bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrating Decision Support with Electronic Referrals
Authors: Bury Jonathan  , Humber Michael  , Dunlop Robert  , Fox John
Published: February 2025

The Early Referrals Application (ERA) is a web-based system to support the electronic referral of patients with symptoms suspicious of cancer from primary to secondary care. In developing the application, we have investigated the integration of decision support into the data-gathering, electronic referral and appointment-booking processes that may accompany an urgent referral.
Development of a Knowledge Support System Linked with an HIS
Authors: Miyo Kengo  , Ohe Kazuhiko
Published: February 2025

Recently hospital information systems have come into wide use. It has become easier for healthcare providers to retrieve patient data. However they need to have the ability to analyze the patient data using the most reliable and upto- date medical knowledge. We think that the next generation of hospital information system (HIS) should not only provide patient data but also support interpretation of the data for the healthcare providers. In order to provide appropriate medical knowledge to them, we developed a system which dynamically creates linkage between an HIS and an electronic medical textbook (EMT).
The Development and Evaluations of the Appointment System for Clinics through i-mode and WWW
Authors: Uchino Yasuki  , Tamagawa Hiroo  , Sogo Motofumi  , Maeda Yosinobu
Published: February 2025

We will report on a 24 hour appointment system with a cellular phone(i-MODE) and a world wide web (WWW) server for dental clinics. In Japan, as an essential infrastructure for communication, i-mode cellular phones are playing an important role with the increasing number of their subscribers reaching over 10 million in November, 2000. This system is useful for both patients and clinics with regards to saving time and cost.
On Approximate String Matching of Unique Oligonucleotides
Authors: Hyyrö Heikki  , Vihinen Mauno  , Juhola Martti
Published: February 2025

The current research considers the approximate string matching search for important subsequences from DNA sequences, which is essential for numerous bioinformatics computation tasks. We tested several approximate string matching algorithms and furthermore developed one for DNA data. Run times of the algorithms are important, since the amount of data is very large.
Multimodal Simulation of Laparoscopic Heller Myotomy Using a Meshless Technique
Authors: De S.  , Manivannan M.  , Kim J.  , Srinivasan M. A.  , Rattner D.
Published: February 2025

In this work we focus our attention on developing a surgical simulator for performing laparoscopic Heller myotomy using force feedback. A meshless numerical technique, the method of finite spheres, is used for the purpose of physically based, real time haptic and graphical rendering of soft tissues. Localized discretization allows display of deformations in the vicinity of the tool tip as well as interaction forces at high update rates (kHz). Novel cutting algorithms are implemented using point-based representation of anatomical models. Graphical rendering is accomplished by using a recently developed volumetric rendering technique known as splatting.
Advancements in Immersive VR as a Tool for Preoperative Planning for Laparoscopic Surgery
Authors: Mastrangelo Jr Michael J  , Stich Jeremy  , Hoskins James D  , Witzke Wayne  , George Ivan  , Garrison Jason  , Nichols Mathew  , Park Adrian E
Published: February 2025

The utility of three-dimensional (3D) models for planning laparoscopic surgery and surgical training has been demonstrated. (1) Computed tomography (CT) scans with oral and intravenous contrast medium are frequently used for preoperative evaluation of patients undergoing complex laparoscopic surgery. Immersive 3D VR overcomes many of the conceptual limitations encountered when conveying or teaching 3D relationships via 2D images traditionally produced by these scans. Over the past year we have made advancements in several areas. First, we have improved the quality of our datasets by utilizing higher resolution multi-detector scans and altering the protocols used. Second, we now register multiple isosurface views with standard axial views and volume textured views to provide additional information and perspective. Third, we now routinely use auto-segmentation techniques to visualize individual structures.
Retrospective Results in Immature Idiopathic Scoliotic Patients Treated with a Chêneau Brace
Authors: Rigo M.  , Quera-Salvá G.  , Puigdevall N.  , Martínez M.
Published: February 2025

This paper reports a retrospective series which includes 105 idiopathic scoliotic patients treated with a Cheneau brace. With an average age of 12.5 years old and a mean Risser sign of 0.9, the initial major Cobb angle was 36.8° corrected to 25.9° in the brace (31.1% of the primary correction), and the major torsion angle was 16.8° corrected to 12.9° in the brace (22.2% of the primary correction). 37 patients have finished the treatment with a mean follow-up of 16.8 months. For this group, the initial Cobb and torsion angles were not significantly changed (36.4° Cobb to 34.1° Cobb at follow-up, and 16.9° Perdriolle to 15.7° Perdriolle at follow-up). The proportion of patients without progression greater than 5° Cobb (n=20) and with an improved final Cobb angle (n=10) was greater than failures (n=7). However, due to the catastrophic nature of some progressions which generally coincide with a high Cobb angle right from the start, with low primary correction, and with non-compliance, the final Cobb angle showed a slight tendency to decrease but without reaching high significance. These preliminary results demonstrate that the Cheneau brace can effectively prevent the progression of Cobb and torsion angles, even in cases of bad prognosis.
Intra-Operative Measurement of Vertebral Bone Strength
Authors: Bardas A.M.  , Raso V.J.  , Ouellette N.W.  , Moreau M.J.  , Mahood J.K.  , Fyfe K.R.
Published: February 2025

