bluuebunny/crossref_metadata_2025 huggingface dataset:
Consequences of Switching to Blended Learning: The Grenoble Medical School Key Elements
Authors: Houssein Sahal  , Di Marco Lionel  , Schwebel Carole  , Luengo Vanda  , Morand Patrice  , Gillois Pierre
Published: February 2025

Introduction: In 2006, the Grenoble-Alpes University Medical School decided to switch the learning paradigm of the first year to a blended learning model based on a flipped classroom with a continuous dual assessment system providing personal follow-up. We report a descriptive analysis of two pedagogical models.
Signal Detection for Baclofen in Web Forums: A Preliminary Study
Authors: Karapetiantz Pierre  , Audeh Bissan  , Lillo-Le Louët Agnès  , Bousquet Cedric
Published: February 2025

Web forums are proposed as a new complementary source of knowledge to spontaneous reports by patients and healthcare professionals due to underreporting of adverse drug reactions (ADRs). Some authors suggest that signal detection could be a convenient method for gathering mentions of ADRs in patients' posts. Signal detection methods were proposed to mine pharmacovigilance databases, but little is known about their applicability to web forums. We describe a method implementing several traditional decision rules on signal detection with baclofen applied to a set of more than 6 million posts. We then cross-validated four unexpected signals applying a logistic regression method. Most adverse effects (AEs) described in the summary of product characteristics of baclofen were detected by signal detection methods. Some unexpected AEs were too. Therefore, web forums are confirmed as a complementary resource for improving current knowledge in pharmacovigilance by detecting unexpected adverse drug reactions.
Obstacles to Successful Implementation of eHealth Applications into Clinical Practice
Authors: Voogt Marianne P.  , Opmeer Brent C.  , Kastelein Arnoud W.  , Jaspers Monique W.M.  , Peute Linda W.
Published: February 2025

eHealth can improve healthcare worldwide, and scientific research should provide evidence on the efficacy, safety and added value of such interventions. For successful implementation of eHealth interventions into clinical practice, barriers need to be anticipated. We identified seven barriers by interviewing health professionals in the Dutch healthcare system. These barriers covered three topics: financing, human factors and organizational factors. This paper discusses their potential impact on eHealth uptake. Bridging the gap between studies to assess effective eHealth interventions and their value-based implementation in healthcare is much needed.
Advantages of a Web-Based Real-Time Bed-Management System for Hospital Admission Monitoring in Iran
Authors: Abedian Somayeh  , Bitaraf Ehsan  , Askari Marjan
Published: February 2025

Lack of up-to-date information of hospitals beds, specifically in emergencies, is a significant problem in many large countries; The Ministry of Health and Medical Education of Iran (MOHME) designed and implemented a dynamic system that reports the status of beds in 2012. This system created great opportunities for national bed management, including real-time hospital admission monitoring, especially for emergency departments, ICUs and CCUs. Therefore, an additional online system was planned to be implemented for monitoring hospital admissions, including a national alert system. Prior to the design of this system, a study was done using literature study and expert opinion to investigate the advantages and features that this monitoring system was required to have. We used the MoSCoW method to prioritize the requirements of the system. This system was designed to have the following advantages, among other things: the hospitals as well as government should be able to track the patients, manage patient distribution in healthcare centers, and make policy for supplying extra beds. It should also be possible for the hospitals executive board, as well as the government, to monitor the performance of the hospitals regarding patient admissions (i.e., the rate of rejection of patients with severe conditions).
Using RDF and Git to Realize a Collaborative Metadata Repository
Authors: Stöhr Mark R.  , Majeed Raphael W.  , Günther Andreas
Published: February 2025

The German Center for Lung Research (DZL) is a research network with the aim of researching respiratory diseases. The participating study sites' register data differs in terms of software and coding system as well as data field coverage. To perform meaningful consortium-wide queries through one single interface, a uniform conceptual structure is required covering the DZL common data elements. No single existing terminology includes all our concepts. Potential candidates such as LOINC and SNOMED only cover specific subject areas or are not granular enough for our needs. To achieve a broadly accepted and complete ontology, we developed a platform for collaborative metadata management. The DZL data management group formulated detailed requirements regarding the metadata repository and the user interfaces for metadata editing. Our solution builds upon existing standard technologies allowing us to meet those requirements. Its key parts are RDF and the distributed version control system Git. We developed a software system to publish updated metadata automatically and immediately after performing validation tests for completeness and consistency.
Automated Syntactic Analysis of Language Abilities in Persons with Mild and Subjective Cognitive Impairment
Authors: Lundholm Fors Kristina  , Fraser Kathleen  , Kokkinakis Dimitrios
Published: February 2025

