bluuebunny/crossref_metadata_2025 huggingface dataset:
2.2 Epidemiological Study Designs
Authors: Diomidus Marianna
Published: February 2025

This chapter illustrates the study designs most frequently encountered in the medical literature. In medical research, either subjects are observed or experiments are undertaken. Experiments involving humans are called trials. Experimental studies may also use animals and tissue, although we did not discuss them as a separate category; the comments pertaining to clinical trials are relevant to animal and tissue studies as well. Each type of study discussed has advantages and disadvantages. Randomized, controlled clinical trials are the most powerful designs possible in medical research, but they are often expensive and time-consuming. Well-designed observational studies can provide useful insights on disease causation, even though they do not constitute proof of causes. Cohort studies are best for studying the natural progression of disease or risk factors for disease; case-control studies are much quicker and less expensive. Cross-sectional studies provide a snapshot of a disease or condition at one time, and we must be cautious in inferring disease progression from them. Surveys, if properly done, are useful in obtaining current opinions and practices. Case-series studies should be used only to raise questions for further research.
3.11 Multimedia Technologies in Education
Authors: Liaskos Joseph  , Diomidus Marianna
Published: February 2025

In general multimedia is the combination of visual and audio representations. These representations could include elements of texts, graphic arts, sound, animation, and video. However, multimedia is restricted in such systems where information is digitalized and is processed by a computer. Interactive multimedia and hypermedia consist of multimedia applications that the user has more active role. Education is perhaps the most useful destination for multimedia and the place where multimedia has the most effective applications, as it enriches the learning process. Multimedia both in nursing education and in medical informatics education has several applications as well. A multimedia project can be developed even as a “stand alone” application (on CD-ROM), or on World Wide Web pages on Internet. However several technical constraints exist for developing multimedia applications on Internet. For developing multimedia projects we need hardware and software, talent and skill. The software requirements for multimedia development consist of one or more authoring systems and various editing applications for text, images, sounds and video. In this chapter different software tools for creating multimedia applications are presented. In the last part of this chapter, two examples of multimedia educational training programs are discussed. Both are “stand alone” applications (CD-ROMs). The first, examines several aspects of the electronic patient record by using videos, audio descriptions, lectures and glossary, while the second one presents several topics regarding epidemiology and epidemiological research by using graphics, sound and animation.
Telemedicine in the Malaysian Multimedia Super Corridor: Towards Personalised Lifetime Health Plans
Authors: Abidi Syed Sibte Raza  , Yusoff Zaharin
Published: February 2025

The Malaysian Telemedicine initiative advocates a paradigm shift in healthcare delivery patterns by way of implementing a person-centred and wellness-focused healthcare system. This paper introduces the Malaysian Telemedicine vision, its functionality and associated operational conditions. In particular, we focus on the conceptualisation of one key Telemedicine component i.e. the Lifetime Health Plan (LHP) system—a distributed multi-module application for the periodic monitoring and generation of health-care advisories for all Malaysians. In line with the LHP project, we present an innovative healthcare delivery info-structure—LifePlan—that aims to provide life-long, pro-active, personalised, wellness-oriented healthcare services to assist individuals to manage and interpret their health needs. Functionally, LifePlan based healthcare services are delivered over the WWW, packaged as Personalised Lifetime Health Plans that allow individuals to both monitor their health status and to guide them in healthcare planning.
Knowledge Discovery for Advanced Clinical Data Management and Analysis
Authors: Babic Ankica
Published: February 2025

Knowledge discovery is a broad research field in which methods are developed to support discovery of novel and potentially useful knowledge from clinical databases and registers in systems for patient care. However, the techniques available are not readily applicable in medical domains, due to, among other reasons, low user friendliness and lack of proper methodological background.
A Development Protocol for a Diagnostic DSS
Authors: Ying-Lie O  , ter Burg W.J.P.P.  , ter Braak E.W.M.T.  , Neijt J.P.  , Wiegerinck W.A.J.J.  , Nijman M.J.  , Kappen H.J.
Published: February 2025

A diagnostic decision support system (DSS) in medicine is an expert system that aids the physician in the determination of the diagnosis based on findings and test results. The DSS can be divided into 2 different types of components: the knowledge component and the information system component. Methods from software engineering, knowledge engineering and management are combined into a dynamic development cycle that allows stepwise update and refinement. The development of the knowledge component is based on knowledge engineering. In the starting phases, rapid prototyping is convenient to determine and evaluate the specification. The content of the knowledge base is frequently updated during its life time. For this purpose, a knowledge modelling protocol is supplied.
Compulsory Health Insurance Databases
Authors: Svoljšak Janez  , Dovžan Irma
Published: February 2025

The compulsory health insurance databases represent fundamental infrastructure to the implementation of the Health Insurance Institute of Slovenia (HIIS) operations, i.e. for its effective performance in all the fields of its business. This paper presents the legal bases of the database management, the logocal database structure, the supply of data from various data sources, and the role of databases as the primary source of supply for the data collections kept by other institutions in Slovenia.
Trans-Urethral Ultrasound (TUUS) Imaging for Visualization and Analysis of the Prostate and Associated Tissues
Authors: Holmes III David R.  , Robb Richard
Published: February 2025

