bluuebunny/crossref_metadata_2025 huggingface dataset:
The Development of Protocols to Cover Clinical Care in Cardiology
Authors: Duwel C.M.B.  , Kruijssen H.A.C.M.
Published: February 2025

PROCAS (PRofiles Of CAre System) is one of the Arm projects whose objectives are to improve the quality and efficieny of medical treatment. These will be realised in establishing a methodology for defining and developing what are termed “Profiles of Care”. These are sets of options for clinicians which are meant to create acceptable ways of managing patients with similar conditions and which represent good clinical practice. Moreover, a prototype system will be realised by the application of informatics and telematics, to enhance the provision of efficient and effective care in both hospitals and outpatient departments.
Protocol-Directed Shared Care in Cardiology
Authors: Pitty David  , Reeves Philip  , Rickards Anthony
Published: February 2025

In the new market-oriented UK National Health Service, hospitals succeed or fail on the quality of service they provide to their customers. It is therefore important that institutions like the Royal Brompton Hospital can meet the information and communication needs of General Practitioners and hospitals who use their services so that co-ordination between healthcare professionals involved in the cooperative care of individual patients can be ensured. One method of improving the relationship between healthcare professionals is by the use of consensus-based clinical protocols which define ‘best practice’ co-operative care for a particular condition. The Royal Brompton Hospital has been a clinical partner in the AIM project DILEMMA which has been examining technology and methodologies for applying clinical protocols supported by telematics to general practice and shared care. A detailed requirements analysis has been carried out to look at the problems of shared care in cardiology and this has resulted in a demonstration system being developed to show how protocol-directed shared care and its supporting technology could be implemented to solve real clinical problems. Conclusions have been drawn that concern the use of protocols and information technology generally in routine clinical care.
Practice guidelines and healthcare telematics: towards an alliance
Authors: Gordon Colin
Published: February 2025

This chapter reviews the motives behind the promotion, development and application of practice guidelines, defined as ‘systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances’. It surveys the state of progress and future prospects for telematics applications in this area, and reports the action points recommended by the 1994 AIM Conference. There exists significant evidence that use of guidelines can improve healthcare process and outcome, and that computerised aids assist this effect. they may also enhance the potential uses of guidelines and protocols for audit, resource management and shared care. A standard generic model for computerised representation of guidelines as knowledge bases in a common format has been proposed and may be a key factor in future progress. The development of computerised patient records of adequate scope and quality is generally recognised as an essential condition for computer-aided guideline use. Support for development, dissemination and application of healthcare guidelines and use has emerged, notably through the AIM EPISTOL study, as a feasible and useful application area of medical knowledge-based systems. It is essential that telematics developments in this field are grounded in an understanding of the healthcare practices to which guidelines are being applied, and of the changes in practice which guideline use may entail.
From Assessment to Decision-Making
Authors: Nøhr Christian
Published: February 2025

Technology assessment are intended to support decisions about future actions. These decisions are characterized by uncertainty conditions. This paper introduces a model to clarify the variable uncertainty conditions. In relation to technology assessment activities the use of the concepts efficacy and effectiveness have often been confused. The two concepts are here presented and discussed in relation to the systems theory framework: structure – processes – outcome. One method to reduce uncertainty situations from an economic viewpoint is to peiform a cost benefit/effectiveness analysis. Performing a cost benefit/effectiveness analysis can be protocolled in ten steps, and these steps are outlined. The true value of a cost benefit/effectiveness analysis lies more in the process of analysis than in the final result. There is no guarantee that benefits will be achieved and reports are often seen to be very technical. More emphasis should be put in reporting the results of cost benefit/effectiveness analysis.
Evaluation in the TELEGASTRO-Project
Authors: Ohmann C.  , De Dombal F.T.  , Winding O.
Published: February 2025

The goals of the TELEGASTRO-project are to develop a consensus view about specific areas of gastroenterology, to develop a multi-media package with this information and to distribute and evaluate the package. The evaluation procedure is monitored by an independent evaluation panel and has been specified in a detailed protocol. The evaluation covers the validation of the knowledge-base, piece by piece and as a whole, and the evaluation of the functionality and usability of the program. Evaluation achieved so far has shown clearly that the Knowledge base of the system is of high quality and accepted by clinical experts and that the usability and functionality is credited very high by different user groups. The next step is to evaluate the clinical impact.
Protocol for the Clinical Functionality Assessment of a Workstation for Stereotactic Neurosurgery
Authors: Verbeeck Rudi  , Michiels Johan  , Nuttin Bart  , Knauth Michael  , Vandermeulen Dirk  , Suetens Paul  , Marchal Guy  , Gybels Jan
Published: February 2025