A significant complication of surgical correction of the deformed spine is pull out of the vertebral hooks or screws. This complication can be partly attributed to poor bone stock. Currently, there are few methods available for surgeons to assess the mechanical strength and stiffness of the vertebra, and even fewer methods that provide in-vivo measurements. An “upbiter” is often used to form a seat in the lamina for the hook. A typical upbiter was modified and instrumented with strain gauges to investigate the feasibility of determining the forces and displacements needed to cut through laminar bone during surgical procedures. The calibration showed that the system was repeatable and could highly correlated with applied force (R2=0.98) and displacement (R2=0.99) with resolutions of 0.72 N and 0.40 mm respectively. This system was tested on three females, on lamina ranging from T4 to T12 regions. The average maximum force for bone failure was at 470 ± 128N.
Evaluation of a Laser Scanner for Surface Topography
Authors: Hill D.L.  , Berg D.C.  , Raso V. J.  , Lou E.  , Durdle N.G.  , Mahood J.K.  , Moreau M.J.
Published: February 2025

A Minolta VIVID 700 portable non-contact 3D laser scanner was evaluated on 15 subjects with idiopathic scoliosis. The 3D map was compared to two structured light pattern (lines and dots) techniques to determine the reliability, ease of use, speed, and quality. The parameters used for the clinical assessment of scoliosis were measured twice for the Minolta and light projection systems. The edges of the image and areas where occlusion typically occur were examined. The absolute distance in calculated depth between adjacent points was examined to determine errors. The Minolta system and the dot pattern produced regular grids of points. The light projection pattern produced an irregular grid, with more resolution along the video line and less resolution between projected lines, resulted in a somewhat jagged appearance of the surface map. The Minolta system was less sensitive to edge effects, occlusion, and sharp transitions of depth. The comparison of clinical parameters showed good results between repetitions but moderate results between techniques.
Time Stamp Services for Trustworthy Health Communications
Authors: Pharow Peter  , Blobel Bernd
Published: February 2025

Trustworthy communication and co-operation requires in general static TTP services describing status and relation of communicating principals as well as their corresponding keys and attributes. Additional TTP services are needed to provide trustworthy information about dynamic issues of communication and co-operation such as message identifier, time and location of processes, workflow relations and system behaviour. Certified time stamps are important notary's functions dealing with the services mentioned above. Within the European RESHEN project, the ONCONET regional health network for improving cancer care has been moving from system-related to certified time stamps using a local secure time stamp server or deploying remote time stamp services provided by an accredited CA. After implementing such services at the beginning of 2002, an evaluation of the operation modes will be performed during 2002 to derive recommendations for optimisation of these important services in national and international health networks.
A New Approach for Integration of Telemedicine Applications into Existing Information Systems in Healthcare
Authors: Tobman Matvei  , Nätscher Catharina  , Sussmann Helmut  , Horsch Alexander
Published: February 2025

In order to take the full advantage of telemedicine applications, they must seamlessly be integrated into healthcare services and their information systems (e. g. HIS, POS, RIS). In our approach an HL7/XML- based integration module is used 1) to exchange documents with information systems; 2) to generate and administer documents internally; 3) to present documents. The module fills in pre-defined CDA-conforming XML templates with data from HL7 V2 messages. The approach is first applied to the teleconsultation service EST in the project ENDOTEL.
Comparing nursing terms from patient records to the ICNP, Beta version
Authors: Marin Heimar F.
Published: February 2025

Information about patient care is documented in order to promote continuous care and outcomes evaluation. With the computer advent in the healthcare area, standards documentation became mandatory. Many vocabularies are being developed, however, they are still insufficient to support clinical documentation. This study investigated the words used to document inpatients clinical assessment. These words were mapped into the International Classification for Nursing Practice (ICNP). The mapping process showed that only 247 words from 761 selected were included into the classification. Consequently, improvements have to done to facilitate the use of standard terminologies in the practice to improve the documentation itself.
A one-step approach to data retrieval, analysis and documentation
Authors: Karlsson Johan  , Eklund Patrik
Published: February 2025

In this paper we propose a system architecture to support data retrieval from patient records, together with data analysis, and report generation. Moving from retrieval all the way to documentation should be done as in a pipeline, and computer support must minimize manual steps in this knowledge refinement scenario. A case study is drawn from urology for surgery on patients with lower urinary tract symptoms.
Co-ordination between clinical coding systems and pragmatic clinical terminologies based on a core open system: the role of ISO/TC215/WG3 and CEN/TC251/WG2 standardisation?
Authors: Rodrigues Jean Marie  , Trombert Paviot Beatrice  , Martin Caroline  , Vercherin Paul  , Samuel Olivier
Published: February 2025

