bluuebunny/crossref_metadata_2025_split huggingface dataset:
User Evaluation of an Integrated Medical Workstation for Clinical Data Analysis
Authors: Timmeis T. , van Bemmel J. H. , van Mulligen E. M. 
Published: March 2018

AbstractResults are presented of the user evaluation of an integrated medical workstation for support of clinical research. Twenty-seven users were recruited from medical and scientific staff of the University Hospital Dijkzigt, the Faculty of Medicine of the Erasmus University Rotterdam, and from other Dutch medical institutions; and all were given a written, self-contained tutorial. Subsequently, an experiment was done in which six clinical data analysis problems had to be solved and an evaluation form was filled out. The aim of this user evaluation was to obtain insight in the benefits of integration for support of clinical data analysis for clinicians and biomedical researchers. The problems were divided into two sets, with gradually more complex problems. In the first set users were guided in a stepwise fashion to solve the problems. In the second set each stepwise problem had an open counterpart. During the evaluation, the workstation continuously recorded the user’s actions. From these results significant differences became apparent between clinicians and non-clinicians for the correctness (means 54% and 81%, respectively, p = 0.04), completeness (means 64% and 88%, respectively, p = 0.01), and number of problems solved (means 67% and 90%, respectively, p = 0.02). These differences were absent for the stepwise problems. Physicians tend to skip more problems than biomedical researchers. No statistically significant differences were found between users with and without clinical data analysis experience, for correctness (means 74% and 72%, respectively, p = 0.95), and completeness (means 82% and 79%, respectively, p = 0.40). It appeared that various clinical research problems can be solved easily with support of the workstation; the results of this experiment can be used as guidance for the development of the successor of this prototype workstation and serve as a reference for the assessment of next versions.
Health Information, the Fair Information Principles and Ethics
Authors: Kluge E.-H.W. 
Published: March 2018

Abstract:If advanced electronic patient records are construed as epistemic patient analogues in information space, then the traditional property-model of patient records is longer appropriate. A new paradigm is required. This paper suggests a new paradigm, examines its ethical implications and explores ways in which these could be reflected in legal and regulatory mechanisms. Special attention is paid to privacy, security and access relative to the so-called “fair information principles”.
Computerized Databases for Emergency Care: What Impact on Patient Care?
Authors: Pugh G. E. , Tan J. K. H. 
Published: March 2018

Abstract:A field-based evaluation is conducted of a Clinical Computerized Information System (CCIS™). Following training, the use of the CCIS™ database, word processing and other programs by thirteen full-time practicing emergency physicians in two urban emergency departments of a University-associated teaching hospital was studied over a one-year period. A tracking program automatically logged frequency and duration of use by the physicians, and user satisfaction was assessed by a reliable and validated questionnaire instrument. Based on utilization data and verbal reports of these physicians, CCIS™ database searching was not only found to be easy-to-leam but was readily accessible during emergency shifts. Individual physicians were found to perform an average of 3.5 searches per month lasting a mean search time of 8 min. Positive notes about the CCIS™ system included ease-of-use, accuracy of data, accessibility of system, and value of output while negative perceptions included a lack of integration with other systems, a lack of system completeness, and a high subscription cost. It was suggested that a less costly telephone link to a high-volume Centre would be desirable in actual implementation of the system.
Terminology of the Thalamus and its Representation in a Part-Whole Relation
Authors: Axer H. , Niemann K. 
Published: March 2018

Abstract:In stereotaxic neurosurgery, a variety of operative procedures focus on thalamic targets. The nomenclature of thalamic nuclei and sub-nuclei, however, has not yet been settled. In clinical and laboratory environments several terminologies coexist. This is an obstacle to both communication and a better understanding of recent electrophysiological findings. In the late 1980s, the application of new histochemical and immunohisto-chemical methods led to a deeper insight into existing correlations between the nomenclatures. As a uniform terminology of the thalamus is still lacking, we created a knowledge-based system (thalamus) which gives a comprehensible survey about the most important terminologies. The different nomenclatures are related to each other by organizing them in a component-integral relation. This part-whole relation contains both the knowledge on the subdivisions of the thalamus as well as the knowledge on the correlations between the various nomenclatures.
Therapie und Monitoring neuromuskulärer Repeat-Erkrankungen
Authors: Schneider-Gold C. , Petri S. 
Published: March 2018