This paper describes a protocol for the technical and clinical evaluation of a workstation for the planning of stereotactic neurosurgical interventions that is being developed in the framework of a joint European research project (COVIRA). Although several such workstations have been proposed before, the final and most important step, that of clinical validation, often lacked. The developers failed to rigorously prove that their product was useful.
Case Acquisition for Knowledge-Based Decision Support System Validation
Authors: Talmon Jan  , Smeets Raymond
Published: February 2025

To assess the validity of the knowledge base of a decision support system dynamically, one needs to apply the system to a number of cases. This contribution discusses issues related to the composition of the testing data base and the methods for establishing the reference against which the outcome of the decision support system has to be compared.
Tactile Feedback for Endoscopic Surgery
Authors: Fischer Harald  , Neisius Bernhard  , Trapp Rainer
Published: February 2025

The length and rigidity of the instruments used in minimally invasive surgery make it very difficult to handle these instruments with a high sense of touch. In this paper a novel system will be described which determines the distribution of pressures and the handling forces (X, Y and Z-axes) at the distal end of a laparoscopic forceps, represents it graphically on the PC screen and plotter, and generates tactile feedback to the finger tips of the surgeon. This system allows to measure the handling forces created during surgery and allows to transmit differences in tissue hardness directly to the finger tips of the surgeon.
A Virtual Environment for a Surgical Room of the Future
Authors: Kaplan Kenneth  , Hunter Ian  , Durlach Nathaniel I.  , Schodek Daniel L.  , Rattner David
Published: February 2025

This paper outlines the proposal, approved by the Advanced Research Projects Agency of the U.S. Department of Defense, to develop an innovative virtual design environment and to use this design tool to build a surgery room of the future.
Transmission of Olfactory Information for Telemedicine
Authors: Keller Paul E.  , Kouzes Richard T.  , Kangas Lars J.  , Hashem Sherif
Published: February 2025

While the inclusion of visual, aural, and tactile senses into virtual reality systems is widespread, the sense of smell has been largely ignored. We have developed a chemical vapor sensing system for the automated identification of chemical vapors (smells). Our prototype chemical vapor sensing system is composed of an array of tin-oxide vapor sensors coupled to an artificial neural network. The artificial neural network is used in the recognition of different smells and is constructed as a standard multilayer feed-forward network trained with the backpropagation algorithm. When a chemical sensor array is combined with an automated pattern identifier, it is often referred to as an electronic or artificial nose. Applications of electronic noses include monitoring food and beverage odors, automated flavor control, analyzing fuel mixtures, and quantifying individual components in gas mixtures. Our prototype electronic nose has been used to identify odors from common household chemicals. An electronic nose will potentially be a key component in an olfactory input to a telepresent virtual reality system. The identified odor would be electronically transmitted from the electronic nose at one site to an odor generation system at another site. This combination would function as a mechanism for transmitting olfactory information for telepresence. This would have direct applicability in the area of telemedicine since the sense of smell is an important sense to the physician and surgeon. In this paper, our chemical sensing system (electronic nose) is presented along with a proposed method for regenerating the transmitted olfactory information.
Interactive Fluoroscopic Controlled Anterior Cruciate Ligament Reconstruction
Authors: Klos Tiberius U.S.  , Banks Scott A.  , Cook Frank F.  , Harman Melinda K.  , Banks Ann Z.
Published: February 2025

This research provides parameters to radiographic insertion plaeces for an anterior cruciate ligament reconstruction. With this parameters fluoroscopic guiding instrumentation is capable of aiming a guide pin for cannulated drilling in to a desired position. Video object recognition software is supporting the surgeon interactively in real time during the surgery.
The Development of a Remotely Controlled Laparoscope Manipulator
Authors: Ornstein Markus H.
Published: February 2025

Before any form of remote or telepresence surgery can be considered methods must be developed for mechanical manipulation of surgical instruments. Laparobot was a prototype laparoscope manipulator which has now been replaced by EndoSista, a production model.
Emergency Medicine Internetwork
Authors: Rittger Kevin
Published: February 2025

Emergency Medicine is a fast paced highly interactive discipline at the leading edge of today's health care system. The development of a sophisticated electronic network for the Emergency Medicine community will provide greater access to patient data for research purposes, and for instantaneous nationwide communication regarding the practice and teaching of Emergency Medicine.
Human Interface Hardware for Virtual Laparoscopic Surgery
Authors: Rosenberg Louis B.
Published: February 2025

