bluuebunny/crossref_metadata_2025 huggingface dataset:
An Architecture for a Virtual Electronic Health Record
Authors: Talmon J.  , Tange H.  , Boers G.  , Hasman A.
Published: February 2025

The Healthcare Domain Taskforce of the Object Management Group has specified standards for secure access and retrieval of demographic and medical data. This paper discusses the strengths and weaknesses of an electronic healthcare record that implements these specifications.
Interactive Image Processing as Learning by Doing Component of a WBT Application
Authors: Horsch Alexander  , Nätscher Catharina  , Tobman Matvei  , Balbach Thomas  , Danninger Maria  , Schulz Steffi  , Stapf Daniel
Published: February 2025

Web Based Training (WBT) is of increasing importance [1][2]. In [5] the main author has presented and discussed an overall approach to WBT for medical image processing. In the present contribution the interactive part of the approach is discussed in detail and its prototypical realisation in the framework of a client server teaching application is presented.
Leveraging Intelligent Agents for Knowledge Discovery From Heterogeneous Healthcare Data Repositories
Authors: Zaidi Syed Zahid Hassan  , Abidi Syed Sibte Raza  , Manickam Selvakumar
Published: February 2025

This paper presents a case for an intelligent agent based framework for knowledge discovery in a distributed healthcare environment comprising multiple heterogeneous healthcare data repositories. Data-mediated knowledge discovery, especially from multiple heterogeneous data resources, is a tedious process and imposes significant operational constraints on end-users. We demonstrate that autonomous, reactive and proactive intelligent agents provide an opportunity to generate end-user oriented, packaged, value-added decision-support/strategic planning services for healthcare professionals, manages and policy makers, without the need for a priori technical knowledge. Since effective healthcare is grounded in good communication, experience sharing, continuous learning and proactive actions, we use intelligent agents to implement an Agent based Data Mining Infostructure that provides a suite of healthcare-oriented decision-support/strategic planning services.
A Controlled Vocabulary for Nursing Practice and Research
Authors: Saranto Kaija
Published: February 2025

The paper describes the process of evolving a controlled Nursing Vocabulary for indexing and information retrieval purposes. The vocabulary is based on terms of the thesaurus of Medline i.e. MeSH (Medical Subject Headings) by National Library of Medicine and the International Classification for Nursing Practice (ICNP) by the International Council of Nurses. The vocabulary consists of 10 themes central to nursing domain. The vocabulary is added as an independent theme to the Finnish thesaurus FinMeSH. The validity of the vocabulary has been tested for indexing nursing research once and has afterwards been revised. The validity will be tested again during spring 2002.
Informal versus Formal knowledge: IT Development in Health Care
Authors: Bertelsen Pernille
Published: February 2025

Sustainable IT operation and maintenance through user participation in design and implementation of IT-systems in health care, is only secured if informal and formal knowledge are equally recognized. The paper argues that informal situated knowledge is of significance for the individual health care worker's performance. The concept indigenous knowledge is analyzed as a subset of informal knowledge and reference is made to the concepts of social capital and cultural capital. Finally, an approach rooted in Participatory Learning and Action methods is recommended as a technique for involving staff in IT-system design for technological change.
Inter-participant Agreement in the Selection of Symptoms for the Description of Seizures
Authors: van Ast J.F.  , Talmon J.L.  , Ahles P.P.M.  , Hasman A.
Published: February 2025

Purpose: To evaluate the inter-participant agreement in the selection of symptoms for the description of seizure types.
Comparative analysis of cartilage structure on MR and CT images
Authors: Punys Jonas  , Punys Vytenis  , Puniene Jurate
Published: February 2025

The magnetic resonance (MR) imaging device outperforms the quality of CT images for diagnosis related to soft tissues. The cartilage structure is intermediary between soft tissue and bones. The methodology to compare visualisation quality of two different CT and MR techniques was developed. It enabled to evaluate the equipment priority. Before carrying out the comparative analysis of cartilage structure images the method of reducing radiation dose for a CT examination has been developed. It was based on relationship between CT adjustment parameter (reconstruction increment) and image quality. The method enabled to carry out CT examination with a considerably reduced radiation dose for a patient and the medical personnel, taking part in the experiment.
Integrating the Lightweight Authentication Protocol (LAP) with Access Control Mechanisms in Wireless Health Care Information Systems
Authors: Chousiadis C.  , Georgiadis C.K.  , Pangalos G.
Published: February 2025

Health information networks are expected to support information exchange that is authentic, accurate, private and available when, where and to whom is needed. With the increase of the shared medical information and resources in healthcare wireless information systems, unauthorized access to the information by illegal users also increases. The security of the transmitted information is a vital issue.
New Czech Postgraduate Doctoral Program in Biomedical Informatics
Authors: Zvarova Jana  , Svacina Stepan
Published: February 2025