The incidence of prostate disease is high. However, accurate assessment of pathological conditions is still difficult. Although CT, MRI, and TRUS imaging methods provide useful information, each has specific drawbacks. Our work examines the potential and utility of 3D trans-urethral ultrasound (TUUS) for improved imaging of the prostate. Four normal canines were examined with TUUS. The catheter was placed in the urethra and used to image the prostate, rectum, bladder, ureter, neuro-vascular bundles, arteries, and surrounding tissue. 2D and 3D datasets were acquired and digitized. The 2D data provides useful visualization of the tissue. The clinician was also able to watch urine enter the bladder and perform a digital rectal exam in real-time. 3D data visualization required torodial reconstruction. The algorithm was optimized to provide very fast 3D reconstructions of the prostate. Segmentation of the data proved challenging, but 3D visualization, including volume rendered data and surface rendered data, were well accepted by clinicians. Clinicians and researchers determined a number of potential applications of these new techniques, including: prostate cancer diagnosis and staging, assessment of Benign Nodular Enlargement, assessment of physiologic function of the bladder, evaluation of morphologic properties of the prostate, and image guided biopsy and therapy.
Creating Fast Finite Element Models from Medical Images
Authors: Berkley Jeffrey  , Oppenheimer Peter  , Weghorst Suzanne  , Berg Daniel  , Raugi Gregory  , Haynor Dave  , Ganter Mark  , Brooking Cole  , Turkiyyah George
Published: February 2025

The procedure for creating a patient-specific virtual tissue model with finite element (FE) based haptic (force) feedback varies substantially from that which is required for generating a typical volumetric model. In addition to extracting geometrical and texture map data to provide visual realism, it is necessary to obtain information for supporting a FE model. Among many differences, FE-based VR environments require a FE model with appropriate material properties assigned. The FE equation must also be processed in a manner specific to the surgical task in order to maximize deformation and haptic computation speed. We are currently developing methodologies and support software for creating patient-specific models from medical images. The steps for creating such a model are as foljows: 1) obtain medical images and texture maps of tissue structures; 2) extract tissue structure contours; 3) generate a 3D mesh from the tissue structure contours; 4) alter mesh based on simulation objectives; 5) assign material properties, boundary nodes and texture maps; 6) generate a fast (or real-time) FE model; and 7) support the tissue models with task-specific tools and training aids. This paper will elaborate on the above steps with particular reference to the creation of suturing simulation software, which will also be described.
Telementored Laparoscopic Cholecystectomy: A Pilot Study
Authors: Sawyer Michael A.J.  , Lim Robert B.  , Wong Sean Y.T.  , Cirangle Paul T.  , Birkmire-Peters Deborah
Published: February 2025

Few laparoscopic surgical experts exist relative to the number of surgeons needing training in laparoscopic surgical techniques. This study tested application of telemedicine technology in the mentoring of surgeons during laparoscopic cholecystectomy. Our Surgical Telementoring Suite provided real-time audio and video telecommunication to the operating room. Data points for telementored laparoscopic cholecystectomy (TLC, n=6) were compared to age and sex-matched controls having standard laparoscopic cholecystectomy (SLC, n=6) with mentors physically present in the operating room. TLC data were also compared between cases performed with a staff surgeon and resident as mentorees (SRM, n=3), versus two residents as mentorees (RRM, n=3). Data were analyzed with chi-square testing. The level of statistical significance was set at p<0.05. No major operative complications occurred in either group (p>0.05). Total operative times were similar (92.2 ± 18.4 minutes SLC vs. 94.7 ± 25.3 minutes TLC, p>0.05). Additional data compared between SRM and RRM groups included time to establishment of a pneumoperitoneum of 12-15 mm Hg (7.0 ± 6.1 minutes SRM vs. 6.7 ± 2.9 minutes RRM), time to placement of all four trocars (13.0 ± 3.6 minutes SRM vs. 10.3 ± 3.1 minutes RRM, time to isolation and proximal clipping of the cystic duct (38.0 ± 12.1 minutes SRM vs. 55.7 ± 29.0 minutes RRM), and time to removal of the gallbladder (77.3 ± 25.4 minutes vs. 77.7 ± 27.5 minutes RRM). For all data points, p>0.05. We conclude that telementoring is a safe, effective method for teaching the techniques of LC. This is true for operating teams composed of surgical residents, with or without staff surgeons present.
An Automatic Virtual Patient Reconstruction from CT-Scans for Hepatic Surgical Planning
Authors: Soler L.  , Delingette H.  , Malandain G.  , Ayache N.  , Koehl C.  , Clément J.-M.  , Dourthe O.  , Marescaux J.
Published: February 2025

Problem / Background: In order to help hepatic surgical planning we perfected automatic 3D reconstruction of patients from conventional CT-scan, and interactive visualization and virtual resection tools.
Virtual Reality as a New Imaginative Tool in Psychotherapy
Authors: Vincelli Francesco  , Riva Giuseppe
Published: February 2025

