bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Detection of QT Interval Prolongation from the ECG Database System
Authors: Yamaguchi Izumi  , Fujita Hideo  , Ohe Kazuhiko
Published: February 2025

To prevent unexpected sudden cardiac patient death due to drug-induced Long QT syndrome (LQTS), we seek to build a computerized early detection and warning system of QTc interval increase tendency. We built an ECG database system that holds the digital waveform data and related information of the ECGs performed in out hospital, and developed an experimental detection system of QTc increase tendency. Despite the several problems about the accuracy of detection, we succeeded in extracting a patient who seemed to be drug-induced LQTS. A combination of such a detection system with more accuracy and drug prescription database would contribute to the early detection of drug-induced LQTS.
Analyses of Medical Data Models – Identifying Common Concepts and Items in a Repository of Medical Forms
Authors: Breil Bernhard  , Dugas Martin
Published: February 2025

One year ago the portal of Medical Data Models (http://medical-data-models.org) was presented as a resource for the scientific community. As of November 2012 there are approximately 3,300 forms with 102,000 items available in the CDISC ODM format. First descriptive analyses regarding form metadata demonstrate the capability of such a repository to identify commonly used medical concepts. Most common items are administrative attributes which indicates that more clinical information are needed to increase the secondary use of data documented within these forms.
Developing a Survey to Assess Factors that Contribute to Physician Involvement in Clinical Research
Authors: Taliercio Vanina  , Logan Judith R  , Kalpathy-Cramer Jayashree  , Oteroa Paula
Published: February 2025

Background: Investment in research, including clinical research, has positive effects both on health of a population and economic growth of a country. Several factors have been suggested as being related to the performance of clinical research. The goal of this work was to develop and perform initial validation of a survey that measures both current research involvement of physicians, as well as previously noted factors and additional informatics factors affecting this involvement. The survey was developed in both English and Spanish with the goal of its use in Latin America.
Development and Clinical Study of Mobile 12-Lead Electrocardiography Based on Cloud Computing for Cardiac Emergency
Authors: Fujita Hideo  , Uchimura Yuji  , Waki Kayo  , Omae Koji  , Takeuchi Ichiro  , Ohe Kazuhiko
Published: February 2025

To improve emergency services for accurate diagnosis of cardiac emergency, we developed a low-cost new mobile electrocardiography system “Cloud Cardiology®” based upon cloud computing for prehospital diagnosis. This comprises a compact 12-lead ECG unit equipped with Bluetooth and Android Smartphone with an application for transmission. Cloud server enables us to share ECG simultaneously inside and outside the hospital. We evaluated the clinical effectiveness by conducting a clinical trial with historical comparison to evaluate this system in a rapid response car in the real emergency service settings. We found that this system has an ability to shorten the onset to balloon time of patients with acute myocardial infarction, resulting in better clinical outcome. Here we propose that cloud-computing based simultaneous data sharing could be powerful solution for emergency service for cardiology, along with its significant clinical outcome.
Integrating Population- and Patient-Level Data for Secondary Use of Electronic Health Records to Study Overweight and Obesity
Authors: Roth Caryn  , Shivade Chaitanya P.  , Foraker Randi E.  , Embi Peter J.
Published: February 2025

We combined patient-level clinical data derived from the Electronic Health Record (EHR) with area-level environmental and socioeconomic data to study factors independently associated with overweight and obesity. Our multinomial logistic regression model showed that area-level factors such as farmers' markets, grocery stores and percent college-educated at the zip code level were significantly associated with the outcomes. However, mismatch in the granularity of community and clinical data limited us in creating a discriminatory model. While these results are promising, they reveal challenges that must be overcome in order to maximize secondary use of EHR data to further explore population health status.
Actualizing a Mobile Integrated System for Geriatric Care
Authors: Chew Han Ei  , Faber Johannes  , Liu Zhiming  , Madera Vanessa  , Qamar Nafees
Published: February 2025

Population aging looms over countries all over the world. The social and economic implications of this phenomenon extend beyond the individual person and the immediate family, affecting broader society and the global community in profound ways. Aging populations increase pressure on already over-burdened public health care services and expenditures. To address this impending predicament, many health care providers and countries have turned to technological solutions. The near-ubiquity of mobile devices entails that mHealth will rapidly become a key component of technologically-enabled health care delivery services. This poster presents research and engineering challenges for a sustainable ICT solution that supports information exchange for mobile geriatric care.
E-Record – Access to all Danish Public Health Records
Authors: Rahbek Nørgaard Jens
Published: February 2025

E-Record (in Danish: E-Journal) is at National repository of record information from all public hospitals in Denmark. It has been introduced in 2007 and today it is a backbone for interchanging EHR-information across hospitals. It is not a national EHR, but a read-only repository that supplements the local EHR-information with national information. Both GP's and patients/citizens can access the information due to improved patient empowerment. Almost 50.000 different clinicians at hospitals and almost 300.000 patients/citizens have used E-Record in 2012. E-Record contains information about ICD-10 diagnosis, Pro-cedures, Notes and Discharge letters and cave information.
BabySTEPS: A Sugar Tracking Electronic Portal System for Gestational Diabetes
Authors: Arnold Corey W.  , Nguyen Tina  , Janzen Carla
Published: February 2025

