bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatry By Videophone: A Trial Service In North West England
Authors: May C R  , Ellis N T  , Atkinson T  , Gask L  , Mair F  , Smith C
Published: February 2025

In this paper wc report on the use of a video link between two general practices and a hospital based mental health team in North West England to provide a trial telepsychiatry service for individuals with depression and anxiety related disorders. Patients (n=16) took part in an evaluation of the service by both structured questionnaire and semi-structured interview. The results of the evaluation study suggest that patients may be highly critical of telemedicine systems and that they do so not simply on the grounds of the technical quality of video links, but also because the remote link increases the difficulty that the patient faces in expressing deep seated emotional and existential problems. It is not, therefore, simply a matter of technical quality in the link, but also a question of the quality of interpersonal relations perceived by the patient.
ArchAIDS connects a clinical department and a virological laboratory to automatize the follow up of AIDS patients
Authors: Giacomini M.  , Ruggiero C.  , Martini I.  , McDermott J.L.  , Varnier O.E.
Published: February 2025

A communication system for the automation of the follow up of AIDS patients set up by DIST at the Molecular Virology Unit in the Advanced Biotechnology Centre of Genova and at the Department of Internal Medicine of the Medical School of Genova is presented. This system includes a distributed database to store both clinical and virological data and a set of procedures to transfer patient data with a complete respect of requirements about completeness and privacy.
Naive Bayesian-Based Nomogram for Prediction of Prostate Cancer Recurrence
Authors: Demšar Janez  , Zupan Blaž  , Kattan Michael W.  , Beck J. Robert  , Bratko Ivan
Published: February 2025

This paper introduces a schema with naive-Bayesian classifier and patient weighting technique to develop a prostate cancer recurrence prediction model from patient data. We propose the graphical presentation of naive-Bayesian classifier with a nomogram, which can be used both for prediction or can provide means to data analysis. The resulting model was experimentally evaluated; the results were favorable both in terms of interpretability and predictive accuracy.
Education and training possibilities in Europe for chaining ambulatory and hospital inpatients care
Authors: France F.H. ROGER
Published: February 2025

Although there is a trend to the development of the electronic patient record, the need for uniform classification systems to document diagnoses and procedures is still there. In the European Union, some research projects or concerted actions promote the concept of episodes of care, meaning that the clinical status of a patient might be followed by different health professionals in various health care settings (ambulatory care, emergency, inpatient, long term care) through medical record summaries. An inventory of teaching and training tools related to information systems that classify diagnoses in various health care settings has been made during the year 1998. Its results show that casemix tools are mainly used for hospital inpatients, much less for outpatients and almost never yet to link episodes of care. Computerised training tools exist in several countries for coding as well as for grouping patients but this area appears still too knew in the field of education because of a lack of European health policy to use uniform data sets in order to measure the degree of efficiency as well as the quality of health care delivery systems in the European union country members.
Computer-Assisted Planning and Simulation of Hip Operations using Virtual Three-Dimensional Models
Authors: Handels H.  , Ehrhardt J.  , Plötz W.  , Pöppl S.J.
Published: February 2025

In this paper a new software system for virtual preoperative planning and simulation of hip operations is presented. The system simulates the endoprosthetic reconstruction of the hip joint with hemipelvic replacement for bone tumor patients and supports the individual design of anatomically adaptable, modular prostheses. Three-dimensional models of the patient's hip are generated based on CT data. The surgeon simulates the operation and defines the position and shape of the custom- made endoprosthesis. Stereoscopic visualization and 3D input devices facilitate the navigation and interaction in the virtual environment. Special visualization techniques like texture mapping, color coding of quantitative parameters or transparency support the determination of the correct position and shape of the prosthesis. Furthermore, the system can be used for patient information or educational tasks.
Possibilities of See5 software in forecasting of life expectancy not achieving
Authors: Vuletič Silvije  , Kern Josipa  , Sonicki Zdenko  , Ivankovič Davor
Published: February 2025

Results of application of See5 to epidemiological domain were presented. The aim of this paper is to find out if See5 can be used for forecasting whether life expectancy will be achieved or not. The basis for forecasting are data - attributes, predictors (anthropological data, living habits, laboratory data, blood pressure measured in years 1970/71, and the status of examinee - class (alive or dead) in 1990. Data were split at random into 10 blocks with approximately the same number of cases and the same distribution of classes. Results were given in the form of decision trees and rulesets, and tested through crossvalidation. The most interesting question - what are prediction-candidates for not achieving life expectancy estimated in the year of examination - did not give a satisfactory result: the accuracy of classification was about 70%. However, a very interesting fact is that each rule consists of at least one candidate predictor, usually considered as risk factor (e.g. high diastolic blood pressure and animal fat consumption).
Neural Network in Communication with Medical Computer System
Authors: Kącki Edward  , Stempczyńska Joanna  , Wawrzyniak Rafał
Published: February 2025

