bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Need for Requirements Engineering in the Development of Clinical Decision-Support Systems: A Qualitative Study
Authors: Johansson M. , Timpka T. 
Published: March 2018

Abstract:Insufficient requirements analysis has recently been suggested as a problem in clinical decision-support systems development. Therefore, to explore knowledge, practices and attitudes, key professionals in the area from four countries were interviewed regarding the early phases in the development process. For data collection, semi-structured interviews were performed and video-taped. As reference, documentation of the Action Design requirements engineering methodology was used. Two separate qualitative analyses of the data were made. The first was to identify central concepts and attitudes related to requirements engineering. In the second anlysis, concrete circumstances surrounding decisions to use requirements engineering methods were investigated. This paper reports the results of the analyses and discusses changes in the planning and management of clinical decision-support projects in general, and it comments on development methods, using Action Design as reference. It is concluded that studies are needed to further investigate the problems real decision-support projects have to deal with. This knowledge can then be used to develop methods and tools which support design practices where existing structural, procedural and, building on this, technical obstacles are overcome.
Directions and Opportunities in Health Informatics in British Columbia
Authors: Thornton K. 
Published: March 2018

Abstract:The social changes, and changes in perceptions of the effectiveness of health care in British Columbia have resulted in a large number of recommendations in the report of the British Columbia Royal Commission on Health Care and Costs. Many of these recommendations have implications for health informatics. The British Columbia Government, in outlining a response, foresees a major change in the emphases of health care, which will involve four major areas of health informatics: network evolution, automation of the patient record, outcome- and other quality-related databases, and consumer health education. These themes are discussed, in the light of the opinions of academics, health care providers, and the health-informatics industry. The themes must be intercalated into the health informatics curriculum, to equip graduates for the challenges of B.C.’s changing health care system.
The Development of a Graduate Program in Health Information Management
Authors: Johns M. L. 
Published: March 2018

Abstract:The development of a graduate program in Health Information Management is described. The purpose of the program is to prepare individuals to assume executive level roles in a variety of health-care enterprises in health information resources management. The curriculum is based on empirical findings of a role delineation study of chief information officers (ClOs) in the USA. A model of professional practice of the CIO was developed from study findings which describes the role of the CIO from the standpoint of functional areas of entrepreneur, resource allocator, negotiator, information disseminator, information monitor, leader, and operations manager.
MIRACLE: A Time-oriented Data Validation and Analysis System for Clinical Research
Authors: Sinn H. P. , Altendorf A. , Estelmann A. 
Published: March 2018

SummaryMIRACLE is a medical information system designed to validate and analyse time-oriented data. The chronological patient database is composed of user-defined repeating groups stored in numerically coded character records of variable length. A flexible query language gives access to semantic validation, cross-sectional and mixed-longitudinal analysis. The main application is at present a large hospital-based tumor register.
Skull X-Ray Assessment of Head Injuries: A Decision Analytic Approach
Authors: Balla J. I. , Elstein A. S. 
Published: March 2018

SummaryWe demonstrate the value of skull x-rays in the assessment of head injured patients. With the use of the simple decision analytic technique of 2 x 2 tables and literature derived figures, it is shown that in patients with a normal neurological examination following head injuries, skull x-rays are a cost-effective method of detecting preventable complications. The positive predictive value (PVP) of skull x-rays in these patients is. 03, in contrast to .001 of the group as a whole. Such cases should then have a CT scan to detect early cases of intracranial haematoma (ICH). The presence of abnormal neurological signs has a high PVP of .2 for complications; in these patients, skull x-rays do not improve the detection of ICH and CT scanning alone should be carried out.
A Medical Microcomputer Database Management System
Authors: Naddaf-Dezfbli A. R. , Davenport Sandra L. H. , Joyce A. 
Published: March 2018