Gestational diabetes is a condition occurring in up to 18% [1] of pregnant women that results in an increase in blood glucose levels due to the body's inability to produce sufficient insulin given the additional needs of the baby, and/or hormonal changes that lower the body's sensitivity to insulin. If left untreated, the growing baby may become too large, increasing the risk of injury to the mother and baby during delivery. Controlling blood glucose can be a challenging task, especially for women with no previous experience and who may have unhealthy diets. An opportunity exists to further encourage compliance by providing patients electronic access to data generated during their pregnancy. Previous studies have shown the potential of portals for managing general diabetes [2], but no work has targeted glucose control in pregnant women. We present BabySTEPS (Sugar Tracking Electronic Portal System), a patient portal focused on engaging women with gestational diabetes that provides personalized feedback with the goal of reducing complications at birth and subsequent medical problems resulting from poor glucose control.
Developing an Acute-physical-examination Template for a Tegional EHR System Aimed at Improving Inexperienced Physician's Documentation
Authors: Lilholt Lars  , Haubro Camilla Dremstrup  , Møller Jørn Munkhof  , Aarøe Jens  , Højen Anne Randorff  , Gøeg Kirstine Rosenbeck
Published: February 2025

It is well-established that to increase acceptance of electronic clinical documentation tools, such as electronic health record (EHR) systems, it is important to have a strong relationship between those who document the clinical encounters and those who reaps the benefit of digitalized and more structured documentation. [1] Therefore, templates for EHR systems benefit from being closely related to clinical practice with a strong focus on primarily solving clinical problems. Clinical use as a driver for structured documentation has been the focus of the acute-physical-examination template (APET) development in the North Denmark Region. The template was developed through a participatory design where precision and clarity of documentation was prioritized as well as fast registration. The resulting template has approximately 700 easy accessible input possibilities and will be evaluated in clinical practice in the first quarter of 2013.
An Approach for Message Exchange Using Archetypes
Authors: Moraes João L. C.  , Souza Wanderley L.  , Cavalini Luciana T.  , Pires Luís F.  , Prado Antonio F.
Published: February 2025

The application of ICT on the whole range of health sector activities, known as e-health, can simplify the access to health care services and will only be acceptable for realistic scenarios if it supports efficient information exchange amongst the caregivers and their patients. The aim of this paper is present an approach for message exchange to realistic scenarios.
Using ISO 25040 Standard for Evaluating Electronic Health Record Systems
Authors: Oliveira Marília  , Novaes Magdala  , Vasconcelos Alexandre
Published: February 2025

Quality of electronic health record systems (EHR-S) is one of the key points in the discussion about the safe use of this kind of system. It stimulates creation of technical standards and certifications in order to establish the minimum requirements expected for these systems. [1] In other side, EHR-S suppliers need to invest in evaluation of their products to provide systems according to these requirements. This work presents a proposal of use ISO 25040 standard, which focuses on the evaluation of software products, for define a model of evaluation of EHR-S in relation to Brazilian Certification for Electronic Health Record Systems – SBIS-CFM Certification. Proposal instantiates the process described in ISO 25040 standard using the set of requirements that is scope of the Brazilian certification. As first results, this research has produced an evaluation model and a scale for classify an EHR-S about its compliance level in relation to certification. This work in progress is part for the acquisition of the degree of master in Computer Science at the Federal University of Pernambuco.
Inconsistencies between Recorded Opportunistic Infections and WHO HIV Staging in Western Kenya
Authors: Oluoch Tom  , de Keizer Nicolette  , Kwaro Daniel  , Wattoyi Irene  , Okeyo Nicky  , Cornet Ronald
Published: February 2025

Opportunistic infections (OIs) are the main cause of morbidity and mortality among patients with HIV in developing countries. It is therefore critical that accurate diagnoses are made and that they are correctly recorded and managed. We reviewed 200 randomly selected records of clinical encounters with HIV infected pregnant women attending the ante-natal care (ANC) clinic in July 2012 at the Jaramogi Oginga Odinga Teaching and Referral Hospital in Kenya. None of the clients in WHO stage 4 and 2.8% of those in WHO stage 3 had a new OI diagnosis recorded during the clinical encounter. This data suggests current under-recording of OIs and the inconsistency between WHO staging and OI diagnosis. Structured methods such as SNOMED CT have the potential to improve complete and accurate recording of OIs which, in turn, enable automatedand accurate WHO staging.
Categorial Structure of Acupuncture Points for Terminological Resources
Authors: Hirose Yasuyuki  , Togo Toshihiro  , Yamamoto Shunsei
Published: February 2025

Recent increase in the number of clinical reports of acupuncture requires terminological resources based on conceptual frameworks for knowledge management. For this purpose, we developed a categorial structure for acupuncture points based on ISO 17115.
Predictive Variables of the Use of Personal Health Record: The Hospital Italiano de Buenos Aires Study
Authors: Martinez Marcela  , Baum Analía  , María Gomez Saldaño Ana  , Gomez Adrian  , Luna Daniel  , González Bernaldo de Quirós Fernán
Published: February 2025

