bluuebunny/crossref_metadata_2025_split huggingface dataset:
Logical Thinking and the Diagnostic Process
Authors: John I. 
Published: March 2018

A questionnaire was administered to 224 medical students and 16 expert clinicians. The questions were designed to test some elementary thinking processes and basic clinical knowledge.The results indicated that the students and the experts had similar difficulties in solving logical problems. There was no significant change through, the years of the medical course. All had problems in thinking in terms of negative attributes and of prior probability. Students did not understand the significance of so-called specific features of a condition, but experts were good at this.Experts were very good at generating new data from early hypothesis formation. This capacity developed slowly through the medical course. More emphasis on the principles of information processing techniques may be a useful contribution to teaching.Even if logical methods are not necessary for the every day work of the clinician, an understanding of rational thinking may help to improve the accuracy of decision-making.
Comprehensive Cohort Study: An Alternative to Randomized Consent Design in a Breast Preservation Trial
Authors: Olschewski M. , Scheurlen H. 
Published: March 2018

SummaryIf in a clinical trial only few patients consent to randomization, all those patients meeting the clinical inclusion criteria should be considered for analysis. Prerandomization is shown to be efficient only if patients can be persuaded to accept the prescribed therapy and do not introduce a self-selection bias. Under full informed consent conditions, as, for example, in a breast preservation trial, the first requirement must be questioned for ethical, the second one for methodological reasons. Conventionally randomized trials with the inclusion of patients having therapeutic preferences appear to be preferable. We briefly discuss the way of analysing the data from such a cohort study.
On the Mathematical Basis of Zelen’s Prerandomized Designs
Authors: Brunner E. , Neumann N. 
Published: March 2018

SummaryThe mathematical basis of Zelen’s suggestion [4] of pre randomizing patients in a clinical trial and then asking them for their consent is investigated. The first problem is to estimate the therapy and selection effects. In the simple prerandomized design (PRD) this is possible without any problems. Similar observations have been made by Anbar [1] and McHugh [3]. However, for the double PRD additional assumptions are needed in order to render therapy and selection effects estimable. The second problem is to determine the distribution of the statistics. It has to be taken into consideration that the sample sizes are random variables in the PRDs. This is why the distribution of the statistics can only be determined asymptotically, even under the assumption of normal distribution. The behaviour of the statistics for small samples is investigated by means of simulations, where the statistics considered in the present paper are compared with the statistics suggested by Ihm [2]. It turns out that the statistics suggested in [2] may lead to anticonservative decisions, whereas the “canonical statistics” suggested by Zelen [4] and considered in the present paper keep the level quite well or may lead to slightly conservative decisions, if there are considerable selection effects.
Digital Picture Analysis as an Integral Part of the Information System for Experimental Oncopathology of the German Cancer Research Center
Authors: Komitowski D. , Zinser G. , Stute C. 
Published: March 2018

The information system of experimental pathology of the German Cancer Research Center serves to evaluate substantial amounts of data from animal experiments and to utilize the results in the study of the etiology, pathogenesis and therapy of experimental cancer. The system includes a registry of experimental tumors and programs for computer-supported diagnostics and digital picture analysis.The purpose of the digital picture analysis program is to obtain objective data in a form allowing comparisons. The aims of the program are to characterize early stages of pathological processes, to provide quantitatively defined subclasses of tumors which are related to their biology and to identify morphological features important for the diagnosis and prognosis of tumors. Because there are specific problems in digital analysis of histological sections, the authors modified the techniques of general purpose digital picture analysis and developed new methods. These utilize segmentation based on dividing images into segments or transforming the images into a polar-coordinate system, structural analysis of chromatin, and three-dimensional analysis of the images of cell nuclei.
Computer-aided Diagnosis of Acute Abdominal Pain when Taking into Account Interactions
Authors: Séroussi Brigitte ,   Séroussi and the arcaurc cooperative group brigitte
Published: March 2018

