bluuebunny/crossref_metadata_2025_split huggingface dataset:
Redefining and Improving Patient Safety
Authors: Ball M. J. , Douglas J. V. 
Published: March 2018

Summary
Objectives: The Institute of Medicine (IOM) has focused attention on patient safety in the united States. Other countries share these concerns.
Methods: Governmental agencies and professional organizations are redefining approaches to safety, calling upon the use of information and communication technology as an enabler and expanding the range of evidence admissible in documenting success.
Results: Efforts to understand medical errors have used retrospective chart review, incident reporting, and computerized surveillance; the result is an evolving picture of the number, nature, and cause of errors. Approaches used to prevent errors include computerized physician order entry, decision support tools, computerized monitoring, and evidence-based practice; varying levels of evidence document their success.
Conclusions: Technology offers challenging capabilities, not simple solutions. New evidence and new tools demand new approaches and attention to human factors.
A Health Condition Survey of Japanese People in the Prime of Life, Based on National MHTS and Human Dry Dock Statistics
Authors: Sasamori N. 
Published: March 2018

AbstractA health condition survey was made of Japanese persons in the prime of life regarding six abnormalities (obesity, impaired glucose tolerance, hypertension, hypercholesterolemia, hypertriglyceridemia, liver dysfunction) occurring with high frequency. It was demonstrated that impaired liver function and elevation in blood cholesterol are the main causes of health deterioration in persons in the prime of life. The survey results suggest that the deterioration of their health is associated with their lifestyle.
Elimination of Inter-Institutional Discrepancies in Health Check-up Results: Standardization of Diagnostic Decision Level and Uniformity of Examination Data
Authors: Tamura M. 
Published: March 2018

AbstractIn Japan, more people are taking AMHTS and the number of medical institutions where it is provided is also increasing. AMHTS is expected to continue to expand in scope and importance from now on. People do not necessarily take AMHTS at the same medical institutions year after year. For AMHTS to be truly useful from the viewpoint of preventive medicine and be able to continue its development, it is imperative that the level of diagnosis be standardized and the compatibility of examination data be established among different institutions.The Japan Society of MHTS is conducting pilot studies of reversed quality control (RQC) as part of its activities with the aim of clearly understanding inter-institution gaps regarding AMHTS and to establish uniformity in examination data.
Informatics in the Service of Health, a Look to the Future
Authors: Moehr J. R. 
Published: March 2018

AbstractThe paper attempts a balanced look at the directions of health informatics required in the future. In a high level review of impediments to health and health care a number of issues are identified that may be amenable to improvement by contributions from health informatics. Attention is drawn to the improvement ofthe collection and dissemination of knowledge in addition to the analysis of morbid conditions as a focus for health informatics. On this basis a review of the current state of health information systems is undertaken. The importance of adaptable user interfaces for end users and systems personnel, privacy and confidentiality protection, and linkage among clinical support systems and knowledge repositories is stressed. These improvements hinge on advancements in medical concept representation. Canadian contributions to these developments, particularly the instigation of Evidence Based Medicine (EBM) are briefly reviewed.
Obstruction of Valid Race/Ethnicity Data Acquisition by Current Data Collection Instruments
Authors: Rubin L. , Dakis P. 
Published: March 2018

AbstractMethods of collecting race/ethnicity data affect the validity of conclusions based on them as do other factors such as lack of consensus and inadequate definitions for terminology; and misclassification or miscounting of patients. Current data collection instruments do not identify mixed heritage. We propose improving data measurement and collection by including a quantified multiracial/multiethnic heritage category for persons of mixed heritage; a don't know category; and a refuse to reveal category. The resulting problems affect all uses of racial and ethnic data, including health care provision, research, and health planning. More precise race/ ethnicity categories should be encouraged by such means as a 16-category checklist (with instructions to check all which apply) currently in development. The Methods section of all clinical, epidemiologic, and pharmacologic reports should include descriptions of racial measurement and reasons for including or excluding clearly defined populations.
Integrating Legacy Laboratory Information Systems into a Client-Server World: The University of Minnesota Clinical Workstation (CWS) Project
Authors: Willard K. E. , Sielaff B. H. , Connelly D. P. 
Published: March 2018