Imagination, experience and memory play a central role in psychotherapy. These elements are fundamental in the life of everyone but also in the etiology of many psychological disturbance. Thanks to Virtual Reality (VR) it is possible to transcend the absolute and relative limits linked to individual potential. The imagines re-created through VR may be more vivid and real than the one that most subjects are able to describe through their own imagination and their own memory.
ICTS, an Interventional Cardiology Training System
Authors: Cotin Stephane  , Dawson Steven L.  , Meglan Dwight  , Shaffer David W.  , Ferrell Margaret A.  , Bardsley Ryan S.  , Morgan Frederick M.  , Nagano Tad  , Nikom Jacob  , Sherman Paul  , Walterman Michael T.  , Wendlandt Jeffrey
Published: February 2025

In this article, we present an Interventional Cardiology Training System developed by the Medical Application Group at Mitsubishi Electric in collaboration with the Center for Innovative Minimally Invasive Therapy. The core of the ICTS is a computer simulation of interventional cardiology catheterization. This simulation integrates clinical expertise, research in learning, and technical innovations to create a realistic simulated environment. The goal of this training system is to augment the training of new cardiology fellows as well as to introduce cardiologists to new devices and procedures.
CardioOp: an Integrated Approach to Teleteaching in Cardiac Surgery
Authors: Friedl R.  , Preisack M.  , Schefer M.  , Klas W.  , Tremper J.  , Rose T.  , Bay J.  , Albers J.  , Engels P.  , Guilliard P.  , Vahl C.F.  , Hannekum A.
Published: February 2025

Introduction/ Purpose: The complexity of cardiac surgery requires continuous training, education and information addressing different individuals: physicians (cardiac surgeons, residents, anaesthesiologists, cardiologists), medical students, perfusionists and patients. Efficacy and efficiency of education and training will likely be improved by the use of multimedia information systems. Nevertheless, computer-based education is facing some serious disadvantages: 1) multimedia productions require tremendous financial and time recources; 2) the obtained multimedia data are only usable for one specific target user group in one specific instructional context; 3) comupter based learning programs often show deficiencies in the support of individual learning styles and in providing individual information adjusted to the learner's individual needs. In this paper we describe a computer-system, providing multiple re-use of multimedia-data in different instructional sceneries and providing flexible composition of content to different target user groups.
Orthopedic Rehabilitation Using the “Rutgers Ankle” Interface
Authors: Girone M.  , Burdea G.  , Bouzit M.  , Popescu V.  , Deutsch J.E.
Published: February 2025

A novel ankle rehabilitation device is being developed for home use, allowing remote monitoring by therapists. The system will allow patients to perform a variety of exercises while interacting with a virtual environment (VE). These game-like VEs created with WorldToolKit run on a host PC that controls the movement and output forces of the device via an RS232 connection. Patients will develop strength, flexibility, coordination, and balance as they interact with the VEs. The device will also perform diagnostic functions, measuring the ankle's range of motion, force exertion capabilities and coordination. The host PC transparently records patient progress for remote evaluation by therapists via our existing telerehabilitation system. The “Rutgers Ankle” Orthopedic Rehabilitation Interface uses double-acting pneumatic cylinders, linear potentiometers, and a 6 degree-of-freedom (DOF) force sensor. The controller contains a Pentium single-board computer and pneumatic control valves. Based on the Stewart platform, the device can move and supply forces and torques in 6 DOFs. A proof-of-concept trial conducted at the University of Medicine and Dentistry of New Jersey (UMDNJ) provided therapist and patient feedback. The system measured the range of motion and maximum force output of a group of four patients (male and female). Future medical trials are required to establish clinical efficacy in rehabilitation.
5. Security Architecture of the Star Project
Authors: Cooper Paul
Published: February 2025

This chapter provides an introduction to the Star project with a description of the project’s objectives and an explanation of the continuity link through to the Intercare project. It then outlines the security service architecture developed in the Star project along with some conclusions about the common services which have been identified as needed for a regional healthcare network project.
Extended applications with smart cards for integration of health care and health insurance services
Authors: Sucholotiuc M.  , Stefan L.  , Dobre I.  , Teseleanu M.
Published: February 2025

In 1999 in Romania has initiated the reformation of the national health care system based on health insurance. In 1998 we analyzed this system from the point of view of its IT support and we studied methods of optimisation with relational, distributed databases and new technologies such as
Telemedicine: Application of Telepathology- Remote microscopy for intraoperative diagnoses on frozen sections
Authors: Battmann A.  , Knitza R.  , Janzen S.  , Fiedler F.  , Stock B.  , Schulz A.  , Knoblauch B.
Published: February 2025

Due to the time delay, intraoperative consultations result in an extension of operation times, leading to prolonged anesthesia and idle time during surgery. Using a remote controlled microscope for telepathology, transfer times between hospital and pathologist can be eliminated and pathological expertise obtained independently of the geographic location of the hospital.
Gesundheits-Surveillance im ÖGD NRW mit Geoinformationssystemen
Authors: Hellmeier W.  , Queste A.  , Fehr R.
Published: February 2025

