bluuebunny/crossref_metadata_2025 huggingface dataset:
Intelligent Systems For Nursing Education
Authors: Kokol Peter  , Brumec Viljem  , Habjanič Ana  , Turk Dušanka Micetić  , Procter Paula  , Nicklin Linda
Published: February 2025

Health care is one of the fastest growing areas in terms of care, treatment and the exploitation of new technology in Slovenia. There is a great need for new approaches ensuring that education and work of health care professionals will be built upon the state of the art in nursing. As a consequence the educational, governmental and “industrial” institutions from Slovenia, UK, Italy and Greece have determined to work on above problem. EU agreed to support the project under the Phare Tempus Framework and the aim of this paper is to present an educational approach based on intelligent systems and its application in nursing education.
Meeting Education and Training Needs in the New NHS: Optimizing Flexibility and Harnessing New Technology
Authors: Buckner Kathy  , Richardson Rosemary
Published: February 2025

This poster describes the approach used by PACE (Partnerships in Active Continuous Education at Queen Margaret University College) to identify training needs and implement effective open and flexible learning (OFL). The importance of contextualised learning is emphasised. An approach to the support of a community of learners and facilitators is demonstrated. Finally the potential for exploiting new developments in mobile technology, storage media, conferencing techniques and computing embedded in everyday objects in relation to the delivery of open and flexible learning is explored.
Systematic Evaluation of Computer-Based Nursing Documentation
Authors: Ammenwerth Elske  , Kutscha Ansgar  , Eichstädter Ronald  , Haux Reinhold
Published: February 2025

The documentation of the nursing process is an important, but often neglected part of clinical documentation. Paper-based systems have been introduced to support nursing process documentation. Frequently, however, problems, such as low quality, are reported and it is still unclear if computer-based documentation systems can reduce these problems.
Adaptation of the Critical Incident Technique to Requirements Engineering in Public Health
Authors: Ölvingson Christina  , Hallberg Niklas  , Timpka Toomas  , Greenes Robert A.
Published: February 2025

The introduction of modern information systems in public health provides new possibilities for improvements in public health services and hence also of populations' health. However, development of information systems that truly supports public health practices requires that technical, cognitive, and social issues be taken into consideration. In requirements engineering for public health, a notable problem is that of capturing all aspects of the future users’ ‘voices’, i.e., the viewpoints of different public health practitioners. Failing to capture these voices will result in inefficient or even useless systems. The aim of this paper is to report a requirements-engineering instrument to describe problems in the daily work of public health professionals. The issues of concern thus captured can be used as the basis for formulating the requirements of information systems for public health professionals.
Academic and Commercial Development of Open Source Applications in International Health Informatics
Authors: Pepper D.R.  , Ellis N.T.
Published: February 2025

Whilst covertly in the past many ideas developed in academic environments have made their way into commercial applications, there is growing acknowledgment that this model may be necessary for both funding academics and for project enrichment in private ventures. This paper seeks to explore and expound on the various prèssures related to protocol development and the creation of a MAP (Multiphasic Algorithimic Protocol) Engine as a commercial venture based on an evolution from an academic environment, into a service oriented commercial product. It has been determined in a series of symposia that an Object Oriented; Open Source (OS) environment may best meet the needs for this endeavor. Numerous barriers and agreements remain, and explorations of these will, we believe, bring out the best of both sides of the coin – reflecting the strengths of both cultures.
Enhanced Security Services for Enabling Pan-European Healthcare Networks
Authors: Blobel Bernd  , Pharow Peter  , Engel Kjeld
Published: February 2025

Establishing the Shared Care environment, communication and co-operation between healthcare establishments involved must be provided in a trustworthy way. This challenge is even more important for health networks using the Internet. In that context, services assuring both communication security and application security must be provided. Especially in the e-health environment, additionally to identity-related services certifying data or properties of principals, trustworthiness or authorisation for objects, components and functions must be established by Trusted Third Parties (TTP). Within the European Commission's Information Society Technologies (IST) Programme, the HARP project provides the “HARP Cross-Security Platform (HCSP)” needed in the open Web environment of pan-European networks. The solutions are under implementation and evaluation in the German ONCONET enabling a trustworthy framework for both health professionals and patients as well as supporting clinical studies.
Electronic Signature and Certification Models in Health Care
Authors: De Meyer F.  , De Moor G. J. E.  , Roger France F. H.
Published: February 2025

Recently, Belgian legislation has enabled the practical use of electronic signatures. Several implementation options are still open and different models for deployment on a wide scale are possible. This document describes two models that can be applied to the healthcare domain and summarises the recommendations as issued by the Belgian Health Telematics Standards Committee
Expert Systems, Security and Quality Assurance: Implications of Patient Records as Data-Space
Authors: Kluge Eike-Henner W.
Published: February 2025