In this work we analyze the syntactic complexity of transcribed Swedish-language picture descriptions using a variety of automated syntactic features, and investigate the features' predictive power in classifying narratives from people with subjective and mild cognitive impairment and healthy controls. Our results indicate that while there are no statistically significant differences, syntactic features can still be moderately successful at distinguishing the participant groups when used in a machine learning framework.
HS.Register – An Audit-Trail Tool to Respond to the General Data Protection Regulation (GDPR)
Authors: Gonçalves-Ferreira Duarte  , Leite Mariana  , Santos-Pereira Cátia  , Correia Manuel E.  , Antunes Luis  , Cruz-Correia Ricardo
Published: February 2025

Introduction The new General Data Protection Regulation (GDPR) compels health care institutions and their software providers to properly document all personal data processing and provide clear evidence that their systems are inline with the GDPR. All applications involved in personal data processing should therefore produce meaningful event logs that can later be used for the effective auditing of complex processes. Aim This paper aims to describe and evaluate HS.Register, a system created to collect and securely manage at scale audit logs and data produced by a large number of systems. Methods HS.Register creates a single audit log by collecting and aggregating all kinds of meaningful event logs and data (e.g. ActiveDirectory, syslog, log4j, web server logs, REST, SOAP and HL7 messages). It also includes specially built dashboards for easy auditing and monitoring of complex processes, crossing different systems in an integrated way, as well as providing tools for helping on the auditing and on the diagnostics of difficult problems, using a simple web application. HS.Register is currently installed at five large Portuguese Hospitals and is composed of the following open-source components: HAproxy, RabbitMQ, Elasticsearch, Logstash and Kibana. Results HS.Register currently collects and analyses an average of 93 million events per week and it is being used to document and audit HL7 communications. Discussion Auditing tools like HS.Register are likely to become mandatory in the near future to allow for traceability and detailed auditing for GDPR compliance.
Challenges in Design and Creation of Genetic openEHR-Archetype
Authors: Maranhão Priscila A.  , Bacelar-Silva Gustavo  , Gonçalves-Ferreira Duarte  , Vieira-Marques Pedro  , Cruz-Correia Ricardo
Published: February 2025

Since the Human Genomic Project discovered the sequencing of human genome, the interest about genome content in clinical practice has increased. Genetic information has become a key point to understand diseases or improve treatments, for example, the nutrigenomic and nutrigenetics. However, the huge amount of data generated raises the need for Electronic Health Record (EHR) improvements as it becomes increasingly necessary that it includes more specific genetic information. Thus, we aim to propose standard genetic archetypes (in openEHR) and describe our main challenges in this context. We assessed 2 bibliographical databases (Pubmed and Web of science) to determine the main clinical statements needed to create the archetypes. The clinical statements were organized in archetype-concepts, and they were created in openEHR archetype editor. One archetype - genetic test results - was created from a set of genetic data and submitted to CKM repository for review. Based on the modeled archetypes, an openEHR template can be created from the proposed archetype, mainly in the nutrigenomic area, genetic labs and others related to genetic.
EHR Text Categorization for Enhanced Patient-Based Document Navigation
Authors: Kreuzthaler Markus  , Pfeifer Bastian  , Vera Ramos José Antonio  , Kramer Diether  , Grogger Victor  , Bredenfeldt Sylvia  , Pedevilla Markus  , Krisper Peter  , Schulz Stefan
Published: February 2025

Patients with multiple disorders usually have long diagnosis lists, constitute by ICD-10 codes together with individual free-text descriptions. These text snippets are produced by overwriting standardized ICD-Code topics by the physicians at the point of care. They provide highly compact expert descriptions within a 50-character long text field frequently not assigned to a specific ICD-10 code. The high redundancy of these lists would benefit from content-based categorization within different hospital-based application scenarios. This work demonstrates how to accurately group diagnosis lists via a combination of natural language processing and hierarchical clustering with an overall F-measure value of 0.87. In addition, it compresses the initial diagnosis list up to 89%. The manuscript discusses pitfall and challenges as well as the potential of a large-scale approach for tackling this problem.
Towards Designing a Secure Exchange Platform for Diabetes Monitoring and Therapy
Authors: Weiß Jan-Patrick  , Welzel Tobias  , Hartmann Bernd J.  , Hübner Ursula  , Teuteberg Frank
Published: February 2025

Background: Diabetes mellitus is one of the most prominent examples of chronic conditions that requires an active patient self-management and a network of specialists.
Proof of Concept of a Partial Weight-Bearing Supporting Real-Time Feedback System
Authors: Tkachenko-Bril Andrés I.  , Jagoš Harald  , David Veronika  , Pils Katharina  , Gaudernak Jakob  , Rafolt Dietmar
Published: February 2025

Background: Patient compliance with lower limb partial weight bearing (PWB) instructions during post-surgical early mobilization is often low and many are unable to adhere to the prescribed limits without the implementation of concurrent biofeedback.
A Predictive Model for Patient Similarity: Classes Based on Secondary Data and Simple Measurements as Predictors
Authors: Dudchenko Aleksei  , Kopanitsa Georgy  , Knaup Petra  , Ganzinger Matthias
Published: February 2025

