bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospects of Medical Informatics Education in Greece : Can we bridge the gap?
Authors: Maglaveras Nicos
Published: February 2025

Medical Informatics education is a complex task,, since it aims in educating inhomogeneous groups of people coming from different disciplines. In Greece, recently considerable advancements in the medical informatics education field are made. These advancements aim in bridging gaps in various areas of MI users interactions. In particular, an overview of the strategy of the Greek ministry of education shall be given, some examples of MI related educational programs shall be referred to, and finally the MI educational structure used in the Aristotelian University shall be presented in detail, laying out the strategy of this University for bridging various types of gaps.
2. The Legal Challenges
Authors: Furberg Per  , Klein Gunnar O.
Published: February 2025

When information Systems and networks are replacing traditional document procedures, archiving and postal services in the healthcare sector, insecure routines may be avoided by elaborating appropriate procedures and technical protection measures.
Partnership for Excellence in Asthma Care: Evidence-Based Disease Management
Authors: Richman Mary Jane  , Poltawsky Jeffrey S.
Published: February 2025

Partnership for Excellence in Asthma Care, a practical example of evidence-based disease management, was launched by Egleston Scottish Rite Children's Health Care System. The process of development and implementation of evidence-based practice guidelines for the outpatient management of asthma is described. Methods to influence physician practice patterns and the preparation of feedback reports are discussed. The method for measuring outcomes and preliminary outcome data are shared.
Physicians' attitudes towards health telematics - an empirical survey
Authors: Langer B  , Wetter T
Published: February 2025

Telemedical networks and services have received high attention in professional and scientific media in the recent past. In Germany some institutions and few physicians volunteer in experimenting with diverse telemedical service offerings. However, much is speculated but little is known about attitudes and expectations of the majority of physicians in local offices towards this new medium. Therefore we conducted an empirical survey using a random regional sample to poll the respective opinions. Encouraged by a high response rate to our paper questionnaire, we offer as conclusion: that physicians are surprisingly realistic about costs and benefits and can therefore be expected to subscribe as soon as benefits become obvious; that this trend increases with offices being taken over or newly established by younger physicians; and that the establishment of networks of comprehensive care offered by health care professionals from different disciplines is regarded as essential future advantage of telemedical networks.
The Croatian Telemedicine
Authors: Kovai Luka  , Lonari Sven  , Paladino Josip  , Kern Josipa
Published: February 2025

Telemedicine developed in Croatia in two phases. The first phase during the 1970s was limited because of insufficient technology and scarce resources. But that phase was important as a learning process and the preparatory stage for the promising future. The communications infrastructure was heavily destroyed during the 1991-92 war but it was reconstructed and rebuilt as a modern technology based on optical fibres. The new technical and technological infrastructure was the base for the development of CARNet (Croatian Academic and Research Network). CARNet was linked to the Internet and enabled the international exchange of information for the scientific community. Telemedicine projects started firstly as pilot projects around the same time as in other countries. They were financially covered mostly by the Ministry of Science either directly or through the CARNet. The telemedicine projects, like telepathology, teleradiology, teleneurosurgery, teleeducation, developed in a very sophisticated way and are now in the phase of implementation into the routine health practice. Some projects are still in the pilot phase, but thanks to highly trained professionals, they are promising and it can be expected that with the growing economic stuation they will be implemented soon.
Implementation of a Dedicated Optical Fibre Network for Real Time Stereo Imaging
Authors: Chios Polydoros S.  , Tan A C
Published: February 2025

This paper describes the successful implementation of a dedicated fibre optic network for the real time stereo video imaging. It shows the approach in the design of both configuration and signalling requirements. It overcomes problems associated with standard optical network components and budget constraints of using specialised designs. The flexible configuration, using patch panels, allows for endless scenarios of routing the various audio, video and computer equipment signals to multiple locations. This arrangement permits dedicated point to point link or multicasting to two locations simultaneously. Redundancies in the fibre allocation enable fail safe operations and future expansion capabilities for other medical and IT applications.
TEAC-Health - Research-based Recommendations for European Certification of Health Telematics Services
Authors: Forsström Jari  , Rigby Michael
Published: February 2025

Health Telematics services are now a major part of health care delivery, and of citizens' health behaviour, and will rapidly develop further in scope and significance. However, despite their pivotal position in care and treatment, they are unregulated - unlike all other aspects of health care services. This anomaly is potentially putting the citizen at risk, and also underpinning good clinical practice as clinicians are uncertain of the integrity of specific health telematics tools. The TEAC-Health project, funded by the European Commission, has studied the issues, and produced evidence-based recommendations.
Application of Genetic Programming for the Differential Diagnosis of Acid - Base and Anion Gap Disorders
Authors: Malolepszy Andrzej  , Kacki Edward  , Dogdanik Tadeusz
Published: February 2025

