bluuebunny/crossref_metadata_2025 huggingface dataset:
The Need for Information on Standards on eAccessibility&eInclusion – Based on the Experience of the EU-Project IN LIFE
Authors: Galinski Christian  , Giraldo Perez Blanca Stella
Published: February 2025

Recent investigations in several EU-projects, incl. IN LIFE revealed that experts in the field of eAccessibility & eInclusion (eAcc&eIncl) – but also general ICT developers, decision makers in industry and administration – are quite unaware of the importance of standards for interoperability and sustainability of ICT solutions. Especially, if persons with disabilities (PwD) are concerned, system development and the design of services can become unnecessarily costly. For accessibility in general and eAcc&eIncl in particular, knowing about pertinent standards is becoming an asset of personal competencies of experts and decision makers, and particularly benefit small enterprises. Given the complex world of standardization and the multitude of standards developing organizations (SDOs) easy access to information on standards is critical.
Measuring AT Usability with the Modified System Usability Scale (SUS)
Authors: Friesen Emma L.
Published: February 2025

The modified System Usability Scale (SUS) is a widely used generic measure of product usability. This study concerns the usability of mobile shower commodes using correlations between the SUS and AT device-specific measures. Results suggest the modified SUS, and corresponding adjective-anchored rating scale, are appropriate for measuring MSC usability, and have potential for use with other AT devices.
Exploring the Perspectives of People Who Use Alternative and Augmentative Communication Aids (AAC)
Authors: Broomfield Katherine  , Sage Karen
Published: February 2025

This paper outlines the clinical doctoral research plan (funded by HEE/NIHR Integrated Clinical Academic Programme) to engage the wide range of people who use alternative and augmentative communication (AAC) to understand the perspectives of users in order to develop a Patient Reported Outcome Measure (PROM) to evaluate equipment and services.
Customised City Maps in Mobile Applications for Senior Citizens
Authors: Reins Frank  , Berker Frank  , Heck Helmut
Published: February 2025

Map services should be used in mobile applications for senior citizens. Do the commonly used map services meet the needs of elderly people? – Exemplarily, the contrast ratios of common maps in comparison to an optimized custom rendered map are examined in the paper.
Developing an Assessment (Tool) for Touch Screen Devices
Authors: Danial-Saad Alexandra  , Chiari Lorenzo
Published: February 2025

Touch screen devices have become prevalent in our lives. Assistive technology experts working with people with disabilities face difficulty in understanding and assessing the problems experienced by individuals with disabilities in operating touch screen devices. This paper presents the processes of collecting and creating the required knowledge needed for assessing the user's skills for operating various touch screen devices, in order to develop an application for assessing the user's abilities and limitations. A six step procedure was used to collect and validate the required knowledge for the assessment from a multidisciplinary team. To determine the agreement levels between the experts, content validity was calculated. To test correlation between the experts from the different disciplines, a comparison was made between the discipline groups and their choice of specific skills/measurements. The final number of domains and skills/measurements was 15 domains and 50 skills/measurements. The result of Cronbach's α test for the final assessment questionnaire (50 skills/measurements) was 0.94, which indicates a high degree of reliability. The results of Kruskal-Wallis test showed the lack of any significant difference between agreements of the clinicians and the technicians groups, but significant differences were found between the educators and the clinicians groups. Each of the skills appearing in the final questionnaire was illustrated in a flowchart in preparation for developing the assessment (tool) for using touch screen devices.
DUCK: A DeDUCtive Soft Keyboard for Visually Impaired Users
Authors: Raynal Mathieu  , Roussille Philippe
Published: February 2025

Touch screens rapidly and significantly replace physical keyboards on mobile devices. Hence, text entry is now dependent on soft keyboards that are widely used by sighted people, but raise accessibility issues for visually impaired users. These users rely on tactile exploration with vocal feedback of the whole screen for entering text, which is time consuming. A software keyboard that aims reducing tactile exploration and speeding up text entry for VI users was designed. It relies on the selection of the first letter of a word and rapid and inaccurate typing of the remaining letters. It then proposes a list of words having the same first letter and a similar total distance between letters. The evaluation with twelve VI users showed that this keyboard is very efficient for words larger than five characters. It also helps preventing certain typing errors.
A Self-Service Approach to Promote Self-Sufficiency, Independence and Inclusion Amongst Disabled Students
Authors: Christensen Lars Ballieu  , Stevns Tanja
Published: February 2025

This paper presents how SensusAccess has been adapted and is being used in higher education to create inclusive educational environments. Reflecting on challenges of providing alternate versions of educational material to students with disabilities, it also discusses how the service can benefit mainstream learners.
Wr2Fdr Tool Maintenance for Models Checking
Authors: Sakka Rouis Taoufik  , Bhiri Mohamed Tahar  , Kmimech Mourad  , Moussa Faouzi
Published: February 2025