The article addresses the need to co-ordinate efforts to develop clinical coding systems and pragmatic clinical terminologies like SNOMED CT. In the first part, a description is given of the current context of divergent and replicated efforts. Then is presented a “reference terminology representation” approach based on a formal terminology representation as an open source available in the public domain with diversity in the linguistic expressiveness of end users let to competing developers and researchers. The last part is devoted to the contribution of the standardisation process in healthcare terminology initiated by CEN/TC251 and supported now by the work of CEN/TC215/WG3 to this new approach which can be summarised as the practical realisation of an ontology.
Using N-Gram Method in the Decomposition of Compound Medical Diagnoses
Authors: Héja Gergely  , Surján György
Published: February 2025

Compound diagnoses are often assigned to just one disease code. This is a known cause of coding error. Our paper outlines an efficient, cheap and easy to implement method for semi-atutomatic decomposition of such diagnostic expressions. The proposed method is based on n-grams. To verify the method two human encoders were asked to analyse the same set of 92 clinical diagnoses. Their results were compared to the analysis produced by the method. The results demonstrate the reasonability of the approach.
Diabetes patients’ ability to estimate dietary carbohydrate content for use in a decision support system
Authors: Jensen Karin D.  , Jensen Birgitte  , Lervang Hans-Henrik  , Hejlesen Ole K.
Published: February 2025

The aim of the study was to assess Type 1 (insulin-dependent) diabetic patients’ ability to give valid information of the dietary carbohydrate (CHO) intake and to use the log function of a blood glucose meter for easy transfer of data to a decision support system. 18 Type 1 diabetic patients were enrolled from the Diabetes Outpatient Clinic at the Department of Endocrinology, Aalborg Hospital, Denmark. The patients were divided in subgroups of 4 or 5 patients and was instructed by the dietitian how to estimate the CHO intake and by the doctor in the use of the Accutrend DM® blood glucose meter. During a 3 days data collecting period the patients were asked to keep a written diary containing a description of the meals, the estimated CHO intake, the insulin-dosage and the time of the meals and insulin injections, and to make 8-point blood glucose profiles daily. They were furthermore asked to use the log function of the Accutrend DM® blood glucose meter. At the second visit the data were discussed individually with the patients and if there where more than three data points missing using the log function the patients were asked to repeat the data collection. A deviation of 10 grams or more, between the patient’s and the dietician’s estimate, was seen in 7.3% of the meals following the first instruction, in 1.0% of the meals following the second instruction, and in 2.4%) o f the meals following the third and last instruction. In conclusion, this study showed that Danish Type 1 diabetic patients were able to estimate the dietary carbohydrate content with a high degree of correctness, and to use the log function of the blood glucose meter, after a maximum of 3 hours of training.
Telelearning in Ophthalmology
Authors: Sussmann Helmut  , Horsch Alexander  , Korda Wolfgang  , Muth Bertil  , Parasta Amir-Mobarez
Published: February 2025

The virtual ophthalmic clinic has been developed to provide an interactive learning platform within the correspondence courses of the Virtual University of Bavaria. It presents clinical case examples from ophthalmology. Basic concepts are a case-based learning dialogue (didactics), peer reviewing (quality), role- based access (organization) and thin web clients (availability). The following requirements had to be fulfilled: Best possible accessibility for students, authors and reviewers; learning control function; comfortable management. The application architecture is based on a relational data base, a ColdFusion® (Allaire, Newton, MA, USA) web application server, a standard web server. So far, the application was used in four terms of the virtual university.
Citizen Health System: Telehealth Homecare
Authors: Maglaveras Nicos
Published: February 2025

The Citizen Health System (CHS) is a European Commission (CEC) funded project in the field of 1ST for Health. Its main goal is to develop a generic contact center which in its pilot stage can be used in the monitoring, treatment, and management of chronically ill patients at home in Greece, Spain, and Germany. Such contact centers, using any type of communication technology, and providing timely and preventive prompting to the patients, are envisaged in the future to evolve into well-being contact centers providing services to all citizens. In this paper, we present the structure of such a generic contact center and in particular the telecommunication infrastructure, the communication protocols and procedures, and finally the educational modules that are integrated into this contact center. We present the procedures followed for two target groups of patients, namely diabetic patients, and congestive heart failure patients, in which two randomized controlled clinical trials are under way. We present examples of the communication means between the contact center medical personnel and these patients, and elaborate on the educational, user, and telecommunication issues involved.
Federal Initiatives in Information Technology to Improve Patient Safety and Quality of Care
Authors: Ortiz Eduardo
Published: February 2025