Among the most technically viable and economically feasible applications of virtual reality technology is the simulation of minimally invasive medical procedures such as Laparoscopic and Endoscopic surgery. From procedure planning to medical training, such virtual reality simulations have generated much interest from both the research and industrial communities. Although there is significant development activity in the area of virtual simulation of Laparoscopic and Endoscopic procedures, this work is often hindered when researchers find that no off-the-shelf tools satisfy the human interface requirements of virtual reality surgical simulations. The Virtual Laparoscopic lnterface™ is a new product from Immersion Corporation which provides an easy to integrate, off-the-shelf solution to the human interface requirements associated with simulating Laparoscopic and Endoscopic surgical procedures. Although only a single component of a full virtual simulation environment, this piece of hardware provides an affordable and easy to integrate solution to simulating and tracking the manual activities associated with minimally invasive medical procedures. Two commercial versions of the hardware are available. One is solely a human input device, tracking manipulations of real surgical tools mounted in a virtual patient. The hardware feeds tool position and tool orientation information to the host computer. The second is both an input and output device, tracking manipulations of the surgical tools while also providing realistic force feedback to the user through the tool handle.
MAGNOBRAIN
Authors: Anogianakis G.  , Apostolakis M.  , Harding G.F.A.  , Krotopoulou K.  , Nendidis G.  , Psaltikidou M.  , Spyrakis P.  , Terpou D.  , Tsakalidis A.
Published: February 2025

MAGNOBRAIN is an applied research project which has been designed to integrate known radiological, anatomical and electrophysiological information about the human brain for use in localization of brain activity. The main aspects of MAGNOBRAIN include a mathematical approach to source localization which makes use of a priori information about the brain, the building of the Brain DataBase (BDB) which contains a multitude of data about the brain, and the development of software tools for Magnetic Resonance Image processing and for 3D visualization. It is expected that these tools will evolve into a virtual medical environment which will allow interactive navigation through the brain, as well as easy and inexpensive access to a huge amount of medical information.
Advanced Concepts for Distributed Rehabilitation
Authors: Bullinger H.-J.  , Fröschle H.-P.  , Riedel O.  , Rössler A.
Published: February 2025

The Fraunhofer-Institute for Industrial Engineering developed a concept of distributed rehabilitation to overcome the difficulties of the introduction of Virtual Reality to Rehabilitation. The concept will be realised in three steps. Virtual Reality-work places will be implemented in large rehabilitation centres for testing and improvement. In the second step sub-centres will be integrated via network and integrated in orthopaedic, physiotherapic or medical gymnastics departments. The primary advantage of this solution is closeness to the patient. Although the maintenance and care of the system will be done centrally. Step three is to decentralise applications to be used by patients at home.
Anatomical Surfaces Based 3D/3D and 3D/2D Registration for Computer Assisted Medical Interventions
Authors: Bainville E.  , Champleboux G.  , Cinquin P.  , Dessenne V.  , Hamadeh A.  , Troccaz J.  , Lavallée S.  , Péria O.  , Sautot P.  , Szeliski R.
Published: February 2025

This paper briefly reviews techniques for registration between 3D objects. A new method is introduced in a first part, dealing for the case where non-rigid registration is required. Some typical medical applications of rigid registration are then described in a second part.
SAMMIE: Software Applied to MultiModal Images and Education
Authors: Newell John  , Schuier Franz  , Staemmler Martin  , Hübner Ursula
Published: February 2025

This project, SAMMIE, has developed software, known as Brainworks, to assist the neuroclinician in both diagnosis and teaching. The software is incorporated in a workstation to provide an integrated environment for the acquisition, storage, retrieval and display of digital images of the brain (e.g CT, MR, scanned X-rays) and their manipulation. It contains 2D and 3D atlases for use in matching with patient images, a statistical atlas, and a symbolic atlas giving considerable information about brain objects which can be added to by the user. It can incorporate time-related signals (Evoked Potential) and the spatial location of their sources. Case collections can be built up to cover particular diseases or conditions and these can include non-image patient information, even including video clips. These case collections can be used to help diagnosis or can be built up by a hypermedia tool to provide tutorial material. The whole system consists of a number of modules (tools) for performing the various functions, and these operate within a uniform environment. Thus the user finds that each tool is operated in a similar background manner, and the tools can communicate with each other through the common background, or desktop. Being modular, the software can be developed further, as required, to incorporate extended facilities. It is independent of particular hardware, and so can be used on a wide variety of computers. Brainworks has already undergone limited clinical validation, but will benefit from more.
EDUCTRA: Education and Training in Health Informatics
Authors: Hasman Arie
Published: February 2025

This paper presents the results obtained in the EDUCTRA Concerted Action (AIM project A2102). EDUCTRA, Education and Training in Health Informatics aimed to improve the knowledge of health professionals with respect to health informatics and the use of information technology. On the basis of the results of a survey, that showed that the knowledge of health professionals with respect to IT (information technology) and health informatics was rather low, it was decided to formulate guidelines for curricula in health informatics. These guidelines can be used both for designing courses for health professionals and for the education of students in health informatics. Also a first version of a program package was developed that can be used to support the courses.
PrimSIFT: An Investigation into the Future of Telematics in Primary and Community Care
Authors: Randall T.  , Frassine R.  , Boydell L.
Published: February 2025

