bluuebunny/crossref_metadata_2025 huggingface dataset:
Record Linkage Strategies: Part II. Portable Software and Deterministic Matching
Authors: Roos L. L. , Layefsky M. , Singleton J. A. , Wajda A.
Published: March 2018

Software to perform record linkage should have several characteristics: (1) portability in being able to function with researchers’ current arrangement of computer systems and languages, (2) flexibility in handling different linkage strategies, and (3) low cost in both computer time and researchers’ efforts. A linkage package (LINKS) is described which satisfies these criteria; LINKS provides tools for both deterministic and probabilistic linkage as well as test modules for assessing data quality and structure. Because each linkage project is different, the modular nature of the software allows for better control of the programming process and development of unique strategies. Since the user provides the weights and decision rules, he may modify data between steps and/or develop extra steps to supplement the basic modules. In two information-rich linkage projects involving California AIDS data, LINKS identified mortality using deterministic approaches and permitted comparisons with other software and strategies. Flexible software and a deterministic approach would have eliminated the expensive key entry used to add full names and social security numbers as additional identifiers to one of the California data files.
LIED - Liver: Information, Education and Diagnosis
Authors: Console L. , di Meana V. , Torasso P. , Molino G.
Published: March 2018

In this paper we describe LIED (Liver: Information, Education and Diagnosis), a diagnostic expert system devoted to medical education in the field of hepatology6. LIED combines the facilities of a traditional expert system for clinical diagnosis with several modules designed for educational purposes. The goal of such modules is to train physicians, in particular as regards the improvement of their problem solving ability (at the end of their curricula students in medicine usually lack experience in organizing an efficient and accurate diagnostic process). Training on real and simulated cases has been widely recognized as a proper approach to clinical experience. The architecture of the diagnostic system is introduced, which forms the core of LIED, and which has been derived from our previous experience, and the various educational functions are discussed that were developed on top of the basic architecture.
Checkup Interval and Cancers in Automated Multiphasic Health Testing and Services
Authors: Takahashi T. , Uemura H. , Noto T. , Shinozuka T. , Kinoshita H. , Matsuyama M. , Suzuki S. , Osamura Y. , Oogushi Y. , Hinohara S.
Published: March 2018

The purpose of this study was to disclose which types of cancer and how many persons with cancer were detected among the AMHTS examinees of our AMHTS center by using the hospital information retrieval system, and to study the relationship between cancer and the number of examinees, checkup intervals, and frequency in AMHTS. The examinees who had checkups more than twice were divided into three groups based on their checkup intervals: within one year, one to two years, and over two years. The relationship between cancer ratios and checkup intervals was evaluated in each group of examinees. In those having checkups within one year and from one to two years the cancer rate was 2.9 patients per 1,000 persons. However, in those having checkups after a two-year period or longer, the cancer rate was 4.3, clearly greater than the rate of the other two groups.
Intelligent Processing of Loosely Structured Documents as a Strategy for Organizing Electronic Health Care Records
Authors: Essin D. J.
Published: March 2018

Loosely structured documents can capture more relevant information about medical events than is possible using today’s popular databases. In order to realize the full potential of this increased information content, techniques will be required that go beyond the static mapping of stored data into a single, rigid data model. Through intelligent processing, loosely structured documents can become a rich source of detailed data about actual events that can support the wide variety of applications needed to run a health-care organization, document medical care or conduct research. Abstraction and indirection are the means by which dynamic data models and intelligent processing are introduced into database systems. A system designed around loosely structured documents can evolve gracefully while preserving the integrity of the stored data. The ability to identify and locate the information contained within documents offers new opportunities to exchange data that can replace more rigid standards of data interchange.
The Computerized Medical Record is not the Patient Analog. A Four Partners Scenario in Clinical Encounters
Authors: Leplège A. , Heve D. , Grémy F.
Published: March 2018

Response to: Kluge E-HW. Advanced patient records: some ethical and legal considerations touching medical information space. Meth Inform Med 1993; 32: 95-103.
The Use of Documents for Computer-Based Patient Records
Authors: Collen M. F.
Published: March 2018

Response to: Essin DJ. Intelligent processing of loosely structured documents as a strategy for organizing electronic health care records. Meth Inform Med 1993; 32: 265-8.
A Model for Estimation of the Pulmonary Capillary Pressure
Authors: Jensen E. W. , Demant L. , Sanchez R.
Published: March 2018

To estimate the pulmonary capillary pressure, a theory was introduced by Holloway and coworkers. Based upon this, a mathematical model describing the measured data was developed. Because the physiologic data are embedded in noise and the pulmonary capillary pressure cannot be measured directly, we simulated an extensive series of data. The noise properties of the data were as analyzed to design a signal-processing tool, that cancels the noise from the measured data. The signal processing tool developed for the current application consists of pre-processing with a moving time average filter and post-processing with a neural network. After a verification procedure the tool can be applied to measured data, hence a more reliable measurement of the pulmonary capillary pressure is achieved.
Adaptive Signal Analysis and Interpretation for Real-time Intelligent Patient Monitoring
Authors: Manders E. J. , Lindstrom D. P. , Dawant B. M.
Published: March 2018