Differential diagnostics of very complex disorders in the acid -base status and in the accompanying electrolyte balance belongs to the most difficult diagnostic procedures in clinical practice. The goal of our study was to create computer genetic programs, able to aid the diagnostics of acid-base disorders, taking into account a set of laboratory gasometric and electrolyte measurments. Seven (7) single acid-base disorders, eleven (11) double acid-base disorders and six (6) triple complicated disorders with accompanying anion gap alterations were approached by our study. A set of simulated laboratory measurements was prepared, providing 250 results for the evaluation of the fitness function of the designed computer genetic programs, plus some additional results for testing.
Möglichkeiten der Telemedizin in Anästhesie und Intensivmedizin
Authors: Quinzio L.  , Junger A.  , Fuchs C.  , Sciuk G.  , Meier T.  , Michel A.  , Hempelmann G.
Published: February 2025

Der zunehmende Einsatz computergestützter Arbeitsplätze zur Dokumentation in der Anästhesie und Intensivmedizin erweitert die ärztlichen Kommunikationsmöglichkeiten inner- und außerhalb einer anästhesiologischen Abteilung. Über vernetzte Computer kann durch den Einsatz von Telekommunikationssoftware standortunäbhangiges medizinisches Expertenwissen zur Verfügung gestellt werden (Telekonsultation). Im Rahmen eines von der hessischen Landesregierung geförderten Projektes (Hessen Media, Telemedizin in der Anästhesie [1]) konnte an der Abteilung Anaesthesiologie und Operative Intensivmedizin ein System zur intemen Telekonsultation zwischen den 146 klinischen Arbeitsplätzen sowie für exteme Telekonsile etabliert werden. Für die interne Telekonsultation wurde die Remote Control Software Timbuktu Pro® (Netopia, Alameda, USA) verwendet, die es unabhangig vom Standort erlaubt, über eine gemeinsame Sicht auf die aktuelle computergestützte Patientendokumentation (NarkoData®, ICUData®) dem am Narkose- oder Intensivarbeitsplatz tatigen Anüsthesisten Unterstützung zu leisten. Eine Videokonferenzsoftware ermöglicht via ISDN z.B. bei Verlegung von Patienten der Intensivstation eine direkte Verbindung zu extemen Kliniken.
Differences in demographic data regard- ing physicians and patients in the US or abroad using a medically oriented internet information service
Authors: Quade Gustav  , Zenker Sven  , Burde Bernd  , Riedel Rolf-Reiner  , Goldschmidt Andreas
Published: February 2025

Since early 1994 we have offered access to the National Cancer Institute's guide- lines for current cancer therapy to physicians via WWW. These guidelines, which are provided by the NCI in accordance with the rules for evidence-based medicine, are accompanied by general information for non-professionals. Since we launched this comprehensive cancer-related WWW information service in 1994, more than about 1 million customers retrieved documents from our CancerNet™ service via WWW (http://www.meb.uni-bonn.de/cancernet/).
Knowledge Engineering the UMLS
Authors: Schulz Stefan  , Romacker Martin  , Hahn Udo
Published: February 2025

In order to transform a major portion of the Unified Medical Language System (UMLS) into a formally sound description logics system we have developed a four-step knowledge engineering approach. We report on experiments with a LOOM knowledge base which consists of 164,000 concepts and 76,000 relations covering human anatomy and pathology. We discuss the fully automatized as well as interactive semiautomatic steps. The latter ones focus on the manual work necessary to render the formal target representation structures complete and adequate.
Nearest Neighbour Classification with Heterogeneous Proximity Functions
Authors: Laurikkala Jorma  , Juhola Martti
Published: February 2025

Heterogeneous proximity functions are similarity or distance functions which process data differently according to the scale of attributes. We compared two Minkowskian distance functions with three heterogeneous proximity functions to test whether these functions were better in data sets with attributes of mixed type. Significant differences in nearest neighbour classification accuracy were found in 11 of all the 21 data sets. City-block and Euclidean distance functions outperformed Gower's similarity function and Heterogeneous Euclidean-Overlap Metric, while Heterogeneous Value Difference Metric (HVDM) was better than the other functions. HVDM classified mixed data best, because it treats nominal attributes more carefully than the other functions.
A Data Mining Approach to the Development of a Diagnostic Test for Male Infertility
Authors: Dzeroski Saso  , Hristovski Dimitar  , Kunej Tanja  , Peterlin Borut
Published: February 2025

The paper presents a database of published Y chromosome deletions and the results of analyzing the database with data mining and other heuristic techniques with the goal of developing a diagnostic test for male infertility. The database describes 382 patients for which 177 markers were tested. Two data mining techniques, clustering and decision tree induction were used, as well as a heuristic set cover algorithm. Clustering was used to group markers according to their appearance across patients, while a heuristic set covering algorithm was used to select as small a set of markers that cover as many patients with deletions as possible. This algorithm created a diagnostic set of 13 markers that cover more than 90% of the patients with deletions. Finally, decision tree induction was used to relate deletion patterns to the severity of the clinical phenotype. A decision tree induced from the data uses 5 markers, all of which are also in the diagnostic set of 13 markers, to show relations between the severity of the clinical phenotype and deletion patterns which have not been known previously.
Finding similar cases within a Hospital Information System
Authors: Borst F.  , Thurler G.  , Breant C.  , Lehner-Godinho B.  , Calmy A.  , Meier C.
Published: February 2025

