bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of a New Logic Domain Method for the Diagnosis of Hepatocellular Carcinoma
Authors: Giacomo Paola Di  , Felici Giovanni  , Maceratini Riccardo  , Truemper Klaus
Published: February 2025

In this paper we describe the application of a new learning tool for the diagnosis of hepatocellular carcinoma. The method adopted operates in the logic domain and presents several interesting features for the development of medical diagnostic systems. We consider a database of 128 patients, 64 of which affected by hepatocellular carcinoma, while the others affected by cirrhosis but not from hepatocellular carcinoma. Each patient is described by a number of attributes measured in non-invasive way. The system, after the training, is able to correctly separate the 64 patients affected by cirrhosis from the others 64 affected by hepatocellular carcinoma and is now ready to produce automatic diagnosis for new patients. The hepatocellular carcinoma is one of the most widely spread malignant tumors in the world. The ability to detect the tumor in its early stages in a minimally invasive way is crucial to the treatment of patients with this disease.
Guideline Development: Focus on Breast Cancer Screening in the EsPeR Project
Authors: Dufour Jean-Charles  , Giorgi Roch  , Fieschi Dominique  , Gouvernet Joanny  , Gillois Pierre  , Piana Lucien  , Degoulet Patrice  , Fieschi Marius
Published: February 2025

We describe in this paper, the implementation of a clinical practice guideline focused on breast cancer screening. Our aim in conceiving such a computerized guideline was first to help general practitioners in appreciating the risks their female patients might develop breast cancer and secondly to suggest them the screening measures adapted to each particular case. This implementation enables us to present our general methodology to elaborated and promulgate guidelines within the EsPeR project. This methodology aims at providing guidelines based on knowledge validated according to the EBM principles, that can be used in real time and updated according to current knowledge.
Are Clinicians Correct When They Believe They are Correct? Implications for Medical Decision Support
Authors: Friedman Charles  , Gatti Guido  , Elstein Arthur  , Franz Timothy  , Murphy Gwendolyn  , Wolf Fredric
Published: February 2025

The process of clinical decision support is linked to the validity of clinicians’ confidence in their judgments. Clinicians who are appropriately confident—highly confident when they are correct and less confident when they are incorrect—will access computer-based and other information resources only when they are needed. Clinicians who are consistently underconfident will rely on external resources when they are not needed. Those who are overconfident, who believe they are correct when in fact they are not, will be prone to medical errors. An extensive literature indicates a general tendency toward overconfidence in human judgment.
Risk Assessment in Genetics: A Semi-quantitative Approach
Authors: Glasspool David W.  , Fox John  , Coulson Andrew S.  , Emery Jon
Published: February 2025

Public awareness of genetic predisposition to diseases such as breast cancer threatens to put severe strain on genetics services. Computer-based decision support for general practitioners (GPs) has the potential to reduce unnecessary referrals, but issues of communicating about levels of risk and uncertainty must be addressed. An argumentation logic formalism can subsume both traditional probability theory and more qualitative, reason-based approaches to communicating uncertainty, and we propose that qualitative, argument-based presentation will make uncertainty information more accessible and comprehensible to both patient and GP. We describe software that uses an argumentation approach to assess genetic risk during a GP consultation and provide referral advice along with detailed qualitative explanations for its advice. The software was evaluated in real-life GP consultations in which actors played patients concerned about genetic risk, and in use by GPs evaluating simulated cases. Significant improvement in accuracy of assessment and appropriateness of referrals was found. GPs viewed the software and the qualitative reporting approach highly favourably.
Structured Physical Examination Data: A Modeling Challenge
Authors: Doupi Persephone  , van Ginneken Astrid M.
Published: February 2025

The success of systems facilitating collection of structured data by clinicians is largely dependent on the flexibility of the interface. The Open Record for CAre (ORCA) makes use of a generic model to support knowledge-based structured data entry for a variety of medical domains. An endeavor undertaken recently aimed to cover the broader area of Physical Examination by expanding the contents of the knowledge base. The model was found to be adequately expressive for supporting this task. Maintaining the balance between flexibility of the interface and constraints dictated by reliable retrieval, however, proved to be a considerable challenge. In this paper we illustrate through specific examples the effect of this trade off on the modeling process, together with the rationale for the chosen solutions and suggestions for future research focus.
An Electronic Health Record System in the Neuropediatrics Clinic at CIREN
Authors: Fleitas Faustino Benítez  , Figueredo Eritk Guerra  , Rodriguez Gabriel
Published: February 2025

The growing demand of medical information for research, for educative programs and as a way to improve the quality of health care, made possible the introduction of an Electronic Health Record System (EHRS) as a main priority in any medical center.
Fusion in Medical Imaging: Theory, Interests and Industrial Applications
Authors: Barra Vincent  , Briandet Philippe  , Boire Jean-Yves
Published: February 2025