The concept of data-space is fruitful in trying to understand the ethical rights and duties that surround the treatment of patient records. However, it also provides a solution to three apparently unconnected problems: the construction of expert diagnostic systems, the development of an internal security element within the sphere of permitted data-access for health care professionals, and the development of a professional quality assurance mechanism. This paper presents a model of how these diverse aims may be achieved. It does so by developing the notion of the logical form of data within a data-space and by showing how the path taken by a health care professional through a profession-relative data-space can provide checks for the security, quality and appropriateness of the path itself. The result is important in that it provides an integrated method for information specialists to meet their fiduciary obligations towards the patients whose records are in their care, and towards the institutions that employ them.
A Formal Framework for Modelling and Validating Medical Systems
Authors: Eleftherakis George
Published: February 2025

Medical computerised systems which have a major effect on human lives (e.g. those used for diagnosis, therapy, surgery, in the intensive care units, etc) are considered as safety critical systems. Such systems are sometimes responsible for major damages and injuries due to unpredicted malfunction. Misleading user requirements, errors in the specification and in the implementation are the usual reasons responsible for non-safe systems. This paper advocates the use of an integrated formal framework based on a computational machine (X-Machine), in the development of safety critical medical systems. This formal framework gives the ability to intuitively as well as formally model a system, then automatically check if the produced model has all the desired properties, and finally test if the implementation is equivalent to the specification by applying a complete set of test cases. Therefore, the use of this framework in the development of systems in safety critical medical domains can assure that the final product is valid with respect to the user requirements by revealing errors during the whole development life cycle and subsequently add to the confidence of their use. The proposed framework is accompanied by an example, which demonstrates the use of X-Machines in specification, testing and verification.
Diagnosis Supporting Rules of the Hepar System
Authors: Bobrowski Leon  , Wasyluk Hanna
Published: February 2025

The “Hepar” system comprises a clinical database and the shell of procedures that aim at data analysis and the support of diagnosis. The database consists of hepatological patient cases. Each case is described by about 200 medical findings and histopathologically verified diagnosis. The diagnosis supporting rules of “Hepar” are based on visualizing data transformations and on the similarity based techniques. The applied linear visualizing transformations of data sets on the plane aim at separatintg of the groups of patients associated with different diseases. The resulting diagnostic maps by the visual inspection allow to find such cases in the database that are similar to the previously diagnosed patients. This paper examines combining of data transformations with the nearest neighbors techniques in the support of diagnosis. We report the results on the experimental comparisons of different decision rules including the feature selection procedure.
UMIN – Key Information Infrastructure for the Japanese Medical Community
Authors: Kiuchi Takahiro  , Ohe Kazuhiko  , Sakurai Tsunetaro
Published: February 2025

University hospital Medical Information Network (UMIN) was established in 1989 as a collaborative project of national university hospitals in Japan funded by the Ministry of Education, Science, Sports, and Culture, and it started its Internet-based service for medical professionals in 1995. Since then, many services including those for academic societies and research groups have been added. Currently, due to batch registration of the members of large academic societies, the number of registered users and Web accesses are rapidly increasing (about 87, 000 registered users and 4,500,000 page views in November, 2000). More than one hundred homepages of academic societies and research groups (including forty- two member-only ones) and one thousand mailing lists are operated. More than one hundred thirty academic societies collect abstracts using the UMIN server. All the Internet-based clinical and epidemiological research projects in Japan are now under way using UMIN. The characteristics of UMIN are its large variety of services and large number of user accounts of medical professionals, which are beneficial to both users and information service providers. UMIN is now important for some medical specialties and will be so for further ones in the future. UMIN is, in fact, evolving into a collaborative project of the Japanese medical community and is considered as its key information infrastructure.
Sharing Medical Data for Patient Path Analysis with Data Mining Method
Authors: Le Duff Franck  , Happe André  , Burgun Anita  , Levionnois Sophie  , Bremond Marc  , Le Beux Pierre
Published: February 2025

The Agora Data project started in October 1997 in France. The objective was to share medical data between several medical institutions to analysis medical care pathways for patients that suffer from low back pain. The analysis of the medical records decomposed in three steps allowed us to produce knowledge on medical contacts of patients with the health care system. In order to study the relations between these contacts, we created medical path of patients within the framework of the possible contacts we had isolated. This work relates the implementation and the first results of the pilot study.
Domain Analysis and Modeling to Improve Comparability of Health Statistics
Authors: Okada Mihoko  , Hashimoto Hideaki  , Ohida Takashi
Published: February 2025