In November 1999, the Institute of Medicine (IOM) released a report that focused on patient safety in the United States (U.S.), in which it estimated that up to 98,000 people die in U.S. hospitals each year from medical errors. In March 2001, the IOM released a follow-up report encompassing a broader range of quality issues in the U.S. health care system. It concluded that health care in the U.S. is plagued by a variety of problems which stem from an outmoded system that does not provide high-quality care on a consistent basis. The IOM also outlined a strategy for redesigning U.S. healthcare to achieve safe, dependable, high-quality care, which emphasizes information technology as an integral part of the solution. In 2001, the Agency for Healthcare Research and Quality (AHRQ) spent $50 million on initiatives to reduce medical errors and improve patient safety. The crux of these initiatives was a series of solicitations that form an integrated set of research and demonstration projects for reducing medical errors in multiple health care settings. This chapter will discuss some of these initiatives, focusing on the role of clinical informatics in the Agency’s efforts to improve the safety and quality of health care in the U.S.
Communication Support : A Challenge for ICT in Health Care
Authors: Toussaint P.J.  , Alpay L.L.  , Zwetsloot-Schonk J.H.M.
Published: February 2025

Communication makes up a very important part of the daily practice of health professionals. Current trends in health care indicate that this will even increase. However, the explicit application of Information and Communication Technologies (ICT) in order to support communication is relatively rare. This leaves a great potential of ICT in health care unused. The clinical informaties group at the Leiden University Medical Centre has established a research program which aims at eliciting, analysing, and specifying requirements for communication supporting ICT-applications in health care. Several research projects are part of this program already. Two of these, that focus on supporting a specific kind of health professional/client communication, are discussed in this paper against the background of the research program.
Assessment of a Three-Year Experience with a Belgian Primary Care Data Network
Authors: De Clercq E.  , Vandenberghe H.  , Jonckheer P.  , Bastiaens H.  , Lafontane M-F.  , Van Gasteren V.
Published: February 2025

The paper describes the experiences with a Belgian Primary Care data Network from 1999 till 2002. Three cycles of data collection have been performed. The network involves about 300 general practitioners (GPs) and up to 8 different software packages. This network is semi-anonymous, semi-automatic and mixed (paper and electronic with various software’s). For the coming next years, efforts should be focused on solving some frequently occurring problems with the data collection through the EPR, such as a considerable number of data lacking and the fact that GPs do not always use the problem oriented structure of the EPR (Electronic Patient Record). Afterwards, more promising usage could be considered and developed such as repeated data collection using a same GPs ‘ sample, long term recording studies, usage of larger GPs’ samples, etc.
An Augmented Reality System for MRI-Guided Needle Biopsies
Authors: Khamene Ali  , Acker Frank W  , Vogt Sebastian  , Azar Fred  , Wendt Michael  , Sauer Frank  , Lewin Jonathan
Published: February 2025

A navigation system can increase the speed and accuracy of MR guided interventions that make use of scanners with high-field closed magnets. We report on first needle placement experiments performed with an Augmented Reality (AR) navigation system. AR visualization provides very intuitive guidance, resulting in a faster procedure. The accuracy of the needle placement depends on the registration accuracy of the system. In the present trials, the needle was placed as good as 1mm close to the target center, however in a small number of cases substantially larger errors occurred and were most likely caused by needle bending.
Simulation of a Preperitoneal Mesh in Laparoscopic Herniorrhaphy
Authors: Sugavanam Sivashanmugaraman  , Devarajan Venkat
Published: February 2025

During a laparoscopic hernia surgery, a preperitoneal mesh is tacked or stapled to the defect on the inside in order to close the fissure created by the hernia. Here we have proposed and implemented a novel technique for simulating the movement and stapling of the mesh for use in a virtual reality based laparoscopic trainer. The use of particle based system and Mass-Spring model in simulating the movement of the mesh is also discussed.
Measurements of the Level of Surgical Expertise Using Flight Path Analysis from da Vinci™ Robotic Surgical System
Authors: Verner Lawton  , Oleynikov Dmitry  , Holtmann Stephen  , Haider Hani  , Zhukov Leonid
Published: February 2025

Laparoscopic surgical procedures require precise hand and eye coordination based on a 2-dimensional representation of 3-dimensional space. Currently, no metric exists to guide the educational process while surgeons are still on the learning curve. In this paper, we propose to identify and qualify the patterns of movements recorded from the da Vinci™robotic surgical system (Intuitive Surgical, Sunnyvale CA) that are most consistent with mastery and can define levels of proficiency. We have recorded velocities and positions of complex movements made by both novice and expert surgeons using da Vinci™system and performed geometric and statistical analysis of the data.
Information System Interoperability in a Regional Health Care System Infrastructure: a pilot study using Health Care Information Standards
Authors: Spyrou Stergiani S.  , Berler Alexander A.  , Bamidis Panagiotis D.
Published: February 2025

