bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonparametric Selection Method of Survival Predictors with an Application to Breast Cancer
Authors: Troupé M. , Manuceau J. , Lánska V. , Vaillant J. 
Published: March 2018

AbstractMutual information between a survival variable and covariables provides a new tool for selecting covariables with a high predictive value whenever there is no reasonable parametric model with respect to the observed phenomena. The information rate carried out by covariables can be tested by means of a decomposition similar to the analysis of variance. Moreover, a method based on information conservation can be used for aggregating survival curves corresponding to different modalities of the same selected predictor which increases the prediction efficiency. These results are applied to survival data from 1304 patients with breast cancer followed over a period of ten years.
On Prognostic Models, Artificial Intelligence and Censored Observations
Authors: Anand S. S. , Hamilton P. W. , Hughes J. G. , Bell D. A. 
Published: March 2018

AbstractThe development of prognostic models for assisting medical practitioners with decision making is not a trivial task. Models need to possess a number of desirable characteristics and few, if any, current modelling approaches based on statistical or artificial intelligence can produce models that display all these characteristics. The inability of modelling techniques to provide truly useful models has led to interest in these models being purely academic in nature. This in turn has resulted in only a very small percentage of models that have been developed being deployed in practice. On the other hand, new modelling paradigms are being proposed continuously within the machine learning and statistical community and claims, often based on inadequate evaluation, being made on their superiority over traditional modelling methods. We believe that for new modelling approaches to deliver true net benefits over traditional techniques, an evaluation centric approach to their development is essential. In this paper we present such an evaluation centric approach to developing extensions to the basic k-nearest neighbour (k-NN) paradigm. We use standard statistical techniques to enhance the distance metric used and a framework based on evidence theory to obtain a prediction for the target example from the outcome of the retrieved exemplars. We refer to this new k-NN algorithm as Censored k-NN (Ck-NN). This reflects the enhancements made to k-NN that are aimed at providing a means for handling censored observations within k-NN.
Effects of Case Removal in Prognostic Models
Authors: Vinterbo S. , Ohno-Machado L. 
Published: March 2018

AbstractConstructing and updating prognostic models that learn from training cases is a time-consuming task. The more compact, and yet informative, the training sets are, the faster one can build and properly evaluate such models. We have compared different regression diagnostic methods for selection and removal of training cases in prognostic models. Univariate determinations were performed using classical regression diagnostic statistics. Multivariate determinations were performed using (1) a sequential “backward” selection of cases, and (2) a non-sequential genetic algorithm. The genetic algorithm produced final models that kept few cases and retained predictive capability. A genetic algorithm approach to case selection may be better suited for guiding removal of cases in training sets than a univariate or a sequential multivariate approach, possibly because of its ability to detect sets of cases that are influential en bloc but may not be sufficiently influential when considered in isolation.
Prognosis of Body Fluid Level by Fuzzy Logic Technique
Authors: Chan W. , Naghdy F. 
Published: March 2018

AbstractSurgical fluid replacement is a critical issue in medicine as the fluid volume excess or deficit can both complicate the patient’s condition. Currently, the administration of fluid volume is carried out primarily based on the experience and expertise of the anaesthetist as there is no analytical method available to estimate the patient’s fluid level. The development of a decision support system (DSS) to assist the anaesthetist in estimating the required fluid infusion rate for a particular patient has been the focus of this research paper. The DSS is developed based on Fuzzy Logic Control (FLC) technique which is ideal for developing input/output models in an unstructured and/or complex environment. The fuzzy rules used in the DSS are derived automatically from the clinical data produced in surgical operations. The DSS employs a Multi Rule Base (MRB) learning scheme to adapt its model according to the significant variation in the physiological parameters of a patient. The performance of the developed algorithms is validated through experimental work using clinical data. The results obtained so far are encouraging.
Standardization of Health Informatics – Results and Challenges
Authors: Klein G. O. 
Published: March 2018

Summary
Objectives: This review article aims to highlight the importance of standards for effective communication and provides an overview of international standardization activities.
Methods: This article is based on the experience of the author of European standardization in CEN, which he leads, and the global work of ISO, where he is leading the security working group, and an overview of the work of DICOM, IEEE and HL7, partly using their web presentations.
Results: Health communication is highly dependent of the general development of information technology with standards coming from ISO/IEC JTC1, ITU and several other organizations e.g. IETF, the World Wide Web consortium and Open group. A number of standardization initiatives have been in progress for more than ten years with the aim to facilitate different aspects of the exchange of health information. Electronic record architecture, Message structures, Concept representation, Device communication including imaging and Security are the main areas.
Conclusions: Important results have been achieved, and in some fields and parts of the world, standards are widely used today. Unfortunately, we are still facing the fact that most healthcare information systems cannot exchange information with all systems for which this would be desired. Either the existing standards are not sufficiently implemented, or the required standards and necessary national implementation guidelines do not yet exist. This causes unacceptable risks to patients, inefficient use of healthcare resources, and sub-optimal development of medical knowledge. Fortunately, the different bodies are now largely co-operating to achieve global consensus.
Computer Order Entry System Decreased Use of Sliding Scale Insulin Regimens
Authors: Payne T. H. , Anawalt B. D. , Achtmeyer C. E. 
Published: March 2018