Today, a critical issue for complex systems design is the modeling and analysis of its architectures. Different ADLs support analyzers of different properties. For example, Unicon and MetaH allow the analysis of specific qualitative properties such as safety and security levels, while Rapide is focused on the dynamic aspect of architectures. However, the Wright ADL defines eleven standard properties related to the consistency and completeness of software architectures. These standard properties are automated and analyzed by the Wr2fdr tool accompanying the Wright ADL. In addition, the Wr2fdr tool can translate a Wright specification into another CSP acceptable by the FDR2 model-checker. Following the importance of this Wr2fdr tool, a maintenance activity of this tool was proposed in this paper. Our maintenance activity was mainly related to the implementation of these Wright standard properties. To achieve this, a functional testing and a reverse engineering were used.
The Implementation of Medical Informatics in the National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM)
Authors: Behrends Marianne  , Steffens Sandra  , Marschollek Michael
Published: February 2025

Introduction: The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) describes medical skills and attitudes without being ordered by subjects or organs. Thus, the NKLM enables systematic curriculum mapping and supports curricular transparency. In this paper we describe where learning objectives related to Medical Informatics (MI) in Hannover coincide with other subjects and where they are taught exclusively in MI.
Identification and Description of Healthcare Customer Communication Patterns Among Individuals with Diabetes in Clalit Health Services: A Retrospective Database Study
Authors: Benis Arriel  , Harel Nissim  , Barkan Refael  , Sela Tomer  , Feldman Becca
Published: February 2025

HMOs record medical data and their interactions with patients. Using this data we strive to identify sub-populations of healthcare customers based on their communication patterns and characterize these sub-populations by their socio-demographic, medical, treatment effectiveness, and treatment adherence profiles. This work will be used to develop tools and interventions aimed at improving patient care. The process included: (1) Extracting socio-demographic, clinical, laboratory, and communication data of 309,460 patients with diabetes in 2015, aged 32+ years, having 7+ years of the disease treated by Clalit Healthcare Services; (2) Reducing dimensions of continuous variables; (3) Finding the K communication-patterns clusters; (4) Building a hierarchical clustering and its associated heatmap to summarize the discovered clusters; (5) Analyzing the clusters found; (6) Validating results epidemiologically. Such a process supports understanding different communication-channel usage and the implementation of personalized services focusing on patients' needs and preferences.
A Case Study of the Technology Use and Information Flow at a Hospital-Driven Telemedicine Service
Authors: Smaradottir Berglind  , Fensli Rune
Published: February 2025

Health care services face the challenge of providing individualised treatment to a growing ageing population prone to chronic conditions and multi-morbidities. The research project Patients and Professionals in Productive Teams aims to study health care services that are run with a patient-centred teamwork approach. In this context, a case study was made of a hospital-driven telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge, with a focus on information flow and technology use. The methods used were observation and interviews with key informants. The results showed that the technology was perceived as well-functioning for telemedicine support, but the technology used was a standalone system and not integrated with the electronic health record of the hospital. In addition, there was lack of support to provide the patients at home with written instructions on advices of medical treatment and care. The electronic information used for this telemedicine services, allowed shared access of information for teamwork between professional only within the hospital.
Performance Optimization of Self Reference Plastic Optical Fiber Displacement Sensors
Authors: Buchade P.B.  , Maske S.M.  , Shaligram A.D.
Published: February 2025

: This paper reports the effect of various geometries of fibres in the Fiber Optic Displacement Sensors (FODS). Basically three geometries are studied. i) Two Fiber Sensor; with different offset, separation and inclination. ii) Fiber Optic Bundle Displacement Sensor (FOBDS) Configurations; Concentric Configuration (CC), FOBDS Random Configuration (RC), FOBDS Hemi Circular Configuration (HC). iii) Linear Array; here different type FODS consisting of one transmitting fiber and two non-identical receiving groups are studied. Linear array FODS with weighted sum (FODSWS) is also studied for the performance improvisation. The mathematical replica for the study of intensity modulated fibers, inclined with some angle is developed. It is found the performance parameters of the developed sensor are controlled by different geometrical parameters of the sensor. The model is obtained for sensor consisting of group of fibers, termed as fiber optic bundle displacement sensor (FOBDS) using a ray tracing method. The sensor performance for different geometries like, concentric, random and hemispherical fiber bundle configurations is simulated by means of the generated model. The experimental and simulated results of fiber optic bundle displacement sensor (FOBDS) shows that hemispherical configuration is best for FODS and it shows improvement in sensor performance with respect to two fiber sensor. A scheme of linear array based self-referenced fiber optic displacement sensor with weighted sum (FODSWS) is reported for simultaneous improvement on both linear displacement range and sensitivity. Simulations for linear array based self-referenced FODSWS was carried out. An effect of weight factors applied to each receiving fiber in second receiving group on sensor performance is investigated. Experimentation for linear array based self-referenced FODSWS was also carried out. Sensitivity is increased 5.2 times in comparison with simple self-referenced FODS. Linear displacement range also increased 1.05 times.
Class Level Research on Modifying Information Transmission Path of the Cooperative Network Based on the Cohesion of Class
Authors: Zhao Xiaolin  , Xue Jingfeng  , Zhang Yiman  , Zhang Qi
Published: February 2025