Introduction: although trends in consumer research suggest growing interest in using electronic PHRs, actual utilization of PHRs technologies is still low. Objective: to identify those conditions that make patients at Hospital Italiano de Buenos Aires (HIBA) use a PHR. Study Design: Analytic Cross-sectional study. Results: the average age was 55.5 years (SD 19.8), 60.5% were female (39.5%, IC95%). The rate of enrolled were almost 50% and the rate of people usage was 29.1% (95% IC 28, 87 – 29.4). The patient's characteristics that influence in PHR usage were: the presence of at least one comorbidity (disabilities or chronic conditions), look for medical assistance during the last year, female and middle age. Conclusion: In this study the patient's characteristics that were most likely to use our PHR were similar to what another authors published. Future research is needed to understand social, cultural and organizational issues that influences into the rate of adoption and usage.
Does the Low Power Mode of the Actigraph GT3X+ Accelerometer Influence the Device Output in Sleep Research in Healthy Subjects?
Authors: Gorzelniak Lukas  , Dias André  , Bakhirev Alexander  , Knoll Alois  , Horsch Alexander
Published: February 2025

We measured lower limb activity by means two, above each ankle vertically aligned GT3X+ accelerometers in 4 healthy adults during a single night. Triaxial raw data vector magnitude units (VMU) were recorded at 100 Hz, in order to compare two different modes of operation (i.e. low power mode (LPM)on vs. off).
A Hospital Survey on the Utilization of the Master File of the Standardized Nursing Practice Terminology in Japan
Authors: Tsuru Satoko  , Wako Fumiko  , Watanabe Chitose  , Uchiyama Makiko  , Okamine Eiko  , Inoue Manami  , Omori Miho
Published: February 2025

A common language in nursing facilitates better communication among nurses and other healthcare providers, assuring better nursing care, hence better patient outcomes. As we developed and disseminated the standardized terminology of nursing which provided nurses with a set of terms to describe nursing observations and nursing actions, we run a survey to see how much it was recognized and utilized in actual clinical settings. The result showed that approximately 60% of the respondents were cognizant of our terminology, and again 60% of them were either actually using the terminology or interested in using it in the future. For them, the main purposes of utilizing the terminology were nursing documentation and care planning. Sometimes it was used as an educational tool. This suggests that we should further develop a tool to assist nurses with their documentation and care planning alongside the revision of the terminology itself.
Noninvasive Diagnosis of Nonalcoholic Steatohepatitis Disease Based on Clinical Decision Support System
Authors: Douali Nassim  , Abdennour Meriem  , Sasso Magali  , Miette Veronique  , Tordjman Joan  , Bedossa Pierre  , Veyrie Nicolas  , Poitou Christine  , Aron-Wisnewsky Judith  , Clément Karine  , Jaulent Marie Christine  , Daniel Zucker Jean
Published: February 2025

Non-alcoholic fatty liver disease (NAFLD) is a hepatic disease associated with metabolic syndrome. NAFLD covers a spectrum of liver disease from steatosis to non-alcoholic steatohepatitis (NASH) and cirrhosis.
Developing and Applying a Cross-disciplinary Team Handover Information System
Authors: Lee Ying-Li  , Chien Tsai-Feng  , Hsu Su-Chen  , Chang Polun
Published: February 2025

In order to avoid medical errors, it is very important to communicate with the medical team correctly, timely and efficiently. One of main reasons for the poor outcome of multidisciplinary handover in hospital is lacking effective tools for multidisciplinary handover. The project aimed to develop a workflow-based multidisciplinary handover information system, integrated with medical record browsing, multidisciplinary handover and event tracking, to improve the correctness and effectiveness of communication among the medical team members.
A Mobile Health Approach to Tuberculosis Contact Tracing in Resource-Limited Settings
Authors: Ha Yoonhee P.  , Littman-Quinn Ryan  , Antwi Cynthia  , Seropola Gorewang  , Green Rebecca S.  , Tesfalul Martha A.  , Ho-Foster Ari  , Luberti Anthony A.  , Holmes John H.  , Steenhoff Andrew P.  , Kovarik Carrie L.
Published: February 2025

Tuberculosis remains a leading cause of morbidity and mortality worldwide. In 2011, there were 8.7 million new cases and 1.4 million deaths from the disease, with >95% of these deaths taking place in low- and middle-income countries [1]. Contact tracing prevents the spread of tuberculosis by identifying and screening a case's contacts and referring symptomatic individuals to health care providers. Traditionally, contact tracing has been conducted with paper forms, which can lead to considerable inefficiencies in data collection, storage, and retrieval. These inefficiencies are problematic as tuberculosis can continue to spread if disruption of disease transmission is delayed. Mobile health approaches to tuberculosis contact tracing remain largely unaddressed and limited to management and monitoring of multidrug-resistant tuberculosis [2].To address these limitations, a mobile health application that digitizes and automates contact tracing was developed. This poster presents work currently underway to evaluate this new approach in Botswana, which has the tenth highest incidence rate of tuberculosis in the world [3]. Operational considerations for implementing a mobile health approach to contact tracing in resource-limited settings are also presented.
Hierarchical Semantic Structures for Medical NLP
Authors: Taira Ricky K.  , Arnold Corey W.
Published: February 2025

