bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a Decision-Support System for Inoperable Non-Small Cell Lung Cancer
Authors: Kolari P. , Wigren T. 
Published: March 2018

Abstract:The purpose of this study was to find out whether a decision-support system is able to assist a clinician in predicting patient outcome and in selecting optimal treatment in oncology. The domain of the evaluated decision-support prototype was primary therapeutic decision making in inoperable non-smali cell lung cancer. The performance of the prototype was tested on retrospective material consisting of 112 patients treated by radiotherapy. Survival was the endpoint for examining whether the treatment decision proposed by the system was more accurate than the decision actually made by the clinician. Certain prognostic variables were used by the system to classify patients into two treatment groups, radical or palliative radiotherapy. The median survival times of these groups were 15 and 7 months, respectively, compared with 9 and 8 months in the corresponding groups classified by the clinician. Our results indicate that clinicians need support in treatment selection and that decision-support systems could be a potential answer.
Human Performance Evaluation of a Metaphor Graphic Display for Respiratory Data
Authors: Stewart J. G. , Cole W. G. 
Published: March 2018

Abstract:Metaphor graphics are data displays designed to look like corresponding variables in the real world, but in a non-literal sense of “look like”. Evaluation of the impact of these graphics on human problem solving has twice been carried out, but with conflicting results. The present experiment attempted to clarify the discrepancies between these findings by using a complex task in which expert subjects interpreted respiratory data. The metaphor graphic display led to interpretations twice as fast as a tabular (flowsheet) format, suggesting that conflict between earlier studies is due either to differences in training or to differences in goodness of metaphor, Findings to date indicate that metaphor graphics work with complex as well as simple data sets, pattern detection as well as single number reporting tasks, and with expert as well as novice subjects.
Integrated Advanced Medical Information Systems (IAIMS): Payoffs and Problems
Authors: Clayton P. D. 
Published: March 2018

Abstract:IAIMS (Integrated Advanced Information Management Systems) is an initiative to improve the access to information needed to provide patient care, health-oriented education, biomedical research, and management of large medical center environments. This paper will review the goals, history, and accomplishments of the IAIMS initiative. Shortcomings and frustrations, lessons learned, and the future of such initiatives will also be discussed.
MEDUSA: A Fuzzy Expert System for Medical Diagnosis of Acute Abdominal Pain
Authors: Fathi-Torbaghan M. , Meyer D. 
Published: March 2018

Abstract:Even today, the diagnosis of acute abdominal pain represents a serious clinical problem. The medical knowledge in this field is characterized by uncertainty, imprecision and vagueness. This situation lends itself especially to be solved by the application of fuzzy logic. A fuzzy logic-based expert system for diagnostic decision support is presented (MEDUSA). The representation and application of uncertain and imprecise knowledge is realized by fuzzy sets and fuzzy relations. The hybrid concept of the system enables the integration of rulebased, heuristic and casebased reasoning on the basis of imprecise information. The central idea of the integration is to use casebased reasoning for the management of special cases, and rulebased reasoning for the representation of normal cases. The heuristic principle is ideally suited for making uncertain, hypothetical inferences on the basis of fuzzy data and fuzzy relations.
Patient Records: from Single Events to Elements for Health Planning
Authors: Pisanelli D. M. , Ricci F. L. 
Published: March 2018

Abstract:Data collected in patient records are not only the kernel of a ward information system, but also the groundwork for planning and evaluating services in health care. The aim of this study was to analyze the problem of aggregate data generation starting from separate items in patient records. After describing the different uses of patient record data, we outline the process which generates aggregate data starting from individual records. This process leads to the definition of the “view on aggregation” as an intermediate step between patient records and aggregate data.A simplified schema is presented based on the Entity-Relationship model representing a conceptual model of the integration of aggregate data and patient record items. Finally, the role is discussed of automation in this process and the perspectives for its implementation.
The PEN & PAD Medical Record Model: Development of a Nursing Record for Hospital-based Care of the Elderly
Authors: Heathfield H. A. , Hardiker N. , Kirby J. , Tallis R. , Gonsalkarale M. 
Published: March 2018