In the paper we describe the new Czech program in Biomedical informatics with doctor degree. The agreement on cooperation of Charles University in Prague and Academy of Sciences of the Czech Republic in postgraduate doctoral studies was signed on April 23rd, 1997. The main goal of this agreement has been cooperation in development and running of joint education and training of young researchers. Nowadays there are 19 boards of scientific disciplines in postgraduate doctoral studies in biomedicine, one of them the scientific board on Biomedical informatics established in 2001. The involvement of university teachers and researchers from the EuroMISE center – Cardio in the board of biomedical informatics discipline in the postgraduate doctoral studies of biomedicine and first activities of the board are described.
Evaluation of Medical Informatics Curriculum at the Rijeka University School of Medicine in Croatia
Authors: Bilić-Zulle Lidija  , Petrovečki Mladen
Published: February 2025

This paper presents preliminary results from the study to evaluate the Medical Informatics curriculum at the Rijeka University School of Medicine, Rijeka, Croatia. Evaluation is based on the written anonymous, survey filled out by students after passing the exam. Questionnaire consisted of questions considering basic data (age, gender, study year, etc.), as well as students' opinions and marks on informatics, computer usage and teaching skills during the lessons. In total 459 students from five consecutive generations (from 1996/97 to 2000/01) were evaluated. Collected data define guidelines for teachers to improve organization and contents of curriculum. This study proved that, from one generation to the next, students show more and more interest in Medical Informatics, more of them have their own computer and more of them use Internet and e-mail communication.
Quantitative Indicators of Sonographic Image of Thyroid Gland and Their Relation to Anti- Thyroid Antibodies in Hashimoto’s Lymphocytic Thyroiditis
Authors: Smutek Daniel  , Sucharda Petr  , Šára Radim
Published: February 2025

Sonography is a widely used non-invasive diagnostic tool and its main advantage is low cost in comparison with other diagnostic methods such as immunological analyses. In this work it is presented the relation between a sonographic image of thyroid gland and an immunological status of the patients with Hashimoto's lymphocytic thyroiditis (chronic inflammation of the thyroid gland). The results, evaluated on a set of 740 B-mode sonographic images from 37 subjects, show that raw values of individual image pixels in sonogram of thyroid gland with presence and without presence of anti-thyroid antibodies are significantly different (means 31.87 and 44.56; standard deviations 8.6 and 11.82; t=3.4; p=0.0017) and that they can be used for the prediction of presence of anti-thyreoglobulin and anti-thyreoperoxidasis antibodies. This result suggests the possibility to use this method in clinical diagnostic process for reducing the costs. Also the correlation between the image features and the level of antibodies was examined. The highest correlation was found for inverse difference moment and the level of anti-thyreoperoxidasis (coefficient of determination 0.43).
Is the central nervous system a causative factor in idiopathic scoliosis?
Authors: Potoupnis M.  , Kapetanos G.  , Kimiskidis V.K.  , Symeonides P.P.
Published: February 2025

The present study was designed to investigate the involvement of central nervous system (CNS) in the pathogenesis of idiopathic scoliosis.Seventeen female patients with right thoracic idiopathic scoliosis (mean age = 13.36y) and ten normal controls (mean age =12.6y) entered the study. Magnetic stimulation of the brain was performed. Threshold measurements included upper (UT) and lower threshold (LT). Cortical latencies of MEPs during muscle activation were also measured.
Morphometric characteristics of the thoracic and lumbar pedicles in the Greek population
Authors: Christodoulou A.  , Apostolou T.  , Terzidis I.
Published: February 2025

Objectives: To measure the dimensions of the pedicles of Tl to L5 in the Greek population.
Assessing Changes in Three Dimensional Scoliotic Deformities with Difference Maps
Authors: Hill D.L.  , Berg D.C.  , Church T.  , Raso V.J.
Published: February 2025

Topographical difference maps were used to compare the trunk surfaces of subjects over the course of their treatment. Three-dimensional points representing the trunk surfaces were aligned accounting for growth and positioning. A goodness-of-fit score was calculated and a color map used to display trunk surface changes. Fifty-one successive subjects were assessed with difference maps. Two subjects each had 10 repetitions taken on the same day to assess reliability. A blinded observer used a five-point scale that extended from full agreement to full disagrment to judge the maps according to the extent and location of changes. The observations were compared to clinical measures mapped onto the same scale by another blinded observer. Goodness of fit for repeated measures averaged 5±1, for subjects deemed to have no change 7±2, for subjects with slight change 9±2, and 14±2 for subjects with significant change. Judges were in full agreement or in agreemnt with forty of the fifty-one subjects (78%) and in slight disagreement with the remaining eleven. When the cohort was subdivided in surgical, brace and no treatment groups, the judges were in full agreement or in agreement 76%, 80%, and 85% respectively. The difference map provides a qualitative and quantitative measure of how the trunk surface has changed as a whole.
Accuracy of rasterstereography versus radiography in idiopathic scoliosis after anterior correction and fusion
Authors: Hackenberg Lars  , Hierholzer Eberhard  , Liljenqvist Ulf
Published: February 2025