SummaryThe assumption of conditional independence between symptoms is commonly used in statistical computer-aided medical diagnosis. It permits to estimate the probability laws on small samples and leads to procedures easy to implement. Data from 6,916 patients suffering from acute abdominal pain were collected by the Arc& Aurc Cooperative Group. The data were analysed with a statistical approach, first under the independence assumption, then with the Lancaster first-order interactions model. The evaluation made on a 1,000-patient test set showed that, when taking into account interactions, results were comparable to clinicians’ . performance. But the comparison with the classical Bayesian independence approach revealed a significant improvement.
A Medical Record and a Computer Program for Diagnosis of Thyroid Diseases
Authors: Cobelli C. , Salvan A. 
Published: March 2018

A program for computer-aided diagnosis of thyroid diseases is presented. The program is mainly oriented to an analysis of the current criteria of classification of thyroid diseases. The problem of rare diseases has been considered.A computer-oriented medical record for thyroid diseases is presented and discussed. The computer program is dimensioned for diagnosis of 30 different diseases with a maximum of 200 symptoms freely chosen from the medical record. The main features of the program are discussed. Results were obtained on a group of rather infrequent thyroid diseases (thyroiditis).
A Computerized Information System for Pathology
Authors: Hercz L. , Laszlo Ch. A. , Reesal M. R. 
Published: March 2018

This paper describes a Computerized Information System for Pathology (CISP) capable of storing, retrieving and correlating essential information in pathology reports.Reports are entered in text form using established diagnostic terms recognizable in the system’s dictionary. Although some pre-editing of the report may be necessary, the comprehensive dictionary minimizes this effort. Dictionaries provide the vocabulary for a language which enables an economic storage of essential information in a compact and easily retrievable form. Reports and dictionaries stored on disk form the system’s data base.CISP consists of a set of modules shared by a, number of specific load module programs which store reports, retrieve them, and process requests. The system was programmed in PL/I on the IBM 360/75 OS computer system. CISP is operated from terminals situated in hospitals.
The Use of Medical Record Linkage for Population and Genetic Studies
Authors: Newcombe H. B. 
Published: March 2018

Methods are described for deriving personal and family histories of birth, marriage, procreation, ill health and death, for large populations, from existing civil registrations of vital events and the routine records of ill health. Computers have been used to group together and »link« the separately derived records pertaining to successive events in the lives of the same individuals and families, rapidly and on a large scale. Most of the records employed are already available as machine readable punchcards and magnetic tapes, for statistical and administrative purposes, and only minor modifications have been made to the manner in which these are produced.As applied to the population of the Canadian province of British Columbia (currently about 2 million people) these methods have already yielded substantial information on the risks of disease: a) in the population, b) in relation to various parental characteristics, and c) as correlated with previous occurrences in the family histories.
MEDLARS: Its Utilization in Research, Education and Practice
Authors: Tagliacozzo Renata 
Published: March 2018

A study of the utilization of the MEDLARS bibliographic service at one of the regional MEDLARS Centers is described. Data were obtained by sending a questionnaire to a sample of users who had requested bibliographic searches in previous months. The characteristics of the users, their awareness of the service availability, the purposes of their search requests, and their satisfaction with the results of the search were analyzed. The relation between outcome of the search and user’s satisfaction was examined.There was a ratio of 2:1 between high and low satisfaction. A favorable appraisal of the MEDLARS search was found to be prevalent among users who had received large bibliographies. The group of requesters with teaching status also showed a higher proportion of satisfied users than the group of students or trainees.
Direktverschlüsselung von EEG-Befunden für maschinelle Datenverarbeitung
Authors: Bochnik H. J. , Mentzos St. 
Published: March 2018