Most of the theoretical medical knowledge comes from literature. The knowledge obtained from the vast majority of patients is then lost. The vast majority of patients do not participate in the elaboration of medical knowledge, apart from the lucky few entering a clinical trial or a published case study. Moreover, locally treated patients do not always correspond to the same time, space or age context as literature patients. How can the knowledge of one patient be used for treating other patients?
Design Principles of a Clinical Information System for Intensive Care Units (ICUData)
Authors: Michel A.  , Benson M.  , Junger A.  , Sciuk G.  , Hempelmann G.  , Dudeck J.  , Marquardt K.
Published: February 2025

The aim of this project was to develop a cost-effective, standard-based and scalable clinical information system for use in Intensive Care Units (ICUs). The development started in 1998 at the University Giessen, Germany. Since its introduction as the basic documentation system at the ICU ward of the Department of Anesthesiology and Intensive Care Medicine in January 1999, all relevant clinical data of 1723 patients have been recorded. The implementation of the system in two further ICUs is scheduled for the year 2000. The following article describes some of the principal design goals of the system, including the medical vision that drove its interface design, and focuses on the technological underpinnings of the overall system architecture.
Comparison of manual and automated documentation of adverse events with an Anesthesia Information Management System (AIMS)
Authors: Benson M.  , Junger A.  , Michel A.  , Sciuk G.  , Quinzio L.  , Marquardt K.  , Hempelmann G.
Published: February 2025

In this study, an Anesthesia Information Management System (AIMS) is used for the comparison of manually recorded adverse events with automatically detected events from anesthesiological procedures. In 1998, data from all anesthesia procedures, including the data set for quality assurance defined by the German Society of Anesthesiology and Intensive Care Medicine (DGAI), were recorded online with the documentation software NarkoData 4 (IMESO GmbH, Hüttenberg, Germany) followed by storage into a relational database (Oracle Corporation). The occurrence of manually recorded adverse events, as defined by the DGAI, is compared with automatically detected events. Automated detection was done with SQL-statements. The following adverse events were selected: hypotension, hypertension, bradycardia, tachycardia and hypovolemia. Data obtained from 16,019 electronic anesthesia records show that in 911 patients (5.7%), one of the selected adverse events was documented manually whereas in 2,996 patients (18.7%) a adverse event was detected automatically. The incidence of automatically detected events is obviously higher compared to manually recorded events. With the help of an AIMS, automatic detection proved significant deficiencies in the manual documentation of adverse events.
Development Of An Oncology Data Network In Germany
Authors: Altmann Udo  , Dudeck Joachim  , Eisinger Bettina  , Kunath Hildebrand  , Schott Günther  , Kurbjuhn Hasso  , Wächter Werner  , Tafazzoli Ali Gerhard  , Katz Frank Rüdiger
Published: February 2025

In the 1990ies, an oncology data network has been set up mainly in the New States of Germany. Although not formally planned and established as a whole, it consists of a number of initiatives, that co-operate well and gain added value from this co-operation. From the technological view, the centre of the network is the Gießener Tumordokumentationssystem (GTDS), that was developed at Gießen University. We present important basic conditions in which this development took place, show some results and describe future directions of the development.
Chapter 2.2 - General Practitioners and Neurotelemedicine
Authors: Teles Araújo Madalena  , Paiva Teresa  , Correia Jesuino Jorge  , Magalhães Manuela
Published: February 2025

Predicting attitudes towards teleconsultation systems and intentions of use is crucial at the beginning of the implementation phase, due to the critical role of human factors in its acceptance and continuous utilisation.
Chapter 2.3 - Needs and Costs of Sleep Monitoring
Authors: Escourrou Pierre  , Luriau Sylvain  , Rehel Marlène  , Nédelcoux Hélène  , Lanoë Jean-Louis
Published: February 2025

Sleep disorders have a high prevalence in the general population: insomnia (10-20 % of adults), sleep apnoea syndromes (4-6 %). They are responsible for high costs of investigations and treatment modalities. The investigations are usually done in sleep laboratories at the expense of cost in personnel and long waiting lists. Remote monitoring could be an alternative to sleep laboratory studies.
Clinical Fluoroscopic Fiducial-Based Registration of the Vertebral Body in Spinal Neuronavigation
Authors: Abbasi Hamid R.  , Grzeszczuk Robert  , Chin Shao  , Fahrig Rebecca  , Holz Hilary  , Hariri Sanaz  , Kim Daniel  , Adler John  , Shahidi Ramin
Published: February 2025

