bluuebunny/crossref_metadata_2025 huggingface dataset:
Workflow Design as a Basis for Component Interaction
Authors: Karlsson Johan  , Eklund Patrik
Published: February 2025

This paper presents a workflow case study on radiation therapy. The workflow model was developed with a conventional CASE tool aiming to effectively support further developments in respective directions of simulation, effects on organisational structures, quality assurance, component interaction and logistics of information with efficient human-computer interactions.
Knowledge Discovering from Clinical Data Based on Classification Tasks Solving
Authors: Ignat'ev N.A.  , Adilova F.T.  , Matlatipov G.R.  , Chernysh P.P.
Published: February 2025

After the abundant literature on normative decision analysis centered on Bayes' rule, the artificial intelligence approach left aside the proposed formalism in favor of symbolic approach. Thus, diagnosis was identified as a dynamic cognitive process, characterized by the search for evidence to test a given hypothesis where heuristic thinking plays a significant role.
Proposal Workshop: National Efforts towards the EHR — Electronic Health Record
Authors: de Faria Leão Beatriz  , Schloeffel Peter  , Gronlund Toto Ann  , Hanmer Lyn  , Pascal William
Published: February 2025

This workshop aims at providing an opportunity for the presentation of national efforts towards the electronic health record. Perspectives from different countries with different levels of IT utilization in health care will be presented.
Evaluation in the UK's National Health Service
Authors: Kaplans Bonnie  , Atkinson Chris  , Ellis Nikki  , Jones Matthew  , Klecun-Dabrowska Ela  , Teasdale Sheila  , Wyatt Jeremy
Published: February 2025

Electronic patient records, physicians’ office systems, telehealth projects, resource management endeavors, and other applications are undergoing evaluation in the UK. This workshop provides an overview of these projects and an opportunity to discuss evaluation.
An Object-oriented Model for Representing Semantic Locality in the UMLS
Authors: Bodenreider Olivier
Published: February 2025

Several information models have been developed for the Unified Medical Language System (UMLS). While some models are term-oriented, a knowledge-oriented model is needed for representing semantic locality, i.e. the various semantic links among concepts. We propose an objectoriented model in which the semantic features of the UMLS are made available through four major classes for representing Metathesaurus concepts, semantic types, interconcept relationships and Semantic Network relationships. Additional semantic methods for reducing the complexity of the hierarchical relationships represented in the UMLS are proposed. Implementation details are presented, as well as examples of use. The interest of this approach is discussed.
Enabling Guidelines for Computer-based Decision Support - Process and Tools
Authors: Moser Wolfgang  , Heller Ulrich  , Gries Friedrich Arnold  , Engelbrecht Rolf
Published: February 2025

Many guideline only implicitly or vaguely define the process of health care delivery. However, an explicit model of the medical tasks comprising this process is needed before active decision support at the patient encounter can take place.
Development of a Template Model to Represent the Information Content of Chest Radiology Reports
Authors: Rocha Roberto A.  , Huff Stanley M.
Published: February 2025

The authors describe the application of a methodology for developing representational models for loosely structured medical domains. The methodology is subdivided in two interrelated tasks: terminology acquisition and template generation. The methodology is applied to the domain of chest radiology, producing a domain-specific lexicon and a series of templates to represent all the relevant clinical information stated on a chest x-ray report. Details about the successive application of the methodology and the resulting versions of the lexicon and templates are presented. The most relevant aspects of the methodology utilization are discussed and compared with evidence from other authors.
DIAMED: A Probabilistic Diagnostic Aid System on the Web
Authors: Cléret Mireille  , Le Duff Franck  , Fresnel Annie  , Le Beux Pierre
Published: February 2025

DIAMED is a system to assist the physicians in the diagnostic process using probabilistic networks as knowledge representation. These networks make it possible to reason on medical data by applying Bayesian methods and to take into account uncertainties of the facts in the resolution of the clinical cases. The proposed model reuses knowledge contained in an existing knowledge base (ADM). An interface of DIAMED developed on a Web server remotely assists the experts of each medical specialty in updating and validating the knowledge base. Most of the data processing is automated while being based on information preexistent in the ADM base : Constitution of lexicons starting from the existing dictionaries of the ADM system, are then used to work out the requests for selection and update of the knowledge base. . One of its assets resides in its pseudo-segmented structure in several layers. The propagation of information is thus limited to only one part of the probabilistic network and calculations are therefore limited.
Development and Evaluation of a Nursing Service Management and Administration Information System at District Hospital
Authors: Stamouli Maria-Aggeliki  , Mantas John
Published: February 2025

