bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality Improvements based on detailed and precise Terminology
Authors: Tvede Ida  , Bredegaard Kirsten  , Andersen Jakob Steen
Published: February 2025

This article describes a comparative study within intensive care where possibilities for quality monitoring have been examined regarding the data input. The study compared the results of making quality statistics based on ICD10 and on SNOMED CT. The article describes the method deployed for defining the subset used in the study and how the data comparison has been established. The study shows that the use of a more granulated, precise and well defined terminology used in daily clinical work can help clinicians doing better quality monitoring and quality development and at the same time may reduce time and costs in quality management. The study shows further that the use of an international terminology can increase the possibilities of international benchmarking and research. The article ends up by drawing attention to some challenges which must be dealt with especially regarding reimbursement.
Clinical Events Classification for Using the EHR to Provide Better Patient Care
Authors: Lugovkina Tatyana  , Richards Bernard
Published: February 2025

The Healthcare Record has been used in a “Before and After” situation to improve patient care. The main paradigm of the modern Health Care is changing towards pervasive person-centric care including prevention and home care. Medical compunetics is a very important applicative field for improving the interoperability and the quality of the healthcare information system, especially in the current climate with the empowerment patients. The success depends on the choice of the Clinical Events Classification for structuring the span of clinical information. For the purposes of universalizing medical electronic data-bases, it is very important to organize the data regarding Clinical Events in such manner that it would be possible to use this information-structure in different fields of Clinical Practice: e.g., for the creation of the diagnostic and drug-assistance protocols, for the evaluation of the quality of drug prescribing, and for communication with patients as well. For this purpose all Clinical Events were divided to 5 classes. This Paper will describe a “Before and After” situation consequent upon the introduction of the Clinical Events Classification and the introduction of Protocols for drug-prescribing. Use of the Protocol brought about a 50% reduction in mortality.
Co-morbidity Analysis And Decision Support on Transplanted Patients using Machine Learning Techniques
Authors: Corbal G. Iago  , Cabrero Mariano J.  , Carrajo Lino  , Vázquez Olaia  , Rimada Loli  , Vazquez Guillermo
Published: February 2025

The A Coruña University Hospital Complex is developing an expert system to improve the decision support for transplanted patients. The system will access the data collected during the monitoring of patients and generate a database of statistics that will aid health professionals in several stages of the transplant process. All historical data will be revised to give an estimation of the patient's parameters evolution depending on his medical record and his actual treatment. We will use two different machine learning techniques to do both clustering and classification.
Collaboration across Organizational Boarders, the Referral Case
Authors: Heimly Vigdis
Published: February 2025

Referrals are requests for medical examination and evaluation by a specialist, outpatient clinic or a hospital. The referral can be sent from a GP, specialist or from one hospital to another. The referral transfers fully or partly the responsibility for further treatment of the patient. The diffusion of electronic referrals in the health sector has been slow in many countries despite the fact that EHR-systems, referral standards and technical infrastructure are available. This paper addresses shortcomings that have been seen in the Norwegian deployment process, and how collaboration can support, and be supported by, the involved actors in different organizations. Special attention is paid to how GPs that work in part time positions as practice consultants in Hospitals can act as boundary spanners in order to improve the collaborating actors understanding of each other's needs and work processes. Practice consultant should also be used actively in design of ICT-systems that support collaboration across organizational boarders in health care.
Sustainable Mobile Information Infrastructures in Low Resource Settings
Authors: Braa Kristin  , Purkayastha Saptarshi
Published: February 2025

Developing countries represent the fastest growing mobile markets in the world. For people with no computing access, a mobile will be their first computing device. Mobile technologies offer a significant potential to strengthen health systems in developing countries with respect to community based monitoring, reporting, feedback to service providers, and strengthening communication and coordination between different health functionaries, medical officers and the community. However, there are various challenges in realizing this potential including technological such as lack of power, social, institutional and use issues. In this paper a case study from India on mobile health implementation and use will be reported. An underlying principle guiding this paper is to see mobile technology not as a “stand alone device” but potentially an integral component of an integrated mobile supported health information infrastructure.
Does telehomeconsultation lead to substitution of home visits? Analysis and implications of a telehomecare program
Authors: Van Offenbeek Marjolein A.G.  , Boonstra Albert
Published: February 2025

This study's objective was to determine and to explain the potential substitution effects of a nurse-led video teleconsultation service for homecare clients. To that end the largest program in the Netherlands up till 2009 was analyzed. This program's aim was to realize partly substitution of homecare visits by telecare for carefully selected clients. The study was multi-method. Each video contact was registered, and a sample was described on forms during an 8- month period starting half a year after implementation. (Changes in) the homecare visit consumption of the subscribing (n=335) and of a non-subscribing group (n=288) were compared. Moreover, we interviewed care coordinators, clients, managers, and telenurses and observed the latter's work. Results show that the frequency of telehomecare contacts varied greatly. For this homecare client population the sheer provision of a video channel to nurses does not lead to substitution. Only for a few clients substitution of the regular homecare visits proved feasible The discussion section explains this disappointing outcome by technology push and an inconsistent implementation mode. It is argued that telehomecare can potentially serve four different goals, including substitution. For future research we propose consistent implementation modes to realize these goals.
Aggregated review of route cause analyses related to medication
Authors: Hellebek Annemarie  , Skjoet Peter
Published: February 2025