SummaryIntroduction
Objectives: Despite evidence documenting their ineffectiveness, sliding scale insulin is a commonly used regimen for glucose management for hospitalized patients with diabetes mellitus. At the Veterans Affairs Puget Sound Medical Center, where computer order entry has been mandated, we tested the hypothesis that an evidence-based minimal intervention order (supplemental insulin only when fasting serum glucoses exceeded 400 mg/dl) would decrease the use of sliding scale insulin orders.
Methods: Using a computerized order entry system, providers were initially offered a traditional sliding scale order or their own ad hoc orders for glycemic control of inpatients. After 34 weeks providers were offered a third option; a “minimal intervention order” with supplemental insulin only for glucose >400 mg/dl. We extracted all regular insulin orders and performed a retrospective review of insulin sliding scale orders written between December 1, 1998 and November 16, 1999. We compared the frequency of traditional insulin sliding scale orders before and after the introduction of the minimal intervention order.
Results: Nearly all orders in the first 34 weeks were traditional insulin sliding scales. We found a significant decrease in the number of traditional insulin sliding scale orders in the 16 weeks after the introduction of a computerized quick-order for minimal intervention, from 978/1007 (97.1%) to 254/398 (63.8%) (P <0.001).
Conclusions: A simple, evidenced-based quick-order in a computer order entry system rapidly and significantly reduced use of sliding scale insulin regimens for glycemic control of inpatients.
Prevalence and Conditions of Urinary Incontinence among the Elderly
Authors: Koyanagi A. , Mihara S. , Kawazu S. , Uemura T. , Nakano H. , Gotou Y. , Nishizawa M. , Noyama A. , Hasegawa C. , Nakano M. , Koyama W. 
Published: March 2018

AbstractIn Japan, elderly disorders and diseases have markedly increased in recent years, because of rapid aging and an increasing number of older persons. The situation is creating serious social and community problems. These disorders, particularly dysuria and urinary incontinence (UI), disturb the quality of life (QOL) in latelife. Few reports on UI have been published, but precise investigation into the community level remains to be made. Our presentation is the development, implementation and evaluation of elderly UI in Kumamoto Prefecture. This study includes 2,304 people (male: 856, female: 1,448), over 65 years of age, living in two different communities; one is an urban (K) and the other is a typical rural area (S). The rate of UI was in homebound elderly persons, male: 4.7%, female: 11.3%, and in nursing home residents, male: 16.2%, female: 23.2%. The condition of UI was: almost Urinary Urgency in male (61.5%), and Stress Incontinence (such as, caused by coughing, sneezing, and exercise) in female (46.3%). The influence of UI on the activity of daily life was investigated. Most of the male cases were giving concerns for family and community. In contrast, females hesited to participate in group excursions and outdoor exercise, and had a tendency to live alone or indoors. However, most persons (81.5%) with UI did not visit a physician. From this investigation, we conclude that a community health care program and public support system are essential for proper understanding and solution of the elderly UI problem.
Tailoring Communications for Primary Care Settings
Authors: Glassman B. , Rimer B. K. 
Published: March 2018

AbstractIn more and more medical settings, physicians have less and less time to be effective communicators. To be effective, they need accurate, current information about their patients. Tailored health communications can facilitate positive patient-provider communications and foster behavioral changes conducive to health. Tailored communications (TCs) are produced for an individual based on information about that person. The focus of this report is on tailored print communications (TPCs). TPCs also enhance the process of evaluation, because they require a database and the collection of patient-specific information. We present a Tailoring Model for Primary Care that describes the steps involved in creating TPCs. We also provide examples from three ongoing studies in which TPCs are being used in order to illustrate the kinds of variables used for tailoring the products that are developed and how evaluation is conducted. TPCs offer opportunities to expand the reach of health professionals and to give personalized, individualized massages in an era of shrinking professional contact time.
Communication in Health Care
Authors: Duisterhout J. S. , Branger P. J. 
Published: March 2018

Abstract:For routine communication, care providers still mainly rely on paper documents and paper mail. Evidence exists, however, that this communication can be improved, both by a better content of information exchange and by a more timely deliverance of this information. At present, several alternatives to paper-based communication are available, such as the Fax, the Smart Card, electronic mail, and electronic data interchange. This paper describes existing communication problems, and examines the current state of development and research aimed at improving this communication using electronic communication techniques that are gradually replacing paper-based communication. Applicability and shortcomings of these new techniques are also discussed.
Multi-dimensional Visualisation of Laboratory Findings and Functional Test Results for Analysing the Clinical Course of Disease in Medicine
Authors: Luz C. J. , Giere W. , Lüdecke R. , Jonas D. , Goldschmidt A. J. W. 
Published: March 2018