The rapid development of information technology and the multiple usage of Information Systems make indisputable their appliance in all the sectors including the Nursing Service area. Information Systems that have been developed for the Nursing Service Administration are extremely useful in the processing and the categorisation of a large number of information, providing significant advantages such as information storage, information availability, information precision and reliability. In addition, the appliance of Information Systems provides important advantages in the administration of the nursing personnel’s data, contributing to the improvement of the operating effectiveness of the Nursing Service. This paper describes the development and the evaluation of an Information System for the Nursing Service Administration that classifies all the information related to the nursing personnel and helps the administration to handle the appropriate nursing data. The method of Life Cycle Model was decided as the most appropriate for the development of the System, because of the important advantages that it offers. For the evaluation of our own designed system we based on the standards, which are used for evaluating Information Systems in general. The evaluation of this Information System is carried out by a survey among the undergraduate and the postgraduate students of the Nursing Department of the University of Athens and the Nursing Personnel of a number of Hospitals. Useful conclusions have been derived concerning those characteristics, which should be fulfilled by the system. Important conclusions have been also drown out concerning the dependencies of the variables under study, the future readjustments of the system, and the general perception of the newcomers in health profession towards the application of the information technology.
Towards Virtual Reality Stimulation in Force Platform Posturography
Authors: Tossavainen Timo  , Juhola Martti  , Pyykkö Ilmari  , Toppila Esko  , Aalto Heikki  , Honkavaara Pekka
Published: February 2025

We developed a stimulation technique on the basis of virtual reality methods for balance investigation performed in balance laboratories of otorhinolaryngological clinics and institutes of occupational health. Such a stimulation technique is greatly progressive in the sense that by creating virtual moving views and “virtual worlds” inside which the subject is located it is possible to make effective stimuli that would be very difficult or even impossible to set in any real environment. We tested our system on healthy subjects and found out that this kind of virtual reality stimulation system is very useful for balance analysis.
A Screening Gate for Detection and Classification of Mobile Telephone Handsets in the Speaking or Stand-by Mode
Authors: Hanada Eisuke  , Watanabe Yoshiaki  , Nose Yoshiaki
Published: February 2025

We present an automatic screening gate that detects concealed mobile telephone handsets and classifies them by type. The screening method used in the gate does not require any additions to or reconstruction of mobile telephone systems.
GenePath: A Computer Program for Genetic Pathway Discovery from Mutant Data
Authors: Demšar Janez  , Zupan Blaž  , Bratko Ivan  , Kuspa Adam  , Halter John A  , Beck Robert J  , Shaulsky Gad
Published: February 2025

The sequencing of the human genome and the genomes of several model organisms is the first step toward the long-term objective of genetic research: the identification of all genes, and the discovery of their functions and mutual interactions. This article presents a methodology and a computer program called GenePath to support the discovery of gene function. GenePath uses mutant data and available genetic knowledge to identify potential genetic pathways. Several pilot applications based on experimental results from Dictyostelium and C. elegans confirmed the usefulness of the proposed schema. Our results suggest that GenePath is a valuable tool that can be used as an intelligent assistant to support genetic reasoning.
Augmented Reality and Training for Airway Management Procedures
Authors: Davis Larry  , Ha Yonggang  , Frolich Seth  , Martin Glenn  , Meyer Catherine  , Pettitt Beth  , Norfleet Jack  , Lin Kuo-Chi  , Rolland Jannick P.
Published: February 2025

Augmented reality is often used for interactive, three-dimensional visualization within the medical community. To this end, we present the integration of an augmented reality system that will be used to train military medics in airway management. The system demonstrates how a head-mounted projective display can be integrated with a desktop PC to create an augmented reality visualization. Furthermore, the system, which uses a lightweight optical, tracker, demonstrates the low cost and the portability of the application.
Interactive Simulation of the Teeth Cleaning Process using Volumetric Prototypes
Authors: Gockel Tilo  , Laupp Ulrich  , Salb Tobias  , Burgert Oliver  , Dillmann Rüdiger
Published: February 2025

In this paper, an interactive simulation system for teeth cleaning is presented. This simulation system offers assistance for optimizing design and manufacturing of new toothbrushes. Data acquisition and pre-processing techniques for the model generation are shown and the mathematical method for modelling of the elastic behaviour of the toothbrushes parts is explained. Afterwards, a new approach to collision detection based on simple volumetric prototypes is described, user interaction is discussed and results of the project are shown.
PROTOCOLS FOR CLINICAL TESTS ON PARKINSON DISEASE AFFECTED PERSONS AN]) COMPARISON WITH HEALTHY PEOPLE WITH A QUANTITATIVE METHOD OF A NEW SYSTEM DAPHNE
Authors: Rovetta A.
Published: February 2025

This paper deals with Daphne, a portable equipment for the evaluation of the state of health in Parkinson disease. The protocols have been developed, according to the design, to the characteristics, to the performances of the system. Tests on patients and healthy persons are presented, as application of protocols.
The application of eyeglass displays in changing the perception of pain
Authors: Tse Mimi M.Y.  , Ng Jacobus K.F.  , Chung Joanne W.Y.  , Wong Thomas K.S.
Published: February 2025