Health statistics is an essential element to improve the ability of managers of health institutions, healthcare researchers, policy makers, and health professionals to formulate appropriate course of reactions and to make decisions based on evidence. To ensure adequate health statistics, standards are of critical importance. A study on healthcare statistics domain analysis is underway in an effort to improve usability and comparability of health statistics. The ongoing study focuses on structuring the domain knowledge and making the knowledge explicit with a data element dictionary being the core. Supplemental to the dictionary are a domain term list, a terminology dictionary, and a data model to help organize the concepts constituting the health statistics domain.
Constructing Influence Views from Data to Support Dynamic Decision Making in Medicine
Authors: Qi XinZhi  , Leong Tze-Yun
Published: February 2025

A dynamic decision model can facilitate the complicated decision-making process in medicine, in which both time and uncertainty are explicitly considered. In this paper, we address the problem of automatic construction of a dynamic decision model from a large medical database. Within the DynaMoL (a dynamic decision modeling language) framework, a model can be represented in influence view. Thus, our proposed approach first learns the structures of the influence view based on the minimal description length (MDL) principle, and then obtains the conditional probabilities of the model by Bayesian method. The experiment results demonstrate that our system can efficiently construct the influence views from data with high fidelity.
CHESS: Ten Years of Research and Development in Consumer Health Informatics for Broad Populations, Including the Underserved
Authors: Gustafson David H.  , Hawkins Robert P.  , Boberg Eric W.  , McTavish Fiona  , Owens Betta  , Wise Meg  , Pingree Suzanne
Published: February 2025

This paper reviews the research and development around a consumer health informatics system CHESS (The Comprehensive Health Enhancement Support System) developed and tested by the Center for Health Systems Research and Analysis at the University of Wisconsin. The review will place particular emphasis on what has been found with regard to the acceptance and use of such systems by high risk and underserved groups.
Children's Health at the Heart of Health Care
Authors: Copping Marina  , Sturgeon John
Published: February 2025

A clinically led information needs analysis was carried with health visitors over a three-month period using questionnaires and focus groups. This analysis identified three key areas of need - improved communication tools, centralising of disparate data sources related to child health e.g. screening data, and minimal data collection. These needs have now been met in full. This led to the development of a Clinical Information System (CIS).
Professionals' Perceptions of a Patient Information Management System for Multiprofessional Teamwork, Patient Focused and Seamless Care
Authors: PyykkÖ Virpi  , Saranto Kaija
Published: February 2025

The purpose of this paper is to describe the outcomes of the survey made before the implementation phase of an electronic patient information management system. The data were gathered using a questionnaire compiled for this study. The amount of 97 health care professionals with different backgrounds participated the survey. According to results the respondents have positive attitudes towards the information system implementation. The realization of seamless care was estimated to be a great advantage compared to manual system.
Empirical Formulation of a Generic Query Set for Clinical Information Retrieval Systems
Authors: Cucina Russell J.  , Shah Maulik K.  , Berrios Daniel C.  , Fagan Lawrence M.
Published: February 2025

Information needs in clinical practice take the form of specific questions about a given clinical situation, and are best satisfied by concise and specific information retrieval. We sought to develop a comprehensive set of generic queries for information retrieval from electronic medical information resources. We collected one hundred and ten real-world questions asked at the point of care in a variety of settings, and from these developed a set of generic queries of which each of the real-world queries could be shown to be a special case. To provide allowed values for each of the concept terms in the queries, we defined generic nouns as unions of UMLS semantic types, and specified which of these were appropriate to each query. We have begun to use the set to index reference texts from general and subspecialty medicine, and found it capable of full text indexing in the clinical domain. We hypothesize that the query set can serve as a basis for more specialized query sets, and that it will remain generalizable to other electronic medical resources, indexing tasks, and non- UMLS controlled vocabularies.
An Approach to Guideline Implementation with GEM
Authors: Shiffman Richard N.  , Agrawal Abha  , Deshpande Aniruddha M.  , Gershkovich Peter
Published: February 2025

Implementation of practice guidelines refers to the creation of strategies and systems to operationalize the knowledge and recommendations set forth by guideline developers. We describe an approach to guideline implementation that makes direct use of the guideline document as a knowledge base. The Guideline Elements Model (GEM) provides an XML-based guideline document model that facilitates implementation of guidelines. Knowledge extraction using GEM requires document markup rather than programming and can promote authenticity and consistent knowledge encoding. Knowledge customization for the local enterprise requires addition of meta-information to pertinent components of the GEM hierarchy in a design database. GEM provides an audit trail to track local adaptation. Knowledge integration with patient data can be promoted using information management services. A design goal is to devise a system that can be applied by local clinical domain experts, quality assurance experts, and information systems programmers without requiring trained informaticians and knowledge engineers to serve as intermediaries
A Multilingual Medical Thesaurus Browser for Patients and Medical Content Managers
Authors: Göbel Georg  , Andreatta Stefan  , Masser Joachim  , Pfeiffer Karl Peter
Published: February 2025