Abstract:The development of an innovative clinical decision-support project such as the University of Minnesota’s Clinical Workstation initiative mandates the use of modern client-server network architectures. Preexisting conventional laboratory information systems (LIS) cannot be quickly replaced with client-server equivalents because of the cost and relative unavailability of such systems. Thus, embedding strategies that effectively integrate legacy information systems are needed. Our strategy led to the adoption of a multi-layered connection architecture that provides a data feed from our existing LIS to a new network-based relational database management system. By careful design, we maximize the use of open standards in our layered connection structure to provide data, requisition, or event messaging in several formats. Each layer is optimized to provide needed services to existing hospital clients and is well positioned to support future hospital network clients.
Methods for Improving the Repeatability of Automated ECG Analysis
Authors: Aitchison T. C. , Macfarlane P. W. , McLaughlin S. C. 
Published: March 2018

Abstract:Statistically-based smoothing techniques are described which have been applied to the existing framework of the Glasgow ECG Analysis program. These methods have been designed with the aim of improving repeatability in the computer interpretation of ECGs which have been recorded either several minutes or 24 hours apart from patients in a clinically stable condition. With respect to the ECG diagnosis of Left Ventricular Hypertrophy (LVH), these flexible methods have the effect of reducing the number of inconsistent day-to-day interpretations by 36% from 33 to 21 in330 pairs of ECGs recorded one day apart. Similarly, when comparing agreement in the diagnosis of LVH in 249 pairs of ECGs which were recorded several minutes apart, the number of discordant computer interpretations was 6 using the new methodology, compared with 13 using conventional criteria, i. e. there was a 54% reduction in disagreements.
Improving Coded Data Entry by an Electronic Patient Record System
Authors: Puerner F. , Soltanian H. , Hohnloser J. H. 
Published: March 2018

AbstractData are presented on the use of a browsing and encoding utility to improve coded data entry for an electronic patient record system. Traditional and computerized discharge summaries were compared: during three phases of coding ICD-9 diagnoses phase I, no coding; phase II, manual coding, and phase III, computerized semiautomatic coding. Our data indicate that (1) only 50% of all diagnoses in a discharge summary are encoded manually; (2) using a computerized browsing and encoding utility this percentage may increase by 64%; (3) when forced to encode manually, users may “shift” as much as 84% of relevant diagnoses from the appropriate coding section to other sections thereby “bypassing” the need to encode, this was reduced by up to 41 % with the computerized approach, and (4) computerized encoding can improve completeness of data encoding, from 46 to 100%. We conclude that the use of a computerized browsing and encoding tool can increase data quality and the percentage of documented data. Mechanisms bypassing the need to code can be avoided.
Pseudonyms for Cancer Registries
Authors: Miller M. , Schmidtmann I. , Michaelis J. , Pommerening K. 
Published: March 2018

AbstractIn order to conform to the rigid German legislation on data privacy and security we developed a new concept of data flow and data storage for population-based cancer registries. A special trusted office generates a pseudonym for each case by a cryptographic procedure. This office also handles the notification of cases and communicates with the reporting physicians. It passes pseudonymous records to the registration office for permanent storage. The registration office links the records according to the pseudonyms. Starting from a requirements analysis we show how to construct the pseudonyms; we then show that they meet the requirements. We discuss how the pseudonyms have to be protected by cryptographic and organizational means. A pilot study showed that the proposed procedure gives acceptable synonym and homonym error rates. The methods described are not restricted to cancer registration and may serve as a model for comparable applications in medical informatics.
Instantiating and Monitoring Skeletal Treatment Plans
Authors: Uckun S. 
Published: March 2018