Rasterstereography enables to reduce the number of radiographs in the conservative treatment of idiopathic scoliosis (Cobb angles below 50°). The aim of the present study was to evaluate the use of rasterstereography in severe scoliosis before and after anterior surgery. The results show that the accuracy (as compared to radiographs) is lower in the pre-operative rasterstereographs. However, after operation the Cobb angles were less than 50° in all cases and the accuracy of the rasterstereographs was similar to that of non-operated scolioses. This finding might allow a significant reduction of post- operative radiographs.
Spine-rib Rotation Differences at the Apex in Preoperative Patients with Adolescent Idiopathic Scoliosis (AIS): Evaluation of a Three-Level Ultrasound Method
Authors: Burwell R. G.  , Aujla R. K.  , Cole A. A.  , Kirby A. S.  , Pratt R. K.  , Webb J. K.  , Moulton A.
Published: February 2025

This paper evaluates a new real-time ultrasound method to assess the difference between axial spinal (laminal) rotation and rib rotation at the apex of the scoliosis curve. An Aloka SSD 500 portable ultrasound machine with a veterinary long (172mm) 3.5 MHz linear array transducer was used to assess the reproducibility of the method in 13 preoperative patients with AIS. With the subject in a prone position and her head supported, readings of laminal and rib rotation were made directly on the back at 18 and 12 levels respectively The subject was repositioned after walking around the room and a second set of spinal and rib rotations obtained (repeats). All the readings were made by one observer (ASK). After plotting on graphs three levels of maximal difference between spine rotation and rib rotation about the apex were chosen visually by one observer (RGB) for which the mean apical spine-m/wws-rib rotation difference (SRRD) was calculated for each repeat. Findings for apical SRRDs. The mean apical SRRDs for the two repeats are 7.1 degrees and 6.9 degrees (range 2-18 degrees) with coefficients of variation of 49% and 62% respectively. Reproducibility. Graphic representation of spinal and rib rotation by 12 levels shows a fairly good agreement between repeats for most subjects. Spinal rotation is always greater than rib rotation. A paired t-test for the mean apical SRRD of the repeats shows no significant difference. Linear regression analysis of the mean apical SRRD repeats correlate significantly (r=0.70, P=0.008) with a residual mean square of 6.9 degrees (rms = 2.6 degrees). The technical error of the measurement (TEM) is 2.3 degrees and coefficient of reliability (R) 0.66. Conclusions. Real-time ultrasound can assess the difference between spinal and rib rotation about the apex of the scoliosis curve without the altered position detectably affecting the findings. The error (2-3 degrees) is high relative the mean apical SRRD (6-7 degrees). The apical SRRD findings have relevance to the pathogenesis of AIS.
Sagittal and transversal plane deformity in thoracic scoliosis
Authors: Kotwicki Tomasz
Published: February 2025

The aim of the study was to assess the sagittal and transversal plane deformity of the spine in thoracic scoliosis by the mean of 3-D radiographic analysis. 46 patients admitted for surgery for thoracic idiopathic scoliosis underwent preoperative radiographic assessment. All patients presented the same pattern of the coronal plane deformity: single right thoracic curve (Lenke 1, King 3). Neither lumbar nor proximal thoracic structural curve were present. The Cobb angle varied from 41Γ to 77 T (mean 55,4 Γ ± 8,6 Γ). Long cassette standing antero-posterior and lateral radiographs were analysed. Three-dimensional reconstruction with Rachis 91TM software was performed for each pair of radiographs. The following parameters were assessed: sagittal thoracic Cobb angle (Th4-Thl2), upper thoracic kyphosis angle (Th5-Th8), lower thoracic kyphosis angle (Th9-Thl2), superior and inferior hemi-curve sagittal angles, lumbar lordosis, sacral slope, sacral incidence, vertebral plate index, segmental vertebral axial rotation throughout the thoracic and lumbar spine. Results showed great variability of parameters assessed. The non-harmonious distribution of kyphosis was demonstrated in the thoracic spine. Local Th9- Thl2 hypokyphosis and adjacent local Th5-Th8 hyperkyphosis constitute the most typical sagittal pathologies. So called normokyphotic curves were composed of one hyperkyphotic and one hypokyphotic zone. Thl-Th4 segment revealed two patterns of segmental rotation distribution: a purely compensatory curve with no vertebral axial rotation or a rotated curve presenting the morphology intermediate between Lenke 1 and Lenke 2 types (or King 3 and King 5). In conclusion: curves presenting the same coronal plane deformity differ in their morphology assessed in the two other planes; global thoracic kyphosis angle is a misleading parameter because it covers hypo- and hyperkyphotic zones; local distal thoracic (Th9-Thl2) hypokyphosis is present in idiopathic thoracic scoliosis.
3D Biplanar Statistical Reconstruction of Scoliotic Vertebrae
Authors: Benameur S.  , Mignotte M.  , Parent S.  , Labelle H.  , Skalli W.  , De Guise J. A.
Published: February 2025