This paper introduces a user-friendly browser interface which integrates multilingual search and browsing functionalities within medical thesauri via the internet. The tool is being developed as part of the GIN Austria Patient Information System and is based on an adapted datamodel of the MeSH thesaurus. A prototype offers the possibility to build up queries and export lists of MeSH main headings collected during browsing the relevant MeSH trees. The thesaurus browser can be used both by patients and citizens to build queries based on a controlled vocabulary to match them with existing documents within GIN and by medical information managers to find out appropriate keywords for interactive tagging or indexing of medical contents. A key component of this tool is the flexible choice of different languages of the MeSH datasource as well as of the user interface. Both can be changed independently at any point during a session. Another central aspect is the use of the UMLS Metathesaurus in combination with localized Thesaurus versions due to existing international character set problems.
A New Approach to the Concept of “Relevance” in Information Retrieval (IR)
Authors: Kagolovsky Yuri  , Möhr Jochen R.
Published: February 2025

The concept of “relevance” is the fundamental concept of information science in general and information retrieval, in particular. Although “relevance” is extensively used in evaluation of information retrieval, there are considerable problems associated with reaching an agreement on its definition, meaning, evaluation, and application in information retrieval. There are a number of different views on “relevance” and its use for evaluation. Based on a review of the literature the main problems associated with the concept of “relevance” in information retrieval are identified. The authors argue that the proposal for the solution of the problems can be based on the conceptual IR framework built using a systems analytic approach to IR. Using this framework different kinds of “relevance” relationships in the IR process are identified, and a methodology for evaluation of “relevance” based on methods of semantics capturing and comparison is proposed.
Automatic Extraction of Acronym-meaning Pairs from MEDLINE Databases
Authors: Pustejovsky James  , Castaño José  , Cochran Brent  , Kotecki Maciej  , Morrell Michael
Published: February 2025

Acronyms are widely used in biomedical and other technical texts. Understanding their meaning constitutes an important problem in the automatic extraction and mining of information from text. Here we present a system called ACROMED that is part of a set of Information Extraction tools designed for processing and extracting information from abstracts in the Medline database. In this paper, we present the results of two strategies for finding the long forms for acronyms in biomedical texts. These strategies differ from previous automated acronym extraction methods by being tuned to the complex phrase structures of the biomedical lexicon and by incorporating shallow parsing of the text into the acronym recognition algorithm. The performance of our system was tested with several data sets obtaining a performance of 72 % recall with 97 % precision. These results are found to be better for biomedical texts than the performance of other acronym extraction systems designed for unrestricted text.
Patient and Clinician Vocabulary: How Different Are They?
Authors: Zeng Qing  , Kogan Sandra  , Ash Nachman  , Greenes Robert A.
Published: February 2025

Consumers and patients are confronted with a plethora of health care information, especially through the proliferation of web content resources. Democratization of the web is an important milestone for patients and consumers since it helps to empower them, make them better advocates on their own behalf and foster better, more-informed decisions about their health. Yet lack of familiarity with medical vocabulary is a major problem for patients in accessing the available information. As a first step to providing better vocabulary support for patients, this study collected and analyzed patient and clinician terms to confirm and quantitatively assess their differences. We also analyzed the information retrieval (IR) performance resulting from these terms. The results showed that patient terminology does differ from clinician terminology in many respects including misspelling rate, mapping rate and semantic type distribution, and patient terms lead to poorer results in information retrieval.
Data Quality Measurement and Assurance in Medical Registries
Authors: Arts D.G.T.  , de Keizer N.F.  , de Jonge E.
Published: February 2025

The value of a medical registry strongly depends on the quality of the data contained in the registry. The first objective of this study was to develop a model for measuring and quantifying data quality in medical registries. In addition, we developed a framework of procedures for the organisation of high quality data collection in medical registries. This framework can be used to identify points in the organisation of data collection that need to be adjusted in order to improve data quality. The quality measurement model and the quality assurance framework have been used for analysis of data quality and data collection procedures in the National Intensive Care Evaluation (NICE) registry.
A Before-After Study Using OncoDoc, a Guideline-Based Decision Support-System on Breast Cancer Management: Impact upon Physician Prescribing Behaviour
Authors: Bouaud Jacques  , Séroussi Brigitte  , Antoine Éric-Charles  , Zelek Laurent  , Spielmann Marc
Published: February 2025

-4) to reach 85.03% after using the system. Comparison of initial and final decisions showed that physicians modified their prescription in 31 % of the cases. Clinical trial accrual rate increased of 50%, though not statistically significant because estimated on small figures.
Neural Network and Wavelet Recognition of Facial Electromyographic Signals
Authors: Laakso Jouni  , Juhola Martti  , Surakka Veikko  , Aula Anne  , Partala Timo
Published: February 2025