ZusammenfassungRepeat-Erkrankungen sind hereditäre durch pathologische Expansionen sich wiederholender Triplettoder Multiplett-DNA-Sequenzen (Repeats) hervorgerufene, in der Regel multisystemische Erkrankungen. Bevorzugt das neuromuskuläre System betreffen die myotonen Dystrophien Typ 1 und 2 (DM 1, 2), die okulopharyngeale Muskeldystrophie (OPMD), die spinobulbäre Muskelatrophie (SBMA, auch Kennedy-Syndrom) und eine Form der ALS, die durch Repeat-Expansionen im C9ORF72-Gen verursacht wird. Zunehmendes Verständnis der molekularen Pathogenese dieser Erkrankungen bildet die Grundlage für neue kausale Therapiestrategien, die sich überwiegend noch im präklinischen Stadium befinden oder in ersten klinischen Studien getestet werden. Das Monitoring und die Therapie von neurologischen und internistischen Symptomen (wie respiratorischer Insuffizienz oder kardialer Mitbeteiligung) erfordert eine interdisziplinäre Betreuung.
Mitochondriale Erkrankungen
Authors: Büchner B. , Kornblum C. , Klopstock T. 
Published: March 2018

ZusammenfassungMit einer Gesamtprävalenz von 1:5 000 zählen mitochondriale Erkrankungen zu den häufigsten hereditären Stoffwechselerkrankungen. In den letzten Jahren kam es zu enormen Fortschritten in der Diagnostik und im Verständnis der molekularen Mechanismen bei diesen Krankheitsbildern. Die Entwicklung ursächlicher Therapieansätze war demgegenüber lange unbefriedigend, hat aber deutlich an Dynamik gewonnen. Mit Idebenone bei Leberscher hereditärer Optikusneuropathie (LHON) ist seit 2015 das erste Medikament zur Behandlung einer mitochondrialen Erkrankung zugelassen. Zahlreiche weitere therapeutische Ansätze befinden sich in der fortgeschrittenen klinischen Entwicklung, darunter auch eine Gentherapie für LHON. Das deutsche Netzwerk für mitochondriale Erkrankungen (mitoNET) trägt mit seinen Strukturen erheblich zu diesen Fortschritten in der mitochondrialen Medizin bei.
Neues zur Amyotrophen Lateralsklerose
Authors: Dorst J. , Ludolph A. C. 
Published: March 2018

ZusammenfassungAuch wenn die Therapieoptionen der Amyotrophen Lateralsklerose (ALS) nach wie vor unbefriedigend sind und Riluzol das einzige Medikament ist, das den Krankheitsverlauf beeinflusst, so gibt es doch vielfältige neue Forschungsergebnisse hinsichtlich Genetik, Biomarkern und Pathogenese, welche auf die Entwicklung neuer Therapieansätze hoffen lassen. Zudem gibt es Fortschritte auf dem Gebiet der symptomatischen Therapie. In diesem Artikel sollen die wichtigsten Erkenntnisse der ALS-Forschung der vergangenen Jahre zusammengefasst werden.
The Measurement of Performance in Probabilistic Diagnosis IV. Utility Considerations in Therapeutics and Prognostics
Authors: Habbema J. D. F. , Hilden J. 
Published: March 2018