Nach einem kurzen Überblick über die Aufgaben des Öffentlichen Gesundheitsdienstes (ÖGD) im allgemeinen und des Landesinstitutes für den Öffentlichen Gesundheitsdienst (lögd) NRW im speziellen wird ein Projekt vorgestellt, welches den Einsatz von Geoinformationssystemen (GIS) im lögd NRW testete. Für dieses Projekt wurden verschiedene Themenbereiche ausgesucht, die nicht nur typische GIS-Einsatzbereiche im Gesundheitswesen abdecken, wie z.B. im Bereich der Umweltepidemiologie, der Raumplanung unter gesundheitlichen Aspekten oder der Überpriifung und Überwachung von Versorgungsstrukturen. Vielmehr wurden die Themen, die durch die Kooperation mit mehreren Gesundheitsämtern NRWs ermöglicht wurden, danach ausgewählt, wie vielfältig die Einsatzbereiche eines GIS sein können. Dazu gehört die Anwendung als Informationssystem oder die Nutzung zur Erstellung einfacher thematischer Karten . ebenso wie die Verschneidung von Gesundheits- mit Geodaten, die geographische Visualisierung und die räumliche Abfrage- und Analysemöglichkeit. Mit der Durchführung des Projektes sollte gezeigt werden, dass ein GIS als modernes Werkzeug die Arbeit mit räumlichen Gesundheitsdaten sinnvoll unterstützen und sein Einsatz im Rahmen der GBE zu einer Verbesserung und Intensivierung der räumlichen Datenanalyse beitragen kann.
Systems of evidence-based healthcare and personalised health information: some international and national trends
Authors: Gordon Colin  , Muir Gray J.A.  , Toth Ben  , Veloso Mario
Published: February 2025

In Europe, North America and elsewhere, growing interest has focussed on evidence-based healthcare systems, incorporating the deployment of practice guidelines, as a field of application for health telematics. The clinical benefit and technical feasibility of common European approaches to this task has recently been demonstrated. In Europe it is likely that, building on recent progress in electronic health record architecture (EHRA) standards, a sufficient state of maturity can be reached to justify initiation within CEN TC251 of a pre-standards process on guideline content formats during the current 5thFramework of EC RT&D activity. There is now a similar impetus to agree standards for this field in North America. Thanks to fruitful EC-USA contacts during the 4thFramework programme, there is now a chance, given well-planned coordination, to establish a global consensus optimally suited to serve the world-wide delivery and application of evidence-based medicine. This review notes three factors which may accelerate progress to convergence:
Modelling Health Care Processes for Eliciting User Requirements: A Way to Link a Quality Paradigm and Clinical Information System Design
Authors: Staccini Pascal  , Joubert Michel  , Quaranta Jean-François  , Fieschi Dominique  , Fieschi Marius
Published: February 2025

Hospital information systems have to support quality improvement objectives. The design issues of health care information system can be classified into three categories: 1) time-oriented and event-labelled storage of patient data; 2) contextual support of decision-making; 3) capabilities for modular upgrading. The elicitation of the requirements has to meet users' needs in relation to both the quality (efficacy, safety) and the monitoring of all health care activities (traceability). Information analysts need methods to conceptualise clinical information systems that provide actors with individual benefits and guide behavioural changes. A methodology is proposed to elicit and structure users' requirements using a process-oriented analysis, and it is applied to the field of blood transfusion. An object-oriented data model of a process has been defined in order to identify its main components : activity, sub-process, resources, constrains, guidelines, parameters and indicators. Although some aspects of activity, such as “where”, “what else”, and “why” are poorly represented by the data model alone, this method of requirement elicitation fits the dynamic of data input for the process to be traced. A hierarchical representation of hospital activities has to be found for this approach to be generalised within the organisation, for the processes to be interrelated, and for their characteristics to be shared.
Analysis and Modeling of the Treatment Process Characterizing the Cooperation within Multi-professional Treatment Teams
Authors: Ammenwerth E.  , Ehlers F.  , Eichstädter R.  , Haux R.  , Kruppa B.  , Parzer P.  , Pohl U.  , Resch F.
Published: February 2025

We would like to introduce several aspects of the analysis and modeling of the treatment process characterizing the cooperation within multi-professional treatment teams. We will determine what is meant by a treatment process in order to then look at five views and four levels of their description. We will introduce possible methods for surveying and describing it. Currently an extensive analysis of the current state of the treatment process and of the weaknesses is underway in the Department of Child and Adolescent Psychiatry of the Heidelberg University Medical Center.
Long Term Preservation of Electronic Health Records Recommendations in a large teaching hospital in Belgium
Authors: Roger France F.H.  , Beguin CI.  , van Breugel R.  , Piret CI.
Published: February 2025