We present a framework for building a medical natural language processing (NLP) system capable of deep understanding of clinical text reports. The framework helps developers understand how various NLP-related efforts and knowledge sources can be integrated. The aspects considered include: 1) computational issues dealing with defining layers of intermediate semantic structures to reduce the dimensionality of the NLP problem; 2) algorithmic issues in which we survey the NLP literature and discuss state-of-the-art procedures used to map between various levels of the hierarchy; and 3) implementation issues to software developers with available resources. The objective of this poster is to educate readers to the various levels of semantic representation (e.g., word level concepts, ontological concepts, logical relations, logical frames, discourse structures, etc.). The poster presents an architecture for which diverse efforts and resources in medical NLP can be integrated in a principled way.
PHIO: A Knowledge Base for Interpretation and Calculation of Public Health Indicators
Authors: Shaban-Nejad Arash  , Okhmatovskaia Anya  , Izadi Masoumeh T.  , Naderi Nona  , Mondor Luke  , Jauvin Christian  , Buckeridge David L.
Published: February 2025

Existing population health indicators tend to be out-of-date, not fully available at local levels of geography, and not developed in a coherent/consistent manner, which hinders their use in public health. The PopHR platform aims to deliver an electronic repository that contains multiple aggregated clinical, administrative, and environmental data sources to provide a coherent view of the health status of populations in the province of Quebec, Canada. This platform is designed to provide representative information in near-real time with high geographical resolution, thereby assisting public health professionals, analysts, clinicians and the public in decision-making. This paper presents our ongoing efforts to develop an integrated population health indicator ontology (PHIO) that captures the knowledge required for calculation and interpretation of health indicators within a PopHR semantic framework.
Usage and Perceptions of a Mobile Self-Management Application for People with Type 2 Diabetes: Qualitative Study of a Five-Month Trial
Authors: Tatara Naoe  , Årsand Eirik  , Bratteteig Tone  , Hartvigsen Gunnar
Published: February 2025

Despite a growing number of clinical-intervention studies of mobile applications for diabetes self-management, details of participants' engagement with the intervention tools and of usability and feasibility issues are seldom reported. The Few Touch application is a mobile-phone-based self-management system for people with Type 2 diabetes mellitus (T2DM) developed by involving patient-users in design processes from an early phase to a long-term trial. An improved version was tested in a five-month trial by 11 individuals either with T2DM or at high risk of T2DM. Results showed clearer correlations between usage and perceived usefulness among these individuals compared with those involved in the design process. However, feedback on usability issues was mostly consistent between the two trials. This study therefore confirmed: 1) the value of including patient-users not only in design-concept development but also in a long-term trial to identify as many factors critical to usability and usage as possible, and 2) the importance of reflecting their feedback in design iterations to minimize the number of critical factors.
An Electronic Dashboard to Improve Nursing Care
Authors: Tan Yung-Ming  , Hii Joshua  , Chan Katherine  , Sardual Robert  , Mah Benjamin
Published: February 2025

With the introduction of CPOE systems, nurses in a Singapore hospital were facing difficulties monitoring key patient information such as critical tasks and alerts. Issues include unfriendly user interfaces of clinical systems, information overload, and the loss of visual cues for action due to paperless workflows. The hospital decided to implement an interactive electronic dashboard on top of their CPOE system to improve visibility of vital patient data. A post-implementation survey was performed to gather end-user feedback and evaluate factors that influence user satisfaction of the dashboard. Questionnaires were sent to all nurses of five pilot wards. 106 valid responses were received. User adoption was good with 86% of nurses using the dashboard every shift. Mean satisfaction score was 3.6 out of 5. User satisfaction was strongly and positively correlated to the system's perceived impact on work efficiency and care quality. From qualitative feedback, nurses generally agreed that the dashboard had improved their awareness of critical patient issues without the hassle of navigating a CPOE system. This study shows that an interactive clinical dashboard when properly integrated with a CPOE system could be a useful tool to improve daily patient care.
Utilizing Electronic Health Record Data to Determine the Health of the Medication Process after the Relocation of a Children's Hospital
Authors: Scharnweber Corinna  , Mollenkopf Nicole L.  , Fackler James  , Dover George J.  , Lehmann Christoph U.
Published: February 2025

Hospital relocation is a highly complex undertaking, which has the potential to interrupt operations and poses risks for patients, staff, and providers. Little is known how hospital relocation impacts on workflow and communication.
Early Experiences from a Guideline-based Computerized Clinical Decision Support for Stroke Prevention in Atrial Fibrillation
Authors: Chen Rong  , Valladares Carlos  , Corbal Iago  , Anani Nadim  , Koch Sabine
Published: February 2025

