bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of Digital Sound in Health
Authors: Labrada Luis  , Pereira Samáris Ramiro  , Bandiera-Paiva Paulo
Published: February 2025

With the advent of computing and micro computing, several applications based on Digital Sound have emerged around the world. Much analog equipment and electronics have gained new functions due to evolution and the low cost of microprocessors and integrated circuits. The rapidly expanding user community of such equipment allowed the advancement of research and development of numerous applications in which the Digital Sound participates actively, including, tests, treatments and therapies. In addition to solutions for use in laboratories, clinics and hospitals, there emerged devices for domestic use and handling, enabling faster dissemination and exploitation of advances, and providing the necessary feedback in the evolution of technologies applied. The massive use of Digital Sound encouraged research involving frequency bands used widely in health equipment (infrasounds and ultrasounds). Through the methodology of literature review, this paper seeks to explain the evolution of different applications of Digital Sound in Health, as well as indicate future research.
Annotation for Information Extraction from Mammography Reports
Authors: Bozkurt Selen  , Gulkesen Kemal Hakan  , Rubin Daniel
Published: February 2025

Inter and intra-observer variability in mammographic interpretation is a challenging problem, and decision support systems (DSS) may be helpful to reduce variation in practice. Since radiology reports are created as unstructured text reports, Natural language processing (NLP) techniques are needed to extract structured information from reports in order to provide the inputs to DSS. Before creating NLP systems, producing high quality annotated data set is essential. The goal of this project is to develop an annotation schema to guide the information extraction tasks needed from free-text mammography reports.
QALYs: incorporating the rate of change in quality of life
Authors: Katostaras Theofanis  , Katostara Niki
Published: February 2025

The need for comparisons and economic evaluations between various health care interventions requires the evaluation of health-related quality of life. To ensure comparability in terms of the duration of any given condition, measures of quality have to integrate the parameter of time, as is the case in measures like QALY. Usually, the rate of change of quality that results from a given intervention is not incorporated in these measures, resulting in a systematically erroneous estimation of QALYs. This estimation error may lead to either a lower QALYs' value compared to the true one, when quality of life improves with a decreasing rate or deteriorates with an increasing rate, or to a higher QALYs' value compared to the true one, when quality of life improves with an increasing rate or deteriorates with a decreasing rate. The proposed method for the estimation of QALYs takes into account the rate of change in health-related quality of life at all stages and discloses deviations up to 16.67% from currently used methods.
Telemedicine Systems In Organ Transplantation: A Feasibility And Reliability Study Of The Integrated Teleradiological and Tele-Pathological Evaluation Of Pancreas Graft
Authors: Mammas Constantinos S.  , Lazaris Andreas  , Geropoulos Spyros  , Saatsakis George  , Lemonidou Chryssa  , Patsouris Eustratios
Published: February 2025

Aim: To determine feasibility and reliability of the integrated Tele-Radiological (TRE) and Tele-Pathological (TPE) evaluation of the Pancreas Graft (PG) on Telemedicine Systems (TS). Material and Methods: A sensitivity-specificity analysis by a simulation of the TRE of PG on 15 MR abdominal images by a radiologist and of the TPE of PG by 26 specialists based on 130 human PG images assessing damages and lesions. Results: The integrated analysis of TRE and TPE of PG showed: Sensitivity= 93.3%, Specificity=100% and Accuracy=95.1%. Conclusion: The TRE integrated with the TPE of PG is feasible and reliable for PG transplant decision support and planning.
Reuse of Routinely Collected Health Data for Clinical Research: Considerations in a Central England Case Study
Authors: Lim Choi Keung Sarah N.  , Zhao Lei  , Rossiter James  , Langford Gavin  , Taweel Adel  , Delaney Brendan C.  , Peterson Kevin A.  , Speedie Stuart M.  , Hobbs F.D. Richard  , Arvanitis Theodoros N.
Published: February 2025

An increasing amount of electronic health data is being collected for patient care, and with it the opportunity to explore reusing this data, for example to support clinical research. We explore how researchers can be supported in identifying potential study participants using a semi-automated approach to query anonymised datasets remotely. This paper describes the socio-technical considerations when answering this question in a central England case study.
Informal education of medical doctors on the Internet
Authors: Schmidt Thomas
Published: February 2025

Physicians achieve parts of their knowledge informally on the Internet. In a first study we analyzed the quality of online content of prenatal screening and diagnosis on elements like Wikipedia, Twitter or YouTube. Furthermore, own content was published on blogs, forums and static pages, and visitor's data was measured. The second study consists of three surveys among physicians: Doctors use public pages like blogs or Wikipedia rather than professional or scientific communities and talk about patients via mailing lists or direct messages.
Evaluating Virtual Reality Mood Induction Procedures with Portable EEG Devices
Authors: Rodríguez Alejandro  , Rey Beatriz  , Alcañiz Mariano
Published: February 2025