Predictive models optimized for average cases might work not perfect for cases deviating from average because they are based on a cohort of all patients. Models could be more personalized if they were built on a sub-cohort of patients similar to a current one and to train models on data collected from those similar patients. In this paper, we consider patient similarity as a classification task. We suppose that data such as diagnoses and treatment obtained by physicians (secondary data) are more relevant for similarity than tests and measurements (primary data). We defined several classes based on diagnoses and outcomes and apply a predictive model for classification. We used five commonly used and easy to obtain measurements as predictors for the model. All measurements were collected during the first 24 hours after admission. We have shown that classes of similar patients can be defined on the basis of a previous patient's secondary data and new patients can be classified into these classes.
Developing an Android-Based Patient Decision Aid Based on Ottawa Standards for Patients After Kidney Transplant and Its Usability Evaluation
Authors: Zare Moayedi Mahboobeh  , Aslani Azam  , Fakhrahmad Mostafa  , Ezzatzadegan J. Shahrokh
Published: February 2025

Objectives: This study was conducted to develop an android based patient decision aid (PDA) as a self-care instrument for patients after kidney transplant and its usability evaluation.
Needs Assessment and System Design of Nursing Information Operation Simulation Learning System
Authors: Lin Mei-Ling  , Chiou Shwu-Fen  , Chou Shin-Shang  , Liu Chieh-Yu
Published: February 2025

This study explored needs and content of nursing information simulation learning system for different nursing staff levels. A questionnaire survey method was conducted in this study. A total of 300 clinical instructors and new nurses were recruited from a medical center through purposive sampling. The results show the core framework of a learning system includes five objectives. The mean scores of the five objectives of clinical instructors all were higher than the new nurses. These findings can serve as a reference for the design framework and system functions, and will function as an important learning resource.
Undergraduate Student Nurses' Functional Requirements for e-Portfolios: A Qualitative Research Study
Authors: Chang Chi-Ping
Published: February 2025

The advantages of e-portfolios when may assist schools in constructing teaching tools better suited to professional clinical education thereby enabling students to acquire clinical competency and the confidence to practice. The purpose of this study was to investigated senior nursing students' e-portfolio the needs and perceptions of student nurses regarding the use of e-portfolio in the Last Mile practicum course.
Towards Preventative Healthcare: A Review of Wearable and Mobile Applications
Authors: Huang Weidong  , Li Jane  , Alem Leila
Published: February 2025

Wearable and mobile devices are now commonly used in our daily activities, giving users instant access to various information. One the one hand, wearable and mobile technologies are developing at a fast rate and have been increasingly ubiquitous. On the other hand, the potential of their application in health is yet to be fully explored. This paper attempts to sketch an overview of wearable and mobile applications in the healthcare domain. We first review how various wearable and mobile applications are being used to monitor and manage health conditions. Then how connections between physiological factors and psychological factors can help with disease prevention is presented. Finally, challenges and future directions for further developments of these emerging technologies in health are discussed.
Alternative Medicine Patient Records Moving to a Digital Environment
Authors: Ripa Andrei  , Bogdan Razvan  , Crişan-Vida Mihaela  , Jupaneant Ovidiu  , Jupaneant Letiţia  , Stoicu-Tivadar Lăcrămioara
Published: February 2025

As technology immerses in daily life, all types of clinical practices migrate more on storing medical records on electronically media. The issue is up for debate on several fronts, as both paper and electronic records offer strengths and weaknesses. This paper presents the process of changing from paper medical records to a digital environment in the case of an alternative medicine clinic, having years of stored paper records, with its benefits and challenges. Focusing on quality criteria, the current study shows how beneficial an electronic medical record could be, while arguing how the diagnosis coding from the paper-based patient record resulted in major qualitative disadvantages.
Developing an Evidence-Based Clinical Dataset for the Comprehensive Implantable Medical Device Registry (CIMDR)
Authors: Afzal Jawad  , Househ Mowafa  , Alshagathrh Fahad  , Roomi Asad  , Alanazi Abdulrahman  , Alsaab Yassir  , Shahbaz Anam  , Baig Mansoor Ali
Published: February 2025