Es wird ein neuer differenzierter Dokumentationsschlüssel für das klinische EEG mitgeteilt, der auf elektronische Datenverarbeitung abgestellt ist.Die Dokumentation erfolgt durch Anstreichen eines vorgedruckten Schlüsselblatts, das einerseits direkt als Beleg für die Erstellung von Maschinenlochkarten dient und das andererseits als systematisch geordneter Befundbericht dient. Die Übertragung auf Lochbelege mit ihren Fehlermöglichkeiten und ihrem Zeitaufwand einschließlich der Prüfung wird dadurch gespart.Der Kartenentwurf ist ein wertvolles Hilfsmittel einer klinischen Verbundforschung, denn beliebig viele derartige Karten, verbunden durch einen gemeinsamen Schlüsselkopf, können wie eine große Krankengeschichte, die aus vielen Spezialbeiträgen besteht, im Einzelfalle gelesen und in der Gruppe statistisch analysiert werden.
Datenerfassung und Katalogherstellung mit Hilfe des FRIDEN-Flexowriter-Selectadata-Systems
Authors: Lauther H. 
Published: March 2018

In der Katalogabteilung der Universitätsbibliothek Ulm (Medizinisch-Naturwissenschaftliche Hochschule) wird das System FRIDEN-Flexowriter (2201)-Selectadata (2214) eingesetzt, um die Daten bei der Titelaufnahxne für die spätere elektronische Verarbeitung zu erfassen (Erzeugung eines Lochstreifens) und gleichzeitig auf halbkonventionellem Wege Katalogkarten für Formal- und Sachkataloge herzustellen.Der Selectadata-Suchleser selektiert zu diesem Zweck die verschiedenen Ordnungsbegriffe automatisch aus dem Text der Titelaufnahme und setzt sie in den Kopf der Katalogkarte. Das Programm wird in Einzelheiten beschrieben.
Lumbosacral disc disease in a cat
Authors: Jaeger G. H. , Early P. J. , Munana K. R. , Hardie E. M. 
Published: March 2018

SummaryAn eight-year-old male castrated domestic shorthair admitted with a two-day history of acute back pain, flaccid tail, and urinary and faecal incontinence. Diagnostic tests, including myelogram, epidurogram, and CT scan revealed an extradural lesion at the L7-S1 disc space. Exploratory surgery and histopathology confirmed a Type II lumbosacral intervertebral disc protrusion. The cat regained neurological function by six weeks after surgery. This is the first case report of a cat with documented lumbosacral disc disease. Lumbosacral disease should be considered as a differential diagnosis in cats with caudal lumbar pain or neurological signs localizable to the S1-S3 spinal cord segments or peripheral nerves.
Three Solutions to Problems of Categorized Medical Nomenclatures
Authors: Dunham G. S. , Henson D. E. , Pacak M. G. 
Published: March 2018

SummaryThree problems arising with the use and improvement of SNOP are discussed with their solutions: 1.) complete categorical encoding of disease; 2.) dual categorization of nomenclature terms; 3.) coding physiological function and dysfunction as a function and a topography. These solutions entail the expansion of the class of mathematical models for classified nomenclatures from tree hierarchies to partially ordered sets.
Bayesian Method Applied to Decision Making in Neurology — Methodological Considerations
Authors: Salamon R. , Bernadet M. , Samson M. , Derouesne C. , Gremy F. 
Published: March 2018

This article presents an analysis of the method used in an experiment in computer-aided diagnosis, applied to the whole field of neurology.While the method is based on the classical Theorem of Bayes, it nevertheless contains a number of new elements:— By means of a self-learning procedure, it makes use of the patient sample as it grows in size;— there is an overall analysis of results as well as an individual analysis of each diagnosis.
Consensus Statement: Feature and Function Recommendations to Optimize Clinician Usability of Direct Interoperability to Enhance Patient Care
Authors: Lane Steven , Miller Holly , Ames Elizabeth , Garber Lawrence , Kibbe David , Schneider Joseph , Lehmann Christoph ,   DirectTrust Clinicians' Steering Group
Published: March 2018