The 1stand 2ndRegional Health Care System Authority of Central Macedonia (1stand 2ndPeSY) are two of the seventeen Regional Healthcare System Authorities in Greece. Every single PeSY aims to improve the level of quality that health care organisations offer as well as to control the expenditure of health care services provided by the health care organisations, Hospitals and Primary Care Health units. There is currently an urgent need for Regional Health Authorities to deploy integrated healthcare information system, based on secure networks. The limited interoperability of current hospital information systems (HIS) poses a risk for the management of patient related information since there is a difficulty to transform processed data into useful information and knowledge. Thus, a pilot system was developed to achieve data integration record synchronisation using the Health Level 7 protocol between the existing HIS of two Hospitals of Thessaloniki and the central Offices of the PeSY. The pilot was funded by the Third Community Support Framework (jointly funded by EU and Greece) funds in order to prepare the forthcoming major healthcare IT projects in Greece. It is shown that such a system is pragmatic, achieves data integration and provides acceptable integration costs.
Integrating Content-Based Visual Access Methods into a Medical Case Database
Authors: Müller Henning  , Rosset Antoine  , Vallée Jean-Paul  , Geissbuhler Antoine
Published: February 2025

In the computer vision domain, content-based access methods to all forms of multimedia data are a hot research topic. A large number of tools have been developed to find documents in multimedia repositories and to manage the (visual) information that has been created, for example by the Internet. Although no general breakthrough has been achieved with respect to searching diverse databases with automatically extracted features, the techniques have gained acceptance in a few well-defined domains such as image agencies (Corbis) and trademark research.
Tracing Computerized Incidents to Manage and Improve Quality Health Care in Hospitals
Authors: Le Duff F  , Daniel S  , Kamendjé B  , Duvauferrier R
Published: February 2025

The promotion of quality and safety care in public and private Hospitals has become a crucial stake. To succeed in this, a quality process is necessary for quality management. To set it up, it is necessary to have different piloting tools .Data collection of effective information is one of these tools. It is necessary to be able to process the data quickly in order to answer the various demands rapidly. This project consists in proposing the possibility of declaring different dysfunctions and incidents by a simple formular integrated into the intranet services of the hospital for the medical, nursing and administrative staff. This should lead to quality management of the medical units.
Opinions and e-Health behaviours of Patients and Health Professionals in the U.S.A. and Europe
Authors: Provost Melanie  , Perri Matthew  , Baujard Vincent  , Boyer Celia
Published: February 2025

Background: There exists a gap in the use of Internet for health purposes between patients and health professionals and between various countries. The Internet has the potential to be a global tool for health professionals and their patients but, as seen in other fields, cultural differences may lead to divergent opinions and preferences. Objective: To identify the opinions, preferences and types of behaviours regarding the use of Internet for health purposes, for health professionals and patients in selected regions of the United States and Europe. Methods: An announcement of an online survey was posted on more than 100 web sites during May and June of 2002. Members of HONnewsletter were also invited via email. The online questionnaire consisted of 28 questions with sections designed specifically for patients or health professionals. Sub-samples of respondents were created based on their geographic location. Results: 2621 respondents mainly from the United States (38%, n=984) and Europe (29%, n=739) completed the survey. For the USA, the majority of respondents were patients (68.7%), while in Europe, the majority were health care professionals (63.6%). In both regions, health professionals preferred using medical search tools but patients preferred general search tools. Concerns about the accuracy of information and trustworthiness were shared by all groups. The majority of respondents reported that they preferred certified web sites. The patients from USA (69%) and Europe (47%) have discussed the results of their Internet searches with their doctors, while health professionals are receptive to the discussion and find it helpful. Other e-health behaviours are also reported by both parties. Conclusion: Based on the self- reported e-health behaviours noted in this study it appears that the use of the Internet for health purposes is growing in importance to the patient physician relationship in Europe and the USA.
Interchange of nominative patient data between health-care organizations
Authors: Marchand Boris  , Herengt Gilles  , Jay Nicolas  , Hazemann Murielle  , Toussaint Eliane  , Kohler François
Published: February 2025

In the context of the current evolution of healthcare, hospitals will have to share medical files with different structures. Thus, it is necessary to establish procedures to identify, the patients. A team professionals working with such medical information proposes a system of identification based on the matching of identification traits respecting various regulations in order to retrieve the information. We will see how this is made possible, with the help of a correlation engine enabling us to exchange medical documents between different health-care organizations.
Modeling and Implementing a Health Information Provider on the Internet
Authors: Aymard Sylvain  , Falco Laurent  , Dufour Jean-Charles  , Joubert Michel  , Fieschi Marius
Published: February 2025

Objectives: To model and implement a medical web portal providing access to well qualified and high-quality information. Material and methods: The Unified Medical Language System (UMLS) knowledge sources of the U.S. National Library of Medicine and an Information Sources Catalog (ISC) resulting from the ARIANE project are described The XML technology that allows files transformations by the means of XSLT is briefly presented Results: The design and implementation of software modules that exploit knowledge sources, operate the translation of a user’s query to selected information sources, and wrap obtained results are detailed Discussion: Current implementation and wrapping perspectives are discussed in terms of integration and interoperability of health information resources.
Health Telematics and Telemedicine for Improving Patients' Care
Authors: McDonald Clement  , Blobel Bernd
Published: February 2025