Medical registries are in a need of a data set that is based on clinical evidence. In 2014, the Saudi Food and Drug Administration (SFDA) launched a plan to develop the national Comprehensive Implantable Medical Device Registry (CIMDR). One of the primary goals of the CIMDR is to develop a clinical -and population- based data set. The aim of this study is to report on the process of developing the data elements for the CIMDR. We used an iterative process of multi-stakeholder consultation over a two year period (2014–2016). The goal of the multi-stakeholder consultations was to build a dataset to address the need for device traceability, effectiveness, safety, and the recall of implantable medical devices. We investigated international and local standards for implantable medical device information capture, conducted a review of the literature, and consulted expert opinions in the development of the CIMDR dataset. The CIMDR data framework includes demographics, patient history, diagnosis, procedure information, and follow-up details for orthopedic and cardiac related implantable medical devices. Most of the dataset elements are logically validated with minimal free text entry to avoid human error and facilitate ease of entry. We use the International Classification for Diseases-Australian Modification as the standardized nomenclature for the CIMDR.
Smart Oncology Care Networks: An Approach in Information Systems to Support Brazilian National Cancer Institute
Authors: de Castro Silva Sandro Luís Freire  , Gonçalves Antônio Augusto  , Martins Carlos Henrique Fernandes  , Cheng Cezar  , Barbosa José Geraldo Pereira  , de Oliveira Saulo Barbará
Published: February 2025

In last decades Information Technology (IT) has been established as the main tool to support processes. Medical area has noticed the opportunity for improvement and interacting with IT has enabled solid interdisciplinary instruments for improvement. The aim in this project is composed by an analysis of the relationship between the application of information technologies, oncological assistance and innovation. Next, the project will focus to present the case of a proposal to reformulate the national cancer care system, with IT and Innovation being the base instrument for this process.
A Hospital Information System Application May Facilitate Staff Compliance with Quality Protocols in a Medical Unit: A Case Study
Authors: Karampela Irene  , Tzortzis Evangelos  , Nikolopoulos Markos  , Dalamaga Maria  , Diomidous Marianna  , Armaganidis Apostolos
Published: February 2025

Quality standards have been widely adopted in healthcare, while the Hospital Information Systems (HIS) support quality management in modern hospitals. However, staff compliance lags behind. In this study, we investigated the effect of a novel application, implemented in the HIS, on staff compliance in the Intensive Care Unit of a tertiary teaching hospital. This application integrates quality protocols to the HIS, which is routinely used by the nursing staff. Demographic data and self-reported compliance were recorded before and after the intervention. We found that the compliance rate was significantly increased and the application was well accepted by the majority of the staff. We also showed that previous ICU working experience is independently and positively associated with compliance (p=0.02, OR=2.86; 95% CI: 1.16 – 7.06), after adjustment for age and total nursing experience In conclusion, we developed an effective application for quality improvement aiming at facilitating educational processes and enhancing staff compliance.
Healthcare IT Strategic Alignment: Challenges and Recommendations
Authors: Alsharif Sahar  , Benslimane Nabila  , Khalifa Mohamed  , Price Colin
Published: February 2025

Information technology (IT) has dramatically transformed business processes in many industries including healthcare, where electronic health records, electronic prescribing and computerized provider order entry systems have positively changed the practice of healthcare. Recently, King Faisal Specialist Hospital and Research Center, Saudi Arabia, implemented various IT systems in multiple clinical and administrative departments leading to major transformation in healthcare workflows and business processes. At the pharmacy department, many Healthcare-IT alignment challenges are still perceived. Information about challenges of strategic alignment were gathered using qualitative survey methods, through conducting semi-structures interviews, to collect opinions, experiences and suggestions. Findings were first validated, according to published literature and research work, then sorted into fourteen challenges categorized into four main areas and recommended solutions: 1) Improving organizational communication, 2) Enhancing organizational governance, 3) Specifying the alignment scope and building the architecture and 4) Developing organizational and human skills.
Accessibility and Readability of Dementia-Related Information on Websites
Authors: Arief Muzawir  , Kinnunen Ulla-Mari  , Saranto Kaija
Published: February 2025

The study aimed to identify websites with dementia-related content and evaluate their readability and accessibility. A purposeful sample of 300 websites, which provided information on dementia, were identified from searches using the Google, Yahoo and Bing search engines. Two generic evaluation tools based on WCAG2.0 were used to assess the accessibility of information on dementia and two readability tests (Flesh-Kincaid Grade level and SMOG) were used to evaluate the websites. Only 94 websites have a HON certificate (31.3%), while 38 of the finally selected websites have an average of 56.89 and 32 problems in relation to the Axe and Achecker tools respectively. The most common problems (for images on 19 and 17 of the websites respectively) were related to text resize and the lack of text explanation, and an insufficient color contrast was found on 35 websites. The readability score was 8.2 (FKG) and 7.4 (SMOG) on average, which meant that the sites in question were not recommendable for the general population.
Designing Interaction and Guidance Technologies for Remote Consultations in Healthcare
Authors: Li Jane  , Huang Weidong
Published: February 2025

We present our work in designing mobile interaction and guidance technologies for the application of remote consultation between healthcare professionals. We describe design case studies which address the needs and scenarios in this application: a hybrid and rich media tool which supports mobile one-on-one consultations; a remote guidance tool which allows an expert to remotely guide a nurse or junior clinician to perform clinical procedures; an integrated collaboration platform which supports remote consultations in a group meeting environment by enabling shared interaction with patient records and mobile interaction with large displays. These tools have been evaluated in usability studies in which the usefulness and potential value have been demonstrated. By presenting these case studies, we highlight the trend of incorporating emerging collaboration technologies and the need of integrated and multi-model interaction systems in a broader telehealth context.
Barriers for Implementation and Use of Health Information Systems from the Physicians' Perspectives
Authors: Malekzadeh Somayeh  , Hashemi Nasim  , Sheikhtaheri Abbas  , Hashemi Niyoosha-sadat
Published: February 2025