Health records should be readily accessed by authorised persons for diagnosis, treatment and legal security purposes during patient’s lifetime and thereafter for research and training purposes. Technology makes difficult the preservation of digital material, because of rapid changes in information media, hardware and software evolution, and because of the multiplicity of its location as well as the complexity of its environment. A committee in a large teaching hospital in Belgium, recommends two complementary approaches : (1) After a patient departure, all his health information should be managed by a unique organisation that would update regularly accesses to all data bases concerned by this patient. Health archives should be formatted using XML (Extensible Mark up Language) software family, and set on supports such as DVD-ROM, to be upgraded or updated when needed. This archive media is fast but not safe. (2) Computer output microfilm (COM) and scanners for non electronic data to be preserved appears to be also needed, as it is storage safe for at least 250 years and readable directly by eye. This archive media is safe but not fast.
Case-based Reasoning for Medical Knowledge-based Systems
Authors: Schmidt Rainer  , Gierl Lothar
Published: February 2025

In many domains Case-based Reasoning (CBR) has become a successful technique for knowledge-based systems. In medical domains, attempts to apply the complete CBR cycle are rather exceptional. Some systems have recently been developed, which on the one hand use only parts of the CBR method, mainly the retrieval, and on the other hand enrich the method by a generalisation step to fill the knowledge gap between the specificity of single cases and general rules. So, in this paper we discuss the appropriateness of CBR for medical knowledge-based systems, point out problems, limitations and possibilities how they can partly be overcome.
AIDA - ZAHNMEDIZINISCHE ENTSCHEIDUNGSUNTERSTÜTZUNG
Authors: Ekkehard Finkeissen  , Ralf Weber  , Ulrich Koke  , Stefan Haßfeld  , Thomas Wetter
Published: February 2025

Vor der Entwicklung einer wissensbasierten Entscheidungsunterstutzung für die Zahnmedizin ist eine grundsätzliche Analyse der Entscheidungsstrukturen notwendig. Bei der Modellierung mussen unter anderem zahnmedizinische, technische, psychologische und ergonomische Fragestellungen berücksichtigt und in einem Modell abgebildet werden. Erst auf dieser Grundlage kann geklärt werden, welche Teilaufgaben der Entscheidungsfindung formal beschrieben und welche darüber hinaus auf einem Computersystem repräsentiert werden können. Diese Vorgehensweise sichert die praktische Einbettung der Systementwicklung in die zahnärztliche Behandlungsumgebung und vermeidet somit Integrationsprobleme.
Data Warehouse and Data Mining in a Surgical Clinic
Authors: Tusch Guenter  , Müller Margarete  , Rohwer-Mensching Katrin  , Heiringhoff Karlheinz  , Klempnauer Jürgen
Published: February 2025

Hospitals and clinics have taken advantage of information systems to streamline many clinical and administrative processes. However, the potential of health care information technology as a source of data for clinical and administrative decision support has not been fully explored. In response to pressure for timely information, many hospitals are developing clinical data warehouses. This paper attempts to identify problem areas in the process of developing a data warehouse to support data mining in surgery. Based on the experience from a data warehouse in surgery several solutions are discussed.
Conception of an XML-based Ontology for a Web-based Medical Information Service
Authors: Grütter Rolf  , Eikemeier Claus  , Fierz Walter  , Steurer Johann
Published: February 2025

In order to be useful for practice, medical information on the World Wide Web must be relevant, reliable, well designed, and easy accessible. Approaches towards improving these requirements include evidence-based medical information services such as EVIMED. This research paper considers the question of how a user can be supported in accessing requested information from EVIMED and how further, semantically related information can easily be retrieved. The presented method of resolution is based on Schmid's concept of media and on Gruber's concept of the ontology. The use of the emerging Web standard extensible Markup Language (XML) in order to implement it, allows for the design of a component-based solution supporting an easy adaptation of the representational vocabulary in accordance with the conceptualization of the user, i.e., the practitioner.
A simulation approach to study planning for large-scale epidemiological surveys
Authors: Alte Dietrich  , Adam Christiane  , Lüdemann Jan  , John Ulrich
Published: February 2025

In study planning for large-scale epidemiological studies with multi-type examinations, important resource questions have to be answered, e.g. study horizons, personnel and other resources and cost estimates are needed. A simulation approach for scheduling that uses relevant parameters to simulate examination times gives simulation distributions that can be utilised to answer planning questions.
An ICT Solution for Community Mental Health - Putting Virtuality into the Vision
Authors: Draper Ronald  , Rigby Michael
Published: February 2025

The digital age has brought about revolutionary changes in the capacity and methods of managing information. There has been an evolutionary pathway leading from information technology through informatics to communication technology. The ‘nineties’ has been a decade of patient empowerment fuelled by Internet access and legal rights to information. Clinicians as a whole have lagged in their adoption of the new technologies. Mental health has been seen as a particularly difficult domain because of its multi-professional and multi-locational patterns of service delivery and its traditional reliance upon narrative in the absence of bio-pathologic data. The Hospitaller Order of St John of God has been facing these challenges. The authors describe an integrated information/communication technology (ICT) which can be provided on the clinician’s desktop and show that the new integrated ICT affords new opportunities for addressing the needs of community-based mental health services.
Decision Support System for Medical Triage
Authors: Sadeghi Sarmad  , Barzi Afsaneh  , Zarrin-Khameh Neda
Published: February 2025