The traditional and mainstream method to study the software system with the complex network is building a collaborative network of the software system on the class level, which is effective to study the software complexity. In the class collaborative network, if the information is passed from a node, it may pass through the nodes at different probabilities. So, the node can block some information dissemination. Due to this feature, there are some problems, such as traverse path errors, inaccuracy of topological properties, inaccuracy propagation domains and propagation costs. Therefore, this paper explores the attributes that affect the probability that information dissemination based on the comparison between topological property of network class nodes and the structure of class. Besides, this paper defines the cohesion of matrix and designs a method of using the cohesive matrix to eliminate the error traversal path method. The experiment shows that this method is valid and effective to exclude error path and is great significant for the class collaborative network.
Building Geographical Information Application System to Water and Soil Preservation
Authors: Yu Ming  , Tang Zhi-cheng  , Wu Yong
Published: February 2025

Combining Arcobjects with the high-resolution image of Google Earth, this paper built and realized GIS application system of the water and soil loss in Ninghua County, Fujian Province. Ninghua County, located in the west of Fujian Province, is a key content in this paper. Realizing the constructed system can be served as an example for GIS theory, which supplies some references for the regional water and soil preservation as well as the prevention and reduction of disasters.
Successful System, Incomplete Data: Caveats in Reusing Activity Data from Emergency Department Whiteboards
Authors: Hertzum Morten
Published: February 2025

During the daily treatment of patients large quantities of data are recorded in electronic health records (EHRs). Compared to data in paper records, these EHR data are easily available for reuse in research and quality improvement. However, the opportunities for reuse depend on the quality of the data. In this study we analyze the completeness with which main treatment activities are recorded on emergency department (ED) whiteboards and whether completeness varies with the severity of the patients' condition. Data from 381,231 ED visits show that after the whiteboard had been in successful use for several years the clinicians recorded four of the five main treatment activities with a completeness of less than 50%. Completeness tended to increase with three indicators of the severity of the patient's condition: triage level, length of stay, and patient age. We conclude that the low completeness of the activity data probably prevents most types of reuse.
A Design of a Surgical Site Verification System
Authors: Shen Biyu  , He Yan  , Chen Haoyang
Published: February 2025

Patient security is a significant issue in medical research and clinical practice at present. The Surgical Verification System (Patent Number: ZL 201420079273.5) is designed to recognize and check surgical sites of patients so as to ensure operation security and decrease the risk for practitioners. Composition: (1) Operating Room Server, (2) Label Reader, (3) E-Label, (4) Surgical Site Display, (5) Ward Client, (6) Label Rader-Writer, and (7) Acousto-Optic Alarm. If the Surgical identification, the surgical site, and so on are incorrect, a flashing label control will appear when the alarm rings. You can specify a sound to play for the alarm, a picture to draw, and a message to send. It is a user-friendly system.
Concept Embedding for Relevance Detection of Search Queries Regarding CHOP
Authors: Deng Yihan  , Faulstich Lukas  , Denecke Kerstin
Published: February 2025

Automatic encoding of diagnosis and procedures can increase the interoperability and efficacy of the clinical cooperation. The concept, rule-based and machine learning classification methods for automatic code generation can easily reach their limit due to the handcrafted rules and a limited coverage of the vocabulary in a concept library. As the first step to apply deep learning methods in automatic encoding in the clinical domain, a suitable semantic representation should be generated. In this work, we will focus on the embedding mechanism and dimensional reduction method for text representation, which mitigate the sparseness of the data input in the clinical domain. Different methods such as word embedding and random projection will be evaluated based on logs of query-document matching.
Explore Care Pathways of Colorectal Cancer Patients with Social Network Analysis
Authors: Huo Tianyao  , George Jr. Thomas J.  , Guo Yi  , He Zhe  , Prosperi Mattia  , Modave François  , Bian Jiang
Published: February 2025

Patients with colorectal cancer (CRC) often face treatment delays and the exact reasons have not been well studied. This study is to explore clinical workflow patterns for CRC patients using electronic health records (EHR). In particular, we modeled the clinical workflow (provider-provider interactions) of a CRC patient's workup period as a social network, and identified clusters of workflow patterns based on network characteristics. Understanding of these patterns will help guide healthcare policy-making and practice.
Mobile Learning in Nursing Undergraduates in China: Current Status, Attitudes and Barriers
Authors: Xiao Qian  , Zhang Qiannan  , Wang Lanlan  , Wang Yanling  , Sun Liu  , Wu Ying
Published: February 2025