Abstract:The PEN & PAD Medical Record model describes a framework for an information model, designed to meet the requirements of an electronic medical record. This model has been successfully tested in a computer-based record system for General Practitioners as part of the PEN & PAD (GP) Project.Experiences of using the model for developing computer-based nursing records are reported. Results show that there are some problems with directly applying the model to the nursing domain. Whilst the main purpose of the nursing record is to document and communicate a patient’s care, it has several other, possibly incompatible, roles. Furthermore, the structure and content of the information contained within the nursing record is heavily influenced by the need for the nursing profession to visibly demonstrate the philosophical frameworks underlying their work. By providing new insights into the professional background of nursing records, this work has highlighted the need for nurses to clarify and make explicit their uses of information, and also provided them with some tools to assist in this task.
On the Selectivity of the Identification Number in the Patient Data Base of the Medical System Hannover
Authors: Feldmann U. , Reichertz P. L. , Sauter K. 
Published: March 2018

The clinical data of patients at the Medical School of Hannover is collected in a central patient data base by the Medical System Hannover. A 9-digit »ID-number« is used to identify each patient.At the end of the year 1978 the data base contained data of 137,474 patients and 5.1% of the new admissions in the year 1978 hit upon a previously issued ID-number.The selectivity of the ID-number is presented according to empirical frequency distributions of the ID-number’s components and it is evaluated with the aid of information theory.A method, derived from occupancy theory, for quantitively estimating the ID-number multiples depending on the number of patients and considering the frequency distributions of the individual IDnumber components is presented and successfully proven.
The Information System of Experimental Pathology of the German Cancer Research Center
Authors: Komitowski D. , Köhler C. O. , Naumann D. , Lance B. 
Published: March 2018

The information system of experimental oncopathology of the German Cancer Research Center is a computerized data processing program for studying the etiology, pathogenesis and therapy of experimental cancer. This program is adapted to correlate stored data with those from the thesaurus of human pathology. The system is developed and administered by the histodiagnostic facility which serves to collect and register standardized, centralized and current data from all sources. These are: individual investigators, animal laboratory, and central histodiagnostic facility. To record uniform data, a standardized protocol is introduced which entails data sets for information about animals, substances under study, experimental design, and necropsy and histological changes. The data entry takes place semi-automatically by using different codes grouped into three files: for substances, for animals, and for pathological changes. The code for pathological findings is based on SNOP. For data processing the system ALIS is employed which permits input, check and update; reorganisation and confirmation; evaluation.The information system is adapted to the organization and research programs of the German Cancer Research Center. It is a flexible system applicable for different conditions in registering and processing diverse information about animal experiments.
Incorporating Individual Patient Preferences in Scheduling Bitewing Radiographs
Authors: Pliskin J. S. , Shwartz M. , Gröndahl H. G. , Boffa J. 
Published: March 2018

SummaryConcern about the potential risks of low dose radiation has focussed increased attention on the question of how often to perform bitewing radiographs. To consider this question, a mathematical model was developed that describes the initiation and progression of dental caries on the approximal surfaces of permanent teeth. This model enables calculation of benefit as a function of the frequency of bitewing radiographs. The model does not, however, capture patients’ (and dentists’) subjective attitudes towards various outcomes such as dollar costs, radiation exposure, inconvenience of treatment, anxiety and pain. This paper presents a multiattribute utility approach to quantifying patient preferences for possible outcomes of decisions on radiographic frequencies. Five relevant attributes are considered and reduced to two, over which a quasi-additive utility function is found plausible. The paper demonstrates the assessment method and presents aggregate data from a group of individuals.
Assessment of Social Value in the Allocation of CT Scanners – A Case Study
Authors: Gottinger H. W. 
Published: March 2018