We have been examining the potential value of visual stimulation via the eyeglass displays in changing the perception of pain. In this randomized, controlled, cross-over study, 72 healthy university student volunteers were asked to wear a light-weighted eyeglass projecting a feeling of watching a fifty-two-inch television screen in a close distance while pain was produced by a modified tourniquet technique. There is a significant increase of pain threshold and pain tolerance with the effect of visual stimulation. These findings having implications of using visual stimulation as positive adjunct to other methods of pain relief and to different pain conditions in clinical areas.
Open Surgery Simulation
Authors: Bielser Daniel  , Gross Markus H.
Published: February 2025

The design of simulators for surgical training and planning poses a great number of technical challenges. Therefore the focus of systems and algorithms was mostly on the more restricted minimal invasive surgery. This paper tackles the more general problem of open surgery and presents efficient solutions to several of the main difficulties. In addition to an improved collision detection scheme for computing interactions with even heavily moving tissue, a hierarchical system for the haptic rendering has been realized in order to reach the best performance of haptic feedback. A flexible way of modeling complex surgical tools out of simple basic components is proposed. In order to achieve a realistic and at the same time fast relaxation of the tissue, the approach of explicit finite elements has been substantially improved. We are able to demonstrate realistic simulations of interactive open surgery scenarios.
Virtual Reality in 3D Echocardiography: Dynamic Visualization of Atrioventricular Annuli Surface Models and Volume Rendered Doppler-Ultrasound
Authors: Wolf Ivo  , De Simone Raffaele  , Hastenteufel Mark  , Kunert Tobias  , Link Sibylle  , Meinzer Hans-Peter
Published: February 2025

Knowledge about annuli shape and blood flow patterns, both optimally assessed by transesophageal 3D Doppler echocardiography, can be used in computer assisted surgical planning of heart valve reconstruction. Moreover, information about the individual shape of the annulus anatomy can guide the design of annular prostheses. The problem is that the annulus cannot be easily differentiated from the valve and the myocardium with standard visualization methods. We have developed a nearly automatic method for annulus segmentation. The algorithm provides the annulus shape in a symbolic description, which can be used for surface visualization. Best results to visualize the blood flow from the Doppler signal and the myocardial morphology are obtained by volume rendering. A hybrid visualization technique combining surface rendering and volume rendering enables to dynamically visualize the surface rendered annulus combined with a volume rendered 3D (plus time) reconstruction of either backscatter (morphology) and Doppler information (in original color coding), or together with backscatter only or Doppler only. Visualization of annuli structures combined with blood flow and general myocardial morphology provides a new tool to analyze heart diseases.
Generalized Interactions Using Virtual Tools within the Spring Framework: Cutting
Authors: Bruyns Cynthia D.  , Montgomery Kevin
Published: February 2025

We present schemes for real-time generalized mesh cutting. Starting with the a basic example, we describe the details of implementing cutting on single and multiple surface objects as well as hybrid and volumetric meshes using virtual tools with single and multiple cutting surfaces. These methods have been implemented in a robust surgical simulation environment allowing us to model procedures ranging from animal dissection to cleft lip correction.
Biomechanical Simulation of Colorado Instrumentation of the Scoliotic Spine: a Preliminary Study
Authors: Verniest F.  , Petit Y.  , Chopin D.  , Godellon-Maquinghen A-P.  , Cheriet F.  , Drazetic P.  , Aubin C-É
Published: February 2025

Few biomechanical models of the scoliotic spine were developed to simulate the Cotrel-Dubousset instrumentation, although none was dedicated to the Colorado system. The objective of this study is to adapt and assess an existing biomechanical model to simulate the effect of the Colorado instrumentation of the scoliotic spine as a function of pre-operative geometry and surgical planning. Fifteen scoliotic patients operated with a Colorado system were analysed using a knowledge extraction technique to simplify surgical procedure and to establish the biomechanical model (boundary conditions, simulation procedures,${\ldots}$). Preliminary results on one patient show that the Colorado surgical technique can be adequately modelled using the pre�operative geometric data and limited simulation strategy parameters.
A Web-based Central Diagnostic Data Repository
Authors: Müller Thomas H.  , Adelhard Klaus
Published: February 2025

A central repository for diagnostic information about individual patients was created as a service to diagnostic laboratories participating in the Compentence Network for Acute and Chronic Leukemias in order to support health care delivery to patients suffering from leukemia. During the diagnostic phase several specialised laboratories perform different assays on samples from the same patient. The use of these assays in the diagnostic process and during the treatment phase may be improved in terms of both rapid delivery and cost if any one laboratory is aware of preliminary or final results from the assay carried out in other laboratories. In order to support a more efficient communication of these results, a central diagnostic data repository (CDDR) was created and web-based user interface was developed. Currently, the CDDR maintains documents in the form of portable document format® (PDF) files. Several other formats are accepted and converted automatically upon entry. Patient identification is accomplished by pseudonym rather than proper name and the data is held on the CDDR for a limited time interval to accommodate the stringent privacy regulations in Germany. The principle operation of a CDDR may also be applied to the diagnostic or therapeutic process of other diseases.
Combining voice recognition and automatic indexing of medical reports
Authors: Happe André  , Pouliquen Bruno  , Burgun Anita  , Cuggia Marc  , Le Beux Pierre
Published: February 2025