This paper describes the aims, methods, results and conclusions of the PrimSIFT Study into the future of telematics in Primary and Community care. The Study was commissioned by A.I.M. to investigate the views of the users of telematic systems on current implementations and their future requirements. Interviews have been conducted in six member states with health care organisers, from ministry to local level; professionals and their organisations, in the primary and community health care sectors; and commercial companies supplying telematic services and information systems. In general, the professionals were interviewed in focus groups and the other people individually. The study is qualitative and the results are based on analysis of verbatim transcripts of interviews (approximately 3000 A4 sheets). The results presented include: Who wants to communicate with whom? What do they want to communicate? What are the main perceived benefits? and what are the main issues surrounding telematics?
Smart Cards, Technologies and their Application
Authors: Beyer R.
Published: February 2025

The presentation will provide an overview of a modern Smart card architecture. Technological aspects - inclusive of processors on the card and their performance - will be discussed. The infrastructure from the card itself via “acceptance devices”, networks to PCs and central hosts will be described. Security aspects, especially WHO is allowed WHAT to be read respectively write; and the fencing of individual applications on the card from one another will be covered. This includes the use of biometrics and signature recognition/validation. Future possibilities and limitations of storage media (chips and others) for Smart cards will be described. A focus item will be the addition of new applications to existing cards without having to exchange the cards. An application example is discussed.
Plans and Experiments with Health Cards in Greece
Authors: Karounou V.  , Vassilakopoulos G.
Published: February 2025

A small number of experiments with smart cards in the health care sector take place in Greece. In general, these experiments are led by various individual research institutions without co-ordination. They are mostly financed either by the European Union or by the Greek Ministry of Research and Technology and their main goal is gaining of experience. Smart card projects focused on applications in primary health care, chronic diseases care (diabetes and cancer) and telemedicine. Recently, emphasis is being placed on the emergency card. As a result there is Greek participation in the consortium CARDLINK-2 from the National Technical University of Athens, Municipality of Amaroussion and State Children Hospital of Pendeli. The Greek Health Authorities (Ministry of Health, Welfare and Social Security) have expressed considerable interest in the results of the aforementioned research efforts. A national initiative has been launched for introducing a National Health Insurance Card which initially is going to cover health insurance requirements for civil servants.
MediCard - Health Smart Card System
Authors: Webb K.H.  , Lout J.
Published: February 2025

Precis Smart Card Systems (formerly Advantage Data Systems) of Oklahoma City, Oklahoma, USA, developed the first worldng health care smart card system in the United States. The MediCard system allows a patient to carry their personal information, medical history and insurance data throughout a health care system using their personal smart card. This process expedites the medical process, reduces administrative time and costs, decreases paperwork, provides for better health care through more accurate information, reduces redundant testing and procedures, decreases harmful drug interactions, improves the provider - patient relationship and provides a private and secure information storage system. The MediCard reader systems are located at pharmacies, physician offices, hospitals, mobile emergency units and other health care facilities. The company’s advances in biometrics and EDI, to reduce fraud, provide needed solutions for insurance and governmental areas.
Administrative Uses of Patient Data Cards
Authors: Markwell D.C.
Published: February 2025

This paper is based on work done by Working Group 3 of the AIM Concerted Action EUROCARDS. The aim of this work was to help people involved in planning or implementing a health care card system to understand the main issues relating to health care administrative uses of these systems. The paper identifies the possible health care administrative functions of data cards and the data-sets required to support these functions. It also considers the key management and organisational issues related to the introduction of a health care card system for these functions. It goes on to explore the business case, risks and potential benefits of such systems. It explores the relationship between work on standards, research and development activities and practical widely implementable systems that meet identified user requirements.
Health Care Support Information System Based on Optical Cards
Authors: Hara S.
Published: February 2025

We are engaged in the development of a computerized health data storage and carrying system using an optical card. This system gets good evaluation by medical doctors, health nurses and nutritionists. As its next step, we begin to study the possibility of using health data profiles as means for the early detection of health abnormalities. However, a heterogeneous aspect of data description in medical/health field (e.g., character coding, terminology, units, data record formats, data transfer formats and so on) is the major impediment to circulate these data among the medical/health information systems. To overcome this bottleneck, a meta-syntax approach should be introduced to describe medical/health data. In this paper, data is considered as a readable document, which plays a key role to apply document processing techniques to medical/health data. SGML (Standard Generalized Markup Language) is used as the meta-syntax description language to define medical/health data structure, by which computer can parse transferred data on networks and reconstruct meaningful information for each system.
Activities in Other European Countries
Authors: Ecker Wolfgang  , De Roo R.  , Frellsen Mads  , Gomes Antonio F.  , Gutowski Richard
Published: February 2025

This paper comprises a compilation of five papers, originating from Austria, Belgium, Denmark, Portugal and the United Kingdom. It discribes the actions and measures taken for the transposition of the medical devices directives as well as the implementation of a vigilance system. It also includes aspects of the implementation of a trans-European system for data exchange in the field of medical device vigilance system.
Data Exchange in the European Pharmacovigilance
Authors: Monteagudo José L.
Published: February 2025