SummaryThis paper describes a case study on the application of decision analytic procedures to the allocation of computer tomography in a given metropolitan health service area, the Munich Metropolitan Area. The analysis could be used as a decision-aiding and decision-supporting instrument for government regulators in making rational resource allocation decisions as to locating high-cost, high-technology medical equipment. Explicit value judgments, reflecting the monetary equivalent of the different categories of benefit, are introduced to facilitate the comparison between decision options. The difference between the (incremental) benefits, measured in monetary terms, and the (incremental) costs is called the net social value and used as the overall decision criterion.Any alternative with positive net social value is judged economically justifiable, and the alternative with the greatest net social value - subject to its stability as to various sensitivity tests on input parameters - is judged to be most attractive from a societal viewpoint.
Examination of Disease Names Using Non-Abelian Symbolic Logic
Authors: Hutchins G. M. , Miller R. E. , Moore G. W. 
Published: March 2018

SummaryDespite many investigations of the potential role of formal symbolic logic in medicine, little attention has been paid to the distribution of words in large quantities of natural language text and how this might affect the choice of a logic system. With the emergence of communicating word processor technology, it is now possible to enter large amounts of routine medical text in computer-readable form and study its implications for symbolic logic formalisms.We examined the word distribution in the Anatomical Diagnosis reports of 7,000 consecutive autopsied patients from the Department of Pathology of The Johns Hopkins Hospital. We found that uncommon disease entities consisting of common component words were best recovered using a search algorithm which examines conjunction (and) logic in ascending order of word frequency and alternation (inclusive or) logic in descending order of word frequency. This logic is non-Abelian, non-distributive, and associative for conjunction but not for alternation. Our results suggest that natural language text analysis, which is essential for studying medical documents by computer, may require heretofore little studied variant forms of symbolic logic.
Remission Control of Pre-Post Treatment Comparisons by Two-Sample Symmetry Testing
Authors: Havránek T. , Lienert G. A. 
Published: March 2018

SummaryStarting from one-sample symmetry testing in pre-post treatment square contingency tables, two-sample symmetry tests were constructed and suggested for control of spontaneous remission in clinical trials. The fourfold tests presented are sensitive to the alternatives of specified improvement effects, global improvement effects and differential improvement effects in subgroups of patients and include a composite fourfold omnibus test which is rather insensitive to many alternatives. The application of two-sample symmetry testing is illustrated numerically by an example from controlled psychotherapy research.
A Computerized Coding System for Processing Basic Histopathological Changes – Application to Vascular Pathology
Authors: Mauriello A. , Sambuy Y. , Bonanno E. , Orlandi A. , Palmieri G. , Spagnoli L. G. 
Published: March 2018

SummaryAmong the numerous existing computer-based systems for processing pathological data, none contains sufficient space for encoding data on the basic cytological or histological changes of a certain organ or tissue, upon which the final diagnosis is based.An “analytical record” was constructed listing all the basic changes that can be encountered in the various pathological conditions of the vascular wall. The data collected on the “analytical record” were coded by means of an alphanumeric code and stored in an Apple II 48 K minicomputer.The advantages of this system include the computerization of the data by non-specialized personnel and the possibility to’ quantitatively analyze the histocytopathological parameters used for diagnosis in vascular pathology. This coding system may easily be adapted, with minor modifications, to the histopathological study of other organs and tissues.
Computation of Expected Deaths for Prediction and for Long-Term Follow-up Studies
Authors: Simpson J. C. , Woolson R. F. , Tsuang M. T. 
Published: March 2018