A new 3D reconstruction method of scoliotic vertebrae of a spine, using two calibrated conventional radiographic images (postero-anterior and lateral), and a global prior knowledge on the geometrical structure of each vertebra is presented. This geometrical knowledge is efficiently captured by a statistical deformable template integrating a set of admissible deformations, expressed by the first modes of variation in the Karhunen-Loeve expansion of the pathological deformations observed on a representative scoliotic vertebra population. The proposed reconstruction method consists in fitting the projections of this deformable template with the preliminary segmented contours of the corresponding vertebra on the two radiographic views. The 3D reconstruction problem is stated as the minimization of a cost function for each vertebra and solved with a gradient descent technique. The reconstruction of the spine is then made vertebra by vertebra. The proposed method allows also to efficiently obtain an accurate 3D reconstruction of each scoliotic vertebra and, consequently, it allows also to get an accurate knowledge of the 3D structure of the whole scoliotic spine. This reconstruction method is in final phase of validation.
Influence of method of asymmetric trunk mobilization on shaping of a physiological thoracic kyphosis in children and youth suffering from progressive idiopathic scoliosis
Authors: Dobosiewicz Krystyna  , Durmala Jacek  , Jendrzejek Hanna  , Czernicki Krzysztof
Published: February 2025

Idiopathic scoliosis (IS), which is substantially a three- dimensional deformation of a spine, causes not only lateral curvature and axial rotation of vertebral column, but also lordotisation of vertebrae in structural curve extension. In an effect physiological thoracic kyphosis diminishes or even disappears. Method of asymmetric trunk mobilisation in strictly symmetric positions according to Dobosiewicz not only deteriorates progression of IS or even reduces lateral curvature, but also significantly rebuilds physiological thoracic kyphosis in cases of IS accompanied by straight back.
Etiology of the so-called “idiopathic Scoliosis”. Biomechanical explanation of spine deformity. Two groups of development of scoliosis. New rehabilitation treatment; possibility of prophylactics
Authors: Karski Tomasz
Published: February 2025

Introduction: Between various etiological factors of idiopathic scoliosis we also studied the biomechanical causes connected with the hip and pelvic regions. At all children with idiopathic scoliosis there is a real or functional abduction contracture of the right hip (sometimes plus flexions- and out-rotation contracture). The right hip abduction contracture is connected with “syndrome of contractures” at newborns and babies.
Long-term Follow-up of Surgically Treated AIS Patients
Authors: Hill D.  , Raso V.J.  , Moreau K.  , Moreau M.  , Mahood J.
Published: February 2025

The aim of this study was to determine the long-term changes in spine and trunk alignment in patients who have undergone scoliosis surgery. Twenty-three (16F; 7M; at age of surgery 15.7±4.9 years) patients with adolescent idiopathic scoliosis agreed to participate and had posterior-anterior radiographs and surface topography prior to derotation surgery, within 6 months of surgery, at 2 years post-operatively and 5-10 years (mean follow-up period 6.11± 1.6 years) after surgery. Cobb angles, surface trunk rotations, and cosmetic scores were measured at each visit. A questionnaire assessed back appearance and pain at the 5-10 year follow-up. The results of the questionnaire were compared to 25 patients with idiopathic scoliosis who had recently undergone surgery. A paired two-tailed Student's t-test with p=0.05 was used to compare the deformity between visits. The Cobb angle and cosmetic score improved after surgery while the change in trunk rotation was insignificant (p=0.37). Between the two-year and 5-10 year review, the Cobb angle, cosmetic score, and surface trunk rotation significantly increased. Self- perception of appearance and pain were similar to the control group. Surgical correction of scoliosis is not completely maintained during adulthood although the radiographic and surface deterioration does not appear to be clinically significant.
Is the labyrinthine dysfunction a causative factor in idiopathic scoliosis?
Authors: Kapetanos G.  , Potoupnis M.  , Dangilas Ang.  , Markou K.  , Pournaras J.
Published: February 2025

The cause of idiopathic scoliosis remains unknown, although research has possibly eliminated some hypothetical causes. Recent reports associating scoliosis convexity with equilibrium control central processing and motor lateralization have suggested that idiopathic scoliosis is connected causally with the motor cortex. In order to analyze these factors a study of labyrinthine function was carried out. This study included seventeen female patients 12 to 14 years old (mean age= 13.36y) with right thoracic idiopathic scoliosis and twelve normal control females 12 to 14 years old (mean age =13.1y).An electro-nystagmographic study of labyrinthine function (potential nystagmus) was performed in all the patients of the study with caloric tests. The nystagmus was recorded with the electronystagmographic technique (ENG) using Hartmann device. We evaluate these parameters: Slow phase velocity (SPV), Total amplitude (Tamp), Frequency of nystagmus (Freq). No children of the study presented spontaneous nystagmus. No correlation was found between the convexity of the curvature and the direction of nystagmus in posture tests. There were no significant differences between left- and right- beating nystagmus. The results are discussed with special reference to aetiology in idiopathic scoliosis.
Business Models for Cost Effective Use of Health Information Technologies: Lessons Learned in the CHCS II Project
Authors: Riley David L.
Published: February 2025