To explore the current status, attitudes and barriers of nursing undergraduates toward mobile learning, 157 nursing students were investigated. more than half of them used mobile learning frequently in past half year. The mean score of students' intention towards mobile learning was 10.5 (ranged from 6 to 15), and it related to students' gender, expected effect, ease of operation, influence of other students, self-learning management and perceived interest. Some barriers affected students' mobile learning. Therefore, students had positive attitude and perception toward mobile learning, then we should create enough conditions to promote students' mobile learning.
The Impact of PACS on Radiograph Interpretations in an Orthopedic Outpatient Clinic
Authors: Hurlen Petter  , Borthne Arne  , Gulbrandsen Pål
Published: February 2025

We found no significant change in the accuracy of clinicians' reading of skeletal radiographs before and after PACS- introduction. The level of inter-rater agreement between clinicians and radiologists was high in both periods, but they disagreed in significantly more cases after PACS.
Advancing Towards a CDA-Based Trauma Registry Data Submission
Authors: Staemmler Martin  , Nischwitz Alexander  , Blätzinger Markus  , Sturm Johannes
Published: February 2025

This poster presents an assessment to which extent the data submission to one of the largest trauma registries worldwide can be structured compliant to the clincial document architecture (CDA) and semantically annotated. Overall, complete annotation was achieved for 75% of the items, for the remaining ones annotation failed due to missing codes or concepts for individual items or values of value sets.
Trust Model for Protection of Personal Health Data in a Global Environment
Authors: Ruotsalainen Pekka  , Blobel Bernd
Published: February 2025

Successful health care, eHealth, digital health, and personal health systems increasingly take place in cross-jurisdictional, dynamic and risk-encumbered information space. They require rich amount of personal health information (PHI). Trust is and will be the cornerstone and prerequisite for successful health services. In global environments, trust cannot be expected as granted. In this paper, health service in the global environment is perceived as a meta-system, and a trust management model is developed to support it. The predefined trusting belief currently used in health care is not transferable to global environments. In the authors' model, the level of trust is dynamically calculated from measurable attributes. These attributes describe trust features of the service provider and its environment. The calculated trust value or profile can be used in defining the risk service user has to accept when disclosing PHI, and in definition of additional privacy and security safeguards before disclosing PHI and/or using services.
Development and Validation of Various Phenotyping Algorithms for Diabetes Mellitus Using Data from Electronic Health Records
Authors: Esteban Santiago  , Rodríguez Tablado Manuel  , Peper Francisco  , Mahumud Yamila S.  , Ricci Ricardo I.  , Kopitowski Karin  , Terrasa Sergio
Published: February 2025

Precision medicine requires extremely large samples. Electronic health records (EHR) are thought to be a cost-effective source of data for that purpose. Phenotyping algorithms help reduce classification errors, making EHR a more reliable source of information for research. Four algorithm development strategies for classifying patients according to their diabetes status (diabetics; non-diabetics; inconclusive) were tested (one codes-only algorithm; one boolean algorithm, four statistical learning algorithms and six stacked generalization meta-learners). The best performing algorithms within each strategy were tested on the validation set. The stacked generalization algorithm yielded the highest Kappa coefficient value in the validation set (0.95 95% CI 0.91, 0.98). The implementation of these algorithms allows for the exploitation of data from thousands of patients accurately, greatly reducing the costs of constructing retrospective cohorts for research.
From Bench to Bedside: A View on Bioinformatics Pipelines
Authors: Flores Blanca  , Hose Dirk  , Seckinger Anja  , Knaup Petra  , Ganzinger Matthias
Published: February 2025

Although sequencing technology has become widely available in recent years, the steps in bioinformatics pipelines are time-consuming and barely standardized. New tools to improve individual steps in a pipeline are frequently published and configurations can be quickly adapted to use new versions. We performed case studies with a representative set of pipeline management tools using the GEP-R pipeline, and a qualitative study of different software packages covering relevant classes of software tools. We use a software toolset of R environment, Docker, KNIME, and BPEL to review our first aim of technical and organizational challenges. We propose snapshotting, documentation management, and a hybrid approach for our second aim of approaches to reproducibility. In order to have fully reproducible results derived from raw data, we think that it is necessary to archive biomedical analysis pipelines and their necessary software components.
Graph Clustering System for Text-Based Records in a Clinical Pathway
Authors: Yamashita Takanori  , Onimura Naoya  , Soejima Hidehisa  , Nakashima Naoki  , Hirokawa Sachio
Published: February 2025

The progressive digitization of medical records has resulted in the accumulation of large amounts of data. Electronic medical data include structured numerical data and unstructured text data. Although text-based medical record processing has been researched, few studies contribute to medical practice. The analysis of unstructured text data can improve medical processes. Hence, this study presents a clustering approach for detecting typical patient's condition from text-based medical record of clinical pathway. In this approach, the sentences in a cluster are merged to generate a “sentence graph” of the cluster after classified feature word by Louvain method. An analysis of real text-based medical records indicates that sentence graphs can represent the medical treatment and patient's condition in a medical process. This method could help the standardization of text-based medical records and the recognition of feature medical processes for improving medical treatment.
Developing Digital Health and Welfare Services in an International Multidisciplinary Student Team
Authors: Ahonen Outi  , Rajalahti Elina  , Tana Jonas  , Lejonqvist Gun-Britt  , Kinnunen Ulla-Mari  , Saranto Kaija
Published: February 2025