The paper explains the application of an artificial intelligence tool for the purpose of medical decision-making. The first product of this application is a triage engine, available on the Internet, to help laypersons make a decision about the urgency of their situation by providing tailored and accurate information. The expansion of this tool can lead to diagnostic tools for professionals or for educational purposes.
A Medical Platform for Simulation of Surgical Procedures
Authors: Thurfjell Lennart  , Lundin Anna  , Mclaughlin John
Published: February 2025

Surgery simulation is a promising technique for training of surgical procedures. The overall goal for any surgical simulator is to allow for efficient training of the skills required and to improve learning by giving the user proper feedback. This goal is easier achieved if the training is performed in a realistic environment. Therefore functionality such as soft tissue deformation, tearing and cutting, penetration of soft tissue etc. is necessary. Furthermore, a realistic simulator must provide haptic feedback so that all senses match, that is, there should be a correspondence between what you see and what you feel with your hands. In this paper we describe a medical platform that provides all this functionality. It is based on the ReachIn Magma API, which has been extended for surgery simulation. We describe the development of the platform and illustrate the use of it for the development of two different types of surgical simulators, both of which represents work in progress.
THE VIBE OF THE BURNING AGENTS: SIMULATION AND MODELING OF BURNS AND THEIR TREATMENT USING AGENT-BASED PROGRAMMING, VIRTUAL REALITY, AND HUMAN PATIENT SIMULATION
Authors: von Lubkz D.KJ.E  , Van Dyke Parunak H.  , Levine H.  , Beier K-P.  , Freer J.  , Pletcher Tim  , Sauter J.  , Treloar D.  , Wolf Eric
Published: February 2025

“SAPERE AUDE”
Neuronavigational Epilepsy Focus Mapping
Authors: Abbasi Hamid Reza  , Hariri Sanaz  , Martin David  , Risinger Michael  , Heit Gary
Published: February 2025

The localization of a seizure focus for resective surgery often requires invasive monitoring for precise localization of the target as well as structures to avoid. We report on the use of intra-operative surgical navigation to precisely localize and co-register subdural electrodes to regions of know radiographic pathology. Additionally, the navigation system was used to develop intra-operative electrode maps. These maps were subsequently used in the sub-acute recording phase to assign electrographic pathology and function (e.g. speech) to a specific cortical surface anatomy. This permitted for more precise planning of surgery and better assessment of potential risk, based on functional as well as anatomical criterion.
Development and Evaluation of an Epidural Injection Simulator with Force Feedback for Medical Training
Authors: Dang Thao  , Annaswamy Thiru M.  , Srinivasan Mandayam A.
Published: February 2025

Performing epidural injections is a complex task that demands a high level of skill and precision from the physician, since an improperly performed procedure can result in serious complications for the patient. The objective of our project is to create an epidural injection simulator for medical training and education that provides the user with realistic feel encountered during an actual procedure. We have used a Phantom haptic interface by SensAble Technologies, which is capable of three-dimensional force feedback, to simulate interactions between the needle and bones or tissues. An additional degree-of-freedom through an actual syringe was incorporated to simulate the “loss of resistance” effect, commonly considered to be the most reliable method for identifying the epidural space during an injection procedure. The simulator also includes a new training feature called “Haptic Guidance” that allows the user to follow a previously recorded expert procedure and feel the encountered forces. Evaluations of the simulator by experienced professionals indicate that the simulation system has considerable potential to become a useful aid in medical training.
Nursing Informatics Education based on the Text Type RDBMS and Its Effect
Authors: Narita Yuichi  , Kikuchi Yukiko  , Takemoto Yoshio  , Murakami Teruko  , Kurata Yuziro
Published: February 2025

We have developed a text type RDBMS by which those who are not computer experts, like nursing students, can easily develop a practical web page, or achieve data processing using RDBMS corresponding to groupware. The nursing students can use the system by learning a small amount of information technology.
Method to Determine the Bed Capacity, Different Approaches used for the Establishment Planning Project in the University Hospital of Nancy
Authors: Toussaint Eliane  , Herengt Gilles  , Gillois Pierre  , Kohler François
Published: February 2025

In France hospital bed capacity is determined according to a national and regional authorization which has been established by the regional hospital agency. The bed capacity evolution in a hospital is fixed by considering the different proposals of the hospital in negotiation with the regional hospital agency. Types of beds are differentiated according to the patients' needs : medicine, surgery and obstetrics_ The first approach is taken at the national level and then at the regional level using a specific ratio of beds for 100 000 inhabitants in each category. For a given hospital, the authorized number of beds takes into consideration their occupation. Target bed occupation ratios were fixed in 1992 and are still in use. In the establishment project of the University Hospital of Nancy (developed over a five year period) four approaches have been formulated and their results have been compared.
An Australian Case Study of Patient Attitudes Towards the Use of Computerised Medical Records and Unique Identifiers
Authors: Bomba David  , de Silva Ashley
Published: February 2025