Virtual Environments (VEs) have been used as mood induction procedures. In this context, it is necessary to have instruments to analyze the emotional state during VE exposure. Objective techniques such as EEG should be evaluated for this purpose. The aim in this work was to study the changes in the brain activity with a portable EEG device during a negative mood induction based on a VE. A virtual park was used to induce a negative mood (sadness) in ten participants. Changes in the brain activity of subjects were compared between two moments (before and after emotional induction). Obtained results were in accordance with previous scientific literature regarding frontal EEG asymmetry, which supports the possibility of using the portable EEG as a reliable instrument to measure emotions in VE.
Estimation of Usefulness of Positron Emission Tomography (PET) in the Diagnosis of Post-Traumatic Stress Disorders – Preliminary Report
Authors: Wojtłowska-Wiechetek D.  , Tworus R.  , Dziuk M.  , Petrovic A.  , Szymańska S.  , Zbyszewski M.  , Ilnicki S.  , Krzesiński P.
Published: February 2025

The aim of this study was to evaluate the possibility of using PET both in assessing the susceptibility to stress and in the diagnosis of post-traumatic stress disorders.
Validation of a Low-Cost EEG Device for Mood Induction Studies
Authors: Rodríguez Alejandro  , Rey Beatriz  , Alcañiz Mariano
Published: February 2025

New electroencephalography (EEG) devices, more portable and cheaper, are appearing on the market. Studying the reliability of these EEG devices for emotional studies would be interesting, as these devices could be more economical and compatible with Virtual Reality (VR) settings. Therefore, the aim in this work was to validate a low-cost EEG device (Emotiv Epoc) to monitor brain activity during a positive emotional induction procedure. Emotional pictures (IAPS) were used to induce a positive mood in sixteen participants. Changes in the brain activity of subjects were compared between positive induction and neutral conditions. Obtained results were in accordance with previous scientific literature regarding frontal EEG asymmetry, which supports the possibility of using this low-cost EEG device in future mood induction studies combined with VR.
Usability of Implementing a Tablet-Based Decision Support and Integrated Record- Keeping (DESIRE) Tool in the Nurse Management of Hypertension in Rural Kenya
Authors: Blank Evan  , Tuikong Nelly  , Misoi Lawrence  , Kamano Jemima  , Hutchinson Claire  , Kimaiyo Sylvester  , Fustera Valentin  , Were Martin  , Vedanthan Rajesh
Published: February 2025

In sub-Saharan Africa (SSA), cardiovascular disease (CVD) is the leading cause of death among individuals over the age of 30. Hypertension, a major risk factor for CVD, contributes significantly to the CVD burden in SSA. In order to address the human resource challenge of managing hypertension in low- and middle-income countries (LMICs), task-shifting hypertension care from physicians to nurses has been proposed. To support this task-shifting strategy, the Academic Partnership Providing Access to Healthcare (AMPATH) has developed an Android tablet-based electronic Decision Support and Integrated Record-Keeping (DESIRE) tool to record patient data and assist with clinical decision-making. We investigated the usability of the DESIRE tool in the setting of nurse management of hypertension in rural western Kenya through the use of “mock patient” encounters and “think aloud” exercises. Fiftyseven critical incidents were identified and twenty-three design changes were suggested. Optimization of the tool has the potential to broadly impact treatment of non-communicable diseases in LMICs by providing a model of electronic decision-support in task shifting.
A Study of User Requests Regarding the Fully Electronic Health Record System at Seoul National University Bundang Hospital
Authors: Yoo Sooyoung  , Kim Seok  , Lee Kee-Hyuck  , Baek Rong-Min  , Hwang Hee
Published: February 2025

Although the adoption rates for Electronic Health Records (EHRs) are growing, significant opportunities for further advances in EHR system design remain. The goal of this study was to identify issues that should be considered in the design process for the successful development of future systems by analyzing end users' service requests gathered during a recent three-year period after a comprehensive EHR system was implemented at Seoul National University's Bundang Hospital (SNUBH) in South Korea. Data on service requests from end users of the EHR system made from 2008 through 2010 were analyzed and categorized. From our study, we found that the EHR system has evolved to optimize ease of use and special functionalities for particular groups of users and particular subspecialties.
Building Electronic Forms for Elderly Program: Integrated Care Model for High Risk Elders in Hong Kong
Authors: Yiu Rex  , Fung Vicky  , Szeto Karen  , Hung Veronica  , Siu Ricky  , Lam Johnny  , Lai Daniel  , Maw Christina  , Cheung Adah  , Shea Raman  , Choy Anna
Published: February 2025

In Hong Kong, elderly patients discharged from hospital are at high risk of unplanned readmission. The Integrated Care Model (ICM) program is introduced to provide continuous and coordinated care for high risk elders from hospital to community to prevent unplanned readmission.
Evaluation of an Electrocardiogram on QR code
Authors: Nakayama Masaharu  , Shimokawa Hiroaki
Published: February 2025