Since 2001 when the systematic analysis of serious patient safety incidents was implemented, a number of root cause analyses have been completed. Common to these is that the medication of the patient has been problematic and has had serious consequences for the patient. In the analyses the events causing the patient safety incidents are described in detail, the causes are identified and a plan of actions is created.
Towards safer medication use – in practice
Authors: Hamre Gro A.  , Berntsen Kirsti E.  , Monteiro Eric
Published: February 2025

We study the drug order and delivery process for patients receiving municipal home care services in Norway. Using interpretative qualitative methods we document an extensive but “invisible” manual and distributed quality assurance among the involved health care providers. We call for selective automation of medication use processes in this setting as these distributed, highly manual micro-practices are vital to quality assurance in practice.
Healthcare IT Usability and Suitability for Clinical Needs: Challenges of Design, Workflow, and Contractual Relations
Authors: Koppel Ross  , Kreda David A.
Published: February 2025

While healthcare information technology (HIT) offers extraordinary promise of clinical improvement and greater efficiencies, the realization of the promise must confront and overcome a number of challenges caused by incomplete and inappropriate software design. In this paper, we review several types of HIT design and workflow decisions that limit the value and utility of HIT in electronic health (medical) record (EHR/EMR), computerized physician order entry (CPOE), and electronic medication administration record (eMAR) systems. While remedies for problems of design or workflow may be either easy or difficult, , the industry creates additional barriers in the contractual relationships it creates between itself (HIT vendors) and the clinical facilities (hospitals, clinics, and physician offices) that purchase its systems. We suggest that the structure of those relationships may retard the progress and responsiveness of HIT.
Classification of Adolescent Idiopathic Scoliosis Using Kohonen Self-Organizing Maps
Authors: Phan Philippe  , Mezghani Neila  , De Guise Jacques A.  , Labelle Hubert
Published: February 2025

Introduction: To determine curve type, Lenke classification for AIS uses strict cut-off values on radiological measurements such as Cobb angles which are known to have significant inter-observer variability. There is a documented variability in surgical treatment of AIS, yet the influence of curve types on that variability has not yet been studied.
Melatonin Modulates Proliferation and Differentiation of Human Growth Plate Chondrocytes
Authors: Sun Guang-Quan  , Wang William Wei-jun  , Yeung Benson Hiu-yan  , Man Gene Chi-wai  , Lee Kwong-man  , Ng Tzi-bun  , Qiu Yong  , Cheng Jack Chun-yiu
Published: February 2025

Introduction: Longitudinal growth of long bone is a process of new bone formation involving progressive endochondral ossification which occurs at the growth plate before skeletal maturity. It is documented that melatonin plays an important role in bone formation and metabolism. The role of melatonin in human growth plate chondrocytes (GPCs), however, is relatively poorly studied.
Influence of Experimental Protocols and Mathematical Modelling on the Mechanical Proprieties of the Intervertebral Disc
Authors: Recuerda M.  , Coté S.P.  , Villemure I.  , Périé D.
Published: February 2025

Aim:The intervertebral disc plays an important role in the mobility of the spine. Degeneration, main cause of back pain, leads to changes in its mechanical properties. Their quantification is realised by mechanical tests and approximation of the experimental curves by mathematical models. However the variability of data is problematic. The purpose of this study is to determine the influence of the mathematical model and experimental protocols on the mechanical properties computation.
Biomechanical Model of Postural Control for the Analysis of Spinal Fusion Surgery in Adolescents with Idiopathic Scoliosis
Authors: Bustamante Valles K.D.  , Long J.T.  , Sovol A.M.  , Riedel S.A.  , Graf A.  , Krzak J.  , Riordan M.  , Zaharski K.  , Hassani S.  , Sturm P.F.  , Harris G.F.
Published: February 2025

Introduction: This study presents a biomechanical model for bi-planar analysis (anterior-posterior, medial-lateral) of postural control in the time and frequency domains. This may be a useful tool to assess and gain insight into a basic functional ability. This model has been evaluated for characterizing balance strategies in adults, typical children, children with cerebral palsy, and most recently, adolescents with idiopathic scoliosis (AIS).
Back Pain in Adolescent with Idiopathic Scoliosis
Authors: Smigielska M.  , Czernicki K.  , Durmala J.
Published: February 2025