The accumulation of several data coming from medical images and signals, expert knowledge and databases is becoming very common for the study of a given pathology. The aggregation of all this information is mentally performed by a clinician, and generally allows for a better medical decision in clinical studies. We propose in this article a fusion method that models this aggregation process. This method is a three step scheme, that first transforms all the available information in a common theoretical frame, then aggregates these data using their redundancy and their conflicts, and finally computes a new information synthesizing all the initial knowledge. We first introduce in this article the fusion scheme and its theoretical aspects, and we particularly focus on the three steps of the process. We then detail the software implementation of this concept, achieved in collaboration with SEGAMI Corporation Inc. We finally apply this concept to a real clinical problem, the study of Alzheimer's disease using MR and SPECT images, and we show very encouraging preliminary results.
A Review of Technical Advances in Virtual Colonoscopy
Authors: Vos Frans  , Serlie Iwo  , van Gelder Rogier  , Stoker J.  , Vrooman Henri  , Post Frits
Published: February 2025

Early detection of polyps has proven to lead to a decrease in incidence of colon cancer. In the past few years, virtual colonoscopy has been developed as a patient-friendly screening technique. The procedure comprises the following steps. First, the patient's colon is cleansed and transanally inflated with air. Subsequently, a 3D image volume is acquired of the abdomen by CT or MRI. Finally, the bowel surface is extracted and visualized, after which the physician virtually navigates through the colon and examines the surface for abnormalities. This paper describes the progress in research for virtual colonoscopy.
A Virtual Environment for Esophageal Intubation Training
Authors: Kesavadas T  , Joshi Dhananjay  , Mayrose James  , Chugh Kevin
Published: February 2025

Esophageal intubations are performed for urgent airway control in injured patients. Current methods of training include working on cadavers and mannequins, which lack the realism of a living human being. Work in this field has been limited due to the complex nature of simulating in real-time the interactive forces and deformations which occur during an actual patient intubation. This study addressed the issue of intubation training in an attempt to bridge the gap between actual and virtual patient scenarios. The two haptic devices along with the real-time performance of the simulator give it both visual and physical realism. The three dimensional viewing and interaction available through virtual reality make it possible for physicians, pre-hospital personnel and students to practice many esophageal intubations without ever touching a patient. The ability for a medical professional to practice a procedure multiple times prior to performing it on a patient will both enhance the skill of the individual while reducing the risk to the patient
Anesthesiology Point of Care Project
Authors: McDonald John S.  , Noback Carl R.  , Cheng Drew  , Lee T.K.  , Nenov Val
Published: February 2025

We are developing a dynamic prototype visual communication system for the operating room environs. This has classically been viewed as an isolated and impenetrable workplace. All medical experiences and all teaching remain in a one to one closed loop with no recall or subsequent sharing for the training and education of other colleagues. The “Anesthesia Point of Care” (APOC) concept embraces the sharing of, recording of, and presentation of various physiological and pharmacological events so that real time memory can be shared at a later time for the edification of other colleagues who were not present at the time of the primary learning event. In addition it also provides a remarkably rapid tool for fellow faculty to respond to obvious stress and crisis events that can be broadcast instantly at the time of happening. Finally, it also serves as an efficient and effective means of paging and general communication throughout the daily routines among various healthcare providers in anesthesiology who work as a team unit; these include the staff, residents, CRNAs, physician assistants, and technicians. This system offers a unique opportunity to eventually develop future advanced ideas that can include training exercises, presurgical evaluations, surgical scheduling and improvements in efficiency based upon earlier than expected case completion or conversely later than expected case completion and even as a unique window to development of improved billing itemization and coordination.
Virtual Reality Therapy: Case Study of Fear of Public Speaking
Authors: North Max M.  , Schoeneman Curt M.  , Mathis James R.
Published: February 2025

The major goal of this research case study was to investigate the effectiveness of Virtual Reality Therapy (VRT) in the treatment of the fear of public speaking. A twenty-eight-year-old Caucasian male was selected from questionnaires distributed to a class of undergraduate students enrolled at Kennesaw State University. Two assessment measures were used in this study. The first measure used was the Attitude Towards Public Speaking (ATPS) Questionnaire. The second measure used was the eleven-point Subjective Units of Disturbance (SUD) scale. These measurements assessed the anxiety, avoidance, attitudes and disturbance associated with the subject's fear of public speaking before and after each VRT treatment session. This case study of public speaking fear indicates that VRT may be used as an effective treatment method for reducing self-reported anxiety.
The DextroBeam: a stereoscopic presentation system for volumetric medical data
Authors: Serras Luis  , Kockro Ralf  , Chia Goh Lin  , Hem Ng  , Lee Eugene Chee Keong
Published: February 2025