The present aim was to explore the possibilities of using neural networks for recognizing significant changes in electrical activity of human facial muscles. We used multilayer perceptron neural networks to recognize bursts of electromyographic signals recorded with bipolar surface electrodes from two subject’s facial muscles. Wavelets were applied for the detection of high frequency components of electromyographic signals. Coefficients of wavelets were used as an input to a neural network in order to differentiate bursts from the signals. The results showed that the recognition of bursts was very successful resulting to 84-97 percent total accuracies. The results were very encouraging and suggest further that the measurement of facial muscle activity may be a potentially useful computer input signal, for example, for affective computing which can be seen as a future versatile interaction between the computer and the user.
Employment of Intra-Individual Variability to Improve Computerized ECG Interpretation
Authors: Schijvenaars Bob J.A.  , Kors Jan A.  , van Herpen Gerard  , van Bemmel Jan H.
Published: February 2025

One of the reasons for the limited practical utility of computer programs for interpretation of electrocardiograms (ECGs) is their susceptibility to intraindividual variability. Two of the most prominent sources of intra-individual variability in ECGs, electrode placement variations and respiration, were studied for their effects on computerized ECG interpretation. Previous research has shown that the effects of intra-individual variability on computerized ECG interpretation depend largely on the individual ECG. To enable the assessment of chest electrode position variations for individual standard 12-lead ECGs, ECGs resulting from simulations of such position variations were interpreted. Variability due to respiration was assessed by interpretating all individual ECG beats instead of an averaged beat.
A Prototype Decision Support System for MR Spectroscopy-Assisted Diagnosis of Brain Tumours
Authors: Underwood Joshua  , Tate A. Rosemary  , Luckin Rosemary  , Majós Caries  , Capdevila Antoni  , Howe Franklyn  , Griffiths John  , Anús Caries
Published: February 2025

Our objective is to develop a decision support system that improves the accuracy of non-invasive brain tumour diagnosis and grading by enabling radiologists to use data from Magnetic Resonance Spectroscopy (MRS). The system, which uses pattern recognition techniques, is trained on a validated database of spectra and associated clinical information to provide automated classification of spectra from brain tumours. An innovative user-interface presents classification results as a two-dimensional overview plot in which points representing cases of different diseases form distinct clusters. Users can inspect any cases in these plots and compare them with the new, unknown spectrum. Hence, the overview plot can both communicate the classification of a case and help provide explanation for that classification in part by supporting human case-based reasoning. This paper describes the development of a prototype system implemented in JA VA.
Degree of Patient Complaints and Its Influence on Clinical Diagnosis
Authors: Fujimoto Shinichi  , Danno Daisuke  , Fujimoto Takashi  , Matsumura Masahiko  , Kanno Masatoshi  , Maeda Kouichi  , Nakamura Shinobu
Published: February 2025

The doctor patient relationship is an important factor in the decision making process of clinical medicine. Evaluating the degree of complaints is sometimes a crucial problem for general clinics. However, we have no scale for measuring the degree of complaints. In the present study we attempted to make a scale for grading the degree of complaints. We continuously evaluated 116 new patients at our outpatient clinics and graded the degree of complaint on the basis of the influence to the history taking process. 90 patients had a normal degree of complaint, however 18 cases had a relatively high degree of complaints and 8 cases had lower degrees of complaints. Patients with a high degree of complaints tended to consult additional divisions. Patients with lower degrees of complaints tended to drop out during the follow-up period. To obtain a grade for the degree of patient complaints could be useful for efficient clinical diagnosis.
Object-oriented Business Process Analysis of the Cooperative Soft Tissue Sarcoma Trial of the German Society for Paediatric Oncology and Haematology (GPOH)
Authors: Weber Ralf  , Knaup Petra  , Knietig Robert  , Haux Reinhold  , Merzweiler Angela  , Mludek Volker  , Schilling Freimut H.  , Wiedemann Timm
Published: February 2025

The German Society for Paediatric Oncology and Haematology (GPOH) runs nation-wide multicentre clinical trials to improve the treatment of children suffering from malignant diseases. We want to provide methods and tools to support the centres of these trials in developing trial specific modules for the computer-based DOcumentation System for Paediatric Oncology (DOSPO). For this we carried out an object-oriented business process analysis for the Cooperative Soft Tissue Sarcoma Trial at the Olgahospital Stuttgart for Child and Adolescent Medicine. The result is a comprehensive business process model consisting of UML-diagrams and use case specifications. We recommend the object-oriented business process analysis as a method for the definition of requirements in information processing projects in the field of clinical trials in general. For this our model can serve as basis because it slightly can be adjusted to each type of clinical trial.
XML-Based Application Interface Services – A Method to Enhance Integrability of Disease Specific Systems
Authors: Altmann Udo  , Tafazzoli Ali Gerhard  , Katz Frank Rüdiger  , Dudeck Joachim
Published: February 2025