We present a system involving a computer-instrumented fluoroscope for the purpose of 3D navigation and guidance using pre-operative diagnostic scans as a reference. The goal of the project is to devise a computer-assisted tool that will improve the accuracy, reduce risk, minimize the invasiveness, and shorten the time it takes to perform a variety of neurosurgical and orthopedic procedures of the spine. For this purpose we propose an apparatus that will track surgical tools and localize them with respect to the patient's 3D anatomy and pre-operative 3D diagnostic scans using intraoperative fluoroscopy for in situ registration and embedded fiducials. Preliminary studies have found a fiducial registration error (FRE) of 1.41 mm and a Target Localization Error (TLE) of 0.48 mm. The resulting system leverages equipment already commonly available in the operating room (OR), providing an important new functionality that is free of many current limitations, while keeping costs contained.
Quantification of the Gravity-Dependent Change in the C-arm Image Center for Image Compensation in Fluoroscopic Spinal Neuronavigation
Authors: Hariri Sanaz  , Abbasi Hamid Reza  , Chin Shao  , Steinberg Gary  , Shahidi Ramin
Published: February 2025

In the quest to develop a viable, frameless spinal navigation system, many researchers are utilizing the C-arm fluoroscope. However, there is a significant problem with the C-arm that must be quantified: the gravity-dependent sag effect resulting from the geometry of the C-arm and aggravated by the inequity of weight at each end of the C-arm. This study quantified the C-arm sag effect, giving researchers the protocol and data needed to develop a program that accounts for this distortion. The development of spinal navigation algorithms that account for the C-arm sag effect should produce a more accurate spinal navigation system.
Intraoperative Visualization of Surgical Planning Data Using Video Projectors
Authors: Hoppe Harald  , Däuber Sascha  , Raczkowsky Jörg  , Wörn Heinz  , Moctezuma José Luis
Published: February 2025

The Institute for Process Control and Robotics has developed a new system using projector based augmented reality for the intraoperative visualization of preoperatively defined surgical planning data. Projector based augmented reality in medical applications represents a new field of research and gives an alternative solution to the commonly used Head Mounted Display technology. Moreover, the projector is not only used for visualization, but also for registration of the patient without the usage of invasive fiducial techniques as e.g. screw markers or frames. Recent results showed an achieved accuracy of ±1.5 mm which roughly meets clinical demands.
An Integrated Simulator for Surgery of the Petrous Bone
Authors: John Nigel W.  , Thacker Neil  , Pokric Maja  , Jackson Alan  , Zanetti Gianluigi  , Gobbetti Enrico  , Giachetti Andrea  , Stone Robert J.  , Campos Joao  , Emmen Ad  , Schwerdtner Armin  , Neri Emanuele  , Franceschini Stefano Sellari  , Rubio Frederic
Published: February 2025

This paper describes work being undertaken as part of the IERAPSI (Integrated Environment for the Rehearsal and Panning of Surgical Intervention) project. The project is focussing on surgery for the petrous bone, and brings together a consortium of European clinicians and technology providers working in this field. The paper presents the results of a comprehensive user task analysis that has been carried out in the first phase of the IERAPSI project, and details the current status of development of a pre operative planning environment and a physically-based surgical simulator.
Development of Virtual Environment for Treating Acrophobia
Authors: Ku Jeonghun  , Jang Dongpyo  , Shin Minbo  , jo Hangjoon  , Ahn Heebum  , Lee Jaemin  , Cho Baekhwan  , Kim Sun I.
Published: February 2025

Virtual Reality (VR) is a new technology that makes humans communicate with computer. It allows the user to see, hear, feel and interact in a three-dimensional virtual world created graphically. Virtual Reality Therapy (VRT), based on this sophisticated technology, has been recently used in the treatment of subjects diagnosed with acrophobia, a disorder that is characterized by marked anxiety upon exposure to heights, avoidance of heights, and a resulting interference in functioning. Conventional virtual reality system for the treatment of acrophobia has a limitation in scope that it is based on over-costly devices or somewhat unrealistic graphic scene. The goal of this study was to develop a inexpensive and more realistic virtual environment for the exposure therapy of acrophobia. We constructed two types virtual environment. One is constituted a bungee-jump tower in the middle of a city. It includes the open lift surrounded by props beside tower that allowed the patient to feel sense of heights. Another is composed of diving boards which have various heights. It provides a view of a lower diving board and people swimming in the pool to serve the patient stimuli upon exposure to heights.
Objective Laparoscopic Skills Assessments of Surgical Residents Using Hidden Markov Models Based on Haptic Information and Tool/Tissue Interactions
Authors: Rosen Jacob  , Solazzo Massimiliano  , Hannaford Blake  , Sinanan Mika
Published: February 2025

