bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Overview of Education and Training of Medical Informatics in India
Authors: Sarbadhikari S. N. , Gogia S. B. 
Published: March 2018

Summary

Background:
Medical Informatics in India is still in its infancy. Although the Indian Association for Medical Informatics (IAMI) was foundedin1993, proposed bymajorhealthcaredelivery institutions, the absence of independent career options in medical informatics in India hasresulted eitherinthe exodusofthe needed facultymembersfor supporting education in the field. However, this situation may have been changing in the past few years, but a large gap exists which needs to be filled up quickly. The purpose of this report is to provide an assessment of the present situation of research and training in medical informatics in India, and its implications for future development of the field.

Objectives:
To assess the current situation regardingthe opportunities for research and education in Medical Informatics in India and related issues like availability of career options.

Methods:
Asurveyquestionnairewassentbypostalmailtowell-known Indian institutions engaged in medical informatics training and research. In addition, key stakeholders working towards impartingeducation and awareness on the principles and practice of medical informatics were contacted to provide information about training and researchinmedicalinformaticsinIndia.This was a purposivesamplingbased onpriorknowledge. Theresponseswerethematicallyanalyzed.

Results:
A total of six courses were identified in the survey. These were administered through face to face (F2F), e-learningand other modes of distance learning. In general, most of the students are graduates in medicine (allopathic, homeopathic, ayurvedic), allied sciences (nursing, physiotherapy) and medical administrators or graduates in engineering or library and information sciences. Most of them are also working, thus, the majority of the courses are for part-timers and act as on-job value addition. Most of the courses however do not directly train for jobs. Therefore, as most of the participants are already working somewhere, the question of placement due to the course may not be measurabledirectly. Since most of the students from India are already employed, by attending this course they gain further insights into health informaticsthat they want to pursue as a career.
State of the Art in Clinical Informatics: Evidence and Examples
Authors: McCoy A. B. , Wright A. , Eysenbach G. , Malin B. A. , Patterson E. S. , Xu H. , Sittig D. F. 
Published: March 2018

Summary
Objective: The field of clinical informatics has expanded substantially in the six decades since its inception. Early research focused on simple demonstrations that health information technology (HIT) such as electronic health records (EHRs), computerized provider order entry (CPOE), and clinical decision support (CDS) systems were feasible and potentially beneficial in clinical practice.
Methods: In this review, we present recent evidence on clinical informatics in the United States covering three themes: 1) clinical informatics systems and interventions for providers, including EHRs, CPOE, CDS, and health information exchange; 2) consumer health informatics systems, including personal health records and web-based and mobile HIT; and 3) methods and governance for clinical informatics, including EHR usability; data mining, text mining, natural language processing, privacy, and security.
Results: Substantial progress has been made in demonstrating that various clinical informatics methodologies and applications improve the structure, process, and outcomes of various facets of the healthcare system.
Conclusion: Over the coming years, much more will be expected from the field. As we move past the “early adopters” in Rogers' diffusion of innovations' curve through the “early majority” and into the “late majority,” there will be a crucial need for new research methodologies and clinical applications that have been rigorously demonstrated to work (i.e., to improve health outcomes) in multiple settings with different types of patients and clinicians.
Usability Methods for Ensuring Health Information Technology Safety: Evidence-Based Approaches Contribution of the IMIA Working Group Health Informatics for Patient Safety
Authors: Kushniruk A. , Nohr C. , Takeda H. , Kuwata S. , Carvalho C. , Bainbridge M. , Kannry J. , Borycki E. 
Published: March 2018

Summary
Objectives: Issues related to lack of system usability and potential safety hazards continue to be reported in the health information technology (HIT) literature. Usability engineering methods are increasingly used to ensure improved system usability and they are also beginning to be applied more widely for ensuring the safety of HIT applications. These methods are being used in the design and implementation of many HIT systems. In this paper we describe evidence- based approaches to applying usability engineering methods.
Methods: A multi-phased approach to ensuring system usability and safety in healthcare is described. Usability inspection methods are first described including the development of evidence-based safety heuristics for HIT. Laboratory-based usability testing is then conducted under artificial conditions to test if a system has any base level usability problems that need to be corrected. Usability problems that are detected are corrected and then a new phase is initiated where the system is tested under more realistic conditions using clinical simulations. This phase may involve testing the system with simulated patients. Finally, an additional phase may be conducted, involving a naturalistic study of system use under real-world clinical conditions.
Results: The methods described have been employed in the analysis of the usability and safety of a wide range of HIT applications, including electronic health record systems, decision support systems and consumer health applications. It has been found that at least usability inspection and usability testing should be applied prior to the widespread release of HIT. However, wherever possible, additional layers of testing involving clinical simulations and a naturalistic evaluation will likely detect usability and safety issues that may not otherwise be detected prior to widespread system release.
Conclusion: The framework presented in the paper can be applied in order to develop more usable and safer HIT, based on multiple layers of evidence.
Health Informatics in Developing Countries: Systematic Review of Reviews Contribution of the IMIA Working Group Health Informatics for Development
Authors: Otero C. , Marcelo A. , Luna D. 
Published: March 2018