On-line intelligent monitoring, diagnosis, and control of dynamic systems such as patients in intensive care units necessitates the context-dependent acquisition, processing, analysis, and interpretation of large amounts of possibly noisy and incomplete data. The dynamic nature of the process also requires a continuous evaluation and adaptation of the monitoring strategy to respond to changes both in the monitored patient and in the monitoring equipment. Moreover, real-time constraints may imply data losses, the importance of which has to be minimized. This paper presents a computer architecture designed to accomplish these tasks. Its main components are a model and a data abstraction module. The model provides the system with a monitoring context related to the patient status. The data abstraction module relies on that information to adapt the monitoring strategy and provide the model with the necessary information. This paper focuses on the data abstraction module and its interaction with the model.
Bonhoeffer-van der Pol Oscillator Model of the Sino-Atrial Node: A Possible Mechanism of Heart Rate Regulation
Authors: Sato S. , Doi S. , Nomura T.
Published: March 2018

A Bonhoeffer-van der Pol equation with a stable limit cycle is proposed as a model of the pacemaker in the sino-atrial node to exptain heart rate regulation. Standard tools, such as the phase transition curve in nonlinear dynamic system theory, are used to analyze the model and results are compared with other studies on experiments with dogs.
Heart Signal Recognition by Hidden Markov Models: The ECG Case
Authors: Thoraval L. , Carrault G. , Bellanger J. J.
Published: March 2018

Wave recognition in ECG signals by Hidden Markov Models (HMMs) relies on the stationary assumption for the set of parameters used to describe ECG waves. This approach seems unnatural and consequently generates severe errors in practice. A new class of HMMs called Modified Continuous Variable Duration HMMs is proposed to account for the specific properties of the ECG signal. An application of the latter, coupled with a multiresolution front-end analysis of the ECG is presented. Results show these methods can increase the perfomance of ECG recognition compared to classical HMMs.
Neural Network for Automatic Analysis of Motility Data
Authors: Kruse-Andersen S. , Kolberg J. , Jakobsen E.
Published: March 2018

Continuous recording of intraluminal pressures for extended periods of time is currently regarded as a valuable method for detection of esophageal motor abnormalities. A subsequent automatic analysis of the resulting motility data relies on strict mathematical criteria for recognition of pressure events. Due to great variation in events, this method often fails to detect biologically relevant pressure variations. We have tried to develop a new concept for recognition of pressure events based on a neural network. Pressures were recorded for over 23 hours in 29 normal volunteers by means of a portable data recording system. A number of pressure events and non-events were selected from 9 recordings and used for training the network. The performance of the trained network was then verified on recordings from the remaining 20 volunteers. The accuracy and sensitivity of the two systems were comparable. However, the neural network recognized pressure peaks clearly generated by muscular activity that had escaped detection by the conventional program. In conclusion, we believe that neu-rocomputing has potential advantages for automatic analysis of gastrointestinal motility data.
Nonlinear Interpretation of Respiratory Sinus Arrhythmia in Anesthesia
Authors: Loula P. , Lipping T. , Jäntti V. , Yli-Hankala A.
Published: March 2018

A non-parametric method is presented for modelling nonlinear dynamic mechanisms of respiratory sinus arrhythmia (RSA) in anesthesia caused by positive pressure ventilation. RR interval sequences are shown with Tsay’s linearity test to contain both short-term and long-term nonlinear components, which cannot completely be modelled with optimal linear methods. The nonlinear approach is based on Wiener’s theory for broad-band random input signal. The input-output model is formed for tracheal pressure and RR interval sequence. Second-order and third-order nonlinearities in RSA fluctuation are found and demonstrated.
Reconstruction of Repetitive Signals
Authors: van Bemmel J. H. , Schijvenaars R. J. A. , Kors J. A.
Published: March 2018

A technique is presented for the reconstruction of signals that suffered sampling-frequency decimation. Two assumptions are made: the original signal has to be repetitive, and no anti-aliasing filter has been used before frequency decimation. The performance of the technique is assessed by using test signals of which the original signal is known.
Selective Averaging of Evoked Potentials using Trajectory-Based Clustering
Authors: Nyberg H. N. , Zouridakis G. , Jansen B. H.
Published: March 2018

A clustering method has been developed to group evoked potentials that display similar prestimulus dynamic behavior. The procedure involves using the method of time delay embedding to construct a trajectory in state space from a time series. Certain features that characterize the geometry of the trajectory have been defined. The trajectory-based clustering algorithm has been applied to visual evoked potentials to determine relationships between prestimulus EEG and evoked potential shape.
Parameters for a Knowledge Base for Acute Appendicitis
Authors: Ikonen J. , Juhola M. , Eskelinen M. , Pesonen E.
Published: March 2018

Acute appendicitis is the most common cause of acute abdomen requiring surgical intervention. The clinical diagnosis of acute appendicitis is not always easy due to variable symptomatology, particularly at the onset. The contributions of history-taking and physical examination in the diagnosis of acute appendicitis was studied in connection with the Research Committee of the World Organization of Gastroenterology (OMGE) survey of acute abdominal pain. Especially the suitability of diagnostic parameters in the construction of an expert system for automatic decision making was studied. The results clearly show that it is possible to construct an expert system for automatic decision making in the diagnosis of acute appendicitis.
Time-Frequency Analysis of Ventricular Late Potentials
Authors: Khadra L. , Brachmann J. , Dickhaus H.
Published: March 2018