Laparoscopic surgical skills evaluation of surgery residents is usually a subjective process, carried out in the operating room by senior surgeons. By its nature, this process is performed using fuzzy criteria. The objective of the current study was to develop and assess an objective laparoscopic surgical skill scale using Hidden Markov Models (HMM) based on haptic information, tool/tissue interactions and visual task decomposition. Methods: Eight subjects (six surgical trainees: first year surgical residents 2 × Rl, third year surgical residents 2 × R3 fifth year surgical residents 2 × R5; and two expert laparoscopic surgeons: 2 × ES) performed laparoscopic cholecystectomy following a specific 7 steps protocol on a pig. An instrumented laparoscopic grasper equipped with a three-axis force/torque sensor located at the proximal end with an additional force sensor located on the handle, was used to measure the forces and torques. The hand/tool interface force/torque data was synchronized with a video of the tool operative maneuvers. A synthesis of frame-by-frame video analysis was used to define 14 different types of tool/tissue interactions, each one associated with unique force/torque (F/T) signatures. HMMs were developed for each subject representing the surgical skills by defining the various tool/tissue interactions as states and the associated F/T signatures as observations. The statistical distance between the HMMs representing residents at different levels of their training and the HMMs of expert surgeons were calculated in order to generate a learning curve of selected steps during laparoscopic cholecystectomy. Results: Comparison of HMM’s between groups showed significant differences between all skill levels, supporting the objective definition of a learning curve. The major differences between skill levels were: (i) magnitudes of F/T applied (ii) types of tool/tissue interactions used and the transition between them and (iii) time intervals spent in each tool/tissue interaction and the overall completion time. The objective HMM analysis showed that the greatest difference in performance was between Rl and R3 groups and then decreased as the level of expertise increased, suggesting that significant laparoscopic surgical capability develops between the first and the third years of their residency training. The power of the methodology using HMM for objective surgical skill assessment arises from the fact that it compiles enormous amount of data regarding different aspects of surgical skill into a very compact model that can be translated into a single number representing the distance from expert performance. Moreover, the methodology is not limited to in-vivo condition as demonstrated in the current study. It can be extended to other modalities such as measuring performance in surgical simulators and robotic systems.
Collaborated surgical works (Surgical planning) in virtual space with tactile sensation between Japan and Germany
Authors: Suzuki Naoki  , Hattori Asaki  , Suzuki Shigeyuki  , Sumiyama Kazuki  , Kobayashi Susumu  , Yamazaki Yoji  , Adachi Yoshitaka
Published: February 2025

Surgeons in Japan and Germany applied tele-virtual surgery and a force feedback device during a hepatectomy simulation. Using this system, surgeons in each country were able to perform various surgical maneuvers upon the same patient. They palpated abdominal skin, made electrical scalpel incisions and wid- ened the incision line by using surgical tools in virtual space. While surgeons performed a virtual operation, the force feedback device conveyed tactile sensations. In each location, the force feedback devices and two graphic workstations of equal capability were employed. As each workstation communicated only event signals through an ISDN (64Kb) line, it was possible to obtain real time tele-virtual surgery without a large capacity communication infrastructure.
Intelligent System and Risk of Different Diseases in the General Population
Authors: Zarrin-Khameh Neda  , Barzi Afsaneh  , Sadeghi Sarmad
Published: February 2025

This is a new approach to define the risk of the general population for a specific disease. We use Bayesian theory to define the risk of the population. Analyzing the major risk factors of a disease, how they affect the incidence and/or prevalence of the disease, and the statistics of each risk factor in the population, along with the power of the Bayes theorem helps us define the risk of that population for that disease. To find out what the risk of the general population for a disease is, prospective epidemiological studies in the population shown are needed. These studies usually lead to the identification of the major risk factors for a disease and their impacts which are quite costly and requires a long time to get to the results. Also a large personnel is needed to perform effectively in the study. The result of the risk of the general population for a first heart attack using our software is in agreement with the result of the Framingham heart study. Large studies like Framingham is not available for other diseases to enable us to evaluate the accuracy of our software precisely. To overcome this shortage we have sought medical experts’ evaluation of the predicted risk of the general population for other disease by this software, which needs to be completed.
The PROforma Guideline Specification Language: Progress and Prospects
Authors: Bury Jonathan  , Fox John  , Sutton David
Published: February 2025

Medical guidelines are constructed with the aim of assisting clinicians in making decisions that are informed by the best available medical evidence. In order to achieve this aim, they must be disseminated in a form that makes them easy for clinicians to use and easy for domain experts to critique. Furthermore, the language in which they are expressed must facilitate their transfer between institutions and their adaptation to local conditions. This paper describes PROforma, a knowledge representation language that attempts to meet these desiderata. PROforma is formal knowledge representation language designed to capture the content and structure of a clinical guideline in a form that can be interpreted by a computer. The language embodies many contemporary themes in machine interpretable guideline representation schemas whilst retaining some distinctive features. This paper describes the key features of the PROforma language in the context of recent trends and developments in the field of electronic guideline representation formats. We describe our experiences in applying PROforma to a range of clinical decision making and workflow problems, and the benefits and limitations of the current language specification are discussed. Finally, we outline plans for the further refinement of PROforma.
Design of a CSCL Environment for Clinical Reasoning Learning and Problem-Based Learning in Medicine
Authors: Medélez Elizabeth  , Burgun Anita  , Le Duff Franck  , Le Beux Pierre
Published: February 2025