Introduction: Idiopathic scoliosis (IS) is referred as a cause of a back pain in adults, probably on the basis of spinal overload and degeneration. Back pain in children and youths has been assessed only occasionally.
A Longitudinal Study on the Growth of Fusion Mass in Posterior Spinal Fusion with Advance High-resolution Peripheral Quantitative Computed Tomography – Preliminary Findings
Authors: Hui Celine F.  , Yeung Hiu Yan  , Chan Chun Wai  , Lee Kwong Man  , Qin Ling  , Li Gang  , Hu Yun Yu  , Cheng Jack Chun-yiu
Published: February 2025

Introduction: Various means have been attempted to enhance osteogenesis of posterior spinal fusion (PSF) surgery. Stem cells treatment and biophysical intervention have been shown to enhance PSF. Before optimizing the treatment effect, it is necessary to understand the temporal and spatial pattern of osteogenesis during the PSF. With the advanced high-resolution peripheral quantitative computed tomography (HR-pQCT), the fusion mass can be monitored with relatively smaller number of animals.
Fatal Spontaneous Hemoperitoneum in a Patient with Cervical Spine Injury: A Case Report
Authors: Angthong Chayanin  , Chavasiri Cholavech  , Watthananaapisith Thanet
Published: February 2025

Introduction: Severe spontaneous hemoperitoneum has been rarely reported in the literature. The morbidity and mortality rates were quite high from the previous report.
Using Ultrasound to Guide the Insertion of Pedicle Screws during Scoliosis Surgery
Authors: Lou Edmond  , Zhang Chan  , Le Lawrence  , Hill Douglas  , Raso Jim  , Moreau Marc  , Mahood James  , Hedden Douglas
Published: February 2025

Scoliosis surgery involves the insertion of screws and/or hooks into selected vertebrae to secure a pre-bent rod placed along the concave side of the spine. Usually conventional x-rays will be taken before the surgery to plan the alignment and positioning of the pedicle screws. However, reports state that perforation rate range from 6% to 54%. A misalignment of a pedicle screw can potentially cause permanent neurological spinal cord injury or even a lifethreatening vascular injury. Because of the importance of positioning and aligning of pedicle screws, we are working on an ultrasound method to guide the insertion of pedicle screws in real time. A pulse-echo immersion experiment was set up to study how well the edges of cortical bone could be detected using a bovine spinous process in-vitro. Two ultrasound frequencies (3.5 MHz and 5.0 MHz) were considered in this study. This preliminary study shows that ultrasound is able to penetrate cortical bone and reflect back from the outer boundary. All interfaces are clearly identified for both frequencies. Strong reflection signals are obtained when the beam is normal to the interface. Derived thickness values from the reflections are comparable with those from micro-CT image. The 5.0MHz ultrasound frequency provided better resolution than the 3.0 MHz frequency.
Ontologies for Rapid Integration of Heterogeneous Data for Command, Control, & Intelligence
Authors: Obrst Leo  , Stoutenburg Suzette  , McCandless Dru  , Nichols Deborah  , Franklin Paul  , Prausa Mike  , Sward Richard
Published: February 2025

Ontologies enable explicit expression of collective concepts and support Machine-to-Machine (M2M) interactions at the semantic level. Ontologies expressed in a standard language, such as the Web Ontology Language (OWL) and exposed on a network offer the potential for unprecedented interoperability solutions since they are semantically rich, computer interpretable and inherently extensible. In this chapter, we describe how we applied ontologies in OWL for rapid enterprise integration of heterogeneous data sources to track objects in a battlespace. We found that once a robust foundational domain ontology is established, it is easy and quick to integrate new data sources and therefore rapidly provide new system capabilities. In particular, we demonstrate how moving tracks can be quickly integrated with intelligence and space events to provide enhanced situational awareness using ontologies. This chapter also describes the overall SEER and SWORIER systems we developed, the latter of which translated OWL ontologies (and RDF instances) and Semantic Web Rule Language (SWRL) rules into Prolog, applied knowledge compilation techniques, and then at runtime, utilized a combined OWL/logic programming reasoned for efficient automated reasoning. We also briefly describe a more recent extension to the prototype and to the ontologies that we made to address more rigorous geospatial rules for unmanned autonomous vehicle (UAV) avoidance. Finally, we consider some issues raised by our work and future lines of research to address these.
Décrypthon Grid – Grid Resources Dedicated to Neuromuscular Disorders
Authors: Bard N.  , Bolze R.  , Caron E.  , Desprez F.  , Heymann M.  , Friedrich A.  , Moulinier L.  , Nguyen N.H.  , Poch O.  , Toursel T.
Published: February 2025

Thanks to the availability of computational grids and their middleware, a seamless access to computation and storage resources is provided to application developers and scientists. The Décrypthon project is one example of such a high performance platform. In this paper, we present the architecture of the platform, the middleware developed to facilitate access to several servers deployed in France, and the data center for integrating large biological datasets over multiple sites, supported by a new query language and integration of various tools. The SM2PH project represents an example of a biological application that exploits the capacities of the Décrypthon grid. The goal of SM2PH is a better understanding of mutations involved in human monogenic diseases, their impact on the 3D structure of the protein and the subsequent consequences for the pathological phenotypes.
Formability of heat treated Al-Mg-Si Alloys
Authors: Kumar Manoj  , Poletti Cecilia  , Degischer Hans Peter
Published: February 2025