This paper describes an interaction system called the DextroBeam designed for manipulating objects in 3D space while looking at a 3D stereoscopic display located in front of the user. Three-dimensional interaction is two-handed and is achieved by means of a stylus with a single button or switch. We have been planning several neurosurgical cases with the DextroBeam, including the separation of Nepalese Siamese twins in April 2001, and have conducted a course on surgery of the Temporal Bone (as part of the 9th ASEAN ORL Head and Neck Congress in Singapore, March 2001).
Evaluation of Visualization Techniques for Image-guided Navigation in Liver Surgery
Authors: Vetter Marcus  , Hassenpflug Peter  , Thorn Matthias  , C´rdenas Carlos  , Richter Götz Martin  , Lamadé Wolfram  , Herfarth Christian  , Meinzer Hans-Peter
Published: February 2025

A substantial component of an image-guided surgery system (IGSS) is the kind of three-dimensional (3D) presentation to the surgeon because the visual depth perception of the complex anatomy is of significant relevance for orientation. Therefore, we examined in this contribution four different visualization techniques, which were evaluated by eight surgeons. The IGSS developed by our group supports the intraoperative orientation of the surgeon by depicting a visualization of the spatially tracked surgical instruments with respect to intrahepatic vessels that have to be conserved vitally, the tumor, and preoperatively calculated resection planes. In the prelimenary trial presented here we examined the human ability to percept an intraoperative virtual scene and to solve given navigation tasks. The focus of the experiments was to measure the ability of eight surgeons to orientate intrahepaticaly and to transfer the percepted spatial relation to movements in real space. An autostereoscopic visualization with a prism-based display yielded that the navigation can be performed faster and more accurately than with the other visualization techniques.
Modelling and Analysis of Vertebra Deformations with Spherical Harmonics
Authors: Lefaix Gildas  , Haigron Pascal  , Rolland Yan  , Collorec René
Published: February 2025

In this paper we present an elaborate and precise geometrical model of the spine structure based on spherical harmonics. We first describe the application of spherical harmonics to the modelling of the vertebra surface, then we study the behaviour of the model under particular deformations. The first results of this study show that we can obtain a realistic model of each vertebra of the spine and that it is possible to estimate particular deformations with a good accuracy from the spherical harmonics coefficients of the deformed surface. Furthermore, this model constitutes an a prior i geometrical knowledge for the diagnosis of the spine scoliosis in a three- dimensional approach (reconstruction from 2D images).
Rehabilitation of Scoliosis Patients with Pain after Surgery
Authors: Weiß Hans-Rudolf
Published: February 2025

In our centre, the postoperative scoliosis rehabilitation consists in stabilizing postural and respiratory exercises lasting several hours a day (5 Vi to 7 hours). Additionally to pain treatment, we apply pain physiotherapy, physical therapy, acupuncture and besides manual medicine, also a psychological intervention and pain treatment by medication.
InfoServerPlus: Providing a Medical Library as Application Service
Authors: Pschichholz Holger  , Boeker Martin  , Gaudes Ralf  , Schulz Stefan  , Klar Rüdiger
Published: February 2025

Clinical decision making necessitates convenient access to high-quality content. The advanced requirements for a multipurpose application must be met technologically by an appropriate system design in the form of a client-server architecture which demonstrates a functional view in differentiating three tiers: presentation, application and data supply. The technical realisation has been accomplished by an application server which serves thin clients on several platforms. Despite considerable expenditures, this solution represents a promising way of disseminating information and knowledge via Intra- and Internet. The requirements and the accompanying system architecture could be satisfactorily implemented.
Setting up a common architecture for EPR in primary care: The Belgian experience
Authors: De Clercq E.  , Piette P.  , Strobbe J.  , Roland M.  , Vandenberghe A.  , Steenackers J.  , Pas L.
Published: February 2025

A couple of years ago, the Belgian Federal Ministry of Health decided to back the development of a basic conceptual model for Electronic Patient Record (EPR) in primary care. Using consensus and modeling relational techniques, a working group of experts and experienced practitioners identified 7 key structuring concepts: Health Care Element, Health Approach, Contact, Subcontact, Service, Health Agent, Period. This model could roughly be seen as a restrictive sub-model of the current CEN proposal (prENV 13940) or as a first step to assess this CEN pre-Norm in Belgium. The conceptual model is already used in teaching activities and in a Belgian software labeling process.
Retrieval of Brain CT Reports and Images Using Interaction Information Retrieval
Authors: Dominich Sándor  , Góth Júlia
Published: February 2025

The application of Interaction Information Retrieval to retrieve brain CT images is presented. After describing briefly the method and the architecture of the Web application, experimental results are reported and discussed.
Electronic Patient Record for N.N.Burdenko Neurosurgical Institute: on the Road to Paperless Patient Record
Authors: Shifrin Michael A.  , Kalinina Elena E.  , Kalinin Eugene D.
Published: February 2025