Summary
Objectives: An evidence-base is important for medicine and health informatics. Despite numerous publications showing the benefits of health informatics, the emergence of health information systems in developing countries has been slower than expected. The aim of this paper is to identify systematic reviews on the domain of health informatics in developing countries, and classify the different types of applications covered.
Methods: A systematic review of reviews was conducted. The literature search spanned the time period between 2000 and 2012 and included PubMed, EMBASE, CINAHL, Scopus, Cochrane Systematic Reviews, LILACS, and Google Scholar. The search term was ‘systematic reviews of health informatics in developing countries’, and transparent and systematic procedures were applied to limit bias at all stages.
Results: Of the 982 identified articles, only 10 met the inclusion criteria and one more article was added in a second manual search, resulting in a total of 11 systematic reviews for the analysis.
Conclusions: Although it was difficult to find high quality resources on the selected domain, the best evidence available allowed us to generate this report and create an incipient review of the state of the art in health informatics in the developing countries. More studies will be needed to optimize the results.
From Usability Testing to Clinical Simulations: Bringing Context into the Design and Evaluation of Usable and Safe Health Information Technologies
Authors: Nohr C. , Jensen S. , Borycki E. M. , Kushniruk A. 
Published: March 2018

Summary
Objectives: The objective of this paper is to explore human factors approaches to understanding the use of health information technology (HIT) by extending usability engineering approaches to include analysis of the impact of clinical context through use of clinical simulations.
Methods: Methods discussed are considered on a continuum from traditional laboratory-based usability testing to clinical simulations. Clinical simulations can be conducted in a simulation laboratory and they can also be conducted in real-world settings. The clinical simulation approach attempts to bring the dimension of clinical context into stronger focus. This involves testing of systems with representative users doing representative tasks, in representative settings/environments.
Results: Application of methods where realistic clinical scenarios are used to drive the study of users interacting with systems under realistic conditions and settings can lead to identification of problems and issues with systems that may not be detected using traditional usability engineering methods. In conducting such studies, careful consideration is needed in creating ecologically valid test scenarios. The evidence obtained from such evaluation can be used to improve both the usability and safety of HIT. In addition, recent work has shown that clinical simulations, in particular those conducted in-situ, can lead to considerable benefits when compared to the costs of running such studies.
Conclusion: In order to bring context of use into the testing of HIT, clinical simulation, involving observing representative users carrying out tasks in representative settings, holds considerable promise.
Formal Ontologies in Biomedical Knowledge Representation
Authors: Jansen L. , Schulz S. 
Published: March 2018

Summary
Objectives: Medical decision support and other intelligent applications in the life sciences depend on increasing amounts of digital information. Knowledge bases as well as formal ontologies are being used to organize biomedical knowledge and data. However, these two kinds of artefacts are not always clearly distinguished. Whereas the popular RDF(S) standard provides an intuitive triple-based representation, it is semantically weak. Description logics based ontology languages like OWL-DL carry a clear-cut semantics, but they are computationally expensive, and they are often misinterpreted to encode all kinds of statements, including those which are not ontological.
Method: We distinguish four kinds of statements needed to comprehensively represent domain knowledge: universal statements, terminological statements, statements about particulars and contingent statements. We argue that the task of formal ontologies is solely to represent universal statements, while the non-ontological kinds of statements can nevertheless be connected with ontological representations. To illustrate these four types of representations, we use a running example from parasitology.
Results: We finally formulate recommendations for semantically adequate ontologies that can efficiently be used as a stable framework for more context-dependent biomedical knowledge representation and reasoning applications like clinical decision support systems.
Leitlinie: Medizinischer Thromboseprophylaxestrumpf
Authors: Wienert V. , Waldermann F. , Zabel M. , Rabe E. , Jünger M. , Kahle B. , Földi E. 
Published: March 2018