Recent research work on feasible solutions for electronic data exchanges in the european pharmacovigilance domain (EPhV) has facilitated a better understanding on strategic and operational factors inherent to such a class of transnational vigilance information systems. Most of the material presented here has resulted from the CARE - Pharmacovigilance Pilot project of the ENS-Telematics Programme, and from other subsequent research activities like the IDA feasibility study and the TEDIS-EuroSCape project. Attention has been paid to design principles and features of a communication scheme that must be used to support cooperative problem solving within a network of loosely connected autonomous and hetereogeneous agents. Experience confirmed two key-success factors : a) the users leading role, and b) the Pilot approach putting the focus on standardized electronic data interchange for communicating existing different local systems.
Advanced Telepresence Surgery System Development
Authors: Jensen Joel F.  , Hill John W.
Published: February 2025

SRI International is currently developing a prototype remote telepresence surgery system, for the Advanced Research Projects Agency (ARPA), that will bring life-saving surgical care to wounded soldiers in the zone of combat. Remote surgery also has potentially important applications in civilian medicine. In addition, telepresence will find wide medical use in local surgery, in endoscopic, laparoscopic, and microsurgery applications. Key elements of the telepresence technology now being developed for ARPA, including the telepresence surgeon’s workstation (TSW) and associated servo control systems, will have direct application to these areas of minimally invasive surgery. The TSW technology will also find use in surgical training, where it will provide an immersive visual and haptic interface for interaction with computer-based anatomical models. In this paper, we discuss our ongoing development of the MEDFAST telesurgery system, focusing on the TSW man-machine interface and its associated servo control electronics.
Developing a Virtual Reality–Multimedia System for Anatomy Training
Authors: Hoffman Helene M.  , Murray Margaret  , Irwin Ann E.  , McCracken Thomas
Published: February 2025

The University of California, San Diego, School of Medicine’s Learning Resources Center is developing a prototype next-generation application for anatomy education which combines virtual reality and multimedia curricular resources. The anatomy lesson utilizes polygon-based 3-D models of the hepatobiliary system created by BioGraphics Inc. of Fort Collins, Colorado which were derived from the National Library of Medicine’s Visible Human Project™ Dataset. This article describes the needs assessment, learning objectives, and preliminary design of the current prototype. The multivariate design, the development strategy for implementing functionalities, and the engineering of critical software interface components are also outlined.
Toward Virtual Teleconferencing for Telemedical Applications
Authors: Fuchs Henry
Published: February 2025

Over the last several years we have been building an augmented reality system that will allow physicians to see real time ultrasound data superimposed on a live view of their patients. We are also hopeful that the same technology can be used for a number of telemedical tasks, including training, emergency consulting and general clinical consultation. Our most recent ultrasound work has focused on breast biopsies and the aspiration of cysts in the breast. The system uses real-time video compositing to combine ultrasound volume rendering with a view of the patient, a view that is captured by two video cameras that are mounted on an HMD. This same light-weight head-mounted display presents the fused images to both eyes of the physician. Careful calibration of several tracking systems are necessary to provide an effective, stable fusion of the views. Recent trials by our physician collaborator on synthetic cysts in a mannequin indicate that we are close to having a system that will be useful to the working physician. Much of the technology that is used in this system will be directly applicable to remote telemedicine.
MRI- and CT-Scopic Microsurgery and Drug Installation for Outpatient Treatments
Authors: Grönemeyer Dietrich H.W.  , Seibel Rainer M.M.
Published: February 2025

Micro invasive MRI- and CT-scopic treatments for common diseases like back pain, disk prolapse, tumors or arterial occlusive diseases with endoscopes, lasers or micro mechanical instruments as well as drug instillations like ethanol-ablation techniques are routinely performed in our interventional center. Lasers are used for tumor ablation or hyperthermia and in combination with endoscopes for diskectomies. Percutaneous Ethanol Instillation (micro-PEI) is performed for palliative treatment of tumor pain and cancer therapy and also for therapy of low back pain-facet-joint denervations under local anesthesia. Also sympathectomies for pain of herpes zoster or osteoporosis and arterial occlusive diseases are realized with ethanol. Cortisone is high precisely instillated for chronical back pain or neuralgias.
BIOMEDICAL IMAGING: INTEGRATION OF IMAGE ENGINEERING, BIOLOGY AND MEDICINE
Authors: Coatrieux Jean-Louis  , Roux Christian
Published: February 2025