The Department of Defense (DoD) has embarked on an initiative to create an electronic medical record for all of its eligible beneficiaries. The Clinical Information Technology Program Office (CITPO) is the joint-service program office established to centrally manage this multi-year project. The Composite Health Care System II (CHCS II) is the name of the system under development. Given the historical failure rate of large-scale government information system projects, CITPO has employed an incremental acquisition approach and striven to use industry best practices to the greatest degree possible within the constraints of federal acquisition law. Based on lessons learned during the concept exploration phase of this project, CITPO, in partnership with Integic Corporation, the prime integration contractor, has reengineered its software acquisition process to include industry best practices. The result of this reengineering process has resulted in a reduction of the total projected life cycle costs for CHCS II from the original estimate of $7.6 billion over a 14-year period to between $3.9 and $4.3 billion.
A Framework for Considering Business Models
Authors: Anderson James G.
Published: February 2025

Information technology (IT) such as computerized physician order entry, computer-based decision support and alerting systems, and electronic prescribing can reduce medical errors and improve the quality of health care. However, the business value of these systems is frequently questioned. At present a number of barriers exist to realizing the potential of IT to improve quality of care. Some of these barriers are: the ineffectiveness of existing error reporting systems, low investment in IT infrastructure, legal impediments to reforms, and the difficulty in demonstrating a sufficient return on investment to justify expenditures for quality improvement. This paper provides an overview of these issues, a framework for considering business models, and examples of successful implementations of IT to improve quality of patient care.
Framework for a Clinical Information System
Authors: Van De Velde R.  , Lansiers R.  , Antonissen G.
Published: February 2025

The design and implementation of Clinical Information System architecture is presented. This architecture has been developed and implemented based on components following a streng underlying conceptual and technological model. Common Object Request Broker and n-tier technology featuring centralised and departmental clinical information Systems as the back-end store for all clinical data are used. Servers located in the “middle” tier apply the clinical (business) model and application rules. The main characteristics are the focus on modelling and reuse of both data and business logic. Scalability as well as adaptability to constantly changing requirements via component driven Computing are the main reasons for that approach.
A Surgical Simulator for Cleft Lip Planning and Repair
Authors: Montgomery Kevin  , Sorokin Andrea  , Lionetti Giancarlo  , Schendel Stephen
Published: February 2025

The objective of this project was to develop a computer-based surgical simulation system for cleft lip planning and repair. This system allows the user to interact with a virtual patient to perform the traditional steps of cleft-lip repair. The system interfaces to force-feedback (haptic) devices to track the user's motion and provide feedback during the procedure, while performing real-time soft-tissue simulation.
Web-access to a Lung Deposition Model for Radiation Protection and Physiological Modeling
Authors: Ward Richard C.  , Eckerman Keith F.  , Ahmad Lin S.
Published: February 2025

A C++ implementation of the ICRP Lung Deposition Model was validated and made accessible by creating a web interface using Perl. Considerable understanding of this lung deposition model was obtained and a small number of errors identified in the code during this process. Documentation was developed using MathML and scalable vector graphics (SVG).
Anatomically Accurate Individual Face Modeling
Authors: Zhang Yu  , Prakash Edmond C.  , Sung Eric
Published: February 2025

This paper presents a new 3D face model of a specific person constructed from the anatomical perspective. By exploiting the laser range data, a 3D facial mesh precisely representing the skin geometry is reconstructed. Based on the geometric facial mesh, we develop a deformable multi-layer skin model. It takes into account the nonlinear stress-strain relationship and dynamically simulates the non-homogenous behavior of the real skin. The face model also incorporates a set of anatomically-motivated facial muscle actuators and underlying skull structure. Lagrangian mechanics governs the facial motion dynamics, dictating the dynamic deformation of facial skin in response to the muscle contraction.
Development of an Interactive Teaching System Based on Motion Synchrony Between Physical and Virtual Models
Authors: Fineberg David A.  , Kesavadas T.  , Pape Dave
Published: February 2025

In advancing our capabilities in the realm of virtual reality, the development of haptic technology has been a rate-limiting factor in producing tactile sensations directly onto the human hands. The Living Anatomy Program seeks to obviate the need for such technology by designing physical objects based on anatomic components that feel realistic to the touch. Furthermore, synchronizing motion between physical and related virtual objects infinitely expands visual design options and provides a profound level of immersion into content.
How should we evaluate patient access to their own records? An example with cancer patients in Scotland
Authors: Jones Ray  , Cawsey Alison  , Bental Diana  , Pearson Janne
Published: February 2025