The paper presents a concept of an experimental module designed to recognise spoken utterances that cover a limited range of words indispensable in dialogues with computer medical systems. Research into the recognition of spoken words by a module based on artificial neural network is described. Usefulness of the obtained results for surgery-assisting multimedia systems and for a patient simulator supporting medical education of students in case history-taking and diagnosing is also discussed.
Preliminary study on relevant data for health management in hospitals
Authors: Brusaferro S.  , Scarbolo M.
Published: February 2025

Data and information are nowadays keys of success. We experienced the building of an hospital Information System (IS) selecting data from those already routinely produced and sharing them with health care units and general management. IS should be shaped to accomplish mission, vision and strategic direction of the hospital and in this direction our efforts are oriented.
Guidelines in Healthcare: the experience of the Prestige project
Authors: Gordon Colin  , Veloso Mario
Published: February 2025

The paper reports the work and results of PRESTIGE: Guidelines in Healthcare, a large EU project designed to applying ICT to assist the application of clinical practice guidelines.
Synapses/SynEx goes XML
Authors: Jung Benjamin  , Grimson Jane
Published: February 2025

This paper describes the first approach to use the Extensible Markup Language (XML) as a data interchange/delivery format in the Synapses and SynEx healthcare environment. It will ease the semantic mapping between healthcare systems (server-server, server-client) and make them more interoperable.
German Adaptations of ICD-10
Authors: Graubner Bernd  , Brenner Gerhard
Published: February 2025

The introduction of the ICD-10, published by WHO 1992-94 in English and by DIMDI 1994/95 in German, is a very slow process. Some states introduced ICD-10 for the preparation of statistics of mortality, but only few use it for morbidity. ICD-9 is in Germany only in hospitals still in use. Much effort was put into the improvement of the official ICD-10 and the development of additional aids for more simple and better encoding of diagnoses. Thus a revision especially for ambulatory health care (ICD-10-SGBV with the incorporated ICD-10-Basisschlussel) and a collection of German terms and expressions of diagnoses that are not at all part of the official ICD-10 (ICD-10-Diagnosenthesaurus) were published. Three years ago a conversion table ICD-9/-10 was developed which can now be harmonised with WHO’s Translator. The experiences with all these instruments are satisfying. The development of methods for automatic encoding of free-text phrases of diagnoses has now been started.
Towards a Nursing Information System in Slovenia
Authors: Filej Bojana  , Kersnič Petra  , Pretnar Kunstek Veronika  , Šlajmer Japelf Majda
Published: February 2025

In the paper are described the starting points of health informatic system developement in Slovenia as also the situation in nursing. There are presented the goals, which nurses want to achieve with informatic system development and the activities for their attainability.
A survey on the current state of development, dissemination and implementation of guidelines of clinical practice in European countries
Authors: Courté-Wienecke Sonja  , Struppe Markus  , Engelbrecht Rolf
Published: February 2025

In the context of ProGuide, a support action in the EU Telematics Application Programme, a survey was conducted in summer 1998 to collect information on the current state of the development, dissemination and implementation of guidelines of clinical practice in European countries. A survey questionnaire was mailed to a total of 292 organisations in all EU member countries and five Non-EU-member countries. A follow-up survey was conducted in April 1999 with a reduced set of questions and an altered questionnaire dissemination strategy relying more on telephone and fax communication. By May 1999, 69 organisations had answered and 43 questionnaires could be evaluated. Preliminary results suggest that in most of the responding countries, a wide range of organisations is involved in development, dissemination or implementation of guidelines. Paper-based ways of guideline dissemination still play a major role, although this may change in the future. Obstacles to guideline implementation range from policy issues to practical challenges of integrating guidelines into the care process.
Interactive Realtime Doppler-UItrasound Visualization of the Heart
Authors: Heid Volker  , Evers Harald  , Henn Chris  , Glombitza Gerald  , Meinzer Hans-Peter
Published: February 2025

Heart valve insufficiencies can optimally be assessed using transesophageal, triggered, three-dimensional ultrasound imaging. The dynamic ultrasound data contain morphological as well as functional components which are recorded and displayed simultaneously. It allows the visualization of intracardiac motion which is an important parameter to detect abnormal flow caused by defect valves. A realtime reconstruction is desired to get a spatial impression on the one hand and to interactively clip parts of the volume on the other hand. Therefore, we use the OpenGL Volumizer API. Scalability of the visualization was tested with respect to different workstations and graphics resources using a Multipipe Utility library. The combination of both APIs enables a visualization of volumetric and functional data with frame rates up to 10 frames per second. By using the proposed method, it is possible to visualize the jet in the original color-coding which is employed during a conventional two-dimensional examination for displaying the velocity values. The morphological and the functional data are handled as two independent data channels. A good scalability from low cost up to high end graphic workstations is given by the use of the MPU. The quality of the resulting 3D images allows exact differentiation of heart valve insufficiencies to support the diagnostic procedure.
Web-based VR Training Simulator for Percutaneous Rhizotomy
Authors: Li Ying  , Brodlie Ken  , Phillips Nicholas
Published: February 2025

