non-hierarchal roles, emphasizing reciprocity in giving and receiving support – are integral to social media and provide great hope for its effective use.
Personal Health, Person-centred Health and Personalised Medicine – Concepts, Consumers, Confusion and Challenges in the Informatics World
Authors: Rigby M.
Published: March 2018

To define and assess ‘Consumer Health Informatics’ and related emergent issues in an era of new media and of personalisation of care, and from this to define what actions need to be taken to optimise benefits and address risks.

Definition of key concepts; review of health personalisation, emergent health information and communication technologies and knowledge sources available to citizens and social media; and identification of unresolved issues threatening optimal use of each.

A structured review supported by citations and examples.

Several new aspects of consumer health informatics are emerging, including new knowledge sources, feedback on treatments and care providers, on-line videos, and a new generation of patient experience sites including those which are for profit and seek to influence treatment paradigms. Not just the information usage, but also the potential social challenges and malicious abuses, are global issues, and also transcend the traditional health community and thus should be addressed in partnership with other global agencies.
Critical Advances in Bridging Personal Health Informatics and Clinical Informatics
Authors: Vimarlund V. , Koch S.
Published: March 2018

To provide a survey over significant developments in the area of linking personal health informatics and clinical informatics, to give insights into critical advances and to discuss open problems and opportunities in this area.

A scoping review over the literature published in scientific journals and relevant conference proceedings in the intersection between personal health informatics and clinical informatics over the years 2010 and 2011 was performed.

The publications analyzed are related to two main topics, namely “Sharing information and collaborating through personal health records, portals and social networks” and “Integration of personal health systems with clinical information systems”. For the first topic,resultsarepresentedaccordingtofivedifferentthemes:”Patient expectationsandattitudes”,”Realuseexperiences”,”Changesforcareproviders”,”Barrierstoadoption”and”Proposedtechnicalinfrastructures”.Forthesecondtopic,twodifferentthemeswerefound,namely”Technicalarchitecturesand interoperability”“and”Security,safetyandprivacyissues”.

Results show a number of gaps between the information needs of patients and the information care provider organizations provide to them as well as the lack of a trusted technical, ethical and regulatory framework regarding information sharing.

Despiterecentdevelopmentsintheareasofpersonal health informatics and clinical informatics both fields have diverging needs. To support both clinical work processes and empower patients to effectivelyhandleself-care, anumberofissuesremainunsolved.Open issues include privacy and confidentiality, including trusted sharing of health information and building collaborative environments between patients,theirfamiliesandcareproviders.Therearefurtherchallengesto meet around health and technology literacy as well as to overcome structural and organizational barriers. Frameworks for evaluatingpersonal health informatics applications and pervasive health technology are needed to build up an evidence basis.
Empowering Patients: Making Health Information and Systems Safer for Patients and the Public
Authors: Househ F. M. S. , Kushniruk A. W. , Nohr C. , Takeda H. , Borycki E. M.
Published: March 2018

The objectives of this paper are to explore issues and perspectives from four regions of the world where health information systems are contributing to patient empowerment and influencing patient safety.

Members of the IMIA Working Group for Health Information Systems Safety came together to explore global issues at the intersection of health information systems safety, patient empowerment and patient safety. The group carried out a review and synthesis of the empirical and grey literature in four different regions/countries of the world that have differing health information system safety priorities.

Regions/countries from differing parts of the world are developing: (1) high quality, safe information for individuals to use in their health related decision making, (2) patient portals and testing them for their safety, (3) methods for identifying unsafe health information system features and functions, and (4) ways of engaging citizens in identifying unsafe features and functions of health information systems.

Internationally, there has been a rise in the number of health information systems and technologies that are being developed to support patient care. The amount of health information available on the World Wide Web (WWW), and the use of mobile phone software to support consumer health behaviours and self-management of chronic illnesses has also grown. The use of some of these health informationsystems and technologies has helped citizens to improve their health status (e.g. patient portals, mobile phones). However, the safety of these systems and technologies has come into question. As a result, there is a need to refine these systems and ensure theirsafetywhentheyareusedbypatientsandtheirfamilies.
Sensors, Medical Images and Signal Processing: Ubiquitous Personalized Health Monitoring
Authors: Müller H. , Foncubierta-Rodriguez A. , Depeursinge A. ,   Section Editors for the IMIA Year-book Section on Sensor, Signal, and Imaging Informatics
Published: March 2018

To summarize excellent research in the field of medical sensor, signal and imaging informatics published in the year 2011.

Synopsis of the articles selected for the IMIA (International Medical Informatics Association) Yearbook 2012 through a manual initial selection and a peer review process to find the best paper in this domain published in 2011.