Medical records have been evolving from the traditional paper-based records to digital ones, from the method of dictating reports and transcription to voice recognition systems. The transition to digital operations will not be complete until we have the ability to combine voice recognition with automated indexing of texts. This paper introduces the methods we used to evaluate existing voice recognition software programs and presents NOMINDEX, a system that turns a medical text into MeSH codes, using the French ADM lexical database. Those systems were applied to 28 patient discharge summaries in French, produced after a coronarography, and extracted from the MENELAS corpus of texts. Using the best configuration for voice recognition, the rate of accurate recognition exceeds 98 percent. Among the indexing concepts assigned by NOMINDEX, 25 percent were not pertinent and 12 percent of the relevant concepts were missing. Most errors were related to confusion between common language and medical language, and to the coverage of the ADM lexical database. Best results would be expected with a more comprehensive lexical resource In addition, only 3 percent of the errors generated by inadequate voice recognition that remained in the configuration that performed better, impacted on automatic indexing by NOMINDEX.
Toward a Quantitative Analysis of Skin Lesion Images
Authors: Caputo B.  , Panichelli V.  , Gigante G.E.
Published: February 2025

Melanoma is the most dangerous form of skin cancer. Skin cancers, and particularly melanomas, can be easily cured if detected early. The regularity of the pigment network structure is a significant sign for early diagnosis of melanoma. We present here a quantitative analysis of the morphology of the pigment network structure. Our method is based on the extraction of the pigment network structure using digital image processing techniques. Once the network is extracted, it is possible to derive statistical indicators relative to its regularity or irregularity. We report experiments on a database of 14 images, showing the effectiveness of our method.
BioDAQ - a simple biosignal acquisition system for didactic use
Authors: Csaky Z.  , Mihalas G.I  , Focsa M.
Published: February 2025

A simple non expensive device for biosignal acquisition is presented. It mainly meets the requirements for didactic purposes specific in medical informatics laboratory classes. The system has two main types of devices: ‘student unit’- the simplest one, used during lessons on real signals and ‘demo unit’ which can be also used in medical practice or for collecting biological signals. It is able to record: optical pulse, sphygmogram, ECG (1-4 leads) EEG or EMG (1-4 channels). For didactical purposes it has a large scale of recording options: variable sampling rate, gain and filtering. It can also be used in tele-acquisition via Internet.
Discharge and referral data exchange using global standards - The SCIPHOX project in Germany
Authors: Heitmann Kai U.  , Schweiger Ralf  , Dudeck Joachim
Published: February 2025

The goal of the German project “Standardization of Communication between Information Systems in Physician Offices and Hospitals using XML” (aka SCIPHOX) is to provide an XML based information exchange between Hospital Information Systems (HIS) and Physician Office Systems (POS). HL7's Clinical Document Architecture (CDA) was chosen to serve as the “backbone” specification. The CDA is an ANSI approved document architecture for exchange of clinical information using XML. The SCIPHOX proposal specifies the use of the CDA in the context of discharge and referral letters in Germany, taking local needs (insurance information etc.) into account.
Joint Segmental Kinematic Trunk Motion and C.O.P. Patterns for Multifactorial Posturographic Analysis
Authors: D'Amico Moreno  , Roncoletta Piero
Published: February 2025

Measurements of postural sway are used to determine a subject ability to maintain upright stance. In many clinical analyses, postural control measured during a quiet standing provides very useful insights about CNS and Motor control behaviour. The aim of this paper is to present a new posturographic methodology including both classical parameter extraction techniques and new specially developed figuring algorithms, in which both kinematic patterns and ground reaction force COP evolution are jointly processed in order to identify the biomechanical behaviour in particular of the spine at each metameric level for both orthostatic posture and lateral bending test.
An experimental model of adult-onset slip progression in isthmic spondylolistesis
Authors: Patwardhan Avinash  , Ghanayem Alexander  , Simonds James  , Hodges Scott  , Voronov Leonard  , Paxinos Odysseas  , Havey Robert
Published: February 2025

Progressive spondylolisthesis may occur in adults with isthmic spondylolysis with an estimated incidence of 20%. This biomechanical study showed that in adult spines with bilateral L5 pars fractures, an anterior slip of L5 depends on the extent of the load-bearing deficiency of the disc and the presence of shear force across L5-S1. A combination of disc degeneration and muscle dysfunction may be responsible for converting a stable isthmic spondylolysis into an unstable progressive spondylolisthesis.
Side Shift Exercise for Idiopathic Scoliosis after Skeletal Maturity
Authors: Mamyama Toni  , Kitagawal Tomoaki  , Takeshita Katsushi  , Nakainura Kozo
Published: February 2025