An electrocardiogram (ECG) is an indispensable tool to diagnose cardiac diseases, such as ischemic heart disease, myocarditis, arrhythmia, and cardiomyopathy. Since ECG patterns vary depend on patient status, it is also used to monitor patients during treatment and comparison with ECGs with previous results is important for accurate diagnosis. However, the comparison requires connection to ECG data server in a hospital and the availability of data connection among hospitals is limited. To improve the portability and availability of ECG data regardless of server connection, we here introduce conversion of ECG data into 2D barcodes as text data and decode of the QR code for drawing ECG with Google Chart API. Fourteen cardiologists and six general physicians evaluated the system using iPhone and iPad. Overall, they were satisfied with the system in usability and accuracy of decoded ECG compared to the original ECG. This new coding system may be useful in utilizing ECG data irrespective of server connections.
Development of the Electronic Patient Record System based on Problem Oriented System
Authors: Uto Yumiko  , Iwaanakuchi Takashi  , Muranaga Fuminori  , Kumamoto Ichiro
Published: February 2025

In Japan, POS (problem oriented system) is recommended in the clinical guideline. Therefore, the records are mainly made by SOAP. We developed a system mainly with a function which enabled our staff members of all kinds of professions including doctors to enter the patients' clinical information as an identical record, regardless if they were outpatients or inpatients, and to observe the contents chronologically. This electric patient record system is called “e-kanja recording system”. On this system, all staff members in the medical team can now share the same information. Moreover, the contents can be reviewed by colleagues; the quality of records has been improved as it is evaluated by the others.
Personal Health Records are Designed for People Like Us
Authors: Showell Chris  , Turner Paul
Published: February 2025

Current approaches to designing, implementing and evaluating personal health record systems reflect the attributes and assumptions of well-educated and well to-do users (People like Us: PLUs) rather than the needs of the most disadvantaged in society (the disempowered, disengaged and disconnected: DDDs). These electronic systems for increasing accessibility to personal health information may accentuate rather than mitigate the emerging eHealth divide. Using a PubMed review of literature on personal health record systems, we identified only seven of 73 papers, and one of 29 abstracts which made specific mention of users who were disadvantaged by low literacy levels or difficulties with access to technology. This work is part of a larger study into personal health records and disadvantage.
Empirical Analysis of Knowledge Bases to Support Structured Output in the Arden Syntax
Authors: Jenders Robert A.
Published: February 2025

Background: Structured output has been suggested for the Arden Syntax to facilitate interoperability.
An Efficacy Driven Approach for Medication Recommendation in Type 2 Diabetes Treatment Using Data Mining Techniques
Authors: Liu Haifeng  , Xie Guotong  , Mei Jing  , Shen Weijia  , Sun Wen  , Li Xiang
Published: February 2025

We demonstrate how data mining techniques can help recommend effective medications when physicians need to control the glucose level of patients with type 2 diabetes. We first identify the factors that may affect physicians' medication decisions and then develop a patient-similarity based approach to automatically recommend medications for a patient with the specific condition so that his blood glucose level (measured by HbA1C value) can be well controlled. The approach is validated through experiments on real data sets and compared with the recommendations by following a clinical guideline.
Development and Maintenance of a Controlled Vocabulary Via an Electronic Collaborative Platform
Authors: Wong Austen  , Lau Maggie  , Fung Vicky  , Ho Eric  , Szeto Karen  , Chan Ellen
Published: February 2025

The development of electronic health records and clinical information systems has been progressing at a quickened pace in recent years. With such change, the use of standard vocabulary has aroused much interest. However, classification code sets are developed for their distinctive purposes, no single vocabulary set could satisfy the needs of all specialties; moreover, local customization would be inevitable. This poster describes how a controlled vocabulary with contribution from frontline clinicians was set up in Hong Kong Hospital Authority (HA). The adoption of an electronic maintenance portal with collaboration of representatives from all institutions would also be discussed. The use of such table has helped to maintain the interoperability of captured data between departments, specialties and institutions.
Experience Implementing Electronic Health Records in the Antenatal Clinic of a Teaching and Referral Hospital in Kenya
Authors: Chemwolo Benjamin  , Caloia David  , Wools-Kaloustian Kara  , Sidle John  , Spitzer Rachel F.  , Were Martin  , Bell April  , Tierney William M.
Published: February 2025

Introduction: Electronic health records (EHRs) are receiving a lot of attention for their potential to improve care.
Evaluation of a Web-based Educational Program for Women Diagnosed with Breast Cancer: Why is the Intervention Effect Absent?
Authors: Ventura Filipa  , Sawatzky Richard  , Öhlén Joakim  , Karlsson Per  , Koinberg Ingalill
Published: February 2025

To provide accurate and tailored information to women diagnosed with breast cancer a web-based educational program was developed and tested in a randomized controlled trial for impact on health self-efficacy, healthcare participation, and anxiety and depression levels. Multilevel modelling with an intention-to-treat analysis revealed no treatment effect on the above-mentioned outcomes. Reasons for the non-identified effect are discussed and raise methodological questions concerning e-health supportive interventions for further research.
3D Visualization Environment for Analysis of Telehealth Indicators in Public Health
Authors: Filho Amadeu S. Campos  , Novaes Magdala A.  , Gomes Alex S.
Published: February 2025