The rapid growth of digital health and welfare services demands new competences for health and social care, information technology, and business professionals. This study aims to describe the competences that students have before their studies and those they expect to gain from the study module “Developing Digital Health and Welfare Services” in multiprofessional groups during their bachelor studies. This study reports open-ended questions about students' knowledge concerning digital health prior to the study units. The results, analyzed by QSR NVivo 10 for Windows, show that students are keen to learn about developing digital health and welfare services, and they see that multiprofessional work requires a communicative environment and respect for every profession. Students also believe that they have competences to bring to the multiprofessional group. A successful multidisciplinary development of digital health and welfare services requires changes and cooperation in education between various professions.
Clinical Decision Support and Primary Care Acceptance of Genomic Medicine
Authors: Chase Dian A.  , Baron Sherry  , Ash Joan S.
Published: February 2025

Clinical decision support systems (CDS) have an important role in the implementation of precision medicine, particularly for pharmacogenomics. This study examines potential factors for their acceptance by primary care clinicians.
The New HIT: Human Health Information Technology
Authors: Leung Tiffany I.  , Goldstein Mary K.  , Musen Mark A.  , Cronkite Ruth  , Chen Jonathan H.  , Gottlieb Assaf  , Leitersdorf Eran
Published: February 2025

Humanism in medicine is defined as health care providers' attitudes and actions that demonstrate respect for patients' values and concerns in relation to their social, psychological and spiritual life domains. Specifically, humanistic clinical medicine involves showing respect for the patient, building a personal connection, and eliciting and addressing a patient's emotional response to illness. Health information technology (IT) often interferes with humanistic clinical practice, potentially disabling these core aspects of the therapeutic patient-physician relationship. Health IT has evolved rapidly in recent years – and the imperative to maintain humanism in practice has never been greater. In this vision paper, we aim to discuss why preserving humanism is imperative in the design and implementation of health IT systems.
Estimating Actual Evapotranspiration from NDVI Using Landsat 8 and Sentinel-2 Imagery
Authors: Jermthaisong Panath  , Kingpaiboon Sununtha  , Chawakitchareon Petchporn
Published: February 2025

Evapotranspiration (ET) is the sum of evaporation and transpiration from the surface to the atmosphere. ET is a hydrologic cycle component and importance in agricultural water management such as schedules of irrigation water requirement, irrigation system design and watershed management. Evapotranspiration can be measured or estimated using several methods. The objectives of this study were simple methods and quick analyses for the estimating of crop coefficients (Kc) and daily actual evapotranspiration (ETa) from Normalized Difference Vegetation Index (NDVI) derived from Landsat 8 and Sentinel-2 satellite images. Subsequent comparison of ETafrom both satellite images at Ban Nong Bua, Amphoe Ban Fang, Khon Kaen Province, Thailand. The results showed that good correlation between NDVI and ETafrom both satellite images (coefficient of determination (R2) = 0.85 and 0.87, respectively). Both satellite images can be used or combined to detect temporal and spatial analysis. Sentinel-2 can provide more fine resolution of 10 m in VIS-NIR bands than Landsat 8 and is suitable for precision farming or site specific management, while Landsat 8 TIRS bands were advantages.
Consumer Wearable Information and Health Self Management by Older Adults
Authors: Borda Ann  , Gilbert Cecily  , Gray Kathleen  , Prabhu Deepa
Published: February 2025

Background: The present study was undertaken to build an evidence base focusing on an ageing population who are using or have used consumer wearables to collect and manage information about their personal health status. The primary objective was to understand the health self-management requirements, frailty and age related changes, and the health information support provided by consumer wearable devices, specifically in the context of older adults living independently.
Automated Differentiation of Incident and Prevalent Cases in Primary Care Computerised Medical Records (CMR)
Authors: Smith Nadia  , Livina Valerie  , Byford Rachel  , Ferreira Filipa  , Yonova Ivelina  , de Lusignan Simon
Published: February 2025

Identifying incident (first or new) episodes of illness is critical in sentinel networks to inform about the seasonal onset of diseases and to give early warning of epidemics, as well as differentiating change in health service utilization from change in pattern of disease. The most reliable way of differentiating incident from prevalent cases is through the clinician assigning episode type to the patient's computerized medical record (CMR). However, episode type assignment is often made inconsistently. The objective of this collaborative study between the Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC), University of Surrey and the National Physical Laboratory (NPL) is to develop a methodology to reconstruct missing or miscoded episode types. The data, gathered from the RCGP RSC network of over 230 practices, are analyzed and poor episode typing reconstructed by disease type. The methodology is tested in practices with good episode type data quality. This method could be used to improve prediction of epidemics, and to improve the quality of historical rates retrospectively.
Conception of an Expert Advisory Board for the European Reference Network for Rare Respiratory Diseases
Authors: Walther Désirée  , Steinmann Olivia  , Schaefer Johanna  , Wagner Thomas O.F.  , Storf Holger
Published: February 2025