The paper is devoted to one of a number of highways of medical informatics: a road from traditional paper patient record (PPR) to future paperless patient record (PLPR). This road runs via modern electronic patient record (EPR), usually blending together electronic and paper technologies of gathering, storing, retrieving, presentation and legalization of data. The following is based on the experience of modelling, engineering, deployment, support and evolution of electronic patient record for N.N.Burdenko neurosurgical institute. Three basic facets of the problem will be discussed: technological, psychological and legal.
Shallow linguistic analysis of a large corpus of drug prescriptions
Authors: Thurin Anders  , Wennberg Mats  , Antonov Karolina  , Klein Gunnar
Published: February 2025

We report on first experiences from linguistic analyses of patient instructions from 198404 actual drug prescriptions regarding seven pharmaceutical products frequently prescribed in Sweden. The analysis includes expressions for amount, dose unit, dose interval, mode of administration, purpose and a few further details. Even simple processing seems useful to extract information from these short, rather formal text strings. We estimate the potential for calculation of prescribed dose from this material, and collected material gives a good starting point for more advanced linguistic analyses.
Using Text Generation to Access Clinical Data in a Variety of Contexts
Authors: Torgersson Olof  , Falkman Göran
Published: February 2025

MedView is a joint project with participants from oral medicine and computer science. The aim of the project is to build a large database from patient examinations and produce computerised tools to access data in various ways. One way to access data is to read case descriptions generated from stored cases. We give a description of how documents are generated from data and how these are used in a variety of contexts to supply useful information.
Evaluation of a frame-based Ontology A formalization-oriented Approach
Authors: Cornet Ronald  , Abu-Hanna Ameen
Published: February 2025

This paper describes the evaluation of our current frame-based ontology in Intensive Care. Our approach to the evaluation consists of formalizing the ontology. The motivation for formalization is twofold: a. The formalization process itself can shed light on the implicit ambiguities in the ontology and b. The result of this process is a representation that facilitates automatic inference. The evaluation has revealed various ambiguities in the current ontology, and has clarified the path for migration towards a formal representation supporting automatic inference.
Impact of data encoding and thyroids dysfunctions
Authors: Gibert Karina  , Sonicki Zdenko  , Martín Juan Carlos
Published: February 2025

In medical environments it is usual to previously encode some variables following medical criteria. In the context of thyroids dysfunctions, the levels of the hormones T3, T4 or TSH are usually treated as low, normal or high instead of using their numerical form, and this is a very common practice in other items. In medical environments it is also frequent to need a clustering process to analyze data. Clus-tering algorithms use always some distance or similarity coefficient to decide which elements have to be grouped in a cluster. The nature of the data determines which distance/similarity can be used, and can change results. In this paper, the impact of preprocessing numerical levels of hormones into categorical labels for clustering is studied, by means of a real sample of patients from a Hospital in Zagreb (Croatia).
An integrated knowledge management system for the clinical laboratories: an initial application of an architectural model
Authors: Bountis Christos  , Ds Kay Jonathan
Published: February 2025

eLABook is a web-distributed knowledge management system designed to support the needs of clinicians and laboratory staff in the selection and interpretation of investigations in laboratory medicine. Access can be by hyperlinks at any point through the request-report cycle, by browsing down a hierarchy, and by various search approaches. The information describes service issues, which are predominantly locally determined, and clinical implications, which may be local, national, governmental and international.
MedRapid – Medical Community Business Intelligence System
Authors: Finkeissen E.  , Fuchs H.  , Jakob T.  , Wetter T.
Published: February 2025

Objective: currently, it takes at least 6 months for researchers to communicate their results. This delay is caused (a) by partial lacks of machine support for both representation as well as communication and (b) by media breaks during the communication process.
Methodological Studies Related to Cardiovascular Risk Assessment
Authors: Kozmann György  , Jokuthy András  , Virányi Veronika  , Vassányi Istvan
Published: February 2025

Based on Framingham risk estimating equations by computer simulation graphical tools were gained allowing reasonable decision threshold adjustments in cardiovascular screening procedures. Results quantitatively characterize the percentage of the population selected for detailed evaluation vs. the decision threshold in a hypothetical screening procedure. In the second part of the study, the effect of blood pressure (BP) measurement uncertainties on coronary heart disease incidence estimates was characterized. According to our results the use of daily BP averages instead of instantaneous measurements has a significant impact on the risk estimation reliability.
Training in Health Informatics in Brazil
Authors: Marques Eduardo P.  , Marin Heimar F.  , Massad Eduardo  , Fraser Hamish  , Ohno-Machado Lucila
Published: February 2025

Developing countries, such as Brazil, are increasingly suffering from a severe shortage of health informatics specialists. Training of professionals in this field is expensive, and there is a limited supply of high-quality teaching resources available. We report on five initiatives of the Brazil/USA training program in health informatics. The main goal of this program is to train professionals in establishing medical informatics programs in Brazilian universities and major healthcare facilities.
Virtual Reality Stimuli for Force Platform Posturography
Authors: Tossavainen Timo  , Juhola Martti  , Pyykkö Ilmari  , Aalto Heikki  , Toppila Esko
Published: February 2025