Limited formability of AWA6082 alloy can be improved by applying a short time (15 to 30 s) annealing heat treatment before warm forming. The flow stress decreases with increasing temperature, the fracture strain increases up to 300°C and the true uniform strain remains constant up to 250°C, but decreases drastically at higher temperatures. After warm deformation further age hardening is achieved by a paint baking treatment. Formability was optimum at 250°C, which is the recommended temperature for warm forming of AW6082 tubes.
An Investigation of dynamic Recrystallization during hot Extrusion of Al-4.5Zn-1Mg Alloy
Authors: Eivani A.R.  , den Bakker A.J.  , Zhou J.  , Duszczyk J.
Published: February 2025

The effect of ram speed during extrusion at 460°C on the number density of DRX grains at the periphery of the extrudate was investigated. The variation in the number density of DRX grains through the thickness of a sample extruded at 460°C and a ram speed of 5 mm/sec was investigated and correlated to strain rate as a function of the distance from the surface of the extrudate. The number density of DRX grains was higher at the periphery rather than that at the centre of the extrudate. In addition, it was found that the number density of DRX grains at the periphery of the extrudate increased with increasing ram speed.
An Integrated Approach for Predictive Control of Extrusion Weld Seams: Experimental Support
Authors: den Bakker A.J.  , Werkhoven R.J.  , Sillekens W.H.  , Katgerman L.
Published: February 2025

In hollow aluminium extrusions, longitudinal weld-seams are formed through a solid-state bonding process at elevated temperatures and under conditions of interfacial pressure and plastic deformation. For structurally loaded components, sound weld seams are imperative. In our research, a weld seam integrity indicator as a means of quantifying bonding efficiency is introduced and the feasibility of this concept is investigated by means of lab-scale experiments. Characterisation of these weld seams through mechanical testing, provides a basis for an estimation of the weld seam indicator introduced in this paper, thus demonstrating the feasibility of this concept.
Aligning UniProt and MeSH – A Case Study on Human Protein Terms
Authors: Beisswanger Elena  , Wermter Joachim  , Hahn Udo
Published: February 2025

Terminologies which lack semantic connectivity hamper the effective search in biomedical fact databases and document retrieval systems. We here focus on the integration of two such isolated resources, the term lists from the protein fact database UNIPROT and the indexing vocabulary MESH from the bibliographic database MEDLINE. The generated semantic ties result from string matching and term set inclusion. We investigated the implicit terminological overlap between both resources in the domain of human proteins and evaluated our approach on a sample of 550 randomly selected UNIPROT entries that were manually mapped to their corresponding MESH headings. We achieved 90% precision and 79% recall (applying taxonomy-sensitive metrics). Fortunately, those proteins we were able to map to the MESH are ten times as frequently discussed in the literature as those on which we failed.
Implementing rules to improve the quality of concept post-coordination with SNOMED CT
Authors: Navas H.  , Lopez Osornio A.  , Gambarte L.  , Elías Leguizamón G.  , Wasserman S.  , Orrego N.  , Luna D.  , de Quirós F. Gonzalez B.
Published: February 2025

The use of SNOMED CT as a standard reference terminology enables interoperability between clinical systems. This reference tool provides a method for creating post-coordinated terms by users according to local needs. While the creation of these terms is free, there are a number of rules, as defined in the user manual of SNOMED CT that must be followed.The Hospital Italiano of Buenos Aires has a Terminology Server that encodes medical terms, using SNOMED CT as the reference vocabulary. An interoperability analysis performed with the Nebraska Medical Center in 2006 found a high error rate (26%) in post-coordinated terms. Therefore, we implemented an automatic system of rules within the Terminology Server as defined in the user manual. Following rules implementation, the error rate decreased from 26% to 2%.
Mapping BFO and DOLCE
Authors: Temal Lynda  , Rosier Arnaud  , Dameron Olivier  , Burgun Anita
Published: February 2025

Upper level ontologies are key technology for integrating heterogeneous information coming from different sources. DOLCE and BFO, are the favorite candidates which propose rigorous foundational principles to model any domain. The objective of the AKENATON project is to improve alert management and to support patient-centered medical decision in telecardiology. This requires to integrate information transmitted by implantable cardiac devices with clinical data extracted from patient health records. To achieve this goal, we have designed an ontology of telecardiology based on DOLCE. In order to integrate ontologies based on BFO such as FMA, we have developed a framework for mapping BFO and DOLCE categories in terms of equivalence and subsumption between categories.
Development of Structured ICD-10 and its Application to Computer-Assisted ICD Coding
Authors: Imai Takeshi  , Kajino Masayuki  , Sato Megumi  , Ohe Kazuhiko
Published: February 2025