It is argued that it is preferable to evaluate probabilistic diagnosis systems in terms of utility (patient benefit) or loss (negative benefit). We have adopted the provisional strategy of scoring performance as if the system were the actual decision-maker (not just an aid to him) and argue that a rational figure of merit is given by the average loss which patients would incur by having the system decide on treatment, the treatment being selected according to the minimum expected loss principle of decision theory.A similar approach is taken to the problem of evaluating probabilistic prognoses, but the fundamental differences between treatment selection skill and prognostic skill and their implications for the assessment of such skills are stressed. The necessary elements of decision theory are explained by means of simple examples mainly taken from the acute abdomen, and the proposed evaluation tools are applied to Acute Abdominal Pain data analysed in our previous papers by other (not decision-theoretic) means. The main difficulty of the decision theory approach, viz. that of obtaining good medical utility values upon which the analysis can be based, receives due attention, and the evaluation approach is extended to cover more realistic situations in which utility or loss values vary from patient to patient.
GENDIAG: A Computer-assisted Facility in Medical Genetics Based on Belief Functions
Authors: Gouvernet J. , Caraboeuf M. , Ayme S. 
Published: March 2018

SummaryThe method is based on a diagnosis data base, each diagnosis being identified by a list of signs indexed by à rough estimation of their relative frequency. Signs are terms of a tree-structured thesaurus, the relationship child – father being equivalent to implication. Furthermore, any sign is weighted according to the possibility of it being a variant characteristic rather than a pathological one. The patient’s description being provided, the credibility of each diagnosis is computed according to Glenn Shafer’s theory of belief functions, and the most plausible diagnoses are proposed for the clinician’s choice. The results obtained during a validation phase were satisfying so that we have been routinely using the model for assistance in diagnosing uncommon genetic syndromes observed in our hospital or submitted by other centers.
Staging Cancer: TNM Literature 1963—1982
Authors: Wagner G. , Posner G. , Wolf T. 
Published: March 2018

The prognosis of a malignant tumour largely depends on the stage of the disease at the beginning of a specific therapy; statistics of therapy are comparable only if they show the distribution of the cases to the different stages of the disease. Aiming to improve the comparability of the data and findings acquired from the cancer patient, the UICC has, for more than 30 years, been endeavouring to develop uniform rules for acquiring the stage of the disease and the degree of spread with malignant tumours. For this purpose, UICC has developed the TNM system which makes it possible to state accurately and in a reproduceable form the stage of the primary tumour (T) and the regional lymphatic nodes (N) as well as the possible existence of metastases (M). The third edition of the TNM rules appeared in English in 1978, in the following years in numerous other languages. Today the TNM system represents the only basis for the documentation of the cancer stage which has been introduced worldwide. However, it is by no means »complete«; for some forms of cancer proposals for TNM classification are still outstanding (e.g., tumours of the pancreas, the central nervous system, the bones and the soft tissues). Moreover, malignant lymphomas cannot be classified according to the principles of TNM. Here the so-called »Ann Arbor Classification« from the year 1971 is recommended.The UICC has called upon its national committees to check the classification proposals available so far as to their usefulness and practicability. Corresponding field studies are under way in several countries. This bibliography covers a section of the TNM literature of the last 20 years. From a total number of about 2,000 publications, applying the TNM system, we selected 300 which discuss the system critically and, in most instances, make suggestions for its improvement. The first part of the bibliography contains an alphabetically arranged list of the titles according to authors’ names; the second part differentiates the tumors dealt with by their site.We thank Mrs. L. Blumenthal, Mrs. I. Schäfer and Mrs. U. Wolber for their cooperation in setting up this bibliography.
Visual Stimulator for Eye Movement Studies Based on a Microcomputer System
Authors: Juhola M. , Virtanen K. , Helin M. , Jäntti V. , Nurkkanen P. , Aantaa E. 
Published: March 2018

SummaryA visual stimulator system for studies of eye movements has been developed. The system is controlled by an inexpensive microcomputer. It is employed for otoneurological studies both in clinical work and in research, but can also be applied for studies of eye movements in other medical areas. Three types of eye movements are produced, viz. saccadic and smooth pursuit eye movements and optokinetic nystagmus. The stimulator system can be connected to another computer for an analysis of eye movements.
Concerning the Representativeness of Psychiatric Catamnestical Studies - The Influence of Various Approach Strategies on the Response of Former Patients
Authors: Steinhart I. , Bosch G. , Muhr Th. , Mohlfeld E. 
Published: March 2018