Current problems and solutions to establish health telematics and telemedicine for patient's seamless care have been analysed referring to experiences of advanced institutions especially in, but not restricted to, the USA. In that context, problems at institutional boundaries as well as technical and personal problems for communication and co-operation have been explored. Entering coded clinical data and the ubiquitous access to that information are crucial challenges to be met.
Soft Tissue Deformation using a Hierarchical Finite Element Model
Authors: Faraci Alessandro  , Bello Fernando  , Darzi Ara
Published: February 2025

Simulating soft tissue deformation in real-time has become increasingly important in order to provide a realistic virtual environment for training surgical skills. Several methods have been proposed with the aim of rendering in real-time the mechanical and physiological behaviour of human organs, one of the most popular being Finite Element Method (FEM). In this paper we present a new approach to the solution of the FEM problem introducing the concept of parent and child mesh within the development of a hierarchical FEM. The online selection of the child mesh is presented with the purpose to adapt the mesh hierarchy in realtime. This permits further refinement of the child mesh increasing the detail of the deformation without slowing down the simulation and giving the possibility of integrating force feedback. The results presented demonstrate the application of our proposed framework using a desktop virtual reality (VR) system that incorporates stereo vision with integrated haptics co-location via a desktop Phantom force feedback device.
The Personal Digital Assistant (PDA) as a tool for telementoring endoscopic procedures
Authors: Gandsas Alex  , McIntire Katherine  , Montgomery Kevin  , Bumgardner Cody  , Rice Linda
Published: February 2025

The telementoring of surgical procedures is currently achieved via a wired infrastructure that usually requires sophisticated videoconference systems. This project represents the first step in assessing the potential for using handheld computers as a mobile alternative to current telementoring systems. Specifically, this project compares a handheld computer to a standard CRT monitor regarding their capability to accurately display video images from an endoscopic procedure.
If Ontology is the Solution, What is the Problem?
Authors: Pisanelli Domenico M.  , Gangemi Aldo
Published: February 2025

In this paper we show the usefulness of an ontological approach for solving some problems arising in medicine. We point out the relevance of terminological ontologies for disambiguating polysemous terms, for re-organizing very large corpora and detecting possible inconsistencies and for managing a catalog of bio-medical equipments. We also put in evidence the fundamental role played by ontologies when integration and interoperability of heterogeneous knowledge sources is needed, in particular in the field of clinical guidelines and evidence-based medicine.
Using the Sense of Smell in Telemedical Environments
Authors: Spencer Brandon S.
Published: February 2025

It is widely recognized in the medical community that the sense of smell plays a very important role in the diagnosis of various associated medical disorders. With the advent of computerized scent detection and scent production devices, smell as a medical diagnostic and educational tool could be carried over into the world of telemedicine, tele-surgery, and distance education.
Tele-Homecare for Chronically Ill Persons: Pilot Trials, Medical Outcomes and Future Perspectives
Authors: Robinson Simon  , Stroetmann Karl A.  , Stroetmann Veli N.
Published: February 2025

Socio-economic trends including the ageing of populations in the developed world have let to markedly increased interest in improving society's ability to deliver effective care to older and chronically ill patients at home. The paper reports progress from recent European research on three key fronts faced in the diffusion of tele-homecare: Pilot applications to explore the features of as yet untried care domains, full clinical trials to present hard evidence of desired medical outcomes, and R&D to expand the capability of tele-homecare systems to meet the needs of a yet wider variety of chronic illnesses and patient groups.
A Reference Architecture for Telemonitoring
Authors: Clarke Malcolm
Published: February 2025

The Telecare Interactive Continuous Monitoring System exploits GPRS to provide an ambulatory device that monitors selected vital signs on a continuous basis. Alarms are sent when parameters fall outside preset limits, and accompanying physiological data may also be transmitted. The always-connected property of GPRS allows continuous interactive control of the device and its sensors, permitting changes to monitoring parameters or even enabling continuous monitoring of a sensor in emergency.
Secondary Use of the EHR via Pseudonymisation
Authors: Pommerening Klaus  , Reng Michael
Published: February 2025

The Electronic Health Record (EHR) has many secondary uses, such as health economy and health care research, or disease specific clinical or epidemiological research. For these uses in general the patient identity is not needed, therefore the data must be anonymised or pseudonymised. Whereas for one-time use of the data this procedure is straightforward, long-term data accumulation or the necessity of re-identification require a more sophisticated approach. This paper describes possible model architectures, developed for medical research networks, but useful in other contexts as well.
Speak-ER: An Audible Web-Based Medical Record for Emergency Patients
Authors: Pinciroli Francesco  , Corbetta Emanuela  , Tamburini Matteo F.  , Mattasoglio Andrea  , Bonacina Stefano  , Masseroli Marco  , Melonl Giovanni  , Spaggiari Piergiorgio
Published: February 2025