Government policy in many European countries now assumes that patients should have access to their own medical records. Increasingly such access can be used as one method of tailoring a wide range of information to the patient. Process evaluation, to ensure that human computer interfaces of such systems are appropriate, is needed during their design and implementation. However, studies to assess the impact on health outcomes are relatively expensive and time consuming so are they worth doing? We are carrying out a randomised trial of different types of computer produced booklet including one based on information from the medical record Four hundred cancer patients in Glasgow Scotland have been randomised on three binary variables: (a) whether patients chose the information themselves or if it was chosen for them; (b) whether it included personal information from their own medical record or not; (c) whether it included advice on the management of anxiety. We are investigating two ‘levels’ of outcome: (i) whether booklets are used to help engage and so improve patients' social support, and (ii) whether booklets and the level of social support affect patients' anxiety. We are also assessing anxiety in the patient's ‘significant other’. To assess the views of both professionals and patients about the utility of our study, we developed a website which described our project and asked for users' predictions of our outcomes and their assessment of our method. There was no consistent prediction for the results of our stud, suggesting that it will be worthwhile to complete the study to inform discussion. The results will influence the way we give patients access to their medical records and could influence perceptions of its importance compared with other health service activities. Even though health service policy is to give patients access to their records we still need to assess outcomes in terms of health, and wellbeing both for patients and their families.
Secure Communication and Management of Clinical and Genomic Data: the Use of Pseudonymisation as Privacy Enhancing Technique
Authors: Claerhout Brecht  , De Moor Georges J.E.  , De Meyer Filip
Published: February 2025

The growing need of managing both clinical and genetic data raises important legal and ethical challenges. This article introduces some of the privacy protection problems related to genomic medicine and highlights the relevance of Trusted Third Parties and of Privacy Enhancing Techniques (PETs) in the context of e.g. research. Practical approaches based on two pseudonymisation models, for both batch and interactive data collection and exchange, are presented.
Mapping care processes within a hospital: a web-based proposal merging enterprise modelling and .ISO normative principles
Authors: Staccini Pascal  , Joubert Michel  , Quaranta Jean-François  , Fieschi Marius
Published: February 2025

Today, the economic and regulatory environment are pressuring hospitals and healthcare professionals to account for their results and methods of care delivery. The evaluation of the quality and the safety of care, the traceability of the acts performed and the evaluation of practices are some of the reasons underpinning current interest in clinical and hospital information systems. The structured collection of users' needs and system requirements is fundamental when installing such systems. This stage takes time and is generally misconstrued by caregivers and is of limited efficacy to analysts. We used a modelling technique designed for manufacturing processes (SADT: Structured Analysis and Design Technique). We enhanced the initial model of activity of this method and programmed a web-based tool in an object-oriented environment. This tool makes it possible to extract the data dictionary from the description of a given process and to locate documents (procedures, recommendations, instructions). Aimed at structuring needs and storing information provided by teams directly involved regarding the workings of an institution (or at least part of it), the process mapping approach has an important contribution to make in the analysis of clinical information systems.
Modelling and implementing Electronic Health Records in Denmark
Authors: Bernstein Knut  , Bruun-Rasmussen Morten  , Vingtoft Søren  , Andersen Stig Kjær  , Nøhr Christian
Published: February 2025

The Danish Health IT strategy [1] points out that integration between electronic health records (EHR) systems has a high priority. A prerequisite for real integration and semantic interoperability is agreement of the data content and the information models. The National Board of Health is working on a common model for EHR, but it is not yet fully developed. At the same time several development and implementation projects are taking place at a regional level. These EHRs are built on information models from different vendors and are based on different integration platforms. The Danish EHR observatory, which has been monitoring the development of EHRs in Denmark since 1998, have analysed the challenges of using different information models and integration platforms. This paper also reports new tendencies in modelling and integration platforms globally and how this is reflected in the National development.
Analysis of hospitalised patient flows using data-mining
Authors: Dart Thierry  , Cui Yongmei  , Chatellier Gilles  , Degoulet Patrice
Published: February 2025

Face to the development of hospital information system in the “Hôpital Européen George Pompidou” (HEGP), computerized patients records made medical data easier to analyse than before. We use data-mining technology to analyse intrahospital patients' paths with one year of PMS1 data (a French medical information system similar to Diagnosis Related Group). Methods: 1. “sequential patterns mining” was used to analyse the most frequent patients' paths, 2. an integrated framework of “association rules mining” and “classification rule mining” was used to build prediction rules of patients' paths. Result: we construct a rule based prediction model, which gives the tendency of the patient's paths between the different medical units.
Novel Neuroradiological Image Processing and Information Retrieval in a Telestroke System
Authors: Szabó Tamás  , Góth Júlia  , Dominich Sándor  , Kozmann György  , Szolgay Péter  , Bársony Péter
Published: February 2025

A Cellular Neural Network based image processing system and a system based on Interaction Information Retrieval which are basic elements of a stroke teleconsultation system with most recent applications are introduced in this paper. Both of them are novel approaches in the image processing and information retrieval fields.
Models of Surgical Procedures for Multimodal Image-Guided Neurosurgery
Authors: Raimbault Mélanie  , Jannin Pierre  , Morandi Xavier  , Riffaud Laurent  , Gibaud Bernard
Published: February 2025