The time-frequency characteristics are studied of averaged and filtered ECG records from 21 patients with sustained ventricular tachycardia and 29 healthy control subjects. Simulated data as well as real ECG records reveal the detection accuracy of the wavelet transform of signals with late potentials. The wavelet-transforms of preprocessed ECG signals are plotted in the time-frequency plane. These representations of the signals are well suited to describe the different characteristics of the patients and healthy subjects. A quantitative discrimination was performed with a sensitivity of 90% and a specificity of 72% by the energy underneath the squared modulus of the time-frequency distribution plots of the computed wavelet transforms.
From Nursing Information Systems to Patient Information Systems
Authors: Coward P. M.
Published: March 2018

Clinical information systems, developed for specific disciplines, reinforce the fragmentation of patient care and fail to support integrated, patient centered approaches. Fundamental restructuring of systems development is required to prepare the health care system and the practice of nursing for the future.
Recommendations for Medical Informatics Training in The Netherlands
Authors: Hasman A.
Published: March 2018

In this contribution recommendations for education and training in Medical Informatics as they have been formulated end 1987 by the Subcommittee Medical Informatics of the Royal Netherlands Academy of Arts and Sciences are described. The current situation of education and training is presented and compared with the recommendations. It is concluded that not all recommendations have yet been followed up.
Twenty Years Medical Informatics Education at Heidelberg/Heilbronn: Evolution of a Specialized Curriculum for Medical Informatics
Authors: Leven F. J. , Haux R.
Published: March 2018

The medical informatics curriculum at University of Heidelberg/School of Technology Heilbronn started in 1972 as a specialized university curriculum. In this paper, we report on 20 years of experience and the evolution of this educational approach with respect to structure and content of the curriculum. We emphasize that this evolution parallels the development of medical informatics to a medical discipline in its own right, with distinct application domains and specific methodological approaches. Based on our experience and on recommendations from the national and international community, we describe and discuss the features of the curriculum.
Diagnoses Generated by Numerical Taxonomic Methods Applied to Standard Blood Variables
Authors: Abbott L. A. , Mitton J. B.
Published: March 2018

Data taken from the blood of 262 patients diagnosed for malabsorption, elective cholecystectomy, acute cholecystitis, infectious hepatitis, liver cirrhosis, or chronic renal disease were analyzed with three numerical taxonomy (NT) methods : cluster analysis, principal components analysis, and discriminant function analysis. Principal components analysis revealed discrete clusters of patients suffering from chronic renal disease, liver cirrhosis, and infectious hepatitis, which could be displayed by NT clustering as well as by plotting, but other disease groups were poorly defined. Sharper resolution of the same disease groups was attained by discriminant function analysis.
Towards the Use of a Tree Branching Logic in the Environment of a Hospital Information System
Authors: Berney J.-Ph. , Baud R. , Scherrer J.-R.
Published: March 2018

It is well known that Frame Selection Systems (FFS) have proved both popular and effective in physician-machine and patient-machine dialogue. A formal algorithm for definition of a Frame Selection System for handling man-machine dialogue is presented here. Besides, it is shown how the natural medical language can be handled using the approach of a tree branching logic. This logic appears to be based upon ordered series of selections which enclose a syntactic structure. The external specifications are discussed with regard to convenience and efficiency. Knowing that all communication between the user and the application programmes is handled only by FSS software, FSS contributes to achieving modularity and, therefore, also maintainability in a transaction-oriented system with a large data base and concurrent accesses.
A Computerized Repository System for Collection and Retrieval of Acceleration Stress Research Data
Authors: Whinnery J. E. , Slaughter J. W.
Published: March 2018

A data repository system for use in aeromedical acceleration research has been developed and is currently in use at the USAF School of Aerospace Medicine. The major functions of the repository include: a) increasing safety in human acceleration experimentation, b) documentation of clinical aeromedical evaluations, c) interface with management utilization systems, and d) rapid retrieval of data for analysis to enable a more in-depth understanding of +Gz physiology. The repository utilizes the System 2000 Data Base Management System. The applications of the data base are illustrated by several examples including the electrocardiographic response to acceleration stress.
ARMA – Filtering of Evoked Potentials
Authors: Heinze H.-J. , Künkel H.
Published: March 2018

A method of evoked potential data processing alternative to the averaging method will be discussed. It is to extract evoked potentials only from two segments. The theoretical basis of this procedure is the so-called ARMA model which gives a high frequency resolution of a periodic signal mixed with noise in a relatively low signal-to-noise ratio. The method is tested by simulation studies. The applicability will be demonstrated by clinical examples.
A New Procedure for Analysis of Medical Classification
Authors: Woodbury M. A. , Manton K. G.
Published: March 2018

A number of classification techniques have been applied to the analysis of medical diagnostic systems and decision making. Commonly used approaches such as cluster analysis, linear discriminant analysis and Bayesian classification are subject to logical and statistical limitations. In this paper we present a methodology, called »grade of membership« analysis, which resolves many of those limitations. This methodology deals simultaneously with the dual problems of case clustering and estimation of discriminant coefficients. The methodology also permits the assessment of the reliability of externally defined medical diagnoses, multiple diagnoses for individuals, disease progression and severity, and permits the representation of patient heterogeneity within diagnostic category. Maximum likelihood principles are invoked both to obtain parameter estimates and as a basis for likelihood ratio testing of complex hypotheses about the model structure. The model is illustrated by an analysis of data on abdominal symptoms and disease.
A Stochastic Model for the Inheritance of the Cancer Proneness Phenotype
Authors: Tautu P. , Wagner G.
Published: March 2018