People relying much on vision in the control of posture are known to have an elevated risk of falling. Dependence on visual control is an important parameter in the diagnosis of balance disorders. We have previously shown that virtual reality methods can be used to produce visual stimuli that affect balance, but suitable stimuli need to be found. In this study the effect of six different virtual reality stimuli on the balance of 22 healthy test subjects was evaluated using force platform posturography. According to the tests two of the stimuli have a significant effect on balance.
Use of Functional Tests to Increase the Efficiency of Scoliosis Screening Diagnosis by COMOT Method
Authors: Sarnadskiy V.N.  , Fomichev N.G.  , Mikhailovsky M.V.
Published: February 2025

COMOT technique was developed at Novosibirsk Research Institute of Traumatology and Orthopaedics as a pilot study in 1997 was used for screening for spine deformities in schoolchildren in Novosibirsk, Omsk and Moscow. Topographic screening was performed with patient standing in his natural free and easy posture. The criteria for scoliosis detection was an angle of lateral asymmetry (LA), calculated on the basis of topographic data, which was an analogue of Cobb angle. An additional criterion for structural spine deformation was an angle of scoliotic arch apex rotation (R). The analysis of responsiveness and specificity of topographic test (TT) at detection of structural arches of 10 and more degrees (according to Cobb) showed that they depend on the level of taken thresholds.
Self-Calibration of Biplanar Radiographs for a Retrospective Comparative Study of the 3D Correction of Adolescent Idiopathic Scoliosis
Authors: Novosad J.  , Cheriet F.  , Delorme S.  , Poirier S.  , Beauséjour M.  , Labelle H.
Published: February 2025

A novel technique for the 3D reconstruction of the spine from X-ray images is presented. The algorithm is based on the self-calibration of biplanar radiographs. It allows the 3D reconstruction of spines from old uncalibrated preoperative and postoperative radiographs. The reliability of the new self-calibration technique was investigated by validating its results against those of the Direct Linear Transform (DLT) on real images. An accuracy experiment was also performed using a dry spine specimen under controlled conditions. The results indicate that self-calibration is a viable technique, accurate enough to extract meaningful 3D clinical data for retrospective studies.
Quality Control in Management of Pain
Authors: Tuil W.S.  , Zanstr P.E.
Published: February 2025

Since 1987 several painclinics in the Netherlands have started with some kind of computer-assisted recording of data, mainly for purposes of quality control. However, this has not yet led to routinely generated reports about the quality of these clinics because a consensus on how to assess quality in pain-treatment is missing.
Lessons Learned in Modeling Virtual Pediatric Patients
Authors: Hubal Robert C.  , Deterding Robin R.  , Frank Geoffrey A.  , Schwetzke Henry F.  , Kizakevich Paul N.
Published: February 2025

In two applications the authors are developing virtual pediatric characters for training and assessment. One application, a virtual pediatric standardized patient, is intended for medical school students rotating through pediatrics to train and assess their basic communications and procedural skills while interacting with kids. The other application presents at-risk teenagers with vignettes to assess risky behavior and impulsivity. Both applications rely on existing responsive virtual human technology. The authors are engaged in preliminary clinical trials for the work described in this paper.
The Wireless and Paperless E.R.: an Economical and Ergonomic Approach
Authors: Laurent Christophe R.
Published: February 2025

An approach is presented to achieve a wireless and paperless recording of acquired patient data and other administrative tasks such as prescription of x-rays and laboratory tests in an emergency room in an ergonomic and economic way by means of the use of bar code technology, which is linked to the existing hospital informatics systems.
Virtual Instruments: A Generalized Implementation
Authors: Montgomery Kevin  , Bruyns Cynthia
Published: February 2025

The proliferation of surgical simulators would be increased if a common framework and set of virtual instruments existed for use by the application developer. We describe such a framework consisting of a powerful abstraction of a user interaction device, a functional taxonomy of surgical instruments, and a method for linking these components together. A series of example virtual instruments is also provided.
Real-Time PC based X-ray Simulation for Interventional Radiology Training
Authors: Muniyandi Manivannan  , Cotin Stephane  , Srinivasan Mandayam  , Dawson Steven
Published: February 2025

The ability to simulate realistic fluoroscopic images in real-time is a key aspect of any interventional radiology training system. In this paper, we propose a method for rendering X-ray images in real-time on a PC with consumer level graphics hardware, while improving the quality of the images. Although volume rendering techniques form the basis of our algorithm, we studied the characteristics of actual X-ray images to develop a method that can provide a new level of realism. In addition, the integration of the various levels of information contained in a CT scan in the rendering pipeline can be exploited to produce even more realistic, patient-specific X-ray or fluoroscopic images. Although the results presented here are preliminary, the performance of multi-texturing and multi-stage rasterization features available on recent low-cost graphics hardware already allows us to render X-ray images at about 30 frames per second.
Virtual Reality Therapy in Aid of Senior Citizens Psychological Disorders
Authors: North Max M.  , Rives Jason
Published: February 2025