This study aimed to investigate barriers to the implementation and use of health information systems (HIS) in Iran by physician's view. This cross-sectional study was conducted in 2016 on 163 physicians employed in 10 teaching hospitals. Data collection was carried out through a questionnaire with questions about the technical, organizational, ethical and personal barrier categories. Data analysis demonstrated that technical (e.g. inadequate planning for implementation and use of HIS) (3.56±1.32), organizational (e.g. inadequate facilities for fast and easy access to the Internet) (3.67±1.91), personal (e.g. inadequate awareness of healthcare providers about the benefits of HIS) (3.33±1.28), as well as legal and ethical (e.g. concern about the security and confidentially of HIS) (3.15±1.31) were the most important barriers to the implementation and use of HIS. Reducing barriers, especially technical and personal ones will increase the implementation and use of HIS based on the physicians' perspectives.
Benefits of Using Mobile Technologies in Education from the Viewpoints of Medical and Nursing Students
Authors: Sheikhtaheri Abbas  , Hashemi Nasim  , Hashemi Najmeh-alsadat
Published: February 2025

Increasing the use of mobile phones in education depends on the understanding of its benefits. The purpose of this study was to assess the vision of medical and nursing students about the benefits of using mobile technology in education. This study was conducted on medical and nursing students in 8 hospitals affiliated to Tehran University of Medical Sciences in 2016. 372 students participated in the study. Data were collected by a questionnaire consisting of 11 questions in Likert scale. Students' efficiency, improvement in quality of care, faster access to information and the positive effect on education were emphasized. Nursing students have more positive attitude regarding the use of this technology to save time at the time of providing services, faster access to patient information and influence on education. In summary, students considered mobile technology to be useful for educational purposes, so by eliminating the barriers in this field, it is possible to promote mobile learning for medical and nursing students.
Pharmacy Interweaving Safety Within Hospital Health Information Technology
Authors: Lichtner Valentina  , Westbrook Johanna I.  , Franklin Bryony Dean
Published: February 2025

Research on the impact of hospital technology on medication safety usually focuses on prescribing and administration. Less is known about the pharmacy-related processes of reviewing, ordering and dispensing medications and how technology supports this work. We carried out a qualitative exploratory study of a hospital in England (UK) with the aim of gaining insight into processes of digitalisation. We found that hospital pharmacy staff perform safety work with technology aiming to prevent harm, such as ‘scaffolding’ people's thinking processes, or linking-up unintegrated systems. Their work seems to ‘interweave’ safety in between others' medication activities, but they do so sometimes struggling with technological deficiencies.
Online Health Seeking Behaviours: What Information Is Sought by Women Experiencing Miscarriage?
Authors: Pang Patrick Cheong-Iao  , Temple-Smith Meredith  , Bellhouse Clare  , Trieu Van-Hau  , Kiropoulos Litza  , Williams Helen  , Coomarasamy Arri  , Brewin Jane  , Bowles Amanda  , Bilardi Jade
Published: February 2025

One in four pregnancies ends in miscarriage, a distressing event which can cause significant psychosocial impacts for many women, and yet often remains unseen and unspoken. Many would-be mothers turn to the internet for information and emotional support, and to share their experiences. In this paper, we present the results from 12 semi-structured interviews with women, investigating how and what online information they searched for at the time of miscarriage. We found that women are passive information seekers, searching for causes and preventive strategies to inform future pregnancies. Women want information presented in an easy to understand manner that is not overly clinical, and informed by credible sources. Women also seek psychological support and emotional relief through reading about others' experiences and sharing their stories online. The findings from this study provide a unique insight into the support and information needs of women, and will be used to guide the content, design and functionality of web-based technologies for women experiencing miscarriage.
Non-Contact Sensor-Based Falls Detection in Residential Aged Care Facilities: Developing a Real-Life Picture
Authors: Borda Ann  , Gilbert Cecily  , Said Cathy  , Smolenaers Frank  , McGrath Michael  , Gray Kathleen
Published: February 2025

Background. Few studies of sensor-based falls detection devices have monitored older people in their care settings, particularly in Australia. The present investigation addressed this gap by trialling the feasibility and acceptability of a non-contact smart sensor system (NCSSS) to monitor behaviour and detect falls in an Australian residential aged care facility (RACF).
Application of the Social Network Analysis to Better Comprehend Relationships in Qualitative Health Data
Authors: Lam Lawrence T.  , Lam Mary K.  , Benrimoj Charlie S.  , Cardens Victoria G.
Published: February 2025