Atrial fibrillation (AF) affects 1–2% of the population. Twenty percent of all strokes are caused by AF. In this study, we represented the clinical knowledge in the European Society of Cardiology guideline using Guideline Definition Language (GDL), a format that binds openEHR archetypes, rule languages, and reference terminologies together. The computerized guidelines are applied to electronic health record (EHR) data retrospectively in order to identify possible gaps between current clinical practice and optimal care recommended by the evidence-based guidelines. Treatment compliance is checked in two patient groups: one received treatment from a cardiologist who is responsible for AF treatment in the region (n=514) and the other was a much larger patient group from the whole region (n=8130). The compliance checking shows the cardiologist group has substantially higher percentage of compliant treatment compared with that of the general population group. Based on this important finding, we are now implementing at-point-of-care clinical decision support reusing the same computerized guideline knowledge in GDL format in order to increase the guideline adherence of the treatment.
Non-contact Screening System with Two Microwave Radars in the Diagnosis of Sleep Apnea-Hypopnea Syndrome
Authors: Kagawa Masayuki  , Ueki Katsuhiko  , Kurita Akira  , Tojima Hirokazu  , Matsui Takemi
Published: February 2025

There are two key problems in applying Doppler radar to a diagnosis system for sleep apnea-hypopnea syndrome. The first is noise associated with body movement and the second is the body position in bed and the change of the sleeping posture. We propose a new automatic gain control and a real-time radar-output channel selection method which is based on a spectrum shape analysis. There are three types of sleep apnea: central sleep apnea, obstructive sleep apnea and mixed sleep apnea. In this paper we paid attention to the obstructive sleep apnea and attempted to detect the disorder of corrugated shape compared with usual breathing or the paradoxical movement of the reversed phase with chest and abdominal radar signals. A prototype of the system was set up at a sleep disorder center in a hospital and field tests were carried out with eight subjects. Despite the subjects engaging in frequent body movements while sleeping, the system was quite effective in the diagnosis of sleep apnea-hypopnea syndrome (r=0.98).
Designing for Redundancy: Nurses Experiences with the Wireless Nurse Call System
Authors: Klemets Joakim  , Evjemo Tor Erik  , Kristiansen Lill
Published: February 2025

Patients rely on the nurse call system when in need of nurses' assistance, while nurses rely on the nurse call system to coordinate work. In order to handle the highly mobile nature of nurses' work, a wireless nurse call system has been introduced at a Norwegian hospital. In light of findings from previous research that identify challenges associated with wireless nurse call systems, we have conducted qualitative and ethnographically inspired fieldwork, i.e. workshops including both ordinary and student nurses to describe nurses' present system use. We further identify challenges related to wireless nurse call system usage, in particular how nurses manage the interruptive nature of wireless nurse calls so as to ensure continuous patient support. Our analysis acknowledges that High Reliability Organization (HRO) principles are transferable to a hospital organization. Based on our data, we propose improvements for design that hopefully can help reduce disruptive interruptions, ensure quick responses to patients, and further improve quality of care and patient safety. Further, we suggest that technology should facilitate and strengthen the redundancy of function.
The Austrian e-Medikation Pilot Evaluation: Lessons Learned from a National Medication List
Authors: Janzek-Hawlat Stefan  , Ammenwerth Elske  , Dorda Wolfgang  , Duftschmid Georg  , Hackl Werner  , Hörbst Alexander  , Jung Martin  , Woertz Klemens  , Gall Walter
Published: February 2025

The objective of this paper is to present results and recommendations from the Austrian e-Medikation pilot project. e-Medikation comprises a national medication list of all prescribed and dispensed medications as well as central medication checks. Evaluation was based on log-file analysis and survey of all participants (physicians, pharmacists, patients). During the evaluation period, 97 physicians, 58 pharmacies and more than 5.000 patients, participated. All user groups found that e-Medikation has the potential to improve patient safety, but that software quality and system architecture is not yet suitable for routine use. The evaluation resulted in 34 recommendations for further development and roll out of e-Medikation in Austria. Most of these recommendations have already been included in the recently passed law concerning the upcoming Austrian electronic health record system called “ELGA”.
Clinical Practice Guidelines and Comorbid Diseases: A MiniZinc Representation of Guideline Models for Mitigating Adverse Interactions
Authors: Wilk Szymon  , Michalowski Martin  , Michalowski Wojtek  , Farion Ken  , Lin Di  , Hing Marisela Mainegra  , Mohapatra Subhra
Published: February 2025