Due to low prevalence of rare diseases and lack of expertise, patients suffering rare diseases are challenged with finding experts that are specialized and experienced in treating their conditions and get qualified answers. To address this issue, the approach of an interactive platform was made, which should allow affected patients or physicians the possibility to ask experts their specific questions to gather and improve their knowledge about their condition. This paper introduces the pan-European Internet platform EXABO, an Expert Advisory Board, which is developed within the framework of the European Reference Network for rare respiratory diseases (ERN-LUNG). The purpose of establishing this platform is initially dedicated to rare respiratory diseases in whole Europe, whilst the set-up is however, planned to be a generic tool for additional diseases or groups of diseases. This paper gives an overview of the concept and planning of the EXABO platform and shows how the platform is to be implemented.
The Perspective of Nurses on Nursing Information System: A Case Study in a Developing Country
Authors: Sarbaz Masoumeh  , Kimiafar Khalil  , Nazari Elham
Published: February 2025

The purpose of this study was to investigate the effect of nursing information system (NIS) on clinical performance from the perspective of nurses in an academic hospital affiliated to Mashhad University of Medical Sciences in Iran. This descriptive cross-sectional study was conducted in 2016. We collected data targeting nurses with over three years' experience in using the NIS (120 nurses). NIS had caused improvement in “accuracy the consistency of drug, lab tests and radiology requests”, “increasing the speed of the automated extracting of minimum data set for decision making and care trends” with the means of 4.89 and 4.27 respectively (5 point Likert). Findings showed that “workload of nurses” (Mean 4.05), “duplication in recording patients' information” (Mean = 3.99) obtained the highest mean. Furthermore, “appropriateness of the data entry tools to tasks” (Mean=3.29) and “the ability of adapting the software to new responsibilities of nurses “(Mean=3.25) gained the lowest mean.
Interactive Dialogue-Based Patient Education for Juvenile Idiopathic Arthritis Using Argument Theory
Authors: Rose-Davis Benjamin  , Stringer Elizabeth  , Abidi Samina  , Abidi Syed Sibte Raza
Published: February 2025

Families of children with Juvenile Idiopathic Arthritis need a way to interact with Patient Education Materials (PEM) so that learning occurs at their own pace, on topics that are relevant to them. This paper proposes a novel, dialogue-based approach to address these needs. Using an extended version of Toulmin's model of argument as a theory-based classification method, we digitized paper-based PEM to render an interactive dialogue. The dialogue allows the user to explore a topic with respect to their interests and apprehensions as opposed to providing a static, generic document.
A Methodology for Fine-Grained Access Control in Exposing Biomedical Data
Authors: Trifan Alina  , van der Lei Johan  , Díaz Carlos  , Oliveira José Luís
Published: February 2025

Biomedical data integration and processing is a very sensitive issue and a main barrier for research, since it normally implies dealing with private clinical information. To overcome this problem, we propose a solution based on multiple levels of data visibility, combined with a fine-grained access control over the shared data. Through our proposal, on one hand, data custodians can decide the level of detail at which they want to share data, in a flexible manner that can be adjusted along the time. On the other hand, adequate permissions are provided to the users that want to access the data, according to their role and research plan.
Metadata to Describe Genomic Information
Authors: Delgado Jaime  , Naro Daniel  , Llorente Silvia  , Gelpí Josep Lluís  , Royo Romina
Published: February 2025

Interoperable metadata is key for the management of genomic information. We propose a flexible approach that we contribute to the standardization by ISO/IEC of a new format for efficient and secure compressed storage and transmission of genomic information.
Socio-Technical Considerations for the Use of Blockchain Technology in Healthcare
Authors: Wong Ming Chao  , Yee Kwang Chien  , Nøhr Christian
Published: February 2025

Blockchain technology is often considered as the fourth industrial revolution that will change the world. The enthusiasm of the transformative nature of blockchain technology has infiltrated healthcare. Blockchain is often seen as the much needed and perfect technology for healthcare, addressing the difficult and complex issues of security and inter-operability. More importantly, the “value” and trust-based system can deliver automated action and response via its smart contract mechanism. Healthcare, however, is a complex system. Health information technology (HIT) so far, has not delivered its promise of transforming healthcare due to its complex socio-technical and context sensitive interaction. The introduction of blockchain technology will need to consider a whole range of socio-technical issues in order to improve the quality and safety of patient care. This paper presents a discussion on these socio-technical issues. More importantly, this paper argues that in order to achieve the best outcome from blockchain technology, there is a need to consider a clinical transformation from “information” to “value “ and trust. This paper argues that urgent research is needed to address these socio-technical issues in order to facilitate best outcomes for blockchain in healthcare. These socio-technical issues must then be further evaluated by means of working prototypes in the medical domain in coming years.
Generalizing the Arden Syntax to a Common Clinical Application Language
Authors: Kraus Stefan
Published: February 2025