SummaryThe possible conclusions reached by catamnestical studies are often significantly restricted because of the lack of representativeness of the sample. The example of an investigation of former patients of the Department of Social Psychiatry proves that positive responses to an interview are influenced by various factors. As expected, patients were more inclined to participate in the research project the closer their discharge was to the time of the project itself. Further, it became clear that various different approach strategies, such as letters, enquiries with the registration authorities, phone calls and house visits, effectively increased the motivation of former patients, and that only this kind of graded registration procedure guarantees motivation leading to a sample representative of the total population. Personal contact plays an especially important role. These empirical findings indicate the necessity of careful planning and implementation of sample collection in catamnestical studies. Without this approach, representative results cannot be expected.
From Medical Data to Health Knowledge
Authors: Martin J. M. , Benamghar L. , Junod B. , Marrel P. 
Published: March 2018

SummaryThe problems of assisting in the medical decision-making process are attracting more and more attention.Actually a certain number of computer systems have considerably improved the availability of medical data. However, we encounter some difficulties when extending these systems. In order to surmount these problems, it is necessary to proceed further in the analysis and comprehension of medical information and processes.To accomplish this goal, it is necessary to have a better understanding of the way in which a group of medical data is derived from one piece of medical knowledge and also how a chunk of medical knowledge is related to its corresponding medical data.This article is a beginning in the study of the transition from medical data to health knowledge, and this transition represents only part of the global entity, the nature, the representation, and use of medical information.
Bayes Theorem and Conditional Dependence of Symptoms: Different Models Applied to Data of Upper Gastrointestinal Bleeding
Authors: Ohmann C. , Yang Qin , Künneke M. , Stöltzing H. , Thon K. , Lorenz W. 
Published: March 2018

Summary:In computer-aided prognosis theoretical arguments in favour of a sophisticated model often do not result in a markedly better performance. In this study, straightforward extensions of the simple and comprehensive independent Bayes model, taking interactions between variables into consideration, are investigated, using a clinical data set of upper gastrointestinal bleeding, four sets of variables and different measures of performance (discriminatory ability, sharpness, reliability). For all criteria of performance, the differences between the models were small in the sets with few variables. In the sets with many variables there were marked differences between the models; however, no model was superior in all aspects of performance. Incorporation of interactions in models based upon Bayes’ theorem are worthwhile if many variables are used and the discriminatory ability is considered.
Analysis of Mortality Data due to Infectious Diseases: Life Table Methods Complementary to Direct Rates
Authors: Moussa M. A. A. , Khogali M. M. , Sugathan T. N. 
Published: March 2018

SummaryLife table methods are employed complementary to standard rates to analyse Kuwaiti mortality data due to infectious diseases. The procedure comprises total mortality, multiple-decrement, cause—elimination and cause—delay life tables. To improve reliability of estimated age-specific death rates, the numerator was based on the three-year average of deaths (1981-83), while the denominator was the mid 1982 population projected from the 1980 and 1985 population censuses. To overcome the difficulty of age heaping, both mortality and census data were graduated using the natural cubic spline approach. Proportional mortality was maximum in intestinal infectious diseases particularly in the rural Jahra Governorate. Infectious diseases caused 29.4 and 37.1% of male and female deaths respectively in infancy and early childhood. The male and female life expectancy at birth were 67 and 72 years, respectively.The multiple-decrement life tables showed that 3,346 men and 2,986 women out of the birth cohort (100,000) will ultimately die from infectious diseases. The average number of years lost due to infectious diseases were 0.75 years in both men and women. Relating this loss to the affected (saved) subpopulation only, large gains in life expectancy occur (22.3 and 25.2 years in men and women respectively).
Analysis of the Multi-Channel Epileptiform EEG Using the Markov Chains Formalism
Authors: Penczek P. , Grochulski W. 
Published: March 2018

Abstract:A multi-level scheme of syntactic reduction of the epileptiform EEG data is briefly discussed and the possibilities it opens up in describing the dynamic behaviour of a multi-channel system are indicated. A new algorithm for the inference of a Markov network from finite sets of sample symbol strings is introduced. Formulae for the time-dependent state occupation probabilities, as well as joint probability functions for pairs of channels, are given. An exemplary case of analysis in these terms, taken from an investigation of anticonvulsant drug effects on EEG seizure patterns, is presented.
Setting up a Decision Support System with Decision Tables
Authors: Schwarz V. , Hohenberger P. , Köhler C. O. , Schlag P. 
Published: March 2018