This chapter will introduce the issues of major importance in medical imaging. These elements will be examined first through the technological evolution and the clinical areas of concern. After a brief overview of medical imaging issues, the third section is devoted to image analysis going from reconstruction, segmentation, and object extraction up to object modeling (shape description and metrics derivation). These key steps, extensively developed in the other chapters of the book, raise a number of questions about our capability to detect, precisely delineate the organs and characterize the lesions from one imaging modality or multiple sources (i.e. multimodal imaging where image fusion and the accompanying registration problems have to be solved). The next section brings more insights into three topics not covered in the sequel of the book : (i) motion analysis in 2-D or 3-D image sequences; (ii) virtual reality which allows medical operations to be simulated, planned and controled, and (iii) the evolution from intermediate to high level description, a necessary step between low level and interpretation level. They suppose high technology environments and also efficient solutions to realistically view, track and act on the organs.
ITHACA: Telematics for Integrated Client Centred Care
Authors: Boydell Leslie
Published: February 2025

The ITHACA project aims to improve quality of care provided to people living in the community through integration and validation of telematic services, capable of supporting the sharing of relevant information between health and social care professionals. The project is part of the fourth framework health telematics programme of the European Commission and the demonstrator will be validated on ten pilot sites to support care of the elderly, mentally ill and maternal and child health.
Human issues in the Development of Regional (National or Provincial) Health Information Systems and Services
Authors: Neame Roderick
Published: February 2025

There is a growing recognition of the need for enterprise-wide integration of information management. Technically this is becoming much easier, with growing numbers of data sets defined and exchanged as messages to meet the various business requirements, largely independent of computing platforms, architectures or standards in use by the communicating systems. However there is still only one national health information system in operation world-wide, in New Zealand, despite efforts to move in that direction in various other countries.
Development and Implementation of a Hybrid Medical Information System
Authors: Chen X.  , Vaughan-Jones R.  , Hawthorne M.  , Kendal S.  , Potts I.  , Smith P.
Published: February 2025

The development of integrated systems has recently received a great deal of attention from the computer application community in medicine and health care. In this paper, we describe the design and implementation of a hybrid medical information system, which combines components both in traditional information system and expert system. The system construction approach and an object-oriented medical knowledge representation method are emphasised in detail. The system can support activities in hospital and the community which include, patient registration, drug management, investigations, diagnosis and clinical research.
Success Through Evaluation - PROBE
Authors: Gronlund Toto Anne
Published: February 2025

This paper reports on the development of guidance for the NHS on the evaluation of Hospital Information Systems and other Information Management and Technology investments. The PROBE (Project Review, OBjective Evaluation) guidance is a framework that considers the context, processes and outcomes of the investment, emphasising the role of evaluation as a learning - rather than audit - tool. Some of the key findings to date from hospital site evaluations of integrated information systems implementations are also reported.
Seamless Telematics Across Regions - star$\openstar$
Authors: Frandji Bruno  , Cooper Paul
Published: February 2025

The premise of star$\openstar$ is that if the medical record is region-wide then the care that is delivered to the patient will be seamless. A number of sites across Europe will soon be demonstrating heterogeneous information systems intenworking in real-time, enabling the delivery of seamless care to patients.
Towards a Knowledge Acquisition and Management System for ECG Diagnosis
Authors: Bourlas Ph.  , Sgouros N.M.  , Papakonstantinou G.  , Tsanakas P.
Published: February 2025

We propose a knowledge acquisition and management system for 12-lead electrocardiogram (ECG) diagnosis. This system uses an extended form of Quinlan's ID3 algorithm to learn rules, synthesizing decision trees by inductive inference from examples. Furthermore, the system includes a knowledge management component that continuously optimizes the knowledge base by learning new rules and merging them with the old ones. We have developed a set of ECG attributes on which the classification of the training set and the extraction of the diagnosis rules are based. An expert system for ECG diagnosis provides the initial knowledge base for this diagnosis environment.
The PEN&PAD Data Entry System
Authors: Kirby John  , Cope Neil  , De Souza Anthony  , Fowler Helen  , Gain Richard
Published: February 2025

The PEN&PAD Data Entry System (P&P DES) is a selfcontained software module for entering detailed clinical data into an existing electronic healthcare record system. Based on a “compositional’ approach, the P&P DES consists of: a user interface for selecting a clinical topic; and forms for entering additional detail on the selected topic and related topics. These user interfaces are underpinned by a GALEN style terminology server which maintains medical sense; carries out automatic classification of entered data; generates readable natural language expressions; and automatically produces Read and other codes.
Teleradiology System MEDICUS: Software Architecture and First Experiences
Authors: Engelmann Uwe  , Schröter Andre  , Baur Ulrike  , Schroeder Antje  , Werner Oliver  , Wolsiffer Kerstin  , Baur Hans-Jürgen  , Saurbier Frank  , Göransson Bengt  , Borälv Eric  , Meinzer Hans-Peter
Published: February 2025