Background Secure clinical messaging and document exchange utilizing the Direct Protocol (Direct interoperability) has been widely implemented in health information technology (HIT) applications including electronic health records (EHRs) and by health care providers and organizations in the United States. While Direct interoperability has allowed clinicians and institutions to satisfy regulatory requirements and has facilitated communication and electronic data exchange as patients transition across care environments, feature and function enhancements to HIT implementations of the Direct Protocol are required to optimize the use of this technology.
Objective To describe and address this gap, we developed a prioritized list of recommended features and functions desired by clinicians to utilize Direct interoperability for improved quality, safety, and efficiency of patient care. This consensus statement is intended to inform policy makers and HIT vendors to encourage further development and implementation of system capabilities to improve clinical care.
Methods An ad hoc group of interested clinicians came together under the auspices of DirectTrust to address challenges of usability and create a consensus recommendation. This group drafted a list of desired features and functions that was published online. Comments were solicited from interested parties including clinicians, EHR and other HIT vendors, and trade organizations. Resultant comments were collected, reviewed by the authors, and incorporated into the final recommendations.
Results This consensus statement contains a list of 57 clinically desirable features and functions categorized and prioritized for support by policy makers, development by HIT vendors, and implementation and use by clinicians.
Conclusion Fully featured, standardized implementation of Direct interoperability will allow clinicians to utilize Direct messaging more effectively as a component of HIT and EHR interoperability to improve care transitions and coordination.
The Requirements of an Electronic Medical Record to Suit all Clinical Disciplines
Authors: Hayes G. 
Published: March 2018

AbstractThe design of the electronic medical record is becoming increasingly Sophisticated as techniques develop to improve the understanding of user requirements. Such techniques must develop as it becomes increasingly important to improve the use and uptake of such records. An outstanding question is whether the same electronic medical record can fulfil the requirements of users in different clinical disciplines. To evaluate such a requirement it is necessary to understand the different information management the needs of different clinical disciplines.Only once these differing needs are understood, will it become possible to consider whether a common record is feasible in terms of both data modelling and the user interface. This paper describes the move towards a better understanding of user requirements. It outlines the differences between the requirements of various disciplines and discusses the implications. It concentrates on the differences between the requirements for hospital specialists and family medicine as an example of the problems.
Graduate Program in Medical Informatics at the University of Utah
Authors: Warner H.R. 
Published: March 2018

AbstractThe graduate student program in medical informatics at the University of Utah described in this paper comprises a Master of Science degree (since 1976) and a Ph.D. degree (since 1962). The average program length is 2 years for M.Sc. and 3-5 years for Ph.D. The aims of the program are to prepare graduates for careers in medical informatics in academic; hospital or industrial settings. There are several different courses of study, or tracks, within the department ranging from Expert Systems, Genetic Epidemiology, Health Care Quality, Hospital Information Systems, Medical Imaging, Medical Physics, to an intensive one year M.Sc. degree course for physicians. After the first three quarters the students are require 4 to take a qualifying examination in which they qualify for a -Masters or Ph.D. degree. The program covers the total spectrum of medical informatics. About 10 students are admitted each year. There are 14 full-time faculty and 9 adjunct faculty. The total number of graduates is 151.
Electronic Patient Records and Clinical Research
Authors: Safran C. 
Published: March 2018

Abstract:The digitalization of patient records promises clinicians researchers, health administrators, and politicians new tools to transform data into information, information into knowledge, and perhaps even knowledge into wisdom. This paper will review the status of clinical databases that can be derived from electronic patient records, discuss how databases derived from routine clinical care are being used, and outline the pitfalls and limitations of using electronic patient records for clinical research.
Health Informatics at the University of Victoria
Authors: Fisher P. , Protti D. 
Published: March 2018

AbstractThe University of Victoria has the only program in Canada offering a Bachelor of Science degree in Health Information Science. To meet the requirements of the degree, students must complete 60 units of course work (normally 40 courses) and 4 CO-OP work terms over 4.3 years. The School admits approximately 30 students each year. Seventy-five percent of the students come from British Columbia, ranging in age from 18 to 50 years with the average age being 26 years. In addition to recent high school graduates, over 40% have previous degrees or diplomas, and 65% have over 5 years of work experience. The School’s teaching team consists of 4 full-time faculty, 2 professional staff, 2 clerical staff, 7 adjunct faculty and a variable number of sessional teaching staff. The majority of the faculty have health backgrounds, totalling 150 person-years of health care experience. As of November 1995, the School had 168 graduates 75% of whom are employed in British Columbia, 17% in other parts of Canada and 8% outside the country. Sixty-five percent of the graduates work in government departments including community health agencies; 10% work in hospitals, 20% work for management consulting firms, software houses, or computer hardware firms, and 5% are otherwise employed. Almost 100% of the graduates are gainfully employed in professional positions in which their health information science degree is valued. They work as systems analysts, system designers/developers, consultants, research assistants, health-care planners, information system-support staff/trainers and client-account representatives. Some are already in senior management positions.
Standardization of health informatics - results and challenges
Authors: Klein G.O. 
Published: March 2018

