bluuebunny/crossref_metadata_2025_split huggingface dataset:
Standards to Support Development of Terminological Systems for Healthcare Telematics
Authors: Consorti F. , Galeazzi E. , Rossi Mori A. 
Published: March 2018

AbstractThe Technical Committee on “Medical Informatics” of the European Committee for Standardization (CEN{TC251) is supporting developers ofterminological systems in healthcare by a series of standards. The dream of “universal” coding system was abandoned in favor of a coherent family of terminologies, diversified according to tasks; two ideas were introduced: (1) the “categorical structure”, i.e. a model of semantic categories and their relations within a subject field and (2) the “cross-thesaurus”, i.e. a system of descriptors to build a systematic representation (called here “dissection") for each terminological phrase, coherent across diverse terminologies on a given subject field.The goal is to assure coexistence and interoperability (and reciprocal support for development and maintenance) to three generations of systems: (1) traditional paper-based systems (first generation); (2) compositional systems built according to a categorical structure and a cross-thesaurus (second generation) and (3) formal models (third generation).Various scenarios are presented, on the exploitation of computer-based terminological systems. The idea of “operational meaning” of terminological phrases within administrative and organizational contexts and the idea of “task-oriented details” are also introduced, to justify and exploit design constraints on terminological systems.
Rationale and Design Considerations for a Semantic Mediator in Health Information Systems
Authors: Sauquet D. , Jaulent M.-C. , Zapletal E. , Lavril M. , Degoulet P. 
Published: March 2018

AbstractRapid development of community health information networks raises the issue of semantic interoperability between distributed and heterogeneous systems. Indeed, operational health information systems originate from heterogeneous teams of independent developers and have to cooperate in order to exchange data and services. A good cooperation is based on a good understanding of the messages exchanged between the systems. The main issue of semantic interoperability is to ensure that the exchange is not only possible but also meaningful. The main objective of this paper is to analyze semantic interoperability from a software engineering point of view. It describes the principles for the design of a semantic mediator (SM) in the framework of a distributed object manager (DOM). The mediator is itself a component that should allow the exchange of messages independently of languages and platforms. The functional architecture of such a SM is detailed. These principles have been partly applied in the context of the HEllOS object-oriented software engineering environment. The resulting service components are presented with their current state of achievement.
Thesauri and Formal Classifications: Terminologies for People and Machines
Authors: Rector A. L. 
Published: March 2018

AbstractTerminologies are now software. They are key components of the integration of electronic patient records, decision support systems and information retrieval systems. To be used as software, the different types of content in traditional terminologies must be separated, which we term here: conceptual, linguistic, inferential and pragmatic. The conceptual knowledge at the heart of the terminology needs to be expressed formally in order to provide a dependable framework for the other types of knowledge. Information left implicit in most existing coding and classification systems must be made explicit. The test of the resulting terminologies is how well they support software for key functions: including data entry, information retrieval, mediation, indexing, and authoring.
Evaluation of a Semantic Data Model for Chest Radiology: Application of aNew Methodology
Authors: Huff S. M. , Haug P. J. , Evans D. A. , Bray B. E. , Rocha R. A. 
Published: March 2018

AbstractAn essential step toward the effective processing of the medical language is the development of representational models that formalize the language semantics. These models, also known as semantic data models, help to unlock the meaning of descriptive expressions, making them accessible to computer systems. The present study tries to determine the quality of a semantic data model created to encode chest radiology findings . The evaluation methodology relied on the ability of physicians to extract information from textual and encoded representations of chest X-ray reports, whilst answering questions associated with each report. The evaluation demonstrated that the encoded reports seemed to have the same information content of the original textual reports. The methodology generated useful data regarding the quality of the data model, demonstrating that certain segments were creating ambiguous representations and that some details were not being represented.
Scalable Methodologies for Distributed Development of Logic-Based Convergent Medical Terminology
Authors: Cohn S. P. , Chute C. G. , Shortliffe E. H. , Rennels G. , Campbell K. E. 
Published: March 2018

AbstractAs the size and complexity of medical terminologies increase, terminology modelers are increasingly hampered by lack of tools and methods to manage the development process. This paper presents our use and ongoing evaluation of a description-logic classifier to support cognitive scalability of the underlying terminology and our enhancements to that classifier to support concurrent development utilizing semantics-based concurrency control methods. Our enhancements, collectively referred to as the Galapagos, consist of several applications that take locally-developed terminology enhancements from multiple sites, identify conflicting design decisions, support the modelers' reconciliation of the conflicting designs, and efficiently disseminate updates tailored for locally enhanced terminologies. We have tested our ideas through concurrent evolutionary enhancement of SNOMED International at three Kaiser Permanente regions and the Mayo Clinic. We have found that the underlying environment has met our design objectives, and supports semantic-based concurrency control, and identification and resolution of conflicting design decisions.
Semantic Definition of Disorders in Version 3 of the Read Codes
Authors: O'Neil M. , Price C. , Brown P. J. B. 
Published: March 2018