Emergency conditions can inhibit the use of clinical data, even when it has been professionally collected and structured. Our aim is to improve the assessment of patients' medical histories in emergency situations. Under emergency conditions, when it may be impractical for health care providers to interact with a visual display of patient data, a “speaking” medical record may be useful. We are investigating the use of a voice synthesizer in conjunction with MyAngelWeb®, an Italian web-based medical record service. Only the textual subset of patient medical records was considered and restructured according to the needs imposed by voice communication. The quality of the received messages was tested. Some quantitative features, including the number of words and time durations, were considered together with other subjective features, including intelligibility of single words and overall significance of the voice messages. Provided that the linguistic architecture of a medical records' text is arranged to minimize the number of choices presented to the user, and phrases are kept short with few acronyms, health care providers can satisfactorily interact with the service.. Audible medical record delivery may be considered as an effective enhancement to those datasets needed in emergencies.
Q.U.i.P.S. – a Quality Model for Investigating Risk Exposure in e-Health Systems
Authors: Croll Peter R  , Croll Jasmine
Published: February 2025

The increasing dependency being placed on electronic health information systems presents new challenges for today’s health managers and systems developers. This paper uses Electronic Health Records to demonstrate how there are four critical attributes for e-health system development. To produce dependable and viable IT solutions, each attribute needs to be specifically addressed and prioritized. It will be shown how these attributes possess a number of interdependencies making the analysis and prioritization tasks complex and hence, in practice, often incomplete. The proposed QUiPS model aims to provide a complete framework for building trustworthy solutions. It identifies the pertinent issues and the tools and techniques needed to determine the risk exposure with a given system. The results from one of the Case Studies that focuses on Usability is detailed, while other studies relating to Safety and Privacy are outlined. The outcomes to the proposed approach are e-health systems that the clinicians and patients alike can trust and will, therefore, be fully accepted.
A New Quality Improvement Study Every Day? Using QTools to Build Quality Improvement Projects Around Primary Care Electronic Medical Record Systems
Authors: Treweek Shaun
Published: February 2025

Greater and more appropriate use of information technology has been proposed by the US Institute of Medicine as one way in which the quality of health care can be improved. Electronic medical record systems offer particular advantages because they can support clinicians at the point of care as well as allowing patient care to be monitored over time. Developing quality improvement tools that make use of the electronic medical record can, however, be difficult and often requires special software. This paper describes a system called QTools that provides a range of general-purpose tools to support quality improvement work in Norwegian primary care. The paper discusses how QTools has been used in two studies involving over 100000 patient consultations and how it is supporting current work to improve the prescription of anti-hypertensive drugs. Features that have not yet been used in a quality improvement study are also discussed.
Whole population secondary prevention of Coronary Heart Disease in Scotland: The HEARTS database
Authors: Sullivan Frank  , Donnan Peter T  , Love Tom
Published: February 2025

Implementing the evidence base for the management of chronic disease is as challenging as discovering which interventions are effective. The HEARTS collaboration (Heart disease Evidence-based Audit and Research in Tayside Scotland) is achieving that goal for the secondary prevention of coronary heart disease (CHD by linking national databases to manually validated hospital and family practice electronic patient records. Specific data from the system is fed back to practices in a facilitated educational process and through the NHS intranet. This paper describes some ofthe key features of this strategic decision support system. All residents of the Tayside region of Scotland (n=484 013 mid year estimate 2002) are covered by the system. 9 828 patients who have suffered a myocardial infarction(MI) or who have undergone angioplasty or bypass surgery are registered on the system. Improvements in clinical status and prescribing of effective therapies are 5-10% greater than elsewhere in Scotland.
Inter-document Coreference Resolution of Abnormal Findings in Radiology Documents
Authors: Son Roderick Y.  , Taira Ricky K.  , Kangarloo Hooshang
Published: February 2025

In the clinical environment, it is often necessary to track the progression of a condition or various pertinent findings over time. Establishing automatic mechanisms for tracking pertinent findings can aid in the management of a condition as well as provide feedback for treatment outcomes assessment. This workfocuses on the challenge of correlating observation of pertinent findings, specifically lung masses, across documents from serial computed tomography examinations for lung cancer patients. A probabilistic model is presented to characterize the likeliness of two observed findings from different documents referring to the same entity. A greedy algorithm is also presented that utilizes the probabilistic model to establish coreference links between findings. Results from a preliminary evaluation of this methodology show a precision of 72% and a recall of 63% for the described inter-document coreference resolution task.
Gathering, Structuring and Describing Information Needs in Home Care: A Method for Requirements Exploration in a “Gray Area”
Authors: Toivanen Marika  , Häkkinen Heidi  , Eerola Anne  , Korpela Mikko  , Mursu Anja
Published: February 2025