Abstract:Current emphasis on protocol-based care has stirred interest in planning research as applied to clinical medicine. However, many assumptions made in designing traditional planners and plan-execution algorithms do not hold in medical domains. The problems include the unpredictable nature of the domain, uncertainty and the variability in the utility of available actions, and the need for parallel and continuous execution of treatment plans. In the context of our research on intelligent monitoring and control, we developed an approach for plan instantiation and execution which takes advantage of readily available treatment protocols. The system, named SPIN, instantiates treatment protocols based on current context, executes plans and closed-loop control actions, monitors the execution of plans and actions, and modifies plan execution as necessitated by patient response. The system is incorporated in the Guardian system for intensive-care patient monitoring and control. We address the strengths and limitations of the representation and the execution framework and discuss how the methodology may be improved and used in clinical practice.
Inter-Observer Variation in Decision-Making Regarding Patients on Chronic Hemodialysis: A Study Using the Kappa Index
Authors: Timpka T. , Buur T. 
Published: March 2018

AbstractTo examine inter-observer variation in the monitoring of patients with chronic disease, four nephrologists independently assessed 62 patients on maintenance hemodialysis. Deviation from normal was determined for adequacy of dialysis, protein intake, and metabolic state. The kappa-index, which allows to adjust for chance agreement, was used to analyze each monitoring diagnosis. Low agreement was found on decisions concerning adequacy of dialysis (kappa 0.12-0.26), while agreement was higher about protein intake (kappa 0.21-0.46), and metabolic state (kappa 0.24-0.52). Two physicians classified no patient as overdialyzed, while 16-18% were thus categorized by the other two. Routines for review of recent medical history also differed significantly between the physicians. Measures are needed to increase the reliability of decisions regarding the monitoring of chronic hemodialysis. A long lasting physician-patient relationship is not a sufficient prerequisite for diminishing decision variation. Medical audit as part of the clinical routine, and use of additional sources of information, exemplified by urea kinetic modeling, are discussed.
Eltern-Kind-Projekt Chance zur Unterstützung von Kindern inhaftierter Eltern
Authors: Fegert J. M. , Ziegenhain U. , Zwönitzer A. 
Published: March 2018

ZusammenfassungKinder inhaftierter Eltern stellen eine Hochrisikogruppe dar. Sie wachsen häufig in Familien auf, die diversen Risikofaktoren ausgesetzt sind. Im Vergleich zur Normalpopulation weisen sie eine erhöhte Lebenszeitprävalenz für eine psychiatrische Erkrankung, v. a. von Persönlichkeitsstörungen auf und haben ein erhöhtes Risiko selbst straffällig zu werden.Im “Eltern-Kind-Projekt Chance” werden erstmals Kinder von inhaftierten Eltern in Baden- Württemberg systematisch unterstützt. Diese Initiative ist seit 2011 Teil der regulären Arbeit der Straffälligenhilfe Baden-Württemberg. Sie wird von dem gemeinnützigen Verein “Projekt Chance e. V.” getragen und von der Baden-Württemberg Stiftung finanziert. Sie unterstützt im Rahmen dieses Projektes Kinder und deren Familien, die von der Inhaftierung eines Elternteils betroffen sind. Die wissenschaftliche Begleitung und Evaluation des Projektes erfolgte von 2011 bis 2016 durch die Universitätsklinik für Kinder- und Jugendpsychiatrie/ Psychotherapie Ulm.Die Ergebnisse der Evaluationsstudie bilden eine erste systematische Datengrundlage zur Situation von Kindern inhaftierter Eltern in Deutschland. Es zeigt sich, dass die Kinder inhaftierter Eltern (n = 113/n = 165) psychisch hoch belastet (Beziehungsprobleme/Verhaltensauffälligkeiten) sind. Im Vergleich vor und nach der Betreuung im Eltern-Kind-Projekt kam es im Mittel jedoch zu einem Rückgang der Verhaltensauffälligkeiten und Symptomen bei den Kindern (n = 60).
Alternative Inventory and Distribution Policies for a Regional Blood Banking System
Authors: Page B. 
Published: March 2018