With the growth of telehealth applications and the need for public health managers to have tools that facilitate visualization of indicators produced by telehealth services arose the need to have simple systems to better planning the interventions. Furthermore, Health systems are considers difficult in order to visualize the right information by many health professionals [1] because of the complexity of its Graphical User Interface (GUI) and the high cognitive load needed to handle it. To overcome this problem, we have proposed a 3D environment for the analysis of telehealth indicators in public health by managers of public health sites. Users who will use the environment are part of public health manager of family health sites that participate of Network of Telehealth Centers of Pernambuco (RedeNUTES) [2] that is part of Brazil telehealth program. This paper aims to present a 3D environment for analysis of telehealth indicators by public health manager.
Development of Best Practice Principles for Simplifying Eligibility Criteria
Authors: Doods Justin  , Holzapfel Kirstin  , Dugas Martin  , Fritz Fleur
Published: February 2025

Real world data is crucial for clinical research. In hospitals this information is more and more stored in electronic health records (EHR) and could be used for clinical trial feasibility and patient recruitment. On the other side eligibility criteria within study protocols are complex and usually not written in a way that is intuitively understandable or electronically usable. As part of overcoming the gap between eligibility criteria and the data that is available in EHRs we simplified eligibility criteria and created a guideline with best practice principles. The guideline explains how understandable criteria should be formulated and illustrates with examples what ‘good’ and ‘bad’ criteria are.
Health Management System with Smart TV Using Zero-configuration
Authors: Bae Sungchul  , Kim Il Kon  , Yi Byoung-kee  , Lee Do-Youn
Published: February 2025

The health services using mobile devices are available in the world. But mobile services with mobile devices still have Zero configuration problem. If the problem is solved, various services are available. Smart TV has input problem. The service using Smart TV is not yet activated. So In this Study, we propose new health management service using Smart TV using Zero-configuration.
Recommendations for Collecting and Processing Accelerometry Data in Elderly People
Authors: Ortlieb Sandra  , Gorzelniak Lukas  , Dias André  , Schulz Holger  , Horsch Alexander
Published: February 2025

Due to the large variety of methods for collecting and analyzing accelerometer data to assess physical activity, it is difficult to compare results from different studies. Therefore, this work aims to provide recommendations for the collection and processing of such data in older people, focusing on the assessment of wearing time and intensity levels.
Human Factors Considerations for Contraindication Alerts
Authors: van der Sijs Heleen  , Baboe Imtiaaz  , Phansalkar Shobha
Published: February 2025

Alert fatigue is a ubiquitous problem in clinical decision support systems. Several remedies to alert fatigue have been proposed including improving the specificity of alerts and compliance with human factors principles. Human factors principles that are relevant for drug safety alerting have been identified and operationalized for drug-drug interactions (DDIs), resulting in a previously developed and validated quantitative instrument. Such an instrument is lacking for contraindications. This study describes the operationalization of human factors principles for contraindication alerting. Thirty items associated with 10 human factors principles are included in the instrument: 4 items are new, 5 are similar, and 21 are equal to the DDI-instrument. The instrument was further operationalized to a test protocol. Three independent persons used the test protocol. Inter-rater reliability indicated moderate agreement (κ=0.540) It is feasible to test the implementation of human factors in contraindication alert design with the newly developed instrument.
An Ontological Approach for the Exploitation of Clinical Data
Authors: Assélé Kama Ariane  , Choquet Rémy  , Mels Giovanni  , Daniel Christel  , Charlet Jean  , Jaulent Marie-Christine
Published: February 2025

Clinical data captured in hospital information systems may be unusable in their original format due to missing information or knowledge. The use of external resources (e.g. domain ontology) could be a way of dealing with this lack of knowledge. Our study thus aimed to develop a framework allowing a user to perform medical queries in the context of infectious diseases. By creating an interaction between a knowledge source and clinical data, using semantic and semantic web tools and methods, the users are able to perform queries on a database to obtain results about antibiotic resistance. This work has been performed in the context of the DebugIT European project that aims to control and monitor the antibioresistance growth via a semantic interoperability platform. The results obtained by the use of different semantic web tools were quantitatively evaluated by comparison of the number of results and the query execution time. We have compared our approach with classic business intelligence approaches in terms of usability and functionality.
Ensuring the Security and Availability of a Hospital Wireless LAN System
Authors: Hanada Eisuke  , Kudou Takato  , Tsumoto Shusaku
Published: February 2025

Wireless technologies as part of the data communication infrastructure of modern hospitals are being rapidly introduced. Even though there are concerns about problems associated with wireless communication security, the demand is remarkably large. Herein we discuss security countermeasures that must be taken and issues concerning availability that must be considered to ensure safe hospital/business use of wireless LAN systems, referring to the procedures introduced at a university hospital. Security countermeasures differ according to their purpose, such as preventing illegal use or ensuring availability, both of which are discussed. The main focus of the availability discussion is on signal reach, electromagnetic noise elimination, and maintaining power supply to the network apparatus. It is our hope that this information will assist others in their efforts to ensure safe implementation of wireless LAN systems, especially in hospitals where they have the potential to greatly improve information sharing and patient safety.
Steps to Consider for Effective Decision Making when Selecting and Prioritizing eHealth Services
Authors: Vimarlund Vivian  , Davoody Nadia  , Koch Sabine
Published: February 2025