Leitlinien sind systematisch erarbeitete Empfehlungen, um Kliniker und Praktiker bei Entscheidungen über die angemessene Patientenversorgung im Rahmen spezifischer klinischer Umstände zu unterstützen. Leitlinien gelten für so genannte Standard-situationen. Sie berücksichtigen aktuelle, zu den entsprechenden Fragestellungen verfüg-bare wissenschaftliche Erkenntnisse.Leitlinien bedürfen einer ständigen Überprüfung und eventuell der Änderung auf Basis des wissenschaftlichen Erkenntnisstandes und der Praktikabilität in der täglichen Praxis. Durch die Leitlinien soll die ärztliche Methodenfreiheit nicht eingeschränkt werden. Ihre Beachtung garantiert nicht in jedem Fall den diagnostischen und therapeutischen Erfolg. Leitlinien erheben keinen Anspruch auf Vollständigkeit. Die Entschei-dung über die Angemessenheit der zu ergreifenden Maßnahmen trifft der Arzt oder die Ärztin unter Berücksichtigung der individuellen Problematik.
The Effect of Preoperative Biliary and Pancreatic Drainage on Postoperative Pancreatic Fistula: A Retrospective Cohort Study
Authors: Manipadam John , S. Mahesh , Kadamapuzha Jacob , H. Ramesh 
Published: March 2018

Background Surgeons and endoscopists welcome routine preoperative biliary drainage prior to pancreaticoduodenectomy despite evidence that it increases complications. Its effect on postoperative pancreatic fistula is variably reported in literature. Simultaneous biliary and pancreatic drainage is rarely performed for very selected indications and its effects on postoperative pancreatic fistula are largely unknown. Our aim was to analyze the same while eliminating confounding factors.
Methods Retrospective single center cohort study of patients who underwent pancreaticoduodenectomy over the past 10 years for carcinoma obstructing the lower common bile duct. Patients who underwent biliary stenting alone, biliary and pancreatic stenting, and no stenting prior to pancreaticoduodenectomy were the three study cohort groups and their records were scrutinized for the incidence of postoperative pancreatic fistula.
Results Sixty-two patients underwent biliary stenting alone, 5 patients underwent both biliary and pancreatic stenting, and 237 patients were not stented in the adenocarcinoma group without chronic pancreatitis. The pancreatic fistula rate was similar in the patients who underwent biliary stenting alone when compared with the group which was not stented. (24/62 versus 67/237, odds ratio [OR] =0.619, confidence interval (CI) =0.345–1.112, p = 0.121). However, the patients who underwent both biliary and pancreatic stenting had a significant increase in postoperative pancreatic fistula compared with the not stented (p = 0.003). By univariate and multivariate analysis using Firth logistic regression, pancreatic texture (OR = 1.205, CI = 0.103–2.476, p = 0.032) and the presence of a biliary and pancreatic stent (OR = 2.695, CI = 0.273–7.617, p = 0.027) were the significant factors affecting pancreatic fistula.
Conclusion Preoperative biliary drainage alone has no significant influence on postoperative pancreatic fistula except when combined with pancreatic stenting. We need more such studies from other centers to confirm that the rare event of preoperative biliary and pancreatic stenting has indeed this harmful effect on healing of postoperative pancreatic anastomosis.
Personal Health Informatics. Editorial
Authors: Kulikowski C. A. , Geissbuhler A. 
Published: March 2018

SummaryTo provide an editorial introduction to the 2012 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors.A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2012 IMIA Yearbook.This 2012 issue of the IMIA Yearbook highlights important developments in personal health informatics, impacting the activities in research, education and practice in this interdisciplinary field.There has been steady progress towards introducing individualization or personalization into informatics systems by taking advantage of the increasing amounts of personal information that is relevant to medical decisions and application in clinical practice. At the same time, there are serious issues about the limits of existing systems being able to effectively personalize information within both practical and ethical constraints so critical to the practice of medicine. Recent literature bearing on these questions includes the selected papers published during the past 12 months, and articles reported by IMIA Working Groups on these topics.Surveys of the main research sub-fields in biomedical informatics in the Yearbook provide an overview of progress and current challenges across the spectrum of the discipline, focusing on the challenges and opportunities involved in personal health informatics.
Personal Health and Consumer Informatics
Authors: Guardia A. , Boyer B. C. ,   Section Editors for the IMIA Yearbook Sections on Personal Health Informatics and on Consumer Informatics
Published: March 2018

SummaryTo summarize current outstanding research in the field of Personal Health and Consumers Informatics.A selection of excellent research articles published in 2011 in the field of Personal Health Informatics and Consumer Informatics.This selection of articles shows that Personal Health Informatics is changing. Indeed, the different solutions tended to the doctors and their interaction, but also tended to the patient in order for him to be more active in his own medical healthcare. The consumer section highlights the development of the social network and the possible limitations.
Business Process Modelling is an Essential Part of a Requirements Analysis
Authors: de Lusignan S. , Krause P. , Michalakidis G. , Vicente M. , Thompson S. , McGilchrist M. , Sullivan F. , van Royen P. , Agreus L. , Desombre T. , Taweel A. , Delaney B. 
Published: March 2018