The Arden Syntax for Medical Logic Systems is a standard for encoding and sharing knowledge in the form of Medical Logic Modules (MLMs). Although the Arden Syntax has been designed to meet the requirements of data-driven clinical event monitoring, multiple studies suggest that its language constructs may be suitable for use outside the intended application area and even as a common clinical application language. Such a broader context, however, requires to reconsider some language features. The purpose of this paper is to outline the related modifications on the basis of a generalized Arden Syntax version. The implemented prototype provides multiple adjustments to the standard, such as an option to use programming language constructs without the frame-like MLM structure, a JSON compliant data type system, a means to use MLMs as user-defined functions, and native support of restful web services with integrated data mapping. This study does not aim to promote an actually new language, but a more generic version of the proven Arden Syntax standard. Such an easy-to-understand domain-specific language for common clinical applications might cover multiple additional medical subdomains and serve as a lingua franca for arbitrary clinical algorithms, therefore avoiding a patchwork of multiple all-purpose languages between, and even within, institutions.
Combining Semantic and Lexical Methods for Mapping MedDRA to VCM Icons
Authors: Lamy Jean-Baptiste  , Tsopra Rosy
Published: February 2025

VCM (Visualization of Concept in Medicine) is an iconic language that represents medical concepts, such as disorders, by icons. VCM has a formal semantics described by an ontology. The icons can be used in medical software for providing a visual summary or enriching texts. However, the use of VCM icons in user interfaces requires to map standard medical terminologies to VCM. Here, we present a method combining semantic and lexical approaches for mapping MedDRA to VCM. The method takes advantage of the hierarchical relations in MedDRA. It also analyzes the groups of lemmas in the term's labels, and relies on a manual mapping of these groups to the concepts in the VCM ontology. We evaluate the method on 50 terms. Finally, we discuss the method and suggest perspectives.
The Presence of eHealth Support for Childhood Obesity Guidance
Authors: Deshpande Shalmali  , Rigby Michael J.  , Blair Mitch
Published: February 2025

A rising global obesity epidemic in children has implications for an increase in other chronic diseases and a negative social impact, which should not be ignored. A useful resource in this context could be eHealth due to its popularity amongst children. Additionally, telephone guidance is also considered a powerful health promotion tool. The aim of this study was to investigate the availability of mobile applications (apps), websites, helplines, and advice lines for child obesity guidance, in European countries. A survey was conducted in 28 European Member States and 2 European Economic Area countries, in 2017. Twenty-three responses were collected. Fourteen countries stated the presence of an obesity management website.
Modular Architecture for Integrated Model-Based Decision Support
Authors: Gaebel Jan  , Schreiber Erik  , Oeser Alexander  , Oeltze-Jafra Steffen
Published: February 2025

Model-based decision support systems promise to be a valuable addition to oncological treatments and the implementation of personalized therapies. For the integration and sharing of decision models, the involved systems must be able to communicate with each other. In this paper, we propose a modularized architecture of dedicated systems for the integration of probabilistic decision models into existing hospital environments. These systems interconnect via web services and provide model sharing and processing capabilities for clinical information systems. Along the lines of IHE integration profiles from other disciplines and the meaningful reuse of routinely recorded patient data, our approach aims for the seamless integration of decision models into hospital infrastructure and the physicians' daily work.
A Survey of Managers' Access to Key Performance Indicators via HIS: The Case of Iranian Teaching Hospitals
Authors: Ahmadi Maryam  , Khorrami Farid  , Dehnad Afsaneh  , Golchin Mohammad H.  , Azad Mohsen  , Rahimi Shafei
Published: February 2025

Background: The challenges of using health information systems in developing countries are different from developed countries for various reasons such as infrastructure and data culture of organizations.
Estimation of the Accuracy of Prognostic Scores for the Treatment of Children with Severe Trauma in a Specialized Trauma Hospital
Authors: Vasilyeva Irina V.  , Shvirev Sergey L.  , Zarubina Tatyana V.  , Karaseva Olga V.  , Samoylov Alexander S.  , Udalov Yuri D.
Published: February 2025