Managing a patient with comorbid diseases according to multiple clinical practice guidelines (CPGs) may result in adverse interactions that need to be mitigated (identified and addressed) so a safe therapy can be devised. However, mitigation poses both clinical and methodological challenges. It requires extensive domain knowledge and calls for advanced CPG models and efficient algorithms to process them. We respond to the above challenges by describing our algorithm that mitigates interactions between pairs of CPGs. The algorithm creates logical models of analyzed CPGs and uses constraint logic programming (CLP) together with domain knowledge, codified as interaction and revision operators, to process them. Logical CPG models are transformed into CLP-CPG models that are solved to find a safe therapy. We represent these CLP-CPG models using MiniZinc, a standard language for CLP models. As motivation and illustration of our mitigation algorithm we use a clinical case study describing a patient managed for hypertension and deep vein thrombosis according to two individual CPGs. We apply the algorithm to this scenario and present MiniZinc representations of the constructed CLP-CPG models.
Real-time Multidimensional Temporal Analysis of Complex High Volume Physiological Data Streams in the Neonatal Intensive Care Unit
Authors: McGregor Carolyn  , James Andrew  , Eklund Mike  , Sow Daby  , Ebling Maria  , Blount Marion
Published: February 2025

The intensive care of immature preterm infants is a challenging, dynamic clinical task that is complicated because these infants frequently develop a range of comorbidities as they grow and develop after their premature birth. Earliest reliable condition onset detection is a goal within this setting and high frequency physiological analysis is showing potential new pathophysiological indicators for earlier onset detection of several conditions. To realise this, a platform for multi-stream, multi-condition, multi-feature risk scoring is required. In this paper we demonstrate our multi-stream online analytics approach for condition onset detection and demonstrate a user interface approach for patient state that can be available in real-time to support condition risk scoring.
Interface Map as a User-Driven and Activity-Driven Interoperability Standards Portfolio
Authors: Virkanen Hannu  , Mykkänen Juha  , Tuomainen Mika
Published: February 2025

Use of interoperability specifications such as standards and their implementation guides is currently hindered by lack of systematic directories. It is difficult for potential users of standards to locate potential specifications which could be useful for their specific development needs. We introduce a multi-directory interface map approach which supports systematic description of healthcare interoperability specifications through consistent metadata and complementary classifications. The approach is built on basic premises of standards portfolios in enterprise architectures as well as activity-driven and interoperability paradigm-based classifications. We illustrate the approach through a case project in Finland.
Accuracy of an Electronic Problem List from Primary Care Providers and Specialists
Authors: Luna Daniel  , Franco Mariano  , Plaza Claudio  , Otero Carlos  , Wassermann Santiago  , Gambarte Maria Laura  , Giunta Diego  , González Bernaldo de Quirós Fernán
Published: February 2025

Accurate patient problem lists in Electronic Health Records (EHRs) are valuable tools for improving the quality of care, communication among professionals, facilitating research, quality measurement and the implementation of clinical decision support systems. However, problem lists are frequently inaccurate and out-of-date, and use varies widely across providers. These deficiencies limit problem list benefits.
Early Detection of Hospitalized Patients with Previously Diagnosed Obstructive Sleep Apnea Using Computer Decision Support Alerts
Authors: Evans R. Scott  , Flint Vrena B.  , Cloward Tom V.  , Beninati William  , Lloyd James F.  , Megwalu Kimberly  , Simpson Kathy J.  , Alsharit Ahmed M.  , Balls Shayna B.  , Farney Robert J.
Published: February 2025

Obstructive sleep apnea (OSA) is a worldwide problem affecting 2–14% of the general population and most patients remain undiagnosed. OSA patients are at elevated risk for hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, stroke and death during hospitalization. Clinical screening questionnaires are used to identify hospitalized patients with OSA; especially before surgery. However, current screening questionnaires miss a significant number of patients and require more definitive testing before specific therapy can be started. Moreover, many patients are admitted to the hospital with a previous diagnosis of OSA that is not reported. Thus, many patients with OSA do not receive appropriate therapy during hospitalization due to the lack of information from previous inpatient and outpatient encounters. Large enterprise data warehouses provide the ability to monitor patient encounters over wide geographical areas. This study found that previously diagnosed OSA is highly prevalent and undertreated in hospitalized patients and the use of early computer alerts by respiratory therapists resulted in significantly more OSA patients receiving appropriate medical care (P < 0.002) which resulted in significantly fewer experiencing hypoxemia (P < 0.006). The impact was greater for non-surgery patients compared to surgery patients.
Exploring End Users' System Requirements for a Handheld Computer Supporting Both Sepsis Test Workflow and Current IT Solutions
Authors: Samson Lasse Lefevre  , Pape-Haugaard Louise Bilenberg  , Søgaard Mette  , Schønheyder Henrik Carl  , Hejlesen Ole K.
Published: February 2025

Sepsis is a systemic response associated with very high mortality. Early initiation of the correct antimicrobial therapy remains a cornerstone in the treatment of sepsis.
Developing a Self-Service Query Interface for Re-Using De-Identified Electronic Health Record Data
Authors: Cimino James J.  , Ayres Elaine J.  , Beri Andrea  , Freedman Robert  , Oberholtzer Ellen  , Rath Sachi
Published: February 2025