Virtual Reality offers great potential for surgical training - yet is typically limited by the dedicated and expensive equipment required. Web-based VR has the potential to offer a much cheaper alternative, in which simulations of fundamental techniques are downloaded from a server to run within a web browser. The equipment requirement is modest – an Internet-connected PC or small workstation - and the simulation can be accessed worldwide.
Computer and Robotic Assisted Osteotomy Around the Knee
Authors: Phillips Roger  , Hafez Mahmoud A  , Mohsen Amr MMA  , Sherman Kevin P  , Hewitt James R  , Browbank Ian  , Bouazza-Marouf Kaddour
Published: February 2025

The outcome variability and failures of conventional osteotomy have been attributed to lack of preoperative planning and inaccuracy in performing the correction. We present a computer and robotic assisted surgery system that can aid in accurate surgical planning for realignment, and in precisely implementing the plan in theatre. The approach seeks to avoid the cost and risks associated with the use of CT, and the insertion of fiducial markers, which are characteristic of existing computer assisted surgical systems.
The Changing View of the Heart Through the Centuries
Authors: Palladino Joseph L.  , Noordergraaf Abraham
Published: February 2025

In human perception, the heart was not always part of the blood circulating system. It was later included as a suction pump until Harvey argued that the heart is actually a compression pump, the central organ of the circulation, and the only organ responsible for the motion of blood. Considered initially as an autonomous pump, the heart gradually became viewed as subservient to the needs of the peripheral organs it perfuses. Constant properties assigned to the heart had to be replaced, one after another, by adjustable parameters. Even the adequacy of the heart as the sole pump has been doubted, an issue that resurfaces today.
Modelling Blood Flow in the Left Side of the Heart
Authors: Jacobsen Jacob M.
Published: February 2025

Qualitative similarity is demonstrated between velocity fields predicted by C S. Peskin's mathematical model for blood flow in a plane section through the left side of the mammalian heart and human velocity data measured with MRI-technique. Also, the underlying muscle model for the heart model is investigated with respect to simulated ventricular pressure.
Learning Just-In-Time in Medical Informatics
Authors: Sancho Juan J  , Sanz Ferran
Published: February 2025

Just-in-time learning (JITL) methodology has been applied to many areas of knowledge acquisition and dissemination. The paradigm is a challenge to the traditional classroom course-oriented approach with the aim to shorten the learning time, increasing the efficiency of the learning process, improve availability and save money. The information technology tools and platforms have been heavily involved to develop and deliver JITL. This paper discusses the main characteristics of JITL with regard to its implementation to teaching Medical Informatics.
The Card Integrated into the Slovene Health Care Information System
Authors: Sušelj Marjan
Published: February 2025

At the time of the congress, the health insurance card system national scale introduction in Slovenia is completed. This paper presents the main features of the implementation process and of the resulting system. In its first phase configuration, the system addresses administrative tasks in the health care and health insurance sectors. Yet, technological and organisational infrastructure introduced, as well as experiences gained, provide sound grounds for the system enhancement with new functions, the development of which has been carried out in parallel with the basic system implementation. Furthermore, the system is designed to be open to the integration into the overall health care information system and to be a component of the continuous process of bringing the health care to the citizens.
European Projects in Radiological Data Bases for Telemedicine and Teaching
Authors: Drudi F.M.  , Salcito G.  , Trippa F.  , Righi A.  , Cascone F.  , Passariello R.
Published: February 2025

Aim of this study is to describe the main characteristics of the European projects IAEVAII and HERMES whose principal objective is to render the already functioning computer systems more efficient. The medical environment is in continuous need of faster and better ways of communication, particularly in a radiological context, and this work therefore presents the above projects mainly from a radiological point of view.
Artificial Neural Networks for Classifying Olfactory Signals
Authors: Linder R.  , Pöppl S.J.
Published: February 2025

For practical applications, artificial neural networks have to meet several requirements: Mainly they should learn quick, classify accurate and behave robust. Programs should be user-friendly and should not need the presence of an expert for fine tuning diverse learning parameters. The present paper demonstrates an approach using an oversized network topology, adaptive propagation (APROP), a modified error function, and averaging outputs of four networks described for the first time. As an example, signals from different semiconductor gas sensors of an electronic nose were classified. The electronic nose smelt different types of edible oil with extremely different a-priori-probabilities. The fully-specified neural network classifier fulfilled the above mentioned demands. The new approach will be helpful not only for classifying olfactory signals automatically but also in many other fields in medicine, e.g. in data mining from medical databases.
Heart rate Variability During Sleep Stages in Normals and in Patients with Sleep Apnea
Authors: Penzel Thomas  , Bunde Armin  , Grote Ludger  , Kantelhardt Jan W.  , Peter Jörg-Hermann  , Voigt Karlheinz
Published: February 2025