SummaryTo perform a requirements analysis of the barriers to conducting research linking of primary care, genetic and cancer data.We extended our initial data-centric approach to include socio-culturalandbusinessrequirements.Wecreatedreferencemodels of core data requirements common to most studies using unified modelling language (UML), dataflow diagrams (DFD) and business process modelling notation (BPMN). We conducted a stakeholder analysis and constructed DFD and UML diagrams for use cases based on simulated research studies. We used research output as a sensitivity analysis.Differences between the reference model and use cases identified study specific data requirements. The stakeholder analysis identified: tensions, changes in specification, some indifference from data providers and enthusiastic informaticians urging inclusion of socio-cultural context. We identified requirements to collect information at three levels: microdata items, which need to be semantically interoperable, meso-the medical record and data extraction, and macro-the health system and socio-cultural issues. BPMN clarified complex business requirements among data providers and vendors; and additional geographical requirements for patients to be represented in both linked datasets. High quality research output was the norm for most repositories.Reference models provide high-level schemata of the core data requirements. However, business requirements’ modelling identifies stakeholder issues and identifies what needs to be addressed to enable participation.
Smartphone as a Personal, Pervasive Health Informatics Services Platform: Literature Review
Authors: Wac K. 
Published: March 2018

SummaryThe article provides an overview of current trends in personal sensor, signal and imaging informatics, that are based on emerging mobile computing and communications technologies enclosed in a smartphone and enabling the provision of personal, pervasive health informatics services.The article reviews examples of these trends from the PubMed and Google scholar literature search engines, which, by no means claim to be complete, as the field is evolving and some recent advances may not be documented yet.There exist critical technological advances in the surveyed smartphone technologies, employed in provision and improvement of diagnosis, acute and chronic treatment and rehabilitation health services, as well as in education and training of healthcare practitioners. However, the most emerging trend relates to a routine application of these technologies in a prevention/wellness sector, helping its users in self-care to stay healthy.Smartphone-based personal health informatics services exist, but still have a long way to go to become an everyday, personalized healthcare-provisioning tool in the medical field and in a clinical practice. Key main challenge for their widespread adoption involve lack of user acceptance striving from variable credibility and reliability of applications and solutions as they a) lack evidence-based approach; b) have low levels of medical professional involvement in their design and content; c) are provided in an unreliable way, influencing negatively its usability; and, in some cases, d) being industry-driven, hence exposing bias in information provided, for example towards particular types of treatment or intervention procedures.
IMIA Accreditation of Health Informatics Programs
Authors: Hasman A. 
Published: March 2018

SummaryTo develop a procedure for accrediting health informatics programs.Development of a procedure for accreditation. Test of the accreditation procedure via a trial including four or five health informatics programs. A site visit committee consisting of three members evaluates the program based on a self-assessment report written by the program and the experiences and observations of the site visit committee during the site visit.A procedure for accreditation has been developed. The instructions for health informatics programs have been written and a checklist for the site visit committee members is available. In total six subjects are considered, each one consisting of one or more facets. Each facet is judged using its corresponding criterion. Five health informatics programs volunteered. One health informatics program in Finland has already been visited and a report has been produced by the site visit committee. The next site visits are in June and July 2012. The site visit in Finland showed that English summaries of master theses are not enough to get a first impression of the methods used in the thesis. A table of contents is also needed. This information then can be used to select theses written in a language other than English for discussion.The accreditation procedure document with instructions about writing the self-assessment report was very well structured and the instructions were clear according to the Finnish program. The site visit team could work well with the checklist. Self-assessment report model was very well structured and the instructions were clear.
Stellenwert von Milch und Milchprodukten in der Kinderernährung
Authors: Müller Claudia 
Published: March 2018

ZusammenfassungMilch und Milchprodukte tragen auf Grund ihrer hohen Nährstoffdichte wesentlich zu einer gesunden und vielseitigen Ernährung bei und sollten Bestandteil des täglichen Speiseplans von Kindern und Jugendlichen sein. Diese Lebensmittelgruppe ist u. a. reich an Kalzium, das im Kindes- und Jugendalter für den Aufbau einer maximalen Knochenmasse benötigt wird. Verschiedene Studien zeigen, dass sich der Knochenmineralgehalt durch Supplementation mit Kalzium bzw. vermehrten Milchkonsum bei Kindern und Jugendlichen erhöhte. Vermutlich üben auch andere Inhaltsstoffe der Milch einen positiven Effekt auf den Knochenmineralgehalt aus. Gleichzeitig wurde in Untersuchungen beobachtet, dass eine erhöhte Kalziumaufnahme mit einer geringeren Körpermasse einhergeht. Der Verzehr von Milchprodukten scheint sich des Weiteren positiv auf die Blutfettwerte auszuwirken. Trotz der gesundheitsfördernden Eigenschaften gibt es nach wie vor einige Vorbehalte gegenüber diesen Lebensmitteln, die sich jedoch durch eine wissenschaftlich begründete Argumentation entkräften lassen.