Improvement of image guided surgery systems requires a better anticipation of the surgical procedure. This anticipation may be provided by a better understanding of surgical procedures and/or the use of information models related to neurosurgical procedures. We are introducing a generic model of surgical procedures in the context of multimodal image-guided craniotomies. The basic principle of the model is to break down the surgical procedure into a sequence of steps defining the surgical script. Each step is defined by an action; the model assigns to each surgical step a list of image entities extracted from multimodal preoperative images (anatomical and/or functional images) which are relevant to the performance of that particular step. The model has been built in two phases: creation and consolidation. Besides, a planning software prototype based on the generic model has been built. The resulting generic model is described by an UML class diagram and textual description. Some initial benefits of this approach can already be outlined: improvement of multimodal information management, enhancement of the preparation and the guidance of the surgical act.
Modeling patient-specific therapeutic strategy in the guideline-based management of a chronic disease
Authors: Séroussi Brigitte  , Bouaud Jacques  , Chatellier Gilles
Published: February 2025

Like any chronic disease, hypertension is complex to manage. Despite the availability of evidence-based clinical practice guidelines in most countries, a lot of hypertensive patients remain inadequately managed. One difficulty lies in the synchronization of a patient's own therapeutic history with the guideline strategy. We propose a formal model to represent guideline-based therapeutic strategies as bi-dimensional matrices. We built the knowledge base as a two-level decision tree to be read during an hypertextual navigation. The first level is used to identify a patient-specific clinical situation on the basis of key elements of clinical examination (complication of hypertension, associated diseases). The second level aims at dynamically refining the theoretical strategy, a priori established in the guideline for the corresponding clinical situation, by the specific therapeutic history of the patient. Finally, depending on the patient’s response to the ongoing treatment, the system provides a recommendation consistent with the guideline strategy, whatever the patient’s past treatments. A first evaluation of the system on simulated cases has been well accepted by general practitioners.
An Evaluation of Hybrid Methods for Matching Biomedical Terminologies: Mapping the Gene Ontology to the UMLS$^{\reg}$
Authors: Cantor M.N.  , Sarkar I.N.  , Gelman R.  , Hartel F.  , Bodenreider O.  , Lussier Y.A.
Published: February 2025

Integration of disparate biomedical terminologies is becoming increasingly important as links between biological science and clinical medicine grow. Mapping concepts in the Gene OntologyTM(GO) to the UMLS may help further this integration and allow for more efficient information exchange among researchers. Using a gold standard of GO term — UMLS concept mappings provided by the NCI, we examined the performance of various published and combined mapping techniques, in order to maximize precision and recall. We found that for the previously published techniques precision varied between (0.61-0.95), and recall varied from (0.65-0.90), whereas for the hybrid techniques, precision varied between (0.66-0.97), and recall from (0.59-0.93). Our study reveals the benefits of using mapping techniques that incorporate domain knowledge, and provides a basis for future approaches to mapping between distinct biomedical vocabularies.
Personalising e-learning modules: Targeting Rasmussen levels using XML
Authors: Renard J-M.  , Leroy S.  , Camus H.  , Picavet M.  , Beuscart R.
Published: February 2025

The development of Internet technologies has made it possible to increase the number and the diversity of on-line resources for teachers and students. Initiatives like the French-speaking Virtual Medical University Project (UMVF) try to organise the access to these resources. But both teachers and students are working on a partly redundant subset of knowledge. From the analysis of some French.courses we propose a model for knowledge organisation derived from Rasmussen's. stepladder. In the context of decision-making Rasmussen has identified skill-based, rule-based and knowledge-based levels for the mental process. In the medical context of problem-solving, we apply these three levels to the definition of three students levels: beginners, intermediate-level learners, experts. Based on our model, we build a representation of the hierarchical structure of data using XML language. We use XSLT Transformation Language in order to filter relevant data according to student level and to propose an appropriate display on students’ terminal. The model and the XML implementation we define help to design tools for building personalised e-learning modules.
Ten years of Medical Informatics education experience at the Faculty of Medicine in Sarajevo
Authors: Masic Izet  , Pasic Emina  , Pandza Haris  , Kudumovic Mensura
Published: February 2025