SummaryThe Patient Data Handler (PDH) is an interactive, microcomputer-based database management system. It is written in DEC BASIC-11 and runs on a DEC compatible LSI-11/03. The PDH is a relational database specifically designed to handle a very large number of attributes per patient. The retrieval program is capable of performing any combination of Boolean operations on the patient records. Data security is provided by several levels of password protection. The current application has 3,500 attributes associated with a research project on deaf-blind syndromes. Specific retrieval examples are shown from this database.
Graphical Access to Medical Expert Systems: III. Design of a Knowledge Acquisition Environment*)
Authors: Walton Joan , Musen M. A. , Combs D. M. , Lane C. D. , Shortliffe E. H. , Fagan L. M. 
Published: March 2018

SummaryKnowledge acquisition for expert systems typically is a tedious, iterative process involving long hours of consultation between the domain experts and the computer scientists who serve as knowledge engineers. For well-understood domains, however, it may be possible to facilitate the knowledge acquisition process by allowing domain experts to develop and edit a knowledge base directly. Administration of protocol-directed cancer chemotherapy is such a well-understood application area, and a knowledge acquisition system, called OPAL, has been developed for eliciting chemotherapy-protocol knowledge directly from expert oncologists. OPAL’s knowledge acquisition approach is based on the interactive graphics environment available on current generation workstations. The use of graphics improves the interface by reducing typing, avoiding natural language interpretations, and allowing flexibility in entry sequence. The knowledge in OPAL is displayed using an arrangement of hierarchically related, graphical forms. The position of a particular form in the hierarchy defines the context of the knowledge contained in the form. Intelligent editing programs such as OPAL can streamline the knowledge engineering process for highly structured domains requiring repetitive knowledge entry.
A Computer-based Clinical Information System
Authors: El-Gamal S. S. 
Published: March 2018

SummaryModern information technology offers new opportunities for the storage and manipulation of hospital information. A computer-based hospital information system, dedicated to urology and nephrology, was designed and developed in our center. It involves in principle the employment of a program that allows the analysis of non-restricted, non-codified texts for the retrieval and processing of clinical data and its operation by non-computer-specialized hospital staff.This Hospital Information System now plays a vital role in the efficient provision of a good quality service and is used in daily routine and research work in this hospital. This paper describes this specialized Hospital Information System.
Bivariate Structural Regression Analysis: A Tool for the Comparison of Analytic Methods
Authors: Feldmann U. , Schneider B. 
Published: March 2018

SummaryThis paper introduces the concept of bivariate structural regression analysis, a new technique which offers some advantages compared to the well-known structural relationship approach. The concept is not restricted to multivariate normal distribution, and without additional constraints the model remains identifiable in the bivariate case. A bivariate calibration line is developed first by the maximum likelihood method and then also distribution-free by applying rank statistics. Both estimation procedures coincide, if the distribution assumption is satisfied. Hence, the distribution-free approach has an efficiency of 100%. Our concept of analysis is applied to the comparison of analytical methods in clinical chemistry. Appropriate statistical tests concerning accuracy and precision as well as the model fit are offered.
Monitoring Intervals between Rare Events: A Cumulative Score Procedure Compared with Rina Chen’s Sets Technique
Authors: Wolter Chr 
Published: March 2018

SummaryA cumulative score procedure (cuscore) is compared with Rina Chen’s sets technique. Cumulative score procedures make a faster detection of subtle epidemics of rare diseases possible. Besides, the implementation of this new sequential technique is very simple. Therefore, the use of the cuscore procedure instead of the sets technique is recommended.
A Nonparametric Law of Initial Values (LIV) Test for Comparing Spreads in Two Paired Samples
Authors: Lienert G. A. , von Eye A. 
Published: March 2018

SummaryWilder’s law of initial values suggests that treatments lead to an increase of originally low and a decrease of originally high scores. The paper proposes a nonparametric test to determine whether in pre-post designs measurements differ in their relative dispersion. The test is based on a similar rationale as Westenberg’s interquartile range test for comparing unpaired samples. Modifications and applications are discussed. The test is illustrated using a biomedical data example.
Modeling Hospital Information Systems with Petri Nets
Authors: Peimann C.-J. 
Published: March 2018