Making the best choice for an organization when selecting IT applications or eHealth services is not always easy as there are a lot of parameters to take into account. The aim of this paper is to explore some steps to support effective decision making when selecting and prioritizing eHealth services prior to implementation and/or procurement. The steps presented in this paper were identified by interviewing nine key stakeholders at Stockholm County Council. They are supposed to work as a guide for decision making and aim to identify objectives and expected effects, technical, organizational, and economic requirements, and opportunities important to consider before decisions are taken. The steps and their respective issues and variables are concretized in a number of templates to be filled in by decision makers when selecting and prioritizing eHealth services.
e-Labs and the Stock of Health Method for Simulating Health Policies
Authors: Couch Philip  , O'Flaherty Martin  , Sperrin Matthew  , Green Benjamin  , Balatsoukas Panagiotis  , Lloyd Stephen  , McGrath James  , Soiland-Reyes Claudia  , Ainsworth John  , Capewell Simon  , Buchan Iain
Published: February 2025

Regional outcomes of national health policies are difficult to forecast. This is partly due to a lack of realistically complex models that can be used to appraise policy options and partly a lack of accessible and adaptable tools that can be used to simulate the consequences of policy decisions. These barriers might be overcome by exploiting the commoditization of massively parallel computing architectures, advances in machine learning, and the increased availability of large-scale linked healthcare data. This paper presents a novel modelling methodology, The Stock of Health, for harnessing emerging data and computational resources to simulate health policy, with application initially to coronary heart disease. We detail the use of multi-core graphical processing architectures to facilitate a micro-simulation approach. The simulation tools have been deployed through the IMPACT Framework. We explore how this framework can be extended to support the sharing and reuse of policy models and simulations based on the digital publishing concept of e-Lab.
Comparing Approaches to Measuring the Adoption and Usability of Electronic Health Records: Lessons Learned from Canada, Denmark and Finland
Authors: Kushniruk Andre  , Kaipio Johanna  , Nieminen Marko  , Nøhr Christian  , Borycki Elizabeth
Published: February 2025

Internationally, the adoption of health information technology is increasing. However, a number of issues have complicated the adoption of electronic health records (EHRs). In addition to adoption issues, it is becoming increasingly recognized that healthcare providers face a variety of usability issues. In this paper, we consider approaches that have been taken to assess both adoption and usability of EHRs in Canada, Denmark and Finland. Although all three countries deploy surveys to assess adoption, the approach and focus of the surveys differs across the countries. In Denmark and Finland, these surveys are dedicated to assessing information technology (IT) usage; while in Canada, questions about IT usage are part of a larger physician survey. Regarding usability, approaches vary considerably. In Finland, the approach includes a national survey about EHR usability. In Canada, ratings of system usability are reported regionally on web sites; while in Denmark, regional study results are reported based on evaluation of commercial products. This paper highlights the need to consider different evaluation approaches internationally.
Patient-tailored Workflow Patterns from Clinical Practice Guidelines Recommendations
Authors: Sacchi Lucia  , Fux Adi  , Napolitano Carlo  , Panzarasa Silvia  , Peleg Mor  , Quaglini Silvana  , Shalom Erez  , Soffer Pnina  , Tormene Paolo
Published: February 2025

MobiGuide is a project devoted to the development of a patient-centric decision support system based on computerized clinical guidelines for chronic illnesses including Atrial Fibrillation (AF). In this paper we describe the process of (1) identifying guideline recommendations that will require patients to take actions (e.g., take measurement, take drug), thus impacting patients' daily-life behavior, (2) eliciting from the medical experts the corresponding set of personalized operationalized advices that are not explicitly written in the guideline (patient-tailored workflow patterns) and (3) delivering this advice to patients. The analysis of the AF guideline has resulted in four types of patient-tailored workflow patterns: therapy-related advisors, measurements advisors, suggestions for dealing with interventions that may require modulating patient therapy, and personalized packages for close monitoring of patients. We will show how these patterns can be generated using information stored in a patient health record that embeds clinical data and data about the patient's personal context and preferences.
Integrated System to Automatize Information Collecting for the Primary Health Care at Home
Authors: Oliveira Edson N.  , Cainelli Jean  , Pinto Maria Eugênia B.  , Cazella Silvio C.  , Dahmer Alessandra
Published: February 2025

Data collected in a consistent manner is the basis for any decision making. This article presents a system that automates data collection by community-based health workers during their visits to the residences of users of the Brazilian Health Care System (Sistema Único de Saúde – SUS) The automated process will reduce the possibility of mistakes in the transcription of visit information and make information readily available to the Ministry of Health. Furthermore, the analysis of the information provided via this system can be useful in the implementation of health campaigns and in the control of outbreaks of epidemiological diseases.
Sociotechnical Evaluation of the Safety and Effectiveness of Point-of-Care Mobile Computing Devices: A Case Study Conducted in India
Authors: Sittig Dean F.  , Kahol Kanav  , Singh Hardeep
Published: February 2025