This paper presents: (1) a framework of formal representation of ICD10, which functions as a bridge between ontological information and natural language expressions; and (2) a methodology to use formally described ICD10 for computer-assisted ICD coding. First, we analyzed and structurized the meanings of categories in 15 chapters of ICD10. Then we expanded the structured ICD10 (S-ICD10) by adding subordinate concepts and labels derived from Japanese Standard Disease Names. The information model to describe formal representation was refined repeatedly. The resultant model includes 74 types of semantic links. We also developed an ICD coding module based on S-ICD10 and a ‘Coding Principle,’ which achieved high accuracy (>70%) for four chapters. These results not only demonstrate the basic feasibility of our coding framework but might also inform the development of the information model for formal description framework in the ICD11 revision.
Clinical Task-Specific Query Expansion for the Retrieval of Scientifically Rigorous Research Documents
Authors: Yoo Sooyoung  , Choi Jinwook  , Choi Sungbin
Published: February 2025

To support the practice of evidence-based medicine (EBM), clinically relevant and scientifically sound articles should be easily accessible. Due to the huge volume of medical literature and the low performance of present retrieval models, clinicians could only get relevant documents in the order of publication time. This study propose a new clinical task-specific retrieval technique that improves retrieval accuracy by exploiting clinical task-specific EBM terms to query expansion using co-occurrence analysis technique. The idea is aimed at selecting query expansion terms that are relevant to a specific clinical-task using task-specific EBM terms. Focusing on treatment and diagnosis tasks, the new method which was performed on the OHSUMED collection showed a further improved result than the existing method.
A qualitative analysis of Emergency Department physicians' practices and perceptions in relation to test result follow-up
Authors: Callen Joanne  , Georgiou Andrew  , Prgomet Mirela  , Paoloni Richard  , Westbrook Johanna
Published: February 2025

Follow-up of abnormal test results for discharged Emergency Department (ED) patients is a critical safety issue. This study aimed to explore ED physicians' perceptions, practices, and suggestions for improvements of test result follow-up when using an electronic provider order entry system to order all laboratory and radiology tests and view results. Interviews were conducted with seven ED physicians and one clinical information system support person. Interviews were analyzed to elicit key concepts relating to physicians' perceptions of test result follow-up and how the process could be improved. Results described the current electronic test result follow-up system with two paper-based manual back-up systems for microbiology and radiology results. The key issues for physicians were: responsibility for test follow-up; the unique ED environment and time pressures, and the role of the family physician in test result follow-up. The key suggestion for improvement was a complete integrated electronic information system with on-line result endorsement. The study highlighted the complexity of the test result follow-up process and the importance of engaging clinicians in devising solutions for improvements.
A Block-matching based technique for the analysis of 2D gel images
Authors: Freire Ana  , Seoane José A.  , Rodríguez Álvaro  , Ruiz-Romero Cristina  , López-Campos Guillermo  , Dorado Julián
Published: February 2025

Research at protein level is a useful practice in personalized medicine. More specifically, 2D gel images obtained after electrophoresis process can lead to an accurate diagnosis. Several computational approaches try to help the clinicians to establish the correspondence between pairs of proteins of multiple 2D gel images. Most of them perform the alignment of a patient image referred to a reference image. In this work, an approach based on block-matching techniques is developed. Its main characteristic is that it does not need to perform the whole alignment between two images considering each protein separately. A comparison with other published methods is presented. It can be concluded that this method works over broad range of proteomic images, although they have a high level of difficulty.
Three-Dimensional Morphometric Analysis of the Distal Femur: A Validity Method for Allograft Selection Using a Virtual Bone Bank
Authors: Ritacco Lucas Eduardo  , Espinoza Orías Alejandro A.  , Aponte-Tinao Luis  , Muscolo Domingo L.  , de Quirós Fernan González Bernaldo  , Nozomu Inoue
Published: February 2025

Tumor excision is the primary treatment of aggressive or recurrent benign bone tumors and malignant bone sarcomas. This requires a surgical resection with the potential for large residual osseous defects that could be reconstructed using fresh frozen allografts. Virtual bone banks enable the creation of databases allowing a 3D pre-surgery evaluation of such allgorafts, based on segmentation of DICOM-CT images. This study demonstrates the usefulness of patient specific 3D models for an accurate host–donor allograft match. We describe one way to select the best match according to size and shape. The results suggest that a robust and realiable technique has been established. Since it is difficult to plan an allograft on a distal femur deformed by the tumor, we propose to plan the surgery on the contralateral side. Our results support this limb symmetry hypothesis. The use of this measurement protocol enables accurate selection of allografts from a contralateral healthy femur 3D CT model achieving the best match possible considering the geometry of available allograft candidate femur specimens.
Towards iconic language for patient records, drug monographs, guidelines and medical search engines
Authors: Lamy Jean-Baptiste  , Duclos Catherine  , Hamek Saliha  , Beuscart-Zéphir Marie-Catherine  , Kerdelhué Gaetan  , Darmoni Stefan  , Favre Madeleine  , Falcoff Hector  , Simon Christian  , Pereira Suzanne  , Serrot Elisabeth  , Mitouard Thierry  , Hardouin Etienne  , Kergosien Yannick  , Venot Alain
Published: February 2025