A total of 69 patients with idiopathic SCOl∼OS∼S who were treated only by side shift exercise after their skeletal maturity were reviewed. The average age at the beginning of the side shift was 16.3 years and the average follow-up period was 4.2 years. Size ofthe curve was 31.5°+11.2 at the beginning ofthe side shift and 3O.3∼il2.3 at the final follow-up. The side shift exercise can be a useful treatment option for the management of idiopathic scoliosis after skeletal maturity.
Surgical treatment of scoliosis in myelomeningocele
Authors: Parisini Patrizio  , Greggi Tiziana  , Di Silvestre Mario  , Giardina Federico  , Bakaloudis Georgios
Published: February 2025

The high incidence and rapid progression of scoliosis in myelomeningocele make it one of the most disabling aspects of such disease. The choice of the surgical procedure to treat scoliosis in myelomeningocele is related to the peculiar features of this deformity.
Comparison of body weight and height between normal and scoliotic children
Authors: Grivas Theodoros B  , Arvaniti Akrivi  , Maziotou Christina  , Margarita Manesioti M  , Fergadi Anna
Published: February 2025

Aim: The creation of a database with somatometric parameters (body weight and eight) from school screening children and the comparison of nonscoliotic children with their counterparts suffering of scoliosis to Cobb angle >10° curves.
Positional cloning strategies for idiopathic scoliosis
Authors: Bashiardes Stavros  , Veile Rose  , Wise Carol A.  , Szappanos Laszlo  , Lovett Michael
Published: February 2025

Aim: Idiopathic scoliosis (IS) affects approximately 1-2% of the population and has a heritable component. It is clear that in general IS displays the features of a complex genetic disorder; however families displaying a Mendelian inheritance pattern have been described. Our aim is to identify families segregating rare, highly penetrant loci. In the case described here the disorder appears to cosegregate with a chromosomal rearrangement.
Web-Access to a Central Medical Record to Improve Cooperation Between Hospital and Referring Physicians
Authors: Bellon E.  , Aerts W.  , Vanautgaerden M.  , Feron M.  , Pierlet N.  , De Deurwaerder A.  , De Coninck Y.  , Suetens P.  , Van Den Bosch B.
Published: February 2025

We set up Web-access to the central electronic medical record of the University Hospitals Leuven. Purpose was to enable extemal physicians to more actively participate in the care process as full members of the multidisciplinary treatment team. They get a view on the complete care process in the hospital, and can access results as these become available instead of being provided summary information post factum. This complements traditional electronic exchange between healthcare records. We report on technical setup and results from an extended pilot. We believe that this approach can enrich the discussion on how to provide the “global medical record”.
Real-time Web-based Telerehabilitation Monitoring
Authors: Lewis Jeffrey  , Boian Rares  , Burdea Grigore  , Deutsch Judith
Published: February 2025

Distance monitoring of rehabilitation exercises has been primarily conducted using two-way video conferencing. This paper presents a real-time web-based monitoring system that greatly enhances the capability of the clinician to direct rehabilitation therapies.
Validation of a web-based training tool for lumbar puncture
Authors: Moorthy K  , Jiwanji M  , Shah J  , Bello F  , Munz Y  , Darzi A
Published: February 2025

WebSET is an Internet based educational tool that can be used on any standard personal computer. It has been developed by a European collaboration and integrates high quality courseware, self-assessment exercises, video clips and VR simulation. This pilot study was carried out to validate the lumbar puncture (LP) module in training. Subjects who had never performed an LP participated in the study. The subjects were randomized into 2 groups: 1) underwent training and 2) control group. Both groups performed a pre-test and post-test LP on a synthetic mannequin. There was a significant improvement in the training group in terms of performance assessment as compared to the control group. This study showed that there was a significant improvement in the performance of the procedure and in procedural knowledge after training with WebSET.
Online Training Evaluation in VR Simulators Using Gaussian Mixture Models
Authors: de Moraes Ronei Marcos  , Santos Machado Liliane dos
Published: February 2025

A new approach to evaluate training in simulators based on virtual reality is proposed. This approach uses Gaussian Mixture Models (GMM) for modeling and classification of the simulation in pre-defined classes of training.
An implementation of a virtual patient record using web services
Authors: Malamateniou F.  , Vassilacopoulos G.
Published: February 2025

Virtual patient records provide a means for integrated access to patient information that may be scattered around different healthcare settings. Within the boundaries of a health district providing all levels of care, this concept can be implemented in a corporate Intranet environment to support longitudinal patient care activities across the participating healthcare providers. In this context, a virtual patient record implementation enables autonomous healthcare providers to operate in a cooperative working environment and apply continuity of care. Workflow and web services technologies provide an appropriate infrastructure for satisfying collaboration and coordination requirements by integrating heterogeneous healthcare applications and by automatically routing the medical information needed to authorized actors in a healthcare process. This paper presents a virtual patient record architecture that allows integrating geographically dispersed medical information within a health district and enhancing collaboration and coordination of authorized workgroups using workflow and web services technologies. An implementation of the proposed architecture is also presented
Cardiovascular Risk Calculators: Understanding Differences and Realising Economic Implications
Authors: Quaglini Silvana  , Stefanelli Mario  , Boiocchi Lorenzo  , Campari Fabio  , Cavallini Anna  , Micieli Giuseppe
Published: February 2025