This paper deals with the application of mathematical methods to the inventory of blood units in a regional supply system.A complex simulation model was designed and implemented in the discrete simulation language SIMSCRIPT to investigate alternative inventory and distribution policies for blood units by means of defined objective criteria. These procedures include a method for inventory forecasting and blood donor call-up and a heuristic allocation model for blood units.Empirical data was collected from the Berlin Blood Donor Service for model construction and validation.The simulation results suggest that the inventory procedures presented may lead to a considerable cost reduction in a regional blood banking system.A specific statistical testing procedure was employed to justify the simulation results statistically. In the final section it is suggested that the inventory methods described in this paper can be implemented within a computer information system providing the blood bank management with decision aids.
Effects of Observer Variation on Performance in Probabilistic Diagnosis of Jaundice
Authors: Llndberg G. 
Published: March 2018

A system for probabilistic diagnosis of jaundice has been used for studying the effects of taking into account the unreliability of diagnostic data caused by observer variation. Fourteen features from history and physical examination were studied. Bayes’ theorem was used for calculating the probabilities of a patient’s belonging to each of four diagnostic categories.The construction sample consisted of 61 patients. An equal number of patients were tested in the evaluation sample. Observer variation on the fourteen features had been assessed in two previous studies. The use of kappa-statistics for measuring observer variation allowed the construction of a probability transition matrix for each feature. Diagnostic probabilities could then be calculated with and without the inclusion of weights for observer variation. Tests of system performance revealed that discriminatory power remained unchanged. However, the predictions rendered by the variation-weighted system were diffident. It is concluded that taking observer variation into account may weaken the sharpness of probabilistic diagnosis but it may also help to explain the value of probabilistic diagnosis in future applications.
Clinical Estimation of the Duration of Pregnancy in Legal Abortion—Are Doctors Biased by their Knowledge of the Duration of Amenorrhoea?
Authors: Gjørup Th. , Saurbrey Nina , Hermann N. 
Published: March 2018

SummaryIn 35 women referred for induced abortion, the duration of pregnancy was stated with an accuracy of one week on the basis of the gynaecologic examination. This was done by one doctor with knowledge of the duration of amenorrhoea (clinical estimate) and by one doctor without this knowledge (“blind” estimate). Agreement was found between the duration of amenorrhoea and the duration of pregnancy for 89% of the clinical estimates and for 46% of the “blind” estimates. Prior to the study the doctor who made the “blind” estimates had—with knowledge of the duration of amenorrhoea—examined 26 similar women and had obtained agreement as to 88% of her estimates. For the clinical estimates, the difference between the duration of amenorrhoea and the duration of pregnancy did not exceed one week, whereas for the “blind” estimates, it amounted to as much as 3 weeks. It is concluded that doctors’ clinical estimate of the duration of pregnancy is influenced by their knowledge of the duration of amenorrhoea.
Clinical Trial Size: Fixed versus Group-Sequential Designs
Authors: Moussa M. A. A. 
Published: March 2018

SummaryThis paper deals with the estimation of the size of clinical trials for comparing two binomial proportions in both fixed and group-sequential designs. In the fixed size approach, it focuses on 1.) equal sample size design; 2.) unequal allocation designs that either maximize the test power subject to fixed total cost or minimize the total expenditure subject to prespecified power using the simplex procedure for function minimization. Emphasis is also placed on group-sequential designs, based upon closed stopping rules, multiple testing and range of clinical equivalence. The efficiency of different allocation designs is assessed by computing the power of the exact conditional Fisher-Irwin test. Designs were applied in planning a clinical trial in which the drug Pancuronium Bromide was compared with a standard treatment to reduce intraventricular haemorrhage in preterm infants.
The Design of Computer Forms for Tropical Medical Research
Authors: Byass P. 
Published: March 2018