SummaryIn the development of hospital information systems it is difficult to describe data and activities simultaneously and equivalently. Most of the methods used so far are only suitable for either data structures or functional modeling. In particular, it is not possible to comprehend the functional interdependence of hospital procedures.In this paper it is shown that Petri Nets are well suited for the development of complex software systems. Their exceptional properties are, on the one hand, the simulative capacities which allow to visualize interlinked and interdependent procedures of the real world. On the other hand, it is pointed out that Petri Nets comply with the demands of software engineering. In order to make these characteristics clear, two models from real developments are used: Firstly the organizational model of a small hospital and secondly the model of the data entry in the follow-up of tumor patients.
Recall of Injury Events by Thirteen Year Olds
Authors: Cecchi J. C. , Williams S. M. , Langley J. D. 
Published: March 2018

Abstract:The level of under-reporting of injury events which resulted in medical treatment was determined for a group of 631 thirteen-year olds. Two-year recall data was compared with the medical records of an accident and emergency department. Thirty-nine percent of all visits to the accident and emergency department were not recalled. Recall was shown to be related to the number of injury events, time elapsed since an injury event, type and severity of injury but not to whether the victim was hospitalized. Logistic regression analysis suggested that the recall of injury events depended on the type of injury sustained, time elapsed since the injury event, the number of injury events, and an interaction effect between the time and the number of injuries.
Discriminating Powers of Partial Agreements of Names for Linking Personal Records
Authors: Newcombe H. B. , Fair M. E. , Lalonde P. 
Published: March 2018

Abstract:Machines have difficulty when using people’s names to link medical and other records pertaining to the same individuals because of nicknames, ethnic synonyms, truncations, misspellings and typographical errors. Present algorithms used to compute the discriminating powers (or ODDS) associated with partial agreements of names are based, inappropriately, on the degrees of outward similarity alone. They are particularly ineffective in dealing with names that look alike but are unrelated, and with related names that have little apparent similarity. A fundamentally different rationale is, therefore, proposed which, like the human mind, assesses the relatedness of two alternative forms of a name in terms of how often they are used, interchangeably in practice. This must be taken into account if the associated discriminating powers (ODDS) are to be correctly computed. A way of implementing this more precise approach is described and illustrated, using the given names on linked records from an earlier epidemiological study. This first study of two describes the logical basis for record linkage, a second one the empirical test.
The Data Dictionary – A Controlled Vocabulary for Integrating Clinical Databases and Medical Knowledge Bases
Authors: Linnarsson R. , Wigertz O. 
Published: March 2018

Abstract:The medical information systems of the future will probably include the entire medical record as well as a knowledge base, providing decision support for the physician during patient care. Data dictionaries will play an important role in integrating the medical knowledge bases with the clinical databases.This article presents an infological data model of such an integrated medical information system. Medical events, medical terms, and medical facts are the basic concepts that constitute the model. To allow the transfer of information and knowledge between systems, the data dictionary should be organized with regard to several common classification schemes of medical nomenclature.
Neue Auswertungsmöglichkeiten pathologisch-anatomischer Befundberichte. Klartextanalyse durch Elektronenrechner
Authors: Röttgeb P. , Reul H. , Sunkel H. , Klein I. 
Published: March 2018