Disease specific systems usually offer excellent functionality for the management of the covered diseases. But the restriction to a certain disease also often hampers their wide spread use since they aren’t optimised for clinical workflow. The Gießener Tumordokumentationssystem (GTDS) is such a disease specific system. It is not only designed for the use in tumour registries but also to support clinical care. In order to integrate it into hospital information systems, we implemented standard communication interfaces, but this measure is not sufficient since it doesn’t consider aspects of the normal workflow of a clinical user. Therefore, we developed a strategy that should ease the access to the system in the environment of existing systems. From the technical point of view, XML with its capabilities to represent even complex data in a rather simple way helped to implement this strategy. We use it to communicate with API-like services and also created a WWW environment to demonstrate the access to these services. Since this environment itself is a means to integrate systems, we intend to expand this environment to an appropriate region based means to improve the communication with registries.
Structured Data Entry of Clinical Information for Documentation and Data Collection
Authors: Cheung N.T.  , Fung Vicky  , Chow Y.Y.  , Tung Y.
Published: February 2025

Routine databases containing large amounts of clinical data represent a tremendous opportunity for the evaluation of health care practices and outcomes. However, data collected for administrative purposes has limitations in content, accuracy and completeness. Routine entry of clinical information directly into clinical information systems by care providers is one strategy to address this problem. We developed a structured data entry method, the Clinical Data Framework (CDF), which has been used to support the capture of clinical information by clinicians in the normal process of care delivery. A study of the CDF over a two month period showed that it improved the accuracy of completeness of data collection over a coding method which was based on selection of ICD-9-CM codes.
Meta-Modelling: The Appropriate Solution for a Family of Applications
Authors: Huet Bernard  , Artigou Jacques-Yves  , Pokier Jérôme  , Blain Gilles
Published: February 2025

The aim of this paper is to present an appropriate framework able to generate models and to implement them, in the objective of computerizing a family of medicotechnical reports. The accelerated rate of technical development makes it necessary to design computerized applications independently of data-processing technology. This apparent paradox is a quite real challenge which needs research and development software environments to support frameworks. In this article, we present a metamodel (i.e. a generic structure — supported by the Méta-Gen software tool) ) which is able to generate various models of medico-technical reports. These models in turn are able to generate various types of instances. This meta-model is a “Meta-medical record”, it is constituted of basic concepts : « User Semantic Group » to which are attached a set of «sentence-type», a set of several corpus of variables with a set of graphs (“navigators”). Five models (echocardiography for hospital “A”, echocardiography for hospital “B”, gastroscopy, fibercoloscopy A.E.P). were already generated from this “Meta-Medical Record”. A beginning of implementation in echocardiography report is presented here. The advantages are a very thorough personalization of the document for the user, and a greater independence of the design diagram from the technological platform.
Building the Basics of a Unified Healthcare Information System in Hungary
Authors: Békési László  , Simon Pál  , Loványi István  , Kellner Dénes
Published: February 2025

A project is about to start in Hungary aiming to create the overall design and some concrete components as well of a unified national public health information system. The goal of the project is to build-up a unified information base structure (Public Health Middleware and Bitpath Layers), including portable record structures, virtual workstations, problem-oriented information services and related IT solutions.
New Millennium Hospital Management Information System: Experience of the National Cancer Institute – Cairo University
Authors: Hattab Omar El
Published: February 2025

The National Cancer Institute-Cairo University (NCI) is a leading cancer center in the Middle East and Africa. It serves more than 15,000 new cases and more than 250,000 patient visit every year. The implementation of its Hospital Management Information System was completed and the system was operational in 1992. Although different modules were added to the HMIS, the core of the system has never been changed or updated. NCI evaluated its current system. NCI also evaluated the modern tools in databases and programming. NCI came to the conclusion that a new HMIS need to be installed. The needs of NCI staff were analyzed with consideration to budget issues and the limitations of a developing country. Different hardware, networking and software issues had to be considered in the updating. Arabization and customization were main factors in decision making.
From Data to Knowledge - the Visible Human Project Continues
Authors: Ackerman Michael J.  , Yoo Terry  , Jenkins Donald
Published: February 2025

The U S. National Library of Medicine (NLM) has long been a world leader in the archiving and distribution of the print-based images of biology and medicine. NLM has also been a pioneer in the use of computer systems to encode and distribute textual knowledge of the life sciences. NLM's Long Range Planning effort of 1985-86 foresaw a coming era where NLM's Bibliographic and factual database services would be complemented by libraries of digital images, distributed over high speed computer networks. The NLM Planning Panel on Electronic Imaging recommended that NLM should undertake the building a digital image library consisting of computerized tomography (CT) and magnetic resonance (MR) images, and cryosection images of a representative, carefully selected and prepared male and female cadaver -- the “Visible Human Project®.” The male and female Visible Human data sets are now being made available through a license agreement with the NLM. The data sets are supporting a wide range of educational, diagnostic, treatment planning, and commercial uses. The NLM, in partnership with other U.S. government research agencies has begun a three prong effort within the Visible Human Project to address: the creation of a new online, interactive, digital head-and-neck atlas; the development of a tool kit of computational programs capable of automatically performing many of the basic data handling functions required for using Visible Human data in applications; and the improved resolution of future Visible Human data sets through the reduction of the anatomical artifacts introduced by the methods used to stabilize and section the anatomical materials and the development of staining and wide-spectrum methods for increasing tissue contrast.
Inference and Prediction of Courses of the Diseases Caused by Pathologic Viruses by Estimating Molecular Evolution of Within-host Virus
Authors: Ren Fengrong  , Ogishima Soichi  , Tanaka Hiroshi
Published: February 2025