Abstract:The aim of our study was to develop a decision support system using a conventional method which can be used as a shell for different applications. So it was necessary to find a method which allows separation of decision principles and decision algorithms. In addition, documentation of the patient records should be simplified. This could be attained by using the decision table technique and the programming language MUMPS.The general system developed was applied to the therapy decision for patients with liver metastases. The application system was clinically evaluated in a randomized group of patients. In 84% of the study group the therapy proposal of the system concurred with the therapy actually applied.Representation of knowledge in the form of tables is easily understandable by physicians. Since decision tables can be seen as a medium of communication between physician and system manager, knowledge acquisition is simplified.
A Numerically Coded File of Operative Procedures Derived from a Free Text Data Collection System : A Measure of the Accuracy
Authors: Scudiero Carmen A. , Wong Ruth L. 
Published: March 2018

A free text data collection system has been developed at the University of Illinois utilizing single word, syntax free dictionary lookup to process data for retrieval. The source document for the system is the Surgical Pathology Request and Report form. To date 12,653 documents have been entered into the system.The free text data was used to create an IRS (Information Retrieval System) database. A program to interrogate this database has been developed to numerically coded operative procedures. A total of 16,519 procedures records were generated. One and nine tenths percent of the procedures could not be fitted into any procedures category; 6.1% could not be specifically coded, while 92% were coded into specific categories. A system of PL/1 programs has been developed to facilitate manual editing of these records, which can be performed in a reasonable length of time (1 week). This manual check reveals that these 92% were coded with precision = 0.931 and recall = 0.924. Correction of the readily correctable errors could improve these figures to precision = 0.977 and recall = 0.987. Syntax errors were relatively unimportant in the overall coding process, but did introduce significant error in some categories, such as when right-left-bilateral distinction was attempted.The coded file that has been constructed will be used as an input file to a gynecological disease/PAP smear correlation system. The outputs of this system will include retrospective information on the natural history of selected diseases and a patient log providing information to the clinician on patient follow-up.Thus a free text data collection system can be utilized to produce numerically coded files of reasonable accuracy. Further, these files can be used as a source of useful information both for the clinician and for the medical researcher.
Beitrag zur Literaturdokumentation mit kombiniertem Einsatz von Randund Sicht-Lochkarten
Authors: Hexte H. -J. 
Published: March 2018

Das wesentliche Problem bei der Dokumentation wissenschaftlicher Literatur ist das alphabetische Sortieren nach dem Anfangsbuchstaben des ersten Autors bzw. nach mehreren Schlagworten.Eine Lösungsmöglichkeit anhand von Kerbkarten wird dargelegt. Hierbei wird der eine Kartenrand zur Markierung und möglichen Nadelsortierung nach dem Alphabet, ein anderer Kartenrand zur Markierung einer dreistelligen Schlagwortziffer benutzt. Ein Kunstgriff, der die Zahl heraussortierter Fehlkarten bei überlagernder Markierung von 2 oder 3 Schlagwortziffern verringert, wird erläutert.Als weitere Lösungsmöglichkeit wird die kombinierte Führung einer Literaturstellenkartei in Kombination mit einer Schlagwortkartei mit Siditlodikarten dargelegt. In der Sichtlochkartei werden die laufenden Nummern der anfallenden Literaturstellen nidit allein nach einer Ziffer, sondern nach einer Kombination von Buchstaben und Ziffern markiert. Auf diese Weise werden die nach einer laufenden Nummer sortierten LiteraturStellenkarten so weitgehend alphabetisch vorsortiert, daß es keine Mühe macht, eine Karteikarte nach dem Autor herauszusuchen. Damit ist das Ziel einer gleichzeitigen Sortierung nach dem Alphabet und nach einer beliebigen Anzahl von Schlagwörtern realisiert.