Research into patient attitudes towards the use of technology in health care needs to be given much greater attention within health informatics. Past research has often focused more on the needs of health care providers rather than the end users. This article attempts to redress this knowledge bias by reporting on a case study of the responses gained from patients in a selected Australian medical practice towards the use of computerised medical records and unique identifiers. The responses (n=138) were gained from a survey of patients over a 13 day period of practice operation. This case study serves as an example of the type of future consumer health informatics research which can be undertaken not just in Australia but also in other countries, both at local regional levels and at a national level.
National Electronic Medication Management Systems
Authors: Badham Jennifer  , Seah Lim Peck  , Kidd Michael  , Smith Jaye
Published: February 2025

This workshop will discuss the development of Electronic Medication Records with a focus on systems being developed in Australian and Singapore. The Australian Better Medication Management System (BMMS) brings together information about medications prescribed by different doctors and dispensed by different pharmacists, to provide doctors and pharmacists with greater knowledge about medications patients are using. There are privacy, consent, legal, technological and political issues to be addressed in implementing this system. The purpose of the workshop is to promote discussion about electronic medication record systems and the challenges faced in their development and implementation, with participants drawing on similar experiences or knowledge about the use of information technology in the health arena.
Guideline for Health Informatics: Controlled Health Vocabularies - Vocabulary Structure and High-level Indicators
Authors: Elkin Peter L.  , Brown Steven H.  , Chute Christopher G.
Published: February 2025

Developers and purchasers of controlled health terminologies require valid mechanisms for comparing terminological systems. By Controlled Health Vocabularies we refer to terminologies and terminological systems designed to represent clinical data at a granularity consistent with the practice of today's healthcare delivery. Comprehensive criterion for the evaluation of such systems are lacking and the known criteria are inconsistently applied. Although there are many papers, which describe specific desirable features of a controlled health vocabulary, to date there is not a consistent guide for evaluators of terminologies to reference, which will help them compare implementations of terminological systems on an equal footing1,2This guideline serves to fill the gap between academic enumeration of desirable terminological characteristics and the practical implementation or rigorous evaluations which will yield comparable data regarding the quality of one or more controlled health vocabularies.
The Interface between Information, Terminology, and Inference Models
Authors: Rector Alan L.
Published: February 2025

The interface between information, terminology, and inference (problem solving) models is now a central issue for the development of standards and of principled information systems. There is potential overlap amongst the models, and principled means are required to choose how to allocate information items amongst them. Any given set of choices implies mutual constraints and obligations amongst the models which together form a well defined interface allowing work on each to proceed independently of the other. This paper outlines the criteria for these choices and a possible notation for recording these choices and their consequences.
The Brazilian National Health Informatics Strategy
Authors: Leão Beatriz de F.  , Bernardes Malde Maria VB.  , Levin Jacques  , Moura Lincoln  , Bandarra Ernani  , Modesto Lucia Maria  , Sousa Arnaldo Machado  , Cunha Rosani E.  , Machado Filho Manoel Renato
Published: February 2025

This paper describes the Brazilian National Strategy for the development of the national Health Informatics Infrastructure. An overall description of the use of IT in the Brazilian Health scenario is presented with emphasis on the federal initiatives by DATASUS, the informatics division of the Ministry of Health. The national health card project is discussed and the strategies to establish interoperability among systems are presented. The adopted standards and methodologies used are also discussed.
On Classification Capability of Neural Networks: A Case Study with Otoneurological Data
Authors: Juhola Martti  , Viikki Kati  , Laurikkala Jorma  , PyykkÖ Ilmari  , Kentala Erna
Published: February 2025

We investigated the capability of multilayer perceptron neural networks and Kohonen neural networks to recognize difficult otoneurological diseases from each other. We found that they are efficient methods, but the distribution of a learning set should be rather uniform. Also it is important that the number of learning cases is sufficient. If the two mentioned conditions are satisfied, these neural networks are similarly efficient as some other machine learning methods. The conditions are known in the theory of neural networks [1,2], but not often taken seriously in practice. Both networks functioned as well, excluding the case with several input variables, where the Kohonen neural networks surpassed the perceptron.
ASTI: A Guideline-based Drug-Ordering System for Primary Care
Authors: Séroussi Brigitte  , Bouaud Jacques  , Dréau Hervé  , Falcoff Hector  , Riou Christine  , Joubert Michel  , Simon Christian  , Simon Gérard  , Venot Alain
Published: February 2025

Existing computer-based ordering systems for physicians provide effective drug-centered checks but offer little assistance for optimizing the overall patient-centered treatment strategy. Evidence-based clinical practice guidelines have been developed to disseminate state-of-the-art information concerning treatment strategy but these guidelines are poorly used in routine practice. The ASTI project aims to design a guideline-based ordering system to enable general practitioners to avoid prescription errors and to improve compliance with best therapeutic practices. The “critic mode” operates as a background process and corrects the physician's prescription on the basis of automatically triggered elementary rules that account for isolated guideline recommendations. The «guided mode» directs the physician to the best treatment by browsing a comprehensive guideline knowledge base represented as a decision tree. A first prototype, applied to hypertension, is currently under development.
Document-based Approach for Guideline Implementation - XML and Related Technologies
Authors: Hoelzer Simon  , Schweiger Ralf K.  , Boettcher Hanno A.  , Dudeck Joachim
Published: February 2025

