bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta-Analysis
Authors: Böhning D. 
Published: March 2018

Summary

Objectives:
This contribution provides a unifying concept for meta-analysis integrating the handling of unobserved heterogeneity, study covariates, publication bias and study quality. It is important to consider these issues simultaneously to avoid the occurrence of artifacts, and a method for doing so is suggested here.

Methods:
The approach is based upon the meta-likelihood in combination with a general linear nonparametric mixed model, which lays the ground for all inferential conclusions suggested here.

Results:
The concept is illustrated at hand of a meta-analysis investigating the relationship of hormone replacement therapy and breast cancer. The phenomenon of interest has been investigated in many studies for a considerable time and different results were reported. In 1992 a meta-analysis by Sillero-Arenas et al. [1] concluded a small, but significant overall effect of 1.06 on the relative risk scale. Using the meta-likelihood approach it is demonstrated here that this meta-analysis is due to considerable unobserved heterogeneity. Furthermore, it is shown that new methods are available to model this heterogeneity successfully. It is argued further to include available study covariates to explain this heterogeneity in the meta-analysis at hand.

Conclusions:
The topic of HRT and breast cancer has again very recently become an issue of public debate, when results of a large trial investigating the health effects of hormone replacement therapy were published indicating an increased risk for breast cancer (risk ratio of 1.26). Using an adequate regression model in the previously published meta-analysis an adjusted estimate of effect of 1.14 can be given which is considerably higher than the one published in the meta-analysis of Sillero-Arenas et al. [1]. In summary, it is hoped that the method suggested here contributes further to a good meta-analytic practice in public health and clinical disciplines.
Propagation of EEG Activity in the Beta and Gamma Band during Movement Imagery in Humans
Authors: Ginter J. , Kamiński M. , Durka P. J. , Pfurtscheller G. , Neuper C. , Blinowska K. J. 
Published: March 2018

Summary

Objectives:
The objective of the paper was the determination of electrical brain activity propagation in sensorimotor areas during hand movement imagery.

Methods:
Right-hand and left-hand movement imagination was studied in three subjects. The 10-channel Multivariate Autoregressive Model (MVAR) was fitted to EEG signals recorded from subsets of electrodes overlying central and related brain areas. By means of the Short-time Directed Transfer Function (SDTF) the propagation of brain activity as a function of frequency and time was found.

Results:
During imagery the relation between propagations in gamma and beta bands changed significantly for electrodes overlying sensorimotor areas, namely the increase in gamma was accompanied by the decrease in the beta band.

Conclusions:
The hypothesis was put forward that these kinds of changes in flow of electrical brain activity are connected with the specific information processing.
Containing Acute Disease Outbreak
Authors: Prince A. , Chen Xin , Lun K. C. 
Published: March 2018

Summary

Objective:
The objectives of epidemiological surveillance and research of infectious diseases are to address disease prevention, identify outbreaks and monitor and evaluate control strategies. In this paper, we report on the development of a Geographical Information System (GIS) based on a novel Digital Ring Fence (DRiF) strategy for the containment of acute infectious diseases.

Method:
Data from probable cases are captured in a secure database. Postal codes of addresses facilitate precise mapping of the location of each probable case on a multi-layered GIS system. A digital ring fence is constructed around each location (hot-spot) using Non-Homogeneous Poisson Process (NHPP) modeling based on data of individuals coming into contact with each probable case. The radius of the DRiF gives the overall risk of infection from its epicenter, the probable case. By annotating the DRiF to a GIS, areas of population concentrations could be readily identified to direct outbreak containment efforts.

Results:
Simulation studies have demonstrated that the DRiF strategy could provide a novel approach to containment of acute disease outbreaks.