The aim of our research is to develop a method for “requirements exploration” – gathering, structuring and describing requirements for information systems in previously weakly understood areas. In health care, information systems are usually developed for a single organization, or for information flow from one organization to another. In our case domain, multi-professional and multi-organizational home care, this approach is not very helpful. Moreover, home care takes place in “noman's-land”; outside the organizations' infrastructure, in the customer's home, and technology is used scarcely. In this paper, we describe how information requirements were explored in this scantly understood domain by using an activity-theoretical approach. We also explain how this approach served our purposes. The method proved useful in grasping the network of activities and the information needs. The holistic nature of the method was particularly important, since technology is not the only solution to the needs we discovered.
Remote Display Performance for Wireless Healthcare Computing
Authors: Lai Albert Max  , Nieh Jason  , Laine Andrew  , Starren Justin
Published: February 2025

Organizations are beginning to recognize that health care providers are highly mobile and optimal care requires providing access to a large and dynamic body of information wherever the provider and patient are. Remote display protocols (RDP) are one way that organizations are using to deliver healthcare applications to mobile users. While many organizations have begun to use RDPs to deliver real-time access to health care information to clinicians, little formal work has been done to evaluate the performance or the effectiveness of thin-client computing with health care applications. This study examines the performance of wireless thin-client tablets with two web-based clinical applications, a text-centric, graphics-poor EMR and a graphic-rich image analysis program. The study compares the performance of two popular RDP implementations, Citrix and Microsoft Remote Desktop, with the performance of a traditional web browser in a wireless environment. For both applications, the RDPs demonstrated both higher speed and reduced bandwidth requirements than the web browser.
An Evaluation of Automatically Generated Briefings of Patient Status
Authors: Jordan Desmond  , Whalen Gregory  , Bell Blaine  , McKeown Kathleen  , Feiner Steven
Published: February 2025

We report on an evaluation of MAGIC, a system that automatically generates briefings of patient status after coronary bypass surgery, completed in the Cardio Thoracic Intensive Care Unit at New York Presbyterian Hospital. Through enhancements in system design, robustness and speed, we compared information obtained by nurses against two briefings, one automatically generated by MAGIC and one provided by physicians upon the patient's arrival to the ICU. Our results show that MAGIC and the physician briefing provide a substantial increase in the amount of information than is available prior to the patient’s arrival and that the information MAGIC provides is accurate. In many aspects, MAGIC outperforms the physician briefing; information is reported earlier and is always available. We conclude that MAGIC provides the CTICU staff early on with a better assessment of the patient’s status than in current practice and allows them to better prepare for the patient’s arrival.
A Neural Network Model of Lexicalization for Simulating the Anomie Naming Errors of Dementia Patients
Authors: Järvelin Antti  , Juhola Martti  , Laine Matti
Published: February 2025

Word-finding difficulty (anomia) is the most common linguistic deficit in dementia. It is often measured by picture naming tasks as naming a picture taps all the major processes in word production, i.e., activation of a concept, retrieval of lexical-semantic information on that concept, retrieval of the corresponding word form and articulation. Naming and naming errors have extensively been simulated by neural network models of lexicalization (see e.g. [1,2]). A common feature of these models is that they are static, i.e. non-learning. However, naming is a dynamic process that changes as a function of normal learning or re-learning after neural damage. These important patterns cannot be caught by the static models of lexicalization. Therefore we have developed a learning model of lexicalization based on multi-layer- perceptron (MLP) neural networks. We tested the model by fitting it to the naming data of 22 Finnish-speaking dementia patients and 19 neurologically intact control subjects. The tests showed an excellent fit between the model’s and the subjects naming response distributions. Thus our model seems be suitable to simulate naming disorders of dementia patients.
An Application of One-class Support Vector Machines to Nosocomial Infection Detection
Authors: Cohen Gilles  , Hilario Mélanie  , Sax Hugo  , Hugonnet Stéphane  , Pellegrini Christian  , Geissbuhler Antoine
Published: February 2025

Nosocomial infections (NIs)—those acquired in health care settings—are among the major causes of increased mortality among hospitalized patients. They are a significant burden for patients and health authorities alike; it is thus important to monitor and detect them through an effective surveillance system. This paper describes a retrospective analysis of a prevalence survey of NIs done in the Geneva University Hospital. Our goal is to identify patients with one or more NIs on the basis of clinical and other data collected during the survey. In this two-class classification task, the main difficulty lies in the significant imbalance between positive or infected (11%) and negative (89%) cases. To cope with class imbalance, we investigate one-class SVMs which can be trained to distinguish two classes on the basis of examples from a single class (in this case, only “normal” or non infected patients). The infected ones are then identified as “abnormal” cases or outliers that deviate significantly from the normal profile. Experimental results are encouraging: whereas standard 2-class SVMs scored a baseline sensitivity of 50.6% on this problem, the one-class approach increased sensitivity to as much as 92.6%. These results are comparable to those obtained by the authors in a previous study on asymmetrical soft margin SVMs; they suggest that one-class SVMs can provide an effective and efficient way of overcoming data imbalance in classification problems.