A new approach for inferring the evolutionary process of within-host virus is presented in this study. This approach includes a sequential-linking algorithm developed by us that can deal with the sequential viral samples that are obtained at different time points from the same host, and reconstruct a longitudinal phylogenetic tree in which the evolutionary relations between viral variants can be shown. A codon-based model, which uses a Markov process to describe substitutions between codons, is also employed in this approach to calculate synonymous and nonsynonymous substitution rates and to distinguish positive selection and neutral evolution. The approach is applied to a data set of the V3 region of the HIV-1 envelope genes sequenced in different years after infection of a single patient. The results suggest that this approach may provide a more realistic description of viral evolution than the traditional evolution models because it accounts for both neutral and adaptive evolution. Most important of all, since this approach make it possible to follow up the evolutionary process of within-host virus by analyzing the sequential viral samples, it could be used in inference and prediction of the course of the diseases caused by pathologic viruses and evaluation of the treatment.
Achieving Reuse of Computable Guideline Systems
Authors: Johnson Peter  , Tu Samson  , Jones Neill
Published: February 2025

We describe an architecture for reusing computable guidelines and the programs used to interpret them across varied legacy clinical systems. Developed for the PRODIGY 3 project, our architecture aims to support interactive, point of care use of guidelines in primary care. Legacy medical record systems in UK primary care are diverse, using different terminologies, different data models, and varying user-interface philosophies. However, our goal is to provide common guideline knowledge bases and system components, while achieving full integration with the host medical record system, and a user interface tailored to that system. In conjunction with system suppliers, we identified areas of standardization required to achieve this goal. Firstly, standardized interfaces were created for mediation with the legacy system medical record and for act management. Secondly, a standard interface was developed for communication with the User Interface for guideline interaction. Thirdly, a terminology mapping knowledge base and system component was provided. Lastly, we developed a numeric unit conversion knowledge base and system component. The standardization of this architecture was achieved by close collaboration with existing vendors of Primary Care computing systems in the UK The work has been verified by two suppliers successfully building and deploying systems with User Interfaces which mirror their normal look and feel, communicating fully with existing medical records, while using identical Guideline Interpreter components and knowledge bases. Encouragingly further experiments in other areas of clinical decision support have not required extension of our interfaces.
A Cognitive Approach for Designing a Computer-based learning Tool in Dentistry: ODONTOS Application
Authors: Barac'h Victoire  , Shleyer Titus  , Le Duff Franck  , Le Beux Pierre
Published: February 2025

This work emphasises a cognitive approach to build ODONTOS, a computer-based education system in dentistry. It aims at providing for both instructors and students without any particular knowledge in computer programming; a tool dedicated to dental disease learning. For instructors, it implements for knowledge construction e.g. creating and proposing clinical cases according to student learning style, using multimedia technology.
Intraoperative 3D Shape Recovery of Abdominal Organs for Laparoscopic Data Fusion
Authors: Hayashibe Mitsuhiro  , Suzuki Naoki  , Nakamura Yoshihiko  , Hatori Asaki  , Suzuki Shigeyuki
Published: February 2025

Precise measurements of geometry should accompany robotic equipments in operating rooms if their advantages are further pursued. For deforming organs including the liver, intraoperative geometric measurements play an essential role in computer surgery in addition to pre-operative geometric information from CT/MRI. The laser-scan endoscope system acquires and visualizes the shape of the area of interest in a flash of time. Results of in-vivo experiments on the liver of a pig verify the effectiveness of the proposed system. In the next stage, we aim to make a data-fusion in laparoscopy.
Atlas-based segmentation of pathological knee joints
Authors: Heinze Peter  , Meister Dietmar  , Kober Rudolf  , Raczkowsky Jörg  , Wörn Heinz
Published: February 2025