Objective: To explore social network analysis (SNA) as an additional approach to elucidate quantifiable insight from qualitative health-related textual data.
Tensions in Health Care Networks and the Role of IT
Authors: Teckert Özlem  , Litfin Thorsten
Published: February 2025

Interprofessional health care networks provide the opportunity to improve the care of chronically ill people, making it more effective and efficient. However, interprofessional relations as well as network activities must be mediated, and tensions have to be balanced. IT has the capacity to support the bridging of temporal and spatial distances within these networks. But the introduction of IT may cause unintended changes. Based on a literature study and observations in two networks for patients with chronic wounds, potential tensions and their shift caused by IT were systematically recorded, based on a categorization of Sydow. The findings of this qualitative study enable network managers to raise the awareness of potential tensions. In this way possible consequences of the introduction of IT can be counteracted at an early stage of its occurrence. Furthermore, the study revealed that the introduction of IT results in shifts within the state of tension, and amplifies conflicts in many cases. Ideally, IT may serve as a ‘translator’ with unifying implications, while fostering the diversity of a network at the same time.
Finding Needles in the Haystack: Identifying Patients with Rare Subtype of Multiple Myeloma Supported by a Data Warehouse and Information Extraction
Authors: Krebs Jonathan  , Bittrich Max  , Dietrich Georg  , Ertl Maximilian  , Fette Georg  , Kaspar Mathias  , Liman Leon  , Einsele Hermann  , Puppe Frank  , Knop Stefan
Published: February 2025

Finding patient cases with extremely rare pathologies is a laborious task. To decrease time spent on manually searching through thousands of discharge letters and reports, a data warehouse with a fast fulltext search index was queried. Our use case is to find “macrofocal myeloma”, i.e. Multiple Myeloma patients with few large lesions. We guessed the number of those patients in the University Hospital Würzburg at about 20. Most criteria were available in the data warehouse in an unstructured form requiring information extraction. 8 patient cases were found by searching for different spellings of “macrofocal myeloma” in discharge letters directly. With an indirect search combining several criteria, we found additional 23 candidate patient cases, from which 10 were classified by a domain expert as correct. The most difficult criteria were determining the degree of bone marrow infiltration. We achieved an F1 score of 93.2 % for this task. The number of patient cases to be screened manually for this disease decreased from about 25000 to 23.
Building a Community of Inquiry Within an Online-Based Health Informatics Program: Instructional Design and Lessons Learned
Authors: Ammenwerth Elske  , Hackl Werner O.  , Felderer Michael  , Sauerwein Clemens  , Hörbst Alexander
Published: February 2025

The rapid medical and technological progress and the resulting need for life-long learning lead to the proliferation of online-based programs in health informatics for health care and health informatics professionals. Effective learning in these online-based programs demands close interaction and cooperation between students and instructors. In such cooperative online-based programs, special emphasis is thus put on fostering a community of inquiry between all participants. The online-based master program on Health Information Management at the University UMIT is firmly based on the constructivist theory of situated learning in such a community of inquiry. Online activities in this master program are designed to promote social presence, cognitive presence and teacher presence as preconditions for successful learning. To verify whether these three forms of presences are visible and whether learning was successful, the first four six-week online-based modules with overall 60 participants were analyzed in depth, combining data from community of inquiry surveys, student evaluations, workload assessments and final assessment results. Results indicate that it was possible to build a community of inquiry (with scores of 4.2 and higher) and to foster effective learning. We conclude with recommendations on how to build a community of inquiry in online-based cooperative learning and also discuss some constraints.
Investigating the Capabilities of FHIR Search for Clinical Trial Phenotyping
Authors: Gulden Christian  , Mate Sebastian  , Prokosch Hans-Ulrich  , Kraus Stefan
Published: February 2025

Clinical trials are the foundation of evidence-based medicine and their computerized support has been a recurring theme in medical informatics. One challenging aspect is the representation of eligibility criteria in a machine-readable format to automate the identification of suitable participants. In this study, we investigate the capabilities for expressing trial eligibility criteria via the search functionality specified in HL7 FHIR, an emerging standard for exchanging healthcare information electronically which also defines a set of operations for searching for health record data. Using a randomly sampled subset of 303 eligibility criteria from ClinicalTrials.gov yielded a 34 % success rate in representing them using the FHIR search semantics. While limitations are present, the FHIR search semantics are a viable tool for supporting preliminary trial eligibility assessment.
User Expectations of Metadata Repositories for Clinical Research
Authors: Löbe Matthias
Published: February 2025