Heart rate and heart rate variability are under the control of the autonomous nervous system. It can be assumed that during sleep internal influences dominate the autonomous nervous system. During the different sleep stages heart rate regulation differs in normal subjects. Obstructive sleep apnea is a disorder which has its origin in sleep and has strong modulating effects on the autonomous nervous system with prominent heart rate variations in consequence. In order to separate the influences of sleep stages and sleep apnea on heart rate variability we applied detrended fluctuation analysis in 12 healthy subjects and 20 patients with sleep apnea. We could show that the differences between sleep stages observed in healthy subjects were still present in subjects with sleep apnea despite their cyclical variation in heart rate. We conclude, that detrended fluctuation analysis is able to separate the influences of sleep stages and sleep apnea on heart rate variability.
Über das retrospektive Erkennen von Problempatienten
Authors: Kretzschmar F.
Published: February 2025

In Krankenhäusern der Maximalversorgung wird immer wieder im Zusammenhang mit den stark gestiegenen Kosten im Krankenhausbetrieb diskutiert, daß dies auch am zunehmenden Anteil von Problempatienten an den insgesamt behandelten Patienten liegt.
Typing of diseases in the Hungarian minimal basic data set for hospital treatment episodes
Authors: Surján G  , Héja G
Published: February 2025

For reimbursement and epidemiological statistics the coded diagnoses should be classified in types like principal diagnosis, complication, co-morbidity etc. Computer assisted semi-automatic coding systems usually does not pay attention to this problem. After the description of pertaining national regulation, we present a logical framework of an algorithm, which minimise the clerical work for physicians and presumably will satisfy the need of epidemiology and reimbursement. The algorithm makes difference between diagnosis and disease, various diagnostic statement types, and uses causal chains among conditions expressed by diagnoses.
Improving the calculation of confidence intervals for the number needed to treat
Authors: Bender Ralf
Published: February 2025

The number needed to treat has gained much attention in the past years as a useful way of reporting the results of randomised controlled trials with a binary outcome. Defined as reciprocal of the absolute risk reduction the number needed to treat is the estimated number of patients who need to be treated to prevent an adverse outcome in one additional patient. As with other estimated effect measures, it is important to document the uncertainty of the estimation by means of an appropriate confidence interval. Confidence intervals for the number needed to treat can be obtained by inverting and exchanging the confidence limits for the absolute risk reduction. Unfortunately, the only method used in practice for calculating a confidence interval for the absolute risk reduction seems to be the usual asymptotic method, which yields confidence intervals which are too short in many cases. In this paper it is shown that the application of the Wilson score method improves the calculation and presentation of confidence intervals for the number needed to treat.
Telecare of Diabetic Patients with Intensified Insulin Therapy
Authors: Biermann E.  , Dietrich W.  , Standl E.
Published: February 2025

BACKGROUND: Patients with insulin dependent diabetes require frequent advice if their metabolic control is suboptimal. A telemedical system for transmission of self monitoring blood glucose values from the patients' home to the diabetes center with a combined modem-interface is described. Data are processed by PC and advice is given by telephone. The study focuses on metabolic outcome, fiscal and administrative aspects. METHODS: A prospective, randomized trial with 46 patients with intensified insulin therapy was conducted, 30 patients used telecare and 16 conventional care. RESULTS: HbAlc, as a parameter of metabolic control, dropped from 8.3% to 7.3% in the telecare group and from 8.0% to 6.8% in the conventional group after 8 months of observation. There was no significant difference between the two groups. Time expenditure for telemanagement, compared to conventional advice, was moderately higher, but there was a substantial amount of time on the patients side that could be saved mainly by reduction of to travel time and work stoppage. Setting up an optimal telemanagement scenario a cost analysis was done. This yields a cost saving of about 650 EURO per year. CONCLUSION: Telemanagement of insulin-requiring diabetic patients is a cost and time saving procedure for the patients and results in metabolic control comparable to conventional outpatient management.
Clinical Trial Management and Remote Data Entry on the Internet based on XML Case Report Forms
Authors: Wübbelt Peter  , Fernandez Guillermo  , Heymer Joachim
Published: February 2025