Die Klartextanalyse ist eine neue Methode der automatischen statistischen Auswertung des Sektionsgutes. Sie wurde mit folgenden Ergebnissen an einem vollständigen Jahrgang von Befundberichten erstmals erprobt:Die Überprüfung der Vollständigkeit der Befunderfassung am Beispiel der »Lungenembolie« ergabdie gleiche Zuverlässigkeit wie die Auswertung von Hand.Die statistische Auswertung konnte bei Bedarf sofort mit einer Wahrscheinlichkeitsberechnung kombiniert werden.Befunde wie »Arteriosklerose«, »Karzinom«, »Tuberkulose«, »Lungenembolie«, »Cholelithiasis« und »Myokardinfarkt« konnten auf ihre Häufigkeit sowohl einzeln als auch in Kombination ausgezählt werden.Zusatzinformationen zu diesen Befunden, wie Angaben über Lokalisationen, Intensität, Befundalter und morphologische Varianten, konnten gleichfalls statistisch erfaßt werden.Numerische Daten aus den Befundberichten (z. B. Patientenalter) konnten in Korrelation zu Befunden wie »Karzinom« und deren weitere Einengungen, wie »Lungenkarzinom« oder »Magenkarzinom«, gebracht werden.Auch Informationen, die erst durch die automatische Standardisierung zusätzlich in die primären Texte eingebracht worden waren, konnten ausgewertet werden. Als Beispiel für solche Notationen des Facetten-Thesaurus wurden Krankheitsobergruppen, die nach allgemein-pathologischen Gesichtspunkten zusammengestellt worden waren (»Kreislaufleiden«, »bösartige Geschwülste« usw.), in Korrelation zu einem bestimmten Befund (»Lungenembolie«) ausgezählt.Die Auszählergebnisse stimmten im wesentlichen mit den Resultaten konventionell durchgeführter statistischer Untersuchungen am Sektionsgut überein. Sie ergaben außerdem Anregungen zu weiteren, mit der gleichen Methode durchzuführenden Untersuchungen.
Current Status of a Medical Information System
Authors: Van Brunt E. , Davis L. S. , Terdiman J. F. , Singer S. , Besag E. , Collen M. F. 
Published: March 2018

A pilot medical information system is being implemented and currently is providing services for limited categories of patient data. In one year, physicians’ diagnoses for 500,000 office visits, 300,000 drug prescriptions for outpatients, one million clinical laboratory tests, and 60,000 multiphasic screening examinations are being stored in and retrieved from integrated, direct access, patient computer medical records.This medical information system is a part of a long-term research and development program. Its major objective is the development of a multifacility computer-based system which will support eventually the medical data requirements of a population of one million persons and one thousand physicians. The strategy employed provides for modular development. The central system, the computer-stored medical records which are therein maintained, and a satellite pilot medical data system in one medical facility are described.
Zur Erfassung und Verarbeitung medizinischer Daten mittels Computer
Authors: Gieee W. 
Published: March 2018

Das Dekodierungsund Text-Ausgabe-Programm (DUTAP) wird beschrieben. DUTAP dient der weiteren Verarbeitung der Daten, die nach dem in den früheren Mitteilungen beschriebenen System DUSP erfaßt wurden.Basis des Programmsystems ist eine leicht verständliche, problemorientierte Programmiersprache in Form einer sogenannten »Meta-Sprache«. Die Umwandlung der Befehle durch den Sprachübersetzer ergibt das Benutzerprogramm mit einem der Erhebungsbogenstruktur entsprechenden Ablaufteil und den aus Gründen der’ Verarbeitungsgeschwindigkeit im Programm formulierten Textkonstanten. Mehrere problemorientierte DUTAP-Moduln in Uberlagerungsstruktur werden durch die systemorientierten DUTAP-Moduln zu einem Programm großer Flexibilität ergänzt. Ein gemeinsamer Verständigungsbereich dient der Übergabe von Information aus der jeweils aktuellen -Problemin die Systemphase und vice versa.Die Anwendung des DUSP/DUTAP-Systems ermöglicht es einerseits den Ärzten, sich zur Befundung im Regelfall mit einer Art Kurzschrift zu begnügen, andererseits läßt sich die Programmierung der Kurzschrift-Entschlüsselung zur allgemein verständlichen Langtextausgabe in der DUTAP-Programmiersprache nach kurzer Einarbeitungszeit von Hilfskräften erledigen.
Automated Management of Routine Medical Records in General Practice
Authors: CLARKE A. H. , DIXON R. A. , RICKARDS D. F. , SAXBY N. V. 
Published: March 2018