In recent years, the concept of “global cardiovascular risk assessment” has grown in interest for its role in primary prevention of cerebro-cardiovascular diseases. Interventions for reducing the risk of relapse for persons with past history of these diseases are well agreed-on. On the contrary, the risk status of persons without such a history varies greatly, and this variability implies a range in the intensity of interventions. In several countries, guidelines for general practitioners have been diffused about pharmaceutical prescriptions in presence of various risk degrees. In particular, in Italy, a governmental drug management commission has established that statins, the most used cholesterol lowering medicines, can be refunded by the National Healthcare System only if prescribed to hyper-cholesterol patients with a global risk greater than 20%. The question is: how to calculate the risk? We performed a review of both the web and the literature and we found a lot of different “risk calculators”. By means of a simulation study, we showed that these tools, when applied to the same person, may lead to very different results. We estimated the economic impact of using one or another calculator.
Archetypes and the EHR
Authors: Beale Thomas
Published: February 2025

The health information systems of today lack many of the desirable characteristics for clinical care or cost-effective data management which are required for shared care in an ever-changing domain. One of the most important aspects of the clinical information environment is knowledge, as distinct from information. This paper describes how small constraint models of domain concepts, known as archetypes, can be added to the knowledge environment, significantly improving interoperability, software economics and quality of care.
High Level Security Policies for Healthcare Information Systems
Authors: Katsikas Sokratis  , Kokolakis Spyros
Published: February 2025

Healthcare Establishments (HCE) have are today highly dependent upon Information and Communications Technologies (ICT). This increasing reliance upon ICT has stressed the need to foster security in Healthcare Information Systems (HIS). Security policies may have a significant contribution to this effort, but they could become the cause of portability and interoperability problems. Moreover, policies that fail to take into account all the aspects of HIS security, the legal and regulatory requirements, and the existence of several stakeholders may lead to ineffective or inefficient security measures. Policies of a special category, named Generic Security Policies (GSPs), should be developed to provide policy-level harmonisation and guidance to policy-makers within HCEs. Five such policies are comparatively reviewed herein.
Implementation of TeleCare Services: Benefit Assessment and Organisational Models
Authors: Stroetmann Karl A.  , Stroetmann Veli N.  , Westerteicher Chris
Published: February 2025

All industrial societies are ageing. This has profound socio-economic and health sector implications. Innovative services based on Information Society Technologies (IST), like telehomecare are regarded as promising avenues to follow both to allow (national) health Systems to cope with these challenges and to improve the quality of life of chronically ill and frail older Citizens. The aim of the TEN-HMS project is to convincingly prove that telemonitoring of congestive heart failure (CHF) patients at home can improve medical outcome for these patients as well as their quality of life and the efficiency of healthcare delivery processes. But this will not (yet) be enough for the sustained success of such a service. Unless it takes into account the interests of the various players in the health care arena and a long-term Business Case can be proven, it will be very difficult to integrate such services into routine health care delivery processes. Before developing concrete delivery models for such a telemonitoring service, the “players” directly involved in such a service need to be identified - customers/patients, health services providers, IT services suppliers, and public/private insurance funds as payers - and their assessment perspectives considered. Then four concrete telemonitoring delivery models and their probability of success are discussed. Our analysis suggests that telemonitoring will presently only be successful if the service delivery model applied reflects national health system idiosyncrasies, takes into account established organisational boundaries and adapts to patient quality of life and health professional preferences. In the longer term, the new paradigm of seamless, patient-centred care will, however, require new, more efficient service delivery models integrating all aspects of the health services value chain.
Architecture and Tools for Open, Interoperable and Portable EHRs
Authors: Blobel Bernd
Published: February 2025

Electronic Health Record (EHR) Systems provide the kernel application of health information Systems and health networks which should be independent of complexity, localisation constraints, platforms, protocols, etc. Based on shared care information Systems' requirements for high level interoperability, a generic component architecture has been introduced. For implementing, running and maintaining acceptable and useable health information Systems components, all views of the ISO Reference Model – Open Distributed Processing have to be considered. Following the Model Driven Architecture paradigm, a reference model as well as concept-representing domain models both independent of platforms must be specified, which are combined and harmonised as well as automatically transferred into platform-specific models using appropriate tools.
Automated Kinematic Generator for Surgical Robotic Systems
Authors: Jung David L.  , Dixon Warren E.  , Pin François G.
Published: February 2025