Abstract:The illustration of a patient’s history by a graphical primitive is discussed. Illustration technology is presented which simultaneously represents quantitative examination findings (e. g., laboratory values) and qualitative findings (e. g., from function diagnostics) by a single geometrical figure. Depending on the medical results, this figure takes on characteristic forms which can be identified as patterns typical for a specific disease. The procedure developed is integrated in a user interface which is implemented in the form of a computerized medical record for use on a pentop computer. This portable computer assists the physician during ward rounds, supplies additional, intelligence-based information, serves quality control, and streamlines working procedures making them more efficient.
The Medical Record: Narration and Story as a Path Through Patient Data
Authors: Kluge E.-H. W. 
Published: March 2018

AbstractKay and Purves' proposed narratological model of the medical record is based on the familiar phenomenological insight that the perception of data is conditioned by the conceptual framework of the perceiver. Unfortunately, unless handled very carefully, this approach will make the significance of a medical record unique to the person who constructed it and impermeable to outside scrutiny. However, when integrated into the analog-model of the medical record, the narratological model can be accommodated as the clinician-relative construction of a patient profile within the data that make up the medical record. Some implications for the construction of expert systems and competence analysis are indicated.
An Object-Oriented Class Library for Medical Software Development
Authors: McColligan E. E. , O’Kane K. C. 
Published: March 2018

Abstract:The objective of this research is the development of a Medical Object Library (MOL) consisting of reusable, inheritable, portable, extendable C++ classes that facilitate rapid development of medical software at reduced cost and increased functionality. The result of this research is a library of class objects that range in function from string and hierarchical file handling entities to high level, procedural agents that perform increasingly complex, integrated tasks. A system built upon these classes is compatible with any other system similarly constructed with respect to data definitions, semantics, data organization and storage. As new objects are built, they can be added to the class library for subsequent use. The MOL is a toolkit of software objects intended to support a common file access methodology, a unified medical record structure, consistent message processing, standard graphical display facilities and uniform data collection procedures. This work emphasizes the relationship that potentially exists between the structure of a hierarchical medical record and procedural language components by means of a hierarchical class library and tree structured file access facility. In doing so, it attempts to establish interest in and demonstrate the practicality of the hierarchical medical record model in the modern context of object oriented programming.
Database and Knowledge Base Integration – A Data Mapping Method for Arden Syntax Knowledge Modules
Authors: Shahsavar N. , Åhlfeldt H. , Wigertz O. , Johansson B. 
Published: March 2018

Abstract:One of the most important categories of decision-support systems in medicine are data driven systems where the inference engine is linked to a database. It is, therefore, important to find methods that facilitate the implementation of database queries referred to in the knowledge modules. A method is described for linking clinical databases to a knowledge base with Arden Syntax modules. The method is based on a query meta-database including templates for SQL queries which is maintained by a database administrator. During knowledge module authoring the medical expert refers only to a code in the query meta-database; no knowledge is needed about the database model or the naming of attributes and relations. The method uses standard tools, such as C++ and ODBC, which makes it possible to implement the method at many platforms and to link to different clinical databases in a standardized way.
Use of Information from Clinical Trials for an Integrated Cancer Registry
Authors: Michaelis J. , Kaatsch P. 
Published: March 2018

AbstractThe registry of childhood malignancies in the F.R.G. is a combination of a population-based and hospital-based cancer registry. A large amount of the collected data originates from multicenter clinical trials which are integrated into the documentation system of the cancer registry. The paper describes the information flow and the system of data storage which consists of a central database on a departmental system at the registry and of several coordinated peripheral databases on microcomputers at the trial centers. Practical experience shows an increased availability and validity of the data in the registry since the implementation of the system. Aspects of data integrity and security are discussed. Although the system was designed according to specific demands of the registry, it may serve as a model for similar tasks of cooperative documentation and information exchange.
Expert Systems for the Prediction of Ovulation: Comparison of an Expert System Shell (Expertech Xi Plus) with a Program Written in a Traditional Language (BASIC)
Authors: Schreiner A. , Chard T. 
Published: March 2018