SummaryIn this paper we discuss an uncomplicated procedure for computing the expected number of deaths in a heterogeneous study sample without requiring any information about the number or distribution of observed deaths. This procedure can thus be used to compare grouped mortality data to a large reference population and also to make predictions about the number of deaths to be expected in the not too distant future based on current population rates. The estimation procedure is introduced in a simple context and later extended to allow for multiple hazard rates, for right censoring, and for competing causes of death.
A Comprehensive Database Management System for a Variety of Clinical Trials
Authors: Koval J. J. , Kwarciak L. M. , Grace M. G. A. , Lockwood B.J. 
Published: March 2018

SummaryA multicentre database management system has been developed which permits individual centres to enter, update, and retrieve their data while allowing detailed analysis to take place on a multicentre basis. Individual centres can access only their own data; summaries, reports and graphics output can be used as a teaching device for seminars and rounds. In one instance, the system provides interactive services to 12 kidney transplant centres spanning a distance of 5000 kilometres; the database contains 20,000,000 items.The database management system is discussed and comparisons are made with other available systems.
Statistical Analysis of a Clinical Trial in Orthostatic Hypotension -a Nonparametric Approach
Authors: Haux R. , Immich H. , Schumacher M. 
Published: March 2018

SummarySome basic problems and considerations of analyzing clinical trials, in which a large amount of data is recorded on very few patients - mostly in the form of serial measurements -, are highlighted within the framework of a clinical trial in orthostatic hypotension. The method suggested to analyze these kinds of trials renounces the use of complex mathematical models and complicated statistical methods. It is simply based on the derivation of relevant aspects of the patient’s profiles and the use of well-known nonparametric tests and requires only a very simple study design. With this procedure, however, it is possible to satisfy at least the basic requirements of clinical trial methodology.
New Trends of Image Analysis in the Medical Field
Authors: Dengler J. , Bertsch H. , Desaga J. F. , Schmidt M. 
Published: March 2018

SummaryImage analysis with the aid of the computer has rapidly developed over the last few years. There are many possibilities of making use of this development in the medical and biological field. This paper is meant to give a rather general overview of recent systematics regarding the existing methodology in image analysis. Furthermore, some parts of these systematics are illustrated in greater detail by recent research work in the German Cancer Research Center. In particular, two applications are reported where special emphasis is laid on mathematical morphology. This relatively new approach to image analysis finds growing interest in the image processing community and has its strength in bridging the gap between a priori knowledge and image analysis procedures.
Technology Assessment and Forecasting of Medical Expert Systems (MEST)
Authors: Gottinger H. W. 
Published: March 2018

SummaryThis paper provides an analytical framework for technology assessment of emerging medical expert system technology (MEST). It is argued that expert system technology, though based on different principles of technological design, emanates generically from computerized systems of medical decision-making and automated decision aids.A taxonomic decision procedure is developed to assess comprehensively the benefit/cost impacts of prototypical MEST.The results obtained will be used in a technology diffusion model to forecast the spread of the use of MEST among major teaching and research hospitals. Key factors likely to constrain the use of MEST will be subject to additional evaluation.
The Computerized Problem-Oriented Medical Record at Karolinska Hospital — Format and Function, Users’ Acceptance and Patient Attitude to Questionnaire —
Authors: Mellner Ch. , Selander H. , Wolodarski J. 
Published: March 2018

In the last five years computerized medical records have come into routine use at some departments of the Karolinska Hospital. These records were to a large extent based on the problem-oriented approach.This paper describes the format and function of this record, reports the acceptability thereof to the users compared to the traditional source-oriented medical record, and discusses patient attitudes to the questionnaire method for medical history-taking.
The First Decade of Effort: Progress Toward a Hospital Information System at the UCLA Hospital, Los Angeles, California
Authors: Lamson B. G. , Russell W. S. , Fullmore J. , Nix W. E. 
Published: March 2018