The potential for health information technology (IT) to enhance quality of care is limited by unanticipated problems following adoption of new systems and technologies. Proactive assessment of system vulnerabilities can help improve existing systems and ease implementation of new innovations. We applied a comprehensive socio-technical model of safe and effective health IT use to the formative evaluation of a novel tablet-based device designed to support primary care practice in rural India. Based on our conceptual model, we developed an assessment guide for the tablet system that was informed by literature review, interviews, and observations of health workers and supervisors. Our assessment revealed and addressed both technical (functionality, content, usability, user interface) and non-technical (workflow, processes and policies etc.)areas of improvement.
Evaluation of a Computerized Tool allowing Retrospective Detection of Potential Vitamin K Antagonist Overdoses in Complex Contexts
Authors: Ferret Laurie  , Luyckx Michel  , Merlin Béatrice  , Ficheur Grégoire  , Chazard Emmanuel  , Beuscart Régis
Published: February 2025

Management of vitamin K antagonists (VKA) is difficult, and overdoses can have dramatic hemorrhagic consequences. These works form part of a European computerized medical data processing project, which aims to develop IT tools for describing adverse drug events (ADEs).
Machine vs. Human Translation of SNOMED CT Terms
Authors: Schulz Stefan  , Bernhardt-Melischnig Johannes  , Kreuzthaler Markus  , Daumke Philipp  , Boeker Martin
Published: February 2025

Objective: In the context of past and current SNOMED CT translation projects we compare three kinds of SNOMED CT translations from English to German by: (t1) professional medical translators; (t2) a free Web-based machine translation service; (t3) medical students.
Applying Multiple Methods to Assess the Readability of a Large Corpus of Medical Documents
Authors: Wu Danny T.Y.  , Hanauer David A.  , Mei Qiaozhu  , Clark Patricia M.  , An Lawrence C.  , Lei Jianbo  , Proulx Joshua  , Zeng-Treitler Qing  , Zheng Kai
Published: February 2025

Medical documents provided to patients at the end of an episode of care, such as discharge summaries and referral letters, serve as an important vehicle to convey critical information to patients and families. Increasingly, healthcare institutions are also experimenting with granting patients direct electronic access to other types of clinical narratives that are not typically shared unless explicitly requested, such as progress notes. While these efforts have great potential to improve information transparency, their value can be severely diminished if patients are unable to read and thus unable to properly interpret the medical documents shared to them. In this study, we approached the problem by contrasting the ‘readability’ of two types of medical documents: referral letters vs. other genres of narrative clinician notes not explicitly intended for direct viewing by patients. To establish a baseline for comparison, we also computed readability scores of MedlinePlus articles – exemplars of fine patient education materials carefully crafted for lay audiences. We quantified document readability using four different measures. Differences in the results obtained through these measures are also discussed.
An Examination of Electronic Health Information Privacy in Older Adults
Authors: Le Thai  , Thompson Hilaire  , Demiris George
Published: February 2025

Older adults are the quickest growing demographic group and are key consumers of health services. As the United States health system transitions to electronic health records, it is important to understand older adult perceptions of privacy and security. We performed a secondary analysis of the Health Information National Trends Survey (2012, Cycle 1), to examine differences in perceptions of electronic health information privacy between older adults and the general population. We found differences in the level of importance placed on access to electronic health information (older adults placed greater emphasis on provider as opposed to personal access) and tendency to withhold information out of concerns for privacy and security (older adults were less likely to withhold information). We provide recommendations to alleviate some of these privacy concerns. This may facilitate greater use of electronic health communication between patient and provider, while promoting shared decision making.
A Guideline-Derived Model to Facilitate the Implementation of Test-Ordering Rules within a Hospital Information System
Authors: Yasini Mobin  , Duclos Catherine  , Venot Alain  , Lepage Eric  , Lamy Jean-Baptiste
Published: February 2025

The culture of evidence-based practice includes also the field of laboratory medicine. Clinical laboratory expenditure is growing rapidly for various reasons including increased utilization. Delivering decision support to requesters at the point of care is one of the main incentives for implementing laboratory guidelines. Laboratory guidelines were analyzed to extract test-ordering rules. Each rule was explicated in at least one clinical situation with triggers that launch the execution of the implemented rule. The Unified Modeling Language was used to represent the categories of information elements found in the guidelines and underline the information elements that need to be structured and coded in the EHR. These information elements are related to conditions including clinical conditions, habits, family history, demographic information, medical treatments, laboratory tests, and non-laboratory test procedures. Timestamping of each event is also important for implementing laboratory prescription rules. A linkage between the conditions of this model and HL7 RIM was feasible. Use of this model facilitates the implementation of evidence-based test-ordering rules and clarifies the EHR requirements for successful implementation of guidelines.
An Efficient Pancreatic Cyst Identification Methodology Using Natural Language Processing
Authors: Mehrabi Saeed  , Schmidt C. Max  , Waters Joshua A.  , Beesley Chris  , Krishnan Anand  , Kesterson Joe  , Dexter Paul  , Al-Haddad Mohammed A.  , Tierney William M.  , Palakal Mathew
Published: February 2025