Conclusion:
SARS has provided convincing evidence that the key to tackling acute infectious disease outbreaks lies in containment and making disease containment one step ahead of its spread. The DRiF strategy achieves this by providing a zone to corral the spread of infection through person-to-person transmission. Other useful applications of the DRiF technique include demarcating culling zone for the containment of bird flu infection and containment of person-to-person transmission should it occur.
Methods for Evaluation of Medical Terminological Systems
Authors: Cornet R. , de Jonge E. , de Keizer N. F. , Arts D. G. T. 
Published: March 2018

Summary

Objectives:
The usability of terminological systems (TSs) strongly depends on the coverage and correctness of their content. The objective of this study was to create a literature overview of aspects related to the content of TSs and of methods for the evaluation of the content of TSs. The extent to which these methods overlap or complement each other is investigated.

Methods:
We reviewed literature and composed definitions for aspects of the evaluation of the content of TSs. Of the methods described in literature three were selected: 1) Concept matching in which two samples of concepts representing a) documentation of reasons for admission in daily care practice and b) aggregation of patient groups for research, are looked up in the TS in order to assess its coverage; 2) Formal algorithmic evaluation in which reasoning on the formally represented content is used to detect inconsistencies; and 3) Expert review in which a random sample of concepts are checked for incorrect and incomplete terms and relations. These evaluation methods were applied in a case study on the locally developed TS DICE (Diagnoses for Intensive Care Evaluation).

Results:
None of the applied methods covered all the aspects of the content of a TS. The results of concept matching differed for the two use cases (63% vs. 52% perfect matches). Expert review revealed many more errors and incompleteness than formal algorithmic evaluation.

Conclusions:
To evaluate the content of a TS, using a combination of evaluation methods is preferable. Different representative samples, reflecting the uses of TSs, lead to different results for concept matching. Expert review appears to be very valuable, but time consuming. Formal algorithmic evaluation has the potential to decrease the workload of human reviewers but detects only logical inconsistencies. Further research is required to exploit the potentials of formal algorithmic evaluation.
Record Linkage in the Cancer Registry of Tyrol, Austria
Authors: Stühlinger W. , Oberaigner W. 
Published: March 2018

Summary

Objective:
Record linkage of patient data originating from various data sources and record linkage for checking uniqueness of patient registration are common tasks for every cancer registry. In Austria, there is no unique person identifier in use in the medical system. Hence, it was necessary and the goal of this work to develop an efficient means of record linkage for use in cancer registries in Austria.

Methods:
We adapted the method of probabilistic record linkage to the situation of cancer registries in Austria. In addition to the customary components of this method, we also took into consideration typing errors commonly occurring in names and dates of birth. The method was implemented in a program written in DELPHITM with interfaces optimised for cancer registries.

Results:
Applying our record linkage method to 130,509 linkages results in 105,272 (80.7%) identical pairs. For these identical pairs, 88.9% of decisions were performed automatically and 11.1% semi-automatically. For results decided automatically, 6.9% did not have simultaneous identity of last name, first name and date of birth. For results decided semi-automatically, 48.4% did not have an identical last name, 25.6% did not have an identical date of birth and 83.1% did not have simultaneous identity of last name and date of birth and first name.

Conclusions:
The method implemented in our cancer registry solves all record linkage problems in Austria with sufficient precision.
Application of Resampling Techniques to the Statistical Analysis of the Brier Score
Authors: Itoh S. , Ishigaki T. , Yamauchi K. , Ikeda M. 
Published: March 2018

Abstract:We investigated the application of resampling techniques to the statistical analysis of the Brier score (B), and extended them to the statistical comparison of two Bs derived from the same set of patients. The re-sampling techniques are helpful in the statistical analysis of B, and there are almost no differences between the jackknife method and the bootstrap method in this analysis. Thus, we believe that B should be used more often as an index to evaluate probabilistic judgments in the case in which the data sets for the assessment are “degenerate” as the “receiver operating characteristic data sets.”
Graphic Representation of Sequential Bayesian Analysis
Authors: Heller I. , Topilsky M. , Shapira I. , Isakov A. 
Published: March 2018