The medical curriculum is changing, student-centered learning is currently used in medical schools. Problem-based Learning and Clinical Reasoning Learning develop the students' reasoning strategies. CSCW (Computer-Supported Cooperative Work) technology is used in Problem-Based Learning systems. We have designed a CSCL (Computer-Supported Collaborative Learning) environment for improving group coordination and communication in Clinical Reasoning Learning sessions. To support these new educative technologies, a prototype has been developed.
Security Development of a Pocket-Sized Teleradiology Consultation System
Authors: Niinimäki Jaakko  , Holopainen Arto  , Kerttula Jari  , Reponen Jarmo
Published: February 2025

Telemedicine widens the access to sensitive data and therefore data security development is an essential part of telemedicine projects. Publicly available security evaluation methods provide a good starting point for security work. We built a mobile teleradiology consultation system that is integrated into hospital information system and systematically evaluated possible security threats that may endanger it. Based on the analysis, a security model was designed and implemented. We conclude that systematic approach to data security development facilitates the process but does not give all answers to the practical questions.
Mining Association Rules from Clinical Databases: An Intelligent Diagnostic Process in Healthcare
Authors: Stilou S.  , Bamidis P.D.  , Maglaveras N.  , Pappas C.
Published: February 2025

Data mining is the process of discovering interesting knowledge, such as patterns, associations, changes, anomalies and significant structures, from large amounts of data stored in databases, data warehouses, or other information repositories. Mining Associations is one of the techniques involved in the process mentioned above and used in this paper. Association is the discovery of association relationships or correlations among a set of items. The algorithm that was implemented is a basic algorithm for mining association rules, known as a priori. In Healthcare, association rules are considered to be quite useful as they offer the possibility to conduct intelligent diagnosis and extract invaluable information and build important knowledge bases quickly and automatically. The problem of identifying new, unexpected and interesting patterns in medical databases in general, and diabetic data repositories in specific, is considered in this paper. We have applied the apriori algorithm to a database containing records of diabetic patients and attempted to extract association rules from the stored real parameters. The results indicate that the methodology followed may be of good value to the diagnostic procedure, especially when large data volumes are involved. The followed process and the implemented system offer an efficient and effective tool in the management of diabetes. Their clinical relevance and utility await the results of prospective clinical studies currently under investigation.
The Cyber Transformation of Health Care: Critical Social and Ethical Issues
Authors: Anderson James G.
Published: February 2025

The Internet is changing the way that health services are organized and delivered. Unresolved issues pose barriers to full realization of the Internet's potential in health care.
Health Informatics World Wide - A WWW Service for the Health Informatics Community
Authors: Klar Rüdiger  , Schlachter Stefan  , Schulz Stefan
Published: February 2025

Health Informatics World Wide, a Web index of research and educational institutions in the fields of Health Informatics and Medical Informatics has been available to WWW users since 1995. In this paper we report on the original conception of this service, its subsequent modifications and address its maintenance and related problems. Access statistics are presented which demonstrate its relevance as well as the geographical focus of Health Informatics research and development.
Web Architecture for the Remote Browsing and Analysis of Distributed Medical Images and Data
Authors: Masseroli Marco  , Pinciroli Francesco
Published: February 2025

To provide easy retrieval, integration and evaluation of multimodal medical images and data in a web browser environment, distributed application technologies and Java programming were used to develop a client-server architecture based on software agents. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. The client side is a Java applet running in a web browser and providing a friendly medical user interface to perform queries on patient and medical test data and integrate and visualize properly the various query results. A set of tools based on Java Advanced Imaging API enables to process and analyze the retrieved bioimages, and quantify their features in different regions of interest. The platform-independence Java technology makes the developed prototype easy to be managed in a centralized form and provided in each site where an intranet or internet connection can be located. Giving the healthcare providers effective tools for browsing, querying, visualizing and evaluating comprehensively medical images and records in all locations where they can need them – e.g. emergency, operating theaters, ward, or even outpatient clinics – the implemented prototype represents an important aid in providing more efficient diagnoses and medical treatments.
Knowledge-Based Interpretation of Toxoplasmosis Serology Test Results Including Fuzzy Temporal Concepts – The ToxoNet System
Authors: Kopecky Dieter  , Hayde Michael  , Prusa Andrea-Romana  , Adlassnig Klaus-Peter
Published: February 2025