A continuous parameter, stationary Gaussian process is introduced as a first approach to the probabilistic representation of the phenotype inheritance process. With some specific assumptions about the components of the covariance function, it may describe the temporal behaviour of the “cancer-proneness phenotype” (CPF) as a quantitative continuous trait. Upcrossing a fixed level (“threshold”) u and reaching level zero are the extremes of the Gaussian process considered; it is assumed that they might be interpreted as the transformation of CPF into a “neoplastic disease phenotype” or as the non-proneness to cancer, respectively.
Automated Indexing of SNOMED Statements into ICD
Authors: Wingert F.
Published: March 2018

A formal language is presented which is used to generate a transformation table for mapping SNOMED statements to ICD codes. Non-terminal symbols define parts of the SNOMED space, the highest order of which corresponds to ICD categories. Performance of the corresponding program system and remaining problems are described.
The Kappa Coefficient and the Prevalence of a Diagnosis
Authors: Gjørup Thomas
Published: March 2018

The kappa coefficient is a widely used measure of agreement between observers’ independent recording of diagnoses. Kappa adjusts the overall agreement for expected chance agreement. The dependence of kappa on the prevalence . of a diagnosis has not previously been emphasized. This dependence means that kappa does not give a general statement of the reproducibility of a diagnosis. The result of a study of observer agreement should, therefore, not – as it has been done in several studies – be given by the kappa value alone. The kappa value should always be given together with the original results of the study.
A Knowledge-based System for Data Analysis and Interpretation
Authors: Chowdhury Shamsul , Wigertz Ove , Sundgren Bo
Published: March 2018

Traditionally, statistical packages are employed to derive or infer facts about a Universe of Discourse through data analysis and interpretation. It is analysis that serves to transform data into information. Statistical packages provide the users with relatively easy-to-use and powerful mechanics of data analysis, but up to now they do not provide much help with the design and strategies of the analysis. As such, there is a risk of misuse of these packages by statistically inexperienced users. We propose the use of knowledge-based interfaces to support this category of users in statistical evaluations. This paper discusses our experiences from the implementation of a knowledge-based system called MAXITAB. It provides guidance in the processes of data analysis and interpretation and has been programmed as an interface to the statistical package MINITAB.
Validating the Knowledge Base of a Therapy Planning System
Authors: Shwe M. A. , Tu S. W. , Fagan L. M.
Published: March 2018

Validation of expert system knowledge bases has proved to be difficult. This paper presents a description of a system called ScriptGen that generates test data for validating the knowledge base of the ONCOCIN cancer therapy planning system. Because of the size and complexity of the ONCOCIN knowledge base, we require tools for automated validation. ScriptGen, which applies techniques developed in testing both traditional software and expert systems, uses a parallel model of the ONCOCIN knowledge base and its own inference engine to generate test cases. We derived the limits of the system from a study that seeded errors into an existing knowledge base.
Fit of a Rayleigh Distribution on Censored Data — Study of Atrial Fibrillation
Authors: Rey W. J. J. , Martin L. J. , Bernard R.
Published: March 2018

This paper attempts to verify whether the threat to life caused by the fact that an event is delayed increases with the length of the delay. Such a mechanism would be a safety feature. Assessment is given in the special case of the RRj variate or interval between successive cardiac contractions for patients in atrial fibrillation. Fit of a Rayleigh distribution on censored data and Monte Carlo methodology assessment are discussed.
In terms of reliability theory, we present a linearly increasing failure rate model and test whether the observed process permits its validation.
Experiences with the Use of Automation for Collecting and Recording Medical-History Data
Authors: Mayne John G.
Published: March 2018

For the past several years, experimental studies have been undertaken at the Mayo Clinic to evaluate the feasibility of utilizing electronic data processing to handle medical information, especially the medical information which makes up a medical record. We have experimented with automated techni- ques for collecting and storing medical-history data, specifically with techniques for computer generation and processing of health questionnaires, for computer-controlled administration of health questionnaires, and for computer-controlled entry and retrieval of medical-history data directly by physicians in ordinary English language by use of a video-screen and light-pen computer terminal.

The questionnaire studies are concerned with ways of entering into computer storage medical-history data obtained from patients without physician involvement; the video-screen studies are concerned with entry into computer storage of medical-history data obtained by physicians in their interview with the patient. The paper describes our experiences in these studies.
Computer-Assisted Research of Medical Records
Authors: Schneiderman L. J. , Baylor M.
Published: March 2018

The Facilitated Access File, described herein, has proved to be an acceptable, relatively simple, yet feasible strategy for general medical record information retrieval at a university hospital clinic. Physicians record physical examination data in free-text mode, then through a rapid exercise of judgment, create an index to these data which is computer-stored. Such an index file provides future investigators facilitated access back to the original handwritten data and permits a variety of statistical studies. The system has been in use for over a year and has proved to be of value in clinical research and student teaching.
Erfahrungen mit der routinemäßigen Anwendung einer automatisierten Röntgenbefundung (System ORVID)
Authors: Tbeichel J. , Hirsch M.
Published: March 2018

Die Arbeit berichtet über Erfahrungen mit der routinemäßigen Anwendung einer Methode zur programmierten Befundung und Dokumentation in der Röntgendiagnostik (ORVID). Bei der Befundung von 2 286 Röntgenuntersuchungen erwies sich das System ORVID als praktikabel.