AbstractThe disorder chapter of Version 3 of the Read codes is a rich source of clinically derived terminology. The file structure has been designed to meet a clinical need to support both enumerated and compositional taxonomy. This requirement coupled with the maintenance of multiple classification necessitates a mechanism to identify consistent hierarchical placement and equivalence between concepts. The early work on the semantic definition of the disorder chapter, to support these requirements, is outlined and the attributes that have been found to be important are presented. We also describe different categories of completeness of definition that have been identified, and the scope of those that are likely to remain incompletely characterised.
Evaluating Natural Language Processors in the Clinical Domain
Authors: Hripcsak G. , Friedman C. 
Published: March 2018

AbstractEvaluating natural language processing (NLP) systems in the clinical domain is a difficult task which is important for advancement of the field. A number of NLP systems have been reported that extract information from free-text clinical reports, but not many of the systems have been evaluated. Those that were evaluated noted good performance measures but the results were often weakened by ineffective evaluation methods. In this paper we describe a set of criteria aimed at improving the quality of NLP evaluation studies. We present an overview of NLP evaluations in the clinical domain and also discuss the Message Understanding Conferences (MUC) [1-41. Although these conferences constitute a series of NLP evaluation studies performed outside of the clinical domain, some of the results are relevant within medicine. In addition, we discuss a number of factors which contribute to the complexity that is inherent in the task of evaluating natural language systems.
The Distinction between Linguistic and Conceptual Semantics in Medical Terminology and its Implication for NLP-Based Knowledge Acquisition
Authors: Buekens F. , De Moor G. , Waagmeester A. , Ceusters W. 
Published: March 2018

AbstractNatural language understanding systems have to exploit various kinds of knowledge in order to represent the meaning behind texts. Getting this knowledge in place is often such a huge enterprise that it is tempting to look for systems that can discover such knowledge automatically. We describe how the distinction between conceptual and linguistic semantics may assist in reaching this objective, provided that distinguishing between them is not done too rigorously. We present several examples to support this view and argue that in a multilingual environment, linguistic ontologies should be designed as interfaces between domain conceptualizations and linguistic knowledge bases.
Automated Coding of Patient Discharge Summaries Using Conceptual Graphs
Authors: Burgun A. , Seka L. P. , Delamarre D. , Le Beux P. 
Published: March 2018

Abstract:In medicine, as in other domains, indexing and classification is a natural human task which is used for information retrieval and representation. In the medical field, encoding of patient discharge summaries is still a manual time-consuming task. This paper describes an automated coding system of patient discharge summaries from the field of coronary diseases into the ICD-9-CM classification. The system is developed in the context of the European AIM MENELAS project, a natural-language understanding system which uses the conceptual-graph formalism. Indexing is performed by using a two-step processing scheme; a first recognition stage is implemented by a matching procedure and a secondary selection stage is made according to the coding priorities. We show the general features of the necessary translation of the classification terms in the conceptual-graph model, and for the coding rules compliance. An advantage of the system is to provide an objective evaluation and assessment procedure for natural-language understanding.
The Feasibility and Accuracy of Anonymized Record Linkage to Estimate Shared Clientele among Three Health and Social Service Agencies
Authors: Roberts J. , Browne G. , Jamieson E. 
Published: March 2018

Abstract:This study was designed to test the effectiveness of three computerized methods of record linkage, using minimal identifiers. The goal of the linkage was to determine the proportion of persons receiving Public Health Nursing Services (n = 5,749) who also receive income assistance from the region (n = 38,800) or the province (n = 16,741). The first linkage method was based on full agreement of a number of variables (deterministic matching) and the second was based on the likelihood of the match (probabilistic matching). The third method combined information from methods 1 and 2. Method 3 proved to be the most effective linkage technique, with a specificity of 0.98 and sensitivity of 0.94. The linkage showed that only 17% of the Public Health clientele received income assistance from the region or province, much lower than expected. Factors which have probably led to an underestimate are discussed.
Performance of Multi-Layer Feedforward Neural Networks to Predict Liver Transplantation Outcome
Authors: Subotin M. , Marsh W. , McMichael J. , Fung J. J. , Dvorchik I. 
Published: March 2018