The US National Institutes of Health has developed a repository of clinical research data drawn in part from electronic health records. A new de-identified data query tool under development has been developed to support re-use of these data. We used a collection of 30 human-mediated user queries to determine whether features of the tool will be sufficient to allow users to carry out the queries themselves. The results show that the tool implemented in February 2013 will carry out a small percentage of user queries but the planned extensions will be sufficient for carrying out the majority of such queries. Future development of the tool will include extensions that correspond to the features found in human-mediated queries.
Identifying Unproven Cancer Treatments on the Health Web: Addressing Accuracy, Generalizability and Scalability
Authors: Aphinyanaphongs Yin  , Fu Lawrence D.  , Aliferis Constantin F.
Published: February 2025

Building machine learning models that identify unproven cancer treatments on the Health Web is a promising approach for dealing with the dissemination of false and dangerous information to vulnerable health consumers. Aside from the obvious requirement of accuracy, two issues are of practical importance in deploying these models in real world applications. (a) Generalizability: The models must generalize to all treatments (not just the ones used in the training of the models). (b) Scalability: The models can be applied efficiently to billions of documents on the Health Web. First, we provide methods and related empirical data demonstrating strong accuracy and generalizability. Second, by combining the MapReduce distributed architecture and high dimensionality compression via Markov Boundary feature selection, we show how to scale the application of the models to WWW-scale corpora. The present work provides evidence that (a) a very small subset of unproven cancer treatments is sufficient to build a model to identify unproven treatments on the web; (b) unproven treatments use distinct language to market their claims and this language is learnable; (c) through distributed parallelization and state of the art feature selection, it is possible to prepare the corpora and build and apply models with large scalability.
Understanding Waste for Lean Health Information Systems: A Preliminary Review
Authors: Kalong Nadia Awang  , Yusof Maryati Mohd.
Published: February 2025

Despite the rapid application of the Lean method in healthcare, its study in IT environments, particularly in Health Information Systems (HIS), is still limited primarily by a lack of waste identification. This paper aims to review the literature to provide an insight into the nature of waste in HIS from the perspective of Lean management. Eight waste frameworks within the context of healthcare and information technology were reviewed. Based on the review, it was found that all the seven waste categories from the manufacturing sector also exist in both the healthcare and IT domains. However, the nature of the waste varied depending on the processes of the domains. A number of additional waste categories were also identified. The findings reveal that the traditional waste model can be adapted to identify waste in both the healthcare and IT sectors.
The Usefulness of Activity Trackers in Elderly with Reduced Mobility: A Case Study
Authors: Lauritzen Jonas  , Muñoz Adolfo  , Luis Sevillano Jose  , Civit Anton
Published: February 2025

This study was conducted to determine the accuracy and usefulness of two current commercially available activity trackers in rollator dependent elderly with reduced mobility (RME), compared with elderly with normal mobility (NME) and healthy adults (HA).
Human Factors Affecting the Quality of Routinely Collected Data in South Africa
Authors: Nicol Edward  , Bradshaw Debbie  , Phillips Tamsin  , Dudley Lilian
Published: February 2025

Evaluations that have looked at the people aspect of the health information system in South Africa have only focused on the availability of human resources and not on competence or other behavioural factors.
Clinical Documentation as a Source of Information for Patients – Possibilities and Limitations
Authors: Wibeab Torunn  , Ekstedta Mirjam  , Hellesø Ragnhild  , Øyrid Karl  , Slaughter Laura
Published: February 2025

Recent legislation in many countries has given patients the right to access their own patient records. Making health-care professionals' assessments and decisions more transparent by giving patients access to their records is expected to provide patients with useful health information and reduce the power imbalance between patient and provider. We conducted both a mail survey and a face-to-face interview study, including patients who had requested a paper copy of their patient records (EPR), to explore their experiences. For many study participants, a view of their records filled in holes in the oral information they previously received. They had problems understanding parts of what they read, but rarely asked for help. Instead they searched for explanations on the Internet or attempted to understand based on the context. Patients are still afraid of seeming suspicious or displeased if they indicate that they would like to read their records. Health-care organizations should consider actively offering patients the chance to view their clinical documentation to a larger extent than what has been done so far.
Exploring Pharmacoepidemiologic Groupings of Drugs from a Clinical Perspective
Authors: Winnenburg Rainer  , Bodenreider Olivier
Published: February 2025

Objectives: To investigate the extent to which pharmacoepidemiologic groupings are homogeneous in terms of clinical properties. Methods: In our analysis, we classified drug subgroups from the pharmacoepidemiologic Anatomical Therapeutic Chemical (ATC) classification system based on clinical drug properties. We established mappings from ATC fifth level drug entities to drug property annotations in the National Drug File Reference Terminology (NDF-RT), including therapeutic categories, mechanisms of action, and physiologic effects. Based on the annotations for the individual drugs we computed homogeneity scores for all ATC groups and analyzed their distribution. Conclusions: We found ATC groups to be generally homogeneous, more so for mechanisms of action, and physiologic effects than for therapeutic intent. However, only half of all ATC drugs can be analyzed with this approach, in part because of missing properties in NDF-RT.
Exploring the Use of Large Clinical Data to Inform Patients for Shared Decision Making
Authors: Hill Brent  , Proulx Joshua  , Zeng-Treitler Qing
Published: February 2025