Out-dated methods for recording details of routine consultations in general practice in England and Wales indicate the need for a more logically structured and automatically summarised patient record, particularly as large group practices increase in number.Progress is reported of a flexible phased programme for the construction of computer-stored, long-term medical histories of individual patients. These are derived from details of every consultation in a group general practice, recorded in structured narrative form on paper tape. No additional work is required of the doctor, and the additional work of the secretarial staff is minimised by the use of program tapes and punched cards bearing patient identification. Lists giving full details of all doctor/patient contacts can be produced. The corresponding master tapes can be searched and subsidiary lists printed out.
Automated Multiphasic Health Testing and Services. Total Systems Analysis and Design
Authors: FLAGLE Ch. D. 
Published: March 2018

The design of a multiphasic health testing centet must be based simultaneously upon knowledge of the population to be served and upon the capabilities of the medical services available to those who are tested. Multiphasic testing may be regarded as a regulator of patient flow from the population into a variety of health services, where rate of patient referral is a function of the rate of testing, the prevalence of medical conditions requiring service, and the sensitivity and specificity of tests used. Rules are given for choice of tests to be administered, and the needs of data banks, including results of follow-up examinations are described.Given the selection of a sequence of tests and the daily , range of rate of testing of individuals, the design of the facility is influenced by the service times required in each test station. Suggestions are given for arrangement of the testing sequence and continuous evaluation of the multiphasic health testing process.
Compartmentmodelle in der Medizin
Authors: Fuchs G. 
Published: March 2018

Die Begriffe Compartment und Compartment-Modell werden definiert, und ein Katalog möglicher Typen wird vorgestellt. Zur mathematischen Bearbeitung von Aufgaben müssen drei Gruppen von Gleichungen formuliert bzw. postuliert werden: Bilanz-Gleichungen, Übergangs-Gleichungen, Modell-Gleichungen. Mit Hilfe dieser mathematischen Ansätze können drei verschiedene Typen von Fragestellungen theoretisch bearbeitet werden.An fünf Beispielen aus dem Gesamtgebiet der Medizin wird das Verfahren der Modellaufstellung und die Durchführung der Modellrechnungen erläutert. Die Beispiele sind aus sehr verschiedenen Bereichen der Medizin ausgewählt, doch kann gezeigt werden, daß das formale Vorgehen in seinen Grundzügen immer das gleiche ist.
Drug Recording and Classification by the WHO Research Centre for International Monitoring of Adverse Reactions to Drugs
Authors: Helling Margaretha , Venulet J. 
Published: March 2018

Recording and classifying drugs reported in relation to suspected drug adverse reactions by fifteen countries has required the development of a special system. A comprehensive cross reference system between different types of drug names (INN, other nonproprietary names, trade names, etc.) and their occurrence in single and multiple ingredient products has been developed. Separate pharmacologic and therapeutic classifications designed for the needs of drug monitoring provide for farther special grouping.On the basis of accumulated data, some analysis is given of reporting patterns and drug profiles in different countries.
Factor Analysis in the Evaluation of Criteria and Variants of Systemic Lupus Erythematosus
Authors: Mustakallio K. K. , Lassus A. , Putkonen T. 
Published: March 2018

The value of factor analysis in defining complex diseases was tested with a series of 135 patients with more or less evidence of systemic lupus erythematosus (SLE).The factor analytic classification of the patients according to the interdependence of 25 unweighed criteria for’ SLE concurred rather well with a clinical classification into definite, probable, and possible SLE cases obtained by transforming the »diagnostic«, »major«, and »minor« criteria into numerical values. The clinical evaluation of the criteria appeared thus to have a sound statistic basis, even if there was evidence of that too much confidence had been paid to the diagnostic value of certain criteria, especially in oligosymptomatic cases.Five factors corresponded to a clinically meaningful symptom complex or variant of SLE: the classical visceral and erythematous types of SLE, and rheumatoid, discoid and drug associated variants. This suggests that the factorial structure of SLE obtained in this study is rather invariant, i.e., susceptible to profound alterations neither by réévaluation with other series nor by addition of new characteristics to the set of criteria for SLE.