Pancreatic cancer is one of the deadliest cancers, mostly diagnosed at late stages. Patients with pancreatic cysts are at higher risk of developing cancer and their surveillance can help to diagnose the disease in earlier stages. In this retrospective study we collected a corpus of 1064 records from 44 patients at Indiana University Hospital from 1990 to 2012. A Natural Language Processing (NLP) system was developed and used to identify patients with pancreatic cysts. NegEx algorithm was used initially to identify the negation status of concepts that resulted in precision and recall of 98.9% and 89% respectively. Stanford Dependency parser (SDP) was then used to improve the NegEx performance resulting in precision of 98.9% and recall of 95.7%. Features related to pancreatic cysts were also extracted from patient medical records using regex and NegEx algorithm with 98.5% precision and 97.43% recall. SDP improved the NegEx algorithm by increasing the recall to 98.12%.
Segmentation of Mammography by Applying GrowCut for Mass Detection
Authors: Cordeiro Filipe R.  , Santos Wellington P.  , Silva-Filhoa Abel G.
Published: February 2025

Accurately segmenting tumors in digital mammography images is a hard task. However, quality of segmentation is important to avoid misdiagnosis. In this work, the GrowCut technique, which is based on cellular automaton, was used to segment tumor regions of digitized mammograms available in the Mini-Mias database. A set of images was submitted to GrowCut technique and segmented images were compared with ground truth in terms of metrics of area, perimeter, Feret's distance, form factor, and solidity. For segmenting tumors, low user interaction is required. Results showed that GrowCut segmentation images obtained similar properties and shape of the ground-truth images, with an average estimated error close to zero, for all metrics analyzed.
Overrides of Clinical Decision Support Alerts in Primary Care Clinics
Authors: Slight Sarah P.  , Nanji Karen C.  , Seger Diane L.  , Cho Insook  , Volk Lynn A.  , Bates David W.
Published: February 2025

Clinical Decision Support (CDS) systems can alert physicians about potential clinical risks and suggest suitable treatment alternatives at appropriate times in the health care process. We evaluated the frequency with which physicians overrode medication alerts and the override reasons provided. Data obtained from primary care practices affiliated with two Harvard teaching hospitals were downloaded. Physicians overrode more than half of CDS medication alerts, with formulary, age-based, and renal substitutions the most likely. Many drug-drug and drug-allergy interactions overridden had the potential to cause patient harm.
Understanding Responses to a Renal Dosing Decision Support System in Primary Care
Authors: Cho Insook  , Slight Sarah P.  , Nanji Karen C  , Seger Diane L  , Dykes Patricia  , Bates David W.
Published: February 2025

Renal dosing clinical decision support (CDS) systems have demonstrated clinical effectiveness and potential benefits for patient outcomes. However, the high override rates consistently reported are problematic and undesirable. To understand providers' use patterns of renal dosing CDS, we investigated the override reasons obtained from primary care practices affiliated with two teaching hospitals. We selected a stratified random sample of 300 alerts and reviewed electronic medical records. Appropriateness criteria and an inter-rater reliability process were used. We found that two thirds of alerts were overridden inappropriately, and this proportion was similar for frequent over-riders as compared to the remainder of physicians. These findings imply that strategies are needed to convince providers to accept more clinically appropriate suggestions, though they need to be broadly targeted.
Interdisciplinary Care Team Adoption of Electronic Point-of-Care Documentation Systems: An Unrealized Opportunity
Authors: Sockolow Paulina S.  , Bowles Kathryn H.  , Rogers Michelle  , Adelsberger Marguerite C.  , Chittams Jesse L.  , Liao Cindy
Published: February 2025

We conducted three health care evaluation studies in community and hospital settings to examine adoption of point-of-care documentation systems among interdisciplinary care team clinicians. Both community studies used a mixed methods design to assess actual system usage and clinician satisfaction. In the hospitals, scenario testing was used. Results indicated clinician adoption of the systems was universal, although not always timely with: (1) a mismatch between system functionality and workflow which was a barrier to clinician system access during patient care and reduced clinician efficiency; (2) no increase in interdisciplinary team communication; and (3) no impact on patient outcomes identified by clinicians. To facilitate adoption, clinicians should see the value of using the system as intended by receiving patient care and patient safety feedback that uses system data.
Patients Prefer Electronic Medical Records – Fact or Fiction?
Authors: Masiza Melissa  , Mostert-Phipps Nicky  , Pottasa Dalenca
Published: February 2025