Unlike traditional assembly line robotic systems that have a fixed kinematic structure associated with a single tool for a structured task, nextgeneration robotic surgical assist systems will be required to use an array of endeffector tools. Once a robot is connected with a tool, the kinematic equations of motion are altered. Given the need to accommodate evolving surgical challenges and to alleviate the restrictions imposed by the confined minimally invasive environment, new surgical tools may resemble small flexible snakes rather than rigid, cable driven instruments. Connecting to these developing articulated tools will significantly alter the overall kinematic structure of a robotic system. In this paper we present a technique for real-time automated generation and evaluation of manipulator kinematic equations that exhibits the combined advantages of existing. methods-speed and flexibility to kinematic change – without their disadvantages.
Argonaute 3D: A real-time cooperative medical planning software on DSL network
Authors: Le Mer Pascal  , Soler Luc  , Pavy Dominique  , Bernard Alain  , Moreau Johan  , Mutter Didier  , Marescaux Jacques
Published: February 2025

Today, diagnosis of cancer and also therapeutic choice imply many specialized practitioners. They are generally located at different places and have to take the best decision as promptly as possible with the difficulty of CT-scan or MRI interpretation.
LR-Spring Mass model for Cardiac Surgical Simulation
Authors: Mosegaard Jesper
Published: February 2025

The purpose of the research conducted was to develop a real-time surgical simulator for preoperative planning of surgery in congenital heart disease. The main problem simulating procedures on cardiac morphology is the need for a large degree of detail and simulation speed. In combination with a demand for physically realistic real-time behaviour this gives us tradeoffs not easily balanced. The LR-Spring Mass model handles these constraints by the use of domain specific knowledge.
Virtual Patients in Clinical Medicine
Authors: Simo Altion  , Cavazza Marc  , Kijima Ryugo
Published: February 2025

Virtual Patients are an essential component of medical virtual reality. Most work to date has been dedicated to virtual patients in surgery. However, virtual patients also have a strong potential in clinical medicine, where they can be used as visual interfaces to knowledge-based systems in various simulation and training applications. In this paper, we describe the implementation of a virtual patient in the field of cardiac emergencies and propose directions to extend the development of virtual patients towards the integration of multiple physiological sub-systems.
Reconstruction and Enhancement in Monocular Laparoscopic Imagery
Authors: Caban Jesus J.  , Seales W. Brent
Published: February 2025

Constrained minimally-invasive surgical environments create a number of challenges for the surgeon and for automated tools designed to aid in the performance and analysis of complex procedures. The 3D reconstruction of the operative field opens up a number of possibilities for immersive presentation, automated analysis, and post-operative evaluation of su gical procedures.
Validation of Soft Tissue Properties in Surgical Simulation with Haptic Feedback
Authors: Sur Hariom  , Faraci Alessandro  , Bello Fernando
Published: February 2025

Numerous experiments are being conducted to extract soft tissue values for their integration into VR surgical simulations with haptic feedback. Haptic feedback has been shown to be relevant in laparoscopic surgery, however to date no experiments have been conducted to test user sensitivity to changes in soft tissue values in surgical simulations, and how users perception of ‘reality’ differs from experimentally determined soft tissue values. In this study we conduct a series of experiments investigating haptic sensitivity, haptic differentiation and comparing experimental and empirical values.
The use of VR in the treatment of Eating Disorders
Authors: Riva Giuseppe  , Bacchetta Monica  , Cesa Gianluca  , Conti Sara  , Molinari Enrico
Published: February 2025

In the treatment of eating disorders, the cognitive behavioral therapy (CBT) is still considered the best approach but could present different limitations related to costs of behavioural procedures (such as exposure and desensitization) or difficulty of cognitive techniques (such as imagination of daily scenarios). The major aim of this contribution is the description of a new Virtual Reality-enhanced treatment named Experiential Cognitive Therapy (ECT). Rationale and protocols about this new approach are explained. Moreover data about clinical trials, carried on with the VEPSY Project, are shown comparing different groups: experimental group (ECT), cognitive-behavioural therapy group (CBT), nutritional group and control group.
A Generic Interface to XML Documents for Guidance Information
Authors: Lewis Bryn
Published: February 2025

We present a generic means of interfacing XML documents and clinical systems. The interface has been developed to allow the integration of best practice guidance information within prescribing systems.
The changes caused by modification of biomechanical properties of a bone
Authors: Binkowski Marcin  , Wróbel Zygmunt  , Dyszkiewicz Andrzej
Published: February 2025

The paper presents the distribution of the parameters of mechanical stiffness in a sample of animal bone. The parameters are measured at different distances from the cortical bone. As it is widely known, bone properties vary significantly depending on the length of the bone. Additionally, the properties of trabecular bone also depend on its distance from the cortical bone. The study presents the results for both samples of normal bone tissue and samples of bone tissue with chemically modified biomechanical properties.
Mobile guidelines for pharmacologic treatment of hypertension
Authors: Eklund Patrik  , Näslund Annica
Published: February 2025