AbstractA novel multisolutional clustering and quantization (MCO) algorithm has been developed that provides a flexible way to preprocess data. It was tested whether it would impact the neural network’s performance favorably and whether the employment of the proposed algorithm would enable neural networks to handle missing data. This was assessed by comparing the performance of neural networks using a well-documented data set to predict outcome following liver transplantation. This new approach to data preprocessing leads to a statistically significant improvement in network performance when compared to simple linear scaling. The obtained results also showed that coding missing data as zeroes in combination with the MCO algorithm, leads to a significant improvement in neural network performance on a data set containing missing values in 59.4% of cases when compared to replacement of missing values with either series means or medians.
Systematic Planning of Clinical Documentation
Authors: Haux R. , Leiner F. 
Published: March 2018

AbstractAll information obtained from a patient in the course of medical care is a potential part of clinical documentation. The documentation usually serves a number of different purposes. The task of a documentation system is to fulfil these purposes in a methodically correct manner and as economically as possible. This requires that the properties of the documentation system be planned systematically with a view to the goals pursued. To support systematic planning, a “documentation protocol” is proposed analogous to the “study protocol” used for controlled clinical trials. The individual sections of the proposed documentation protocol are described and the design options which exist in the corresponding planning phases are pointed out. Experience gained by the application of the documentation protocol is discussed.
FreeCall, a System for Emergency-Call-Handling Support
Authors: Koster W. , Šrámek M. , Schreiber G. , Zocca V. , de Vries B. , Post W. M. 
Published: March 2018

Abstract:This article describes a system for the optimization of the pre-hospital assessment of emergency, in cases involving thoraco-abdominal complaints and consciousness problems. This assessment is performed by nurses on the basis of a telephone interview at ambulance dispatch centers. The system has a body of biomedical and policy knowledge available to guide the interview and to provide advice.
Medical Informatics: Once More Towards Systematization
Authors: Haux R. 
Published: March 2018

Abstract:Commenting on a paper by Van Bemmel (Medical Informatics, Art or Science? [1]), the following questions are raised: What is the meaning of medical informatics?, How to systematize medical informatics?, Is medical informatics an art, a science or a technology?. It is argued that medical informatics is concerned with the systematic processing of data, information and knowledge in medicine and health care, and that medical informatics is not just the application of computers in these fields. Three classifications for medical informatics research and education are presented. It is concluded that medical informatics is a scientific medical discipline, similar to surgery, internal medicine, epidemiology, or microbiology; and that medical informatics has a strong relationship with the health sciences concerning its field of application, and to informatics concerning its methods and tools. It is a cross-sectional discipline, with relevance for virtually all other specialties of medicine and the health sciences. This is the reason for its impact on research and education in these specialties. It also causes that the quality of the processing of data, information and knowledge has a direct and considerable effect upon the quality of health care in practically all these specialties.
District Level Information Systems: Two Cases from South Africa
Authors: Braa J. , Shung King M. , Heywood A. 
Published: March 2018

Abstract:The health system in South Africa has to date been fragmented and centralised. The priority of the new government is to establish an integrated and decentralised district health system of which a key element is the development of district health and management information systems (H & MIS). This paper presents experiences from two projects in the Western Cape in which a process to establish a district-based H & MIS was initiated and a situation analysis of the information systems was done. The two projects applied different research methods but the results show with remarkable consistency that much time is used on data collection, but information is not used at local level. The projects have applied different approaches towards developing a district H & MIS but in both important pre-requisites for a successful, action-led H & MIS include local ownership and motivation, a process based around existing local management structures and the active involvement of the community
Detecting Hidden Relations between Time Series of Mortality Rates
Authors: Helfenstein U. 
Published: March 2018

AbstractIn the present report a method is described which may help to decide if a disease is influenced by an environmental factor which fluctuates in time: For each of two naturally arising subgroups of a population (such as males and females) an ARI MA model (autoregressive integrated moving average model) is identified. These models are used as filters to remove the autocorrelation in each series. If the resulting crosscorrelation function between the two filtered series shows a marked peak at time lag 0 this may indicate that such an environmental factor is present. The procedure is demonstrated using yearly data of mortality rates among the elderly.
Development of an Instrument for the Management of Computer User Attitudes in Hospitals
Authors: Bailey J. E. 
Published: March 2018

AbstractMeasuring and managing user attitudes toward various aspects of computer systems is an important part of making those systems effective. In this paper, results of an effort to adapt and test a technique for measuring user satisfaction in hospitals are presented. These results include extensive empirical tests of the technique. Comparison norms for hospital computer user satisfaction are also presented and interpreted. Analysis software for using the technique as a management tool is presented. Finally, experiences using the concept are presented.
The Delphi Method to Validate Diagnostic Knowledge in Computerized ECG Interpretation
Authors: Kors J. A. , Sittig A. C. , van Bemmel J. H. 
Published: March 2018