Metadata Repositories (MDR) are databases for data elements that can be utilized in research as well as in medical care. These data elements are not the actual patient data (facts), but a complete definition of the variables or characteristics used, including coding, unit of measurement, data type and other aspects. The aim of the project described here was to evaluate possible application scenarios for MDRs by a larger group of experts. The focus was not on specific software, but on the community's basic expectation of such a database of data elements. To achieve this goal, a questionnaire was designed that contained questions on general aspects of setting up a registry for data elements in biomedical research as well as more specific points with regard to necessary functionalities, desired contents, tools for community work and the quality of data elements. One of the main results was that the users attach more importance to the quality of the content than to the efficiency in implementing their documentation concepts. At the same time, they consider the effort involved in using existing software systems to be too much compared with the benefits and have concerns about the use of their designs by third parties.
Curriculum Development of a Health Informatics Master Course in Understanding Technology
Authors: Smaradottir Berglind  , Gerdes Martin
Published: February 2025

Education in health informatics is an important contribution to the digital transformation in health care services, and there is a need to combine health and technology competencies. Traditional ways with separation of health sciences and computer science have shortcomings, and there is need for individuals with a holistic view and relevant education background for improving the technology-supported clinical work processes. This paper presents how the curriculum was organised in a course in “Understanding Technology”, which was a part of a Master's Programme in Health Informatics. The course targeted different aspects of technology for students with a diverse background, and it was organised with the aim to provide the students with theoretical technical insights and apply the knowledge through problem-solving and practical use. The course was decentralised and had a student-centred teaching approach over one semester.
Dual Purpose, Dual Audience: MCDA-Based Tools Can Simultaneously Support Personal Health Decisions and Educate Persons and Clinicians
Authors: Kaltoft Mette Kjer  , Nielsen Jesper Bo  , Dowie Jack
Published: February 2025

In this vision paper we envisage paradigmatic change transforming the health professional from the empowered agent of a dependent patient into the final decision supporter of an empowered person; a person who comes equipped with the preliminary opinion of an apomediative personalised decision support tool and the enhanced health decision literacy it produces. The anomalies in the current paradigm that will produce this change arise from unworkable attempts to combine multicriterial personal preferences and the best available evidence in a medical reasoning model. Multi-Criteria Decision Analysis (MCDA)-based decision support tools provide one mechanism for achieving this synthesis in a transparent way in a specific case whilst, simultaneously, increasing the generic health decision literacy and competencies of both person and clinician. The educational task for both is less than might be expected because of their familiarity, as consumers, with the many comparison websites and magazines for products and services using an informal version of MCDA. The educational task, particularly for the clinician, is primarily one of acknowledging that MCDA is a decision competence that has the potential, not only to enhance decision quality, but also facilitate communication between person and professional, who will now be talking the same decisional language. Experience from developing the MyBoneHealth tool confirms both the feasibility and challenges of delivering a MCDA-based decision support and educational tool.
Bridging Clinical and Social Determinants of Health Using Unstructured Data
Authors: Bettencourt-Silva Joao  , Mulligan Natasha  , Cullen Conor  , Kotoulas Spyros
Published: February 2025

There is a growing interest in identifying, weighing and accounting for the impact of health determinants that lie outside of the traditional healthcare system, yet there is a remarkable paucity of data and sources to sustain these efforts. Decision support systems would greatly benefit from leveraging models which are able to extend and use such cross-domain knowledge. This paper describes an approach to identify and explore related social and clinical terms based on large corpora of unstructured data. Using word embedding techniques on relevant sources of knowledge, we have identified terms that appear close together in the high-dimensional space. In particular, having created a model with cross-domain knowledge on the social determinants of health, we have been able to demonstrate that it is possible to surface terms in this domain when querying for related clinical terms, thereby creating a bridge between the social and clinical determinants of health. This is a promising approach with significant applicability in decision support efforts in healthcare.
How Agile Teams Regard and Practice Universal Design During Software Development
Authors: Bai Aleksander  , Mork Heidi  , Stray Viktoria
Published: February 2025

It is essential to focus on universal design in agile software development to ensure that the software developed is usable by as many people as possible. This work studies how members of agile teams regard universal design, how the team is organized to focus on universal design, and how the team practices universal design. We have questioned 89 members of agile software projects including developers, tester, designers and project leaders. We present a detailed breakdown of the results based on roles, domains, experience and other factors that explain the differences and similarities among teams. Our findings show that there is a significant difference between what members think, what management think and what members actually do to ensure universal design.
Universal Mosque/Masjid Design
Authors: Al-Mansoor Nazem Fawzi
Published: February 2025