Mobile health technologies provide case studies with potentially rather huge impacts. Examples are provided e.g. by guidelines involving pharmacologic treatment. Knowledge and reasoning need to interact with information management, and often involves utility of various devices. Well organised databases for pharmacological information are also necessary for successful engineering of mobile extensions in these case studies.
Quality management issues for medical ICT
Authors: Dumay A.C.M.  , Freriks G.
Published: February 2025

Information and Communication Technology (ICT) assist healthcare professionals in the process of diagnosis, treatment, monitoring, medication prescription, referral, information retrieval and communication, documentation and transactions. This applies to intramural, transmural and extramural conditions. About 67% of patients involved in safety incidents believe that the incidents could have been prevented had an electronic health record been available. However, preliminary research also suggests that about 30% of patient safety incidents relate to software problems. ICT might improve quality of healthcare provided that ICT products, the ICT administration and use comply to essential requirements. This paper presents information about the state of the art of software quality, the measuring of software quality, quality management systems and a evaluation and certification method.
The Relationship of Usability to Medical Error: An Evaluation of Errors Associated with Usability Problems in the Use of a Handheld Application for Prescribing Medications
Authors: Kushniruk Andre  , Triola Marc  , Stein Ben  , Borycki Elizabeth  , Kannry Joseph
Published: February 2025

This paper describes an innovative approach to the evaluation of a handheld prescription writing application. Participants (10 physicians) were asked to perform a series of tasks involving entering prescriptions into the application from a medication list. The study procedure involved the collection of data consisting of transcripts of the subjects who were asked to “think aloud” while interacting with the prescription writing program to enter medications. All user interactions with the device were video and audio recorded. Analysis of the protocols was conducted in two phases: (1) usability problems were identifiedfrom coding of the transcripts and video data (2) actual errors in entering prescription data were also identified. The results indicated that there were a variety of usability problems, with most related to issues of ease of use. In addition, other problems were identified which were related to limitations of the content of the program. In examining the relationship between usability problems and errors, it was found that certain types of usability problems were closely associated with the occurrence of specific types of errors in prescription of medications. Implications for the improvement of safety of health care information systems are discussed.
Finding the answers in primary care: Information seeking by rural and nonrural clinicians
Authors: Gorman Paul N.  , Yao Patricia  , Seshadri Veena
Published: February 2025

$\underline{Background:}$ Information systems for rural practice may assume that rural clinicians have different information needs, but studies have not directly compared rural and nonrural information needs using common methodology. $\underline{Objective:}$ Compare rural and non-rural: 1) information needs; 2) information seeking; 3) effectiveness of information seeking; and 4) use of information resources. $\underline{Design:}$ Observation and interviews during one halfday of office practice; telephone follow-up 2-10 days later. $\underline{Participants & Setting:}$ Primary care physicians (39), nurse practitioners (42), and physician assistants (22) in ambulatory practices in rural and nonrural Oregon. Measures: 1) number of questions asked, 2) number of questions pursued, 3) number of questions answered), and 4) use of knowledge resources. $\underline{Resuits:}$ Rural clinicians practiced in smaller groups, but were otherwise similar to nonrural clinicians. During half-day interviews, clinicians cared for an average of 8.2 patients (95% CI 7.5 - 8.8) and asked an average of 0.83 questions per patient seen (95%CIO. 73 - 0.92). At follow up, they had pursued an average of 47% of their questions (95% CI40 - 53%), and reported being successful in finding an answer to 77% of those they pursued (95% CI 70 - 84%). There were no statistically significant differences between rural and nonrural clinicians for any of these variables. $\underline{Conclusions:}$ Rural and nonrural clinicians had similar information needs, information seeking, knowledge resource use, and effectiveness at finding answers to their questions. Human consultants, digital resources, and library-based resources were less available, but these differences in availability had little impact on their use.
A Model of Developing Medical Terms in Indigenous Languages: A Step Towards Consumer Health Informatics in South Africa
Authors: Mbananga Nolwazi  , Mniki Sindiswa  , Oelofse Alet  , Makapan Sylvia  , Lubisi Moses
Published: February 2025

This paperpresents a methodology that has been used in the development of medical terms in the indigenous languages of South Africa. Development of medical terms in indigenous languages is the primary step towards Consumer Health Informatics in the country. This process has been driven by, among others, an emerging paradigm shift in patient care management, whereby patients and other members of the community are encouraged to participate in the process of making treatment or management choices regarding their illnesses or health conditions. In view of this change in the health environment, language and understanding seem to playa major role. Without clear communication and understanding between health providers and the consumers of health services, little can be achieved. Language comprehension is invaluable to empower patients to engage in the decision-making process regarding their health problems. African languages in South Africa do not have equivalent health or medical terms used in patient-doctor communication. This limits the patients' understanding and ability to make informed choices. The project on developing health Imedical terms (ongoing) has created a methodology of how to develop medical terms in indigenous languages which will need a validity test.