Barriers to patient participation in the shared decision making process prevent patients from fully participating in evaluating treatment options and treatment selection. Patients who use a decision aid are more informed and engaged in the shared decision making process. Patient decision aids do not use real clinical data for patient information and may not represent the data well. We designed an interface, for a shared decision making aid, that leverages clinical data to inform risk ratios and create patient stories, or vignettes, and present a visual representation of quantified treatment outcomes data. Usability testing was conducted with experts to evaluate the interface and the utility of using real clinical information that patients can explore. The experts' comments were transcribed and coded for themes. Themes were quantified and comments were interpreted for refinement and modification to the patient decision aid interface and data visualization.
A Vision for the Systematic Monitoring and Improvement of the Quality of Electronic Health Data
Authors: Dixon Brian E.  , Rosenman Marc  , Xia Yuni  , Grannis Shaun J.
Published: February 2025

In parallel with the implementation of information and communications systems, health care organizations are beginning to amass large-scale repositories of clinical and administrative data. Many nations seek to leverage so-called Big Data repositories to support improvements in health outcomes, drug safety, health surveillance, and care delivery processes. An unsupported assumption is that electronic health care data are of sufficient quality to enable the varied use cases envisioned by health ministries. The reality is that many electronic health data sources are of suboptimal quality and unfit for particular uses. To more systematically define, characterize and improve electronic health data quality, we propose a novel framework for health data stewardship. The framework is adapted from prior data quality research outside of health, but it has been reshaped to apply a systems approach to data quality with an emphasis on health outcomes. The proposed framework is a beginning, not an end. We invite the biomedical informatics community to use and adapt the framework to improve health data quality and outcomes for populations in nations around the world.
Building a Time-Saving and Adaptable Tool to Report Adverse Drug Events
Authors: Parès Yves  , Declerck Gunnar  , Hussain Sajjad  , Ng Romain  , Jaulent Marie-Christine
Published: February 2025

The difficult task of detecting adverse drug events (ADEs) and the tedious process of building manual reports of ADE occurrences out of patient profiles result in a majority of adverse reactions not being reported to health regulatory authorities. The SALUS individual case safety report (ICSR) reporting tool, a component currently developed within the SALUS project, aims to support semi-automatic reporting of ADEs to regulatory authorities. In this paper, we present an initial design and current state of of our ICSR reporting tool that features: (i) automatic pre-population of reporting forms through extraction of the patient data contained in an Electronic Health Record (EHR); (ii) generation and electronic submission of the completed ICSRs by the physician to regulatory authorities; and (iii) integration of the reporting process into the physician's work-flow to limit the disturbance. The objective is to increase the rates of ADE reporting and the quality of the reported data. The SALUS interoperability platform supports patient data extraction independently of the EHR data model in use and allows generation of reports using the format expected by regulatory authorities.
Impact of variations in Anonymous Record Linkage on Weight Distribution and Classification
Authors: Nasseh Daniel  , Stausberg Jürgen
Published: February 2025

Anonymous or privacy preserving record linkage is the term for systems allowing the linkage of data from different sources while maintaining an individual's anonymity. This work displays the impact of variations in the process of generating weights in a probabilistic record linkage system on different datasets, the resulting set of weights of candidate pairs and consequently on the final classification process. Furthermore, the results give insight into general problems of current unsupervised classification methods.
Improving Medication Adherence for Chronic Disease Using Integrated e-Technologies
Authors: Dixon Brian E.  , Jabour Abdulrahman M.  , Phillips Erin O'Kelly  , Marrero David. G
Published: February 2025

Diabetes mellitus (DM) is a chronic disease affecting more than 285 people worldwide and the fourth leading cause of death. Increasing evidence suggests that many DM patients have poor adherence with prescribed medication therapies, impacting clinical outcomes. Patients' barriers to medication adherence and the extent to which barriers contribute to poor outcomes, however, are not routinely assessed. We designed a dashboard for an electronic health record system to integrate DM disease and medication data, including patient-reported barriers to adherence. Processes to support routine capture of data from patients are also being explored. The dashboard is being evaluated at multiple ambulatory clinics to examine whether integrated electronic tools can support patient-centered decision-making processes involving complex medication regimens for DM and other chronic diseases.
Securing SSL-VPN with LR-AKE to Access Personal Health Record
Authors: Eizen Kimura  , Masato Saito  , Kazukuni Kobara  , Yoshihito Nakato  , Takuji Kuroda  , Ken Ishihara
Published: February 2025

Using SSL-VPN requires special considerations for well-known issues such as attackers exploiting web browser vulnerabilities and phishing sites using man-in-the-middle attacks. We used leakage-resilient authenticated key exchange (LR-AKE) to develop a comprehensive solution to SSL-VPN issues. Our results show that the LR-AKE should contribute to building a robust infrastructure for personal health records.
Diavideos: a Diabetes Health Video Portal
Authors: Sánchez-Bocanegra C.L.  , Rivero-Rodriguez A.  , Fernández-Luque L.  , Sevillano J.L.
Published: February 2025

DiavideosDiavideos web http://ehealth.norut.no/diavideos