The treatment for senior citizens suffering from psychological disorders seems to be different from therapeutic procedures used for other populations. This pilot study is the first known in-depth case study of the effectiveness of virtual reality therapy (VRT) as a treatment for senior citizens. The fear of flying treatment was chosen for this study. The subject of the study was a 62-year-old married female, whose anxiety and avoidance behavior was interfering with her normal activities. For treatment, she was placed in the cabin of a virtual commercial aircraft environment accompanied by a virtual therapist. After a few sessions in which she spent time in a virtual airport scene, she spent four sessions in which she was flown over a simulated city. While under the virtual reality treatment, the subject experienced a number of physical and emotional anxiety-related symptoms. These symptoms included sweaty palms, loss of balance, weakness in the knees, etc. In this study, the virtual reality treatment caused a significant reduction in the anxiety symptoms in the subject and enhanced her ability to face phobic situations in the real world. Since termination of the treatment, she has taken several flights to professional conferences and reported feeling more comfortable and has fewer symptoms than those experienced prior to the VRT treatment.
Use of an Augmented Reality Display of Patient Monitoring Data to Enhance Anesthesiologists’ Response to Abnormal Clinical Events
Authors: Ormerod D.F.  , Ross B.  , Naluai-Cecchini A.
Published: February 2025

One obstacle to safety in the operating room is anesthesiologist distraction — having to shift attention back and forth from the patient to a vital sign monitor while performing either routine or emergency procedures. The purpose of this study was to measure the decrease in anesthesiologist distraction made possible by using a head-worn, see-through personal display (HWD) using retinal scanning technology. With the head-up display, they were able to focus their attention exclusively on the patient and the task at hand. The Nomad reduced the number of times the anesthesiologist had to shift their attention by a more than a third (17 times versus 58 times). This allowed them to spend more time focused on the patient.
Minimally Invasive Surgery Task Decomposition – Etymology of Endoscopic Suturing
Authors: Rosen Jacob  , Chang Lily  , Brown Jeffrey D.  , Hannaford Blake  , Sinanan Mika  , Satava Richard
Published: February 2025

The analogy between Minimally Invasive Surgery (MIS) and the human language inspires the decomposition of a surgical task into its primary elements. The frequency of different elements or words” and their sequential associations or “grammar” both hold critical information about the process and outcome of the procedure. Modeling these sequential element expressions using a multi finite states model (Markov model) reveals the grammatical structure of the surgical task and is utilized as one of the key steps in objectively assessing surgical performance. The experimental protocol included 30 surgeons at different levels of training (5×Rl,R2,R3,R4,R5, and experts) performing Laparoscopic suturing on an animal model (pig). The kinematics and dynamics of left and right endoscopic tools along with the visual view of the surgical scene were acquired by the Blue DRAGON system. The methodology of decomposing the surgical task is based on a fully connected, finite-states (30 states) Markov model (MM) where the left and right hands are represented by 15 states each. In addition to the MM objective analysis, a scoring protocol was used by an expert surgeon to subjectively assess the subjects’ technical performance. An objective learning curve was defined based on measuring quantitative statistical distance (similarity) between MM of experts and MM of residents at different levels of training. The objective learning curve (e.g. statistical distance between MM) was similar to that of the subjective performance analysis. The MM proved to be a powerful and compact mathematical model for decomposing a complex task such as laparoscopic suturing. Systems like surgical robots or virtual reality simulators that inherently measure the kinematics and dynamics of the surgical tool may benefit from inclusion of the proposed methodology for analysis of efficacy and objective evaluation of surgical skills during training.
A New Concept for an IntegratedHealthcare Access Model
Authors: Costa Carlos  , Silva Augusto  , Ribeiro Vasco Gama
Published: February 2025

The increase of population mobility has been promoting a crescent dispersion of patient clinical records in Healthcare Information Systems. In this scenario, it is mandatory that new services will be available for healthcare practitioners, namely web-based interfaces with strong control access mechanisms providing effective authentication and identification of persons, and the establishment of new access models to the disperse patient information.
Beds Simulator 1.0: a software for the modelisation of the number of beds required for a hospital department.
Authors: Nguyen Jean-Michel  , Six Patrick  , Antonioli Daniel  , Lombrail Pierre  , Beux Pierre Le
Published: February 2025

The determination of the number of beds needed for a hospital department is a complex problem that try to take into account efficiency, forecasting of needs, appropriateness of stays. Health authority used methods based on ratios that do not take into account local specificities and use rather to support an economic decision. On the other side, the models developed are too specific to be applied to all type of hospital department. Moreover, all the solutions depend on the LoS (Length of Stay). We have developed a non parametric method to solve this problem. This modelisation was successfully tested in teaching and non teaching hospitals, for an Intensive Care Unit, two Internal Medicine and a surgical departments. A software easy to use was developed, working on Windows available on our website www.sante.univnantes.femed/stat/
Criteria for Classification of Medical Information
Authors: Mihalas George  , Lungeanu Diana  , Vernic Corina  , Kigyosi Anca  , Focsa Mircea
Published: February 2025