The Internet and the World Wide Web have recently been introduced into the management of some aspects of clinical trials such as remote randomisation and data entry and the distribution of information on trial progress. A few larger trials use electronic Case Report Forms (eCRFs) built with HTML. This article describes a more flexible approach using the Extensible Markup Language XML.
A Toolset for Medical Text Processing
Authors: Baud Robert H  , Lovis Christian  , Ruch Patrick  , Rassinoux Anne-Marie
Published: February 2025

The processing of medical texts is a burden in the absence of a toolset designed for simple operations such as recognizing morphological variants, updating and accessing a word dictionary of the domain and segmenting words with multiple morpho-semantems. The apparent simplicity of these basic operations is an illusion because it soon becomes clear that quality implementation is a long-term task. Coherency between subtasks may be lacking unless strict rules are enforced. In fact, good tools are rarely available or have not been tailoredfor the medical profession. This paper aims at defining a complete toolset for medical word processing. In addition, it provides relevant examples of the inherent difficulties of this task. It reports on typical results that can be expected from an industry-standard implementation.
The Electronic Medical Record : Using Documents For Information Capture
Authors: Laforest F.  , Flory A.
Published: February 2025

This work concerns the management of electronic medical records. Classical systems based on databases do not satisfy end users, as the provided capture forms are never completely adapted to the patient case and to the physician's way of working. Electronic documents proved to be a better user interface paradigm, but still do not provide satisfying querying performance. Our work concerns the use of semi-structured documents as a user interface for a database-based system. The captured documents are analyzed so that information is extracted and used to fill in a database. We illustrate our proposition with the prototype we have developed and a short example.
From Primary Edges to Contours: Modelling Contour Integration in Human Early Vision
Authors: Lungeanu Diana  , Cotîrlea Viviana  , Hanga Lucian
Published: February 2025

According to the experimental observations, contour integration should occur in the primary visual area (VI). We propose a computational model of contour perception in human visual cortex using a recurrent neural network. Our approach is based on the neuro-physiological findings about the columns of ocular dominance and orientation in VI, and on some other existing mathematical models. We also developed a computer application for implementing and testing the proposed model.
What is Digital Medicine?
Authors: Shaffer David Williamson  , Kigin Colleen M.  , Kaput James J.  , Scott Gazelle G.
Published: February 2025

Changes in health care are a fundamental part of social and intellectual evolution. The modern practice of scientific medicine depends on the existence of the written and printed word to store medical information. Because computers can transform information as well as store it, new digital tools cannot only record clinical data, they can also generate medical knowledge. In doing so, they make it possible to develop “digital medicine” that is potentially more precise, more effective, more experimental, more widely distributed, and more egalitarian than current medical practice. Critical steps in the creation of digital medicine are careful analysis of the impact of new technologies and coordinated efforts to direct technological development towards creating a new paradigm of medical care.
Implementing a Virtual Reality Paradigm in Human Anatomy/Physiology College Curricula
Authors: Aubin Helen St.
Published: February 2025

Modes of instruction in the college course called Human Anatomy/Physiology are changing. Due to ethical concerns and the ever-increasing source of new physiological data, there is a need for enhancements to assist the instructor and student. The computer science of virtual reality (VR) provides a method to electronically educate, train, prototype, test and evaluate new enhancements to the college curricula. This study detailed the modeling and simulation of a skeletal human hand with degrees of freedom of movement, which provided the students with a physiological representation of some of the movements of the hand. The primary objectives of the study were to assess the use of the VR simulation by college students and to assess the potential learning outcomes of students in their use of the VR simulation. The simulation was implemented into classes of Human Anatomy/Physiology as an adjunct enhancement for the students’ use. The expectation centered on the constructivist theory that students develop an analytic outlook to the various articulations of the human skeleton. Positive results were shown based on the answers to the questionnaire, summary and post-test taken by the students, after their use of the VR simulation. The results supported the constructivist theory that critical thinking took place. The results showed that the virtual reality simulation enhanced the learning ability of the students. The recommendations of the study include future experimentation to be done on increasing the number of VR simulations, incorporating the VR simulations into undergraduate courses, testing the outcomes, and following the progression of students into graduate programs that are using VR simulations. Faculty and administration are advised to consider implementing the paradigm of VR simulations in undergraduate courses of Human Anatomy/Physiology.
Stereoscopic x-ray image processing
Authors: Berestov Alexander
Published: February 2025

A three-step stereoscopic image-processing algorithm is proposed in order to improve image quality and depth perception of stereoscopic radiographs taken with C-arm equipment. The steps include illumination correction, geometry conversion and screen parallax adjustment. Flipping of stereoscopic radiographs is also discussed.
Issues in Validation of a Dermatologic Surgery Simulator
Authors: Berg Daniel  , Berkley Jeff  , Weghorst Suzanne  , Raugi Gregory  , Turkiyyah George  , Ganter Mark  , Quintanilla Fernando  , Oppenheimer Peter
Published: February 2025