Practicing physicians have limited time for consulting medical knowledge and records. We have previously shown that using icons instead of text to present drug monographs may allow contraindications and adverse effects to be identified more rapidly and more accurately. These findings were based on the use of an iconic language designed for drug knowledge, providing icons for many medical concepts, including diseases, antecedents, drug classes and tests. In this paper, we describe a new project aimed at extending this iconic language, and exploring the possible applications of these icons in medicine. Based on evaluators' comments, focus groups of physicians and opinions of academic, industrial and associative partners, we propose iconic applications related to patient records, for example summarizing patient conditions, searching for specific clinical documents and helping to code structured data. Other applications involve the presentation of clinical practice guidelines and improving the interface of medical search engines. These new applications could use the same iconic language that was designed for drug knowledge, with a few additional items that respect the logic of the language.
Methodology of integration of a clinical data warehouse with a clinical information system: the HEGP case
Authors: Zapletal Eric  , Rodon Nicolas  , Grabar Natalia  , Degoulet Patrice
Published: February 2025

Clinical Data Warehouses (CDW) can complement current Clinical Information Systems (CIS) with functions that are not easily implemented by traditional operational database systems. Here, we describe the design and deployment strategy used at the Pompidou University Hospital in southwest Paris. Four realms are described: technological realm, data realm, restitution realm, and administration realm. The corresponding UML use cases and the mapping rules from the shared integrated electronic health records to the five axes of the i2b2 CDW star model are presented. Priority is given to the anonymization and security principles used for the 1.2 million patient records currently stored in the CDW. Exploitation of a CDW by clinicians and investigators can facilitate clinical research, quality evaluations and outcome studies. These indirect benefits are among the reasons for the continuous use of an integrated CIS.
Clinicians, security and information technology support services in practice settings – A pilot study
Authors: Fernando Juanita
Published: February 2025

This case study of 9 information technology (IT) support staff in 3 Australian (Victoria) public hospitals juxtaposes their experiences at the user-level of eHealth security in the Natural Hospital Environment with that previously reported by 26 medical, nursing and allied healthcare clinicians. IT support responsibilities comprised the entire hospital, of which clinician eHealth security needs were only part. IT staff believed their support tasks were often fragmented while work responsibilities were hampered by resources shortages. They perceived clinicians as an ongoing security risk to private health information. By comparison clinicians believed IT staff would not adequately support the private and secure application of eHealth for patient care. Preliminary data analysis suggests the tension between these cohorts manifests as an eHealth environment where silos of clinical work are disconnected from silos of IT support work. The discipline-based silos hamper health privacy outcomes. Privacy and security policies, especially those influencing the audit process, will benefit by further research of this phenomenon.
A Lab-EMR Interoperability Profile as an eHealth Architecture Component for Resource-Constrained Settings
Authors: Lober William B.  , Revere Debra  , Hills Rebecca
Published: February 2025

Implementation of computerized systems in resource-constrained settings have been gaining traction as a means of improving the delivery of health care, the use and reuse of information, and providing a standards-based capacity for assessing the process and impact of health care. In a resource-constrained environment, systems are often implemented as stand-alone entities focused on specific care activities (for example, delivering antiretroviral therapy). As such, in many countries, taking a generalized approach to linking electronic medical record systems with laboratory information systems (EMR-LIS) is an important area in which to achieve interoperability. In this paper we describe a scenario of use and information interaction interoperability profile based on our experience implementing EMR-LIS integration in two resource-constrained settings. Of significance, the profile emphasizes queued matching in order to avoid mutual dependence while achieving interoperability between systems.
LuMiR: The region-wide EHR-S in Basilicata
Authors: Contenti Mariangela  , Mercurio Gregorio  , Ricci Fabrizio L.  , Serbanati Luca D.
Published: February 2025

The Lucania – Medici in Rete (LuMiR) project aims to support the shift from organization-centric to patient-centric healthcare in Basilicata, a region in the southern Italy. Main objective of the project is to foster collaborative, multidisciplinary and cross-organizational healthcare processes by developing and stimulating the adoption of a region-wide, software infrastructure, the LuMiR system. It is a suite of e-services that facilitates the sharing of patient related clinical data among authorized professionals, by enabling the interoperability among Electronic Medical. In the paper the LuMiR project approach is discussed, pointing out the methodology adopted in the design and development of the LuMiR system, the peculiarities of the system architecture and interventions scheduled to mitigate the risks related to the large scale adoption of the LuMiR system itself.
Is population-oriented IT supported preventive care in general practice feasible? A database study
Authors: van Wyk Jacobus T.  , Mosseveld B.  , van der Lei J.
Published: February 2025