AbstractPreviously undescribed algebraic transforms of Bayes’ theorem define families of operating points in the receiver operating characteristic (ROC) space which, at given pre-test probability, produce constant post-test probabilities. These isopredictive operating points form straight lines in the ROC space. The lines can be used to emulate Bayesian sequential analysis in a strictly graphic procedure, which can be applied in clinical work and medical education.
The Search for Synergy: Interrelating Medical Work and Patient Care Information Systems
Authors: Berg M. 
Published: March 2018

Summary
Objectives: This article aims to search for the way patient care information systems can be most fruitfully put to work in health care.
Methods: Given the calls for improved health care quality, there is a need for IT’s coordination capacities in health care. Yet IT’s track record in this area is less than many expected. Moreover, many argue that the nature of health care work sets natural limits to the possibilities of IT to revolutionize this work. Starting with an analysis of the paper record, this article explores the way IT and professional work can be interrelated synergistically.
Results: Two principles are discussed: 1) The key to a fruitful operation of IT in health care work lies in the unraveling of the care process, and the redistribution of tasks between professionals and the IT application. 2) Professionals should be given the skills and resources to adapt the IT application’s demands to the needs of their work practices.
Conclusion: IT can bring true process support to health care when taking the two principles discussed here into account.
Structured Representation of Drug Indications: Lexical and Semantic Analysis and Object-Oriented Modeling
Authors: Duclos C. , Venot A. 
Published: March 2018

Abstract:No standardized representation of drug indications is currently available that could be used in drug knowledge bases. We describe an object-oriented representation of indications that should make it possible to develop new tools for selecting drugs and checking prescriptions in computerized drug prescription systems. The model was developed using the results of a lexical and semantic analysis of drug indications, collected into a single file and processed using natural language processing software. It distinguishes both the diseases for which the drug may be given and the efficiency of the drug for a given indication. Two aspects of the model were evaluated: the differences if two independent evaluators filled the attributes independently and the loss of information induced by the use of the model. A system based on this model, making it possible for the physician to select all the drugs satisfying various criteria, is also presented.
An End-to-End Secure Patient Information Access Card System
Authors: Singer H. , Yakami M. , Takahashi T. , Alkhateeb A. 
Published: March 2018

Abstract:The rapid development of the Internet and the increasing interest in Internet-based solutions has promoted the idea of creating Internet-based health information applications. This will force a change in the role of IC cards in healthcare card systems from a data carrier to an access key medium. At the Medical Informatics Department of Kyoto University Hospital we are developing a smart card patient information project where patient databases are accessed via the Internet. Strong end-to-end data encryption is performed via Secure Socket Layers, transparent to transmit patient information. The smart card is playing the crucial role of access key to the database: user authentication is performed internally without ever revealing the actual key. For easy acceptance by healthcare professionals, the user interface is integrated as a plug-in for two familiar Web browsers, Netscape Navigator and MS Internet Explorer.
A Process View of Medical Practice by Modeling Communicative Acts
Authors: van Reijswoud V. E. , Toussaint P. J. , Harms E. H. , Zwetsloot-Schonk J. H. M. , Maij E. 
Published: March 2018

Abstract:The need of an electronic patient record with a process view on medical care is widely acknowledged. Characteristics of DEMO (Dynamic Essential Modeling of Organizations) suggest that with this methodology an adequate process view of medical practice can be obtained. In applying DEMO to the care process of the emergency department at the University Medical Centre Utrecht, it was investigated if DEMO fulfilled our expectations. This practical application showed that DEMO yields an adequate process view by a clear and comprehensible view of the core processes, responsibilities, co-ordination of activities, and a clear description of causal and conditional relations between activities.
Understanding Terminological Systems I: Terminology and Typology
Authors: Abu-Hanna A. , Zwetsloot-Schonk J. H. M. , de Keizer N. F. 
Published: March 2018