At the University of Washington, we have been developing a suturing simulator using novel finite element model techniques which allow real-time haptic feedback. The issues involved in measuring validity in a suturing model have not been examined in a systematic way. Very few studies exist on the surgical factors that lead to good sutures. We have examined published data on these factors as well as previously studied metrics in suture training. This information has been combined with a review of types of validity (e.g., face, construct, predictive and concurrent) and reliability that must be considered in assessing any surgical simulator.
Virtual Medical School: A Distributed Medical Education Network
Authors: Chen Heng-Shuen  , Lin Chung-Chih  , Guo Fei-Ran  , Chen Ching-Yu  , Hou Sheng-Mou
Published: February 2025

A virtual Medical School (VMS) was established on the website of the School of Medicine, National Taiwan University (NTU). It consists of virtual classrooms, virtual groups, a virtual library, and virtual patients. In the future, VMS can be developed to many distributed medical education resource centers in all medical colleges, teaching hospitals, and other medical education organizations to establish a national medical education network.
Data Quality Probes – A Synergistic Method For Quality Monitoring Of Electronic Medical Record Data Accuracy And Healthcare Provision
Authors: Brown Philip J.B.  , Harwood Jocelyn  , Brantigan Pam
Published: February 2025

Increasing reliance is being placed on electronic medical records to support clinical care and achieve improved quality standards. In order for clinical information systems (CIS) to deliver, the data within needs to be complete, consistent and accurate. This data of course only forms part of the process in delivering quality health care during the clinician patient encounter. This paper outlines a method of assessing the quality of the processes involved in healthcare provision and data quality within a CIS. It proposes a principle of Data Quality Probes (DQP) that can be used to assess the performance of the whole encounter system. The main feature of this is the generation of a query which clinical knowledge predicts should not retrieve any cases in a system performing flawlessly. This approach is applied practically within the paradigm of a UK family practice testing the DQP that only patients who have had a hysterectomy should be prescribed unopposed oestrogen hormone replacement therapy.
Design of a Computerized System for the Retrospective Analysis by the Physician of His Own Drug Prescriptions
Authors: Liu Jun Hui  , Venot Alain
Published: February 2025

The quality of drug prescription is known to be poor in many medical domains. Feedback information may help the physician to improve this component of his medical activity. The increasing use of computerized drug prescription systems makes possible the retrospective processing of prescriptions made over a given time period. This paper describes the design of a computerized system for providing feedback information to the physician about the quality of his drug prescribing activity. It is designed to be used by the physician himself. The analysis is based on two groups of quantitative indicators, simple and composite. The constraints that must be satisfied to calculate these indices automatically are given. They are related to the coding systems used for drug prescription, knowledge on drugs and patient data. The system design is based on modeling according to UML formalism. We give also a concrete view of the main functions of the system, based on a pictorial illustration with a component of the user interface. Some limitations and the possible extensions of this system for analyzing simultaneously the prescriptions made by set of physicians are discussed.
IT Sophistication in Hospitals : A Field Study in Quebec
Authors: Paré Guy  , Sicotte Claude
Published: February 2025

The Quebec health sector has been experiencing a period of great turmoil over the last five years and hospitals are faced with huge pressures from government funding cuts. Several empirical studies in the information systems field have shown that the use of computer-based information systems could have positive impacts on organizational performance. Many agree to say that health care institutions are no exceptions. But if one wishes to identify the effects of IT on the delivery of care, one must be able to characterize IT for operationalization purposes. Our main objective consists in developing and validating a measurement instrument of IT sophistication in hospitals. Such instrument should provide hospital managers with a diagnostic tool capable of indicating the profile of their respective institutions in regard to IT use and comparing this profile to those of other similar health institutions.
Reinventing Patient-centered Computing for the Twenty-first Century
Authors: Goldberg Howard S.  , Morales Alfredo  , Gottlieb Lawrence  , Meador Lawrence  , Safran Charles
Published: February 2025

Despite evidence over the past decade that patients like and will use patient-centered computing systems in managing their health, patients have remained forgotten stakeholders in advances in clinical computing systems. We present a framework for patient empowerment and the technical realization of that framework in an architecture called CareLink. In an evaluation of the initial deployment of CareLink in the support of neonatal intensive care, we have demonstrated a reduction in the length of stay for very-low birthweight infants, and an improvement in family satisfaction with care delivery. With the ubiquitous adoption of the Internet into the general culture, patientcentered computing provides the opportunity to mend broken health care relationships and reconnect patients to the care delivery process. CareLink itself provides functionality to support both clinical care and research, and provides a living laboratory for the further study of patient-centered computing.
Establishing an Online Telemedicine Community in the UK
Authors: Briggs Jim  , Curry Dick  , Madge Bruce
Published: February 2025