AbstractThe use of an expert system shell (EXPERTECH Xi Plus) in the construction of an expert system for the diagnosis of infertility has been evaluated. A module was devised for predicting ovulation from the medical history alone. Two versions of this system were constructed, one using the expert system shell, and the other using QuickBASIC. The two systems have been compared with respect to: (1) ease of construction; (2) ease of knowledge base update; (3) help and explanation facilities; (4) diagnostic accuracy; (5) acceptability to patients and clinicians; (6) user-friendliness and ease of use; (7) use of memory space; and (8) run time. The responses of patients and clinicians were evaluated by questionnaires. The predictions made by the computer systems were compared to the conclusions reached by clinicians and to the “gold standard” of day 21 progesterone.The conclusions of this pilot study are: (1) the construction of this expert system was NOT facilitated by the use of this expert system shell; (2) update of the knowledge base was not facilitated either; (3) the expert system shell offered built-in help and explanation facilities, but as the system increased in complexity these became less useful; (4) after initial adjustment of decision thresholds the diagnostic accuracy of the system equalled that of the clinician; (5) the patient response to computer history-taking was very favorable but much less favorable to computer diagnosis; (6) the clinicians took a positive attitude to computer diagnosis; (7) the systems were easy to use; (8) the expert systems shell required much more memory space and had a much slower response time than the system written in BASIC.
Fitting and Interpreting Loglinear Interactions in Cross-Classifications from Health Policy and Medicine
Authors: Brown M. L. 
Published: March 2018

AbstractA nontechnical exposition is presented of current statistical techniques for the analysis of multidimensional tables of counted data. Performing an original analysis of a data set of interest to researchers in health policy and medicine, the paper considers what kinds of questions an analysis by loglinear modeling can address, and what kinds of answers it can obtain and how they may be sought. Unlike most previous expository accounts seeking to provide introductions to this field, this paper does not require a background from the reader in either regression or the analysis of variance. By a thoroughgoing use of odds ratios and higher-order odds ratios, it nevertheless provides a technically accurate account of the key concepts of higher-order interactions among variables, and of models being hierarchical.Statistically more advanced readers are provided with a means of effectively expositing their loglinear modeling methods and conclusions to nonstatisticians; a number of footnotes are directed toward such readers.
Rationale for a Community Strategy in the Field of Information and Communications Technologies Applied to Health Care
Authors: Jensen O. , Bach E. F. , Barber B. , van Bemmel J. H. , Bravar D. , van Eimeren W. , Greinacher C. , Lamberts H. , PuppincklO C. , Puybasset B. , Rienhoff O. , France F. H. , Sachot E. , Zöllner F. K. , Santucci G. 
Published: March 2018

AbstractThe challenge for Europe in the field of information and communications technologies applied to health care is that of addressing positively the problem of the widening gap between the expectations of the citizens of the type of care that can be made available and the limited resources to provide that care. If the expectations of the population are to be fulfilled, it will be necessary to find innovative ways of delivering health services and to do it more efficiently than has yet been the case. Advanced information and communications technologies will be important tools for Member States to achieve the levels of efficiency required. Based on the results of the Community AIM Exploratory Action, further collaborative work is required at EEC level to create an Integrated Health Information Environment (lHE) allowing essentially for integration, modularity and security.
Dazugehören!
Authors: Kölch M. , Fegert J. M. 
Published: March 2018

ZusammenfassungDie Verbesserung von Teilhabe ist zentraler Bestandteil sowohl der UN-Behindertenrechtskonvention als auch der UN-Kinderrechtskonvention. Zentrale Aspekte für Inklusion und Teilhabe sind die Lebensbereiche von Kindern, wie Schule, Einbindung in Freundesbeziehungen und Familie. Derzeit sind in Deutschland die Anspruchsgrundlagen für Maßnahmen zur Reduzierung der Teilhabebeeinträchtigung in den Sozialgesetzbüchern niedergelegt. Dies führt zu Problemen in der Praxis, da Kinder oft mehrfachbehindert sind, und kann für Familien bei der Erlangung von Hilfen schwierig sein. Es wird eine gesetzliche Veränderung diskutiert, die alle Leistungen für alle behinderten Kinder und Jugendlichen unter dem Dach der Jugendhilfegesetzgebung vereint. Die Teilhabebeeinträchtigung muss umfassend strukturiert, aber auch wissenschaftlich evaluiert erfasst werden. Im Beitrag werden einige verwendete Instrumente vorgestellt.
Data Acquisition and Processing in Medicine: Contribution of the Microprocessor
Authors: Werner J. , Graener R. 
Published: March 2018

Microprocessor systems facilitate to an increasing extent economical laboratory and process automation in the field of medicine.The general aspects of hardware architecture and the software problems of the microprocessor are briefly demonstrated. Boundary lines to hardware logic on the one hand and to minicomputers on the other hand and the significance and position of the microprocessor in the biomedical EDP spectrum are discussed. As a reasonable concept for biosignal processing and laboratory automation we propose the »distributed microprocessor system« making use of parallel »basic systems«, which may operate independently or may be controlled by a supervisory processor. By way of a concrete example from our laboratory, some of the problems of realization of microprocessor systems are demonstrated.