With increased emphasis on evidence-based medicine, there has been a renewed interest in clinical practice guidelines. Guidelines promise to improve the efficiency and quality of health care by reducing practice variability. However, it has been recognized that the use of these guidelines by clinicians in their daily practice is rather low. Current evidence from controlled trials indicates that guideline-based advice at the point of care is more likely to be successful at influencing clinical behavior. The objective of our project is to provide an infrastructure using XML and related technologies for retrieving and presenting guideline content in order to enhance the applicability and effectiveness of guidelines.
Application of an Intelligent Graphical Interface to Electronic Patient Records
Authors: Simkus Raymond
Published: February 2025

Physicians are under a lot of pressure to perform. The power of the computer can be used to reduce the cognitive stresses. The use of an intelligent graphical interface can tailor the information that is presented to the physician. The user can be assured that all the information is presented and that important facts are brought to the users attention. The screen displays can be made to be self organizing. This saves the user the effort of moving and resizing windows. The technology to do this has been developed and has been applied to a web browser interface. This paper describes the advantages of applying this technology to medical records databases.
Impact of an EMR on Communication between Tertiary and Primary Care Providers in a Neurology Teaching Clinic
Authors: Capp Joseph A.  , Hoch Daniel B.
Published: February 2025

One benefit of an electronic medical record (EMR) is enhanced communication. In this study the impact of an EMR on the sharing of medical information in a neurology teaching clinic is described. Methods: An observational retrospective chart-review was undertaken of 237 patient encounters selected at random for each resident in a Neurology teaching practice. The electronic and paper charts were reviewed for documentation. The availability of this documentation to the primary care physician was also determined. Results: EMR documentation by residents was 94%, and supervising staff was 60%. There was no supervisor note in 27%. Only 14% of the primary care physicians had access to the electronic or paper Neurology notes. Conclusions: the addition of an electronic medical record to traditional paper-based methods did not result in excellent communication between providers.
An Approach to Electronization of Hand-written Patient Records - Scanned Hand-Written Chart
Authors: Nagira Masami  , Tsumoto Shusaku
Published: February 2025

Electronic patient records (EPR) have been introduced in large hospitals and its usefulness has been reported. However, there are few studies on how to deal with the large amount of documents that recorded before the introduction of EPR. Also, EPR has a problem with storage of pictures handwritten by medical experts. In order to solve these problems, we developed a system electronizing patient records handwritten by using image-scanners. This system contains a high-speed scanner (Kodak — Kodak Digital Science DS3500), which can read the 60 sheets per minute. When a chart is scanned, it is stored in the server of the hospital information system (HIS) with the identification codes. Medical staff members in the hospital can refer to the scanned chart and read it on the PCs in the HIS. It takes about 5-20 seconds to acquire the scanned chart from the server; this is much faster and easier than manual lending service. Another advantage of this system is that it also achieves the storage of the non-character information such as drawings or tables on the paper chart, which plays an important role in the record of some department, such as surgery. This poster reports the experience of the usage of this system in Shimane Medical University Hospital.
Russian Telemedicine Project
Authors: Eltchiian Radik  , Mironov Sergey  , Emelin Ivan
Published: February 2025

Implementation of the Telemedicine network is discussed. Specialized medical centers of Moscow and St.-Petersburg will render Telemedicine services to a number of regional healthcare facilities. To achieve more interoperability healthcare messaging standards HL7, DICOM and medical terminology classifications SNOMED, LOINC are under question.
Mobile Access to a Cardiology Database
Authors: Vassányi István  , Mógor Emil  , Szakolczai Krisztina  , Tarna Katalin
Published: February 2025

Mobile telecommunication offers simple and fast methods for solving several medical problems. Most of the methods are based on Internet and World Wide Web applications. In this paper we demonstrate the remote access to a cardiology database, using both the Internet and WAP (Wireless Application Protocol). First, we describe the structure of the system and the database. Then we introduce the mobile interface of the system and draw conclusions.
Experimental and Theoretical Analysis of Wavelet-Based Denoising Filter for Echocardiographic Images
Authors: Kang Su Cheol  , Hong Seung Hong
Published: February 2025

One of the most significant features of diagnostic echocardiographic images is to reduce speckle noise and make better image quality. In this paper we proposed a simple and effective filter design for image denoising and contrast enhancement based on multiscale wavelet denoising method.
Quantitative Tissue Characterization in Sonograms of Thyroid Gland
Authors: Smutek Daniel  , Šára Radim  , Sucharda Petr  , Svačina Štěpán
Published: February 2025

Sonography is the basic diagnostic tool for diseases of the thyroid gland. Nonetheless, conventional sonographic findings are still qualitative. This paper shows that it is possible to obtain quantitative tissue characterization by means of automatic texture analysis and to use it in diagnostic process when discriminating between the chronic inflammation and the normal tissue. Classification success rate of 93%, evaluated on a set of 1170 B-mode sonographic images, proves that exact evaluation of sonographic findings is possible.