Telemedicine is an important mode of healthcare delivery. The UK government wanted to disseminate information about telemedicine practice and to build an online community. The British Library and the University of Portsmouth were commissioned to create the Telemedicine Information Service – the main part of which is a website supported by an email distribution list. Since its launch, approximately 40, 000 visits have been made to the website, and the mailing list has over 300 subscribers. By analysing the readership of both, it is possible to conclude that most readers are UK based. Hence, it can be argued that an online telemedicine community has been established.
Information Sharing System on Periodic Health Examinations by a Regional Medical Association
Authors: Yahata Katsuya  , Higashi Toshiaki  , Umetani Takanori  , Shiraishi Kimihiko
Published: February 2025

We developed an information sharing system by recording the results of in periodic health examinations on database center with the cooperation of companies that have contracts with Kokura Medical Association. Registered doctors can share this information that includes text information and medical images. They access the database center by ISDN and check companies staff medical information using browser software with security checking by IC card. This system enables the sharing of medical information and widens the possibility of better regional medical service.
Bioinformatics and Medical Informatics: Discovering and Connecting Diverse Islands of Researchers and Knowledge
Authors: Kulikowski Casimir A.
Published: February 2025

Bioinformatics, genomics, proteomics, and pharmacogenetics describe some of the most promising directions for achieving breakthroughs in 21st century medicine. Presently they are growing by leaps and bounds as disciplines only loosely related to medical informatics. This presents a number of interesting opportunities and challenges as the implications of bioinformatics for developing molecular medicine come into better focus.
Computerization of Guidelines: Towards a “Guideline Markup Language”
Authors: Dart Thierry  , Xu Yigang  , Chatellier Gilles  , Degoulet Patrice
Published: February 2025

Medical decision making is one of the most difficult daily tasks for physicians. Guidelines have been designed to reduce variance between physicians in daily practice, to improve patient outcomes and to control costs. In fact, few physicians use guidelines in daily practice.
Handling Expressiveness and Comprehensibility Requirements in GLIF3
Authors: Peleg Mor  , Boxwala Aziz A.  , Tu Samson  , Greenes Robert A.  , Shortliffe Edward H.  , Patel Vimla L.
Published: February 2025

Clinical guidelines are aimed at standardizing patient care and improving its quality and cost effectiveness. Guidelines represented in a computer-interpretable (CI) format can be used to provide automatic decision support applied to individual patients during the clinical encounter. The process of creating computer-interpretable guidelines (CIG) removes ambiguities contained in paper-based guidelines, thus making the guideline more comprehensible. For these reasons, CIGs may have a larger impact on clinician behavior than paper-based guidelines. Since much effort goes into creating guidelines in a CI format, it is desirable that different institutions and software systems share them. In a guideline representation workshop hosted by the InterMed Collaboratory in March 2000, the need for a standard representation format for sharable CIGs was recognized. As a first step towards achieving this goal, we proposed a set of functional requirements for sharable CIGs. The requirements encompass the entire life cycle of a CIG: development, implementation, use and maintenance. In this paper we discuss requirements that are important during the development stage of a CIG. We have abstracted the requirements into two groups: expressiveness – the ability to express the knowledge content of different types of guidelines – and comprehensibility – the ability to manage complexity, facilitate coherence, and visualize a guideline model to aid in human comprehension. The Guideline Interchange Format version 3 (GLIF3) is a language for structured representation of CIGs. It is under development to facilitate sharing CIGs among different institutions and systems. We illustrate how GLIF3 meets the specified development requirements.
Kaiser Permanente's “Metadata-Driven” National Clinical Intranet
Authors: Dolin Robert H.  , Boles Myde  , Dolin Ron  , Green Suzy  , Hanifin Shawn  , Hochhalter Brad  , Inglesis Rea  , Ivory Melody  , Levy David  , Nadspal Kara  , Rae Mary-Anna S.  , Rucks Cheryl J.  , Snyder Aaron  , Stibolt Tom  , Stiefel Matt  , Travis Victoria
Published: February 2025

This paper describes the approach taken to build Kaiser Permanente’s national clinical intranet. A primary objective for the site is to facilitate resource discovery, which is enabled by the use of “metadata”, or data (fields and field values) that describe the various resources available. Users can perform full text queries and/or fielded searching against the metadata. Metadata serves as the organizing principle of the site - it is used to index documents, sort search results, and structure the site's table of contents.
Medical Case-based Reasoning Systems: Experiences with Architectures for Prototypical Cases
Authors: Schmidt Rainer  , Gierl Lothar
Published: February 2025

In this paper we discuss the importance to create prototypes automatically within medical Case-based Reasoning systems. We present some general ideas about prototypes deduced from analyses of our experiences with prototype designs in domain specific medical CBR systems. Four medical Case-based Reasoning systems are described. As they use prototypes for different purposes, the gained improvement is different as well. Furthermore, we claim that the generation of prototypes is an adequate technique to learn the intrinsic case knowledge, especially if the domain theory is weak.
Ranking of Information in the Computerized Problem-Oriented Patient Record
Authors: Bayegan Elisabeth  , Nytrø Øystein  , Grimsmo Anders
Published: February 2025