This paper gives an introduction to the teleradiology system MEDICUS which has been developed at the Deutsches Krebsforschungszentrum (German Cancer Research Center) in Heidelberg, Germany. The system is designed to work on ISDN lines as well as in a local area network. The global software architecture is explained in the article. Special attention has been given to the design of the user interface and data security, integrity and authentication. The software has been evaluated in a field test in Germany at 15 radiology departments in university clinics, small hospitals, private practices, and research institutes. First experiences show that the system is easy to use and can save time, patient transports and reduce film costs. It is well suited for remote consultation or for sharing resources, such as expensive equipments or radiologists.
Knowledge Representation and Clinical Practice Guidelines: the DILEMMA and PRESTIGE projects
Authors: Gordon Colin  , Herbert Ian  , Johnson Peter
Published: February 2025

DILEMMA was a project within the 1991-94 EC AIM programme to develop computerised decision support in oncology, general practice and shared care, focussed on support for prescribing and the use of clinical guidelines and protocols. One of our goals in DILEMMA was to develop a generic model for representing the knowledge content of guidelines and protocols. The DILEMMA Generic Protocol and Guideline Model comprises a set of constructs and constraints which are intended to allow the operational knowledge content of any clinical guideline or protocol to be fully represented in a uniform declarative style. The use of a common model means that the same software components can be used to assist implementation of clinical guidelines in different clinical applications and user contexts. If such a model can in due course provide the basis of an international agreed standard, it promises the further, greater reward of a shared medium through which guideline authoring bodies can disseminate their information, and healthcare software vendors can make accessible to professionals in the context of their clinical practice a wide repertoire of validated clinical practice knowledge. This paper provides an introductory outline of a generic approach to representing guideline knowledge.
DBIRA: A Data Base Insulin Regimen Advisor
Authors: Gogou G.  , Ambrosiadou V.  , Goulis D.  , Maglaveras N.  , Pappas C.
Published: February 2025

Insulin regimen prescription is performed by medical personnel based on a number of patient related factors such as age, activity, type of current medication, desirable control, whether the patient belongs to a special category, for example whether he has fever or undergone surgery and other. No general rules apply, so that each expert adopts his/her own rules for insulin regimen specification based on his/her experience, intuition and expertise. This is why there is very little in medical literature concerning this issue. This paper describes a data base system supporting the decision making of medical personnel with respect to the specification of insulin regimens. The choice of the factors participating in the decision making of the system described in this paper, is based on medical literature and an extensive interviewing of a number of diabetologists in leading diabetological centres in Greece.
Decision Support of Nosocomial Infection Therapy
Authors: Bohanec Marko  , Rems Miran  , Slavec Smiljana  , Urh Božo
Published: February 2025

A prototype system for decision support of nosocomial (hospital-acquired) infection therapy is presented in the paper. The system is based on a chronologically organised database of infections and therapies. It facilitates four types of analyses related to the effectiveness of antibiotics and resistance of bacteria to antibiotics. The underlying methods construct time series of resistance vectors from the database, and present their results graphically.
Integrated System for Traditional Chinese Diagnosis and Treatment in Alternative Medicine
Authors: Alecu Simona  , Raclariu Adina  , Loghin Maria  , Ionescu-Tirgoviste Constantin  , Patrugan Victor  , Serbu Lavinia  , Necula Andrei  , Stanciu Emilia
Published: February 2025

The paper presents a system developed for the assistance of diagnosis and treatment in alternative medicine, based on traditional Chinese methods. The system, named CompAc, is a result of an interdisciplinary cooperation and is designed for the phisician, specialist in acupuncture.
A Decision Support System for Biomedical Research Evaluation
Authors: Hristovski D  , Rozic-Hristovski A  , Adamic S
Published: February 2025

The paper describes a decision support system developed for biomedical research evaluation in Slovenia. The system was first used for research project evaluation in medicine. The submitted project proposals were evaluated using various scientific indicators, generally falling into the categories of bibliometric and non-bibliometric indicators. The system is implemented as a client-server system, using Oracle 7 database management system on a Unix computer on the server side and several client programs for data entry and reporting running on MS-Windows. In addition, we developed an interface from WWW (World Wide Web) to the Oracle server to allow access to the data from Internet using any WWW browser.
An Original Method to Generate the FourieriDescriptors, Related with the Biological Signal Acquisition Through its Essential Points
Authors: Tarata Mihai
Published: February 2025

One of the important problems in biomedical engineering is the difficult task of the biological signals recognition. In order to provide a convenient description of the biological signals, useful to their classification shape, in a first step to alleviate the constraints implied by the classic equidistant acquisition of the signal i.e. large memory, long processing time, high frequency noise, high sampling rate, I have developed a specific acquisition method and an interface. Accordingly, the signal is analogically preprocessed and acquired through its essential points (zero crossings and turning points), the result being an approximation of the signal, namely the polygonal line thus defined. It has been proved that the error induced by such an approximation stays in acceptable limits, so the method is consistent, and results in a much less amount of data, thus simplifying and accelerating the further processing. In a second step, I developed a new method to compute a set of Fourier descriptors (FD) for signals acquired through their essential points, which prove valuable in describing and selecting the signals on their shape, providing in the same time the advantage of an easier processing. The paper deals with these topics, pointing in the same time to an effective application which validated the method.
X-Ray Computed Transaxial Micro Tomography in Dental Research
Authors: Thuesen Gøsta  , Bjørndal Lars  , Darvann Tron
Published: February 2025