Total information and communication systems within hospitals have been designed, but successful complete implementation, to date, has not been achieved. Limited applications with both patient medical data, notably in the clinical laboratories, and in the hospital accounting offices have been numerous. Although total programs are not yet a reality, it is apparent that the computer will serve ultimately many communication requirements, both medical and financial, within the hospital.Sound hospital management requires that costs of all component operations be known in order that value judgments concerning worth and efficiency may be made. Accrual accounting systems which match revenue and expense over the same time period are a prerequisite. Cash and modified cash hospital accounting cannot provide current reliable data for sound decision making.Costs of hospital operations cannot be evaluated unless related to the characteristics of the patient service load. Average per diem costs mean little except when large similar populations of patients are being compared. A modern hospital accrual accounting system should be able to provide information concerning the costs of caring for specific diseases in patients with known age and sex and disease severity characteristics. Without information of this type, it will not be possible to objectively evaluate alternative systems of financing and organizing patient care.Medical record management offers the promise of prospective use of patient disease information in the planning and scheduling of facilities. The prose content of medical record summaries, such as diagnostic statements in tissue pathology, radiology, and admission and discharge diagnoses, may be susceptible to non-coded, full prose input into computer controlled diagnostic files. Thesauri in the several medical specialties will be necessary for this achievement.There is little immediate prospect for complete hospital communication systems that can be made available as a package to any hospital without substantial local alteration. Pilot projects in teaching centers should be viewed for the time being as opportunities to define objectives, evaluate feasibility, and determine degree of risk and expense.A brief survey of applications in the United States which have been successfully implemented or which appear suitable for successful implementation is recorded.Eleven general principles which have been associated with successful implementation of computer applications within the UCLA Hospital are enumerated.
VARTAB — A System to create VARiable TABulations without any Knowledge in Programming
Authors: Thome R. , Köhler C. , Wagner G. 
Published: March 2018

Also in the field of medicine the computer is used increasingly for statistical evaluation of data. Unfortunately, the physician ▪— unlike the natural scientist — is, as a rule, not yet able to write himself the programs for the processing of his own data. This situation, on the one hand, frustrates the medical scientist, and, on the other hand, burdens the official programmers, who are expected to help the doctor.The steadily growing number of requests for programming support led us to develop a variable tabulation program (VARTAB) the rules of which are so simple that they can be learned in very short time also by physicians who have no programming knowledge at all. The VARTAB system consists of two parts: 1. a data-standardizing conversion program STAND and 2. the tabulation outprint program TABOUT. The concepts of both programs, the work to be done by the user and the potential and the restrictions of the system are discussed in detail.
Computerhilfe in der klinischen Differentialdiagnostik Verfahren und Problematik der Diagnosen Selektion bei großer wahrscheinlichkeitsparameterfreier Symptom-Krankheitsmatrix
Authors: WEIDTMAN V. 
Published: March 2018

Die Anwendung der EDV als Hilfsmittel in der Differentialdiagnose seltener Krankheiten konnte sich bisher nur auf Datenmatrizen stützen, bei denen die A-priori-Wahrscheinlichkeit der Symptome und Krankheiten unbekannt war. Da somit nicht bekannt ist, welches der Symptome eines Patienten Bedeutung für den diagnostischen Prozeß hat, mußte jeder Symptom-Krankheits-Zusammenhang in die differentialdiagnostischen Überlegungen mit einbezogen werden. Befolgt man diese Strategie, so ergeben sich endlose Listen möglicher Krankheiten, eine unerwünschte Mischung redundanter und wichtiger Information.Zwei Methoden werden vorgestellt, welche die Symptom-Krankheits-Beziehungen nach ärztlichen Gesichtspunkten heraussuchen. Hierdurch wird de Auslistung redundanter Information drastisch reduziert, ohne daß relevante Information verlorengeht. Die Datenmatrix mit ungefähr 1500 seltenen Syndromen und mehr als 10 000 Symptomen, dem »Leiber-Olbrich, Wörterbuch der klinischen Syndrome« entnommen, ergab einige Probleme bezüglich der Anwendung von Synonyma in den Symptom-Listen der Krankheiten.