Abstract:Terminological systems are an important research issue within the field of medical informatics. For precise understanding of existing terminological systems a referential framework is needed that provides a uniform terminology and typology of terminological systems themselves. In this article a uniform terminology is described by putting relevant fundamental notions and definitions used by standard organizations such as CEN and ISO into perspective, and interrelating them to arrive at a useful typology of terminological systems. This typology is illustrated by applying it to five well-known existing terminological systems.
CISMeF: A Structured Health Resource Guide
Authors: Leroy J. P. , Baudic F. , Douyère M. , Piot J. , Thirion B. , Darmoni S. J. 
Published: March 2018

Abstract:In 1999, the Internet has become a major source of health information. The objective of CISMeF is to catalogue and index the main French-speaking health resources. In September 1999, the number of indexed resources totaled over 7,100 with a mean of 75 new sites per week. CISMeF uses two standard tools for organizing information: the Medline bibliographic database MeSH thesaurus and the Dublin Core metadata format. Resources included in CISMeF are described by the following: title, author or creator, subject and keywords, description, publisher, date, resource type, format, identifier, and language. To index resources, CISMeF uses five levels of hierarchy: “meta-term”, category, keyword, subheading, and resource type. CISMeF contains a thematic index, including medical specialities and an alphabetic index. CISMeF respects the Net Scoring, criteria to assess the quality of health information on the Internet. The CISMeF project offers a valuable tool for the French-speaking health community: 2,500 computer users visit the Web site each working day.
Injury Detection for Central Nervous System via EEG with Higher Order Crossing-based Methods
Authors: Qiu T. , Kong X. 
Published: March 2018

Abstract:Higher order crossing (HOC) is a powerful tool for time series analysis. Two HOC-based EEG analysis methods are developed for brain injury detection and quantification. The first method explores EEG spectrum characteristics via an estimate of the dominant frequency of a pre-processed EEG signal. The second method is based on the norm of the AHOC, an HOC obtained from the -filter prefiltered EEG signal. Both methods are shown to be effective in detecting hypoxic/asphyxic injuries as well as assessing the severity of the injury.
Appropriateness and Necessity Research on the Internet: Using a “Second Opinion System”
Authors: Faisst K. , Kapetanios E. , Wyss P. , Norrie M. C. , Gutzwiller F. , Schilling J. 
Published: March 2018

AbstractAppropriateness and necessity research of various procedures in medicine may be the most complex field of innovation in healthcare and technology assessment. Nevertheless, the appropriateness of the indication of any medical intervention is probably more important than the outcome since even ideal quality components of structures, processes and outcomes become irrelevant without a proper indication. The first part of our appropriateness initiative in interventional cardiology and gynecology was to formulate guidelines. To define the appropriateness for coronary angiography, coronary revascularization and hysterectomy, literature-based consensus methods were used. The second part was to disseminate the guidelines in a user-friendly manner via the Internet. Therefore, we relied on a system-driven query facility for propositional (experts) rules. The next part of the appropriateness initiative may be a user-friendly Internet-based data collection system to validate the national accepted guidelines. Most important may be that only data that is needed can be collected using a refined database technology. The described Second Opinion System can be found under: http://sos.inf.ethz.ch. Research on indications with data on clinical outcome may open new opportunities to validate indication guidelines using Inter-net/database technology for data analysis and browsing of decision graphs concerning clinical decision-making. This new technology facilitates the evaluation of appropriateness and necessity criteria in combination with clinical outcomes.
Sociotechnical Requirements Analysis for Clinical Systems
Authors: Pratt W. , Dourish P. , Shabot M. M. , Reddy M. 
Published: March 2018