AbstractWe investigated the applicability of the Delphi method for increasing the agreement among multiple cardiologists on, firstly, their classifications of a set of electrocardiograms and, secondly, their reasons for these classifications. Five cardiologists were requested to judge the computer classifications of a set of thirty ECGs. If a cardiologist disagreed with the computer classification, he had to provide a new classification and a reason for this change. The results of this first round were compiled and anonymously fed back to the cardiologists. In a second round the cardiologists were asked once again to judge the ECGs and to rate the reasons provided in the first round. The level of agreement was estimated by means of the kappa statistic. The Delphi procedure substantially increased the agreement on the classifications among the cardiologists. The final agreement was very high and comparable with the intra-observer agreement. There was also a high level of agreement on the reasons provided by the cardiologists. However, their use in improving the program’s performance is hampered by the qualitative nature of many of the reasons. Suggestions are given for a more formalized elicitation of knowledge.
Converting the Representation of Medical Data: Criteria to Code the Underlying Cause of Death
Authors: Pisanelli D. M. , Rossi-Mori A. 
Published: March 2018

AbstractThis study deals with a set of coding directives that were conceived for trained coding clerks and rely upon knowledge of their cultural background. These directives were formalized and adapted for computer use and in this form must rely upon a background of explicit medical knowledge. Medical data on death certificates are an invaluable source of information regarding prevention of major causes of death. These causes are coded and tabulated worldwide by means of the International Classification of Diseases (ICD). The ICD manual issues directives to achieve uniformity of coding throughout the world. The coder is required to trace back the flow of events which caused death and to single out the most significant concept from the statistical point of view. After emphasizing the problems encountered in the formalization, the methodological contribution of this work to the identification of a modular architecture for a system which represents and “reshapes” knowledge from medical documents is presented. Therefore we focus on the features of the two kinds of knowledge that must be supplied to a knowledge-based system, in order to enable it to perform semantic conversions on given medical data, namely: i) generic guidelines; ii) detailed medical knowledge.
Sensitivity and Specificity of Acid Phosphatase to Detect Prostate Cancer Using Data from a Hospital Information System
Authors: Zwetsloot-Schonk Johanna H. M. , Hermans J. , Frolich Marijke , Snitker P. , Zwartendijk J. , Souverijn J. H. M. 
Published: March 2018

AbstractIndices of diagnostic tests, such as sensitivity and specificity, should be determined using diagnostic test results of patients tested in clinical practice. Hospital information systems that store data on diagnostic tests and diagnoses might be used for sampling the desired study population and in the actual process of collecting the data.This paper presents, as an example, a study calculating the sensitivity and specificity of the prostate-specific acid phosphatase test. All data needed in the study were obtained from the hospital information system of Leiden University Hospital. The final health status of each patient was assessed by the cancer registry of the system. The reason for ordering the test was deduced from data on histopathological examinations of prostatic tissue. The actual selections made from the central database are described in dataflow diagrams. The sensitivity of the test was found to be 0.34 and the specificity 0.88, using a discrimination value o f 1.00 U/I. The impact of the reason for ordering the test on the specificity is illustrated. Possible biases of these measured values are discussed.
Use of a Hospital Database to Determine the Characteristics of Diagnostic Tests
Authors: Zwetsloot-Schonk Johanna 
Published: March 2018

AbstractTest indices are often determined by comparing test results of healthy persons with test results of patients known to have the disease. However, the patient population for which the test is ordered in clinical practice often differs from the study population on which the test indices are based. Hence, these indices are not applicable to clinical practice and should be recalculated using data from daily clinical practice. Two major problems of using routinely collected data are discussed: the assessment of the final health status and tracing the reason for ordering the test. Prior considerations are given to the use of hospital information systems (HIS) to sample the patient population that is desired and to collect the necessary data for calculating test indices. We investigated whether the HIS of Leiden University Hospital (which is presented as an example) can be used to calculate the indices of clinical laboratory tests, histopathologic examinations and radiodiagnostic investigations. The results indicate that the registration of diagnoses must be improved and that a way must be found to capture the implicit reasoning for ordering diagnostic tests.
Methodology of ECG Interpretation in the Glasgow Program
Authors: Devine B. , Latif S. , McLaughlin S. , Shoat D. B. , Watts M. P. , Macfarlane P. W. 
Published: March 2018

AbstractThis paper describes the methods currently used in Glasgow Royal Infirmary for computer analysis of electrocardiograms. The software is designed to analyse from 3 to 15 simultaneously recorded leads, with facilities for analysis of rhythm and serial changes. Options for Minnesota Code (with serial comparison) and XYZ lead interpretation are available.