Transplacental transmission of Toxoplasma gondii from an infected, pregnant woman to the unborn that occurs with a probability of about 60 percent [1] results in fetal damage to a degree depending on the gestational age. The computer system ToxoNet processes the results of serological antibody tests having been performed during pregnancy by means of a knowledge base containing medical knowledge on the interpretation of Toxoplasmosis serology tests. By applying this knowledge ToxoNet generates interpretive reports consisting of a diagnostic interpretation and recommendations for therapy and further testing. For that purpose it matches the results of all serological investigations of maternal blood with the content of the knowledge base returning complete textual interpretations for all given findings. The interpretation algorithm derives the stage of maternal infection from these that is used to infer the degree of fetal threat. To consider varying immune responses of particular patients, certain time intervals have to be kept between two subsequent tests in order to guarantee a correct interpretation of the test results. These time intervals are modelled as fuzzy sets, since they allow the formal description of the temporal uncertainties. ToxoNet comprises the knowledge base, an interpretation system, and a program for the creation and modification of the knowledge base. It is available from the World Wide Web by starting a standard browser like the Internet Explorer or the Netscape Navigator. Thus ToxoNet supports the physician in Toxoplasmosis diagnostics and in addition allows to adopt the way of making decisions to the characteristics of the particular laboratory by modifying the underlying knowledge base.
Combining Diagnosis and Treatment Using Asbru
Authors: Seyfang Andreas  , Miksch Silvia  , Marcos Mar
Published: February 2025

Traditionally, diagnosis and treatment have been seen as two distinct tasks. Consequently, most approaches to computer supported health care focus on one of the two — mostly on diagnosis or rather on the interpretation of measurements which is much better understood and formalized. However, in practice diagnosis and treatment overlap and influence each other in many ways. Combinations range from . repeatedly going through the diagnosis-treatment loop over a period of time to permanent monitoring of the patients' health condition as it is done in intensive care units.
A New Prognosis Factor Analysis Based on Nonhomogeneous Markov Description
Authors: Shibata Takeo  , Tanaka Hiroshi  , Tsujimoto Yoshihiro  , Yoshimura Kimio  , Fukutomi Takashi  , Nanasawa Takeshi  , Yamaguchi Naohito
Published: February 2025

To evaluate prognosis factors, Cox’s proportional hazard model has been used. But it was found that the analytical ability was not sufficient. So we propose a new evaluation method combining Markov chain model and multiple logistic regression analysis to estimate the prognosis factors.
Building and Using an Outcomes Oriented Patient Record in Clinical Practice
Authors: Wells John D.  , Crocker Steven  , Taylor Valerie H.
Published: February 2025

Continuous, site-specific outcome assessment can indicate opportunities for improvement and can measure the results of changes in local health care practices. We have built a computer based clinical record which brings a variety of outcome measures to everyday clinical practice. Some of these measurement tools are objective, others subjective. All are practical, validated, and clinically relevant. Serial records in an electronic format generate a database which allows useful definitions of populations and outcomes. After using our model for over 1000 records we exported it successfully from our office to offices of colleagues and to local hospital clinics. In this electronic poster, we discuss the construction of such site specific, outcomes oriented, electronic clinical records.
Community Health Information and Its Management System: A New Form for the Next Century
Authors: Din Bao-Ffn  , Wu Lie-Ping  , Zhang Yang
Published: February 2025

The development of community health service brings a new branch of Medical Informatics, Community health care informatics and a new management system, Community Health Care Information System in the beginning of nest century. The paper first advance and explore this new concept. It states the focus of Community health care informatics as the promotion of health for the whole community. It not only gives treatment to individual patients through ways of disease management and information network, but also improves health condition of the whole community by “diagnosis of community health” and “prescription for community health”. The paper also introduces the community health information system and its formation, technology, function and practical use, pointing out the crucial point of its research work to be precisely discovering the “information origin” and “three-in-one” working group.
Developing a District Health Information System in South Africa: A Social Process or Technical Solution?
Authors: Williamson Louisa  , Stoops Norah  , Heywood Arthur
Published: February 2025

South Africa initiated a national District Health Information System rollout strategy in the latter half of 1999. Experience has demonstrated that the implementation of an information system as a vehicle for the delivery of accountability in the management of health services, demands organisational change within a framework of human resource development and technical support. The aim of training, to empower facility and district staff to use locally generated information to improve coverage and quality of primary health care services, can only be realized if training and innovation for change are appropriately marketed and supported.
Reliability and Validity of EndoTower, a Virtual Reality Trainer for Angled Endoscope Navigation
Authors: Haluck Randy S.  , Gallagher Anthony G.  , Satava Richard M.  , Webster Roger  , Bass Thomas L.  , Miller Cynthia A.
Published: February 2025

We hypothesized that a simulator designed to train surgical novices angled laparoscopic navigation would show an improvement in subjects’ performance, a high test re-test reliability and high internal validity as measured by standardized coefficient alpha. It was also predicted that simulator performance would be strongly related to objectively assess perceptual and visuospatial ability. EndoTower has good face validity in that it mimics precisely the performance of an angled laparoscope and previous studies suggest construct validity. In this study, EndoTower is shown to be a trainer intended for laparoscopic skill than can test for inherent perceptual and visuospatial ability.
Improved Haptic Rendering of Anatomical Data
Authors: Heike Florian  , Ley Andre  , Riener Robert
Published: February 2025