SummaryThe design of forms for recording medical research data in the field is discussed in the light of the computer hardware and software to be used for their subsequent analysis. In particular, the principles of relational database management systems are extrapolated to the structure of forms. Specific issues of subject identification, layout of forms, different types of data and coding methods are developed. Finally, the special problems of applying these principles in the tropics, and experiences of so doing, are considered.
Data Systems in Mental Health
Authors: Laska E. , Siegel Carole , Meisner M. , Bank Rheta , Zeitz Baila 
Published: March 2018

The proper utilization of data information systems in mental health care can noticeably improve the quality and efficacy of such care. The World Health Organization is in a key position to encourage and assist governments in achieving the fullest possible application of knowledge in the development and utilization of such systems to the benefit of the greatest numbers of the world’s population.This paper briefly delineates some of the common information needs of the providers of mental health care, discusses the feasibility of automated data systems, and describes some already existing psychiatric information systems. Finally, it proposes ways and means by which the WHO can more efficiently aid its member nations by coordinating efforts in establishing mental health information systems. Recommendations include establishment of an information clearinghouse on data systems, a group coordinating dissemination of this information, a common pool of specialists in the area, and development of regional computing facilities under the auspices of the WHO.
A Method of Analysing Hospital Surgical Waiting Lists
Authors: Kennedy T. C. S. 
Published: March 2018

This paper discusses the meaning which can be derived from the careful analysis of surgical waiting lists.During the development of a minicomputer-based hospital administration system at Southend Hospital, such an analysis has become a routine part of the administrative procedures applied within the hospital. In the event of a more widespread use of computer systems it is argued that the type of analysis proposed could have a wide application since it can cut across environmental and other boundaries which generally prevent a comparison of different situations. This in turn could lead to a more uniform application of resource allocation policies on a regional and national scale.
Methods for Computer Linkage of Hospital Admission-Separation Records into Cumulative Health Histories
Authors: Smith Martha E. , Newcombe H. B. 
Published: March 2018

A study involving the design and testing of a computer system for linking hospital admission-separation records into longitudinal health histories is described. Although this study is based on a sample of the machine-readable files for a single Canadian province, essentially similar punch cards are prepared routinely across Canada as part of a system of universal health care. No data are included in the study that are not already recorded by provincial authorities.The essential step in the linkage is the recognition of whether two or more independently derived records relate to the same person. The methods are designed to extract and use the maximum amount of discriminating power inherent in items of personal identifying information, which may be incompletely reported or variant on some of the records. A statistical weighting system is employed to indicate the degree of assurance that two records should or should not be linked.The computer successfully matched over 99% of all pairs of potentially linkable records, at a rate of 3000 incoming records per minute. These methods are being used as part of an overall operation in which vital and health records are being integrated into individual and family health histories.
Anschluß und On-line-Betrieb eines Szintiscanners an einem Digitalrechner
Authors: Habermehl A. , Eisenhauer P. , Joseph K. , Graul E. H. 
Published: March 2018

Das Betriebssystem enthält 2 Arten von Wiedergabeprogrammen: Wiedergaben am Sichtgerät und Druckausgaben. Beide werden durch ein Codewort vom Teletype aus aufgerufen.Bei dem Programm SSWE werden auf dem Sichtgerät alle Werte dargestellt, die über einer bestimmten Schwelle liegen. Diese Schwelle wird bei diesem Programm mit der Hand eingestellt, während sie bei dem Programm SASW automatisch angehoben wird und so einen Bilderzyklus liefert. Weitere Programme zeichnen die Höhenschichtlinien und liefern eine perspektivische Darstellung des Aktivitätsgebirges.Bei den Druckausgaben liefert das Programm FSWE eine Schwellendarstellung, während das Programm FVZE eine Darstellung der verschiedenen Niveaus mit verschiedenen Druckzeichen ausgibt. Ein ähnliches Programm ergibt eine Darstellung in mehrfachen Niveaugruppen. Außerdem ist in dem Betriebssystem noch ein Programm zur Druckausgabe von Höhenschichtlinien enthalten.