Das System bringt für den befundenden Arzt einen erhöhten Zeitaufwand mit sich, der durch Verbesserung der benutzten Satzbibliotheken und durch programmtechnische Änderungen herabgesetzt werden konnte. Einen gewissen zeitlichen Mehraufwand wird man bei jeder datenverarbeitungsgerechten Erfassung medizinischer Befunde in Kauf nehmen müssen.
Assessment of Questions and Questionaries
Authors: YOUNG D. W.
Published: March 2018

A method is presented for the evaluation of. both individual questions and whole questionaries. The method involves two stages, administering the questions and later an interview at which the questions are reasked and the answers checked. It is suggested that questions can be described by means of nine properties and that questionaries can be described by means of these same nine properties plus two others. A set of indices representing these properties is derived from the evaluation of a particular set of questions. The way certain indices are selected for different purposes is discussed.
Diagnose-Modelle in der Medizin
Authors: JESDINSKY H. J.
Published: March 2018

Diagnose-Modelle werden beschrieben und durch einfache Beispiele veranschaulicht. Nach dem deterministischen Modell mit starrer Symptom-Krankheits-Matrix kommen die Wahrscheinlichkeitsmodelle, Bayessche Formel und Likelihood-Verfahren, zur Sprache. Von verschiedenen Modifikationen werden vor allem gewisse sequentielle Diagnosestrategien betrachtet. Schließlich wird ein Beispiel für die Anwendung der statistischen Entscheidungstheorie angeführt, Das Ziel dieser elementaren Einführung ist es, den Kliniker mit den Problemen der Anwendung von Diagnose-Modellen, insbesondere den Erfordernissen hinsichtlich genauer Definition und Qantifizierung aller in diesem Zusammenhang auftretenden Begriffe, bekannt zu machen.
Pattern-Recognition: A Comparison of the Performance of Clinicians and Non-Clinicians - with a Note on the Performance of a Computer-Based System
Authors: DE DOMBAL F. T. , HORROCKS J. C. , STANILAND J. R. , GUILLOU P. J.
Published: March 2018

This paper describes a series of 10,500 attempts at »pattern-recognition« by two groups of humans and a computer based system. There was little difference between the performances of 11 clinicians and 11 other persons of comparable intellectual capability. Both groups’ performances were related to the pattern-size, the accuracy diminishing rapidly as the patterns grew larger. By contrast the computer system increased its accuracy as the patterns increased in size.

It is suggested (a) that clinicians are very little better than others at pattem-recognition, (b) that the clinician is incapable of analysing on a probabilistic basis the data he collects during a traditional clinical interview and examination and (c) that the study emphasises once again a major difference between human and computer performance. The implications as - regards human- and computer-aided diagnosis are discussed.
SYS — Konzept und Anwendungsmöglichkeiten eines benutzerfreundlichen Systems
Authors: Leiser E.
Published: March 2018

Ein Benutzersystem sollte vielseitig sein und unkompliziert in der Anwendung. In SYS wird versucht, diese beiden Forderungen zu vereinigen. Das System setzt auf der Benutzerseite keinerlei spezifische EDV-Kenntnisse voraus und deckt auf der Problemseite ein breites Spektrum möglicher Anwendungen ab. Die Möglichkeiten und Eigenschaften des Systems SYS in seiner jetzt vorliegenden Ausbaustufe — stark erweitert im Vergleich zur ersten veröffentlichten Fassung — werden beschrieben und zur Diskussion gestellt.
AMAP - A General Optical Mark Reader Form Evaluation Program
Authors: Pocklington P. R.
Published: March 2018

Due to the increasing use of Optical Mark Reader forms for recording data it is desirable that we have a system to process such data from various aspects.

This paper describes the requirements of a system that performs such evaluation along with the statements that enable the user to formulate conditions both for the plausibility of marking of such forms and also the necessary evaluation.

Also touched upon is the use of such statements for general data evaluation and the link between such a data acquisition program and a general patient data-base.

The interpretation modules for AMAP meet the criteria of a problem-oriented compiler and the system makes use of the ASSEMBLER and ASSEMBLER MACRO languages. It has been implemented on the IBM/360—67 computer at the Medical School Hannover.

AMAP is a subsystem of the project »DIES« (Data Interpretation and Evaluation System) the aim of which is the production of program modules for the interpretation and evaluation of freely defined structured data.
Validity of a Diagnostic Test Designated by a Single function
Authors: Muic V. , Petres J. J. , Telisman Ž.
Published: March 2018

We have designated the validity of a diagnostic test by a single function S taking into account the values of clinical specificity, sensitivity, and the morbidity rate. Thus, by the use of this function each possible diagnostic test can be characterized and easily differentiated from each other.