We perform haptic rendering of a polygonal mesh at a high speed, independent of its face count, using a topologically structured data representation that avoids edge gap effects from small numerical errors. Constraints on the virtual proxy's position on the mesh give good results in rendering concave edges. The algorithm allows force shading and smoothing at convex corners and edges by an approach originally developed for graphic rendering.
Quantitative Methodology of Evaluating Surgeon Performance in Laparoscopic Surgery
Authors: McBeth Paul B.  , Hodgson Antony J.  , Nagy Alex G.  , Qayumi Karim
Published: February 2025

Quantitative performance and skill assessments are critical for evaluating the progress of surgical residents and the efficacy of different training programs. Current evaluation methods are subjective and potentially unreliable, so there is a need for objective methods to evaluate surgical performance. We identify a feasible method to measure kinematic data in the live operating room setting and to assess the repeatability of an analysis method based on a hierarchical decomposition of surgical tasks. We used an optoelectronic motion analysis system to acquire postural data and tool tip trajectories of one expert surgeon over a period of four months. To assess repeatability of performance measures, we created a hierarchical decomposition diagram describing the procedure in terms of surgical tasks, tool sequences and fundamental tool actions. From the kinematic data, we extracted characteristic measures of individual tool actions and compared these measured distributions using the Kolmogorov- Smirnov statistic. The comparisons of distributions show consistent performance over time by a trained surgeon and little effect from patient variability, and so are likely reliable measures of performance. An expanded set of reliable kinematic measures will form thc’ basis for quantifying surgical skill and should be useful in validating surgical simulations for use in training, certifying surgeons and designing and evaluating new surgical tools.
Soft-tissue simulation using LEM - Long Elements Method
Authors: Balaniuk Remis
Published: February 2025

This paper discusses the use of the Long Elements Method – LEM in soft tissue modeling and surgery simulation. The LEM is a new method for real time, physically based, dynamic simulation of deformable objects, based on a new meshing strategy, using long elements. The method uses a combination of static (state-less) and dynamic approaches to simulate deformations and dynamics, obtaining a higher degree of compliance per time step. Global deformations that conserve volume and are convincingly compliant are obtained. Models are defined using bulk material properties. Elastic and plastic deformations can be simulated. The real time performance of the method and its intrinsic properties of volume conservation, modeling based in material properties and simpler meshing make it particularly attractive for soft tissue modeling and surgery simulation.
SELF-ADMINISTERED DECISION SUPPORT TOOL FOR TRIAGE: RESULTS OF A RETROSPECTIVE STUDY
Authors: Barzi Afsaneh  , Sadeghi Sarmad  , King Brent R.
Published: February 2025

BACKGROUND: This study was designed to evaluate the safety of a self-administered triage tool. MATERIALS: Ninety-five patients older than 14 years who presented to Memorial Hermann Hospital emergency room (ER) with chief complaint of abdominal pain were included in the study. Their ER disposition and final diagnoses were logged into a database. The assigned disposition and top three diagnoses by the triage tool for each patient were also logged into the database. An emergency physician blinded to the actual disposition reviewed all cases and provided a disposition for each patient. RESULTS: The system disposed 51.1% of cases appropriately and under-disposed 4.4% of cases. Comparison between the system and the emergency physician shows that all cases under-disposed by the system are also under-disposed by the physician.
Volumetric Implant-Planning Based on Symmetry Considerations
Authors: Burgert Oliver  , Salb Tobias  , Gockel Tilo  , Dillmann Rüdiger  , Hassfeld Stefan  , Mühling Joachim
Published: February 2025

Symmetry Considerations can be used not only to plan the desired shape of reconstructured bone structures, but also to generate prototypes for soft tissue implants. The poster describes a system which allows to calculate a symmetry plane in the facial area automatically and computes proposals for implants or transplants. The system presented has been used to calculate soft tissue implants and a replacement for parts of the lower jaw.
Case Mix in Austria : Five Years Experience with a New Hospital Financing System
Authors: Pfeiffer Karl P.
Published: February 2025

Since 1997 there is a new case based hospital financing system for inpatients in Austria. Before these hospital have been paid for the length of stay independent of the diagnoses and procedures. The fees for the length of stay have not been sufficient and therefore the deficit. was paid by the owners of the hospitals. The new system is called “Leistungsorientierte Krankenanstaltenfinanzierung (LKF)”, which means that diagnoses as well as procedures are used for the classification of a patient. The system is similar to the DRG-system in its basic concept. A learning set of approximately 500.000 data set was used for the identification of cost-homogenous groups of patients. The system is very flexible and it was possible in the last years to improve, modify and adapt it continuously.