As a public building, a mosque (or any prayer area for Muslims in public buildings) should remove all barriers that may confront persons with disabilities and hinder them from performing their religious rituals. A mosque is regularly used at least five times a day for praying, and for weekly events such as Jumu'ah (Friday prayers). Therefore, a mosque should be accessible for all. But in fact, persons with disabilities still find difficulties in accessing mosques. For example, the calling to prayer and Friday sermon (Khutba) through loudspeakers, is a problem for persons with hearing loss. Persons with physical disabilities, especially users of wheelchairs, walkers or crutches, have difficulties in several areas in the mosque, including the entrance, place of ablution, the lavatories and the area for removing shoes at the entrance to the prayer hall. People are not allowed to enter the place of ablution or prayer hall wearing shoes, people are also not allowed to enter with their personal mobility devices. This is so that dirt from outside does not get carried into the mosque. In order to understand the accessibility requirements for persons with disabilities in a mosque, we have to know the essential parts in the construction of the mosque and the mobility pattern that usually occurs in a mosque. In this paper, an accessibility checklist which has been developed on the basis of an analysis of accessibility requirements in mosques is presented.
Planning Accessibility Strategies and Connectivity for Malaysian Urban Built Environment
Authors: Abd Samad Nur Amirah  , Said Ismail  , Abdul Rahim Asiah
Published: February 2025

Access to our buildings relies to the accessibility of its external environment and the route taken. Developments and planning in urban areas has many several requirements and restrictions. Planning accessibility for Malaysian built environment is achievable by designing in compliance to the requirements enforced by authorities. Accessible design is commonly associated with providing facilities for Persons with Disabilities (PwDs), the issue that is often brought up is the inaccessibility of the external environment and lacking of seamless connectivity between buildings and the outdoor. The intention is to formulate accessibility strategies and work out planning process on how accessibility can be achieved. Universal Design will be the basis for the design and planning concept to accommodate all users to enjoy our urban built environment. It is notable that developed countries advances more in terms of implementing and enforcing accessibility measures via legislative and regulatory documents, government strategies and initiatives within its planning approach than the developing nations. The methodology will be looking into the establishment of strategies and measures of international and local planning policy, local and action plans of City of London as selected Local Authority to be analyzed its inclusive policy has been successfully implemented in their jurisdiction. The findings, discussions and result will be an outcome of generating a framework of accessibility strategies that is derived from interviews and government documents accordingly to targeted Malaysian urban areas focusing the City of Petaling Jaya and Putrajaya and how it can be improvised. Therefore, an interpretation of adopting accessibility planning strategies of developed country, to be adapted locally according to Malaysian legislation, culture and lifestyles.
Teaching for Critical Thinking: A Study of Teaching Strategies Employed by Instructors in Ontario Colleges Through General Education Courses
Authors: Thompson Barry
Published: February 2025

It has been sixteen years since the New College Charter introduced general education courses into Ontario college programs with the purpose of strengthening student's communication skills, problem solving ability, critical thinking, and to provide some breadth of knowledge beyond their program's vocational field of study. There are no past or current evaluation tools used to determine whether these skills are, indeed, strengthened through general education courses. Despite the lack of measurement, we can examine the educational conditions under which general education courses are taught and determine whether those are the same conditions that strengthen or develop these skills. Specifically, this study examines the curriculum development and teaching strategies used by general education instructors at an Ontario college to determine whether the strategies coincide with those that adult education literature would suggest to strengthen or develop student's critical thinking skills.
Clients' Approach to Universal Design – A Slow Change?
Authors: Grangaard Sidse
Published: February 2025

When new buildings do not comply with the accessibility requirements of the Danish Building Regulations, the main reason is often attributed to a lack of knowledge and prioritization. It is the experience of architectural firms that clients decide their own focus on accessibility during the design process, and also whether the level of accessibility should be higher than that stipulated in the Danish Building Regulations. Post-occupancy evaluations point out that when the client is particularly conscious of, or ambitious about, accessibility/Universal Design (UD), the result is a building with an extensive level of accessibility. Thus, the client is a key figure for the project and the level of ambition. Based on interviews with 15 Danish clients, this paper presents a characterisation of their conception of Universal Design. It is significant that, as a concept, UD has not gained currency among the clients that let their ambition level be defined by the Danish Building Regulations. In order to capture differences between clients, a description of the client's conception of users and designs is based on an analytical framework about the concepts of particular, universal, market and equality. The analysis shows that three conceptions about accessibility/UD can be characterized among the clients: 1) accessibility by design, 2) broad accessibility 3) added value. Above all, the findings show that a development is going on towards UD, although slowly.
Healthcare Data Are Remarkably Vulnerable to Hacking: Connected Healthcare Delivery Increases the Risks
Authors: Koppel Ross  , Kuziemsky Craig
Published: February 2025

Healthcare data are attractive to cyber-criminals because they contain financial and personal data, can be used for blackmail, and most valuable, are ideal for fraudulent billing. They are also remarkably vulnerable to penetration because of the fluid and always-evolving nature of a patient's medical care and because of the number of clinicians, facilities and transactions required to connect patient care across multiple settings. The addition of mobile healthcare devices and connected healthcare delivery systems (e.g., wearables, monitoring devices, cell phone images) makes healthcare data more attractive but also more vulnerable. Wide variations of digital health use patterns complicates design security solutions for each context or clinician. In this paper we propose a set of connected healthcare patterns, and then discuss security challenges and potential solutions for each of the connected health patterns.