The aim of the present work was to study the validity and prognostic accuracy of scores for assessing the severity of the condition in children with severe trauma, located in the Department of Anesthesiology and Resuscitation in the Clinical and Research Institute of Urgent Pediatric Surgery and Trauma. The prospective study was conducted using clinical and physiological data collected at the admission and during the first 24 hours of hospitalization from 474 patients. The validity and prognostic accuracy of prognostic scores were assessed by determining their discrimination and calibration ability. A comparison of the discriminatory ability of scores was carried out by comparing the areas under the ROC curves with the z-criterion. Four prognostic scores were included into the study: PRISM, APACHE II, ISS-RTS-TRISS, which were used for calculating the severity of injury and for prognosis of death. Score PTS was used for evaluating the severity index only. Our results indicate that only score ISS-RTS-TRISS may be useful in practice (has excellent discrimination ability and significant calibration ability). The other lack either discrimination ability (PRISM) or calibration ability (PTS, APACHE II). The result of the study has shown that only one of the four prognostic scores, ISS-RTS-TRISS, can be successfully used in everyday practice in the department of anesthesiology and resuscitation in the specialized hospital of children's traumatology to assess the severity of the condition, with the possibility of predicting the likelihood of a lethal outcome.
Achieving Interoperability Between Arden-Syntax-Based Clinical Decision Support and openEHR-Based Data Systems
Authors: Spineth Martin  , Rappelsberger Andrea  , Adlassnig Klaus-Peter
Published: February 2025

Background: Arden Syntax is an international standard for medical knowledge representation and processing. The openEHR Foundation publishes specifications for the creation of electronic health records based on interoperable data models.
Cross-Enterprise Communication and Data Exchange in Radiology in Austria: Technology and Use Cases
Authors: Helm Emmanuel  , Schuler Andreas  , Mayr Herwig
Published: February 2025

Background: The research project REPO (Radiology Ehealth PlatfOrm) was started in 2017 with the goal to “enable cross-enterprise collaboration in radiology using the Austrian eHealth infrastructure”.
Facilitating the Information Exchange Using a Modular Electronic Discharge Summary
Authors: Denecke Kerstin  , Dittli Pascal A.  , Kanagarasa Niveadha  , Nüssli Stephan
Published: February 2025

Background: Discharge summaries are a standard communication tool delivering important clinical information from inpatient to ambulatory care. To ensure a high quality, correctness and completeness, the generation process is time consuming. It requires also contributions of multiple persons. This is problematic since the primary care provider needs the information from the discharge summary for continuing the intended treatment. To address this challenge, we developed a concept for exchanging a modular electronic discharge summary.
Decision Support System Based on FHIR Profiles
Authors: Semenov Ilia  , Kopanitsa Georgy
Published: February 2025

In some healthcare systems, it is common that patients address laboratory test centers directly without a doctor's referral. Russia is one of such countries with about 28% of the patients going directly to the laboratory test center for diagnostics. This leads to a situation when patients are not supported by healthcare professionals in the interpretation of test results. Interpretation of test results is a resource-consuming task that will delay the results and increase costs of each test. However, this can be done by computer-based decision support systems that have proved to solve such tasks efficiently. So, the design and implementation of a decision support system that would generate reports for the patients who referred to a test center without a doctor's referral can increase motivation and support patients to make better informed decisions. The goal of this study is to implement a decision support system for patients. We developed a clinical decision support system for the patients that solves a classification problem by relating a vector of test results to a set of diagnoses and find a set of recommendations associated with every diagnosis from this set.
Medical Device Integrated Vital Signs Monitoring Application with Real-Time Clinical Decision Support
Authors: Moqeem Aasia  , Baig Mirza  , Gholamhosseini Hamid  , Mirza Farhaan  , Lindén Maria
Published: February 2025

This research involves the design and development of a novel Android smartphone application for real-time vital signs monitoring and decision support. The proposed application integrates market available, wireless and Bluetooth connected medical devices for collecting vital signs. The medical device data collected by the app includes heart rate, oxygen saturation and electrocardiograph (ECG). The collated data is streamed/displayed on the smartphone in real-time. This application was designed by adopting six screens approach (6S) mobile development framework and focused on user-centered approach and considered clinicians-as-a-user. The clinical engagement, consultations, feedback and usability of the application in the everyday practices were considered critical from the initial phase of the design and development. Furthermore, the proposed application is capable to deliver rich clinical decision support in real-time using the integrated medical device data.
Personalized Monitoring and Assistive Systems: Case Study of Efficient Home Solutions
Authors: Lhotska Lenka  , Doležal Jaromír  , Adolf Jindřich  , Potůček Jiří  , Křížek Miroslav  , Chbani Baha
Published: February 2025

The rapid emergence and proliferation of connected medical devices and their application in healthcare are already part of the Healthcare Internet of Things (IoT) – as this area started to be named. Their true impact on patient care and other aspects of healthcare remains to be seen and is highly dependent on the quality and relevancy of the data acquired. There is also the trend of application of IoT in telemedicine and home care environment. Currently many research groups focus on design and development of various solutions that can assist elderly and handicapped people in their home environment. However, many of these solutions are sophisticated and require advanced users that are able to control the device, handle error states and exceptions. They are frequently using expensive technologies that are good for laboratory environment but they are not affordable for many elderly or handicapped persons. In the paper we will analyze the current situation, present identified needs of elderly population and propose potential solutions. On a case study of efficient home solution of a personalized and assistive system we will show possibilities of technologically simple solutions using off-the-shelf devices and elements.