Summary
Objective: We explore sociotechnical requirements by examining the use of a computerized patient record system in an intensive care unit of a U.S. hospital and present two sociotechnical requirements, awareness and coordination, embedded in the users’ work.
Method: The study is based on observation during seven months of the use of a computerized patient record system in a surgical intensive care unit. During that period semi-formal interviews, informal interviews were held.
Results and Conclusions: A key step in the design of clinical systems is the development and analysis of requirements. However, traditional requirements analysis is based on a set of assumptions that break down in the highly collaborative, exception-filled clinical domain. Sociotechnical requirement analysis enabled the designers to gather a much richer description of the environment surrounding the computer system, highlighting awareness and coordination, embedded in the users’ work.
Integrating Quantitative and Qualitative Methods in Patient Care Information System Evaluation
Authors: Berg M. , Stoop A. P. 
Published: March 2018

Summary
Objective: The aim of this paper is twofold. First, we describe two important dimensions of patient care information systems (PCIS) evaluation: the domain of evaluation and the different phases of the PCIS implementation. Second, we claim that, though Randomized Controlled Trials (RCTs) are often still seen as the standard approach, this type of design hardly generates relevant information for the organizational decision maker.
Method: Interpretive study of evaluation literature. Results and Conclusions: The field of evaluation is scattered and the types of questions that can be asked and methods that can be used seem infinite and badly demarcated. Different stakeholders, moreover, often have different priorities in evaluating ICT. The most important reason for the lack of relevance of RCTs is that they are ill suited for investigating why and how a PCIS is being used, or not, and what the (often unplanned) effects and consequences are. Subsequently, our aim is to contribute to the discussion about the viability of qualitative versus quantitative methods in PCIS evaluation, by arguing for a specific integration of quantitative and qualitative research methods. The joint utilization of these methods, we claim, yields the richest results.
Medical Informatics Specialists: What Are their Job Profiles?
Authors: Knaup P. , Frey W. , Haux R. , Leven F. J. 
Published: March 2018

Summary

Objectives:
Since 1972, the University of Heidelberg and the University of Applied Sciences Heilbronn have jointly been running a medical informatics program. To continuously provide high quality education, the curriculum is regularly evaluated among its graduates. The objectives of this study were to assess the job situation of the graduates and to evaluate the curriculum from their viewpoint.

Method:
Anonymous inquiry of all medical informatics graduates, having finished their studies before March 31, 2001 (n = 1024) using a structured questionnaire.

Results:
The questionnaire was answered by 446 (compliance: 45.5%) graduates. About one third (146 of 444 valid cases) are working in software/ hardware companies. 179 (43.0% of 416 valid cases) graduates are working within medical informatics, 214 (51.4%) are working outside of medical informatics, but within other informatics. 23 (5.5%) graduates are working neither in medical nor in other informatics. 15 percent of the responding graduates have received a doctor’s degree. Software engineering, database and information systems are regarded as most important parts of the education. The majority of the graduates are satisfied with their education as well as with their personal career.

Conclusions:
The variety of jobs, the job profiles, and the high level of our graduates’ satisfaction with their education indicate the relevance of specialized medical informatics programs with a curricular profile like the one in Heidelberg/Heilbronn. Investigations like this can help to adjust the contents of the curriculum to professional needs.
ORCA: The Versatile CPR
Authors: Stam H. , van Mulligen E. M. , de Wilde M. , van Mastrigt R. , van Bemmel J. H. , van Ginneken A. M. 
Published: March 2018

AbstractThe introduction of computer-based patient records (CPRs) that fully replace paper records proves especially difficult in specialized care, despite the potential advantages of CPRs for patient care and research. Improved data legibility, availability, sharing of records, and decision support may directly benefit patient care. Barriers to the introduction of CPR applications at institutions may be caused by lack of infrastructure, or by financial or organizational issues. To have clinicians interactively enter data at the point of care is still a big challenge. This paper presents an overview of ORCA (Open Record of CAre): a generic CPR, designed for integration with existing systems, presentation of multi-media patient data, and the collection of structured data, directly by clinicians. ORCA can easily be tailored to the needs of a variety of medical specialists without the need for changes to its data model, functionality, or interface. The paper describes the essence of the architecture of ORCA and the user benefits with emphasis on the support of structured data entry.