Medical information, which is the central notion in medical informatics, covers a large scale of structures and forms. Several classifications are possible and two criteria have been used in this paper: structural level and informational level. According to structural level we can distinguish three major areas: bioinformatics and neuroinformatics for molecular/cellular level, medical informatics for individual level and health informatics for community level and healthcare units. According to informational level the terms of data and knowledge are used and the representative information for each structural level is analysed also from this point of view: Finally, information transfer from living systems to computers is also seen through the structural point of view.
Fusing a Systematic and a Case-based Repository for Medical Decision Support
Authors: Barth Carmen  , Tobman Matvei  , Nätscher Catharina  , Sußmann Helmut  , Horsch Alexander
Published: February 2025

In order to take full advantage of computer-based decision support in clinical practice, it makes sense to combine systems which support the same subject, but contribute to this task in different ways. At the Technical University of Munich, a Combined Clinical Decision Support System (C-CDSS) of this kind has been designed for gastroenterologists. The main goal of the system is to help the physicians in finding information which is relevant for making the right diagnoses or applying the proper therapy to his patients. To achieve this goal, not only systematic knowledge of the medical domain, but also case-based data is useful for a comparison of the actual case with well-documented similar cases of colleagues. The systematic knowledge comprises state-of-the-art textual information and selected multimedia contents in the sense of a standard textbook. The case-based information includes practice-related information on a pool of anonymized cases from clinical routine and also demonstrations of new techniques. By integrating these information resources into one service via a rule-based retrieval system, a powerful decision support system can be generated.
Multidimensional Evaluation of a Clinical Information System for anaesthesiology: Quality management, Usability, and Performances
Authors: Beuscart-Zéphir Marie-Catherine  , Menu Hervé  , Evrard Fabienne  , Guerlinger Sandra  , Watbled Ludivine  , Anceaux Françoise
Published: February 2025

This paper describes a multi-dimensional assessment methodology to support the choice and selection process of Clinical Information Systems. The methodology includes 4 evaluation components: Fulfilment of Users Requirements, Usability Inspection, Usability Testing and Performance Evaluation. The methodology is illustrated with the case study of a selection of a CIS for anaesthesiology. It proved to be very efficient and powerful to support the selection process, to enhance users’ involvement in the project, and to initiate the necessary re-engineering of the HCI.
From Computerized Patient Records to National Resource
Authors: Zuker Alton
Published: February 2025

To help curb constantly rising costs of medical services, healthcare providers in Israel have been busy incorporating computerized patient record systems (CPR) into their organizations since the early 1990s. Our CPR based integrated system solutions (named Clicks®) now serve over 90% of primary and secondary medical care professionals throughout the country, covering over 90% of the population across medical fields with all healthcare providers.
The PRIDEH Project: Taking Up Privacy Protection Services in eHealth
Authors: De Meyer Filip  , De Moor George J.E.  , Claerhout Brecht
Published: February 2025

PRIDEH (Privacy Enhancement in Data Management in e-Health) is a project that runs for two years and is partly funded by the European Commission. The focus of PRIDEH is on the stimulation of the take-up of privacy enhancing technologies within the health domain. Privacy enhancing technologies build upon available cryptographic and communication technologies. The concept of privacy enhancing services delivery through the use of intermediary trusted third parties has already been described in literature but rarely turned into practice. A number of limited PET (Privacy Enhancing Technologies) applications exist in closed domains. The very few existing solutions are not based on an independent TTP (Trusted Third Party) concept which renders their trustworthiness questionable. PRIDEH wants to enhance the take-up of PET delivery based on sound TTP principles in the domain of healthcare.
Realistic Simulation of Surgical Cutting of Soft Tissues in Real Time with Force Feedback
Authors: Lim Yi-Je  , De Suvranu
Published: February 2025

In this paper we present a geometrically efficient algorithm coupled with a physically based numerical scheme using a meshfree approach for the simulation of surgical procedures including surgical cutting in multimodal virtual environments. Progressive cutting, without the generation of new primitives, is achieved by snapping the nearest nodes to the interaction point between the cutting tool and the underlying polygon edge. The realism of the simulations is enhanced by employing a local subdivision algorithm in the vicinity of the tool-tissue interaction region and a cutting gutter to display the interior structure of the soft tissue as the cut opens up. A meshfree method is used to compute the deformation fields and interaction forces.
Reminder-based or on-demand decision support systems: a preliminary study in primary care with the management of hypertension
Authors: Séroussi B.  , Bouaud J.
Published: February 2025