Background: Introducing a clinical decision support system (CDSS) in general practice that provides broad support based on all available guidelines for preventive care might dramatically increase the workload of a general practitioner. Aim: We evaluated the potential effect on workload of a CDSS that aims to support the whole breadth of preventive guidelines currently used in The Netherlands. Methods: We analysed the guidelines of the Dutch college of General Practitioners (DCGP) for preventive activities, developed a CDSS based on the guidelines and studied the behaviour of the system on real patient data. Results: 20 of the 87 DCGP guidelines contained data on preventive activities which was incorporated in the system. Out of 485 793 patients, the system indicated that for 138 885 (28.6%) a preventive action was needed. Conclusion: A CDSS that aims to support the whole breadth of preventive activities in general practice will have a substantial effect on workload. Further tailoring of the support will be needed.
A full-text information retrieval system for an epidemiological registry
Authors: Cuggia Marc  , Bayat Sahar  , Garcelon Nicolas  , Sanders Lauren  , Rouget Florence  , Coursin Arnaud  , Pladys Patrick
Published: February 2025

Case finding for epidemiologic registries still relies mainly on a manual process. In this paper, we show that retrieval information tools could be a complementary way to identify cases for a pediatric malformation registry. We developed a full-text and metadata search engine plugged to a clinical documents repository and used it to identify Epi/Hypospadia and Spina bifida cases. The queries were enriched with Snomed terminologies. We compared the performances of this prototype versus the hospital DRG database (classical method). The best precisions of prototype for identification of Spina bifida and Epi/Hypospadia were respectively 73% and 87%. The prototype overlap with the DRG system was 83% and 97%. Compared to DRG, 13 new not referenced and 2 miscoded cases were detected. This free full-text retrieval system prototype allows efficiently reusing clinical documents for case finding for an epidemiologic purpose.
Obesity Atlas and Methodbox: Towards an Open Framework for Sharing Public Health Intelligence Workflows
Authors: Thew Sarah  , Jarvis Paul  , Ainsworth John  , Buchan Iain
Published: February 2025

The large growth in data sources relevant to public health has not been matched by a growth in human resource for producing intelligence to support decisions or generate new insights. There is a need to bring scarce public health expertise into closer alignment with data and data processing methods to support timely public health analysis. The difficulties of developing and sharing this expertise in large organisations such as the UK's National Health Service have long been recognised. We report findings in this area across two projects Obesity Atlas and Methodbox, which are developing and sharing best practice between Public Health Analysts in England, and we address the relevant generic knowledge management problems in the Public Health community.
Documentation in Pharmacovigilance: Using an ontology to extend and normalize Pubmed queries
Authors: Delamarre Denis  , Lillo-Le Louët Agnès  , Guillot Laetitia  , Jamet Anne  , Sadou Eric  , Ouazine Theo  , Burgun Anita  , Jaulent Marie-Christine
Published: February 2025

Objectives: To assess and understand adverse drug reactions (ADRs), a systematic review of reference databases like Pubmed is a necessary and mandatory step in Pharmacovigilance. In order to assist pharmacovigilance team with a computerized tool, we performed a comparative study of 4 different approaches to query Pubmed through ADR-drug terms. The aim of this study is to assess how an ontology of adverse effects, used to normalize and extend queries, could improve this search. Material and Method: The ontological resource OntoEIM contains 58,000 classes and integrates MedDRA terminology. The entry point is a ADR-Drug term and the four methods are (i) a direct search on Pubmed (ii) a search with a normalized query enhanced with domain-specific Mesh Heading criteria, (iii) a search with the same elaborated query extended to the MeSH sub-hierarchy of the adverse effect entry and (iv) a search with a set of MedDRA terms grouped by subsomption in the OntoEIM ontology. For each of the 16 queries performed and analysed, relevant publications are selected “manually” by two pharmacovigilant experts. Results: The recall is respectively of 63%, 50%, 67% and 74%, the precision of 13%, 26%, 29% and 4%. The best recall is provided by the ontology-based method, for 4 cases out of 16 this method returns relevant publications when the others return no results. Conclusion: Results show that an ontology-based search tool improves the recall performance, but other tools and methods are needed to raise the precision.
Clinical users' perspective on telemonitoring of patients with long term conditions: understood through concepts of Giddens's structuration theory & consequence of modernity
Authors: Sharma Urvashi  , Barnett Julie  , Clarke Malcolm
Published: February 2025

This study involves conducting focus group discussions with clinical users (nurses and technicians) prior to the launch of telehealth service in Nottingham, UK, to elicit their initial perceptions about the service. It describes the findings from preliminary phase of otherwise a larger longitudinal study. Using Giddens's concepts from structuration theory and consequence of modernity, we were able to acknowledge trust and sense of security as two very salient aspects that govern adoption of new technological innovation. Unattended, these aspects contribute to arousal of conflict and contradiction within a system. In order for successful telehealth implementations in health care setting, providers of the service, need to focus on ways in which clinical users' trust can be gained and sense of security can be promoted while using the telehealth service and technology.
Web-Based Asynchronous Teleconsulting for Consumers in Colombia: A 2-year Follow Up
Authors: Valenzuela José Ignacio  , López Catalina  , Guzmán Yuli  , Fajardo Roosevelt
Published: February 2025