When integrating function S over all x’s (morbidity rates), a parameter Is is obtained which can provide information on the total diagnostic capacity of a test because it comprises the diagnostic properties of both the positive and the negative test results (p+ and p-) in all possible samples with the morbidity rate (x) ranging from 0 to 1.

p+ and p- parameters being a posteriori probabilities were used to denote the diagnostic validity,of the positive and the negative test results respectively. By these parameters diagnostic conclusions could be drawn even from unselected population samples (with x values between 0 and 1) in which sensitivity and specificity parameters have no diagnostic properties.
Benefit-Cost and Cost-Effectiveness Analyses in Rehabilitation Research Programs
Authors: Thball R. M. , Cardus D.
Published: March 2018

There exists a disproportion between the requirements of an optimal rehabilitation research and the financial means available. For this reason, the official financial backers are interested in analytical methods (models) for the evaluation of such research projects which will furnish them with a numerical justification of their actions. The authors present such a model which has been developed by a TIRRRice interdisciplinary team.
Epidemiological Research in Total Communities: Settings and Perspectives
Authors: Epstein F. H.
Published: March 2018

Problems of epidemiological research into the causes of disease and questions relating to medical care can both be studied with advantage either in a representative sample of the population or in a community in its totality. The advantages and shortcomings of the sample approach and the total community operation have been contrasted and discussed. The ecological orientation of total community studies has been described in some detail; an actual example of such a study was given. The essential unity of medical research and medical practice in community health was stressed.
Zur Methode der maschinellen Dokumentation histologischer Befunde in der Pathologie
Authors: Jacob W.
Published: March 2018

Verf. beschreibt das von ihm für die routinemäßige Erfassung der histologischen Befunde eines großen pathologischen Instituts entwickelte Dokumentationssystem, das bei Verwendung eines bis zu 5stelligen alphabetischen Kurzschlüssels für die diagnostischen Begriffe den Vorteil der Lesbarkeit der Karten bietet. Sortiert nach dem Namen des Patienten dienen die Karten als Suchkartei und für die Beantwortung von Anfragen; ein zweiter Kartensatz dient der wissenschaftlichen Auswertung der Befunde. Die Bearbeitung des Materials erfolgt mittels eines Maul-Selektors AS 12, der die gleichzeitige Selektion von bis zu 12spaltigen Begriffen gestattet.
Eine Einführung in die Statistik der Todesursachen
Authors: Ebbing H. C.
Published: March 2018

Der Arzt ist offensichtlich geneigt, den medizinischen Wert einer Statistik der Sterblichkeit und der Todesursachen zu unterschätzen. Er ist häufig der Ansicht, daß die Beteiligung des Arztes an der Beurkundung eines Sterbefalles eigentlich nur im Hinblick auf die Notwendigkeit einer Personenstandsgesetzgebung erforderlich ist. Diese Betrachtungsweise ist durchaus verständlich. Der Arzt hat in der Krankheit zunächst nur individuelles Schicksal zu sehen gelernt.

Krankheit ist aber auch Massenerscheinung. Das Phänomen ,,Krankheit” betrifft viele Individuen gleichzeitig unter ähnlichen Umständen. In der Morbiditäts- und Mortalitätsstatistik prägen sich Faktoren aus, die bei der Krankheits entstehung mitwirken. Fehlerquellen machen eine richtige Deutung der Statistik freilich oft schwierig. Um Fehlschlüsse zu vermeiden, bedarf es besonderer Erfahrung. Für den kritischen Benutzer ist die Statistik der Sterblichkeit und der Todesursachen jedoch eine wichtige Quelle allgemein-ärztlicher und sozial-medizinischer Erkenntnisse. Sie verdient mehr wissenschaftliche Beachtung als bisher.
Ergebnisse einer Umfrage zur Zeitschriften-Grundausstättung einer medizinisch en Fakultätsbibliothek
Authors: Köhler C. , Hardegg W. , Wagner G.
Published: March 2018

Zur Ermittlung des unbedingt erforderlichen Zeitschriften-Grundstockes für die geplante Medizinische Fakultätsbibliothek an der Universität Heidelberg wurden die Angehörigen des Lehrkörpers gebeten, in einer Liste von 890 verschiedenen Zeitschriftentiteln aus den Bereichen der Medizin ünd der Naturwissenschaften den jeweils für sie persönlich zutreffenden Dringlichkeitsgrad zu vermerken. 92 Dozenten beteiligten sich an der Umfrage; ihre Antworten wurden einem Gewichtungsverfahren unterzogen, das eine objektive Vergleichbarkeit gestattet.

Die Umfrage bestätigte die alte Bibliothekserfahrung, daß nur relativ wenige Zeitschriften sehr häufig, die meisten dagegen relativ selten bzw. nur von einem kleinen Benutzerkreis gelesen werden. Nur 10 (= 1, 1%) der 890 in der Titelliste enthaltenen Periodika wurden von mehr als 50% der Dozenten als »häufig gebraucht« gekennzeichnet. Die Theoretiker scheinen einen wesentlich breiteren Sektor der medizinischen und naturwissenschaftlichen Fachliteratur zu lesen als die Kliniker; sie gaben fast doppelt so viele Titel als »dringend benötigt« an wie letztere. Bei den Klinikern wurden deutschsprachige Fachzeitschriften am häufigsten gewünscht; bei den Theoretikern überwiegen die englischsprachigen Periodika. Zeitschriften in anderen Sprachen spielen nur eine untergeordnete Rolle.