Incomplete patient medical history compromises the quality of care provided to a patient while well-kept, adequate patient medical records are central to the provision of good quality of care. According to research, patients have the right to contribute to decision-making affecting their health. Hence, the researchers investigated their views regarding a paper-based system and an electronic medical record (EMR). An explorative approach was used in conducting a survey within selected general practices in the Nelson Mandela Metropole. The majority of participants thought that the use of a paper-based system had no negative impact on their health. Participants expressed concerns relating to the confidentiality of their medical records with both storage mediums. The majority of participants indicated they prefer their GP to computerise their consultation details. The main objective of the research on which this poster is based was to investigate the storage medium of preference for patients and the reasons for their preference. Overall, 48% of the 85 participants selected EMRs as their preferred storage medium and the reasons for their preference were also uncovered.
An Ontology Model for Nursing Narratives with Natural Language Generation Technology
Authors: Min Yul Ha  , Park Hyeoun-Ae  , Jeon Eunjoo  , Lee Joo Yun  , Jo Soo Jung
Published: February 2025

The purpose of this study was to develop an ontology model to generate nursing narratives as natural as human language from the entity-attribute-value triplets of a detailed clinical model using natural language generation technology. The model was based on the types of information and documentation time of the information along the nursing process. The typesof information are data characterizing the patient status, inferences made by the nurse from the patient data, and nursing actions selected by the nurse to change the patient status. This information was linked to the nursing process based on the time of documentation. We describe a case study illustrating the application of this model in an acute-care setting. The proposed model provides a strategy for designing an electronic nursing record system.
Real-time Surveillance of Laboratory Confirmed Influenza Based on the Danish Microbiology Database (MiBa)
Authors: Voldstedlund Marianne  , Haahr Malene  , Emborg Hanne-Dorthe  , Bang Henrik  , Krause Tyra
Published: February 2025

The Danish microbiology database (MiBa) is a national database that automatically accumulates patient test results from all Danish Departments of Clinical Microbiology. As an example for use of MiBa, we describe the real-time surveillance of laboratory confirmed influenza established in October 2012. It functions without any extra burdens of reporting by laboratories or clinicians. This is an important improvement of the existing surveillance for influenza like illness (ILI) which includes only limited virological testing. The MiBa based surveillance adds complete national virological data which are specific for influenza, in contrast to ILI, and serves as a tool for regional and national preparedness and planning.
Clinical Knowledge Governance: The International Perspective
Authors: Garde Sebastian
Published: February 2025

As a basis for semantic interoperability, ideally, a Clinical Knowledge Resource for a clinical concept should be defined formally and defined once in a way that all clinical professions and all countries can agree on. Clinical Knowledge Governance is required to create high-quality, reusable Clinical Knowledge Resources and achieve this aim. Traditionally, this is a time-consuming and cumbersome process, relying heavily on face-to-face meetings and being able to get sufficient input from clinicians. However, in a national or even international space, it is required to streamline the processes involved in creating Clinical Knowledge Resources. For this, a Web 2.0 tool that supports online collaboration of clinicians during their creation and publishing of Clinical Knowledge Resources has been developed. This tool is named the Clinical Knowledge Manager (CKM) and supports the development, review and publication of Clinical Knowledge Resources. Also, post-publication activities such as adding terminology bindings, translating the Clinical Knowledge Resource into another language and republishing it are supported. The acceptance of Clinical Knowledge Resources depends on their quality and being able to determine their quality, for example it is important to know that a broad umber of reviewers from various clinical disciplines have been involved in the development of the Clinical Knowledge Resource. We are still far from realizing the vision of a global repository of a great number of reusable, high-quality Clinical Knowledge Resources, which can provide the basis for broad semantic interoperability between systems. However progress towards this aim is being made around the world.
Exploring the Contextual and Human Factors of Electronic Medication Reconciliation Research: A Scoping Review
Authors: Monkman Helen  , Borycki Elizabeth M.  , Kushniruk Andre W.  , Kuo Mu-Hsing
Published: February 2025

Medication reconciliation (MedRec) is an important task that occurs in a variety of different contexts. Similar to other healthcare practices, MedRec is transitioning from being a paper-based process to one that is performed electronically. This paper will provide a scoping review of the prevalent research topics from both contextual and human factors perspectives. Methods: PubMed and CINAHL were searched for all articles including the term “medication reconciliation”. The 139 articles that met inclusion criteria were reviewed for themes and findings. Results: Three primary themes surfaced through this analysis: a) The contextual factors of MedRec, b) information technology (IT) in MedRec, and c) obstacles and opportunities for improving MedRec. Discussion: MedRec is performed in a variety of settings. The transition to electronic MedRec (eMedRec) has the potential to mitigate errors associated with a paper-based system but also creates opportunities for new technology-induced errors to occur. Interoperability with other health information systems is ideal. Additionally, Process standardization and workflow are important considerations when transitioning to eMedRec. Conclusion: As the process of medication reconciliation transitions from a paper-based to an electronic task, it is imperative to minimize the opportunity for human error and maximize the effectiveness of the system as a whole. Further, it is important for research to continue to explore original strategies for IT to enhance medication reconciliation.