We propose a framework for a problem-oriented patient record for general practice’ and defend that the problemoriented medical record represents an intuitive way to organize the patient record. By adding a layer of knowledge to the electronic patient record the record system is able to better utilize the information stored in the record. If a record system is process aware, having knowledge of work processes and is able to distinguish between different contexts in use, the system can provide relevant and useful information during the handling of patients ‘ medical problems. Information is ranked according to its relevancy in a given context by using action patterns -- traces. Traces give valuable indications of what is going on during the process of patient care. Decision frames represents relevant contexts based on the information in the record. Both decision frames and traces provide an environment in which more optimal medical decisions can be made.
Implementing Real-Time System Interfaces to Support the Shared Care of Diabetes Patients
Authors: Bissell Ron  , Fernando Bernard  , Scobie Ian  , Briscoe Els  , Simmonds Doug  , Trigg Peter  , McDowell David
Published: February 2025

This paper describes a collaborative project: the Medway Integrated Care Support (MEDICS) Project, involving GP and Hospital system suppliers, an NHS Trust, General Practitioners and the NHS Information Authority. The objective of the project is to assess the Object Management Group's (OMG/CORBAMed) Clinical Observations Access Service (COAS) standard, by demonstrating its use in implementing a real-time interface between a GP system and a hospital clinical system, supporting the shared care of diabetes patient.
Clinical Benchmarking Enabled by the Digital Health Record
Authors: Ricciardi Thomas N.  , “Chip” Masarie F.E.  , Middleton Blackford
Published: February 2025

Office-based physicians are often ill equipped to report aggregate information about their patients and practice of medicine, since their practices have relied upon paper records for the management of clinical information. Physicians who do not have access to large-scale information technology support can now benefit from lowcost clinical documentation and reporting tools. We developed a hosted clinical data mart for users of a webenabled charting tool, targeting the solo or small group practice. The system uses secure Java Server Pages with a dashboard-like menu to provide point-and-click access to simple reports such as case mix, medications, utilization, productivity, and patient demographics in its first release. The system automatically normalizes user-entered clinical terms to enhance the quality of structured data. Individual providers benefit from rapid patient identification for disease management, quality of care self-assessments, drug recalls, and compliance with clinical guidelines. The system provides knowledge integration by linking to trusted sources of online medical information in context. Information derived from the clinical record is clinically more accurate than billing data. Provider self-assessment and benchmarking empowers physicians, who may resent "being profiled" by external entities. In contrast to largescale data warehouse projects, the current system delivers immediate value to individual physicians who choose an electronic clinical documentation tool.
Dissemination of Electronic Patient Records Using Primary Care Referrals as a Vector for Change
Authors: Sands Daniel Z.  , Rind David M.  , Safran Charles
Published: February 2025

The Online Medical Record (OMR) is a full featured shared electronic patient record in use since 1989 at Beth Israel Deaconess Medical Center in Boston. The first practice to use the OMR was a primary care practice. We observed the pattern of voluntary adoption of the OMR and the referral patterns from primary care to specialists. Adoption of the OMR among specialists has accelerated in recent years, in many cases mirroring the referral patterns from primary care to specialists. We hypothesize that referral of patients from primary care providers to specialists exposes these specialists to the benefits the electronic patient record and may promote the use of this technology. We conclude that these referral patterns provide a vector for the dissemination of electronic patient records. The important lesson is that EPR implementation in a health care network should begin with primary care to ensure the most efficient diffusion of this technology throughout the enterprise.
Telemedicine in Sweden: National Co-operation, Development & Evaluation
Authors: Sjögren Lotta Holm  , Schwieler Åsa  , Karlsson Leif
Published: February 2025

In 1998 The Federation of Swedish County Councils initiated a national telemedicine project. In 2000 the Federation also established Carelink, a new organisation for national IT co-operation in Healthcare. This poster describes some of the telemedicine development work within these national initiatives.
Modelling Space Perception in Human Early Vision: A Computational Approach
Authors: Lungeanu Diana
Published: February 2025

A computational approach in studying vision is important for understanding the biological mechanisms, as well as for integrating the known cortical architecture of primary visual area (VI) and the physiological functions (some of them experimentally proved, some only presumed). We present, in parallel, two models for early vision mechanisms: one for obtaining the disparity map in stereo vision, and the other for edges enhancement in contour integration, both of them seen from such a computational perspective. We implemented the two models and the results of the simulation were consistent with the biological data. They also account for the importance of interactions between parallel channels of visual information processing.