Efficiency, comparability and simplicity are key aspects for user acceptance of surgical planning systems in the long term. Automatic segmentation and identification of geometric reference systems of the anatomical structures are essential to fulfill these requirements. A statistical motivated shape atlas of the knee joint, based on 235 normal and abnormal MR and CT volume sets, is constructed for automatic segmentation of CT image data. In the first step of the atlas construction, the bony structures of the knee were segmented semi-automatically and processed into a dense and a sparse triangulated surface mesh to obtain training data sets. To establish an inter-individual correspondence, a skeleton-based registration method is used. The registered sparse surface meshes are retriangulated to estimate a pointwise inter-individual correspondence. The shape atlas is build upon these correspondences and integrated into a segmentation algorithm. An iterative segmentation scheme is proposed, which consists of a combination of the iterative-closest-point algorithm for spatial registration and of a downhill-simplex optimization procedure for deformation of the statistical motivated shape atlas to the image data. We expect the statistical shape model to be a robust and image modality independent method for the segmentation of pathological knee joints in CT image data.
Visible Korean Human: Another Trial for Making Serially-Sectioned Images
Authors: Kim Jin Yong  , Chung Min Suk  , Hwang Woo Sup  , Park Jin Seo  , Park Hyung-Seon
Published: February 2025

In this ongoing study, we are trying to make Visible Korean Human (Mar 2000 - Feb 2005). The complete MRIs and CTs of the Korean cadaver’s entire body are scanned. The cadaver is serially-sectioned at 0.2 mm thickness without any missing images. The anatomical structures in the sectioned images are segmented. The Visible Korean Human is expected to be more helpful than Visible Human in the following ways. First, the Korean data will be more helpful in diagnosing and treating the patients belonging to the yellow race. Second, MRIs and CTs of the entire body at 1 mm thickness will be more helpful in studying the MRIs and CTs. Third, sectioned images without any missing images will be more helpful in making the complete 3D images. Fifth, small pixel size (0.2 mm × 0.2 mm) and thin thickness (0.2 mm) of sectioned images will be more helpful in showing the small anatomical structures greater than 0.2 mm. Sixth, the additional segmented images will be more helpful in making the 3D image and virtual dissection software. The Visible Korean Human will be the basis for making better 3D image and virtual dissection software which will be more helpful in medical education.
Spring: A General Framework for Collaborative, Real-time Surgical Simulation
Authors: Montgomery Kevin  , Bruyns Cynthia  , Brown Joel  , Sorkin Stephen  , Mazzella Frederic  , Thonier Guillaume  , Tellier Arnaud  , Lerman Benjamin  , Menon Anil
Published: February 2025

We describe the implementation details of a real-time surgical simulation system with soft-tissue modeling and multi-user, multi-instrument, networked haptics. The simulator is cross-platform and runs on various Unix and Windows platforms. It is written in C++ with OpenGL for graphics; GLUT, GLUI, and MUI for user interface; and supports parallel processing. It allows for the relatively easy introduction of patient-specific anatomy and supports many common file formats. It performs soft-tissue modeling, some limited rigid-body dynamics, and suture modeling. The simulator interfaces to many different interaction devices and provides for multi-user, multi-instrument collaboration over the Internet. Many virtual tools have been created and their interactions with tissue have been implemented. In addition, a number of extra features, such as voice input/output, real-time texture-mapped video input, stereo and head-mounted display support, and replicated display facilities are presented.
Training and Assessment of Laparoscopic Skills using a Haptic Simulator
Authors: Rolfsson Göran  , Nordgren Anna  , Bindzau Stefan  , Hagström J-P  , Mclaughlin John  , Thurfjell Lennart
Published: February 2025

Surgical simulation is a promising technique for training of laparoscopic surgery. Computer based simulation provides not only a cost effective alternative to traditional training but also a way to assess the surgeons performance. In this paper, we present a haptic simulator that allows for training and assessment of basic laparoscopic skills. The skills trained are modeled around a cholecystectomy procedure and include bi-manual dissection, clips setting, catheter insertion and cutting. The system uses accurate anatomic models of the organs involved in the procedure. This combined with effective methods for soft tissue deformation and haptic feedback, giving the surgeon a precise feeling of the interaction between organs and surgical instruments, provides a realistic training environment. The system has been designed with procedural training in mind and by putting together the individual tasks it will be possible to train on performing a complete cholecystectomy procedure.
ADAPTIVE HYBRID INTERPOLATION TECHNIQUES FOR DIRECT HAPTIC RENDERING OF ISOSURFACES
Authors: Sankaranarayanan Ganesh  , Devarajan Venkat  , Eberhart Robert  , Jones Daniel. B.
Published: February 2025

Direct Haptic rendering of voxels from an anatomical dataset provides patient specific haptic feedback vital for diagnosis and surgical planning. Our algorithm uses zero sets of scalar trivariate function for polynomial interpolation with sixty-four neighborhood points to generate isosurfaces on the fly for haptic rendering. This approach gives continuity in surfaces as well as better capture of isosurface features of the medical dataset. The detailed algorithm is presented along with the description of results from haptically rendering medical datasets.