Die 50 am häufigsten gelesenen Zeitschriften sowie die jeweils 3 am höchsten bewerteten Fachblätter in 64 unterschiedenen Spezialgebieten werden mitgeteilt.
Die Anzahl verschlüsselter Diagnosen in einem dokumentationsgerechten Krankenblatt für internistische Patienten
Authors: Günther O. , Paul I. , Poser H. , Müller Fr.
Published: March 2018

Anfang 1963 wurde in der Medizinischen Universitäts-Klinik Greifswald die Krankenblatt-Dokumentation mit Maschinenlochkarten eingeführt; der dafür entwickelte Krankenblattkopf gestattet die Verschlüsselung von maximal 6 Diagnosen.

Die vorliegende Arbeit ist hauptsächlich statistischen Untersuchungen über die Verteilung der verschlüsselten Diagnosen auf Diagnosengruppen und Altersklassen gewidmet. Sie lassen nach Ansicht der Verfasser den Schluß zu, daß in einem dokumentationsgerechten Krankenblattkopf für internistische Patienten vier Diagnosen-Felder ausreichen.

Abschließend wird kurz das Problem der Krankenblattbearbeitung diskutiert und auf die Bedeutung von Dokumentationsfachkräften hingewiesen.
Medizinische Dokumentation mit Markierungsbelegen in der Hals-, Nasen-, Ohren-Heilkunde
Authors: Neumannund H. , Spindelberger W.
Published: March 2018

Seit Jänner 1967 werden an der HNO-Klinik der Universität Wien IBM-Markierungsbelege — ein relativ neues Verfahren für die Datenerfassung — für die Dokumentation von Anamnese und Status verwendet. Bevor diese Belege im Routine-Betrieb eingesetzt werden konnten, mußten einige Studien hinsichtlich der Auswahl und Anordnung der Begriffe durchgeführt werden. Es wurden zwei Formulartypen, »Belegheft« und »Schuppenformular« genannt, entwickelt und längere Zeit hindurch in der Praxis erprobt. Das »Belegheft« wurde schließlich hauptsächlich aus preislichen Gründen bevorzugt und ausnahmslos auf allen Stationen eingesetzt. — Die im Markierungsbeleg eingestrichenen Daten werden vom Computer eingelesen und in einer festgelegten Reihenfolge im Hinblick auf spätere mathematisch-statistische Auswertungen gespeichert. Beim übertragen der Daten auf Magnetband wird ein Bericht gedruckt, der alle wesentlichen Daten von Status und Anamnese enthält.
Medizinische Forschung und mathematisches Denken
Authors: Fuchs G.
Published: March 2018

Mathematische Denkverfahren, können der Medizin bei ihren Forschungsaufgaben helfen, wenn die Medizin in der Lage ist, für ihre Probleme diesen Methoden angepaßte gedankliche Modelle aufzustellen. Die Mathematik hat im Verlauf ihrer Entwicklung drei typische Denkformen zu Ausgangspunkten ihrer Forschung gemacht: das Zahlendenken, das Funktionsdenken und das Strukturdenken. Jede Denkform hat eine methodische Brücke zur medizinischen Forschung eröffnet, wobei die Medizin besondere, diesen Denkformen jeweils angepaßte Modelle entwickelt hat: die mathematisch-statistischen Methoden, angewendet auf numerische Modelle, die funktionellen Methoden, angewendet auf biometrisch-biophysikalische Modelle, sowie die logistischen Methoden, angewendet auf Strukturoder Ordnungsmodelle. Alle drei Methoden sind, wie durch Beispiele belegt wird, bei medizinischen Fragestellungen anwendbar und haben zu den drei Aufgabengebieten Medizinische Statistik, Medizinische Biometrie und Medizinische Dokumentation geführt.
Computer Evaluation of Graphical Physiologic Data for Diagnosis of Coronary Heart Disease
Authors: Harrison W. K. , Talbotand S. A.
Published: March 2018

Assessment of clinical significance in these records is sharpened by discriminant analysis. The selection and conditioning of data, requires hand measurements at kilobits, or machine measurement at nearly megabit quantities, since multiple channels are essential. Clinically significant features of the graphical pattern of the BCG were determined, over adequate age-matched populations of normals and of patients with ischemic heart disease. This required repeated calculation of the discriminant function, including several subsidiary statistics and graphical print-outs. Optimal features of a single physiologic trace thus produce a separatrix or a severity scale for the single disease-entity. Repeating this for other physiological traces, yields a sequential approach to diagnosis, in contrast to the unitary or parallel approaches of the Bayesian (probability-density) methods that have been used.
Improved Communications within a Clinic through the Use of a Realtime Patient Queue
Authors: Ragan D. P.
Published: March 2018

Communication within a medium to large sized medical clinic is difficult. The problems of exchanging information among muses, technicians and doctors have become a critical issue in many clinics. These problems manifest themselves in patient waiting rooms by

1. forgotten patients,

2. inequitable scheduling of physician consultation,

3. low staff morale due to ambiguous verbal communication, and

4. anxiety and discomfort on the part of the patients.