A digital x-ray imaging system consisting of microfocus x-ray apparatus, image intensifier, framegrabber, and PC has been extended to work as a computerised transaxial microtomograph by adding an object turntable and some acquisition and reconstruction software. The microtomograph has been applied to the examination of extracted teeth for improvement of the understanding of caries progression in 3D.
Medical Data Warehouse, an Investment for Better Medical Care
Authors: Niinimäki J  , Selén G  , Kailajärvi M  , Grönroos P  , Irjala K  , Forsström JJ
Published: February 2025

The concept of data warehouse has been utilised for decision support in business world for some years. Medical care has similar demands as business companies, since the quality of care is a central criterion for hospital efficiency. Information collected in hospitals is often scattered and cannot be efficiently used to improve the quality of care. A data warehouse, which is a central database separated from operational databases, was used to investigate how frequently drugs that may have affected the result of a common laboratory test were prescribed. Similarly, data warehouse was used to survey the frequency and types of potential drug interactions in hospital. Medical data warehouse comprising laboratory results, patient medications, diagnoses and medical procedures facilitates clinical research and consequently improves the quality of medical care.
A Study of Behavioural Instability in Visual Function Self-Testing
Authors: Liu Xiaohui  , Cheng Gongxian  , Wu John
Published: February 2025

Ever since the inception of the cathode-ray-tube (CRT) display industry, the race has begun among psychophysical researchers to apply the CRT as a stimulus display device for visual function testing. One important and challenging research issue in this field has always been to manage human behavioural instability during the testing, especially in a self-testing environment. Learning effects, inattention and fatigue are among the most common behavioural factors which lead to measurement noise in the test data. In this paper we describe a systematic way of dealing with these behavioural factors in METRO, a project set up to establish an inexpensive, reliable and user-friendly visual function test which can be customised to the needs of individual subjects and can be easily used for self-testing on portable PCs or the Internet.
Medical Emergency Aid through Telematics (MERMAID)
Authors: Anogianakis G.  , Maglavera S.  , Harding GFA
Published: February 2025

Council Directives 92/29 and 93/103 establish the “use of long distance medical consultation” for the protection of the safety and health of maritime workers and distant or isolated populations of the EU. In response to these needs, MERMAID will set up an integrated 24-hour multilingual, telematic, around-theworld, medical emergency service that will transfer medical expertise via satellite and ground based ISDN networks when and where necessary. Since, (a) voice medical teleconsultation is obsolete, (b) videotele-phony has introduced “face-toface” medical teleconsultation and remote visual inspection and (c) telemedical interventions, (which are critically dependent on local paramedic skills), can now receive multimedia support on medical procedure, MERMAID will develop: (1) A locally $\underline(resident \ multimedia \ medical \ guide \ for \ ships)$ to serve both for training and as a reference during emergencies. (2) $\underline(A \ system \ of \ INMARSAT-A \ (ship \ to \ shore) \ links)$ (for transfering images, sounds, text / patient anamnesis and signals), $\underline(which \ is \ feeding \ into \ an \ ISDN \ network \ that links \ together \ the \ MERMAID \ health \ service \ providers)$. (3) $\underline(The \ telematic \ means \ for \ the \ medical \ teleconsultant \ to \ remotely \ interact \ with \ the \ local \ multimedia \ medical \ guide)$ and efficiently demonstrate health care procedures to local paramedics. Requests for help, broadcast over MERMAID INMARSAT-A links will be routed to one or more specialists depending on type of help needed, language(s) required for efficient communication, proximity to the site of emergency etc. Thus MERMAID, relying on telepresence and combining locally stored multimedia reference material with remote consultation, it proposes a viable solution to the problem of missing medical expertise for isolated populations. It is significant that the MERMAID pilot users represent 1% of the world merchant marine, a size that guarantees the validity of its outcome and is a good start for disseminating the MERMAID results.
A Hypermedia Computer-Aided Learning System for Bronchoscopy
Authors: Colman A  , Richards B  , Lewis R
Published: February 2025

Bronchoscopy is a medical procedure in which a flexible fibre-optic endoscope is used to explore the bronchial passages and it is a major tool in the diagnosis and management of respiratory disease. This paper describes an interactive Microsoft Windows-based program for teaching normal bronchial anatomy and common bronchial pathology using high quality still photos and digital video.