Abstract:A number of standardization initiatives have been in progress for more than ten years in several parts of the world with the aim to facilitate different aspects of the exchange of health information. 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. This article will review some of the difficulties surrounding standards, as well as highlight the achievements and main global actors, while focusing on the challenges facing the international consensus process.
Immuntherapie – Die neue Ära in der Onkologie
Authors: Kansy Benjamin , Lang Stephan 
Published: March 2018

ZusammenfassungIn den letzten Jahren wurden bedeutende Fortschritte auf dem Gebiet der Immuntherapie erreicht mit teils langanhaltendem Therapieansprechen bei unterschiedlichsten Tumorentitäten. Die Basis hierfür bildet ein verbessertes Verständnis der Interaktion zwischen Tumor und Immunsystem und der damit verbundenen Integration immuntherapeutischer Ansätze in die klinische Routine. Die hierbei eingesetzten immuntherapeutischen Strategien greifen auf unterschiedlichen Ebenen der Immunantwort ein, fördern direkt oder indirekt die Zerstörung der Tumorzellen durch die körpereigene Abwehr und reichen von Zytokintherapien über Vakzinierungen und den Einsatz onkolytischer Viren bis hin zu monoklonalen Antikörpertherapien und dem adoptiven Zelltransfer.
Radiomics: Big Data statt Biopsie in der Zukunft?
Authors: Scheckenbach Kathrin 
Published: March 2018

ZusammenfassungDie Präzisionsmedizin wird – auch mit Zunahme gezielter Therapieoptionen durch Biologicals – immer mehr vorangetrieben. Die individuelle Charakterisierung einer Erkrankung auf der Grundlage von Biomarkern im weitesten Sinne ist eine grundlegende Voraussetzung hierfür. Diese Biomarker können bisher klinisch, histologisch oder molekular bestimmt werden. Die Entwicklung breiter Screening Methoden und gleichzeitig die Möglichkeit, große Datenmengen („Omics“ ) mit geeigneter Software immer besser zu analysieren, führen dazu, dass man sich nicht nur auf einzelne Biomarker beschränkt, sondern Biomarker-Signaturen darstellen kann. Die „Radiomics” finden neben „Genomics“, „Proteomics“ oder „Metabolomics” in den letzten Jahren zunehmendes Interesse und erweitern das Biomarkerfeld. Basierend auf radiologischen Bildern werden eine Vielzahl von Merkmalen mithilfe spezifischer Algorithmen extrahiert. Diese Merkmale werden mit klinischen, (immun-) histopathologischen und genomischen Daten korreliert. Erfasste Strukturunterschiede sind Bestandteil der den Bildern zugrundeliegenden unbearbeiteten Metadaten. Diese sind für das bloße Auge oft nicht sichtbar und insofern ohne spezifische Software für den Untersucher nicht zu erfassen. Sie lassen sich aber numerisch abbilden und grafisch visualisieren. Ein besonderer Reiz der „Radiomics“ ist, dass bereits routinemäßig durchgeführte Bildgebungen einen Biomarker-Charakter zeigen. Dieser hat das Potenzial, Zusatzuntersuchungen oder Biopsien idealerweise durch eine „Radiomics“ Analyse zu ersetzen. Alternativ könnten „Radiomics“-Signaturen andere Biomarker suffizient ergänzen und hierdurch eine präzisere, multimodale Aussage ermöglichen. Bisher finden Radiomics vor allem in der Onkologie solider Tumore Anwendung. Auch bei Kopf-Hals-Karzinomen wurden bereits erste vielversprechende Untersuchungen veröffentlicht.