In an attempt to solve these problems a computerized patient queue was developed in the radiation therapy clinic at Mallinckrodt Institute of Radiology (MIR). This system has been used successfully since 1975.
Data Security in Health Information Systems by Applying Software Techniques
Authors: Sauter K.
Published: March 2018

The problems encountered in achieving data security within computer-supported information systems increased with the development of modern computer systems. The threats are manifold and have to be met by an appropriate set of hardware precautions, organizational procedures and software measures which are the topic of this paper. Design principles and software construction rules are treated first, since the security power of a system is considerably determined by its proper design. A number of software techniques presented may support security mechanisms ranging from user identification and authentication to access control, auditing and threat monitoring. Encryption is a powerful tool for protecting data during physical storage and transmission as well.

Since an increasing number of health information systems with information-integrating functions are database-supported, the main issues and terms of database systems and their specific security aspects are summarized in the appendix.
Morphosyntaktische Zerlegung von Komposita der medizinischen Sprache
Authors: Wingert F.
Published: March 2018

Die Vorteile der Zerlegung von Komposita bei der Klartextanalyse werden dargestellt. Dazu werden verschiedene Wortmodelle erläutert. Für ein Wortmodell, bei dem ein Wort interpretiert wird als Folge von Wortteilen aus drei Typen von Segmenten, wird eine Sprache definiert, die eine formale komprimierte Notation der Regeln für die Wortanalyse erlaubt. Die Implementierung des Verfahrens wird mit einer Beschreibung der Lexika und des Wortsegmentierungsalgorithmus vorgestellt.
Some Misuses of Discriminant Analysis
Authors: Lachenbruch P. A.
Published: March 2018

In this paper some of the common misuses of discriminant analysis are discussed. The problems fall into four groups :

1. Study goals are unfocused;

2. improper sampling procedure ;

3. assumptions are violated;

4. variables are poorly defined or selected.

Identification of these problems leads to the appropriate corrective action.
Why We Need Laboratories for Applied Research in Academic Information
Authors: Matheson Nina
Published: March 2018

A common vision for an electronic management environment is emerging. Fundamental to this vision is a radical change in the way that knowledge is captured, stored, manipulated, visualized and accessed. To bring these visions to reality, partnerships need to be formed between authors, publishers, and libraries. Research and development in knowledge management is essential and universities must identify more clearly their roles as knowledge creators and distributors.
Description ofa Blockcourse in Medical Informatics
Authors: Hasnian A.
Published: March 2018

This paper describes a blockcourse in medical informatics. The course is presented to fourth, fifth and sixth year medical students and lasts one week. During the course all aspects of medical informatics are considered. Programming, databases, information systems, signal analysis, pattern recognition, expert systems, etc. are explained. Lectures alternate with hands-on experience. The subjects discussed in the lectures are rehearsed during the practical sessions, so that gaps in the student´s knowledge are immediately detected. The blockcourse has been positively rated by the students.
Education in Medical Informatics in The Netherlands: A Nationwide Policy and The Erasmus Curriculum
Authors: van Bemmel J. , SoUet P. , Grashuis J.
Published: March 2018

The curricula of all Medical Faculties still bear the characteristics of an era in which the physician was not educated in managing medical information systems, using communication networks, and processing knowledge. In attempting to formulate the prerequisites for developing and adjusting future curricula, we discuss the evolution of medical information technology during the past 25 years and give examples to illustrate that, by extrapolating current trends, future developments in information technology, medicine and education can be predicted. A plea is made for a strong interaction between scientific developments in medical informatics and academic education. In addition, a model based on our experience in medical informatics education of over 15 years, is pointed out. Furthermore, a nationwide policy on medical informatics in The Netherlands, is discussed. Our treatise is concluded by presenting the outline of the curriculum in medical informatics at the Erasmus University in Rotterdam. Educational recommendations conclude the paper.
Integration of Medical Informatics with Other Courses in the Medical Curriculum
Authors: Tumstra C.
Published: March 2018

The introduction of a new structure in the Medical Curriculum at the Leiden University Medical School has facilitated the integration of medical informatics subjects with other subjects. The paper describes the holistic nature of the new curriculum, the way Medical Informatics is interwoven with other subjects and the problems which have been encountered.
Medical Education System in Czechoslovakia: Achievements and Perspectives of Medical Informatics Education
Authors: Zvárová Jana , Vacek Zdenek
Published: March 2018

In this paper we describe medical education systems in Czechoslovakia and introduce the structure of medical informatics education in the medical curriculum at the Medical Faculty of Charles University in Prague. We state the results of a recent Prague conference on “Computers in Medical Education" and summarize the state ofthe art and perspectives in this field.
Teaching Medical Informatics to Biomedical Engineering Students: Experiences over 15 Years
Authors: Wigertz O. , Persson J. , Ahlfeldt H.
Published: March 2018

The Departments of Biomedical Engineering and Medical Informatics at Linkoping University in Sweden were established in 1972-1973. The main purpose was to develop and offer courses in medicine, biomedical engineering and medical informatics to students in electrical engineering and computer science, for a specialization in biomedical engineering and medical informatics. The courses total about 400 hours of scheduled study in the subjects of basic cell biology, basic medicine (terminology, anatomy, physiology), biomedical engineering and medical informatics. Laboratory applications of medical computing are mainly taught in biomedical engineering courses, whereas clinical information systems, knowledge based decision support and computer science aspects are included within the medical informatics courses.