ASTI is a guideline-based decision support system for therapeutic prescribing in primary care with two modes of interaction. The “critic mode” operates as a reminder system to detect non guideline-compliant physician drug orders, whereas the “guided mode” operates on demand and provides physician guidance to help her establishing best recommended drug prescriptions for the management of hypertension. A preliminary evaluation study was conducted with 10 GPs to test the complementary nature of both modes of decision support. Results tend to validate our assumption that reminder-based interaction is appropriate for simple cases and that physicians are willing to use on-demand systems as clinical situations become more complex.
The GLARE Approach to Clinical Guidelines: Main Features
Authors: Terenziani Paolo  , Montani Stefania  , Bottrighi Alessio  , Torchio Mauro  , Molino Gianpaolo  , Correndo Gianluca
Published: February 2025

In this paper, we present GLARE, a domain-independent prototypical system for acquiring, representing and executing clinical guidelines. GLARE has been built within a 7-year project with Azienda Ospedaliera San Giovanni Battista in Turin (one of the largest hospitals in Italy) and has been successfully tested on clinical guidelines in different domains, including bladder cancer, reflux esophagitis, and heart failure. GLARE is characterized by the adoption of advanced Artificial Intelligence (AI) techniques, to support medical decision making and to manage temporal knowledge.
Inflammation Ontology Design Pattern: An Exercise in Building a Core Biomedical Ontology With Descriptions and Situations
Authors: Gangemi Aldo  , Catenacci Carola  , Battaglia Massimo
Published: February 2025

Formal ontology has proved to be an extremely useful tool for negotiating intended meaning, for building explicit, formal data sheets, and for the discovery of novel views on existing data structures. This paper describes an example of application of formal ontological methods to the creation of biomedical ontologies. Addressed here is the ambiguous notion of inflammation, which spans across multiple linguistic meanings, multiple layers of reality, and multiple details of granularity. We use UML class diagrams, description logics, and the DOLCE foundational ontology, augmented with the Description and Situation theory, in order to provide the representational and ontological primitives that are necessary for the development of detailed, flexible, and functional biomedical ontologies. An ontology design pattern is proposed as a modelling template for inflammations.
Information Technology and Behavioral Medicine: Impact on Autism Treatment & Research
Authors: Oberleitner Ron  , Laxminarayan Swamy
Published: February 2025

Families, clinicians and researchers involved with varying neurological disorders face amazing challenges to understand, treat, and assist the people they are serving. Autism brings unique challenges and serves as an important model for the application of important concepts in information technology and telemedicine. The rising incidence of autism with limited professional resources has led to more consideration for using information technology and related specialties to link families and professionals, and to implement strategies which implement information technology to improve the outcomes for individuals with autism and their families. These are reviewed in context of the unique health, education, and the research issues facing those dealing with autism.
Cognition, interaction and ageing: an Internet workshops exploratory Study
Authors: Xavier André  , Sales Márcia  , Ramos Luiz  , Anção Meide  , Sigulem Daniel
Published: February 2025

Gerontology is known more and more as an interdisciplinary and functional knowledge. Geriatrics as one of its branches intends to make possible longevity with health. World population ageing occurs along with important economical and social inequalities for elder people, which are likely to be more affected by deficiencies (physical and/or cognitive) than younger groups.
A service for remote screening of physiological data and follow up of patients using a home gateway and domestic wireless technologies
Authors: Pepe G.  , Frumento E.  , Garlaschelli A.
Published: February 2025

The availability and the reduced costs of more sophisticated electronic devices makes possible to develop and use sophisticated systems also for domestic use. This opportunity beside new emerging market needs is bringing to new life the Home-Care scenario. This paper will present a Home Care system developed in the context of the FUTUREHOME IST project. Its key features are interacting with external health-care service providers, such as the Hospitals, Private Clinics or Emergency Departments, from our own houses by means of innovative solutions. It enables the telemonitoring of vital parameters of the home/family members. Using wireless connections, data collected from different devices (weight scale, ox-meter, glucose meter, etc...), are stored into the Home Network Service Point (HNSP), the FUTUREHOME network's core, from where they are used for further consultations (e.g. patients follow-up).
JUST in Time Health Emergency Interventions: An innovative approach to training the citizen for emergency situations using Virtual Reality Techniques and Advanced IT Tools (The Web-CD)
Authors: Manganas A.  , Tsiknakis M.  , Leisch E.  , Karefilaki L.  , Monsieurs K.  , Bossaert L.L.  , Giorgini F.
Published: February 2025

This paper reports the results of the first of the two systems developed by JUST, a collaborative project supported by the European Union under the Information Society Technologies (IST) Programme. The most innovative content of the project has been the design and development of a complementary training course for non-professional health emergency operators, which supports the traditional learning phase, and which purports to improve the retention capability of the trainees. This was achieved with the use of advanced information technology techniques, which provide adequate support and can help to overcome the present weaknesses of the existing training mechanisms.