Background: Remote consultation was implemented in 2006 in our institution, through an open-access Web-based Teleconsulting service: Doctor Chat. This tool was created with the aim of improving access to health care services in Colombia, especially in underserved areas. Objective: The aim of this paper is to report our experience with the free Web-based application for teleconsultation. Methods: After validating the tool, we analyzed the queries submitted between May 2007 and June 2009. Requests were classified into three axes: purpose of the query, specialty, and geographic area of origin. Descriptive statistics were gathered for each category (name, email, city, country, age, gender). Results: We received 1624 consultations, with an average of 59 requests per month. 52.7% of the users were aged 18 to 29 years. Users asked mainly about sexual and reproductive health issues. 79.2% of consultations came from Colombia and 32.91% of the users were students. Conclusions: Doctor Chat is an innovative tool to deliver health care information, but advertising, preventive and technical strategies must be implemented to improve its impact on Colombia's health system.
Learning of each other – online: On the division of labour between technology and supervisors
Authors: Stokken Roar  , Eikli Gjermund
Published: February 2025

The article discuss challenges and solutions when an existing course programme, in which contributions from the group form an integral part, is to be converted into an online programme. The focus is on division of labour between technology and supervisors. The case is the Norwegian online version of Chronic Disease Self-Management Program from Stanford University. The interplay between humans and technology is discussed from a theoretical framework developed from the works of Latour and Nonaka. In special difference between human modelling and a technological systematic and rule-based approach is emphasised. By delegating parts of the role in classroom courses to the e-learning solution, it has been possible to create a solution where participants are learning from each other. This demands knowledge on the part of the supervisors so that they help to increase the effect of the technology and not work against it.
Ambulatory Orthopaedic Surgery Patients Knowledge with Internet-Based Education
Authors: Heikkinen Katja  , Salanterä Sanna  , Leino-Kilpi Helena
Published: February 2025

There is a growing need for patient education and evaluation of the outcomes of it. The aim of this study was to compare the ambulatory orthopaedic surgery patients' knowledge with Internet-based education and face to face education with a nurse. The following hypothesis was set: Internet-based patient education (experiment) is as effective as face to face education with a nurse (control) in increasing patients' level of knowledge and sufficiency of knowledge. In addition the correlations of demographic variables were tested. The patients were randomised to either the experiment (n=72) or to a control group (n=75). Empirical data were collected with two instruments. Patients in both groups showed improvement in their knowledge during their care. Patients in experiment group improved their knowledge level significantly more in total than those patients in control group. There were no differences in patients' sufficiency of knowledge between the groups. Knowledge was correlated especially with patients' age, gender and earlier ambulatory surgery. As a conclusion, with the Internet-based education could achieve positive results on patients' knowledge. Internet is usable method in ambulatory care.
An open repositories network development for medical teaching resources
Authors: Soula Gérard  , Darmoni Stefan  , Le Beux Pierre  , Renard Jean-Marie  , Dahamna Badisse  , Fieschi Marius
Published: February 2025

The lack of interoperability between repositories of heterogeneous and geographically widespread data is an obstacle to the diffusion, sharing and reutilization of those data. We present the development of an open repositories network taking into account both the syntactic and semantic interoperability of the different repositories and based on international standards in this field. The network is used by the medical community in France for the diffusion and sharing of digital teaching resources. The syntactic interoperability of the repositories is managed using the OAI-PMH protocol for the exchange of metadata describing the resources. Semantic interoperability is based, on one hand, on the LOM standard for the description of resources and on MESH for the indexing of the latter and, on the other hand, on semantic interoperability management designed to optimize compliance with standards and the quality of the metadata.
A Compositional Personalization Approach for Designing Personalized Patient Educational Interventions for Cardiovascular Risk Management
Authors: Davis Selena  , Abidi Syed Sibte Raza  , Stewart Sam
Published: February 2025

Providing patients with personalized educational messages can improve self-management of Cardiovascular Disease (CVD) risk factors. We present our compositional personalization approach that generates personalized educational material by dynamically selecting fine-grained information snippets, as per the patient profile, and then synthesizing them in a educational template to yield personalized patient education interventions. We apply our personalization approach in the PULSE system – Personalization Using Linkages of SCORE and behavior change readiness to web-based Education – that generates personalized patient education for CVD risk management. The PULSE framework involves the calculation of CVD risk assessment using the Systematic COronary Risk Evaluation (SCORE) algorithm, the estimation of readiness to change using the Transtheoretical Model (TTM) of intentional behavior change. The educational interventions were derived from evidence-based staged lifestyle modification materials and Canadian guidelines for CVD risk management.