Current research in the field of sensors, signal, and imaging informatics is characterized by theoretically sound techniques and evaluations with focus in imaging informatics. An increased number of systems with embedded signal processing where sensors include signal processing were observed in 2011. In all domains, pragmatic solutions with the goal of clinical impact have grown, including in developing countries where simple, robust techniques are combined to address primary and simple medical problems with potentially high impact. Finally, recent advances in image and signal processing are moving towards patient-based modeling.

The best paper selection of articles on sensors, signal, and imaging informatics shows examples of excellent research on methods concerning theoretically sound original development in this field in the year 2012.
Data Integration in Genomic Medicine: Trends and Applications
Authors: Seoane J. A. , Aguiar-Pulido V. , Pazos A. , Dorado J.
Published: March 2018

In a near future, each person will incorporate his/her own sequenced genome in his/her electronic health record. In that precise moment, genomic medicine will be fundamental for clinical practice, as an essential key of personalized medicine. All the genomic data, as well as other ‘omics’ and clinical data necessary for personalized medicine, are stored in several distributed databases. Research and patient care require each time more biomedical data integration of several distributed heterogeneous datasources.

This work develops a comprehensive review of the most relevant works in biomedical data integration, specifically in genomic medical data, analyzing the evolution of architecture and integration techniques during the last 20 years, and its usage.

Most of these solutions, based on cross-linking, data warehouse or federated approaches, are suitable for specific domains. However, none of the models found in the literature is completely appropriate for a general biomedical data integration problem.
Translational Bioinformatics Embraces Big Data
Authors: Shah N. H.
Published: March 2018

We review the latest trends and major developments in translational bioinformatics in the year 2011-2012. Our emphasis is on highlighting the key events in the field and pointing at promising research areas for the future. The key take-home points are:

• Translational informatics is ready to revolutionize human health and healthcare using large-scale measurements on individuals.

• Data–centric approaches that compute on massive amounts of data (often called “Big Data”) to discover patterns and to make clinically relevant predictions will gain adoption.

• Research that bridges the latest multimodal measurement technologies with large amounts of electronic healthcare data is increasing; and is where new breakthroughs will occur.
Emerging eHealth Directions in the Philippines
Authors: Fernandez-Marcelo P. G. , Ho B. L. , Faustorilla J. F. , Evangelista A. L. , Pedrena M. , Marcelo A.
Published: March 2018

This paper aims to provide an overview of research and education initiatives in the Philippines. Moreover, it outlines the various agencies and organizations that spearhead the eHealth projects.

The researchers utilized internet-based review of literature, key informant interviews and proceedings from two eHealth conferences among Filipino researchers in 2011 organized by the authors.

eHealth capacities in the areas of research, education and service have progressed dramatically in the last four decades as a result of improved access to information and communication technology. The National Unified Health Research Agenda initiatives have been led largely by higher educational institutions and organizations specializing in eHealth. Educational reforms have been seen with the establishment of the Masters of Science in Health Informatics, infusion of Nursing Informatics into the nursing under-graduate curriculum and offering of short courses on eHealth. Service-oriented organizations and innovations have also been formulated to meet the needs of the practitioners as information and communication technologies are embedded into the healthcare de-livery system.

Experts, researchers, practitioners and enthusiasts have successfully promoted awareness and uplifted the standards in the practice of eHealth in research, education and service. However, three main areas of improvement need to be given priority: (1) Policy and standards creation, (2) capability building and (3) multi-sectoral collaborations.
Update zu Immuntherapien, Hirnmetastasen et al.
Authors: Kretzschmar Alexander
Published: March 2018

Rund 2000 Teilnehmer trafen sich Anfang Mai in Genf auf der European Lung Cancer Conference (ELCC) 2017. Zu den Schwerpunkten des Kongresses zählten neue Erfahrungen mit den Immuntherapeutika, das Management von Hirnmetastasen, Screeningmaßnahmen zur Früherkennung von Lungenkarzinomen sowie Fortschritte bei der molekularen Definition des nicht-kleinzelligen Lungenkarzinoms (NSCLC) und dem neuen IASLC-Staging.
Therapieeffektivität besser später beurteilen
Authors: Krome Susanne
Published: March 2018

Die Standardbehandlung für Plattenepithelkarzinome des Anus besteht in der Chemoradiotherapie. Die aktuellen Leitlinien sehen nach sechs bis zwölf Wochen eine Nachuntersuchung vor. In der ACT-II-Studie erfolgten drei Kontrollen für die Beurteilung des Behandlungserfolgs. Die Post-hoc-Analyse zeigt, dass jeder zweite Patient nur langsam anspricht und mit einem späteren Untersuchungstermin übertherapien vermieden werden könnten.