Introduction: The medical informatics as the separate medical discipline very quickly gets developed, both in Bosnia and Herzegovina. In our country, the medical informatics is a separate subject for the last ten years, regarding to the Medical curriculum at the biomedical faculties in Bosnia and Herzegovina is in accordance with the project of the education related to Bologna declaration and the project EURO MEDICINA. This year the Chair of the Medical Informatics of the Medical Faculty in Sarajevo celebrates ten years of its existence. Work method: By the descriptive method of the research which included the questionnaire of about 400 students of the biomedical faculties, we established the attitudes and we took into consideration opinions of the students of these faculties about the validity of the contents of the subject of the medical informatics, the availability of the adoption of the material by the theoretical and practical performance of the teaching process and the suggestions and recommendations of the students about the contents that have to be throwned out from the curriculum and the teaching material that needs to be included. Work results: The research was performed using the separate questionnaire patterns data carriers with the defined characteristics for the quality assessment of the performed course. The total attitude of the assessed students speaks about dominantly expressed satisfaction with the majority of the parameters that are important for assessment of the quality and the tuition contents that was evaluated during the questionnaire. The results are shown in the tables and graphs, and they are describing the program of the tuition and the contents of the methodical units, and the system of the examination for the students using the method of "multiple choice". Conclusion: The education in the field of the medical informatics is based at the concept which is used in the developed countries of the world, and according the recommendations of the working groups of the European and world association of the medical informatics. The theoretical and practical teaching and training performance in the wholeness is performed by use of the computer equipment, and the final knowledge check of the students also is performed using the Data Base Management System MSAccess specifically designed to cover full teaching and training material by using questions set in the data base which encircled nearly 1500 questions combinations.
Evaluation of a web-based system for survival estimation in breast cancer
Authors: Lundin Johan  , Lundin Mikael  , Isola Jorma  , Joensuu Heikki
Published: February 2025

$underline{Objectives}$ To evaluate the accuracy of an internet-based method for survival estimation in breast cancer.
Electronic Discharge Letters Using the Clinical Document Architecture (CDA)
Authors: Müller Marcel Lucas  , Butta Rahul  , Prokosch Hans-Ulrich
Published: February 2025

Communication between hospitals and general practitioners is often restricted to paper-based discharge letters. In order to meet the growing need for improved data communication between various actors in the healthcare domain, it is necessary to overcome the barriers of software heterogeneity and lack of standards. HL7's clinical document architecture (CDA) is a new tool to exchange clinical documents. In this paper we show how CDA can be used to share electronic discharge letters generated in the hospital information system with general practitioners. Ease-of-use and data security and integrity were the main design principles. Although there still remain technical and organizational issues to be solved, this is a promising method in order to enhance data exchange between hospital and primary care and to move towards an electronic patient record (EPR) crossing institutional borders.
Health data managment an Strategic management in Brittany: some practical problems
Authors: Tchokobou Blaise Kainendje  , Leduff Frank  , Le Beux Pierre  , Chaperone Jacques
Published: February 2025

Recent changes in the organisation of the French health system include 1996's ordinances, and more recently (4thLaw march 2002). The general tendency of all theses reforms is the management of the health system at the regional level in France. In This paper we try to find how health data management systems could be concerned by this changes. In the first part we will explain why the health data management systems are implicated in theses changes. After that we sped the kind of information needed for strategic management of health at the regional level in Brittany. Then we discuss what information is available from all health data management systems at the regional level as far as decision making in health is concerned Keywords:
A Strategy for System Improvement and Data Processing in a National GP Sentinel Network
Authors: Stoicu-Tivadar Lacramioara  , Stoicu-Tivadar Vasile  , Marginean Marius  , Berian Dorin
Published: February 2025

This paper presents the results and strategies concerning the running of MediNET sentinel dispensaries network in Romania. MediNET stations network consists in 100 computerized dispensaries all around the country, where doctors collect data from primary care and send it to a central server through Internet. The network is fully functional and the collection of data started. We present a low-cost solution for developing the system, the preliminary results of collected data, the strategy for improving and developing the system and the strategy for future data processing.
European Security Framework for Healthcare
Authors: Ruotsalainen Pekka  , Pohjonen Hanna
Published: February 2025

eHealth and telemedicine services are promising business areas in Europe. It is clear that eHealth products and services will be sold and ordered from a distance and over national borderlines in the future. However, there are many barriers to overcome. For both national and pan-European eHealth and telemedicine applications a common security framework is needed. These frameworks set security requirements needed for cross-border eHealth services. The next step is to build a security infrastructure which is independent of technical platforms. Most of the European eHealth platforms are regional or territorial. Some countries are looking for a Public Key Infrastructure, but no large scale solutions do exist in healthcare. There is no clear candidate solution for European-wide interoperable eHealth platform. Gross-platform integration seems to be the most practical integration method at a European level in the short run. The use of Internet as a European integration platform is a promising solution in the long run.
Health Cards as a Part of French Health Telematics
Authors: Kleinebreil Line  , Saba Renato  , Razafindramanana Njaka
Published: February 2025

The concept of the healthcare smart card is being discussed by more and more countries all over the world since the late eighties. After a long period of pilots, health cards are now an important part of the French health telematics. How did this happen? This paper highlights the prerequisite for a large implementation.
A Telemedicine Guideline for the Practice of Teleconsultation
Authors: Asbach Patrick  , Nerlich Michael
Published: February 2025

To establish a guideline for the use of teleconsultation, which is one of the most important applications in telemedicine beeing perfomed very frequently in daily medical practice in almost any field of medicine. Evidence: The recommendations are based on expert knowledge, because of the lack of evidence based data in the telemedical scientific literature. In addition, scientific articles of the highest level of evidence available published between 1970 and 1999 were reviewed.